Agenda item

A presentation was made at the meeting by Will Blandamer (Executive Director, Strategic Commissioning, Bury Council and Bury CC) who provided an overview of Health & Care Recovery and Transformation.

This report was intended to identify areas that the committee may want to focus their attention on at future meetings.

The presentation provided information on the refreshed Bury locality plan for health and care reform (2019-2024).

An un-transformed health and care system was projecting a financial deficit of £86m by 2024 due to anticipated growth in demand.

Work was required to:

•Significantly improve population health and tackle health inequalities.

•To support people to take charge of their health and care and lives.

•To have access to integrated out of hospital services that promote independence, prevention of poor health, and early intervention.

•To access good quality hospital services where required.

•To reduce dependence on institutional care –hospitals and care homes.

A whole system approach was required because the health and care system was unaffordable unless there was reduced demand and costs due to:

•Many of the determinants of health and wellbeing along with the demand for health and care services are found within the council and other partner services.

•There was a need to join health and care services together to provide a better service to patients/residents, and it is a precondition for spotting opportunities to prevent poor future poor health.

•Need to support patients/residents to be in control, and not only look at them from our own individual organisational perspective.

•Bury residents access hospital services across other boroughs and we need to have a shared view of how to transform those.

Conditions were being created to work as effectively as possible in a system and these included:-

•Joint appointments between the Council and CCG, two organisations working as one.

•Joined up commissioning, Strategic Commissioning Board, clinical and political leadership having a single view of the money available and aligned.

•Joined up provision of out of hospital services with the Bury Local Care Organisation.

•Building strong relationships with care providers in the borough as part of the system not outside it.

•Part of the GM arrangements, particularly in relation to the reconfiguration of some hospital services to be clinically and financially viable.

•Working with Oldham, Rochdale and Salford, because the hospital services most of Bury residents access are organised by a hospital trust on that footprint.

•Making a clear strategic alignment between the health and care transformation programme and the emergent Bury 2030 vision.

A diagram of the partnership system in Bury, Health & Care Recovery and Transformation Programme Structure was presented to Members.

Details on SCB budgets and 2020/21 savings plans (pre Covid) mapped to work programmes were also highlighted at the meeting.

Big issues coming forward from the recovery and transformation programme which the committee may want to list on future meetings, included:-

•Urgent care system reform, alternatives to attending A&E and reduction of unplanned admissions to hospital and urgent care by appointment.

•Planned care system reform, different ways of delivering outpatient services.

•Community Based services, focus on neighbourhoods.

•Intermediate care, to support people to recover or to stay out of institutional care.

•Changing nature of primary care (GP and others).

•Learning Disabilities service transformation (all age and integrated).

•End of Life Care.

•Children's Health and Care Commissioning (SEND).

•Mental Health (Children's and young people).

•Population health, wider determinants, lifestyle issues and community connections.

Councillor Walker questioned if more concentration should be aimed at Covid and Dr Schryer added the crisis had provided an opportunity of closer working partnerships with systems changed for the better within the last 6 months. There was a challenge but feedback had been positive and opportunities presented to move forward different health problems in Bury.

Tyrone Roberts, Director of Nursing at Fairfield Hospital felt it was an exciting vision for Bury and being proactive was a good way forward for public health. He added that the circumstances of Covid had made organisations and departments work closer together than ever before.

Councillor Walmsley commented on health inequalities and life expectancy along with examples of mental health services. Will Blandamer stated that the presentation was aimed at the committee to provide a framework and opportunity to focus on topics over time and that the right people will attend and report.

Health inequalities would be in the Bury 2030 strategy and mental health services waiting times were a real challenge at the moment with Covid. Other mental health factors would be considered by engaging with local communities on items such as loneliness although there was real concern on the impact of mental health and wellbeing due to the current pandemic.

The Chair, Councillor Stella Smith understood the current situation was hard to place timescales on the plans and what strategies were in place to achieve the required goals.

Again under challenging times there were huge demands on some reduced services which may continue with a second wave. The aim was for operational arrangements to be in place pre Covid levels with a transformation programme set and embracing the use of digital technology within the health and care sector.

The focus has to be on delivering a transformation programme to achieve the required outcomes and be financially viable.

Frontline staff were praised along with their managers in doing an amazing job and there was a need to continue and keep supporting transformation.

Councillor Walker talked about Government grants to join up health work across an area and it was explained that there were rules in place which prevented some pooled budgets in the NHS.  

The structure in Bury provided an opportunity for both political and clinical leadership in a joint approach.

Councillor Grimshaw gave an example of a local resident contacting her having severe fears of Covid and how it was affecting their OCD mental health condition but could not access any health service support.

It was acknowledged that mental health would be affected and the Chair commented that this topic would be covered again on the Health Scrutiny work programme at future meetings.

It was agreed:

That the report and presentations be noted.