Agenda item

The Board will receive an update on the progress with the Stockport Together project, the recent visit undertaken by NHS England supporting the New Models of Care ‘Vanguard’ project, and developments at a Greater Manchester level with the integration of health & social care and the devolution of powers and resources.

Enclosed with the agenda is a briefing paper prepared by the Greater Manchester Combined Authority and NHS in Greater Manchester in relation to devolution.

Officer contact: Jonathan Vali,  0161 474 3201, jonathan.vali@stockport.gov.uk

The Corporate Director for People (Stockport Council) submitted a report (copies of which were circulated) providing the Board with an update on progress with the development of the Stockport Together, the programme of reform of the health and social care system in Stockport that brought together the Council, Clinical Commissioning Group (CCG), Stockport NHS Foundation Trust and Pennine Care NHS Foundation Trust.

A copy of a briefing pack produced by Greater Manchester NHS on progress with preparation for greater devolution was also submitted (copies of which had been circulated).

The Corporate Director highlighted the following key areas:-

·         The governance arrangements for Stockport Together had to accommodate the requirements of each partner organisation. There was a strategic Leaders Group, supported by the Integrated Care Board (ICB) that was responsible for overseeing the four workstreams.

·         A Senior Responsible Owner had been appointed to co-ordinate the activity of the ICB and to identify obstacles to system integration and make recommendations to partners.

·         A ‘deep dive’ review had been undertaken of the four Stockport Together workstreams, and recommendations to enhance this activity had been made to the Leaders Group. One key recommendation was to begin to roll-out the integrated service model within the Cheadle & Bramhall Locality. Building on the lessons of the Marple & Werneth Hub and drawing on the ‘Vanguard’ programme it was proposed to accelerate the implementation of the new hub for the end of October with a view to full implementation across Stockport by the end of the 2015/16 financial year.

·         Challenges remained in having two different models of care being commissioned and delivered simultaneously, including resourcing and clinical governance.

·         Discussions were ongoing between the Council and CCG in relation to the future arrangements for the pooling of resources to further support integrated working.

·         Stockport Together partners were also developing their Locality Plan that would feed into the Greater Manchester-wide plan for health and social care integration and reform, linked to the devolution agenda.

·         The recent announcements by the Chancellor of the Exchequer about in-year budget reductions could potentially pose significant challenges to the Stockport Together Programme as prevention formed a key element of the programme.

The Service Director (Adult Social Care), (Stockport Council) reported on the outcome of a recent visit by the NHS England ‘Vanguard’ Team. The ‘Vanguard’ Programme was supporting innovative approaches to developing new models of care. The Team had been impressed by the ambition shown by partners in Stockport but had cautioned on the need to ensure deliverability of local plans. It was hoped that the Vanguard input would provide greater impetus to the development of the integrated hubs. Particular interest had been shown in the local approach to People Powered Health.

The Chief Operating Officer (Stockport CCG) reported that work was ongoing with the development of detailed designs and plans for service models. ICT and Organisational Development were key enabler projects cutting across all the Stockport Together workstreams. Ensuring an appropriate IT solution was essential to the success of integrated care, but ensuring an appropriately skilled workforce was needed to ensure that staff worked differently and more effectively.

Announcements had been made on 7 day working and the development of primary care services as part of plans being developed at Greater Manchester level, although these plans were more advanced within the NHS context than within social care.

The Director of Public Health reported that the Greater Manchester Devolution agreement included an ambitious public health programme that would complement other Greater Manchester projects such as the work in developing a Dementia Friendly City and a Healthy Ageing City, and Work and Health programmes. These projects were essential to reducing demand on health and social care services in the longer-term. There were also a number ‘quick win’ projects planned relating to tackling diabetes, hypertension, health checks and physical activity.

The following additional comments were made/ issues raised:-

·         There was a balance between developing models of care for smaller local populations and the need to commission services for larger population clusters and on a different basis. It was suggested that area committee should be informed of the development of the locality hubs.

·         It was queried whether the view of the Vanguard Team that Stockport’s plan were ambitious was an indication that they were unachievable. In response it was stated that the Stockport Together approach to a citizen’s wellbeing, their needs identified via the JSNA, and supported in part by People Powered Health was the most advanced in the country. There remained significant risks to address and manage including those related to clinical governance and financial risks. The involvement with Vanguard would provide support to address these issues and to push the boundaries of what was possible within existing NHS commissioning frameworks.

·         A question was asked about how the proposals for integrated care would be effected by residents who choose to access NHS services outside of the borough, and whether the joint arrangements would be in place with these other providers. In response it was stated that this issue was recognised and would need further work, particularly given the differing responsibilities of each partner.

The Chair highlighted some key issues for further consideration:-

·         The complexities of the governance of the Stockport Together programme.

·         The role and importance of the JSNA in the development of service models.

·         Workforce capacity and organisational development.

·         Engagement with the wider public, balancing the need for public input without creating a ‘referendum’ style consultation.

·         The need to map the connections between Stockport Together and other reform programmes and the need for an indicative timescale.

RESOLVED – (1) That the report be noted.

(2) That the Democratic Services Manager be requested to circulate a copy of the Healthwatch Stockport report ‘What would a good experience of a health or social care service look like to you: Stockport JSNA Public Opinion’ and for this to be included on the agenda for the next meeting.