Meeting documents

1. Update on NHS Long Term Plan and Integrated Care Partnership – to be presented by Mr D Williams, Director of Strategy and Business Development, Buckinghamshire Healthcare Trust and Ms J Hoare, Managing Director, Integrated Care Partnership (ICP).

2. Future arrangements for NHS Commissioning - to be presented by Mr R Majilton, Deputy Chief Officer, Buckinghamshire CCG.

3. Service Design and Engagement Framework – Ms K Parfitt, Head of Communications, Communities, Health and Adult Social Care, Buckinghamshire Clinical Commissioning Group and Buckinghamshire Integrated Care Partnership.

4. Better Care Fund – to be presented byMs J Bowie, Service Director, Integrated Commissioning.

1. Update on NHS Long Term Plan and Integrated Care Partnership 

Ms J Hoare, Managing Director, Integrated Care Partnership highlighted the following:

• Work by the Integrated Care Partnership continued and the approach had been streamlined to ensure effectiveness.
• There were three work streams; children and young people, primary care networks (integrating physical and mental health) and social care teams.  The mental health work stream had been established for a period of time with a focus placed on easy access to services. 

• All groups were multiagency and used population data to locate the areas where they would have the most impact.
• A focus was placed on respiratory problems and coronary disease. 
• Clinics were established within the community to allow residents quick access to services.  Available services included help with physical and mental health and were a good example of services coming together.

Mr D Williams, Buckinghamshire Health Care NHS Trust highlighted the following:

• Two briefing sessions were held with Health and Wellbeing Board members in 2019.  Focus was placed on the detail of the NHS long term plan and how it would affect the Buckinghamshire area.

A number of key themes were highlighted at the last session in October:

·         A focus on prevention and health inequalities.

·         A focus on quality of estates to ensure patients felt welcome in health and care settings.

• Communication and engagement with patients. This would help to ensure that members of the public were aware of their own care responsibilities and how they could access emergency care. 
• The plan had been submitted on 1 November 2019 and would be published at the start of 2020.  The plan would set a strong template for refreshing the health and wellbeing strategy.
• Thanks were given to members of the board for their commitment and support.

The following points were highlighted in response to questions raised by members of the board:

• A key priority needed to be ensuring that patients had their views represented.
• Communication with members of the public required improvement. 
• The publication of the plan would be an opportunity to open up conversations on what public expectations should be; how they would take responsibility for their own care and how to properly access care.
• One of the main priorities for the service was to make every contact count.  Discussions had taken place with patients to highlight the support available in order for them to improve their own health.
• It would be useful to have further clarity for members of the public on the definitions of "a partnership" and "a system."

2. Future arrangements for NHS Commissioning

Mr R Bajwa, Clinical Chair, Buckinghamshire Clinical Commissioning Group (Bucks CCG) provided an introduction to the presentation circulated with the agenda and highlighted the following:

• A number of changes had been made in recent years.  The most notable was the establishment of Sustainability and Transformation Partnerships (STPs).  The role of the STPs was formalised in the long term plan with a drive towards more effective integration, now known as Integrated Care Systems (ICS).
• The main challenge was setting out expectations within the long term plan.  One priority was to ensure that the momentum of developments in Buckinghamshire were not lost.
• Current effective measures would not be sacrificed to ensure the development of a future system. 
• A series of meetings had taken place to discuss what the plan would mean for Buckinghamshire.  The CCG was keen to ensure that the process was responsive to the opinions of stakeholders. 
• The first stage of the engagement process ended on 1 December 2019.  A meeting would be held to discuss the findings. 

·         Emphasis that future arrangements were still being considered and arrangements put in place would focus on local commissioning and reducing health inequalities in Buckinghamshire.

Mr R Majilton, Deputy Chief Officer, Buckinghamshire CCG delivered the presentation circulated with the agenda. The following points were highlighted and discussed in response to questions raised by members of the board:

• The local priority was to work with ICS partners to make decisions on future budgeting.  Funding would be decided in response to future proposals.

·         Future plans would look at how Bucks CCG could provide strong leadership through the Health and Wellbeing Board – especially looking at what would be commissioned on a regional and local level and how the Board could work to develop clarity on this.

·         Feedback from Board members that elected representative accountability needed to be reflected across system and local plans.

3. Service Design and Engagement Framework

Ms K Parfitt, Head of Communications, CCG highlighted the following:

·         The framework was a checklist used to plan the delivery of a new service. Service users should be at the core of any new services. 

·         Plans were originally in place for health and social care, but this would be extended to wider council services.

The following points were highlighted and discussed in response to questions raised by members of the board:

·         Reassurance was needed that Children’s Services were included in the plan.  Opinions were expressed that the plan appeared to be written from an Adult Social Care perspective.  Ms Parfitt would feed this back.

ACTION: Ms Parfitt

·         Assurance was given that when a similar framework was used in other organisations it had allowed for issues not initially included in the plan, such as access to transition services for children. 

·         An internal communications plan would come into immediate effect to promote the plan across all partners throughout the system.

RESOLVED:  Members of the board APPROVED the framework.

4. Better Care Fund

Mr Majilton delivered a presentation circulated with the agenda.  The following points were highlighted and discussed in response to questions raised by members of the board:

·         It was important for residents and communities to keep well over winter months as pressure on A&E services was already high.

·         During the winter months, additional resources were put in place, as per the winter resilience plan.  The impact of the winter plans would be reviewed at the next meeting. 

·         There were social workers present in A&E to assess the needs of vulnerable adults.  43% of patients that accessed A&E were seen and discharged on the same day. This figure would be reviewed to monitor improvements.

·         A member of the board asked for clarification on whether the 11% increase in domiciliary care hours and increase of complex patients being cared for at home is sustainable in the long term and how this chimed with the effectiveness of reablement targets which have not been met. It was confirmed that this would be looked at in more detail by the Integrated Care Executive team and reported back to the Board in March.

ACTION: Mr Majilton

RESOLVED:  Members of the board NOTED the update.