Agenda item

Report attached.

Officers explained that the Integrated Care Partnership (ICP) sought to bring forward further integration between the Council and the NHS. This was in response to the rising population and changing demographics within Havering. It was accepted that the £55 million deficit facing the three local Clinical Commissioning Groups was a significant challenge.

The ICP sought to bring together a number of different services that were involved in e.g. discharging a person from hospital. Work was in progress to develop a locality model with three localities covering the north, central area and south of Havering, each with a population of around 80,000. This took into account the demographic growth expected over the coming years.

In order to better understand the needs and demands of communities, the Council’s Joint Strategic Needs Assessment could be split by locality. There would be different needs and growth in each locality with for example, a lot of population growth in Rainham. The Council’s social care services had already begun to integrate its services around localities with those offered by the North East London NHS Foundation Trust.

The Partnership aimed to look beyond just health and social care at other factors such as employment and housing that impacted on health and wellbeing. Children’s Services also supported the model, with feedback from GPs that access to mental health services was difficult, being addressed by the establishment of a virtual team covering a variety of children’s mental health services at an earlier stage.

Child and Adolescent Mental Health Services (CAMHS) was designed for only the most seriously ill children and funding had been received to seek to offer services at an earlier stage. Localities could be used to support a young person’s family and network.

The transition from child to adult services had been criticised by OFSTED and the Partnership work aimed to give young people the support to be as independent as possible. It was aimed to support children’s behaviour in the place where it was happening by skilling up families and teachers to manage challenging behaviour.

Support was offered to children with a variety of conditions such as ADHD, autism, Asperger’s Syndrome, self-harming and anxiety. It was hoped that schools could talk to the locality team about any initial concerns over children although a child’s family would also be worked with. Systemic therapy would be used to focus on what a child’s family thought was important.

Officers felt that the School Nurse should be the first point of contact if a school had concerns over a child, rather than the school going direct to a child’s family. The School Nursing Service was a universal provision and referral to this would not necessarily indicate a problem with the child’s family. A representative of Healthwatch added that healthcare professionals often confused social problems for medical problems and the integration of health and social care should address this.

It was clarified that schools could prompt children to take their medication but could not administer this directly. Any parents with concerns in this area should speak to the School Nurse or Head Teacher.

It was planned move away from just receiving a list of problems from the person towards looking at a person’s strengths, goals and support networks. Officers accepted that this was a different approach that would require an element of workforce transformation in order to achieve.

The north locality would focus on children’s issues whilst the other localities would focus on areas such as urgent and emergency care. Adult Services’ work would focus on intermediate care, covering areas such as reablement, rehabilitation services and the Community Treatment Team. These services aimed to keep people away from being admitted to hospital. As part of this work, the Council’s reablement service had been brought together with the NELFT community rehabilitation service. The new service had started within the last week and would focus initially on people coming out of hospital although this would be extended in the future.

A lot of different people and services visited people in their houses and it was felt it would be useful if these services could be used to assist with monitoring people who were vulnerable. Housing officers for example could potentially refer clients for psychological therapies. Community networks were also needed that could support people at a lower level. It was also hoped to equip GPs to start to deal with these issues and allow intervention at an earlier stage.

The Chairman added that these aims of keeping out of hospital were shared by the Barking, Havering and Redbridge University Hospitals’ NHS Trust and it was hoped to arrange a briefing for Members with a senior officer from the Trust.

Members felt that the Clinical Commissioning Group should consider the issue of repeat prescriptions as there were significant variations between practices in how these and medication reviews were administered. It was confirmed that a pharmacy representative was a member of the Integrated Care Partnership design group.

The Sub-Committee noted the report and it was agreed that an update on the work of the ICP should be taken at a future meeting.