The Chair of the Health and Care Executive Board will submit Document “A” which reports that the NHS England/ Improvement engagement paper ‘Integrating Care’ proposes significant change for both regional ‘Integrated Care Systems’ (ICS) and local place based partnerships for health and care ‘Integrated Care Partnerships’ (ICP).

The report sets out the main opportunities and challenges, and clarifies how this will be handled within the local place based partnership for health and care.

The views of the Board on the issues set out in Document “A” are requested. 

                                                            (James Drury – 07970 479491)

The Chair of the Health and Care Executive Board submitted Document “A” which reported that the NHS England/ Improvement engagement paper ‘Integrating Care’ proposed significant change for both regional ‘Integrated Care Systems’ (ICS) and local place based partnerships for health and care ‘Integrated Care Partnerships’ (ICP).

The report set out the main opportunities and challenges, and clarified how these would be handled within the local place based partnership for health and care.

The Chair commenced discussion on this item by noting that West Yorkshire was already well advanced in terms of such a partnership as it already had an Integrated Care System in place.

The Board was advised that the report reflected the direction of travel around existing policy and aimed to draw threads together in terms of local involvement. Five responses to the engagement paper from Bradford had been provided to NHS England by the deadline of 9 January 2021 and had shown that all partners had responded consistently as they had all endorsed the partnership approach.

The Board went on to discuss the principle of a place based approach and its connection to the principle of subsidiarity. The report outlined a place based approach in terms of access to advice; access to treatment; digital and non-digital communication and providing proactive support to the most vulnerable. It also raised the issue of governance, which would be a matter for this Board to consider.

The Executive Board Programme Director stressed that it was essential to maximise autonomy as well as demonstrating to NHS England how partners intended to work together to ensure that systems were robust.

The Chair asked for an indication of the necessary timetable to progress matters and was advised that the NHS England/ Improvement paper suggested that Integrated Care Partnerships should be fully functional by April 2022. However, some of the changes proposed would require Parliament to legislate, before they could be fully enacted. Therefore, local work would be undertaken on strengthening governance, finance and systems arrangements, in readiness for legislation. The legislation for integrating care had been included in the last Queen’s speech so it may reasonably be assumed that Parliament would be considering this over the coming year.

The Chief Executive of Bradford District Care NHS Foundation Trust commented that her response had highlighted the importance of service user and patient needs to the issue of governance and the need for their involvement in decision making as well as the importance of the on-going involvement of local councillors.

The Chief Executive of the Bradford Teaching Hospitals NHS Foundation Trust commented that there was a great deal to be optimistic about. She considered there should be an emphasis on both place and autonomy and noted that local work on both put West Yorkshire well ahead of the game.

The Chief Executive of Bradford Metropolitan District Council commented that the local ICS was one of the biggest in the country and that meant that effective arrangements in each place were therefore essential. While noting that the track record of the West Yorkshire ICS was good in this regard, she considered that robust governance needed to both reflect and address that. She also stressed the need to maintain focus on health inequalities.

The Deputy Cahir of the Board agreed with his colleagues’ comments and advised that his own response had stressed the need for strengthened communication. He had been disappointed at how the paper had been announced and considered it vital to keep a local focus and strong ownership of the project going forward.

The Executive Board Programme Director stressed that the team from the Clinical Commissioning Group would be fully embedded so that their expertise would be retained in the ICP as Dr Abbas highlighted.

The Chair considered it would be useful to compare notes with other areas and to ensure that local partnerships at Place and across the ICS remain forward thinking, contributing to the national direction of travel, rather than waiting to follow.

Board members concurred with that, stating that local leadership was very strong and that the opportunity should be taken to lead on issues. A lot of good initiatives were already on-going and should be built upon.

The Chair concluded the discussion by stressing the need to continue to make progress rather than waiting for the outcome of the consultations to be disseminated.

Resolved-

That the views of the Board on the proposed changes to integrated care systems and place-based integrated care partnerships be noted and the Board be kept updated on the progress being made.

Action:  Executive Board Programme Director