Agenda and minutes

In line with its terms of reference, the Joint Committee is asked to appoint a Chair for the 2024/25 municipal year.

In line with its terms of reference, the Joint Committee agreed to appoint Councillor Jill Green of Gateshead Council as the Chair for the 2024-25 municipal year.

In line with its terms of reference, the Joint Committee is asked to appoint a Vice Chair for the 2024/25 municipal year.

In line with its terms of reference, the Joint Committee agreed to appoint Councillor Wendy Taylor of Newcastle City Council as Vice Chair for the 2024-25 municipal year.

The Joint Committee is asked to note the attached Protocol/Terms of Reference.

The Joint Committee agreed to note the terms of reference.

To agree the minutes of the last meeting held on 18 March 2024.

RESOLVED the minutes of the meeting held on 18 March 2024 be agreed subject to the following amended in relation to Access to Pharmacy Services:

In the sentence ‘Relaunching the free blood pressure checks will help to identify the 5.5 million people with undiagnosed blood pressure that are at risk of heart attack and stroke’ replace the word undiagnosed with high.

Committee members to declare an interest in any particular agenda item where applicable.

The following declaration of interests were made:

Councillor J Shaw – CNTW Governor

Councillor J McCabe – wife employed by the NHS as a Theatre Nurse Specialist

Councillor A Herridge – employee of Newcastle upon Tyne Hospitals NHS Foundation Trust

The Joint Committee will receive an update presentation from Peter Rooney, Director of Transformation, Mental Health, Learning Disability, Neurodiversity and Wider Determinants, NENC ICB

Peter Rooney, Director of Transformation, Mental Health, Learning Disability, Neurodiversity and Wider Determinants, NENC ICB, was in attendance to provide the Committee with an update on Children and Young People’s Emotional Mental Health and Wellbeing.

Committee members were informed of the definitions in place for ‘mental health’, ‘learning disability’ and ‘neurodiversity’.  It was noted that mental health and learning disability are not the same thing but that people with learning difficulties often have poorer mental health.  It was acknowledged that children’s brains are very different to that of adults, which impacts on issues such as sleeping patterns.  It was also recognised that there is a link between deprivation and mental health.

Members were informed of the I-Thrive model, which centres around prevention and promotion, and a graduated level of support from getting advice, getting help, getting more help and getting risk support.

In relation to key priorities for children and young people’s emotional mental health and wellbeing, these were identified as:

-        Neurodevelopmental: needs led model and diagnostic capacity

-        Mental Health School Teams

-        Access to Mental Health Support

-        Perinatal and Maternal Mental Health Transformation

-        Trauma informed approaches and complex needs

The Joint Committee was informed that referral waiting times for mental health and neurodiversity services were not where anyone would like them to be.  It was noted that referrals for children and young people to these services have increased three fold between 2019 and 2024.  The biggest referral increase was for neurodevelopmental pathways.  Around 75% of all children and young people on the waiting list is for these services.  It was highlighted that referral times vary across North East and North Cumbria but that waiting times are much longer for neurodevelopmental pathways.  Data was presented that illustrated that in April 2019 there had been 105 referrals for neurodevelopmental pathways, with 267 children and young people on the waiting list.  In contrast, in March 2024 there were 1,262 referrals and 16,327 children and young people on the waiting list.  It was acknowledged that no service would be able to cope with this level of increased demand.

It was noted that there were a number of societal reasons for the increase in referrals for neurodevelopmental pathways and that significant additional investment would take place in 2024/25 in relation to neurodevelopmental diagnosis.  Investments had already been made with school support teams being put in place.  It was noted that some families choose to use private providers in order to speed up the assessment and diagnosis process.  This could however lead to frustration if seeking any medication, as families would need then to through NHS services for assessment for the prescription of the medication, and they would need to join the waiting list for this to happen.

It was agreed to note the information presented.

The Joint Committee will receive a presentation from Wendy Adams, Workforce Project Lead, Skills for Care and Steph Downey, Service Director, Gateshead Council/NE ADASS Workforce Representative.

Wendy Adams, Workforce Project Lead at Skills for Care, and Steph Downey, Service Director, Gateshead Council, and both representatives the Association of Directors of Adult Social Care (Adass) were in attendance to provide the Joint Committee with an update on the Social Care Workforce.  Adass is a membership organisation for those working in adult social care, raising awareness of the benefits social care can bring to individuals and communities.

Members were presented with data which set out the size of the social care sector in the Northeast, with the number of total posts in each Local Authority area and the number of CQC regulated establishments in each area.  It was noted that the vacancy rate in the social care workforce and the turnover rate were challenges that the sector face, with recruitment historically being a challenge.  On average 70% of social care provider recruitment is an individual coming from another social care provider.  It was highlighted that young people need to be encouraged to see social care as a career opportunity and for more males to be recruited into the sector.

In relation to addressing recruitment challenges, it was noted that 112 small grant payments of £2500 have been provided to CQC registered providers to support the development of international recruitment.  Across the Northeast region, ‘Cultural Competence’ training has been delivered to increase understanding within teams of working with more culturally diverse colleagues.  Whilst international recruitment has an important role to play in the sector, it was noted that it was not the answer to all challenges and that regional and national recruitment also needed to be looked at.

The Joint Committee was informed that to support regional social care recruitment and retention, a set of principles was established for each Local Authority to have a ‘Care Academy’ to support the workforce, though it was recognised that this would differ in each local authority area.  Work had also been done in exploring the implications and embedding of the DHSC Social Care Workforce Pathways and new Care Certificate qualification to provide a career pathway for social care.

Information was provided in relation to the Social Work and Occupational Therapy Degree Apprenticeship that was launched in 2019 and co-produced with the University of Sunderland.  The scheme was initially focused on upskilling the internal workforce, enabling people to stay in employment and qualify as a social worker or occupational therapist.  The Apprenticeship Scheme has delivered additional social work training capacity, with no drop off in the number of social workers training via other routes.  All local authorities across the integrated care provider area now have some level of apprenticeship offer.  Within the first cohort undertaking the apprenticeship degree, all participants achieved either a 1^st or 2:1.  Whilst the proof of success will be in the apprentices longer term career paths, evidence to date suggests that apprentices adapt to the social work role with greater ease than their counterparts who trained via a different route.

The apprentice model has had a positive impact  ...  view the full minutes text for item 7.

The Joint Committee will receive a presentation from Professor Graham Evans, Chief Digital and Infrastructure Officer, NENC ICB, on the development of the Infrastructure Strategy.

The Joint Committee received a presentation from Graham Evans, Chief Infrastructure and Digital and Infrastructure Officer, NENC ICB, in relation to the development of the Infrastructure Strategy.  The Strategy was currently in draft form, to be signed off by the ICB Board on 30^th July 2024.

The Committee was informed that the vision for the strategy was ‘to enable the delivery of integrated, safe, sustainable and quality driven healthcare services, maximising the use of our collective resources and data, continually innovating, transforming and supporting the people and population we serve’. 

The strategy was shaped by 8 core infrastructure principles:

-        Collaboration - working together and sharing good practise to optimise infrastructure utilisation

-        Integration - infrastructure responding and supporting our evolving health and care pathways

-        Future Proofed -  making informed, evidenced based infrastructure decisions

-        Delivering Quality - optimising management and maintenance to make the best use of our infrastructure resource is through consistent standards, working practises and risk management

-        Innovation - maximising the use of digital, data and technology across our infrastructure and in service delivery

-        Maximising Funding Opportunities - proactively making the case for infrastructure investment to transform health and care services

-        Sustainable - implementing our vision to be the greenest ICS

-        Attracting and retaining our workforce - using our vision, ways of working and culture to attract, retain and grow an inspired and flexible workforce

In terms of the delivery of the strategy, it was noted that being strategic and decisive in planning and decision making was key to delivery and that this could only be achieved by working together as a system.  The following tools had been identified to support the delivery of the strategy:

-        Collaborate – across the system with all stakeholders

-        Partnerships – growing and expanding partnerships

-        Innovate – take advantage of digital technology and new ways of delivering care

-        Standardisation – one system approach across all infrastructure management, decision making and investment

-        Workforce – attract and retain a motivated and flexible workforce

-        Core, Flex & Tail – categorising assets based on health and care needs

-        Investment – using data and evidence to attract and maximise funding

-        Places – creating the right network of local infrastructure

-        Leadership and Governance – right resources, roles and structures to lead delivery

-        Data and Intelligence – to drive action and enable innovation

It was noted that there is work to be done in acute care, in terms of new infrastructure to enable transformation and to reduce the backlog, so that safe services can be delivered now and in the future.  This will include replacement hospitals, upgrades, refurbishments and new developments across existing sites.  In relation to primary care, the ambition is for streamlining access to care and advice, providing more proactive and personalised care.  In delivering this, there would be a continuation of identifying sites to deliver out-of-hospital/non-acute infrastructure, to bring more healthcare to local communities using empty high street buildings.

It was  ...  view the full minutes text for item 8.

The Joint Committee is asked to approve the proposed work programme for the municipal year and Members are invited to identify any further topic suggestions.

The Joint Committee received a proposed work programme for the 2024/25 municipal year.  It was noted that a further suggestion had been received in relation to men’s mental health, and that this would be slotted into the work programme following consultation with health colleagues.  It was also suggested that the Committee take a look in greater detail at gender dysphoria services.

It was agreed that the proposed work programme for the Joint Committee be approved.