Integrated Transformation Fund

An Area Team Perspective

Les Williams

Director of Operations and Delivery

Birmingham, Solihull and the Black Country

• 7 CCGs across the patch – Wolverhampton, Walsall, Birmingham Cross City, Sandwell & West Birmingham, Solihull, Birmingham South and Central and Dudley

• 143 people in new roles within the Area Team for Birmingham, Solihull and the Black Country. In addition to Family Health Services (FHS) for registration of patients with contractors

• Covers area of 6 Local Authorities

• CCGs supported by Central Midlands Commissioning Support Unit

Area Team Overview

Area Team Functions

Area Teams in England share the same core functions, with responsibility for:

• CCG development and assurance

• Emergency Preparedness, Resilience and Response

• Quality and safety

• Partnerships, includes Local Authorities, particularly through Health and Wellbeing Boards

• Configuration

• System oversight.

• Commissioning a range of services directly

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Integrated Transformation Fund • ITF Guidance already issued, 4th and 17th October

• Strategic and operational planning in the NHS 4th November

• Full guidance to NHS England Board on 17th December, published 19th December, along with CCG and Area Team allocations

• Plans for 2015/16 needs to start in 2014/15

• £3.8bn pool arrangement, brings together NHS and local authority resources already committed to existing core activity

• First draft plans 14th February

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Integrated Transformation Fund • Conditions:

• Support adult social care services with health benefit

• Local authority to agree with health how best used in social care and demonstrate positive difference to social care services

• Have regard to JSNA and existing commissioning plans

• Health benefit to be seen in:

• DTOCs, emergency admissions, admissions to care homes

• Effectiveness of re-ablement and patient and service user experience

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Plans

• 2 year operational

• 5 year strategic

• Shared plan for totality of health and social care activity and spend

• Involve all stakeholders and signed off through H&WB Board

So what’s our view?

Area Team Perspective • Great opportunity to develop real shared integrated planning

• Realisation of long term aspirations

• Build on existing S 75 and S 256 experience of pooled budgets

• Many CCGs looking to go beyond minimum requirements, eg all emergency admissions spend

• Recognise complexity and difficulty of changes – for social care, for funds, for NHS providers

• See 2014/15 as a start and continuing negotiation to deliver true transformation in 2015/16

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Some issues• Transfer not seen as free gift

• Incentivising large acute providers to change

• NHS England as contributors to plan – specialised services, primary care commissioning responsibilities

• GP providers as one of potential recipients of investment to drive change in acute hospitals

• Important facets:

• good local relationships within very effective governance

• clarity of purpose established early

• risk sharing

• Role to encourage CCGs, but not direct them

• Assurance of quality and content of plans for NHS 8