The Board is asked to note the update provided on the recent activity within the Surrey Heartlands and Frimley Integrated Care Systems (ICS) regarding the Integrated Care Partnerships and Integrated Care Boards; including an update on both systems’ implementation of the ‘Next steps for integrating primary care: Fuller stocktake report’.
Dr Charlotte Canniff - Joint Chief Medical Officer, Surrey Heartlands
Integrated Care System / HWB Vice-Chairman
Dr Pramit Patel - East Surrey Place representative / Primary Care Clinical Leader, Surrey Heartlands Integrated Care System
Tracey Faraday-Drake - Director for Children and Young People and All Age Learning Disabilities and Autism / Place Convenor for Surrey Heath, NHS Frimley Integrated Care Board
Key points raised in the discussion:
1. The Joint Chief Medical Officer (Surrey Heartlands ICS) / Vice-Chairman outlined the Surrey Heartlands ICS update adding that there were significant pressures in the NHS around demand and capacity, a briefing had been provided around the current industrial action underway by junior doctors.
2. The East Surrey Place representative / Primary Care Clinical Leader (Surrey Heartlands ICS)added that:
· Since the publication of the ‘One system, One Plan’ document in response to the Fuller Stocktake, the four places in Surrey Heartlands ICS undertook work around the key workstreams: streamlining access, complex care management, how to prioritise those cohorts and be more proactive within the prevention agenda. It required a whole system response, for example through the Growing Health Together initiative in East Surrey.
· Of the approximately 62,000 high users of healthcare services, 624 or 1% were very high users in terms of: A&E attendances, outpatient appointments, admissions and general practice contacts. Multi-disciplinary integrated neighbourhood teams needed to be created to support those cohorts across Surrey, work was underway via the anticipatory care hubs and a reduction had been seen in attendances and admissions.
3. The Chairman noted that the Hewitt Review would be published on 29 March, it had sensible recommendations that would help inform local strategies. A key part of the request and the evidence heard through that Review had been to empower ICSs to manage their own systems, moving decision-making closer to residents. He noted that the towns work was a positive step forward, building multi-disciplinary teams around the geographical cohorts.
4. The Director for Children and Young People and All Age Learning Disabilities and Autism / Place Convenor for Surrey Heath (NHS Frimley ICB) outlined the Frimley ICS update adding that:
· Operational planning and budget setting for next year had been challenging due to the huge priorities and challenges around NHS funding.
· The joint forward plan was being developed and welcomed the chapter on neurodiversity; more work needed to be done on that across Surrey particularly around children and young people and Special Educational Needs and Disabilities.
· The draft Frimley ICS Strategy had six ambitions: starting well, living well, people, places and communities, our people, leadership and cultures, and outstanding use of resources; feedback was welcomed, ensuring that it was aligned with other Surrey organisations’ strategies.
· The ICB was focused on prioritising the reduction of health inequalities and its next meeting would be a development day.
5. A Board member noted that the system was not going far enough in the right direction. To save money and for people to have better lives, focus needed to be on looking beyond services; working with communities to enable them to have better lives for example the asset-based community development learning programme. She noted that there were many VCSE organisations who had been working with communities for many years, it was vital to work with them, commissioning them to do further work as necessary. Her concern was replacing that work via the public sector whose personnel would be more expensive.
- The Priority 3 Sponsor highlighted an example of asset-based community development work underway in East Surrey with colleagues in Tandridge, empowering residents within those communities to identify what prevention looks like at place/neighbourhood level. The work in Merstham was about the public sector and organisations across the system enabling and facilitating what communities want to do for themselves.
- The East Surrey Place representative / Primary Care Clinical Leader (Surrey Heartlands ICS) noted the importance of understanding how data is used and empowering teams within neighbourhoods to have a large impact in terms of prevention and wellbeing. For example, 80% of residents in Nailsworth Crescent, Merstham, are smokers, that data enabled targeted work to happen with the Merstham Community Hub to start proactively inviting those people to start using the One You Surrey service - which was underutilised - becoming the highest referrer into that service.
- The Chairman highlighted the work of the Leatherhead Community Hub which was undertaking some fantastic work. He noted that there was a multitude of good work underway but some of it was unknown and he emphasised that the VCSE sector was a key part of the work.
1. Noted the update provided on the recent activity within the Surrey Heartlands and Frimley Integrated Care Systems (ICS) regarding the Integrated Care Partnerships and Integrated Care Boards; including the update on both systems’ implementation of the ‘Next steps for integrating primary care: Fuller stocktake report’.
Actions/further information to be provided: