Meeting documents

Apologies were received from Mr C Etholen and Mrs S Jenkins.

There were no declarations of interest.

of the meeting held on Tuesday 6 September to be confirmed as a correct record.

The minutes of the meeting held on Tuesday 6 September were confirmed as a correct record.

Follow-up on actions

·         Item 4 – the Committee & Governance Adviser confirmed that a discussion had taken place with the Clinical Commissioning Groups in terms of a consistent approach to reporting trends.

·         Item 6 - Bedfordshire and Milton Keynes Healthcare review – representatives had been invited to attend this meeting to discuss the STP plans for this footprint but no-one had confirmed their attendance.

·         Item 8 – NHS England had been invited to a future meeting to update the Committee on the results of the ongoing research.

·         Item 9 – Committee Members had been invited to attend provider meetings but due to limited room capacity were unable to attend.

This is an opportunity for members of the public to put a question or raise an issue of concern, related to health.   Where possible, the relevant organisation to which the question/issue is directed will be present to give a verbal response.  Members of the public will be invited to speak for up to four minutes on their issue.  A maximum of 30 minutes is set aside for the Public Questions slot in total (including responses and any Committee discussion). This may be extended with the Chairman’s discretion. 

For full guidance on Public Questions, including how to register a request to speak during this slot, please follow this link:

http://www.buckscc.gov.uk/about-your-council/scrutiny/getting-involved/

There were no public questions.

For the Chairman to update Members on the recent Clinical Commissioning Group’s AGM and Bucks Healthcare Trust’s AGM.

The Chairman reported the following:

·         Pharmacy cuts – having reported at the last meeting that the proposed cuts had been withdrawn, the latest position showed that the Government were now re-considering the cuts.  The Chairman asked for the Committee’s agreement to write to the local MPs asking for a current situation on this issue.

ACTION: Chairman to send a letter to the local MPs in relation to the proposed pharmacy cuts asking them to confirm the current position.

·         Clinical Commissioning Group AGM – the Chairman reported that he had attended the recent AGM and mentioned the over 75s initiative which was currently being trialled, the digitalisation of patient records, current financial pressures within the system and a question from one of the delegates around when the STP would be published (item on the agenda for this meeting).

·         Bucks Healthcare Trust AGM – the Committee & Governance Adviser attended on behalf of the Chairman and the following areas of improvement were mentioned – Urgent Care, Patient Experience, Care Quality Commission rates BHT as "requires improvement" but now looking to move this towards a "good" rating.  Key areas of focus for BHT - Musculoskeletal services, Diabetes, Cardiac and stroke services, community hubs and teams and innovation.

·         The Bedfordshire and Milton Keynes Healthcare Review – there will be a meeting on Monday 14^th November in Bedford to discuss the Bedfordshire and Milton Keynes Healthcare review and the continuation of some of its work as part of the STP process.

ACTION:  Committee Members to let Mrs Wheaton know if they are intending to attend this meeting.

District Councillor Dr Matthews reported back on the care visits which she attended with a care manager from Prime Care – no major concerns were reported.  

The NHS Shared Planning Guidance asks every health and care system to co-create an ambitious local blueprint to accelerate implementation of the Five Year Forward View – Sustainability and Transformation Plan (STP).  Buckinghamshire is part of a Buckinghamshire, Oxfordshire and Berkshire West footprint.

In January 2015, the NHS invited individual organisations and partnerships to apply to become ‘vanguard’ sites for the new care models programme, one of the first steps towards delivering the NHS Five Year Forward View and supporting improvement and integration of services.  In March 2015, the first group of 29 vanguard sites were chosen. 

There were three vanguard types:

·         Integrated primary and acute care systems;

·         Enhanced health in care homes; and

·         Multi-speciality community providers.

Members will receive a briefing on the progress on the STP to date as well as further information about the locality working model in Buckinghamshire – what it will look like and what new models are currently being developed.  What can Buckinghamshire learn from the vanguard sites?

Attendees:

Lou Patten, Chief Operating Officer, Clinical Commissioning Groups

Robert Majilton, Deputy Chief Officer, Aylesbury Vale and Chiltern Clinical Commissioning Groups

Sophie Payne, Head of Customer Experience and Communications

Papers and background documents:

1.    Update briefing – power point presentation

2.    Update on locality working/new models of care

a.    New Care Models: Vanguards – developing a blueprint for the future of NHS and Care Services

b.    Primary Care Strategy

c.    Frail Older Person Strategy

d.    Primary Care Home model – see link below http://www.napc.co.uk/control/uploads/files/1457539294~PCH_Story_Feb2016.pdf

e.    NHS England guidance on Multi-speciality Community Providers – see link below

https://www.england.nhs.uk/wp-content/uploads/2016/07/mcp-care-model-frmwrk.pdf

3.    Local planning for engagement – a brief summary of engagement intentions

The Chairman welcomed Ms L Patten, Chief Officer, Clinical Commissioning Groups, Mr R Majilton, Deputy Chief Officer, Clinical Commissioning Groups and Mrs S Payne, Head of Customer Experience and Communications.  Apologies were received from Mr Raj Bajwa.

The item was separated into three areas:

·         An update on the NHS Plan including the Sustainability and Transformation Plan;

·         New models of care;

·         The engagement exercise.

Mr Majilton took Members through his presentation and made the following main points:

·         There were 44 Sustainability & Transformation Plans (STPs) footprints across England largely based on patient flows into tertiary acute hospitals.

·         Buckinghamshire was part of the Buckinghamshire, Oxfordshire and Berkshire West (BOBW) ‘footprint’.

·         The STP was being developed "bottom up" and represented a small proportion of the Bucks health & care system.

·         The main plan was being developed locally across the health & care system – the Bucks ‘chapter’ built on work already ongoing.

·         The Bucks ‘chapter’ continued to progress Buckinghamshire’s health and care system approach to developing plans under the leadership of Healthy Bucks Leaders’ Group which included representatives from the Clinical Commissioning Groups, the Local Authority and the Hospital Trust.

·         Considerable transformation of NHS services nationally and locally was required to meet three identified gaps – health & wellbeing, quality and finance & efficiency.

·         The focus was on reducing spend on bed-based care into prevention and care at home.  It required a shift in funding from bed-base to community services.

·         The Plan built on the priorities identified in the Health & Wellbeing Strategy and the Joint Strategic Needs Assessment.  A number of programme workstreams had been set-up to deliver the specific aims of the Plan.

·         A Transformation Delivery Group had been set up to oversee the progress on the delivery of the workstreams.

·         There was a Thames Valley Urgent Care network which focused on reducing lengths of stay in Hospitals.

·         The Clinical Commissioning Groups commissioning intentions were around the delivery of transformation and new models of care; the delivery of integrated community based services around a cornerstone of sustainable primary care; collaborative provider model of local primary and mental health and secondary care and commissioning the iMSK service and exploring a new model of care delivery for the Diabetes pathway.

Ms Patten provided an update on locality working and new models of care.

·         The proposed new models of care built upon the Primary Care and Older People’s strategy.

·         People wanted more control over their care and wanted to be treated closer to home so this provided the focus for the health needs of the population.

·         The two CCGS were divided into 7 localities – Aylesbury Vale North, Aylesbury Vale Central, Aylesbury Vale South, Amersham and Chesham, Wycombe, South locality and Wooburn locality.

·         The community hub was described as integrated services tailored to the population.  GPs were determining their community hub size based on the health needs of their population which varied across the localities.

·         Providing care outside of the Hospital required a shift in resource which must be at scale and take costs out at the  ...  view the full minutes text for item 7.

For Members to discuss and agree the work programme for future meetings.

Members agreed the items for the January meeting and noted the forward plan items.

The next meeting will take place on Tuesday 24 January 2017 at 10am in Mezzanine Room 2, County Hall, Aylesbury.

The next meeting is due to take place on Tuesday 24 January 2017 at 10am.