Agenda item

Report attached.

Conor Burke

Start time: 13.15

CB explained that the NHS five-year forward view encourages the development of sub-regional devolution pilots. In addition the NHS had also introduced Sustainability and Transformation Plans (STPs) for providers and commissioners. It was noted that the STP for Havering also covered the whole of North East London. The North East London STP had been put forward in December 2015 and sought to achieve a financially sustainable health system by 2021. It was accepted that this would be challenging, particularly given the deficits at BHRUT and Barts Health. 

Given the financial challenges, there had been a lot of focus on finding different ways of delivering care. Many savings were targeted around the acute hospital pathway although it was accepted that not all interventions required to close the financial gap had been identified at this stage.

CB and MH had met with the national STP team the previous week and felt that the meeting had been quite successful with the primary focus being on delivery in the current year – both financial factors and outcomes.

The STP sought to address a number of key priorities including managing the demand for health services from a rising population and transforming the way care was provided. Other priorities included ensuring providers remained sustainable and transforming specialist services, the commissioning of which was likely to be devolved from NHS England to a local level. The development of a system-wide decision making model and the maximisation of the use of estates were also priorities under the STP.

There was work underway with housing re the STP although this was in its early stages. It was accepted that people’s environment was critical to their health. All partners were required to be transparent about costs involved in the STP and it was hoped that any issues involving costs sharing etc could be resolved quite quickly. The Local Authority’s financial gap was not included in the STP but would be picked up by the ACO work.

It was hoped there would be more buy-in from other councils in the STP area as political support was required from Councils in order to make the changes work. CB felt that if a strong case was made for the value of the STP then the business case would succeed but this again needed buy-in from all the Councils involved.

The Board AGREED that it should record its displeasure that NHS England would not allow the contents of STPs to be shared. CB would communicate this to NHS England.

The business case for the ACO set out to answer similar questions for the Barking & Dagenham, Havering and Redbridge area. The business case addressed how the financial challenge would be met and proposed a direction of travel for how this work could be delivered in partnership.

Work on localities was fundamental as this was considered the best way to transform health outcomes. The business case proposed how localities could be created and trialled. The aim of the programme was to put the person at the centre and focus on preventative care and the impact of areas such as housing, leisure and work.

A lot of progress had been made but it was accepted that this work remained a big challenge. It was planned to agree the business case for the ACO in September 2016 and a lot of engagement would be needed between the parties involved in the work.

The ACO was an overall vision but it would not be possible to cover care at all stages of life within the 18 month pilot period.

The Board NOTED the position with the ACO and STP.