C&P ICB Commissioning & Investment Committee and Improvement and Reform Committee

 6^th October 2023

 Miriam Martin (Caring Together)

• Non-emergency patient transport services – an update on planned procurement process and timetable. Now open for tender. New service will commence in October 2024.
• Integrated urgent care –Current contract extended by two years to Oct 25 when new contract will start. Extension was agreed to ensure opportunity to engage stakeholders and patients in creating the spec.
• Winter capacity – In 2023/34monies have been received including some monies for adult social care.
• Targeted lung health checks – paper identified options for roll out in preparation for an expected national lung cancer screening programme. The committee approved the end to end service model to be outsourced to a single provider.
• Cardio-vascular disease programme – Monies have been made available from Public Healt to support CVD prevention. The committee approved the proposal to support improved outcomes in the detection and treatment of CVD risk factors.
• Managed Care Hub – The committee approved a proposal to establish a facility in the North Cambs/Peterborough partnership to provide a dynamic managed care hub targeting hard to reach patients. This provides an opportunity for the Voluntary sector to engage and become part of a holistic service offer for a range of conditions.

The next meeting is 15^th December.

 

Quality Performance and Finance 

27^th October 2023

Rachel Talbot (Cambridge CAB)

Finance They are on track and doing pretty much the best in the region however the Deputy CEO warned that this Winter will bring as many difficulties as during Covid. She asked that everyone do what they can to make savings wherever they can.

Prescribing Facing a large overspend although apparently doing better than most areas. Key problems = population increase; cost of drugs; increasing/better  diagnosis of conditions like diabetes (= more statins); overprescribing.

We are the 4^th lowest cost per 1000 patients. Nd 4^th best for procurement. Sharing more amongst regional and national networks.

Learning disabilities 54 deaths up from 23 in 2019. Leading cause of death = respiratory system.

National:

• Continuing industrial action in the NHS has had a significant impact on patients, with almost 400,000 appointments having to be rescheduled during June, July and August 2023 as a result
• of strikes
• Demand for cancer services continued at record levels in July 2023, with the number of urgent suspected cancer referrals at 130% of pre-pandemic levels.
• The NHS M4 year to date financial position is £794m above plan

Local: October headlines

• The systems financial position-at Month 6- shows in deficit
• A&E performance 4 hour performance : is off trajectory for September at a system level 67% against a trajectory of 71.1%;
• Overall outpatient activity: remains below the set operational plan, currently at 92%.
• Cancer performance is becoming increasingly more challenged. The 28 Day Cancer Faster Diagnosis standard has regressed from the previous month, falling below the 75% target
• Annual Physical Health Checks (APHC ) for Severe Mental illness register patients: For Qtr 2 C&P delivered 59% (2284) of our annual target of 4027 checks. The End of the year forecast position: 110% of target of 4027, a 75%uptake against SMI register.
• Inappropriate Out of Area Bed days – Mental Health: has reduced from 920 bed days a month in April to 690 in latest month (July).
• Patients not meeting the criteria and not discharged: Performance continues to be strong, and significantly better than the same period in 22/23, and ranks in the top quartile nationally.
• Urgent Community services: The number of referrals and response within 2 hours continues to show month or month improvement with a 25% increase in referrals April to August
• Theatre Productivity: Remains high at 79.2% comparative to peers although below the target at 85%.
• Diagnostic activity across all areas is performing above the planned level at 102% (CUH 103%, NWAFT 101%, and RPHFT 104%).

 

System Leadership Group

13^th November 2023

Sharon Allen (Arthur Rank)

Following the meeting in September to review structures and working of Local People Board and it’s sub-groups, this group has combined the work of two previous groups; Leadership and Organisational Development and System OD and is co-chaired by Anita Pisani, Deputy CEO at Cambridgeshire Community Services and Sam Carr, Assistant Director Systems and Organisational Development, CCS who also has a system role.

The group has four objectives:

• Work as a system to embed Compassionate Culture through design and delivery of OD interventions and ensure the Leadership Compact is embedded through the system;
• Develop a systematic and coordinated approach to managing talent and succession planning across the ICS;
• Use staff surveys (NHS and system partners) to identify improvement actions;
• Develop system leadership, teaching everyone to work beyond our own organisational boundaries to support the needs of local people. Create collaborative and inclusive cultures across the ICS that engenders joint working and common purpose.
• We discussed Talent Management and the support being provided to progress this and how we can ensure this is genuinely system wide, recognising the challenges of different parts of the system not being equally resourced or able to offer comparable T&C for colleagues. NHS England is currently piloting a programme called Scope for Growth and information was shared on this.
• The importance of everyone in our system being aware of and integrating the Leadership Compact (which is referenced in our VCSE strategy) was reinforced to foster a shared approach to leadership across our system.

Update on Leadership programmes:

• An update of Springboard programme was given and information circulated separately to Health Alliance
• Mary Seacole is a programme aimed at middle managers and the programme is looking for additional facilitators, particularly from the North of the county, training will be provided.
• A further cohort of Leading Beyond Boundaries is underway and we have several Health Alliance colleagues on this programme and it will be good to hear back from them in due course about their experience. The alumni event that had to be postponed due to impact of industrial action is still be rescheduled.
• Stepping Up and Ready Now programmes are leadership programmes for colleagues from ethnically diverse backgrounds. A local provider has been sourced, and the system needs to determine how to resource secure this. BLMK (Bedford, Luton and Milton Keynes) ICS has suggested a joint approach which will share costs and places and the group agreed to pursue.

Actions for VCSE partners or Health Alliance

• It would be good to know how many Alliance members complete any form of staff survey and particularly any who are willing to share results for comparison across the system.
• Consider applying for Springboard Women’s Leadership programme – also any women leaders in our sector who are willing to share your career journey at one of the sessions, please contact Mel Paine, melanie.paine1@nhs.net – it would be great for more colleagues from across the system to hear from voluntary sector women leaders!

 

Local People Board

17^th November 2023

Sharon Allen (Arthur Rank)

A risk was raised under the BAF (Board Assurance Framework) about the reservist programme that has been running. The funding for the project managers supporting this programme is ending at the end of March and the board was asked to note this and the risks to the programme. This is of course a risk across many programmes and one that the voluntary sector is very familiar with so I raised the point that the ICS needs to be aware of all projects that are at risk due to loss of specific funding to determine how best to prioritise any ongoing support.

There was also discussion about where Freedom to Speak Up Guardians sit within the approach to managing risk.

There was an update on the structure and the Enabler groups that sit under the People Board:

• EDI (rep Gemma Manning, ARHC)
• Leadership and OD (Sharon Allen, ARHC)
• Recruitment (Sharon Allen, ARHC)
• Retention (Tbc)
• Education and Development (Kay Hardwick, ARHC)
• Workforce Planning (tbc)
• Health and Wellbeing (Kat Shepherdson, Hunts Vol Forum?)
• Futures (tbc)

Brief update on ‘Above Difference’ Programme starting Jan 2024, Health Alliance has three members joining who will share feedback.

Presentation from Jo Oldfield from the Training Hub which supports GP practices and Primary Care Networks (PCN’s) with Organisational Development, recruitment and retention, learning and development, leadership and strategic growth. The Training Hub is the delivery arm for national NHSE primary care workforce initiatives locally.

The Health and Care Academy is delivering an ICS careers expo for Year 10 students and potential apprentices/ new recruits, on the 27th & 28th March 2024 at ARU-P.

I continue to raise the point about the challenge of trying to implement initiatives that are One Workforce focused when there are such differences across our sectors, this is acknowledged which is positive. The ICB has employed Bev Hoskin as Head of Pay and Reward across the system, a very challenging role. I have had an induction meeting with her in my role as HA rep on the People Board and shared what we have done. It would be good to invite her to a future HA meeting.

Actions for VCSE partners or Health Alliance

• Are any Health Alliance members able to attend the Enabler groups where we do not currently have representation?
• It would be good to know which Health Alliance members have a Freedom to Speak Up Guardian, there is a system wide network which we need to be linked into.
• Look out for details of ICS careers expo in March and ensure Health Alliance members participate.
• Are colleagues happy for me to share the work we did some time back from Hunts Voluntary Forum CEO network on T&C in our sector (anonymised) with Bev Hoskins