Agenda item

Will Blandamer, Executive Director of Strategic Commissioning to present at the meeting. Reports attached.

Will Blandamer, Executive Director of Strategic Commissioning, presented a report regarding the operating model for the Bury Integrated Care Partnership and the refreshed Bury Locality Plan which set out the ambition for strategic reform.

Members noted that the legislation to abolish the CCG from 1 April 2022 had been delayed until 1 July 2022. CCGs currently carried the bulk of funding for NHS services in Bury, but CCG functions would be taken over by a Greater Manchester (GM) Integrated Commissioning Board (ICB). Recruitment of the leadership for that organisation had begun, with Sir Richard Leese appointed at the Chair and Chief Exec and Non-Executive Directors yet to be appointed.

Even though the CCG was being abolished, Bury was committed the Council and the NHS working together to establish a shared understanding of the needs of the borough and of budgets (including the pooled budget). Architecture for the wider integrated care system was forming, not just from the Council and CCG but including colleagues from all over the system collaborating to drive transformation. This would enable decision making structures currently working well in Bury to endure and be amplified.  

Work was ongoing to build this architecture, with clarity over governance, relationships, and decision making required as well as need to ensure clinical expertise was not lost in the leadership of Bury. This was being addressed through a Clinical and Professional Senate which would support the Locality Board (which led on strategy for the borough) and the Delivery Board (which would drive programmes of work). These groups were already operating in shadow form, and clarity over financial flows was being developed to ensure that oversight of funding for the borough as a whole was retained. 

With regards to the Locality Plan, Will advised this was the strategy document setting out the aims and ambitions. A step-change was wanted, with residents in control of their own wellbeing and in control of how services were organised around them. Services would be provided close to home, joining up teams in neighbourhoods, and there would be a focus on early intervention and prevention. Retaining the best of having clinical and political leadership would enable every opportunity to collaborate with colleagues across the GM footprint to control costs through economies of scale, while ensuring Bury retained localised services to address residents’ needs.

Councillor Andrea Simpson, Cabinet Member for Health and Wellbeing, advised that further investment into early intervention and prevention was needed if real change to health inequalities was to be achieved. Continuing as currently wouldn’t secure a different outcome, and she hoped this change would provide the opportunity to do that. She stated that residents wouldn’t see a huge change for the first few years, in order not to destabilise existing services, but that if services could be commissioned in a different way it may change the way our community worked for the better.

Councillor Lewis expressed his hesitancy about the proposals. He expressed concern that this was reliant on trust, with 10 boroughs working together but with their own interests, and believed each borough should control their own finances. Will Blandamer offered clarity that the issues regarding financial flows related to NHS spend, not Council budgets. He further advised that NHS monies already flowed to CCGs through a GM structure, so this would not be changing.

Councillor Birchmore raised a point regarding the complexity of the care system, particularly regarding independent living and institutionalised care, and stated she thought this would be worse in a bigger system.

Councillor Brown stated that there were suggestions the system was not working and queried GM involvement, stating that he suspected eventually GM would overrun localities. Will Blandamer advised that governance was important to ensuring Bury’s needs were addressed. To this end, a Place Based Lead would be selected for each locality who would have accountability from GM and from the locality, as well as the authority to drive forward priorities from their borough. Local accountability and leadership were built into the model, with the Bury Locality Board and GM ICB holding each other to account. Will advised that GM was “of us” not “doing to us”, and this model would help ensure a balance between some services being commissioned once throughout the GM footprint, and others commissioned locally and under local control.

Councillor Simpson advised that getting the structure right was important in ensuring Bury had a say in how things were managed. The biggest risk was around deprivation, with other GM boroughs having higher levels of deprivation and therefore possibly requiring more funding. She acknowledged that Bury was part of GM and needed to be responsive to our partners and raise standards across the region.

Councillor Holt asked about the involvement of children’s services and Will Blandamer advised that this was included in the locality plan, with opportunities being explored for health and care services to work with children’s services and schools in neighbourhood.

It was agreed:

That the update be noted.