The Committee gave consideration to a report jointly written by the Director of Adults (Social Care) Trafford Council, the Programme Director Health and Care Trafford Council and Trafford Clinical Commissioning Group (CCG), the Director of Commissioning Trafford Council, the Managing Director Trafford Local Care Organisation, the Joint Accountable Officer Trafford CCG and the Corporate Director for Adults Trafford Council.
The report sought to provide an update on the latest developments since the launch of Trafford Together Locality Plan: the blueprint for the transformation of health and social care over the next five years which also incorporated the NHS 10 year plan.
Trafford Together Locality Plan had been brought to the attention of this Committee in November 2019. Since then, Covid-19 pandemic had caused the pause of the original delivery plan. However, following the introduction of the White Paper, “Working Together to Improve Health and Social Care for all” 2021, the plan had been resumed and reviewed in light of the creation of the statutory Integrated Care Systems (ICS) across England and the disestablishment of the CCGs by April 2022.
The Committee requested this item on today’s agenda to be informed of the imminent changes to the planning and delivery of health and social care services in Trafford, what they meant for residents and how they could help to address the existing health inequalities in the population.
The Executive Members for Adult Social Care and Health, Wellbeing and Equalities, the Joint Accountable Officer, the Corporate Director for Adults and the Programme Director Health and Care were in attendance to present the information and address the questions of the Committee.
Officers informed members of the pivotal points of the plan such as the “culture of collaboration” across social care, health, voluntary sector, Trafford Local Care Organisation (TLCO) and Primary Care network which underpinned the multi-disciplinary neighbourhood working model. This meant that Trafford was divided into four geographical areas. In each area, partner organisations would work together to achieve and improve the health outcomes for the residents, maximising the use of local resources. This model also drew from the positive experience of the Community Hubs during the pandemic.
The development of some of the work strands included in the plan, such as the hospital discharge process and the digital solutions, would be a joint work with the other local authorities in Greater Manchester.
Officers presented the other key points in the plan such as the strategic lead of the One System Board, the Collaborative Provider and the Practitioners Leadership. Officers were confident that the transition from CCG to ICS would be completed by April 2022.
Members asked whether the new ICS would resolve the issue that Trafford residents often experienced to access secondary care in Trafford if their G.P. was based in Manchester. Officers explained that, although the G.P. registration system would not change with the implementation of the ICS, a greater collaboration amongst primary and secondary care providers would assist with this matter.
Members sought and received reassurance that the transition from CCG to ICS would be seamless and residents would not experience any interruption in the healthcare service they required.
Members asked about the communication strategy for ICS and how the progress in its implementation would be shared with residents. Members also noted that the wider Council’s membership would need to be informed of the refreshed strategy for the Locality Plans and the introduction of a statutory ICS.
Members stressed their interest in accessing the Elected Members’ performance dashboard to measure progress against the Locality Plan aspirations and health and social care targets. Officers reassured them that these would be made available in due course. Other performance dashboards were already available on line and brought to the Executive on a quarterly basis and to the One System Board on a monthly basis. Members said that they would find particularly helpful a performance dashboard that put together data concerning neighbourhoods and health inequalities.
Members sought and received reassurance that the IT systems would be upgraded to be able to support the transition from CCG to ICS.
The Executive Member for Adult Social Care noted that this was a complex piece of work and a simpler way to communicate its development and implementation was one of the items on the agenda of the next meeting of the Association of Directors of Adult Social Care Services (ADASS) at the end of July. The Executive Member offered to share with the Committee the content of the ADASS’ presentation on ICS once this was available.
Members asked whether this plan would be successful, considering previous trials of integration of health and social care. Officers reminded members that ICS was an evolution of existing partnerships whose work was outcome focused and featured providers’ leadership across the four neighbourhoods.
Members asked for a concrete example of how the ICS would help to tackle health inequalities. Officers referred to the methods implemented to communicate the importance of vaccination against Covid-19 in certain areas of Trafford where vaccination hesitancy was high. These methods relied on targeted intervention through a system approach where professionals from different agencies worked with community leaders. The focus was on community engagement work supported by information for health and social care staff on the importance of the vaccination. The outcome was the increase in the vaccination uptake in the targeted areas. The same method could be applied to issues such as obesity, sharing GP data across organisations to implement a system approach to tackle the problem.
1. That the content of the report be noted;
2. That the Locality Plan Refresh be made available to the Committee with more information on how to access the performance dashboards to measure progress against the Locality Plan aspirations and health and social care targets (i.e.: health inequalities and neighbourhood data);
3. That a briefing on the Locality Plan Refresh and the Integrated Care System be delivered to all Members of the Council.