To receive a presentation from Mark Adams, Chief Officer of the North Tyneside Clinical Commissioning Group, on the Department of Health and Social Care's legislative proposals for a Health and Care Bill.
The Board received a presentation from Mark Adams, Chief Officer of the North Tyneside Clinical Commissioning Group, in relation to the White Paper – Integration and Innovation: working together to improve health and social care for all.
The Board was informed that the White Paper aimed to improve population health and healthcare, tackle unequal outcomes and access, enhance productivity and value for money and help the NHS to support broader social and economic development. A key responsibility emerging from the White Paper would be to support place-based joint working between the NHS, local government, community health service and other partners such as the voluntary and community sector. Place level commissioning within an integrated care system would align geographically to a local authority boundary and the Better Care Fund would provide a tool for agreeing priorities.
It was noted that legislation could help to create the right conditions, but it would be the hard work of the workforce and partners in local place and systems that would make the real difference. There was a real chance to strengthen and assess patient voice at place and system levels.
The approach to place in the White Paper would allow the NHS to shift away from an adversarial and transactional system centred on contracting and activity payments to one that is far more collaborative and dedicated to tackling shared problems. Whilst NHS provider organisations would retain their current structure and governance, they would be expected to work in close partnership with other providers and with commissioners to improve outcomes and value.
The Board was informed that it was not expected that there would be any legislative provision about arrangements at place level. Place based arrangements would be left to local organisations to arrange, with the expectation that local areas would develop models to best meet their local circumstances. Health and Wellbeing Boards would remain in place and continue to have an important responsibility at place level to bring partners together.
The Board was presented with the legislative timetable for the White Paper, which indicated that the (Health and Care) Bill would receive Royal Assent and become an Act in January 2022, with the provisions of the Act, including the establishment of the new NHS Integrated Care System (ICS) bodies, coming into force on 1 April 2022 (subject to parliamentary decision). The ICS would be a statutory board in its own right and have a set of principles. A key area of focus would be that decisions taken closer to the communities that they affect are likely to lead to better outcomes. Collaboration between partners in a place across health, care services, public health, and the voluntary sector could overcome competing objectives and separate funding flows to help address health inequalities, improve inequalities and deliver joined-up services. The ICS NHS body would take on the commissioning responsibilities of the Clinical Commissioning Groups (CCGs).
The Board was informed that ISCs would need to be able to ensure collectively that they were addressing the right priorities for their residents and using collective resources wisely. Work would need to undertaken across partners to determine a number of factors, including distribution of financial resources targeted at areas of greatest need and workforce planning, commissioning and development to ensure that people and teams were supported.
It was noted that models of place-based working were emerging but no decisions on structures had yet been made. National guidance on ICS development was imminent and a way forward would need to be planned with partners. It was important to build on existing joint arrangements at place between local authorities, the NHS and wider partners.
Members of the Board commented on the complexities of the emerging changes and the need to ensure that members of the public know where to go to get the care they need. It was noted that there would be a clear focus on what needed to be done to ensure that the public were aware of and understood changes related to patient care.
The Chair thanked Mr Adams for his attendance and for the information presented.
Resolved that the information presented be noted.