Agenda item

Report of the Director of Community and Children’s Services

The Committee received a report of the Director of Community and Children’s Services updating Members on the progress of the integrated commissioning programme and two current key pieces of work within it – the development of a local integrated care model and the pooling of budgets for Continuing Health Care and Adult Social Care.

The Director of Community and Children’s Services informed the Committee that there were various changes including the introduction of a Sustainability and Transformation Partnership. Local authorities and the CCG had looked at introducing a single system for better delivery and outcomes. It was stressed that this would not be a merger with Hackney, but rather the pooling of some resources with the CCG which would aim to enable quicker design and delivery and drive better outcomes and efficiency. The City of London alone was a small part of the market and this model would give the City of London more of a voice and increased ability to make changes. The emergence of neighbourhood delivery would help with the City’s smaller population base. Implementation would be overseen by the Integrated Commissioning Board which included three City of London Corporation representatives. The Board would have oversight of CCG budgets. The governance structure included four workstreams, each with a Director and Senior Responsible officer. These workstreams were Unplanned Care, Planned Care, Prevention and Children, Young People and Maternity.

The changes were about collaboration and partnership and hoped to see real service delivery change, aiming for equality of service and shared understanding within and between neighbouring CCGs. Along with the 111 service, this approach would allow for more choice and opportunities in areas such as out-of-hours services.

The Committee noted the development of the neighbourhood model with regards to GP services. Members were aware of the national challenges for GP practices around recruitment and particularly attracting partner GPs, as well as practices merging or entering into joint office support arrangements. The Neighbourhood Model would aim to make City and Hackney attractive to GPs and work was ongoing with the local GP confederation. An integrated structure would be more appealing to GPs and the model would be based on geographical location to inform the understanding of local needs. Members suggested that bureaucracy and the administrative burden for partners was another barrier to GP recruitment.

The aim was to provide more continuity of care and to join up a broader range of services. The Committee noted models used elsewhere such as Acute Providers taking on GP functions which alleviated the administrative burden. Better recruitment in other areas could also help GPs. Members felt that the admin support issue, continuity of care and health and social care integration were key in providing better GP services. There was an inherent risk in having a high turnover of GPs, whilst poor administrative support and patients visiting GPs with non-health issues was uneconomical for both patients and doctors. The essence of the new model was to create structures for local ownership, to enable long term sustainability and flexibility for local leaders.

The Committee noted the progress of the integrated commissioning programme and key pieces of work within it, and agreed they were steps in the right direction. The Committee thanked Nina Griffith for attending and for her contributions to the meeting.

RESOLVED – That the report be noted.