To receive items raised by members of scrutiny which have been submitted to the Leader (copied to Chief Executive and Governance Officer) by 4.30pm on Friday 13 April 2018.
Minutes:
Mrs L Stephenson, Chairman of Adults and Health Scrutiny Panel, had submitted an item to the Leader, on behalf of the Adults and Health Scrutiny Panel, in relation the LLR Clinical Commissioning Group.
The Leader invited Mrs Stephenson to read the submission as follows:
Cabinet members have received the notes from the chair of the previous Adults and Health Scrutiny panel meeting held on Thursday 5th April. Further to these notes the panel would like the following to be brought to the attention of cabinet:
As a panel we are increasingly concerned by the CCG. Over the last two years we have received many strategies for consideration of the scrutiny panel; the opening preamble invariably speaks of ‘fragmentation’ in services and emphasises the need for all agencies / stakeholders to be working together in order to provide services that are sustainable.
We have now had the STP on our forward plan for several meetings but it has yet to materialise. Our understanding is that this document is crucial in terms of providing a blue print for how services can indeed be coordinated to avoid fragmentation and ensure that the various agencies / stakeholders are indeed working together.
On Thursday evening we had the representatives from the Leicester hospitals giving a presentation about the intensive treatment units. During this presentation it was made very clear that the strategy had been formulated under tight time scales driven by fiscal need and was separate from the STP.
We also received the LLR dementia strategy; a paper of some considerable significance for Rutland when considering the current and future demographic of our population. We have yet to see how this strategy fits with the overarching STP.
The Mental Health task and finish group has identified information that only the CCG can provide as a crucial starting point for its work. The group needs to know the statistical context for the varied mental health services that are currently available for the residents of Rutland before it can consider individual case studies and how these fit with the strategy. The group has now been asking for specific data since December 18th 2017. We have yet to meet the associate director of commissioning and contracting from the CCG. Whilst there have been good reasons for 2 postponements of meetings at which the group were due to meet Mr. Bosworth, it has been a drawn out process setting dates and the CCG seemingly have nothing in place to mitigate against unforeseen circumstances by sending an equally knowledgeable colleague to meet with the group.
We have therefore, in one meeting of the panel covered crucial areas that need addressing by the CCG:
• Communication
• Partnership working
• Planning to meet timescales
• Strategic thinking that demonstrates an holistic approach to meeting the health needs of the population
We hope that the portfolio holder will, in his capacity as chair of the Health and Wellbeing Board raise these concerns. The CCG must offer assurance with substance and be held to account for the delays in the STP. The future needs of our population are reliant on the CCG working effectively and efficiently. The panel currently lacks confidence in the ability of the CCG to do this.
Mr A Walters, Portfolio Holder for Health, Adult Social Services, and Community Safety, provided a response as follows:
I am grateful to Cllr Stephenson for her timely intervention.
There are a number of areas of concern identified, and I share her frustration.
Firstly, I must say that Rutland has an excellent record of working with partners including the CCG at a local level. For example, our successes at preventing delayed transfer of care from hospital are the envy of many other authorities. We could not have achieved this progress without the support of our partners, and we must take care to not be over-critical of our partners who may themselves be frustrated by procedures imposed on them from higher authorities.
That having been said, I share the frustration that the authority continues to receive strategies seemingly piecemeal, that we still await a clear plan for Rutland, and that we have been largely uninvolved in the production of the STP as a strategic piece of work. Of course, our work on the Rutland Hub may help to alleviate our frustration, and the CCG is also looking at an alternative should the Hub not be achievable for any reason.
I support the recent decision by Leicestershire County Council that, the STP once published, it is clearly identified as a document of the NHS, and that we are not joint publishers of the plan.
I also support the call for a review of the methodology of the plan and lack of engagement with local authorities. To this end I am particularly frustrated that the name was changed from Sustainability and Transformation Plan – to the Sustainability and Transformation Partnership.
I will be meeting with the CEO after this meeting, to discuss possible future arrangements for the three CCGs in the LLR region. At the same meeting I will discuss our concerns regarding the STP and the response from Leicestershire.
In respect of failure to provide information from the CCG to the Task and Finish group – I do not recall having this brought to my attention before, but will of course stand corrected if need be. I am happy to speak directly to the CCG or to ask senior officers to do so on behalf of the authority and would hope to be kept informed of any progress and indeed any further delays.
Mrs Briggs, Chief Executive, also confirmed that she would be attending a meeting with Dr O’Neill, Director for People, and senior colleagues across health from the three local authorities on 19 April 2018. The meeting was in relation to the Sustainability and Transformation Partnership and would provide an opportunity to raise concerns as expressed by the Portfolio Holder and Chair of Adults and Health Scrutiny Panel.