Agenda item

A report was provided to the Committee that set out the background and context to the NHS Long Term Plan.  It highlighted areas of focus within the Plan that included clinical priorities, key service area commitments and enablers to delivery.

It was explained how the plan was intended to provide a framework for local planning over the next five years.  The report outlined how SYB ICS would engage with its many audiences to determine what the NHS Long Term Plan meant for them and to co-design the most effective ways to put the commitments into practice locally.  It was recognised that healthcare was constantly evolving and this resulted in changing expectations and its own challenges.

It was expected that the changes set out in the Plan could be achieved within the current legal framework, although it was stated that proposals were being made to change legislation that related to the NHS.  Members were informed that national consultation had been launched on potential proposals for changing current primary legislation relating to the NHS and this would close on the 25th April 2019.

It was stated that in respect of procurement, a “best value test” could be applied and where best value could be offered by a NHS provider, then the service would not necessarily need to go through the procurement process.

It was noted that the Plan, alongside primary care networks, was committed to developing ‘fully integrated community-based health care’. It was reported that this involved developing multi-disciplinary teams, including GPs, pharmacists, district nurses, and allied health professionals working across primary care and hospital sites.  It was recognised that it was about how everything worked together as a system and what it would take to achieve that ambition.

It was noted that the SYB ICS response to the NHS Long Term Plan will be published in the autumn. The areas of focus will form the basis of the ICS work plan for the next five years and therefore the current workstreams will be reviewed and aligned.   Priorities included smoking, obesity, air pollution, resistance to antibiotics, maternity, Children and Young People mental health, learning disabilities and autism, children and young people with cancer. 

It was reported that some of the key messages developed since the publication of the plan included;

·         Boosting out of hospital care;

·         Publication of new GP contract;

·         Encouraging to work in networks going forward;

·         Backed up by new staff in out of hospital care.

Reference was made to the next steps for public engagement as outlined in the report.  It was reported that the above reports and updates would be shared with Members of the Committee.  The steps included that;

·         the communications and engagement plan would be shared with the Collaborative Partnership Board and Executive Steering Group and once finalised, shared with Boards and Governing Bodies for their meetings in public. 

·         updates on the engagement and themes emerging from the feedback would be brought to the Collaborative Partnership Board and Executive Steering Group.

·         a report on the engagement would be brought to the Collaborative Partnership Board and Executive Steering Group in the summer, in order to inform the South Yorkshire and Bassetlaw Integrated Care System response to the NHS Long Term Plan.

The Committee held a discussion and the following areas were raised;

Public Engagement - In terms of what lessons had been learnt from previous engagement, the Committee was informed that work was being undertaken to ensure that there was a broader representative from members of the public who did not normally engage with NHS.  Reference was made to “working well” people who did not tend to use health services, therefore, work was being undertaken with larger employers and through Healthwatch utilising their contacts in the community.  The Committee was informed that although engagement had been positive and meaningful at deliberative events, those sessions did not provide the opportunity to engage with larger groups of people.

It was clarified that Healthwatch England had tasked local Healthwatch groups to undertake some targeted work, personalised around the priorities and remit to work with seldom heard groups.  It was noted that the national approach was to engage with Healthwatch as part of the process and this would provide the necessary expertise and steer to take it forward and identify other areas to engage with.

A Member of the Committee highlighted that information on patient and public engagement in shaping health services was lacking from National Plans. Therefore, it was especially important that we ensure this is undertaken in our local area; to which the NHS representatives agreed.

Prevention - A Member of the Committee raised their concern that although individuals were keen to keep well in terms of prevention, issues around health inequalities could work against that.  It was considered important that communities had the necessary resources to be able to work effectively together to support the agenda around prevention and deliver services effectively. Concern was also raised that smaller community groups may lose out to larger more established organisations, which would not be able to provide a more localised service.

Members supported holding a separate session to discuss what resources were available at this stage and the financing available behind it. 

Budget Cuts - A Member of the Committee expressed concern that reductions had been made to Public Health money and questioned the impact of this at a time when Councils own budgets were also being reduced.

Members were reminded of the role that Simon Stevens had played lobbying for a settlement for social care and health.  It was also noted that there was hope for the outcome of the Spending Review, which was due to be published later this year.  Members were informed that there had been a focus around the investment into health inequalities and that a great deal was already happening in place.  Reference was made to Social Prescribing Link Workers and Cancer Champions, demonstrating what investment had been made within health and how there were a number of exemplar places within the system.

Workforce – Reference was made to Paragraph 18 in the report about the challenges that workforce issues were presenting in delivering the agenda. 

It was reported that the Plan recognised the scale of the challenge and had set out a number of specific measures to address it. It was noted that many wider changes would not be finalised until after the 2019 Spending Review, when the budget for training, education and continuing professional development (CPD) was set. It was continued that to inform these reforms, NHS Improvement, Health Education England and NHS England would establish a cross-sector national workforce group and publish a workforce implementation plan later in 2019.

It was noted that some areas of South Yorkshire and Bassetlaw were experiencing difficulties with recruiting in from outside of South Yorkshire and Bassetlaw.  It was explained that there had been ongoing issues with recruiting GPs although there had been success around the recruitment of clinical pharmacists.  It was commented that the closer individuals were in distance to a teaching hospital, the simpler it was to recruit to those areas.  It was expressed that service changes (such as that of Hyper Acute Stroke) had progressed workforce issues as consideration had been given as to how the population could access safer and sustainable services.

Concerns were raised around shortages in workforce, whether that was in relation to not training sufficient numbers and also that some members of staff moved outside the NHS once they have been trained.  It was outlined how there had been attempts to build a more local workforce and Members were informed that the establishment of the workforce hub in the ICS work had been supported.  It was also noted that the workforce team were looking at the strategy for the whole region through developing pathways schools or apprenticeships and partly through other non-traditional routes.

It was raised that individual areas had the potential to build their own expertise and that it was part of collaborative working how that could be developed.  It was noted that with a lack of guidance from the national plan, there was a need to focus on delivering the plan as best as possible.

RESOLVED that the Committee;

       i.          Note the report; and

      ii.          That the Committee receive further information on;

·                     The SYB ICS NHS Long Term Plan communications and engagement plan by the end of April 2019.

·                     Updates on the engagement and themes emerging from feedback in June 2019

·                     A report on the engagement as taken to the Collaborative Partnership Board and Executive Steering Group summer 2019, in order to inform the South Yorkshire and Bassetlaw Integrated Care System response to the NHS Long Term Plan by August 2019.

3. That the Committee hold a session on the ICS approach to the prevention agenda, including the role of the Voluntary Community and Faith Sector;