Appendix 1

Summary of new statutory arrangements and the supporting principles underpinning how we will work together

1) New statutory arrangements for partnership across the NHS and Local Government

· There are two new statutory bodies that make up the Sussex Integrated Care System (ICS): the new Sussex NHS Integrated Care Board (ICB) and the wider Sussex Health and Care Assembly ‘integrated care partnership’. 

· The Chair of the Health and Wellbeing Board will represent the County Council on the Sussex Health and Care Assembly;

· The three upper tier Councils in Sussex are represented on the NHS Sussex ICB by a Director of Adult Services, a Director of Children’s Services and a Director of Public Health drawn from across the Councils;

· The Sussex Health and Care Assembly has been established by NHS Sussex ICB, East Sussex County Council (ESCC) West Sussex County Council (WSCC) and Brighton & Hove City Council (BHCC) as a statutory joint committee, to formally act as the Sussex ‘Integrated Care Partnership’ with responsibility for agreeing the strategic direction which meets the broader health, public health and social care needs of the population in the Sussex ICS footprint.

2) Agreed principles for ‘Place’ within the Sussex ICS

The importance of ‘Place’ within our ICS has already been recognised by our Sussex ICS to ensure a strong focus on local population health and care needs, integrated care and reducing health inequalities. 

There are three Places in the Sussex ICS based on the upper tier Local Authorities and Health and Wellbeing Board boundaries in Sussex – Brighton and Hove, East Sussex and West Sussex – each with informal health and care partnerships that enable joint working across organisations working at Place. In summary it has been agreed that the focus of Place and Place-based partnership plans is on the coordination and delivery of the following:

· Population health management using public health principles

· Addressing health inequalities

· Transformation of clinical pathways and health and care service models

· Primary care – accelerate the development of Primary Care Networks (PCNs) and neighbourhood working

· Priorities for social care and housing, and other services related to delivering outcomes for our community

· Operational issues and pressures

The following high level principles have been produced to underpin how the NHS Sussex ICB will work with and at Place, to support close working between the three Local Authorities and the NHS in the ICS:

· The three Place-based Health and Care Partnerships in Sussex are collaborative and non-statutory arrangements where all the organisations responsible for planning commissioning and delivering health and care services for the populations in that geographical area work together.

· In collaboratingat Place, individual statutory organisations are responsible for agreeing decisions relating to their budgets and services according to their existing practice and processes. 

· The Joint Strategic Needs Assessments and the Health and Wellbeing Strategies agreed through the three Health and Wellbeing Boards set the evidence base and strategic framework within which priorities at Place are identified.

· Place-based planning, commissioning and delivery will be focussed on a clear scope of services aimed at integrating care, improving health and reducing health inequalities.  Wider partners in the voluntary, community, social enterprise (VCSE) and independent care sector, and Borough and District Councils (where applicable), will be engaged to mobilise and support the best use of the resources collectively available.

· At a pan-ICS level, the Sussex Health and Care Assembly will be responsible for producing the Integrated Care Strategy for the system. This high level strategy will reflect the priorities in, and be built from, the three Health and Wellbeing Strategies.

· NHS Sussex is required to develop and implement a Delivery Plan that delivers the Assembly’s Integrated Care Strategy. The principle of subsidiarity is paramount – NHS Sussex’s Delivery Plan will be implemented through the three place-based Health and Care Partnerships, unless there is collective agreement that it makes more sense to deliver an element at the pan-Sussex level. NHS Sussex will align resources and management capacity to support the three place-based Health and Care Partnerships to implement the Delivery Plan

· Effective delivery at place therefore requires the full involvement of local authority partners in the development of NHS Sussex’s Delivery Plan and other key related decisions before those decisions are taken by the NHS Sussex Board or its executive.