The Director of Adult Services will give details of work in Havering to establish an Accountable Care Organisation for local health services.
Minutes:
The Director of Adult Services explained that the Accountable Care Organisation was now called the Integrated Care Partnership (ICP) and agreed that progress on this work had slowed recently. Officers were however now working more closely with patients themselves.
Borough Health and Wellbeing Boards had oversight of the ICP and the ICP Partnership Board was chaired by the relevant Lead Member from Barking & Dagenham. Havering’s Leader and Lead Member also attended the Partnership Board as did Chief Executives and Chairs of the Councils, CCGs and providers involved.
Consideration was currently being given to which areas the ICP would look at first. The ICP Board also had representation on the board of the Sustainability and Transformation Plan for North East London which covered seven CCGs and 8 Local Authorities across the sector. It was suggested that an update on governance of the Sustainability and Transformation Plan could be given at a future meeting of the Sub-Committee.
Locality models were being developed as part of the ICP work. The areas of the three localities for Havering were almost confirmed and the localities would be population based as research had shown that the best health outcomes were seen with localities of 70-90,000 population size. Areas such as Romford or Rainham where there were likely to be considerable rises in population had also been mapped as part of this work.
The key priorities for locality models were children’s health, referral to treatment issues and urgent care pathways. A recent workshop on the locality models had been held successfully with representation from GPs, other clinicians and a urology consultant from BHRUT. An officer from NELFT added that it was wished to have discussions with people at any contact point, not just health and social care. Contacts promoting health could therefore take place in housing offices, libraries, leisure centres etc. A client with for example difficulties paying their rent could well have issues with anxiety and could therefore be referred from the housing service direct to talking therapies available in the locality. This would represent better value for public money.
The ICP also aimed to make services more efficient and to avoid any repetition between health and social care. The Havering Locality Design Group included representatives from Healthwatch, the Local Pharmaceutical Committee, the voluntary sector as well as the Council’s Directors of Adults and Children’s Services. A workshop with the community and voluntary sector was also planned for March 2017.
The locality model had been designed in conjunction with staff and patients and would be a small programme initially. The ICP wished to improve self- care as many people did not need any other support in order to stay healthy. More intensive interventions would be as planned as possible under the new model.
The Locality Design Group would continue to meet fortnightly until April to develop the proposals and engagement would also continue with key stakeholders including the Local Medical Committee and the community & voluntary sector.
Members welcomed the proposals, feeling that early intervention was the best policy for improving local health outcomes. It was confirmed that GPs were involved in the design of the model although there remained workforce issues with many GPs approaching retirement age. The role of community pharmacies also needed to be determined.
Officers felt that there was now more appetite from GPs to look at how they could work differently. The Director of NELFT added that there were variations in how people accessed health services across the UK. In London, GPs had been somewhat deskilled and other areas such as hospitals had been overskilled. There was an image that a hospital was the best place for health care but this was not necessarily the case.
The Sub-Committee NOTED the position.