Suffolk & North East Essex STP/ICS Board

Suffolk & North East Essex STP/ICS Board Meeting held on Friday 15th January 2021 from 0930 - 1100 On Microsoft Teams DRAFT Notes and Actions Attendance:

Professor Will Pope WP Independent Chair, Suffolk and North East Essex ICS Ed Garratt EG ICS Executive Lead, Suffolk and North East Essex ICS Susannah Howard SH ICS Programme Director Apologies PF Essex County Council Nick Presmeg NP Essex County Council Sue Cook SC Suffolk County Council Pam Donnelly PD North East Essex District & Borough Councils VACANCY - Suffolk District & Borough Councils Stuart Keeble SK Public Health Suffolk Apologies MG Public Health Essex Stephen Dunn SD West Suffolk Hospital NHS Foundation Trust Nick Hulme NH East Suffolk & North Essex NHS Foundation Trust Shane Gordon SG East Suffolk & North Essex NHS Foundation Trust Apologies NM East Suffolk & North Essex NHS Foundation Trust Jonathan Warren JW Norfolk & Suffolk NHS Foundation Trust Paul Scott PS Essex Partnership University NHS Foundation Trust Frank Sims FS Anglian Community Enterprise David Allen DA East of England Ambulance Trust Lisa Nobes LN Suffolk and North East Essex CCGs Apologies AL Suffolk and North East Essex CCGs Richard Watson RW Suffolk and North East Essex CCGs Andy Yacoub AY Healthwatch Sharon Alexander SA Voluntary Sector Representative – North East Essex Barbara Gale BG On behalf of the three Hospices Christine Abraham CA Voluntary Sector Representative – Suffolk Apologies JS GP Primary Choice VACANCY - Suffolk GP Federation Peter Smye PS Suffolk LMC Vaiyapuri Raja VR North Essex LMC Stephen Singleton SS Suffolk Community Foundation Mark Jarman-Howe MJH North East Essex Alliance Ann Humphries AH Patient & Carer Representative Paul Duell PDu LPN Chairs Group – Suffolk & NE Essex Sheila Childerhouse SC STP/ICS Chairs Group Mark Shenton MS ICS Clinical Lead & STP/ICS Chairs Group Jane Payling JP STP/ICS Directors of Finance Group Lisa Llewelyn LL ICS Director of Workforce Tom Burton TB NHS England and NHS Improvement

Also, in attendance:

Sharon Rodie SR ICS Gary Norgate GN West Suffolk Hospital NHS Foundation Trust Helena Jopling HJ West Suffolk Hospital NHS Foundation Trust Michelle Grant-Richardson MGR ICS Central Team Simon Morgan SM CCG/ICS Comms Lead Hollie Oldfield (tech and notes) HO ICS Central Team

Part 1 – Covid-19 System Leaders’ Summit

Ref Item Action 1.0 Covid 19 System Leaders’ Summit

Will Pope welcomed the Board to the meeting and explained that the following minutes will be Action focused.

Nb. This meeting was recorded solely for the use of the minutes and shall be deleted by Friday 15th January PM.

1. Managing Covid-19 demand

The meeting highlighted many of the challenges that the system is facing now, including: • The rapid rise in infections, in Tendring. • The rise in outbreaks of Covid-19 in care homes. • The high number of patients with Covid-19 in hospitals, which is expected to continue to grow. These issues impact on people and communities, and place further pressure on already- stretched services.

Several measures are already being taken to expedite existing plans, for example to improve hospital discharges. The role of the VCSE is paramount in supporting statutory services. However non-elective care has once again stopped, and primary care has paused non- essential services, and our learning from Wave 1 has shown us that we need a robust plan to reintroduce services when we can.

In Essex a major incident has been declared, with civil contingency measures in place. Essex County Council gave an update on the Essex LRF position, whilst the Alliance CCG’s updated on the Suffolk LRF position. In both Essex and Suffolk County Councils the provider of last resort has been utilised, and plans are in place if this measure is no longer sufficient to support care services to continue.

Action: West Suffolk Foundation Trust will provide mutual aid to Essex County Council to manage the impact of increased demand upon services. EG will support to facilitate these SD / EG discussions.

Both Suffolk and Essex county councils also identified that delays in obtaining results of Covid-19 testing meant that some care home staff were continuing to work whilst unaware they were Covid-positive, and delayed the ability of health and care services to support and manage outbreaks.

Action: ESNEFT will support both councils to obtain test results more quickly. Collaboration with Mid and South Essex Partnership will also be explored to enable NH / SG greater support across Essex.

The meeting identified several principles that should guide how we move forward. We should:

• Ensure we do not exacerbate health inequalities; we should plan for the few as well as the many. • Build on effective collaborations within our system and between systems and address those areas where it is not working well. • Ensure we can demonstrate the link between our decisions and our actions so that we can be accountable to patients and the public. • Enable staff to access the psychological support available, and leadership support and mentoring. • Consider the impact of reduced usage of health services on the future burden of disease. • Continue to accelerate innovations. • Continue to reflect and learn. • Look forward and prepare for the future after the pandemic.

2. Covid-19 vaccine programme

EG confirmed vaccine sites have launched in hospitals and primary care, and two larger vaccine sites will be opening soon. Vaccinations in care homes are continuing. We have a website giving information for the public, www.sneevaccine.org.uk, which also links to the Mid and South Essex Partnership and Waveney systems. However much of the programme is centrally driven, and it is important that we also identify and tackle local issues, such as the need for both formal and informal carers to be vaccinated.

The meeting identified several principles to support the vaccine programme. We should: • Extend opportunities and capacity to volunteer both in communities and in care settings. • Start recovery planning incorporates support for the sustainability of the VCSE sector. • Continue to develop our Equality and Health Inequalities Impact Assessment and mitigations. • Continue to develop communications that will enable mitigations of inequalities and ensure equality of access to vaccines. • Develop data recording and analysis to monitor health inequalities, identifying and tackling trends as early as possible. • Focus on supporting BAME people, in particular older adults at this time, and shielding groups, who may not have left their homes for many months. • Continue to communicate effectively with service users and families, who feel frightened and vulnerable at this time. • Plan how best to reach marginalised and vulnerable adults to ensure equality of access to vaccines. • Continue our broader ICS health inequalities programmes, including our population health management and anchors programmes. • Continue to reflect and learn.

Part 2 – Specific key items for discussion

Ref Item Action 2.0 West Suffolk Hospital Strategic Outline Case

Gary Norgate updated the Board on the Strategic Outline Case (SOC) prepared in support of West Suffolk Foundation Trust’s bid to build a new health and care facility. It should be noted that a strategic outline case needs to prove that there is a case for change, whereas the outline business case that follows it demands the case be made for the specific changes that

are recommended. Clinical modelling, consequently, remains in outline form and the plans for developing the outline business case include an explicit workstream for a clinically led provider collaboration.

The paper covers each of the main sections within the SOC and Suffolk and North East Essex Integrated Care System (ICS) are invited to provide feedback on its content and to provide a statement as to the extent to which they support the case. Issue 1 of the full SOC will be provided to the ICS Board during week commencing 18th January, allowing time for members to absorb the detail and confirm their support for the case prior to its submission to Department of Health and Social Care.

The Strategic Outline Case concentrates on the development of the Strategic case for change. Approval of the Outline Business Case (OBA) is sought in order to affirm that the assumptions made, and the options appraised, lead to the best available option being identified. The OBC adds detail in terms of clinical design (reflecting the potential for provider collaboration), associated schedule of accommodation and the identification of construction partners. It is also the period during which planning permission is confirmed.

The Full Business Case completes the clinical, physical and digital designs for the programme and finalises partners, contracts, budgets and timescales.

Gary Norgate updated the Board on the 5 parts of the case which are detailed below:

1. The Strategic Case – a compelling case for change, an inclusive approach and a holistic fit. 2. The Economic Case – documents a wide range of options that have been considered in response to the potential scope identified within the strategic case. Demonstrates that the proposal represents best public value 3. The Financial Case – sets out the indicative financial implications of the Preferred option (4) compared to the Business as Usual (0) 4. The Commercial Case - provides an overview of the commercial arrangements for the successful delivery of the preferred option 5. The Management Case – addresses the ‘achievability’ of the scheme. Its purpose is to set out the actions that will be required to ensure

The Chairs group have passed on their recommendations and approval and the Board made comments on the importance of provider collaboration across the ICS and beyond to reflect clinical linkages, patient flows and opportunities for service improvement and service sustainability, which was widely agreed. An offer was made from ESNEFT to start to investigate the detail for the future of the workforce challenge as a collaborative approach. This offer was given with a caveat that there is clear evidence of involving other providers in the development of plans, particularly considering the requirement for provider collaboration. The Board also noted that there will be work through the clinical boards at an ICS level, so we provide the best possible care to everyone we serve across the ICS. The Board agreed their approval and formally support the SOC.

ACTION – SH, EG, and WP to agree draft letter from the ICS in support of the SOC. SH/EG/WP

Nb. Shelia Childerhouse noted declaration of interest in the paper

Part 3 – Papers proposed for update or approval on block – discussion only by exception should be held offline

Ref Item Action 7.0 Minutes