Agenda item

Considered –

An update from Wendy Balmain, as summarised below:-

Strategic Overview

-          The recently published Darzi report detailed what would be the 10-year strategy for the NHS, which included three big shifts.

1.     Hospital to community care

2.     Analogue to digital

3.     Treating sickness to preventing sickness

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-          That prior to the report, the ICB was already underway with partners to look at how services were delivered for the future, work partnerships were affordable, quality was improved, and long-term mortality rates were improved for the population, in particular those who have a low quality of life. The report would however support how the ICB moved its plans forward.

-          That the new ICB strategy included four health priorities, which would be the focus of the ICB.

1.       Reducing harm from cancer

2.       Cutting cardiovascular disease

3.       Living with frailty

4.       Aiding mental health and resilience

-          The ICB strategy had a ‘golden priority’ around how we improve life chances of children and young people.

-          As part of the strategy, the ICB had worked with leaders across the system to look at the design for the future, or ‘blueprint’. It would become public in the autumn for consultation. The Blueprint would look at three key areas.

1.       The integrated out of hospital model across primary, community, and social care.

2.       Mental Health.

3.       Hospitals.

-          The ICB was looking at a ‘delegation to places’ model, which would put places at the centre for the delivery of the integrated model around primary, community, and social care. The Place Board, acting as an executive forum, was looking at what this meant for North Yorkshire, what they wanted delegation to look like, and whether it would deliver something different from what currently existed.

Practical Overview

-          The ICB was working through the model of community health and what it should look like for the future, its core offer, and its ability to deliver equitable access to its services. She suggested there was an opportunity to cooperate across York and North Yorkshire and its providers of community services.

-          There were two primary care network pilots in North Yorkshire which would provide insight into what primary care would look like in the future.

-          There was a Health and Inequalities programme in its third year which was testing ways of working with local organisations. It was amongst other smaller schemes of which the findings could be shared at a future meeting.

Louise Wallace added that the schemes had been discussed at the North Yorkshire Place Board, of which many would complement the Health and Wellbeing Strategy. Further, that as Chair of the Population Health Prevention Executive Committee for the ICB, they were keen to find a balance between initiatives which were done as one-offs on a local authority level, and initiatives at the local level could be done on a basis that reflected local needs.

The Chair observed that in the short-term much the operational side was spent enabling people to leave hospitals, freeing beds, or block-buying beds in care homes; while the long-term strategy would redesign services. Wendy added that strategically, they were seeking ways of delivering care closer to home rather than using more nursing and residential care. They would redesign services so that pressure on services were lifted and coordinated differently.

In regard to the Darzie report Ashley commented that it was more than the way people received care, but importantly the issues on why they need it. Social determinants around education, housing, green spaces all contributed to health outcomes, of which the prevention agenda should address.