“Could Council please be given an update as to the progress made, actions undertaken and agreements entered into with Hywel Dda Health Board in establishing a truly integrated community care service throughout the area. Could Council also be informed as to the anticipated timetable for its establishment”.
Minutes:
“Could Council please be given an update as to the progress made, actions undertaken and agreements entered into with Hywel Dda Health Board in establishing a truly integrated community care service throughout the area? Could Council also be informed as to the anticipated timetable for its establishment?”
Response byCouncillor Jane Tremlett, Executive Board Member for Social Care and Health
Thank you for the question. As you know for some time we have had an integrated structure based on the three localities for older people. We share a head of service for older people with the health board and a head of commissioning with Pembrokeshire. Over the last 6 months progress has been slow although we have maintained a positive working relationship with Ceredigion, Pembrokeshire and the Health board. I can report progress in the following areas:
- There is now a consensus across the region that community health and social care should be organised by 7 localities across the region.
- A transformation bid has been developed by the regional partnership and positively received by Welsh Government although we are still awaiting formal agreement.
- The chief Executives of the 4 regional organisations have agreed a broad approach to reforming and strengthening the regional partnership and we hope to have formal agreement for new strengthened arrangements signed off by the end of March.
Progress has, however, been particularly slow on agreeing the detail of the structures that will need to be put in place to deliver the integrated offer of primary and social care. In particular, there is yet to be a common understanding as to how localities will relate to GP clusters and what specific services would be delivered at locality, county and regional levels. Indeed, in the last year some health services such as therapies have been centralised in the region.
As a council we are clear we wish to progress rapidly and remain optimistic that our good working relationship will translate into practical proposals and a clear timetable for implementation over the coming year.
Supplementary Question by Councillor Gareth John:
“Thank you for that response of which there were several positive elements. The Minister for Health and Social Care told Assembly members yesterday that even with Transformation Fund there’s still much to do on bridging gaps connecting, streamlining and reshaping how people access health care. He also expressed the critical role that the Regional Partnership Boards have in making this happen as they are the mechanism for the leaders of health and social care to work together with others to plan and deliver services and meet the needs of their local populations. He went on to add that he had begun to see change and improved relationships across health and social care with a greater sense of shared ambition. Given the huge cultural and organisational differences between the NHS and Local Government, Hywel Dda’s track record in partnership to-date and that their strategic capacity is totally focussed on keeping acute services going, balancing its budget and finding a field somewhere between St Clears and Narbeth, would you be able to confirm the Minister’s optimism that our regional partnership board, in its current format, will deliver the goods?
Response by Councillor Jane Tremlett, executive Board Member for Health and Social Care:-
I think, knowing the amount of work that has gone on over the past year, or so, I’m going to hand over to the Director to give you some good news.
Response by the Director of Communities:
I guess we’ve always got to be optimistic. These are really hard miles to make this work and it’s something the whole of the U.K. has tried to work on and have tried to battle. So I think I’d be optimistic but, I’d put the word cautious before it. So I’d be cautiously optimistic. The Partnership Boards were formed for one purpose. They’ve now been used as a vehicle for a much bigger change. As the Lead Member has said, we’re working with our health partners and neighbouring authorities to go some-way to reforming that to making the governance fit for purpose to deliver pooled budgets of circa £100m, fully integrate health and social care. Huge reform which has to have a balance between dynamic executive leadership and political oversight. And therein lies the challenge to get the governance right and to reform the partnership boards to be fit for purpose to deliver. So, optimistic, yes, but cautiously optimistic, because as you know, I’ve been at this a very long time. Relationships are good and there’s a willingness. But to say we were there yet, would be a significant overstatement.