Although a formal committee of Brighton & Hove City Council, the Health & Wellbeing Board has a remit which includes matters relating to the Clinical Commissioning Group (CCG), the Local Safeguarding Board for Children and Adults and Healthwatch.

Title:

Sussex Integrated Care Strategy and Shared Delivery Plan

Date of Meeting:

7 March 2023

Report of:

Lola Banjoko - Executive Managing Director NHS Brighton & Hove

Robert Persey – Executive Director Health & Adult Social Care – Brighton and Hove City Council

Contact:

Tel: 01273

Email:

Harpreet.kaur38@nhs.net

Wards Affected:

All

FOR GENERAL RELEASE

Executive Summary

The Sussex Health and Care Assembly signed off the Sussex Integrated Care Strategy with full support and engagement from system partners on 14 December 2022. The Strategy was noted at Full Council on 15 December 2022 and published alongside a week of media campaigns on 30 January 2023.

The Department for Health & Social Care have published guidance for Integrated Care Boards (ICB) to develop a five-year Shared Delivery Plan (SDP) providing the integrated care system with a flexible framework which builds on existing system and place strategies and plans, which includes Joint Health and Wellbeing Board Strategies.

The Shared Delivery Plan will describe how NHS Sussex and its partner trusts intend to arrange and/or provide NHS services to meet their population’s physical and mental health needs the delivery of universal NHS commitments, addressing the Health and Care System’s four core purposes and meeting legal requirements.

The ICB is required to provide a first draft of the SDP by 1st April 2023.NHSE guidance for publishing and sharing the plan is 30th June 2023, with a focus on year 1 allowing for the process of engagement with the local population, Integrated Care Partnerships, Health & Wellbeing Boards (HWB) & NHSE to continue after 31st March but ensuring a final iteration is signed off by 30th June.

The Shared Delivery Plan will be delivered as a single plan that incorporates the Operating Plan requirements for 2023/24 and the delivery plan for the five-year Sussex Health and Care Improving Lives Together Strategy set within a framework document that will bring together a consistent narrative around strategic change and operational delivery, pulling in content from the approved Strategy and respective Place plans.

The March 2023 submission will consist of high-level information on the Operational Plan and the detail of Year One response to the Integrated Care Strategy, plus a vision and roadmap for years two to five of the Strategy (noting that an initial draft of the Operating Plan must be submitted to NHSE on 23 February 2023). For Brighton and Hove this will include the key milestones for the Place Transformation Programme (Improving Brighton and Hove Lives Together) that is focussed on adults with multiple compound needs.

The June 2023 submission will set out the delivery objectives for years two to five of the Strategy in more detail and will include all the 5 Place based priorities, cancer, children and young people, mental health, multiple long-term conditions, and multiple compound needs.

In developing the SDP, it has considered BH Health and Wellbeing Strategy with a particular focus on living well domain and health inequalities.

1. Decisions, recommendations, and any options

1.1 That the Board is asked to.

a) Note the update on the development of the Shared Delivery Plan for Sussex and the deadline set for a first submission by 30 March 2023 to provide a high-level response to the NHS Operating Plan and Year 1 response to Integrated Care Strategy and Place based programme focussed on adults with multiple compound needs.

b) Note the second deadline of 30 June 2023 to submit a final Shared Delivery Plan setting out the delivery objectives for years two to five of the Strategy in more detail and the five Place Plan priorities.

c) Agree to hold a special meeting of the Board in June 2023 to consider whether the Shared Delivery Plan takes sufficient account of Joint Local Health & Wellbeing Strategy priorities

d) Note the role of and Health Overview and Scrutiny Committee in holding NHS Sussex and partners to account for the ongoing delivery of the SDP.

2. Relevant information

2.1 Introduction:

2.2 The Sussex Health and Care Assembly was responsible for signing off the Sussex Integrated Care Strategy, with full support and engagement from system partners. This was achieved at the Health and Care Assembly’s Meeting in public 14 December 2022. The Strategy was noted by Full Council on 15 December 2022 and published alongside a week of media campaigns on 30 January 2023.

2.2 The Integrated Care Strategy sets out the ambitions for health and care that aim to improve the lives of people living across Sussex and describes what we want to achieve over the next five years.

2.3 The Strategy has been built on Health and Wellbeing Strategies that are already in place across Brighton and Hove, East Sussex, and West Sussex, is influenced by supporting information and evidence, has been shaped by feedback and insight from partners and the public engagement, and responds to several national strategies, plans and guidelines that need to be met.

2.4 The Department for Health & Social Care have published guidance for Integrated Care Boards to develop a five-year Shared Delivery Plan providing the integrated care system with a flexible framework which builds on existing system and place strategies and plans, which includes Joint Health and Wellbeing Board Strategies.

2.5 The Shared Delivery Plan will describe how NHS Sussex and its partner trusts intend to arrange and/or provide NHS services to meet their population’s physical and mental health needs the delivery of universal NHS commitments, addressing the Health and Care System’s four core purposes and meeting legal requirements.

2.6 The Shared Delivery Plan will also set out the delivery objectives over the next 5 years for the 5 Place based priorities: cancer, children and young People, mental Health, multiple long-term conditions, and multiple compound needs. The first submission due by 30 March 2023 will outline the year 1 key milestones for the Place Transformation Programme (Improving Brighton and Hove Lives Together) that is focussed on adults with multiple compound needs.

2.7 The Planning Guidance sets out a clear role for Health and Wellbeing Boards and Health Overview and Scrutiny Committees in supporting the development of the Shared Delivery Plan and holding NHS ICB’s to account for their ongoing delivery.

2.8 This paper provides an update on the Shared Delivery Plan Framework and the proposed approach for developing the Plan including engagement with Health and Wellbeing Boards.

2.9 Shared Delivery Plan Framework:

2.10 The Planning Guidance outlines three principles describing the Shared Delivery Plan’s nature and function that have been co-developed with ICBs across the country, trusts and national organisations representing local authorities and other system partners. They include.

· Principle 1: Fully aligned with the wider system partnership’s ambitions.

· Principle 2: Supporting subsidiarity by building on existing local strategies and plans as well as reflecting the universal NHS commitments.

· Principle 3: Delivery focused, including specific objectives, trajectories, and milestones as appropriate.

2.11 Work is already underway on some areas of the planning guidance. However, there are areas that require significant focus, and these will be an operational priority. These are:

· Urgent and Emergency Care

· Planned Care

· Primary Care

· Discharge

2.12 As well as planning to deliver our operational priorities the Shared Delivery Plan will respond to the delivery of our Integrated Health and Care Strategy. The key areas of focus in the strategy are:

· Place and Integrated Community Teams

· Digital and Data

· Workforce

2.13 In addition, to enable delivery across all our plans, there is a need for us to develop strong Clinical Leadership across the system, as well as to continue our focus on addressing health inequalities and managing our finances in a sustainable way.

2.14 These ten areas (highlighted above) will be the key priorities for the next year and will be subject to robust engagement with system partners on how best we can deliver these as part of the Shared Delivery Plan

2.15 The Shared Delivery Plan will be delivered as a single plan that incorporates the Operating Plan requirements for 2023/24 and the delivery plan for the five-year Sussex Health and Care Improving Lives Together Strategy set within a framework document that will bring together a consistent narrative around strategic change and operational delivery, pulling in content from the approved Strategy and respective Place plans.

2.16 Engagement Approach to Developing the Plan:

2.17 National guidance stipulates the local approach to the development of the Plan to be determined by NHS Sussex and partner trusts. It should build on and reflect existing joint strategic needs assessments, joint health and wellbeing strategies and NHS delivery plans as well as local patient and public engagement exercises already undertaken.

2.18 Given the extensive and successful engagement approach to co-developing the Sussex Integrated Care Strategy, feedback and insight already gained from citizens and our workforce will be used to inform development of the Shared Delivery Plan. In addition, a robust governance structure overseeing the development of the plan, will ensure that this insight is directly applied to the areas identified by the national guidance.

2.19 In line with the national guidance, key stakeholders, and groups, such as Healthwatch, Health and Wellbeing Boards and the Sussex Health and Care Assembly will be actively engaged. The respective Health Overview and Scrutiny Committees will be invited to scrutinise the final plans, in the usual way.

2.20 Close engagement with partners will be essential to the development of Shared Delivery Plan. This includes working with:

· Sussex Health and Care Assembly (ensuring this also provides the perspective of social care providers)

· Primary care providers

· Local authorities and each relevant Health and Wellbeing Board

· other ICBs in respect of providers whose operating boundary spans multiple ICSs

· NHS collaboratives, networks, and alliances

· Voluntary, community and social enterprise sector

· People and communities that will be affected by specific parts of the proposed plan, or who are likely to have a significant interest in any of its objectives, in accordance with the requirement to consult.

2.21 Role of the Health & Wellbeing Board:

2.22 In preparing or revising the Shared Delivery Plan, NHS Sussex and partner trusts are subject to a general legal duty to involve each Health and Wellbeing Board.

2.23 NHS Sussex and partner trusts must send a draft of the Shared Delivery Plan to each Health and Wellbeing Board when initially developing it or undertaking significant revisions or updates. They must consult the Health and Wellbeing Board on whether the draft takes proper account of each joint local health and wellbeing strategy that relates to any part of the period to which the shared delivery plan relates – describing how NHS Sussex proposes to implement the joint health and wellbeing strategies.

2.24 A Health and Wellbeing Board must respond with its opinion and may also send that opinion to NHS England, telling NHS Sussex and its partner trusts it has done so (unless it informed them in advance that it was planning to do so).

2.25 Role of Health Overview and Scrutiny Committees:

2.26 NHS Sussex and their partner trusts should expect to be held to account for its delivery – including by their population, patients and their carers or representatives and through the Sussex Health and Care Assembly, Healthwatch and the local authorities’ health overview and scrutiny committees.

2.27 Sign off process for the Shared Delivery Plan:

2.28 The timeline for the development and governance signs off the Shared Delivery Plan is detailed in the attached appendices. However, NHS Sussex is required to provide a first draft of the Shared Delivery Plan by 1st April 2023.

2.29 The March 2023 submission will consist of high-level information on the Operational Plan and the detail of Year One response to the Integrated Care Strategy, plus a vision and roadmap for years two to five of the Strategy (noting that an initial draft of the Operating Plan must be submitted to NHSE on 23 February 2023).

2.30 The final date for publishing and sharing the plan is 30th June 2023, allowing the process of engagement with the Sussex Health and Care Assembly, Health and Wellbeing Boards and NHS England to continue after 31st March but ensuring a final iteration is signed off by 30th June.

2.31 The June 2023 submission will set out the delivery objectives for years two to five of the Strategy in more detail, including for the 5 Place based priorities: cancer, children and young People, mental Health, multiple long-term conditions, and multiple compound needs. The first submission due by 30 March 2023 will outline the year 1 key milestones for the Place Transformation Programme (Improving Brighton and Hove Lives Together) that is focussed on adults with multiple compound needs.

2.32 High level Milestones for Year 1 Place Transformation Programme – Improving Brighton and Hove Lives Together:

2.33 Multiple Compound Needs is a Place based priority and to respond to this we have established our Transformation Programme (Improving Brighton and Hove Lives Together).

2.34 People with Multiple Compound Needs are amongst the most marginalised and vulnerable members of society that face significant health inequalities. There is a 34-year life expectancy gap for people within this cohort compared to the general population.

3. Important considerations and implications

Legal:

3.1 As described in the body of this report NHS Guidance requires the development and submission of the Shared Delivery Plan. The report is for noting and recommends a special meeting in June 2023 for the Board to consider the Shared Delivery Plan which is appropriate given the NHS deadline submission date.

Lawyer consulted: Sandra O’Brien Date: 16 February 2023

Finance:

3.2 The Sussex Integrated Care Strategy and Shared Delivery Plan will provide the integrated care system with a flexible framework which builds on existing system and place strategies and plans, which includes Joint Health and Wellbeing Board Strategies. The plan will describe the strategic direction for meeting the broader health, public health and social care needs of the population of Sussex to agree an Integrated Care Strategy for Sussex.

3.3 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.

Finance Officer consulted: Sophie Warburton Date: 16/02/2023

Equalities:

3.4 None directly for this report. Members may wish to note that equalities issues have been closely considered in determining the Integrated Care Strategy system and place priorities, and that all the place priorities, specifically seek to improve the health of people with protected characteristics.

Sustainability:

3.5 None identified.

Health, social care, children’s services, and public health:

3.6 These implications are already covered in the main body of the report.

Supporting documents and information

Appendix 1: slides on the Integrated Care Strategy and the Shared Delivery Plan