Agenda and minutes

Apologies were received from County Councillor Mohammed Iqbal and Cllr Hasina Khan (Chorley Borough Council)

Members are asked to consider any Pecuniary and Non-Pecuniary Interests they may have to disclose to the meeting in relation to matters under consideration on the Agenda.

None disclosed.

The Minutes of the Health Scrutiny Committee meeting held on the 15 July 2015 were presented and agreed.

Resolved: That the Minutes of the Health Scrutiny Committee held on the 15 July 2015 be confirmed and signed by the Chair.

Report to follow.

Dave Carr, Head of Policy, Information and Commissioning (Start Well) presented the report to the Committee

The report explained the concerns about fragmented commissioning and delivery of services exists at both a national and local level. It provided members with:

•  An overview of commissioning responsibilities for health and social care.

•  An overview of the Governance arrangements in Lancashire.

•  Examples of activity intended to help determine future commissioning priorities.

Nationally, the Independent Commission on the Future of Health and Social Care in England concluded that "people needing access to care will be forced to continue to navigate the complexities and inconsistencies of the current fragmented systems of funding and entitlement" without a fundamental rethink of how health and social care should be funded and provided.

Locally, there are well known examples of fragmented commissioning. For example, the Lancashire Health and Wellbeing Board received a report on Children and Young People's Emotional Health and Wellbeing which identified a number of key issues and areas for improvement in relation to the current partnership and commissioning arrangements.

The report highlighted the fact that it was important to get a consistent view of the current situation regarding commissioning as a starting point to move forward from and members were reminded that the new corporate strategy for the County Council would form the basis for decisions in the future.

Members of the Committee were invited to comment and raise questions and a summary of the discussion is set out below:

•  Members were concerned that there didn't appear to be any single overarching organisation with lead responsibility. It seemed that different organisations took the lead for different areas so there was no single level of accountability. Dave Carr responded that it would be the Health & Wellbeing Board who were well positioned to take that role.

•  Members were also concerned that the multiple number of partners involved  made it even less clear what the overall direction was for the future

•  Dave Carr suggested that part of the issue within Lancashire is about the governance of the system and where we take a steer from, normally it would be from partners own individual organisations, however as there are many partners involved he felt that the Health & Wellbeing Board was best placed to take the overall responsibility for governance.

•  CC Holgate stated that the Health Scrutiny Committee has the opportunity to hold decision makers and commissioners to account and provided the Committee with the example of ambulance services being commissioned by Blackpool CCG on behalf of all north west CCGs. He questioned whether the Committee would have the capacity to hold each different service area to account and considered whether members should hold the Health & Wellbeing Board to account instead if they have the lead responsibility for overall governance.

•  It was agreed that the members of the Health Scrutiny Committee need to be more aware of the decisions taken by the Health & Wellbeing Board (HWB) and they were reminded that all HWB  ...  view the full minutes text for item 4.

On 22 June the Steering Group had met to with the Care Quality Commission to discuss the process for inspections of Acute Trusts. A summary of the meeting was at Appendix A to the report now presented.

On 13 July the Steering Group had met with Lancashire Teaching Hospitals Trust regarding the review of their clinical services strategy and the current financial position following an inspection by Monitor. A summary of the meeting was at Appendix B to the report now presented.

Wendy Broadley presented the report and informed members that a small amendment to the notes of the meeting held on 13 July with Lancashire Teaching Hospitals Trust had been suggested by Trust officers

Resolved: That the report be received and the amendments be made to the notes of the meeting held on 13 July.

Appendix A to the report now presented sets out a draft work plan for both the Health Scrutiny Committee and its Steering Group. A discussion took place on potential different ways to address scrutiny topics and Wendy Broadley suggested that the members be provided with a range of options for the future.

Resolved: That:

  i.  The report be noted

  ii.  A range of options for how health scrutiny can be delivered in the future be produced for consideration by the Committee.

The Committee's attention was drawn to forthcoming decisions and decisions recently made by the Cabinet and individual Cabinet Members in areas relevant to the remit of the committee, in order that this could inform possible future areas of work.

Recent and forthcoming decisions taken by Cabinet Members or the Cabinet can be accessed here:

http://council.lancashire.gov.uk/mgDelegatedDecisions.aspx?bcr=1

Resolved: That the report be received.

An item of urgent business may only be considered under this heading where, by reason of special circumstances to be recorded in the Minutes, the Chair of the meeting is of the opinion that the item should be considered at the meeting as a matter of urgency.  Wherever possible, the Chief Executive should be given advance warning of any Member’s intention to raise a matter under this heading.

No urgent business was reported.

The next meeting of the Health Scrutiny Committee will be held on Tuesday 13 October 2015 at 10.30am at County Hall, Preston.

It was noted that the next meeting of the Committee would be held on Tuesday 13 October 2015 at 10.30am at County Hall, Preston.