Agenda item

The Board received a presentation from Peter Rooney with regards to the Draft Integrated Care Strategy.

Peter advised that the ICP is a statutory committee, established by the NHS and local government as equal partners, and involving partner organisations and stakeholders. It forms part of the arrangements for the Integrated Care System (ICS).

•        Each Integrated Care Partnership is required to develop an integrated care strategy covering the whole ICP population by December 2022

•        ICBs and local authorities must ‘have regard to’ the strategy when making decisions, and commissioning or delivering services

•        The strategy must use the best evidence, building from local assessments of needs (JSNAs), and enable integration and innovation.

It was noted that the ICP should set an overarching strategic direction, the following was noted in relation to our Assets and Case for Change.

•         We have strong communities, an amazing Voluntary, Community and Social Enterprise sector, World Class natural assets and vibrant industries

•         We have a strong foundation of partnership working, an outstanding health and care workforce, and some of the best research and development programmes of any system

•         Our health outcomes are some of the worst in England, with deep and protracted inequalities, which correlate with socio-economic deprivation

•         Life expectancy at birth is 81 (women) and 76.9 (men), compared to 82.6 and 78.7 for England

•         Healthy life expectancy is 60.2 (women) and 59.4 (men), compared to 63.9 and 63.1 for England.

There is a key commitment to reduce the gap by 2030.

The following comments were fed back to Peter and it was noted that a response on behalf of the Gateshead health and care system had also been sent in response to the consultation:

•     It was noted that the strategy was high level and provides an overall strategic vision.

•     The focus of the strategy on prevention and preventative measures could be enhanced.

•     There needs to be a number of different plans to find solutions to key health challenges - sometimes we have tended to look at a complex problem to see what might be a simple solution which in turn can create perverse incentives.

•     Noted that in Cuba there have a significant focus on prevention. The country has 9 doctors and 9 nurses per 1,000 of population, whereas the UK has 3.1 doctors per 1,000 which raises the question of how do we increase the focus on prevention.

•     Increase the focus on Children and Young People – not very strong within the strategy currently.

•     Would like an assurance that children will very much be at the forefront of the strategy – a focus on children will provide much more ‘bang for your buck’.

•     Reference was made to the detailed response from the Directors of Children’s Services about the lack of reference to Children and Young People and the need to make key commitments in terms of Children’s Mental Health.

•     The strategy should incorporate a more asset-based approach around connected communities.

•     The strategy could move away from a ‘deficit approach’ in terms of how aspirations are set out e.g. increase the number of smoke free families instead of reducing smoking amongst individuals.

•     There should be discussions with relevant Strategic Housing Leads to make sure the community is supported with good housing which promotes good health.

•     There should be a focus on place, in terms of the determinants of health and wellbeing – housing is critical and people should live in a decent house in a decent place with a decent job and be able to have local places such as parks where they can walk, exercise, spend time etc. If we are required to have regard to the ICS strategy in terms of our local decision making, we need to have shared data and an evidence base.

•     What we do with the strategy - that is the important thing. As there will be national priorities, regional priorities and local priorities, it raises the question how do we develop something meaningful locally (our local strategy), when we are also being directed by other strategies - national, regional etc. There needs to be the right balance between the ability to develop a local strategy, develop a local response to health and care challenges and responding to the requirements of strategies developed at broader geographies.

•     If we don’t get the finances right and budgets pooled, we will not be able to make this work. Currently, local government finance and health finance arrangements are not aligned - we need to get this right first. Also, we have major shortages of health professionals and social care professionals which needs to be addressed early on within the strategy.

RESOLVED

(i)               That the information presented be noted and the comments provided as part of the Board’s consultation response.