Agenda item

4.1  Members gave consideration to a briefing paper NEL Integrated Care Strategy development.

4.2  The Chair stated that this was discussed at the previous meeting and this would be a further update and the full document was about to be submitted to NHSE.

4.3  The Chair welcomed for the item:

  Zina Etheridge (ZE), Chief Executive Officer, NHS NEL

  Hilary Ross (HR), Director of Strategy, NHS NEL

  Breeda McManus (BM), Chief Nurse and Director of Governance, Homerton Healthcare

  Diane Jones (DJ), Chief Nursing Officer, NHS NEL

4.4  ZE and HR took Members through the paper.  It was noted that there had been systems wide workshops to develop the content and it had involved all the health and wellbeing partnerships. Recognising the backdrop of the cost of living crisis was going to be key as there will be a need to focus on the rising impact of poverty. The Strategy sets out a context and case for change, lays down priorities for system action and it puts together more measurable outcomes which will be tracked.  There are 6 themes: Health inequalities; focus on prevention and early intervention; more holistic, personalised and trauma informed care; co-production with local people and partners; working towards a high trust environment across the system and  working as a learning system.  It will provide a clear direction for the funding planning round and the local response to the 5 year National Plan. They would also be planning a ‘Big Conversation’ with residents and stakeholders to highlight it further.

4.5  The Chair asked whether there is an underlying dataset which can form the basis of future comparisons. HR replied that they had not completed work on the KPIs to be used. The work is based on a number of datasets. She added that they have a Population Health Profile across NEL which gives a good picture on prevalence and wider determinants.  They are building on use of indicators for items they already have data on so that outcomes can be carefully tracked. The Chair asked at what point will they lock down a dataset against which they can judge performance and HR explained that a mix of longer term outcomes and shorter term metrics will be built into the forward plan and there will be close clinical input to this.

4.6  Cllr Sweden asked whether there are implications for a re allocation of resources and what those might be. HR replied that the Financial Strategy will say more about how they are going to move resources to focus on prevention and health inequality. ZE added that they will first need to work out how they are to move resources into prevention and the Strategy is aiming to do this.

4.7  Common Councilman Sales asked about the 31% having Long Term Conditions and who defined these. HR explained that LTCs refer to conditions such as cardiovascular disease or COPD or diabetes which, broadly speaking, are not curable. Some are preventable so they focus on how to manage them.  LTCs refer to a generally agreed set of conditions which are ongoing and a GP would diagnose them in the first instance.

4.8  Cllr Adams asked how the Strategy will deal with Staff Retention and the 23% churn rate. HR replied that the focus is on expanding the workforce and on a local employment strategy. ZE described the pressures on the staff over the last three years, in particular the pandemic, and how they are looking at having more seamless career pathways so staff starting in social care can move easily to other posts in care but also in the health system. They are also looking at how to drive up local recruitment and looking at best practice in comparator Trusts.

4.9  Cllr Patrick asked about overseas staff not feeling fully supported/valued. BM described the operation of the Capital Nurses Programme. More was being done to recognise staff’s past experience and to develop better career pathways.  More were now being promoted especially in specialist areas. Housing remained a key challenge. DJ explained how the recruitment process from overseas operates and discussed staff support for foreign staff and encouraging social networking amongst them. She described how overseas recruitment is a national programme and pastoral support for internationally recruited nurses was key.  Building up social networks help them feel connected and rooted. The did not wish to take health care staff from countries with shortages so a balance has to be struck. ZE replied that it was preferable to retain the staff they’ve got than rely on recruitment. She added it was really important too that foreign nurses feel valued. 

4.10  Cllr McAlmont asked if we were depleting the health systems of less developed countries by our recruitment drives. DJ replied that under the programme there were only certain countries they could recruit from.  She added that they cannot recruit from countries where there is shortage and an international agreement has to be in place. The Key Worker programme was in place to support and welcome nurses.  On housing it varied, many wanted to stay together and they supported them to secure affordable accommodation.

4.11  The Chair thanked ZE and HR for the briefing and added that it was good to see that it was now a much more fleshed out document. He asked if the final submitted version could be shared with members.

ACTION:

NHS NEL CE to provide Members with a copy or link to the final version of the NEL Integrated Care Strategy.