Meeting documents

For Members to receive an update on the Buckinghamshire, Oxfordshire and Berkshire West Sustainability and Transformation Plan, including an update on delivering the "Bucks" chapter.

Attendees:

Lou Patten, Chief Accountable Officer, Clinical Commissioning Groups

Neil Dardis, Chief Executive, Buckinghamshire Healthcare NHS Trust

Mike Appleyard, Deputy Leader and Cabinet Member for Health & Wellbeing

Graeme Betts, Interim Managing Director, Adult Social Care

Attached is a copy of the draft Buckinghamshire, Oxfordshire and Berkshire West Sustainability and Transformation Plan and the vision and programme for digital transformation in health and care.

Lou Patten, Chief Executive, Clinical Commissioning Groups, Neil Dardis, Chief Executive, Buckinghamshire Hospital Trust, and Graham Jackson, Clinical Lead for Aylesbury Vale attended the meeting to give an update on the Buckinghamshire, Oxfordshire and Berkshire West Sustainability and Transformation Plan. The presentation in full can be found here (will attached presentation to notes)

The Committee discussed the individual work streams contained in the STP.

The following points were discussed:

·         How the finances would be set out across the footprint and the debt inherited that would be factored into the baseline

·         The 70/30 split referred to the Bucks "chapter" with 70% efficiencies coming from local plans and that this would be monitored through progress checks

·         The assurances needed that the STP would not result in reductions for Bucks residents and the confidence that the plans would build services locally for residents

·         Assurances relating to the Governance of the decision making process

·         Ensuring key stakeholders were involved so have a whole system integrated working

·         The need to ensure services were accessible to all including those in deprived areas or that did not have access to digital solutions and the requirement to give people options

Prevention

The following points were discussed:

• The link between the STPs project plans, how they were broken down to a County level and if timescales would be included in the project tracker.  It was confirmed that the plans would be shared with key stakeholders in May
• Assessing would the success of the agenda for patients and ensuring the patient voice was heard.  Examples were given of engagement happening already and feedback used from patients to inform the plans

Urgent Care

The following points were discussed:

• Who decided if a request put through by a GP was urgent or put on the routine list
• The need for the treatment pathway to be communicated to patients and put in place so that delays were minimised.  
• The requirement to maximise the use of technology between departments and the GP
• How  extended GP services could be put in place to prevent patients visiting A&E
• How Wexham Park Hospital/Frimley were integrated into the plans to overcome the current disjointed nature of provision.  It was confirmed that there were links with Wexham Park discharge planning and links between the teams.  It was also confirmed that some capital funding for GPs had been sought in order to be able to talk digitally with the hospitals
• The need for engagement with the ambulance service.  It was confirmed that the South Ambulance Service has been heavily involved

Acute Care

The following points were discussed:

• The Committee questioned whether the £7.2m saving from Acute services included procurement and sought reassurance that savings would be made from procurement.  Members were assured that numbers in the STP were realistic and if not made would present challenges

Mental Health

The following points were discussed:

·         Concerns were raised about what needed to be done for Mental Health in Buckinghamshire and the feeling that the County was behind what others were doing

·         The need to think differently about how we provided services and that this would be picked up as part of the Community Hubs initiative

Specialised Commissioning

The following points were discussed:

• Substantial savings could be made in this area and the need to have the expertise to ensure breadth of knowledge.  It was discussed that this was a specialised end of health care and expensive
• Areas of savings suggested had included having diagnostic tests carried out locally and liaising with the specialist clinicians to ensure joined up working

Workforce

The following points were discussed:

• The option to move towards 7 day working, which mean there would be less contrast between weekday and weekend patient experiences and if this would be sustainable.  It was noted that there was already a lot of work in Buckinghamshire that was proving successful

Digital

The following points were discussed:

• Historically communications within the NHS had not been good.  It was confirmed that all Aylesbury Vale clinicians were now on the same system and more digital solutions were being used across the sector
• Work was ongoing between the Adult Social Care and GPs in order to better access information

A 12 month update was requested to come back to the Committee on the developments in this particular area.

Action: Lou Patten

Primary Care

The following points were discussed:

• The development of Community Hubs, their location and the resources that would be used
• How services were going to be delivered closer to home for patients