To receive a verbal update and discuss the Integrated Care System (ICS).
Minutes:
Neil Gouldbourne and Mike Bell, Croydon Health Services NHS Trust, introduced the ICS update, outlining the following:
· There was a national timetable to move away from Clinical Commissioning Groups (CCGs) to the new statutory bodies in the Integrated Care System (ICS), with duties transferred.
· There were several elements important to note of the South West (SW) London ICS in the context of Croydon:
Ø There would be two Boards for the district: the Integrated Care Board, which would hold the NHS budgets, and an Integrated Care Partnership Board to focus on the wider detriments on health (which would include more collaboration from the council and the voluntary sector).
Ø Discussions were taking place about how the Boards should relate to one another, their membership and remit.
Ø There was understanding that Croydon was already working in an integrated and collaborative way that the upcoming changes were aimed to enable across the country, and Croydon would continue on its own journey in that context.
Ø A hallmark trait of CCGs was the prominent positions of GPs in the running and management of the health service, and in Croydon it was clear that had brought value. They intended to continue that strong voice for GPs in Croydon following the structure changes.
Ø With the dissolve of CCGs, it was important to investigate what GP leadership should look like going forward. A number of workshops took place to review what had worked well in Croydon and now there was a draft plan for the future arrangements of a GP leadership group within the Croydon structure and a position in the One Croydon Alliance.
· There were successful acute provider collaboratives in SW London, which run the SW London elective orthopaedic centre, SW London Pathology and a range or other initiatives. ICS was intended to further develop provider collaboratives and potentially provide a larger vehicle for the planning for the standardisation of clinical pathways procedures.
· The leadership of the ICS: the Chair had been confirmed as Millie Bannerjee and the process of appointing the induvial as the Chief Executive was underway.
· The staffing of the ICS: the ICS would inherit the CCG staff. There would be decisions to follow on how they would be deployed, given the move to a strategic commissioning model.
Dr Agnelo Fernandez, Vice Chair, stated the following:
· It was important to retain aspects of the clinical leadership in the new model. There would likely be only one representative at the ICS level for SW London.
· There was concern over the budgets going forward for clinical leadership, which were vital for its provision. Croydon was already currently underfunded. Croydon started the year with a deficit and ending in surplus due to efficiencies made and supported by good working relationship of the CCG and the integration agenda.
There would be risks and opportunities with the new model, however there was a history of Croydon of working together to achieve the best outcomes and working with communities that would put Crouton in a strong position in the future.
Councillor Yvette Hopley, Shadow Cabinet Member for Families, Health & Social Care, raised the following points of concern over:
· the process of funding and control moving away from Croydon;
· the separation of the GP voice in the new system and one representative SW London level seeming limited; and
· the politician’s role in the new model. Currently there was an active role in the One Croydon Alliance and CCG of communication to residents that may be disassociated going forward in the new structures.
Edwina Morris, Healthwatch CEO, stated the following:
· Currently it felt that the views of residents and the work of Healthwatch was respected on a local level to Croydon. Going forward, working with five other Healthwatch groups in SW London may be be difficult to maintain an affective voice to still speak on behalf of local residents and needs, before decisions were made.
· Healthwatch England had been lobbying to the Department for Health and Social Care, meeting with ICS Chairs to make the point that Healthwatch needed to remain effective at all ICS levels.
Mike Bell, Croydon Health Services NHS Trust representative, stated in response to the concerns raised, that many of the options discussed were not set in stone and there were still exercises taking place to take into account the ambitions and anxieties of all parties affected. Going forward, Croydon would seek maximum delegation streams (funding and ambitions) from the ICS to establish local priorities. Additionally, Croydon’s ambition was to co-produce more with the public. He encouraged any partners involved to engage with the process of promoting Croydon’s self determination within the ICS.
The Chair thanked everyone for their contributions.