Agenda item

To receive a presentation from the Leicester City Clinical Commissioning Group (LCCCG) providing an overview of the Sustainability and Transformation Plan and the next steps and expected milestones.  Sarah Prema, Director Strategy and Implementation, (LCCCG) will be present at the meeting.

The Commission received a presentation from Sarah Prema, Director Strategy and Implementation, Leicester City Clinical Commissioning Group (LCCCG) providing an overview of the Sustainability and Transformation Plan (STP), the next steps and the expected milestones.

It was noted that the STP was a place based plan to accelerate the implementation of the Five Year Forward View required in the NHS Planning Guidance 2016/17 – 2020/21.   The STP covered all areas of CCG and NHS England commissioned services including specialised services and primary medical care.  The plan also covered the better integration with local authority services.  Toby Sanders, Chief Officer, NHS West Leicestershire CCG was the lead officer for STP. 

The Better Care Together programme would form an integral part of the STP and Leicester, Leicestershire and Rutland were ahead of many areas of the country in developing the BCT programme.

In developing the STP each area has to show how they are going to ensure sustainability in the following areas:-

·         Health and Wellbeing

·         Improving care and quality

·         Ensuring financial sustainability (improving productivity and closing the financial gap)

The feedback from NHS England on the initial submission in April had been positive and further work had been undertaken to develop where LLR could go further on the three areas listed above.  A detailed submission has to be submitted to NHS England by 30 June 2016 and this was based upon both the BCT Programme and the STP emerging priorities. 

The emerging priorities for the STP were:-

·         BCT Phase 1 service reconfiguration.

·         Public sector efficiency.

·         Prevention.

·         Urgent and emergency care.

·         Mental Health.

·         Integrated place based community teams.

·         Primary medical care.

·         Digital technology.

·         Public sector estate.

·         Health and care workforce.

·         LLR place based system approach.

These priorities would be developed by the 6 STP work-streams of:-

·         Improving health outcomes and independence.

·         Delivering care in the right place.

·         Making better use of resources.

·         Integrated place based teams.

·         Resilience in primary care.

·         System leadership.

It was expected the STP would not be finally approved until late autumn.  As part of this process the pre-consultation business case for the BCT was being refreshed.  As a consequence, public consultation on BCT could not start until this business case had been approved.

Members made the following comments:-

a)         Place based planning could be a topic for the planned Primary Care Health Summit.

b)         The requirement to prepare the STP was frustrating as it appeared to be yet another strategic plan on top of the BCT which had still not progressed to public consultation after two years of development.

c)         Further details of the financial gap outlined on page 3 of the presentation and the proposals to address this should be made available to the Commission.

d)         Documents made available to the public should be written in a clear non-technical style that was easily understood by non-health professionals.

e)         There were concerns that insufficient resources would be spent on twin tracking of services ant his may not be in the best interests of people living in the city.

In response to other further comments made by Members, it was noted that:-

a)         Implementation was considered a key element of delivering the plan and its outcomes, which was reflected in it being a key work-stream of STP.

b)         Placed based teams were at an initial stage but the CCG shared Members’ view that STP was not just a health plan but a system wide plan to deliver best health outcomes to people living in the city.  Preventative measures were equally important to delivering health care and reducing demand upon the system as a whole.

c)         The initial draft of the STP would not be available until further guidance had been received.

d)         Consultation would start on the BCT when the STP had been formally signed off.  The CCG were equally frustrated by the delay on the consultation process but expected to be able to proceed soon after receiving approval of the STP as the BCT was further advance than other parts of the country.

The Chair commented that redesigned services should be fully embedded and sustainable before any reduction in the number of hospital beds was implemented.  She stated that there should be concrete evidence as to the reasoning behind the plans and how they will deliver better outcomes for people in the city. She also recognised that staff were working in difficult situations to deliver improvements to services whilst at the same time making savings within unrealistic circumstances at times.   

AGREED:

            1)         That the update on the STP be noted.

2)         That the Commission receive a report at its next meeting giving costs of producing the BCT and STP and listing actual examples of what has been implemented and what will be implemented to provide assurance that good quality services are embedded before any bed reduction programme is implemented.