a.     System Update – Karen Calder (15 minutes).

b.     STP Neighbourhoods Update – Mel Duffy (10 minutes).

c.     Workforce Planning - (15 minutes).

a)    System Update

The Chair stated that all comments about the recent Future Fit announcement were welcome, whilst stressing that the solution had to be a whole systems solution for everyone.  Sadly some organisations had acted only with their own interests at heart which was disappointing.  She said that change was inevitable and pleaded to the STP Board to recognise the stress that was happening across the entire system. She accepted that change was inevitable, but the thought of an external team being parachuted in to sort things out was not acceptable.  There was a global phenomenon coming across that the public wanted to be listened to.  Bearing this all in mind, the Chair proposed that a formal letter be written on behalf of the H&W Board to the STP Board raising the following two big questions;

·       What is the STP Board doing to address the many concerns raised?

·       How will the STP Board challenge what they do?

This proposal was welcomed by Shropshire Healthwatch, who had also written a similar communication to the STP Board, and the H&W Board generally.

Main comments made;

o   Local Authorities had been charged with developing neighbourhood commissioning, but unfortunately there were no resources to do this currently.  The Chair asked around the meeting for honest and frank suggestions to deal with this.

o   It was noted that the CCG Team had improvements to make going forward.

o   The Chair stressed it was important for everyone to work together.

o   The STP in principle was good, but the timelines were too tight and largely undeliverable.

o   There was a lack of clarity around the STP and finances.

o   The NHS was criticised for having a lack of respect for Health and Wellbeing Boards and for not being actively involved enough.

o   Another view was that there was a clash of cultures – the NHS worked top-down, with Councils working bottom-up.  It was very early days at the moment and it was important to build on the good things that had happened recently.  Another big issue was a lack of time to undertake the work required properly.

o   Hopefully if the right questions were asked, then everyone could move on and work together in future.

b)    STP Neighbourhoods Update

A PowerPoint presentation was given by the Chief Executive, Shropshire Council, copy attached to the signed minutes, updating the Board on the progress to date.  Headlines covered were that;

Ø  NHS England had not assured the plan – out of hospital/place based model and financial plan does not form a credible basis for operational planning.

Ø  Plan is too acute focussed and lack of detail on the neighbourhood model

Ø  Financial Plan is not credible

The STP Neighbourhoods Group had developed a positive joint working group and were at a good starting point.  They had embarked on weaving prevention, resilient communities and care models into place based plans.

Their key priority for moving work forward was Leadership, Governance and Culture Change.

It was anticipated that the Frail and Elderly work stream would form the cornerstone of reducing admissions, whilst Support in the communities and around GP practices would support achieving the long term vision.

In discussing the Frail and Elderly in more detail, it was noted that the Neighbourhood Group was beginning to understand the nature and to quantify the scale of frail elderly inpatient activity that could be supported outside of hospital with appropriate services.

The Shropshire STP Neighbourhoods Group recognised this was just the tip of the iceberg and that much more could be achieved by working collectively.

c)     Workforce Planning

Victoria Maher, Workforce Director, SaTH, gave a PowerPoint presentation to the Board on Workforce Planning, copy attached to the signed minutes, which briefly covered

vThe Current State and workforce challenges across the system

vApproach – understanding future models of care

vWorkforce Plan – Acute Services

vAction