Agenda item

To consider and provide feedback on the draft North East and North Cumbria NHS Joint Forward Plan 2023/24 - 2028/29.

The North East and North Cumbria NHS (Integrated Care Board (ICB)) and its partner NHS trusts were required, before the start of each financial year, to prepare a joint forward plan setting out how they proposed to exercise their functions in the next five years. The ICB were required to provide the Board with a draft of the forward plan and consult the Board on whether the draft takes proper account of its joint local health and wellbeing strategy.

Peter Rooney, the Director of Strategy and Planning at the North East and North Cumbria NHS, attended the meeting to present details of the Plan and answer any questions from members of the Board.

The draft Joint Forward Plan was complementary to the Integrated Care Partnership Strategy, which had been presented to the Board at its meeting on 10 November 2022. It was a delivery plan for the parts of our strategy related particularly to NHS delivered or commissioned services, but within the broader partnership context. It provided a strategic overview of the key priorities and objectives for the medium term, a high-level summary of the ICB’s priorities and objectives and a summary of the work programmes it would deliver to achieve its medium-term objectives. More detailed action plans had been developed for each of the integrated care strategy goals, the integrated care strategy enablers and specific service areas such as urgent and emergency care and mental health.

A place based action plan for each local authority area would also be developed and the Board were presented with details of the themes contained on the North Tyneside plan.

The Board were invited to make comments on the draft joint forward plan, in particular whether there was anything missing from the plan, anything wrong in the plan, whether the plan was aligned to the Board’s priorities and whether the Board would be comfortable offering an endorsement of the plan. Once the ICB had received all the feedback by the deadline for comments on 31 August 2023, it intended to re-publish the plan in September. It would also continue to review and update the plan each year going forward and would publish a revised version every March in line with the national guidance.

Following the presentation members of the Board made comments and asked a series of questions when the following issues were raised and discussed:

a)  It was noted that the plan contained a lot of focus on prevention and so the the Board queried the extent to which the ICB would be committing or re-focussing its funding away from treatment and towards prevention.

b)  Board members made reference to some of the fundamental problems  experienced by users of NHS services, such as access to an NHS dentist, access to GPs, waiting times for CAMHS and neurodevelopmental diagnosis, access to mental health services for adults including waiting times for IAPT and those in crisis in A&E, ambulance response times and waiting times in A&E, and queried whether these types of issues ought to be recognised in the forward plan together with plans as to how they are to be addressed.

c)     The Board understood that the forward plan was about what the NHS and the NHS Trusts needed to deliver to achieve the goals set out in the Integrated Care Partnership Strategy. It was stated that the plan was not clear or specific enough in describing what the NHS would do to contribute towards these broad goals. For example the plan included an objective to reduce the smoking rate to 5% by 2030, but this objective could not be achieved by the NHS alone and so the plan needed to be more specific about what action the NHS needed to take to contribute to the achievement of this target. Similarly there were references in the plan to broader determinants of health such as housing, dampness in homes and employment which were the responsibility of, and led by, other authorities. Such references to broader topics diluted the focus of the plan which ought to have sharper and clearer plans on what the NHS was required to deliver and to tackle the immediate pressures, such as those described in b) above. It was suggested that the broader topics and partnership working could be recognised in the plan by cross referencing to the Integrated Care Partnership Strategy.

d)    It was suggested that the plan ought to frame the objectives around health inequalities in terms of where the NHS can make a difference for example improving access to services and maximising the use of its staff.

e)    From the perspective of older people it was stated that that there were three important issues for the NHS to consider:

i)                 Access to NHS services

ii)               Good information and advice to allow older people to navigate around services and self prescribe; and

iii)              Co-ordination of care, to recognise users as customers on a single journey and not pass them on from one service to another.

f)      The Board highlighted the need to stabilise the primary care sector in the light of diminishing community services such as dentistry and pharamcies.

g)    The Board sought more detail on how the NHS would improve access for support for carers.

h)    It was stated that the objectives contained in the plan relating to the mental health and wellbeing of children and young people were weak, in part because of nationally determined constraints, and failed to reflect the experiences of parents of children in need.

i)       It was suggested that the plan contained too many objectives and that the use of metrics to support the objectives would help show the progress being made.

Resolved that the Board provide a written response to the North Cumbria and North East NHS before the deadline 31 August 2023 on its draft Joint Forward Plan 202-24 – 2028/29 based on the comments set out above.