Agenda item

Anne Bristow, Strategic Director for Service Development and Integration, LBBD, reminded the Board that the next few years would bring a combination of financial challenge and rising demand for local health and social care partners and that managing this situation would require more than the incremental cutting of elements of service. 

The Board was advised that an expression of interest bid had been made to NHS England for funding, which would allow a business case to be drawn up that would assess whether an Accountable Care Organisation (ACO) across LBBD, Havering and Redbridge could form a viable approach to managing the demands that were ahead.  An ACO would form a platform for the devolution of the commissioning and management of some NHS services, and the realignment of financial incentives, which could offer a fundamentally different approach to the management of the health and social care system for LBBD, Havering and Redbridge.  One of the major principles behind ACOs was that the system was built around prevention and community support and the Partners would need to accelerate the work that was already being undertaken in those areas.  All stakeholders would be jointly responsible for ensuring that the ACO delivered better outcomes for residents.  An ACO would also offer better value for money as it would remove the current incentives in the health and social care system, which were thought to drive more expensive activity in hospital and residential care settings. 

The details of the current position on the development of a business case to pilot an ACO for LBBD, Havering and Redbridge, which included the outline timetable for future developments and some of the background on Accountable Care Organisations generally, were set out in the report. 

The Board discussed how an ACO would promote the removal of ‘silo’ thinking and would also offer the opportunity to decide how the ACO would work, what type of services would or would not be included, the staff needed, new / novel ways of working, better use of management tools and integrated systems and processes, especially in regards to IT systems and data transfer.  The Board felt that the Partnership was now mature enough to recognise the opportunities and to work together cohesively on the challenges.

Tamara Finkelstein, Director General and Chief Operating Officer, Department of Health, welcomed the Partnership’s ambition and way of working and commented that to achieve success one of the fundamental issues was to identify and challenge barriers to change so that organisations could became seamless in partnership operation.

The Board noted:

(i)  That a proposal had been submitted to NHS England’s London regional team to develop a business case for the formation of an Accountable Care Organisation across the Barking and Dagenham, Havering and Redbridge health economy;

(ii)  That this would be accompanied by a substantial process of consultation to determine how the Accountable Care Organisation would operate, its governance, the services that would be in the scope and the financial parameters within which it would work; and

(iii)  That should the proposal be accepted by NHS England, it would provide the opportunity to challenge artificial barriers to change and enable Partners to jointly consider innovation and radical redesign of service delivery and funding usage.