Agenda item

Report attached.

At the request of the Committees, an update was provided in relation to population health management, urgent and emergency care, primary care networks, cancer, mental health, workforce and estates, which was initially scheduled for the meeting held on 6 November 2019.

Jane Milligan (ELHCP Accountable Officer), Dr Jagan John (Chair Barking and Dagenham CCG) and Simon Hall (ELHCP Director of Transformation) introduced a detailed presentation which outlined a background to the NHS Long Term Plan; selected workstreams, ongoing work to develop an integrated care partnership for North East London, the role of the acute collaborative group, and projected delivery and next steps.

The Plan was published in January 2019 setting out a vision for the NHS over a 10-year period including the development of a number of work programmes. It was submitted to NHS England and published on the ELCHP website in November 2019.

Jane Milligan made reference to the questions received from the members of the public and explained that a single CCG (NEL Integrated Care System) was in development across north east London to remove barriers to integration, improve governance structures and speed up decision making in key areas, and Marie Gabriel was due to commence in her role as Chair on 1 April. 

The final plan was due to be submitted to NHS England / Improvement in March 2020 and ELCHP would continue its boroughwide engagement with local authorities and NHS provider organisations as well as the JHOSCs, particularly as services are redesigned.

Questioning outlined the following:

-       The Accountable Officer acknowledged the importance of co-production across the various partner organisations to deliver integrated care health and social care for north east London and the constraints of national policy and welcomed further developments in national policy, such as the Green Paper. 

-       Resources would be made available to support the transformation of services in north east London, particularly in relation to Primary Care Networks and workforce development, and work programmes would build on the learning from previous transformations, in terms of integrated working and engagement, such as maternity services and mental health.

-       An Acute Collaboration Group exists which worked across acute providers to share good practice.

-       Joint commissioning arrangements were a work in progress and both the Plan and a move to a single CCG would aid decision-making and the alignment of resources.

-       The Accountable Officer acknowledged the challenges regarding A&E waiting times and explained that Marie Gabriel would be undertaking a governance review. The Director of Transformation clarified that the Plan included ongoing work to develop workforce initiatives including the offer of apprenticeships and collaborative work with partner organisations.

-       The Chair Barking and Dagenham CCG explained that the transformation plan across the CCGs aimed to ensure that people could access the right services in the right location and nearer to home and reduce A&E activity, particularly at BHRUT which was seeing a rise in activity relating to access and workforce, and to create a more stable system. He acknowledged the national and local challenges caused by retiring single handed GPs and explained that flexible work opportunities and physical associates programmes would enable a more diverse workforce model from traditional models.

-       The Chief Finance Officer explained that a move away from PBR (payment by results) was part of the Long Term Plan with the aim of working collaboratively to deploy resources based on the needs of the demographic population. 

-       Further to a suggestion by a Member of the INEL/ ONEL JHOSCs, the Accountable Officer agreed to amend the Plan to include the following references:

i)     Assurances that in planning out of hospital care it was not envisaged that any tasks currently carried out by the NHS would be devolved to local authorities without financial recompense.

ii)    The need for affordable accommodation for NHS staff.

iii)   An aspiration that no one should access mental health treatment through the criminal justice system or A&E for want of an earlier intervention by mental health services, ensuring a clear pathway to mental health services.

-       The Accountable Officer invited any further comments or engagement with the JHOSCs and local borough OSCs regarding the Plan both prior to March 2020 and beyond, as services are redesigned.

-       The Chairman (ONEL JHOSC) referred to his commentary on the NHS LTP and a briefing paper produced by the Redbridge Public Health Team, which was shared with members of the JHOSCs for their information, and offered to share it with the Accountable Officer.

It was agreed that the JHOSCs note the update and the Chairmen thanked those present for their attendance and contributions to the discussion.