The document discusses the creation of an Integrated Care System (ICS) for Norfolk and Waveney to improve how the NHS, social care, and voluntary, community and social enterprise (VCSE) sector work together. Key points: 1) An ICS will take collective responsibility for resources, standards, and population health. It aims to improve health equity, coordinate care, and make the area the best place to work in health and care. 2) Care will be increasingly integrated at the neighborhood and local place levels involving primary care, acute care, mental health, social care, and VCSE organizations. 3) A proposed ICS Partnership Board and VCSE Assembly are discussed to strengthen partnership working

1. Health, social care and the VCSE
sector: changing how we work
together
Melanie Craig, Chief Officer, NHS Norfolk and Waveney CCG
James Bullion, Executive Director of Adult Social Services, Norfolk
County Council

2. Eight months and twelve days
• Whether you work for the NHS, social care or the VCSE sector, the
pandemic been simultaneously challenging, tiring and inspiring.
• We’ve had many successes that show what we can achieve when we
work together. And we know there have been times when we haven’t
got it quite right.
• We all know that the VCSE sector saves lives and it helps to protect the
NHS and social services too. It did this before the pandemic; it will do
so afterwards.
• Today though, we want to say thank you for everything that you, your
colleagues and your organisations have done during the past eight
months and twelve days.

3. Changing how we work together:
becoming an Integrated Care System
• How we work together is as important as what we do - if we get our
partnership right it will deliver material outcomes and improvements for
our local communities.
• One of the next steps we are taking which will change how we work
together is to create an Integrated Care System, or ICS, for Norfolk and
Waveney.
• In an Integrated Care System, NHS organisations, in partnership with
local councils and others, take collective responsibility for managing
resources, delivering NHS standards, and improving the health of the
population they serve.

4. Why create an Integrated Care
System for Norfolk and Waveney?
Over and above everything else we want to achieve as a partnership, we’ve set
ourselves three goals:
1. To make sure that people can live as healthy a life as possible. This means
preventing avoidable illness and tackling the root causes of poor health. We know the
health and wellbeing of people living in some parts of Norfolk and Waveney is
significantly poorer – how healthy you are should not depend on where you live. This is
something we must change.
2. To make sure that you only have to tell your story once. Too often people have to
explain to different health and care professionals what has happened in their lives, why
they need help, the health conditions they have and which medication they are on.
Services have to work better together.
3. To make Norfolk and Waveney the best place to work in health and care. Having
the best staff, and supporting them to work well together, will improve the working lives
of our staff, and mean people get high quality, personalised and compassionate care.

5. Neighbourhood, place and system
Neighbourhood-
Primary Care
Network (PCNs)
(population 30-50k)
• Defined by GP practices and their registered lists
• Strengthen primary care
• Promote prevention and self-care
• Be responsive to the characteristics and needs of their local
populations – e.g. addressing the needs of a more deprived
population than the rest of the footprint
• Care for their populations through multidisciplinary community teams
including VCSE
Places- (population
circa 200k)
• Integrate primary care, acute care, community/mental health and
social care services together as well as VCSE
• Greater district council involvement at this level particularly housing,
leisure and community developments
• Potential for provider-led partnerships
System- Norfolk and
Waveney (population
1 million)
• System strategy and planning for the future
• Develop accountability arrangements across the system including
VCSE assembly.
• Set and implement strategic change and transformation at scale (e.g.
workforce planning, digital/information governance etc.)
• Manage performance and finances

6. Locality focus: the new context
• COVID-19 has underlined the case for collaboration and integration,
and accelerated some aspects of integration.
• Much of this innovation was led at a more local level than ICSs/STPs.
• As ICSs have developed, it has been clear that much of the work to join
up delivery and planning of care will need to take place more locally, in
‘places’ and ‘neighbourhoods’.
• These more local levels are particularly key to tackling health
inequalities and the wider determinants of health, as are stronger
relationships with local councils and the VCSE sector.

7. Developing an
in-depth
understanding
of local
communities
and
neighbourhoods
Working in
partnership
across multiple
agencies to
coordinate
service delivery
Driving service
transformation,
particularly for
community-
based services
Mobilising the
local community
and building
community
leadership
capacity
Making use of
local assets
Enabling local
organisations to
use all of their
resources to
support health,
social and
economic
development
Emerging functions / purpose

8. ICS Partnership Board
• The responsibilities of the Partnership Board include:
• Bringing key NHS, social care and public health partners to the
table, to ensure commitment of those with statutory responsibilities
and funding.
• Providing support and challenge to the ICS executive leadership
team.
• Enable partners to have honest conversations and reach decisions,
including on priorities and resources.
• The health and wellbeing boards will hold the ICS Partnership Board to
account, providing local democratic accountability.

9. Possible members Comment
Independent Chair Required by the NHS Long Term Plan
Commissioner GP Chair of Norfolk and Waveney CCG
STP Executive lead/ CCG AO
Health providers:
3 Acutes
2 Community
1 Mental Health
1 EEAST
3 representatives including 1 from each trust to include chair and CEO.
1 Chair, 1 CEO to represent community providers (from ECCH and NCHC)
Chair and CEO NSFT
Either Chair/CEO from EEAST
County Councils 1 representative and 2 officers (including Director of Public Health) nominated
by Norfolk County Council
1 representative and 1 officer nominated by Suffolk County Council
VCSE Assembly 1 representative from the VCSE Assembly
Primary Care Networks 1 PCN clinical director nominated to represent 17
Total membership: 18
ICS Partnership Board: Proposed
membership

10. VCSE Assembly
• The term ‘Assembly’ is used to frame our discussions around a model
of how we work together to improve the health and wellbeing of local
communities. It will be an important part – but not the sum total – of
how we work together.
• It will be open to all, and its purpose will be to:
• Strengthen our partnership working and further our mutual priorities
– e.g. prevention and support to the most vulnerable, or in
sustainability of our sectors.
• Increase the influence and participation of VCSE organisations with
health and social care in the design and delivery of health and
wellbeing services in Norfolk and Waveney.

11. Key areas for development
• Equal partnership: Support for the development of a culture,
behaviours and processes that are consistent with whole system
working and recognise the VCSE sector as an equal partner.
• Sustainable resources model: A model of resourcing that ensures
VCSE services that support the system’s effectiveness are resourced in
a sustainable, effective and efficient way.
• Digital integration: An approach to digital integration that is inclusive
of VCSE organisations and seeks to enable the best use of digital tools
across the system, enabling integrated working for our teams.
• Data sharing: The appropriate sharing of operational and intelligence
data across the sector and organisational boundaries.

12. Key areas for development
• Consistent evidence and evaluation: The identification of a
consistent set of tools recognised by both sectors, and used across
organisations consistently to provide reduced reporting demands,
support comparable results and enable stronger evidence-led delivery.
• Commissioning: The development of a joint health and social
framework for VCSE commissioning, that supports a strong market of
VCSE providers and market development aligned with the sector’s own
aims; is partnership-driven with VCSE involvement throughout the
whole commissioning cycle; and delivers contracting arrangements that
support the delivery of outcomes and are tailored to the needs of the
sector.