Agenda item

To provide an update on the formation of the BOB ICS in line with the proposals set out within the Health and Care Bill.

Amanda Lyons (Interim Director of Strategy and Partnerships) presented the item on the BOB ICS update (Agenda Item 8).

The Health and Care Act 2022 was approved on 28 April and the focus was on establishing the Integrated Care Board (ICB) by 1 July. Activities undertaken in April and May included:

·         ICB Constitution submitted to NHS England on 20 May.

·         Consultation on the Working with People and Communities Strategy.

·         Integrated Care Partnership (ICP) working group had met.

·         The Readiness to Operate Statement had been subject to Internal Audit and Regional Office review.

·         The CCG Staff TUPE transition consultation had closed and the interim ICB team was in place.

In relation to the System Delivery Plan:

·         This had been submitted to NHS England - it set out the year 1 establishment plan for the ICS while the ICP Strategy was in development.

·         The Plan focused on the ICB architecture (governance and staff transition) and ICS development.

·         The Strategy was published on the ICS development microsite: https://bobics.uk.engagementhq.com/strategic-delivery-plan

·         The focus of recent weeks had been in the establishment of the ICB on 1 July. Work on the ICS would take precedence once the ICB and ICP were established.

Integration as a driver to deliver better outcomes:

·         Development of the ICS was based on the four aims set out in the White Paper:

o   Improving population health and healthcare

o   Tackling inequalities in outcome, experience and access

o   Enhancing productivity and value for money

o   Helping the NHS to support broader social and economic development

ICS development roadmap:

·         Various workstreams were progressing for ICB architecture and ICS development.

·         It was stressed that these were not focused on operational planning and delivery for the NHS

Key outcomes:

·         April 2022 milestones had been achieved

·         Good progress had been achieved in working towards the July 2022 milestones.

·         Recruitment for the place executive director was underway

Managing the ICS development programme:

·         This was intended to be a ‘living document’.

·         There were key roles for the ICB and ICP, and the Place Based Partnerships (PBPs).

ICP Strategy:

·         There was a degree of ambiguity about the ICP Strategy.

·         The Strategy must be completed by 31 December 2022, which was a tight timescale, so preparatory work had already begun:

o   Looking at the 5 Health and Wellbeing Strategies and the NHS Core 20 plus 5 analysis of health inequalities.

o   Establishing close working relationships with ICS Directors of Public Health.

o   Understanding the requirements of the Health and Care Act 2022.

o   Developing an ICS level fact base, including a Joint Needs Assessment.

BOB ICS Emerging Vision:

·         This will be developed in collaboration with system health and care partners.

·         Preparatory work to start in April 2022, but the core vision and strategy development will coincide with the formation of the ICP Board on 1 July 2022.

·         Current priorities of the ICS include:

o   Elective care recovery

o   Provision of urgent and emergency care

o   A focus on child and adolescent mental health services and temporary staffing

ICP Strategy Development – preparatory phase:

·         Key activities were highlighted

·         It was expected that children and young people would feature prominently in the Strategy

The Chairman noted that there were three rather than five Health and Wellbeing Strategies, since there was a joint strategy in Berkshire West.

The Chairman also highlighted significant disquiet amongst elected Members at the lack of involvement in the development of the ICP.

It was noted that the ICB membership was yet to be finalised – the three partner members from the local authorities, NHS Trusts and Primary Care Networks were yet to be appointed.

Councillor Martha Vickers agreed the importance of involving elected Members, since they were an important channel of communication to residents who may not be aware of the changes. She expressed concern that health services remained accessible so patients did not have to travel unnecessarily.

The Chairman noted that the NHS Trusts and PCNs would not change. He emphasised that delivery of the Health and Wellbeing Strategies would be key, but conversations were needed with the ICP as to how this would happen.

Garry Poulson highlighted that he had been working with colleagues across the BOB region to ensure that the community and voluntary sector’s voice was heard within the new framework. He also noted that Healthwatch was working hard to ensure that the patient voice was heard. He stressed it was important to have involvement at the start of the commissioning process and asked that someone from Berkshire West CVS should be involved to represent the sector’s voice on delivery.

Andy Sharp welcomed the comments about children and young people being important. However, he was concerned about membership of the development group and the lack of representation from children’s services. He suggested that there was a similar issue in terms of public health involvement.

Action: Andy Sharp and Amanda Lyons to discuss options for widening the membership of the development group.

Andrew Sharp welcomed the improved engagement of the Healthwatch serviced by the ICS in recent months. However, concerns remained about how the programme boards were changing and about poor stakeholder communications, with key partners often missing from meetings. He stressed the need to have a whole system approach.

Dr Abid Irfan confirmed that work was ongoing with the new Chief Medical Officer to review the various programme boards. Structures may not be finalised by 1 July, but he was confident that it would happen with the new leadership. He agreed about the need to have the right people involved.

Amanda Lyons welcomed the comments. She stressed that there would be involvement of the voluntary sector and Healthwatch in developing the ICP Strategy. She indicated that there would be work around community engagement, which would involve elected Members and stressed the importance of the preparatory phase. She indicated that she had been given mixed messaged in relation to the Berkshire West Health and Wellbeing Strategy. She was pleased to see consistent priorities across all of the BOB Health and Wellbeing Strategies, but the challenge would be in catching the local nuances.

The Chairman noted that in order to achieve synergies between the ICP and the Health and Wellbeing Boards, it would be helpful to engage the Chairmen of the Health and Wellbeing Boards. This would help to avoid duplication of efforts in progressing aspects of the delivery plans.

Action: Amanda Lyons and Councillor Graham Bridgman to discuss how best to engage of Health and Wellbeing Board Chairmen.