Members to receive a report providing an overview of the LLR Integrated Care System taking into account recent guidance issued by NHS England and the Health and Care Bill.
The Chair invited Robert Ball to put his questions.
From Robert Ball:
Q1: What provider collaboratives are under development or being anticipated?
Q2: Can ISC leads confirm that commercial providers will be excluded from these provider collaboratives?
Andy Williams, Chief Executive ICS responded that they were looking at collaboratives based on care areas. The focus would be on care areas such as elective care, learning, disabilities, children services etc. ICS were keen to progress the first two care areas then set up other collaboratives over the next 12 to 18 months
In relation to the second question, the government had not placed any commercial providers in governance although it was unavoidable there would be some involvement in the collaboratives as it was an integral part of service delivery.
Leadership would therefore be through the ICB, and collaboratives would be through public sector but would involve the independent sector in collaboration work.
The Chair invited Andy Williams to continue that discussion with Robert Ball outside this meeting.
Sarah Prema, Executive Director of Strategy and Planning briefly reminded members of the situation around ICS which had already been discussed in detail at independent Health Scrutiny Commissions of local authorities across LLR.
Members noted that the process to develop ICS was 2 fold; the legal process to close existing CCG’s and importantly improving experience and outcomes. The statutory footing of ICB and ICS provided the facility to remove barriers and enable faster co-ordination of care across pathways and increase improvement of outcomes for patients.
Sarah Prema presented details of the approach for LLR, examples of what was being done to integrate services, the priorities for integration and transformation in LLR, the overview of the ICS infrastructure, the high level responsibilities of each place group and draft place based governance.
Members noted the progress and next steps which included:
· A designated Chair (David Sissling) in place and appointment of Andy Williams as Chief Executive.
· Recruitment processes and ICP governance arrangements to be finalised.
· Due diligence to complete in closing CCG’s establishing the Board.
· Finalising leadership arrangements.
Members discussed the presentation which included the following comments:
· It was clarified that Andy Williams had been appointed by the Chair as designate CEO and through NHS England. In due course the ICB would become the statutory board and that would be the legal employer. ICB would be the board whereas the ICP would be the partnership body in between.
· In relation to governance arrangements, equal partnership and involvement of local government, it was clarified that both upper and lower tiers would be engaged however it would be for the Health and Wellbeing Board to determine that involvement. The board (ICB) would advocate 3 places around the table from local government and that could include officers. The board would be subject to scrutiny at all levels and there was no attempt to differentiate between place and system scrutiny.
· With regards to maintaining patient care during the transition arrangements there was a long history of re-organisation and with support of CCGs they had already effectively re-organised into a shadow ICS form, there would not be a need to further re-organise, and they were ready to make the change which would mostly be a change of name.
· It was recognised that communication with the public was ongoing but driven by availability of policy within NHS and this communication had largely been with specific interest groups. It was noted that in terms of statutory consultation as this was a national policy there was no public consultation but locally, they were trying to be open about the process.
Chair thanked health partners for the update.
That the contents of the presentation update be noted.