Agenda item

To present progress on health and social care integration including Enhanced Primary Care and neighbourhoods work and planning for 2018-2019.

Mr David Bonson, Chief Operating Officer, Blackpool Clinical Commissioning Group, presented an update on health and social care integration in Blackpool (as part of the wider Fylde Coast local delivery partnership) including Enhanced Primary Care and neighbourhoods work and planning for 2018-2019.

Also present were Mr Roy Fisher, Chairman, Blackpool Clinical Commissioning Group; Ms Jeannie Harrop, Senior Commissioning Manager; and Ms Kate Dalton, Team Leader, Blackpool Clinical Commissioning Group.

Members had considered integration first in November 2016 in the early stages of development and received a further update in September 2017. They had felt that there was not sufficient detail of local work within the original Sustainability and Transformation Plan (STP) for Lancashire and South Cumbria nor financial costings.

There had also been concerns whether sufficient transformation progress was being made in good enough time to deliver the five-year plan to better manage integrated care for people’s health and wellbeing and reduce service demand / cost pressures.

Members commented that the various changes referred to within the report were not easy to follow. Mr Bonson explained that the local delivery arm for pursuing transformation was the new Fylde Coast Integrated Care Partnership (ICP). This comprised of Blackpool Clinical Commissioning Group, Fylde and Wyre Clinical Commissioning Group and Blackpool Teaching Hospitals Trust working together to deliver shared plans as part of the wider Lancashire and South Cumbria Integrated Care System (ICS) which took forward Sustainability and Transformation Planning.

Mr Fisher explained that the Lancashire and South Cumbria finance lead, Mr Gary Raphael had become unavailable for the meeting but had suggested that a dedicated meeting be held on the wider sub-regional picture (i.e. Integrated Care System / Sustainability and Transformation Planning) allowing current focus to be on local delivery through the Integrated Care Partnership. Ms Amanda Doyle, Chief Clinical Officer, Blackpool Clinical Commissioning Group would also be requested to attend.

The Chairman referred to winter planning and the stated potential for an additional ninety beds. He also queried transformation progress, after three years planning, with reducing the number of unnecessary admissions to hospital, which was estimated to be around 25% and bed blockages/shortages particularly this winter. Members re-iterated previous concerns about delayed discharges from care.

Mr Bonson explained that provision was based on 2017-2018 outturns when extra beds had been taken from elective care wards following a bad winter with subsequent impact throughout the year. The ninety beds would be provision for unscheduled care. Bed availability would be managed through reducing unnecessary admissions, reduced length of stays (higher than the national average so a priority), improved discharges of patients (with effective case management) and better planning of elective care. Improving patient flow was central to all work. High priority areas, including elective cancer treatment, would not be impacted, i.e. would not be targeted for beds.

Mr Fisher explained that not all services had been commissioned through the sub-regional Sustainability and Transformation Planning. Most services (70%) were commissioned locally through the Fylde Coast Integrated Care Partnership. He added that innovative work was taking place through the neighbourhood hubs aiming to help to secure more outcomes at primary care stages.  This local work was important as it brought together a range of health and social care professionals to offer integrated care and reduce the need for secondary care through hospitals.

Ms Harrop confirmed that beds were purchased at other hospital sites but patients’ safety was maintained and GP consent had to be obtained. She added that innovative methods were being pursued to reduce hospital attendance, e.g. live case management system allowing patients’ movements through the care system to be actively tracked. Ms Dalton added that the case management system coupled with shared information/discussions between the various neighbourhood hub professionals liaising with nurses allowed more effective pathways of care.

In response to concerns raised by some Members, the representative from Blackpool Carers’ Centre reported that carers formed part of the neighbourhood teams. Ms Harrop added that care services were also commissioned from other organisations such as the British Red Cross. She and Ms Dalton offered to discuss the concerns raised outside the meeting to help identify best support options. Contact details for all the neighbourhood hubs would be forwarded to Members.

In response to a query about people being able to access social care payments, Members were advised that social workers were in the neighbourhood teams so provided support with payment arrangements.

The Committee agreed:

1. To receive a further report on health and social care integration, focusing on the Lancashire and South Cumbria Integrated Care System / Sustainability and Transformation Planning.
2. To request that Ms Harrop forwarded contact details for all the neighbourhood hubs.