Agenda item

Geographical alignment of public services at populations of 30-55,000

Minutes:

The Board gave consideration to a report which asked it to endorse the development of 5 geographical footprints at populations of 30-55,000 across

the borough. These 5 footprints would align the geographical footprints of key public services including Primary Care Networks, Community Health and Adult Social Care IMDTs (Community Provider), Council Districts, Police beats and Housing management. The Board was asked to endorse the

decision and recommend that the respective partner organisations - the Council and CCG and others – seek geographical alignment on 5 common footprints.

 

The report detailed the preferred option for developing 5 common geographical operational footprints. The Board were informed that place-based, multi-agency integration was key to the transformation and reform of public services and communities both in Oldham and across Greater Manchester. Only by developing a single approach to building resilience, that is informed by insight into what drives demand and shapes behaviour in communities, would the stubborn inequalities that existed within the borough be shifted. Place based integration was not new to Oldham and was not a “project” unrelated to the way mainstream services are delivered.  Rather it was the way mainstream services should be delivered across the whole system and in partnership with residents.

 

The Board noted the forms of multi-agency integration that had already been put in place and the benefits of these. They were informed that the model for place-based integration across the whole system was currently being developed, that would articulate how the mainstream delivery of services would be fundamentally reshaped by bringing staff together in a common geographic footprint, operating to a shared purpose and working in a holistic way with people and communities.

 

Members were informed that, without geographical alignment, it was unlikely that the full integration and reform of public services would be progressed, as staff, resources and capacity would not align. The building blocks for Locality Care Organisations and public health management, police beats and district working were at a 30-55,000 footprint. This was the optimum size for services to organise themselves as it was big enough to create economies of scale and small enough to be locally sensitive. Any footprint below this would make it difficult for services to align their capacity and resources to a place-based model. However, more localised and focused approaches could be needed below this footprint and natural communities could be defined at this population size.

 

Discussions and negotiations had taken place across public services over the past 12 months. This had included engagement with elected members, GPs and colleagues from across the whole system of public services. Following this, 5 geographical footprints appeared to be the most feasible both operationally and financially and this was the current number of health and social care Primary Care Networks (PCNs). To increase the number to more than 5 would have both financial, resource and logistical implications as staff and assets were already co-located on this footprint. However, whilst 5 footprints were the most operationally sound, there was agreement that the current PCN boundaries were not sustainable and that any new arrangements should use ward boundaries as the legitimate building blocks for service footprints. 

 

Via the Oldham Leadership Board, the Clinical Commissioning Group, Greater Manchester Police and First Choice Homes, along with other key Oldham partner agencies had agreed to change and amend their existing boundaries to align to the same geographies. This would enable the full integration of services at this footprint, as it was expected other agencies would follow-suit.

 

Options/Alternatives Considered

a)   Not to endorse geographical alignment across public services at 30-55,000 populations.

b)   Not to endorse geographical alignment on 5 common geographical footprints (but ask to recommend 6 or 7 footprints).

c)   To endorse geographical alignment on 5 footprints, close to PCNs but using wards as building blocks and the preferred option.

 

RESOLVED that geographical alignment on 5 footprints, close to PCNs but using wards as building blocks and the preferred option for doing this be endorsed.

 

 

Supporting documents: