Minutes from the Integrated Care System Board,  2 September 2020

The role of the Integrated Care System (ICS) Board is to provide leadership and development of the overarching Lancashire and South Cumbria ICS strategy, oversight and facilitation of delivery of sustainability, transformation and design of the future state of health and care. The meeting was chaired by Isla Wilson, Non-Executive Director.

Key messages

1.    Phase 3 planning submission

At the end of April 2020, NHS England and NHS Improvement set out national expectations for moving the NHS back towards business as usual following the COVID-19 pandemic with priorities for action across a number of service areas. The guidance set out the four phases of an NHS COVID-19 Restoration and Recovery Plan:

• Phase 1 - Management of COVID-19 demand and impact
• Phase 2 – Restoration (June 2020 to August 2020) - re-establishing essential services in a safe way for patients, staff and the public
• Phase 3 – Recovery (August 2020 to March 2021)
• Phase 4 - A New NHS (April 2021 and beyond).

Members of the ICS Board have been updated each month on the Phase 2 restoration work led by the Hospital and Out of Hospital cells.

The ICS Board received an update on the draft submission of the Lancashire and South Cumbria ICS Phase 3 plan, setting out what we have been able to do within the time constraints; how we are managing the risks arising from what we haven’t been able to do; and what we intend to do next as a system to finalise recovery plans for the rest of 2020/21. It is important to note that recovery plans are at an early stage and need further refinement.

2.    System Reform

The ICS Board received a paper for discussion and decision to confirm the expectation placed on each ICS in the Phase 3 planning guidance to set out a System Reform Implementation plan. In doing so, the paper summarises a number of the key activities taking place now in relation to system reform across Lancashire and South Cumbria.

The ICS Board endorsed the role of the System Leaders Executive in overseeing the System Reform Implementation plan by the beginning of October 2020. The Board endorsed a proposal for collaboration on ICP development. This includes the creation of an ICP Development Advisory Group to ensure the programme of work is delivered. It was noted that proposals for Provider collaboration for Acute Hospitals and Mental Health services will be included in the System Reform implementation plan. The ICS Board agreed to request that CCGs agree a timeline for the key stages of a commissioning reform process which can be included in the System Reform Implementation plan.

3.    Population Health Management

The ICS Board discussed the systematic population health management approach to develop a truly system approach to delivering proactive, anticipatory care focussing on high demand, high need and high morbidity. It sets out how ‘Civic’, ‘Service’ and ‘Community’ interventions can work together in a synchronised way to strengthen existing action and maximise assets and resources at place level. The Board were made aware of the immediate priority for targeting comprehensive support toward vulnerable groups, which have been agreed by Directors of Public Health, and to reduce the impact of health inequalities to help the system respond to challenges around COVID-19 and winter pressures.

4.    People Plan

ICS Board members discussed a proposed approach to implementing the NHS People Plan in Lancashire and South Cumbria. The national plan focuses on how we must look after each other and foster a culture of inclusion and belonging, as well as action to grow and train our workforce, and work together differently to deliver patient care.

The discussion focused on what the ICS is doing in these areas as a system and how it aims to meet the actions in the People Plan for the NHS, acknowledging that as a system our remit will be broader, including primary care, social care, VCFSE and other relevant partners.

5.    Voluntary, Community, Faith and Social Enterprise Sector Update

The Independent Chair for the Lancashire and South Cumbria Voluntary, Community and Faith Sector Alliance, Peter Armer, provided an update to the ICS Board with the following key messages:

• The VCFSE Alliance comprises of chairs of VCFSE networks in each ICP which has an accepted and agreed VCFSE vision for Lancashire and South Cumbria.
• Discussions are being held with ICP Programme Directors to develop proposals for sufficient involvement and funding for VCFSE Leaders within ICPs, thereby reducing reliance on goodwill from their "home" organisations. 
• The Alliance is working with Lancashire and South Cumbria NHS Foundation Trust to identify opportunities for greater VCFSE involvement by looking at three areas; the frequent attenders scheme, the peer support workers and the service user and carer council.

6.    Finance Reports

The ICS Board noted Finance reports which included the month 4 financial performance for the Lancashire and South Cumbria system in the context of the current finance regime and the response to COVID-19. It covers the revenue and capital positions of all Lancashire and South Cumbria partners and the position on ICS central functions. The ICS Board also approved a revised scheme of delegation for the ICS Central Function to ensure appropriate management of ICS income and expenditure budgets.

The ICS Board also received a number of items for information including COVID-19 Cell Logs, High Level COVID-19 Risk Register, ICS Programme Summary Report and CQC Lancashire and South Cumbria Provider Collaboration Review Feedback.