Issue - meetings

The Select Committee will receive a presentation on this item from Jane Shayler and Dr Ian Orpen.

The Director for Integrated Health & Care Commissioning gave a presentation to the Select Committee. A copy of the presentation can be found on their Minute Book and as an online appendix to these minutes, a summary is set out below.

National and local context

•  Future arrangements for commissioning and delivery of services are changing

•  Recognition of  benefits of working more closely with the Council to join up services locally

•  Desire to secure ongoing clinical leadership and develop place-based approaches

Key terminology

•  Neighbourhoods (30k-50k) – Groups of GP practices coming together e.g. primary care at scale, Primary Care Home models 

•  Place (250k-500k) – In line with Council boundaries - integration of primary, secondary and social care

•  Systems (1million +) – Like Strategic Health Authorities - self-regulating with 7-8 regions nationally each covering populations of  5-10m

The plan for B&NES

From 1 April 2019:

•  One team made up of CCG and People & Communities directorate

•  One management structure

•  One integrated commissioning and delivery function for health, social care, children & young people’s services and education transformation

What does this mean?

•  Pool or align all commissioning budgets

•  Create a new governance structure

•  Co-location of staff (over time) 

Case study: Joint Agency Panel

•  Funding packages for individuals with a high level of needs

•  Combined resources allocated to meet individual requirements

Our organisations in numbers

•  Council: 700 employees work in People & Communities / £85m budget (75% of overall Council budget)

•  CCG: 75 employees / £261m budget

Three groups

•  Group A – Integration (inc. commissioning, quality and safeguarding) – Formal consultation on new structure for some departments in September whilst options are still being considered on others.

•  Group B – Centralisation – Mapping exercises underway, timescales vary.

•  Group C – Delivery – Savings plans and change processes already underway (independent of integration programme).

Engagement activities

•  Online survey / Lunchtime drop-in events

•  Team meetings / Interviews with senior managers

Key themes – positives

•  Emphasis on staff training & development

•  Joining up IT systems

•  Key values: open, honest, supportive, positive, curious, inclusive, understanding each other

Key themes – challenges

•  Too high-level, more detail required

•  Capacity to deliver multiple change programmes

•  Some groups fearful of being overlooked:  Children and young people’s services /  Social workers /  Clinicians

Governance arrangements

•  Dual decision making process, both with a formal vote.

•  Meeting in shadow form currently, public meetings from end of 2018 / early 2019

•  Observer status intended to be similar to the arrangements for the Health & Wellbeing Board

Fitting the pieces together

•  Transfer of some commissioning functions to Virgin Care

•  The Council’s ‘Changing Together’ Programme

•  Council & CCG Integration Programme

•  Commissioning at scale across B&NES, Swindon and Wiltshire (STP)

Councillor Lin Patterson asked if any loss of staff was planned as part of this process.

The Director for Integrated Health & Care Commissioning replied that none was anticipated. She  ...  view the full minutes text for item 25