Agenda and minutes

Councillor (s); Foy and Maughan (Gateshead Council) Taylor (Newcastle CC) Bell, Grayson and Hall (North Tyneside Council), Simpson and Watson (Northumberland CC) Flynn (South Tyneside Council) Robinson (Durham CC) Heron and Leadbitter     (Sunderland CC)

Councillor Mendelson (Newcastle CC) declared an interest as a member of NTW NHS FT Council of Governors.

Councillor K Chequer (Sunderland CC) declared an interest as an employee of NTW NHS Trust and Gateshead Health NHS Trust?

The minutes of the last meeting of the Joint Committee held on 13 November 2017 are attached for approval.

The minutes of the last meeting held on 13 November 2017 were approved as a correct record subject to it being noted that, at item 3 Declarations of Interest, Councillor Chequer (Sunderland CC) had declared an interest as an employee of NTW NHS FT and Gateshead Health NHS FT.

Report Attached. NHS Leads for the Prevention Workstream will attend and provide the Joint Committee with an update on the above.

Dr Guy Pilkington, Chair of the regional STP Prevention Board, explained that a Board had been established to progress this area of work to demonstrate a system wide commitment to prevention work in the north east.

Dr Pilkington advised that his role was that of SRO and he was supported by Directors of Public Health from across the patch and Terry Collins, Chief Executive Durham County Council who was acting as sponsor for the work and Alan Foster STP Lead so that assurance can be provided to the STP Board in relation to this area. Prevention is viewed as central to the success of the STP process.

Dr Pilkington noted that Prevention work was critical. Although there are financial constraints in the north east there are still good services being delivered. However, in spite of these factors there are still very poor health outcomes in the north east and there is a significant health and wellbeing gap that needs to be closed.

Dr Pilkington stated that the North East Combined Authority and local NHS organisations had established a Commission for Health and Social Integration in 2016 as part of a devolution bid and this had reported its findings in “ Health and Wealth: Closing the Gap in the North East”  which had provided a good steer. This work had complemented the NHS Five Year Forward View which set out the need for the NHS to support a step change increase in prevention. The Marmot Report in 2010 also supported the need for building on existing prevention activity.

As NHS budgets are fully stretched it is important to shift the focus towards prevention otherwise services will always struggle to meet demand. There has also been an increasing recognition that to progress prevention work there cannot be a reliance on local authorities alone. It is also important to shift activity and investment to support the prevention agenda in order to close the health and wellbeing gap.

As part of upscaling prevention work there is a regional ambition to address the harm caused by tobacco and the target is to reduce smoking to 5% by 2025.

Dr Pilkington advised that there is a need for system leadership to drive forward the prevention agenda and this would be the role of the Board. Dr Pilkington set out the proposed work programme for the Board.

Work focuses on action to embed prevention at all levels and in particular for the STP primary and secondary prevention.

In relation to primary prevention, this would deal with what is being done to improve the health of the population before they become ill and focus on tackling key areas such as smoking, alcohol, providing children with the best start in life and preventing / reducing obesity. Dr Pilkington stressed the importance of people being active to keep well and the fact that there is significant evidence to support intervention in this area.

In relation to secondary prevention, this would look at reducing premature mortality in areas such as Cardio  ...  view the full minutes text for item 13.

Mark Adams, Joint Lead for Combined Cumbria and North East STP will provide the Joint Committee with a verbal update on the above.

The Joint Committee received a video presentation outlining the role of Accountable Care Organisations.

Mark Adams advised the Joint Committee that the focus in NE and Cumbria STP areas was on developing Accountable Care Systems and looking at how organisations could work together more.

The approach involved the NHS working under set budgets to improve health and working together with other services such as Social Care and Public Health to achieve this. Some of this work was taking place within the Vanguard pilots which were trialling new models of delivering community based services.

Mark highlighted that this approach would mean that whilst patients would still see their GP and access hospital care they may receive more support and treatment at home. It might also mean that individuals might have to travel further to access hospital care.

Mark stated that the Joint Committee would be able to see from the video presentation that as far as STPs are concerned there has been a lot of discussion around how individual organisations come together and work in different ways. Mark highlighted that one of the key areas in our STP is the emphasis on Prevention which as the video highlighted has not always been seen in other areas. Mark stated that within this STP the key focus will be on looking at what other areas can do and working with other organisations, not just local authorities to see how the best use of resources can be achieved. Mark advised that it will be really important to make sure that the organisations that come together are rooted in local work.

Mark stated that the discussion around Prevention highlight the general understanding of what we want to do collectively and what works well and less well and how it is planned to make changes.

Alan advised that the aim was to have systems working together rather than implementing organisational change. Alan stated that where it makes sense to work at scale there are a lot of things that can be done to try and provide an equitable approach. However, Alan advised that what can be achieved locally is also important. Alan stated that an accountable care systems approach means working together in the North East to agree how we deliver care and how we want to collaborate more with partners such as local authorities and the voluntary sector to create local systems which will meet needs and improve services for local people. Alan stated that he believed there were real opportunities in progressing such an approach and in ensuring a real interface for patients at a local level.

Alan highlighted that some hospital services in the patch were vulnerable due to staff shortages in areas such as radiology and other areas are also under pressure so this may mean that patients have to travel further.

The Chair stated that on the issue of further privatisation of the NHS this was not in the interests of most people and the recent collapse of Carillion and the  ...  view the full minutes text for item 14.

The proposed provisional work programme for the Joint Committee is set out below:-         

The views of the Joint Committee are sought.

The Joint Committee considered and agreed its provisional work programme as follows:-

It was agreed that progress updates on the development of the Accountable Care System be provided to the Joint Committee on a regular basis and that information on how it is proposed to engage and involve communities in the whole STP/ACS process be brought to the Joint Committee at a future meeting.

The Joint Committee also indicated that it would be helpful to be provided with information on how the unions are being involved in the Workforce Workstream and have information as to how work in relation to the social care workforce was linking with the STP workforce workstream at a future meeting.

To be confirmed.

AGREED        That the next meeting of the Joint Committee be held on 19 March 2018 at 1.30pm at Gateshead Civic Centre.