Agenda item

Report of Professor Sir Chris Ham, Better Health, Better Care, Better Value

The Board considered a report of Professor, Sir Chris Ham, Independent Chair of the Coventry and Warwickshire Health and Care Partnership, on the review of the governance arrangements in the Coventry and Warwickshire Health and Care Partnership. The review had been carried out in preparation for becoming an accredited Integrated Care System. The objective of the review was to ensure that any future architecture would enable efficient and effective decision making and that there was alignment across the system with regard to the agreed vision and purpose. 

The report detailed the membership of the Task and Finish Group set up to undertake the review along with their agreed principles to inform and steer discussions. The Group held 4 formal meetings supplemented by informal conversations between the Chair and various leaders across the system to ensure that a wide range of views and experiences were fed into the discussions. 

The report referred to the building of existing arrangements to develop new, collaborative relationships. Reference was made to the 19 neighbourhoods/ primary care networks where GP practices worked with community and social care services to offer integrated health and care services. These services sat within the four local Places (Coventry, Rugby, South Warwickshire and Warwickshire North). These were the primary units for partnerships between NHS services, local authorities, charities and community groups who worked together to improve people’s health and the quality of their health and care services. The focus of these partnerships would be to move away from simply treating ill health to preventing it and to tackling the wider determinants of health such as housing, employment, social inclusion and the physical environment. The Board were informed that the Place-based partnerships were key to achieving these ambitious improvements. 

The place-based partnerships needed to be complemented with a common vision and shared plan for Coventry and Warwickshire as a whole system. The benefits of system working were highlighted.

The Board noted the proposed Partnership governance arrangements which would build on existing system arrangements, particularly the work undertaken by the Coventry and Warwickshire Place Forum. A new Partnership Board would be established to provide the formal leadership for the Health and Care Partnership. This would be strongly aligned to and heavily influenced by the Health and Wellbeing Boards, their Concordat and the Place Forum. The Board would meet in public at least four times a year and would be responsible for setting strategic direction. It would provide oversight of all partnership business, a forum to debate issues and make recommendations as partners on collaborative action.

The Board were informed that the new Board would work alongside the Place Forum. It would oversee the emergence of the Coventry and Warwickshire Integrated Care System and would be chaired by the independent chair of the partnership. The report detailed the membership of the new Board.  In addition, the current Better Health, Better Care, Better Value Board was to be replaced by a new Partnership Executive Group whose members would be drawn from NHS organisations and both Warwickshire and Coventry Councils. This Group would report to the Partnership Board and members would be expected to recommend that their organisations supported agreements and decisions made.

The report provided an update on the Place based partnerships highlighting that the extent and scope of these arrangements were a matter for local determination. Arrangements built on existing partnerships working by bringing commissioning and providing services into even stronger alignment with each other and with a wide range of partners. The four places were where most of the ambitions of the Coventry and Warwickshire Health and Care Partnership would be delivered. They would report to the Partnership Board and over time would be expected to meet in public.

The Board noted that a Clinical Forum would supersede the Clinical Design Authority, reporting to the Partnership Group and the Partnership Executive Group. The purpose of this Forum was to be the primary forum for clinical leadership, advice and challenge for the work of the partnership in the Triple Aim: improving health and wellbeing; improving care and the quality of services; and ensuring that services were financially sustainable. The Forum ensured that the voice of clinicians drove the development of new clinical models and proposals for the transformation of services.

The report also informed of other governance arrangements between partners. 

The Board welcomed the transparency in the new governance arrangements.

RESOLVED that:

(1) Approval be given to the new governance arrangements for the Coventry and Warwickshire Health and Care Partnership to be adopted from September 2019.

(2) The intention to review the new arrangements after 12 months to ensure that they are fit for purpose be noted.