In a report of the Scrutiny Support Officer Members were advised that the Chair of the Board and the Executive Member for Adult Social Care and Public Health had agreed that it would be beneficial for the Board to receive a presentation on the current Health Landscape in Middlesbrough owing to a number of recent changes since April 2014.
A diagram showing the current health and care system at April 2013 was provided at Appendix 1 of the report submitted.
The Chair welcomed Craig Blair, Head of Commissioning and Delivery at the South Tees Clinical Commissioning Group who gave a PowerPoint presentation which summarised the key changes in 2013 within the context of prevailing legislation and current economic constraints.
A DVD was played, entitled, 'An alternative guide to the 'new' NHS' from the King's Fund aimed at wider audiences which provided an insight into how the new organisations worked and fitted together. Members considered that it demonstrated the complexities of current arrangements.
Members were reminded of the rationale for reform from clinical leadership to drive improved outcomes and efficiency and resulting White Papers and legislation. The new system had become fully operational on 1 April 2013.
NHS England with regional and local presence through Area Teams had taken on many responsibilities previously undertaken by PCTs particularly in relation to primary care services, specialised commissioning and emergency planning. NHS England played a key role in the Government's vision to modernise the NHS and secure the best possible outcomes for patients. The aims of NHS England would enable patients and the public to have more choice and control over their care and services; clinicians to have greater freedom to innovate to shape services around the needs and choices of patients; and the promotion of equality and the reduction of inequality in access to healthcare.
Reference was made to the Durham, Darlington and Tees Area Team which was the local arm of NHS England the core functions of which were clinical based estate strategies; CCG development and assurance; emergency planning, resilience and response; quality and safety partnerships; and configuration/system oversight.
Clinical Commissioning Groups became statutory bodies on 1 April 2013 and took on responsibilities from primary care trusts for commissioning mainly hospital-based and other non-primary care health services for their local populations. The CCG comprised of local groups of doctors (49 GP practices across Middlesbrough, Redcar and Cleveland). The CCGs were responsible for around 80% (£60 bn) of NHS funds with the South Tees CCG budget around £380m.
Public Health England was established as an Executive Agency of the Department of Health and included the remit of the former Health Protection Agency.
Members were keen to receive information if the required level of savings in overall terms had been achieved and if the perceived benefits and reinvestment had been realised. From the STCCG's perspective it was indicated that it was very difficult to determine as the CCG was given a disaggregate budget to manage although Members were advised that further information on the requested information would be sought.
Following Members' questions regarding the main challenges it was indicated that apart from the initial understanding of the health reforms and what the CCG was accountable for the other key challenge was finance as with many other organisations. Confirmation was given of ongoing discussions with the Local Authority on making best use of available resources and pursuing joint opportunities in relation to public health, promotions and current focus on urgent care.
With reference to current monitoring processes confirmation was given of the CCG's own assurance process together with others such as the Care Quality Commission.
Taking into account the complexities of the changes Members sought assurances regarding the measures in place for the patient's voice and engaging with the public. An assurance was given of the CCG's intention to embrace the opportunity to engage with the public. The Board's attention was drawn to the current clinically led workstreams comprising of GPs, managers, local authority representatives, stakeholders and patient groups and of links to Healthwatch. There was recognition that there had previously been significant gaps in terms of pursuing the opportunities of engaging with the public. Specific reference was made to a Public Engagement Event by the CCG to be held on 11 December 2013 to consider some of the current challenges in relation to an ageing population with long term and complex needs, financial pressures, illnesses associated with smoking and alcohol, and managing hospital admissions and demand within primary care services.
In terms of progress, specific reference was made to improved arrangements with social workers and benefits of GP Practices opening for longer hours, such as 8.00 a.m. to 8.00 p.m. and the availability of walk-in facilities.
ORDERED that Craig Blair be thanked for the information provided which was noted.