Agenda item

Conor Burke, Accountable Officer, Barking and Dagenham, Havering and Redbridge Clinical Commissioning Groups, presented the report on the shaping work that had been undertaken on the Accountable Care Organisation following the successful expression of interest for the ACO pilot.  Conor reminded the Board that it was anticipated that the ACO pilot would provide complete integration of health and social care through the removal of silo working and its ethos would be people centred and seamless service provision.  It was also becoming clear that input and partnership working with the Police, Fire Brigade and London Ambulance Service, was also import to the new ways of working and also to the success of any new processes.  The practical work and initial case for change was being overseen by the Accountable Care Organisation Executive Group and a Steering Group of officers and meetings were now scheduled to be held on 15 and 20 June.

The deadline for the submission of the draft STP was the end of June 2016. 

Work was now underway to ensure consistency of the narrative with other authorities and also providers such as BHRUT.  For Barking and Dagenham, Havering and Redbridge CCG areas, the details of the NEL STP will form the propositions, which would then be developed through though the established programmes and those would then form the basis of the business case for the ACO.  The STP will also inform and provide linkage with the high level financial and challenge of the ACO.  In addition, the increasing pressures meant that it was also becoming clear that it would be necessary to accelerate the implementation of the NHS Five Year Forward View.  It was expected that the combined changes could result in £500m/£600m savings to the NHS over five years.

Conor stressed that the report was to assure the Board that progress was being made and that it was consistent with Five Year Forward View and emerging vision.

The Chair felt that this issue was of such importance that significant time needed to be set aside at the next Board for its discussion and that the Forward Plan needed to be adjusted to allow this.  The biggest challenge was the Hospital trusts serving the area were both in special measures.  Once the stock-take was undertaken at the Steering Group, decisions could start on what was monitored and how that would be undertaken.  The Chair reminded the Board that the bid had been based upon assurances that national frameworks and existing regimes could and would be challenged and that would be essential to allow new radical ways of working to emerge.

In response to a question from Cllr Carpenter, Conor advised that it was his belief that Barking and Dagenham, Havering and Redbridge areas were more advanced and it would be some time before the rest of NE London were in a position to form an ACO.  Conor also explained that it was expected that the ACO would cover about 95% of the whole budget. 

Helen Jenner, LBBD Corporate Director Children’s Services, pointed out that there needed to be a significant education and  prevention approach  to stop people turning up at A&E or going into hospital in the first place in order to ensure pressures and demographic changes could be met in the medium and long-term future.

Conor explained that initially there was likely to be three or four pilot localities and that these will be based around multi health professional hubs, which could deal with issues internally and would reduce the need for hospital attendances.  Dr Mohi concurred with this and stressed that it was about working together and making positive changes locally that would in turn achieve the removal of the variations in service provision.  Dr Mohi said the most important thing would be an ethos step change and an understanding that the ACO was not just another organisation, but a radical new way of working.

The Board:

(i)  Discussed the approach, set out in Appendix A, covering the vision, draft priorities and enablers which had been identified to support the work;

(ii)   Provided feedback to the NEL STP Team, as outlined above;

(iii)  Asked for a full report on the Sustainability and Transformation Plan to the 26 July Board meeting; and

(iv)  Agreed that in order to enable sufficient time for discussion of this issue at the 26 July Board meeting, that report authors would consider which of their reports scheduled on the Board’s Forward Plan could be deferred to the 27 September Board and advise Democratic Services accordingly.