Agenda item - Caring Together - September Update

Verbal update from the Executive Director for Health & Adult Social Care and the Accountable Officer for the CCG.

26.1    The Chair invited Dr Supple and The Executive Director for Health and Adult Social Care to update the board on Caring Together. The Board agreed to hear both updates on Care Together and integration of Health and Social Care as a single item.

26.2    The Executive Director for Health and Adult Social Care spoke to the presentation on Integration of Health and Social Care. He highlighted; the national pressures on funding across Health services especially on historically underfunded mental health provision, pressure had also increased on GP services and there had been a number of practice closures in the city. The CCG and the Council were looking at how to; manage this pressure, reduce bureaucracy and focus spending on front line services. An ageing population was creating new challenges and improvements needed to be made in treating long term problems and providing end of life care outside of a hospital setting.

26.3    Dr Supple then updated the committee on Caring Together. He highlighted: the potential for a commissioning alliance between surrounding CCGs, Caring Together planning had now moved out of Hove Town Hall to take into account views from a wide range of stakeholders, draft are care programmes were likely to be released at the end of September 2017.

26.4    Councillor Page expressed concern about the potential of future cuts to exacerbate the existing pressure on access to primary care and noted that the CCG had previously stated that Brighton & Hove had a very low ratio of GPs to patients.

26.5    Councillor Janio stated that with multiple public sector bodies commissioning health service in the city there would be potential for duplication of effort and therefore a loss of resources. He asked the presenters how commissioning would be arbitrated and what the governance arrangements for joint commissioning would be? The Chair and Mr Dennett both agreed with the sentiment that good governance is vital and added that commissioning should expand to include all stakeholders including providers. Outcomes should be agreed by all parties so all commissioners are expecting the same thing to be delivered.

26.6    In response to the points raised by the Board members Dr Supple stated that he agreed there was a high level of duplication present in commissioning efforts and the wider health service in general. He suggested that the way to remedy this issue was to move away from the siloed decision making which had proved difficult under the old governance arrangements. Caring Together represented a new way of working.

26.7    The Chief Executive of Brighton & Hove City Council responded that political leadership would come from the Secretary of State through the CCG and Local Councillors through the Council’s budget. The first step to improving how these interact would to align key dates for the CCG, Council and NHS England.

26.8    Councillor Penn noted the shortage of staff especially psychiatrist in the city and that policy decisions required adequate frontline staff before they could be implemented. The Executive Director for Health and Adult Social care responded that improving the workforce situation was a critical aim for the directorate. 

26.9    Mr Liley was hopeful that Caring Together would take into account the mistakes made in the STP process and would consult a wide variety of stakeholders including patients and the third sector.

26.10  RESOLVED: The Board noted both updates.