Agenda item

This item provides Members will an overview of the Buckinghamshire, Oxfordshire and Berkshire West (BOB) Integrated Care System (ICS) and the role of the Integrated Care Board (ICB).  It provides an opportunity to review the key system challenges, system goals for 2024/25 and to discuss the ICB’s approach to embedding these in planning.

Presenters:

Sim Scavazza, ICB Acting Chair

Dr Nick Broughton, ICB Chief Executive Officer (Interim)

Papers:

Presentation attached

The Chairman welcomed Sim Scavazza, ICB Acting Chair and Dr Nick Broughton, ICB Chief Executive Officer (Interim) to the meeting.  In response to a question about when these roles would be made permanent, Ms Scavazza explained that she had been acting chair since April 2023 and an announcement was expected soon on both roles.

The following main points were made during their update.

·       Clarification about the roles and responsibilities of the ICB and the ICP was provided – the Integrated Care Board (ICB) is a statutory NHS body with responsibility for the finances surrounding delivery of health services across the defined geographical integrated care system (ICS).  The Integrated Care Partnership (ICP) is made up of key partners within the ICS who work together to deliver the services locally.

·       The BOB ICB became a statutory organisation in May 2022 and whilst there had been some leadership changes over this period, the senior management team was strong and able to deliver the strategic responsibilities.  All the non-executive members had been in post since May 2022.

·       The ICB had produced an Integrated Care Strategy which detailed how the ICB would work with partners, with a clear focus on collaboration and delivering seamless care for residents against very challenging financial constraints.

·       The BOB ICS was one of 42 ICS’s across the country and was responsible for a population of 1.8 million and an NHS budget of £3.3 billion.

·       The Integrated Care System comprised 5 NHS organisations and one ambulance trust.

·       All GP practices in Buckinghamshire were rated “good” or “outstanding” buy the Care Quality Commission and GP practices in Oxfordshire and Berkshire West were of a similar standard.  The three geographical areas had significant areas of deprivation which had led to health inequalities but the ICS was working had to address health inequalities.

·       Budget pressures meant that there was a need to think differently about how services would be delivered in future with an emphasis on innovation.

During the discussion, Members asked the following questions and made the following comments.

·       A Member referred to a recent Rowntree report which was published on 23^rd January, which highlighted poverty and the related health inequalities.

·       In response to a question about ICB monitoring of the South Central Ambulance Service (SCAS), the Chief Executive explained that the ICB works closely with all partners and supports partners on their improvement journeys.

·       Tackling health inequalities was acknowledged as a key priority across the ICS.  The Deputy Chief Executive provided examples where better outcomes had been achieved in areas such as maternity and COPD.  Greater partnership working across the system was recognised as way of tackling health inequalities.

·       In response to a question about whether there were specific projects aimed at tackling obesity and providing more support for people with learning disabilities, the Chief Executive Office explained that the primary care strategy recognised Cardio-Vascular Disease as a priority area, in terms of prevention and weight management was part of this work.  The Director of Primary Care added that Health Checks were available for people with learning disabilities but agreed more could be done to support people.

·       The Chief Executive explained that in order to undertake more preventative work, there needed to be a shift resources into primary care.

·       Members raised concerns about the lack of any mention of independent scrutiny within the governance structure outlined in the presentation slides.  The Chief Strategy and Partnerships Officer explained that a more detailed Board paper had been published recently and agreed to circulate this to Members.

Action: Chief Strategy and Partnerships Officer

·       A Member raised issues around very lengthy waiting lists for assessing children with mental health issues, including autism and other neurological disorders (around 2 years in some cases).  The Chief Executive Officer acknowledged that access to mental health services for children and young people was very challenging and would continue to be as the demand continued to increase at a significant rate.  He went on to say that a number of improvements had been made to this service but acknowledged that more needed to be done.

·       A Member mentioned the scorecard and asked whether it was robust enough to track progress of the ICB’s key goals.  The Chief Strategy and Partnerships Offices explained that the Board paper included a set of metrics for each key goal which was a transparent way of measuring progress in each area.

·       The Chairman suggested that ICB colleagues be invited back to a future JHOSC meeting to provide more detailed information on the key goals and the metrics being used.  The Chief Executive agreed and went on to suggest a workshop for JHOSC Members and ICB colleagues might be a useful way to impart some of the information discussed during this item and to clarify further the current health landscape, in terms of the roles and responsibilities of the ICB and the ICP.

The Chairman thanked Sim and Nick for attending the meeting and providing a useful overview on the work and priorities of the BOB ICB.