Agenda item

A system-wide transformation programme to transform and improve urgent and emergency care services for Dorset residents is underway.  Involving health and care partners it is anticipated that the transformation programme will take 2 years to deliver and should substantially reduce the number of people admitted into hospital when better outcomes could be achieved elsewhere and should result in fewer people waiting in hospital to be discharged while ongoing care is arranged.  Work has now progressed and in parallel with other health and care organisations across Dorset the Council must now consider whether to participate in the next phase of the programme.

The Director of Adult Social Care and the Corporate Director for Wellbeing presented a report, a copy of which had been circulated to each Member and a copy of which appears as Appendix 'C' to these Minutes in the Minute Book. The Committee was informed that a system-wide transformation programme to transform and improve urgent and emergency care services for Dorset residents was underway.  The programme involved health and care partners, and was anticipated to take 2 years to deliver and should substantially reduce the number of people admitted into hospital when better outcomes could be achieved elsewhere and should result in fewer people waiting in hospital to be discharged while ongoing care was arranged.  Work had now progressed and in parallel with other health and care organisations across Dorset the Council must consider whether to participate in the next phase of the programme. Issues raised by the Committee in discussion of this item included:

·       Key areas of the Programme Partnership Agreement – It was close to being signed off and was going through all of the different partners. It was expected there may be further minor amendments to the agreement. There would also be further legal consideration of the item. The programme operated on a fee guarantee. The Partnership agreement set out that the BCP share of the fee would be proportionate to the Council’s share of the benefits. In July 2025 the programme would be reviewed to ensure confidence in making the share of costs and benefits work.

·       Oversight of the Programme - There were mechanisms in place to address how the Council would monitor this as a system. The operational mechanism behind this was that there would be 6 workstreams and each of these work streams would have an SRO, and each of the work streams would be very clear about the diagnostic work that was undertaken with Newton's support.

·       External Partner involvement - It was noted that there were many different factors impacting on this and it would not be possible to work through this as an individual organisation. It needed to be done in partnership with a systems-based approach. There would be much greater impact and improved outcomes for individuals if this was done as a partnership. There were governance and monitoring plans in place. Concern was raised regarding the involvement of Newton in an extremely complex process as it appeared that they hadn’t delivered on this scale previously. The Committee felt that it would be good to see more robust evidence for them being the right partner to take this forward.  The Committee was advised that Dorset Council was the lead partner and BCP were involved in the initial decision to bring in Newton to work on the diagnostic. The Corporate Director confirmed that Newton did have significant experience in this area. Other local authorities were already engaged in similar work which was being delivered through Newton and assurance had been received on how the programme had progressed. Measures of success – The Committee questioned what success would look like for this programme. It was explained that this would be based on the outcomes of people’s experience, for example a reduction in the need for acute hospital beds and improved short term interventions.

·       Fulfilled Lives Programme – The Committee questioned how the programme would be separated.  It was noted that the fulfilled lives programme is broader and less directed. The reablement strand of the programme was the area with synergies with this programme.

·       Financial implications – The Committee asked about the savings which would be generated through the programme. Assessed the extent of the cashable benefits and looked at £3.6 million by 27/28 being able to be included within the balance sheet for the BCP budget.

The Committee requested that the issues which the Committee had raised be communicated to Cabinet. The Committee wanted BCP to achieve the outcomes which the programme was seeking to achieve. The Committee suggested that there should be an opportunity to check progress prior to the time of the Mid-year review and that Cabinet should ensure that all options, including not using a partner to deliver the programme and keeping it as an inhouse project, had been fully considered. It was noted that the basis for the partnership agreement was on a share of costs and benefits and there was a fee guarantee which was set out in the agreement. Newton would be an ongoing partner in the programme and there had been robust negotiations around fees and benefits.

RESOLVED that the Committee supported the following recommendations to Cabinet:

(a)           Notes the summary of the diagnostic review, including improved outcomes for residents and financial benefits for the Council.

(b)           Notes that under the draft Partnership Agreement with Dorset health and care partners, anticipated benefits are significantly in excess of costs to the Council.

(c)           Delegates to the Corporate Director for Wellbeing, in consultation with the Portfolio Holder for Health and Wellbeing, the Director of Law and Governance and the Director of Finance, authority to enter into the Partnership Agreement to undertake the proposed transformation programme.

Voting: Nem. Con. happy with recs an Chair will make comments to Cabinet.