Agenda and draft minutes

Deborah Fellowes, Scrutiny Manager, reported that, with regard to the proposed closure of the Children’s Cardiac Surgical Hospital in Leeds, the Secretary of State for Health had asked the Independent Reconfiguration Panel to look at the Joint Committee of PCTs’ decision.  The Yorkshire and Humber Joint HOSC had asked for a letter to be written to the Independent Panel outlining its concern about the potential impact of the Service relocation to children and their families in Rotherham.

The Panel had met in Leeds with representatives of the Joint HOSC and other stakeholders earlier that week with a comprehensive presentation by councillors from the Joint HOSC.  The outcomes from the meeting was not known.  The Independent Panel had a provisional deadline to report back to the Secretary of State at the end of January, 2013.

An update would be given in due course.

Consideration was given to the minutes of the previous meeting of the Health Select Commission held on 6th December, 2012.

Arising from Minute No. 43 (Rotherham Foundation Trust), it was noted that a summary of outstanding issues from the presentation had been sent by e-mail to which there had been no response as yet.

Concern was also expressed regarding reports in the local press of an alleged letter of resignation from the former Chief Executive which raised important issues relating to the manner in which business was being conducted.  The Trust had released a press statement but it did not clarify the situation.

It was proposed that a letter be sent to the Trust expressing the Select Commission’s disappointment.  If a response was not forthcoming, consideration should be given to requesting the Trust to attend a further meeting.

Resolved:- (1)  That the minutes of the previous meeting be agreed as a correct record for signature by the Chairman.

(2)  That Councillor Dalton be added to the membership of the Childhood Obesity Working Group.

(3)  That a letter be sent to the Foundation Trust expressing the Select Commission’s disappointment that no response had been received to the outstanding issues from the Acting Chief Executive’s presentation to the December meeting.

(4)  The consideration be given to the areas it would wish the Trust to focus it work in 2013/14 at the next meeting.

Consideration was given to the minutes of the meeting of the Health and Wellbeing Board held on 16th January, 2013.

Attention was drawn to the Board’s 6 Priority Themes, in no priority order of ranking. 

An issue for the Board was ensuring all partners were signed up to the information sharing protocol.  The British Medical Association had its own guidelines for Doctors which fitted with the protocol. 

It was noted that HealthWatch had been put out to tender again with a closing date of 23^rd February, 2013.

Resolved:- That the minutes of the Health and Wellbeing Board meeting be noted.

Councillor Wyatt, Cabinet Member for Health and Wellbeing, gave the following powerpoint presentation:-

National Context – Health and Social Care Act 2012

-          NHS Commissioning Board established October, 2012, to commission some national health services and co-ordinate

-          Local GP-led Clinical Commissioning Groups

-          Public Health England established and local responsibility transferred to local authorities

-          Increased democratic accountability and public voice through establishment of local Health and Wellbeing Boards and HealthWatch

Local Implementation - Health and Wellbeing Board

-          Local authorities leading co-ordination of health and wellbeing through the creation of high level Health and Wellbeing Boards

-          Rotherham Health and Wellbeing Board established September, 2011 as a sub-committee of the Council

-          Chaired by the Cabinet Member for Health and Wellbeing

-          Produced Joint Strategic Needs Assessment and Joint Health and Wellbeing Strategy

-          Would take on statutory responsibility April, 2013

Core Membership of the Board

-          Cabinet Member for Health and Wellbeing (Chair)

-          Cabinet Member with responsibility for Adult Services

-          Cabinet Member with responsibility for Children’s Services

-          Director of Public Health

-          Chief Executive, RMBC

-          Strategic Director of Neighbourhoods and Adult Services

-          Strategic Director of Children and Young People’s Services

-          Strategic Director of Environment and Development Services

-          Chair of Clinical Commissioning Group

-          Chief Operating Officer, CCG

-          NHS Commissioning Board

-          Chief Executive, Voluntary Action Rotherham Metropolitan Borough Council Rotherham HealthWatch (once in place 2013)

-          Chief Executive, Rotherham Foundation Trust

-          Chief Executive, RDaSH

-          Co-optees as and when required

Rotherham Clinical Commissioning Group

-          Established January, 2011 - all Rotherham GP practices part of it

-          CCG Committee currently in place made up of GPs, NHS managers and lay-members

-          Chair of Health and Wellbeing Board had a seat on CCG Committee

-          Received first wave authorisation to assume full responsibility for commissioning majority of healthcare services for local people April, 2013

Public Health

-          Local authorities would take on statutory duty for Public Health in April, 2013

-          Rotherham was ahead of the game with Public Health staff now located within the Council whilst the transition took place

-          No decision yet as to the long term structural model locally

-          Directors of Public Health would be jointly appointed between the Local Authority and Public Health England from April, 2013

Joint Health and Wellbeing Strategy

-          Set the strategic priorities for collective action to improve the health and wellbeing of local people

-          Demonstrated how the needs and issues identified within the Joint Strategic Needs Statement and other local knowledge would be tackled

-          Supported the Health and Wellbeing Board to tackle the wider determinants of health and wellbeing – such as Housing and Education

-          Enabled commissioners to plan and commission integrated services that met the needs of the whole local community

-          Service providers, commissioners and local voluntary and community organisations would all have an important role to play in identifying and acting upon local priorities

-          Now in implementation phase with 6  ...  view the full minutes text for item 53.

Councillor Hoddinott presented a report on a conference she had recently attended, held in Leeds on 17^th January, 2013, entitled “Taking on inequalities in Health and Wellbeing locally – how Health and Wellbeing Boards can lead the way” highlighting the following:-

-          Health and Wellbeing Boards – “too pink and fluffy”

-          Life expectancy had increased by 5 years

-          The gap between non-manual and manual workers had not narrowed – social class still mattered more than where you lived

-          The most deprived were a long way behind and would require more resources to make a difference

-          Employment was positive for health outcomes

-          Indirect taxes hit the poorest the hardest

-          Miles on the Clock – description for health inequalities

-          Be bold – danger that commissioning could follow fads and fashions and had a project piecemeal approach

-          Diversity of Boards – membership, frequency of meetings, support networks

-          A Board had to have Partnership, Vision and Strategy, Leadership and Engagement

-          Importance of making every contact count

-          Health Equity Audit

-          Community engagement

Discussion ensued on the report with the following issues raised/clarified:-

·           The need to look at the gaps of drop-offs

·           Resources for Health Scrutiny – the size of the new Health agenda would require more resources

·           Best Start in Life – should be looking at children from birth – 2 years of age was too late

·           Work had taken place 3 years ago in Rotherham – 100 Babies - demonstrating that if there was no intervention with children from birth they were less likely to succeed

·           Need to be clear as to why the Authority/agencies were doing what they were doing to tackle social injustice and putting things into place to redress the balance

Resolved:-  That the report be noted.

Cath Saltis, Yorkshire and Humber, reported on the work she was conducting on behalf of the Centre for Public Scrutiny and the Local Government, Yorkshire and Humber on the development of the Health Scrutiny Regulations.

Consultation on the future Regulations governing local authority Health Scrutiny had taken place between July and September, 2012.  The Regulations had been expected in January, 2012, however, the Department of Health had published a response to the consultation which gave a good indication as to what the Regulations would look like.

The Act shifted the power of health scrutiny from Health Scrutiny Committees to the Local Authority with powers to enable the Authority to arrange for the functions to be discharged through a HOSC or indeed some other arrangement.  The scope had been extended to include providers of NHS and Public Health services commissioned by the NHSC, CCG and local authorities that included providers in the independent and third sectors.

Cath also highlighted the following issues:-

-          Power to refer to the Secretary of State should be by the full Council rather than the designated Health scrutiny committee - the draft response suggested that should the local authority pass the function to a body other than the Overview and Scrutiny Committee then it should be full Council

-          If the Health scrutiny committee had the delegated function, additional safeguards should be set in place e.g. requiring the Health scrutiny committees to notify full Council of their intention to refer a matter to the Secretary of State before the referral was made giving the opportunity to debate that intention

-          Joint Scrutiny – the Government agreed that this had been an effective means of examining proposals that spanned more than 1 area.  It would require the formation of joint scrutiny arrangements where the change proposer consulted with more than 1 local authority

-          Health and Wellbeing Boards – would be subject to Health scrutiny.  HealthWatch would be able to refer matters to Health scrutiny and should get a response within 20 working days and keep the referrer informed of any action it intended to take

-          HealthWatch – described as a “critical friend”.  There was potential for scrutiny work to duplicate and there were some things that HealthWatch could do that the Health Select Commission could not.  HealthWatch at local level would have the power to access that the Select Commission did not but it did have lots of other powers.  It had been suggested that as far as possible endeavour to maintain a good collaborative working relationship with HealthWatch whilst maintaining the differing levels of responsibility

-          The Health and Wellbeing Board and CCG etc. would be subject to Overview of Health.  The working relationship of those bodies would have to be worked through and shared agreement and protocol

-          Public Health – whilst coming to the local authority it would be an Executive function and therefore subject to Over and Scrutiny

-          National Bodies – some were trying to look at how they  ...  view the full minutes text for item 55.

Deborah Fellowes, Scrutiny Manager, reported that she had met with colleagues from the Clinical Commissioning Group.  The Access to Healthcare Services was on the current work programme to look at GP Surgeries, the Walk-in Centre and A&E.  The meeting had suggested that they were better divided into 2 areas - Access to Emergency Health Care and Access to GP Services.

Access to Emergency Health Care was going out to consultation. An all Members Seminar had been arranged for 13^th February, 2013, to inform Members of the proposals.  A formal consultation process would then follow.

It was suggested that consideration be given to any further necessary work after the seminar.

Work would then take place on the Access to GPs area.

Resolved:-  That a further meeting be held on Thursday, 7^th March, 2013, commencing at 9.30 a.m.