Agenda item

Andrew Bland provided an update based on the presentation that had been circulated with the agenda on the OHSEL Integrated Care System. He stated that the CCG had written to NHS England to say that the timing of the national engagement, at Christmas/New Year 2020/21, was not ideal. A White Paper covering proposals for England had been published on 11 February 2021 – “Integration and innovation: working together to improve health and social care for all.”  An integrated care system had been in place in South East London since June 2019, but the current proposals would provide a legislative basis from 1^st April 2022, at which point the CCG would cease to exist.  The four principles underlying the changes were –

(i)  improving population health and healthcare;

(ii)  tackling unequal outcomes and access;

(iii)  enhancing productivity and value for money;

(iv)  helping the NHS to support broader social and economic development.

Much of the proposals reinforced how South East London worked already. In particular, decisions would continue to be taken as close to communities as possible, with more commissioning brough together at local level, collaboration with providers would be supported and there would be deeper collaboration with partners including local government. The White Paper covered a range of issues beyond integration.

The new ICS NHS body would have a chairman and chief executive responsible for day to day running of services, with an ICS Health and Care Partnership bringing together a wide range of partners to address health, public health and social care needs, including leading Members from each of the six boroughs. NHS providers would not see any change to their sovereignty, but would have new statutory duties to focus on the needs of local populations.

Responding to questions and concerns from members, Mr Bland stated that NHS England had also launched a consultation on competition, and there was likely to be further discussion around this. Provider trusts would be required to be part of integrated care systems and to work within peer provider collaborative arrangements. Provider trusts would be included withing the ICS Health and Care Partnership. The CCG merger had anticipated the new arrangements and enshrined joint commissioning across South East London. There was intended to be a provider framework, but it had not been issued yet.

There were no firm changes to Public Health, but there was an encouragement towards more collaborative working. Borough based boards had been operating over the past year, but the pandemic had meant that many of the spending decisions had been taken centrally. Bringing commissioners and providers together to make local decisions in public would improve accountability.

There had been a commitment to providing granular information at borough level, but Mr Bland explained the pandemic had limited this. However, the queues for services  were not formulated by borough, so patients wanting to know how long they would have to wait need to know the aggregate figures across the region for each provider. Planning services should be carried out around populations rather  than around institutions.

Asked whether the South East London Stakeholder Reference Group could be re-instated, Mr Bland commented that something similar could possibly be developed. The ICS proposals did not have any prescriptive proposals on engagement and consultation.

The proposals were likely to change, so the Joint Committee needed to continue to monitor what was proposed and how it would be applied in South East London.