The Integrated Care Board will update the board on the proposed footprints of the City Neighbourhoods.
Minutes:
The Consultant of Public Health introduced the item, noting that so much work went into the project to make it work for LPT, UHL, primary care, local authorities, etc. It was noted that the initiative was not an attempt to reinvent the wheel but was building on an already existing framework.
It was noted by the LCC Health Consultant that:
· The process was based on dividing the city into units based on Middle Layer Super Output Areas (MSOA), a statistical unit of geography developed by the Office of National Statistics. This was important because MSOAs were linked to the census and other related data, providing the detailed information needed at this level.
· The objective was to ensure that, however the city was divided based on attaining the goals, it was built on grouping MSOA units.
· The team went through several iterations of what this should look like and settled on four neighbourhoods, which were different in size in terms of geography and population. Ideally, there would be more than four neighbourhoods based on the structure of the community and where people go for service provisions, as well as the NHS recommendations for neighbourhoods. However, the goal was to offer a pragmatic solution to all partners involved.
· Each neighbourhood contained multiple Primary Care Networks (PCN). In practice, consideration was given to ensuring community access to services without unnecessary travel, financial burden or time loss for users. Hence, the neighbourhood boundaries would need to evolve continually on a community level, in terms of resource allocation and economies of scale. This also highlighted the importance of ongoing community engagement.
· Adult Social Care (ASC) operated across eight localities (2 localities = 1 neighbourhood) because they needed smaller footprints for their localities due to the number of people accessing their services. However, the neighbourhood division was designed to be scalable while maintaining the MSOA as the base unit.
· Three of the four neighbourhoods were of similar size in terms of population size, range of GP and PCN numbers. While the sizes were not perfect, the framework offered a good starting point to formalise and expand the neighbourhood work that had been developing.
· The current structure allowed focus on main challenges/priorities in particular neighbourhoods and a structure to enable data-driven decision making.
· The governance and approval were outlined, including working closely with GP practices. The success of this depended on identifying priority issues through data and pairing with practical solutions tailored to the needs of each neighbourhood and community.
The ICB lead further noted that:
· PCNs were not geographically assigned, and a lead PCN was being identified per neighbourhood, who would be the coordination point.
· In terms of next steps, this would be taken to all forums to get a form of agreement with the understanding that this is the future.
· A community-led approach had been adopted. Consequently, there were plans to look at undertaking a workshop in respective neighbourhoods and to get the public narrative as to neighbourhoods' needs and how people feel involved, so that they can own it. Additionally, being able to demonstrate the impact, how we can develop and grow and implement changes where necessary.
· The priorities of this initiative were outlined, from the perspectives of the Health and Wellbeing Board as well as PCNs. There was a lot of crossovers, and further work was required on individual neighbourhoods because of potential peculiarities in the needs of the population.
· National priorities emphasised complex health needs, while local priorities required a clear focus to ensure that all partners recognised and aligned with a shared sense of purpose.
· Plans were underway to advance this work through workshops and to develop the structure within the ICB from a city-wide perspective, ensuring it remains streamlined, action-oriented, and focused on driving positive progress in the city’s key indicators.
· The immediate next step was a meeting on 2nd October with the city on how to develop the four workshops to progress the plan.
In response to the request for comments and questions, the following points were made:
· The initiative was important and commendable, particularly being able to design services for communities at the level outlined in the presentation. However, notice was drawn to the constraints of the ICB, emphasising the need to address inequalities in the system as a whole, rather than focusing on small areas. For example, the life expectancy gap between the city and county was highlighted, noting that if this disparity were to be reduced, resources to be strategically allocated across the entire system.
· It was important to have measurable outcomes, ensuring understanding of the frameworks for each group and be clear on the baseline of the programme from the perspective of each area.
· The Healthwatch representative assured that discussions had been had with regards to this neighbourhood work and the next steps, including potential professional patient engagement groups to ensure communities come along and have their say.
· There was a desire for continuing engagement by members.
AGREED:
That the Board note the report.