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Update - Integrated Care System/Partnership/Board and Locality Partnerships (1 hour)
- To receive the enclosed presentations/briefing note followed by an opportunity for discussion and member questions:
a. Update: Health and Social Care – integrated working (15 mins)
Presentation enclosed from Nicola Knowles, Policy & Public Affairs Manager, BCC
b. Locality Partnerships and Community Mental Health Transformation Programme (45 mins)
Briefing note and presentation enclosed.
Attendees for this item will include:
Stephen Beet, Co-Chair of South Bristol Locality Partnership (and Director: Adult Social Care, BCC)
David Jarrett, Director of Primary and Integrated Care, BNSSG ICB
Sharron Norman, Delivery Director - North & West Bristol Locality Partnership
Joe Poole, Delivery Director - Inner City and East Locality Partnership
Emily Kavanagh, Head of Locality - South Bristol Locality Partnership (on behalf of Steve Rea, Delivery Director - SBLP)
At the end of this item, there will be a 5 minute break.
Minutes:
a. Integrated Care System and related governance - update
The Committee received and discussed a presentation providing an update on the establishment of and governance arrangements for the Integrated Care System / Partnership / Board.
Summary of main points raised:
1. In noting and welcoming, in general terms, the purpose and expected benefits of the Integrated Care System, it was noted that there would inevitably also be forthcoming pressures on the Council’s and partners’ budgets given the context and impact of the national economic situation. These pressures would need to be taken into account as necessary as part of ICP/ICB planning activity.
2. It was noted that tackling health inequalities, improving people’s experience of and access to health services, together with improving outcomes in population health with a particular focus on those ‘most in need’ were fundamental principles for the ICP.
3. The proposal to allocate 8 seats within the 28 seat ICP membership to the voluntary, community and social enterprise sector was welcomed, noting that there was a degree of local discretion in determining these arrangements. It was noted that careful engagement was taking place in relation to the representation arrangements in line with the commitment to developing a citywide approach to working equitably with the sector in Bristol. It was hoped that the progressive approach being taken could potentially be seen as a model for elsewhere. The full detail was being worked through but would include a clear job role/description/application process with a view to ensuring a best practice approach.
4. It was noted that developing an Integrated Care Strategy (within a timescale of December 2022) was a key area of immediate attention for the ICP/ICB. The strategy would include a focus on:
- the challenge of reducing inequalities and disparities in health and social care.
- improving service quality and performance.
- promoting control, choice and flexibility in how individuals receive care and support.
- setting out how commissioners in the NHS and local authorities, working with providers and other partners, can deliver more joined-up, preventative, and person centred care.
- working closely with local people and communities, with a view to delivering
system level, evidence-based priorities in the short, medium and long term.
b. Locality Partnerships and Community Mental Health Transformation Programme
The Committee considered and discussed a presentation providing an update on Locality Partnership development and implementation of the Community Mental Health Framework.
Summary of main points raised:
1. It was noted that the Community Mental Health Framework was being delivered across all 6 locality partnerships within the BNSSG geographical area. Through mental health teams or integrated personalised care teams, the Community Mental Health Programme Board, in partnership with each Locality Partnership, would evaluate how this approach:
- increased people’s access to high quality and personalised care, close to home.
- affected people’s mental health outcomes.
A phased approach was being taken to an integrated community mental health service that was personalised, proactive and preventative to support individuals in getting the right service, at the right time in the right place. The approach started in April 2022 and was scheduled to complete in April 2024.
2. In terms of the South Bristol Locality Partnership, it was noted that key elements of the community mental health response included:
- Supporting communities: agreeing commitment from partners (including engagement with care providers) to a person-led and asset-based community development approach.
- Linking professionals: enabling existing teams to better seek advice and support without referrals.
- Development of the Integrated Personal Care Team and work with individuals who have complex needs, with teams working across disciplines to support the full needs of the individual person.
3. In terms of the North and West Bristol Locality Partnership, it was noted a key element of the community mental health response included a ‘foundations’ approach to building collaboration through:
- Working with trust and openness between partners.
- Understanding gaps based on both population health data and people’s lived experiences; and shared identification and ownership of these gaps.
Through co-production involving service users and frontline staff, the key outcomes expected from the community mental health model were:
- A person centred, holistic model of care that suited the locality population.
- Improved parity of awareness/wider knowledge of how people can access mental health services.
- Planning ahead with an understanding of the needs of ‘whole’ population community mental health (e.g. including children and young people).
To ensure effective governance, separate leadership, delivery and community wellbeing boards were being set up.
4. In terms of the Inner city and East Bristol Locality Partnership, it was noted that key elements of the community mental health response included:
- Establishing reference groups to drive design processes including people with lived
experience, frontline workers and community and faith groups.
- A commitment to asset-based community development approaches, building on the resources in communities.
- Through the above, utilising the local network of community representatives to identify and maximise community assets, and proactively seek to build the community workforce.
5. The Chair and other members welcomed the commitment within Locality Partnerships to wide engagement and co-production in helping to understand local needs and then looking to deliver against them. It would be important to continue to ensure that progress updates were communicated regularly to local ward councillors across each locality as part of the approach to encourage wide collaboration. Members noted and were supportive of the fact that future member briefings on ICS/Locality Partnerships would be provided separately for each of the 3 locality partnership areas serving Bristol, with information tailored accordingly (rather than through a wider citywide briefing for all councillors as had been the case previously).
6. Members also noted and welcomed the approach being taken through Integrated Personal Care Teams to work across disciplines to find the best solutions for individuals with complex needs.
7. In discussion, it was noted that whilst there would be some variations in approach (e.g. in terms of the local detail of the co-production approach), there were common outcomes, with an emphasis also on sharing best practice.
8. It was noted that there was a system-wide issue around workforce gaps, and staff recruitment and retention, particularly in relation to care staff. Work was ongoing in relation to addressing these issues, including the issue of developing clearer and more fluid career pathways and related opportunities.
9. It was noted that it was important to highlight recognition of the contribution of care workers. Cllr Holland referred, for example, to the Annual Care and Support West Care Awards event held on 8-9 October, arranged specifically to acknowledge the positive impact of care professionals/workers on the lives of vulnerable people across the BNSSG area. It was also important to recognise the value of very local and more informal initiatives – for example, individuals leading local walking groups could be seen as making a positive contribution to the mental health of participants.
The Committee RESOLVED:
- To note the above updates and information.
Supporting documents:
- 8a - Health Social Care integrated working, item 20. PDF 5 MB
- 8b1 - LPs and delivery of CMH transformation briefing note, item 20. PDF 121 KB
- 8b2 - LPs and CMH, item 20. PDF 1 MB