This meeting will include a discussion of how the Bexley Health and Care system is planning for the future, what the key priorities are going to be, and how the NHS is going to be paying for it all. There will also be an update on the progress being made on Bexley's Pharmaceutical Needs Assessment.

Bexley's response to the 10-Year Health Plan

The Board will consider Bexley Council's response to the engagement exercise on the new NHS 10-Year Health Plan. This is a plan that will set out how the NHS in England will work for the next 10 years.

Bexley Council's response to the engagement exercise sets out their priorities for the new Plan. They want to see the plan deliver:

• Fairer access to good quality acute services
• A shift in care from hospitals to the community
• More collaboration with partners, including the third sector and Adult Social Care
• Fairer funding for Bexley
• More devolution of health budgets and decision-making to local areas

The response also highlights the need for the NHS to recognise and address the wider determinants of health. These are the social, economic, and environmental factors that can impact on people's health, such as poverty, housing, and education. The Council's response also sets out some specific policy ideas for change, such as improving access to dental health services and reducing waiting times.

South East London Integrated Care System - System Sustainability Programme

The Board will be provided with a presentation on the South East London Integrated Care System's plans to address what they have described as ‘significant financial pressure’. The report pack says that:

Even if these [cost improvement] programmes deliver in full, there is still a recurrent financial gap that needs to be filled. This recurrent gap is expected to be c £300m and will need to be mitigated in a 3-5 year time horizon.

The presentation will outline the System Sustainability Programme, which is being established to try to address these pressures. The presentation will also include discussion of specific opportunities for making savings across the whole system.

Bexley Integrated Neighbourhoods Model Roadmap

This paper outlines the development of Bexley's Integrated Neighbourhood Teams, and in particular how they are going to be working in the community to support people. The report says that this is:

a continuation of a journey that Bexley has already been on, while also responding to wider regional and national priorities.

Bexley's existing integrated care service, called Bexley Care, is delivered by Oxleas NHS Foundation Trust and the London Borough of Bexley. The Trust will be working with Bexley's four Primary Care Networks, across the three existing Local Care Network areas, Clocktower, Frognal and North Bexley.

The Board will hear about the two key areas of focus for the new model of care, which will be delivered by Integrated Neighbourhood Teams.

The first is Frailty, which will be delivered borough-wide. The ambition for this programme of work is to:

develop an end-to-end pathway that can wrap around individuals at the neighbourhood level.

The focus will be on the 5220 people in Bexley identified as moderately frail. This work will be delivered at Place level, building on the existing Bexley Care service.

The second area of focus will be on supporting people who have Multiple Long-Term Conditions. This work will be delivered by Integrated Neighbourhood Teams at the existing Local Care Network level, and will build on work done across the six boroughs of South East London.

Better Care Fund Update and Winter Planning

The Board will be asked to sign off the latest Better Care Fund return for Quarter 2 of 2024/25, which was submitted to NHS England on 31 October 2024. The report pack notes that:

Planning for this winter is in the context of already high levels of pressure on the acute system and concern continues regarding the lack of funding to support additional capacity should we need it.

The Board will be updated on the progress being made on the Better Care Fund and related metrics, including how the system is responding to increased pressures on hospitals, and what is being done to support people at home so that they can avoid having to go to hospital.

Pharmaceutical Needs Assessment (PNA) - Progress Update

The Board will receive a progress update on the production of the Pharmaceutical Needs Assessment (PNA) for Bexley.

It is a statutory requirement for a PNA to be developed and published every 3 years (or sooner where major changes have occurred) for each area covered by Health and Wellbeing Board.

Soar Beyond Ltd, a consultancy who specialise in helping councils develop and deliver Pharmaceutical Needs Assessments, are supporting the development of the new PNA. The draft of the new assessment will be considered by the PNA Steering Group at a meeting scheduled to be held in the week commencing 13 January 2025. If it's approved by the Steering Group it will then be subject to a 60-day public consultation, scheduled to run from 10 February to 11 April 2025. The final PNA is scheduled to be published on 1 October 2025.