Agenda item

The Medway NHS Clinical Commissioning Group Two Year Operational Plan is closely aligned to the Kent and Medway Sustainability and Transformation Plan. The Operational Plan sets out the CCG’s plans for local implementation of the STP over the next two years.

Discussion

The Medway CCG Operational Plan 2017 to 2019 was introduced by the Chief Operating Officer of Medway NHS Clinical Commissioning Group (CCG). He advised that there was a statutory duty for a CCG to produce an operational plan, with Medway NHS CCG having produced a two year plan. There were a range of strategic drivers underpinning the plan, which included the Medway Joint Strategic Needs Assessment (JSNA), the Kent and Medway Health and Social Care Sustainability and Transformation Plan (STP), the Medway Local Plan and local care arrangements. The Plan, which was also influenced by national priorities, was framed around nine ‘must do’s’ which had been set out by NHS England.

The Operational Plan included the following sections:

·         Sustainability and Transformation Plan – this section was replicated in all CCG operational plans across Kent and Medway

·         Finance and Quality, Innovation, Productivity and Prevention (QIPP)

·         Local care – this included the Medway Model, GP Forward View, Healthy Living Centres and prevention work

·         Primary care, community services, prevention, integration and coordinated care

·         Urgent and emergency care

·         Planned care

·         Cancer

·         Mental health

·         Learning Disabilities: Transforming Care

·         Improving Quality

·         Enablers – this includes areas of work such as IT and Estates which will facilitate improved services in relation to the other areas.

The Board raised a number of points and questions as follows:

Contents of Plan – A Member of the Board said that strategic plans should contain a clearly defined roadmap setting out what had already been achieved and future plans. Operational Plans should include milestones and conditions for success. They should set out activities and budgets for the time period covered by the plan. There should also be a list of objectives, detail of the activities required to deliver these and information in relation to quality standards and staffing and resource requirements. Plans should also set out an implementation timetable. There was no clear roadmap within the Operational Plan presented and the Member also considered that details of joint working required with other organisations should be clearly set out in the Plan.

In response, the Chief Operating Officer advised that the contents of the Plan were somewhat constrained by NHS England requirements. It was noted that although no detailed budgetary information had been included in the main Plan, there was some budgetary information in one of the appendices. The Plan did also contain some clear deliverables and timescales, planned care being one example.

Housing Needs – A Member said that some good joint work had taken place in relation to estates. It was requested that more detail of joint working in relation to this be included in the Plan. There was an opportunity for the Council to facilitate the provision of new accommodation at some premises in order to help meet the need for 30,000 new homes to be built in Medway during the next few years. The Member suggested that the development of Extra Care accommodation could be explored and that this should be at the forefront of future development in Medway. The Chief Operating Officer acknowledged that utilising estates effectively was a significant enabler, with the Accountable Officer of the CCG agreeing that there was a significant opportunity in relation to estates. The CCG would be looking to engage with the Council in this area. Support from Councillors was particularly welcome.

Revisions to the Plan – In response to a Member question that asked whether it was possible for revisions to be made to the Plan, the Chief Operating Officer stated that this would be possible as the Plan had not yet been signed off by NHS England. The Accountable Officer advised that, although it would be possible to amend the Plan, it was seen as being an evolving document with the focus being on how thoughts and ideas would translate into improved health provision.

Executive Summary of the Plan – A Member stated that the Executive Summary of the Plan should set the theme of the main document. He considered that the Executive Summary presented did not do this effectively as children and young people were not mentioned sufficiently and the role of technology was also not mentioned. Other gaps included the need to highlight successes in relation to delayed discharge from hospital as well as including information in relation to workforce strategy and the need to promote Medway as a place where health professionals would want to work. The Member considered that there was a lack of focus in other parts of the document, although it was helpful and constructive overall. The CCG representatives agreed that additions would be made to the Executive Summary, particularly in relation to children and young people. It was also agreed that further discussion was required with regard to promoting Medway as a place.

The Interim Director of Public Health was fully supportive of the need for there to be a greater focus on children and young people in the executive summary. This was covered throughout the document. The mental health of children was particularly important as the majority of mental health issues experienced by adults started in childhood. The Interim Director also welcomed the support offered in relation to the prevention agenda and emphasised the need to prevent avoidable ill health and disability. The emphasis on cancer was also welcome in view of the fact that Medway had above average mortality rates, as was the importance placed on staff training by the CCG. The reference to the Medway and Swale Centre for Organisational Excellence (MASCOE) in the Operational Plan was also welcome.

The Chairman of the Board noted that the Operational Plan was a part of the overall Kent and Medway Sustainability and Transformation Plan. He considered that Medway was well represented in this process.

Decision

The Board:

i)     Reviewed and commented on the contents of the Medway NHS CCG Operational Plan and confirmed that it considered that the

commissioning intentions took account of the Medway Joint Health and Wellbeing Strategy.

ii)    Requested that information in relation to children’s services and other areas identified by the Board be added to the Executive Summary of the Operational Plan and that further consideration be given to the structure of the document.

iii)  Acknowledged the importance of underutilised estates in helping to meet the housing needs of Medway.