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Minutes from the Integrated Care System Board, 14 October 2020

The role of the Integrated Care System (ICS) Board provides leadership and development of the overarching Lancashire and South Cumbria ICS strategy, oversight and facilitation of delivery of sustainability, transformation and design of the future state of health and care. The meeting was chaired by David Flory, Independent Chair of Lancashire and South Cumbria Integrated Care System.

 

Key messages

1. Phase 3 planning submission

Lancashire and South Cumbria ICS has submitted Phase 3 recovery and restoration plans to NHS England and NHS Improvement (NHSEI). The ICS Board received a report summarising the outcomes of these plans, which do not quite enable the system to meet national requirements across all dimensions. The ICS Board noted the further work undertaken post submission to continue to improve this position, especially in relation to 52-week waiters.

The ICS Board noted that the system appears to have reached an inflection point and considered the impact on recovery plans of a second wave of COVID related demand.

Phase 3 plans did not and could not have taken account of finances, given that ICS financial envelopes were not received in time to enable this to happen. Following a report to the System Leaders Executive, a process of check, challenge and prioritisation of costs of COVID, restoration and winter schemes is underway to enable funds to be applied fairly.

The Board will receive further information on the ongoing prioritisation process at its meeting to support review and direction-setting, in advance of a final submission of financial plans on the 22 October.

The ICS Board agreed that sign-off of the ICS financial plan for phase 3 should be at the System Leaders Executive (SLE) meeting on the 21 October. The Board supported the proposal to invite medical, nursing and operations directors to review and endorse System Leaders Executive recommendations prior to confirmation by 22 October.

2. System reform

A plan has been developed to set out the next phase of system reform in the Lancashire and South Cumbria Integrated Care System. The document responds to the national Phase 3 planning guidance published on 31 July 2020. The plan builds on discussions on various aspects of system reform which have been taking place in the ICS Board, Joint Committee of CCGs, Provider Collaborative Board and in our Local Authorities.

Reference has been made in several places to our early understanding of Phase 4 guidance and the plan makes clear that, once it has been published, this guidance should offer additional clarity in taking forward these change programmes. As previously agreed, this document was reviewed and endorsed by the SLE so that it could be submitted to the Regional Director on October 2 2020. It is hoped that informal feedback on the plan will be received by the 14 October to be reported to the ICS Board.

The ICS Board endorsed the System Reform plan and supported a proposal that the document is considered in part 2 meetings of the Boards/Governing Bodies/Cabinets of partner organisations across the ICS.

3. Local government reform

The ICS Board received a presentation from Angie Ridgewell, Chief Executive for Lancashire County Council, and Katherine Fairclough, Chief Executive for Cumbria County Council. The presentation updated on Local Government Reforms including a summary of proposals, work with health partners, formal processes, engagement and an illustrative timeline.

4. Health Infrastructure Plan (HIP2) 

ICS Board members received an update on the HIP2 programme and progress over the period August to September 2020. This included the background to the HIP2 programme, the agreed governance structure, progress on recruitment to the programme team, communications, engagement and stakeholder management along with an update on the health planning process.

The ICS Board noted the inclusion of East Lancashire Hospitals NHS Trust (ELHT) and Blackpool Teaching Hospitals NHS Foundation Trust (BTHT) in the HIP2 programme. The ICS Board supported the recommendation of quarterly reporting Boards starting November/December 2020. The ICS Board noted the intention to hold a Board to Board (University Hospitals Morecambe Bay and Lancashire Teaching Hospitals) in quarter 4 2020/21.

5. Finance reports

The ICS Board noted a finance report which included the month 5 financial performance for the Lancashire and South Cumbria system in the context of the current finance regime and the response to COVID-19. It covers the revenue and capital positions of all Lancashire and South Cumbria partners and the position on ICS central functions. Terms of reference for a Finance Advisory Committee were endorsed.

6. COVID-19 

The ICS Board also received a number of items for information including COVID-19 Cell Logs, High Level COVID-19 Risk Register and ICS Programme Summary Report.