Agenda item

Julie Billett introduced the report and presentation which provided an update on the North Central London Sustainability and Transformation Plan.

The following main points were noted in the discussion:

·         The Plan would seek to improve health outcomes, reduce inequalities in the quality of care and support the sustainability of services across North Central London. There were robust governance arrangements surrounding the development of the Plan in which Islington was strongly represented.

·         An initial plan had been submitted to NHS England. Although this did not include specific details, it did indicate the broad areas of transformation, which would be developed further over the coming months.

·         A Clinical Cabinet had been appointed to develop the Case for Change. Work was underway to establish a shared understanding of the clinical challenges faced across North Central London and a unified vision of how these should be addressed. Initial messages agreed by the Clinical Cabinet included an emphasis on prevention and early intervention. There was a need to reduce the demand on acute services by supporting people in staying well and delivering services in community and primary care settings.

·         It was commented that there were variable outcomes and a variable quality of care across North Central London. It was hoped that the STP would identify best practice to raise standards and improve consistency across the area. This work had already commenced through bringing clinicians and medical directors together in the Clinical Cabinet.

·         It was intended for the STP to provide a fully integrated system in which patients accessed the right services, at the right place and time, supported by the right systems. A review of the most effective use of estates, workforce and ICT systems would be crucial to this.

·         It was commented that analysis of the financial pressures facing the health and care sector typically focused on NHS services and it was queried why local authorities were not included. In response, it was advised that local authorities were required by law to set a balanced budget and therefore accounted differently to NHS bodies which could operate a managed deficit. Furthermore, the pressures on local government finances were more generalised and it was difficult to attribute specific shortfalls to particular services.

·         It was reported that the Directors of Adult Social Services in the North Central London area met regularly, including in London-wide settings. The budgets of local authority social services departments varied considerably depending on demographic factors and local priorities. Although it was thought that some social care services could be implemented at a cross-borough level, it was suggested that more specialist services generally needed a more localised focus, as this eased integration into other local services.

·         Public engagement activity was to commence in the autumn. It was suggested that the national Healthwatch network could be approached about the most effective way to engage residents in the production of STPs. Detailed proposals and clear messages would be needed in advance of any engagement activity on both the STP and the Haringey and Islington Wellbeing Partnership. The Board noted that patient feedback often commented on the need for more integrated services.

RESOLVED:

(1)  That the update on the North Central London Sustainability and Transformation Plan be noted; and

(2)  That the final STP be received at a future meeting.