Agenda item

The Committee considered a report of the Integrated Care Board regarding the recently published NHS 10 Year Health Plan for England. A copy of the report, marked ‘Agenda Item 8’, is filed with these minutes.

The Committee welcomed to the meeting for this item Pete Burnett, Chief Strategy Officer, Leicester, Leicestershire and Rutland Integrated Care Board. Pete Burnett clarified that he was not attending as a government spokesperson, but was present to explain the contents of the Plan and how the Integrated Care Board intended to implement it.

Arising from discussions the following points were noted:

(i)           A lot of what was set out in the NHS 10 Year Health Plan was not new and was taking place already. For example, the shift from hospital to community had been a key strategy for a while. A member raised concerns that if the content of the 10 Year Health Plan was not new then how would the Plan make a difference to the state of the NHS.  It was queried how would the Plan solve the funding problems and could savings be made without staffing cuts being made. In response it was explained that treating patients in their own homes would be more cost-effective, and when those patients were admitted to hospital it would be carried out in a much more planned way than was done currently.

(ii)         The 10 Year Plan set out an intention to have Neighbourhood Health Centres (NHCs) in every community which would act as local one-stop hubs, co-locating GPs, community services, diagnostics, and mental health support, open 12 hours a day, 6 days a week to improve access and ease hospital pressure. It was intended to have 250 to 300 new neighbourhood health centres nationally by the end of the plan and 40 to 50 over the course of this Parliament. In response to a query from a member, it was explained that there were enough NHS buildings in Leicestershire to house the neighbourhood health centres but not all of them were fit for purpose so renovations would have to take place.

(iii)        Work on developing the Neighbourhood Health Programme was already underway in Leicestershire.

(iv)       A key part of the 10 Year Health Plan was making greater use of technology and Artificial Intelligence (AI) to save time for clinicians and administrators. AI would be able to help patients stay in their own homes rather that at a hospital which would be more cost effective. AI was still developing and in the future it was likely to be possible for patients to receive AI powered advice without needing to engage with a clinician. The Rapid Health pilot was taking place in Leicestershire which was an online clinical triage system which used AI to ask patients about their problem and then allowed them to book appointments without needing to phone the practice.  However, there were difficulties with AI powered advice that needed to be overcome such as governance and making it clear which organisation was accountable for the patient.

(v)         In the past when the NHS had overspent in some areas, funding was often taken from the digital programme to make up the loss. There was a commitment in the 10 Year Health Plan that this would not happen going forward and the required funding for digital programmes would be ringfenced.

(vi)       A member raised concerns that the NHS app had not developed and improved as quickly as had been promised and queried whether the technology proposals in the 10 Year Health Plan were too ambitious and whether there was a disconnect between the plans and reality. Members also raised concerns that not everyone would be able to access technology such as mobile phone apps. Some elderly people in particular would not have the ability to use a phone or computer due to eyesight or other physical problems. In response reassurance was given that it was not a ‘one size fits all’ approach and there would still be other avenues for patients to receive medical advice. Part of the role of the ICB and the Neighbourhood Teams was to know their cohort of patients well enough so that they could put measures in place to help their particular needs.

(vii)      The NHS was developing Shared Care Records which were a safe and secure way of bringing a patient’s separate records from different health and care organisations together digitally in one place. Members raised concerns that the NHS had attempted a similar project in previous years which had not been successful and been very costly.

(viii)    The 10 Year Health Plan aimed to reduce the NHS’s dependence on overseas staff, and instead NHS employers would recruit more from their communities rather than looking to international recruitment agencies. The 10 Year Health Plan would be accompanied by an NHS 10 Year Workforce Plan which would set out how the NHS would tackle the issues of retention, productivity, training and attrition. One of the reasons why overseas staff had to be recruited currently was because the courses at universities in the United Kingdom were oversubscribed. The lack of courses was partly due to a lack of funding and also because of insufficient staff available to teach the courses. Training was organised on a regional and national basis and was therefore not within the control of the ICB.

(ix)       The 10 Year Health Plan set the NHS a target for the next 3 years to deliver a 2% year on year productivity gain. A member raised concerns that NHS productivity in Leicestershire had decreased. In response it was explained that further multi-year guidance was due to be published which could make this issue clearer.

(x)         In response to concerns from a member that NHS services would not keep pace with the amount of housing development in Leicestershire, it was explained that the NHS did apply for developer contributions under Section 106 of the Town and Country Planning Act 1990. However, the process was not straightforward and the funding did not always arrive at the time it was needed.

RESOLVED:

That the update regarding the NHS 10 Year Health Plan be noted.