Agenda item

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

The Board considered a report of Andrea Green, Coventry and Rugby Clinical Commissioning Group (CCG) which informed of the current status of the Out of Hospital project, key areas for development and the anticipated progress to March, 2019. Andrea Green and Jenni Northcote, Coventry and Rugby CCG, and Justine Richards, Coventry and Warwickshire Partnership Trust (CWPT) attended the meeting for the consideration of this item. Councillor Abbott, Cabinet Member for Adult Services was also in attendance.

The report indicated that the Out of Hospital (OoH) programme represented a significant component of the Health strategy for the CCG and the Better Health, Better Care, Better Value partnership plan. It was an ambitious programme which aimed to achieve integrated community services capable of meeting population needs through using an outcome based commissioning approach. Commissioners had jointly undertaken a process which aimed to transform the commissioning and delivery of the service across Coventry and Warwickshire. Underpinned by extensive public, patient and stakeholder engagement the programme sought to address the structural, cultural and professional barriers to delivering person centred care. 

The Board were informed that Coventry and Warwickshire Partnership Trust and South Warwickshire Foundation had collaborated to develop a new operating model to support the future delivery of the OoH services across Coventry and Warwickshire. The Coventry and Rugby CCG Governing Body subsequently adopted this clinical model. In July the Governing Body gave approval to progress the Coventry element by developing a lead provider contract with CWPT. The report detailed the CWPT contracted services included in the scope of the model.

The report set out the following objectives required to be delivered by the project:

·  To reduce health and wellbeing inequalities

·  To address the care and quality gap by ensuring more services use evidence based best practice

·  Identify those in most need and co-ordinate their care more effectively by commissioning and ensuring interdisciplinary working

·  To work within tight financial parameters by developing and delivering services around the needs of patients and carers, and reduce duplication and waste of resources.

Further information was provided on the City Wide Hub which co-ordinated the delivery of the Coventry and Rugby wide services. The Hub would support active case management for planned care and deploy resource responsively across the care system. It would co-ordinate access for urgent community and hospital services which had extended operating hours and was universally accessible for all healthcare professionals. The hub would hold information and be the central contact for the local hubs supported by access to shared care plans.  In addition, placed based teams would be set up, built around populations of 50,000 based on groups of GP practices who would work together to co-ordinate and lead the local placed base system i.e. primary care homes. There would be multi-disciplinary teams with primary care at the centre.

The report detailed what the first year of the three year implementation period would look like including anticipated improvements and the impact for Coventry residents. This included people experiencing more person-centred and co-ordinated care and support in their community due to increased collaboration between partners. The total value of the model for Coventry and Warwickshire was £57.4m with Coventry’s element being £21.7m. The governance arrangements for the programme were set out. The Board were informed how the project would further integration between health and social care. 

Members raised a number of issues arising from the report and responses were provided, matters raised included:

·  The potential links with the existing family hubs

·  The opportunities to put health centres in local schools

·  Further information about the options to connect fragmented services

·  Request for a detailed explanation of the city wide hub and where it would be based

·  Clarification about the funding arrangements

·  How the success and quality of the Out of Hospital programme would be measured

·  The commissioning arrangements for the primary care homes

·  Whether each primary care home would provide different services to meet the differing needs of the populations

·  What the future provision would look following the full implementation of the programme

·  Details about the partnership working with Adult Services

·  The potential to have just one organisation to be responsible for health care. 

RESOLVED that:

(1) The content of the report detailing the current status of the Out of Hospital Project, key areas for development and the progress expected to be made up until March 2019 be noted.

(2) A further report on how the Out of Hospital model is working be submitted to a future Board meeting in approximately 6 to 12 months.