Agenda item

The appendices to this item are included in the ‘Supporting Documents’ pack.

Mark Tyson, Commissioning Director Adults’ Care and Support,

Presented the report on the creation of the East London Health and Care Partnership (ELHCP), formerly referred to as the Sustainability and Transformation Plan Partnership (STP).  The consultation had commenced in July 2017 on future payment mechanisms within the NHS and this had introduced the need for reform and key considerations, the details of which were contained in the appendices attached to the report.  As a result, the deadline for response had now been extended to the 29 September 2017 to accommodate any further comments from local Board meetings.  Mark advised that the proposals were still very general and were also consistent with the work on the Business Case for the Accountable Care Organisation at the end of 2016

With increasing pressures and reducing resources it is clear that things need to change to reduce the spiralling demands on the NHS, and in particularly the number of hospital admissions.  To achieve those reductions in the medium and long-term, significant increases in funding and effort was now needed in prevention and healthy lifestyle education.  Prevention needed to have a higher priority and come much higher up the funding agenda now however, it is difficult to ascertain or make a specific case on how much will be saved because early intervention could stop the need for acute care in 5 or 50 years in the future.  There are no cost specifics at each stage of a patient’s journey.  Commissioning and funding streams need to incentivise both prevention and people being kept out of hospital.  Discussions are ongoing with the ELHCP / STP.

Mark drew attention to the governance issues and it was noted that BHR response on Governance was still awaited.  In response to a question from Cllr Turner, Mark explained that the report contained two separate issues, and apologised for any confusion and explained that Appendix B to E were to provide general updates. 

Cllr Carpenter commented that one thing the report did provide was a reminder on how complex the new structures would be. Cllr Turner was concerned about preventing conflict of interests between commissioners and contractors.  Mark was asked to produce a structure chart indicating who was on which part of the governance structure.

Further comment was made on payment mechanisms for the prevent activities and on the opportunity to think anew about how to contract services, when purchasing for broader service user outcomes, together with health commissioners.  Work would also need to be undertaken to incentivise localities.  The Chair indicated that there was clearly an opportunity to use joint commissioning as a lever for change and for service development that could possibly create a once in a generation step-change in local health outcomes.

The Chair advised that the discussions on elected representation on the ELHCP Board were still ongoing

Mark also drew the Board’s attention to the need to explore the issues of data analysis and flows and the ongoing development of the local digital roadmap.  Mark suggested that the ELHCP could play an important role in the refresh of the East London Information Sharing Agreement and also in resolving the problems of providing more integrated and responsive health and care system data and record management systems.  The development of shared analytical capacity within BHR, rather than creating capacity at ELHCP level also needed to be considered further.

The local relevance and lack of detail in the plans were questioned.  Ian Tomkins, Director of Communications & Engagement ELHCP, advised that the structures and reporting links are now becoming clearer and that they were currently in the first phase of strategy production.  The current document was at the decision point for planning and aspiring aims for service delivery: what those means for local people will be on the ELHCP website soon.  The Chair asked if timescales and achievement dates could be provided against the aims detailed in the current report in in order that the progress and overall picture could be seen.  Ian advised that a complete document would be provided in due course.  Ian was also asked to provide the links to the ELHCP web pages to Board Members.

Sharron Morrow offered to provide a report on some of the narratives and real action and progress that was being made in cross-borough initiatives.

The Board:

(i)  Noted the consultation and the impact that future joint commissioning will have as a lever for change and on service development;

(ii)  Suggested that:

(a)  The Local / London Information Sharing Agreement is considered as a priority task for the ELHCP to deliver.

(b)  A payment mechanism for prevention activity and service specific sharing needed to be put into place to improve outcomes and reduce resource demands;

(iii)  Noted that a further report and document is being prepared by the ELHCP and this would be presented to the Board in due course. 

In this regard the Board requested that specific timelines and achievement dates should be stated against the aims detailed in the appendix attached to the current report.

(iv)  Delegated authority to the Chair of the Board to approve the final response on behalf of the Board for submission by the deadline of 29 September 2017.  Noted that the response would be a joint response with the LBBD Health and Adult Services Select Committee (HASSC).