Agenda item

To receive a verbal update on the integrated care system, local care forum and population health.

Ms Frances O Callaghan introduced the item and stated that:

·         The Health bill was still moving through Parliament. The date had been delayed for statutory formation of the Integrated Care System (ICS) from 1 April 2022 to provisionally 1 July 2022, subject of that bill to go through Parliament.

·         She thanked Zina Etheridge for her help and support she had given into the developing ICS.

·         An Integrated Care Board and Integrated Care Partnership Forum needed to be created. There was also a Community Partnership forum which was not as part of the legislation. 

·         A major task was to create a leadership team for the Integrated Care Board (ICB). It needed to have a fair and transparent process relating to any CCG changes.

·         Non -executive appointments would be made for the ICB.

·         The Integrated Care Partnership (ICP) would work with the Integrated Care Board (ICB) to set the strategy with the ICB having the responsibility of delivering the strategy.

·         The ICP would be broadly representative around elected members.

·         Local authority representation would be made to the ICB.

·         A white paper was due to be published on the integration at place level.

·         A significant emphasis was being place on clinical and professional leadership in the ICB. The CCG has been a clinically led body and care would be taken to not lose the clinical and professional leadership already established.

·         There would be a formal medical and nursing appointment but via local authority engagement, it was important to note the public health work and ensure a public health voice.

·         The development of the borough partnership was important and the work of the Population Health Committee would be important for understanding priorities. It was important to address inequalities and wider determinants of health.

In response to questions, the Board heard that:

·         There was a commitment to create strategies that were effective that meant something to the local population.

·         Any proposals created would be better if they were informed by the local view, local authorities and other stakeholders.

·         Some things needed to be done differently. Some ideas in the NHS about how the services were best delivered did not meet the needs of the local population due to location or lack of information. 

·         Patients at hospitals, for example, needed to be worked with more closely via the primary care teams to ensure the right steps were being taken.

·         There was a significant rise in demand on primary care in terms of the number of appointments available. It was at least a 10% increase from two years ago.

·         There was the Winter Access Fund which would help primary care to increase opening hours to provide more support to patients. Online consultation was useful and it was important to maintain face to face contact.

·         Whilst the CCG would lose some of the clinical leadership, it was important to ensure that there was a safeguard against any wider change that would result in a diminution of the primary care voice.

·         The mental health review was underway and was examining the expenditure of funds in the area across the five North Central London boroughs.

·         Mental health investment would be protected going forward, but a balance would have to be struck around community hospital and mental health spend.

·         It was important to ensure staff members were supported and that their wellbeing was considered.

·         Primary Care already had difficulties regarding service user access, before the coronavirus crisis. Primary Care was entering into a very difficult time. Many GPs in Haringey were over the age of 55 and would be retired in the next five to ten years. There was also an issue around attracting young GPs to come to live and stay in Haringey.

·         Wood Green would be opening a diagnostic hub, which would be more community centric.

·         There was a lot of positive work that the Community and Mental Health teams had done on the review to expose certain inequalities and in a manner that people can accepted.

·         There was more delegation around dentistry and optometry and community pharmacy who could potentially release some of the burden on primary care.

·         Some GP's had a better administration and digital infrastructure. The role of a GP was not the same in all areas. There was also work to make access to dentistry more accessible.

·         There was a commitment to bringing care closer to residents to addressing the wider determinants.

·         It was important to that the independent voice of patients was still heard.

·         There were other issues that were integral and circumstantial to health and wellbeing such as quality of housing.

·         In May 2021, the borough had an opportunity to bid for around £580,000 worth of investment helping the borough work on mental health within in the east of the borough.

·         Funding applications had been made for around £850,000 which was also going into the east of the borough assisting peer support for people with mental health issues, long term conditions and mentoring for families.

·         There has been work around localities to consider the neighbourhood infrastructure. This would help the borough to have a neighbourhood level profile to address the specific needs of the locality. 

·         The North Central London developments on NHS had a focus on population health.  The Population Health Committee was focused on tackling inequalities, prevention and looking at the wider determinants of health. As part of that work, an outcomes framework was being developed across North Central London that would feed into the plans for the integrated care system.

RESOLVED:

That the update be noted.