Agenda Item No. 22 Part 1 X Part 2 NHS TRAFFORD CLINICAL COMMISSIONING GROUP GOVERNING BODY Tuesday 29 th April 2014 Title of Report Purpose of the Report Healthier Together Update Minutes of the Healthier Together Committee-in-Common meeting on 19 March 2014 To provide an update on Healthier Together and the Committee-in-Common meeting Actions Requested Decision Discussion Information X Strategic Objectives Supported by the Report Recommendations 1. Consistently achieving local and national quality standards. 2. Delivering an increasing proportion of services from primary care and community services from primary care and community services in an integrated way. 3. Reduce the gap in health outcomes between the most and least deprived communities in Trafford. 4. To be a financial sustainable economy. That the Governing Body note the minutes Discussion history prior to the Governing Body Financial Implications Risk Implications Impact Assessment Communications Issues Public Engagement Summary Prepared by Responsible Director Updates on Healthier Together provided at previous Governing Body meetings As outlined As outlined N/A As outlined As outlined Dr Nigel Guest, Chief Clinical Officer Dr Nigel Guest, Chief Clinical Officer
Shared Minutes of the Healthier Together Committees in Common Date of meeting: 19 March 2014 Date of paper: 09.04.2014 Subject: Healthier Together Committees in Common Decision / Opinion Required: For approval Author of paper and contact details: Minutes of Committees in Common Meeting Held in Public held on 19 March 2014 Purpose of paper: For record of the Shared Minutes of the Healthier Together Committees in Common meeting held on 19 March 2014. The item has been discussed previously at these meetings: n/a
Title Author Minutes taken at the meeting of the Greater Manchester CCG Healthier Together Committees in Committee Held in Public Lisa Murch Version 0.1 Target Audience Healthier Together Committees in Common Date Created 23/03/2014 Date of Issue To be Agreed 16/04/2014 Document Status (Draft/Final) Description File name and path Draft Greater Manchester CCG Healthier Together Committees in Common minutes of meeting held in public 19/03/2014 S:\Transformation\SERVTRAN\HealthierTogether\Boards&SubGrps\Committee in Common (HTCiC)\2014 Meetings\03. 19.03.14\2014 03 19 HT CiC Minutes Part A Held in Public.docx Document History: Date Version Author Notes 06/03/2014 0.1 L Murch Draft minutes created 01/04/2014 0.2 L Murch With amendments from A Heritage Approved: 16 th April 2014 Signature: Phil Watson CBE, Chairman
Greater Manchester CCG Healthier Together Committees in Common (HTCiC) Held in Public SHARED MINUTES OF MEETING Wednesday 19 March 2014 Committee Room 1, Manchester Town Hall, Albert Square, Manchester Chair Phil Watson CBE ATTENDANCE Confirm meeting of the 12 Committees of: Bolton CCG Bury CCG Central Manchester CCG Heywood, Middleton & Rochdale CCG North Manchester CCG Oldham CCG Salford CCG South Manchester CCG Stockport CCG Tameside and Glossop CCG Trafford CCG Wigan Borough CCG Other organisations in Attendance: GM Service Transformation North Derbyshire CCG East Lancashire CCG Eastern Cheshire CCG Members in Attendance: Phil Watson CBE Dr Wirin Bhatiani Dr Kiran Patel Dr Michael Eeckelaers Dr Chris Duffy Dr Ian Wilkinson Dr Paul Bishop Dr Bill Tamkin Dr Ranjit Gill Dr Alan Dow Dr Nigel Guest Dr Tim Dalton Ian Williamson Dr Debbie Austin Dr Thomas Mackenzie Jerry Hawker Leila Williams Alex Heritage Chris Brookes Joanne Newton Independent Chair Bolton CCG Bury CCG Central Manchester CCG Heywood, Middleton & Rochdale CCG Oldham CCG Salford CCG South Manchester CCG Stockport CCG Tameside and Glossop CCG Trafford CCG Wigan Borough CCG HT Lead CCG & Chair of the Healthier Together Steering Group North Derbyshire CCG East Lancashire CCG Eastern Cheshire CCG Director, Service Transformation Team Healthier Together Programme Director Medical Director, NHS Greater Manchester Services Transformation & Chair of the Healthier Together Clinical Reference Group Chair of the Healthier Together Finance & Estates Group Page 1
Other Attendees: Laura Foster Martin McEwan Paul Horrocks Lisa Murch Hamish Steadman Rachel Volland Michelle Davies Nicola Onley Members of the Public Ian Barker Associate Director, NHS Greater Manchester Service Transformation Associate Director, NHS Greater Manchester Service Transformation Communications Team, NHS Greater Manchester Service Transformation Portfolio Support Manager, Service Transformation Team Chair of Association of CCGs Governing Group Assistant Director, Service Transformation Team Events Manager, Service Transformation Team Partnership/Engagement Manager, Service Transformation Team Representing Stockport NHS Watch Apologies: Dr Martin Whiting Steven Pleasant Geoff Little Dr Andrew Davies Dr Raj Patel Sophie Hargreaves North Manchester CCG AGMA (Association of Greater Manchester Authorities) AGMA (Association of Greater Manchester Authorities) Warrington CCG Local Area Team (LAT) Representative Associate Director, NHS Greater Manchester Service Transformation Quorate Requirements: Achieved For a meeting at which no Category 1 decisions will be made, as close to 75% (in terms of whole numbers) of the voting members of the HTCiC are required to be in attendance or able to participate virtually by using video or telephone or web link or other live and uninterrupted conferencing facilities (9 out of the 12 voting members). AGENDA Item Paper/ Verbal Presenter 1. Welcome and Introductions Verbal Chair 1.1 Apologies for Absence Verbal Chair 1.2 Quorum Confirmation Verbal Chair 1.3 Declaration of Interests Verbal Chair 1.4 Opening Remarks Verbal Chair 1.5 Confirmation of Part A Minutes Paper Chair 2. Locality Led Stakeholder and Public Conversation Update Verbal Members 3. Communication & Engagement Plan 4. Healthier Together Health and Adult Social Care Financial Challenge 5. Any Other Business Presentation Paper Verbal Martin McEwan Laura Foster Chair Page 2
Item 6. Open Questions Paper/ Verbal Verbal Presenter Chair Date, Time & Venue of Next Meeting Wednesday 16 April 2014, 2.00 5.00 pm Manchester Town Hall, Albert Square, Manchester, M60 2LA (SatNav Use M60 2LA) http://www.manchester.gov.uk/location MEETING NARRATIVE & OUTCOMES 1. Welcome and Introduction The Chair welcomed all to the Public Meeting of the HTCiC. 1.1 Apologies for Absence Apologies were as recorded above. 1.2 Quorum Confirmation It was noted the meeting was quorate. 1.3 Declaration of Interests It was established that there were no new Declarations of Interest to be recorded for this meeting and members were advised to indicate any interests arising during the course of the meeting immediately. 1.4 Opening Remarks The Chair advised CiC members and the public that Item number 3 three would be by way of a presentation. 1.5 Confirmation of Part A Minutes The minutes of the previous meeting were accepted as a true and accurate record. 2. Locality Led Stakeholder and Public Conversation Update Martin McEwan introduced the item and thanked all the Chief Officers and colleagues in Communications and Engagement as feedback had been received from all but two CCG s in relation to evidence for the assurance process and has provided a good understanding of who is being engaged with and where the gaps still are. When all feedback has been received it will be circulated to all the Chief Officers so that a complete look across the conurbation and where all are up to with engagement of stakeholders and the public. Chris Duffy advised that Heywood, Middleton & Rochdale have held two public events and the number of public events that are being planned has grown, following suggestions from people who have attended events of others groups to engage with. He also added that during the events the public took over and had actually made the case for change themselves. Martin McEwan said this was very positive and reported that engagement activity is ever growing across the conurbation. Page 3
Ian Wilkinson wanted to pass on thanks to the Healthier Together Communications Team for their support at the engagement events in Oldham they were well received. He also wanted to point out that during these sessions the question arose about what it means moving from conversation to consultation. Alan Down advised that Tameside and Glossop took a different approach and had conversations with formed groups. Michael Eeckelaers asked when consultation starts will it be a necessity to have a preferred option. Leila Williams advised it is important to have meaningful discussions around all the possibilities but Martin McEwan will come to that in the next item. ID Type Risk/Issue/Action/Decision/Outcome Description Owner Nil 3. Communication & Engagement Plan Martin McEwan presented Joining In to the CiC members which outlined the concept and highlevel approach for the next phase of engagement with stakeholders and the public. The presentation described how the consultation needed to be aspirational and inspirational and a strength, weakness, opportunities and threats analysis had been undertaken. The aim would be to start with a vision and build up and so far the words best care has been used, this may change. Formal materials would be produced and key message testing was being undertaken and initial feedback was positive. The Next steps will include the development of the creative approach working with CCGs and partners. Tim Dalton said it was good to be reminded why we are here and that all the CCGs were here to make it better for the population and wanted to ensure that the message about saving lives would not be lost when utilising a creative agency. Martin McEwan stated that it would be GPs, Clinicians, patients and community champions that would deliver the message. Chris Duffy asked that consistency remained when developing new material in terms of the Healthier Together logo and style. Debbie Austin commented that the wording around better access to GPs may set the wrong expectations. The Chair thanked Martin McEwan for the presentation. ID Type Risk/Issue/Action/Decision/Outcome Description Owner Nil 4. Healthier Together Health and Adult Social Care Financial Challenge Laura Foster introduced the item. The first step was identifying the scale of the financial challenge that Greater Manchester faces; and it has been undertaken at that level and the numbers have been validated by Deloittes. The Healthier Together financial challenge which is based on a set of planning assumptions that was agreed across the CCG s is, 742Million over the next five years. Local Authority partners have also been liaised with to identify the Adult Social Care challenge. Page 4
This challenge financially cannot be met by doing the same thing and shaving off costs so the financial case for change supports the clinical case for change in that working differently is the only way. Part of the financial analysis would be to identify the level of contribution that Healthier Together would make to towards the scale of the financial challenge. The problem with numbers is they are based on assumptions, and assumptions move and different views of assumptions follow so the paper sets out consistent assumptions that takes the overarching GM challenge and divides this out across localities to give a number to link the case for change to for each individual organisation. Chris Duffy asked for clarity around the 750Million by 2017/18 was this cumulative? Laura Foster confirmed this was based on a do nothing scenario and would rise to 750million recurrently by 2017/18. Ian Williamson commented that the motivation for colleagues to gather here was not to pour over figures but about the health of the population of Greater Manchester linked to the financial challenge and needs to be considered in conjunction with the case for change paper. Wirin Bhatiani said there were no surprises in the paper and looking at the impact now on patients is significant. Alan Dow illustrated that it was a clear concise validated paper. Michael Eeckelaers stated that some of the gap will be realised by Healthier Together and some by Integrated Care and resourcing Primary Care to enable it to meet the access challenges. Ranjit Gill asked if it would be better to illustrate the numbers in each locality as a percentage of the overall spend in each locality. He also said it would be useful to have another column to identify the distance from the challenge as a percentage to draw attention to the fact that across GM in total we are short of resource. This would be a powerful vehicle to show the public and for those who are in a position to assist the change. Laura Foster advised that the information could be presented in a different way as requested. Leila Williams said it would be useful to link Martin McEwan s presentation to the financial discussion here today. Hamish Steadman said the main focus was the challenge and budget setting is important and needs to be discussed elsewhere but the focus with the public should be the clinical challenges and the financials should work in parallel. Michael Eeckelaers said that overall this would meet the financial challenge whilst improving the quality and it is a very ambitious project that addresses essential issues. Chris Duffy stated it should be driving from the quality area contributes to the challenge. ID Type Risk/Issue/Action/Decision/Outcome Description Owner 043 Action Financial information to be presented in a different way. L Foster 5. Any Other Business There was no other business. Page 5
6. Open Questions The Chair invited questions from members of the public. Mr Ian Barker representing Stockport NHS Watch Mr Barker asked Martin McEwan about the next phase of engagement for Healthier Together as he understood and in Stockport there is a series of engagement activity with the CCG over the next month with the public can they not be done together? Martin McEwan advised that local conversations were taking place with the CCGs and then Healthier Together would go out to the wider public to increase the conversations across Greater Manchester to advise what the proposals are and to receive feedback. This will increase over the summer period. Mr Barker said there was no other business in the meeting and wondered what other things the Committees in Common discuss that is outside of the public domain? Alex Heritage advised that the meetings are opened up to the press as well as the public to engage in dialogue but outside of that members look at draft documents and comment on such documents that are then amended prior to entering the public domain so the right message is received by the public. The Committees in Common are preparing for consultation not preparing for the answer. Hamish Steadman informed Mr Barker that there was strong desire from all CiC members to have as much as possible in the public domain so we ensure that what enters the public domain is accurate and correct and is was a very important question to ask as the Committees in Common are here to serve the public. Meeting Conclusion The Chair thanked everyone for attending and for their interest and closed the meeting. Dates of Future Meetings Wednesday 16 April 2014 Wednesday 21 May 2014 Wednesday 18 June 2014 All meetings to be held at Manchester Town Hall, Albert Square, Manchester, M60 2LA (SatNav Use M60 2LA) - http://www.manchester.gov.uk/location OUTSTANDING ACTIONS FROM PREVIOUS MEETINGS ID Type Open Action Owner 042 Action Response required to questions submitted by Mr Ian Barker A Heritage CLOSED ACTIONS FROM PREVIOUS MEETINGS ID Type Open Action Owner Nil Page 6
SUMMARY OF OUTCOMES/DECISIONS FROM THIS MEETING ID Risk / Issue/ Action / Decision Description Owner Nil SUMMARY OF NEW ACTIONS FROM THIS MEETING ID Risk / Issue/ Action / Decision Description Owner 043 Action Financial information to be presented in a different way. L Foster Page 7