Agenda item

To update the Health and Wellbeing Board on community services commissioning.

Jonathan Turner (CCG) introduced the report, explaining that at the end of the previous year LNWUHT gave notice on some of the community services they had provided to Brent for a considerable amount of time. This had since been reviewed at ICS level and largely the vast majority of those services would now need to transfer to another organisation. The report explained how they had came to the conclusion of who would provide those services, and the following key points were highlighted in relation to the report:

·         The aim was to stabilise services during a period of significant change of demand on health services and a changing NHS environment, with legislation anticipated to go through later in the year which would mean a move away from choice and competition commissioning to a more collaborative approach. Instead of running procurement processes the new model would look within the NWL health economy to determine who was best placed to provide those services. Given the timescale and the need to mobilise services they had ran a relatively short process to determine who to award to, and determined to award to Central London Community Healthcare NHS Trust (CLCH). There were also a limited number of services in Harrow but they were not relevant to this group. The award would include district nursing, nutrition and dietrics, respiratory, long term conditions in the community and children’s services. There would only be a change in the provider of the services rather than the content of the services, with staff remaining the same. The contract award notice had been published which was a legal requirement and the period for challenging the award was about to expire. The expected transition date was 1 August 2021.

·         The Board heard that the ICS would have hoped to do more community engagement prior to award but had not been able to due to the short timescales involved and the need to make a quick transition of services. They were going through a review process in terms of how they could continually improve the service specifications and that would involve members of the public and Healthwatch.

·         There was a working group between CNWL, CLCH and LNWUHT to manage the transition and the quartet would be involved in the future, reporting into the ICS. Simon Crawford (LNWUHT) expanded, explaining that the weekly working group meeting focused on staffing issues, digital issues, estates issues, estates IT and workforce and there was a joint project plan in relation to that. He had been engaging staff on the change since December 2020 with major Teams meetings, and 2 weeks ago CLCH and CNWL joined the conversation with staff around the transfer process and were setting up their own engagement plan for staff transferring. It was expected that the effective working relationships already held with CLCH and CNWL would continue, and which had strengthened during the pandemic, and that partners would work together delivering effective services.

The Chair thanked the health colleagues for their introduction and invited comments and questions from those present, with the following issues raised:

·         The Board noted that over the past ten years community services had been most impacted by commissioning, and this would be the 5^th organisation they would work for in the past decade, and wanted to know whether staff would have the resilience to cope with another change. Simon Crawford advised that CLCH had a good reputation of providing community services to a number of Boroughs in NWL and across London and would have a Borough director lead managing those services. He added that CLCH were more robustly linked into the community framework across ICS around community services and innovation and he felt they would have a stronger voice representing change and what should be different going forward. He highlighted that they also had a level of professional expertise in community services to draw upon. He felt the change would give a stronger voice and stronger cohesion through community services and better access to strong leadership, support and a sense of identity. In relation to supporting staff through the change he advised that he had continued to liaise major events since December 2020 to communicate to staff what was happening. He added that there was a relatively small amount of service transfer.

·         A question was raised in relation to clinical governance, and Jonathan Turner advised there was an infrastructure at the moment of working groups, subgroups and various other groups looking at this aspect including practical issues such as transferring records from one system to another, and risks and issues would be logged. Simon Crawford added that they had experience of governance and transfer of clinical information through part of an Ealing transfer therefore colleagues were aware of what ‘good’ looked like, and had a robust process in place with CLCH and CNWL regarding logging all critical incident reports, complaints and there would be a process for handing those things over as well as the consideration of the safety and security of patient data.

·         The Board highlighted that where there were lists of services a lot had broken links online and wanted to know where residents could access information about new changes, management, and whether there was an opportunity to have a single Brent services directory. Jonathan Turner advised that there was a communications workstream however until the notice period for the award had expired communications had been halted. All community leads across the different trusts involved and the CCG were working up a communications plan and there would be a series of announcements about the change, but he also acknowledged the need to ensure websites and information on how to access services was kept as up to date as possible. He was happy to link in with the Council’s communications department for message streams.

·         A query was raised about the STARRS service, and Sheik Auladin (CCG) confirmed that STARRS had always been a Brent service and was commissioned for community services for Brent residents and would continue delivering services in the same way, and the CCG had been trying to secure commitment from CLCH that it would remain where it was within Northwick Park so that it did not affect the flow into and out of the emergency department.

RESOLVED: To note the decision to transfer community services to CLCH and the transition process.