Agenda item

The Integrated Care Strategy has been created by the Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Partnership. Joint Scrutiny Committee is invited to consider the report of the Head of Policy and Programmes and to ask questions about the strategy attached.

Vale cabinet member for Healthy Communities introduced the item. Cabinet member for South was unable to attend, but the South council leader was present remotely, as a South Oxfordshire member of the Integrated Care Partnership.

The cabinet members for Healthy Communities were members of the Oxfordshire Health and Wellbeing Board and contributed to the formation of this strategy over many months with other partners, such as GP’s, Local Authorities, Health Charities and NHS. Both South and Vale cabinets had endorsed the strategy at their last meetings.

The strategy was created by the ICP for Buckinghamshire, Oxfordshire and West Berkshire (BOB). This replaced the previous Clinical Commissioning Group (CCG).

Dan Leveson, Place Director for Oxfordshire (referred to as Place Director), gave a presentation on the strategy, which can be found published with these minutes. The committee then asked questions.

The committee gave their observations. Overall, committee were pleased with the focus on prevention.

Observations from the committee:

• Committee members asked about what was perceived to be the difference or improvement in having a multi authority partnership over the previous single Oxfordshire partnership (previously known as a Clinical Commissioning Group, or CCG)? The Place Director explained that on looking at variations in access to services, there were deficiencies that were different across authorities, and working together could help to bridge the differences. It would also help reduce bureaucracy. He also stressed the importance of some areas of work that were done locally and were still important and to be continued.
• Members queried how improvements would be monitored? It was explained that measures were reported at the monthly executive, and that the Place Director reports into boards, such as the ICB. Using the Health and Wellbeing Strategy, we will identify aims and report on them.
• Members asked how they could help at a local level. The Place Director meets with Oxfordshire Chief Executives each week, so members could feed in any comments or queries that way. The Place Director suggested how can we co-locate staff and mentioned “health on the high street” as a potential idea to help revive the high street and access to healthcare.
• Place Director shared a link to the King’s Fund as a suggested read: https://www.kingsfund.org.uk/publications/driving-better-health-outcomes-integrated-care-systems-role-district-councils
• The focus on prevention and wellness was commended by committee members. There was discussion around private interests. Place Director commented that if there were underutilised resources privately, they would be considered for use, for example, body scanners
• Committee considered geographical overlap
• Discussion about notoriously difficult IT integration
• A member wanted to better understand the link between strategic, operational and tactical approaches
• Members discussed the issue of people who are hard to reach through IT. Place Director explained that the same approaches would be available for those who don’t use IT  and there will be an inclusion and equality assessment.
• Regarding operational risk, members were asked to consider this with their Cabinet member.
• Members considered the issue of BOBICP not being able to procure property to set up new surgeries etc. Place Director raised the issue of ongoing costs of new builds, and that it may be more cost effective to consider vacant existing buildings. Members considered whether local councils could be landlords?
• Bed blocking was felt to be an area that should be focussed on. Place Director confirmed that Social Care and Community Services would be worked with. Focus on primary care and supporting people in their own homes. There was no new investment and funding so would need to look elsewhere for funds.
• Members raised the issue that ONS figures do not include housing growth. Place Director explained that figures would also be used from Housing and Economic Development Needs Assessment (HEDNA). Post meeting, the Place Director contacted the strategy team about the 5% population growth reference in the ICS strategy.
• Death / dying well – should this be included alongside “start well, live well, age well”?
• Breastfeeding – a member questioned why no mention of this as it links to ‘start well’?
• How do we measure outcomes? Place Director explained that there were measures such as school nonattendance and adults on sick leave as examples.
• Members would like to find out more about how Community Infrastructure Levy and Section 106 contributions could be utilised to assist with the property issue.
• A member stated that we should challenge the history of austerity and its impact. Place Director stated that partnership relationships were good, however it was expected that there was no funding over the next three to five years, and we need to work with those in the voluntary and community sector who were already supporting and working well together
• Community midwives, school nurses and health visitors, give young families life skills. ‘Sure Start’ and youth centres are no longer. A member saw the benefit of two-year old’s free childcare hours funding
• Members wondered how the transitions between age ranges would be managed
• Consideration should be given to the role of pharmacists

The main point members wished to take away was to consider how councils can help regarding property, and whether we can utilise available S106 and CIL funds that were earmarked for CCG and the timescales for using those funds.

The chair thanked the Place Director, Dan Leveson, for speaking to the committee and hoped to invite him back in the future for an update.