Draft minutes

As acting Chair, Gary Hall welcomed everyone to the meeting, and apologies for absence were noted.

Minutes from the meeting of 27.09.2016 were approved with no matters arising.

Actions from this meeting were all cleared:

Implementation Group to develop proposals on workstreams and present this back to the Executive in November, utilising TCA funding to fast track relevant activity in line with funding objectives.

Update – proposals formed part of the Agenda Pack in November, with accompanying note from Chair to ask for agreement to approach.

Executive members to communicate support for evaluation findings and recommendations to respective Implementation Group members and facilitate mobilisation of resources to deliver year 2. Update – commitment to work activity and agreement of resources part of the consideration in November.

It was noted that the meeting planned for 22.11.16 was cancelled due to availability of members. Also noted was the response from the Clinical Commissioning Group (Chorley and South Ribble) regarding the primary care hub (dated 13.12.16):

The CCG supports the initiative, and recognises that this model has been effective in other geographies. Currently the CCG is finalising its operational plans for the next 2 years and at this point in time cannot fully commit any resources to the evaluation or mobilisation of this project. It is worth noting that this model is not currently within commissioning intentions for 2017/18. However we recognise that we may need to look more closely at this initiative as part of our primary care strategy. We have a new Head of Primary Care in post in December will discuss this work in more detail. As raised previously one of our concerns as a membership organisation was that we were transparent and managed any potential conflicts of interest appropriately, and treated our member practices fairly in respect of investment and pilots, however as this investment has oversight from the Chorley reform Executive we are assured that appropriate governance has been followed.

Vicky Willett and Steve Winterson presented the update from the Implementation Group. Vicky advised that since the Executive had met last, excellent progress had been made by the Implementation Group in designing and developing activity against the workstreams.  Since the last meeting, the two hub formats have been mobilised with the primary care hub now operational. These include:

·         Collocated Hub

·         Primary Care Support Team

·         Integrated Community Wellbeing Service

·         Building Community Capacity

·         Workforce Development

The programme update was very positive, although it also included some considerations from the Executive around any concerns on work delivered to date, in particular around the establishment of the integrated hubs.  Shared case management solutions; additional service resource; and constraints around estates and accommodation were highlighted as potential future issues for wider system level integration activity.

Updates on key workstreams were provided:

Collocated Hub

John Buck and Mike Adamson reported that a lot of work had been progressed to reach the point of bringing in services that would be set up in the hub initially. A recent meeting with services was very positive and had commitment from all involved. John was assured that the right services are involved and Mike advised that additional services could be linked when required. This has enabled operational considerations to be identified, including limitations on a PFI building (legal agreement needed); how the hub will work operationally, including referral process/process mapping/case identification; access to shared case management; links with other hubs (Integrated Community Wellbeing Service/IAT/Primary Care); co-ordination resource; and Wi-Fi access.

The hub is working to a go live date of1^st March, subject to relevant IT and occupancy agreement being in place.

A meeting has been arranged to discuss operational issues further. The main issue around case management for integrated services was discussed further. To work effectively together as an inter-agency group, teams and services will need to have a central point to record and view case activity. Understanding that a potential longer term solution will be Liquid Logic, which is an LCC system. Councillor Martin advised that this system has been brought into essential services as a priority, but third party access to support integrated hubs could be considered, and has been piloted in Preston.

ACTION: Councillor Martin to provide LCC contact regarding access to Liquid Logic system to support integrated hub activity.

Gary advised should any issues be flagged which may cause delay to this collocated hub, that support could be identified to help progress i.e. legal support.

Primary Care User Support Team

Dr Shashidhar Khandavalli advised that the Primary Care User Support Team has been established from 9^th January, operating three days each week, with involvement from Lancashire Wellbeing Service, experienced health care workers, with admin support. The work focuses on supporting patients from being managed in the acute sector, to community based services, with a view to creating capacity in primary care, to help meet needs quicker and at an earlier point of intervention.  Process maps have been developed, including case identification across four  ...  view the full minutes text for item 3.

Hayley Hughes presented a framework to evaluate the activity planned for year 2. This looks to produce credible evidence from all the workstream activity, which will be proportionate to the programme of activity agreed, as well as being suitable to link in with wider strategic programmes. Criteria has been set out to cover both the overall programme, and workstreams, and sights how it will be gathered and shown against the principles of the programme, including reducing demand, improving integration, increasing prevention, adding social value and improving wellbeing outcomes.

The PMO will ensure that all workstream leads have the ability to collect relevant information, and this will be reported at relevant points to the Executive.

The framework was approved by the Executive.

Vicky Willett advised that through the community resilience workstream, SPICE have been commissioned to deliver an assessment of befriending across the borough. A report “Realising the Potential – Befriending in Chorley” has been received which sets out the benefits of befriending, what current services provide, and how these are delivered, and sets out a number of recommendations on how services could be improved, across a range of levels of investment.

Overall the report confirms that the provision is fragmented, and that befriending can take a number of forms, from peer support, coaching, face to face contact, and telephone support. Many good practices and services are highlighted, including Friends for You and the Age Concern Take Home and Settle service. 

The Executive advised that the report was noted, and that it would be valuable to consider as part of the wider understanding of resilient communities, and to consider as part of the larger piece of work with SPICE which is building community capacity.

Executive members were advised to consider the report in own organisations, and how befriending support could add value to vulnerable residents, in particular with Carers in identifying support and help available.

Sustainability and Transformation Plan (STP)

Gary Hall advised that STP is looking to identify issues in the Health and Social Care system, and reconfigure how services are delivered. It is a five year plan to deliver changes, and will support the Our Health, Our Care programme (local delivery plan for central), although not all timescales between the two programmes are aligned, and differing requirements are leading to some confusion. Clarity on decision making and communications are needed, as the STP work programme is not yet confirmed. Local programme management is moving to the CSU. Complexity on boundaries covered by the local delivery plans was also noted.

Our Health, Our Care

Sarah James advised that the Our Health, Our Care covers the local delivery plane for Chorley, South Ribble and Preston, and is in the fourth month of a seven month programme of redesign. This includes how we join up services by integration to support reducing demand of planned and unplanned admissions. Governance and assurance is being managed through the Central Health and Wellbeing partnership. Design workshops have taken place with a wide range of partners every six weeks to consider how services are delivered in the community; locality; home based etc. Public engagement events have also been happening across the locality.

Go on Chorley

Lynne Johnstone provided an overview of the Go on Chorley project, which initially began as national campaign (Go on UK). The project aims to show residents the benefits of being on line, and aims to ensure that no-one is left behind in the digital world. A network for the North West is in place, which includes corporate support (e.g. Barclays Digital eagles/EE), and Go on Chorley is a test model for a pan-Lancashire approach. The activity increases skills in communities, for individuals, charities and with SME businesses, which supports community resilience. A local website has been developed to be a conduit to help people learn skills, through data input.

A group is based at Community House and supported by the Volunteer Academy; new volunteers have an induction and are supported in building confidence and skills. It is intended that further groups are set up across the borough which increase opportunities for volunteers in building skills, improving health and wellbeing as well as employability.

A launch event will be held on 1^st February, and a plan of activity, including roadshows will be developed. Partners are engaged with the project and key metrics have been identified including supporting activity with primary care by being on-line for GP appointments/prescriptions.

Interest from primary care in linking in with high intensity users, Lancashire Wellbeing Service, LC and CCG was noted.

Progress on the above programmes will continue to be update to the Executive.

Gary Hall asked LCC colleagues for further clarity on neighbourhood hubs, and what these will potentially look like. Mel Ormesher advised that these will differ in service provision depending on needs of community, and timing will be reflective of which services are in place, and which need to be re-configured. Mel agreed to produce some narrative on the types of services being considered for Chorley, with estimated timings. The larger services including Wellbeing and Early Help service and Libraries will have an impact on the timings provided, and it was noted that over 30 changes to services had been made following the consultation last year.

ACTION: Mel Ormesher to provide a narrative on potential neighbourhood hubs for Chorley, with indication of services involved and estimated timings.

A revised Terms of Reference was issued with the agenda pack, and Executive were asked to raise any comments by 17.02.2017.

To be held on 21^st March 2017 at 16.00, Chorley Town Hall