Agenda item

Report of the Harrow Borough Director – North West London - Integrated Care Board.

The Board were briefed by the Harrow Borough Director on the North West London - Integrated Care Board’s (ICB) organisational restructure, initiated in response to NHS England's directive to reduce running costs by 30% and to ensure a fit for purpose ICB in light  of the changing NHS landscape.

The ICB, covering a diverse population of 2.1 million in North West London with an annual budget of £6 billion, aims to improve healthcare quality, tackle inequalities, and optimise resource use.  The restructure involves significant reductions, primarily in staffing and estate costs, to align with the financial requirements.

Priorities and Local Alignment:

The nine priorities of the Integrated Care System (ICS) were reviewed, aligning with the borough partnership priorities and focusing on reducing health inequalities.  Key priorities included:

·                 The development of Integrated Neighbourhood Teams (INTs) to improve access and provide proactive joined up care for people with LTC and complex needs.

·                 Improved CYP mental health services, including targeted interventions.

·                 Improved Mental Health services in the community for those in crisis.

·                 Embed access to high quality community-based services.

·                 Optimise and improve ease of movement of people – ensuring residents were treated in the most appropriate setting.

·                 Transform maternity services to reduce inequalities in outcomes and improve overall quality.

·                 Perinatal Deaths.

Impact of Restructure on Harrow Team:

The Harrow Borough team had been reduced from 24 to 14 staff members, which covered both clinical and non-clinical roles, with limited full-time clinical support.  The team focused on adapting to new ways of working and strengthening collaboration with stakeholders to ensure effective service delivery.

The following questions and observations were made by the Board:

The Board raised questions on Harrow’s specific funding allocation within the ICB’s £6 billion budget and asked for clarification on monitoring measures to assess performance against the plan’s goals.  The Harrow Borough Director for North West London - Integrated Care Board advised that the NHS funding formulas were very  complex, which considered GP-registered populations and deprivation levels but confirmed that Harrow historically faced underfunding challenges.  There was also a call for more transparency on resource allocation.

The Harrow Borough Based Partnership Managing Director addressed historic funding gaps, particularly in Harrow’s primary care, stating the ICB's commitment to equalising funding across the system.  Significant recent investments in Harrow’s primary care were noted as part of this "levelling up" agenda, with ongoing efforts to address community service shortfalls.

The Board expressed concerns over the reduction in Harrow's team from 24 to 14 members, questioning the potential impact on service delivery and whether partnership organisations were prepared to support affected areas.  The Harrow Borough Director for North West London - Integrated Care Board assured that all workstreams continue to be supported but noted a reduction in support depth, managed by assigning broader responsibilities across partnerships and NWL ICB Programme Teams.

The Board enquired about gaps resulting from the centralisation of ICB resources.  The Harrow Borough Based Partnership Managing Director  observed that Harrow teams there might be a need to focus on delivery rather than strategic functions, with centralised ICB teams providing support as needed.  The need for local relationships to remain strong, especially for services like continuing healthcare and mental health aftercare, was emphasised.

The Chair proposed that this should be monitored, and any potential risks related to capacity issues in Harrow, with any emerging concerns be escalated to the Council.  The Director of Public Health suggested logging these risks on the BBP risk register for ongoing review.

RESOLVED:  That the report be noted and approved further monitoring measures.