North East and North Cumbria Integrated Care System Alan Foster ICS Executive Lead

Progress update and next steps ICS status for North East & North Cumbria now formally approved by NHSE/I; a real vote of confidence in our system approach Our ICS is a collaboration of NHS commissioners and providers (and our partners), and not a new organisation with statutory powers MOU will follow from Richard Barker setting out our responsibilities as a system and how NHSE/I will work with us Subsidiarity remains our guiding principle, with the majority of our work focused in places and neighbourhoods But, alongside this, our ICS provides a mechanism to build consensus on those issues that need to be tackled at scale. We’ve listened to our member bodies and have already reduced ICS workstreams from 22 to 6 Our voice is already being heard nationally: with ARC funding and Interim Workforce Plan pilot status secured, and an invitation to bid for Population Health Mgt funding  Next steps Formal endorsement of the high-level ICS MOU at governing bodies & boards in Sept In depth work with you all to agree a governance and clinical leadership model for our ICS Engage with Local Authorities on the opportunities of joint working, and agree ICS Partnership Assembly arrangements (Neil Mundy leading)

“doing the right things at the right level with the right partners” Key challenge: “doing the right things at the right level with the right partners” National Neighbourhoods/Primary Care Networks (30-50,000 population sizes) Place-based (Local Authority/CCG size) ICPs (Sub-regional/Combined Authority level) ICS (North East & North Cumbria) Regional & National People

NHS North & Yorkshire in 2018 One NHSE/I region, with Four Integrated Care Systems NHS in 1948

One North East and North Cumbria ICS with four Integrated Care Partnerships (ICPs) North East Ambulance Service FT covers North, Central &South ICPs NTW Mental Health FT covers the North and part of Central ICP TEWV Mental Health FT covers the South and part of Central ICP ‘North’ Population 1.025M 3 CCGs: Northumberland, North Tyneside, Newcastle Gateshead 24 Primary Care Networks 3 FTs: Northumbria, Newcastle, Gateshead 4 Council areas: Northumberland, North Tyneside, Newcastle, Gateshead ‘North Cumbria’ Shadow ICP 1 April 2018 Population 327,000 North Cumbria CCG 8 Primary Care Networks North Cumbria University Hospitals Cumbria Partnership FT Cumbria County Council North West Ambulance Service ‘Central’ Population 992,000 4 CCGs: South Tyneside, Sunderland, North Durham, DDES 24 Primary Care Networks 3 FTs: South Tyneside & Sunderland CDDFT 3 Council areas: South Tyneside, Sunderland, County Durham Overall population 3,191,000 North ‘South’ Population 847,000 4 CCGs: HAST, Darlington, S Tees, HRW 17 Primary Care Networks 3 FTs: CDDFT, North Tees, South Tees 6 Council areas: Hartlepool, Stockton on Tees, Darlington, Middlesbrough, Redcar & Cleveland, North Yorkshire

1 North East & North Cumbria ICS 4 Integrated Care Partnerships (ICPs) Local Authority Engagement opportunities – via Health and Wellbeing Boards and Combined Authorities 1 North East & North Cumbria ICS 4 Integrated Care Partnerships (ICPs) North of Tyne Combined Authority Newcastle upon Tyne North Tyneside Northumberland North East Combined Authority County Durham Gateshead Sunderland South Tyneside Tees Valley Combined Authority Darlington Hartlepool Middlesbrough Redcar and Cleveland Stockton-on-Tees 3 Combined Authorities 2 Counties with districts (Cumbria and N Yorks)

ICS Places and neighbourhoods Integrated Care Partnerships ICP ICP ICP Areas of focus Partnership working between NHS and local authorities via Health & Wellbeing Boards Ensuring the quality, safety and accountability of local health services Public and political engagement and consultation Primary Care Network development Health and Social Care Integration initiatives Joint-working with the local voluntary sector Places and neighbourhoods North Focus on acute services sustainability: clinical networking between neighbouring FTs and coordination of service development proposals One streamlined commissioning hub per ICP Work towards a single, shared approach to finances, and risk-sharing where appropriate. Make best use of the existing premises and facilities and jointly plan capital investments Integrated Care Partnerships ICP ICP ICP ICP Strategic Commissioning (e.g. ambulance) Overarching clinical strategy and clinical networks Shared policy development Emerging ICS-level priorities: Population Health & Prevention Optimising Health Services Workforce Transformation Digital Care Mental Health Learning Disabilities Integrated Care System ICS

Emerging ICS Workstreams ICS Health and Care Strategy (response to LTP) 1. Optimising Health Services (including all our clinical networks) 4. Population Health & Prevention 2. Workforce Transformation 5. Mental Health 3. Digital Care 6. Learning Disabilities Financial strategy Operational delivery

DRAFT Governance flowchart for issues escalated to ICS-level only CCG Joint Committee Local Authorities CCG Governing Bodies FT Boards and Committees in Common Stage 4 Formal approval at one or more of these decision-making bodies (as required) Health Strategy Group (Wider Clinical & Managerial Leadership) Stage 3 Discussion at CCG governing bodies, FT boards and Health and Wellbeing Boards as appropriate Sign-off from ICS senior leaders at HSG ICS Management Group (CEO reps from each ICP) Stage 2 Assessment and quality assurance of : ICS work programme proposals, or Risks and issues raised by ICPs ICS Clinical Leadership Group ICS Financial Leadership Group Stage 1 Recommendations from ICS work-programme boards (eg Prevention Board, Workforce Board) , quality monitoring groups and clinical networks, or Escalation of risks and issues from ICPs PROPOSALS, RISKS AND ISSUES ICS Partnership Assembly? Shaping and influencing our strategic priorities

ICS Partnership Assembly (TBC) Shaping and influencing our strategic priorities Statutory decision making CCG Joint Committee CCG Governing Bodies FT Boards Health Strategy Group (Wider Clinical & Managerial Leadership) ICS Clinical Leadership Group Local Authorities ICS Management Group (CEO reps from each ICP) ICS Financial Leadership Group North ICP South ICP Central ICP North Cumbria ICP 13 Health and Wellbeing Boards Optimising Health Services Workforce Transformation Population Health & Prevention Digital Care Mental Health Learning Disabilities Integrated Care Partnerships ICS Priority Workstream boards

Thank you