Venue: Civic Centre Gateshead
Contact: Angela Frisby Tel 0191 4332138
Councillor(s): Hetherington and Huntley (South Tyneside Council), Simpson (Northumberland) and Stephenson (Durham), Thirlaway, Clark and Craven (North Tyneside)
The minutes of the meeting of the Joint Committee held on 24 September 2018 are attached for approval.
The minutes of the meeting of the Joint Committee held on 24 September 2018 were approved as a correct record.
Declarations of Interest
Councillor Taylor (Newcastle CC) declared an interest as an employee of Newcastle Hospitals Foundation Trust.
Councillor Mendelson (Newcastle CC) declared an interest as a member of NTW NHS FT Council of Governors.
Matters Arising from the Minutes
Request that NEAS attend a future meeting of the Joint Committee to provide an update on the work of NEAS and the challenges it is facing.
It was confirmed that representatives of NEAS would attend the next meeting on 21 Jan 2019 to provide a presentation on the above.
Data re Impact of Brexit
Request that Dr Groen attend future meeting of OSC to provide information on data related to specific worker groups and groups other than EU nationals/ information on staff due to retire within those groups plus areas of risk to staffing levels in particular specialities (other than cardiovascular surgery which has already been highlighted).
Dr Groen confirmed he would attend the meeting on 21 Jan 2019 and provide this additional information as part of the proposed update on Workforce scheduled for that meeting.
Workforce Communications Update
Councillor Flynn had queried how proposals to move clinicians around the region could be communicated so that it would not seem a negative move as there may be concerns that such moves might destabilise provision in a particular area.
The Committee was informed that there is no one perfect way to communicate and it was recognised that the large and diverse workforces will have different communications needs and preferences. There was a need to ensure that the narrative and communications relating to the wider health and care challenges, opportunities and changes were as good as they could be for our local populations and workforces.
The Committee was advised that where there is a need to move clinicians or any staff, it would be important to be clear about the reasons for this and what it was hoped and expected that the changes in working practices would achieve in terms of delivery of services and benefits to patients, always taking account of the whole picture and the views of clinicians and those working in services. Where there is a need to formally consult, then this will take place with engagement with relevant trade unions.
Councillor Flynn had also heard that individuals wishing to train as paramedics had a year training but then had to do two years unpaid work experience and he had queried how this would encourage individuals into the workforce.
The Committee was informed that there is currently a two - year diploma course, which employees of NEAS can undertake while continue to work with NEAS. Alternatively, for people outside of NEAS considering a career in the ambulance service, the route now is to undertake a three-year degree course as a university student and this is the same pathway as nurses.
The Vice Chair, Councillor Taylor had previously highlighted IT as the biggest barrier to cross working over NHS sites but acknowledged that work on the Great North Care Record might assist with this and had asked for further information on this for the Committee.
The Committee was advised that in the last few weeks we have appointed Graham Evans as the Chief Digital Officer for our STP ... view the full minutes text for item 52.
Mental Health Workstream - Progress Update
Gail Kay, Mental Health Programme Lead will provide the Joint Committee with a presentation on this issue.
Gail Kay, Mental Health Programme Lead, provided the Committee with a progress update on the work of the mental health workstream.
The Committee was informed that an overarching aim of the Integrated Care System covering NE and Cumbria was the development of more integrated preventative and early intervention services with a view to
· Reducing the risk of ill health
· Developing individual and community resilience
· Improving the health and wellbeing of the population
· Supporting a financially sustainable system.
The mental health workstream is one of the delivery programmes in place working to deliver the above and its purpose is to:-
· Ensure that mental health is fully integrated across the ‘whole system’ in order to progress the delivery of ‘No health without mental health’ (Department of Health, 2011)
· Support the service transformation process through communication, information, sharing best practice, reducing duplication and progressing system wide engagement
· Inform locality arrangements to progress Integrated Care Systems (ICS) aligned to an informed needs profile
· Understand variation and promote innovation and evidence - based practice to address gaps
The Committee was advised that work was taking place to try and understand what work was taking place across NE and Cumbria and other ICS which was making a difference and an event had taken place in April 2018 to consider what actions needed to be progressed, which had good representation from across the patch and a review of progress had subsequently been carried out in October.
The Committee was advised that the mental health work stream does not have a surveillance or performance monitoring role and does not have statutory authority, this remains with provider organisations and commissioners.
The Committee was advised that following priorities for the mental health workstream have been collectively agreed across NE and North Cumbria:-
· Child health
· Suicide zero ambition
· Acute optimisation (Optimising Acute Services)
· Long term conditions and medically unexplained symptoms
· Older people
· Physical health of people with SMI
The Committee was also provided with a progress update on each of the priority areas and information on the prevalence of mental health conditions/ depression/ percentages of mental health patients with care plans/ premature mortality rates for individuals with serious mental illness/ suicide rates as recorded across NE and Cumbria CCGs.
The Committee was informed that the NE and Cumbria ICS was one of the most complex emerging ICS in the country as many areas were classed as countryside but had an industrial / mining heritage. In addition, more than 20% of the population in the patch was over 65 and there was negative population growth in some areas.
The Committee was advised that population differences are important in terms of informing service need and the population data had been broken down by local authority. The North East authorities tended to be quite similar in terms of age structure, high deprivation and the % of population from ethnic minorities (lower than England) although Newcastle has a younger (median age = 33) and more ethnically diverse population. The more rural areas (e.g. ... view the full minutes text for item 53.
Update on Communications and Engagement / Empowering Communities
Mary Bewley, Head of Communications and Engagement, North East Commissioning Support will provide the Joint Committee with a verbal update on this issue.
Mary Bewley, Head of Communications and Engagement, North East Commissioning Support provided an update to the Committee.
Mary advised that since the last update to the Committee she had been liaising with Healthwatch organisations across the patch with a view to facilitating their involvement in future engagement work.
Mary advised that she had talked to Healthwatch organisations about seeking expressions of interest for one of them to act as a Facilitation Lead to start a dialogue in relation to the ICS as it progresses. Mary advised that she was now about to issue the formal document seeking those expressions of interest.
Mary also advised that there would be four events early in the new year which would lead up to a regional summit event to engage local authorities and the third sector regarding the key priorities for the ICS with a view to creating a Strategy for the ICS.
Healthwatch organisations from across the patch had been invited to the events.
In terms of work to link up resources relating to the patient and public voice and those who work in patient experience roles they were also looking to set up a Network to take this forward. A further development was that funding had been gained for CCG lay members and Trust non-executive directors to be involved in patient voice.Mary advised that the aim was to link architecture that might support some regional work. Mary indicated that a long-term plan is emerging nationally and the expectation was that engagement around that plan would then need to be put in the context of the NE and Cumbria. Mary stated that she would be liaising with NHS England around this in the new year.
The prevention work programme is now looking at developing a public facing campaign to support engagement around ICS messages.
Mary explained that in relation to the aspirant Integrated Care System there was a need to be clearer about priorities so that a Strategy could be in place for April 2019.
Mary stated that she would be issuing another bulletin shortly.
Councillor Green noted the reference to prevention and considered that this should be top of the agenda for the ICS and look at health and wellbeing and prevention.
Mary agreed and considered that this was at the root of other issues.
Councillor Taylor stated that her concern was that she did not know what a Shadow ICS involved and who would be making decisions. Councillor Taylor considered therefore that deciding what to do therefore appeared to be the wrong way round.
The Chair noted that this was an issue for Alan Foster when he came to update the Committee on the development of the ICS.
Councillor Spillard stated that she was pleased to note the engagement work with Healthwatch. Councillor Spillard felt that this was the one of the achievements of this Committee so far. However, Councillor Spillard stated that she was horrified that the priorities for the ICS were still not known given that work ... view the full minutes text for item 54.
Draft Work Programme for 2018 - 19
The Committee considered and agreed its provisional work programme as follows:-
Issue to slot in
KONP NE - Petition and Card
Mr John Whalley, Co-ordinator, Keep Our NHS Public (KONP) North East, will present the following two items to the Joint Committee:-
A petition from people across the region outlining the requirement that any future changes to health services in the NE are designed to maximise health and wellbeing and are not financially driven.
A large scale card which contains hundreds of messages from people across the NE, which sets out the wishes of individuals regarding healthcare at the time of the NHS 70 birthday.
Mr John Whalley, Co-ordinator, Keep Our NHS Public (KONP) North East presented the following two items to the Committee:-
· A petition from people across the region outlining the requirement that any future changes to health services in the NE are designed to maximise health and wellbeing and are not financially driven.
· A large-scale card which contains hundreds of messages from people across the NE, which sets out the wishes of individuals regarding healthcare at the time of the NHS 70 birthday.
Mr Whalley stated that he wished to thank councillors in the North East for supporting a fully funded and publicly provided NHS. Mr Whalley advised that he had worked full time in the NHS for thirty years as a nurse. Mr Whalley advised he was here with his colleague Dr Helen Groom a GP.
Mr Whalley stated that it was a special year for the NHS as it was 70 years old and the fact that it provides healthcare on the basis of need was a cause for celebration.
There had been a number of events across the NE to celebrate the hard work of all those NHS staff who go the extra mile and KONP had stepped up its campaign against the closure of services and cuts in the region and the work of the group could be seen on its website.
Mr Whalley stated that KONP had wished to present the petition to this Committee has it has a mandate to scrutinise the NHS which is publicly funded and based on need. The petition had been signed by over 1,200 people at various campaign events throughout the year.
Mr Whalley stated that he called upon both CCGs and local authorities to be transparent about future plans
Dr Groom stated that she was concerned that CCGs were being forced to develop a system which would eventually lead to further privatisation and she believed the underfunding of the NHS was a political decision which should be rejected. Dr Groom stated that she believed that there was a dismantling and privatisation of the NHS taking place under the cover of integration. Dr Groom stated that local authorities are integrated care systems and are part of the system and she noted the cuts that local authorities had been forced to make. Dr Groom stated that she believed that what would really reduce health inequalities was work such as reducing income inequalities and providing decent homes.
Dr Groom noted that there were many councils who had voted against integrated care systems / accountable care systems.
Dr Groom thanked the Committee for accepting the card and petition and advised that KONP would be emailing all councils setting out their concerns regarding the Integrated Care Programme.
The Chair stated that a front page of the petition would be forwarded to all Councils and it would then be a matter for them as to how they considered the petition.