Agenda item

An update from the Buckinghamshire Executive Partnership, including the Health and Care Integration programme and use of inequalities funding update.

Neil Macdonald, Chief Executive Officer, Buckinghamshire Healthcare NHS Trust.

Neil Macdonald, Vice Chairman and Chief Executive Officer, Buckinghamshire Healthcare NHS Trust, explained that the Buckinghamshire Executive Partnership (BEP) was where the CEO and senior officers of the statutory organisations came together to deliver shared agendas, particularly relating to the Health and Wellbeing Strategy.  The report to the HWB was a regular update report for information.  Neil reported that there had been positive progress on the integrated discharge teams and the building of pathways out of hospital into the community and preventing re-admission.  However, more progress was needed on Special Educational Needs and Disabilities (SEND) and children’s services, particularly to improve access for vulnerable children; this was a collective responsibility across health, mental health, physical health, primary care and the Council.

The Chairman then read out the public question from Mike Etkind.

Question - Will there be any co-production involved in the primary care deep dive referred to in the paper for agenda item 8 (particularly engagement with patient participation groups)?

Summary Response - The Buckinghamshire Deep Dive into primary care was a deep dive undertaken in the context of wider work underway across Buckinghamshire, Oxfordshire and Berkshire West Integrated Care System (BOB ICS) to develop a Primary Care Strategy for the system.

The Primary Care Strategy being developed across the BOB ICS is engaging widely with partners. Local HealthWatch teams are involved and a clear part of their role is to ensure patient participation groups (PPGs) are engaged.

The Chairman stressed that it was good to engage with the PPGs, adding stakeholder engagement did not always include communities and members of the public or of the diverse range of service users.  The Chairman made a plea that any strategies being developed were mindful of that and highlighted that co-production was extremely important.

The following key points were raised in discussion:

·   David Walker, Chair of Oxford Health, advised that Oxford Health was rolling out community hubs for high street presence and improved integration of voluntary sector, local authority and mental health community provision in Oxfordshire and thought there could be some synergy in Buckinghamshire.  Neil agreed that the voice of mental health could be stronger at the BEP and how it linked into the programme for re-generation of the high street was critical and added that the BEP would be delighted to work with Oxford Health.  The Chairman stated that mental health was woven into the HWB strategy and advised that there was an initiative, in its early stages, called ‘health on the high street’ in Aylesbury and that this was the type of initiative which needed to be available at in the levelling up wards.

·   Zoe McIntosh, CEO, Healthwatch Bucks, did not think the ICB would say that the Primary Care strategy was being co-produced as the principle of co-production started too late in the day, however, the deep dive that took place at the BEP did look at patient feedback and experience.

·   Philippa Baker, Bucks Place Director, BOB ICB, thanked Zoe for Healthwatch Bucks’ report on pharmacies; a formal response would be sent.  Philippa explained that pharmacies would have a critical role over the winter.  In Buckinghamshire there was a Critical Advisory Service (CAS) to ensure distribution of demand to the correct place and use pharmacies wisely.  In relation to the primary care strategy, work had started on analysing the current state of care across BOB; it would be partly research based and partly involve engaging with partners and would cover GP, pharmacy, optometry and dentistry across the geography of BOB.  Philippa stated that the GP representatives had produced a paper on the primary care deep dive which Philippa would review and report back to Zoe.

Action:  Philippa Baker

·   A Primary Care Strategy System care workshop would be held; Healthwatch and other partners were to be invited, including representatives from PPGs and the aim was to launch public engagement in October which would involve the wider public, communities and the voluntary sector in order to have the right model for primary care going forward.  A fuller stockwork framework was being considered which included, e.g., estates, integrated neighbourhood teams, digital workforce.  The Chairman added that primary care estates was a prime concern for residents.  Engagement was key and the Chairman stressed the importance of co-production. 

·   John Meech encouraged the ICB to ‘think outside the box’ as he had learnt from the Healthwatch England conference that there were some good solutions around e.g., directly employing dentists to carry out check-ups and routine dental care.  The Chairman asked John to share the information with Philippa.

Action:  John Meech

·   Dr Bajwa stated that there were two datasets that would be looked at in the Primary Care Strategy; the IPSOS MORI Poll and the friends and family test that every practice ran on a monthly basis which provided a wealth of information about the patient experience, levels of satisfaction and the comments.  These would form critical parts of forming a view of what the public felt.

·   The Chairman referred to the appendix on page 25 of the agenda pack, an update on health and inequalities funding and asked what age group the health awareness for people of child bearing age encompassed?  Dr Jane O’Grady, Director of Public Health and Community Safety, advised that this came about due to huge inequalities in deprived areas and black and ethnic minority groups and looked at what needed to happen before a woman became pregnant to ensure a healthy pregnancy.  Work was being undertaken with women from afro Caribbean and Asian groups, to find out what they wished they had known before they became pregnant.  This insight would decide what other age groups to target.  A survey was also being carried out to find out key issues.

·   The Chairman asked whether there had been any feedback from patients and carer service users on the imminent launch of the transfer of care hubs at the end of October.  Craig McArdle, Corporate Director, Adults and Health, explained that patient experience had not been captured yet but they were seeing good performance information coming out of the hubs.  The fourth hub had opened up in the north of the county. In discharge to assess beds one of the key metrics was to reduce the time people were spending in hospital beds as well; there was a target of 28 days and it was currently running at 30 days.  The integrated discharge team was in place at the moment and there were good indicators of success.  Zoe advised that Healthwatch Bucks would be starting a project with people from care home hubs.  The Chairman asked that the patient experience item be brought to the HWB in the Spring.

Action:  Rebecca Carley to add to the forward plan