Agenda item

This report provides the Health and Wellbeing Board with an update on the Development of the Medway and Swale Integrated Care Partnership.

Discussion:

This report provided an update on the development of the Medway and Swale Integrated Care Partnership (ICP). The Board was reminded that the Integrated Care System (ICS) would comprise of:

·         a single CCG operating at a Kent and Medway level from April 2020;

·         four ICPs operating across local geographies; and

·         43 GP-led Primary Care Networks.

The ICP footprints had been developed to reflect patient flows to acute hospitals and related directly to where people accessed hospital care in their local areas. The Medway and Swale ICP covered the whole of the existing Medway and Swale CCG areas and would operate in shadow form from April 2020. The Board’s attention was drawn to the shadow operating model set out at paragraph 3.4 of the report. It was explained that during the shadow period, models would be tested and refined and mobilisation was expected in April 2021.

Essential components to the operating model were: (1) the principle of co-production to ensure that the patient voice was heard; (2) parity of ownership and control between ICP organisations; and (3) continued oversight and scrutiny.

The ICP’s strategic direction was taken from a number of plans including the Kent and Medway Joint Health and Wellbeing Strategies, Joint Strategic Needs Assessment and the NHS Long Term Plan. It was anticipated that the first draft of the ICP’s Plan would be completed in the new financial year.

In response to questions in relation to the success of the new arrangements, it was recognised that the timeline to mobilisation was ambitious. It was incumbent on system leaders to work together to accelerate progress. It was anticipated that there would be a reduction of duplication and a more effective use of resources, including a fit for purpose IT system. A single Project Management Office had already been established which would enable system leaders to align work programmes across respective footprints. It was added that the right resources and expertise were in place to rethink arrangements going forward if something was not working. A request was made that the Board receive regular updates on the ICP Plan.

In response to questions regarding accountability, it was recognised that there needed to be separate accountability as the ICP moved forward. However, the frameworks were still being developed and at present organisations were still accountable to their sovereign boards. It was anticipated that new legislation would be enacted setting out lines of responsibility and accountability.

A concern was expressed that the Kent and Medway Safeguarding Adults Board (KMSAB) had not been involved within the ICP development. Clarification was also sought on how the ICP would guarantee the delivery of the KMSAB Strategy. In response, the importance of ensuring that safeguarding was not missed was recognised. There was a need to work through which responsibilities sat at a strategic Kent and Medway level and which responsibilities were delegated to a local level. The Senior Responsible Officer for the Medway and Swale Integrated Care Partnership (ICP) undertook to liaise with the Accountable Officer of the Kent and Medway single CCG regarding the input of the KMSAB in the development of the ICP.

In relation to a concern around the complexity of the arrangements, the importance of public engagement was emphasised. It was noted that patient participation groups and patient experience surveys were in place and it was important to build on these. Public engagement in the ICP development had been carried out as part of the wider STP system transformation work; an event was recently held at Gillingham Football Ground and further events were planned.

With reference to a recent presentation on Medway’s draft Local Plan, a concern was expressed that there was an expectation that circa 29,000 homes would be built in Medway. However, no additional funding would be provided from the Government to deliver health infrastructure to support the additional people living in the area.

Decision:

The Health and Wellbeing Board:

a)    noted the update;

b)    noted that the Senior Responsible Officer for the Medway and Swale Integrated Care Partnership (ICP) would liaise with the Accountable Officer of the Kent and Medway single CCG regarding the input of the Kent and Medway Safeguarding Adults Board in the ICP development;

c)    agreed to add future updates on the ICP Plan to the Board’s work programme which would be discussed in more detail at the next pre-agenda meeting;

d)    requested that a letter be sent to Medway’s MPs expressing the Board’s concerns in relation to housing delivery and future funding for health infrastructure and asked that the Leader of the Council also raises this concern at his periodic meetings with the MPs.