Agenda item

- presentation by Linda Phipps, CfPS, and Kate Taylor

Kate Taylor, Policy and Scrutiny Officer, and Linda Phipps, Centre for Public Scrutiny, gave the following powerpoint presentation:-

 

Centre for Public Scrutiny (CfPS) Programme

-        Programme funded by the Healthy Communities Team at Local Government Improvement and Development

-        To provide early insight into the development of accountability arrangements

-        Consider ways of working between Scrutiny, Health and Wellbeing Boards and Clinical Commissioning Consortia

 

Project aims: Rotherham

-        To understand new structures and accountabilities within the context of the new health reforms

-        To examine ways in which the Health Select Commission, GPs, Clinical Commissioning Groups and Health and Wellbeing Boards can work together

-        To understand how scrutiny can remain effective in a situation of reduced but more integrated resources

-        To enable Rotherham to demonstrate its leadership in health scrutiny through participation in the next phase of Scrutiny Development Area (SDA) activity

-        To participate in learning activities to capture and share project learning and insight

-        To enhance Rotherham’s own process of scrutiny

 

Workshop 1: Health and Wellbeing Board Representatives

Stakeholder and Role Mapping

-        Vast number of organisations identified – demonstrating the complexity of the Health and Wellbeing agenda

-        There are a number of ‘layers’ in the structure from local organisations and agencies which Rotherham can control, to those which Rotherham has no control over

-        There needs to be a relationship between other Boards which sat alongside the Health and Wellbeing Board locally

-        Organisations are changing or being re-shaped and although the map may look the same, the roles and responsibilities may change

-        Health Select Commission is “Cat with a Paw” – probing and asking questions about what difference X has made and what could be done differently

 

Questions raised

-        Health and wellbeing is also about economic wellbeing, regeneration and education – where does this fit in and how does the Health and Wellbeing Board influence these aspects?

-        How do we get private sector (providers) involved; how do we influence them including workplace health?

-        What is the future of joint planning boards – will GP commissioning become the new partner when PCTs are abolished?

-        How does the general public input into the Health and Wellbeing Board?  Is this through GPs/Councillors etc. who already have a relationship with people in communities?

-        How do Safeguarding Boards fit with the Health and Wellbeing Board?

-        How does the Health and Wellbeing Board fit the Local Strategic Partnership, Safer Rotherham Partnership/Adults and Children’s Boards?

-        How will public health be commissioned?  Does there need to be a public health commissioning board?

-        Are we doing enough for young people?

 

Worksop 2: Members of the Health Select Commission

Structure Processes and Protocols

-        Paul Plsek on good governance – 3 dimensions: structures, processes, patterns

-        Produced table of ‘What is needed’ and diagram to show processes:-

Structures                       

Terms of Reference

§         Is the membership right?

§         Do we have people common to both the Health and Wellbeing Board and GP Commissioning?

§         What are the accountabilities?

 

Processes

§         Monitoring and performance

§         Communicating between various groups

§         Review of big themes e.g. education and health

§         Democratic deliberation

 

Protocols/Behaviours

§         Conflict resolution

§         Learning from other areas

§         Managing conflicts of interest

 

Questions raised in relation to Scrutiny Role

-        What do we mean by ‘holding to account’ – does this mean ‘influencing’ or calling organisations in to ask why outcomes/targets had not been met?

-        Who has the power to control and direct things around to achieve the best outcomes?

-        Who checks that contracts enable the right activity in relation to the commissioning plans?

-        Is if the role of scrutiny to look at and ask questions regarding major service changes or will these go to the Health and Wellbeing Board in the future or both?

-        Where will ideas come from in future for scrutiny work programmes?

o       Should this be developed with the Health and Wellbeing Board or the chair?

o       Should this be ‘bottom up’ from direct local experience as a Council, the Joint Strategic Needs Assessment or Health and Wellbeing Strategy and complaints?

o       Or from all directions?

 

What should Scrutiny be asking

-        Are we commissioning the right services to meet Joint Strategic Needs Assessment priorities?

-        Are contracts producing the right activity in relation to commissioning plans?

-        Are we meeting national targets for Health inequalities outcomes.  If not, what more should be done?

-        Are we reducing specific conditions e.g. diabetes or teenage pregnancy?

 

National learning

-        Rotherham project had formed part of national learning

-        Action learning Event attended by Councillors Jack and Wyatt

-        CfPS Publication in October, 2011

 

Rotherham Learning

How do you see Health Scrutiny in the future?

-        What are the key issues

-        How would you like to work with the Health and Wellbeing Board

-        How do we keep ‘Scrutiny’ at the centre

 

Discussion ensued on the presentation with the following points raised:-

 

-        Include the Fire Service and Ambulance Service on the list of providers

-        The need to get the questions, actions and purpose right so as to achieve the best outcomes for the people of Rotherham

-        The need to work with the Cabinet Member for Health and Wellbeing and the Health and Wellbeing Board

 

Resolved:-  (1)  That the report be noted.

 

(2)  That the officers and Members involved in the Workshop be thanked for their efforts.