Agenda item

Officer: Guy Van-Dichele

Key decision: no

The Leader of the Council delegated authority to the Cabinet to make the following decisions:

RESOLVED: To

1.    Note the current status and progress in relation to the integration of health and social care and the developments locally and sub-regionally in South West London as a result of the NHS Long Term Plan. 

2.    Note and agree the next steps for One Croydon’s journey to health and social care integration.

3.    Agree any actions arising from the equality analysis. 

The Deputy Cabinet Member for Families, Health & Social Care provided Cabinet with an overview of the journey undertaken to-date to integrate health and social care within Croydon.

Staff within the health and social care were thanked for their hard work and dedication, especially over the busy winter period, in supporting residents.

Members were provided with highlights on the progress made to integrate health and social care including; the LIFE Service (Living Independently for Everyone) and Integrated Community Networks (ICN) which had been live for two years and investment in the voluntary and community sector with social prescribing and telemedicine in most care homes. These developments had seen a reduction in emergency admissions of older adults and reduced lengths of stay in hospital. However, despite these improvements demand remained high, particularly from hospital discharge to community reablement which continued to impact the social care budget.

The Deputy Cabinet Member informed Members future developments would include mental health adult community transformation which would focus on community provision and enhanced primary care provision and that ICN Plus, which would be piloted in Thornton Heath, would take a whole population approach to locality working. 

Lessons had been learnt learnt from the One Croydon Alliance work with older people, such as the establishment of a whole population outcomes framework and increased engagement with the wider population planned for the future. An economic review had been undertaken in late 2018/early 2019 which had identified funding gaps, predominantly in adult social care, which had been recognised as requiring addressing. However, there remained a commitment to further integrate health and social care services using current resources to ensure improved outcomes for residents.

In terms of the governance of the integration, the Deputy Cabinet Member highlighted that Croydon CCG and Croydon Health Service had aligned their senior management with a joint Place based leader, Matthew Kershaw, and committees where appropriate. Furthermore, Members were informed that Croydon CCG would merge into the South West London (SWL) CCG as the SWL CCG were preparing their application to become an Integrated Care System. Finally, there had been a proposal to change Croydon Transformation Board to a Health and Care Board in April 2020 which would have a strategic relationship with the Health & Wellbeing Board and SWL CCG. The Health and Care Board, Members were informed, would have delegated budgets and responsibilities.

The Deputy Cabinet Member noted that in terms of finance, the ten year One Croydon integrated contract agreement would need to be developed to reflect the whole population approach. It was further noted by Members that demand in both health and social care sectors continued to exceed the financial resources available which remained a challenge. The aims of the integration, however sought to address these challenges with the development of a single Section 75 agreements, shadow budget arrangements for 2020/21 and revised business cases being produced to support investment.

The Deputy Cabinet Member concluded with providing Members with a case study which showed the positive impact that health and social care integration was having, with a 91 year old resident with a few physical health issues being supported by the GP huddle and Complex Care Support Team. The support, it was stated, had enabled carers to visit the home and enable the gentleman’s wife to remain at home and the resident to relax as he was no longer concerned that his wife would be moved into care. This case study showed that through using a whole system approach residents could be supported to live long, happy, healthy and independent lives.

The Chair of the Health & Wellbeing Board thanked officers and health workers for their hard work in caring for the most vulnerable residents in the borough. It was noted that there had been a number of events which the council and the health service had taken part in which were examples of engaging across organisations and services.

Section nine of the report was highlighted by the Chair of the Board and it was noted that organisations were cautiously ambitious, particularly in terms of budgets however it was recognised by all that it was necessary to ensure health and social care were properly aligned.

The report was welcomed by Members and was recognised as being a large and important piece of strategic work. The ambition to support residents to live long, happy, healthy and independent lives was supported by all and Members welcomed future reports being taken to the Health & Wellbeing Board.

In response to Member questions, the Deputy Cabinet Member confirmed that the Vice-Chair of the Health & Wellbeing Board, Dr Agnelo Fernandes, was continuing to work with the two GP practices which were not on board with the plans. 

Whilst it was recognised that a number of initiatives had started in the north of the borough, Members were reminded that social prescribing had been piloted in the south of the borough and that it was the intention of all involved to start more initiatives in the south of the borough as it was recognised that there were a high number of elderly residents with high need levels in those communities also.

The Chair of Scrutiny & Overview Committee expressed disappointment that the work of the Health & Social Care Scrutiny Sub-Committee had not been recognised in section 11 of the report, as the committee had looked at integration in the past year and it continued to be a priority on the committee’s work programme. In response, the Chair of the Health & Wellbeing Board recognised the work of scrutiny on this matter and stated that officers and health professionals valued the comments and recommendations of the scrutiny committee.

Members recognised the value of integration and ensuring all residents were supported. Croydon had been successful in leading the way in integration which had seen improved outcomes for residents, the council and the health service. With the funding gap in adult social services it was noted that innovation was key to ensure the delivery of services for residents.

Officers were thanked for their work in progressing this further and it was noted that a further report would be taken to Cabinet in March that would outline future provision.

The Leader of the Council delegated authority to the Cabinet to make the following decisions:

RESOLVED: To

1.    Note the current status and progress in relation to the integration of health and social care and the developments locally and sub-regionally in South West London as a result of the NHS Long Term Plan. 

2.    Note and agree the next steps for One Croydon’s journey to health and social care integration.

3.    Agree any actions arising from the equality analysis.