Agenda item - Brighton and Hove CCG 5 Year Strategic Plan 2014-2019 and 2 Year Operating Plan 2014-2016

Report of Chief Operating Officer, CCG (copy attached).

            Introduction

7.1       The Board considered a report of the Chief Operating Officer, CCG which informed members that Clinical Commissioning Groups were required by NHS England to produce a 5 year strategic plan covering the period 2014-2019 and a 2 year operating plan covering 2014-2016.  Both plans should be based on the needs of the local population as described in the Joint Strategic Needs Assessment, aligned to the priorities described in the Joint Health and Wellbeing Strategy and must clearly articulate how the system will address health inequalities and improve health outcomes.

7.2       Brighton and Hove CCGs 5 year strategic plan set out the vision and objectives of the CCG and demonstrated how the CCG would harness clinical and managerial skills, expertise and context of the financial challenges facing the NHS.  The strategic objectives for the five year plan were set out in sections 3.2 to 3.9 of the report.  The 2 year Operating Plan described how the CCG intended to deliver the vision outlined in the 5 year strategy.  The report was presented by Geraldine Hoban, Chief Operating Officer, CCG.  

7.3       Ms Hoban highlighted the following areas: - the strengthened collaborative arrangements for cancer treatment – paragraph 3.2.2.  Addressing the gap in life expectance – paragraph 3.2.3.  The focus on dementia – paragraph 3.5.3.  Meeting the needs of the diverse community –  Paragraph 3.2.4.  The major programme of work to re-model the front door of A&E – paragraph 3.6.3.  The Integration of physical and mental health services to improve outcomes and the health and wellbeing of all the population – paragraph 3.7.   The sustainability plan – paragraph 3.8.  To exploit opportunities provided by technology – paragraph 3.9.

            Questions and Discussion

7.4       Councillor Norman supported the plans and quoted paragraph 3.3 – ‘ensuring that citizens will be fully included in all aspects of service design and change, and that patients will be fully empowered in their own care’  and 3.3.1 ‘We are determined to put patients at the heart of what we do as a CCG….‘    Councillor Norman considered these quotes encapsulated the aims of the report. 

7.5       Councillor Norman asked for clarification that the plans could be continually reviewed.  Councillor Norman also asked for confirmation that mindfulness and talking therapies were already being used in the system.   

7.6       Geraldine Hoban explained that there was a requirement to refresh the five year plan annually.  There was also the opportunity to influence the plan throughout the year through the engagement process.  With regard to mindfulness, the CCG did provide talking therapies.  There was a new service of which mindfulness was a part.  In fact the CCG also provided mindfulness for its own staff. 

7.7       Councillor Morgan thought the report was welcomed the report.  He asked for more information on health inequalities..

7.8       Dr Christa Beesley explained that public health colleagues helped the CCG with this work.  Brighton and Hove was a very mixed area and there needed to be more integrated work with the third sector.  

7.9       Tom Scanlon was pleased to see the issue of health inequalities in the report.  There had been an improvement over the last 10 years; some of these improvements had an immediate impact. 

7.10    Graham Bartlett was surprised to see no mention of children’s safeguarding in the report.  He asked what the intentions were with regard to safeguarding.   Geraldine Hoban explained that there was a section on children in the more detailed plans.  There had been a fundamental review of how the children’s service was commissioned.  A report would be submitted to the next Health and Wellbeing Board on children’s services and safeguarding.  The report would suggest more joined up working and more clinical leadership.

7.11    Pinaki Ghoshal reported that there had been positive discussions and there was a real intention to work more closely with the CCG.  However, he was disappointed that the current report made no reference to children and young people.  There was a great deal of work to carry out and gaps in outcomes. 

7.12    Dr Christa Beesley replied that this could be made more obvious in future reports.  She was not satisfied with the health outcomes.  Ongoing work included a review of CAMHS.  There was a rising problem with self harm among young people and the rates of young people going into hospital was increasing.  There was a need to make primary care much more accessible. 

7.13         The Chief Executive emphasised that the CCG plans were covering cradle to grave services.  Children’s services were implied in the plans. The Chief Executive suggested that if the report was going to be presented at any further meetings there should be more explicit mention of children’s services. 

7.14    Trudy Mills was pleased to see the recommendations and priorities in the report.  She agreed with the comments with regard to children’s services. 

7.15    Frances McCabe asked if the mental health needs of older people were being taken into account.  She would like to see this recognised.  Ms McCabe referred to involvement and participation.  She asked if this work could be co-ordinated, including with the Area Team.

7.16    Dr Christa Beesley replied that with regard to older people, there was recognition that there were multiple long term conditions and that it was important to treat both mental and physical health problems.  Physical check ups would also consider mental health care.

7.17    Councillor Theobald stated that he fully supported the emphasis on cancer commissioning & care.  With regard to dementia and older people, Councillor Theobald was aware that in some cases physical illness sometimes led to dementia.    He expressed concern about the negative effect on the mental health of some older people of moving into residential care.  Councillor Theobald agreed that work with children and young people was very important.  He asked if the plans would include work to prevent children smoking.  

7.18    Dr Beesley explained that early intervention would help keep elderly people supported in their own homes.  She agreed that a change in environment could make a condition deteriorate.  The CCG did commission a care and support team as part of the work on frailty.

7.19    Tom Scanlon reported that the local authority commissioned a smoking cessation service.  There was a need to deliver 2000 quitters a year.  There was also a bigger focus on preventing people smoking in the first place. 

7.20    The Chief Executive informed members that she had signed up to the  Dementia Friends campaign which was supported by the Alzheimer’s Society and Public Health England.  She suggested that the Health and Wellbeing Board should sign up to be a Dementia Friend.  It was a very simple action that would help to raise awareness.   The Board agreed to this suggestion. 

7.21    RESOLVED – (1) That the content of the report be noted.

(2)       That it be agreed that the CCG plans do align with the local needs and priorities indentified in the JSNA and JHWS. 

(3)       That the Health and Wellbeing Board sign up to become a Dementia Friend.