Agenda item

A report will be submitted which provides the Committee with a progress update on the work of the Lead Councillors - Primary Care Networks and Local Health Improvement.

Contact:

Emily Parry-Harries, Consultant in Public Health

Vina Randhawa, Democracy Manager

A report was submitted which provided the Committee with a progress update on the work of the Lead Councillors - Primary Care Networks and Local Health Improvement.

Richard Parry, Strategic Director for Adults and Health and Emily Parry-Harries, Consultant in Public Health attended to present the report, including the following points:

·       The background to the introduction of Primary Care Networks (PCN) in 2019, as a result of a national requirement.

·       Each PCN should cover a population within the range of 30,000 and 50,000 people and had to make sense geographically.

·       There were nine PCNs in Kirklees.

·       One of the challenges associated with this piece of work was that the areas they covered did not align with Council wards.

·       The Fuller Review, which had considered the progress to date, and direction of travel, for PCNs had emphasised the potential for the development of the community health function of primary care.

·       The Lead Councillor – PCNs and Local Health Care Improvement initiative aimed to help develop PCNs connections with the communities they served through establishing relationships between them and the Lead Councillor. This would allow them to take advantage of the reach and local knowledge of elected members and to benefit from their starting point of how and where people live their lives.

·       It was noted that the relationships were at a relatively early stage, but it was anticipated that opportunities would be realised as they became better developed.

Questions and comments were invited from Committee Members, with the following issues being covered:

·       Prior to the initiative being introduced, a number of conversations had taken place with the Director of Primary Care for the Clinical Commissioning Group (now the Health and Care Partnership). The initial concept had been to allow the working relationships to develop organically, although it was now recognised that a focus on specific outcomes would be beneficial in the early stages.  A more prescriptive approach, using the relevant data packs, was now being taken with the Lead Councillors.

·       In the early stages PCNs had been seen as an opportunity to connect GPs to the wider capacity within communities although subsequent national and NHS requirements had moved them in a different direction. The challenge was working out how best to connect and collaborate.

·       It was questioned whether a public health specialist should undertake the role rather than an elected member, who may not have the detailed knowledge of the wider area covered by a PCN and was likely to have constraints on their time. In response it was explained that it was considered that there was a role for both; elected members brought a specific knowledge of their area and how to/what would work with the communities within.

·       It was acknowledged that it would be beneficial to engage with members of the wider teams delivering primary care, such as health visitors, in respect of the wider wellbeing and inequalities agenda.

·       Engagement with Practice Managers was also proving to be helpful.

·       It appeared that the feedback and learning from Place Standard work was helpful.

·       There was a need for communication and engagement with ward councillors on the priorities for the local areas, as had been undertaken through the Place Partnerships role; this would assist the Lead Members, giving them a stronger foundation for their discussions with the PCNs.

·       Feedback had been sought from all nine Lead Members. Additional support was being provided to those who wanted it and a series of workshops was scheduled for May/June.

·       There may be a need for the authority to consider how it wanted to be able to engage with and influence the PCNs as they developed into being the point of access to the healthcare system for most people.

·       The levels of operational pressure on the individual PCNs could differ and could impact on the level to which they were able to engage externally.

·       It was considered possible that the PCNs could have been better aligned with the district’s wards/geography.

·       There was a need for the Council to be assured of the return on the time and investment and to be clear on the outcomes that there was a desire to achieve.

·       A formal evaluation of the initiative should be undertaken, including what added value was being achieved.

·       One of the challenges to be considered was how to blend the increasing organisational delivery structure of the PCNs with local variations and having a sensitivity to place.

·       A focus on early intervention and prevention was considered to be key in addressing health inequalities.

·       A range of people, across the partners, were involved in working out where outcomes were not being delivered or people were not being reached in terms of early intervention and prevention. They would work together to influence how the whole range of resources could be used bring about improvement. The approach might be different in the case of each PCN.

·       Within a ward there could be a number of communities or sub-communities and there was a need to invest in roles at a very local level, to achieve the necessary level of understanding and have an impact.

·       The importance of continuity in the new municipal year was stressed. Assurance was given that there would be stability in terms of the officers who would be supporting the Lead Members which would assist if anyone new was appointed to the role for 2023/24.

Resolved-

(1)That, in undertaking their review of the role of the Lead Councillors – Primary Care Networks and Local Health Improvement, the Corporate Governance and Audit Committee be requested to give consideration to:

• The need for a formal evaluation of the role to be undertaken, including outcomes achieved and an assessment of the added value.
• The need for more prescriptive guidance/support for Councillors undertaking this role.

(2)That the following issues be taken on board in progressing the Lead Councillors -  Primary Care Networks and Local Health Improvement initiative:

• The need for engagement with all relevant ward councillors, as this will aid the Lead Members in assessing priorities for their area and assist in their discussions with the PCNs.
• The benefits of engagement with the wider teams involved with the delivery of primary care to further the place-based approach to improving health outcomes.
• The importance of place and the need for work to take place at very local level to ensure effective understanding of the needs of an area and how to address them.
• The importance of the focus on early intervention and prevention.
• The need for partners to work together to understand how the whole range of resources can be used effectively within each PCN.