Tag Archive for: ICB update

VCS Rep Report : Improvement and Reform Committee IRC) – April 2023

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Title of Group Improvement & Reform Committee (IRC)
Date 21/04/2023 Reps names Michael Firek
Summary of agenda items / key themes discussed

–       Board Assurance Framework (BAF)

–       Draft ICS Digital Strategy

–       Reports from feeder groups

Planned Care Board

Unplanned Care Board

System Strategy & Planning Group

Quality Improvement & Transformation Group (previously Transformation Hub)

Diagnostics Board

 
Implications for the VCS

 

Draft ICS Digital Strategy – attached (Presentation pages 16 – 34, Strategy pages 35 – 66).

–       The strategy was presented by Hadleigh Stoller from Healthcare Innovation Consortium.

–       MF asked, How will the VCSE be able to contribute in this area? Governance put in place, access to systems, training, voice and input into DEG or other key delivery / strategic groups?

–       The digital engagement to date is probably contribution to the Joy app and some specific work / services that are using SystmOne. Is this something that we can escalate or scale up? To be an effective system partner we would need to ensure we are or can be integrated.

–       Dorothy Gregson advised that the NHS App is central to digital inclusion. Patients can opt / choose to share their information with VCSE through this. Are our services doing this? Should we be doing this and supporting other VCSE to do so? I’m not sure what this looks like.

–       The following news article was shared by Hadleigh after the meeting – https://www.digitalhealth.net/2023/04/the-nhs-app-is-a-critical-tool-in-tackling-the-elective-care-backlog/
Actions

–       Hadleigh shared his email address and invited MF to arrange a call to discuss whether there is a need to invite VCSE to contribute into the DEG.
Date, time and venue of next meeting and name of representative who will be attending

Friday 16th June 2023 – 9.00 – 10.45. MS Teams.

 

VCS Rep Report : ICS Supply, Information and Planning (SIP) – April 2023

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Title of Group Supply, Information and Planning (SIP)

This is the group that the R&R sub-group reports into and SIP reports to Local People Board
Date 19 April 2023 Reps name  Sharon Allen, Arthur Rank Hospice Charity
Summary of agenda items / key themes discussed

Action and Decision Log: AHP (Allied Health Professionals) Faculty funding ends May, will limit capacity for contribution. Carol Anderson taken action to talk to ICB, looking at alternative solutions ie releasing colleagues to rotate chair. Sally Drake raised point that this approach excludes LA and vol sec as we don’t have leads in this way.

Risk Log: There is a major piece of work ongoing around supply of affordable accommodation for colleagues working in care and health. This started as an issue recognised in relation to international recruits but has widened to all parts of the system.

Update from Working Groups:

Recruitment and Retention: see separate update report. Legacy practitioner – applicable for vol sec, (ARHC already expressed interest), Pastoral support, will share information and access with sector.

Workforce Planning: the importance of the data issue discussed in previous feedback reports is exemplified here, the data available (which does not include our sector yet) is used to inform the Joint Forward Plan which all colleagues should read and comment on. Ade Tams new Deputy Chief People Officer has experience from a previous role of capturing voluntary sector data so I’m having a discussion with him about this. Rebecca Tuten who is leading on the work is keen to engage and attend a meeting of the Health Alliance.

Education and Development: 10 July hold the date for Innovations and Education, Health and Care Workforce, more details to follow.

ARU Destination report, a fuller discussion will happen at the next meeting, ARU has provided a report on where graduates go on completion of their studies as there is concern that our system is not fully benefitting from the investment.

VCS Rep Report : Recruitment and Retention Sub-Group – April 2023

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Title of Group Recruitment & Retention Sub-group of Local People Board
Date 17 April 2023 Reps name  Sharon Allen, Arthur Rank Hospice Charity
Summary of agenda items / key themes discussed

Review ToR and Milestones

Action Plan and SRO’s: each provider asked to provide recruitment plans, will be sharing of good practice. The meeting was focused on agreeing the top three or four priorities (there are currently eight) in the Action Plan.

NHS E High Impact Interventions, Next Steps and Provider Plans (NHS providers only)

Co-chair for the group
Implications for the VCS

When collation of recruitment plans happens, see what our sector can learn, adapt and contribute from these (ARHC has shared our People Plan as a vol sec example).

What do we want in terms of joint recruitment initiatives? Move to on-line? And identifying risk points of colleagues leaving at 6 and 9 months and what we can collaboratively do to address this.

What involvement does our sector want in work ongoing with Anglia Ruskin University on innovations in R&R?

What engagement do we want in international recruitment either as a pipeline for our own workforces or to support with pastoral care for international recruits to the NHS?

Accommodation project – how do we want to be engaged with this?

Can we provide turnover rates for HCSW (Healthcare support worker) or equivalent?

Do we have views on areas of greatest clinical risk (probably only impacts a small number of sector orgs)

Adult Social Care has secured regional funds for ethical recruitment (re international recruitment). The meeting agreed to take this off this Action Plan for this group as Chris Hill (chair) sits on the oversight group for this work so will provide updates.
Actions

Any responses to any of the above points, or requirements for further information, please contact Sharon.

Invite Rebecca Tuten who is leading on the data project to a Health Alliance meeting to discuss our sector needs, capacity so that we have a system workforce data set not just NHS.
Date, time and venue of next meeting and name of representative who will be attending

15 May, 14.00 – 15.30, via Teams, Sharon attending

VCS Rep Report : ICS Local People Board – April 2023

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Meeting attended: Local People Board

VCS Representatives: Sharon Allen, Arthur Rank Hospice Charity, Deborah Katznelson, COPE

Date of meeting: 23 April 2023

Summary of agenda items / key themes discussed:

Leadership compact review and ICB delivery framework; how to ensure this is lived in working with partners. Developing programme of activity to ensure compact becomes second nature – links to work of Leadership & partnership sub-group. The Wall (included in Joint Forward Plan)

– each of the ‘bricks’ has been allocated to a member of ICB Exec Team.

BAF (Board Assurance Framework) to note

Industrial Action review, our system was disproportionately impacted due to number of organisations in our system who met the threshold for strike action. Lot of work undertaken to plan for and seek to mitigate impact on patients. Impact for patients on planned appointments, procedure, diagnostic, surgery as well as people seeking emergency care. Looking at learning and what can be taken forward into future ways of working. Discussion of impact on team dynamics, morale, moral injury etc.

Workforce planning review, NHS submission although does reference VSCE and Local Authority. Submitting breakeven financial plan (bringing down significant deficit but plan includes £50m unmitigated risk)

Doctors in primary care, opportunity to become an interested site for non GP medics to work in primary care (no additional funding). Lots of interesting discussion, early days, lots more debate to be had, particularly with Medical Directors and to risk assess implications and mitigations. Noted as a good opportunity to test the hypotheses through a system lens.

SIP update:

R&R (please see separate updates provided from this sub-groups)

EDI – Staff survey results still show concerns re experience of colleagues from minoritized racial backgrounds, Regional Lead joining soon to support with actions, Beyond Difference programme will be developed, developing a toolkit to tackle institutional racism.

Leadership – changing culture and embedding compassionate leadership, reintroducing Stepping in to my shoes programme, interplay of culture of integrated team working (several programmes coming on stream including; Civility Saves Lives, Above Difference, Psychological Safety/Just Culture and Quality Improvement Approach), System relationships and collaboration and Leadership.

CPICS ARU collaboration, this work follows on from a workshop held in February, focused on innovation in R&R (lead Ade Tam, Deputy Chief People Officer), portability ED & Training. A symposium to develop ideas is being held 10 July.

Forward plan:

June – Health and Wellbeing and Efficient and Effective Ways of Working

Aug – Education Learning and Development

Oct – Creating Healthy Communities and Workforce aligned with service transformation

Implications for the VCS

Think about how we also embed the Leadership compact priorities within our organisations aligned to our own values and approaches and in our dealings with partners across the system.

Industrial action impact could then impact on voluntary sector organisations with increased demand?

What can we do to support more efficient working across the system to support with deficit reduction without impacting quality of support to our community?

Actions

  • Ensure Health Alliance meeting has workforce focus, invite Sam Carr, Claudia Iton and Rebecca Tuten
  • Familiarise selves with The Wall and where our activity aligns.
  • Ensure we are represented at symposium July 10th (Sharon attending)

Date, time and venue of next meeting and name of the representative who will be attending

23 June, 13.30 via Teams, Sharon attending

VCS Rep Report : ICS Local People Board 24 Feb 2023

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Meeting attended: Local People Board

VCS Representatives: Sharon Allen

Date of meeting: 24/02/2023

Summary of agenda items / key themes discussed:

Board Assurance Framework – the main focus of discussion was the implications of industrial action

Voluntary sector presentation –   click here

Unfortunately there was very low attendance at the meeting so this presentation and discussion has been deferred to the next meeting

Implications for the VCS

Actions

Please advise if the industrial action across NHS is impacting on services

Date, time and venue of next meeting and name of the representative who will be attending

Friday 28th  April,  (via Teams), Sharon will be attending

VCS Rep Report : C&P ICB Commissioning & Investment 17/2/23

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Meeting attended: C&P ICB Commissioning & Investment Committee

VCS Representatives: Miriam Martin

Date of meeting: 17/2/2023

Summary of agenda items / key themes discussed:

  1. ICB board assurance framework was presented.  The framework details the strategic risks the ICB is managing currently.
  2. ICS allocations strategy – The aim of this strategy is enable driving evidence based resource allocation with a focus on outcomes. It will give a model and shape on how to evidence best value for the public pound and will provide a tool for this committee to make the right decisions that achieve best economic return and may be used for future commissioning decisions. The expectation is that this model will be created following engagement fully across the system. It is intended to be a high level strategic piece of work and not about operational planning and delivery.
  3. Estates strategy – this item provided a detailed summary of the state of current estates. At this stage it is work in progress. It is ambitious and I got the impression it will be difficult to deliver because of all the various stakeholders and what they see as the future compared to the leadership of the system!
  4. Pre-delegation assessment framework (specialist services) – The health and care act 2022 determined that from April 2023 specialist services, previously the remit of NHS England could be delegated to ICB’s based on their readiness. Following the completion of an assessment it has been agreed that specialist services can be delegated to ICB’s in the East of England. 23/24 will be a preparatory year with the development of this work being overseen by a joint committee comprising of reps from all ICB’s in the East. There are 59 specialist services including: specialist cardiology, ophthalmology and cancer services. The key risk with this is needing to ensure that funds match what is currently commissioned and that this doesn’t worsen the position of already challenged ICB’s (I can share the documents in relation to this if of interest)
  5. Pharmacy, dental and optometry services – these will now be hosted regionally and will come under ICB accountability. ICB is anxious about this given the current pressures on dentistry so concerned about how to improve when the current services are so restricted.
  6. DWP employment support with IAPT services (offering employment support alongside mental health therapies)– the committee approved a proposal for dispensation from the tendering process for this contract. It is currently held by Richmond Fellowship.

Implications for the VCS

  • Item 2 – We need to ensure our engagement in this as it has the potential to shape future commissioning of services.

Actions

  • Re above – could we invite a member of the consulting team to a future health alliance meeting? Happy to chase down a contact

Date, time and venue of next meeting and name of the representative who will be attending

21st April 11am – 1pm.  Miriam Martin expects to attend

Attendees:

Ged Curran                         –          Chair

Nicci Briggs                          –           CFO ICB

Martin Wheelhan               –           Representative of the chief of staff

Simon Barlow                      –           Representative of the chief of staff

Dr Gary Howsam               –           ICB Chief clinical improvement officer

Dr Fiona Head                    –           ICB Medical director

Louis Kamfer                        –           ICB Managing director strategic                                              commissioning

Dr Simon Hambling           –           ICB Primary medical services

Ellie Addison                        –           Healthwatch

Wanda Kerr                         –           Assistant director special projects

Sarah Hughes                     –           NEM ICB

VCS Rep Report : ICS Quality, Performance and Finance Committee 24/2/23

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Meeting attended: Quality, Performance and Finance Committee

VCS Representatives: Rachel Talbot

Date of meeting: 24/2/2023

Summary of agenda items / key themes discussed:

Board Assurance Framework (BAF)  – Every meeting

Finance update – expecting a breakeven from deficit at the start. This should result in higher allocation in the next round for both capital and service

Draft Forward and operational Plan – still being finalised by 30th March. Includes in the appendix – Coordination of frailty pathways across the ICS with a focus on developing a longer-term integrated frailty model Delivery of a voluntary sector single point of access supported by a wide network of VCS organisations

System Prescribing Expenditure – Biggest spend in budgets alongside staff so a massive concern

Beds – length of stay longer than national

Workforce Wellbeing- covered all sorts of things inc recruitment etc but also the wellbeing of current staff. They only referred to staff mental health wellbeing. Staff may need much more than that: child care; care for other relatives; practical advice on money, housing, consumer etc

Unnecessary GP appointments – key area to target especially as most people find it difficult to get an appointment in the first place!

Patient Safety and Quality – “good” and above regional and national average. Covers a variety of areas but 2 interesting statements: They have no crisis solution in the community for their Learning Disability & Autism patients; the safeguarding team have been told that Children’s Services will have 2 day deep dive review of the Multi-Agency Safeguarding Hub (assume that some vol sector organisations are part of this?)

Implications for the VCS

BAF refers to Impact of wider determinants of health (such as housing, employment, income, education, and the environment) influence our population’s health unequally, resulting in poorer health outcomes • Increasing cost of living and the disproportionate effect this will have on population groups.

I raised the data project Health Alliance is sponsoring a but also asked that they ensure to engage with Vol sector about “wider determinants”

Cost of prescribing – can vol sector be involved in helping the reduction in cost in some way?

Beds – they are looking at “pathways” and a more holistic look at what happens i.e. not just in hospital. Point made that contact needs to be made when admitted not just at the point of trying to get people out.

Actions

Workforce wellbeing – can Vol sector be involved?

Beds – Some Vol/charitable organisations are already engaged but do we need more info on what is available in the community that can inform better/quicker discharge?

Date, time and venue of next meeting and name of the representative who will be attending

24-3-23 – Rachel Talbot

VCS Rep Report : ICS Supply, Information and Planning Group (sub-group of Local People Board)

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Meeting attended: Supply, Information and Planning Group

VCS Representatives: Sharon Allen, Arthur Rank Hospice Charity

Date of meeting:  23/01/2023

Summary of agenda items / key themes discussed:

Review action plan/KPIs

Legacy Nursing

Joint recruitment

Reservists

Accommodation update

Return to practice/legacy nursing

The following are proposed from the Local People Board as the objectives for the R&R group to focus on:

  1. C&P ICS to have a dedicated OSCE (objective structured clinical examination), centre for preparation and support (this is related to recruitment of international nurses) – it is not going to happen because the Nursing and Midwifery Council does not consider it necessary to establish a further centre. The group has clarified that what is required is the availability of training, education and assessment for these colleagues.
  2. Reduce vacancy rate for HCSW (healthcare support workers) across the ICS
  3. Develop one clear, supportive and affordable accommodation process for IRNs (international registered nurses) within C&P
  4. Determine professions / areas of greatest clinical risk (from workforce pressures) and focus retention efforts there
  5. Develop career pathways and related marketing campaigns for target audiences
  6. Develop an ethical recruitment policy
  7. Alleviate cost of living crisis

As you can see, it is very NHS/clinically focused

The system has received funding from Health Education England to set up the Legacy Nurse programme. Colleagues have looked at BLMK (Bedford, Milton Keynes and Luton) and Norfolk & Waveney ICS’ to see what they’re doing. These are experienced colleagues who may be considering or have retired or be returning from maternity leave or long term ill health who no longer wish to or are able to work in direct service provision, but have a wealth of skills and experience to support less experienced colleagues through for example, training, mentoring etc. The system is looking for host organisations for these practitioners. CPFT already has this role so anyone interested could talk to Rachel King there.

Two joint recruitment fairs for employers looking for healthcare support workers have been organised. ARHC commented on the promotional material to make it more inclusive of voluntary sector and local authority. We are taking part in these. A recruitment bus is planned for March.

A further new project focused on utilising the skills of reservists has been set up with Hayley Stock employed as the ICB lead. This is another national initiative and our system is partnering with Norfolk and Waveney. The focus for our system is primary care working through Primary Care Networks. The project is also looking to see if there are reservists with Occupational Health experience to help with capacity in this area.

The accommodation project has lots of activity going on and a workshop taking place in February (we are not able to attend this so if another voluntary sector colleague wishes to represent our sector please let me know and I can send details). This project started due to concerns about international nurse recruits being unable to afford accommodation in Cambridge, it has now broadened to recognise that many working in care and health struggle with affordable accommodation. They are considering conducting a housing needs survey.

A further new post focusing on digital inclusion targeting 16 – 19 year olds and linked to apprenticeships will be starting in March.

Implications for the VCS

Any colleagues wanting to be involved in future recruitment fairs please get in touch (these are specifically for health and care support workers)

Actions

None from the meeting

Date, time and venue of next meeting and name of the representative who will be attending

Monday 20th February 2023 – 13.30 – MS Teams. Sharon attending

VCS Rep Report : ICS Local People Board 13 Jan 2023

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Meeting attended: Local People Board

VCS Representatives: Sharon Allen

Date of meeting: 13/01/2023

Summary of agenda items / key themes discussed:

Board Assurance Framework (BAF)

Recommendations from the Leadership and Culture Exercise

Priority 3 – Equality, Diversity, and Inclusion

BAF will be updated and go through committee cycle (this LPB meeting was rescheduled from December so we are out of sync, ICB met the morning that LPB was in the afternoon). A new risk has been added focused on recruitment and retention (R&R) . It was agreed to recommend to the board that this risk should be re-rated to red due to the pressures across the whole system.

In her introductory remarks, the chair acknowledged that much of the focus of the Board is still very NHS. She plans to speak with Local Authority colleagues and with me as the voluntary sector rep, we have a date set for an initial conversation.

There was an update on R&R: there is a sub-group focusing specifically on R&R (see separate update from this group which I also attend). Much of this is also NHS focused, eg looking at support for training for international recruits, concerns about accommodation provision for international recruits (although the cost of living crisis has meant this is now seen as a wider workforce issue). There is a new programme being funded on Legacy practitioner roles, experienced colleagues who may no longer wish to work in service providing roles but have lots of experience to support less experienced colleagues. Another new project is making use of Reservists, There is a further joint recruitment fair aimed at recruiting Healthcare Support Workers and ongoing discussion about data collection and analysis,

Oonagh Monkhouse is Director or Workforce at Royal Papworth Hospital and leads the system EDI group (Gemma Manning, Director of People and Operations at Arthur Rank Hospice Charity represents our sector on this group). The groups activity thus far has focused on anti-racism because racism is the biggest issue of concern identified from the NHS staff survey. The issue of data and lack of consistently available data across the system was raised again (the NHS has the Workforce Race Equality Standard – WRES, Workforce Disability Equality Standard – WDES and it’s staff survey) the Local Authority and VCSE do not have anything comparable (although I shared that Skills for Care and Local Government Association have been working to develop and social care workforce race equality standard, I am meeting with colleagues from Skills for Care to find out what the latest position on this is and whether this might a tool the voluntary sector can also use as we found the WRES not transferrable)

The East of England NHS has developed an anti racism strategy that our system has signed up to. The three priorities are: leadership and management, talent and career progression and tackling racist abuse toward colleagues from patients and the public.

North West Anglia Foundation Trust is piloting a Fair Recruitment Practice approach which will set minimum standards, this is in early days and we will receive a fuller report in due course.

A proposal to sponsor a new programme, Above Difference, which will support the development of a cultural intelligence framework to support leaders and staff to become more culturally aware through the use of personal analysis andeconomic modelling was approved. It was explicitly stated that this is aimed at leaders from across the whole system and applications from voluntary sector organisations will be welcomed.

We had an update from the Leadership & culture strategic session at the previous Local People Board. Anita Pisani who chairs the Leadership and OD sub-group reported back on a number of programmes and plans for programmes in the coming year. Anita is going to speak with me about opportunities for our sector to participate.

Implications for the VCS

How can the data project that Healthwatch and CAB have undertaken contribute to this wider EDI work?

Sorry for being a broken record on this – how do we ensure that voluntary sector workforce data and therefore recruitment and retention challenges are part of the system picture?

Ensure that recruitment and retention issues are reported back so that our issues and any solutions we have identified are part of the system response.

We should try and ensure we have good representation on the Above Difference programme once this is launched.

Actions

No specific actions from this meeting.

Date, time and venue of next meeting and name of the representative who will be attending

Friday 24th  February,  13.30  (via Teams), Sharon will be attending

VCS Rep Report : ICS Quality, Performance and Finance Committee 25/11/22

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Meeting attended: Quality, Performance and Finance Committee

VCS Representatives: Rachel Talbot

Date of meeting: 25/11/2022

Summary of agenda items / key themes discussed:

Almost impossible to summarise 3 – 4-hour meeting with yet again 100s of pages of papers.

Seems that we are not doing to badly in our area compared with national in general but there is a problem with the support to children/people with mental health/learning disability. No surprise but the committee is taking the learning Disability Death review as a key issue to look at again. It seems that death rates are  high and partly to do with lack of understanding how to communicate – both to individuals and helping people with learning disabilities understand health issues – this was clearly demonstrated during Covid (I think HealthWatch are going to raise some sort of formal point about this. You can get more from Sandie)

Finance: Are underspent (now in “amber”) but mostly around not being able to recruit new staff although they have 8% more staff than last year. (I could not understand what was being said about them having rules to get authorisation for anything over £50k. Not sure if it holds things up. Seems a very small number for buying health things!)

Other issues (too many to put here – but in summary):

Diagnostics and unplanned care “deep dive” report – still seem to be delays beyond target (partly the impact of knock on of covid). Sandie asking for better comms to people/public to explain what the cause of the delays are

Health and well being for asylum seekers trying to get GP access (mostly P’boro)

Working together – Interface between Health and care sector – V short report (the rest of the reports were all very detailed and long!). Dr Katherine Rowe reported that they had had some stake holder meetings.

Occupancy rates at hospital V high and C Diff rates bad because they cannot get the cleaning staff

Implications for the VCS

Think that Healthwatch will be asking for help with feedback/case studies on experiences of people with mental health issues and primary care.

Actions

Need to think about the fact that Sandie Smith is leaving. Will her successor take over? She makes a big contribution.

I am not sure what I can add except listening and get depressed about the state of the system. It is a massive learning curve and V difficult understanding the lingo.

Date, time and venue of next meeting and name of the representative who will be attending

27-1-23 – Rachel Talbot