Venue: Bridges Room, Civic Centre, Gateshead
Contact: Angela Frisby
Appointment of Chair
The Joint Committee has previously appointed Councillor Mary Foy (Gateshead Council) as Chair of the Joint Committee. However, due to unforeseen circumstances Councillor Foy has advised she is no longer able to continue in that position.
In view of the aforementioned, it is proposed that, subject to the approval of this Joint Committee, Councillor Lynne Caffrey (Gateshead Council) be appointed Chair of the Joint Committee in her place.
The Joint Committee had previously appointed Councillor Mary Foy (Gateshead Council) as Chair of the Joint Committee. However, due to unforeseen circumstances Councillor Foy advised she was no longer able to continue in that position.
In view of the aforementioned the Joint Committee:-
RESOLVED – That Councillor Lynne Caffrey (Gateshead Council) be appointed as
Chair of the Joint Committee.
Councillor (s) Huntley (South Tyneside Council) Simpson and Dodd (Northumberland) Bell, Grayson and Hall (North Tyneside Council)
Declarations of Interest
Councillor Taylor (Newcastle CC) declared an interest as a member of Newcastle Hospitals NHS FT.
Councillor Chequer (Sunderland CC) declared an interest as an employee of NTW NHS FT and Gateshead Health NHS FT.
The minutes of the last meeting of the Joint Committee held on 15 January 2018 are attached for approval.
The minutes of the last meeting held on 15 January 2018 were approved as a correct record.
The Chair advised that there had been a launch event in Gateshead relating to the all-party parliamentary report on Creative Health which highlights the use of arts in improving health and wellbeing. The Chair of the Group had attended the launch and Dr Pilkington had provided a presentation on the role of arts in promoting health and wellbeing.
The Chair advised that there was a summary version of the report and a full version which contains a number of case studies which might prove useful for colleagues. A link to the report would be circulated to the Joint Committee following the meeting.
Community Asset Based Approach Event – Durham
Councillor Schofield advised that she had attended the above event which had been held in Durham. Dr Pilkington had also provided a presentation for this event and one of the key issues which had come out was about how it was important to get the voluntary sector much more involved.
Joint STP OSC Work Programme
Councillor Mendeleson noted that it was proposed that the Joint Committee received a progress update on the development of integrated care systems at its June meeting and asked that as part of this update the links to Health and Wellbeing Boards are explained.
It was agreed that Workstream leads be asked to address this issue as part of the proposed update.
The Chair also noted that an NHS consultation had been launched recently in relation to contracting arrangements and she queried whether this would have an impact on the development of integrated care systems.
The Joint Committee was advised that greater clarity was being sought from NHS England on this issue.
The Chair noted that as the Joint Committee would be receiving an update on integrated care systems at its June meeting it would be helpful to have clarification on this matter for that meeting.
Report attached. NHS Leads for the Urgent and Emergency Care Workstream will attend and provide the Joint Committee with an update on the above.
Gary Collier, Senior …….. outlined the structure of the Urgent and Emergency Care Network. Gary advised that the Board has complete oversight of the work undertaken and links with all A& E Delivery Boards to make sure that the strategic direction of the Board can be delivered.
Gary also highlighted the role of the Clinical Reference Group which was made up of multiple clinicians who provide advice to make sure that the work carried out is focusing on the right pathways.
The Network also incorporates two other regional groups, the delivery team and operational groups which focus on identifying challenges which will be progressed via task and finish groups such as the ambulance turn around group which is currently looking at trying to improve arrivals and discharges.
A three year strategy had been signed off at the beginning of 2017 which had subsequently focused on the vanguard programme. However, a longer term programme was now needed focusing on a range of areas.
Gary highlighted a range of outcomes achieved as a result of the strategy so far. These included the development of the flight deck which provides an understanding of activity in A & E and ambulance service pressures; the development of mental health training; behavioural analysis as to why patients move around the system the way that they do as part of the Great North Care Record System; the development of the NHS Health Child App which sets out the types of care children might need and provides information on where services are located and which recently won an award; the development of an emergency care programme which looks at patient flows and training for care home staff on when patients need to move into hospital settings.
Gary stated that one of the key advantages of this Network is that it has an understanding of what is happening in primary care and the demands on the system. This has meant that in Newcastle and South Tees they have been able to implement a cardiology and transport service where there is a dedicated transport service.
Gary also highlighted the work to develop a Directory of Services and stated that as part of this work they were looking to see how they could get more voluntary services included in the Directory.
The Joint Committee was also provided with a high level overview of the income and cashable and non- cashable savings achieved by the Network so far. It was noted that not all of the work of the Network was quantifiable for example work around clinical assessment services which created benefits in ensuring that patients were in the right place.
Gary stated that it was considered that the Network had made some really good progress so far and he introduced Bas Sen, Chair of the Clinical Reference Group, who would highlight some of the performance metrics.
Bas stated that he would provide the Joint Committee with information on the work of the Network and how it dovetails with the STP and would ... view the full minutes text for item 21.
Pharmacy and STP
a) Stephen Blackman, Chief Officer, North of Tyne LPC, will highlight issues on behalf of the LPC.
b) Andre Yeung, Chair of Northumberland Tyne and Wear LPN, will highlight opportunities for pharmacy to support the work being progressed via the STP.
Stephen Blackman, Chief Officer, North of Tyne LPC , advised the Joint Committee that he was here to highlight the role of Pharmacy which he considered was not addressed within the STP currently.
Stephen stated that Pharmacy can support both urgent care and primary care and the key message was that Pharmacy wants to transform and be part of the integration of services at both a national and regional level.
Stephen noted that 88% of the population is within a 20 minute walk of a local pharmacy and that there are 390 pharmacies in our area which deliver important services such as Stop Smoking. Stephen stated that the area has a long history of pharmacies delivering a range of services and in some areas pharmacies help with hospital discharges.
Stephen noted that the NHS 111 Community Referral Scheme was a great success.
Stephen stated that currently there is not a national contract for pharmacy but this is the direction that pharmacy wants to move towards.
In terms of the direction of pharmacy as set out in the Five Year Forward View there were three areas of focus; supporting long term conditions; acting as the first port of call for health advice and treatment and acting as a health and wellbeing hub.
Stephen stated that they had looked at the STP priorities and how it is aligned to the vision of the Forward View and it matches. They had also looked in detail at the services already being delivered and where Pharmacy can evolve and extend.
Stephen stated that currently they have a patchwork of services across the region and nationally and they would like to look strategically at a framework of services. Stephen stated that he considered that there was great potential for Pharmacy to be integrated.
In the area of long term care there are great opportunities as there is much more that can be done to support patients to manage their medicines and conditions eg asthma care. The Community Pharmacy Referral Scheme is already providing some support in this area.
In terms of transfers of care, pharmacy is also providing some help so that discharges can take place more quickly. Stephen stated that moving forwards there were opportunities to build on the foundations of the work already taking place and relieve pressure on other areas and be more integrated with primary and urgent care.
Andre Yeung, Chair of Northumberland Tyne and Wear LPN outlined further details regarding the Community Pharmacy Referral scheme and its achievements to date and opportunities for working better together.
Andre stated that he works closely with colleagues in the Durham, Darlington and Tees Valley area so that there is coverage across the whole region.
Andre explained that in August 2014 Durham University had carried out some research which suggested that community pharmacy bucked the inverse care law and deprived communities were best served by the services it provided.
At that time less than 1% of referrals from NHS 111 were going to community pharmacy ... view the full minutes text for item 22.
Date and Time of Next Meeting
It is proposed that the next meeting of the Joint Committee be held on 25 June 2018 at 2pm, Civic Centre, Gateshead.
AGREED That the next meeting of the Joint Committee be held on 25 June 2018 at 2pm at Gateshead Civic Centre.
Interim Update - Workforce Workstream
NHS Leads for the Workforce Workstream will provide the Joint Committee with a presentation on the above.
Ian Renwick advised that he was Co-Chair of the Workforce Workstream, alongside Amanda Hulme.
Ian advised that he would be attending the Joint Committee meeting in June to provide a full update in relation to the workstream. However, at this stage Ian was able to advise that the workstream was one of three key planks in the STP. This is due to recognition that there are a number of challenges in areas such as recruitment where there are difficulties in relation to recruitment and retention of GP’s and in areas of hospital based care.
Ian stated that these challenges are borne out by recent statistics which highlighted that nationally and locally this is the first year where many more nurses have left the NHS than joined. Within the NHS there are also issues in relation to the employment of locums and agency staff. There are also huge pressures on adult social care as a result of a number of years of austerity which means that for ADASS workforce is also a key area of focus and where the challenges are similar. As a result, ADASS are developing a three year workforce strategy. The aim is to dovetail both areas of work.
Ian advised that together the NHS and ADASS are actively engaging their key workforces.
Ian advised that the Social Partnership Forum brings together NHS employers and Unions and is the route for employers to share information. Going forwards the Forum will be a mechanism for consultation on key service pathways. Ian advised that at the last meeting of the Social Partnership, representatives from local authorities also attended.
A workforce summit was also held on 24 February and the key issues challenges and opportunities highlighted were as follows:-
· Innovation and quality improvement are subordinate to daily fire fighting and crisis management
· Demand, specialisation, reducing numbers of trainees, staff retirement and the intensity of modern working practice
· A reliance on expensive locum and agency staff is making the existing configuration of services unsustainable
· The workforce is fragmented in silos and divided by organisational and professional boundaries
· Social care shares similar challenges and is under significant pressure due to Local Authority budget cuts
· There is huge untapped potential in the community and voluntary sectors – but this too requires investment and development
Group discussions were held in the context of a Cumbria / North East approach and work was carried out to identify potential quick wins. For example it was noted that a lot of back office functions are similar across sectors. Work also focused on potential new ways of working with the NHS and local government. Consideration is also being given to the greater portability of skills and how these might influence integration. In terms of recruitment and retention work is also focusing on sustainable ways of working. An example of this can be seen in the work relating to trainee GPs. Northumbria Healthcare has led on a project called Find Your Place which was a collaborative marketing campaign aimed at ... view the full minutes text for item 24.
Joint STP OSC Work Programme
The proposed provisional work programme for the Joint Committee is set out below:-
Issues to be slotted into future meetings
Empowering Communities – how it is planned to engage with and involve communities in the whole STP / ACS process.
The views of the Joint Committee are sought
The Joint Committee considered and agreed its provisional work programme as follows:-
The Joint Committee agreed that in relation to the Workforce Workstream update in June, trade union representatives should again be invited to the meeting considering this issue.
The Joint Committee also agreed that Professor Pollack should be invited to address councillors on the Joint Committee regarding her perspective on Accountable Care Organisations at a separate session, following on from a Joint Committee meeting. It was considered that this would facilitate a fuller discussion of the issues given the time constraints at meetings of the Joint Committee.
The Joint Committee also agreed to hold an additional meeting (date to be confirmed) to consider an update on how it is planned to engage with and involve communities in the whole Integrated Care System process.
The Chair also advised that, given the full agenda at today’s meeting, councillors and external parties attending the meeting could email any outstanding written questions and a response would be provided in due course.