Agenda item

RESOLVED: That Cabinet;

A.    Noted the progress toward establishing the Integrated Care System and the further work required to describe how the ICS will operate at a Council and neighbourhood level.

B.    Delegated to the Executive Director for Adults, Communities and Wellbeing in consultation with the Cabinet member for Adult Social Care and Public Health the decision whether to modify the adult social care TOM contract (with Newton Europe).

C.    Recommended to Council the approval of one-off revenue funding of up to £1m to be agreed from general fund balances to contribute to the iCAN programme, subject to satisfactory evidence of a likelihood of a positive return on the investment.

D.    Delegated to the Executive Director of Adults, Communities and Wellbeing, in consultation with his Portfolio Holder the Executive Director of Finance (S151 officer), and the Portfolio holder for Finance the power to determine whether there is satisfactory evidence of a likelihood of a return on the investment.

E.    Noted that the iCAN funding will be included within the Better Care Fund section 75 and that this will be reported to and governed through the West Northamptonshire Health and Wellbeing Board.

F.    Agreed that quarterly updates of this report would be presented to Cabinet.

REASONS

A.    To respond to national guidance and requirements including the white paper Integration and innovation: working together to improve health and social care for all (Feb 21) and the formation of the ICS (integrated care system) since April 2021.

B.    To support the realisation of benefits across health and social care to achieve improved outcomes for residents, reduced operating costs and to reduce reliance on acute hospital care

C.    To utilise health funding to support the joint objectives outlined

D.    To progress the proposed changes before the winter of 2021 in order to secure early benefits and changes in ways of working ahead of anticipated high demand in hospitals and risk of poorer outcomes. This will minimise the risks and uncertainty of both demand and costs that are predicted for winter 2021.

E.    To further enable the integration of Adult Social Care and Health

ALTERNATIVE OPTIONS:

A.    Health partners have requested that the Council support the commissioning of the system partner for iCAN. The rationale for this decision is based upon

                 i.                         the strong working relationships between the Council and health partners,

                ii.                         the Councils proven track record in taking forward a similar approach in its implementation of the Adult Social Care TOM

              iii.                         the need to act before winter 2021 to secure the capacity and change and current pressure on health resources to support this themselves

              iv.                         the financial advantages of the Council hosting the arrangements

B.    The local system knows what needs to change and the opportunities available.  However, unless we have the right capacity, with the right skills and experience to help us design new ways of working, based on evidence, we will be unable to implement the required changes sustainably at pace and scale.  The consequential impact for the system of not providing the required capacity will be that at some point the demand for service will become greater than the capacity available.

CONFLICT OF INTERESTS DECLARED AND DISPENSATIONS GRANTED: None.

At the Chairman’s invitation Councillor Golby presented the report, copies of which had been previously circulated. Councillor Golby presented the aims and outcomes and advised one key hope was to bring services together at a neighbourhood level. It was advised that there had been a significant population increase in the county that was expected to continue, there was a steady increase in the number of residents aged 65 and over. There had been a rise in the number of mental health cases. ICAN would be of benefit here as its role would be to work within the community and to support the community. The ICAN programme would improve outcomes and reduce costs and would report through the Northamptonshire Health and Wellbeing Board.

Councillor Nunn agreed with the suggestion of a member briefing in order to give an update on this programme.

Councillors made the following comments.

·       Concern was raised regarding how the Council would deliver what was discussed in the report.

·       The problem of bed-blocking was noted as well as the lack of care packages in place for patients when needed.

·       It was asked if there was a difference in the time taken to provide care packages if the care was self-funded. It seemed that the process would take longer if conducted by the local authority.

·       It was noted that mental health in schools was a concern.

·       With regards to the potential savings that would be made, would the Council benefit from these or would it be the Council’s partners.

·       It was suggested a formal update be presented to Council in early 2022 in order to gauge how far the project had progressed.

Stuart Lackenby made the following comments.

·       The importance of best practice was noted.

·       It was advised that accurate costs would be hard to discuss at present.

·       Further work would be required to find where savings would come from.

·       ICAN had been the first project that had been created through a partnership.

·       Any modifications to contracts would be a last resort.

The Chief Executive advised that ICAN had gone through the Peoples advisory group which had given good feedback.

The Chair of the Scrutiny Committee Rosie Herring made the following comments.

·       It had been disappointing to hear that a 3^rd party was involved in the project.

·       An in-depth look into what the contract was producing would be helpful.

·       She would like to see a working group with a focus on safeguarding.

·       With regards to the risk register, it was questioned whether there could be an impact from the new Social Care Act.

Councillor Golby noted that an update would be presented to Cabinet on a quarterly basis.

RESOLVED: That Cabinet;

1. Noted the progress toward establishing the Integrated Care System and the further work required to describe how the ICS will operate at a Council and neighbourhood level.
2. Delegated to the Executive Director for Adults, Communities and Wellbeing in consultation with the Cabinet member for Adult Social Care and Public Health the decision whether to modify the adult social care TOM contract (with Newton Europe).
3.  Recommended to Council the approval of one-off revenue funding of up to £1m to be agreed from general fund balances to contribute to the iCAN programme, subject to satisfactory evidence of a likelihood of a positive return on the investment.
4. Delegated to the Executive Director of Adults, Communities and Wellbeing, in consultation with his Portfolio Holder the Executive Director of Finance (S151 officer), and the Portfolio holder for
5. Financed the power to determine whether there is satisfactory evidence of a likelihood of a return on the investment.

F.      that the iCAN funding will be included within the Better Care Fund section 75 and that this will be reported to and government through the West Northamptonshire Health and Wellbeing Board