Overview and Scrutiny and the Health and Wellbeing Board by jWH4u22


									                                                                          Agenda Item No: 9
To:                   Adults Wellbeing and Health Overview and Scrutiny
Date:                 15th September 2011
From:                 Jane Belman, Scrutiny and Improvement Officer
Electoral division:   All
Forward plan ref::    N/a                          Key decision: No
Purpose:              To agree ongoing arrangements for developing an effective
                      relationship between Overview and Scrutiny, the shadow
                      Health and Wellbeing Board, and GP commissioning
Recommendation:       The existing member group which was set up to work with a
                      Centre for Public Scrutiny consultant during the summer on
                      developing scrutiny relationships with the Health and
                      Wellbeing Board and GP commissioning takes forward this
                      work by:
                       Liaising with the shadow Health and Wellbeing Board and
                         its members, and with emerging GP commissioning
                       Reporting and making recommendations to the Committee
                         as appropriate.
Key Issues:           The Health and Social Care Bill includes a requirement that the
                      Council set up a Health and Wellbeing Board whose purpose
                      will be to ‘join up’ healthcare, social care and public health
                      commissioning. This includes preparation of a Joint Strategic
                      Needs Assessment (JSNA) and Health and Wellbeing Strategy.
                      Cambridgeshire will be piloting a Shadow Board and Network
                      from September/October 2011.

                      The Committee obtained five days’ consultancy support from
                      the Centre for Public Scrutiny to undertake some early work
                      with members during the summer on developing overview and
                      scrutiny relationships with the Health and Wellbeing Board. A
                      time-limited member working group was set up to work with
                      the consultant. The group has identified a need for ongoing
                      work to develop the relationship with the shadow Health and
                      Wellbeing Board, GP commissioning arrangements, and the
                      emerging Healthwatch.

           Officer contact:                               Member contact:
  Name     Jane Belman                         Name:      Cllr Kevin Reynolds
  Post:    Scrutiny and Improvement Officer    Portfoli   Chairman Adults Wellbeing and Health
                                               o          Scrutiny Committee
  Email:   Jane.belman@cambridgeshire.gov.uk   Email:     Kevin.reynolds@cambridgeshire.gov.uk
  Tel:     01223 699140                        Tel:       01480 496006


1.1   Under the Government’s plans to modernise the National Health Service, local
      authorities will be required to establish Health and Wellbeing Boards (HWBs).
      The purpose of the HWB will be to ‘join up’ healthcare, social care and public
      health commissioning, and its statutory duties include preparation of a Joint
      Strategic Needs Assessment (JSNA) and Health and Wellbeing Strategy. A
      Shadow HWB is being piloted in Cambridgeshire; it is intended that this will
      consist of a board with links to a wider network of stakeholders and partnerships.
      The outcomes of this pilot will inform the development of the HWB, which will be
      formally established by 2013.

1.2   In future, health services will be commissioned by Clinical Commissioning
      Groups (CCGs), made up of GPs and other clinicians. The arrangements for
      CCGs in Cambridgeshire and surrounding areas are currently being developed.


2.1   The Government’s proposals for health services envisage a key role for
      Overview and Scrutiny, particularly in relation to the HWB and CCGs, and the
      legislation contains powers to enable this.

2.2   The Centre for Public Scrutiny identifies four principles of good overview and
      scrutiny that will continue to be relevant under the new arrangements:
       Provides critical friend challenge to people who make policy and decisions
       Enables a voice for the public and its diverse range of communities
       Carried out by Independent and impartial members, who lead and own the
         scrutiny role
       Drives improvement in public services.

2.3   In order to develop its capacity to apply these principles effectively in the
      changing environment, the Adults Wellbeing and Health Overview and Scrutiny
      Committee (OSC) successfully applied to be one of eight Centre for Public
      Scrutiny health reforms scrutiny development areas. This programme aims to
      support the early development of accountability arrangements and ways of
      working between Scrutiny, HWBs and CCGs. Under the scheme, the Committee
      received five days’ consultancy support during July and August, and has taken
      part in shared learning with the other authorities involved that will result in a
      national publication in October. The programme was funded by the Healthy
      Communities Team at Local Government Information and Development.

2.4   The programme in Cambridgeshire focused on the development of the scrutiny
      role and relationships with the shadow HWB, complementing the work the
      Committee has already done to establish links with the GP Senate and individual
      GP commissioning clusters. The consultant worked with an OSC member
      working group to identify issues and ways forward.

2.5   A single issue meeting between the Joint Workstreams Group (the inter-agency
      officer group that is co-ordinating work on the development of the HWB) and the
      OSC working group was held in early August. This explored how OSC might
      relate to and contribute to the development of the HWB between now and 2013.

   3.    MAIN ISSUES

   3.1   Issues which have emerged from these discussions include:
            How OSC can most effectively add value to the work and priorities of the
             HWB, at both strategic and service delivery levels, and ensure that its
             activities result in improved outcomes. This could include exploring equity of
             access to services, the effectiveness of public involvement, and whether the
             strategies are evidence- based, and
            How OSC responds to the challenge of the more localised approach
             envisaged in both the proposed HWB network models and the emerging
             arrangements for clinical commissioning
            The inter-relationships between OSC, the HWB, CCGs and local
             Healthwatch, the body which will replace the Local Involvement Network
             (LINk) as the vehicle for achieving public and patient involvement.


   4.1   There is an opportunity for the Committee to shape the scrutiny role and
         relationships under the new arrangements by working with the shadow HWB,
         emerging CCGs and Cambridgeshire LINk/Healthwatch over the next 18 months
         during this transitional phase, with particular reference to addressing the issues

Source Documents                    Location
Reports to Cabinet 06.09.11         Jane Belman jane.belman@cambridgeshire.gov.uk
                                    tel 01223 699140 or www.cambridgeshire.gov.uk
AWH OSC minutes 07.07.11


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