Agenda and minutes

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Venue: Bury Town Hall

Contact: Emma Kennett, Head of Corporate Affairs and Governance (CCG)  Email: emma.kennett@nhs.net

Items
No. Item

36.

Welcome, Apologies & Quoracy

Minutes:

The Chair welcomed those present to the meeting and noted apologies.

 

The Chair advised that the quoracy had been satisfied.

 

The Strategic Commissioning Board: Noted the information.

37.

Declaration of Interests pdf icon PDF 318 KB

Minutes:

The Chair reported that the CCG and Council both have statutory responsibilities in relation to the declarations of interest as part of their respective governance arrangements.

 

It was reported that the CCG had a statutory requirement to keep, maintain and make publicly available a register of declarations of interest under Section 14O of the National Health Service Act 2006 (as inserted by Section 25 of the Health and Social Care Act 2012). The Local Authority has statutory responsibilities detailed as part of Sections 29 to 31 of the Localism Act 2011 and the Relevant Authorities (Disclosable Pecuniary Interests) Regulations 2012.

 

The Chair reminded the CCG and Council members of their obligation to declare any interest they may have on any issues arising from agenda items which might conflict with the business of the Strategic Commissioning Board.

 

Declarations made by members of the Strategic Commissioning Board are listed in the CCG’s Register of Interests which is presented under this agenda and is also available from the CCG’s Corporate Office or via the CCG website.

 

      Declarations of interest from today’s meeting

 

The Deputy Leader, Cabinet Member Children, Young People & Skills, Bury Council declared a personal interest owing to his employment at Healthwatch Oldham. It was noted that this was included on the Declaration of Interest Register.

 

      Declarations of Interest from the previous meeting

 

There were no declarations of interest from the previous meeting raised.

 

The Strategic Commissioning Board: Noted the published register of interests.

38.

Minutes of the last Meeting and Action Log pdf icon PDF 566 KB

Minutes:

      Minutes

 

The minutes of the Strategic Commissioning Board meeting held on 12 April 2021 were agreed as an accurate record.

 

       Action Log

 

The following updates were provided in respects of the Action Log:

 

       A/04/09 – Noted that a paper on initial thoughts and proposals for the Radcliffe model would be brought to the Board’s meeting in August

 

The Strategic Commissioning Board: Approved the minutes of the meeting held on the 12 April 2021.

39.

Public Questions

Minutes:

There were no public questions raised.

 

The Strategic Commissioning Board: Noted the information.

40.

Chief Executive and Accountable Officer Update

Minutes:

The Chief Executive, Bury Council / Accountable Officer, NHS Bury CCG provided an update on the latest CCG and Council developments.  It was reported that: -

 

       The rates of the Delta variant of Covid-19 were rising across the North West and Bury was working to support people through this next wave, with an increased effort to communicate and engage with residents to ensure safety measures were being adhered to.

       Work was underway to increase levels of testing and vaccinations. Testing on site in schools and colleges was expected in the coming weeks and additional vaccines had been successfully distributed in pop-up centres, although more was required to close the gaps in neighbourhoods with low take-up.

       The first half of the year had been modelled, with work regarding the backlog of cases for elective care and increased demand into primary care, rollout of improvements to mental health services, pressure on the acute sector, and work to manage the budget deficit.

       Members noted that the government had not been forthcoming with enhanced support, despite requests. Although Bury continued to manage the crisis with existing resources, it was agreed that it would be worthwhile to see the revenue cost if no additional support was given.

 

The SCB extended their thanks to everyone involved with the vaccination programme, including clinicians, volunteers, and the senior management team.

 

The Strategic Commissioning Board: Noted the update.

41.

SCB Membership pdf icon PDF 242 KB

Minutes:

The Chief Executive, Bury Council / Accountable Officer, NHS Bury CCG presented a report which set out the revised membership and voting arrangements for the Strategic Commissioning Board in light of the recent changes to the Council Cabinet following the Local Elections in May 2021 and recent changes within the CCG. It was noted that each side would now have eight voting members (down from nine), and that the number of opposition party representatives be increased to three. No changes to quoracy were proposed.

 

The Strategic Commissioning Board: Supported the revised membership and voting arrangements for the Strategic Commissioning Board as set out in the paper and revised Terms of Reference and recommended that the draft Terms of Reference to the respective governance arrangements for formal approval.

42.

Update on the White Paper/Integrated Care System (ICS) pdf icon PDF 1 MB

a)    Update on GM ICS Transition

b)    Update on Bury Partnership Arrangements

Additional documents:

Minutes:

The Chief Executive, Bury Council / Accountable Officer, NHS Bury CCG and the Joint Executive Director of Strategic Commissioning, Bury Council & NHS Bury CCG presented two joint reports on the GM ICS Transition and Bury Partnership Arrangements.

 

Members discussed the reports in detail, making the following points:

       With regards to an accountability framework, the aspiration was for a focus on peer challenge and support, similar to Local Government arrangements, alongside a top down system of assurance.

       There was a need to link forthcoming changes in with the challenges identified over the past years, particularly the lessons learned through responding to Covid, which exposed inequalities in not only the virus but the ability to respond with services.

       Members discussed the importance of people engagement and the need to ensure these systemwide changes were made relevant to and understood by local people. This wouldn’t be limited to engagement with the hubs, as proactive engagement with residents and people with lived experience was needed. Not just codesign but working with people across the system, empowering them to go out to their communities and speak with people, to reach those who didn’t normally engage.

       The structure of the new Boards and their Terms of Reference were being developed but wouldn’t be established until the governance and decision making implications had been fully realised. It was noted sign-off would come before this Board and was expected for the September meeting.

 

The Strategic Commissioning Board: Received and noted the reports.

43.

2021-22 Activity and Primary Care Workforce Plan Update pdf icon PDF 301 KB

Minutes:

The Joint Executive Director of Strategic Commissioning, Bury Council & NHS Bury CCG presented a report which set out the high-level requirements of the 2021-22 plan along with the assumptions applied in the final version. Members discussed the report and noted this had been submitted to the Greater Manchester Health and Social Care Partnership (GMHSCP) which combines submissions from all Greater Manchester (GM) CCGs and providers into a single GM system-wide plan.

 

The Strategic Commissioning Board: Received the updates relating to 2021-22 planning contained within this report.

44.

Northern Care Alliance (NCA) - Urology Reconfiguration pdf icon PDF 374 KB

Minutes:

The Joint Executive Director of Strategic Commissioning, Bury Council & NHS Bury CCG presented a report co-authored by locality commissioners and the NCA, which provided an update on the strategic direction of the Urology Reconfiguration Programme.

 

Members discussed the report, querying the lack of detail particularly with regards to an end-to-end clinical pathway and what can be done in the community, and expressing their reservations regarding mobilisation without this information. 

 

The Strategic Commissioning Board: Noted the strategic direction of the Urology Reconfiguration Programme which is fully consistent with the Greater Manchester Model and the phased approach to mobilisation overseen by the Urology Reconfiguration Programme Board.

45.

Housing Strategy - Delivery Action Plan pdf icon PDF 271 KB

Minutes:

The Chief Executive, Bury Council / Accountable Officer, NHS Bury CCG presented the report which set out an update on the Housing Strategy and delivery of the strategic priority action plan.

 

Members discussed the report, in particular the importance of transition planning for families or elderly residents, and the unknown effect long Covid might have on the demand for accessible housing.

 

The Strategic Commissioning Board: Noted the update on the Housing Strategy and delivery of the strategic priority action plan.

46.

Finance / Budget Update

46a

Integrated Commissioning Fund

Minutes:

The Executive Director of Finance, Bury Council & NHS Bury CCG presented the report which provided an update on the ICF budget. For 2021/22 the net ICF expenditure budget was £520m, a consolidation of the 3 budgets (Pooled, Aligned and In-view). For ease and to enable consistent reporting across the integrated organisation, the CCG had assumed the same level of funding and expenditure for the second half of the year as the first. While the financial framework for the second half of the year was unknown, significant efficiencies were expected.

 

The Board noted that within the ICF were challenging savings targets. For expenditure incurred through the CCG, planning identified a full year savings target of £4.2m of which £0.9m had been identified in the CHC directorate, with schemes for the remaining £3.3m still to be worked up. For expenditure incurred through the Council, proposals on efficiency savings of £4m and service reductions of £4m on top of a £12m planned use of reserves was required to balance the budget.

 

Members discussed the report, noting that Bury was benefitting from the GM system’s peer challenge approach, and that efficiencies were being driven forward while the capacity was there. Outcomes of the programme were monitored as well as the financial aspects and would be brought to the Board in August.

 

The Strategic Commissioning Board:

·         Noted the opening ICF budget based on approved Council and CCG budgets.

·         Approved the pooled budget element of the ICF.

·         Noted the uncertain CCG finance regime beyond September.

46b

Bury CCG Transformation Funding

Minutes:

The Executive Director of Finance, Bury Council & NHS Bury CCG presented the report which provided a position statement on the £19.5m non-recurrent transformation funding received in 2016, including the use from 2016 to March 2021 and those schemes still in operation, how they are currently being funded and the need to find a funding solution for them. It was noted that a follow-up paper would be brought to the Board in August.

 

The Strategic Commissioning Board:

·         Noted the content of this report and the financial risks to the Bury system.

·         Noted the Council is holding a reserve of £0.75m from 2020/21.

·         Noted the CCG £4.5m additional allocation to the Pooled Fund in March 2021 includes £2.5m of transformation funds.

·         Noted GM is holding £1.2m for 2021/22, due to be paid if Covid funding stopped at the end of quarter 1. Given half year (H2) allocations the position needs to be clarified, as this funding could potentially go some way to bridging the gap in H2.

·         Noted the need for regular updates to ensure ongoing accuracy and completeness of the information provided and to evidence the success of the transformation programme and related schemes.

·         Noted the need for a recurrent funding solution/agreement during 2021/22 for the underlying deficit full year effect costs of £5.7m (Programme 3, 6 and LCO costs).

·         Considered the need for an assessment of the realisable benefits for those schemes that have ceased in March 2021.

47.

Performance Update pdf icon PDF 244 KB

Minutes:

The Joint Executive Director of Strategic Commissioning, Bury Council & NHS Bury CCG presented the report which set out the current position against a number of the main CCG Performance Indicators along with an overview of the impact to these during the current response to the COVID-19 pandemic.

 

Members discussed the report, noting that penalties had been suspended for the year but incentives were still offered. With regards to areas of concern, it was noted that despite a robust plan for elective care, the scale of the task was still challenging. Mental health was another area of concern, with the effect from the pandemic yet to be fully realised. It was noted that services had been put in place for lower levels of intervention but more was needed for complex cases. It was agreed that this be brought to a future Board meeting for discussion.

 

The Strategic Commissioning Board:

·         Received the update and noted the areas of challenge and action being taken.

·         Agreed that complex mental health needs be discussed at a future Board meeting.

48.

Minutes of Meetings pdf icon PDF 451 KB

a)   Bury System / Transition Board Minutes

Minutes:

Minutes of the Bury System/Transition Board meeting held on 15th April 2021 were noted.

 

The Strategic Commissioning Board: Noted the minutes.

49.

AOB and Closing Matters

Minutes:

The Chair summarised the main discussion points from today’s meeting and thanked members for their contributions.

 

As this was her last SCB meeting, the Board expressed its thanks to Julie Gonda, Director of Community Commissioning, Bury Council, for her high-quality work, her integrity, honesty, and her innovative role in joint working, and wished her the best for the future.

 

The Strategic Commissioning Board: Noted the information.