Agenda item

Report attached

Janet Soo-Chung, Chief Executive – NHS Lancashire, presented the report (circulated).

Janet gave an update on the implementation of the Health and Social Care Act 2012 and provided updates on the following:

NHS Commissioning Board

The NHS Commissioning Board has been set up.  The overarching role of the Commissioning Board is to ensure that the NHS delivers better outcomes for patients within its available resources. Its responsibilities will include supporting, developing and holding to account an effective and comprehensive system of clinical commissioning groups. The Board will ensure that the new system architecture is cohesive, coordinated and efficient.

The Board has is now in place and has been recruiting to its structure for some months beginning with Director level appointments to the nine Directorates. This national machinery is supported by four sub-national regions and a network of 27 local offices.

The Local Area Office for Lancashire will sit within the North of England region and is similar to the current configuration of the PCT Cluster (I\JHS Lancashire) and the SHA North. It was noted that Richard Barker has been appointed as the Regional Director for the North of England.

A number of key appointments at functional Director level have been confirmed in the last two weeks as follows: 

·  Medical Director Dr Jim Gardner

·  Finance Director John Critchley

·  Director of Commissioning Martin Clayton

·  Director of Operations and Delivery Jane Higgs

The post of Director of Nursing is currently out to advert and an appointment is expected by the end of October.

Each Local Area will be responsible for the direct commissioning of primary care services, performance management of the Lancashire local health system by holding Clinical Commissioning Groups to account and a range of specialised NHS services. In the case of the Lancashire Local Area Team, it will take on the lead role for commissioning health services for Offenders for the whole of the North West.

It is envisaged that the Local Area Office will be based in Preston which has good transport links to the rest of Lancashire and is more convenient for enhancing the opportunities for more integrated working with partner organisations. Approximately 80 staff are expected to be based in the Local Area Office and posts are currently being filled.

Clinical Commissioning Groups (CCGs)

The eight CCGs (six of which fall within the County Council's administrative boundaries)  are already operating with delegated budgets and are increasingly taking on the day-to-day commissioning and contract management/performance responsibilities on behalf of their local PCTs. This transition will move even faster as 31 March 2013 gets closer.

In order to become a statutory organisation in its own right each CCG has to go through a nationally managed authorisation process between now and 31 March 2013. The content of the authorisation process is built around six domains and has been developed through a wide range of stakeholder involvement including patients, carers, clinicians and partner organisations.

The timetable for assessment has been set out in four waves and all the CCGs across Lancashire have opted for Waves 1-3 which means they will have a decision about their state of readiness and further development needs by 31 January 2013.

Commissioning Support Units (CSU)

A key feature of both the eight CCGs and the NHS Commissioning Board local area office is that the staffing structures will be kept to a minimum and they will be expected to acquire additional services (back office and specialist) from the CSU by way of an agreed contract. The Lancashire CSU has been developing a joint venture approach with Cumbria but this work has now been stopped as the Cumbria CCG has determined to purchase its support service from the North East. This is in line with the decision to include Cumbria within a Local Area Office which comprises Northumbria, Newcastle and Cumbria.

Derek Kitchen has been appointed Managing Director of the Lancashire CSU. Derek has been leading the Staffordshire CSU since 2011 and in his new role he will lead the two CSUs. The two CSUs will remain independent and will be hosted by the NHSCB from 1 April 2013 pending further decisions about their future shape and degree of commercial expertise.

Public Health Lancashire

From 1 April 2013 the responsibility for a range of public health services will transfer to the upper tier local authorities. A Steering Group has been working to ensure that this transition works smoothly and effectively for the last few months.

As yet no appointment has been made to the post of Executive Director of Public Health. However appointments have been made to the three posts which will report directly to this post.

These are:

·  Director of Public Health Improvement - Mike Leaf

·  Director of Health Policy and Protection - Deborah Harkins

·  Director of Population Healthcare - Sakthi Karunanithi

A process of re-shaping and rationalising the structures is now underway to bring the three existing teams across the Lancashire PCTs together with the LCC team into one.  A further presentation regarding Public Health Lancashire was also presented at Item 7 during this meeting.

New leadership arrangements through transition

The NHS Chief Executive David Nicholson has written to all NHS Leaders setting out the steps in the transition to the new health and social care system. In the letter he describes arrangements to ensure stability and resilience for the current system through to the new health and care system from April 2013.

This means that anyone appointed to regional and local leadership roles in NHS Commissioning Board will take on responsibility both for teams managing operational delivery in 2012/13 and planning the new system for 2013/14.

The Clinical Commissioning Group Board members commented that work was being undertaken on new pathways and some joint work with the County Council has already been undertaken, for example a project has been running since July regarding Health and Respiratory Issues. A number of other new pathways are also up and running.

Resolved: The Shadow Health and Wellbeing Board noted the report and the progress made to date on the Health and Social Care Reform 2012.