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Agenda item

Update on the North Central London Sustainability and Transformation Plan

Minutes:

Zina Etheridge, Deputy Chief Executive of Haringey Council, made a presentation to the Board providing an update on the North Central London Sustainability and Transformation Plan (NCL STP).

 

The following main points were noted in the discussion:

 

·         The Board noted concerns with the lack of public and democratic engagement on the STP. It was commented that the STP had not been developed transparently and there was a level of scepticism about the plan as a result. It was therefore important that all local health and wellbeing partners had an opportunity to consider the STP in an open forum.

·         The STP identified a financial gap in NCL NHS services of £876m by 2020/21; with an additional £300m gap in social care funding in the same time period. Given the scale of savings required, it was important to ensure that stakeholders gave sufficient focus to transformation and prevention, rather than short terms approaches to achieving sustainability. It was emphasised that reducing demand for services would be essential to achieve savings of such a scale. 

·         The STP had been scrutinised by the NCL Joint Health Overview and Scrutiny Committee. This had identified several themes for scrutiny and challenges for the STP, including the need to further integrate social care and the wider health system.

·         It was noted that the STP did not make specific reference to children’s services. It was considered that further integration of children’s and health services would allow more comprehensive early help services to be provided.

·         The Board noted the strengths of the STP, which included the acknowledgement that care was best provided closer to home, and the recognition of the need to enhance primary care; however considered the lack of public engagement and democratic oversight was a challenge to the STP’s legitimacy. 

·         The Board welcomed that the STP gave mental health conditions parity of esteem to physical health conditions.

·         Concern was expressed regarding the capacity of the voluntary sector to deliver more community care. It was suggested that work would be required to build the capacity of the voluntary sector, which was not referenced in the STP. 

·         The STP identified urgent and emergency care as an area for transformation. The Board noted that the details of this transformation were yet to be confirmed, however indicated that a reduction in urgent and emergency care services would not be supported. It was suggested that an increase in urgent and emergency care capacity would be more appropriate. 

·         A&E services were often operating beyond capacity, with 318 patients visiting A&E at the Whittington the previous day, above the expected number of around 260. Work was needed to reduce the demand on A&E by treating patients in other areas of the health system. It was commented that patients presenting to A&E did not always require hospital admission, with the daily admission rate being as low as 42% on some occasions.

·         The STP was a high level strategic document and delivery plans would be produced to detail how the STP would be implemented. This would provide a new opportunity to engage with the public and key stakeholders on the plans.  

·         It was commented that public engagement on the STP needed to be coordinated and consistent. It was queried when decisions would be made on the form of the engagement, and how engagement initiatives would be supported. In response, it was advised that this would be considered at the next meeting of the Wellbeing Partnership Delivery Board.

·         The Board acknowledged that the STP did not detail the impact of service transformation on particular services. It was suggested that the implications of the STP needed to be known before meaningful public engagement could take place. It was also considered that public engagement should be an opportunity to co-design services with the public.

·         It was advised that a communications and engagement lead had been appointed to improve the engagement process around the STP.

·         It was advised that the governance arrangements around the STP had been altered recently and that Healthwatch was to be incorporated into the oversight group and the delivery group. It was advised that Healthwatch was developing principles of public engagement and it was suggested that these could be incorporated into an engagement plan.

 

RESOLVED:

 

That the update on the Sustainability and Transformation Plan and its implementation in North Central London be noted.

Supporting documents: