Agenda item

To inform the Board of the dissolution of the partnership agreement between the County Council and Northumbria Healthcare NHS Foundation Trust (NHCT), and of a proposed new partnership between the Council and Harrogate and District NHS Foundation Trust (HDFT) covering the public health services for children, young people and families which were included in the partnership with NHCT. 

The Board was informed of the dissolution of the partnership agreement between the County Council and Northumbria Healthcare NHS Foundation Trust (NHCT), and a proposed new partnership between the Council and Harrogate and District NHS Foundation Trust (HDFT) covering the public health services for children, young people and families which were included in the partnership with NHCT.

Cath Mc-Evoy Carr, Executive Director of Adult Social Care and Children’s Services, and Liz Morgan, Director of Public Health gave a presentation to the Board which included the following:-

·            Background to the arrangements dating back to 2001.

·            The steps surrounding the planned review in 2019-20 leading to notice being served to end the partnership, but with an extension until the end of September 2021.

·            Adult Social Care was the largest area of transfer.  The relevant staff had been notified about the appropriate TUPE arrangements.

·            A new model of care had been drawn up which aligned more closely to PCN and Mental Health Services.  Closer links were also planned with Children’s Services and other external services to develop the whole family approach along with links to Northumberland Communities Together and the community and voluntary sector offering greater choice of intervention.  The principles behind this were listed.

·            Service Overview and Plans: Hospital Discharge and Reablement.  To allow safe and appropriately timed discharge from hospital and help people recover their independence with the use of Short Term Support Services, Occupational Therapists and Physiotherapists

·            The new service model was known as RESET, REcovery, Support and Enable Team.

·            Other services affected were

·            NHS Continuing Health Care

·            Learning Disability Community Nurses

·            The Joint Equipment Loan Service

·            Future Opportunities included

·            greater opportunities for joint working over a range of services including CNTW, community health teams and housing and property services

·            integrated support for care homes,

·            improving connections for people with disabilities with local voluntary and community services

·            wider range of accommodation and support options for older people

·            Support for those with chaotic lives due to alcohol, drug or substance misuse.

·            Public Health had two services within the partnership agreement; Integrated Wellbeing and the 0-19 Public Health Service (Healthy Child Programme)

·            Integrated Wellbeing – Team of specialist health improvement practitioners, specialist stop smoking advisors and health trainers.  These staff would transfer to the County Council and most were currently already located in County Hall.

·            0-19 Public Health Service – Staff included health visiting, school nursing and associated staff (not maternity).  The partnership approach was preferred in order to provide greater flexibility, enable integration, more flexible working across organisational boundaries, shared objectives and joint solutions.  The preferred partner was Harrogate and District NHS Foundation Trust (HDFT) which was already provider to six other North East Local Authorities.  The proposed partnership provided an opportunity to transform and innovate and promote greater integration with Children’s Services.  The consultation on entering into the S75 Partnership Agreement would conclude on 15 August 2021.

Liz Morgan introduced Members to Suzanne Lamb, Head of Safeguarding and a Director of Nursing, Harrogate and District NHS Foundation Trust.  Ms. Lamb made a number of points:-

·            HDFT provided services to seven Local Authorities, six of which were in the North East and an immunisation service.

·            The HQ was based at Harrogate hospital but the 0-19 services were based in the community with bases all over the North East.  Ms. Lamb’s office was based in County Hall, Durham.

·            The Trust would develop a model in collaboration by focusing on listening and learning about what already worked well.  The Trust had been able to innovate through this type of collaboration and developed integrated pathways.

·            There had been worries and queries from staff about having to travel to Harrogate, however, this was not the case and they would remain working from their current bases.

·            There was a strong thematic lead approach including a Learning and Best Practice Forum which it was hoped would be brought into Northumberland.

·            There would be an integrated approach at a strategic level.

·            Managers had monthly meetings both in groups and individually with staff.  It was important to look after staff.

·            It was acknowledged that there would be a lot to learn from Northumberland and the learning would work both ways.

·            If the partnership agreement was agreed, the Trust looked forward to working together with Northumberland County Council and learning from its best practice.

The following comments were made in response to the presentation:-

·            Paula Mead (Chair of Northumberland Strategic Safeguarding Partnership) commented that the Harrogate Trust had been invited to attend the next meeting of the Safeguarding Partnership to discuss ongoing arrangements. 

·            From a safeguarding point of view, Northumberland had a very strong safeguarding partnership with all the agencies involved being very committed. 

·            The plans for integration and working for children with the Local Authority were welcomed and there was a longstanding culture and history of working in that way. 

·            Safeguarding was not only about child protection but was a continuum early years, early intervention and help was a very important part of the whole system.  The health visiting and school nursing service were key along with working with early years, children’s centres and schools.  This was a high performing service which met all of its requirements.  The partnership which included the Northumbria Healthcare Trust a strong member of the partnership, would make sure the new arrangements worked. 

·            Councillors R.R. Dodd and V. Jones welcomed the proposed partnership with HDFT.  Both expressed concern at recent events and referred to meetings they had attended with the Northumbria Trust earlier in the year at which the Trust had been very clear that the partnership would end.  Claire Riley, Northumbria Trust, commented that the letters attached to the agenda clearly stated the Trust’s position and that the Trust Chair had attended the Corporate Services Overview and Scrutiny Committee on Monday, 9 August 2021 and answered questions.  A letter had then been circulated welcoming a pause to reflect and sit back around the table.  Realistically, all parties needed to move forward and not lose sight of the collective partnership that had been built up over the years.

·            David Thompson, Healthwatch, stressed the need to put patients first as a priority and was concerned that sight of this could be lost if the past was continually raked over rather than looking to the future and making the new arrangements work.

·            The Chief Executive agreed that Northumberland’s residents were the priority along with staff whether working for the County Council or NHS.  Happy staff would provide good quality care.  The Integrated Model of Care had been pushed out into the community over the last few years, so that residents who were not in bed based services and who were sometimes hidden, isolated and vulnerable would be focused on whether that was providing the best start in life or supporting them at the end of life.  These services were a statutory function and this was recognised by the Cabinet.  The Chief Executive believed that the Harrogate Trust would be a very strong partner and it had evidenced its track record on delivering these services and innovation in the community. 

·            Councillor H.G.H. Sanderson, Leader of Council, emphasised that the political direction was clear and he did not feel that any more time should be spent re-opening negotiations.  He was happy to meet with representatives of the Trust to discuss what had changed so significantly in recent days that would lead to revisiting the decision.  He had received weekly updates throughout the negotiations on all aspects including the financial implications.  It was important to ensure that residents were looked after and that the staff were reassured as to the direction the Council was taking. 

·            Claire Riley stressed the need to thank the staff for their work and dedication during this difficult time.

RESOLVED

(1)     The Board’s comments on the implications for integrated working across health and social care in Northumberland resulting from the ending of the Council’s partnership with NHCT be noted.

(2)     The Board’s comments on the new partnership arrangement for health visiting and school nursing services proposed by the Council and HDFT be noted.

(3)     the contents of the two letters about these matters sent by the Chair of NHCT to the Chair of the Council’s Health & Wellbeing Overview and Scrutiny Committee and the response to these letters from the Council’s Chief Executive be noted.