Ian Wake, Director of Public Health, presented the report that contained the NHS Long Term Plan commitments which were summarised around the following key themes and what these themes meant for Thurrock.
• Finances and Resources – Plan set out the increase to NHS budgets in England of £20.5 billion however the future funding for Adult Social Care was not included. That savings from administration costs of more than £700 million had been made with the CCG being told to reduce their running costs by 20% by 1 April 2020.
• Prevention and Health Inequalities – The plan recognised both individual and place based focus; one million contacts had been made between patients and clinicians every day; funding for more services strongly linked to equalities going forward; raised concern on the services for 0-19 young persons and the sexual health services.
• New Models of Integrated Care – The plan mirrored what had already been started in Thurrock who were now ahead of the game. The move to integrate primary and community health care around mixed skills workforce servicing populations of over 40 thousand which left further questions on the proposed Integrated Care Systems.
• Action to improve care quality and outcomes in different clinical specialities – Partnership arrangements for children and young people in Thurrock had to be strengthened; an ambition plan to increase the proportion of cancers diagnosed at stage 1 and 2 from the current 50% to 75% by 2028. The plan also had a huge range of ambitions to improve mental health treatments.
• Workforce – Plan recognised a shortage in workforce and had been one of the biggest challenges facing the health service. Workforce remained a major challenge in Thurrock and the plan had a lack of detail on how this could be resolved. The new funding had been welcomed and the New Model Care was already mirroring Thurrock’s journey.
Councillor Allen thanked Ian Wake for the report but raised his concern on waiting times for Thurrock MIND. Roger Harris agreed to pick this item up outside the committee with Councillor Allen.
Ian Evans, Thurrock Coalition, referred to the Health Inequalities and questioned which footprints would be agreed and when this would happen. Ian Wake stated at this stage it was not clear on which Health Inequalities footprints these would be compared against.
Councillor Kent thanked Ian Wake for the report and stated the focus should be on the Workforce and thanked the NHS workforce for the fantastic job that they did. Councillor Kent had concerns of the shortage of General Practitioners and had been disappointed that the report had not looked at the recruitment and retention of General Practitioners in Thurrock and how solutions had not been offered. Councillor Kent had welcomed the extra grant but stated there had to be a process to ensure the money was being spent in the right way and how would residents know how this money was being spent. Ian Wake agreed that the report made little reference to the lack of General Practitioners and that some commitment had been made to train doctors and medical replacements. That Thurrock plans would be to have a mixed clinical workforce with placed based practitioners undertaking many of the tasks that General Practitioners would normally carry out.
Mandy Ansell, Accountable Officer, Thurrock Clinical Commissioning Group, referred Members to the out of hours service at Hubs as an example that this was working where appointments to see a physiotherapist were fully booked but there had been available appointments for General Practitioners. That a new medical school had been built in Essex committed to those students to train and stay in Essex. The existing Thurrock Primary Care Networks were ahead of the curve and outcomes were being seen from this.
The Chair stated that the development of education and skills was vital and that it was essential that funding for colleges was available as this would be where future health specialists would come from.
Councillor Allen echoed Councillor Kent’s comment on the lack of General Practitioners and that early intervention was vital.
Councillor Redsell referred to the development of digital services and reminded Officers that not all elderly residents would have access to IT and questioned how General Practitioners and pharmacists were joined up as many of the medical centres in Thurrock operated differently.
Ian Wake stated the digital agenda was strong with the plan that one third of appointments would be made digitally and that traditional channels of appointment booking would still be available. Ian Wake stated that it should not be assumed that not all elderly residents did not have access to digital media.
The Chair asked how pharmacies fit into the Hub process. Mandy Ansell stated there were partnerships between General Practitioners and Pharmacies and these could be found in all parts of the health service.
The Chair thanked Ian Wake for the report and the break down on what the five themes meant for Thurrock.
The Chair referred members to recommendation 1.2 and stated that this recommendation had been added to highlight the complex piece of work and to ensure transparency of where the new NHS funding was being invested. The item would continually be reviewed and would be added to the work programme for 2019/20.
1. That the Health and Wellbeing Overview and Scrutiny Committee consider and comment upon:
· The report and the themes that it addresses.
· How the NHS Long Term Plan may be implemented in the context of the needs of the population of Thurrock and our existing system transformation agenda.
· The risks and opportunities associated with the wider proposed changes to the commissioning arrangements across Mid and South Essex STP.
2. That the Health and Wellbeing Overview and Scrutiny Committee agreed to receive further information about how the new funding will be invested in Thurrock.