Agenda item

This report summarises discussions that have taken place at the Integration and Transformation Board.

Consideration was given to a report which summarised discussions which had taken place at the Integration and Transformation Board.

The Director of Adult Social Care introduced the report and informed the Board that the ITB had taken on the responsibility for management of the Better Care Fund (BCF) in the Vale of York area.

He highlighted that the development of the ITB reflected a longer term change in thinking and as such there was a need for a joint commissioning strategy and joint commissioning plan. He spoke about a Joint Commissioning Forum which would allow for discussion to take place outside of the ITB. This forum would look at the shift from community based models of care and market development in health care. Other topics would also include, rehabilitation services and intermediate care in the city, for example the future proposals for Archways.

Board Members raised the following points;

·        The ITB would bring together providers and commissioners in one place.

·        None of the organisations involved in the Sustainable and Transformation Plan shared the same geographic boundaries, which meant that the ITB would allow for locality based decision making.

·        Consideration of a terms of reference for the Joint Commissioning Board would be brought to the Health and Wellbeing Board.

Discussion took place on the closure of Archways Intermediate Care Unit during which the following comments were raised;

·        Archways was an invaluable resource for those discharged from hospital who needed support before they returned home.

·        Why was an effective resource being closed before a suitable replacement had been put in place?

·        Patients were more likely to stay in hospital as a result of the closure of the rehabilitative unit.

·        The hospital was looking to increase overall capacity rather than reducing resources at Archways.

The Deputy Chief Executive of York Teaching Hospital NHS Foundation Trust informed the Board that;

·        There was evidence that many patients could be cared for in their own homes if community support was given.

·        In order to develop further community services, maintaining Archways alongside this could not be done.

·        GPs, consultants all supported the closure.

·        Their commitment was to inform the staff involved first.

Further comments raised included;

·        There would still be some inpatient beds available for rehabilitative care in the city.

·        Was the setting the best use of resources for the care provided?

·        Further work needed to be carried to enable real co-production with service users, as the consequences of service change on the system had not been made explicit.

·        The closure of Archways would be considered in more depth at the next meeting of the Health and Adult Social Care Policy and Scrutiny Committee.

Resolved: (i) That the report be received and progress noted.

                 (ii) That the work being done to develop a joint commissioning strategy be supported.

                 (iii) That comments made around the need for a Joint Commissioning Board be considered and noted.

                 (iv) That a further report on the Section 75 Agreement be received by the Board.

Reason:        To keep the Health and Wellbeing Board updated on progress being made by the Integration and Transformation Board.