The Board to receive a verbal update on the Integrated Health and Wellbeing Transformation Programme.

Craig Williams, Interim Director for Integrated Health and Wellbeing, Craig McArdle, Head of Corporative Commissioning and Nicola Jones, Commissioning Lead provided the Board with an update on Integrated Health and Wellbeing Transformation Programme.  It was reported that -

(a)           this was an update on progress towards integration, looking back at what we have achieved to date and next steps.  Seeking to build one system one budget for sustainable community care;

(b)          Plymouth does have significant health inequalities, if were to make a lasting change to ensure that everyone in the city had the best start to life which fits with the Marmot agenda this would clearly fit with our ambition;

(c)           there was a greater complexity of need and this was across the system and reflected in packages in care both in continuing healthcare but also adult social care.  There was also a rise in the number of children placements;

(d)          the co-operative principles and values was really big agenda and challenges the way we deliver public services.  The fundamental transfer of responsibility and power to citizens and communities and how we deliver services in a different way.  If we are serious about hubs we need to involve communities of interest;

(e)          this integration was owned by both political parties and the commitment to integration would not change;

(f)            this Board set us the challenges in June 2013 and the Board’s vision for integration to take the challenge back to commissioners and community.  We want to adopt a whole systems approach in three ways –

·         Integrated commissioning

·         Integrated health and care services

·         Integrated systems of health and wellbeing

The Board needs to check back that we are on track to delivering that vision.

(g)           the four strands of work to make up the integrated health and well-being programme -

·           Integrated commissioning

·           Integrated delivery

·           Children and Young People

·           Care Act 2014

(h)          this was a joint programme between PCC and CCG but moving forward we can only achieve this agenda by taking a collaborative approach;

(i)           the outcomes were ambitious and support the agenda for health and wellbeing.   There was a need to focus on prevention and early intervention to reduce health inequalities and ensure the best start to life.  We need to deliver this service co-operatively and we have a strong partnership with the CCG and PCC looking at alternative delivery models and hubs would form a strong part of this.  The children’s agenda would follow the same model;

(j)           the programme focused on the care and support to be co-ordinated around the individual and ensure that the individual is at the centre.  The Director of Public Health provided support and challenge to make commissioning really “smart” and use the integrated information at the heart of that process;

(k)          this was a journey which had already resulted in co-located commissioners at Windsor House which had helped the conversation, networking and trust building.  There were good examples of pooling budgets around dementia and CAMHS and PCH and PCC were actively involved in the role out of care co-ordination.  The emerging co-operative models for children’s services, completion of the Better Care Fund (BCF) and the development of the outline business case was moving us towards an integrated approach;

(l)           the work around transforming community services would inform our design.  The pathways would work in a seamless way with the individual receiving the care they need in their own home.

In response to questions raised, it was reported that -

(m)         the adults agenda was moving faster than the children’s agenda due to additional complexity such as having to arrange a tripartite arrangements with schools.  Whilst the design and outcomes would look similar for children’s services there would be some key differences, further work would be provided to the Board;

(n)          the challenge of highlighting end of life care would be addressed by commissioners;

(o)          with joint commissioning spend we would start to focus on that together to deliver the best outcomes.

Agreed that the Health and Wellbeing Board to be provided with a further update on Integrated Health and Wellbeing Transformation programme in September.