The Improvement and Scrutiny Officer provided the Committee with an update on the South Yorkshire Joint Health Scrutiny Committee which had held a briefing meeting on 22 February to receive information on the Government’s Health and Care White paper and its impact on the local Integrated Care System. On 11 February the Government published its White Paper – “Integration and Innovation: working together to improve health and social care for all.”
Members were reminded that ICSs bring together more joined-up working arrangements between health and social care service providers and the White Paper proposes to place Integrated Care Systems (ICS) on a statutory footing and to make a range of structural and other changes at “place” and neighbourhood level. Other key elements of the White Paper included:
· The legal merger of NHS England and NHS Improvement - to be known as NHS England - which would have a single governance structure and be accountable for all aspects of NHS performance, finance and care transformation;
· The Secretary of State for Health & Social Care to direct NHS England (the merged body), and include their intervention in service reconfiguration changes at any point without need for a referral from a local authority;
· New powers for the Department of Health & Social Care to reconfigure and transfer the functions of arm’s length bodies (including closing them down) without primary legislation;
· The Secretary of State would have a statutory duty to publish a report in each parliament on workforce planning responsibilities across primary, secondary, community care and sections of the workforce shared between health and social care;
· CCGs would be dissolved and their roles in procurement and finance would become the responsibility of the ICS – with Health and Care Partnerships of NHS, LA Social Care and Public Health being established to plan services;
· Accountability systems at a local level to be reduced. Significant power and responsibility would rest at system level – the level at which ICSs would operate. In Derbyshire the ICS was coterminous with county boundaries, but it could raise border challenges, in how accountability was conducted in respect of services in Sheffield and Greater Manchester or across the East Midlands region, for example; and
· ICSs and Health & Care Partnerships would develop plans for future services. These plans would involve wide consultation and public participation and local Health Scrutiny would provide a mechanism to facilitate this participation.
The Centre for Governance and Scrutiny (CfGS) was pressing for Health Scrutiny to be given a formal role in supporting the way services were specified. Potential removal of the power and responsibility of Health Scrutiny Committees to make referrals to the Secretary of State – and giving this power to the Secretary of State direct – could weaken local knowledge and accountability. The CfGS was in active conversation about this with colleagues at NHSE&I and DHSC and it was hoped that there would be a shift in approach between now and when the Bill was published in May. The CfGS would welcome direct feedback from councils about their views on this.
RESOLVED that (1) the report be noted and;
(2) Members submit any comments they wish to make to the Improvement and Scrutiny officer who would collate them into a formal letter to the CfGS from the Committee Chairman.