Agenda item

(To receive a report from Sarah Jane Mills, Chief Operating Officer, Lincolnshire West CCG (on behalf of the Sustainability and Transformation Partnership) on the development of Neighbourhood Teams across Lincolnshire)

Consideration was given to a report by Sarah-Jane Mills, Chief Operating Officer, Lincolnshire West CCG, which provided the Board with an update on the development of neighbourhood working in Lincolnshire.  It was reported that stakeholders across Lincolnshire had all agreed that the default location for providing care and treatment should be the community unless there is a clinical need for an economic case for it to be delivered in an acute hospital setting.

It was also reported that this approach was about preventing people from becoming unwell, and how health organisations could work with partners and other agencies to tackle some of the root causes of poor health.  Another aspect which would be looked at would be the age up until people were living well (healthy life years), for example, in Gainsborough people were expected to be living with at least one long term condition by the age of 58.

There was a need to build resilient communities and it was queried how this could be done.  It was noted that the neighbourhoods were built around a geographical framework and there were 12 neighbourhoods with 10 neighbourhood leads.  The role of the Neighbourhood Lead was about bringing teams together to support the local population.  The Multi-Disciplinary Team (MDT) was not just social care representatives, but also included the Police and the Fire Brigade.  Social prescribing would look for opportunities to connect people with systems, and this could be a variety of services including voluntary organisations, for example breakfast clubs.

Arrangements for supporting people with complex needs were also being built, whilst this would be a relatively small number of patients, the impact it could have would be significant.  There were a few examples highlighted in the report.

Social prescribing was a really important part of the approach going forward, however, it was noted that this was not a new concept, but it was not currently consistent throughout the county.  It needed to be determined what the core things were which should exist in every community, and these core requirements should be signed off in the coming months.

The Board was advised that Stamford was a very good example of neighbourhood working, and work was currently taking place with colleagues in Public Health.  There was a need for safeguards to be in place for information governance and sharing of records etc.

The Board was provided with the opportunity to ask questions to the officers present in relation to the information contained within the report and some of the points raised during discussion included the following:

·         In relation to the Spalding Neighbourhood Team, it was noted that there had been some really good case studies.

·         It was confirmed that there were information sharing agreements in place where appropriate.  However, it was important to note that the information was not the GP's information. It was the patients information to share.

·         It was highlighted that it had taken four years to get to this point.  There was a greater need to get something up and running on the east coast sooner rather than later, as this was where a lot of older people lived and many had a number of health conditions.  It was thought that this work could have lots of benefits.

·         It was important for people to have a point of contact, a person who could support that individual.  It was highlighted that someone with a single long term condition would have one professional to help and support them, however, once they had multiple conditions they would need a team.

·         It was commented that the district councils were working well, but there was more that could be done to promote this work.  It was suggested there was a need for greater use of community assets to support wider individual wellbeing and health colleagues advised that they had an open mind to using infrastructure that was already in place to support a patient's needs, for example using leisure centres for physiotherapy sessions.

·         It was noted that the real concern to some extent was the increasing inequalities, as where it was working, it was working well, but there were some places where it needed to be in place such as on the coast.

·         If there was to be a targeted approach one, of the first areas to be targeted would be the east coast.  The development of this approach was linked to two things, the recruitment of neighbourhood leads, and two east coast leads had now been appointed, and over the coming few weeks there would be clarity over the criteria.

·         In terms of performance indicators, it was really important to understand collectively what 'good' looked like for a neighbourhood team.  What did it look like in terms of reductions, and what would it look like in 6/12/18 months?  It was noted that initial reports were positive but more time was needed to understand the impact in terms of numbers. It was therefore important to start to articulate the 'wins'.

·         It was expected that it would have an impact in areas such as admissions, and it could be seen that it was having a significant impact on individuals, but it had not started to have an effect on the trend yet.

·         There was a need for those core elements to be defined, and then there would be a critical mass to report against.

·         It was acknowledged that this was still early stages.

·         In relation to the care portal, it was noted that benefits were not yet being seen, and it would be really helpful to have some more information on this.  Sarah Jane Mills advised that she would be happy to come back to the Board to talk about this at a later date.

·         In terms of coastal issues, it was highlighted that Mablethorpe did not have a day care centre, and it was suggested that this may be because the community tended to look after itself.

·         A number of different issues had been highlighted, and the high level of need, particularly on the east coast, was recognised.  It was noted that it was easy to draw conclusions that the community was self sufficient, or it could be because they were isolated due to the geographical location.  It was suggested that there was a need to make direct contact with those people described above to work out what support they required.  However, it was important to remember that this was not always about statutory services.  There was a need to look out how it could be ensured that the infrastructure was relevant to the population and that work took place with the community to ensure it was resilient and able to support itself.

·         It was commented that one issue was the tendency to choose projects that were easy to pilot, and not all models would be easy to roll out in the east of the county.

·         It was acknowledged that the numbers were not yet sufficient for performance reports, and counting the number of people helped would not really measure the impacts or improvements.  It was also noted that people were not equal in terms of their needs.

The Chairman requested that Sarah-Jane Mills came back to the Board in six months to speak about performance indicators and the care portal.

RESOLVED

            That the Board note the information within the report and the future plans to further develop neighbourhood working in Lincolnshire.