Agenda item

From 1 July 2022, Integrated Care Systems will have legal status with new responsibilities and structures, including the Integrated Care Board and Integrated Care Partnership.  This item provides Committee Members with an opportunity to review the progress being made in establishing the Buckinghamshire, Oxfordshire and Berkshire West Integrated Care System (BOB ICS).

Presenter

Ms Amanda Lyons, Interim Director Strategic Delivery & Partnerships, BOB ICS

Papers

Cover report

Powerpoint presentation

The Chairman welcomed Ms Amanda Lyons, Interim Director Strategic Delivery & Partnerships, Buckinghamshire Oxfordshire and Berkshire West Integrated Care Board (BOB ICB), to the meeting.

During her presentation, the following points were made:

·       The Integrated Care Board (ICB) was the statutory NHS body brought into effect on the 1^st July 2022 which would see the abolition of the Clinical Commissioning Groups.

·       The staff across all the CCGs within the BOB footprint would transition into a single organisation.

·       The system delivery plan for the ICB and ICS was submitted to NHS England and sets out the formation and development of the ICB and ICS.

·       The NHS had postponed the requirement for delivering a digital strategy, which would provide an opportunity to liaise with Health and Wellbeing Boards before it is drafted. The Department of Health and Social Care would provide guidance on this on 18^th July. An Interim Integrated Care Partnership Strategy would be produced by 31^st December, followed by a five-year joint forward plan to which local authorities and health and wellbeing boards would have an opportunity to respond to.

During the discussion, Members asked the following questions:

·       A Member was interested in understanding how the Buckinghamshire, Oxfordshire and Berkshire West (BOB) ICS would benefit residents and how services would be improved as a result of being part of a bigger geographical footprint. Ms Lyons explained that one of the key benefits of the change would be the focus on the integration of health and social care. This allowed for health services to be looked at across a wider footprint, thus providing opportunities for additional funding.

·        A Member expressed concern about community health funding, particularly around supporting older people. Ms Lyons reassured the Committee around the benefits of integrated care and the overall aim was to work more efficiently with the available resources.

·        The Chairman noted that the Council needed to know more about health services would be delivered across the BOB ICS. The newly formed joint health scrutiny committee would be reviewing this across the system.

·        The Chairman encouraged further communication and regular discussions between the HASC Select Committee and the BOB ICS.

·        A Member expressed concern about residents struggling to receive doctor's appointments. They asked how the establishment of the BOB ICS would improve these issues, particularly in light of frequent re-organisation within the healthcare sector. Ms Lyons advised that establishing the place-based component of the ICB would ensure better links in primary care between the NHS and local authorities.

·       The Chairman noted that the Council's senior management team had raised concerns about the ICB, including the current proposal that only one local authority representative would be on the ICB. She went on to say that the five authorities were very different, and it felt very unrepresentative to have just one person. In addition, the Chairman asked what the local authority representation would be on the ICP. Ms Lyons reiterated that the ICB was a statutory NHS body which required representation from one local authority Member. She advised that the representation of local authorities on the ICP was still being discussed.

·       A Member raised the difficulties in matching the requirements from NHS bodies and the Council (as the planning authority) in terms of the use of section 106 and CIL funding to develop local health services.

·       In response to a question about ICS workforce challenges, Ms Lyons advised that the ICS workforce strategy focused on staff wellbeing and numbers. It also focused on the advantages of working across BOB, and increasing the workforce in more deprived areas, for example, through apprenticeships. With the appointment of the chief medical officer, the clinical leadership aimed to understand the issues to be able to influence workforce strategies effectively.

·       In response to a question, Ms Lyons explained that an interim director of digital transformation had been appointed. The digital strategy was currently being drafted across both health and social care. Local authority representatives attended a meeting to identify strategic enablers. The focus was on the importance of shared care records and data for population health management to effectively address health inequalities. A further meeting to discuss this would be held in July.

·       A Member raised concerns that the three CCGs had unique capabilities that do not naturally support and enable productive work across the ICS. Ms Lyons assured the Committee that it was the right approach. Working together, particularly throughout the pandemic, had shown clear advantages. For example, the Buckinghamshire CCG's finance director set up an arrangement to share the PPE between the different CCGs, which had been the foundation for working together. This had further been shown through the vaccine programme, which is one of the country's most successful.

·       A Member asked how the strategic priorities for tackling inequalities would link with the local council priorities. Ms Lyons noted that the priorities were still in development. She agreed to inform the Committee of any progress in developing these strategic priorities and would ensure their publication on the website.

·       In response to a question, Ms Lyons advised that Mr Nick Broughton (Chief Executive of Oxford Health) would be the Mental Health representative on the ICB.

·       A Member asked how the public and key stakeholders could access records of Board meetings. Ms Lyons explained that two subcommittee boards were still being developed, with a meeting of the workforce and the system and place board meeting taking place on 1^st July. The terms of reference for those subcommittee boards could be found in the ICB board papers, which are publicly available. The importance of transparency, accountability and good communication, both in terms of language and ease of access, were highlighted by several Committee Members.

·       The Cabinet Member for Health & Wellbeing supported the Committee's concerns about inadequate representation of local authorities on the ICB, particularly as this would be the body responsible for making funding decisions. She also asked whether funding decisions would be made before the strategy was approved (due in December). Ms Lyons responded by saying that the CCG governing bodies had approved the operational and financial plan for this financial year (until April 2023). The document would be presented at the meeting on the 1^st July.

·       A Member pointed out that the democratic process for deciding which elected member would represent authorities on the ICB was not transparent. Ms Lyons reiterated that the membership of the ICP was still being discussed. However, the process for appointing partner members to the ICB was set out in the constitution as she emphasised that the ICB was a statutory NHS Board.

·       A Member queried the healthy index detailed in the report, stating that although healthy people live healthy lives, there were not many healthy places. Ms Lyons advised that the healthy places component mostly referred to transport links and levels of air pollution. She explained that this issue needed to be investigated further as part of the ICS development

·       In response to a question about the Better Care Fund, Ms Lyons advised that there would be no changes to how the better care fund operates. In terms of PCN funding, which operated on an annual basis, Ms Lyons was not aware of any changes.

The Chairman thanked Ms Lyons for her attendance and for responding to questions.  She concluded by saying that Ms Lyons and colleagues on the ICB would be invited to future scrutiny meetings to provide progress reports.