Agenda item

Roger Gough (Cabinet Member for Business Strategy, Performance and Health Reform, Kent County Council) was in attendance for this item.

(1)       Mr. Gough introduced the item by giving a presentation on the main points of the topic. This is attached as an Appendix to the Minutes. The last update had been given to HOSC on 9 September. Since this time there had been two meetings of the Shadow Health and Wellbeing Board (HWB) and this was where a lot of focus had been. Mr. Gough explained that the HWB was to be the local systems leader in health and had the responsibility for overseeing the Joint Strategic Needs Assessment which provided the data to inform the Joint Health and Wellbeing Strategy and beyond this, individual commissioning plans. Work was currently underway to prepare for running the proposed new health system virtually during 2012/13 before the old NHS structures went in April 2013.

(2)       Beyond the commissioners, who were represented on the HWB, Mr. Gough also outlined issues around engagement with health service providers as there was a split between the two functions but also a need to draw on clinical advice to redesign care pathways. Kent County Council (KCC) had proposed Pathway Advisory Groups in its response to the Department of Health listening exercise on the proposals earlier this year, and there was also a Clinical Leadership Group set up in Kent to test models of possible HWB/Clinical Commissioning Group (CCG) engagement with providers. There was also a recent KCC initiative, The Kent Health Commission, focused on Dover at present, which was looking at how new ways of working could deliver better care. One Member expressed a measure of scepticism around ideas such as the Pathway Advisory Groups and Clinical Leadership Groups which went against the NHS division between commissioner and provider; Mr. Gough explained that similar reservations were expressed during the discussion on relationships with the provider organisations at that week’s Shadow Health and Wellbeing Board. 

(3)       There were a number of ongoing issues which needed further consideration, including ensuring children’s services were not overlooked, the appropriate way of dealing with service reconfiguration, the role of scrutiny, and operating in a two-tier authority County.

(4)       Members of the Committee picked up on this last aspect and it was pointed out that from the perspective of Locality Boards it was important to know who was in control of the finances. Mr. Gough replied that the CCGs had the largest budgets and were the commissioners of health services, but that it was important not to overlook the role of the NHS Commissioning Board as well as the public health and social services budgets controlled by KCC directly. Mr. Gough stated that a key role for health scrutiny in the future would be holding commissioners and providers to account.

(5)       On behalf of the Kent LINk, Dr. Eddy raised a number of specific points about the HealthWatch update made available to Members before the meeting. While Mr. Gough agreed with the principle that it was important to ensure the future HealthWatch was independent, he did not agree with the stated interpretation of a number of other points.

(6)       The number of issues arising from the complexity of the current proposed reforms was made with the suggestion made that one role for HOSC in the future would be to find out who was responsible for any given decision. Mr. Gough stated that past configurations of the NHS had rarely been simple and that the enhanced role for the local authority was a good thing. The HWB, for example, would bring together all the commissioners and so assist in promoting integrated care locally.

(7)       Mr. Gough made the offer to return with further updates when the Committee felt it would like to know more.

(8)       The Chairman thanked Mr. Gough for his time and valuable contribution.

(9)       AGREED that the Committee note the report.