Agenda item

This report provides an update on the progress of Local Care, including the Local Care Implementation Board, the Local Care deep dives and the Local Care delivery/outcomes framework.

Discussion:

The STP Local Care Lead summarised amendments made to the governance arrangements for Local Care. This included the establishment of a new, smaller strategic Local Care Board which was comprised of senior leaders from key organisations involved in the commissioning and delivery of Local Care services across the Kent and Medway health and social care system. This Board had two key functions which were to hold the CCG footprint Local Care Boards to account and to help create the conditions for success.

She explained that the existing Local Care Implementation Board (LCIB) would not be disbanded, as this Board had been invaluable in bringing together a wide range of organisations. However, it was noted that the focus of LCIB would be amended. It was considered that this outgoing Board would become a “learn and share” forum and would include additional members to focus on: progress across Kent and Medway; learning from other areas nationally and internationally and; ideas and examples of innovation. It was noted that the first event for this forum would be on 22 May 2019.

The Joint Board was reminded of the outcomes of the Local Care deep dives which were explained in detail in Appendix B of the report and had been circulated to the Joint Board following their meeting in December 2018. The Joint Board’s attention was also drawn to the progress on the Local Care Delivery Framework set out in section 4 of the report. This Framework would be shaped by the outcome of the deep dives. It was anticipated that the first populated dashboard would be completed in July 2019.

Members raised a number of points and questions, including:

Workforce - In response to questions concerning the workforce challenges outlined on page 65 of the agenda, Appendix B to the report, the Joint Board was advised that recruitment and retention of the Kent and Medway workforce was considered to be very important. Challenges were being addressed in two ways. Firstly, by adapting the existing workforce by working differently, for example capacity had been released by forming Multi-Disciplinary Teams (MDTs) which had reduced duplication of efforts. Secondly, there was a long term ambition to attract new staff into the area.

With respect to the specific challenge of making it easier for staff to rotate across organisations i.e. a passport or secondment, the Joint Board was advised that this may help with recruitment and retention of staff. In particular, prospective employees had requested an opportunity to develop a portfolio careers and gain experience in different organisations and health sectors. Kent and Medway could be a trailblazer in this regard.

Funding for Local Care - The Joint Board was assured that funding was in place to support Local Care. This was demonstrated as part of the Local Care deep dives. In addition, within the NHS Long Term Plan, £4.5billion had been committed to primary and community care. The first tranche of this funding had been realised, with CCGs receiving an uplift of circa 3% on their budgets. It was explained that this money was ring-fenced for use within primary and community care only.

Estates – In response to questions concerning feedback from the Local Care deep dives regarding the need for a flexible housing stock to attract key workers, it was recognised that collaborative working between Local Authorities and the NHS could yield new opportunities. It was explained to the Joint Board that the NHS were under an obligation to review their estate and release property specifically for building housing. There was a national and local target for identifying surplus accommodation to be put towards the housing stock.

The Joint Board was advised that most of the property across Kent and Medway was owned by individual Trusts, therefore the Trust would have first call on income generated by the estate. Some properties were owned by NHS Property Services and in this instance the money from these property disposals would be held centrally by the NHS.

It was noted that any money released would, in part, help fund any NHS committed funding, such as the circa 3% uplift for primary and community care committed in the NHS Long Term Plan. However, it was added that the Secretary of State for Health and Social Care had recently announced that properties under the responsibility of NHS Property Services could be transferred to local systems, provided there was a business case do so. This would benefit the local area and provide much more flexibility to make the best use of the estate.

It was explained that a Kent and Medway Estates Strategy was being developed. It was suggested that the results of this Strategy could be shared with Joint Board Members.

Decision:

The Kent and Medway Joint Health and Wellbeing Board:

a)    noted the content of this report, in particular:

·         the update provided on the implementation and progress of the new Local Care Board and the proposed Kent and Medway wide Local Care/ Primary Care Network ‘Learn and share’ forums;

·         the outputs from the Local care ‘Deep Dives’, set out at Appendix B of the report and details provided on how the outputs are informing the Local Care work programme and other workstreams;

·         the approach to monitoring progress and agreeing a Local Care Delivery Framework, as set out in section 4 of the report; and

·         the difference between the Delivery Framework and the Kent and Medway overall population ‘Outcomes Framework’ which will be influenced by Local Care.

b)    supported a collaborative approach between the NHS and Local Authorities to effectively utilise their estates portfolio to support the provision of accommodation for key workers.