Agenda item
North East London Sustainability and Transformation Plan; Governance
Minutes:
Jane Milligan, Executive Lead for the North East London Sustainability and Transformation Plan (NEL STP) introduced this item.
She said the STP process signalled a move towards working in a larger geographical area and that the governance arrangements to support the strategy and system level change was essential to ensure the development and implementation of the STP. Twenty organisations in East London have been working together to develop the East London Health and Care Partnership (ELHCP which previously known as NEL) STP.
The ELHCP STP plans to hold roadshows in the summer and is consulting Overview and Scrutiny Committees and other stakeholders, in developing its governance structure. The diagram on Page 27 gives an overview of the structure that the STP is looking to achieve. Task groups will continue to develop the document, as it’s a live document and groups such as the Mayors and Leaders Advisory Group, Community Group and Assurance Group will feed into the structure.
The ELHCP have developed a draft Partnership Agreement for the governance arrangements, which is not legally binding but is intended to ensure a common understanding and commitment between partner organisations.
Jane Milligan informed the Committee that the STP were aiming to shape and refine the structure going forward.
Dr Sam Everington, CCG Chair, Tower Hamlets CCG and NEL STP Clinical Lead then gave the Committee Members examples of how working together can achieve better results for the patient.
Example 1
A project on Palliative Care has seen multi-disciplinary teams managing terminal care enabling patients the choice to die at home with their loved ones present.
Example 2
Maternity Care has been improved with Midwifery-Led Clinics co-existing with Maternity Units and offering more choice and support to new mothers.
Example 3
Outpatient services have been improved with GPs able to refer patients for blood tests with improved systems to view test results via an email response.
Example 4
The STP will allow for Mental Health Care to be on an equal footing with physical disease, as the organisations within the partnership will be working to integrate their specialisms, to provide a more holistic approach to health and care.
Jane Milligan referred to the question raised by the ‘Keep our NHS Public’ group and said discussion was necessary as to how oversight and transparency would be achieved. She said that as the Lead Officer she was a conveyor to the ELHCP STP and each organisation was working collaboratively to achieve the right direction of travel. The ELHCP STP was aiming to bridge the gap between Commissioner and Provider organisations.
The five-year forward view would provide the partnership with an accountable care system and there were no plans to take away the role of Overview and Scrutiny Committees.
This was followed by questions and comments from Members of the Committee and responses from NHS Representatives.
· Cllr M Mustaquim – Top of Page 24 states the shadow arrangement came to an end in March 2017. What is operating in its place?
· Diagram on Page 27, explains what the governance structure should look like. The advisory groups, clinical engagement and assurance groups plus the clinical senate are being developed and local authority Chief Executive representations and political leadership is also being sought. There will be regular periods of review of the structure to ensure the structure is robust and meeting the needs of the partnership.
· Cllr S Masters – What is the composition of the Community Group shown on the diagram and has an equalities assessment been undertaken at a local level? The STP will require a thorough communications and engagement strategy but when will local people have sight of this?
· The Community Group will be quite large and will encompass other community networks, not just organisations but also residents. A meeting has been organised for the 28th June when various voluntary groups will have the opportunity to become the voice of the public but also become a reference group for the STP. Healthwatch organisations, patient groups and representatives, community and faith groups, police and fire brigade will all have a role and will be part of the communication and engagement strategy.
· A detailed piece of work is required with respect to the equalities assessment and the communications and engagement plan is evolving. The ELHCP STP will be meeting with partner organisations and will be launching a coherent communications strategy, with local events planned from June onwards.
· Cllr S Masters – Will the INEL JHOSC have sight of the engagement and communications strategy? What is the timeline for the strategy to become available?
· The Strategy is being pieced together at the moment and will be shared with the INEL JHOSC.
· Cllr C Harrisson - What is the parity between elected councillors being a part of the decision making process and structure as opposed to local authority representation under the ‘Mayors and Leaders’ advisory group?
· Cross working is required to ensure the structure is integrated. The Mayors and Leaders Advisory Group meets on the 26th May and within the partnership agreement a seat will be offered on the Board, with two seats for the Community Group.
· Cllr C Harrisson - Will this be the Mayors and Chief Executives of Local Authorities?
· Yes but also chairs of the Health and Wellbeing Boards. The ELHCP STP requires some help and feedback on how to make this work.
· Cllr A Munn – Diagrams help to show where final decisions are to be made. Is the ELHCP STP Board, shown in the centre of the diagram, making decisions or will local commissioners and providers be allowed to make decisions themselves? Will there be directives from above as to how and who makes decisions?
· The idea of the ELHCP STP partnership is to provide challenge to the organisations which sit directly below it. Commissioners, Providers Local Authorities accept the Health and Care sector has to change with an accountable care system. The Partnership will be making recommendations to partners but ultimately, decisions to implement recommendations will be with the statutory organisation.
· Cllr A Munn – Has the ELHCP STP taken into account the population churn for each local authority area? There needs to be an understanding of this as the population in East London varies from borough to borough.
· We accept the population in East London varies so we are using data from Health and Wellbeing Boards and the Joint Strategic Needs Assessments (JSNA) to inform our predictions and decision making.
· Councilman W Mead – Who will be part of the Assurance Group? Are you seeking representation from individual health scrutiny committees?
· We will be writing to the INEL and ONEL JHOSC’s but wish to work with scrutiny committees to see what will work best for them.
· Cllr C Harrisson – We need to figure out if we need one JHOSC representing the ELHCP STP footprint, however this conversation needs to be had between local authorities to see which Overview and Scrutiny structure would be best.
· Cllr S Masters – Has there been an assessment of the Governance Groups put forward in the diagram? It’s been said the lowest level – commissioner and providers will be making decision, but how realistic is this?
· The ELHCP STP partnership can only make recommendations on broad areas, where working together is for the greater good – e.g. workforce, signposting, prevention, whereas local decisions will be required in respect to population needs and equalities.
The Chair thanked the presenters for their presentation and answers to the questions raised by Members.
Supporting documents:
- item 4 cover sheet STP, item 5. PDF 52 KB
- Item 4_ ELHCP Governance paper INEL JHSOC, item 5. PDF 100 KB
- iTEM 4_ ELHCP STP governance structure, item 5. PDF 219 KB