Agenda item

The report is attached.  Sarah Mansuralli (Deputy Chief Operating Officer, Brent Clinical Commissioning Group) and Phil Porter (Strategic Director Adults, Brent Council) will present the report.

Phil Porter presented the item and stated that Whole Systems Integrated Care (WSIC) Brent Early Adopter project was an ambitious programme that was a key part of the North West London Pioneer Project.  He stated that the WSIC vision contained four main objectives, these being:

·         Ensuring funding flows to where it is needed

·         Patients and communities are recognised as assets

·         Care is provided in the most appropriate setting

·         Care is coordinated around the individual

Phil Porter then referred members to the WSIC approach to population grouping as set out in the report.  Members heard that each GP locality had been given the opportunity to take part in the Early Adopter project, however it was the Harness and Kilburn GP networks that had volunteered to participate.  The WSIC also sought to develop the model of care and this would include four evidence based principles, these being:

·         A collaborative multi-disciplinary team structure

·         Care coordination

·         Self-management by the patient

·         A single shared care plan

Phil Porter advised that there were also significant barriers to overcome as outlined in the report.  In terms of measuring success and the impact on service users and providers, this would not just be measured in terms of reducing admissions and residential care, but also in improving quality and outcomes.  Phil Porter confirmed that the deadline to finalise the business case for the programme was 31 October and the timetable of activities was also a challenging one.

Sarah Mansuralli added that a more collaborative approach with acute providers was being taken across the whole of North West London.

During members’ discussion, Councillor Perrin enquired how patients would be supported to self-manage their health and wellbeing as mentioned in the report and he sought further comments in respect of one of the desired outcomes of over 75s patients to remain at home.  Councillor Hirani enquired whether the programme would cover patients who received services from specialised commissioning.  Ann O’Neill enquired what steps would be taken to inform the public about the programme and the reasons why it was being undertaken. 

At the invitation of the Chair, Elcena Jeffers addressed the Board.  Elcena Jeffers stressed that it was important for all stakeholders to work together to provide more effective care and she felt that another meeting should take place between them before the next HWBB meeting in October. 

The Chair welcomed the report, however he enquired why it lacked any figures and asked how many patients would be affected by the programme and who would it impact upon most, whilst information on the budget was also sought.  He suggested that by offering a simpler and more streamlined service, this was representing a positive message and he enquired whether anyone would be adversely affected by the proposals. 

In reply to members’ queries, Phil Porter advised that patients would self-manage to the extent that was practically possible and the proposals would be an improvement from the current system where decisions by different agencies were not necessarily joined up.  With regard to the desired outcome of over 75s remaining at home, Phil Porter informed members that there needed to be an improvement in making patients feel safer in their homes and this is an area where efforts would be focused on.  Phil Porter advised that budget details had not been finalised, however there would be no increase in cost, although some organisations may be contributing more than they currently were. 

Sarah Mansuralli advised that around 6,000 patients would be involved in the pilot Early Adopter project.  With regard to patients receiving specialised commissioning, she stated that the numbers involved were small, however information would be shared with NHS England to ensure all patients needing to be covered were. Frontline staff would be at the forefront of informing patients about the proposals, whilst workshops would be co-produced by the organisations involved with a view to testing these with individual community groups before preparing patient groups to help disseminate information.

Jo Ohlson added that Harness and Kilburn GP networks had been chosen for the Early Adopter project as it was felt that involving a relatively small number of patients was appropriate for a pilot project.  The proposals would include the creation of a single team, with GPs providing coordinated care.

RESOLVED:

(i)         that Brent’s next phase planning activities, and in particular the deadline of 31October 2014 for submission of the Implementation Plan and the emerging changes, challenges and opportunities in health and social care services that need to be overcome to deliver whole systems integration, be noted;

(ii)        that the positive feedback from the Expert Panel for the process of co-production and the WSIC Outline Plan be noted;

(iii)       that the forthcoming opportunities for engagement and co-production in the WSIC Brent Early Adopter Project and an opportunity to influence the development of the Early Adopter Implementation Plan, and  specifically, the co-production of the vision for WSIC, the Model of Care and the outcomes for measuring success of whole systems integration for the target cohort of patients, be noted;

(iv)       that following the development of the WSIC Implementation Plan for Brent's Early Adopter, that Brent's vision for Whole Systems Integrated Care and the Model of Care to deliver the vision be reviewed; and

(v)        that the next review point, prior to formal approval at the October meeting of the Health and Wellbeing Board, be noted.