Shropshire, Telford & Wrekin (STW) ICS Involvement Strategy

Kate Manning, Senior Engagement and Communications Manager, Shropshire, Telford & Wrekin ICS gave a presentation (copy of slides attached to the signed Minutes) which covered the following areas:

·         Developing our approach to working with people and communities;

·         Integrated Care System (ICS)/ Integrated Care Board (ICB)/ Integrated Care Partnership (ICP);

·         Background & Context;

·         The journey so far;

·         Our draft principles for working with people and communities; and

·         Proposed next steps

The Senior Engagement and Communications Manager drew attention to the associated work which had been developing around involving people and communities.  She explained that the ICB as part of their constitution were required to develop a strategy which set out their intentions and their approach to involving people and communities.  This strategy needed to be finalised by the end of May 2022. 

Involvement would play a strong part across the different areas of the Integrated Care System, and the Integrated Care Partnerships and Place-based partnerships should have representation from people and communities in setting their priorities and in decision making forums.  ICBs were expected to use insight and intelligence about what people needed and their aspirations to support decision making and service quality improvement.

Following on from the work undertaken the previous year with the voluntary and community sector on the Memorandum of Understanding, 10 draft principles had been shaped that would sit at the start of the strategy.  She informed the Board that a workshop had been held the previous day with partners from across the system to test these principles and also shape the approach to involvement which would help inform the strategy going forward. 

In terms of next steps, they were continuing and have been over the last couple of months speaking and reaching out to the public and also different groups within communities, to find out and listen to them about their experiences of getting involved and how they want to be involved in the work and the future of the ICS.  They would also be collating everything they heard at the workshop and asking those that attended to make sure that what was heard from them was right before it informed the strategy and they wished this to be a continuous, ongoing engagement process.  They were proposing to organise a further workshop to really get into the ‘how’ they put their intentions into practical terms.

She confirmed that the national deadlines being worked towards were quite tight, the final draft of the strategy needed to be ready for submission to the NHSCI (NHS Improvement) by the end of May so they were hoping to take a draft of the strategy to the CCG Board by the end of April.

The Director of Public Health welcomed the engagement and the direction of travel as it was really important work that had to be at the heart of everything that was being done, particularly in the new ICS.  She stressed the importance of looking at how to engage representatives of their communities as well as the communities themselves.  For example, parish councils, businesses and workplaces and others who represent a part of our community, whilst appreciating the drive was definitely towards communities and individuals.  She then highlighted the importance of the work of the Integrated Care Partnerships and reported that the new guidance had been received around ICS and the white paper that had just been published and she drew attention to the important role of the Health and Wellbeing Board within that and explained that more discussion would be had around this as a Board in the future.

Shropshire Integrated Place Partnership (ShIPP) update

Penny Bason, Head of Joint Partnerships, Shropshire Council and Shropshire, Telford & Wrekin CCG Shropshire gave a presentation (copy attached to the signed Minutes) which covered the following areas:

·         Priorities and Terms of Reference

·         Local Care – rapid response

·         Personalisation and Social Prescribing

·         Involvement

·         Developing programmes / work

The Head of Joint Partnerships reminded the Board of the ethos of ShIPP and explained that they had used the Health and Wellbeing draft priorities from the Health and Wellbeing Board Strategy as a focus for the ShIPP priorities, but also the priorities of the ICS and those key areas of work that the ICS were delivering.  She further explained that there was a real crossover with the work being done by the Health and Wellbeing Board, what the ICS was doing and how ShIPP delivered that on the ground and in the local place in Shropshire.

A discussion had taken place at the last ShIPP meeting around the Terms of Reference (TOR). It was felt that they were in a bit of a holding place but as the guidance came down around how to develop the ICS and how the ICB and ICP partnerships and boards would develop, ShIPP would need to adjust its delivery and its TOR in accordance to what was required, as well as the guidance from NHS England and the recently published White Paper.

The Head of Joint Partnerships drew attention to one of the key areas of focus, Local Care, which had a number of strands and, focussing on rapid response she reported that good progress was being made.  She explained that one of the key areas of work for ICS was to have more care out of hospital to ensure that people in their communities and their homes could be cared for as much as possible.  After good success in Telford and Wrekin and a pilot in Shropshire, rapid response was being rolled out across Shropshire which was an enhancement of the model trialled in Telford and which looked at a crisis response within two hours.

With regards to personalisation, which was another part of the local care programme, she drew attention to a programme that had a small amount of money attached to it to encourage training and new ways of working that really focussed on individuals and individuals’ strengths taking a strength based approach and what matters to them.  There are some specific projects happening in Shropshire, Telford & Wrekin around asthma and mental health for young people in particular to really understand what needed to be delivered across all of those programmes. 

She drew attention to workforce development and noted that the workforce training and development was open and available to all sectors.  The key areas of development were around shared decision making, motivational interviewing, behaviour change and health coaching.

The Head of Joint Partnerships highlighted to the Board that they had commissioned a tier two behavioural service for weight management that started in February 2022 with a limited amount of funding and that the last intake would be 31 March 2022 and was open to all primary care referrals.  She hoped that more funding would be made available very soon in which case it would carry on beyond that.  They were also looking to enhance that with a healthy lives lifestyle offer going forward.  She then referred to a pilot being undertaken in the southwest of the County with really positive results so far.  This focusses on understanding what the needs of children and young people are by taking a two-pronged approach, one involved having a one-to-one link worker offer and the other was the additional activity available with a wellbeing approach.

Concern was raised that the South East of the county shared the same characteristics and it was hoped it would not be excluded.  In response, the Head of Joint Partnerships explained that the south west of the county was in line with the primary care network and the aim was to eventually deliver the service to the whole of Shropshire. 

A query was raised about the resilience or otherwise of GP practices, especially in the south of the County, and whether some were seen to be vulnerable due to lack of staff. In response, the Accountable Officer felt that it was not just a question of urban / rural but concern around GP practices in general.  It was a competitive market with not enough GPs.  He reported that the quality of primary care services in Shropshire and Telford & Wrekin were very good but there were concerns around pressures on GPs making it less attractive as a career, but this was a national issue.

The Accountable Officer understood that access could be an issue especially for a large rural elderly population.  Due to the pandemic, telephone and other types of digital appointments increased however it was important to ensure that they were not creating digital inequality.  He reported that face to face appointments were returning to pre-pandemic levels.

Joint Commissioning Board/Better Care Fund (BCF)

Laura Tyler, Assistant Director, Joint Commissioning, Shropshire Council and STW CCG introduced her report (copy attached to the signed Minutes) which provided an update from the Joint Commissioning Board and highlighted a number of developments and system challenges that had developed over the last few months, including Government approval of the BCF Plan and metrics. 

The Assistant Director, Joint Commissioning along with the Head of Joint Partnerships also updated the Board in relation to system pressures and their response, an update from the Joint Commissioning Delivery Group, progress on prevention and early help work to support children and young people in Shropshire and finally, Adult Social Prescribing.

The Head of Joint Commissioning informed the Board that although a review of the BCF was being undertaken nationally, it was felt that it was unlikely to change substantially and that she would report back to the Board once further details were available.

The Director of Adult Services, Housing and Public Health expressed her thanks to all officers that had been involved in the response over the Winter who had gone above and beyond.  She thanked The Assistant Director, Joint Commissioning and Head of Joint Commissioning for their update and requested a report to the next meeting of the Board specifically on children and young people prevention and early health and she queried how the pilot could be upscaled.

In response, the Head of Joint Commissioning expressed her desire to see the pilot rolled out countywide.  She explained that the pilot had tested what would work with children in terms of social prescribing.

Other Officers joined the Director of Adult Services in thanking the teams for their hard work.  It was felt that a lot had been learnt from that which would help to set an agreed direction for next winter which, it was felt would be worse.

RESOLVED: 

1.  To note the updates on the joint commissioning approach;

2.  To note the section 75 update approach;

3.  To note progress of Children and Young Peopled Early Help and
     Prevention work; and

4.  To note the good progress of Social Prescribing.