Agenda item

The Senior Communications & Public Affairs Lead for Communications and Engagement team at NHS Leicester, Leicestershire and Rutland submits a report on the NHS Transformation.

The Deputy Chief Operating Officer of Integration and Transformation and the Chief People Officer from the Integrated Care Board (ICB) presented the update. It was noted that:

·       Last year £150million had to be saved from the NHS budget, this was incredibly difficult but was achieved. This year it was expected that £190million needed to be saved.

·       These savings were expected to come from reducing the workforce in non-patient facing roles and reducing the use of agency and bank staff. Services were to be redesigned and recommissioned to remove any duplication, to maximise productivity and ensure value was being provided while promoting equitability.

·       A big area of cost identified was prescribing so medication was to be non-branded where possible.

·       These savings were a huge ask for the NHS.

In response to comments from members, it was noted that:

• The ICB was to provide a paper for circulation on the savings to provide further details.
• The £190million savings were across the whole of the NHS – including the ICB, LPT and UHL. £74million of the savings were the responsibility of the ICB.
• Prescribing had cost £205million, it was hoped £17.9million would be saved from this through switches and optimisation.
• Lot of smaller chunks were to be saved, including the staffing costs at the ICB. £11million was to be saved from the system development fund by closing down and stopping pilots.
• Other savings were to be made by pathway redesigns to improve efficiency, but there was lots of work to be done to make them happen and risks needed to be considered.
• The pressure on budgets had significantly increased in the last 10 years.
• There was the possibility of underspends if there was good financial house keeping.
• Some services which were to be cut would not reach the threshold for public consultation so it was important that the voices around the table raised concerns.
• Saving £150million was incredibly hard and required a continued, concerted effort. It was public money though so there was a responsibility to ensure value for money.
• The team were unable to comment on national government announcements on NHS funding and service expansion as no details were known yet, but it could be that the extra funding was for a particular provision such as digital innovation.
• Members were concerned that Leicester was the worst city for GP rations, faced significant health inequalities and had poorer health outcomes and the impact of £190million cuts were going to have. The NHS was in a difficult position of meeting the needs of the population and improving health outcomes whilst balancing the books.
• The ICB reassured members that safeguarding was only going to move to provider level once there was confidence in the handover, there were statutory duties which the ICB had a legal duty to discharge.
• Further work was going to occur on the full implications of the cuts as well as an equality impact assessment.
• The Chair requested a more in-depth update be brought back to the Commission in September as the changes were occurring so quickly.

The Chair invited the youth representatives to comment. It was noted that:

• Concerns were raised that SEND young people and others in difficult to access populations were at risk of further disadvantage.
• A large consultation occurred for the 10-year plan which considered how to involve young people in Leicester, Leicestershire and Rutland (LLR). The ICB were to share the feedback they received and link in with the youth representatives.

The Deputy Chief Operating Officer of Integration and Transformation and the Chief People Officer from the Integrated Care Board presented a further update on the ICB transitions. It was noted that:

• The ICB were expected to reduce their costs by 33% this year as part of the government’s commitment to reinforce funding for the front-line services. Savings made were not staying in LLR though, they would be with the government.
• The ICB had clustered with Northamptonshire to improve efficiencies and this transition was progressing.
• The ICB had 6 months to remove this cost from the organisation. This meant by the end of December, the work currently being done by the ICB needed to be done with 150 fewer people.
• The transformation programme was intended to see what could be done differently to allow for these changes.
• A further announcement had followed from government that other NHS funded organisations would close down, including Guardian Angels and Healthwatch.

Following the update, as part of questions and discussions it was noted that:

• Whistleblowing may be discouraged without a national structure and that support mechanisms were being removed by taking away organisations like Healthwatch and Guardian Angels.

• Councillors were going to need to provide some of this support to ensure constituents were getting the care they needed and to provide a watchdog element to hold the NHS accountable.

Agreed:

1)    The report was noted.

2)    ICB was to provide funding paper to circulate to Members.

3)    An update to come back to the next meeting on further progression.