Agenda item

This report will be discussed jointly with the Care Services PDS Committee.

This report is to follow.

The Community Services Integration report was written to set out the options for progressing the integration of adult social care assessment and care management functions with community health services, commissioned by Bromley Clinical Commissioning Group.

The report was considered jointly with the Care Services PDS Committee and the PDS Committee was asked to note and comment on the details of the report.

Health and Wellbeing Board Members were asked to have an oversight of the proposals.

The Care Services PDS Committee and Board Members were briefed concerning three possible integration options, and heard that the steering group was requesting authorisation to fully explore the integration options with Bromley Health Care (BHC) and the Bromley Clinical Commissioning Group (BCCG). If authorisation was provided, a report would then be drafted for the attention of the Executive, who would proceed to look at the options in more detail.

The Executive Director for Education, Health and Care Services outlined the three possible options that could be taken in order to work with health partners to progress towards community services integration of health and care services. These were:

1: To work with BCCG on a joint specification for community services in preparation for a joint procurement to deliver a new joint service from 1st April 2017.

 2: To pursue option 1 but also to start looking at ‘soft’ integration opportunities with Bromley Healthcare to start to align the services ready for re-procurement.

3: To pursue option 1, but to test a fully integrated service by formally transferring social care staff to the existing community provider, Bromley Health Care.

The Executive Director for Education, Health and Care Services pointed out that although processes may change, the issue that stayed the same was people, and that at this stage LBB were simply seeking approval to investigate possible integration options. 

A Member enquired what money had been set aside to take this forward. The Executive Director for Education, Health and Care Services stated that £250,000 had been earmarked for “front door services” and that a further £250,000 had been earmarked for future integration. It was confirmed that there was a clear demarcation of funding allocation, and there would be no duplication of resources.

The Chairman of the Care Services PDS Committee enquired how many other local authorities were going down this route, and if LBB were working with any other providers apart from Bromley Health Care. Members were informed that eight other local authorities had met just before Christmas to discuss similar options, and that one other local authority had already gone down this route. 

A Member expressed concerns about the difficulties involved in the local authority and the NHS sharing data with each other. The Member felt that an important issue in the integration process would be suitable housing, and the allocation of key workers.

The Executive Director for Education, Health and Care Services stated that guidance was being developed concerning the sharing of data, and that patient consent would be required. It was possible that patients could hold their own notes, and that data could be stored on hand held computers in the future. It was also acknowledged that housing was an important issue.

A Member expressed concern that the matter of data sharing may be further complicated by IT difficulties.

A Member asked for assurance that the consultation and engagement process would take proper consideration of the views of the residential and voluntary sectors. 

The CCG Chief Officer and Consultant in Public Health stated that the CCG could see the advantages of integrated services and welcomed the opportunity for further discussions. The Chief Officer informed that the Bromley Health Care Contract was due to end in March 2015, but was likely to be extended (subject to a formal consultation) until March 2017. 

Members were informed that LBB, along with BHC and the BCCG would be seeking to tender a bid into a new NHS investment fund that had been set up to support integration. Members noted that the matter of integration was integral to the objectives of the Care Act, Better Care Fund, and with local corporate objectives. It was noted that Community Services Integration was the current leadership preference for both the NHS, and for Social Services.

Members were advised that the financial implications were not clear at this stage, and that legal implications would vary, depending on which option was progressed. 

In conclusion, Members were briefed on personnel implications, which again would vary according to the option taken. If any of the options were progressed, then the council would be obligated to enter into meaningful staff and trade union consultations. 

RESOLVED:

(1) that the Care Services PDS Committee and the Health and Wellbeing Board note the Community Services Integration report

(2)  that the Care Services PDS Committee and the Health and Wellbeing Board agree in principle to the steering group being authorised to explore integration opportunities, and that the matter be referred to the Executive for subsequent analysis and decision.