In accordance with the Scrutiny Procedure Rules, the requisite number of members (Councillors Connett, Brazil, Dewhirst, Greenslade and Way had invoked the call-in procedure in relation to the above decision of the Cabinet, to enable the Health and Adult Care Scrutiny Committee to consider this matter on the grounds of Governance in that the governance for the new proposals was a weakness. In addition, there has been a lack of consultation with the public regarding the proposals. Also, the reference in the report concerning some implementation from April 2018 is an inadequate time for scrutiny through the normal committee timetable.
The Cabinet is advised that the Health and Adult Care Scrutiny Committee considered the ‘call-in’ at its meeting on 22 March 2017 (Minute *52) and RESOLVED to
(a) record the Committee’s concerns over the emerging Devon Integrated Care System being a single Integrated Strategic Commissioner, a number of Local Care Partnerships, Mental Health Care Partnership and shared NHS corporate services;
(b) defer the implementation of the Integrated Care System process until assurances are provided on governance, funding, the future of social care from a democratic perspective;
(c) recommend Councillor Ackland’s paper and proposals on the reformation of the Health and Wellbeing Board as a sound democratic way forward to provide the necessary governance on a new integrated system;
(d) give assurance that the proposals will not lead to deeper cuts in any part of Devon as a result of the ‘equalisation of funding’; and
(e) provide a copy of the business plan being developed and a summary of views from staff consultations.
The Cabinet is required to reconsider the matter in the light of the Scrutiny Committee’s views and may either amend or adopt the original decision, which shall be implemented with immediate effect.
Minutes:
(Councillors Atkinson, Biederman, Connett, Greenslade, Hannaford and Wright attended in accordance with Standing Order 25(2) and spoke to this item).
The Cabinet noted that in accordance with the Scrutiny Procedure Rules Councillors Connett, Brazil, Dewhirst, Greenslade and Way had invoked the call-in procedure in relation to the above decision of the Cabinet, to enable the Health and Adult Care Scrutiny Committee to consider this matter on the grounds of ‘Governance and that the governance for the new proposals was a weakness. In addition, there has been a lack of consultation with the public regarding the proposals. Also, that there was reference in the report concerning some implementation from April 2018 which has given inadequate time for Scrutiny through the normal Committee timetable’.
The Cabinet further noted that the Health and Adult Care Scrutiny Committee had considered the ‘call-in’ at its meeting on 22 March 2018 (Minute *52) and had subsequently RESOLVED to recommend that the Cabinet;
(a) record the Committee’s concerns over the emerging Devon Integrated Care System being a single Integrated Strategic Commissioner, a number of Local Care Partnerships, Mental Health Care Partnership and shared NHS corporate services;
(b) defer the implementation of the Integrated Care System process until assurances are provided on governance, funding, the future of social care from a democratic perspective;
(c) recommend Councillor Ackland’s paper and proposals on the reformation of the Health and Wellbeing Board as a sound democratic way forward to provide the necessary governance on a new integrated system;
(d) give assurance that the proposals will not lead to deeper cuts in any part of Devon as a result of the ‘equalisation of funding’; and
(e) provide a copy of the business plan being developed and a summary of views from staff consultations.
The Cabinet was required to reconsider the matter in the light of the Scrutiny Committee’s views and could either amend or adopt the original decision, which would be implemented with immediate effect.
The Cabinet Member for Adult Care and Health highlighted that the proposed arrangements for bringing health and care commissioning together to deliver more efficient and effective care did not diminish existing governance processes, but offered the Council and its Members an opportunity to further shape and influence the health and care system. He also reported that moving towards integrated care systems was a complex process requiring a developmental and incremental approach and the proposed arrangements were built on a long history of partnership working.
The Cabinet Member further reiterated his on-going commitment and duty to engage the public, including the hardest to reach groups as well as to champion the democratic accountability of Members and the integrity of existing governance arrangements such as Scrutiny Committees, the Health and Wellbeing Board and other Committees of the Council which played a vital role in holding people to account. He further confirmed there was no attempt to dilute current governance arrangements and undertook to review the Health and Wellbeing Board to ensure it had the right membership and structure to give it a greater influence and oversight across the system and to work with local MPs on issues such as ensuring fair funding for Devon residents.
It was MOVED by Councillor Leadbetter, SECONDED by Councillor Hart and
RESOLVED
(a) that the original recommendations of the Cabinet (a – d), as outlined in Cabinet Minute *148 and reproduced below, be re-affirmed:
(i) that the key features of an emerging Devon Integrated Care System being a single Integrated Strategic Commissioner, a number of Local Care Partnerships, a Mental Health Care Partnership and shared NHS corporate services, be noted.
(ii) that the proposed arrangements in Devon as set out in paragraph 4 of the Report be endorsed, reporting to the Cabinet and Appointments and Remuneration Committee as necessary.
(iii) that the co-location of NHS and DCC staff within the Integrated Strategic Commissioner, subject to agreement of the business case, be approved; and
(iv) the Health and Adult Care Scrutiny Committee be invited to include Integrated Care System governance in its work programme.
(b) And, in light of the Scrutiny Committees deliberations, Cabinet further RESOLVE
(i) that the Health and Wellbeing Board is reformed to lead new governance arrangements for the development of integrated strategic commissioning of health and social care; and
(ii) that there is continued proactive communication to the public using clear and consistent messaging and where appropriate there will be relevant involvement and engagement.