Agenda and draft minutes

Members were welcomed to the meeting, introductions made and apologies noted.

Minutes agreed as correct record, with no matters arising. Actions updated as follows:

Action – Vicky to contact LCC regarding Child Protection Order concern

Update - issue raised with Safeguarding Team (LCC), but no update as yet, agreed to clear through Extended MDT group.

Action – Steve to provide contact details to PMO to help develop the dashboard for the next Executive

Update - cleared as contact received, and dashboard to be progressed as part of evaluation in September.

Action – Executive to consider the changes proposed for the Chorley area against each service provider under the LCC Asset Review, and provide a summary of emerging issues and impacts; details of buildings affected in delivery of services; highlight need to link in with wider strategies, with any immediate issues to be flagged direct to Gary Hall

Update - cleared as responses received from Executive

Action – Cllr Bradley to send a collective response to LCC on behalf of the Chorley Public Service Reform Partnership on the Property Strategy Consultation

Update – in progress, further information obtained including links with WPEH strategy to support informed response – consultation closes 14^th August.

Vicky Willett provided an update on work progressed this year through the Implementation Group and task group.  This was acknowledged as a busy and extensive phase of delivery, based on the principles of the strategy agreed last year.

The update presented headline findings and identified key themes to indicate the direction of the full evaluation and prepare the Executive for some of the decisions that will need to be made in when the full evaluation is presented in September.

Key themes included early intervention and prevention, colocation, data and intelligence and organisational culture and workforce, as those present across all reform programmes at both a system and local level.

Delivery of work through the partnership has enabled us to test principles and concepts and apply them in a local context to support rapid development. 

This has included three areas of focus:

Place based service integration - how do we work differently in a place, based on local intelligence? This has been supported by delivering events in the community including a public awareness event, and service collaboration hub in Chorley East, supported by a well-represented cross sector Task Group.

Outcomes from this include understanding what we need to know to support joint delivery, how we can develop frontline services to support early intervention, how we can better understand communities and support cultural change in services.

Effective MDT – how do we strengthen MDT working to manage complex and difficult cases in a sustainable way?  This has been supported by delivering a testbed of primary care joint working across surgeries and partners, with a focus on vulnerability and early intervention.

Outcomes from this include better proactive management of high intensity users, testing ways of sharing information across services, reducing duplication and demand, with critical integration of the Lancashire Wellbeing Service.

Resilient communities - how do we work differently and change our relationship with communities so that they are better able to help themselves and others?  This has been supported by progressing a tender process to identify a provider, SPICE, to deliver engagement activity, assessment of community capacity and befriending services. This work is in the early stages and expected to bring outcomes which will include proposals on approaches and models to encourage and build resilience in communities.

From the learning gathered from the work so far, there are opportunities to test integrating services in a variety of settings, develop workforce, and manage and support high level users of services.

The Executive were asked for comments on the work completed so far, and overall agreed that the work fits with the wider strategies which are being developed to ensure they also fit across services and priorities. Other comments included:

·         Linking into existing structures e.g. INTs and sharing learning across teams

·         Proposals of how the learning and benefits can become sustainable, as part of the everyday approach

·         Understanding of how this links with the Integrated Wellbeing Service, as we move to Year Two of programme, testing integration further.

·         Involvement of education provider early on  ...  view the full minutes text for item 38b

Carole Spencer presented an overview Our Health, Our Care programme, and advised that the Clinical Service Strategy set out in October 2015 involved engagement with patient groups, governors and staff on how models of care would look in the future, which was part of the Your Hospitals, Your Health programme.

The case for change in central Lancashire acknowledges that we have the largest growth in population and significant areas of deprivation, which is impacting services e.g. pressures on admission levels which is leading to worsening patient experiences. Through work on the Healthier Lancashire programme, financial gaps have been defined, and although savings have been identified, there is more to do across services.

The Lancashire and South Cumbria Change Programme has been established (which was Healthier Lancashire) to take forward this transformation on a large scale radical change programme. The Our Health, Our Care programme is the delivery response to the NHS Five Year View, and pan-Lancashire Sustainability and Transformation Plan, which includes a Local Delivery Plan for Central Lancashire

The activity will involve all services working together better and looking at how we develop a sustainable, integrated system which will benefit Chorley, South Ribble and Preston residents. Prevention and early help and community based care will be a key part of the end to end approach considered. Although clinically driven in the main, partners are being invited to be involved in the development of the model and relevant business case, as there is a consensus that we will be able to be stronger in delivery by working together.

To support this activity a PMO has been established, with a six month action plan due to start from September, which will look at solution development and public engagement events. The work done at this level will link up to a pan-Lancashire level. Sarah James is the Programme Director.

Comments from the Executive included:

·         Concerns on timing across the Local Delivery Plans as not all are running at the same pace, but need to be linked across pan-Lancashire, which may impact on wider decisions i.e. use of assets;

·         Many timelines are in place across the levels of activity, and there will be a challenge to dovetail activity to have a Lancashire response;

·         Services delivered within the Lancashire border, and also outside this area, but used by residents will all be part of the review taking place

Carole thanked for the update, and asked to keep the Executive informed of progress of activity, to understand how the work is developing, and how the group can influence any shaping of future services.

Executive were provided with the latest position on the following activity:

Lancashire Combined Authority

Councillor Bradley advised that the combined authority moved to operating in it’s shadow form, using the agreed constitution which will test how the members work together to the new rules over the next few months, moving to full status in Spring 2017. Workstreams include early intervention, housing and health, and the Executive will be updated on progress.

LCC Asset Review

Mel Ormesher advised that the consultation period began on 18^th May and will close on 14^th August, and  information is available on line, in paper form, and in libraries. Meetings are being held with partners and service delivery arms, with a view to take recommendations to Cabinet in September, which will confirm which assets remain and which will need to be decommissioned. Views are welcome from across partnership on what LCC can do differently in manging the assets under the review.

LCC Wellbeing, Prevention and Early Help

Mel Ormesher advised that this is also going through consultation looking at provisions of fixed service delivery, considering group work and targeted work as well as community venues. Colocation of services also being considered, linking with Early Help and Troubled Families, which will support the new staffing structure.

Dr Khandavalli presented a proposal which looked to improve levels of high intensity users of services in acute and primary care, building on the Blackpool vanguard. The proposal covered low level of investment with significant savings, and advised that it could be set up relevantly quickly, needing a low level of resource and equipment. The work would involve working across services to identify the most appropriate need, and take learning from other activity including HIU work being completed by the Police.

The Executive approved the proposal in principle, but advised that further development on the proposal was needed around following considerations:

·         Understanding of costs to cover the six month and 12 month period, in comparison with other projects, and impact of and funding streams;

·         Scalability of project, including potential roll out;

·         Understanding on choice of resource stipulated to support range of cases involved (Acute, Primary, Secondary);

·         Governance and fit with primary care strategy; and

·         Fit with wider models i.e Integrated Wellbeing Service.

Action Dr Dr Khandavalli to bring the proposal back to the Executive in September to cover the issued raised, and for the brief to be issued ahead of the meeting for consideration by the Executive.

Next meeting planned 27^th September at 16.00, Chorley Town Hall

Agreement of bi-monthly meetings remains, and next meetings agreed as:

27^th September 2016 at 16.00, Chorley Town Hall

22^nd November 2016 at 16.00, Chorley Town Hall