The Board meeting opened with a patient story relating to the success of social prescribing in the Erewash area. The story talked about the journey of Sue, who had been referred to a social prescriber by her care co-ordinator. Social prescribing can work for a wide range of people, including those with one or more health condition, who need support with their mental health, who are lonely or isolated or who have complex social needs. Sue had been a frequent caller to 999 and to her GP practice, partly due to her anxiety about being isolated from her usual life and routine and had several admissions to hospital. Intensive support had been provided for Sue and the interventions, which included helplines to call 24/7 when feeling lonely, a referral for a pendant alarm to provide reassurance that she could contact someone if there was a problem, being referred to a phone befriender and to a local peer support group, have made a real difference. The Board reflected on what was a fabulous and heart-warming story, recognising that while there was on-going support required, it had reduced the number of calls to the practice, 999 and admissions quite substantially, and also Sue’s anxiety. The Place Board is currently overseeing the progress of social prescribing, and how we evaluate initiatives.
Derbyshire System Update
Covid-19 cases continue to decline across Derby and Derbyshire with GP Covid-19 activity having decreased by 23% in the week prior to Board, compared to the previous week. There has also been a significant decrease in Covid-19 hospitalisation and a reduction in community and hospital incidence. The Derbyshire system continues to make good progress in delivering the rollout of the Covid-19 Vaccination and is the 3rd highest performing system nationally (NHS data 6 May 2021). Further national direction on rolling out cohort 11 for 35 to 39-year olds is expected imminently, with Derbyshire continuing to deliver within JCVI guidelines. Responding to supply challenges and avoiding wastage continues to be an absolute priority for those involved in the Vaccination programme.
Strategic Commissioning and Strategic Intent
A significant proportion of the meeting was allocated to a discussion around the ‘strategic intent’ of the Integrated Care System. Recognising again that Joined Up Care Derbyshire is ‘the health and social care partnership for adults and children’, making improvements to the Derby & Derbyshire populations’ life expectancy AND healthy life expectancy in comparison to other parts of the country AND reduce the health inequalities that are driving these differences. The existing commissioning functions of the Clinical Commissioning Group will be disseminated in April 2022 to one of either regional, ICS or Place/PCN level. For those responsibilities at ICS level, there will be a requirement for a strategic commissioning function under new statutory powers in April 2022. Strategic commissioning priorities will be informed and guided by the ICS’ strategic intent, which will outline the destination for healthcare in Derbyshire based on a detailed assessment of health evidence and the agreement of clinical models and priorities. Ongoing discussions on this complex and crucial agenda will take place through May and June.
Communications & Engagement
The Board approved a revised communications and engagement strategy for Joined Up Care Derbyshire. In a period of transition, the strategy outlines the principles by which we will communicate and engage with our staff, citizens and other stakeholders, including the primary aims to foster a culture of transparency through our early engagement with local people. The strategy also highlights our ambitions for communications and engagement across major disciplines including public involvement, health campaigning and the use of digital communications.
People and Culture
The JUCD People and Culture Board is tasked in part with devising plans for four areas outlined in NHS England workforce guidance. These are: looking after our people; new ways of working and delivering care; belonging in the NHS; and growing for the future. Derbyshire already has a detailed workforce development programme and the P&C Board is overseeing progress. Wherever possible the Derbyshire system is looking to do things once, to benefit from those partners leading in certain areas, and to avoid duplication where that is possible and desirable. The JUCD Board endorsed the local approach and noted the progress to date.
Joined Up Care Derbyshire ended the 2020/21 financial year with a surplus of £600,000, which was a tremendous achievement given the tumultuous year that has faced the NHS. The JUCD system also has a balanced financial plan for the first half of the 2021/22 financial year, as the covid funding regime continues, but further work is required on the underlying financial position of the system, which is a deficit position of £74million. JUCD is waiting for confirmation of the financial approach for the second half of the financial year and we are aiming for a three-year financial recovery programme. The Board noted that the financial challenge is being tackled in partnership, with one savings figure and without moving any of the financial challenges to a different part of the system.
We look forward to seeing colleagues at the next Board Meeting held in public, on Thursday 15th July at 9am.