Agenda item

To receive an update from the North Central London Clinical Commissioning Group, including the development of Integrated Care Systems and the community and mental health services review.

Rachel Lissauer, CCG Director of Integration, introduced the item and explained that there had been some positive developments. It was noted that, as part of the Integrated Care System (ICS) development, an investment fund had been created to target inequity and racial inequalities. The fund would have £2.5 million this year and it was anticipated that this would be recurrent. It had been decided that 80% of this funding would be given to the 20 wards with the highest deprivation levels and it was noted that seven of these wards were in Haringey. It was noted that there was a relatively short time period to submit bids but that all bids would be developed in partnership with the CCG, Trusts, Councils, and the Voluntary and Community Sector (VCS).

It was noted that the NCL CCG was currently undertaking a Community and Mental Health Services Review and preparing for the transition to ICS. It was added that Joanne Murfitt, CCG Programme Director for Strategic Reviews of Community and Mental Health Services, and Alexander Smith, Director of Transformation, were in attendance to answer any questions.

In relation to the Community and Mental Health Services Review, Joanne Murfitt, CCG Programme Director, noted that there were currently significant inequities in access to and outcomes from services and the CCG wanted to tackle this. It was explained that some examples were provided in the report and this demonstrated that there were some differences between boroughs. The aim was for the review to produce recommendations which would lead to a core and consistent offer, address inequalities, and ensure workforce sustainability. It was anticipated that the review would generate a recommendation by the early autumn.

The Director of Children’s Services noted that the infrastructure in different boroughs was at different starting points and it was enquired whether there would be an opportunity to consider this within the work going forward to ensure that there would be a truly consistent offer for all residents. Joanne Murfitt, CCG Programme Director, noted that the CCG was committed to securing improvements, particularly for areas with less infrastructure, and would aim to focus on the areas which needed additional support. It was acknowledged that it would not be possible to have a fully consistent offer immediately but it was highlighted that there was a commitment to achieve this in the long term.

Cllr Lucia Das Neves noted that patients and service users often played a role in contributing to improvements. As part of the engagement, she stated that it was important to be clear with residents about what was it possible to achieve through the review. Joanne Murfitt, CCG Programme Director, explained that she was conscious of being clear about what was possible. It was noted that there was a multi-pronged approach to engagement and communications and this included design workshops, resident panels and surveys, linking with existing groups, and working with the Communities Team to engage with groups who were generally under-represented.

The Director of Adults and Health noted that equity had to be a key principle for Covid recovery and that resident engagement would be an important starting point. She stated that she was pleased that there was a plan for engagement and suggested further consideration about how this could be done from a localities perspective. It was added that local authorities could bring perspectives that embraced the wider determinants of health given their involvement in areas such as housing, employment, and education.

Geoffrey Ocen, Bridge Renewal Trust, noted that it would be important to ensure sufficient funding was provided for early help and prevention as well as acute services in order to see long term improvements in health. He added that it was important to engage at local level and to invest appropriate time and money to ensure meaningful engagement.

Sharon Grant, Healthwatch Haringey Chair, expressed some concerns about the timetable for the review and stated that it may not have registered with residents or service users. She commented that most service users had little understanding about the service infrastructure and would need to be supported through the consultation process.

Joanne Murfitt, CCG Programme Director, noted these concerns and explained that the review was not a consultation but was viewed as the first phase of generating continuous improvements over a longer time period. It was added that comments previously provided by residents and service users were being considered as part of the review and tested to see whether they were still relevant. It was explained that the interviews so far had mostly been conducted with senior provider trusts and local authority figures but that there would be further engagement. It was noted that the challenge over the next few months would be to engage with and listen to as many people as possible. The Chair noted that, in the past, there had been limited diversity of participants at CCG meetings and that it was important to include under-represented communities.

Richard Dale, Executive Director of Transition, informed the Board that the transition to Integrated Care Systems (ICS) had begun. It was noted that the timeline might be subject to change following the second reading of the white paper in July 2021. It was explained that the NCL CCG was currently listening to and planning with partners and it was aimed to use the connections formed during the pandemic in order to plan the future of the system. It was noted that the CCG would be working with the Health and Wellbeing Board and other partners to consider the government guidance on ICS when it was available.

The Chair suggested that it would be useful to have a series of seminar or discussion events to ensure that partners’ views were included.

RESOLVED

To note the update.