Agenda item

Integrated Care Across Northamptonshire (iCAN) Case for Change

Decision:

RESOLVED

KEY DECISION

That the Executive:

a) Supported the broad direction of travel set out in the iCAN case for change and the ambitions and intentions to improve the experience of people

b) Agreed that the Executive Member for Adults, Health and Wellbeing formulates a written response to the Senior Responsible Officer for the iCAN collaborative and the Chair and Chief Executive of the Integrated Care Board setting-out the Executive’s position regarding concerns identified including:

- Member oversight of the collaborative when it does not report in to the health and wellbeing board and no elected members are members of the Integrated Care Board

- Governance around financial decision making and operational boards if commissioning of services currently funded through the Better Care Fund and earmarked for meeting the needs of North Northamptonshire residents if it were to be included in a countywide pooled budget

- Seeking an opportunity to discuss and address the concerns identified with key members of the Integrated Care Board in order to provide sufficient assurance and resolution to the Council’s Executive regarding the concerns it has identified.

Reasons for Recommendations:

· The broad direction of travel is one that fits with the overarching priorities set out within the corporate plan.

· Whilst socialising the case for change with elected members within the council, there have been some concerns raised regarding adequacy of governance arrangements that it is important are raised with the ICB as part of the Executives feedback on the case for change.

· Member oversight of performance and expenditure for which it is responsible is a fundamental requirement in ensuring that local-authority public money is being spent in accordance with national requirements alongside the priorities set out in the corporate plan.

Minutes:

The Chair invited Cllr Dorothy Maxwell to address the Executive. Cllr Maxwell noted that the report indicated the way forward for integrated care across the county and detailed how this could be achieved. Cllr Maxwell referenced grant funding and the need to ensure it was used to assist those most in need. A request was made for the formal agreement diagram contained within the papers to be recirculated as the existing version was hard to read.

Cllr John McGhee was invited to address the meeting by the Chair. Cllr McGhee raised concerns in relation to the lack of elected member representation on the Integrated Care Board despite guidance stating that the board should operate with such representation.

The Chair invited Cllr Lyn Buckingham to speak to the Executive. Cllr Buckingham had concerns regarding care access routes, noting that older people were not currently getting the services they needed and deserved from primary care. The cost-of-living crisis would impact on social care services and concerns were also raised regarding lack of councillor input.

The Chair thanked speakers for their contributions before inviting Cllr Helen Harrison, Executive Member for Adults, Health and Wellbeing to introduce a report that sought to provide an overview of the case for change for the current Integrated Care Across Northamptonshire (iCAN) transformation programme to develop into an iCAN collaborative. This would mean that the collaborative would have delegated commissioning responsibilities, including some elements of the Better Care Fund (BCF) being proposed as of April 2023.

Cllr Harrison noted that the Better Care Fund programme supported local systems to successfully deliver the integration of health and social care in a way that supported person-centred care, sustainability and better outcomes for people using pooled budgets between the NHS and local authorities, aiming to reduce the barriers created by separate funding streams. Details of the budgets that comprised the fund were provided to the meeting along with details of composition of integrated care systems formed to plan and deliver joined up health and care services, and to improve the lives of people who live and work in their area.

The intention of the iCAN programme was to transform and improve care for the frail and elderly population and build on initiatives in national programmes

to deliver better outcomes and manage demand more effectively to ensure more people stayed well at home and avoided admissions to hospital where there was the potential to design and deliver better “out of hospital” services.

Cllr Harrison noted the need to move to embedding new ways of working by producing a service delivery model for long term integrated work. BCF funding could be used as a foundation for future arrangements with a view that there would be a single contract for our collaborative services that held all partners to common outcomes and improved performance to meet system and national objectives.

The Executive wished to have sufficient confidence in the governance arrangements to ensure that spend had an element of protection or ring-fencing so that the Council was able to account for, and evidence that those funds had been spent for the benefit of North Northamptonshire residents.

It was heard that the operating model was still at an emergent stage, with the Council able to influence its development, problem solve and offer solutions. A number key challenges around governance and democratic accountability had been identified and an opportunity to discuss these was included as part of the recommendations.

Cllr Harrison concluded by recommending that the Executive support the broad direction of travel set out in the iCAN case for change, and that she as Executive Member would formulate a written response setting out the Executive’s position regarding concerns identified.