Agenda item - National Reforms to the NHS and Impact on the Council

The Director of Public Health to present a report which summarises progress on the national reforms to the NHS, health and care, and developments locally to plan for the changes due to come into force in April 2022, and considers the implications of the changes for the council.

Resolved: (i) That the developments be noted, including the proposed structure and arrangements for the NHS and care within the region from the next financial year.

Reason: As both a provider and commissioner of health and care services, and as a partner within the York health and care system, the council has a duty to participate in and influence the direction of the reforms to the NHS and care.

(ii) That the draft constitution of the proposed NHS Humber and North Yorkshire ICB and Humber and North Yorkshire ICP, included in Annex A, be noted.

Reason: The council will have direct and indirect involvement in the new structures, and Executive Members should be involved in shaping the York ‘place’ within health and care.

(iii) That the Chief Operating Officer be recommended, along with the Leader of the Council and the Chair of the Health & Wellbeing Board, to write to the ICS, NHS England and other affected local authorities in the region to highlight York’s concerns; this letter to make clear that:

· as per NHS guidance, the place boards (such as York) should be the statutory sub-committees or joint committees of the Integrated Care Board (ICB) to which delegation is passed, and any further delegation to other regional partnerships (such as York and North Yorkshire) must be agreed from Place and not from ICB;

· each Place should be represented on the Integrated Care System (ICS) Board and ICS Partnership;

· the recently announced pause be used as an opportunity to engage residents and groups with consultation.

Reason: In view of the importance of the topic and issues raised in the report.

The Consultant in Public Health presented a report which summarised progress on the national reforms to the NHS, health and care, and developments locally to plan for the changes due to come into force in April 2022. This followed a report to Executive at an earlier stage of the process, on 18 March 2021.

The changes would involve the replacement of Clinical Commissioning Groups (CCGs) by Integrated Care Systems (ICSs). Humber Coast and Vale (HCV) had been designated an ICS in 2020. Once formally established, it was proposed that it be re-named, with its two arms being known as ‘NHS Humber and North Yorkshire Integrated Care Board’ and ‘Humber and North Yorkshire Health and Care Partnership’. In October, HCV had consulted on the draft constitution attached as Annex A to the report. This set out proposed arrangements for commissioning and planning of health and social care, based on six places (of which York was one) and four sector-based collaboratives, as well as the Board and Partnership.

Implications for York and the council of the place-based partnership, the future role of the Health and Wellbeing Board, and the future of current commissioning arrangements with the CCG were considered in paragraphs 14-29 of the report.

Members welcomed the report, while stressing the importance of ensuring that all places within the HCV area had a direct influence on the ICS. The Chair also stated his commitment to work with Health Scrutiny to secure the best outcome for York.