Councillor Amina Ali, Cabinet Member for Health and Wellbeing introduced the item and set out the context of the health and social care integration plan.  This plan aimed to enable service users to access joined up health and social care services when needed.  The outcomes not only concerned care of service users but also the wider well-being of the individual. Councillor Ali highlighted that delivery was required not only in the context of individuals’ needs but also that of structural changes to  health and social care services and financial challenges.

The Joint Director of Integrated Commissioning then gave a presentation on the health and social care integration plan for the borough; outlining the context, the current arrangements and the proposed Tower Hamlets Together Integrated Plan which will deliver further transformation.

Arising from the presentation, the Board noted that:

·         In 2020 Clinical Commissioning Group (CCG) arrangements would change resulting in one CCG for East London.

·         There was a £60M funding gap between the NHS and CCG in Tower Hamlets.  The Board was informed that, in the context of this financial challenge, an integrated system known as ‘Tower Hamlets Together’ had been devised which was intended to address the challenges around use of resources, pooling and aligning budgets and governance around health and social care while retaining local decision-making.

·         It was necessary that Tower Hamlets consider its present local JSNA in relation to other boroughs and assess if averaged below or above these in its provision.  A key area was good communications between the NHS and the local authority.  The Board was informed that Tower Hamlets had broad relationships with other elements of the Tower Hamlets Partnership and at a London-wide level.

·         There was a risk that the Tower Hamlets Together integrated structure might disempower the Health and Well-Being Board and create tension around governance. Additionally there was risk of diluting community outcomes because of the professionalisation of the Tower Hamlets Together framework.  The Board was informed that the Council intended to ensure engagement was retained within the Tower Hamlets Together framework and work was being undertaken to establish how the future Tower Hamlets Together structure would fit in with other existing bodies.  Other authorities around the country were looking at how decision-making bodies might bring decision-making together in the form of a joint board with delegates from the participating health and well-being points.

The following information was then provided in response to Members’ questions:

• Officers had sought to mitigate the funding gap by assessing how the Council used community related resources and then to reshape what resources were spent on and/or reduced duplication.
• Borough services would be safeguarded because the integrated scheme would support more embedded and sustainable partnerships.
• The integrated arrangements would permit the overarching East London CCG to establish different plans with each of the seven boroughs within each borough partnership.  However, at present, the NHS wished to explore how to achieve consistency and how boroughs could work together. 
• To mitigate potential negative impacts or a risk of failure of the integration plan it was necessary to balance the scheme to ensure that adequate local discretion had been factored to meet local needs and to efficiently provide specialist needs.  Councils would need to ensure these were incorporated in their plans for service provision.
• Concerning whether integrating budgets would produce a more responsive service the Board was informed that the key factors were around pooling resources, improved outcomes or reducing costs and the tension between these.  At present, evidence was towards improved outcomes rather than savings, none the less it would be beneficial to explore eliminating duplications.
• Concerning whether savings had been quantified and when further information around reducing duplication, identifying future efficiencies and achieving savings could be presented; the Board was informed that savings had already been delivered through joint working and integration.  The Tower Hamlets Together plan would take forward initiatives that had been started, each savings proposal remaining with the NHS or the local authority respectively.

RESOLVED

1.    That the report and comment on the progress made to date and future opportunities regarding health and social care integration be noted.

2.    That the comments on how the Transformation and Improvement Board can best support the ongoing work of health and social care integration be noted.