Agenda item

Report by the STP Team attached and presentation by the Chief Executive Lead (STP Team) and Chief Executive Devon County Council  

Ms A Pedder (Lead, Chief Executive, Wider Devon STP),  Ms J Fitzgerald (Chief Officer, NEW Devon Clinical Commissioning Group (CCG)) and Ms L Nicholas (Director of Strategy NEW Devon CCG) attended and spoke to this item at the invitation of the Committee along with Dr P Norrey (Chief Executive Devon County Council).

The Committee considered the report of the Sustainability and Transformation Plan (STP) Team for Wider Devon on the Plan which had been formally published on 4 November 2016 and circulated to all members of the Council. The STP was the local plan developed by the NHS in Devon working with Devon County Council, Plymouth City Council and Torbay Council, to achieve the NHS ‘Five Year Forward View’ and designed to provide the overarching strategic framework to achieve safe, sustainable and integrated local support by 2021.  The Report covered an STP overview and outlined the ‘next steps’.

Ms Pedder with the other NHS representatives also gave a brief presentation covering: the footprint and ambition, the triple aim of the Plan, challenges, STP priorities and the next steps. 

Members recognised the wider funding issues facing the NHS and social care budgets, acknowledging the under investment in areas such as mental health and early care and prevention.  Members accepted – as previously agreed by the County Council – and reflected in the conclusions of the NHS Fairer Funding Task Group – that NHS/social care services were underfunded and acknowledged also the wider expectations nationally that expenditure on health should be closer to 11% of GDP  (currently 7.9%).  Members also heard  and understood the point that were even more resource was made available to the NHS there would still be a need to address current under investment in services and inequalities in provision across the county for the benefit of Devon’s residents.

The Chief Executives of the County Council and the Wider Devon STP re-affirmed  that the County Council was not a formal signatory to the STP nor  did not have to approve or endorse it in whole or in part.  Nonetheless and recognising the County Council’s  involvement in delivery of services generally and in some cases its primary role in securing or co-ordinating the delivery of specific services there would be merit in obtaining agreement to those relevant aspects of the STP, if possible,  enabling progress to be made for those sectors.

The STP Team confirmed/re-affirmed, for the avoidance of doubt, that while reviews of acute services had recently commenced this was only the initial evidence gathering stage which would conclude in March and thereafter consideration could only then be given [having regard to the technical based evidence received] to formulating proposals  [which would also subsequently need to be ‘quality assured’  by NHS England]  for discussion first with this Scrutiny Committee after the County Council elections (possibly June 2017)  and thereafter would then be subject to further public consultations before any final decisions could be made by the Clinical Commissioning Group.

The aforementioned representatives and the Chief Officer for Adult Care and Health (Devon County Council) responded to Members’ questions relating to and including:

·         re-iterating the assurance given by the New Devon CCG that after extensive consultation and engagement implementation of any change to community or acute services would follow strict quality assurance arrangements to ensure safe provision;

·         the principle that resources arising from disposal of surplus NHS assets being used for local services;

·         the need to better reflect in the STP geographical factors relating to access to services within wider Devon;

·         emphasis within the STP to prevention and early intervention, and noting the challenges arising from the reduced Public Health budget; 

·         examples of current health and social integration partnership working by the NHS and County Council.

The Scrutiny Officer undertook to circulate to Members information relating to the role of the Clinical Senate in terms of independent quality assurance as a result of proposed changes to services; the ‘Case for Change’ report (which had been previously circulated); and actual numbers relating to community care staff turnover in the independent sector which compared favourably against local and national averages.   

Having regard also to the representations referred to at Minute 38 above

Councillor Greenslade having first given notice of a Motion, which was duly seconded, to be considered at the meeting and thereafter subsequently having also indicated his willingness to accept subsequent amendment proposed by Councillors Wright it was then MOVED by Councillor Greenslade SECONDED by Councillor Westlake and

RESOLVED

(a) that the Report by the STP Team be noted;

(b)  that the decision to call for a ‘pause’ in the work of the Success Regime/STP process taken by the County Council on an all-party basis be also noted and that the County Council continue to press for this to happen;

(c) that as long as the Success Regime /STP process continues the County Council continues to consider and scrutinise the work being done;

(d) that the Success Regime/STP organisation publish a clear Statement of its proposed next steps, including a timetable as soon as possible;

(e) that Devon MPs be lobbied to act upon the Notices of Motions passed by Devon County Council and urge them to tackle NHS England and Government to halt the Success Regime/STP process and press for fair funding for Devon;

(f) that Devon MPs be also urged to back all party calls for a holistic review of NHS/Social care funding processes;

(g) that NHS England representatives be invited to a further meeting of Health and Wellbeing and People’s Scrutiny Committees with a view to seeking an undertaking that surplus assets would be given back to the community.          

[NB: In accordance with Standing Order 32(4) Councillors Clarance, Greenslade, Gribble, Morse, Julian,  Sellis, Westlake,  Wragg and Wright  voted for the Motion and Councillors Brook and Colthorpe voted against and Councillors Biederman, Channon, Dewhirst, Hannan, Hannaford, Hosking, Randall Johnson and Squires attending in accordance with Standing Order 25(2), also expressed their support for the recommendation now before the Committee and that their vote be recorded].