Agenda and minutes

To note any apologies from Members of the Board.

 Apologies were received from Dr Andrew Johnson.

Board Members to declare and interest which they have in any of the items to be considered as part of the agenda.

There were no declarations of interest on this occasion.

To approve the minutes of the meeting held on 6 April 2017 as a correct record.

The minutes of the meeting held on 6 April 2017 were agreed as a correct record.

To consider and respond to any questions submitted by Members of the Public related to the remit of the Health and Care Integrated Commissioning Board no later than 24 hours prior to the meeting.

Questions should be submitted in writing to laura.latham1@nhs.net

*Any questions requiring detailed response will be shared with the Board and responded to following the meeting in writing.

There were none received on this occasion.

To receive an update from the Director of Integrated Commissioning including:

·         Performance – Discharge Board Proposal and Adult Social Care Strategy Proposal

·         Section 75

·         Scope of 17/18 Pooled Budget

·         Value of 17/18 Pooled Budget

G Mullins provided an overview of a number of matters related to integrated commissioning which had been the subject of significant work in recent months. In particular she noted the continued focus on urgent care performance and the establishment of a Discharge Board.

*Councillor Wild joined the meeting.

The Board considered the proposal regarding the creation of a strategy for adult social care to bring together existing strands of work and to focus on social care service development, current and future demand and capacity, quality improvement of care home / home care capacity, approach to management of transitions from children’s to adult services, workforce development needs and future approach to commissioning. She noted the importance of ensuring the strategy was fully aligned to the Stockport Together Transformation and Business Cases. It was confirmed that the development of a strategy in Stockport would be fully aligned to work being undertaken at a Greater Manchester Level.

M Cullen confirmed that it was proposed that the Pooled Budget for 17/18 would remain broadly the same with only minor amendments being proposed. The Section 75 Agreement was being refined to reflect the current position on the integration journey.

In response to questioning, G Mullins confirmed that the Discharge Board required strong focus and governance and the right representation from partner organisations to ensure business was managed effectively at the required pace and actions implemented.

Resolved: That the Health and Care Integrated Commissioning Board note the updates contained within the report and agree with pulling together strategic approach to adult social care issues, across partnership taking into account Greater Manchester perspective.

To consider a report detailing

·         2016/17 Provisional Outturn

M Cullen presented the provisional financial position at the end of 2016/17 for the pooled budget in place as part of the Section 75 Agreement in place between the Joint Commissioners. He confirmed that the provisional year end position included a deficit of £1.198million and highlighted the specific areas where a deficit or surplus had been reported. He noted in particular that there had been a £257k non-recurrent increase from the Council position on the basis of one off severance costs relating to the public health service.

He confirmed that as per the terms of the Section 75 Agreement, both organisations will include as part of organisational accounts for the 2016/17 year a pooled budget statement as aligned to the approach to risk agreed by Commissioners.

Resolved: That the Heath and Care Integrated Commissioning Board note the outturn position of £1.198m deficit.

To consider an update on the development of the Outcomes Framework

The Board considered an update report from Mark Chidgey on the approach to segmentation in Stockport and the development of the Outcomes Framework at Phase One and outlined the proposed Phase 2 developments. He noted the whole population approach which had been undertaken, including the role of Expert Reference Groups, in developing the detailed clinical and personal measures.

He noted the focus in shifting the Commissioning approach and the delivery of integrated services from one focused on acitivty to one focussed on patient outcomes. The next steps were outlined as finalisation of the clinical measures and development of an approach to monitoring and testing the delivery of outcomes in real time supported with a proposed IT platform. The Board was informed of the significant engagement work which had been undertaken to date and would continue to take place.

The following elements were highlighted in detail by the Board:

•      The importance of ensuring that the Stockport and Greater Manchester approaches to commissioning for outcomes were aligned and Stockport continued proactive engagement and communication with Greater Manchester Health and Social Care Partnership.

•      Recognising that, where risks exist, the mitigations which are in place to ensure they are managed effectively.

•      Acknowledgement of where there are differences between the Stockport strategy and its implementation and the wider Greater Manchester approach.

•      Consideration by the Expert Reference Groups that obesity not be defined as a long term condition within the definition of outcomes framework measures.

•      The importance of developing and managing the value chain as linked to the delivery of the model of care.

•      The link between the segmentation included within the Outcomes Framework and the link to NICE guidance.

•      The need to ensure continued alignment of the development of the Outcomes Framework to the wider Stockport Together Programme and the importance of balancing pace of delivery and the innovative nature of Vanguard work

J Crombleholme acknowledged the progress which had been made in this area of work and its role as fundamental component of the future approach to commissioning in Stockport. The Board confirmed it wished to be kept appraised of continued progress and the development of the framework as part of the implementation of the new care models.

In response to questioning, M Chidgey confirmed that the level of payment attached to the delivery of the outcomes measures within the Framework had to be of a suitable level to incentivise provider organisations to deliver. He explained that there was no clear Greater Manchester view on this at the current time but that Stockport were actively engaged in the ongoing discussions.

Resolved: That the Health and Care Integrated Commissioning Board:

1. Re-confirms that an Outcomes Framework approach is core to the future model of commissioning.

2. Confirms that the work completed to date as Phase 1 progresses the Stockport system towards that goal.

3. Endorses the progression to towards Phase 2 as outlined in the report.

4. Agrees that continued alignment of approaches to Outcomes Framework Development between Stockport and Greater Manchester be proactively undertaken and where differences of strategy emerge, they are fully considered in the light of benefits to the Stockport population.

5. Requests to be kept appraised of the continued development of the Outcomes Framework.

The next meeting of the Health and Care Integrated Commissioning Board will take place on 18 July 2017.

The next meeting of the Health and Care Integrated Commissioning Board will take place on 18 July 2017