Tag Archive for: ICB

Summary of Voluntary Sector Representation from Boards/Committees (Oct-Nov 23)

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

 6th 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 15th December.

 

Quality Performance and Finance 

27th 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 4th lowest cost per 1000 patients. Nd 4th 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

13th 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

17th 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

 

 

 

Summary of Voluntary Sector Representation from Boards/ Committees (June – Aug 2023)

QUALITY PERFORMANCE AND FINANCE COMMITTEE

23rd June- Rachel Talbot

There has been an increase in referrals to paediatric services for preschool children along with an increase in need for children with complex needs. As well as this there are long waiting lists for speech and language therapy.

There is still concern about the number of inappropriate out-of-area mental health placements with work being done to reduce these.

The dementia tour bus that visited care homes across Cambridgeshire and Peterborough earlier in the year was a great success.

27th July- Rachel Talbot

There has been a reduction in turnover of staff since the beginning of the year. Mental Health nursing however had seen an increase in turnover.

A discussion took place about the Learning Disability Health Needs assessment. There was a list of recommendations however with lack of funding these may be difficult to implement.

Ambulance handover time has improved and is being sustained and is now the best in the region.

PEOPLE BOARD AND SUBGROUPS

12 July -Education and Development workshop ARCH representation

The Oliver McGowan training the ability to recruit the right amount of staff and the cost of training were discussed.

Background-the- The Health and Care Act 2022 introduced a requirement that regulated service providers must ensure their staff receive Learning Disability and Autism training appropriate to their role. The suggested training is the Oliver McGowan training.

17 July- Leadership and OD subgroup- Sharon Allen

There is a shift in focus from NHS from Serious Incident Review to Patient Safety Incident Reporting Framework (PSIRF). Understanding what within the organisational system led to an adverse outcome. All NHS and commissioned organisations have to introduce PSIRF and Arthur Rank are doing this.

Sharon had taken part in the System Change Consulting Programme (a Health Education England-funded programme) and she fed back at the meeting. The programme had several modules and they are now available online.

https://eoe.leadershipacademy.nhs.uk/development-support/system-leadership/system-od-and-transformation-learning-modules/

The Leading Beyond Boundaries training had 78 nominations including several from Health Alliance members and all have been offered a place.

If organisations undertake staff feedback and are willing to share results and action plans contact Sharon Allen or Anita Pisani

COMMISSIONING, INVESTMENT AND IMPROVEMENT AND REFORM COMMITTEE

18TH August – Michael Firek

Someone to Talk To- Young people’s Mental Health Service the ICB has agreed to continue to fund this service until June 26. It is a jointly commissioned piece of work with Cambridgeshire County Council and supports young people 13-25 with complex mental health needs. The service is currently delivered by Centre 33.

Continuing healthcare efficiency plan- A plan has been received and approved to reimplement clinical tier rates for nursing care beds. A revised and simplified set of rates has been discussed with providers to manage costs and be more reflective of the client’s needs.

Cambridgeshire and Peterborough ICS Outcomes Framework- work is continuing on this. The intention of the framework is to encompass patient and user experience as well as workforce, culture and leadership elements alongside clinical, care and service outcomes.

PA Consulting- These were engaged on Feb 23 to develop a resource model informed by population health, outcomes and the health economic value of change. Work is currently under way to develop logic models that will help the system to assess the economic benefits of different interventions.

Mental Health Investment Standard (MHIS) Review- more than £183m of funding goes into Mental Health and Learning Disability and Autism services. The ICB has done a deep dive review of expenditure for 22/23 to understand the activity, quality, experience, performance and value for money of the services provided for the local population. Several learning points were identified.

Continuing funding for 23/24 was agreed upon. There was a recommendation to pursue 3-year contracts with Voluntary and Community Sector Organisations who were delivering services funded by the Mental Health Investment Standard (MHIS) or the Service Development Fund.