Regular update reports to the Health and Wellbeing Board are attached:

Shropshire Integrated Place Partnership (SHIPP)

Report attached.

Contact: Tanya Miles, Executive Director of Adult Services, Housing & Public Health, Shropshire Council or Penny Bason, Head of Service, Joint Partnerships, Shropshire Council, Shropshire, Telford & Wrekin CCG

Better Care Fund (BCF) update

Report to follow.

Contact: Penny Bason, Head of Service, Joint Partnerships, Shropshire Council, Shropshire, Telford & Wrekin CCG

Integrated Care Systems (ICS) Update

Report attached.
Contact: Nicky O’Connor, Shropshire, Telford & Wrekin CCG

Shropshire Integrated Place Partnership (SHIPP)

The Director of Adult Services, Housing and Public Health introduced this report (copy attached to signed Minutes) and highlighted that the purpose of SHIPP was to act as a Partnership Board of commissioners, providers of health and social care and involvement leads in Shropshire to ensure that the system level outcomes and parameters agreed by the ICS Programme were implemented at place level in Shropshire.  The Board would focus on objectives and outcomes not on organisations.  It was a partnership of equals with shared collaborative leadership and responsibility, enabled by the Shadow ICS governance and decision-making processes. 

She went on to inform the Board that clinical care and primary care leadership was central to the partnership to ensure that services provided the best quality evidence-based care and support for the people of Shropshire, improving outcomes and reducing health inequalities.  She then referred to the draft priorities set out in the report and the key areas of delivery, which included children and young people, case management, rapid response and hospital at home, end of life care, personalisation (which would include prevention and social prescribing), community service review, support in our primary care and the Joint Strategic Needs Assessment.

The Director of Adult Services, Housing and Public Health explained that the governance for the ICS was still developing and that the governance described in the Terms of Reference attached to the report would be updated as the Board evolved.  She confirmed that SHIPP would report to the Health and Wellbeing Board (HWBB) as well as through the ICS reporting structure.  Integrated Place Boards would hold significance in how the ICS deliver their place in the future.

In conclusion, the Director of Adult Services, Housing and Public Health felt that the SHIPP had great potential through working with the HWBB and ICS Boards and programmes to really drive forward integrated working.  It had the potential to ensure that local people were at the heart of decision making through the HWBB by providing that really important public accountability.  Like all programmes and Boards, SHIPP must now have a key focus on inequalities to ensure that the impacts of Covid-19 were reduced and outcomes for local people were improved.

The Board were pleased that the Terms of Reference included a Memorandum of understanding with the voluntary and community sector who were keen to be real partners in this process however resources were required to allow them to properly participate in the development of the ICS.  The Director of Adult Services, Housing and Public Health confirmed that the VCS were represented on the Integrated Place Partnership as well and that there were ongoing system conversations around the infrastructure within Shropshire as joint Chair she would ensure that the VCS were not just a guest at the table but a valued partner at the table.

The Director of Adult Services, Housing and Public Health responded to a number of questions from the Board.  In response to a query about the governance structure and links to the CCG, there was a head of service for partnership, Penny Bason who was a joint integrated post between Shropshire Council and the CCG, and was leading this forward on behalf of the system and will be attending on a regular basis in terms of any kind of CCG governance meetings.  A report was produced after every SHIPP meeting which went to the current Chief Executive system group meeting every month which had CCG colleagues in attendance.  She was pleased to confirm really good attendance across the whole system and it seemed to be really enthusiastic Board and a real willingness to make SHIPP work as a system partnership and was evolving.   Penny Bason informed the Board that the CCG were involved in development of the Terms of Reference and they had been working hand in hand to develop the SHIPP and Terms of Reference.  She then explained about the three Executives on the Group and referred to the HWBB workshop held in June which looked at both HWBB and ICS priorities, and in particular the six big ticket items.  It was felt that it would become clearer going forward how the link to the CCG would look, along with their role within place.

The Director of Public Health was really pleased to see in the terms of reference that strong equal playing field and that members were equals which was needed and also the importance of the wider population health view and what would really make a difference to achieving those outcomes.  Concern was raised around the language being used across the system and the need to ensure that the population understand what is being talked about and for example what was meant by ‘Place’.  The Head of Service, Joint Partnerships, Shropshire Council / Shropshire, Telford & Wrekin CCG summarised what was happening in terms of engagement with the population.

A brief discussion ensued in relation to the draft priorities of the SHIPP which the Board very much supported. 

RESOLVED:

A.  That the Terms of Reference of the SHIPP be endorsed;

B.  That the draft priorities of the SHIPP be endorsed; and

C.  That the HWBB receive regular reports from the SHIPP.

Better Care Fund update

The Head of Service, Joint Partnerships, Shropshire Council / Shropshire, Telford & Wrekin CCG gave an update on the Better Care Fund.  She drew the Boards attention to the focus on Children and Young People in the system, and in particular, concerns around mental health and wellbeing and the large increase in referrals and lack of tier 4 beds.  She assured the Board that work was ongoing around those issues.

Secondly, the Head of Service, Joint Partnerships, Shropshire Council / Shropshire, Telford & Wrekin CCG highlighted that additional funding had been pledged from NHSCI to support discharge and in particular where patients have Covid-19 until September 2021.

Finally, it was confirmed that the end of year report for the Better Care Fund had been submitted.

A brief discussion ensued on the three areas and the Director of Adult Services, Housing and Public Health and the Head of Service, Joint Partnerships, Shropshire Council / Shropshire, Telford & Wrekin CCG answered a number of queries from members of the Board.

RESOLVED:  

A.    To note the BCF Year End Report for 2020-21.

B.    To note the continued funding for hospital discharge.

C.   To note the concerns of the Joint Commissioning Group regarding children and        young people.

Integrated Care Systems Update (ICS)

The Director of Communications and Engagement Shropshire, Telford and Wrekin Integrated Care System (ICS)gave a presentation (copy of slides attached to the signed Minutes) which gave an update on some of the key programmes that were being delivered by the ICS including development of the ICS, and which covered the following areas:

·         ICS Development including the ten pledges

·         Covid-19 Vaccination programme

·         Covid-19 Restoration and Recovery

·         Community Diagnostic Hubs

·         VCSE Memorandum of Understanding

A brief discussion ensued and the Director of Communications and Engagement Shropshire, Telford and Wrekin Integrated Care System answered a number of queries from Board members.  It was confirmed that the Community Diagnostic Hubs were additional capacity and was not services being moved from one part of the system to another and was separate to acute diagnostics.

The Director of Adult Services, Housing and Public Health thanked the whole social care system for all of their hard work over the past nine months in delivering an outstanding vaccination programme and she queried what was being done in Shropshire to reach those hard to reach Communities.  The Director of Public Health informed the Board that 82% of the population had been vaccinated and that there were approximately 500, 000 people who were not yet vaccinated and this was in the younger population.  She reported that a lot of marketing work had been done in order to target resources and work using the Community Reassurance Team and other teams to work with those communities to encourage uptake and this was backed by a mobile programme that took the vaccinations out to the community and to people’s work places etc.  They were also reaching out to seasonal workers, eg agricultural and farm workers and those in the hospitality sector.  She confirmed that this work was continuing across Shropshire, Telford and Wrekin. 

RESOLVED: 

That the contents of the report and presentation be noted.