Mid and South Essex ICS on the Thurrock Integrated Care Alliance, primary care and more

Let’s take a look at the most recent board papers from Mid and South Essex ICS.

Operational and strategic planning update

The meeting provided updates on continued efforts from the ICB and provider colleagues to prepare the operational plan response, noting that a draft submission was made on 27th February 2023. The operational plan will need to outline the ICB’s financial, provider activity and workforce plans, along with the resulting performance of these key areas. The document states a need to “triangulate these aspects to ensure we are clear on the conditions for delivering out recovery plan.”

The areas for improvement identified in the operational plan include ambulance response times; elective care waiting times; community services; access to primary care; A&E waiting times; diagnostic waiting times; maternity services; mental health services; and cancer waiting times.

Alongside this, the ICB has worked with partner organisations to develop a Joint Forward Plan (JFP) following an engagement period – the resulting draft of which was submitted to the CEO last month. The JFP will set out the strategic ambitions for the ICS over the next five years, taking into account the core commitments set out by the NHS Long Term Plan.

Thurrock Integrated Care Alliance Committee

One of the standout topics of the meeting revolved around the Thurrock Integrated Care Alliance (TICA) terms of reference, which were submitted to the board for approval.

TICA aims to bring key partners together to “create opportunities for people to live well” – acting as the interface between the ICP, ICB and health and wellbeing boards, and will “take actions which improve health and wellbeing outcomes and reduce inequalities across their geography.”

The work within each alliance will reflect local priorities and relationships, providing a greater focus on population health, integrating services around patients’ needs and improving the overall quality of support available in primary and community settings. The alliance will need to ensure the delivery of agreed system standards, outcomes and common clinical policies for the communities they serve.

Alongside the Thurrock Health and Wellbeing Board, the alliance has progressed locally developed existing strategies to deliver the health and wellbeing strategy objectives.

This includes supporting joined-up, informed decisions around an individual’s care by enabling people to access their shared digital care records; agreeing and developing a devolution framework between Thurrock and the ICB which specifies what will be “devolved and delivered from system to place”; and developing integrated multi-disciplinary care. It also involves ensuring strategic oversight of a new infrastructure, and coordinating delivery of local emergents of the estate strategy.

The board will be expected to review the terms of reference on an annual basis, alongside the effectiveness of the alliance’s performance.

Managing risk

The ICB confirmed they were considering the use of a risk management system in the new financial year, in the hopes that this will provide “depth to risk reporting and financial framework.”

It was suggested that it would be useful to include information such as staff capacity and community beds within the ‘Unblocking the Hospital risk’ segment of the Broad Assurance Framework and Risk Management Policy. Additionally, the board identified the usefulness of further updates on the progress of virtual wards.

Workforce capability and capacity

This month (April) marks the transfer of undertakings for a number of staff from dental contracting, primary medical services and finance teams over to the ICB, in order to support the delegation of NHSE pharmacy, optometry and dental services.

The six ICBs in the East of England will be taking a collaborative approach in undertaking these commissioning functions, which will be hosted by Herts and West Essex ICB on behalf of all six ICBs.

In preparation for the new delegation, a due diligence process has continued into 2023 involving national and regional NHSE and ICBs. The process covers four key workstreams: transformation and quality, finance, governance and leadership, and workforce capability and capacity.

Primary care

The document highlights a national lack of workforce as a crucial barrier to primary care; resulting in increased system wide pressures and a lack of efficiency in patient care pathways.

As a result, the ICB has committed to rolling out a cloud based telephone system across 25 practices, alongside a community pharmacy consultation service to meet the demands of residents. New care pathways are being established and an increased recruitment of ARRS roles are being implemented to better meet the needs of the community.

In order to maximise hospital discharge opportunities, the ICB will also be adopting a MSE system capacity and demand model to help mitigate the acute capacity pressures facing local hospitals.

Financial report

Following the adjustment for the two reimbursement programmes still operating during 2022/23, the ICB is on track to deliver its agreed improved forecast position of £16.8m.

Three main risks have been identified which may impact the ICB’s financial position: market pressures, pathway harmonisation and additional inflationary pressures.

In terms of next steps, the ICB will look to develop a comprehensive infrastructure strategy which will give clear vision of the investment pipeline and the impact of the ICB’s financial position.

For more information on the board meeting, please click here.