The Director of Adult Social Care and Health
Integration provided Members with an update regarding the integration of Health
and Social Care. With specific focus on
the current reorganisation of the NHS, 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 North
East and Cumbria, a much larger geographical footprint than at
present.
- The Director,
along with the Director of Public Health, had attended meetings with Tees
Valley partners in relation to the structure of the ICS. It was indicated that there would be a
single local area board responsible for decisions on a Tees footprint, and
a higher level single board responsible for the whole of the
geographical area.
- The
higher level board would be a board of the NHS, with constituent members
determined by the Secretary of State.
The Integrated Care Partnership (ICP) would feed into that
board. The ICP would provide a
committee structure to allow for other partner agencies, such as local
authorities, fire services, voluntary sector, etc., to contribute to
discussions around long-term health needs.
The structure of the ICP was currently being considered; it had
initially been proposed that one single ICP be established to represent
all 13 local authorities within the North East and Cumbria. However, in order to provide more
workability for smaller local authorities, it was possible that a separate
ICP would be established for Teesside.
It was felt that, rather than be concerned about the prospect of
the ICP, it was more likely to offer opportunity for greater representation
locally.
- Reference
was made to the importance of preventative work and the opportunity that
these changes would allow for increased focus in the future.
During discussion that followed, Members
asked a number of queries of the Director.
In response, the following information was provided:
- With regards
to a timescale for implementation of the ICS, it was explained that a
draft constitution was expected to be produced this month in preparation
for going live at the start of the next business year. Reference was made to the impact of the
pandemic and national recognition that some of the structures associated
with the ICS may require further work post-implementation. The importance of ensuring a continued
stable structure as the NHS entered the winter period was key at
present. It was indicated that the
draft constitution would be an internal NHS document and therefore
unlikely to be released into the public domain.
- In
relation to scrutiny, further details regarding the position of the Tees
Valley Health Scrutiny Joint Committee in relation to the NHS changes were
awaited. However, it was indicated
that information had been conveyed through the Health and Wellbeing Board.
- Regarding
the large footprint of the North East and Cumbria ICS and ensuring
sufficient resource allocation for Middlesbrough and the Tees Valley,
Members heard that, at present, CCGs were provided with the financial
resource to make commissioning decisions for health services within the
local area. Following the
implementation of the ICS, monies would be allocated to the board with the
responsibility for all of the North East and Cumbria’s large-scale
financial decisions. It was
indicated that discussions involving the NHS, local authorities and others
in respect of financial delegation with the ICS were currently on-going,
but the understanding was that the Tees funding streams would remain
unchanged, i.e. the amount of monies allocated to the Tees Valley area
would stay the same. There was
nothing to suggest an imminent loss of control, but instead that there was
potential opportunity for local authorities to have a greater influence in
terms of where funds were spent.
The Tees Valley group had been minded of the potential risk for
elements of the ICSA to become ‘area-centric’, and therefore ensuring
sound delegated decision-making around finances were achieved. Reference was made to the challenges
facing Middlesbrough, for example health demographics, and the argument
for greater investment rather than less.
The Chair thanked the Director for the
information presented.
NOTED