Agenda item

The purpose of the report is to seek comment and endorsement from the Board regarding proposed changes to the joint programme of work across health and social care under the Health and Care Transformation Board (formerly Sustainability and Transformation Plan (STP) Board), to maximise benefit to residents and the system.

Tom Shakespeare (Director of Integrated Care) introduced the report seeking the Board’s comments and endorsement to a number of proposed changes to the joint programme of works across health and social care under the Health and Care Transformation Board (formerly known as the Sustainability and Transformation Plan (STP) Board).

In presenting the report the Board noted:

·                The progress achieved against the 2017/18 priorities within the Brent Heath and Care Plan and Better Care Fund (BCF) Plan as detailed within section 3.2 of the report;

·                The outcome of a subsequent review of delivery against the Plan undertaken by the Transformation Board, as detailed within section 3.3 of the report, which had identified that despite good progress being delivered in a number of areas further improvements could be made to the scale of progress and transformation in relation to key priority areas;

·                The criteria agreed by the Transformation Board as a focus for their ongoing work, as detailed within section 3.4 of the report;

·                The key priority areas (as detailed within section 3.5 of the report) which as a result of the review, the Board were now proposing to focus on with the aim to have overseen delivery of the following by April 2019:

Ø   A patient centred older people’s care pathway reducing delays in hospital discharge and improving patient experience;

Ø   A joint commissioning and brokerage function for nursing, residential and home care creating a catalyst for development of a fully integrated care system;

Ø   A joint market management approach, including care home networks and training development and support;

In addition by April 2020 it was proposed that the Board would have overseen:

Ø   Development of an integrated care system;

Ø   Development of new approaches to promote prevention and self-care in the community; and

Ø   An integrated service of support for people with dementia.

·                The revised governance arrangements which it was proposed should be established to support delivery of the priorities based on a new model of distributed leadership as detailed within sections 3.6 and 3.7 of the report.  The aim of the review had not been to cease work on existing programmes but to review the current focus of the Board in order to drive forward a programme of improvement on the basis of the criteria set out in section 3.4 of the report.

The Chair thanked Tom Shakespeare for his introduction and then sought comments on the proposals set out within the report, with the following issues highlighted by members of the Board:

(a)     Councillor Kansagra, highlighting a number of concerns regarding the process for discharge of hospital patients, was keen to explore how these would be addressed within the revised priorities.  Tom Shakespeare advised that it was proposed to address patient discharge through development of the patient centred older people’s care pathway, which included within its remit the aim of reducing inefficiencies and duplication within existing pathways, recognising the number of agencies often involved in the discharge process and also the complexity and processes required for non-routine cases.

(b)     The need identified by Gail Tolley (Strategic Director – Children & Young People), given the focus on the Transformation Board priorities referred to in the report around adult services, to recognise the extent of funding also provided through the Plans for programmes relating to children and young people and to be clear on how these would continue to be delivered under the proposed new arrangements.  In response Helen Woodland (Operational Director – Adult Social Care) advised that under the new distributed leadership model existing programmes and priorities agreed under the Heath and Care Plan and Better Care Fund (BCF) Plan would continue to be delivered including work of the Whole Systems Integrated Care (WSIC) programme, although this would involve more effective use of the shared information dashboard, which Gail Tolley advised the Council would be willing to act as a pathfinder to assist on.

(c)     Given the various funding streams involved, DR MC Patel felt it would be useful if the Board could be provided with an overview of the funding allocated between priorities across each area to assist in clarifying the links with other connected strands of work.  This was supported by Sheik Auladin (Managing Director, Brent CCG) who advised he would also been keen to increase the focus on the detailed outcomes being sought as a result of the priorities identified and how these would impact, as an example, on management of existing pathways such as those relating to winter care.  Whilst the new approach would not prevent a focus on these type of issues, Helen Woodland felt it was important to highlight the main purpose of the review had been to focus on the delivery of transformation in the priority areas identified on a shared, multi-organisational and integrated basis.

As no further issues were raised the Chair thanked Tom Shakespeare and Helen Woodland for their update and the Board RESOLVED to endorse:

(1)     the re-naming of the Sustainability and Transformation Plan Board to the Health and Care Transformation Board, reflecting the focus on shared priorities across Brent (including Brent Health and Care Plan and the Better Care Fund).

(2)     the re-focussed priorities of the programme into three key areas for 2018/19 (Older People’s Pathway, Integrated Commissioning and Market Management and enhance care in homes) along with the scoping of three further priorities for further development (Self Care, Dementia and Integration Development).

(3)     development of a model of distributed leadership across multiple programmes of work to ensure sustained transformation across the breadth of activity across the NHS and local government.