Issue - meetings

To consider a joint report of the Executive Councillors (Adult Social Care) and (Health).

The report sets out the draft business case of the integrated model of care developed through the Stockport Together process, a collaboration between the Council, Stockport Clinical Commissioning Group, Stockport NHS Foundation Trust, Pennine Care NHS Foundation Trust and Viaduct Health (representing GPs in Stockport).

The collective vision of Stockport Together is for a sustainable health & care system for the people of Stockport delivering improved health outcomes, reduced health inequalities, greater independence and a lower need for bed-based care. To achieve this it is proposed to deliver new forms of care to specific cohorts of the population through a new form of organisation constructed from the GP registered list at neighbourhood level and incentivised by a new form of commissioning. The model of care will ultimately serve the whole population.

The business cases introduced here will specifically focus on the GP registered adult population (243,000 people) and the new forms of care proposed to deliver sustainability and improved outcomes. These new forms of care are collectively known as the Integrated Service Solution.

These proposals will be considered through the appropriate governance arrangements of each of the partner organisations.

The Executive is asked to

•        approve the approach to business case approval described in Section 3 of the Business Case Introduction document

•        approve the summary clinical model described in Section 3 of the Business Case Introduction document.

•        note the overall summary financial plan as described in Section 5 of the Business Case Introduction document subject to agreement of the final Business Cases in the context of the Council budget for the year in question.

•        note and further develop the approach to Consultation in Section 6.5 of the Business Case Introduction document.

Officer contact: Andrew Webb, 0161 474 3808, Andrew.webb@stockport.gov.uk

A joint report of the Executive Councillors (Adult Social Care) and (Health) was submitted (copies of which had been circulated) inviting the Executive to consider a draft business case for the creation of the integrated model of care being developed through the Stockport Together process, a collaboration between the Council and local NHS partners. The collective vision set out in the draft business case set out a collective vision for a sustainable health and social care system for people in Stockport.

The Executive Councillor (Health) provided an overview of the business case and the background to the development of the Stockport Together programme and the financial challenges facing the health and social care economy.

The Executive Councillor (Adult Social Services) highlighted the importance of governance and accountability, the need for consultation with residents and patients, and concerns that had been raised at scrutiny committees about variability in services between the proposed neighbourhood models.

RESOLVED – That in relation to the Stockport Together Overview Design Business Case and appendices:-

·           the approach to business case approval described in Section 3 of the Business Case Introduction document be approved;

·           the summary clinical model described in Section 3 of the Business Case Introduction document be approved;

·           the overall summary financial plan as described in Section 5 of the Business Case Introduction document be noted, subject to agreement of the final Business Cases in the context of the Council budget for the year in question; and

·           the approach to Consultation in Section 6.5 of the Business Case Introduction document be noted and further developed.

To consider a report of the Corporate Director for People.

The partner organisations across Stockport (Stockport NHS Foundation Trust, NHS Stockport Clinical Commissioning Group, Pennine Care NHS Foundation Trust, Stockport Metropolitan Borough Council and Stockport’s GP federation, Viaduct Health) are working alongside GPs and voluntary organisations to develop a single strategic plan to improve health and social care services across the borough. The Scrutiny Committee is being consulted on the proposed Integrated Service Model and draft business cases that have been developed to move this project forward.

The Scrutiny Committee is invited to comment on the report.

Officer contact: Andrew Webb on 0161 474 3808 or email: andrew.webb@stockport.gov.uk

The Corporate Director for People and Senior Responsible Officer for Stockport Together submitted a report (copies of which had been circulated) providing the Scrutiny Committee with an opportunity to comment on the Business Case Introduction for the new integrated service model for health and Social Care, developed through the Stockport Together collaboration between the Council, Stockport Clinical Commissioning Group, Stockport NHS Foundation Trust, Pennine Care NHS Foundation Trust and Viaduct Health.

The Executive Councillor for Adult Social Care (Councillor Wendy Wild) also attended the meeting to answer councillors’ questions.

The following comments were made/ issues raised:-

·         Whether the structural changes being implemented would allow for a more readily adaptive approach to healthcare provision which could react more quickly to change.

·         A number of areas in the borough were the subject of significant residential development which would increase the size of the local population, and concern was expressed in relation to the ability of the existing healthcare infrastructure and provision to cope with this.

·         Within the Brinnington area there was a neighbourhood management team which worked locally to promote healthy lifestyles.  With increasing pressure on the Council’s budget, such teams were under threat and it was queried how this important work would be carried out in the future.

·         Concern was expressed in relation to the recent announcement that patients would be taken off GP lists if they had not been seen by their GP within a certain number of years.  It was commented that this would increase pressure on other areas of the NHS such as Accident and Emergency.

·         A discussion took place in relation to walk-in centres and whether these would form part of the Stockport Together programme.

RESOLVED - That the report be noted.

To consider a report of the Corporate Director for People.

The partner organisations across Stockport (Stockport NHS Foundation Trust, NHS Stockport Clinical Commissioning Group, Pennine Care NHS Foundation Trust, Stockport Metropolitan Borough Council and Stockport’s GP federation, Viaduct Health) are working alongside GPs and voluntary organisations to develop a single strategic plan to improve health and social care services across the borough. The Scrutiny Committee is being consulted on the proposed Integrated Service Model and draft business cases that have been developed to move this project forward.

The Scrutiny Committee is invited to comment on the report.

Officer contact: Andrew Webb, 0161 474 3808, Andrew.webb@stockport.gov.uk

Andrew Webb, Corporate Director for People and Senior Responsible Officer for Stockport Together submitted a report (copies of which had been circulated) providing the Scrutiny Committee with an opportunity to comment on the Business Case Introduction for the new integrated service model for health and social care, developed through the Stockport Together collaboration between the Council, Stockport Clinical Commissioning Group, Stockport NHS Foundation Trust, Pennine Care NHS Foundation Trust and Viaduct Health.

Councillor Tom McGee (Executive Councillor (Health)), Ann Barnes (Chief Executive of Stockport NHS Foundation Trust) and Dr Steve Watkins (Director of Public Health) attended the meeting to answer questions.

Andrew Webb outlined the background to the establishment of the Stockport Together Programme, and provided an overview of the models being developed in the four work streams. Partners in Stockport had also been awarded £19m from the Greater Manchester Transformation Fund to help deliver the new models and while maintaining existing services.

The Council and Clinical Commissioning Group had also entered into new joint commissioning and budget pooling arrangements that would support the development of the integrated service model.

Once agreed, the Business Plans would become the implementation plan for partners and would make them more resilient and allow them to live within their budgets. It would also ensure that people were receiving appropriate services through a ‘single service’, but this would have implications on how the separate organisations operated in the future.

Challenges remained for partners to ensure accountability for their resources and activity, as well as through individual organisation’s monitoring and inspection regimes. The process was seeking to re-write the relationships between providers, and between services and the public.

Councillors asked questions and made comments on the proposals. These included the following:-

·      What affect would the recent announcement of the award of the Transformation Fund have on the business cases? In response it was stated that the continuation of the ‘Vanguard’ process was fundamental to the planning of the models, and would be used to support change management, but most significantly to allow the dual running of new and existing services. Because of this the majority of the resources would be allocated to patient care, but the mechanisms for its use would provide sufficient flexibility to allow partners to respond to changing circumstances as the programme developed.

·      How much reliance did the programme have on the voluntary sector, and how much of that was from non-commissioned services? In response it was acknowledged that the voluntary sector was central to the Healthy Communities work stream, and that this involvement was for the most part through the Targeted Preventative Alliance. It was also commented that there would always be community led, non-commissioned activity within the community in response to perceived need, organised through the good will and altruism of the public. Within the Neighbourhood model there was an expectation that professionals within these areas would also commission services from the voluntary sector to respond to and reflect the particular needs of the community they served.

·      Concerns were expressed that previous reductions in funding to the voluntary and third sector had undermined goodwill. Concerns were also expressed about the capacity of the Targeted Preventative Alliance (TPA) to respond to increasing demand as the programme developed, in particularly whether the training provided to staff was sufficient as there was evidence from mystery shopping conducted by Healthwatch Stockport that the public were being given unhelpful and potentially misleading information when seeking advice. Further concerns were also expressed that Healthwatch was unable to get reliable and timely data from the TPA on the types of enquiries they were receiving, as had been the case with its predecessor organisation, and that a potentially useful and mutually beneficial process for identifying patterns and feedback was being lost. In response, the value of feedback from Healthwatch was acknowledge and a request made for the mystery shopping information to feed into future commissioning decisions and to respond  ...  view the full minutes text for item 5