Council and democracy

Agenda item

The NHS Long Term Plan

This item will be presented by Ian Wake, Director for Public Health and Mandy Ansell, Accountable Officer, Thurrock CCG.

 

An Executive Summary of the long term plan and a covering report summarising the plan and the impact for Thurrock is included in member’s papers

Minutes:

Ian Wake, Director for Public Health, presented this item.  Key points included:

·         The report set out the direction of travel for the NHS in England over the next 5 years and what this might mean for the borough

 

·         The 5 key themes were:

1.    Finance and Resources

2.    Prevention and Health Inequalities

3.    New models of integrated care

4.    Action to improve care quality and outcomes in different clinical  specialities

5.    Workforce

 

 

 

·         The most significant aspect of the report was the finance element, the plan set out considerable financial increases to NHS budgets in England of £20.5Bn over the next five years.  This extra spending would be required to deal with current pressures and unavoidable demographic change and other costs, as well as new priorities.

·         There was also a further move away from individual to system control targets centred on new Integrated Care Systems (ICSs) that will operate at STP level – in Thurrock’s case this is Mid and South Essex.

·         Public Health funding was not included within the report and adult social care funding dealt within a future further paper and comprehensive spending review.

·         The plan committed to a ‘more concerted and systematic approach to reducing health inequalities’, with a promise that action on inequalities would be central to everything that the NHS does.

·         The Plan specifically recognised that there are two major sets of work which need to progress in parallel:

1.    Population Health Management approaches – which required action by everyone, including the NHS

2.    Place Based Approaches – including action on wider determinants such as planning, housing, education and employment outcomes and many other aspects the NHS is not set up to deliver on

·         Weight management, diabetes prevention and smoking cessation also included

·         The report stated a stronger role for the NHS in commissioning sexual health services, health visitors, and school nurses, and what best future commissioning arrangements might therefore be.

·         The report discussed new models of care which aligned with what Thurrock were doing locally to have integrated mixed skill workforce teams

·         A number of commitments have been given to a group of clinical specialities where outcomes in the UK have sometimes lagged behind other similar western health systems.  Priorities include cardio-vascular disease, cancer, mental health, maternity and neonatal health, diabetes and respiratory care.

 

During discussions the following points were made:

·         Members commented that there was the possibility that health visiting and school nursing may end up back again in health, particularly around commissioning.  However it was acknowledged this would cause complications regarding existing contracts and budgets; this in turn would have implications for the workforce.

·         Ian Wake was concerned with the possible risk of having the footprint moved to an STP level and how that would impact on the ability to align place and care elements – a top down versus bottom up approach.

·         Ian Wake also commented that the mental health element was disappointing however transformation plans were more ambitious locally.

·         It was acknowledged workforce remained the biggest risk, with little detail provided on how to reduce the vacancy rate. 

·         Mandy Ansell advised that the CCG needed to make 20% cuts in management allowance in turn putting pressure on delivery.

·         Jane Foster-Taylor agreed that workforce remained a concern and commented that definitions of workforce data were not clear as it included voluntary and third sector workers; there was an issue with retaining and recruiting staff. 

 

·         Andrew Pike agreed with all the above comments made and stated there was indeed already a strain on resources and that Basildon was in a relatively good place compare to others within the Trust group.  Also, joint working was encouraged with the CCG to create an operational plan in order to make further strides in urgent care; demand management was reported as key.

·         Roger Harris commented that the wider health and social care demands needed to be considered, the biggest problem in adult social care was reported as domiciliary care.  The key issues were late transfers, the instability in the market, and the ability to recruit quality care staff.

·         Members commented on the timetable for the planning process, the STP plan was reported to be due in April, however colleagues were awaiting guidance and detail on CCG level plans.  A clarity on monies was also required, including what money had been allocated and the visibility of it.

·         Roger Harris urged that the STP plan should be signed off by three Health and Wellbeing Boards.  

 

RESOLVED:  The Health and Wellbeing Board:

·         Noted and commented on the content and recommendations contained within the report.

·         Members agreed for the STP plan to be included on the agenda for the next meeting.

 

Supporting documents: