Children and Families Overview and Scrutiny Committee

Date of Meeting:	23 September 2019

Report Title:	Cheshire East Partnership Five Year Plan

Portfolio Holder:	Cllr Dorothy Flude, Portfolio Holder Children and Families

Senior Officer:	Mark Palethorpe, Acting Executive Director of People

Report Summary

NHS England requires each Sustainability and Transformation Partnership area (now known as Health and Care Partnerships) to prepare Five Year Strategies, as their response to the NHS England Long Term Plan (published January 2019). The Cheshire and Merseyside Health and Care Partnership (C&MH&CP) has started work on its Strategy and, to inform this, has asked that each of the nine ‘Place based’ health and care partnerships in Cheshire and Merseyside (aligned to the local authority geographies) develop their own Five Year Plans.

The draft Cheshire East Partnership Five Year Plan has been shared with residents and staff through an engagement exercise over the summer (1st August to 23rd August). The draft Plan had to be submitted to the C&MH&CP at the end of August. It is now necessary for a final, post-engagement version of the Plan to be prepared for endorsement by the Health and Wellbeing Board, Cabinet and other partner organisation’s governing bodies. To inform this, the draft Plan is brought to the Scrutiny Committee for comment and feedback.

The draft Plan is attached as Appendix One, together with a Technical Appendix (Appendix Two and a summary of the engagement feedback (Appendix Three). It sets out the vision of the Partnership (made up of the Local Authority, the Clinical Commissioning Groups, NHS Providers, the local GPs – and through the Health and Wellbeing Board, the Police and Fire and Rescue Service, the community and voluntary sector, NHS England and Healthwatch). This vision is to improve the health and wellbeing of local communities, enabling people to live longer and healthier lives. We will do this by creating and delivering safe, integrated and sustainable services that meet people’s needs by the best use of all the assets and resources we have available to us. Wellbeing comes from everyone taking ownership of what they can do for themselves and their community, with support available and focussed when and where it is needed.

Recommendations

That the Children and Families Overview and Scrutiny Committee consider and comment upon the draft Cheshire East Partnership Five Year Plan.

Reasons for Recommendations

To ensure the draft Cheshire East Partnership Five Year Plan is considered by the Scrutiny Committee to inform the revision of the Plan, in advance of its endorsement by the Council as a key partner in leading the transformation of health and care in Cheshire East.

To allow the timely submission of the Cheshire East Partnership Five Year Plan to the Cheshire and Merseyside Health and Care Partnership to meet their requirements that all Places submit Plans by October/November 2019.

Other Options Considered

The Local Authority could have chosen not to engage with the work of the Cheshire East Partnership and the drafting of the Five Year Plan. However, with Health and Social Care Integration a key element of the NHS Long Term Plan and a priority of the Department of Health and Social Care, it is important that we are an active partner in this work to influence discussions and decisions. In focussing on better outcomes for our residents and particularly those in need of health and / or care services, this willingness to be an active partner with health colleagues is a key requirement.

Background

The Sustainability and Transformation Partnerships were formed in 2015/2016 as a result of the NHS England ‘Five Year Plan’s’ aspirations to see closer working across health and care and progress being made towards integrated provision. There was also an imperative to make more effective use of resources across the system. The Cheshire and Merseyside STP was formed in January 2016, a partnership of the twelve clinical commissioning groups, twenty NHS provider organisations (hospitals, community and mental health trusts) and the nine local authorities. The STP was re-branded as the Cheshire & Merseyside Health & Care Partnership in 2017.

The publication of the NHS Long Term Plan in January 2019 has re-emphasised the importance of these Partnerships in the NHS future plans, with the transition to Integrated Care Systems (ICS) being the aspiration for each regional partnership by 2021. Achieving ICS status will bring additional resource and a level of autonomy for the Partnership in its decision making. The Five Year Strategy is a key element of this, demonstrating that the C&MH&CP has the maturity and ambition to deliver what NHS England expects from the ICS. Similarly the Place-based Five Year Plans need to show that there is a common vision for the provision of health and care services within that area, with a good understanding of the local challenges, a commitment from local partners to work together and clarity in relation to what needs to be delivered.

The Cheshire and Merseyside Health and Care Partnership (and its equivalents elsewhere in the country) and local place-based health and care partnerships are seen by NHS England as a pragmatic way to join up planning and service delivery across primary and specialist care, physical and mental health and health and social care.

With regard to the Cheshire East Partnership Five Year Plan, the draft Plan was shared with the public from 1st to 23rd August and submitted (as a draft) to the C&MH&CP at the end of August. A revised Plan that incorporates changes initiated through the engagement process has now to be taken through the governing bodies of the Partners for endorsement. The final endorsed version will be submitted to the Cheshire and Merseyside Health and Care Partnership by the end of October.

The Cheshire East Partnership Plan sets out the vision of the Partnership (made up of the Local Authority, the Clinical Commissioning Groups, NHS Providers, local GPs – and through the Health and Wellbeing Board, the Police and Fire and Rescue Service, the community and voluntary sector, NHS England and Healthwatch). This is to improve the health and wellbeing of local communities, enabling people to live longer and healthier lives. We will do this by creating and delivering safe, integrated and sustainable services that meet people’s needs by the best use of all the assets and resources we have available to us. Wellbeing comes from everyone taking ownership of what they can do for themselves and their community, with support available and focussed when and where it’s needed.

The focus of the Partnership is upon:

Tackling inequalities, the wider causes of ill-health and the need for social care support through an integrated approach to reducing poverty, isolation, housing problems and debt;

5.6.2 Prevention of ill health through early intervention, health improvement and creating environments that support and enable people to live healthily;

5.6.3 Ensuring our actions are centred on the individual, their goals, the communities in which they live and supporting people to help themselves;

5.6.4 Having shared planning and decision making with our residents.

The key outcomes that the Partnership through the Plan aspires to achieve are:

5.7.1 To create a place that supports health and wellbeing for everyone living in Cheshire East;

5.7.2 To improve the mental health and wellbeing of people living and working in Cheshire East;

5.7.3 To enable more people to live well for longer in Cheshire East;

5.7.4 To ensure that children and young people are happy and experience good physical and mental health and wellbeing.

Implications of the Recommendations

Legal Implications

Cheshire East is a member of C&MH&CP which has asked each of the nine ‘place based’ health and care partnerships (of which Cheshire East is one) to develop their own Five Year Plans, to inform its Strategy in response to the requirements set by NHS England in its Long Term Plan published in January 2019, for each Sustainability and Transformation Partnership area to prepare Five Year Strategies. It should be noted that the Council has not at this stage, signed the Cheshire East Partnership’s Memorandum of Understanding, because of concerns regarding the different funding streams that the NHS and the Authority draw upon.

There is no formal requirement to consult on the contents of the Cheshire East Place Partnership Plan at this stage but there has been a period of public engagement, which has taken place over the summer 2019.

The Governing Bodies of the Partner organisations of the Cheshire East Place Partnership are being asked to endorse the Plan.

Partnership organisations have had due regard to the Public Sector Equality Duty contained in Section 149 of the Equality Act 2010 when exercising relevant functions.

Any proposed Service changes that may be developed as part of the ongoing work to implement the Partnership Plan will be subject to the appropriate formal consultation and consideration by the Health and Adult Social Care and Communities Scrutiny Committee and individual agency governance arrangements.

There is an explicit expectation from NHS England that NHS partners deliver on the Long Term Plan (see section 9).

Finance Implications

There are no financial implications for the Council at this point. However, if these implications emerge, then formal approval will be sought prior to any agreements being signed off. The level of financial challenge within the NHS in Cheshire East is significant and the Council will be closely monitoring the potential risks to its Medium Term Financial Strategy that might emerge as the work to implement the Plan gets underway.

Policy Implications

The delivery of the Plan will significantly contribute to the Council’s six Priority Outcomes.

Equality Implications

The Plan recognises the disparities in health and wellbeing that are identified through the Joint Strategic Needs Assessment and includes a focus upon reducing inequalities.

Human Resources Implications

In relation to the endorsement of the Plan there are no specific HR implications. In the short term there will be closer working between health and care staff and joint commissioning of services. In due course, as the Plan implementation gets under way there may be integration of health and care staff proposals that are put forward and these will be managed in accordance with appropriate HR guidance and protocols.

Risk Management Implications

The Place Programme Management Office maintains a Risk Log for the transformation programme and will monitor progress made against the Plan’s aspirations. A failure to deliver the work required will raise the risks with regard to the financial and clinical sustainability of the health and care system.

Rural Communities Implications

The work underway to deliver the Plan (including our eight Care Communities), recognises the challenges of providing services within the more rural communities. Closer working between providers, the delivery of more services in the Care Communities and increased use of digital services are some of the ways that will be used to improve accessibility and delivery to the rural populations.

Implications for Children & Young People/Cared for Children

The Cheshire East Partnership is working to transform health and care services for the whole population, from cradle to grave and this is reflected in the Plan. Delivering improvement in health and wellbeing for our children and young people is one of the priority outcomes.

Public Health Implications

There are significant implications for public health with the outcomes of the Plan being intended to deliver improved health and wellbeing outcomes.

Climate Change Implications

6.10.1 A key element within the Plan is to encourage individuals to take responsibility for their own health and wellbeing and lead more healthy lifestyles. Through the promotion of active transport options, (cycling, walking) and thus reduced car usage, there could be beneficial climate impacts. In addition the partners recognise the need for their organisations to be making greater contributions towards reducing their carbon footprints. The NHS Long Term Plan requires all NHS organisations to work towards reducing carbon, waste and water use.

Ward Members Affected

All Wards will be affected.

Consultation & Engagement

Public engagement took place from 1st to 23rd August. It would have been preferable for this to be longer, but the timeline for submission on 30th August made this impossible. The Plan was presented to Overview and Scrutiny Committee on 12th September and has been before the governing bodies of all Partner Organisations. It was endorsed the Health and Wellbeing Board on 24th September.

Access to Information

The NHS Long Term Plan and associated documents can be accessed here https://www.longtermplan.nhs.uk/

A summary of the NHS Long Term Plan is here: https://www.longtermplan.nhs.uk/wp-content/uploads/2019/01/the-nhs-long-term-plan-summary.pdf

Contact Information

Any questions relating to this report should be directed to the following officer:

Name:	Guy Kilminster

Job Title:	Corporate Manager, Health Improvement

Email:	guy.kilminster@cheshireeast.gov.uk