All committee members were present.  Apologies for absence had been received from the following invitees: Councillors Graham Andrews, Paul Andrews and Phillip Howells (members of the children and young people scrutiny committee); Councillor Yolande Watson (cabinet support member adults and communities); Chris Baird (director for children and families) and Amy Pitt (assistant director talk community programme) (Herefordshire Council); Susan Harris (Herefordshire and Worcestershire Health and Care NHS Trust); Nisha Sankey (Taurus Healthcare); and Jane Ives (Wye Valley NHS Trust).

To receive details of any member nominated to attend the meeting in place of a member of the committee.

There were no substitutes.

To receive any declarations of interests in respect of schedule 1, schedule 2 or other interests from members of the committee in respect of items on the agenda.

Councillor Bartlett declared an ‘other’ interest in agenda item 6, NHS White Paper: integration and innovation (minute 40 refers), due to attendance at Integrated Care System executive forum meetings, and clarified that she had not been present at a recent meeting where the White Paper had been discussed and she maintained an open mind on the proposals.

To receive any written questions from members of the public.

No questions had been received from members of the public.

To receive any written questions from councillors.

No questions had been received from councillors.

To consider the attached report on the NHS White Paper from the Herefordshire and Worcestershire Clinical Commissioning Group (HWCCG) and to determine any recommendations the committee wishes to make.

The chairperson advised that this additional meeting had been convened to consider the report on the ‘NHS White Paper: integration and innovation’ from NHS Herefordshire and Worcestershire Clinical Commissioning Group (CCG).  It was noted that members of the children and young people scrutiny committee had also been invited to participate in the meeting, in a non-voting capacity.

David Mehaffey introduced the report, the principal points included:

i.             The NHS White Paper ‘Integration and innovation: working together to improve health’ (hereafter ‘White Paper’) would bring forward measures for a statutory integrated care system (ICS), comprising an ICS Board and an ICS Health and Care Partnership; this would replace the Sustainability and Transformation Partnership (STP).

ii.            The focus was on improved outcomes to health and wellbeing for the population and tackling health inequalities by bringing together local authorities, NHS bodies, primary care, voluntary sector and other bodies.

iii.          The proposals would not affect the role of the Health and Wellbeing Board; it was acknowledged that there would need to be a clear relationship between the board and the ICS Health and Care Partnership to ensure that they worked together well.

iv.          The CCG would be abolished and replaced by NHS Herefordshire and Worcestershire ICS, with its board made up of local partners.

v.           The competition rules would change, giving commissioners more discretion over procurement processes.

vi.          A number of functions currently commissioned from NHS England in the Midlands region would be delegated to the ICS, such as local pharmacy and dentistry services.

vii.         The partners would retain their organisational financial statutory duties but would also be required to have due regard to the balance of the whole system.

viii.       The reforms were due to be implemented in April 2022.  It was noted that there was a strong history of partnership working locally and the new arrangements represented ‘a continuation of that journey’ which would enable partners to work together in a more integrated way.

ix.          The local system was one of eight, out of forty, involved in supporting the development of national guidance.

x.           Attention was drawn to the ‘benefits to the population in Herefordshire’ identified in the report and it was noted that integrating services would result in people experiencing care that was more joined up and digitally enabled; it was anticipated that a single clinical record would make a significant difference.

xi.          It was reported that, since the merger into a single CCG, NHS Herefordshire and Worcestershire CCG had made significant additional investment in Herefordshire and further investments were planned as the system moved into the ICS arrangements.

Simon Trickett reminded the committee that the White Paper set out proposals and would be subject to the formal legislative process in Parliament.  He said the proposals would tidy up and consolidate the work that had been undertaken locally on integrated care in recent years, removing some of the barriers around procurement, and enabling partners to work collaboratively to design services.

Dr Ian Tait considered that the White Paper represented a permissive  ...  view the full minutes text for item 40.

The next scheduled meeting is Monday 29 March 2021, 2.30 pm.

Monday 29 March 2021 at 2.30 pm