Agenda item

A report provided an update to the Committee on the transformation workstream programmes within the South Yorkshire Bassetlaw (SYB) Integrated Care System (ICS).  It was outlined that the corporate services workstream priorities were to 1. Agree the procurement work plan for 2019/20 and 2. Support the development of ‘hosted networks’ that will support shared working between the acute Trusts =.

A presentation was provided on progress made with Hosted Networks.  The following areas were included:-

·         The proposal for Hosted Networks

·         Hosts of Hosted Networks

·         Role of the Hosted Networks

·         Developing Priorities and Resources for each Network

·         Generic Structure

It was explained that there were a number of existing structures to take forward shared working between acute providers, but that some existing structures had failed to gain traction. The the hosted networks therefore represented a formal collaboration between acute providers which were intended to have more levers to support shared working, and a higher degree of transparency, in order to give them the best chance of success.   It was explained that there would be three levels of hosted networks, beginning from collaboration on workforce and clinical standardisation, and gradually moving up the levels with increasing levels of collaboration around resources and capacity. .  The intention of this shared approach was that patients would be receiving services to the same standards across South Yorkshire and Bassetlaw. 

It was added that work was now being undertaken to work with Trusts and commissioners to agree the structure, membership and work programme of the individual networks. It was commented that the work programme for each of the networks would focus on different areas in line with the requirements for that specialty.

It was explained that the role of the Host for each network would be to facilitate this shared working. Trusts had put themselves forward to each host one of the Networks.

It was outlined that each Network would include a Network Steering Group which would provide direct oversight  and ensure that the Hosted Network was linked to the leadership of the Host and the ICS governance structure.  It was noted each network would also have a Clinical Group formed part of the generic structure, which was likely to include representatives from primary care and other services.

It was reported that the networks were provider led but that commissioners would have an important role in ensuring that proposals in line with strategic priorities for the system were deliverable.  It was explained that any areas requiring decisions would be linked into the Joint Committee of NHS CCGs and issues may be escalated into the governance of the Integrated Care System.

Further to concern raised by a Member of the Committee, it was commented that there was no intention to create disengagement amongst those Trusts that were not hosting a particular network.  The Networks would include a variety of roles, such as clinical leadership, which might well be drawn from organisations other than the Host.  

Members were informed that there had been a dialogue with those Trusts beyond the   South Yorkshire and Bassetlaw geographical footprint which footprint, which sent patients to this area. 

It was outlined that Level 1 networks would focus on developing the workforce in each separate organisation. At Level 2 there might be more flexible working across sites, for specific  Trusts and specific groups of staff. It was pointed out that this already happens in some places and for some specialties, for example, where consultants from Sheffield Teaching Hospital deliver outpatient clinics at other Trusts. 

Reference was made to the Long Term Plan, which aims to reduce variation between places across the country.  It was explained that there was a national drive to standardise service specifications, clinical protocols and standards, and that leads needed to consider how the Network might support this national direction.

Conversations had been held with the Trusts to discuss where there were existing patient groups that could appropriately engage with the hosted networks.

A Member of the Committee asked whether there was a need for public consultation on the Hosted Networks. It was noted that the hosted networks themselves do not need to go out for public consultation, since the networks are simply a way of organising shared working between the Trusts. Some of the proposals that the networks go on to develop might potentially need public consultation, if the Networks were to make proposals which impact on how or where services are delivered to patients.

In relation to this, questions were raised about the work that the Hospital Services Programme was taking forward to look at changing the clinical model for maternity, paediatrics and gastroenterology. It was explained that this work was being taken forward with input from Clinical Working Groups and public engagement. It was looking at what was the right clinical model for each trust, to deliver sustainable services in every Place.  

Assurances were provided that the timeline was on track for October 2019.

Other areas discussed included;

Medicines Optimisation - Reference was made to the updates outlined in the report around Medicines Optimisation, one Member commented that within their local NHS CCG, it had been reported that £16 million was lost per year through medicine wastage when there were other alternatives such as ‘over the counter’ medicines that could potentially reduce that figure.  Members were provided assurances that this was considered as a priority area.

Social Prescribing – In terms of how disadvantaged communities could be supported to deliver social prescribing, for example, through available funding streams, it was explained that social prescribing models were being worked to across South Yorkshire and Bassetlaw and ranged from the recruitment of Link Workers to what investment could be made within the voluntary sector.  It was explained that the voluntary sector model might be able to pick up questions around what support was available to disadvantaged communities as this area was progressed within those areas.  Concerns were raised about the impact that austerity has had on this.

It was reported that there was a mix of new monies available for the recruitment of Social Prescribing Link Workers, which in many places were linked to an agency or body that was an umbrella employer.  Members were told how this then allowed those Link Workers to obtain access to voluntary services (in partnership with other authorities) which meant that procurement requirements would be at a minimal.

Mental Health and Learning Disabilities– Reference was made to the update as contained within the report on these services provided across Doncaster, Rotherham and Sheffield.  Members were informed that a great deal of work around this was already happening in each of those places. 

RESOLVED that the Committee note the report