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Decision details

Decision Maker: Health and Adult Care Scrutiny Committee, Cabinet

Decision status: Implemented

Is Key decision?: Yes

Is subject to call in?: No

Decisions:

(An item taken under Section 100B (4) of the Local Government Act 1972)

 

(Councillors J Brazil and M Shaw attended in accordance with Standing Order 25 (2) and spoke to this item)   

 

(Councillor A Leadbetter attended in accordance with Standing Order 25 (1) and spoke to this

item at the invitation of the Committee)

 

(Mr N Roberts (Accountable Officer, NEW Devon CCG and South Devon and Torbay CCG), Dr S Manton, Joint Director (Strategy) North, East and West (NEW) Devon CCG and South Devon and Torbay CCG attended and spoke to this item at the invitation of the Committee)

 

The Chair had decided that the Committee should consider, as a matter of urgency, this issue in view of the recent call-in (as outlined below).

 

In accordance with the Scrutiny Procedure Rules, 5 Members of the Council (Councillors

Connett, Way, Dewhirst, Greenslade and Brazil) had invoked the call-in procedure in

relation to the decision of the Cabinet (Minute *148 of the 14 March 2018) in relation to

Health and Care Integration in Devon.

 

This was on the grounds “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 gives inadequate time for scrutiny through the normal committee timetable”.

 

The Committee considered the Report of the Chief Executive (ACS/18/81) which had been submitted to Cabinet on 14 March 2018 and re-presented to this Committee for consideration in relation to its recommendations.

 

The Report outlined the national context and drivers towards integration of health and social care, the local Devon context and how it was developing its integrated working, further developments and proposals with a common set of objectives and outcomes, proposed arrangements in Devon, noting that governance arrangements would not change from 1 April 2018. 

 

The Chair also reported the receipt of approximately 45 representations from the public on this matter, and written representations from Councillors B Greenslade (circulated at the meeting) and S Russell. A paper from Councillor Ackland on proposals for a revised composition of the Devon Health and Wellbeing Board, which had been presented to the Cabinet at its meeting on 14 March 2018, had also been circulated to Members.

 

The representatives from the Clinical Commissioning Groups and the Chief Officer for Adult Care and Health responded to Members’ questions and/or commented on:

 

·         the benefits of further integration (the process of which had been longstanding) which included improved services, avoidance of duplication, work force efficiency and effectiveness, and greater consistency over the two CCGs and local authorities with better alignment of services; 

·         the emerging proposals which did not represent a change in accountabilities, there was no new organisation being created, and the focus was on a joined-up approach to promote independence for people where it was safe and appropriate so to do;

·         consideration of changes in the composition of the Health and Wellbeing Board and development of local boards with more Councillor representation;

·         the 6 local authorities/NHS pilots and the learning from these, particularly the Dorset experience;

·         local working with Plymouth and the voluntary sector, particularly in South Devon and use of the Joint Strategic Needs Assessment (JSNA) underpinning the process, taking a holistic view of Health and Social care and outcomes;

·         the main messages and themes arising from recent staff consultations;

·         development of the business case for change, the widespread existing co-location of multi-disciplinary (Social Care/NHS) teams (based on 30,000 - 40,000 populations);

·         the Council’s clear and on-going statutory duty to co-operate with its partners; and

·         confirmation that the proposals would not affect the Committee’s legal powers, and its Scrutiny and Overview role which were laid down in statute.

 

Members noted the possibility of further consideration of joint scrutiny of the process across Devon with Torbay and Plymouth Councils.

 

It was MOVED by Councillor Wright, SECONDED by Councillor Way that the Cabinet be requested:

 

(a) to 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) to 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 and when a full engagement process has taken place;

 

(c) to 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) to 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) to provide a copy of the business plan being developed and a summary of views from staff consultations.

 

Councillor Crabb then MOVED and Councillor Trail SECONDED that the motion be amended by the deletion, in (b) above of the words ‘and when a full engagement process has taken place’.

 

The amendment in the name of Councillor Crabb was then put to the vote and declared

Carried and thereafter also carried as the substantive motion (replicated below).

 

that the Cabinet be requested:

 

(a) to 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) to defer the implementation of the Integrated Care System process until assurances are provided on governance, funding, and the future of social care from a democratic perspective;

 

(c) to 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) to 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) to provide a copy of the business plan being developed and a summary of views from staff consultations.

 

In terms of the Committee’s consideration of the Report (outside of the call-in process), as at item 7 of the Agenda,

 

it was MOVED BY Councillor Randall Johnson, SECONDED by Councillor Ackland and

 

RESOLVED that the following be added to the Committee’s Work Programme, where further scrutiny is required to:

 

(a) set out proposals for the Governance of the Integrated Care System;

 

(b) describe the functions and governance of the local partnerships;

 

(c) describe and, if necessary, enhance the engagement and communication of these proposals; and

 

(d) require a forward plan for the design of the ‘Model of Care Audit’ such that its scope and terms of inquiry will address present concerns.

Reason Key: Strategic, Political or Financial Significance;

Divisions Affected: (All Divisions);

Other reasons / organisations consulted

TBC

Consultees

TBC

Contact: Tim Golby, Chief Officer for Adult Care and Health (Interim) Email: tim.golby@devon.gov.uk.

Publication date: 26/03/2018

Date of decision: 22/03/2018

Decided at meeting: 22/03/2018 - Health and Adult Care Scrutiny Committee

Accompanying Documents:


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