Agenda item

Further to the meeting held on 7^th January 2020, the Committee received a further update on the integration agenda for the Community Health and Adult Social Care Service (Community Service) which had been formed in 2018 in response to local, regional and national drivers for integrated care delivery which looked to realise economies of scale, to improve quality of care and to enhance the service experience for people with health and care needs.  The Community Service provided support to vulnerable adults with health and care needs as a collaboration of five partner organisations - Oldham Council, the Northern Care Alliance, Pennine Care Foundation Trust, Oldham CCG and MioCare - with their human, estate and financial resources deployed under one leadership model.

The Community Service is a complex and diverse organisation that delivered a wide range of health and care services comprising approximately 1,450 staff operating across seventy services and supporting over 88,000 people annually.  The shared Community Service goal was to support people to live at home as independently as possible; to use a ‘Home First’ integrated flexible approach; and to deliver services through a sustainable and efficient business model.  The model had been developed over the last two years with the purpose of integrating and joining up service delivery to the most vulnerable citizens. Having completed this first phase of its development, the Service now required a more formalised approach which was being progressed through consideration of a wider integrated system model. 

During the preceding 6-months, the Community Service had primarily been focused on responding to the Covid-19 pandemic, ensuring continued delivery of essential health and social care services to the Borough during the heightened demand across the local health and care system.  Covid-19 had presented opportunities and learning to enhance the Community Service integrated model and to build back better with foundations based on system

wide learning and connectivity.  During the pandemic the Service had provided a significant contribution, collectively with partners, for the locality-wide response, details of which were provided within the submitted report.  The submitted report further considered the position of Community Services in response to legislation, Government directions and the Greater Manchester model of integration, including the requirement to prepare winter plans and the progression of Place-based plans.

Community Services continued to face challenges in the delivery of services due to the complexity of current governance arrangements which, for example, saw around 60 groups making decisions affecting the Service.  A potential delivery model via an Integrated Care Partnership was intended to be progressed to address these challenges, though the individual organisations would retain their own employment responsibilities and clinical governance and safety requirements.  Further areas of work, including development of an integrated approach to commissioning and various particular service-wide challenges going forward, were further outlined in the submitted report.

In response to a query, the financial risks impacting on the Service were acknowledged, both in terms of government funding and the potential for demand to outstrip supply.  Every potential saving opportunity was being looked into, but not without a full risk and impact assessment on individuals being made and assurance that statutory responsibilities would still be achieved.  With regard to public knowledge regarding services and access, it was important to note that the Service would not be able to continue to provide as it had done in the past, and that it would fail and be unable to respond to new demands if it attempted to do so. 

With regard to mental health provision, while acknowledging that it was not always the case that a mental health crisis could be prevented or mitigated against, the availability of services to prevent such crises occurring, or to prevent a person returning into the system, was queried.  It was reported that while there would always be a need for acute care and access to beds, for many people it was important to be able to recognise mental health issues arising and to be able to respond accordingly with a range of services and talking therapies.  Emotional wellbeing was recognised as a key issue for the Service and all staff would receive appropriate training.

RESOLVED – that the update on the integration of community health and adult social care services be noted.