Agenda item

·         Devolution – Taking charge in Manchester: Stuart North, Chief Operating Officer Bury CCG will report at the meeting, presentation attached.

 

·         Public Health Memorandum of Understanding: Lesley Jones, Director of Public Health will report at the meeting.  Presentation attached.

 

·         Bury CCG and Bury Council – One Commissioning Unit: Stuart North, Chief Operating Officer Bury CCG will report at the meeting and Pat Jones-Greenhalgh, Executive Director, Communities and Wellbeing will report at the meeting. 

 

·         Devolution:

 – implications for Children’s Services; Mark Carriline, Executive Director Children, Young People and Culture will report at the meeting.  Report attached.

– implications for Adults Services; Pat Jones-Greenhalgh, Executive Director Communities and Wellbeing will report at the meeting

·         Devolution Taking Charge in Manchester

The Health and Wellbeing Board considered a verbal presentation from Stuart North Chief Operating Officer Bury CCG.  The presentation contained the following information:

 

Greater Manchester Devolution Agreement settled with Government in November 2014; the agreement delegates powers over areas such as transport, planning and housing – and a new elected mayor with £22 billion to be handed to Greater Manchester.

 

Memorandum of understanding for Health and Social Care devolution signed February 2015 by NHS England plus the 10 Greater Manchester councils, 12 Clinical Commissioning Groups and 15 NHS and Foundation Trusts.   Local health and social care decision makers take control of estimated budget of £6 billion from April 2016.

 

The Chief Operating Officer Bury CCG reported that the devolution is necessary to address some of the poor health outcomes across Greater Manchester;

·         more than two thirds of premature deaths in GM are caused by behaviours which could be changed;

·         on any day there are 2,500 people in a hospital bed who could be treated at home or in the community

·         Four out of ten GM children are not ready to start school when they’re five-years-old; and four out of ten leave school with less than five GCSEs

·         By 2021 there will be 35,000 people in GM living with dementia; more than 10,000 will have severe symptoms and need 24 hour care

 

The Chief Operating Officer reported that work is already underway, by the end of December, hubs are operational in each CCG area, providing 7-day access for patients who need medical help across Greater Manchester with further hubs opening early 2016.

 

£450m has been earmarked to fund improvements known as the Transformation Fund.  In response to a Member’s question in respect of the transformation fund, the Chief Operating Officer reported that the Local Authority/CCG and partners will bid for the money; the money will be divided into two pots; an innovation fund and a separate amount for time limited dual running of services.  Effective and independent management of the Transformation Fund will be critical in ensuring the right projects are funded to deliver the agreed strategy.

 

In response to a Member’s query the Chief Operating Officer reported that the Elected Mayor will not have powers over health and social care devolution but instead will be accountable to the Council Leaders of the ten Local Authorities within Greater Manchester.

 

The Chair of the Board commented that the success of health and social care devolution will be reliant on Members of the Public changing the way they access health care and healthcare professionals will be required to focus on preventative work while patients will need to take a greater initiative to self care.

 

The health and social care policy lead reported that a Devolution Manchester engagement event in conjunction with radio station Key 103 will be held on Friday 4^th March.  The event will provide members of the public with an opportunity to express their views on the proposals/the Boroughs locality plan via an online survey and visit stalls which provide information about self care.  Members of the Board are encouraged to attend.

 

Dr Patel, Chair of Bury CCG provided members of the Board with an update in respect of the Primary Care Strategy.  Developed in 2014, the strategy contains four primary care core standards. 

 

Firstly to provide access to primary care seven days a week; Dr Patel reported that the CCG have enabled this access by using monies made available from the Prime Minister Challenge Fund.  Secondly the CCG has provided support to those living with long term conditions in particular those suffering from Dementia, by providing specific care plans and dementia advisors.  Thirdly, the development of sharing of electric records; records can now be viewed by all stakeholders.  Finally by the end of 2016 there will be performance measures for all GPs.

 

The Primary Care Strategy has been revised, taking into account best practice from across all of the twelve CCGS within Greater Manchester; this will be signed off in the next two weeks.

 

In response to a Member’s question, the Chair Bury CGG reported that workforce development remains a big challenge for all partners; different staff will be required to deliver a different type of service going forward.  The Director of Public Health reported that a series of workshops will be held to discuss the future of the primary care workforce. 

 

·         Public Health Memorandum of Understanding (MoU)

 

Lesley Jones, Director of Public Health provided members of the Board with a verbal update in respect of the recently signed Public Health Memorandum of Understanding. This has since been translated into Chapter One of the GM Health and Social Care Strategic Plan which has an ambition for the fastest possible improvement to the health and wellbeing of the 2.8 million citizens of the conurbation.

 

The Director of Public Health reported that the Strategic Plan requires a substantial reduction in demand for health and care services in part as a consequence of transformational improvement of population health and wellbeing.

 

Agreement reached to create a single co-located team and virtual team for Public Health in Grater Manchester reporting to the Director of Population Health Transformation.  Work is underway with PHE to ensure that their staff resources are effectively integrated with NHS England’s public health commissioning function as a core part of the unified public health system.

 

The Population Health element of the Strategic Plan contains areas for specific attention including; more people managing health; finding the missing thousands; starting well; living well and ageing well.  The Director of Public Health provided members of the Board with details of initiatives within the Borough already underway in respect of the different aspects of the plan.

 

The Director of Public Health reported that a campaign is underway, led by the Director of Public Health at Wigan to make health and wellbeing the fifth licensing objective.

 

In response to a Member’s question, the Director of Public Health reported that there have been cuts to the public health budget of one million pounds; the remaining public health budget will be ring-fenced for the next two years.

 

·         Single Commissioning Unit

 

The Chief Operating Officer reported that Bury CCG and Bury Council has signed a radical joint commissioning strategy to integrate the health and social care function.  The senior management team from both organisations continue to meet, cultures will begin to align.

 

In response to a Member’s question the Chief Operating Officer reported that the aim of the integration is to get the best value and the best quality for the money available.  The Executive Director Communities and Wellbeing reported that the success of the integration will be measured in neighbourhoods being further engaged, money being invested more efficiently and a workforce fit for purpose.

 

·         Devolution – implications for Children’s Services

 

Mark Carriline, Executive Director, Children, Families and Culture provided Board members with a Verbal update in respect of the Devolution implications for Children’s Services.

 

In summer 2015 Greater Manchester’s ten local councils agreed to work with central government to undertake a fundamental review of the way children’s services are delivered.

 

 The ambition for the review is to identify and learn from best practice and develop new approaches that will improve outcomes for children across Greater Manchester.

It aims to do this by:

• Supporting families, parents and carers to be confident and resilient

• Developing new models of early intervention, prevention and provision

• Reducing, appropriately, the number of looked after children, children in need and those with child protection plans by making the best use of our shared resources and expertise across Greater Manchester

• Making the most of the money we have to deliver services by developing new integrated commissioning arrangements

 

Each theme area is being led by the Directors of Children’s Services from the different areas of Greater Manchester. The review will involve the development of a range of different options.  These business cases will be reviewed by Chief Executives and will be subject to approval by the Department of Education, HM Treasury and individual local authorities in March with an aim to move to implementation from April 2016.

 

The Chair invited questions:

In response to a Member’s question in respect of CAMHS provision, the Executive Director reported that Children’s Services, the CCG and Pennine Care CAMHS Team submitted a bid for monies via the Local Transformation Plan.  This money will provide additional funding for CAMHS.

 

In response to a question from Stuart North, Chief Operating Officer, Bury CCG in respect of the role of the CCG in supporting Children’s services in instances where a Children’s residential home is rated inadequate.  The Executive Director, Children, Culture and Families reported that there were already a number of statutory interventions in place.  The Executive Director reported that there are no Council run children’s homes in the Borough.

 

·         Devolution – implications for Adult Services

 

Pat Jones Greenhalgh, Executive Director, Communities and Wellbeing and Chris Woodhouse, Improvement Advisor provided Board members with a verbal update in respect of the Devolution implications for Adult’s Services.

 

The presentation included the following information; work is underway through Greater Manchester Directors of Adult Social Services to review the locality plans – to consider what could be done once across Greater Manchester in respect of what would be best across a sector/cluster, and what best, or needs to be done, in the locality.

For Adult Social Care Services there are a number of priority areas:

·         Transformed care models for all types of support provided to people who live in their own homes

·         Redesign of health and care provision to allow people to live and stay at home, a new model of ‘home-care’

·         There are enough beds in the systems, in people’s homes (including supported accommodation)

·         Rapid improvement in intermediate care, discharge to assess facilities and ‘home’ capacity, will improve system resilience

Further develop infrastructure and governance capacity to commission at pace, with stronger links to CCGs and partners including housing and VCS, with modern, fast pace procurement and collaboration over relevant spatial levels