Agenda item

Integration of Health and Social Care - Verbal Update

The Director of Adult Social Care and Health Integration will provide the panel with a verbal update regarding the integration of health and social care.


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.