Council and democracy

Ian Wake introduced the Accountable Care Organisation report that detailed the two initiatives that had been designed to address current issues in the local Health and Social Care system. The Development of an Accountable Care Organisation for the Tilbury Locality and development of four Integrated Healthy Living Centres across Thurrock.

Thurrock remained one of the most “under doctored” areas in England in terms of the ratio between general practitioners and patients and there was an unacceptable level of variation in the clinical care of patients with long term conditions between different general practitioner practice populations.

The Annual Report of The Director of Public Health in 2016 considered the health and social care system sustainability in Thurrock and concluded that fragmentation within constituent parts of the system and inadequate capacity and quality of Primary Care was leading to preventable serious health events within our population and was a key underlying driver of system unsustainability.

Ian Wake updated Members on the development of Thurrock Integrated Healthy Living Centres. Due to the complexity of current National Health Service commissioning arrangements the implementation of the project had been slower than expected.  A team of consultants from Currie and Brown have been appointed to move the project forward so that a business case could be presented to Cabinet to seek approval to borrow the required capital for construction to start and setting out how revenue would be recouped from the National Health Service. It was expected that the business case would be ready in late 2017.

Mandy Ansell expanded on the concept that was being piloted in Tilbury. Jeannette Hucey had been working on the concept of a new Lead Partner Model for 18 months built on learning from the Vanguard sites that had been given specific funding to develop new models of care. Jeanette Hucey had formed a “buddy” arrangement with Dudley in the West Midlands who are a Vanguard site and have been leading on new model development. The challenge in many cases has been getting the providers to work together and full credit should be given to local providers North East London Foundation Trust (NELFT), South Essex Partnership Trust (SEPT), and Basildon and Thurrock University Hospital Trust  (BTUH), where there was now greater trust allowing for conversations around risk and gain share to emerge.  Work continues on the Legal contract, which was incredibly complex and advice being sought from Hempsons in support.

Mandy Ansell stated that this was an incredible exciting project and those involved deserved a “big pat on the back”.

Ian Wake stated that this was one of the most exciting project he had worked on in his 22 year career.

The Chair thanked Officers for the continuing good news on the agenda.

Councillor Collins questioned whether the “double running” would result in the budget doubling over the period of time and for how long was this period of time. Ian Wake stated that it was likely that funding would be placed within the Better Care Fund. Additional government money for primary care will be providing additional funding in the short term to provide a mixed skills work force.   

Mandy Ansell stated that one of the core documents worked to in the National Health Service was the Five Year/GP Forward View which allows for more investment into primary care.

Councillor Sheridan thanked Officers for the report and asked what contingencies would be put in place for all the new housing developments and the increase in population. Ian Wake stated that the proposed models had to be future proof with the health living centres being flexible to accommodate increases in population.

Councillor Watkins questioned the “quick wins” that were required to be addressed by the new Accountable Care Organisation and whether the business cases could be shared. Ian Wake stated that the wider picture had to be addressed. For example, blood pressure tests, and where these could be undertaken using the community assets instead of residents having to go to a hospital.

Councillor Snell thanked Ian Wake but asked when residents would see things happening. Ian Wake stated that in was work in progress and required the business case to be approved. The timescales that were minuted at the Health and Wellbeing Board on the 15 March 2017 was six to nine months.

RESOLVED

1.         That the Health and Wellbeing Overview and Scrutiny Committee note the contents of this report.

2.         That the Health and Wellbeing Overview and Scrutiny Committee support the work of the Director of Public Health in conjunction with the Council’s key partners to develop and pilot an Accountable Care Organisation approach of integrated working for the Tilbury Locality.

3.         That the Health and Wellbeing Overview and Scrutiny Committee continued to support the on-going work to develop the four integrated Healthy Living Centres.