Tony Hoolaghan introduced the report and presented on the progress of the North Central London Sustainability and Transformation Plan (NCL STP).
The following main points were noted in the discussion:
· The NCL STP was transitioning to the implementation phase. It was intended for some joint acute commissioning to be carried out across North Central London in the near future.
· A new CCG leadership team had been appointed across Haringey and Islington.
· NCL STP arrangements had been subject to scrutiny at a local level and at the NCL Joint Health Overview and Scrutiny Committee.
· The STP was a complex and ambitious plan and capacity was needed to deliver the work identified in the plan. It was intended for the STP to enhance prevention, primary care, and community resilience, however, capacity to deliver the ambitious plans set out in the STP will be drawn largely from within existing resources and capacity.
· In response to a question on voluntary sector engagement, it was advised that engagement with the sector had increased as the STP process had developed.
· A member queried how hospital discharge could be improved through the STP. In response, it was advised that national guidance would be followed and patients would be categorised into streams. Work was in progress for patients to be dealt with in a consistent way across Islington and Haringey. Once a patient had been admitted to hospital, it was intended for the patient to be safely discharged as soon as possible.
· It was commented that those with complex care needs were best assessed in their normal place of residence, as those in need of care may have different capabilities in different environments.
· A discussion was had on hospital discharge arrangements. It was emphasised that hospital discharge should only occur when the patient is able to care for themselves independently or with appropriate support. It was commented, for example, that the discharge of patients with mental health conditions should not take place while patients are still vulnerable.
· The Sub-Committee noted the work of the National Housing Federation, which was working with housing providers to support hospital discharge. It was suggested that housing officers should be contacted at the point of admission so bespoke arrangements can be made, if required.
· The Sub-Committee considered examples of patients who did not require acute care, however were returning home to a hazardous environment. It was considered that engagement with housing providers was essential to ensure that vulnerable patients were appropriately supported.
· In Haringey, multi-disciplinary team conferences were held weekly, which considered the needs of vulnerable patients planned for discharge.
· The Sub-Committee noted concerns about the STP process, and on the financial pressures of public bodies. Whilst it was welcomed that progress had been made, it was commented that honest conversations were needed between partner bodies about how services can improve and work closer together within existing resources. It was suggested that the STP needed a stronger focus on social care services and would benefit from a more system-wide approach.
· The importance of public consultation was emphasised. It was commented that engagement with the public must be pitched appropriately.
· The Sub-Committee noted concerns that the need for financial savings was driving short-term approaches rather than long-term solutions in the health and care sector. It was important to ensure that the needs of all STP partners were appreciated and system-wide solutions were found, otherwise positive work to improve services and make savings could be undermined.
· It was suggested that STP processes had previously delayed meaningful conversations taking place, however it was thought that there would be opportunities for all partners to contribute to the STP in the near future.
That the report be noted.