Simon Hall (Director of TransformationEast London Health & Care Partnership) briefed the Board on his work on developing a long term plan for north east London.

Summary of key points:

·         NHS England had instructed the north east London Health and Care Partnership to draw up a Long Term Plan which required the inclusion of three key elements. These were:

o   To develop a strategy delivery plan or ‘the narrative plan’.

o    To submit a planning tool – this would be a spreadsheet containing activities, financial resource and workforce requirement.

o   To submit a Long Term Plan Collection Tool – this was essentially a performance tool with 50 key metrics to monitor. 

·         Engagement exercises included running workshops on mental health, bringing systems together and there was a showcase event in June.  A first draft had been prepared but a firmer second version would be available to executive Board members in the next few days, including the Chair and Director of Public Health.

·         The Board were asked to comment on whether the document looked accurate and whether it was suited to the north east London and local level.

·         Maternity and mental health plans were on the east london health and care partner website. It was noted the work on metrics and workforce would not be completed until the 27 September 2019. These aspects would be completed on the day the first draft is submitted to NHS England. So far out of 50 performance indicators, guidance had been submitted for around 30 of them.

·         The final draft would be submitted to NHS England on 15 November 2019.

·         Local challenges were highlighted. These included: 

o   Significant population growth 2.02 million to 2.28millon by 2028. 13% rise so the new system would need to ensure resources could meet needs. 

o   2. Variation in clinical quality and outcomes across the north east London patch and the need to tackle health inequalities as a system.

o   3. Workforce was identified as a big challenge, difficulty in recruiting staff in all disciples was a concern. It was noted that technology would be required to be used more efficiently and local workforce would need to be grown. 

o   4. It was noted the current health and care system did not have the financial resource to continue with the existing financial model and this would need to be addressed in the plan.

·         In order to mitigate challenges the following solutions were identified:

o   Greater emphasis in preventing ill health and empowering people to take control of their own health.  And putting resources behind prevention.

o   Ensuring the services provided were integrated and joined up.

o   The need to rapidly modernise the approach to service provision including utilising the NHS academic and research base.

·         Emerging vision - the intention behind the plan was for it to be realistic for the north east London area and for it to link with other clinical strategies and the London Mayor’s vision.

·         Transparency and openness was a principle behind the plan. It was important local populations were informed of changes.

·         Members were advised and encouraged to inform Mr Hall of resourcing needs as soon as possible because they would not be guaranteed in the future.

·         A draft of the plan will be submitted to NHS England on 27 September 2019, with a final outward facing plan published on 15 November 2019.

·         It was noted that local sign off by Health and Wellbeing Boards was not advised in the guidance but for the purpose of meaningful engagement, Mr Hall sought the consensus of the Board on the draft document.

Discussion following the briefing:

Realism test.

There was a question on how realistic it was that the plan would be tailored to north east London given the NHS England requirements. Mr Hall acknowledged it was a challenge and explained that a balance had to be met. He said the issue was raised at a recent STP meeting where he reinforced to NHS England representatives that the plans would have to be realistic and right for the north east London area.

Staff

Members asked how staff would be recruited and retained in the new plan. It was noted that there were several ideas to increase the number of people working in the NHS and this included training and developing staff, creating opportunities for younger staff and their partners to build careers in the health system and attracting local people to NHS jobs. Though it was acknowledged staffing would be a challenge.

Resources

Members understood that resourcing needs would have to be identified in the October draft plan because there was a risk additional resourcing would not be guaranteed in the future. Members asked how they could meaningfully engage with the document given the time constraints and the need to align the document with the boroughs Health and Wellbeing Strategy. Members were advised to engage with Mr Hall directly throughout the October period to comment on the draft. The ‘I’ statements were welcomed as an innovative approach. 

Community engagement

The Chair asked whether there was a risk of Tower Hamlets priorities being diluted in the long term plan and asked how residents had been engaged in the plan. Mr Hall explained that the document aimed to ‘build from the bottom up’. He said the local Healthwatch organisations had been consulted and produced advisory reports. He also said the Tower Hamlets Together partnership had been utilised to provide community insight, as well as executive Members of the Local Authority and he welcomed further engagement with these partners in the month ahead.  It was noted that because the NHS Long Term Plan was based on the Tower Hamlets model, there would be an element of familiarity with the plan.

Localised services

Dr Ian Basnett asked for clarification on what services would stay in the plan and what would come out. He highlighted in some situations a localised services were essential. Mr Hall advised that if there were any specific areas that required resourcing he could be contacted.

In addition, Debbie Jones – Corporate Director for Children and Education, requested her comments be noted. She said that it would be difficult to represent the totality of the north east London area and local priorities. Though there were similarities between local authorities, there were significant differences and the Health and Wellbeing Board would have to be very careful and mindful of any commitments it put forward. She said from a local authority perspective the commitments made should be owned by the council and consistent with the local work that had taken place, without losing traction or pace.  

Social Care

It was noted that the draft plan circulated to the Chair and Directors later in the week would not contain guidance on social care due to certain intricacies in formulating the outline but Mr Hall agreed to circulate the draft on 2 October 2019.

Online access

It was noted that the most up to date version of the draft north east London long term plan would be posted on the East London Health and Care website for public viewing and for public comment.

ACTIONS:

1.       For Members of the Board to get in touch with Simon Hall if they had further comments on the draft north east London long term plan.  

2.       For Health and Wellbeing Board executive Members and Simon Hall to meet in October to discuss the final draft plan and circulate it for comment to the Health and Wellbeing Board.

RESOLVED:

1.       To note the update on the north east LONDON long term plan.