Agenda item

Report CSD19178

The Board considered a report providing an update on One Bromley. The report focussed on the context and development of One Bromley – opportunities of an integrated approach across health and social care; the current status of the Bromley place based Local Care Partnership (LCP) system; and outlined the key programmes, initiatives and enabler work streams including progress and next steps.

One Bromley would enable partners and services in Bromley to work as a single system to deliver integrated care. The strategic aims of One Bromley were to improve the health and wellbeing of the Bromley population. Providers and commissioners (CCG and LBB) from sovereign boards committed to working together to develop a single LCP, delivering on joint priorities. One Bromley would bring together partners as a single system coordinating care for the most at-risk and vulnerable individuals.

Achievements to date included a 26% reduction in urgent hospital admissions and a 22% reduction in elected inpatient admissions, which made a difference to services and cost savings for other departments. Similar work had been undertaken for patients with diabetes and respiratory disease, and the end of life service had been extended to patients with chronic diseases. Eight Primary Care Networks (PCNs), including all practices in Bromley, had been established to encourage them to work together to increase resilience in relation to GP and nurse shortages. Currently 24 practices in Bromley were providing online consultations, with another 10 practices pending.

A review of the Transfer of Care Bureau had also been completed, and there was a programme of work currently in place to improve the efficiency of the service it delivered to those patients requiring a supported discharge. There had been a joint approach to improving the health and wellbeing of patients in care and nursing homes, through the establishment of a special general practice exclusively for this population. To date, 31 care homes had mobilised to the Bromleag Care Homes practice contract.

The new Orpington Health and Wellbeing Centre had opened in September 2019. It was located in Orpington town centre, in a new building on the site of the old Police Station. The Managing Director – Bromley CCG advised that a single practice, Knoll Medical Practice, was located in the Centre. However following the closure of the Chaterhouse Surgery, the number of patients registered with Knoll Medical Practice had increased significantly. Other services would be gradually mobilised, including phlebotomy and a MRI suite, and it may provide a hub for an out of hours service. The Head of Service for Early Intervention and Family Support noted that she would be happy for her staff to help publicise and direct people to the facilities offered, and asked if there may be a way for the service to have a presence at the Centre. It was agreed that this would be discussed further with the Managing Director – Bromley CCG, following the meeting.

A Member highlighted that following the closure of the Charterhouse Surgery, there was a risk there some vulnerable patients may not have re-registered with another practice, and asked what had been done to address this issue. The Managing Director – Bromley CCG informed the Board that Bromley Well and Bromley Healthcare had helped identify and signpost the most vulnerable patients to register at another GP practice. There were around 1,500 other non-vulnerable patients who had not yet re-registered. These individuals would be written to again, and if no response was received, they would be allocated to another GP practice.

In relation to the development of a Bromley Health and Wellbeing Centre, the One Bromley Programme Director – Integrated Care was currently working with LBB colleagues, and money to support this project had been identified.

A new programme of work was also being established that would develop into several potential enabler work steams, broadly covering topics which included data sharing and business intelligence.

In response to a question from the Chairman, the Managing Director – Bromley CCG advised the Board that proposal relating to further integration had been provided to the Council’s Executive and Joint Health Overview and Scrutiny Committee. The merger of six CCG’s to create a single South East London CCG, had been approved and a staff consultation had been launched. In Bromley, a Place Based Board was proposed, which would be an oversight group which would look at the services to be commissioned and the strategies to be adopted. The Managing Director – Bromley CCG noted that as part of these changes, the governance and frequency of meetings would be considered.

It was expected that the single South East London CCG would delegate a budget to GP practices and others services to be delivered in the community. Agreement had been requested for a single Head of Commissioning, who would report directly to the LBB Director for Adult Social Care and Place Based Director for Health (CCG). Discussions in relation to the Place Based Board had started, however Terms of Reference were yet to be agreed.

RESOLVED that the update be noted.