Agenda item

To receive a report setting out the implications for the Kent Health and Wellbeing Board of new planning guidance issued by NHS England requiring local areas to draft place-based five year Sustainability and Transformation Plans, changes to the Better Care Fund and the financial settlement for the NHS announced in the Chancellor’s Autumn Statement

(1)       The Chairman said that agenda items 6 and 7 (New Models of Care - Progress Report – Presentation) were closely related and would be considered together. 

(2)       Mark Lemon (Strategic Relationships Adviser) introduced the report on the New Planning Arrangements for Health and Social Care by giving a short presentation a copy of which is available on-line at Appendix 1 to these minutes. 

(3)       Mr Ayres spoke about the planning footprint from a health perspective.  He said the Strategic and Transformation Plans differed from previous plans and needed to be developed by system and by place as well as demonstrating that both individual organisations and the system as a whole could balance their budgets.  There had been some discussion about the options for planning footprints including footprints designed to ensure the viability of acute providers such as an “A21 Corridor” as well as the development of footprints at a Kent level, at CCG level, at joint CCG level such as “East Kent”, or on a “Health Economy” level of north, east and west Kent.

(4)       Ms Davies and Ms Carpenter gave presentations about the development of Strategic and Transformation Plans for the west and east Kent health economies which are available on-line as Appendices 2 and 3 of these minutes.

(5)       Mr Ayres said that “Mapping the Future” project, undertaken a few years ago, had set out the vision of a sustainable future for west Kent and the foundations to build that future had been put in place over the last two years.  This included:

·         Re-commissioning the out of hours service into a two-year contract bringing together a range of services with a view to procuring a fully integrated care service from 2017;

·         Developing Maidstone and Tunbridge Wells Hospital and the Kent Community Health Foundation Trust as a partnership of providers rather than as competitors;

·         Working with GP practices and the development of two emerging federations with a view to them being at the heart of community based service provision;

·         Running pilot programmes with Adult Social Care and other providers to align and integrate services with a view to procuring fully integrated services in a lead provider arrangement

(6)       Mr Ireland gave a presentation about the transformation of Adult Social Care which is available on-line as Appendix 4 to these minutes

(7)       There was general agreement that planning needed to be done: at the most appropriate level for the service; around natural populations rather than around acute service providers; and should focus on developing integrated primary and social care.  Concerns were expressed about the difficulties presented by seeking to extend the footprint beyond Kent and Medway. 

(8)       Dr Stewart said the Kent Integration Pioneer Steering Group had an important role, as a working group of the Kent HWB, to work with and across emerging new models of care including vanguards, integrated care organisations and federations.   New community services and professional blended roles based around GP practice configurations linked to the estates and workforce strategies to support independence could be achieved by the CCGs, Social Care, Public Health and other providers coming together to design, learn and share clinical and social innovation to meet local challenges and integrate health and social care provision. 

(9)       Resolved:

(a)       That the most appropriate planning footprints were the health economies of north, west and east Kent with recognition of the wider Kent and Medway dimension for some aspects of planning;

(b)       That a range of governance models were emerging be noted; that there should be reports on the development of the Strategic and Transformation Plans to the HWB in March and May 2016 and that they should include updates on this aspect as appropriate;

(c)        That the Board’s workplan and forward agenda setting reflect the requirements to consider and agree the various plans to be produced over the coming months, including the evolution of the BCF in Kent, to deliver the wider integration requirement by 2020 in conjunction with the Sustainability and Transformation Plans;

(d)       That the work, to be done outside the meeting, to ensure progress be recognised and that consideration be given to reframing the refreshed Health and Wellbeing Strategy, due in 2017, around plans for the integration of health and social care by 2020, although work to achieve this integration should be accelerated as much as possible;

(e)       To note that, in practice the Assurance Framework covered the review and evaluation of progress towards the objectives of the plans including the nine “must-do’s”.