This item presents a verbal report from the Strategic Director of Social Care, supported by NHS colleagues, and will address the following NHS NW London and H&F activities:
· CCG merger – state of play
· NHS North West London – current priorities, local authority involvement, report of first ICS Chairs meeting
· H&F ICP – Update
Minutes:
The Board received a verbal report from Lisa Redfern and Janet Cree regarding national NHS changes and the introduction of integration systems which included the Integrated Care Partnership. Janet Cree updated the Board on new governance arrangements following consultation with CCG governing bodies and a conditional approval decision to move to a merged, single CCG body covering North West London in November 2020. Acceptance of an amended constitution was recommended for consideration on 25 November by the eight CCGs and GPs would vote on whether to accept the revised constitution this week, with the results to be notified the following week. The deadline to submit any outstanding plans was 31 December and was currently on track, subject to the vote. GPs were expected to undertake a further vote in January on the new governance arrangements and the establishment of a new shadow governing body at the end of February, ahead of the closure of local CCGs in March and with the newly formed single CCG going live in April.
Janet Cree provided outlined the role of an ICS to lead the planning and commissioning of care for their populations providing systems leadership for a collective of NHS providers, commissioners and local authorities working together to improve local health and care provision through an integrated partnership. The ICS would be a non-decision making, strategic group independently chaired by Penny Dash and all provider organisations would be represented including the London Ambulance Service. There was also local government leadership from Harrow Council Leader Councillor Graham Henson and City of Westminster Council Deputy Leader and Cabinet Member for Adult Social Care and Public Health Councillor Tim Mitchell. One of the expected outcomes was to have an initial conversation about the strategic priorities for North West London. The process was about bringing together information which would help to inform and identifying emergent priorities as part of the current NWL evolution. In terms of next steps broad content at the ICP would need to be agreed and assurance that that there would effective engagement with stakeholders. The anticipated vision was about improving life expectancy, health outcomes and to establish initial priorities around this such as mental health.
Janet Cree outlined three key functions: strategic planning, delivery of care and assurance of delivery, and to look at inequality hotspots through gap analysis. The clinical strategy would be evidenced based on interventions and identify models of care suitable for NWL. This would be supported and driven by compliance with governance standards to ensure that the right leadership was in place in each of the organisations. The intention was to provide the very best, equitable and simple local care consolidated to achieve the best outcomes and ensure that this was also reflected in terms of providing specialist care with an effective use of resources.
Having just chaired her first ICP meeting on 23 November, Lisa Redfern reported that the ICP was an alliance of NHS providers that would work together to deliver care through collaboration rather than competition and that this included hospitals, GP practices and third sector providers. The ICP fed into the ICS and although it was established it would undergo a refresh together with a review of governance structures and a workshop planned for the new year. It was noted that CCG would eventually become redundant and Councillor Coleman added that councillors and local authorities would be working together and that this might include a periodic rotation of local authority membership.
Merril Hammer cautioned that the ICS was amorphous and lacked a clear structure and legal identity. Concerns about the move to a merged single CCG entity remained, despite the Long Term NHS plan reference to maintaining local bodies. A key concern was that the public would have no clear understanding of the ICS structure and what the new system would look like. It was noted that there had been a CCG commitment to delivering co-produced services, but it was important to understand how this would work at ICS level and whether there would be a follow through commitment to work with the borough. Dr Cavanagh concurred and accepted that there were issues the ICS structure. The CCGs would eventually be abolished as part of a move away from an internal market model. Providers would work together, and improved co-operation would place patients around the health care system to access the right provision which would be an enormous benefit. Improved co-operation and a strong emphasis on effective, place-based partnership would be critical. Councillor Coleman welcomed this and highlighted the borough’s commitment to doing things with residents and not to residents.
RESOLVED
That the verbal report be noted.