Councillors and committees

Agenda item

JSNA AND COMMISSIONING INTENTIONS (2016/17)

The purpose of this item is to:

·         Share the plans for the future development of the Joint Strategic Needs Assessment (JSNA) and its use to inform commissioning intentions (see report 1 attached).

·         Share at a headline level the commissioning planning timeframes and key commissioning priorities of Board member organisations.

·         Outline how the commissioning intentions are aligned to Surrey’s Joint Health and Wellbeing Strategy.

·         This item is intended to allow for a discussion on the opportunities, gaps and challenges for the Board in implementing Surrey’s Joint Health and Wellbeing Strategy.

 

Minutes:

Witnesses:

 

Rich Stockley, Senior Manager, Research & Intelligence, Surrey County Council

 

Key points raised during the discussions:

 

JSNA

·         The Board was provided with an overview of the amendments identified to further improve the accessibility and functionality of the Joint Strategic Needs Assessment (JSNA) as a resource for Surrey County Council (SCC) and its partners. These included introducing clearer and more succinct chapters which were easier to locate within the JSNA. Support was also sought for the revised JSNA to assume a life course approach in line with the outcomes of the Marmot Review.

 

·         The need for a JSNA Strategic Development Group was also stressed to the Board to ensure that there was an effective means of making decisions on the future strategic direction of the JSNA. Members of the Board were invited to join the Development Group to provide their input into the direction of the JSNA.

 

·         A member of the Board suggested that the final section in the proposed life course approach to the revised JSNA, ‘Aging Well’, be amended to 75 and over to align with the approach taken by the Clinical Commissioning Groups (CCGs). It was further suggested that a representative from Healthwatch Surrey be involved in the work undertaken to update the JSNA so that it also reflected the patients’ voice.

 

·         Members of the public present were invited to ask questions about the JSNA following which it was requested that the minutes of the meeting be circulated as widely as possible to help Surrey residents get a more comprehensive understanding of the work that the Board was doing to set the strategic direction of health and social care in the county.

 

·         The recommendations made in the report were agreed by the Board.

 

Commissioning Intentions

 

·         Presentations detailing the commissioning planning timeframes, key commissioning priorities as well as highlighting potential challenges and opportunities were provided by each of the CCGs with members present, SCC, the districts and boroughs and NHS England.

 

·         It was felt that commissioning intentions should be presented jointly by Board member organisations to reflect the growing collaboration which was taking place between health and social care commissioners. The Board agreed that future presentations on commissioning intentions would be delivered collectively by member organisations. This has been added to the actions tracker as item A5/15.

 

·         The recruitment and retention of staff was highlighted as a particular challenge facing health and social care commissioners in Surrey particularly in light of the new living wage which was being introduced from April 2016 as well as a European Union judgement which required all mobile workers to be paid for time spent travelling between appointments. Given these challenges, it was agreed that the Health and Wellbeing Board would schedule an item on workforce recruitment and retention to be considered in 2016. As well as recruitment and retention of staff, it was suggested this item could also explore ways to flex the existing workforce more effectively and avoid the duplication of work by staff across organisations. This was included on the actions tracker under reference number A6/15.

 

·         Discussions took place on the work that was being done to create consistency in the services being commissioned across the county to ensure that all Surrey residents had access to the same services. It was stressed that identical services did not need to be commissioned within each area of the county but rather that there was a need to ensure each organisation delivered against the agreed set of outcomes.

 

·         Concern was expressed regarding a possible reduction to Public Health funding. Although these proposals were out for consultation it was anticipated that they could result in a £2 million reduction in the Public Health team’s annual budget. If the proposals were approved by the Chancellor of the Exchequer at the Comprehensive Spending Review (CSR), then it was indicated that Public Health would look for savings which may impact on their commissioning intentions for 2016. It was stressed that the potential impact of any reductions to Public Health budgets would have a more significant impact in Surrey than in many other counties due to the fact that Surrey is one of few local authorities which utilised the full extent of its Public Health budget allocation. It was stressed that the potential impact of any reductions to Public Health budgets would have more of a significant impact in Surrey than in many other counties due to the fact that Surrey is one of the lowest funded local authorities per head in the county for PH.

 

·         The Board discussed the Personalisation Prevention and Partnership Fund (PPPF) of £180,000 which SCC had allocated to each district and borough in the county in 2015/16. It was indicated that districts and boroughs had concerns about how they would maintain the services delivered through PPPF once this fund was withdrawn. 

 

·         The way in which patients accessed health care services was raised by the Board who stressed the need to ensure that people are aware of and able to access the services that they require. The role that housing associations could play in reducing the need for residents to access acute care services and the need for improved signposting of appropriate services were also discussed. The strain being place on Police resources by responding to people experiencing a mental health crisis was highlighted as a particular area of concern. It was indicated that more should be done to ensure that out of hours services were available so that those in crisis would be attended to by a mental health professional. Making sure that patients enter the system correctly not only provides better outcomes for the patient but is also often more cost effective.

 

·         Financial strain was highlighted as being a key challenge in 2016 particularly for the CCGs who stressed that they were facing a significant amount of pressure on their budgets.

 

·         Discussion took place regarding the review of stroke services which was being led by Surrey Downs CCG. The Board was informed that, as a result of the review, the CCG was looking to redesign and improve pathways through the establishment of centres of excellence across the county which would provide high quality care to those in Surrey who had suffered a stroke. It was stated that listening events would be held across the county to give patients and residents the chance to respond to the proposals being put forward.

 

 

 

RESOLVED:

 

JSNA:

 

a)    A life course approach is adopted to the JSNA, with a more limited range of chapters to reflect the strategic nature of the JSNA;

b)    A JSNA Strategic Development Group with delegated authority be created and includes representation from the CCGs and Healthwatch Surrey;

c)    A more systematic approach be taken to the production of chapters for the JSNA.

Commissioning Intentions

 

a)    Future commissioning intentions items considered by the Health and Wellbeing Board be delivered collectively by the Board members;

b)    An item on workforce recruitment and retention in health and social care be added to the Board’s Forward Plan;

c)    An item on the outcome of the Comprehensive Spending Review be added to the Health and Wellbeing Board’s Forward Plan.

 

Supporting documents: