Vocare and NHS 111
Councillor Mendelson highlighted that at previous meetings of the Committee there had been some confusion as to the role Vocare had played in the delivery of NHS 111 and what role it would or wouldn’t play going forwards.
Mark Cotton, NEAS, advised the Joint Committee that NEAS was the sole provider of the existing NHS 111 contract and under the new tender which would come into effect next month.
Mark clarified that the difference between the existing and new contract was in how specific expertise would be procured. During the last five years NEAS had sub- contracted to Vocare where they had needed GP involvement. NEAS had opted for a different approach when they tendered for the contract this time around. There would be an alliance approach for the new contract where NEAS would sub contract the necessary clinical experts in their field.
Councillor Mendelson thanked Mark for clarifying the position.
The Chair also thanked Mark and requested that a representative from NEAS attend a future meeting of the Committee to provide an update on the work of NEAS and the challenges it is facing.
LGA Green Paper on Adult Social Care
The Chair reminded everyone of the Green Paper on the future and funding of adult social care and advised that Gateshead had produced a system wide response to the consultation.
Consultation on Contracting arrangements for Integrated Care Providers
The Chair noted that the government is consulting on the contracting arrangements for integrated care providers and this consultation which came out in August was due to close on 26 October 2018. Gateshead would be providing a system wide response.
Councillor Taylor had previously requested information on the numbers of migrant workers leaving the NHS as a result of the impact of Brexit.
Dr Bernard Groen, Health Education England provided the Joint Committee with some statistical information relating to acute trusts only and noted that the key message appeared to be that Brexit appeared to have accelerated the number of people wanting to work in the NHS. However, this might increase the risks faced by services in the NHS if significant numbers of staff were to leave, particularly as migrant workers are not uniformly distributed amongst staff groups.
Councillor Taylor queried whether the figures just applied to the North East and Dr Groen confirmed that this was the case.
Councillor Taylor also queried whether turnover had changed and Dr Groen advised that this was relatively stable although there was movement between NHS organisations.
Councillor Taylor stated that she was particularly concerned about the risk to staffing levels in particular specialities and queried the position. Dr Groen stated that growth had been slowing in staffing levels for specialities. The area at greatest risk was cardiovascular surgery where there could be a significant impairment to the service if highly skilled/trained migrant workers were to leave.
Councillor Spillard asked whether there was any anecdotal evidence that individuals coming to the UK now would be allowed to stay if they were already established. Dr Groen stated that for clinicians the European Framework enables them to move between countries and it is now established and easy for people to register in the UK. The uncertainty will be whether they are able to do so after Brexit.
Councillor Spillard noted that the data related to EU nationals and queried whether there was any data on other groups. Dr Groen stated that he had particularly focused the data on EU nationals but could look at providing this information if the Joint Committee wanted this information, although there had been a declining trend for a while.
Councillor Huntley queried whether it had been compulsory for people to identify themselves as EU or not at the time the data was provided. Dr Groen stated that when individuals commence employment with the NHS there is an identity check which is cross-referenced with the relevant professional regulatory body. To do this robustly, over the last ten years non- native individuals have had to provide ID documents, which for non-UK nationals would normally be either a national ID card (EU nationals) or passport (EU and non-EU nationals) and two other forms of ID. This means that the system is robust in terms of checking identity (for right to practice legally in the UK) and as a result it provides good nationality data as well.
Councillor Hall noted that there had been mention of increased risks to small medical specialities as a result of Brexit and she queried whether there were any additional areas of increased risk and she also queried the position in relation to the numbers of staff due to retire. Dr Groen stated that he would happily do further analysis in this area if the Joint Committee wished and come back to a future meeting of the Joint Committee to share and talk through this data/information. Dr Groen noted however, that caution should be exercised in relation to the figures as although we may well identify potential increased risks in relation to skilled staff leaving the NHS, this did not mean that those staff would take the active decision to leave the UK in April 2019 as many are settled and integrated into life in the UK.
The Chair asked Dr Groen to attend a future meeting of the Joint Committee to report back on the areas highlighted and also requested that as part of the future update information on the impact of Brexit on particular worker groups be highlighted. Cllr Hall also asked that as part of the update information is provided on staff due to retire within those groups also.