Decision details

The Chair welcomed Gary Raphael, Executive Director for Finance and Investment; Andrew Bennett, Executive Director for Commissioning and Neil Greaves, Communications and Engagement Lead; all representing Healthier Lancashire and South Cumbria.

The report presented provided an overview of the partnership in Lancashire and South Cumbria working as an Integrated Care System (ICS) which covered five local areas: Central Lancashire, West Lancashire, Pennine Lancashire, Fylde Coat and Morecambe Bay, collectively known as Integrated Care Partnerships (ICP).  The report also detailed the early implications from the recent publication of the NHS Long Term Plan.

In response to questions raised by members, the following information was clarified:

·  Concerns were raised around the sustainability of hospitals given that at least £4.5 billion of the £20.5 billion national five year funding settlement for the NHS had been budgeted for expenditure on primary and community services to support local solutions to healthcare through the expansion of neighbourhood teams.  The Committee was informed that there would be specific direction as to how this money would be used to ensure accountability and accessibility.  Hospitals accounted for approximately 50% of NHS expenditure and work was underway to make them more sustainable in the longer term as hospitals across Lancashire were currently in financial deficit.  The proposals to change the services provided aimed to improve public health and wellbeing and therefore reduce the demand on hospitals.

·  With regard to recent issues in relation to mental health service provision in accident and emergency departments, it was confirmed that the local NHS and the county council were working through the reasons for this.  It was highlighted that this year, £4million of additional funding had been budgeted to facilitate the management of mental health services with a focus on mental health pathways and appropriate settings for recovery and crisis prevention.

• Members highlighted the need for them to be informed and involved in the neighbourhood model to support population health management. Assurance was sought on the governance arrangements at this level which included GPs, pharmacists, district nurses to physiotherapists, social care workers and colleagues in the voluntary sector. The Committee was informed that GPs and other recipients of additional local funding would be held to account for expenditure and would be expected to adhere to the national direction of investment in health in consultation with the community. 
• Members expressed concern regarding the effectiveness of a Community Action Network (CAN) and the lack of engagement from the public.  It was confirmed that an NHS colleague in this area would look at this with the relevant members to identify the best course of action.

·  Members sought assurance on the £471,000 investment to design better care around communities’ needs; when this was going to happen and the outcomes this would have for the people living in the proposed five test areas including Barrow, Blackpool, Burnley, Chorley and Skelmersdale. It was suggested that the next report should detail what has been done.

·  Concerns were raised regarding the lack of baseline figures in the report which were necessary to evaluate the effectiveness and impact of expenditure.  Members felt that many of the initiatives proposed to be new were already in place and were not working.  In response it was acknowledged that the NHS faced a considerable challenge and the proposals endeavoured to repair the current fragmented system and to address health inequalities by working with local councils and engaging with communities.  The most significant difference in the new plan was the fundamental move away from competitive to partnership working.  Members requested additional detail in future reports regarding the impact of expenditure and specific examples of how additional spending had made a positive change.

In considering the recommendation in the report, it was;

Resolved: That the Healthier Lancashire and South Cumbria five year local strategy be presented to the Committee at its meeting scheduled on 24 September 2019.