Agenda item

To consider and discuss a report from the Head of Democratic Services which presents information and guidance surrounding the new Health and Care Bill and the development of the local Integrated Care System.

The Head of Democratic Services submitted a report which presented information and guidance surrounding the new Health and Care Bill and the development of the local Integrated Care System (ICS).

The following were in attendance:

-  Councillor Fiona Venner, Executive Member for Adult and Children’s Social Care and Health Partnerships

-  Councillor Salma Arif, Executive Member for Public Health and Active Lifestyles

-  Cath Roff, Director of Adults and Health

-  Victoria Eaton, Director of Public Health

-  Tony Cooke, Chief Officer Health Partnerships

-  Sara Munro, Chief Executive, Leeds & York Partnership NHS Foundation Trust

-  Thea Stein, Chief Executive, Leeds Community Healthcare NHS Trust

-  Visseh Pejhan-Sykes, Chief Financial Officer, NHS Leeds Clinical Commissioning Group

-  Stephen Gregg, Governance Lead, West Yorkshire and Harrogate Health and Care Partnership

-  Julian Hartley, Chief Executive, Leeds Teaching Hospitals NHS Trust

In introducing the agenda item, the Chair advised of the ongoing work also being undertaken by the West Yorkshire Joint Health Overview and Scrutiny Committee (JHOSC) in liaising with the West Yorkshire and Harrogate Health and Care Partnership to consider the implications of the legislative proposals for West Yorkshire, including a focus on the potential future role of scrutiny as part of the new ICS. It was noted that the Joint Committee met recently on 20th July to consider this matter further and that the Board would be kept updated on the work of the Joint Committee.

The Executive Member for Adult and Children’s Social Care and Health Partnerships gave a brief introduction to the report and particularly acknowledged the concerns raised by Leeds residents around aspects of the Bill. The Executive Member assured Members that Scrutiny, as well as leaders across the health and care system in Leeds, will have a key role in the development of the ICS and the implications of the Bill moving forward. The Executive Member for Public Health and Active Lifestyles also added to this and particularly emphasised the important role of local authorities throughout the development process in terms of ensuring that local voices are being heard.

The Director of Adults and Health then delivered a PowerPoint presentation which summarised the existing approach to integrating services, including reference to the 5 Year Plan and the 10 Big Ambitions, and the implications of the Health and Care Bill 2021-22 in terms of building on existing arrangements to develop the new ICS.

Members discussed a number of matters, including:

·  The wider health and care system. Members recognised the wider approach necessary to tackle heath inequalities and expressed concern that the Bill does not acknowledge the role of social care working, or the role of public health services, for balanced representation within the ICS.

·  Patient voice. Members noted the importance of incorporating patient voice into the structure of the ICS, including organisations such as HealthWatch, and ensuring that work of patient voice organisations are adequately funded at both local and regional levels.

·  Place-based plans. Members sought clarity on the development of future plans for the place-based approach.  Members also emphasised the importance of ensuring that local and region plans are mutually supportive.  Linked to this, it was highlighted that local plans would need to be submitted to the ICS for approval.

·  Hospital discharge and social care assessments. In discussing the implications of the Bill, particular reference was made to the proposal to revoke the requirement for social care needs assessments to be carried out prior to a person’s discharge from hospital. While further guidance on hospital discharge is expected to set out the requirements of health and social care partners during the discharge process, Members expressed concern and stressed the need to have appropriate safeguards in place.

·  Communications and engagement. Members noted that the number of acronyms and medical jargon used can be confusing, and the need to adapt communications to communities to include simplified plans and terminology, focused on health outcomes as opposed to organisational structures.

·  Left Shift Blueprint. Members recognised the benefits of focus on prevention pathways to reduce patient visits to primary care settings, by focusing on the links between the entire health and care system, including investment and recognition of the third sector.

·  Anticipation of further government guidance.  With the publication of the Bill, it was noted that further guidance was still expected from the government over the coming weeks, particularly surrounding future governance arrangements linked to the ICS.

·  Maintaining a watching brief of progress.  In acknowledging the next steps and key milestones linked to the development of the ICS, it was suggested that the Scrutiny Board receives a further update during its meeting on 7th September 2021.

RECOMMENDED –

(a)  That the contents of the report, along with Members comments, be noted.

(b)  That a further update report is scheduled for the Board’s next meeting on 7^th September 2021.