Agenda item

Integrated Care Northamptonshire

Meeting of People Overview and Scrutiny Committee, Thursday 8th December 2022 6.30 pm (Item 87.)

To consider an update on the development of the Integrated Care System in Northamptonshire.

Decision:

RESOLVED: That the People Overview and Scrutiny Committee

a) Noted the presentation on the development of Integrated Care Northamptonshire.

b) Requested that further information be provided to Committee members on the following matters:

· The resources that will be available to support Local Area Partnerships, including whether all LAPs will have community officers as in the N4 LAP.

· Whether LAPs will be able to bid for funding to support particular projects.

· How any additional demand on voluntary and community sector groups that results from working with LAPs will be managed.

· How National Lottery funding recently awarded to Northamptonshire will be used in the county.

c) Raised the need for all LAPs to operate within a common framework to assist in assessing the outcomes that they produce.

d) Raised the need for LAPs to be informed about how to make bids to relevant local funding streams and for West Northamptonshire Council to be ready to respond effectively to such bids.

e) Agreed to seek to scrutinise the developing outcomes framework for the Northamptonshire Integrated Care Strategy.

f) Agreed that Northamptonshire Police should be requested to update its crime data reporting processes so that they reflect West Northamptonshire Council ward boundaries.

Minutes:

The Cabinet Member for Adult Care, Wellbeing and Health Integration introduced the report and commented on the development of Integrated Care Northamptonshire (ICN), highlighting the following points:

· The 10-year ICN Strategy had been endorsed by the West Northamptonshire (WNC) Cabinet on 6December 2022. The ICN Strategy set out 10 shared ambitions that underpinned the overall aim for residents to ‘Live Your Best Life’. WNC would refresh its corporate plan where necessary to support these ambitions and partners would apply them to their services, reflecting the wide range of services that contributed to good health outcomes.

· The ICN operating model included the Integrated Care Board of chief officers and the wider Integrated Care Partnership. As the portfolio holder he chaired the West Northamptonshire Health and Wellbeing Board.

· ICN benefitted from covering a clear geographical area, whereas some other integrated care system covered multiple local authorities. ICN was made up of two places: West and North Northamptonshire. West Northamptonshire included two localities, Northampton and Daventry and South Northamptonshire, and 9 Local Area Partnerships (LAPs). The LAPs were intended to translate strategic priorities into community-level action to deliver practical outcomes.

· Two pioneer LAPs had been established: N4 in Northampton and DSN4 in the south of the authority. Each had held around four formal meetings so far involving ward councillors and local GPs. WNC had signed up to a local insight data system that provided very good information on issues affecting health and wellbeing.

· Service providers were working to change operating arrangements to align with LAPs. For example, Northamptonshire Police was changing the geography of its beats to take into account LAP areas.

· Metrics for each of the 10 ICN ambitions were currently being developed, which would assist in forming delivery plans.

· The ICN Community Engagement Framework would help to shape how partners worked with local communities.

· Useful information and experience had been gained from the pioneer LAPs. Emerging themes for the N4 LAP included high levels of chronic obstructive pulmonary disease and that crime data showed that 50% of crime in Northampton was caused by people who lived in the N4 area. Local inequalities funding had been received from the government for central Northampton to address some of these issues.

· The DSN4 LAP had raised issues around access to key services and cross-border working as some residents used health services in different authorities.

· The key challenge now was to apply the ICN Strategy so that it made a difference. Part of his role as the WNC portfolio holder was to make sure this was done. Overview and Scrutiny could also consider reviewing delivery against the outcome measures adopted.

The Committee considered the report and overview given and members made the following points during the course of discussion:

· How long would the pioneer LAPs operate and when would others be set up? What lessons had been learnt from the pioneers and would this change the establishment of other LAPs?

· The LAPs would be a very powerful tool for change.

· The ICN Strategy referred to the living wage but this was not the real living wage as identified in the WNC Anti-Poverty Strategy.

· Overview and Scrutiny should look at the ICN outcomes framework.

· The pioneer LAPs had got a head start, which could put other areas at a disadvantage compared to if all had started at the same time.

· If LAPs were able to operate in different ways it would be more difficult to judge their impact as a whole. LAPs should operate within a structured outcomes framework.

· Northamptonshire Police was still reporting crime data based on former local authority ward boundaries and needed to update its processes.

· There were two Community Safety and Engagement officers and a Community Development Officer working in the N4 LAP area. Would there be the same provision in all LAP areas?

· What resources would be available to support LAPs? Voluntary and community sector organisations were already under significant pressure and would find it difficult to accommodate additional demands resulting from LAPs.

· If LAPs would be able to bid for funding then they needed to know how to do so and WNC needed to be ready to respond as an organisation.

· Budgets should not be allocated to individual LAPs until they were seen to be working effectively as collaborative groups.

· How was it intended to use National Lottery funding recently awarded to Northamptonshire?

· All wanted Northamptonshire to benefit from the development of its integrated care system.

· Overview and Scrutiny still needed to identify exactly where it fitted in to the ICN structure.

· LAPs would have a key role in addressing issues such as social isolation and a lack of connectivity.

· All partner organisations needed to be ready to play their part in delivering the 10 ICN ambitions. For example, housing was a significant factor that could affect health and housing services needed to be ready to respond to local issues.

· The number of board and partnerships within ICN could result in confusion, particularly given there were some reporting lines to the Health and Wellbeing Board and some to WNC. There should be a single overarching element. Remaining cultural silos within ICN also needed to be addressed.

The Cabinet Member for Adult Care, Wellbeing and Health Integration made the following additional points during the course of discussion:

· The pioneer LAPs were intended to continue on a permanent basis. A methodical approach was being taken to establishing other LAPs and it was hoped that all would have met for the first time by March 2023.

· The councillors involved in the pioneer LAPs were very enthusiastic as the activity had a local focus.

· The pioneer LAPS had started with the involvement of local councillors based on political proportionality. They were currently being chaired by the Executive Director People Services or the Delivery Director Health and Care Integration, but this could change in future.

· Some aspects of the funding for LAPs were still being considered. National Lottery funding received by Northamptonshire would be split between the West and the North.

· Northamptonshire was setting the pace nationally with the development of its integrated care system.

· LAPs should have some autonomy in their development. Local focus was their strength and LAPs should be able to identify local issues and make a case for resources to address them. Different LAPs would inevitably have different priorities relating to the areas that they covered.

· The ICN outcomes framework should provide a common structure for the operation of LAPs.

· The pioneer LAPs would assist in identifying questions about the resources available for LAPs and how they would be accessed in practice.

· Social isolation and connectivity were issues identified in the ICN Strategy. An emerging issue for the DSN4 Lap was the need for a local service hub rather than residents having to go to Northampton.

· The Executive Director People Services was looking to have co-located teams in local areas as part of ensuring that WNC was in a position to contribute effectively to delivering the ICN Strategy.

· There were still examples of silos that needed to be addressed, such as better working between health and social care. This was a cultural issue that would take time to resolve, but ICN would assist in doing so.