To consider the attached presentation.
The Health and Social Care Programme Director gave an overview of the update on behalf of Joint Accountable Officer for Trafford CCG. The paper provided gave a detailed update, which presented the readiness assessment for Trafford as a locality and what would be in place from day one. The report also covered all the work done to close Trafford CCG. The Health and Social Care Programme Director then picked out the key points from the paper about how the readiness assessment was completed and the core components needed for the Trafford Locality to be effective on day one.
The Health and Social Care Programme Director stated that Trafford were in the best possible place given the uncertainty from Greater Manchester and the lateness in some of the decision making. The six teams of the CCG were due to transfer over on the 1st of July with the senior leadership team continuing to provide leadership for those teams. In addition, a number of shadow governance arrangements would come into effect with Terms of Reference having been agreed.
The local governance arrangements were in place with the Provider Collaborative Board, the Trafford Clinical and Practitioner Senate, and the Locality Board (which sat across the other Boards) all up and running. Those Boards were the key components Trafford needed in place for the new Trafford Integrated Care Partnership to be established and the structure was depicted within the report in the governance diagram. The report also contained information on how the six teams from Trafford CCG would move into the new system and be under the leadership of the Place Based Leader, which was to be the Council’s Chief Executive. The process of appointing the Deputy Place Base Leader was still underway and it was hoped that would be concluded by the end of the following week.
One of the main positives for Trafford was that the Locality Board had been in place for over 12 months and been a driving force throughout the transformation process. A revised terms of reference were to be taken to the July board to update the roles responsibilities and format of the Locality Board. Eventually the Locality Board would become responsible for the Trafford CCG and Trafford Council's section 75 agreements with sufficient co-chairing arrangements in place. The balance between local government and the NHS was pivotal and needed to be reflected in the new chairing arrangements. A workgroup was considering different options and the outcome of that work would be presented to the Locality Board for agreement.
The Health and Social Care Programme Director then detailed the other key elements from the report, which included the work on developing a resilient discharge to assess program and neighbourhood model. The Committee were assured that work was ongoing around holding the new Integrated Health and Care System accountable through system metrics and the identification of outcomes to be achieved. Clinical and care professional leadership would be provided by the Clinical and Practitioner Senate, which was up and running. A draft work plan had been aligned to the work of the Provider Collaborative Board to ensure the right people, organisations, clinicians, and practitioners were assigned to deliver the priorities set and to make sure clinical and practitioner insight is embedded throughout the planning design and delivery of Trafford services across health and social care.
The Trafford GP board had been established which represented a good step forward for primary care in Trafford. The Neighbourhood Program was a key component in connecting the clinical and professional bodies with the VCSE sector and the Living Well in My Community Forum was driving that work forward. The Health and Wellbeing Board was being reviewed to make sure it had a focus on tackling inequalities.
The Health and Social Care Programme Director stated that Trafford’s digital leadership had helped the area have an influential voice within Greater Manchester and the joint arrangements with Manchester had been a positive development for Trafford given the footprint of MFT and the Local Care Organisation. The Health and Social Care Programme Director concluded by stating that the next year would be a year of transformation where the Trafford system would come together. The governance arrangements, partnerships, and relationships that had been set in place would enable Trafford to make the best of the opportunities the Integrated Health and Care System offered.
The interim Chief Finance Officer for Trafford CCG updated the Committee on the close program. A robust due diligence process using the national checklist had been undertaken and the results had gone the Governing Body in May. External assurance had been provided on the process by Mersey Internal Audit Agency and the legal firm supporting Greater Manchester partnership. The due diligence work had continued into June as there were items that would remain open until the 30th of June and would then be transferred to the Integrated Care Board. During the week the strategic and corporate risks from the CCG were to be submitted to the Integrated Care Board.
Following the overview Councillor Gilbert asked about the potential impact on patients and whether they would have a seamless experience. The Health and Social Care Programme Director responded that patients should not see a difference from day one, but there would be a large amount of transformational work undertaken in the following months and years which would impact their experience.
Councillor Acton asked what was being done to ensure the workforce were onboard with the reorganisation. The Health and Social Care Programme Director responded that it had been a difficult time for the workforce and that would no doubt continue as more transformation was undertaken. There was a clear supportive program in place at a Greater Manchester level to keep all colleagues connected and informed. A series of webinars had been held through a centralised program in Greater Manchester which had received positive feedback. Locally Trafford CCG had sent out many communications, which included regular kitchen briefings, newsletters, and detailed supervision between different teams, directorates etc. The Interim Chief Finance Officer for Trafford CCG added that the CCG had been holding weekly briefings to all the staff and any information received from GM had been shared with the staff to ensure they were kept as up to date as possible.
Councillor Taylor asked whether there were any lay people involved with Provider Collaborative Board. The Health and Social Care Programme Director answered that the Provider Collaborative Board had evolved from the Trafford Local Care Alliance. The Provider Collaborative Board was made up of partners from across the health and social care system and did have representation from Healthwatch Trafford, but no other lay members. The Committee were informed that the terms of reference and membership of the Board would be reviewed in due course and that would be something to consider.
The Chair of Healthwatch Trafford confirmed that they had been welcomed by Trafford CCG and the Local Authority to be part of the re-organisation process. Healthwatch Trafford had sat on all the main boards over the past 15 months, so the public was represented. Healthwatch Trafford also submitted reports regularly to the boards and informed them of the public's concerns. The Chair of Healthwatch Trafford stated that everybody involved in the programme should be congratulated for how effectively it had been carried out.
Councillor Hartley asked a question about conflicts of interest and whether the transition reduced the potential for conflicts of interest or worsened it. The Health and Social Care Programme Director responded that external legal advice had been sought to ensure the terms of reference and delegation of powers reduced conflicts of interest as much as possible. The Health and Social Care Programme Director added that the arrangements in place would not cause any conflicts of interest beyond what was experienced with clinical commissioning groups and assured the Committee that plans would be put in place for all eventualities.
The Chair asked whether anybody had compared the number of bodies being set up in the new structure to the number in the outgoing system. The Health and Social Care Programme Director responded that some of the Boards currently in place were to deliver the transition to the new system. A review would be conducted once the Integrated Care System was up and running to ensure all Boards were working efficiently and were adding value to the system. The Health and Social Care Programme Director added that the governance of the Integrated Care System would remain flexible to enable it to be reshaped to meet the needs of the system.
The Chair asked whether the Interim Chief Finance Officer for Trafford CCG could provide assurance that the outstanding items of due diligence were not potential “deal breakers”. The Interim Chief Finance Officer for Trafford CCG responded that the remaining items were things like freedom of information requests that could be received up until the 30th of June. Everything that could be done prior to the 30th of June had been completed and the items that required action after that date would be handed over to the Integrated Care System. All items were captured on the checklist and the information was readily available if anybody required it.
The Chair’s final question was whether the officers still had any major concerns or whether they felt everything was in as good a shape as could be expected. The Health and Social Care Programme Director responded that he thought Trafford were in the best possible position. There had been a slight delay in the appointment of the Delivery Lead, but he did not think Trafford were alone in being in that position.
RESOLVED: That the report be noted.