Agenda item

This report briefs the Committee on changes underway within NHS Kent and Medway Integrated Care Board (ICB), as part of structural reform to the NHS across England.  In particular, the briefing updates on the requirement for ICBs to make a circa 50% reduction in their operating costs by the end of this calendar year (2025).

Discussion:

The Change-25 Transition Director introduced the report which provided information on changes underway at the Integrated Care Board (ICB) in response to the structural reform to the NHS across England which included a requirement for ICBs to make circa. 50% reduction in operating costs by the end of the current calendar year. He reiterated that this would not impact on patient services and that for NHS Kent and Medway, this would result in around 300 redundancies and an estimated redundancy bill of over £20m, which would need to be funded from the ICB. Given the costs involved, discussions around its affordability were ongoing with the Department of Health and Social Care and it was anticipated that the reorganisation would happen in two phases, with the Executive and Senior Leadership Teams being reorganised in Autumn and the remainder of posts being completed towards the end of the financial year.

Members then raised a number of questions and comments, which included:

• Cultural Review – reference was made to the recent ICB Cultural Review and it was requested that the findings be shared with the Committee. The Director undertook to take the request back to the ICB.
• Safeguarding the future ICB – a question was asked about how the ICB was managing requests for voluntary redundancy against ensuring the post transformation workforce remained resilient and retained knowledge. The ICB acknowledged this as a critical focus area for the transformation and managing redundancies and would be developing a criteria to use when considering redundancies, which would be balanced against the operational needs of the organisation going forward.
• Supporting staff – in response to a question about how the ICB was ensuring staff were kept at the heart of discussions andcommunicating with staff effectively, the Director explained that lessons had been learned from previous reorganisations, some of which had caused mistrust by staff in relation to reorganisation activity. Therefore, a Colleague Insight and Involvement Group had been established which included staff from each directorate and each pay band, as well as unions, to ensure co-production around the development and design of the ICB operating model going forward, including determining values and behaviours of the ICB. In addition, the outcomes of the recently commissioned Culture Review were being taken into account as a particular focus of the transition arrangements and a similar group of staff was being set up to focus on taking forward the recommendations of the review.  Weekly blogs were also being provided to staff to keep them updated. It was added that turnover was currently low but was anticipated to change and the ICB was working closely with other ICBs in the South East region to share intelligence and to be able to respond quickly.
• Support and challenge from the Board – in response to a question about the level of challenge and support available, the Director explained that, including the Chair and Chief Executive who were heavily involved, a Freedom to Speak Up Champion was also an Independent Member of the Board. There was a lot of non-executive independent scrutiny on the Board in order to oversee both the Change 25 Programme and the implementation of recommendations from the Cultural Review.
• Liaison with the Department for Health and Social Care (DHSC) – The Director confirmed that the ICB was working closely with NHS England and were keen to get clarity from DHSC about the financial impact of the programme and when they could be expected to finance the redundancies, in order that firm plans and timescales could be determined and provided to staff.
• Determining reductions – concern was raised about how some services would manage with a 50% reduction in the commissioning body, for example Special Educational Needs or safeguarding. Reassurance was provided that some services would not be able to accommodate such a reduction and further guidance from NHS England was anticipated.

Decision:

The Committee noted the report.