Get documents about "Item 8 Public Health Scrutiny
Shared by: HC12080800473
-
Stats
- views:
- 1
- posted:
- 8/7/2012
- language:
- English
- pages:
- 27
Document Sample
Report to Scrutiny
Item Number: 8
Contains Confidential Or No
Exempt Information
Public Health Transition Progress Report
Subject of Report:
Health and Adult Social Services Standing Scrutiny Panel
Meeting:
26 April 2012
Dr Jackie Chin
Service report author: Director of Public Health
Kevin Unwin
Scrutiny Review Officer
Scrutiny officer:
Unwink@ealing.gov.uk
Councillor Jasbir Anand, Health and Adult Services
Cabinet Responsibility:
Director Responsibility: David Archibald, Executive Director of Children and Adults
To update the Members on the Public Health Transition and
Brief ask for comments and feedback.
To consider the information contained in the report and
make comments and recommendations as appropriate,
considering in particular:
(a) the transition plan at appendix 1, and whether
members feel any clarifications, amendments or
Recommendations
additions to the plan are needed;
(b) further to the examples listed at section 2, possible
suggestions of areas for closer working and between
individual council services and public health in the
future.
1 Page of 27
Public Health Transition Progress Report
1. Overview of the report
The purpose of this report is to give Members an overview and update of the
Public Health transition to Ealing Council.
2. Overview
The Health and Social Care Act 2012 proposes the transfer of key Public
Health functions to local authorities by 1 April 2013.
The Government has set out its vision that local authorities will take on a key
leadership role for public health locally. Councils will lead on improving their
populations’ health and Wellbeing, co-ordinate local efforts to protect the
public’s health and ensure health services effectively promote population
health. Building on their central role as democratically accountable bodies
which are ideally placed to shape services to meet local needs, they will be
able to develop holistic solutions to health and Wellbeing embracing the full
range of local services (e.g. health, housing, leisure, planning, transport,
employment and social care). Local authorities’ new public health
responsibilities will be supported by a ring-fenced budget. Directors of Public
Health will lead this work, as the principal adviser on health to the local
authority.
The provisions include a new duty on upper tier Councils, to take steps to
improve the health of their local population. One way those local authorities
may fulfil their new health improvement duty will be through commissioning
public health services.
In performing their public health functions Local Authorities will work with
Clinical Commissioning Groups and representatives of the NHS Commissioning
Board and Public Health England.
Clinical Commissioning Groups (CCG’s) are groups of GP’s that will be
responsible for designing local health services. The NHS Commissioning Board
will oversee CCG’s. Public Health England will lead on health protection
nationally and set the overall outcomes framework for public health.
These new bodies will be created and the transfer of functions to Local
Authorities will take place on 1 April 2013.
The vision for public health in Ealing is one where it has transferred safely and is
integrated with every council function so that taking action to improve health is an
automatic part of the work and culture of every department, section, team and
individual – ‘part of Ealing Council’s DNA’.
A local public health system established with all our local partners – Ealing Clinical
Commissioning Group, NHS Commissioning Board, Public Health England, other
statutory partners such as the police, the community and voluntary sectors, local
LINks/HealthWatch and our providers such that they are an integral part of
delivering improvements.
2 Page of 27
Ealing Council and all political parties are seen leading and influencing all sectors,
communities and individuals, and public health has become a ‘movement for
change’ for healthier lives and environments.
Some examples of closer working in the Council are given below:
Distributing healthy start vitamins in Children’s centres
Joint strategies on obesity, breast feeding and accidents in children’s
centres
Community safety- sharing of information on hot spots so that drug and
alcohol service providers can better target their outreach work
Analysts in the community safety team, drug and alcohol team, probation
team etc meeting to share information
Linking the school Health related behaviour survey in children to the
commissioning of the school nursing team
Using libraries for health trainers to meet with communities and exploring
the possibility of library staff becoming health champions
Exploring Park Rangers helping with leading health walks in their parks
The transfer has resulted in reduced health inequalities, improved health outcomes
and better integration of health and social care through cost effective delivery.
2.1 Commissioning
In ‘Healthy Lives, Healthy People: Update and way forward’ published by the
Department of Heath in July 2011.
(http://www.dh.gov.uk/en/Publichealth/Healthyliveshealthypeople/index.htm)
The government has indicated a provisional view of what should be funded
from the national public health budget, and who the principal commissioner for
each activity should be. Where possible responsibility and resources for public
health services will be devolved to local government. Although in a number of
cases where a public health service is deeply intertwined with the delivery of
clinical services, or where services are part of the primary care contractual
arrangements, the Secretary of State for Health will ask the NHS
Commissioning Board to commission services on his or her behalf (for example
national screening and immunisation programmes).
The Health and Social Care Act 2012 includes a power for the Secretary of
State for Health to prescribe that local authorities take certain steps in the
exercise of public health functions, including that certain services should be
commissioned or provided. The purpose of this power is not to identify some
services as more important than others. Rather the issue is that in some
service areas (particularly health protection) greater uniformity of provision is
required. In others, the Secretary of State for Health is currently under a legal
duty, and needs to ensure that the obligation is effectively delivered when the
3 Page of 27
function is delegated to local government (the provision of contraception is an
example). Finally, certain other steps are critical to the effective running of the
new public health system at a local level, for example ensuring that the local
authority provides public health advice to NHS commissioners.
The proposed list of mandatory functions is:
Appropriate access to sexual health services
Steps to be taken to protect the health of the population, in particular, giving
the local authority a duty to ensure there are plans in place to protect the
health of the population
Ensuring NHS commissioners receive the public health advice they need
The National Child Measurement Programme
NHS Health Check assessment.
The Department of Health has recognised that further work is needed to clarify
responsibilities as between Local Authorities and NHS bodies.
A full list of local authority prescribed functions will be subject to Parliamentary
approval when the regulations are made.
Regarding health protection, at present Directors of Public Health in primary care
trusts play a key leadership role in planning for, and responding to, health
protection incidents, supported by local Health Protection Agency health protection
units. The Health and Social Care Act provides that the Secretary of State for
Health is responsible for taking steps for the purpose of protecting the health of the
population. The Director of Public Health will continue to provide a coordination
role to protect the health of the local population when transferred to local
authorities. The local authority, and the Director of Public Health acting on its
behalf, should have a pivotal place in protecting the health of its population. Local
authorities will need to take steps to ensure that plans are in place to protect the
local population.
Under this duty, local authorities (and Directors of Public Health on their behalf)
would be required to ensure that plans are in place to protect the health of the local
population from threats ranging from relatively minor outbreaks to full- scale
emergencies, and to prevent as far as possible those threats arising in the first
place. The scope of this duty will include local plans for immunisation and
screening, as well as the plans acute providers and others have in place for the
prevention and control of infection, including those which are healthcare
associated.
It is anticipated that the new responsibilities of local authorities would include local
activity on:
Tobacco control;
Alcohol and drug misuse services;
Obesity and community nutrition initiatives
Increasing levels of physical activity in the local population
Assessment and lifestyle interventions as part of the NHS Health Check
Programme;
Public mental health services;
Dental public health services;
Accidental injury prevention;
Population level interventions to reduce and prevent birth defects;
4 Page of 27
Behavioural and lifestyle campaigns to prevent cancer and long term
conditions;
Local initiatives on workplace health;
Supporting, reviewing and challenging delivery of key public health funded
and NHS delivered services such as immunisation programmes;
Comprehensive sexual health services (includes testing and treatment for
sexually transmitted infections, contraception outside of GP contract and
sexual health promotion and prevention)
Local initiatives to reduce excess deaths as a result of seasonal mortality;
Role in dealing with health protection incidents and emergencies
Promotion of community safety, violence prevention and response
Local initiatives to tackle social exclusion.
Improving health through prevention including the out of hospital strategy
Options are being explored regarding joint commissioning, procurement and
contracting with the West London Alliance and the NHS Commissioning Support
organisation.
Recommendations on the way forward will be brought back to Cabinet in due
course.
Spend on Programmes (Top 4) in 2010/11
Programme Area Spend in 2010/11
Sexual Health £5,444,000.00
Drugs £4,809,000.00
Alcohol £2,328,000.00
Children 5-19 £777,000.00
2.2 Governance
Responsibility of the Director of Public Health ( DPH)
The DPH as a public health specialist will be responsible for all new public
health functions for the local authority. The Department of Health has indicated
its intention to make the DPH a statutory officer, although the council may
choose to share this role with another authority or combine it with another role
within the council. They will be a statutory member of the Health and Wellbeing
Board, and will act as the lead officer for health and champion health across the
local authority.
Health and Wellbeing Boards
Health and Wellbeing Boards offer the opportunity for system-wide leadership
to improve both health outcomes and health and care services. They will have
a duty to promote integrated working, and their core purpose is to drive
improvements in health and Wellbeing by promoting joint commissioning and
integrated delivery. Their agenda extends beyond health and adult social care
to include children’s health and Wellbeing, and wider areas that impact on
health such as housing, education and the environment.
Since their role includes partnership working between their members to support
CCG commissioning plans in aligning with the joint health and Wellbeing strategy,
5 Page of 27
they will also consider issues that are generally seen as core NHS services rather
than those mainly at the Council/NHS interface – for instance cancer care, or
hospital configuration.
Under the new legislation Health and Wellbeing Boards will have responsibility for
the joint strategic needs assessment and the joint health and well being strategy.
They have a strategic role in setting the framework for commissioning of health,
social care and public health in their area.
Health and Wellbeing Boards involve an interplay of powers and responsibilities,
and are best seen as a body for shared leadership across the health, care and
Wellbeing system. Elected Members will have a very important role in ensuring the
development of a shared vision and in demonstrating collaborative, inclusive and
consensual leadership.
Ealing has a well established shadow Health and Wellbeing Board, which is well
placed to take on these new duties for 1 April 2013, subject to review of its
membership and terms of reference to ensure that any statutory requirements are
met. The membership of the Health and Wellbeing Board includes representatives
from Community Groups and our stakeholders and partners.
Healthwatch will replace Local Involvement Networks (LINks). HealthWatch will
monitor the work of the health and wellbeing boards. Local HealthWatch will
have a seat on the new health and wellbeing boards, ensuring that the views
and experiences of patients, carers and other service users are taken into
account when local needs assessments and strategies are prepared, such as
the Joint Strategic Needs Assessment (JSNA) and the authorisation of Clinical
Commissioning Groups. This will ensure that Local HealthWatch has a role in
promoting public health, health improvements and in tackling health inequalities
Links with Ealing’s Community Strategy
The Director of Public Health will work with our partners and stakeholders to help
deliver Ealing’s Community Strategy. One of the 4 key priorities agreed with our
partners and stakeholders is to improve public health and support those with
specific needs to achieve well-being and independence.
2.3 Workforce
Primary care trusts and local authorities will be responsible for developing
public health transition plans and consulting with their constituent trade unions
and staff on these and the associated workforce plans. To support this, key
guidance and support has been developed at national level and published by
the Department of Health and the Local Government Association. This
outlines the human resources processes and expectations on primary care
trusts, councils, NHS and local government trade unions in managing this
important change with elements on some remaining key issues being
developed. Further HR guidance is due at the end of March 2012. The
expected date for any transfer of staff that may occur is 1 April 2013.
2.4 Organisational Design
Local Authorities will be working to develop their vision and the structure of
6 Page of 27
their new public health function in dialogue with a range of partners and
representatives over coming months. There is an emerging view that it may
be appropriate for commissioned public health services to be procured jointly
at a West London level, rather than Borough level, in line with the West
London Alliance approach to procuring adult social care, children’s and
transport services. However, a final decision is not proposed to be taken on
this aspect until further work has been carried out with regard to cost,
effectiveness, and feasibility. At an appropriate point, the Council will need to
discuss these plans with Public Health England, the National Commissioning
Board and the Clinical Commissioning Groups.
Recommendations on the way forward for Ealing will be brought back to
Cabinet in due course, once the work referred to above on cost, effectiveness,
and feasibility has been completed.
3. Key Implications
The Department of Health is encouraging PCTs and Local Authorities to put in
place by the 5th April 2012 a clear local plan which sets out the main elements of
transfer including functions, staff and plans for commissioning contracts for
2013/14 and beyond.
Ealing Council and NHS Ealing (Ealing PCT) have established a Public Health
transition sub group to oversee this transition. This group is accountable to the
Ealing Executives Group.
Within NHS NW London, it is anticipated that shadow arrangements will be in
place by 1 April 2012, with Clinical Commissioning Groups operating in their
groups of four, Ealing Clinical Commissioning Group is within the Brent, Harrow
and Hillingdon group.
For Public Health there is an expectation from the NHS that shadow arrangements
are in place by October 2012. This report represents the council’s first step to
achieve this. The Council has also established a shadow Health and Wellbeing
Board and has a development day planned in April 2012. The Board will over see
the refresh of the Joint Strategic Needs Assessment (JSNA) for June 2012 and
refresh its Health and Wellbeing Strategy (HWBS) by September 2012.
During the transitional period in 2012/13 there are key areas that will need to be
covered which include:
Finance
Contracts (including novation of existing contracts where appropriate,
and consideration of whether or not new commissioning arrangements
will be appropriate following transition)
HR
Governance
Legal
Business and IT
Development of JSNA and HWBS
Initial details, timescales and resources are included in Appendix 1 and further
details will be reported in due course.
7 Page of 27
4. Value For Money
Value For Money underpins all developments occurring in the Council. In the
climate of increasingly tight resources under which we operate, all the content of
this plan has been designed with the future financial climate in mind and a need
to ensure that all activities and organisational development enables the Council
to become increasingly effective and efficient. Options for collaboration are also
being explored.
5. Sustainability Impact Appraisal
Not required at this time.
6. Risk Management
The risks associated with implementation of this Plan and the activities prioritised
for 2012/13 are largely related to
a) The ability of the organisation (and its partners) to respond to the demands
of the projects and activities included, particularly in a climate of increasing
financial pressures and organisational change within the NHS. In addition,
the operating model for Public Health England and the National
Commissioning Board is still evolving and their interface with local
government is still unclear.
The plan has been developed and the activities planned for the coming year with
an understanding of risk and our context for operating in mind.
As is currently the case, risk to achieving the key goals in the Plan, will be
managed through quarterly performance monitoring reports sent to Ealing
Executive Group and to the Adult Health and Social Service Scrutiny Panel.
7. Community Safety
None
8. Links to the 5 Priorities for the Borough
From 1 April 2013, Ealing Council is expected to lead on improving its population’s
health and wellbeing, co-ordinate local efforts to protect the public’s health and
ensure health services effectively promote population health. Ealing Council will
shape services to meet local needs and develop holistic solutions to health and
wellbeing embracing the full range of local services (e.g. health, housing, leisure,
planning, transport, employment and social care). Health is already a priority in
the Community Strategy and these objectives will need to be included in future
Corporate Plans and the refreshed Health and Wellbeing Strategy to ensure
delivery of the required public health outcomes.
The key corporate values will be core to its delivery:
Putting residents first
Offering world class customer service
Securing value for money in everything we do, and
Working as One Council.
8 Page of 27
9. Equalities, Human Rights and Community Cohesion
S149 Equality Act 2010 requires the Council to exercise its functions with due
regard to the need to eliminate discrimination, advance equality of opportunity and
foster good relations between people with protected equality characteristics when
carrying out their activities.
The Joint Strategic Needs Assessment and Health and Wellbeing Strategy being
developed by the Health and Wellbeing Board and the other steps that need to be
taken to prepare for the transition of public health functions to the council will be
the subject of robust equalities assessment analysis to support the Council and
key partners to improve the health of the local population and reduce health
inequalities by focussing on meeting the needs of those who may be
disadvantaged and in minority groups.
10. Staffing/Workforce and Accommodation implications:
In January 2012, local government transition guidance set out some basic
principles for the transfer of the public health workforce. Councils will naturally
build on their own policies and procedures, whilst paying close attention to the
basic principles set out below.
The main principles are:
All matters relating to the statutory transfer of public health functions and
any staff transfers are of course subject to the enactment of the Health and
Social Care Act 2012 .
Staff identified as working in the public health functions that will transfer to
local government on a statutory basis under the Health and Social Care Act
2012 will do so on a TUPE or TUPE-like basis under COSOP
Local authorities and PCTs are strongly encouraged to work together jointly
with relevant trade unions to prepare for the transfer
Arrangements should be agreed locally to help transferring staff to engage
more closely with their eventual new employers in the transition year 2012-
13
However, no staff should transfer employment in advance of the due date of
1st April 2013 which is the date the statutory responsibilities transfer
Councils are strongly encouraged to implement best employment practice,
taking account of the need for future recruitment and retention of specialist
public health staff
A number of issues have yet to be fully resolved and will be the subject of further
clarification from the national Concordat Steering Group, including:
A checklist of options for agreed initiatives, including secondments to
engage employees more closely with new employers prior to the final
transfer
Proposals for dealing with staff pensions
Details of a staff commission to be set up under the auspices of ACAS to
deal with any problems relating to individual transfers that cannot be dealt
with locally.
The appropriate involvement of NHS trade union officials in local and
national discussions post 1 April 2013
9 Page of 27
Treatment of current and future trainees
Treatment of individuals close to retirement in the NHS, or close to the
expiry of a fixed-term contract.
Arrangements for future specialist training and development – especially
statutory requirements
Consultation with staff and unions will be carried out in due course.
11. Property and Assets
The PCT Public Health team is already based in Perceval House, and it is
anticipated that they will remain there following 1st April 2013. Cost sharing
arrangements with the PCT for the period up until 1st April 2013 have yet to be
agreed.
12. Financial
From the financial year 2013/14, Public Health will be the responsibility of the
Local Authority and a direct budget will be allocated to Ealing which is based
upon actual expenditure baseline of 2010/11. Shadow arrangements will be in
place for 12/13, but expenditure and budgets remain within Health and the
allocation is £18.025m as notified by the Department of Health in January 2012.
There is currently no specific funding for transition costs that has been
allocated to the Local Authority to assist with the costs of transferring the
responsibility to Ealing. Such costs include legal and contracting costs
associated with the transfer of responsibilities, system upgrades and changes
to ensure that the Council can accommodate the work of Public Health and
other due diligence. An estimate of these costs is currently being calculated.
Funding for these additional costs still needs to be identified. The Executive
Director, Children and Adults has raised this issue with the Department of
Health and awaits a response.
Care will need to be taken, in the transitional period and once the legislation
has been implemented, to ensure that the Council does not assume
responsibilities and costs which are legally the responsibility of NHS bodies.
13. Legal
The formal transfer of statutory responsibilities to the Council will occur on 1
April 2013.
Care will need to be taken to ensure that any transitional arrangements made
by the Council before the new legislation is implemented are within the
statutory powers currently available to the Council.
13.1 Public Health Functions under the new Health and Social Care legislation
A duty to take such steps as the Council considers appropriate for improving he
health of the people in its area. The steps that may be taken include
a) Providing information and advice;
10 Page of 27
b) providing services or facilities designed to promote healthy
living (whether by helping individuals to address behaviour
that is detrimental to health or in any other way);
c) providing services or facilities for the prevention, diagnosis or
treatment of illness;
d) providing financial incentives to encourage individuals to
adopt healthier lifestyles;
e) providing assistance (including financial assistance) to help
individuals to minimise any risks to health arising from their
accommodation or environment;
f) providing or participating in the provision of training for
persons working or seeking to work in the field of health
improvement;
g) making available the services of any person or any facilities.
The steps that may be taken include
a) Providing grants or loans (on such terms as the local authority
considers appropriate).
b) A duty to provide for the medical inspection and treatment of school
pupils and powers to arrange for children to be weighed and measured.
c) A power to conduct, commission or assist the conduct of research for
any purpose connected with the exercise of its functions in relation to the
health service, including the power to obtain and analyse data or other
information and obtain advice from persons with appropriate professional
expertise.
The power to assist any person to conduct research includes power to do so by
providing financial assistance or making the services of any person or other
resources available.
13.2 Director of Public Health
Councils will be required to appoint a Director of Public Health with
responsibilities which include
a) The exercise of prescribed public health functions under the National Health
Service Act 2006 (as amended).
b) Preparing for and responding to public health emergencies
c) Cooperating in the assessment and management of risks posed to the
public by offenders
The Secretary of State must approve the appointment and may direct a Council
to review how the Director has discharged his/her responsibilities.
The Director of Public Health must prepare an annual report on the health of
the people in the area which must be published by the Council.
11 Page of 27
All of these duties are subject to the Secretary of State’s powers to make
further Regulations as to public health functions and to issue Statutory
Guidance
13.3 Additional Functions
A duty to make arrangements for independent mental health advocates to be
available to help ‘qualifying’ patients.
A duty to set up a Local Healthwatch Organisation for the involvement of
people in the commissioning, provision and scrutiny of health and social
services
A duty to make such arrangements as it considers appropriate for the provision
of independent advocacy services to assist people with complaints about health
services
13.4 Strategic Needs Assessment and Health and Wellbeing Strategy
The Council and Clinical Commissioning Group (CCG) must undertake a joint
strategic needs assessment of the health and social care needs for the area
(JSNA) and prepare a joint health and wellbeing strategy (JHWS) for meeting
the needs by the exercise of functions of the authority, the National Health
Service Commissioning Board or the Clinical Commissioning Group.
In preparing a JHWS the Council and the CCG must, in particular, consider the
extent to which the needs could be met more effectively by the making of
partnership arrangements under section 75 of the National Health Service Act
2006 (rather than in any other way).
In preparing a JSNA the Council and CCG must have regard to:-
a) the mandate published by the Secretary of State under section
13A of the National Health Service Act 2006, and
b) any guidance issued by the Secretary of State.
and must—
c) involve the Local Healthwatch organisation for the area and
d) involve the people who live or work in that area.
The Council must publish the JHWS
The Council and the CCG may include in the strategy a statement of their
views on how arrangements for the provision of health-related services in the
area of the Council could be more closely integrated with arrangements for the
provision of health services and social care services in that area.
The Council, the CCG and the NHS Commissioning Board must have regard to
the JSNA and JHWS in the exercise of their functions
13.5 Health and Wellbeing Boards. (HWB) and the future of Health Scrutiny
Committees
Councils will be required to establish a HWB as a committee apppointed under
S102 Local Government Act 1972. Membership must include at least one
councillor, the Directors of Adults Services, Children’s Services and Public
12 Page of 27
Health, a representative of the Local Healthwatch Organisation and the Clinical
Commissioning Group.
The responsibilities of the HWB will include to lead on the production of the
JSNA and JHWS. to promote the integration of health, social care and public
health and to promote joint commissioning.
CCG’s will be required to consult the HWB on their commissioning plans and
HWB’s will advise the NHS Commissioning Board on how well the CCG has
helped deliver the JHWS for the purpose of the annual assessment of the CCG.
The HWB may refer plans back to the CCG of NHS Commissioning Body if
they do not follow the JHWS but may not veto them .
Councils may delegate any other functions to the HWB and two or more HWB’s
may exercise their functions jointly.
There will be no obligation to continue to have a Health Overview and Scrutiny
Committee. However the Council’s functions under S244 National Health
Service Act 2006 review and scrutinise any matter relating to the planning,
provision and operation of health services in their area will remain and may not
be exercised by the HWB.
14. Any other implications
None anticipated.
15. Consultation
The Public Health Transition proposals and process are at an early stage, but
will take account of feedback from officers, members, staff, unions, and partner
organisations.
16. Timetable for Implementation
Details Timescales
Consideration of draft Public Health Transition 24 April 2012
Progress report by Cabinet
Further development and implementation of transition March 2012- March
plan 2013
Formal transfer of statutory responsibilities 1 April 2013
17. Appendix 1
Draft of transition plan
18. Background Information
‘Healthy Lives, Healthy People: Update and way forward’ published July
2011.
http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPoli
cyAndGuidance/DH_128120
A series of policy updates were published on 20 December 2011 to help
partner organisations and staff involved to understand and implement these
reforms. This includes a suite of factsheets on:
13 Page of 27
The New Public Health System
http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/
digitalasset/dh_131897.pdf
Public Health in Local Government
http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/
digitalasset/dh_131904.pdf
PHE’s Operating Model
http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/
digitalasset/dh_131892.pdf
In January 2012, ‘Public Health Transition Planning Support for Primary Care
Trusts and Local Authorities' was published. This is to assist PCT clusters with
their requirements to produce public health transition plans as part of their
overarching plans for the transition year, as set out in the NHS Operating
Framework and planning guidance for 2012/13 recently issued by the
Department of Health.
http://www.dh.gov.uk/health/2012/01/transition-planning/
In addition, ‘Local government transition guidance on public health workforce
issues’ has been developed by the Local Government Association, supported
by local government union colleagues and NHS Employers and union
colleagues. This focuses on public health workforce issues and is primarily for
HR specialists in local authorities who will be responsible for managing
transfers working with PCTs, and is concerned with the key questions and
options where staff are transferring from PCTs to Local Authorities.
http://www.dh.gov.uk/health/2012/01/public-health-workforce/
Draft Statutory Guidance JSNAs and joint health and wellbeing strategies. January
2012 https://www.wp.dh.gov.uk/healthandcare/files/2012/01/JSNAs-and-joint-
health-and-wellbeing-strategies-draft-strats.pdf
14 Page of 27
Consultation
Name of Post held Date Date Comments
consultee sent to response appear in
consultee received paragraph:
Internal
David Archibald Executive Director, 12 Feb 2012 28/2/2012 Various
Children and Adults
Mary Umrigar Business Manager, 12 Feb 2012 15/2/2012 Various
Performance
Adele Taylor Director, Finance 12 Feb 2012 15/2/2012 Finance
Cllr. Jasbir Anand Cabinet Member Health 21 Feb 2012 29/03/2012 Various
and Adults Services
Jane Batalona Head of Legal Social Care 12 Feb 2012 15/2/2012 Legal
and Education
Helen Harris Director of Legal Services 12 Feb 2012 15/2/2012 Legal
Derek Holl HR Business Partner 12 Feb 2012 15/2/2012 Workforce
External
eg voluntary
organisation
Report History
Decision type: Urgency item?
For information No
Report no.: Report author and contact for queries:
Dr Jackie Chin, Director Public Health, NHS Ealing
15 Page of 27
This Page is Intentionally Blank
16 Page of 27
Appendix 1
DRAFT 24 March 2012
London Borough of Ealing
public health transition plan
17 Page of 27
Transition plan
Area 1: Vision, strategy and structures: lead Jackie Chin and David Archibald
RAG Resources
No. Key Tasks Actions Comments / Progress Responsibility Start Finish
/Risk required
1.1 Implementation of this plan Establish stakeholder reference group (SRG) – Established JC/DA April Green
ToR, membership, key work streams: 2012
Communication, HR, Governance, IT and Estates
Agree leads for all areas of this transition plan
Agree overall approach to implementation, agree In progress JC/DA May2012 Green
transition plan and set milestones
1.2 Develop vision and strategy for Health and Wellbeing strategy to be developed in In progress JC/DA Sept Amber
improving health and wellbeing in line with Joint Strategic Needs Assessment and 2012
Ealing ‘Public Health Outcomes Framework’
Design of future operating model for Agree functions to be undertaken in Ealing; develop WLA option for procurement JC/DA Oct Amber
1.3 specialist public health functions in service model being considered 2012?
Ealing Carry out initial EAA
Agree structure of public health Agree functions to be undertaken with other As above
specialist team in Ealing boroughs, within the West London Alliance or
otherwise
Develop structure of public health specialist team: To be developed in line with October Amber
engage with stakeholders WLA 2012
Carry out necessary staffing consultations. In HR section April Green
Consider TUPE implications 2013
Structure approved by CEO Discussion paper on models October Amber
under consideration by CE 2012?
and Exec Director
Complete EAA
Council Cabinet approval TBD ? Nov
2012
Communicate structure
1.4 Develop public health commissioning Identify all current contracts (section 2.5 below for See Section 2.5
intentions for 13/14 in line with public further detail)
health outcomes framework and ring Establish mandatory services (as per grant
fence grant conditions)
Agree commissioning intentions for 13/14
Establish interface / shared service options with
existing council services, or with equivalent
services in other boroughs and evaluate the most
cost efficient options going forward
Consider whether PCT or LBE contract terms and
conditions will apply and establish commissioning
timeframes in the light of this
1.5 Corporate support Agree resource and leads for all areas of this Leads agreed, financial Amber Resources
transition plan (including finance, IT, legal, resources TBD TBD
governance and performance, HR etc)
1.6 Shadow working for 2012/13 Develop principles for shadow working MOU agreed for 12/13 March Green
2012
18 Page of 27
Transition Plan
Area 2: Finance and contracts: lead Inderjit Mattu and Lisa Money NHS Ealing/ Adele Taylor and Kate Graefe LBE
RAG Resources required
No. Key Tasks Actions Comments / Progress Responsibility Start Finish
/Risk
2.1 General Ledger & Respective Agree new hierarchy in Council ledger Needs to involve Agresso support Bob from – July By 31-03- Amber Adults Finance –
Feeder systems: Payroll, Debtors, team Scoffham/Safia 2012 13 Accountancy Team
Creditors, Procurement Khan Time and Agresso
support team time
(IT)
Transfer historic/previous years information and Query – unlikely to be possible in Safia Khan from – July By 31-03- Amber Adults Finance –
ensure it is accessible Agresso so how can we download 2012 13 Accountancy Team
to be able to interrogate Time
Get new licences for and all other associated Query – under BSG. Need further BSG £ Query
software and systems for PH services information from the NHS regarding
licenses required/already held
Transfer debtor and creditor balances as at Liability for debtor and creditor Bob Scoffham 31-03-13 By 30-04- Amber Corporate Finance
31.03.13 to Ealing Council systems balances to remain with NHS 13 – Team Time
Set up new payroll run for PH staff Needs to be part of staffing Helen Furey
transition – need to also liaise with
DH and TH (see section 3) as part
of TUPE
Cancel all existing PH call off orders NHS responsibility NHS
Set up new call off orders as required at LBE Need to identify resource from PH ? Training – Green
to do this on Agresso once structure Feb-Mar
set up. 2013
Agresso training can be provided by Orders –
Ealing Procure to Pay team Mar-Apr
2013
Resolve all outstanding disputed invoice NHS responsibility NHS
queries
Agree which organisation will chase bad debts Liability for debtor and creditor NHS
existing balances to remain with NHS
Transfer PH computers and other small items of NHS responsibility NHS
equipment from NHS Ealing's asset register by Ensure no LBE charge?
writing value down to nil, or minimal value to be
covered by non-recurrent funding transfer
2.2 Financial governance including: Complete full year accounts NHS Ealing NHS responsibility NHS
Financial Controls, Financial Keep open access to PCT and associated NHS responsibility NHS
Reporting, Final Accounts & financial systems post year end in order to
Board Approval for New Budgets complete final accounts
and Financial Plans Amend LBEs SO’s, SFI’s and Scheme of Update finance regulations and Bob from – July By 31-03- Amber Corporate Finance /
Delegation to take account of PH Scheme of delegation Scoffham/Helen 2012 13 Legal – Team Time.
Harris Legal Recharges?
Agree new year Internal Audit plan for PH as Discuss requirements with Sudhi Safia Khan/Sudhi from – By 31-03- Amber Adults HoF & Audit
part of LBE internal audit process Pathak Pathak Sept 2012 13 – Team Time
19 Page of 27
Transition Plan
Area 2: Finance and contracts: lead Inderjit Mattu and Lisa Money NHS Ealing/ Adele Taylor and Kate Graefe LBE
RAG Resources required
No. Key Tasks Actions Comments / Progress Responsibility Start Finish
/Risk
List of signatory at LBE to be updated to Once PH becomes part of scheme Bob Scoffham from – By 31-03- Amber Corporate Finance
include PH staff of delegation, signatories to be Sept 2012 13 and
collated Agresso IT team Agresso support
Agresso approvals (hierarchy) team time (IT)
impact- links to first point above)
Notify all suppliers, both internally and Need agreed list from NHS and then Rupinder Hardy Dec2012 By
externally, of transfer agree with P2P team 31.03.13
Set up a process for inclusion of PH financial Agree format with corporate finance Safia Khan/Amalio Jan 2013 By 31-03- Amber Adults Finance –
position to be included with LBE reports Alcazar 13 Accountancy Team
Time and Corporate
Finance Team Time
2.3 Cash, Reserves, Capital and Amend cash flow forecasts at LBE to take At transfer date ensure that cash Sharon from – By 31-03- Amber Corporate Finance
Financial Plans account of the additional requirements from PH flow amended within Treasury Daniels/Bridget Sept 2012 13 – Team Time
Uku
Identify any reserves within NHS Ealing At transfer date ensure that cash Sharon from – By 31-03- Amber Corporate Finance
budgets being transferred flow amended within Treasury Daniels/Bridget Sept 2012 13 – Team Time
Uku
Upgrades and backlog maintenance issues
should be in the Facilities scope of the
adequacy of premises, equipment and any
associated indemnities
2.4 Non-Pay Expenditure A list of all goods and services provided, Get list from NHS and then provide Safia Khan/P2P from – By 31-03- Amber Adults Finance
product codes, quantities and prices paid to P2P team. Work out the best (Hayden Sept 2012 13 Operations & Adults
(including unit of issues) by provider structure within Agresso Urquhart/Rupinder HoF – Team Time
Hardy)
A comprehensive list of all repetitive items Assuming same as items above from – By 31-03- Amber Adults Finance
required by provider and department including Sept 2012 13 Operations & Adults
the role of NHS Supply Chain HoF – Team Time
A list of all areas, transfer points, and their
geographic Site Locations
Users and delivery point details
Flowchart of existing supply chain processes Share current P2P process with P2P Dec 2012? Green
used, e.g. from request of requirements to NHS and identify differences. Will
payment of invoice need to write to suppliers (captured
above)
Any existing details related to requisition books (P2P)
currently deployed
Review and renew Contracts Agree draft new contract format, ensuring it is Standard contract form/PO already N/A
Signed within the agreed appropriate for clinical care. exists.
timescale Legal to review vs Ealing std terms? Catherine Taylor
2.5 To collate a list of all contracts and service Contract register sent through to April 2012 Oct 2012 Green
specifications requiring transfer with public LBE team
health to Ealing Council Specs and further contract details to NHS
be advised by the NHS
20 Page of 27
Transition Plan
Area 2: Finance and contracts: lead Inderjit Mattu and Lisa Money NHS Ealing/ Adele Taylor and Kate Graefe LBE
RAG Resources required
No. Key Tasks Actions Comments / Progress Responsibility Start Finish
/Risk
Review and revise in line with 2013-2014 PH? April 2012 Oct 2012 Green
Operating Framework and Public Health
outcomes framework and commissioning
intentions (section 1 above)
Identify service specifications to be transferred Part of due diligence on contracts Kate Graefe April 2012 Oct 2012 Green
register
NHS to identify & advise relevant
specs
Establish interface / shared service options (of March Green?
all contracts and service specifications requiring WLA developing potential WLA / John 2012
transfer) with existing council services, or with procurement process to share with Ashley
equivalent services in other boroughs, and the Design Panel on 28th Mar
evaluate the most cost efficient commissioning Contracts lists versus council
options going forward. services initial cross-check
completed – only interpreting
services as common
Future shared commissioning plans PH/Proc Summer
– requires contract information from 2012??
other boroughs
Consider whether PCT or LBE contract terms Part of due diligence on contracts Kate Graefe April 2012 April 2013 Green
and conditions will apply to each contract and register (/Catherine
establish contract and commissioning (Likely to be PCT terms potentially Taylor)
timeframes (and support required) in the light of with some LBE additions depending
this on above review of std terms)
Consider, in relation to any services currently Part of due diligence on contracts Kate Graefe
provided by the NHS Ealing (or successor register
organisation) and required to continue in that
way, whether or not any s.75 or other
agreement is required between LBE and
relevant health body in relation to future service
Service specifications agreed by Ealing Council Part of due diligence on contracts Public Health April 2013
register
Data quality and improvement plans agreed to PH to clarify what to transfer? Diane Malpass
ensure access to data by the contracting team (Michelle Gabay
in her absence)
Provide assurance that all internal support Identify support services where Safia from – By 31-03- Amber Adults Finance –
services are covered by an SLA, and internal charges relate and ensure CSA’s Khan/Richard Sept 2012 13 Accountancy/Adults
recharges to be applied are updated to include PH from Costella (Jenny HoF Team Time and
13/14 Jones on return Corporate Finance
BSG SECTION ACTION from maternity Team Time
leave)
Obtain any necessary LBE approvals (Cabinet / Jackie Chin (with
ICMD / officer) Proc & legal
support as
required)
21 Page of 27
Transition Plan
Area 2: Finance and contracts: lead Inderjit Mattu and Lisa Money NHS Ealing/ Adele Taylor and Kate Graefe LBE
RAG Resources required
No. Key Tasks Actions Comments / Progress Responsibility Start Finish
/Risk
Contract and values agreed using LBE format Part of due diligence on contracts
register (links to comments on
terms, above)
Contract sign off TBD April 2013
As per approvals/scheme of
delegation
Establish a contract payment schedule which Payment schedule to be agreed as Safia Khan/Anne from – By 31-03- Amber Adults Finance
finance and providers are aware of part of P2P work Scanlon/P2P Sept 2012 13 Operations & Adults
HoF – Team Time
To provide and share finance / activity PH
schedules for the main PH contracts
Notice served where appropriate on current PH in liaison with April 2012 April 2013 Green
contracts Links to shared services objective – Proc (& Legal)
need to determine which contracts
to extend/serve notice on, etc
Ensure that all required contracts have been PH/Catherine April 2013 Green
novated to LBE, and approved by LBE legal Taylor
services
Provide assurance that all services required PH
going forward are covered by an SLA or
contract
Where services are provided by NHS Ealing or PH/NHS
successor organisation under an SLA/contract,
there is a supporting finance schedule and the
SLA/contract is accounted for correctly
Further review of the relevant detail on Contract
Register. Ensure all services have formal
documentation in place
Review timeline for commissioning or re PH with support April 2012 April 2013 Green
commissioning of all services, to ensure review Links to collaborative from Proc
/ renewal procedures on track to meet contract commissioning options assessment
expiry deadlines
Non-Clinical Contracts Expenditure by supplier exclusive of VAT Is this collation of current
information? If so, NHS/PH to
2.6 advise
Budget Vs Actuals Is this collation of current
information? (as above)
Risk Ensure risk registers updated in NHS H prior to NHS to update their own plan. NHS
transfer
Ensure arrangements, systems and procedures Risk registers to be developed and John Allsop
are agreed for safe effective transfer in all areas updated. Emergency plan covered
2.7
pertaining to risk including: by Chris Begley.
SUIs ??
Emergency plan Ensure PH staff trained in LBE H&S
Health and Safety procedures
Insurance Ensure LBE insurance covers work to be Liaise with Bob Craik in insurance Bob Craik
2.8
transferred, including clinical activity around clinical activity
22 Page of 27
Transition Plan
Area 2: Finance and contracts: lead Inderjit Mattu and Lisa Money NHS Ealing/ Adele Taylor and Kate Graefe LBE
RAG Resources required
No. Key Tasks Actions Comments / Progress Responsibility Start Finish
/Risk
Internal charging Ensure that list of current charges is Safia Khan to March March/April Green Adults Finance –
supplied to PH collate 2012 2012 Adults HoF &
2.9
BSG SECTION ITEM Accountancy Team
Time
Transition Plan
Area 3: Human Resources- Derek Holl LBE and Tara Healy (NHS Ealing)
RAG Resources
No. Key Tasks Actions Comments / Progress Responsibility Start Finish required
/Risk
3.1 Develop Communication & Development of staff communications and 1;1 with staff have begun in NHS
Engagement Strategy engagement strategy [with internal and external Ealing.
communications]
3.2 Achieve the successful transfer of PH Agree NHS and LA staff in scope for transfer / Guidance awaited and PHE and NHS
staff and ensure full staff deployment to new operating model based on CB models awaited- due May 2012
engagement, communication and guidance re roles of PHE and LA
partnership working Identify all potential NHS employees that should As above
transfer to LA including impact on corporate
SUBJECT TO EVOLVING NATIONAL (business support) functions
GUIDANCE / AGREEMENTS Consider implications of any shared service See WLA proposal to be considered
delivery proposals, either within the West London by Chief Execs
Alliance or otherwise
Confirm TUPE or COT. Identify implication of this, Guidance awaited
including EAA.
Establish pension arrangements for transferring Guidance awaited
staff
Formal notification to Trade Unions re proposed Guidance awaited
transfer
SRG sub group to agree process for populating
posts in new operating model/ structures
Submit first round the workforce employee liability
information / HR Due Diligence
Formal letter to transferee regarding measures
Staff Briefing sessions to continue including
consultation on measures,/ re-structuring process
if appropriate
Letter to assigned staff confirming transfer &
employee liability information
Offer 1-1’s with line managers supported by HR &
trade union rep where individual concerns over
TUPE are raised.
Panel for appeals to consider any objection to
transfer
23 Page of 27
Transition Plan
Area 3: Human Resources- Derek Holl LBE and Tara Healy (NHS Ealing)
RAG Resources
No. Key Tasks Actions Comments / Progress Responsibility Start Finish required
/Risk
Final submission of workforce employee liability
information and staff lists to be produced (with
names) and identifying ongoing CPD requirements
Ensure workforce liabilities and warranties are
agreed as part of contractual documentation –
Business Transfer Agreements
Transferor collate all employment policies,
procedures and agreements relevant under TUPE
and submit to transferee
Transferor complete payroll information template
for all transferring staff and submit to transferee
Personal files to be transferred, including PDP
records
Close consultation & confirm TUPE transfer letter
Clarification on regional holding position to be
sought from SHA & Regional holding position to
be included in consultation if appropriate
3.3 Review the current employment SRG sub group , including staff rep’s to review
policies / HR processes across the 3 position and establish what contractual, what will
organisations and determine what fit be continued with / integrated
for new organisation (i.e. PDR /
Management Of Absence / Training )
3.4 Organisational development / Prepare induction plans for all transferring staff Induction has begun and being further April 2013
Learning & Development developed
Agree CPD arrangements with relevant staff in
order to ensure continuity
Annual training needs analysis to be undertaken
as normal
3.5 Corporate Services Consider other Corporate functions. Link with
other areas on Work on post integration Structure.
PCT current SLAs HR and OH review.
SLAs to ensure transferred organisations have
provision.
3.6 Staff Contracts New contracts issued
24 Page of 27
Transition Plan
Area 4: Performance, Incidents and Freedom of Information lead Mary Umrigar and Peter Morris and Simon Evans Evans- Director Corporate Affairs?
(NHS Ealing)
Responsi RAG Resources
No. Key Tasks Actions Comments / Progress Start Finish
bility /Risk
4.1 Performance Ensure that there are integrated arrangements in place to Will scope integrating into existing Mary April 2012 March Amber
ensure contract continuity and monitor new public health arrangements and possibly part Umrigar 2013
outcomes framework - key performance indicators shadow from June 2012 /Jackie
Chin
Freedom of Information Discussion and agreement Peter April Amber
- Need to ensure that FOI records relevant to the regarding how FOI relating to Morris 2013
transferred PH services are passed over to Public Health will be handled in
LBE future has yet to be concluded. At
- If there are any outstanding complaints to the present there are no
Information Commissioner/Information Tribunal arrangements in place for the
relating to FOI compliance – who will be held transfer of records, hand-over of
liable ongoing enquiries, and future
- Who will be responsible for handling any
handling/approval of Public Health
requests for internal review relating to PCT FOI
related enquiries.
requests? Who will be responsible for handling
any complaints relating to the PCT’s FOI
compliance including any that get taken on to
the Information Commissioner?
4.4 Infection control Establish existing arrangements for Infection Prevention Currently monitored by contract Mary April 2012 March Amber
and Control and develop future safe efficient monitoring officers. Umrigar 2013
arrangements Need to scope further /Jacky
Yates
and Jackie
Chin
4.5 Clinical Effectiveness Establish existing arrangements for clinical effectiveness Currently monitored by contract Mary April 2012 March Amber
and develop and propose safe and efficient officers. Umrigar 2013
arrangements for future service delivery No Research Governance and Jackie
Identify role of LBE in research and development and framework in place Chin
clinical audit Further scoping work required
4.8 Review all outstanding SUIs and Create a database of outstanding / on-going services Within LA covered by Customer Mary April 2012 March Amber
complaints issues Care Unit. Scope possibility of Umrigar 2013
integration with existing system.
Complaints As above for SUIs Amber
25 Page of 27
Transition Plan
Area 4: Performance, Incidents and Freedom of Information lead Mary Umrigar and Peter Morris and Simon Evans Evans- Director Corporate Affairs?
(NHS Ealing)
Responsi RAG Resources
No. Key Tasks Actions Comments / Progress Start Finish
bility /Risk
4.9 Business Continuity Plans Develop BCP for new public health team . Pubic Health function will have Chris Upon Within Amber/ Additional
to be reviewed against council BC Begley transition 12 medium resources
process and priority ratings to Council month may be
agreed with DPH. Priority s required to
Services will then be assisted to produce and
produce BC plans. maintained
BC plans, as
scale is yet
to be
confirmed.
4.10 Customer Service Interface Alison Reynolds
Transition Plan
Area 5: Business IT and Information Governance Mark Newton LBE and Simon Evans Evans and Kevin Fernandes? (NHS Ealing)
Responsibilit RAG Resources
No. Key Tasks Actions Comments / Progress Start Finish
y /Risk
5.1 IT support to PH team Obtain info regarding current IT systems including IT Completed Completed Green
support staff
5.2 IT systems Agree access to NHS data – for public health intelligence / TED completed, finance to be April 2013 Amber Finance to
N3 connection identified ~£45 be
determined
5 .3 Identify Technology licenses and Identify all licenses including consents which need to Completed April 2012 Green
implications transfer from existing organisations into new organisation
5.4 Electronic Records Migrate e-mail and electronic records to LBE systems Completed April 2012
ensuring forwarding of e-mails to new account
5.5 Mobile Phones Identify mobile phones and budget. In progress October Green
2012
5.6 Intranet Ensure current access to Intranet, to include sensitive Completed April 2012 Green
health search terms
5.7 Information Governance Identifying existing information governance arrangements Lead TBD Mark Newton
and implementing in shadow form new systems and
processes to ensure a smooth transition:
Records Management
Archiving
Information assets
Documentation
Policies
Procedures
Patient Literature
Information policies
Policies provided covering info sharing
26 Page of 27
Transition Plan
Area 5: Business IT and Information Governance Mark Newton LBE and Simon Evans Evans and Kevin Fernandes? (NHS Ealing)
Responsibilit RAG Resources
No. Key Tasks Actions Comments / Progress Start Finish
y /Risk
Guidance for personal identifiable information policy
Responding to subject access request
Code of Practice
Information security policy
5.8 Confirm accommodation provision post Identify current accommodation occupied and cost. Current accommodation on Mark Newton April 2013 Amber
April 2013 Identify proposed accommodation Level 3 and Jackie
Costs ~£3000 per person Chin
Need to feed back to PH
allocation Dept of Health
Identify any individual workplace adjustments that may be Completed April 2012 Amber
required including IT
5.6 Health and Safety
Transition Plan Legal Helen Harris ( Jane Batalona) LBE Simon Evans Evans NHS Ealing
Area 6:
RAG Resources
No. Key Tasks Actions Comments / Progress Responsibility Start Finish
/Risk
6.10 Corporate Governance Review Council constitution and Scheme of Delegation HH 31.3.2013
and proposes amendments for Council approval to
ensure statutory requirements are met and
appropriate governance arrangements in place eg with Green
regard to statutory officer and member roles, the TOR
and membership of the Health and Wellbeing Board
and the Scrutiny arrangements
6.2 Litigation Ensure all areas of litigation are flagged (if any) 31.3.2012 Green
Transition Plan Assurance Plans Lead Jackie Chin and NWL Cluster
Area 7
RAG Resources
No. Key Tasks Actions Comments / Progress Responsibility Start Finish
/Risk
7.0 Test arrangements for Emergency Plans to be tested Plans for testing in Oct Jackie Chin/Chris Oct 2012
Green
Planning, Screening and Immunisations 2012 Begley
27 Page of 27
