Agenda item

A report was provided that outlined the next phase of governance arrangements for South Yorkshire and Bassetlaw (SY&B) Integrated Care System (ICS) for 2019/20.  It was explained that work would continue on the full governance arrangements, which recognised both the national developments on NHS system architecture and the work with system partners in order to develop an overall system governance framework for the ICS.

It was noted that shared governance working arrangements had been in place since the South Yorkshire and Bassetlaw (SY&B) Sustainability Transformation Plan (STP) had begun before becoming the Integrated Care System (ICS).  Members were informed how a number of changes would be undertaken this year, which would help strengthen the collaboration.

It was stated that given the work being undertaken amongst partners (and which included the public), there was a need to share information effectively within South Yorkshire so commissioners were able to make shared decisions with providers.  Members were reminded that to date the Joint Committee of CCGs had considered service changes specifically around Hyper Acute Stroke Services as well as Children’s Non-Specialist Surgery and Anaesthesia but that this might not be the case for other areas in the Long-Term Plan.

Members were informed how the SYB ICS leadership had engaged directly with local authority partners to shape proposals for partnership working and identify priorities, which would benefit from system collaboration and where greater value could be added.  The Committee was informed that this was seen as a required step for health partners to do so before undertaking wider discussions with system partners. It was reported that the Collaborative Partnership Board would continue to meet on a bi-monthly basis (to be reviewed) in due course further to work undertaken with local authority partners and system partners.

It was emphasised that the ICS was not an organisation but a partnership and therefore not a decision making body. 

It was explained that further work would be undertaken to consider what the actual governance arrangements would look like.  It was commented that within the majority of local authorities, there were Health and Wellbeing Boards to support this process.

It was outlined that from the outset it had made sense to join up and take decisions collectively in relation to what was taking place around health within each of 5 places that made up the SYB ICS.  It was continued that Health and Wellbeing Boards, local Overview and Scrutiny and local providers had a great deal of work to undertake and that all elements of the architecture were considered as important.

It was noted that Project Management Teams working on behalf of partners, were in place to move the agenda items forward.

It was noted that in comparison to the previous model, the new model was clearer and more focused with decisions being tracked back to state organisation discussions that had taken place in front of the public, therefore providing assurances with the new set of arrangements.

Accountability – The Committee was informed how the ICS partnership was able to exercise what was referred to as ‘mutual accountability’ being the statutory accountability that rested in 5 places with statutory organisations.  It was explained that this was about being able to access care to the same clinical standards.

A Member raised their concerns about how broad the area was and sought assurances that the public would be supported to understand how everything was working together and to alleviate some of their concerns.  It was suggested that further work could be undertaken around ‘myth busting’.

In terms of barriers, it was viewed that in time, greater decisions would need to be considered and made back in place and that was where there may be issues around mutual accountability.

It was outlined that ICSs were required to work together with local partners to develop their local response to the Long-Term Plan through producing an ICS five-year strategic plan by autumn 2019.  It was explained to the Committee that the ICS five-year strategic Plan would set out what was needed to achieve the ambition set out by the Government and that the ICS was on time to produce the plan.

It was expressed that South Yorkshire was currently in a good place to build on what had already been established rather than by producing a fresh strategic plan.

RESOLVED that the Committee;

1. Note the report and;

2. Support further work to be undertaken around myth-busting