Agenda item

Integrated Care Alliance in Wolverhampton

[To receive a report on the Integrated Care Alliance in Wolverhampton]. 

Minutes:

The Director of Strategy and Transformation of the Wolverhampton Clinical Commissioning Group gave a verbal update on the Integrated Care Alliance (ICA) in Wolverhampton.  The STP was going to be in future rebranded as the ICS (Integrated Care System).  Sitting beneath the ICS was going to be the Integrated Care Provider.  In its gestational state, it was being called the Integrated Care Alliance (ICA).  There had been positive progress over the past six months.  One of the key anchors of delivering successful integrated working was changing the way the NHS contracted.  The discussions they had been having with the Trust were around not changing the integrity of the revenue to the Trust as an integrated provider of acute community services, but to align the way money flowed across it.  As an example, he cited that non-elective services would be block aided.  If non-elective services were to be block aided and community services were still with the Trust, it gave the Trust certainty on the money coming in and allowed activity in a non-elective area to be reinvested in the community sector to support people to stay at home and to help primary care practices. 

 

The Director of Strategy and Transformation of the Wolverhampton Clinical Commissioning Group stated that as part of the new collaborative approach they would need to change the way some services were delivered. They were initially focusing on four areas.  He said the first area was how people were supported with frailty to live more at home.  He said that over a certain age, ten days in hospital was equivalent to eight years degenerative muscle tissue.  Hospital was a dangerous place for older frail people, in terms of their general wellbeing, the risk of acquiring secondary infections and their future independence.  Ensuring that frailty was treated in a different way and that the clinicians from the secondary care environment and GP clinicians together with Community Services were agreeing how the services would be setup to support people with frailty was vitally important.   

 

The Director of Strategy and Transformation of the Wolverhampton Clinical Commissioning Group remarked that the second area they were looking at was the End of Life Service.  The current service saw too many people going into hospital to die, instead of dying at home.  This was sometimes due to there being no provision to support the person to die at home.

 

The Director of Strategy and Transformation of the Wolverhampton Clinical Commissioning Group commented that the third pathway they were working on was around short stay paediatrics.  Wolverhampton was a substantial outlier when it came to 24 hours stays for younger children with respiratory problems or lower GI.  There was a deficit in GP training for paediatrics and a deficit in pro-active community paediatric care, both of which were being addressed.  The final key area was regarding mental health, where people in crisis were presenting at the Accident and Emergency Department.  There needed to be more support for people in crisis from a crisis liaison perspective.

 

The Director of Strategy and Transformation of the Wolverhampton Clinical Commissioning Group stated that he realised the new integrated working approach did rely heavily on Public Health to assess the relevant data. There was a sub-group which was working on matters of governance.  It was important to look at services from an end to end perspective, rather than individual parts.  There were risks to the new approach, with the highest being working relationships.  Trust and collaboration would be key to ensuring it was a success. 

 

The Chief Executive of the RWHT commented that there would be people spending their last few hours in the assessment unit at New Cross Hospital, which he saw as a failure of the NHS.  More work was required from the NHS working with the local nursing homes around end of life care provision.  He was happy to provide his transplant nurses to have conversations with the nursing homes and families.  He was thinking about introducing a “Dignity in Death” certificate for nursing homes on a similar model to the infection prevention certificates. 

 

 

Meeting closed at 3:05pm

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