Issue - meetings

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  ...  view the full minutes text for item 25