To provide an updated overview of the Sustainability and Transformation Programme (STP), One Herefordshire and the integration agenda for health and social care.

The chairperson invited Jo-anne Alner, managing director of NHS Herefordshire Clinical Commissioning Group (CCG), to provide the briefing.  Ms Alner delivered the presentation ‘Integrated Care Systems and One Herefordshire’ and the principal points are summarised below.

Integrated Care Systems (ICSs)

1.         ICSs represented an evolution of the Sustainability and Transformation Partnership (STP) model, where health and social care partners worked collaboratively across a geographic footprint, so that ‘… commissioners will make shared decisions with providers on how to use resources, design services and improve population health’ (NHS Long Term Plan, paragraph 1.51).

2.         This was not required in legislation currently but was government policy and seen as the direction of travel.   The aim for Herefordshire and Worcestershire was to become a true ICS from April 2021.

3.         Streamlined commissioning arrangements would typically involve a single CCG for each ICS / STP area and these would become leaner, more strategic organisations.  It was reported that a formal letter had been received that morning confirming the merger of the four CCGs across Herefordshire and Worcestershire into one CCG from April 2020.  This would provide costs savings of £2m to be redirected to frontline staffing and healthcare at a national level. 

4.         There would be emphasis on supporting providers to partner with local government and other organisations on population health, inequalities and service redesign.

5.         There would be changes to funding flows and contract forms, with the aim of moving to a system control total.

Herefordshire and Worcestershire STP Vision

6.         The joint vision would remain ‘Local people will live well in a supportive community with joined up care underpinned by specialist expertise and delivered in the best place by the most appropriate people’.

7.         An outline was provided of the building blocks to enable the transformation, through an integrated approach, from ‘A system too reliant on emergency access and beds where people believe that hospital is the best place to be when you are unwell’ to ‘A system that is built around care close to home, where hospital beds are only used where somebody cannot be cared for safely in their own environment’.

The tiers in an ICS

8.         The system-wide (Herefordshire and Worcestershire), place (Herefordshire), and neighbourhood (Primary Care Network) tiers were outlined.  Within Herefordshire, there would be five Primary Care Networks (PCNs), each led by a clinical director.

One Herefordshire

9.         One Herefordshire was the place based integration plan, involving partners working together locally.  The principles of functional integration included integrating at the point of delivery, looking for shared efficiencies, and not shifting risk.

10.      A five year plan was being developed, aligned to the NHS Long Term Plan.

Integrated care in Herefordshire

11.      It was expected that integration would remove workforce and leadership boundaries, address financial sustainability, and deliver quality improvement.

2019/20 delivery and assurance

12.      The delivery and assurance structure of One Herefordshire was outlined, from the health and care executive alliance down to programme groups (with executive leads) focused on medicines optimisation, integrated community alliance,  ...  view the full minutes text for item 17