Agenda and minutes

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Items
No. Item

15.

Apologies

16.

Declarations of Interest

    Members are required to declare any disclosable pecuniary, personal or personal and prejudicial interests they may have and the nature of those interests relating to items on this agenda and/or indicate if S106 of the Local Government Finance Act 1992 applies to them.   

    Minutes:

    There were no declarations of interests.

17.

Urgent Items of Business

18.

Items for Exclusion of Public and Press

19.

Minutes pdf icon PDF 72 KB

    To consider the minutes of the meeting of the Integrated Commissioning Board held 29th May 2018.

    Additional documents:

    Minutes:

    The Board considered the minutes of their most recent meeting held 29th May 2018.

     

    Further to Minute 6 (Over the Counter Prescribing Medicines – Verbal Update) a member requested that a timetable be prepared which details the anticipated completion of actions approved at the Board’s meeting on 29th May. In addition the Board was advised that the Prescribing Medicines Sub-Group, to which members were appointed on 29th May 2018, was due to hold its first meeting prior to the next Board meeting on 31st July 2018.   

     

    It was requested that an ‘action log’ be prepared to accompany minutes of meetings of the Integrated Commissioning Board.

     

    Decision:

    1.    That the minutes of the meeting of the Integrated Commissioning Board, held 29th May 2018, be approved as a correct record.

    2.    That, further to minute 6 (Over the Counter Prescribing Medicines – verbal update) a timetable be prepared which details the anticipated completion of actions approved at the Board’s meeting on 29th May.

    3.    ‘Action logs’ be prepared to accompany minutes of meetings of the Integrated Commissioning Board with immediate effect.

20.

North East Sector Clinical Services Strategy

    Northern Care Alliance NHS Group to present

    Minutes:

    The Chair introduced Mr Jack Sharp, Group Director of Service Strategy and Planning) - Northern Care Alliance NHS Group, who gave a presentation which summarised the emerging proposals that were to be refined and formally reviewed as part of the development of the North East Sector (NES) acute Clinical Service Strategy.  In particular, the presentation described: the needs of the NES population, the existing acute commissioning intentions and the key drivers for change within the sector; gave a summary of the NES hospital sites and the associated issues that will need to be considered as the Strategy was being refined; agreed fixed points and where decisions may be contingent on Theme 3; detailed the proposed approach to service transformation and cost reduction; examined the potential future state for each site and proposed ‘single service’ approach; refreshed and updated commissioning intentions for the NES; outlined the agreed option appraisal framework and evaluation criteria; noted the key issues to address or consider in order to maximise alignment between the approaches in the NES and Manchester and advised as to the timeline and steps for finalising the NES acute Clinical Service Strategy.

     

    The Board’s presentation brought together and built upon considerable work undertaken by NES commissioners, in conjunction with the Northern Care Alliance (NCA), over the last 12 months to develop a strategy which secured clinically and financially sustainable acute services.  There was a significant platform for change in Bury, Rochdale & Oldham. The combined population of these three Boroughs have significantly poorer health outcomes than most of the rest of the United Kingdom. Hence why there is investment in prevention and community based care, and integrating care through our Local Care Organisations.

     

    Despite real improvements in quality, the current configuration of hospital services within the Pennine footprint was not felt to be sustainable and therefore significant changes were required.

     

    The strategy was to develop a ‘Shared Hospital Service’ uniting Oldham, Bury and Rochdale (and associated with Salford and the North West sector as appropriate), ensuring that the population affected could access resilient and financially sustainable services.

     

    At the conclusion of the presentation Mr Sharp answered various questions that were put forward by Board members and officers that were present.

     

    Decision:

    That the presentation be noted.

21.

Decommissioning Strategy pdf icon PDF 116 KB

    Karen Kenton to report

    Additional documents:

    Minutes:

    The Board considered a report prepared by the Director of Children’s Services regarding the decommissioning strategy. Decommissioning was a part of the commissioning cycle, and should be undertaken in a planned way to ensure that the most effective services are delivered/commissioned making best use of our available resources. It was a spectrum of activity that could range from service redesign through to the full cessation of a service/contract.

     

    It was considered important that a strategic approach to decommissioning be taken to ensure that this would be undertaken as part of a whole system approach to avoid the risks of unintended consequences or costs being moved across the system. Within “Rochdale Borough’s Commissioning Strategy 2017 - 2021” it was noted that the principles for decommissioning, and that decommissioning is a key element of transformation that can support investment in new service delivery models and realisation of efficiencies/savings.  The submitted decommissioning strategy sets out how the authority will approach decommissioning in practice.

     

    In considering the proposed strategy members of the Board were assured that any recommendations for decommissioning would first require the approval of the Integrated Commissioning Board.

     

    The Board considered issues around the Joint Strategic Needs Assessment that would need to be updated in light of the approval of the Decommissioning Strategy and it was agreed that this would be reviewed by the Director of Children’s Services.

     

    It was noted that in the preparation of the report specific discussions had been held with representatives of trade unions and that this fact should be reflected in the document.  

     

    It was suggested that the strategy be reviewed at future dates, yet to be determined, and that such reviews where necessary incorporate examples of joint learning that have arisen from either the CCG or the Council.

     

    It was noted that the strategy document itself is entitled “Rochdale Borough Decommissioning Strategy 2017 – 2021, Stronger starts – Secure Futures”. It was requested that the dates of the document’s title be amended to “2018 – 2021” to acknowledge that the document had become effective from 2018.

     

    Decision:

    The Integrated Commissioning Board formally approves the Rochdale Borough Decommissioning Strategy (2018 – 2021) subject to the inclusion of the amendments and comments detailed above.

22.

Update on Communications and Engagement Activities to Support the Transformation Programme pdf icon PDF 1022 KB

    To consider the Transformation Highlights report - Strategic Commissioning Programme Director (HMR CCG) to report.

    Additional documents:

    Minutes:

    The Board considered a report presented by the CCG’s Strategic Director which presented a communications and engagement plan that had been developed to support the ‘three pillars’ of the Rochdale Transformation programme: development of a single commissioning function; development of the Local Care Organisation; and the delivery of Transformation.

     

    In January 2018 a communications and engagement plan had been drafted to support Rochdale’s Transformation programme. The programme described the core activities that would be included to include key communities and stakeholders in dialogue about the transformation programme and to raise awareness and support for associated work-streams. The submitted report that was considered by the Board provided an update on the activities that had been undertaken to support the transformation programme and included a summary of measures to be implemented in coming months.

     

    In considering the report Board members queried the numbers of people that had responded to the various communications exercises and also in some cases queried their actual value. The Director of Children’s Services, for instance, referred to that section of the report (page 29) that referred to ‘200 local people being reached’, advising that a communications exercise undertake by Children’s Services in respect of the Family Service Model had made contact with over 500 people, details of which were not included in the report.

     

    Decision:

    1.    That the report be noted.

    2.    That a revised and updated report on communications and engagement activities be presented to the next meeting of the Board, on 31st July 2018, as part of the regular Transformation Update report.

23.

Transformation Highlights Report pdf icon PDF 571 KB

    Strategic Commissioning Programme Director (HMR CCG) to report.

    Minutes:

    The Board considered a report of the Transformation Programme Director that updated members on: programme delivery including the effects of the Transformation Fund on the Rochdale Borough locality; an update on the activities of the Local Care Organisation; a consideration of the quarterly ‘transformation risk’ report that had been submitted to the Greater Manchester Combined Authority; and an update on finance issues. The Board was advised that the overall rating for the programme in this period was ‘Amber’.

     

    Decision:

    That the report be noted.

24.

Finance Update on the Greater Manchester Funded Transformation Fund

    Minutes:

    The Integrated Commissioning Board considered a report that updated members on expenditure incurred through to May 2018 on the Greater Manchester funded Transformation Fund Programme and the impact of this on forecasts for 2018/19.

     

    Alternatives considered: Transformation Fund funding from Greater Manchester Health and Social Care Partnership gives the Rochdale locality the up front, “pump priming” funding that is required to fund the transformational activity that is required to help move activity from the acute to the community sector. Without this funding the ability to provide “pump priming” funding in this way would have not been possible.

     

    Decision:

    That the report be noted.

25.

Outcomes Based Commissioning framework

    Director of Public Health to present

    Minutes:

    The Integrated Commissioning Board considered a presentation from the Director of Public Health that considered the development of a ‘Local Outcomes Framework’ for deciding how goals were to be realistically achieved.  In considering this the presentation detailed what was meant by outcomes and in doing so highlighted seven steps that could ensure progression in this regard: agreement on strategic goals; to decide upon the most important actions required; to examine the ‘as is’; to design a solution; to put forward strong measures that can identify success; to ‘try out’ the model and to share it.

     

    Decision:

    That the presentation be noted.

26.

Healthy Lifestyle Expectancy

    Director of Public Health to present

    Minutes:

    Further to minute 5 of the Board’s last meeting held 29th May 2018 (Healthy Life Expectancy) the Director of Public Health updated the Board on the priorities for action.

     

    In terms of the priorities for the next three to five years the following had been identified as the most important issues: a reduction in Accident and Emergency use; reducing the length of stays in hospitals; reducing the costs of care packages; reducing non-elective admissions; reducing demand for elective admissions; reducing outpatient attendances; reducing medicines spending; reducing the costs of transfers to hospital; reducing block contract mental health; and reducing the number of looked after children.

     

    Decision:

    That the presentation be noted.

27.

Health and Social Care Pool Budget Report - Period 2 (May) 2018/19 pdf icon PDF 182 KB

    Chief Finance Officer to report

    Minutes:

    The Integrated Commissioning Board considered a report of the Chief Finance Officer which updated members on the financial position of the pooled budget for the financial year 2018/19 at period 2 (end of May 2018).

     

    The pooled budget excluded the Better Care Fund and the Greater Manchester Transformation funding which was due to be reported separately to the Board during 2018/19.The pooled budget had been amended to take into account the savings reported in April and May 2018, the current gap being reported on the pool budget was £3.2m which was a reduction of £2m since the last Board meeting on 29th May 2018, due to additional one off contributions from additional Adult Social Care grants (£0.3m) and further adjustments to CCG budgets at period 2 (£1.7m).

     

    The Local Authority provider service for Adult Social Care (ASC) was not reporting any variations to budget at period 2. Children’s Social Care (CSC) provider services have identified a potential pressure around residential placements, work is currently ongoing to identify the value of this pressure and a further update will be given at period 4 (end of July).

     

    The Board was asked to note that during 2018/19 any Local Authority provider service variations, being noted in the report for information, would be for the Council to identify mitigating actions. However for future financial years funding of such pressures will be subject to the development of the pooled fund commissioning arrangements.

     

    Decision:

    That the report be noted.

     

    Reasons for the decision: The submitted report updated the Board on the Health and Social Care pooled budgets for 2018/19 in line with National Health Service England guidelines and the Greater Manchester Health and Social Care Partnership requirements. As part of operating a pooled budget regular monitoring reports were required to be submitted.

     

    The Better Care Fund had been excluded from the pooled reporting and should be reported separately to the Integrated Commissioning Board.