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Adult Social Care and Health Scrutiny Committee 5 July 2021

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Adult Social Care and Health Scrutiny Committee 5 July 2021 Adult Social Care and Health Scrutiny Committee 5 July 2021 Integrated Care System, Integrated Care Report Title: Partnership, the White Paper and Local Developments Cabinet Portfolio Integrated Care and Health Cabinet Member Councilor Marlene Quinn Exempt Report No Reason for Exemption N/A Key Decision No Public Notice issued N/A Wards Affected All Mark Palethorpe Executive Director of Integrated Health and Social Care, Accountable Officer CCG [email protected] 01744 671822 Ann Marr OBE Chief Executive, St Helens and Knowsley Hospitals Trust Report of [email protected] 0151 4301242 John Heritage Executive Director of Partnerships, Mersey Care [email protected] 07468 692128 Wayne Longshaw Director of Integration Contact Officer [email protected] 0151 6765721 Ensure children and young people have a positive start in life Promote good health, independence, and care across our communities X Borough Create safe and strong communities and neighbourhoods for all priorities Support a strong, thriving, inclusive and well-connected local economy Create green and vibrant places that reflect our heritage and culture Be a responsible Council 1. Summary 1.1 This report provides the Scrutiny Committee with an update of the developments at a national, regional and local level. This is a co-produced report that has been developed by officers from the Local Authority, CCG and provider partners from St Helens and Knowsley Hospital Trusts and Mersey Care which recently acquired North West Boroughs. The paper apprises members of the latest developments at national, regional/system and local levels. 1.2 National Picture – The government produced its white paper on 11 February 2021, which signaled the Government’s intent legislate for changes and the Queen’s Speech which announced the Health and Care Bill to be read in the current parliament. 1.3 The new Bill will introduce wide ranging changes to health and social care including: Give greater powers of intervention to the Secretary of State for Health and Social Care Create single national NHS hierarchy – NHS England Make ICS’s statutory NHS bodies Abolish CCGs Create a Duty to Collaborate (Local Authorities and NHS bodies) Mandate the creation of Provider Collaboratives 1.4 Region/System Level – The North West Region now has three Integrated Care Systems (ICS): Greater Manchester, Lancashire and South Cumbria and Cheshire and Merseyside which was recently designated an ICS on 1 April 2021. The ICSs will become the main vehicle for the planning, resourcing and monitoring of performance for health investment and outcomes for the sub region from the 1 April 2022 when it becomes a statutory organisation. 1.5 The ICS has established a Joint Commissioning Committee in advance of the legislative changes that would establish a single CCG for Cheshire and Merseyside from April 2022. The Joint Committee consists of the nine CCGs to make some commissioning decisions ‘at scale’ across Cheshire and Merseyside. 1.6 The overarching role of the Joint Committee is to enable the Cheshire and Merseyside CCGs to work effectively together and make binding decisions on agreed service areas, for the benefit of the population registered with a GP practice in Cheshire and Merseyside. 1.7 The default principle is that wherever possible, commissioning decisions should be made at ‘Place’ with only those commissioning decisions which make sense to do at scale being undertaken at a Joint Committee of CCGs across the Cheshire and Merseyside footprint. 1.8 It should be noted that the Regional Director for the North West will be stepping down from his role in July 2021 and the current Chair and Chief Officer for the Cheshire and Merseyside ICS have announced that they will not be putting their name forward for consideration to lead the new statutory organisation. 1.9 Local Developments - St Helens Cares has evolved into an Integrated Care Partnership (ICP). The report highlights the timetable for this year of transition, particularly the establishment of Integrated Care Systems (ICS), the dissolution of CCGs and the implications for St Helens. 1.10 St Helens and Knowsley Hospital Trust (STHK) continues to treat some patients with Covid-19 and is committed to restoring services to reduce backlogs in elective care brought about by the pandemic. The Trust has been operating the Mass Vaccination Centre at St Helens rugby stadium which until recently was also occupied by primary care colleagues delivering vaccines. The Trust is also part of two newly developed provider collaboratives; 1) Mental Health and Community Services and 2) Acute and Specialist Trusts, the latter is led by the CEO of STHK. 1.11 North West Boroughs was formally acquired by Mersey Care on 1 June 2021. Mental Health and Community services have been transferred to the acquiring organization along with staff TUPE-ing across to Mersey Care to ensure a seamless transition of services for our residents. 2. Recommendations for Decision The Scrutiny Committee is recommended to: i) Acknowledge that 2021/22 is a year of significant transition brought about by the forthcoming legislation. ii) Recognise the context and the changing landscape for health and care in the Borough and in the wider Cheshire and Merseyside system iii) Note the focus of local providers working collaboratively to restore services, reducing backlogs impacted by the pandemic, and bringing forward ways of working to improve services for our residents. 3. Purpose of this Report 3.1 This report updates the Scrutiny Committee of the legislative developments resulting from the White Paper and most recently the Health and Care Bill announced in the Queen’s Speech. The new Bill will introduce wide ranging changes to health and social care and is likely to become law by 1 April 2022. The Cheshire and Mersey Care ICS will become a statutory body and the local CCGs will be dissolved with effect from 1 April 2022. 3.2 St Helens Cares has been at the forefront of integration and partners have taken preparative steps with the early development of an Integrated Care Partnership (ICP) with robust governance arrangements to ensure that we continue to lead the way in Cheshire and Merseyside. 3.3 Changes to the provider landscape is taking effect in a number of ways; 1) new legislation, 2) the impact of the pandemic and 3) transactional arrangements through the acquisition of the former North West Boroughs Healthcare NHS FT by Mersey Care NHS Foundation Trust. 4. Background /Reasons for the recommendations Legislation and System Requirements 4.1 The Health and Care Bill will, when enacted in law introduce the widest set of reforms for Health and Care for almost a decade. 4.2 The new Bill will introduce wide ranging changes to health and social care including: Give greater powers of intervention to the Secretary of State for Health and Social Care Create single national NHS hierarchy – NHS England Make ICS’s statutory NHS bodies Abolish CCGs Create a Duty to Collaborate (Local Authorities and NHS bodies) Mandate the creation of Provider Collaboratives 4.3 The statutory Integrated Care System (ICS) for Cheshire and Merseyside will have a considerable remit, being responsible for in excess of £4.5bn of health spending. Key functions include: i. Making decisions about local NHS planning and funding allocations ii. The responsibility for the commissioning functions of the CCGs and some of those of NHS England, as well as CCGs’ responsibilities in relation to Oversight and Scrutiny Committees iii. Have a unitary board - this will be directly accountable for NHS spend and performance within the system, with its CEO the Accounting Officer for the NHS resources allocated to the ICS iv. Be responsible for: o developing a plan to address the health needs of the system; o agreeing the strategic direction for the system; o setting out the plans for both capital and revenue spending for the NHS bodies in the system o establishing a forum for wider system partners to develop collaborative working arrangements (Health Care Partnership) 4.4 The ICS will be able to discharge its statutory duties in three ways: Commission at the system level Discharged through provider collaboratives Delegated to place: Integrated Care Partnership (ICP) The Cheshire and Merseyside ICS plan places great emphasis on “primacy of place” to focus on health inequalities, outcomes and equity of access. Places are based on local authority boundaries and there will remain nine in Cheshire and Merseyside, of which St Helens will be one. 4.5 A statutory ICS will be in place by 1 April 2022, the time-line for the implementation of the new arrangements is shown in the table below: 4.6 Cheshire and Merseyside ICS requires that each place form an ICP which will have seven core features: i. have an ICP Board with a breadth of partners i.e. L.A., PCNs, housing, third sector ii. have a designated place lead who will liaise with the ICS iii. develop a vision for reducing health inequalities in each place iv. agree an ICP development plan v. have defined neighbourhoods/localities which will be clinically led by PCNs vi. have public and stakeholder engagement programmes vii. have integrated commissioning between health and social care e.g. shared posts and pooled budgets 4.7 St Helens is well placed to meet these requirements. We have an established ICP Board; we have a designated place lead and a strong vision for reducing health inequalities. Our ICP development plan is taking shape. A number of development sessions are scheduled in June and we have established localities with primary care networks central to our ambitions to create care communities. We have a well-established stakeholder forum and finally our integrated commissioning is the most advanced in Cheshire.
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