Board Members will be provided with a presentation which gives a brief context on both Health and Care Partnership and the whole place approach, overview of the current infrastructure and the approach to partnership commission intentions as an enabler to new different ways of working.

Details will also be provided on a new agreement called the strategic Partnering Agreement for Bradford and Craven and how it will impact the governance of the Health and Care Partnerships.

                                                                        (Nancy O’Neill – 01274 256173)

It was reported that the presentation was being provided on behalf of the Integration and Change Board and wished to gain views, input and support form Health and Wellbeing Board for the continued development of the Health and Care Partnerships; it built on the update to the Board in October 2018 which primarily focused on “community partnerships”; the idea was to align strategies – local and national, link NHS Long Term Plan, 5 Year Forward View and imminent “Social Care Green Paper”.

Members were informed that the Bradford District and Craven was 1 of 6 places across West Yorkshire and Harrogate Health and Care Partnership.

It was reported that the focus was on 13 Community Partnerships, 4 Localities (Airedale, Wharfedale and Craven, Bradford North, Central and South); 2 Health and Care Partnerships (Airedale, Wharfedale and Craven Health and Care Partnership and Bradford Health and Care Partnership); 1 Place (Bradford District and Craven) and 1 ICS (West Yorkshire and Harrogate).

Members were informed that Health and Care Partnerships were seeking to achieve better outcomes for local people through:

·         Collaboration rather than competition

·         Strategic alignment local and national – NHS Long Term Plan, 5 Year Forward View and anticipated Green Paper

·         Reducing waste and duplication

·         Behaviours focussed on the health and care system, not individual organisations

·         Opportunities to develop new care models that span beyond organisational and service boundaries

·         Developing the workforce together across the health and care system

·         Commitment to managing NHS expenditure in aggregate across the system

The vision was:

·         People would be healthier, happier, and have access to high quality care that was clinically, operationally and financially stable

·         People would take action, and be supported to stay healthy, well and independent through their whole life and would be supported by their families and communities through prevention and early intervention with greater focus on healthy lifestyle choices and self care

·         When people needed access to care and support it would be available to them through a proactive and joined up health, social care and wellbeing service designed around their needs and as close to where they lived as possible

To improve population health through integrated health, care and support the partnerships would:

·         Deliver the Bradford District and Craven Health and Wellbeing Plan (sustainable services against a backdrop of increasing demand)

·         Achieve greater autonomy and control within community partnerships to develop and transform the community based health, care and support services

·         Share collective responsibility for the deployment and management of the resources to secure better outcomes for the population

·         Develop population health management capabilities to improve prevention and manage avoidable demand

Guiding leadership principles that shaped the work of the two partnerships included:

·         Being ambitious for the people who the partnerships serve and the staff they employed

·         Delivering for the citizens; commissioners and providers; Councils and NHS

·         Building constructive relationships with communities, groups and organisations to tackle the wide range of issues that impacted on people’s health and wellbeing

·         Doing the work once – avoiding duplication of systems, processes and waste

·         Undertook shared analysis of challenges and opportunities as the basis of taking action

·         Apply subsidiarity principles in all that was done – with work taking place at the appropriate level and as near to local as possible

Two Health and Care Partnerships Airedale, Wharfedale and Craven HCP and Bradford HCP:

·         Senior representatives from partner organisations of the local health and care system community and voluntary sector, out of hours services, primary care, care homes, clinicians, managers, public health, citizens/public and patient representatives

·         Built up from 13 community partnerships

·         Developing an improved operating framework for financial, governance and contractual working to deliver better outcomes for local people

·         Decisions should be made at the most local level possible

·         As a system the partnership had agreed to make decisions between partners in an open, transparent and collaborative way

·         Responsibility for decision taking remained with individual partner organisations and statutory bodies. Once a consensus was reached as a system, individual organisations would take decisions their internal governance processes

·         There needed to be transparency where the principles of collective decision making could not apply

Following on from the presentation Members made the following comments:

·         Which of the 13 community partnerships were working well?

·         How would you know if the partnerships were making a difference?

·         How were localities accountable in obtaining outcomes and taking and making decisions? where were decisions being made? community partnerships had a small amount of money to make a difference.

·         How were the partnerships that were not doing well being supported?

·         How were the work on the 4 Early Help hubs impacting on the work of the Community Partnerships?

·         Needed to develop a framework on which decisions could be taken by Community Partnerships and by Health and Care Partnership Boards.

·         Needed to ensure that Community Partnerships were focussed on the same objectives as the Health and Wellbeing Board and as those set out in the Health and Care Plan.

·         Progress of the Health and Care Partnerships needed to be reviewed in 12 months.

·         Objectives of the Community Partnerships needed to fit in with the joint Health and Wellbeing Strategy.

·         The Joint Health and Wellbeing Strategy had logic models - when could those be looked at to see if they were working? Needed to revisit to see how it was working.

·         Community Partnerships needed to support the work on longer life expectancy.

·         What were the timescales for funding?

In response it was reported that:

·         All the partnerships were working at different levels some were  developing services while others were still planning; new relationships were being built that were not there before; some were developing pop up clinics, carers events, local community events etc

·         Wharfedale Community Partnership were focussing on wellbeing and had undertaken a lot of work with local schools on mental health of young people

·         There was voluntary sector involvement on all partnerships which was positive and encouraging and there was lots more potential in this area

·         Neighbourhood Ward Officers were designated to each of the partnerships; their presence was very useful in that they had knowledge of the organisation they worked in and made links with community partnerships, police etc; encouraging work was taking place in partnerships.

·         The Community Partnerships had funding; the theory was that through the Community Partnerships there would be better working at community level and better control of overall resources; partnerships needed to look at how they could do things better; there was some positive work being undertaken by some partnerships and the ones that were not doing well needed supporting.

·         Community Partnerships needed to work more on prevention which would in turn help save in other areas

·         Needed to maximise the work with the 4 Early Help Hubs and Community Partnerships and how best the hubs supported the Community Partnerships

·         The benefit of working through four localities was about optimising delivery and the use of scarce resources; work such as diabetes clinics being held at a local community centre etc.  The four localities were based on aggregating the 13 Community Partnerships together.

·         Accountability of the Community Partnerships was with the Board; organisations who formed community partnerships had their own accountability; there was no regulatory requirement for the Community Partnerships. 

Resolved-

That the work carried out in the development of the Community Partnerships and Health and Care Partnership Boards be noted.