Agenda item

To receive a final update on the Care Quality Commission (CQC) Local System Review action plan following the local system review which took place in early 2018.  

The Director of Adults’ Health and Care alongside a representative from the Hampshire and Isle of Wight Partnership of CCGs provided a closure report following the local system review in March 2018. 

Members heard:

• The system review identified strengths and continued development areas for an action plan with key elements to implement within a 12-month period.
• IIC (the previous item) was a key action and will be traveling forward alongside other issues being addressed.
• The action plan was signed off by the Health and Wellbeing Board (HWB) and submitted.  A similar report to the one presented here will be going to the Board.
• A response was submitted to the CQC and DHSC, but there has not been continued interest in the outcomes.
• Hampshire was one of 20 areas selected to undertake such a review, based predominantly on the over 65 population and their experiences and pathways.
• Areas of strengths and improvements, as well as positive developments were based on data submitted alongside a week-long field work on the ground.
• The Health and Wellbeing Strategy and Business Plan, local mechanisms, transformation group, and integrated commission board will drive oversight and improvement for shared investments, funding, and pooled resources.
• The Hampshire Together initiative, workforce planning developments, system improvements with regulated care workforce, building on strengths, and setting the conditions to make the work of provider partners possible, is key.
• There is a limited 1-year view into the funding and confirmation of assumptions already made, and the degree of assurance and funding flow is very pertinent. 
• The action plan is closed but progress continues with bigger pieces of work. 

In response to questions, Members heard:

• The HWB oversees the progress on key actions with time scales for delivery.
• A huge campaign has been undertaken to get the word about Connect to Support Hampshire out there with advertising and the support of partners - district and borough councils, libraries, Fire and Rescue, 111, etc.
• People may be using the services but not recognize it as Connect to Support.
• Finance-wise, a 3-year spending round is typical and would be useful. 
• The NHS has a 5-year funding solution subject to meeting performance and other standards.
• Prudent assumptions have proved true but is challenging and difficult to look forward beyond March 2021 whilst waiting for green and white papers.
• CQC have responsibilities across regulated services for health and social care.
• Inspections are being undertaken but in terms of skill and expertise, there are local team provisions providing a window into service quality and provisions.
• Adding CQC intelligence and insight to the County’s own, allows it to remain above the national average and much has been done but there is more to do.
• Carer feedback (formal and informal) are part of the CQC response and has been used to develop a joint carer strategy. 
• Informal carers are a vital resource and they contribute over £60 billion pounds compared to the £20 billion spent on social care.
• The CQC review was initiated due to delay transfer care performance but proved to be a catalyst in fast-tracking and focusing on actions that needed to be done. 
• Currently, an intense amount of work is taking place with all sectors in terms of winter planning as increasing attendance can overwhelm the system’s capacity.
• Additional capacity options, alongside IIC forerunner projects, and PCN collaborations with well-planned effort, investment, and resources will be key to a sustainable model for a long-term solution.
• Workforce pay is above National Trade Body recommendations, but significantly less than the private sector thus causing employment market challenges.
• No continuing program has been announced but remains to be seen.
• There is a new Chief Inspector for Social Care at the CQC and this needs to be a feature going forwards.
• Learning from system reviews are a catalyst for positive change and collaboration between organizations and more work will continue in the future.

Members were pleased to see the strengths and effort in addressing improvements and they commended the department and partners on the positive progress being made.

RESOLVED

That the Committee:

a.    Noted this final report on the Care Quality Commission’s Local System Review and its Action Plan that was jointly developed by Hampshire’s health and care system leaders to respond to the Review’s findings.

b.    Will endorse in writing the outcome and achievements from the action plan to share with the CQC and DHSC.

The Chairman called for an 8-minute recess until 12:45pm