Agenda item

Frances Howie explained that the Sustainability and Transformation Partnership had produced a Statement of Commitment concerning collaborative working and integrated care across the system. Previously the language used had been 'accountable care,' it had now changed to 'integrated care'. The statement was a commitment to the principles and benefits of working together and would be taken to the Board meetings of all the organisations who were STP partners.

Jo Melling said that NHS England supported the statements and wished to work differently as a regulator in order to support systems better.

During the discussion the following points were made:

·        The Cabinet Member for Adult Services felt that the County Council were broadly supportive of the step forward in integration but wanted the STP to maintain flexibility which it needed to be sustainable and to allow for the differences in the Herefordshire and Worcestershire systems

·        Finances were still a concern. It was accepted that all partners had budgetary constraints and that collective responsibility was needed to address them, but there did not seem to be any clarity over how this would happen and the public still had little idea of what the changes would mean for them

·        It was agreed that the financial gap was enormous due to demographic growth and infrastructure which could not be afforded. Therefore the infrastructure costs needed to be reduced and better use needed to be made of staff and resources

·        The Board asked what role the district councils, housing authorities and voluntary sector could play in the STP and how they could contribute more. They felt excluded but were actually necessary for the prevention agenda. It was noted that until now there had been helpful joint working around drawing up the overarching plan, but that specific co-production was needed as this shapes operational change

·        Integration of partners was important for children too and that message may have been implicit in the statement but was not mentioned explicitly

·        The structural integration between social care and the NHS did not exist in Worcestershire like it did in places such as Manchester but Worcestershire was very good at operational integration. Worcestershire was also becoming good at single line management and working in neighbourhood teams

·        Worcestershire had in the past based all its commissioning on contracts but now services were becoming more based on a local area and it was this set up which would allow district councils to become involved and have an impact. It was felt that the locality emphasis suited care delivered through the three conversation model and community assets added resilience

·        Board Members pointed out that 'Prevention' was not explicitly mentioned in the statements but were assured that this had a high profile in the STP Plan

·        There was some concern that the Herefordshire and Worcestershire footprint was not large enough to deliver expert care in some service areas. The STP Board had already considered that there should be a link to other areas such as Coventry and Warwickshire to provide some services.

RESOLVED that the Health and Well-being Board:

1.     Noted the Statement of Collaborative Working which had been drawn up through the Sustainability and Transformation Partnership (STP) Board for discussion at Board level across the two Counties, and

2.     Confirmed commitment to adopting these principles in the next phase of collaborative work towards an Integrated Care System.