Agenda item

To update the Committee on the progress of the community health services review and next steps.

Dr Josephine Sauvage, an Islington GP and NCL CCG Chair, introduced this item. Adding to the information already provided in the agenda pack, Dr Sauvage observed that the Community Health Services review was not dissimilar to the Mental Health Services review in that it dealt with differences across the NCL region in the service offer, staffing, workforce, resourcing and expected future needs. She noted that, if there was underinvestment in community resources, there may be a consequent equivalent increase in resources required for acute pathways. The process of the review had shone a light on what the differences were between the boroughs and what ‘good’ would look like in terms of the core offer in areas such as investment, hours of service, staffing models, integration and future-proofing.

Community services would need to evolve to work in a more preventative way, supporting people in their own homes. With a more integrated system it would be necessary to consider how community services were linked to other services and how integrated pathways for patients were established.

Following the review process, there was now an understanding of what the core offer should look like and of the required resource envelope. It was recognised that investment in community health services was needed and that resources may need to be reallocated within the system. The review had shown that different service providers operated slightly differently and so there were opportunities for them to learn from one another to solve problems and improve productivity.

Sarah Mansuralli added that there was a statutory Mental Health Investment Standard which increased incrementally each year, but that there was no equivalent standard for community health services. There had been discussions with partners about whether a similar approach could be adopted to enable this kind of incremental annual investment. This could contribute towards an expansion of care provided out of hospital and prevention/early intervention which would help to reduce pressure on acute services. Opportunities for collaboration would help to address fragmentation between providers. A population health approach had been taken to both community health and mental health services and the core offer was designed around the different needs of different population groups.

Dr Sauvage and Sarah Mansuralli then responded to questions from the Committee:

• In response to a question from Cllr Clarke about integration at a local level, Sarah Mansuralli said that this had to happen on a Borough Partnership basis so the implementation and financial plans were being developed at a borough level.
• Asked by Cllr Tomlinson about priorities, Dr Sauvage responded that the focus of a lot of the work had been on inequalities but also recognised that it was not fully understood what the priorities of residents were and that this may vary across boroughs. Borough Partnerships would therefore need to carry out further work to establish the priorities in their area.

Cllr Connor requested that a future update report to the committee should include additional details on the finances, the local offer and delivery through the Borough Partnerships, how the priorities of local population and the specific communities within that would be addressed, how co-production was embedded and workforce challenges. Sarah Mansuralli estimated that it would be possible to bring this update report to the September 2022 meeting of the Committee.

RESOLVED –

That a future update report on the issues discussed should be provided to a future meeting of the Committee to include details on:

• The funding mechanisms to support community health services;
• The local offer and delivery through the Borough Partnerships;
• How the priorities of the local population and specific communities would be identified and addressed;
• How co-production would be embedded in the provision of community health services;
• How the required workforce would be recruited.