The Director of Adult Social Care and Health Integration provided
Members with an update regarding the integration of Health and Social
Care. Particular focus was given towards work currently taking place nationally
around the transformation of NHS structures; the following points were made:
- Locally, Tees Valley Clinical
Commissioning Groups (CCGs) would be dissolved and a new Integrated Care
System (ICS) implemented next year. Middlesbrough would fall under
the North East and Cumbria ICS, a much larger geographical footprint than
at present. It was highlighted that this presented opportunity and
very good relationships with partners had been developed to date.
Reference was made to a recent multi-agency meeting that had been held to
discuss potential operation of the system across the Tees Valley area once
implemented. It was highlighted
that the appointment of the Chair of the ICS had had a very positive
impact on opening up improved communications with partners.
- Work on the local footprint and
determining the most appropriate operational methods was paramount.
This work, which would look at key governance arrangements, would be
undertaken with partners across the Tees Valley. Meetings were being
established by the Managing Director of Redcar and Cleveland Council in
supporting this work. The key question for Local Authorities and
partners to ask concerned the types of issues where control, at local
level, would be most sought.
Additional work, looking at such matters as work force, finances,
etc., was taking place in parallel to this.
During the discussion that followed, Members raised a number of queries
with the Director. In response, the following information was provided:
- In terms of the types of issues that
Local Authorities would wish to exert control, it was explained that there
was a little uncertainty around this at present. Consideration had
been given to economies of scale and the operation of services as part of
a wider geographical footprint. It was felt important to retain as
much control as possible over the direction of funding locally.
Reference was made to preventative work and ensuring sufficient investment
within this area in order to build resilience and tackle long term
challenges. Ensuring a good and
formal relationship with the Primary Care Network (PCN) was also a key
objective. Some matters would be determined statutorily by Ministers
and others at ICS level. The importance of ensuring a collective
position and voice for the Tees Valley with negotiations / the ICS was
highlighted.
- In terms of Member representation on
associated Boards / Committees, the Panel was advised that there would be
discussion regarding Local Authority representation in due course.
It was commented that working relationships with the Directors of the CCGs
was excellent and the success of this initiative would depend on the
quality of relationships going forward. Negotiations were currently
taking place, but the feeling locally was that progress had been positive.
- With regards to local representation on
a regional scale and ensuring that the ICS was representative of all areas
of the North East, it was unknown at present as to what the arrangements
for regional headquarters would be; resources would be spread across the patch.
It was commented that the ICS was concerned with how funding could be
expended more effectively within the NHS. Work was currently being
undertaken to determine how the Tees Valley could be best represented, and
to identify local area priorities in relation to the overall priorities of
the NHS. Mention was made of the health and social challenges
currently being faced within the Tees Valley.
- In terms of the resources available to
support the work currently taking place, Members heard that, at present, a
relatively small number of individuals were involved locally, but it was
working well.
- In respect of engagement with the
Voluntary and Community Sector (VCS), it was explained to the Panel that
the VCS was an important component of the ICS and would enter into the
planning process later; statutory partners were being discussed at
present. It was felt that the VCS held data that could support the
ICS well.
- Regarding responsibility and
decision-making for individual care arrangements, Local Authorities would
still have pre-existing duties under the Care Act for such matters as
assessment, arranging and charging for care. Consideration was given to individuals
receiving NHS support through Continuing Healthcare and the roles of the
local CCGs and North East Commissioning Support (NECS) within that both
now and in the future. With regards
to high cost care placements and dispute resolution, it was unclear at
present as to which body would need to be approached initially in terms of
the appeals process. The importance
of preparation and planning to meet the needs of local people, and
effective working with other authorities to strengthen the voice of the
Tees Valley, was reiterated to Members.
- In terms of the impact of the changes
on local scrutiny arrangements, further information in respect of this was
awaited. A Member referred to the current South Tees Health Scrutiny
Joint Committee arrangements and queried how these would integrate into
the new ICS. The view was that
health scrutiny arrangements would not be impacted by the reforms; in
terms of joint scrutiny, it was felt that further consideration would need
to be undertaken in due course.
The Chair thanked the Director for the information presented.
NOTED