Agenda item

Toby Sanders, Senior Responsible Officer for the Leicester, Leicestershire and Rutland Sustainability and Transformation Plan to submit the draft Sustainability and Transformation Plan that was released on 21 November 2016 and a report on the proposed governance role of Health and Wellbeing Boards in the process.

Toby Sanders, Senior Responsible Officer for the Leicester, Leicestershire and Rutland Sustainability and Transformation Plan submitted the draft Sustainability and Transformation Plan that was released on 21 November 2016 and a report on the proposed governance role of Health and Wellbeing Boards in the process.

It was noted that:-

a)         All 44 STPs in the country had now been published.  The LLR STP was now in the engagement phase to seek the views of partners on its contents.  Work was progressing with partners and the NHS with a view to engaging in formal public consultation in 2017 but this was dependent upon NHS England giving approval for the process to start.  The LLR STP included a number of capital projects necessary to deliver the plan and NHS England had recently indicated that their work on allocating capital resources nationally would be completed in early 2017.

b)         A number of public engagement events were planned ahead of the formal consultation process in Lutterworth, Coalville, Hinckley and Loughborough to seek the public’s views on the proposals for community hospitals.  It was not proposed to hold public meetings on the STP as a whole at this stage as that would effectively amount to undertaking consultation in the engagement period.   However, engagement events could take place where issues of specific concern had been expressed.

c)         Formal statutory consultation would take place on those areas of service configurations in the STP affecting:-

·         The reconfiguration of acute services onto two sites at the Leicester Royal Infirmary and Glenfield Hospital.

·         Remodelling maternity services to consolidate all services onto one site at the Royal Infirmary and, subject to preferences expressed during consultation, provide a midwife lead unit at the General Hospital.

·         Reconfiguring community hospitals to reduce the number of sites with inpatient beds from 8 to 6 and redesigning services in Lutterworth, Oakham and Hinckley.

Members of the Board stated that:-

a)         They were concerned that there were not any specific engagement events planned for the City and felt the people in Leicester would see the engagement events in the county as ‘consultation’ and have concerns that nothing was taking place in Leicester on issues which were of concern to the City.

b)         Healthwatch supported the view that the public perception of engagement would be seen as consultation and there would be confusion on how the distinction between the two was managed effectively.

c)         The Young People’s Council in Leicester had asked to be specifically involved in the engagement and consultation process.

d)         They had concerns that if there was not sufficient and meaningful public consultation upon the proposals, the STP would not gain the public support it would need for it to be successful.

e)         The integration of the health services and social care services within the STP was a particular challenge; given the uncertainty of funding for local authority social care services.  However, it was noteworthy that the current integration arrangements were working well and the City was one of the best performers in the country in relation to the low numbers of delayed discharges from hospitals.

Following comments from Members of the Board, the following responses were received:-

a)         The LLR BCT programme had been at an advanced stage when the STP process had been introduced.  There had been considerable public involvement in the development of the BCT which formed a major part of the STP.

b)         An EIA had been produced and was currently being discussed with the Leicestershire Challenge Group to identify specific groups which may be affected so that a communications strategy could be targeted at specific groups for engagement and consultation purposes.

c)         A staff development plan had been prepared to enable staff in health and social care to work in the future model envisaged by the STP.  Specific interventions would be required to support the training of staff to undertake new integrated working in the community and working more independently.  Some funds had been received from Education UK for this training, but it was acknowledged that this would not be sufficient for all the training needs required.

d)         It was envisaged that approximately 50% of the savings required by the STP process would be achieved through provider savings, skill mix procurement, which would result in a more agile service provision requiring less office space, and day to day efficiencies in proving the same services through different means.

The Board also considered a report on the governance and delivery arrangements for the STP and the proposed role of the 3 Health and Wellbeing Boards in LLR within those arrangements.

The Chair commented that the City Council would take a formal view on the STP proposals in February following consideration of the STP by the Council’s scrutiny function.  Until the Council had taken a formal view, it would difficult for the City Council members on the Board to subscribe to all the proposals contained in paragraph 9 of the report.  He also felt that the Board could not take the responsibility for ensuring that the STP priorities addressed the key place based health and care needs of each Health and Wellbeing area.  He considered that the Board could only seek assurances from those partners responsible for delivering services and the System Leadership Team which met more frequently than the Board and were able to consider the issues in greater detail.

AGREED:-

                        1.         That the draft STP be received and noted.

2.         That the Senior Responsible Officer considers the Board’s  request that specific engagement events be held on proposals in the STP affecting the City, prior to the formal consultation process.

3.         That consideration of the proposed governance arrangements be deferred and discussed further at a Board Development Session.