Agenda item

The Sub-Committee is presented with an update on the delivery of the South West London Integrated Care System for its scrutiny.

The Sub-Committee considered a presentation, set out on pages 15 to 34 of the agenda, which provided an update on the delivery of the South West London Integrated Care System. An introduction was provided to the Sub-Committee by the Croydon Health Services Chief Executive and Place-Based Leader for Health, Matthew Kershaw.

The Sub-Committee noted the representatives on the NHS South West London Integrated Care Board, and asked if Croydon’s VOTP group could be included. The Croydon Health Services Chief Executive explained that this was not in their power to change and was a South West London Integrated Care System responsibility with the formulation of the Board led by national guidance. Members expressed disappointment at the underrepresentation of patients and service users and were of the view that these groups should be included from the beginning of the ICS; the Croydon Health Services Chief Executive stated that they would reflect this back to the ICS, but that there was already some service user representation on the Board and in the Partnership. The Corporate Director Adult Social Care & Health explained that it was important that the workstreams resulting from the Health and Care Plan in Croydon would be shaped by service users.

Members noted the close work between the ICS and Healthwatch and heard that funding had been received by Healthwatch for an executive lead to co-ordinate the six Healthwatch groups in the ICS areas. The Sub-Committee asked about the complexity and pace of implementation in the ICS. The Croydon Health Services Chief Executive explained that so far responses had been timely and effective; an example of this was given on securing funding for health inequalities that had been granted for Croydon at higher levels due to quick responses, as a result of strong and effective relationships in the borough, that demonstrated Croydon’s higher levels of need.

The Sub-Committee asked how it was ensured that the ICS provided value for money for Croydon and heard that some funding was allocated on a population basis (for example, on vaccines), but for other issues need could be greater in Croydon or other boroughs (for example, health inequalities), and for these issues funding was allocated based on the distribution of need. This helped to ensure that value for money was achieved for all areas in the ICS, but it was noted that there was a historic disparity in the funding that Croydon received that would take some time to correct and that work on this was ongoing.

The Chair asked about place-based accountability for the ICS and what would be done to keep the Sub-Committee abreast of upcoming workstreams. The Croydon Health Services Chief Executive responded that he was a representative of Croydon at the ICS, and was responsible for ensuring that Members remained sighted on workstreams at the Croydon and South West London level. The ICS were committed to providing good forewarning of upcoming work and it was highlighted that early work on shifting commissioning responsibility for dentistry to the ICS level was being undertaken following enquiries from the Chair. The Cabinet Member for Health and Adult Social Care added that all Health and Wellbeing Board Chairs were included in the ICS and also met separately. The Chair welcomed the support of both the Croydon Health Services Chief Executive and the Cabinet Member for Health and Adult Social Care in ensuring Croydon was well considered by the ICS.

Members asked about demographic changes and funding pressures. The Croydon Health Services Chief Executive explained that all public services were under pressure for the foreseeable future, but that there were things that could be done to increase efficiency through better integration in addition to strong funding bids to secure additional resource.

Conclusions

1.    The Sub-Committee welcomed the comments made by the Croydon Health Services Chief Executive as the Croydon Place Lead in the ICS and commended the work already undertaken.

2.    The Sub-Committee noted that the Mental Health Strategy was out to consultation, and that the Chair would be having a discussion with the Croydon Health Services Chief Executive about whether this, and changes to NHS Dentistry commissioning, were Croydon or South West London Joint Health & Overview Scrutiny Committee work programme items.

3.    The Sub-Committee requested performance targets and figures were provided for future updates on the ICS.

4.    The Sub-Committee were disappointed by the levels of resident and service user involvement in the ICS and supported inclusion of Croydon’s VOTP group on the Board in the future.