To note the development of the arrangements from a focus on preparation of a sustainability and transformation plan into establishment of a sustainability and transformation partnership (STP), to influence the further work on the plan in the light of national guidance and feedback from local public engagement, and to ensure local implications are addressed.

The director for adults and wellbeing introduced the item and explained that the purpose of the report was to highlight to the board the work done to date on establishment of a sustainability and transformation partnership (STP), and to ask the board to consider whether feedback from local public engagement and local implications had been addressed in the development of the STP plan.

The director drew particular attention to paragraph 10 of the report which set out the three key areas to be considered when reviewing the draft plan, namely:

·         the requirement to have regard to the health and wellbeing strategy and the joint strategic needs assessment adopted by the board;

·         that individual bodies remain accountable and should take account of the STP plan in their own planning; and

·         the triple aim of population wellbeing, high quality service delivery and financial sustainability.

As the STP plan was being revised no specific comments would be made in the public meeting. The revised draft would be circulated to members of the board in the next few days. The director of adults and wellbeing would collate detailed comments from board members.

The chairman commented that she felt broadly assured that the STP plan did adhere to the Herefordshire health and wellbeing strategy. The engagement work that had taken place was welcomed and it was noted that there was nothing in the feedback which suggested either the plan or the strategy were awry.

In the ensuing discussion the following points were raised:

·         that a lot of detailed planning work had taken place prior to the STP and had been used to inform the plan;

·         that Herefordshire could not solve all its challenges alone, there would be a need to work across a greater footprint to tackle some issues, Worcestershire was the prime partner but would not be the only partner engaged with;

·         there were no specific areas in the draft plan on mental health or children and young people, it was important these were included;

·         there was a close alignment between the One Herefordshire work and STP work, Herefordshire was speaking with one voice to influence the overall direction;

·         the approach taken should reassure the board that processes were mutually reinforcing and supportive.

The feedback from the public engagement exercise was noted. There was concern about access to GPs and that information and advice was not as clear as it could be. Concerns about transport were noted but the board was cautioned that this could reflect perceived difficulties rather than actual difficulties experienced by patients. There was a desire from carers for more support and it was noted that while technology could play an important part in providing remote support if the public did not find it easy to use they would not use it. Technology was cited as a good example of the broader role of the council as it led on delivering broadband access and mobile phone coverage across the county.

The healthwatch representative stated that the feedback to the public engagement exercise showed a spectrum of opinions. It was noted that as the STP plan was a high level document and that public feedback had focussed more on what the system looked like now rather than the future direction. The role of healthwatch in supporting the public engagement was welcomed.

The board noted that delivery plans would need to be drawn up to show how the STP plan would be implemented on the ground. These delivery plans should come back to the health and wellbeing board when drafted.

The director of adults and wellbeing noted that it was also difficult at times for staff to embrace the use of technology in delivering care and support as this was traditionally a hands on service. As well as engaging service users with the use of technology, staff would need to change their way of thinking and be comfortable with the tools available.

The board considered the knock on effects of the STP on communities, carers and other services. It was noted that these effects would not necessarily be negative. The STP and the health and wellbeing board would continue to seek out unintended consequences of the plans being put in place.

The board was asked whether the informal briefing held jointly with the Worcestershire health and wellbeing board had been useful. Members felt that it had been a useful conversation, that there were lots of areas where the two counties could work together for mutual benefit and that where it made sense to do so services should be shared. It was noted that discussions had also taken place with Coventry and Warwickshire about sharing ideas, good practice and services where it was beneficial to do so.

RESOLVED

That the board

a)    subject to the comments made, considered that the proposed revisions to the STP plan showed due regard to the Herefordshire health and wellbeing strategy and that the resulting document was likely to fit local needs;

b)    considered those parts of the emerging refreshed plan that impacted on residents/services in both Herefordshire and Worcestershire, and had highlighted aspects for consideration by the STP as it develops its plan; and

c)    identified aspects of the STP plan where common approaches were intended across both counties that may have knock-on effects for other organisations , and had sought assurance from partner organisations that these were being appropriately taken into account within Herefordshire.