Minutes:
The Board received a presentation from Mr Derek Campbell, Chief Executive, Merseyside NHS Cluster on the role and function of the cluster and how it operated within the context of the emerging NHS reforms.
The presentation, which was circulated at the meeting:-
· Gave an overview of the proposed NHS reforms;
· Outlined the Strategic Health Authority and Primary Care Trust roles in transition;
· Detailed the Milestones;
· Demonstrated the current geographic footprint;
· Set out the clinical commissioning groups – phases of authorisation; and
· Detailed the Merseyside cluster priorities during transition.
Mr Campbell introduced himself
and Mr Steve Spoerry, Chief Executive of Halton and
St Helens Primary Care Trust and reported that as he covered the four Primary Care
Trusts he could not be fully involved and had therefore, appointed a managing
director in each PCT. Mr Spoerry would be based in
Mr Campbell reported that since
being in the post he had developed a clear understanding of the relationship
between Runcorn and
Mr Campbell advised the Board that the Clinical Commissioning Groups would lead commissioning and be responsible for 60% of the NHS budget. The National Commissioning Board would allocate resources, set commissioning standards, commission specialised and primary care services and hold commissioners to account. The local Health and Wellbeing Boards would oversee, scrutinise and co-ordinate commissioning plan.
In conclusion, Mr Campbell reported that the NHS Commissioning Board would be in shadow form as a Special Health Authority in October 2011. Local Clinical Commissioning Groups were in the process of undertaking risk assessments and the Group’s authorisation process and ‘dry run’ would begin in October 2011. Delegated budgets would also be in place by 2011 and it was emphasised the importance of the Local Authority establishing the Health and Wellbeing Board on the same timeline as the Clinical Commissioning Group obtaining the delegated budget i.e. October 2011.
Mr Spoerry advised the Board that it would be advantageous if the new system emerged rapidly. Gp’s, he reported, had taken positive steps and were ahead of the timescale and would be receiving their delegated budgets and new functions in October 2011. He emphasised the importance and benefits of the HWBB being established at the same time.
The following comments arose from the discussion:-
· Concern was raised that expertise would be lost during the transition period and whether there would be enough expertise remaining in the new shared system. In response, it was reported that employees from public health would TUPE over and local expertise would remain in the new system. The importance of ensuring that there was a reduction in operational costs, whilst retaining the skills and expertise required in the future was noted;
· Clarity was sought on whether the Health and Wellbeing Board (HWBB) would be able to make decisions or recommendations. In response, it was reported that the HWBB would be the Local Authoritys responsibility and would be responsible for the health of the population. The public health budget would be transferred and the Authority would be responsible for the strategy and have a lead role of working with clinical commissioners;
· It was noted that the size of the clinical commissioning groups had not been specified by the Government. However, it was also noted that it was more important for Merseyside to work together, with good local working relationships and connections;
·
Clarity
was sought on whether it would result in centres of excellence being located
further away. In response, it was
reported that Merseyside health services was underpinned by very strong
localism. There was a need to change and
work together better than previously across the Merseyside area. Standards were also rising constantly. However, the financial situation would need
to be recognised and
·
the Members of the Board emphasised the levels
of deprivation and the increase in the elderly population in Halton. The Members noted the
· Clarity was sought on whether waiting lists would increase as a result of the transition. In response, it was reported that early intervention and prevention was vital. In addition, it was reported that it was important that the HWBB foster and develop a relationship with the clinical commissioners who would be responsible for waiting lists;
· Clarity was sought on the risks associated with the fast pace of the reforms. In response, it was reported that the changes could have an impact on the priorities i.e. improving life expectancy in Halton, retaining the delivery and quality of services and to continue to improve services. There was also a risk of losing the experience and corporate memory;
· It was noted that there was a provision in the Bill that if the HWBB was not satisfied with the overall performance and it did not meet with the JSNA then there was an option to make a referral to the Commissioning Board and the Secretary of State; and
· Clarity was sought on how GP’s would manage their patients if 30% of their time would be used for commissioning. In response, it was reported that funding would be available from the downsizing to pay for additional GP’s to cover the’ commissioning time. It was noted that the budget for Halton could be in the region of £240m.
The following questions had been submitted prior to the meeting and the responses circulated at the meeting:-
1
In
light of the recent poor showing of a major Care Home owner and the CQC to look
after the residents of those homes, do you feel that the Care Home Inspection
and Registration Units should be taken back under the control of the Local
Authorities who had a great deal of success prior to CQC?
Response
It is not the role of the PCT to take a view
on the remit or performance of the Care Quality Commission or Registration
Units.
2 I feel that the PALS system of
overseeing patients complaints has been inferior to the Local CHC system which
was PALS predecessor. What will the NHS
Cluster do to improve the inferior system?
Response
Subject to the passage of the Health and Social Care Bill,
Local HealthWatch organisations would be established
in October 2012, and continue the functions currently provided by Local Involvement
Networks (LINks).
From October 2012, subject to parliamentary approval, Local HealthWatch would also signpost people to information
regarding health and social care services. This was one of a range of services currently
provided by the PCT Patient Advice and Liaison Services (PALS).
HealthWatch would be the independent
consumer champion for the public i.e. service users, citizens, carers and
patients – locally and nationally – to promote better outcomes in health for
all and in social care for adults.
At local authority level, Local HealthWatch would act as a point of contact for
individuals, community groups and voluntary organisations when dealing with
health and social care. Local HealthWatch would also
have a seat on local health and wellbeing boards to influence commissioning
decisions by representing the views of local stakeholders. The information that
Local HealthWatch gathers on patients’ and the
public’s views and experiences of the NHS would inform HealthWatch
The
Department of health was currently asking for views from stakeholders on
options for distributing the additional funding to local authorities for local HealthWatch. The consultation on Allocation Options for distribution of additional funding to local
authorities for Local HealthWatch, NHS Complaints Advocacy, PCT Deprivation of
Liberty Safeguards could be accessed from the Department of Health website:
http://www.dh.gov.uk/en/Consultations/Liveconsultations/DH_128429
This
consultation would be open until 24th October.
RESOLVED: That
(1)
Mr
Derek Campbell be thanked for his informative presentation; and
(2)
The
comments raised be noted.
Supporting documents: