Agenda item

Terri Roche, Director of Public Health, and Anne Charlesworth, Commissioning and Quality Manager, to report

Anne Charlesworth, Public Health Commissioning and Quality Manager, presented details of the Public Health proposed efficiency savings of 1.8% across commissioned services. 

The All Service Review process undertaken by Public Health during June and July, 2015, had identified a savings programme to deliver the requested £1M from the Public Health budget over 3 years from April, 2016-19. Part of the savings programme included a cost efficiency reduction from the large NHS contracts held as follows:-

0-19 Children’s Health including Health Visiting from 2016 full cost

Sexual Health

Substance Misuse

In addition it was also proposed that 1.8% efficiencies could be delivered across the Stop Smoking Support programme area.

The service providers had been asked to identify how the savings could be achieved with minimal impact to patients and to work with leads in Public Health for each area to identify any areas of service that needed to vary in the service specification that was in place.  Timely and helpful responses had been received from the South West Yorkshire Partnership NHS Trust and RDaSH. A less detailed response had been obtained from the Foundation Trust in respect of how the savings would be made, however, they had indicated that they recognised that the efficiencies would need to be delivered.  Some services would also be going out to tender as outlined in the Appendix to the report.

Lynn Cocksedge, Head of Contracts and Business Development, Foundation Trust, stated that the discussions to date had been very difficult but progress had been made and the Trust was confident that they would be able to deliver the savings with as little impact as possible.  With regard to the Health Visitors Intervention, it was a management restructure and not a clinical provision restructure.  A number of meetings had been set up with Public Health to further progress the areas that were referenced in the report and as well as internal meetings within the Trust.  Due to some of the issues impacting upon staff, consultation by the Trust would be carried out in accordance with the associated regulations.     

Discussion ensued with the following issues raised/clarified:-

-          Many of the services were previously under the domain of the NHS.  Part of the process was to bring them in line with all other Council processes and, therefore, the tendering process would be in accordance with the Council’s procurement framework.  There would be supplementary clauses such as adherence to NICE guidelines and registration with the Care Quality Commission if applicable.  Attention was drawn to the briefing paper on procurement and commissioning in the information pack

-          It was the Trust’s intention to look at the footfall of each of the Sexual Health Clinics as some were better used than others but to ensure as limited impact on clients as possible.  It may be that some had different hours of opening to accommodate clients.  It was hoped that detailed information regarding the number of clients at clinics would aid better commissioning of Sexual Health services.  GP surgeries also provided such services

-          The integrated model provision of Sexual Health was provided in Sheffield and one that Rotherham was moving towards as well but had taken a little longer to get embedded within the workforce.  Several other areas of the country had also moved the integrated model to as a way of being able to provide a bigger range of things from more bases effectively and the model Rotherham was looking to recommission

-          The all services review process had not offered a very detailed mechanism to look at the proposals which were very different in nature.  A method had been devised of trying to gauge what the different areas of risk may be which resulted in the risk scores some of which would have greater impact of partners and some on patients.  Those that were still to be worked up with the Foundation Trust had been rated in accordance with the information available at the present time; these could be amended once the work had been completed

-          The School Nursing service would form part of the 0-19s procurement exercise with the current date for publication on Yortender being May. There was a lot of work to be done before then in fully agreeing it with Children and Young People Services to ensure it covered everything they wished the services to cover and consultation with other partners

-          Public Health were currently reviewing both the Public Health statutory functions “must dos” and “would like to dos” within the 0-19s procurement exercise as to what was currently provided and what might not be able to do in the future with possibly a move towards more targeted provision

Resolved:-  (1)  That the proposed savings from SWYFT and RDaSH by way of implementation in the contracts from 1^st April, 2016, be noted.

(2)  That the savings for the Foundation Trust and the proposed recommissioning and procurement of service in 2016/17 be noted.

(3)  That the increased recognition of the serious Public Health challenges facing the Rotherham population and of the relatively small level of the Public Health Grant be noted.

(4)  That the commitment for the grant to be utilised to support the work of the Health and Wellbeing Board and the prevention agenda in the Borough be endorsed.