Agenda item

Jo-anne Alner explained that NHS England had released staff to support the STP and as a result she would now Chair the Partnership Board.

Various points were raised by the HWB at the Joint Herefordshire and Worcestershire HWB meeting in June 2017 and these were answered in the report:

·       The STP reflected the HWB strategy

·       Prevention was key across all the STP programmes

·       The STP was committed to engagement and had recruited a Community Engagement Officer

·       The digital delivery programme was being refreshed and the County Council would be involved in implementation. However those who were not digitally able would not be overlooked

·       It was recognised that patients needed to be seen by the right person at the right time so close working between hospitals and social care was important. Social Care spend would have to be taken into account along-side NHS spend

·       The HWB would receive updates on plans when they were available. The HWB had already received updates on the Future of Acute Hospital Services and the Local Maternity Systems Plan

·       The STP agreed more could be done to work more closely with housing, transport and other partners such as police, fire and District Councillors.

Board members made the following points:

·       There were concerns that there were still outstanding questions regarding finances as well as what changes people would actually see to services when they were made 'sustainable'.  In particular there were concerns about the impact on social care of the shift away from acute care. People wanted more facts and figures although it was understood that actions may be going on behind the scenes

·       It was felt that the language around the STP was difficult to understand, for example people were confused as to the purpose of the Ambulatory Care Unit.  It was clarified that the Unit was for GPs to send patients they were concerned about and it was agreed that clear language should be used in future communications

·       It was explained that the STP was a partnership which aimed to collectively and collaboratively plan health and social care. It was acknowledged that this was complex, with different accountabilities across the system. At the moment, significant progress was being made in integrating care at team level.

Developing Accountable Care in Worcestershire

Accountable care was a progressive step to change the culture of how care was planned. The STP Partnership Board worked together to plan and deliver health and care services within one budget, with the social care budget out of scope.  The planning was done dependent on the needs and budget within a particular area and services from different organisations would be working together for the best outcome. This was different to the previous system which expected to achieve efficiencies through competition.

Accountable care would allow more focus to be on the patient and more control at local level. Place was a layer of provision of 30-50,000 people. As money was decreasing it was important that prevention was a main consideration.

The Worcestershire approach to Accountable Care was to build on the existing infrastructure which moved the system away from privatisation, rather than towards it as some politicians had feared. The system was organised from the bottom up: for example Droitwich would have a single team made up from staff from all organisations; above that was the individual CCG level then County level.

As Hospital, community services and social care needed to work in the same team it was important to get the integration right. Other services such as housing also needed to be considered and included.

In some areas acute services were taking over GP practices but in this area it was the other way round. CCGs would begin implementation and once the system was more robust it would be explained to the wider public.

As services were being integrated, Board members wondered if providers should be considered as representatives on the HWB.

RESOLVED that the Health and Well-being Board;

a)     Received responses to the points they raised at the Joint Herefordshire and Worcestershire HWB in June 2017;

b)    Noted the development towards Accountable Care;

c)     Considered which areas of the plan they would like to receive further detail on from the STP;

d)    Agreed that a briefing would be held for Councillors on the STP and Accountable Care; and

e)     Would further consider membership or attendance of providers at the Health and Well-being Board.