Cathy Winfield, Chief Officer Berkshire West CCGs, submitted a series of papers providing an update on the development of a five year strategy for the BOB ICS.  The five year, one system, plan would describe how partners in the ICS would work together to deliver the ambitions of the NHS Long Term Plan and address the specific priorities, opportunities and challenges within the BOB ICS area.  The first draft of the plan had been submitted to NHS England and had been included in the papers submitted to the Committee.  A second ‘cut’ plan would be submitted in November 2019 and would be informed by feedback from NHS England and the thoughts and views of stakeholders.

The five year NHS plan set out the ambitions and targets that the NHS should achieve for the significant additional investment that had been received.  A huge amount of work locally had been carried out around developing a completely different community based out of hospital sector with fully integrated care.  This should then reduce the demand for both health and social care services in a crisis or emergency situation and would include developing the 111 service and having care close to home and building on the concept of ‘home first’.  There was also a focus on improving mental health particularly in relation to children and young people, and again there would be a focus on care close to home and prevention; there was also an emphasis the physical health of people with mental health issues.  Emphasis was also on trying to get cancer outcomes improved, improving earlier diagnosis and increasing the uptake of screening.  With regard to elective surgery the aim was to get wait times down to ensure the national 18 week wait time was met.  There was also a project to redesign outpatient services so that more people could be treated in GP surgeries, in community settings or by remote monitoring.  There was a much greater emphasis on population health management, for example, the roll-out of the collective care programme would see the sharing of information between GPs, hospitals and the ambulance service and would help to better understand the needs of the population, to predict risk and intervene when people were potentially at risk and to provide anticipatory care for them.

Work was also being carried out to update the Joint Health and Wellbeing Strategies (JHWBS) across Berkshire West and a proposal has been made to create one SharedHealth and Wellbeing Strategy across the Berks West ICP. The JHWBS has the aim of preventing illness and reducing the need for treatment and delaying the need for care by keeping people independent.  The ICS plan also covered maternity, children’s health and autism where the aim was to make similar improvements.  The plan stressed the need to consider workforce and to think differently about technology by creating efficiencies and allowing people to access and check their own results and to take more responsibility for their health and wellbeing.

Across BOB work had been carried out to look at the requirements and the funding allocations and a financial plan that would sit alongside them; the final document would set out what the allocations would be and how it was intended to apply them.  Services would have to be redesigned and there would have to be confidence that some of the interventions that would be made would reduce demand, services would then be reshaped and remodelled.  Finally, the financial plan had not been included as it was still being worked on but it would be included in the next version of the plan that would be submitted to NHS England in November 2019.

The Committee discussed the draft five year plan and a number of points and comments were made including the following:

• Things happening outside of the NHS would impact on the plan and its success, such as cuts to services, the housing crisis, homelessness, cuts to public health budgets and inadequate funding of social care;
• Action plans would be needed to ensure strong emphasis on public involvement and engagement so that what drove the plan was what was important for local people;
• A different approach would be needed for the different areas that the plan covered, for example, the needs of people living in rural areas of West Berkshire and Oxfordshire would be different from those living in areas of Reading;
• It would be vital that the voice of people who would be using the service was heard so that their needs were met rather than relying on other organisations such as Healthwatch.

Finally, the Committee agreed that the views and comments detailed above should be put together by the Lead Councillor for Health, Wellbeing and Sport and the Chair who would then produce a response on behalf of the Committee.

Resolved –

(1)     That Fiona Wise and Cathy Winfield be thanked for attending the meeting;

(2)     That the views and comments detailed above be put together by the Chair and the Lead Councillor for Health, Wellbeing and Sport and a response submitted on behalf of the Committee.