Agenda item

Mary Barber, Programme Director, Better Care Together, to present a report providing an update on the progress of the Better Care Together Programme, focussing on the preparation for Public Consultation.

Mary Barber, Programme Director, Better Care Together, and Sarah Smith, Consultation Lead, presented a report providing an update on the progress of the Better Care Together Programme, focussing on the preparation for Public Consultation.

The briefing was intended as a pre-consultation update to Health and Wellbeing Boards and Scrutiny Committees/Commissions in Leicester, Leicestershire and Rutland on the formal consultation which was due to start on 30 November 2015 and would last for 14 weeks.

Members were reminded that the Better Care Together Programme was being delivered jointly by health and social care services throughout Leicester, Leicestershire and Rutland.  The process started in January 2014 in response to the government’s directive to transform the way health and social care are delivered.  The programme aims to deliver high quality integrated citizen centred patient care with the aim of providing greater patient care in the primary health sector to reduce the time spent in hospitals and thereby relieve the pressure on the more costly acute health sector. 

Some operation changes were already taking place as part of the programme, but where the model of care needed to be changed significantly there was a statutory requirement to undertake public consultation.   The programme also aimed to reduce inequalities in care and treat patients as close to home, or in their own home, if it was safe and suitable to do so.         

It was noted that the consultation would include the following changes:-

a)         Providing sub-acute care in Community hospitals including more clinics for individuals with long term conditions, undertaking 40% more planned procedures and out-patient treatment in community hospitals and as day surgery. 

b)         In response to evidence that some patients treated in acute settings become dependent upon the level of care provided when they do not necessarily require it, part of the programme aimed to reduce this pressure by increasing the number of intensive community support beds in the community from 126 to 250.

c)         Currently 2 Community Hospitals do not meet the NICE or CQC guidance for patient care and it is proposed to reduce the number of community hospitals form 8 to 6.

d)         UHL currently has 3 hospital sites providing acute services and it was proposed to reduce this to 2 sites; with the General Hospital refocusing its service provision.  There would, however, be a need to demonstrate that the patients currently receiving acute care at the General Hospital can be safely accommodated at the other two proposed acute units.

e)         Transferring the maternity services currently provided at the General Hospital to the Leicester Royal Infirmary.

It was proposed to obtain a 2% response rate to the Consultation which would be twice the amount generally regarded as a viable response.  There was an agreement with the CCG to have feedback that was representative of the City demographics.  The consultation team were working with playgroups and local community groups to reach more people in order to receive a representative sample of responses.  Impact Assessments were being prepared as proposals were finalised and it was hoped to include these in the consultation process.

Whilst the consultation process was not a referendum, the responses to the consultation would have to be taken into account as part of the decision making process for the provision of services.  However, there was a requirement from Trust Development Authority and the CCG to deliver a reconfiguration of services as the current model was not deemed to be sustainable in the long term.   

The Chair commented that it was hoped to undertake joint scrutiny with the County Council on elements of the programme including workforce planning, Equality Impact Assessment, Community Hospitals and admissions and discharges. 

Following comments from Members it was noted:-

a)         Existing quality of care standards would remain in place to safeguard patient care.

b)         Some of the intensive community care beds may be hospital beds in patients’ homes with appropriate clinical support.

c)         The Chair commented that in some instances it may not be appropriate for patients to be treated at home, particularly in circumstances where social crowding in a residence occurred.  In response, it was stated that it had been assessed within the rehabilitation business plan that approximately half of the treatment could adequately be provided in a patients’ home.

d)         Lessons had been learned from the previous engagement process on the Programme and steps were being taken to improve engagement with hard to reach groups or those communities and groups that do not normally take part in formal engagement.  Consultation material would be available in the main community languages, and in different formats such as animated and easy to read versions.

e)         The consultation period was due to end on 29 February 2016 and the Director indicated that periodic updates to the Commission could be provided.

f)          The Better Care Together Programme was required to provide sustainable quality services and also make on-year savings of £39m to reduce the £295m budget deficit facing the local health economy by 2019.        

Following Members questions on the operational detail of proposals in the consultation process, the Director, Better Care Together, stated that until the final consultation had been completed it was not appropriate to discuss these in a public arena prior to the start of the consultation.  However, the Director offered to discuss these details with Members in a briefing session. 

In answer to a Member’s question on the costs of the public consultation, the Director stated that the CCG held the budget and she would arrange for the costs to be supplied to Members. 

RESOLVED:

1)         That the Director and the Consultation Lead be thanked for their briefing.

2)         That the offer of a Members briefing prior to the consultation process starting be accepted.

3)         That further periodic updates be submitted to the Commission, as appropriate, and that a further report be submitted on the responses to the Consultation process from City residents and the proposed responses to them.

4)         The Equality Impact Assessment be provided to Members when it has been published.

5)         That the Director provide further details of the measures being taken to reach hard to reach communities that do not have formal representative groups, together with details of the budget for the public consultation.