Linking with Health and Wellbeing Boards, towards a statutory Integrated Care System
The Board welcomed Cllr Carol Hart and Cllr Roy Webb as representatives of the aligned Derby and Derbyshire Health and Wellbeing Boards, to reflect the further collaboration on agendas between those Boards and the Integrated Care System, in line with the merging policy direction in the Health and Care Bill. Our development plan towards proposed statutory ICS status continues, reinforcing partnership working and understanding how the likely NHS ICS Board and Partnership Board will operate, and setting out a clear business plan and roadmap that the Board will follow to track progress. Works continues in earnest on the pillars of our development: the outline of our strategic intent; provider collaboration at scale; provider collaboration at place; and the JUCD role as an anchor institution.
Current System Position
Covid-19 cases continue to decline across Derby and Derbyshire. The number of daily GP appointments related to Covid-19 is currently at 72% of the peak volume seen in late April 2020, whilst the overall bed base occupied by confirmed COVID-19 patients is also improving. This stands at less than 2% across both Chesterfield Royal Hospital and University Hospitals of Derby and Burton, and 0% in Derbyshire Community Health Services and Derbyshire Healthcare). The Derbyshire system also continues to make good progress in delivering the rollout of the Covid-19 Vaccination Programme, with an average of 92% coverage for the over 60 year old age groups.
Whilst welcoming the further lifting of lockdown measures, the risk of a further wave and the impact of these changes will be monitored closely over the coming months. Staff welfare and staff absence levels remain concerning with 39% of hospital staff absences related to Covid-19. In addition, it is clear that the impact of the pandemic on the people of Derby and Derbyshire has been extensive and will continue to impact in future years, and we are working to understand how we can quantify this and plan for the recovery of waiting lists for operations and other services.
Understanding our priorities and finances
The planning guidance for 2021/22 was published in March and sets out the requirements of systems
over the coming year, identifying the following key areas of focus for the first half of 2021/22:
• Supporting the health and wellbeing of staff and taking action on recruitment and retention
• Delivering the NHS COVID vaccination programme and continuing to meet the needs of patients with COVID-19
• Building on what we have learned during the pandemic to transform the delivery of services, accelerate the restoration of elective and cancer care and manage the increasing demand on mental health services
• Expanding primary care capacity to improve access, local health outcomes and address health inequalities
• Transforming community and urgent and emergency care to prevent inappropriate attendance at emergency departments (ED), improve timely admission to hospital for ED patients and reduce length of stay
• Working collaboratively across systems to deliver on these priorities
Important to our planning is creating a common understanding of the system financial position, given that we know there continues to be a significant underlying system financial pressure. The first six months of the year will operate under the existing pandemic funding regime, where costs pressures have been absorbed in support of delivering a pandemic response. From October, we will likely revert to traditional financial management and must understand where the system will stand financially at that time, and what we need to do about it in line with our transformation programme. Partners were clear that there must be a collective understanding of the root of the underlying financial challenge, and that it is a symptom of a broader issue and not the problem itself. The need to recover services whilst at the same time supporting staff who have worked tirelessly to tackle the pandemic for more than a year must be the context in which we understand how we balance the books.
Broadening the input of Governors
Our foundation trust governors have a very important role in holding Boards to account. The Derbyshire system recognises that the skills and knowledge of our governors can support the development of our transformation programme, especially in our communities at Place level. Discussion on this important step will continue with Governors to ensure that their primary assurance role is not compromised, and that Governors are supported appropriately to get involved where desired.
We look forward to seeing colleagues at the next Board Meeting held in public, on Thursday 20th May