Agenda item

This will be a Summary Paper outlining the current position.

This report was written for the Health and Wellbeing Board, by Mary Currie, the Interim Director of Transformation for Bromley CCG and was brought to the HWB to provide an update on the proposed direction of travel for the plans concerning Out of Hospital Care in Bromley. The update at the meeting was provided by Dr Bhan.

The Chairman opened the item by expressing concern that a brake had been applied to the process. Dr Bhan responded that this was not the case, and that in her view, an accelerator was being applied rather than a brake. 

The Board heard that the CCG had been engaging with key stakeholders and local providers to develop a draft Programme Implementation Plan (PIP) aimed at developing a more consistent quality of care for Bromley residents. To this end, a GP provider event had been held on the 19^th January 2016 which further engaged GP’s and other providers with the aim of co-designing and prioritising key elements of the work. The Board were informed that an extra-ordinary meeting of the CCG Membership Body was being planned for February 2016. The aim of this was to further engage with the membership, prior to final PIP approval being sought at the March 2016 CCG Governing Body meeting. A draft PIP was attached as an appendix to the main report.

The draft PIP document focused on the following areas:

·  Governance

·  System Readiness

·  Service Redesign

·  New Service Innovation

·  Engagement with Key Stakeholders

·  Services for Children and Young People 

The Board noted the draft PIP, and that going forward the objective was to develop a model that was more focused on prevention and the proactive management of patients with growing health needs. The report outlined a five point strategy for redefining and fine tuning the PIP. The Board noted the varied work streams on the draft PIP, and Dr Bhan assured the Board that support would be provided to all providers, including third sector organisations. The revision of GP contracts (next item on the agenda) was part of the development process. 

A Carers’ Strategy was being developed. There would also be an attempt to reorganise acute and community services. It was envisaged that Geriatric Teams would be located in hospitals and the wider community. The aim was to improve services around patients to enhance their Health and Social Care experience. It was also hoped to reduce hospital admissions.

The Chairman asked if a timescale was in place for the establishment of a pilot. He also asked if a single Integrated Care Network (ICN) would be set up initially. Dr Bhan responded that there was not a definite timescale. She was not in favour of commencing with a single ICN in isolation. She felt that it would be better if all of the ICNs started working at the same time, and that this would avoid confusion and the allocation of resources to just one geographical area.  Structures would be put in place during 2016/17. Dr Bhan continued that many of the various strategies took time to develop properly, and that this was a gradual process; however she also expressed the view that progress was being made quickly.

The Chairman requested that a Gantt chart be provided so that members of the HWB would get a clearer understanding of the project schedule.  Dr Bhan agreed to provide the Gantt chart along with some explanatory sentences.  Dr Parson commented that a layered approach was best as contracts needed revising, and that levers were required. He stated that a meeting was being convened shortly with CCG members with the aim of endorsing the improvement plan. Mr John informed the Board that LBB, the CCG and IMPOWER were all working together to think about what ICNs were going to look like. Four days of meetings had been arranged with IMPOWER in the near future to take stock of the current position, and how to move forward. 

The Board noted the proposed Governance Structure for the Out of Hospital Strategy which would be headed by the LBB Executive, the Joint Integrated Commissioning Executive (JICE) and the NHS Bromley CCG Clinical Executive.

The Chairman thanked Dr Bhan for her update, and noted that much good work was in progress.

RESOLVED:

(1) that a Gantt chart be provided to members of the HWB so that members would benefit from a clearer understanding of the project schedule 

(2) that the Health and Wellbeing Board note the report, the proposed direction of travel, and the proposed governance arrangements to support the programme.