Meeting documents

To receive the update.

The Somerset Health and Wellbeing Board noted the update.

James Rimmer, Chief Executive-NHS Somerset CCG and System Lead, advised that the 2022 Health and Care Act had been formally approved, meaning that the CCG will close on 30^th June and the ICB (Integrated Care Board), supported by the ICP (Integrated Care Partnership), will commence on 1^st July.  The ICB and ICP together form the ICS (the Integrated Care System).  The ICB which will have a close working relationship with the Health and Wellbeing Board, meaning that the next HWBB meeting will occur in that context.  Everything is currently on track for the closure of the CCG and establishment of the ICB; James Rimmer himself will be leaving and other changes will also occur.

Prof Trudi Grant, Director of Public Health in Somerset, observed that the important work being done is centred on the guidance relating to the ICP sitting alongside the Somerset HWBB in a one-on-one formation, and the responsibilities for each must be worked out.  In order to do this, a workshop was held and new guidance has since been issued; the HWBB needs to transform into a system-wide, multi-agency leadership Board that runs in parallel with the ICB.  It will be seen how the first few months go, beginning 1^st July, then it will be assessed.

Paul von der Heyde, Somerset ICS Chair and Chair Designate for NHS Somerset ICB, noted that the ICB has now confirmed all of the non-executive directors and all but one the executive directors, and there will be a sign-off meeting with the Regional NHS team shortly.  With regard to the ICP, he will be meeting with the HWBB Chair very soon.  He took the opportunity to thank James Rimmer for all of his work.

The Board then discussed the presentation.  It was asked if the intention was to develop the Integrated Care Partnership as a separate body like the Safer Somerset Partnership; it was responded that the idea is for the ICP to statutorily develop the Health and Care Plan and oversee delivery of it, although it also needs to take heed of the Joint Strategic Needs Assessment and the Health and Wellbeing Strategy developed by the HWBB, so it will also interact with the HWBB regarding the wider determinants of health.  Both are statutory boards; duplication will be avoided, but they will be working together.  Another member asked what the current status in Somerset is regarding a single body for all of the acute trusts; likewise for the status of the acutes at the moment; and will the ICS be taking over the commissioning regional commissioning of the NHS services.  It was replied that, first, the planned merger between the Somerset Foundation Trust and the Yeovil District Hospital Foundation Trust, which are separate organisations with one executive team serving two boards, is ongoing and they are increasingly working as one; the business case was drawn up last autumn, and the merger will formally take place in the spring of 2023.  Secondly, with respect to operational performance, it remains a challenge but is improving.  The NHS has established "Opal Systems Operational Performance Escalation Levels" 1-4 (Level 1 was previously denoted as "green" and Level 4 as "black"); during the past six months, the system was in Level 4, which was extremely challenging due to Covid.  The recurrence in the form of Omicron put some of the recovery plans on hold, but Opal level 3 was seen last week for the first time.  The situation remains challenging, but they are working closely with social care, where their colleagues have been doing an incredible job both on the front line and in the planning aspects; they have a plan and a real trajectory working in parallel.  Primary care remains challenging, but there has been innovation, including a new model in Minehead.  As far as the recovery programme goes, there has been a return to elective work but long waits are the longest they have ever been across the NHS and also Somerset; two-year waits are coming down, which they hope to reduce to 400,000 by the end of the year.  As to the third point regarding specialised and regional commissioning, this is currently a transition year for the NHS; at the moment in Somerset, primary care GP commissioning is being done, with pharmacy, optometry and dental to come into the system in April 2023.  More rare, specialised (tertiary) commissioning which was normally commissioned out will also come in.  The plans are still being worked through nationally, but some local and specialised commissioning will be either at the regional or national level, depending on the service.  It was added that, because the South West has a series of smaller systems, there has been collaborative work on the plan, which is progressing well. 

The Somerset Health and Wellbeing Board noted the update.