Agenda item

To consider the next steps for integrated health and social care in Westminster.

9.1       Dylan Champion (Head of Health Partnerships) introduced this item and stated that both NHS Central London and NHS West London Clinical Commissioning Groups (CCGs) had drafted comprehensive strategies for integrating health and social care which set out plans for the next 2 years. Both strategies were committed to the same better outcomes. Dylan Champion stated that the strategies had developed considerably since work had started on them in July.

9.2       Chris Neill then presented NHS Central London CCG’s strategy and stated that it was acknowledged that there were significant health inequalities in Westminster. There was a need for community care to be more connected with local communities, whilst considerable financial challenges also needed to be addressed. Furthermore, action needed to be taken in the context of the recent announcement confirming the devolution of healthcare in London. Chris Neill stated that there was opportunity to work in a different way, including how buildings were used. He confirmed that the strategy’s final business case was due to be submitted in summer 2018.

9.3       Jayne Liddle (Assistant Director, Integrated Care, NHS West London Clinical Commissioning Group) then presented NHS West London CCG’s strategy. She advised that the CCG was building an evidence base and she emphasised the importance of co-locating teams. Key approaches of the strategy included multi-disciplinary working and a focus on promoting self-care.

9.4       During discussions, the Chairman welcomed the close working between the CCGs and the Council and she asked what were the main objectives in terms of co-commissioning. She felt that the first steps had been encouraging and suggested that other partner organisations also start to work closer together with the CCGs and the Council in future. Members asked what engagement with organisations such as Healthwatch would take place to get feedback from patients and what impact would the strategies have on them. It was remarked that the shortfall in funding for social care was a big factor to take into consideration. The approach taken by both CCGs was welcomed and it was acknowledged that changing people’s behaviour through cultural change would be a tough challenge.

9.5       Members acknowledged that there were significant financial pressures that the CCGs faced, however this could help stimulate change. Cultural change was very important and the challenges could not be underestimated and developing and implementing the strategies would be a huge piece of work. It was remarked that the voluntary and community sector was represented on the Partnership Board and as the primary care model was rolled out, organisations from this sector would be able to provide services to the community as part of the offer and this would represent a good opportunity for greater joint working.

9.6       Members commented on the importance of engaging with people to see what outcomes they would like themselves. It was emphasised that the initial focus should be on patient outcomes, whilst putting together the structure to achieve this should follow after. The strategies also needed to align with the North West London Sustainability and Transformation Plan. It was suggested that there needed to be more discussions on identifying the needs of children. A Member also felt that change would happen once staff felt they could achieve this and that they would receive the necessary support to do so. Another Member stated that there were already changes taking place on the healthcare workforce, with staff becoming younger and who may be more open to change.

9.7       Louise Proctor (Managing Director, NHS West London Clinical Commissioning Group) advised that lessons were being learnt from the ‘My Care, My Way’ initiative, which looked at how people could be supported to lead the lives they wished to lead. She added that the existing organisational approaches had to change and it was imperative to take a joined-up approach.

9.8       In reply to issues raised by the Board, Chris Neill advised that the CCG was already involving Healthwatch in respect of identifying what patients needed, however it was acknowledged that there was a lot more work to do on this issue and the Partnership Board was looking into this. He welcomed the views from providers and thanked the Board for their feedback. The challenges in considering how to use property differently was recognised and consideration was being given to the commissioning process. In respect of services for children, Chris Neill advised that the CCG was working with various Council service areas to identify what needed to be provided and the intention was to develop an ambitious and broad service.

9.9       The Chairman confirmed the Board’s commitment to supporting the strategies for changes to health and social care and welcomed progress to date.

9.10      RESOLVED:

1.      That NHS Central London Clinical Commissioning Group’s Central London Accountable Care Commissioning Strategy as attached as appendix 1 of the report be endorsed.

2.      That NHS West London Clinical Commissioning Group’s Integrated Care Strategy as attached as appendix 2 of the report be endorsed.

3.      That it be recognised that the need for a whole system solution is required to ensure that all Westminster residents, whether they live in the north of the borough or the south, receive a high quality and consistent health and social care service.

4.      That it be agreed that the Board play the lead role in shaping and overseeing the delivery of both strategies, receiving regular updates and providing endorsement to proceed following the achievement of key milestones.