Health changes – update on activity post ‘Pause’ and key datesJuly 2011

Contents

• National overview• Local update:

– PCTs, Sussex Cluster – GP Commissioning Consortia– Public Health– Health and Wellbeing Board– HOSC– LINks/HealthWatch

• Timeline• Where can residents find information• What help / support do you need

National overview

• The health and social care agenda has continued to be very busy and is set to continue that way for the lifetime of this Government

• Following the various health and social care White Papers and Bills the Government instigated a Pause, Listen, Reflect, Improve period of time. The aim of this was to allow for further consultation on the NHS changes given the level of concern regarding the new agenda

• The Pause report from Future Forum on 31st and Ministers response came out last week

• Changes will be made to the Bill and timeline• Direction of travel the same

PCTs• Nationally there has been some debate about if the Cluster

groups of PCTs should demise or have a change in role and function – this will be clarified as the Bill progresses

• To reduce expenditure and to try and ensure business continuity PCTs have merged into Cluster groups

• Our 2 PCTs (East Sussex Downs and Weald, Hastings and Rother) are now in a Sussex wide Cluster covering:– West Sussex– Brighton and Hove– East Sussex

• Amanda Fadero is the new Sussex PCT Cluster CEO which is called NHS Sussex

• Cluster arrangements not fully agreed eg Board reporting• Local capacity has been reduced

GP Commissioning Consortia – NOW Clinical Commissioning Group

• Nationally the debate has centred around pace of change and the role of the GP Commissioning Consortia

• These will change to Clinical Commissioning Groups• Key change to Group make up to include a registered

nurse and a secondary care specialist doctor - neither must be employed by a local provider

• Two consortia being established (Hastings and Rother, Eastbourne) and will have to morph into ‘groups’

• A third group of GPs are debating about what they will do. This area covers Lewes, Wealden and the Havens

• Pathfinder status has now been given by the Dept of Health to the established GP Commissioning Consortia who have now had elections and have ‘lead’ GPs

Public Health

• Nationally the debate has focused on the role of Public Health England and the employment of Public Health staff

• East Sussex awarded Early Implementer status by the Dept of Health in recognition of the joint work to date. This involves working with other early implementers and sharing best practice

• The PCTs Public Health commissioning team have co located to County Hall

• This is a ‘shadow’ arrangement until the full responsibilities and budget come to the Council in April 2013

Public Health service review

• Following the stakeholder conference it was clear that a service review of Public health was needed to help plan for the future

• Solutions for Public Health (an NHS trading arm) were appointed to undertake the review

• A report should be available in September

Health and Wellbeing Board• The Board is a statutory requirement of the new legislation• Is a formal but unusual Council committee (officers voting)

with statutory powers• Our aim is to have a Board that is the Guardian of the

whole health and care system for East Sussex –setting the direction for change clearly linked to improvement in patient and service user outcomes and promoting joint working across commissioners

• Promote wider view of health determinates eg housing • The Board is required to develop:

– Joint Strategic Needs Assessment– Joint Health and Wellbeing Strategy

• HOSC will remain

Health and Wellbeing Board

Proposed Membership Voting (as required by legislation):• 4 Elected members of the County Council, as nominated by the

Leader • Director of Adult Social Care• Director of Children and Young People• Director of Public Health• GPCC representation• District and Borough representation – the proposal is 2 as this

mirrors the East Sussex Strategic Partnership thematic groups such as Children’s Trust, Community Safety

• Local HealthWatch – if they remain part of the decision making process rather than scrutiny

Others non voting • Chief Executive of ESCC• Voluntary and Community Sectors as identified by SpeakUp• Others such as the PCTs

Health and Wellbeing Board Suggested model – currently out for consultation

• Assembly approach which has been successful in East Sussex, for example Community Safety

• Assembly feed into Board• Board sets the County overview of the Joint

Health and Wellbeing strategy and its delivery• Consultation is now live until 7th September and

the Shadow Board will receive a report of the outcome

FAQs about the Board • Why voting? While our experience of most committees in the Council is

that consensus can be achieved it is not always possible. We also have to be realistic about the significant changes in the health and social care economy that face us and having the ability to vote if consensus cannot be agreed is the norm. We have given voting rights to those people who are required by legislation to be on the Board and/or are democratically accountable. Those people who do not fulfil these criteria but have an important role to play on the Board have not been given voting rights.

• Why 4 members of the County Council? The most recent update from the Minister has acknowledge that there is a need to allow Councils to appoint who and how many they wish

• Why Districts and Boroughs? The legislation does not formally include them as having a right but suggests including. We feel that many of the determinates of health and wellbeing are supported and often led by the Districts and Boroughs – such as housing, environmental health, leisure and therefore we have sort to replicate the way the Strategic Partnerships forums operate eg having 2 out of 5 on the Board

• We also need to acknowledge that many services and support systems are provided by the Voluntary and Community Sector and therefore there is a representative place on the Board.

• Can anyone come to the Board meetings? Yes The Board will be open to the public.

HOSC

• Scrutiny function now separated from the Health and Wellbeing Board

• We have HOSC

HealthWatch

• HealthWatch England to be established October 2012

• Local HealthWatch to be establisged October 2012

• Local Authorities commissioning NHS complaints advocacy service

• Looking at what can be done local, what may be better sub regionally

• LINks will cease to exist in 2012

Timeline of key dates

• An amended timeline has been issued by Government

• Clear there will be delays• The Government hopes that the new

timetable ill strike a balance between ‘maintaining momentum’ while recognising some organisations would not be ready to take on full responsibilities under the old time frames

Where can people find information• Changes to timeline along with other

information will go on the East Sussex Strategic Partnership website – Health and Wellbeing section

• Web page planned for the County website

AOB

• Changes to timeline along with other information will go on the East Sussex Strategic Partnership website – Health and Wellbeing section

• Please let us know if there is anything the Council can help with. Initial contact is: barbara.deacon@eastsussex.gov.uk

• direct line 01273 - 335012