Agenda item

a) The GM ICS discussion - Partnership Executive Board paper

b) Update on the developing arrangements.

c) An update on the work of Carnall Farrar on the North East Sector footprint.

The Chief Executive, Bury Council / Accountable Officer, NHS Bury CCG and the Chief Officer, Bury Local Care Organisation presented three joint reports on the developing arrangements for the Integrated Care System (ICS)

The Board received a report presented to the GM Health and Care Partnership Executive Board and the GM Health and Care Board which sought to reset a number of GM wider discussions on the future form and shape of the Greater Manchester Integrated Care System (GM ICS). Members discussed the report, making the following points:

·         Workshops would be held over the next month with two representatives for each Borough, including key providers, professionals and clinical leaders to represent a cross section of sectors, organisations and localities in GM.

·         It was noted that the task wasn’t necessarily how to comply with the requirements of white paper, but instead to work out what was best for Bury and ensure the legislation was permissive of that. Although the White paper proposed two boards, it was hoped Bury could continue with a single operating model.

·         The timetable for establishment was clear, with proposals being submitted in spring 2021, shadow arrangements in place for late summer/early autumn, and legislation in spring 2022.

·         With regards to how residents would be involved it was noted that Bury’s representatives at the workshops would bring their understanding based on local views, and that community and voluntary sector representatives were included in the workshops. Moving forwards, neighbourhood focus would be built into design with a grass roots system supported by the ICS.

·         Members discussed the bigger ask on communities and noted that more support and appropriate infrastructure was needed for volunteers to take on these responsibilities. Concerns were raised over the unknowns around governance and finance, and it was noted that key historical knowledge could be lost with staff changes.

The Board received a report which provided an update on progress establishing the previously agreed framework for the system, providing early consideration of the objectives and membership of the Bury Locality System Board and the Bury Integrated Delivery Collaborative Board, and describes the developing work of on building the capacity and capability of integrated neighbourhood teams in health and care. Members discussed the report, making the following points:

·         Innovation was needed to engage with residents in a different and meaningful way, making locality groups fit them and empowering them to tell us what they want. 

·         It was agreed that the aim was to improve health over the course of a generation, not just seeking to deliver services but to address health through a holistic approach.

·         Concerns were raised over the current scattered and hierarchical clinical voice. A representative senate and a ‘golden thread’ was needed throughout governance to facilitate the right conversations at System Board.

·         It was noted that intelligence was needed to enable decision making at neighbourhood level, devolving power and budgets to resource communities effectively.

·         The Board were advised that much of that detail was still to be worked through as well as the governance behind devolving resources. Better understanding was needed of our staff resources, to ensure all managerial, clinical and professional expertise was being utilised.

·         The Board noted that final Terms of Reference would be developed and the LCO agreement expanded to reflect the new arrangements. These would then be ratified by the System Board before being taken through the existing governance arrangements of the Cabinet, Council and Governing Body. It was also noted that this would be a regular agenda item.

The Strategic Commissioning Board: Received and noted the reports.