Agenda item

6.1

The report which provided an update on the work undertaken to develop the initial NHS Five Year Joint Forward Plan for South Yorkshire was introduced by Marianna Hargreaves, (Strategy and Transformation Lead NHS South Yorkshire), Katy Davison, (Deputy Director of Involvement NHS South Yorkshire) and Will Cleary-Gray, (Executive Director Strategy and Partnerships NHS South Yorkshire).

6.2

A presentation was delivered covering the parameters for the Forward Plan, the public engagement and consultation work done to inform the plan, the Joint Strategic Needs Assessment, the Joint Forward Plan Objectives, the phasing of the plan, the outcomes to be measured, and the next steps.

6.3

It was emphasised that the Plan referred to work to establish the Integrated Care Partnership (ICP) across four local authorities, the NHS and wider partners such as universities.  It was required to do the following:

1. Reflect the ambition in the Integrated Care Strategy South Yorkshire which was published earlier in the year.
2. Respond to the needs of communities.
3. Respond to the mandate from NHS England.

The Chair thanked the presenting NHS representatives and acknowledged the huge amount of work done in a short period of time.

6.4

Members raised concerns and asked questions on the following topics:

1. The role of elected Members in the consultation process

Members stressed that they were keen to be involved in consultations as they had a unique insight and established links to the community. 

2. Forward Plan Consultation

Members noted the low response rate to the consultation, i.e. 0.036 of the population of South Yorkshire.  They also queried whether consultations ever led to any real change in approach.  Concerns were raised as to the potentially leading nature of multiple-choice questions.

Members requested that the needs of individuals with additional needs, such as learning difficulties, which meant they would not be able to handle the conventional documentation be considered.

Katy Davison confirmed that lessons are always learned from engagement exercises and new approaches undertaken where necessary in subsequent consultations.

Will Cleary-Gray advised that consultation does influence outcomes, e.g. as with the sites of new GP practices in Sheffield.  Engagement was intended to be meaningful and was ongoing.

Members suggested that Social Housing providers should be included in future consultations.

3. Outcomes

Members stated that they felt the Plan was more about responding to rising demand rather than addressing the cause of rising demand (such as a sedentary lifestyle and poor nutrition), therefore it seemed insufficiently ambitious.

Will Cleary-Gray advised that there was more detail on this in the delivery plan, further information about which could be provided.

Marianna Hargreaves confirmed that the Joint Forward Plan had commitments to initiatives such as smoking cessation, weight management, and physical activity.  Work would be done to scale up initiatives which had been successful locally.

Members raised particular concerns regarding the provision of dentistry, which they felt was grossly under resourced, and that this resulted in very long waiting lists and extreme difficulties in accessing NHS dentistry at all for some patients.  They requested that a robust plan as to how this would be addressed be presented at a subsequent meeting of the Committee.

Members queried whether there were conflicts in the priorities set out in the Plan, in particular being “relentless and creative to prevent ill health”, “to continue the progress in delivering the key ambitions set out in the NHS long term plan” and “transforming the NHS for future generations” and whether this would cause conflict or competition for resources between these priorities.

Will Cleary-Gray acknowledged that there were conflicts as many things needed to be done at the same time.  He added that structural change had resulted in more local autonomy and had allowed for better partnership working.

4. Primary Care

Members queried whether there was enough resource available for any of it to be shifted to primary care, particularly given rising costs.

Will Cleary-Gray acknowledged that whilst resources may be limited, a commitment had been made to direct them to where they were most needed, and this included primary care in its broadest sense.  Communities who were felt to be in the most need, would be targeted. This should become apparent to Members in their own areas over the lifetime of the Plan.  Members felt that the ICB had a role to play as an influencer in this respect.

5. Workforce Strategy

Members raised concerns regarding the lack of any response in the Plan to the issues caused by ongoing industrial action, in particular the potential negative impact on staff retention.  Whilst Members appreciated that the main responsibility lay with the Government, they were keen to hear whether this was being addressed at a local level.

Will Cleary-Gray agreed that the workforce strategy needed to be focussed on staff retention.  He stated that he was not able to comment on the Government’s response to industrial action other than to acknowledge its impact on the ability to deliver services.

With regards to the Ambulance Service, Professor Adam Laynard (System Partnership Director of South Yorkshire Ambulance Service), who was present to deliver the next report to the Committee, advised that work had been done with Trade Unions to mitigate the effect of industrial action on the local population.  The right of the workforce to take industrial action was supported but it was important that they acknowledged and minimised its impact on patient care.

6. Covid and preparedness for Winter

Members raised concerns that rigid commissioning arrangements for vaccinations could make it difficult for some groups to access the service.  If any gaps were to be filled by pharmacies, it would be dependent on whether they had the necessary workforce.

The NHS representatives stated that work was being done to build on what had already worked, such as reaching out to vulnerable communities.  Plans were currently being developed.

By way of summary, Members emphasised that whilst they praised the Plan, they had doubts as to whether it was deliverable due to resource limitations. They asked whether the NHS representatives were pushing back on this to the Government.  Members would send formal feedback regarding the engagement draft plan to the NHS staff present and to the Department of Health and Social Care.

Will Cleary-Gray stated that he believed that the plan was deliverable and felt that it was important to be ambitious, it could always be updated when necessary. He also advised that the 30% cut mentioned was to management resource not to services.

6.5

RESOLVED: That the Committee:-

a)    notes the work undertaken to deliver the initial 5-year Joint Forward Plan for South Yorkshire including the engagement work and will consider the engagement draft plan and provide feedback

b)    requests that further information is brought to a subsequent meeting of the Committee regarding NHS South Yorkshire’s plans for dentistry.