Agenda item

Mr Faiysal Patel, Head of Strategy at NHS North West London (NWL), advised that he would circulate the document that he had prepared to Board members after the meeting.  It was noted that NWL Integrated Care Board (ICB), had been facing significant financial and operational challenges but that action was being taken to respond to those challenges.  Providers were moving towards more joined up working through the development of provider collaboratives and staff were being provided with strategic direction and being asked to do fewer things well (rather than doing everything at once or some things more than once).  Progress would be tracked over the next five years. 

The forward plan looked to tackle six key challenges within NWL:

1.    the nature of the care the local population required had shifted from acute episodic, to chronic;

2.    improvements in life expectancy had stalled in 2012 and life expectancy was now decreasing year-on-year;

3.    the shift in the local population’s needs had been demonstrated in the ICB’s recent activity trends;

4.    there was significant variation across NWL in service availability, access in a timely fashion and population health outcomes;

5.    the pressure on the NWL system would continue as the population continued to grow and age; and

6.    to deliver care more sustainably, three key shifts had been identified as part of the national 10-year plan work: sickness to prevention; hospital to community; and analogue to digital.

Nine long term priorities had been refreshed and carried forward from the ICB’s previous forward plan.  Actions had been prioritised within each of the priorities and had been tied to the NWL needs assessment through three key themes:

·         Integrated Neighbourhood Teams;

·         Community and mental health services - particularly with regard to increasing capacity for young people; and

·         Transforming specific services – particularly in relation to maternity, cancer screening and planned care services.

The document set out the NWL ICB strategic ambition for the next five years.  It included the actions and aims for each of these years and would be used by NHS providers and the ICB.  Professor Ian Goodman, NWL ICB, noted that the NWL ICB outcomes from the previous year had not been published to be able to gauge progress to date on the priorities.

Mr Patel advised that, in Hillingdon, there were similarities in the overarching plan and optimising the system flow.  The next steps would be to update the forward plan to reflect the latest urgent care, planned care and neighbourhood health strategy work.  The document would be refined following the Board’s comments and then submitted to NHS England. 

Ms Lesley Watts, Chief Executive at The Hillingdon Hospitals NHS Foundation Trust, suggested that, when mentioning children’s mental health and community services, the document needed to be more specific about things like dentistry.  If the document was to be circulated more widely, it would be useful to include information about the ageing population. 

Mr Tony Zaman, the Council’s Chief Executive, noted that the NWL ICB Forward Plan appeared to be at odds with the previous item (Draft Joint Hillingdon Health and Wellbeing Priorities 2025-2028).  It was queried whether the biggest drivers for the Forward Plan had been cost or ill health and whether it was the top or bottom of the system that should determine where resources should be focussed. 

Mr Patel advised that there were currently residents in NWL who did not have access to services in their area.  The Forward Plan aimed to reduce the variation across NWL and produce a common offer – the plan would be to add services where required in year 2.  The outcomes and milestones had been included in the document.

Mr Edmund Jahn, Chief Executive Officer at Hillingdon GP Consortium, suggested that a core common offer would not be the right way of delivering services as the system should be trying to achieve equality of outcomes.  The problem with the ICB’s approach was that a common specification might fit one community somewhere in NWL but not the majority of communities.  The forward plan had been over specified in terms of input.  In Hillingdon, partners were trying to do something specific and the forward plan would disrupt what they were doing at ‘place’.

Mr Keith Spencer, Managing Director of Hillingdon Health and Care Partners and Co-Chair, noted that the neighbourhood specification was able to use a flexible workforce but this was not what was being proposed in the forward plan. 

Ms Kelly O’Neill, the Council’s Director of Public Health, noted that the forward plan appeared to be a document that was for NHS consumption.  Clinical care access was only 20% of health so the NHS needed to recognise the importance of involving social care.  Preventative measures were not done very well, so consideration needed to be given to early intervention and every contact should be preventative.  End of life care had not been included and too often became an emergency because it hadn’t been planned. 

Councillor Palmer noted that partners had worked hard to create a joint Health and Wellbeing Board but it seemed that social care was still not being included at a NWL level.  All of the partners wanted what was best for residents and it was recognised that the changes needed to start somewhere but it would be important to stop talking about changes and start taking action. 

Members of the Board were asked to pass on any additional comments to the Democratic, Civic and Ceremonial Manager to collate and forward on to Mr Patel.

RESOLVED:  That:

1.    Board members pass any additional comments to the Democratic, Civic and Ceremonial Manager to collate and forward on to Mr Patel; and

2.    the discussion be noted.