The Overview & Scrutiny Committee will appoint the Chair of the Health Scrutiny Panel for the Municipal Year 2012/2013 at their 19 June 2012 meeting.

However, it is necessary to elect a Vice-Chair of the Health Scrutiny Panel for the Municipal Year 2012/2013.

Councillor Lesley Pavitt nominated Councillor Denise Jones to serve as Vice-Chair of the Committee for the remainder of the Municipal Year. The nomination was seconded by Councillor Emma Jones.

RESOLVED

That Councillor Denise Jones be elected Vice-Chair of the Pensions Committee for the remainder of the Municipal Year 2012/13.

An Apology was received from Cllr Mukit

To note any declarations of interest made by Members, including those restricting Members from voting on the questions detailed in Section 106 of the Local Government Finance Act, 1992.  See attached note from the Chief Executive.

There were no Declarations of Interest.

To confirm as a correct record of the proceedings the unrestricted minutes of the ordinary meeting of Health Scrutiny Panel held on 24 April 2012.

RESOLVED that the unrestricted minutes of 24 April 2012 be agreed as a correct record of the proceedings.  

The Chair presented the Terms of Reference report. The committee was informed that the report sets out the Terms of Reference, Quorum, Membership and Dates of meetings of the Health Scrutiny Panel for the municipal year 2012/2013.

The Chair asked officers to look into the list of health scrutiny panel co-optees in the last five years, in order to review the background of organisations who are generally co-opted to the panel, as various people have expressed an interest.

David Burbridge, named Anna Livingston from the medical committee, as a possible future co-optee.  The Chair stated that Ms Livingston has attended several health scrutiny panel meetings in the past,  but she is however  moving into another role and has nominated other individuals from the local medical committee.

The pharmaceutical committee and opticians were also suggested as possible future co-optees.

Action: Sarah Barr

RESOLVED

That the report be noted

John Wardell, Chief Operating Officer, presented the report. The panel was  informed that the commission support arrangement has been in operation since April 2011. There is already a multidisciplinary board membership in place, consisting for example of GPs, practice managers, nurses, representation from the Local Authority, as well as the Local engagement Think network. Currently undergoing authorisation and will be in phase three by the National Commissioning Board for that process. Also, in the process of compiling the names of the individuals who will be contacted in the 360^o assessment that the national commissioning board will run as part of its authorisation process, and the chair of health scrutiny panel is a nominated individual. 

In terms of the commissioning support offer, the full operating cost for clinical commission group is £25 per head. The panel should be mindful that only functions that would have were the responsibility of the PCT will be taken on, and other functions will move to other departments.  Initial work has been to set up internal governance and managerial arrangement cost. Tower Hamlet’s approach is to look into buying all of its commissioning support service through one organisation. There is an agreement in principle about what that would include, however still awaiting further national guidance about the role of the Clinical Commissioning Group around safeguarding.

The Chief Operating Officer continued that they are keen to work with Public Health and agree a memorandum of understanding, as they want to preserve public health relations with the local PCT to ensure there is robust public health advice around commissioning and to continue working in a partnership way.  There is also a desire to find new ways of working with councillors. 

In response to questions from the committee, the following information was provided.

• With regards to the relationship with commissioning support organisation, a member inquired whether there is an understanding of how that will vary locally.  The Chief Operating Officer stated that each Clinical Commissioning Group (CCG) have taken a different approach, but essentially have gone through a similar process. However, there  will be a core offer in relation to service, but the difference will be about the contracts being commissioned.
• The main changes in the new organisation will be a reduction in management cost, and a lot of time has been spent reducing duplication. However, still awaiting the final guidance about the role of the CCG in safeguarding. Internal communication will be managed by the organisation but broader or national communication will be commissioned. There is a statutory responsibility to manage the finance and therefore a chief finance officer will sit internally. Sam Everington, Chair, Tower Hamlets Clinical Commissioning Group, responded that in a bid to influence commissioning, every practice has a commissioning lead, and that commission lead will attend a locality meeting once a month and give feedback. There are also other ways i.e. setting up intranet service so that any GP or Nurse can send in their message which will be directed to  ...  view the full minutes text for item 5.2

Isobel Cattermole, Corporate Director, Children, Schools and Families provided the update to the committee. The integration board was set up at the beginning of the year, consisting of key people and officers from both directorates across the council. As a result of meetings and discussions with management across both directorates, a list of benefits from the integration has been identified:

·        strengthening family focus and transition pathway for children with disabilities and mental illness.

·        promoting independence and early intervention across the whole life course, and this sets the theme for the new children and young peoples plan. This also aligns with the Health and Wellbeing Board, Public Health and other department priorities.

·        maximising efficiency and reducing duplication in the back office

·        enriching professional skills of work force

·        building on safeguarding and safeguarding adults

The integration is being managed in two phases; phase one will deliver the directorate’s new management team, at which point educational social care and well being will come in, and this is the proposed name of the new directorate. This phase is nearing completion and is expected to be delivered over the summer. 

Phase two is going to be the new directorate management team and there will possibly be a reduction of one service head, which is yet to be approved.  Adult social care and children social care will be kept distinct under two service heads, this will happen after the Olympic, preferably September onwards. The second phase approach will enable the team to plan the change and avoid unnecessary disruption. A risk assessment has been carried out, as this would be the biggest directorate in the council with the most staff and budget, so there is a risk log, and the team report back to the corporate management team.   A paper will be brought to cabinet detailing all the issues covered, as well as the risk in managing the process.

There is plan to have a lead member for Adults and Children services; currently there is a safeguarding board for children and adult and it propose that both of these remain, however there is a desire to have one safeguarding board in the future.

In response to questions from the committee, the following information was provided.

·        With regards to the matter of having one service head, the Corporate Director, Children, Schools and Families replied that this is considered proportionate, but this is a high risk area because of the vulnerability of the client. However, it is measured that both directorates are very well resources and managed. Moreover, the co-oporate risk is being shared by the corporate management team.  Both directorates have worked closely with partners and the risk is shared across a partnership.

·        Public health will move and be part of the new board, but it has not been decided on where it will be housed.  There is a view that it is in line with this directorate, but there are parts of public health that could sit elsewhere. It may be that some of its  ...  view the full minutes text for item 5.3

 Afazul Hogue, Senior Strategy, Policy and Performance Officer presented the update report to the committee. He informed the committee that Local Healthwatch organisations are being set up to give people greater influence over their local health and social care services. Local authorities are to be placed under a statutory duty to commission effective and efficient local Healthwatch organisations by April 2013.

In response to comments and questions from the committee, the following information was provided.

·        A member raised concern that the new organisation may not be able to fulfil all its functions with current staffing levels, especially on the delivery on advocacy which is a highly skilled and time intensive exercise. The Senior Strategy, Policy and Performance Officer confirmed that these concerns were recognised and stated that advocacy will be commissioned separately, a sub group is undertaking analysis of this.

·        A member stated that there may be tensions in how the organisation is set up, and also raised concerns that this could be exacerbated by encouraging people to point out what the issues are, at the same time providing information for the same institution. There needs to be a demarcation of the functions so to avoid potential conflict of interest. The Senior Strategy, Policy and Performance Officer replied that talks with colleagues are underway to ensure that the right balance is achieved, so that the various functions can be carried out without this conflict.

·        A member commented that the healthwartch should have a map of how GPs are organised.

·        A member commented that the local healthwatch has the power to enter and comment on services and therefore would like to see the local healthwatch be the eyes and ears of the Health Scrutiny Panel, and would like to receive reports on such visits so that the committee’s comments can be followed up.

·        A member commented that the local healthwatch should aim to be locate to visible and accessible areas.

RESOLVED

That the report and comments be noted.

The Chair gave an update of the committee’s work programme. As a result of a workshop meeting, three broad areas were identified, which were the scrutiny of Barts, namely the impact of cuts on services and the integration of three trusts. There were concerns about small changes which will affect patients as well as substantial variation. The second area was on ‘accountability to us and beyond us’ which was the promotion of health scrutiny as a channel for serious concerns to be raised by councillors, residents, and healthwatch in a public forum. The third area identified was ‘transition of public health to the council: maximising opportunities across the life course’. 

Sarah Barr, Senior Strategy Policy and Performance Officer stated that the workshop did not produce details of the proposed areas but just outlines. With reference to the work programme paper, the Senior Strategy Policy and Performance Officer highlighted that the proposed work streams have been placed in three columns, the first being issues raised by Councillors, partners, and intelligence gathered, whilst the second and third are spread over two years work stream. The committee has four more meeting this year, so the committee can look at information between meetings and also perform site visit. The Barts Health NHS Trust theme came across very strongly, and so the committee will need to ascertain how to lead on this, and possible obtain outside opinion and assistance. Lewis Russell, Service Head, Corporate Strategy and Equality is leading on the development of the health and wellbeing strategy, on behalf of the health and wellbeing board is keen that health scrutiny panel also contributes and scrutinise this work, which will have to be worked into the programme.

A look at old people and early years may placed on next year’s work programme.

The Chair highlighted that Sam Everington is keen to do more work on public health and schools, and therefore proposed a challenge session on this subject this year.

A member urged the committee to consider a mapping exercise to list PCT services that were being provided in Tower Hamlets before they are disbanded as they are currently very reluctant to provide this information. The chair agreed with this proposal but stated that the PCT may genuinely not know this information. The Chair proposed a follow up question be asked for  the organisation to provide the information.

RESOLVED

That the update work programme be noted

The Chair reported back for information, that the August 2011 cabinet decision setup the health and wellbeing board and said it will meet in public. It was also said that the Chairs of Overview and Scrutiny and Health Scrutiny Panel will attend, however at the last health and wellbeing board meeting she was asked to leave and was told that the mayor no longer wants to stand by his previous decision. Overview and Scrutiny has agreed to write a letter to the mayor setting out the chain of events and asking for a meeting between the Chair of the panel, Ann Jackson and the mayor to have a conversation about how Health and wellbeing board and health scrutiny panel can work together more effectively. The letter will be circulated to the committee.