Agenda item

To receive a presentation on developing the Integrated Care Strategy.

The Committee were updated on the development of the Integrated Care Partnership Strategy by Sarah Webster, Executive Director for Berkshire West, BOB ICB, and Rob Bowen, Deputy Director of Strategy, BOB ICB.

·       With regards to the change in structure of the health service, Sarah Webster reminded Members that the front line services such as the Royal Berkshire Hospital and Berkshire Healthcare Foundation Trust remained unchanged.  The change primarily related to the strategy and commissioning areas.  The three Clinical Commissioning Groups across Berkshire West, Oxfordshire and Buckinghamshire, were now one Integrated Care Board.

·       Within the Integrated Care System there sat the Integrated Care Board which was the largely NHS statutory entity, and the Integrated Care Partnership, a statutory Board bringing together the Integrated Care Board and representatives from the five local authorities.

·       Berkshire West was a Place, the local focus within the Integrated Care System.  Berkshire West had a strong history of health and social care working together.

·       Rob Bowen indicated that in July existing strategies and ambitions across the system, such as the Health and Wellbeing Strategies had been examined.  Consideration had been given to common themes. 

·       Six working groups had been established from September which were mostly led by local authority officers.  Membership was as diverse as possible to represent the partnership, for example there were representatives from the NHS, primary care, local authorities, Healthwatch, and the voluntary sector. 

·       Through conversations in the working groups several different priorities had started to be identified and worked up.

·       Some of the themes that were starting to be developed included:

Ø  Prevention - the need collectively across the system for a greater prevention focus;

Ø  Addressing health and wellbeing disparities in communities;

Ø  Taking a local approach where possible in the design and delivery of services – work at Place level and by Health and Wellbeing Boards would continue to be very important.

·       It had initially been expected that the Strategy would be published at the end of December.  However, this deadline would not have enabled meaningful engagement with partner organisations and the public.  It had since been agreed that an 8-10 week period of formal engagement would be built into the timeframe, beginning at the end of November.  Formal feedback on the emerging priorities would be sought.

·       It was likely that the Strategy would be published at the end of February.

·       A Member commented that a lot of the issues identified such as obesity, alcohol and smoking were not new.  She asked what new initiatives were being considered to address these.  Rob Bowen commented that this question highlighted why prevention continued to need to be prioritised through the Strategy.  Ingrid Slade added that she was the Chair of one of the Working Groups.  There would not be any surprises in terms of the priorities and existing priorities across the broader geography were being drawn together.  Consideration was being given to what could be tackled at scale and what would be better addressed at a more local level, and what new initiatives could be used. 

·       With regards to the Live Well theme and the priority to increase cancer screening, a Member questioned why there was a cut off age for breast cancer screening.  Rob Bowen emphasised that many of the emerging themes and priorities covered various life stages.  Ingrid Slade commented that locally the national breast cancer screening programme had to be followed.  She agreed to provide the evidence behind the upper age cut off point for breast cancer screening.

·       A Member questioned what the Strategy meant for Wokingham and how it would be ensured that the priorities identified by the different local authorities would be addressed.  Sarah Webster emphasised that the Health and Wellbeing Strategies remained key in focusing where action needed to be prioritised.  The ICP Strategy would complement the Wellbeing Strategies.  Whilst priorities were similar, the different local authority areas also had different pressures and challenges.  A focus of developing the Place Based partnership was ensuring that these nuances were not lost.

·       A Member commented that improving access to health services was an issue of great concern to residents.  She questioned how the stronger integrated neighbourhood teams would be developed.  Rob Bowen stated that the ICB was starting a detailed planning piece of work which would look at some of challenges, including supporting primary care.  With regards to the stronger integrated neighbourhood teams, this related to working with GP colleagues in the Primary Care Networks to develop the teams with different roles which could then support the work of the GPs.

·       Earlier in the meeting the GPs had requested support with digital and data.  A Member asked whether this was something which the ICB could assist with.  Rob Bowen confirmed that there would be part of the Strategy relating to digital and data.  Members were assured that the ICB was working closely with GP colleagues across BOB to ensure that there was robust digital support.

·       A Member sought assurance that initiatives to improve health and social care joint working, and to enable people to live well without necessarily accessing primary care, would continue to be supported in the Borough.  Sarah Webster re-emphasised the commitment to a robust social care service that was complementary to the health services.  She had been working with Matt Pope, Director Adult Services, to identify areas where the ICB and the Borough could work together to make improvements.

·       In response to a Member question, Rob Bowen confirmed that excess deaths following Covid had not been specifically considered or identified.  However, the working groups had looked at the impact that Covid had, had on people’s lives.

·       In response to a Member question, Sarah Webster indicated that the pension issue for clinicians was being looked at by the Department of Health and the Treasury.

·       The Committee sought clarification regarding winter funding for primary care.  Sarah Webster stated that previously national winter funding had been made available.  This had not been made available this year.  There had also been extra funding to support additional walk in, on the day primary care capacity.  This funding was now funding an urgent care centre pilot to support on the day demand from a walk in perspective.  In addition, primary care and the emergency department would be able to redirect into this.  If the pilot did not have an impact on, on the day demand this service could be reshaped.

·       The Committee requested a further update as part of the engagement process.

RESOLVED:  That the presentation on developing the Integrated Care Strategy be noted and Rob Bowen and Sarah Webster be thanked for their presentation.