Agenda item

To receive a report summarising existing integration arrangements, describing the conditions of the Integration Transformation Fund (ITF) and providing an overview of opportunities for integration in the future.

To agree to the creation of an Integration Sub Board, the board terms of reference and membership. 

The Board received a report briefing the Board on the proposals for the Integrated Transformation Fund from Ray James (Director of Health and Adult Social Care). 

Bindi Nagra (Joint Chief Commissioning Officer) and Kate Charles (Deputy Joint Chief Commissioning Officer) presented the report to the Board, highlighting the following: 

·       The report describes the proposals for further developing joint integrated working arrangements between the CCG and the Council.

·       A pooled fund including the £3.8m Integration Transformation Fund will be agreed.  This will be partly made up of £20m from the Council and approximately £10m from the CCG.

·       As a minimum, the fund conditions are anticipated to include at least the following:

Ø   Protection for social care in terms of services

Ø   Enabling 7 day working

Ø   Taking a joint approach to assessment and care planning

Ø   Facilitating information sharing including the use of the NHS number across health and social care

Ø   Taking account of the implications for the acute sector of service reconfiguration. 

Ø   Set out arrangements for redeployment of funding held back in the event of outcomes not being delivered. 

·       The proposal includes setting up a sub group to work on the proposals.  Timescales are tight. 

·       Work will be informed by discussions around the JSNA and the Health and Wellbeing Strategy.

2.     Questions/Comments

2.1   It is speculated that funding will be allocated according to a formula which has not yet been decided.

2.2   Ray James said that this was potentially a fantastic opportunity and should facilitate more services for local people.  This is especially welcome in terms of the national context and the 10% reduction in local authority funding.

2.3   The CCG would have to find the money from existing resources.  There would be no new money.  Liz Wise added that this could be a catalyst to enable things to be done in a different way.  However the money for the services could only be found by taking funding from other services which are already being provided, and this could be difficult, especially as there were significant funding pressures on the NHS as a whole.  NHS England have anticipated that the national health service will need an extra £30 billion just to stand still. 

2.4   Deborah Fowler was concerned that the integration of services should considered from the point of view of the client receiving the services, focussing on individuals.

2.5   The new integration sub board will be time limited.  It will be separate from the Joint Commissioning Board and will not replace it. 

2.6   Councillor McGowan was concerned that there was a risk that if targets were not met, a percentage of the money would be lost.  The risk would not be known until the conditions are published.  Lobbying is currently taking place so that the targets can be agreed locally, although it is likely that there will, at the least, be some ministerial sign off of local plans. 

2.7   The Health and Wellbeing Board would seek to influence any target setting to make sure targets were reasonable and deliverable.

2.8   The Health and Wellbeing Board will be the best body to help to help the integration proposals succeed. 

2.9   A two year plan had to be produced within the next two months. 

2.10A suggestion was made that the contribution from the CCG would increase the QIPP.  This did not follow as the money would most likely have to be taken from that currently allocated to acute services. 

2.11Requests were made that Ian Davis, a clinical representative, someone from HealthWatch and service users be included in the membership of the proposed sub group.

2.12Liz Wise said that a decision on the creation of a sub group and its terms of reference would need to be taken back to the CCG Governing Body for approval.   

2.13It was proposed that a working group be set up to work up some detailed recommendations including the two year plan and to develop the proposals for a formal sub board. 

AGREED

1.               To set up a working group including the members of the sub board proposed in the terms of reference attached to the report as well as a representative from HealthWatch, the Director of Environment and a clinical representative from the CCG.

2.               The working group will pull together the initial plans for the Integrated Transformation Fund, once the conditions and expectations are confirmed by Government. 

3.               The Working group will also work on a governance structure, including terms of reference, for future approval by both the Health and Wellbeing Board and the CCG Board.