Agenda item

The Chairman invited the following to the table:

·         Ms Ruth Donaldson – Director of Commissioning, Barnet CCG

·         Ms Kay Matthews - Chief Operating Officer, Barnet CCG

·         Dr Jeff Lake – Consultant in Public Health, London Borough of Barnet

Ms Donaldson explained that the Clinical Commissioning Group was currently in the process of developing two key programmes to support integration locally. These programmes were the development of new approaches to commissioning which support a move toward commissioning on outcomes and the implementation of Care and Health Integrated Networks (CHINS), as the place based delivery model for services. Commissioning on outcomes and integrating where appropriate ensures that there is a greater focus on prevention, and aims to remove the perverse incentives that are currently in place in acute and community contracts.

The Committee queried the cost of implementing these changes. Ms Donaldson said that the key driver in the integration programme was to improve the quality of services that patients receive and to reduce fragmentation. There may also be financial rewards if a focus on prevention and self care results in fewer emergency admissions to hospital.

The Committee acknowledged the importance of getting Primary Care right and the cost benefit attached to this. Ms Djuretic said the aim was to mobilise the whole system and ensure a fully integrated approach. Although there were financial constraints, finding a way to work together on joint delivery was important in order to improve patient experience and both efficiency and value from the Health Care system. Dr Lake said fragmentation needed to be tackled and integrated networks was a way to do this, allowing greater co-ordination and continuation of care, particularly for elderly patients who frequently have chronic conditions. He said there was a need for both Individual and community resilience, with more of an emphasis on how people are involved in their own care. He felt that Members also had a role in driving innovation in their areas.

The Committee asked what risk management process had been followed and had learning from other areas been sought. Ms Donaldson said learning from successful areas such as Manchester and Surrey had been done. CHINS allowed early interventions to be identified and the ability to link this into the wider community and acute services.

The Committee asked what front-line services for young people’s mental health were available.  Ms Donaldson said that a resilient schools programme was available. Ms Djuretic said that 16 schools had signed up and a programme of activities had been held to support parents, teachers and children which included mental health training. Ms Djuretic said there was a digital site available called Kooth, which provides online peer support and counselling. She said the mental health pathway for young people sits within Public Health and is run by the Local Authority.

Ms Matthews explained that five Care and Health Integrated Networks were now up and running and the plan was to have six integrated programmes across Barnet. She said locally commissioned services had been introduced to encourage the last few GP Practices to sign up and by December nearly all should be covered. The Chairman enquired whether the Patient Participation Group with a focus on outcomes for Frailty had been established. Ms Donaldson said that there was an overarching one looking at patients across the Borough from various GP practices.

Ms Matthews commented that there was a significant amount of transformation involved which required engagement with health and social care staff as well as local care professionals. Ms Donaldson said that they had met with CLCH and the Royal Free and both were working toward the same approach. Ms Matthews informed the Committee that they were at the early stages of change and that some programmes of integration were more progressed than others, but the aim was to spend money wisely across all organisations.

The Committee asked how the voluntary sector was being engaged. Dr Djuretic said that voluntary organisations participated in the Health and Wellbeing Board and contributed towards these programmes. Ms Matthews proposed returning to update the Committee in approximately nine months’ time.

RESOLVED that the Committee noted the report.