Learning from the experiences of Local Authorities and Integration Carole Burgoyne Strategic Director for People Plymouth City Council
The vision for our city
Local Challenges
The Joint Local Plan
Health and Wellbeing Board How we established the Health and Wellbeing Board • T o not look or feel like a Council Committee – Membership – Meeting in development session – Jointly working on the Director of Public • Health’s Thrive Plymouth initiative Systems Leadership activity • Sofa engagement for the Plymouth Plan • The home for driving transformation in Health and Wellbeing • Creating a new culture for collective work •
Setting the Integration Ambition The Health and Wellbeing Board set the level of ambition and timeline for • our Integrated Health and Wellbeing Programme Through working in development session, we ended with a very high level • of collective ambition – everything is in The Board set the strategic ambition, but stayed out of the operational • detail Delivery of the • programme was ahead of the Health and Wellbeing Board timeline
We Created One System • Livewell Southwest – An integrated health and social care CIC for the city Integrated governance arrangements • – Integrated Commissioning Board Four Commissioning Strategies and action • plans – with System Design Groups involving stakeholders, service users and carers Co-location in one building; deliberately one • Mixed team Integrated System Performance •
We Created One Budget • Section 75 agreement between NEW Devon CCG and Plymouth City Council • Integrated funds £638 million gross (£462 million net) • Risk share and financial framework Plymouth Integrated Fund The net total of the Pooled and Aligned Fund £462m Net Pooled Fund Net Aligned Fund “Any pooled fund established and “Budgets for commissioning maintained by the Parties as a pooled prescribed services that the fund in accordance with the regulations” Regulations specify shall not be pooled, but which will be managed alongside the Pooled Fund” £241m £221m
Political Consensus Work started under Labour control • Continued under a Labour/Conservative working arrangement • Continued in year 2 with a Conservative/UKIP working arrangement and • then a Conservative majority. Officers and members through H&WB, Cabinet, Shadow Cabinet and • scrutiny achieved complete consensus on integration ambition Maturity of political discussions • Real sense of ‘putting the City first’ •
Scrutiny Pre-scrutiny • A thorough examination of all of the structures and processes of • integration, both in provision and commissioning Special attention to the integrated fund and risk share processes • ‘Positive Scrutiny’ • Presenters helped by making complicated • issues simple Scrutiny made recommendation to Cabinet • to support the proposals
Creating a New T emplate GPs and Elected members – a new rulebook • The importance of Elliot Terrace sessions • Building trust • The importance of relationships • City events – MTV Crashes, Fireworks •
Getting to Know You Purposeful visits • A&E • Glenbourne Acute Psychiatric Unit • Reaching out beyond formal Council roles to build relationships • Change in mind and attitude to the NHS •
Different Leadership Roles Political Leadership • GP Leadership • Executive Leadership • Press – political & GP quotes • Everyone Bound together by a clear and shared purpose – critical to • success The CCG Governing Body •
One Building Co-location critical • But not just tenants in a building • Teams split to drive cross pollination • No petty conversations about money • Desks mingled – but IT still not completely shared! • Joint social events • The sign, the opening • Share all resources – each other’s buildings, spaces, • people, expertise
Integration is a Journey- Next Steps • Despite significant progress challenges remain with improvements driven through System Improvement Board • Commitment to System Integration Remains – Development of Integrated Care Organisation – Integration of Acute and Community – Integration of Primary Care and Community Services – No health without Mental Health – Integrated Children and Young People Services – Integration of Wellbeing Services around Network of Hubs • Integrated Commissioning Remains Driver for Integrated Care
Political Culture Summary City Vision Structure Relationships Carole Burgoyne Development Strategic Director for People
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