We have outlined below the key messages from the meeting and all related papers.
The Board meeting opened with a patient story relating to our Quality Conversations programme, which empowers our staff to engage individuals in their own care and look after themselves, and to help us provide personalised, effective care across all system partners. The aim is to enhance listening and coaching to hold courageous conversations with patients to see things from a new perspective, co-produce their care and is evidenced to result in improved outcomes of care.
We heard two case studies, the first relating to Simon who having been through a period of anxiety and drinking heavily, was living in unstable housing and wasn’t interacting with the proposed treatments. Taking control of the conversation, it helped identify what to tackle first and what were the goals for Simon in his care. The conversation steered away from advice and guidance and saw Simon reducing his alcohol in take and took more control. Simon is now n his own home, engaging with local community through his church and community projects and has received specialist support to set up his own business. Dave was a young stroke survivor having had two strokes. Using active listening to understand how Dave was feeling, the team was able to avoid setting goals for Dave and instead enabled Dave to be at the centre of his goal setting. Dave was able to recognise small improvements, helping his to strive for bigger goals for the future, including investigating driving and supporting his daughter to learn golf, both of which he hadn’t believed initially could be achieved.
There are 595 staff trained, with the potential for nearly 12,000 conversations per week. The board reflected that this was a true example of ‘de-medicalised’ care, with benefits to patients, staff and likely more financially effective care that doesn’t rely on medical intervention with the social prescribing model.
Our journey towards a statutory ICS
The second reading of the new Health and Social Care Bill was completed to schedule on 14th July. This means that national processes can start in earnest towards achieving the 1 April 2022 milestone of our ICS being established as a statutory organisation. We expect to receive a range of guidance and mandates from NHSE during the summer, but JUCD is very well on the way to understanding how we will set ourselves up to deliver the priorities of our system and continues to recognise that this is a continuation of the journey we have been on for the last few years.
The emerging guidance will enhance our previous knowledge and helps us to build upon and accelerate developments to join up health and care services for the people of Derbyshire; whilst embedding lessons learned from the pandemic. All arrangements and duties remain subject to legislation and parliamentary approval and we will continue to review and adapt as necessary whilst factoring in opportunities for local flexibility.
The Board recognised that the draft Health and Care Bill legislation outlines the establishment of an Integrated Care Partnership (a partnership of health and care organisations) an Integrated Care Board (of NHS organisations) and maintains the statutory position of Health and Wellbeing Boards. We are working to devise the leadership and membership of these bodies.
Locally, the JUCD Board has also agreed that our Quality Committee will become a Quality and Performance Committee and that we will develop a Public Partnership Committee, which will replace the existing Derbyshire Engagement Committee with a broader remit.
The board heard the latest thinking on how the statutory functions required of the ICS (planning, financial, governance, legal) have been mapped with an understanding of where they are currently delivered across existing organisations and how we need to transfer them into the new ICS, along with any new functions required by legislation. While most staff have an employment protection during the transition phase, this will not be a simple ‘lift and shift’ of functions, as these will need to develop to reflect the new role for ICSs.
Our central ‘strategic intent’ approach is taking shape. This is our operating model for health and care and aims to identify how we will deliver our aim of reducing health inequalities, increasing life expectancy and increasing healthy life expectancy for our population. The four key functions within strategic intent are:
- strategic commissioning
- health protection & prevention
- population health and clinical strategy
- clinical & care standards, improvement & innovation and learning & development.
Using our challenge in tackling obesity as a case study, the Board reflected on the roles of the component parts of the new ICS, with the ability to see how each element of our work would contribute to improvements to local health and care.
Our work has continued on aligning our ambitions as a large public sector partnership with those other bodies in Derbyshire, both public and private, where by working together we can have combined power to help local people. The development of an Anchor Charter is a way of securing commitment from individual organisations and provide a framework to make changes to benefit communities across the city and county. The adoption of a charter is not about duplicating or preventing work which is already taking place in Anchor Organisations, or assuming responsibility, but harnessing the power of anchor institutions and maximising their impact on delivering agreed strategic outcomes. The charter will be taken through our respective Boards. We are working with partners on employment as our first point of focus, developing our approaches to entry-level recruitment and development pipelines, ensuring that we are creating a more inclusive and diverse workforce. We are also looing at the non-pay offers of anchors, including health and wellbeing provision and develop a marketing approach to maximise take up and social value in low pay groups.
Digital & Data Strategy
Our strategy aims to provide new digital services that improve the patient experience, transform the
delivery of care models and reduces the overall cost of care. This includes delivering and extending our
Shared Care Record programme, supporting and developing our citizens and workforce in the use and
adoption of digital services and building our capability on understanding population health intelligence.
The Board welcomed the strategy as an important step in our development.
As a final item, thanks were expressed to Caroline Maley, who completes her term of office as Chair of
Derbyshire Healthcare NHS Foundation Trust during the summer. Caroline has been a valuable
contributor to the development of JUCD in recent years and the Board wished her well for the future.
We look forward to seeing colleagues at the next Board Meeting held in public, on Thursday 16th
September at 9am.