Agenda item

Darren Summers, Strategic Director for Integrated Health and Care/Southwark Place Executive Lead, will present the enclosed document, which sets outs local health provision and priorities.

Darren Summers, Strategic Director for Integrated Health and Care/ Southwark Place Executive Lead, provided a presentation  setting out local health provision and priorities.

This covered the following points:

·  Partnership Southwark:  was established in its current form in 2022, bringing together representatives from the council, public health, children and adults' services, the Integrated Care Board, NHS trusts, GPs, the voluntary sector, Healthwatch, and care providers. The partnership aims to agree shared priorities and oversee their delivery, focusing on integration across the health and care system.

·  Recent Meeting and Governance: The partnership meets every two months, with the latest meeting chaired by Councillor Chamberlain and Dr Nancy Kuchemann. Key agenda items included integrated neighbourhood health and care teams.  Partnership Southwark operates as a subcommittee of the South East London Integrated Care Board.

·  Financial Challenges and ICB Reform: The Strategic Director highlighted that the Integrated Care Board is undergoing a 35% reduction in running costs, part of a national target, and faces an underlying deficit of over £100 million. Funding convergence is reducing budget allocation, creating significant financial pressures similar to those faced by local authorities.

·  Strategic Priorities: The partnership has agreed five priorities: mental health (children, young people, and adults), primary care access (especially GP access), prevention and health inequalities, services for the elderly, and developing neighbourhood health and care services. These priorities were set in September 2024 and align with national NHS policy directions.

·  Neighbourhood Health and Care Services: Significant progress has been made in developing neighbourhood health teams, now aligned with council neighbourhoods. These teams focus on children with complex needs, people with multiple long-term conditions, and frail elderly populations, with plans to expand to serious mental illness and preventative services, including piloting financial shield workers.

·  Physical Premises and Shared Spaces: Some health centres, such as Tessa Jowell Health Centre, are being repurposed to allow shared use by multiple organisations, moving away from siloed operations. New health centres are planned in Canada Water, Falkland Street, Southwark Park Road, and Elephant and Castle, with regeneration funding supporting these developments.

·  Service Expansion and Pilots: Neighbourhood teams are piloting the inclusion of financial shield workers to address wider determinants of health, such as financial insecurity, which impacts both mental and physical health. The teams plan to expand their focus to serious mental illness and preventative care.

·  Outcomes and Metrics: While system-level outcomes are not yet available due to the recent launch of the teams, metrics being tracked include emergency department attendances, hospital admissions, and care home placements. Early case studies are being collected to assess impact.

The chair invited questions and the following points were made:

·  Workforce Shortages and Causes The Strategic Director clarified that workforce shortages are primarily due to pay not keeping pace with inflation, increased job pressures, and insufficient staff numbers, rather than direct impacts from Brexit or immigration reforms. There is concern about the supply of key professionals, such as speech and language therapists and midwives.

·  Financial Pressures and Service Delivery: The Integrated Care Board is implementing significant cost reductions, which may lead to stopping or reducing some activities. While efforts are made to avoid negative impacts on patient outcomes, the scale of the challenge means some services may be affected.

·  Joint Commissioning and Efficiency: Opportunities exist for joint commissioning between the council and the ICB, allowing for more efficient service delivery and reducing duplication of contracts with providers.

·  Health Inequalities: Members highlighted  the biases towards men in developing prescriptions and treatments , rather than women.  The Strategic Director said that the partnership recognises significant inequalities in health outcomes related to deprivation,  sex, gender, race, and sexual orientation. Efforts are underway to address these through targeted outreach and service improvements.

·  Variation in Service Quality: There are acknowledged variations in service quality across different providers and services, with some rated as outstanding and others requiring improvement. Regular reporting and follow-up with providers such as Kings and SLAM are planned.

·  Language and Accessibility: Translation and interpreting services are commissioned for primary care and other health services, with a wide range of languages covered. However, gaps remain, particularly for certain communities, and feedback from residents is used to identify and address these issues.

·  Mental Health Services and Waiting Times: The commission discussed long waiting times for mental health services, funding challenges, and the effectiveness of partnership working, with the Strategic Director  providing updates on investments and ongoing pressures.

·  Investment and Demand: Despite increased investment in children and young people's mental health services, demand has risen sharply, particularly since the pandemic, leading to continued long waiting times.

·  Service Redesign and Outcomes: Efforts are being made to redesign care pathways and reduce very long waits, with some success in reducing waits over a year. However, overall waiting times remain longer than desired.

·  Partnership Working and Funding Responsibilities: There are ongoing discussions between the council and the ICB about funding responsibilities for services like the NEST, aiming to avoid cost-shifting and promote joint decision-making.

RESOLVED

An update will be provided on the neighbourhood health case studies, with a report back on the outcomes of the pilots, including when adult mental health will be included