Agenda and minutes

In line with the terms of reference of the Joint Committee, the Joint Committee is asked to appoint a Chair for the 2018-19 municipal year.

One nomination had been received for the position of Chair.

AGREED – That Councillor Lynn Caffrey (Gateshead Council) be appointed to the position of Chair.

In line with the terms of reference of the Joint Committee, the Joint Committee is asked to appoint a Vice Chair for the 2018-19 municipal year.

One nomination had been received for the position of Vice Chair.

AGREED – That Councillor Wendy Taylor (Newcastle CC) be appointed to

                     the position of Vice Chair.

Councillor Taylor (Newcastle CC) declared an interest as an employee of Newcastle Hospitals NHS Foundation Trust.

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

The minutes of the last meeting of the Joint Committee held on 19 March 2018 are attached for approval.

The minutes of the last meeting held on 19 March 2018 were endorsed but not approved as the meeting was inquorate.

Matters Arising from the Minutes

Update on Urgent and Emergency Care Workstream

Councillor Huntley noted that Bas Sen, Chair of the Clinical Reference Grouphad informed the Joint Committee as part of the update that he was not saying that all stroke cases should go to major centres, only complex highly specialised cases need to go to major trauma centres. Bas had indicated that most hospitals can deal with strokes and the work they are doing is not about taking good care away.

However, Sunderland and South Tyneside Joint Health OSC subsequently received a letter date 25 April 2018 from Mr Sen clarifying his comments, indicating that time critical emergencies, of which stroke is one, will be taken to specialist stroke centres also known as hyper – acute stoke units (HASU) where they can get the highest quality care. The Sunderland and South Tyneside OSC was advised that the proposed stroke model for the region provides that regardless of where a patient presents he / she will be transferred to the stroke centre (HASU) with minimal delay to receive high quality high tech care.

Councillor Huntley requested that this Joint Committee ask Mr Sen to clarify for this Joint Committee which was the correct position.

Pharmacy and STP

Councillor Taylor noted that the Joint Committee had been informed by Andre Yeung, Chair of Northumberland Tyne and Wear LPN of the Community Pharmacy Referral Scheme which was committed to run until September 2018 when there was to be a full evaluation of the project.

Councillor Taylor requested that the Joint Committee be provided with an update on the outcome of the evaluation once this was available.

Interim Update – Workforce

Councillor Taylor noted that the Joint Committee had requested that information be provided on the impact of Brexit and she queried whether this was to be provided as part of the update today.

Lisa Crichton Jones advised that this information would not be part of today’s update but would be provided to the Joint Committee for its next meeting.

Joint OSC Work Programme

Cllr Schofield noted that it had originally been planned to invite Professor Pollack to speak to the Joint Committee regarding her perspective on Accountable Care Organisations after the meeting on 25 June and she queried the position on this.

It was clarified that Professor Pollack’s diary commitments meant that it was not possible to progress this in June and another date was being sought and would be confirmed with members of the Joint Committee as soon as possible.

Item attached.

Mr Whalley from Keep Our NHS Public NE noted the response to the issues raised by the group but the group also had particular concerns in relation to engagement and public consultation.

Mr Whalley noted that the draft STP had been published in November 2016 which was almost two years ago and since then there had been no further public consultation. The group were therefore concerned as to how business could be carried out without any further public consultation.

The Chair noted that the main item for the Joint Committee’s next meeting would be a presentation in relation to proposals for engagement with communities. A communications pack had also just been made available to the Joint Committee and this would be shared.

The Chair asked if the group had taken advantage of the offer from Mr Foster to have a face to face meeting to discuss their issues. Mr Whalley stated that as members of the group came from a wide area covering Berwick to Teeside they had requested a written response as not all members would be able to attend a face to face meeting.

Mr Whalley also note that the proposal to bring the three STPs in the north together following the approval of the regulator was a huge change and he queried where the consultation had occurred in relation to this either with communities or elected politicians.

The Chair advised that she was sure that Mr Foster would respond to the groups’ concerns directly. However, this meeting was here first and foremost to address the issues raised by the Committee and organisations invited to provide information.

Councillor Mendelson noted the response to the query regarding NHS 111 and asked what role VOCARE had in that service.

The Chair noted that there was not anyone present from NEAS today but she understood that VOCARE had been selected following a full procurement exercise and been awarded a national contract delivering the NHS 111 service in a number of different areas. However, the position had changed and the contract was operating through another provider as VOCARE had been sold. This was separate from the contract NEAS had been awarded for delivering NHS 111 in this region.

Mr Foster confirmed that CCGs had dealt with the procurement exercise and VOCARE was now under a different name.

Mr Foster explained that when he had attended the Joint Committee previously he had made it clear that the work being progressed in relation to STPs and ICS was not about privatisation. The aim of this work was to keep services and jobs in the NHS. Mr Foster noted that the Health and Social Care Act provides for a position of competition but Mr Foster indicated that the system needs to change.

Report attached. Lisa Crichton Jones, Director of Workforce Transformation for NE and Cumbria and Ian Renwick, SRO for Workforce Workstream will also provide the Joint Committee with a presentation on the above.

Lisa Crichton Jones, Director of Transformation for NE and Cumbria and Alex Glover, Locality Director, Health Education England provided the Joint Committee with an update on current and emergent work in relation to the NE and North Cumbria Workforce Programme.

The Joint Committee received information on the current context, opportunities and challenges faced.

It was noted that current service delivery models are struggling to meet the demographic challenge of people living longer often with complex co-morbidities and the increasing demands on the health and care system. In addition, it was noted that we are experiencing a multi-factorial workforce crisis, caused by challenges in recruitment, retention and lack of specialist skills, affordability and a preference for shorter work time commitments. Workforce funding has also reduced significantly. Demand, specialisation, reducing numbers of trainees, staff retirement and the intensity of modern working practice all contribute to complex and often difficult work environments. There is also a reliance on expensive locum and agency staff contributing to making the existing configuration of services unsustainable. The workforce is also fragmented in silos and divided by organisational and professional boundaries. Social Care shares similar challenges and whilst there is huge untapped potential in the community and voluntary sector this requires investment and development.

It was noted that there is now an opportunity through the STP/emergent ICS arrangements to develop a co-ordinated regional workforce strategy, across health and care to meet these challenges, to facilitate planning the future workforce on a whole systems basis, allowing for greater innovation and new models of care.

Early successes to date have been:-

·         A large-scale Workforce Summit event, held in February 2018.

·         Briefings to Health HR Directors and regional Trade Union colleagues at the North East Social Partnership Forum.

·         Beginning to establish links with Directors of Adult and Children’s Social Care and Local Authority Heads of HR.

·         Scoping the opportunity to build on the many examples of good work, already underway within the region.

·         A regular meeting of colleagues from across the system to drive this work forwards; the Workforce Scoping Group, whose membership comprises colleagues from health, local authority, CCGs, Health Education England and a regional trade union representative in their role as Joint Chair of the North East Social Partnership Forum.

Since the Workforce Summit was held in February 2018 a number of priority actions have been progressed.

One of the main actions was the appointment of a Director of Workforce Transformation and Lisa advised the Committee that she was delighted to be in post and would now be focusing on scoping the workforce programme and exploring what could be achieved in partnership with others. Lisa indicated that there was an opportunity to shape a regional workforce strategy for health and care on a whole system basis and to work innovatively to develop new models of care and pathways and explore opportunities to work at scale once for the NE and Cumbria to build resilience and quality and address the needs of the population

Other priority actions underway were :-  ...  view the full minutes text for item 32.

Alan Foster / Mark Adams, Leads for NE & Cumbria STP will provide the Joint Committee with a verbal update.

Alan Foster, Lead for Combined Cumbria and NE STP, noted that a communications pack had been circulated to the Joint Committee in relation to the proposed Integrated Care System and provided an update on current thinking on this issue.

Alan noted that the language had changed since the publication of the draft STP two years ago. Since that time there had been reference to Sustainable Transformation Partnerships, Accountable Care Organisations and then Accountable Care Partnerships and now what was proposed was an Integrated Care System.

Alan stated that he was a great believer in an Integrated Care System which would bring health and social care together. Alan noted that a Green Paper was due to be published this summer setting out how adult social care would be funded which was crucial.

Alan noted that work was taking place right across Cumbria and the NE with a view to improving population health and key to this was a focus on prevention to help people live longer and healthier lives. Alan provided the Joint Committee with information on life expectancy levels in the region for men and women/ mortality levels as a result of smoking/ cardiovascular disease and cancers.

Alan noted that there had been some improvements as a result of the work progressed so far but much more work was needed, particularly in the areas of childhood obesity and screening programmes and a key area of focus was helping to support the local population to look after themselves.

The Joint Committee was advised that an Integrated Care System was needed across Cumbria and the NE for the following reasons:-

·         A long-established geography, with highly interdependent clinical services

·         Vast majority of patient flows stay within the patch. 

·         Strong history of joint working, with a unanimous commitment from NHS bodies to go further as an ICS

·         High performing patch, with a strong track record of delivery

Challenges

·         Fragmentation following the 2012 Act has made system-wide decision-making difficult

·         Significant financial gaps, service sustainability issues and poor health outcomes

·         Maximising our collective impact to delivery the triple aim whilst reducing duplication and overheads.

Developing an Integrated Care System for our area will:

·         Create a single leadership, decision-making and self-governing assurance framework for CNE

·         Coordinate the integration of 4 Integrated Care Partnerships – building on the learning from North Cumbria

·         Establish joint financial management arrangements

·         Aspire to devolved control of key financial and staffing resources

·         Set the overall clinical strategy, standards, pathways and enabling workstreams to reduce variation

·         Coordinate ‘at scale’ shared improvement initiatives

·         Arbitrate where required and hold the Integrated Care Partnershipss to account for the delivery of FYFV outcomes

The Integrated Care Partnerships will be commissioned to :-

·         Deliver integrated primary,  community and acute care (aligned to the overall ICS strategy).

·         Ensure critical mass to sustain vulnerable acute services within their geography

The Joint Committee was advised that whilst work would take place at a system level to do some pieces of work at scale once place based working would continue and needed  ...  view the full minutes text for item 33.

The proposed provisional work programme for the Joint Committee is set out above.

It is also proposed that representatives from Healthwatch across the patch are invited to attend the July meeting and asked to comment on the update and presentation provided.

The views of the Joint Committee are sought.

The Joint Committee considered and agreed the issues to be considered for the additional meeting scheduled for 16 July 2018 were as follows:-

It was noted that Healthwatch Representatives from across the patch would be invited to the meeting and asked to comment on the presentation provided.

The Chair invited members of the Joint Committee to forward any suggestions for the work programme for future meetings for discussion at the next meeting.

It is proposed that future meetings of the Northumberland Tyne and Wear and North Durham STP OSC are held at Gateshead Civic Centre on the following dates and times:-

·         Monday 24 September 2018 at 2pm

·         Monday 26 November 2018 at 2pm

·         Monday 21 January 2019 at 2pm

·         Monday 25 March 2019 at 2pm

Membership

Gateshead Council

Councillor L Caffrey

Councillor M Hall

Councillor P Maughan

Substitutes

Councillor M Charlton

Councillor J Wallace

Newcastle City Council

Councillor W Taylor

Councillor F Mendelson

Councillor A Schofield

North Tyneside Council

Councillor M Thirlaway

Councillor K Clark

Councillor N Craven

Substitutes

Councillor M Green

Councillor T Mulvenna

Councillor L Spillard

Northumberland County Council

Councillor E Simpson

Councillor E Armstrong

Councillor J Watson

Substitute

Councillor R Dodd

South Tyneside Council

Councillor W Flynn

Councillor A Hetherington

Councillor A Huntley

Durham

Councillor J Robinson

Councillor O Temple

Councillor J Stephenson

Sunderland CC

Councillor J Heron

Councillor D Snowdon

Councillor S Leadbitter

AGREED – That future meetings of the Joint Committee be held at the Civic Centre Gateshead on the below dates and times:-

·         Monday 16 July 2018 at 1.30pm – Additional meeting

·         Monday 24 September 2018 at 2pm

·         Monday 26 November 2018 at 2pm

·         Monday 21 January 2019 at 2pm

·         Monday 25 March 2019 at 2pm