Agenda item

Mr Toby Lambert, Executive Director of Strategy and Population Health at North West London Integrated Care Board (NWL ICB), advised that he had not included the Mental Health Strategy in this item but that he would be happy to bring a report on this issue to a future meeting to provide the Board with an update.  The Joint Forward Plan (JFP) for 2024/25 to 2028/29 should originally have been considered by the Board on 11 June 2024.  This meeting had been cancelled following the announcement of the election as an NHS directive had been issued that the JFP should not be discussed in public.  As the timetable for submission of the JFP was subsequently changed to the day after the election (therefore not allowing enough time to arrange a new meeting), Hillingdon’s Director of Public Health had had to submit comments to NWL ICB on behalf of the Hillingdon Health and Wellbeing Board.  Consideration would need to be given to how this process could be improved for the next iteration of the JFP. 

The Board was advised that the JFP had been a ‘joint’ initiative between the ICB and other NHS organisations (rather than between the local authority and the NHS).  It built on the NHS Health and Care Strategy which had been published in November 2023 and included nine priorities with cross cutting principles:

1.    Reduce inequalities and improve health outcomes through population health management;

2.    Improve children and young people’s mental health and community care;

3.    Establish Integrated Neighbourhood Teams with general practice at their heart;

4.    Improve mental health services in the community and for people in crisis;

5.    Embed access to a consistent high quality set of community services by maximising productivity;

6.    Optimise ease of movement for patients across the system throughout their care – right care, right place;

7.    Transform maternity care;

8.    Increase cancer detection rates and deliver faster access to treatment; and

9.    Transform the way planned care works.

To achieve these priorities, the following steps now needed to be followed:

1.    Ensuring a core / common offer across NWL - currently the offer across NWL was inequitable and needed to be levelled up (rather than being levelled to the middle).  However, productivity would need to be pushed to enable funding to be freed up for this to be actioned;

2.    Whilst the provision of a common offer would address some of the inequity in NWL, it was recognised that the ICB would need to work with local authorities to reach out to seldom heard groups in the community which would then result in a shift in resource allocation.  The speed of implementation of these first two steps would need to keep pace with each other; and

3.    Consideration needed to be given to what percentage of the population’s needs could be met by the core offer and where tailored services would be needed.  It was recognised that the core offer would never meet the needs for some communities in NWL, for example, rough sleepers and asylum seekers.  These groups would need bespoke solutions. 

The JFP would be for the whole of NWL and identified a great degree of commonality (80-90%) between the different boroughs’ Health and Wellbeing Strategies.  It would enable interventions to be undertaken at scale through the core offer, and the remaining 10-20% would need to be given space as they would have divergent priorities. 

It was noted that the JFP had been discussed by stakeholders at a Town Hall meeting.  Mr Lambert advised that the NWL ICB was keen to solicit suggestions for improving the process of developing future JFPs. 

The Board recognised that NWL ICB had been given a tight timeframe by NHS England regarding data publication.  Although the Board supported the idea of boroughs levelling up to the same core offer and therefore providing opportunities to improve weaker areas, concern was expressed that those boroughs that were already performing well in specific areas would be required to mark time whilst the others caught up, preventing them from moving even further ahead.  Furthermore, it had been difficult to compare boroughs based on the number of patients registered with GPs as this was inaccurate and could be inflated by up to 15%.  This needed to be acknowledged and addressed by using population figures instead.

The Board queried how the ICB would be supporting the commitment to improve stroke services in NWL and whether the JFP would be backed up by a financial strategy (without which, the JFP would be useless).  Also, with the recent change in Government, concern was expressed about whether or not the JFP would be required in the future. 

RESOLVED:  That:

1. Mr Toby Lambert provide a report on the NWL ICB Mental Health Strategy to a future meeting of the Board; 
2. the comments and suggestions for improving the process for the next Joint Forward Plan be noted;
3. the challenge in securing formal feedback from all Health and Wellbeing Boards within the set deadline due to successive pre-election sensitivity periods be noted; and
4. the submission of the Joint Forward Plan to NHS England on 5 July 2024 be noted.