Agenda item

The Health & Social Care Bill - ICS Update

The Panel will receive a presentation regarding this item from Corinne Edwards, B&NES Chief Operating Officer and Richard Smale, Director of Strategy and Transformation.


Richard Smale, BSW CCG Director of Strategy and Transformation addressed the Panel, a summary of the presentation is set out below.


BSW Integrated Care System (ICS) Development and Transition


Statutory components of an Integrated Care System


Following the abolition of the CCG two new bodies will be created.


·  Integrated Care Board (ICB)

·  Integrated Care Partnership (ICP)


Time has been set aside to discuss with relevant parties how this will work.


All stakeholders will need to play a key role and equality should be given to all views.


Integrated Care Board


The Integrated Care Board is a statutory NHS body / organisation that will:


·  Bring partner organisations together in a new collaborative way

with common purpose;

·  Bring the NHS together locally to improve population health and

establish shared strategic priorities within the NHS, connecting to

partnership arrangements at system and place.


Subject to the legislation,


·  Expect most CCG statutory functions will be conferred on the

Integrated Care Board in April 2022 (including commissioning

responsibilities and contracts).


Integrated Care Partnership


The ICP is a statutory committee established locally and jointly by the ICB and the Local Authorities in the ICB’s area.


The ICP will work on the principle of statutorily equal partnership between the NHS and local government to work with and for their partners and communities.


Responsibility to develop an ‘integrated care strategy’ for the area’s whole population, covering health and social care, and addressing health inequalities and the wider determinants which drive these inequalities. A key body for developing the overarching vision and strategy for health and care in B&NES, Swindon and Wiltshire.


Wide range of partners and organisations – local authorities, the VCSE sector, the NHS, anchor institutions, education, housing, police, etc.


Can only be set up once the ICB is formally established.


Working in partnership


·  Emphasis on working with people and communities; and partnerships with voluntary, community and social enterprise sector.

·  BSW secured £25k to establish a VCSE Alliance at Integrated Care System level and to support involvement within the Integrated Care Board and Integrated Care Partnership.

·  Engagement strategy for 2022/23


Action required


·  Develop a system-wide strategy for engaging with people and communities by April 2022

·  ICBs work with partners to develop arrangements for ensuring that integrated care partnerships and place-based partnerships have representation from local people and communities in priority-setting and decision-making forums.

·  By April 2022, ICBs are expected to have developed a formal agreement

for engaging and embedding the VCSE sector in system-level governance and decision-making arrangements, ideally by working through a VCSE alliance to reflect the diversity of the sector.


Transition arrangements


·  Integrated Care System (ICS) Chief Executive interviews 12/13th October

·  First assessment against the Readiness to Operate Statement due 29th October 2021

·  Integrated Care Board (ICB) draft constitution to be submitted 17 December 2021, final version by 31 December


B&NES Integrated Care Alliance Development


Corinne Edwards, B&NES Chief Operating Officer, BSW CCG addressed the Panel, a summary of the presentation is set out below.


What do we have in place currently at place-level?


·  B&NES Integrated Care Alliance (ICA) established in 2018 as a subgroup of the Health & Wellbeing Board

·  Informal partnership arrangements in B&NES, built on a long history of working together. Rapidly developed as a result of needing to work together more to respond to the COVID-19 pandemic (meeting daily to begin with)


Alliance Strategic Group:


·  Meets monthly as an executive forum

·  Members from CCG (Locality Clinical Chair, Chief Operating Officer & deputy), B&NES Council (Director of Adults Social Services, Director of Children’s Services, Director of Public Health), RUH, Virgin Care, AWP, GPs, 3SG, BEMS+ and HealthWatch B&NES


Alliance Operational Delivery Group:


·  Meets fortnightly

·  Tactical group of the alliance

·  Operational overview of locality pressures, inc supporting patient flow, monitoring Covid surge, recovering from the pandemic

·  Develops plans, oversees the work plan and provides a partnership response


Place-based governance options


·  Option 1 – A consultative forum

·  Option 2 – Individual executives or members of staff of a relevant statutory body

·  Option 3 – A committee of the Integrated Care Board

·  Option 4 – A joint committee established between partner organisations

·  Option 5 – A lead provider manages resources and delivery at place-level


Considered by ICA members with agreement to progress Option 4 - A committee established between statutory organisations (Integrated Care Board, LAs, NHS providers) enabling joint decisions so greater sense of ownership and partnership feel – builds on what we already have.


Next steps – Transition to ICS


·  ICA away days 13th & 14th October to consider ways of working, behaviours, decision-making, membership etc – outputs to inform development of a memorandum of understanding between partners and terms of reference for the joint committee

·  ICA to consider the financial governance framework for place on 28th October

·  Place-based leadership arrangements – draft proposals being considered by ICS and 3 ICAs during October. Include:

o  a partnership convenor as an elected chair of the joint committee and would be a member of the ICS NHS Board

o  To be supported by an Executive lead with formal responsibility for statutory functions delegated to each of the ICAs. The Executive lead would be a joint appointment between the providers, the Local Authority and ICS NHS Board


The Chairman commented that all parties in this process should be considered equal. He added that previously some members had been concerned about access to services, particularly in Bristol.


Richard Smale replied that boundaries have to be considered as porous and that patients should still be able to access the services they need whether that be in Bristol, Oxford, Southampton etc. He added that this work should be seen as a way to strengthen within the community and to add value to work within family units.


Councillor Rob Appleyard said that he hoped there would be a focus on Mental Health within the new arrangements and said that the presentation highlighted the complexities of the work ahead.


Councillor Paul May stated that he was worried that an additional tier would disrupt the democratic process and hoped that a locality focus would be retained where possible.


Richard Smale replied that B&NES, Swindon and Wiltshire all have a unique demographic and that he felt that all would succeed if success was achieved locally. He added that they will also need to come together collectively when needed as they have done during the pandemic.


Councillor Liz Hardman asked how will private company contracts be scrutinised by the ICS.


Richard Smale replied that local democracy can be built into this process and said that Swindon and Wiltshire shared a similar view.


Corinne Edwards added that local accountability is important and that when the new arrangements are in place they will need to be clear about the roles of all parties. She said that it will be a significant change for all partners.


She explained that having an Integrated Care Alliance was not a statutory requirement, but that B&NES had decided to have this function to allow place-based arrangements.


Councillor Paul May asked how the services provided by Virgin Care would be affected.


Corinne Edwards replied that commissioning functions would transfer into the ICS. She added that some contractors do already work across the BSW footprint.


The Chairman thanked Corinne and Richard for their presentation on behalf of the Panel.

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