Integrated commissioning

Integrated commissioning update and changes to the VCSE representative structures 

Changes to health and social care
The picture in Health and Social Care remains very complex and the below is an attempt to explain the main changes. We will update you regularly on changes as they will have an impact on the Voluntary & Community Sector in Hackney.

CCG’s (clinical Commissioning Groups) will be merging across 7 Boroughs
North East London Health & Care Partnership (formerly North East London STP) covers 7 boroughs and will commission North East London wide health care interventions and campaigns and work on workforce development issues across East London. The plan is to merge all the CCG’s into this partnership over the next year or two.

Under this partnership there are 3  health and social care delivery systems known as Accountable Care Systems or Integrated  Commissioning Systems:

  • WEL – covering Waltham Forest, Tower Hamlets and Newham Barts Health, East London NHS Foundation Trust
  • BHR – covering Barking , Havering and Redbridge
  • City and Hackney

City & Hackney accountable care/integrated commissioning system
Is made up of a partnership of City & Hackney CCG (for now) London Borough of Hackney, East London Foundation Trust (ELFT), the City of London Corporation, Homerton University Hospital Trust. The Voluntary & Community Sector are also listed as a partner and have been involved since the beginning of this process.

The ICS has divided itself into the following workstreams:

  • Prevention – Workstream Director – Jayne Taylor – Public Health
  • Planned Care – Workstream Director – Siobhan Harper
  • Unplanned Care – Workstream Director – Nina Griffiths
  • Children Young People and Maternity – Director Amy Wilkinson

Neighbourhoods – Primary Care networks
In Hackney the Neighbourhoods programme has been underway for 18 months. This year the Government required all GP practices to take part in and establish Primary Care Networks. They are getting budgets directly from Central Government. In Hackney the Primary Care networks agreed to align geographically with the neighbourhoods.

There are a number of pilots going on across the neighbourhoods and the VCSE is leading one in Well Street Common neighbourhood that aims to better connect residents to services and activities they need, connect local VCSE and statutory organisations to each other and test and learn how the VCSE can best organise itself to work in neighbourhoods.

Well Street Common Neighbourhood pilot
We will work together to decide priorities for our neighbourhood, knowing that in our first year we will need to develop a ‘map’ of the brilliant local services and activities on offer in the Neighbourhood – helping  residents  find out about and access a broad range of services, groups and activities in our local community.

We will also work to strengthen voluntary and community sector organisations who offer activities and groups so that the Neighbourhood can continue to involve and support residents.

Well Street Common Neighbourhood Partnership meeting
On 19 September we’ll be covering:

  • Sustainability / Fundraising
  • Sharing expertise
  • Sharing results of mapping of services and activities

For more information contact Katie:
Date: 19 September; Time: 10:30am – 3:30pm; Register here.

Why is this transformation happening?
The local NHS and Hackney Council are changing the way they are working in response to the government’s integrated care agenda. Increasingly,  large organisations are recognising that services need to be delivered locally and local organisations and residents know best what is needed in their area.

What are the opportunities for the Voluntary and Community Sector, residents and frontline statutory staff?

  • to work more closely with GPs, social workers, community nurses and other professionals to provide better care and support for residents of all ages
  • to influence the way the NHS and Council provide services in the local area
  • to work together to identify gaps in services locally and jointly fundraise to meet these needs
  • to get to know other groups and agencies working locally so that we can all work together better

The Neighbourhood Health & Care Alliance
Whilst neighbourhoods are the vehicle for ‘transformation’ the funding is with the Health & Care Alliance which the Voluntary & Community Sector are not part of at the moment.

The Homerton, ELFT and the GP Confederation have been working together for several months on how they could deliver community services as a partnership. They have agreed to come to ICB in September to update the board on their progress.

In their discussions with commissioners they have identified some key barriers to progress:

  • Clarity over scope of services, what outcomes are to be achieved, or key quality requirements
  • what the future financial envelope is, including any medium-term efficiency or investment requirements
  • the need to develop a model that can incorporate local authority and VCS services
  • More thinking is needed on how the GP Contract (and forthcoming mental health implementation guidance) will shape the future delivery model

Providers would also seek to agree the best approach to organising themselves to deliver community services in future.

Overall whilst both VCSE representatives and Hackney CVS have been working very hard to ensure the VCSE voice is heard and respected within the ICS, there is still much work to do to get the ICS to see the VCSE as full partners in the system, and a change in the overall culture is needed which is a key plank of the local VCS Strategy that the Council are leading on. We aim to utilise the National Council for Voluntary Organisation best practice guidance (coming soon) to negotiate some written agreements regarding joint working and some funding to ensure we can contribute.