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; the following points were made:


  • Sam Allen had recently taken up the post of Chief Executive of the Integrated Care Board (ICB) for the North East and North Cumbria Integrated Care System (ICS).  Meetings between the Chief Executive and Local Authority Directors would be taking place over the coming weeks.
  • The NHS was amending the way it carried out its internal governance; the intention was for the ICS to be implemented in April 2022, but had been delayed to July 2022.  At present, discussion was taking place with Chief Executives across the region in relation to the operating model for the ICS.  The ICS was concerned with the structure of the NHS, though there was a role for Local Authorities to have representation on the associated Board.  Beneath that, a further structure would be established to consider matters at local level.  The operating model for the ICB was currently under discussion; Tees Valley Chief Executives would next be meeting on 16 March 2022 to feed their collective opinions regarding this back to the NHS.
  • It was felt that the current working relationship that the Local Authority had with the NHS / Clinical Commissioning Group (CCG) was as strong as it had ever been.  It was envisaged that the majority of the current Directors and representatives of the CCG would continue to liaise with the Local Authority once the ICS had formally been established, as there was a requirement of the NHS to retain local structures and linkages.
  • Due to Middlesbrough’s health demographics, it was felt that the ICS provided opportunity for longer term preventative work to be looked at.


During the discussion that followed, Members asked a number of queries of the Director.  In response, the following information was provided:


  • A Member commented that they felt reassured by the information provided, particularly as they had previously held concerns around the alteration of the local structure in relation to the size of the area that the new ICS would cover.  In response, the Director indicated that there would be structural changes.  The ICB, which was a Board of the NHS, covered the large geographical area; to ensure that local areas could ‘feed in’, there would be an Integrated Care Partnership (ICP), which was currently being discussed by the Chief Executives.  The ICP would bring together local statutory and voluntary partners to arrive at collective agreement around what was appropriate for the respective local area.  It was explained that the ICS guidance had been produced with an expectation that there would be one ICP for the whole geographical area.  However, as the largest ICS in England, this would not have been practical and therefore, four ICPs were currently being created (Middlesbrough would belong to the Tees ICP, which was likely to involve the five Local Authorities).  It was felt that this approach would grant opportunity for Middlesbrough to act as an individual Local Authority where choosing to do so, but would also provide a forum where the five Local Authorities could come together to provide a strengthened voice for collective matters.
  • With regards to the statutory guidance for delivering the frameworks, it was explained that there was statutory guidance associated with the establishment of the ICB.  The Chair for the local area had consistently aimed to maintain as much flexibility for individual local areas as possible, essentially because it reflected the statutory guidance and was practical to do so.  Reference was made to the scale and diversity of the ICS area, which covered Redcar to Cumbria, and the need to successfully represent the varying needs of those different localities within it.  There was more flexibility around the establishment of the local ICPs than there was the ICB, primarily because the Board was part of the NHS structure and would therefore be replicated across England.


The Chair thanked the Director for the information presented.