Council
Agenda Item 59
Subject: Sussex Health & Care: the Sussex Health & Care Assembly Final Terms of Reference and the Sussex Integrated Care Strategy
Date of meeting: 15 December 2022
Report of: Executive Director, Health & Adult Social Care
Contact Officer: Name: Giles Rossington
Tel: 01273 295514
Email: giles.rossington@brighton-hove.gov.uk
Ward(s) affected: All
For general release
1.1 The Health & Care Act (2022) requires regional Integrated Care Systems (ICS) to be established to better coordinate the planning and delivery of health and care services. Our local ICS is Sussex Health & Care, bringing NHS organisations, local authorities and other bodies together in partnership on a Sussex-wide basis and as three ‘places’: East Sussex, West Sussex and Brighton & Hove.
1.2 Each ICS must have an Integrated Care Partnership (ICP); our local ICP is the Sussex Health & Care Assembly (SHCA). The Assembly provides strategic leadership, including developing a high-level plan: the Sussex Integrated Care Strategy (Improving Lives Together).
1.3 In May 2022, Policy & Resources (P&R) Urgency Sub-Committee agreed to establish the SHCA as a joint committee of Brighton & Hove City Council, East Sussex County Council, West Sussex County Council and NHS Sussex. However, at the time of the P&R Urgency Sub-Committee decision, the final Terms of Reference (ToR) for the SHCA had not yet been agreed. It was consequently resolved that, once the SHCA ToR were finalised, they would be taken to full Council for approval. This report presents the final SHCA ToR for agreement (see Appendix 1).
1.4 The SHCA has been meeting since summer 2022 to develop an Integrated Care Strategy for Sussex: Improving Lives Together. The Strategy is due to be formally adopted by the SHCA at the 14 December 2022 Assembly meeting. The Integrated Care Strategy is presented to Council for information; Improving Lives Together has been discussed at the ICS Member Working Group. (Improving Lives Together is included as Appendix 2 to this report; a meeting note from the ICS Member Working Group is included as Appendix 3.)
2.1 That Council agrees the Terms of Reference for the Sussex Health & Care Assembly (Appendix 1).
2.2 Notes the Sussex Integrated Care Strategy: Improving Lives Together (Appendix 2); and notes that Improving Lives Together has been considered and noted by the ICS Member Working Group (Appendix 3).
3.1 The Health & Care Act (2022) introduced Integrated Care Systems (ICS), new statutory partnerships of health and care organisations, to operate at both a regional/system and a local/place level. Within each ICS there is an Integrated Care Partnership (ICP) which sets the strategic vision and goals; and also an Integrated Care Board (ICB) which delivers the strategy, including exercising NHS commissioning functions previously carried out by Clinical Commissioning Groups. For Sussex, the ICS is called Sussex Health & Care, the ICP is called the Sussex Health & Care Assembly (SHCA), and the ICB is called NHS Sussex.
3.2 Sussex Health & Care Assembly Terms of Reference
3.2.1 ICBs are NHS bodies, although representatives from partner organisations, including local authorities, sit on them. ICPs are joint committees of the ICB and of the upper-tier local authorities within the ICS footprint. In May 2022 P&R Urgency Sub-Committee approved the appointment of the BHCC Director of Children’s Services as a member of NHS Sussex (ICB), and also approved arrangements for the HWB Chair to attend ICB meetings as an observer. The sub-committee also recommended to Annual Council that the Chair of the HWB be appointed as a member of the Sussex Health & Care Assembly (ICP); this recommendation being subsequently agreed at Annual Council. P&R Urgency Sub-Committee also agreed to the establishment of the SHCA as a joint committee of the city council, East Sussex County Council, West Sussex County Council and NHS Sussex. However, at the time of the sub-committee meeting, the final Terms of Reference (ToR) for the SHCA had not been completed. P&R Urgency Sub-Committee agreed to establish the SHCA, and that the final ToR should come to a future Council meeting for approval. The ToR are included as Appendix 1 to this report and members are asked to approve them.
3.3 Integrated Care Strategy
3.3.1 A principal role of an ICP is to develop an Integrated Care Strategy. The Sussex Integrated Care Strategy is intended as a public-facing accessible strategic statement. Covering the period 2022 – 2027, it sets out the emerging areas that are being focused on for developing the five-year strategy, which aims to improve the lives of everyone living in Sussex now and in the future, and will address the needs of all our communities. Covering all ages across the whole life course it will:
· Help local people start their lives well;
· Help local people to live their lives well;
· Help local people to age well;
· Help local people get the treatment, care and support they need when they do become ill.
3.3.2 Following early Assembly and partner discussions, the Strategy sets out the rationale for supporting a key shared Sussex-wide ambition to deliver this aim. This ambition is focused on a new community-based approach, which will work with and within different communities to better understand local population needs and respond in the best possible way. This will enable a greater focus on keeping people healthy, supporting all aspects of people’s lives and the specific needs of children and young people. The Strategy also sets out how a shared focus on the following critical areas will further enable this ambition to be delivered:
· Doing more to grow and support our workforce;
· Improving the use of digital technology and information, and;
· Building on the partnership working that has developed across health and care, including the Place-based Health and Care Partnerships that report into the three Health and Wellbeing Boards.
The strategy is consistent with the framework we require for implementation of Place based proposals, some of which are established but others will be subject to further development over future years.
3.3.3 More detail can be found in the Sussex Integrated Care Strategy (Appendix 2).
3.3.4 At May P&R Urgency Sub-Committee it was agreed that a Member Working Group would be established to oversee the development of the Sussex ICS. The ICS Member Working Group met on 06 December 2022 to consider the draft Sussex Integrated Care Strategy. The Working Group noted the Strategy, and the system and place priorities within the Strategy. (A note of the member working group meeting is included as Appendix 3.)
4.1 Members could choose not to agree the SHCA Terms of Reference. However, the SHCA is a body that is required, and to a large degree, defined by statute, and its ToR reflect this.
5.1 None undertaken directly for this report.
Members are asked to agree the Sussex Health & Care Assembly (SHCA) Terms of Reference, P&R Urgency Sub-Committee having previously agreed to establish the SHCA as a joint committee. Members are also asked to note the Sussex Integrated Care Strategy, Improving Lives Together.
7.1 The Sussex Health and Care Assembly will build upon the local Health and Wellbeing Strategies and co-ordinate the strategic direction for meeting the broader health, public health and social care needs of the population of Sussex to settle an Integrated Care Strategy for Sussex.
7.2 This will inform priorities, budget development and the Medium-Term Financial strategy of the partner organisations, including the council. This requires a joined-up process for budget setting in relation to all local public services where appropriate, and will ensure that there is an open, transparent and integrated approach to planning and provision of services. Any changes in service delivery for the council will be subject to recommissioning processes and will need to be delivered within the available budget.
Name of finance officer consulted: Sophie Warburton Date consulted: 01/12/22
8.1 The legal background and statutory requirements for an ICP and Integrated Care Strategy are included in the body of this report. The ICP for Sussex – Sussex Health and Care Assembly (SHCA) is already approved as a joint committee of Brighton and Hove City Council and is a statutory requirement.
In relation to the Terms of Reference, Section 26(4) of the Health Act 2022 amends The Local Government and Public Involvement in Health Act 2007 by inserting a new section 116(Z) (A) (2):
The integrated care partnership for an area is to consist of—
(a)one member appointed by the integrated care board,
(b)one member appointed by each of the responsible local authorities, and
(c)any members appointed by the integrated care partnership.
(3)An integrated care partnership may determine its own procedure (including quorum).
In accordance with its statutory duty SHCA has prepared the Integrated Care Strategy (Improving Lives Together). Paragraph 9 of the Terms of Reference make provision for revision of the Integrated Care Strategy. Paragraph 10 of the Terms of Reference provides for a report to each local authority and their Health and Well Being Board highlighting any actions following each meeting of the Assembly .
Name of lawyer consulted: Sandra O’Brien Date consulted 01.12.2022
9.1 None directly to this decision. Equality issues have been considered in the formation of the Sussex Integrated Care Strategy and are detailed in the Strategy (Appendix 2).
10.1 None directly to this decision. Members may wish to note opportunities to use ICS partnerships, including the Sussex Health & Care Assembly, to work jointly with partners (e.g. NHS provider trusts) on sustainability and carbon reduction initiatives.
Supporting Documentation
1. Final Terms of Reference of the Sussex Health & Care Assembly (SHCA)
2. The Sussex Integrated Care Strategy, Improving Lives Together
3. Extract from the draft minutes of the 06 December meeting of the BHCC ICS Member Working Group