The Health and Wellbeing Board met on Wednesday 24 January 2024 to discuss winter pressures, the Better Care Fund, and the refresh of Croydon's Joint Local Health and Wellbeing Strategy. The Board noted progress on the Frontrunner programme and discussed the South West London Integrated Care System restructure.

Winter Pressures

Matthew Kershaw, Chief Executive of Croydon Health Services NHS Trust and Croydon's place-based leader for health, provided an update on winter pressure plans. He highlighted that while the NHS had been planning for winter since September/October 2023, with measures to improve bed capacity and emergency care pathways, services continued to face challenges, particularly with timely patient discharges. Croydon's performance was noted as being close to the national target. A key focus for this winter has been Category 2 ambulance performance and associated waiting times, with a new approach involving hospital staff managing the transition from ambulance to the emergency department helping to reduce waiting times. Collaboration with primary care and adult social care was commended. Simon Robson, Director of Adult Social Care Operations, added that a pilot initiative connected to the Frontrunner Programme had strengthened working relationships and that a dedicated officer was now in place to manage discharges for homeless individuals. Dr Mike Simmonds noted that waiting lists placed added pressure on primary care and heightened patient anxiety. The Board resolved to note the verbal update.

Better Care Fund 2023/24 Quarter 2 Report

The Board reviewed the Better Care Fund (BCF) 2023/24 Quarter 2 Submission for Croydon to NHS England. Daniele Serdoz, Acting Deputy Director of Primary and Community Care Transformation – Croydon, reported that Croydon was meeting all national BCF conditions. The BCF plan included a demand and capacity analysis with minor adjustments made as necessary. Croydon remained on track to meet three out of five national metrics: discharges to a normal place of residence, falls prevention, and residential admissions. The Board resolved to sign off the BCF Quarterly submission for 2023/24 to NHS England.

Frontrunner Programme Update

Hilary Williams, Managing Director for Community Services and Integration NHS Trust, and Simon Robson, Director of Adult Social Care Operations, presented an update on the Frontrunner Programme. The programme's primary objective is to maximise the Croydon Pound by ensuring individuals receive care in the most appropriate setting, reducing overprovision of care, and clarifying funding arrangements. The integrated approach aims to bring all perspectives together to oversee hospital discharges and minimise duplication of efforts. Staff feedback is informing the development of the working model, and joint training has commenced. The programme is expected to go live in April 2024. Challenges were anticipated during implementation, and a quality improvement approach would be adopted. The approach developed under the Frontrunner Programme would be maintained beyond national funding arrangements. Engagement with staff, patients, and their support networks has been substantial, and the programme remains open to working with the voluntary sector. Ensuring the safety of discharges is a priority, with readmissions being monitored. The Chair acknowledged that this integrated approach, supported by robust data, could enhance prospects for securing future funding. The Board resolved to note the progress made and the risks and issues associated with the Frontrunner Programme.

South West London/ICS/ICB Restructure Update

Matthew Kershaw, Chief Executive of Croydon Health Services NHS Trust and Croydon's place-based leader for health, provided a verbal update on the Integrated Care Board (ICB) restructure. This national initiative aims for a 30% cost reduction, with a review underway to assess ongoing work and delivery methods. The new structure has met the cost reduction target, retaining a central ICB team and Croydon's place function. A consultation resulted in minor amendments and the creation of new posts in Croydon. Staff are undergoing interviews for roles in the new structure, which is intended to be implemented from April 2024, with ongoing review. The restructure includes managerial and clinical leadership changes. The Chair expressed concerns about the impact on mental health services but hoped for improvements and stressed the importance of closer links with the Board. It was clarified that the mental health team had faced considerable challenges, including a vacancy freeze and an unfilled lead commissioning post. Efforts are ongoing to secure an interim appointment and a permanent solution. The Board resolved to note the verbal update.

Joint Local Health and Wellbeing Strategy (JLHWS): Healthwatch Croydon Community Engagement Session - Summary Report

Edwina Morris, Healthwatch Croydon Chair, and Gordon Kay, Healthwatch Croydon Manager, presented the findings and recommendations from the community engagement session. Shifa Sarica, Principal in Public Health, confirmed that the recommendations had been considered and actions taken. The Board resolved to note the findings and recommendations and agree to their inclusion in the draft JLHWS refresh consultation document.

Croydon Joint Local Health and Wellbeing Strategy Refresh: progress update and next steps

Jack Bedeman, Consultant in Public Health, provided an update on the refresh of the Joint Local Health and Wellbeing Strategy (JLHWS) for 2024-2029. He noted that the consultation had recently gone live and encouraged Board members to promote it and provide feedback. The consultation closes on 26 February. It was confirmed that the JLHWS would be owned by the Health and Wellbeing Board and published in June 2024, without requiring Full Council approval. The Board acknowledged the importance of a broad equality impact assessment and ensuring the Strategy included clear actions and interacted with other Council strategies. It was confirmed that the JLHWS would incorporate some deliverables from the Health and Care Plan. The Board resolved to note the progress and agree the next steps for collating feedback and finalising the strategy.