Developing Neighbourhood Working - LMC Chief Executive

Following on from the publication of the delayed 10-Year Plan we now have a vision document which sets out a direction of travel for the NHS in general and local service delivery. More detail will emerge in the coming weeks and months but we need an early conversation on what the ICB (and probably more importantly Place Teams) are thinking and a clear sense of direction from them on

· We need to build on the work already done by PCNs and in Care Communities locally How we are a agreeing ‘neighbourhoods’ and what is the population coverage (50k +/-)? What process will we follow if any local PCNs don’t fit the model?

 · Are there any co-terminousity issues? How can we ensure PCNs and neighbourhoods are co-terminus?

 · How will they be supported to facilitate discussion between organisations and other partes?

 · Are we expecting each neighbourhood to have a visible ‘health centre hub’ (looks like a hub and spoke approach)? How will this feature in current estates plans?

With our PCNs and GP federations we need to understand

· What actions do our PCNs need to take in the next 6 months to be ‘Plan’ ready?

· What might our GP federations want to do going forward especially within the context of the announcement that there will be two new primary care contracts (note not necessarily GP contracts)?

· We also need to understand the breadth of other stakeholders and their organisations and ensure they are involved (including the other three Local Representative Committees and the voluntary/ not for profit sector structures).

· What further help would you like from the LMC?

· The emergent GP collaboratives in East and West Cheshire can act as sounding boards and may be pivotal when the two new primary care contracts are available.

Wes Streeting has indicated that he wants development to be delivered “bottom up” to reduce centralised decision making so we are keen to see how this will be contracted as the devil will be in the detail and how other key players are thinking.

With our commissioning colleagues at NHS England and ICBs going through a difficult period of restructuring it looks like providers will be tasked with much of the reorganisation, working in collaborative arrangements. Can we get our interface groups working on these issues with an extended membership (e.g. GP federations etc.)? There is a risk that with a lack of commissioning oversight, success will be contingent on developing good local relationships which may cause more variability for patients.

William Greenwood

Chief Executive and Company Secretary