Agenda item

Briefing note of Rachael Danter, Coventry and Warwickshire Health and Care Partnership, who has been invited to the meeting for the consideration of this item

The Board considered a joint briefing note and received a presentation on the draft Coventry and Warwickshire Strategic Five Year Health and Care Plan 2019/20 - 2023/24, a copy of which was set out at the appendix to the briefing note. The draft Plan was submitted to the Board as part of the current consultation process. The draft Plan had recently been considered by the Coventry and Warwickshire Joint Health and Overview Scrutiny Committee at their meeting on 14^th October 2019. Andy Hardy, University Hospitals Coventry and Warwickshire (UHCW) and Rachel Danter, Coventry and Warwickshire Health and Care Partnership attended the meeting for the consideration of this item.

The briefing note indicated that Sustainability and Transformation Partnerships (STPs) and Integrated Care Systems (ICSs) were required to create five-year strategic plans covering the period 2019/20 – 2023/24, setting out how systems would deliver the commitments in the NHS Long Term Plan. The NHS Long Term Plan Implementation Framework sets out an expectation that STPs/ICSs would bring together member organisations and wider partners as they developed and delivered the plans. A key principle was that the plans should be locally owned. Local systems were required to share a draft of their plans with NHS England / NHS Improvement regional teams by 27 September 2019. The regional team had since provided feedback on this submission. There was now the opportunity for local engagement prior to submission of the final plan, by 15^th November 2019.

The draft plan was informed by a focused engagement exercise undertaken with staff groups across the system (an on-line staff survey), as well as targeted engagement with patients and carers undertaken by Healthwatch. It also drew on engagement activity with a range of public and community groups conducted by the CCGs and local authorities. The understanding of population needs outlined in the draft plan was drawn directly from the local joint strategic needs assessments. The plan had been developed by the senior responsible officers for each of the workstreams, with involvement from stakeholders across the system. Clinicians had been fully engaged in developing the plan and the supporting clinical planning templates.

The briefing note referred to the current period of engagement on the draft Plan from 27 September to 15 November and set out details of the engagement plan in place, which included opportunities for the plan to be considered and approved through formal governance arrangements within the NHS; formal and informal engagement with local authorities; and informal opportunities for awareness-raising and engagement on the content of the plan with key stakeholders, such as Healthwatch Coventry.

The Board noted the summary of the draft plan priorities as follows:

Prevention – Through a strategic and targeted approach to earlier intervention, we will make it easier for people to lead healthy lives and stay well for longer.

Population health – Focus on education, affordable and appropriate housing, stable employment, leisure opportunities and a healthy environment.

Primary care networks – Building on our ‘Out of Hospital’ programme by focussing on preventing ill health, supporting people to stay well and providing high quality care and treatment in the home.

Urgent and emergency care – Simplify our offer and deliver a fully integrated response so that the most appropriate care can be given as quickly as possible.

Mental health – Deliver a step change by focussing on prevention, early intervention, self-care, wellbeing and recovery. Services for children and young people are a particular priority.

Cancer – Identify more people at risk of cancer earlier and undertake more community-based screening. Treat patients more quickly.

Maternity and Children – Respond to the changing needs of women, babies, children and young people. Consider how to most effectively deliver better health outcomes, quality, and patient experience in the context of existing health inequalities.

Stroke – Implement a new agreed model of stroke care, ensuring best possible outcomes and patient experience.

Service improvement – Implement a number of system-wide schemes to remove waste and avoid duplication.

The presentation detailed the learning since 2016 and set out the main issues from the last three years which included a reduction in overall system costs of £300m and a strengthening of partnerships and relationships. Reference was made to the strategic objectives of healthy people, strong communities and effective services. The presentation highlighted how these objectives would be achieved through actions in the following areas: clinical leadership; prevention; integrated care; urgent and emergency care; mental health; cancer; maternity, children and young people’s services; stroke; efficiency; and workforce. The presentation concluded with the benefits to patients as a result of the plan.  

The Board questioned the representatives on a number of issues and responses were provided. Matters raised included:

·  A request for a breakdown of the £300m system saving made over the past three years

·  Further details about the use and funding of consultants to produce the Sustainability and Transformation Plan (STP)

·  Further information about the savings to be delivered and how this would result in improved targets, particularly when the 95% target for patients being seen at A and E wasn’t currently being met and the number of days lost due to delayed transfers of care was increasing

·  Clarification about the reductions in face to face consultations and the implications of this decision 

·  Was the hospital able to cope with the ever-increasing demands from additional patients and more elderly patients

·  Privacy issues when patients had consultations via the use of new technology

·  Concerns about implications of the difficulties in recruiting and retaining drs and nurses and current workforce vacancy rates

·  Details about emergency response times

·  Concerns about the waiting time for blood tests and the need for patients to attend the hospital twice, once for an appointment and then for a second time for blood tests

·  Further information about the outcome benefits for patients of the targets contained within the draft Plan, particularly in light of the required savings and no increase in workforce numbers.

RESOLVED that:

(1) The process for developing and engaging on the draft Plan be noted.

(2) Support be given to the draft plan.

(3) A briefing note be provided for members setting out the breakdown of the £300m system saving made over the past three years across NHS organisations in Coventry and Warwickshire along with details of the outcome benefits for patients.