Agenda item

Briefing Note of the Executive Director of People

Andrea Green, Coventry and Rugby Clinical Commissioning Group (CCG) has been invited to the meeting for the consideration of this item

Further to Minute 23/16, the Board considered a briefing note of the Executive Director of People which set out the background to the development of the Sustainability and Transformation Plan (STP); provided information on the STP; and informed of the next steps in terms of further development and engagement. The STP had been released publicly the previous day and copies had been made available to Members. Andrea Green, Coventry and Warwickshire Clinical Commissioning Group (CCG), Andy Hardy, University Hospitals Coventry and Warwickshire (UHCW) and Chair of the STP Programme Board and David Williams, NHS England attended the meeting for the consideration of this item. Councillor Duggins, Cabinet Member for Policy and Leadership was also in attendance.

The Board were informed in December 2015 NHS England outlined a new approach to help ensure that health and care services were built around the needs of the local population with the introduction of STPs, based upon integration and joint working across the Health and Wellbeing system. They would put into practice the NHS Five Year Forward View and address the health and wellbeing gap, the care and quality gap and the funding and efficiency gap. It had been agreed that Coventry and Warwickshire would form a ‘footprint’ for their STP.

The vision for the Coventry and Warwickshire STP was: ‘To work together to deliver high quality care which supports our communities to live well, stay independent and enjoy life.’ A commitment to both prevention and integration lay at the heart of the STP development. This intent was supported by the Coventry and Warwickshire Health and Wellbeing Boards Alliance Concordat, which was signed by both Boards in October, 2016. A copy of the Concordat was attached at an appendix to the report.

The report indicated that the Coventry and Warwickshire STP was being led by the NHS and the other partner organisations including the City Council were set out. Each of the partner organisations were represented on STP Board who had responsibility for the development of the STP.

The draft STP had been submitted to NHS England for assurance on 21^st October and had been made public the previous day, in accordance with NHS England requirements. Although the document had been leaked the week before. This official publication formed the start of the engagement process to discuss the content and direction of the STP. To ensure that the STP was developed with, and based upon, the needs of local residents, patients and communities and engaged with key stakeholders, a draft Engagement Plan had been developed, Minute 40 below refers. A timeline for communicating with key stakeholders was set out at a second appendix to the report including consideration by Cabinet and Council. 

Andy Hardy, UHCW, further informed the Board of the recent process that had led to the publication of the STP; the reasons behind the decision to introduce STPs; and the challenges to be faced. He drew attention to the five transformation work streams: proactive and prevention, urgent and emergency care, planned care, maternity and paediatrics, and productivity and efficiency. He emphasised that the publication of the STP was the start of a full engagement process and that no decisions had been taken at this stage. He raised a concern about the leaking of the STP and the impact that this had had on staff.

Councillor Duggins, Cabinet Member for Policy and Leadership outlined his support to the Council’s involvement with the STP, clarifying that the Plan was still to be considered by both Cabinet and Council. 

The Board questioned the representatives and officers present on a number of issues and voiced their concerns and responses were provided, matters raised included:

·  Further information about the involvement of NHS England in the process, particularly the assurance of the STP including criteria used to approve the report

·  A concern that the STP included a statement that the statutory organisations, including the City Council, had considered the plan and signed up to it in advance of the submission, when the STP was still to be considered by both Cabinet and Council

·  An explanation of the sign off process

·  How the STP would address the funding challenges to be faced

·  In light of the leaking of the STP to the local media, the need to ensure that the right messages are given out to Coventry residents

·  Clarification about engagement and consultation

·  The suggestion that the STP consultation needs to be informative, clearly explaining the need for patients to engage with the system taking responsibility for their own health and not presenting as an emergency

·  Further information about the proposals for engagement

·  A concern about proposals for better extended access to GPs and for more opportunities for home births – how could the role of GPs be extended if there was no spare capacity and more homebirths would mean the employment of additional midwives

·  An acknowledgement of the significant workforce challenges to be faced in the light of potential changes to the health system

·  Reference to the expertise at Coventry and Warwick Universities in relation to health and wellbeing issues

·  Further information on staff appointments for maternity and paediatrics

·  A concern about the potential for maternity and paediatrics to operate from one site

·  The suggestion of requiring a strategy to deal with all the negative publicity arising from the leaking of the STP document

·  The importance of engaging with local politicians throughout the engagement process and the importance of partnership working

·  The view that the success of the STP depended on the involvement and support of local Councillors

·  Support for the proactive and preventative care work-stream

·  Concerns about the difficulties of getting GP appointments at the current time

·  Further information about the joint Health and Wellbeing Concordat

·  Concerns that the STP was unrealistic in its assumptions about the level of reduction in patient activity including A and E attendances

·  Concerns about the terminology used in the report meaning members of the public would have difficulty understanding the document

·  An acknowledgement that clarity was required on the individual themes prior to engagement with the public

·  Clarification about the suggestions that there would be an application of stricter thresholds for surgery

·  What would be expected when the STP was submitted to Cabinet and Council

·  The importance of all partners committing to work together and sharing experiences when engaging on the five priority work streams.

RESOLVED that the current position and progress of the Coventry and Warwickshire Sustainability and Transformation Plan be noted.