Presentation by Phil Johns, Coventry and Warwickshire CCG who has been invited to the meeting for the consideration of this item along with Rose Unwins, Coventry and Warwickshire CCG
Minutes:
The Board received a presentation on the development of the Integrated Care System from Phil Johns, Coventry and Warwickshire CCG, who attended the meeting along with Dr Sarah Raistrick and Rose Uwins, Coventry and Warwickshire CCG. Andy Hardy, University Hospitals Coventry and Warwickshire was also in attendance.
The presentation referred to the national move to bring health and care organisations together into Integrated Care Systems (ICS) and to the legislative proposals by the Government for a new Health and Care Bill, which built on recommendations in the NHS Long Term Plan. This would establish statutory ICS in each STP/ICS footprint. The proposals were continuing to progress through parliament and were currently at committee stage in House of Lords. In Coventry and Warwickshire partners were already working closely together as a Health and Care Partnership and this was development was seen as what was best for the locality. The Board noted that the earliest Coventry and Warwickshire could become a statutory ICS was July 2022.
The benefits of the ICS were highlighted which included breaking down the barriers between organisations; joining up health and care more effectively to make a difference to people’s lives; and addressing the “wider determinants of health” such as poor housing or socio-economic problems and bringing the right resources from across organisations to tackle public health issues such as obesity.
The presentation set out the vision for the local ICS: ‘We will enable people across Coventry and Warwickshire to start well, live well and age well, promote independence, and put people at the heart of everything we do’ and detailed the proposals for how this would be achieved.
The following three layers made up the structure of the ICS: Primary Care Networks, Place and System and an explanation was provided for each layer. Dr Raistrick highlighted the vision in practice for each of these layers. Enabling everyone to keep well was the System approach to engagement. Pooling knowledge and experience between health and local authorities, working as one team to leverage all connections and reach the diverse communities. Reference was made to the successful partnership engagement carried out during the Covid pandemic.
For Place the vision was to provide the best possible care and the example of improving musculoskeletal services in Coventry was highlighted. All partners across Coventry delivering Musculoskeletal (MSK) services were brought together to design a new model of care - patients first saw a First Contact Practitioner, a specialist physio who could access diagnostics and provide specialist assessment, at a local GP practice. Those patients were assessed through a new Multi-Disciplinary Team (MDT) for MSK triage, made up of experts from different specialties. Patients who would benefit from physiotherapy or similar treatments could be redirected to the correct service directly by the triage team so shortening the process and improving patient experience.
The vision for Primary Care Networks was enabling everyone to keep well and the example of pre-diabetes and weight management at Sowe Valley was detailed. To support weight loss and those at risk of developing type 2 diabetes across the Sowe Valley area, the Primary Care Network hired a full-time health coach to offer one to one and group support about diet, exercise and lifestyle. The coach was based at the Coventry Cricket Club, a central location in the heart of the community offering a non-clinical setting within a healthy living setting.
The presentation provided a chart of how the governance arrangements could work for the Integrated Care System including the place of the Scrutiny Board and the Health and Wellbeing Board.
The presentation concluded with the next steps which involved ongoing work to establish strategies and governance, in collaboration with the population and stakeholders, with the aim the Integrated Care Board and Integrated Care Partnership coming into being on 1st July 2022 and the statutory powers transferring from the Clinical Commissioning Group to the Integrated Care Board.
Andy Hardy, UHCW, outlined his support for the development of the Integrated Care System which was the best way forward for patients and their outcomes.
Members questioned the representatives on a number of issues and responses were provided, matters raised included:
· How would the ICS improve efficiency in the health system
· Would the ICS contribute to the aim of enabling people to remain in independent living in their home for as long as possible rather than going into care
· Information about equality and inclusion in the new system
· The need to improve the process of patient discharge from hospital to the home environment with the right medical community support package in place
· Concerns about the availability of out of hours pharmacy services in relation to patients requiring prescriptions; delays at the hospital pharmacy that can delay patient discharge; and the need for a ‘one Coventry’ approach
· Concerns about the costs to residents of healthy eating items as compared to the costs of unhealthy foods
· Concerns about residents/ patients who don’t have access to IT and a reference to the Connecting Sherbourne IT project.
RESOLVED that:
(1) The contents of the presentation be noted.
(2) A report on how inclusion is being addressed and progressed within the Integrated Care System to be submitted to a future meeting.
(3) A report on plans to improve the system to ensure patients fit for discharge can leave hospital without delay, knowing that the appropriate support package has been put in place to be submitted to a future meeting.
(4) Details about the Council’s IT project ‘Connecting Sherbourne’ be circulated to the health partners.