Quarterly Meeting of
Social Services North West

15 March 2002 at Salford

SOCIAL SERVICES NORTH WEST

MEETING ON 15 MARCH 2002 AT SALFORD

REPORT OF THE CO-ORDINATOR

WORKING WITH THE NATIONAL HEALTH SERVICE

1.         Matter for Consideration:

To report on developments in relation to Involving Patients and the Public in Healthcare; the implementation of the modernised structure of the National Health Service in the North West; and the forthcoming Social Services North West conference which will address both issues.

2.                  Introduction:

2.1       Social Services North West contributed to the Government’s consultations last year on Involving Patients and the Public in Healthcare, and noted at the last meeting that the revised proposals represented a further welcome advance, strengthening the local machinery considerably and providing important independent elements at the local level.  In January, a further consultation document was published, entitled Local Authority Health Overview and Scrutiny.  This is another major component of the new relationships being constructed between the modernised NHS and modernised local government.

2.2            Meanwhile in late December, the Department of Health published a further paper in the Shifting the Balance of Power series, this one entitled The Next Steps.  Concurrently, the Regional Directors of Health and Social Care and the Chairs and Chief Executives of the three new Strategic Health Authorities were being appointed, not to mention the Chairs and Chief Executives of the new Primary Care trusts, which are being brought on line very rapidly and with very substantial delegated power and budgets for managing the local health economy.

3.             Information:

3.1              The paper Local Authority Health Overview and Scrutiny sets out three aims of local health scrutiny on behalf of the local community:

• First, to ensure that people’s needs and wishes for health and health related services that meet the needs of all the population (including minorities, socially excluded groups and other targeted equalities groups) have been identified towards achieving local health improvements.

• Second, to scrutinise whether services provided that impact on the health of local inhabitants are accessible to, and can be accessed by, all parts of the local community.

• And last, to scrutinise whether the outcomes of intervention (whether through services or other intervention designed to positively impact on the health of local inhabitants) are equally good for all groups and sections of the local population.

It is to act as a lever for improving the health of local people, by addressing health inequalities and by working with the NHS and other partners to secure the continuous improvement of health services and services that impact upon health.

3.2            Overview and Scrutiny Committees of local authorities may review or scrutinise health services commissioned or delivered in the authority’s area within the framework set out below:

• arrangements made by local NHS bodies to secure hospital and community health services to the inhabitants of the authority’s area;

• the provision of such services to those inhabitants;

• the provision of family health services (Primary Care Trusts), personal medical services, personal dental services, pharmacy and NHS ophthalmic services;

• the public health arrangements in the area; e.g. arrangements by NHS bodies for the surveillance of, and response to, outbreaks of communicable disease or the provision of specialist health promotion services;

• the planning of health services by NHS bodies, including plans made in co-operation with local authorities setting out a strategy for improving both the health of the local population and the provision of health care to that population;

• the arrangements made by NHS bodies for consulting and involving patients and the public under the duty placed on them by Section 11 of the Health and Social Care Act 2001.

There follows a series of detailed proposals as to how the Overview and Scrutiny Committees will go about their business, and dovetail their work with the other local bodies, established and new, which have a part to play.  It is envisaged that the new arrangements will come into place in January 2003.

3.3       In local government, these proposals have been widely welcomed as a logical development within local authorities’ new discretionary powers “to promote or improve the economic, social or environmental well-being” of their area.  We should be aware however that in NHS circles they are not yet fully understood and accepted.  Concern also centres around the role of Overview and Scrutiny Committees as replacing some of the roles of the independent Community Health Councils.  These are to disappear in their present form and there is considerable resentment about this in many localities.

3.4       Local authorities must therefore approach their new tasks with care and sensitivity and in a spirit of partnership with the other local players, particularly the NHS.  The LGA has already identified a number of key issues in implementing the proposals, including resources, the interface with other health public involvement and consultation bodies, engaging the role of district or borough councils in two tier areas of local government, managing the health / local authority interface, strategic level arrangements for OSC’s to come together for the scrutiny of health service issues dealt with by Strategic Health Authorities, and managing scrutiny within the transition of organisational changes in the NHS.  It is considered that Social Services North West should reply to the consultation before the deadline of 16 April 2002, and the comments of members and officers are invited.

3.5       The paper Shifting the Balance of Power: The Next Steps was published just before Christmas and sets out the way forward on implementing the policy of shifting the balance of power in the NHS.  It states that the whole process is about putting patients and staff absolutely at the heart of the NHS.  It does so by giving greater authority and decision making power to patients and frontline staff and underpinning this with changes in organisational roles and relationships.  Shifting the Balance of Power is said to be radical in concept, but it also needs to be radical in reality. Behaviour needs to change as well as organisation.  And the new structures themselves need to be very different from the old, with greater focus on team working and on enabling and supporting people and less on hierarchy and control.  Changing long established behaviours and ways of working on this scale requires support and development programmes for individuals and organisations at every level.  These need to be planned and sustained over time.  These changes also need to be implemented in a way which reinforces - and is reinforced by - all the other changes involved in implementing the NHS Plan. These many changes - whether involving giving patients greater choice and more information, introducing national standards, improving patient safety or creating new partnerships - need to be introduced in a consistent fashion. Shifting the Balance of Power provides the organisational underpinning to allow this to happen.

3.6       Social Services North West will find much to welcome in this approach, but has stressed in its replies to earlier consultations that the huge organisational change currently going on in the NHS, and the enormous task of continuing to deliver health care against ever-increasing public expectations, is bound to distract the attention of both non-executive members and senior managers from the laudable principles and objectives set out above.  However, it is important that we engage positively with the new structures as they emerge, and show our readiness to address the issues of principle and behavioural change as well as the day-to-day practicalities. 

3.7       We have noted the appointment of Peter Garland as Director of Health and Social Care – North and the Chairs and Chief Executives of the new Strategic Health Authorities (see Appendix).  The Chair of Social Services North West has written to them all, briefing them about Social Services North West and expressing the hope that the constructive liaison we have long had with the NHS regional structure can be continued with the Strategic Health Authorities.  All the Chairs have replied positively to the proposal of a meeting later in the year.

3.8       It was felt at the last meeting, with these two major strands of work on NHS issues very current, that it was time for Social Services North West to hold another conference on health issues, and this has now been arranged for Friday 26 April at our usual venue, the Reebok Stadium, Bolton.  The theme of the morning session will be Modernising the NHS, and we are fortunate to have secured as keynote speaker the new Director of Health and Social Care – North, Peter Garland.  This will be followed by an example of good practice in joint working between health and social care.  Anita Marsland, Director of Knowsley Social Services and Jan Coulter (Deputy Director, Health and Social Care) will lead a presentation focussing on their vision for integrated services and what they hope to achieve by joining up with Health at both a strategic and operational level.  Moya Sutton (Assistant Director, Children and Families) will talk about the inter-agency commitment to establish an integrated children's service within the next two years.

3.9       The afternoon session will focus on Involving Patients and the Public in Health Care, and the keynote speaker will be Hazel Blears MP, the Minister in the Department of Health with responsibility for these new arrangements.  Then Councillor Peter Connor, Lead Member for Social Services on Salford City Council and Eileen Fairhurst, Chair of Salford Primary Care Trust will introduce some Salford people who will present a variety of examples of how local people and communities are being involved in planning strategies and operating services.

3.10     Our two keynote speakers have a national profile higher than any previous guests at Social Services North West conferences, and it is hoped that members and officers of member authorities will support the event.  It is also planned to invite the Chairs and Chief Executives of NHS organisations across the region, in the interests of building close working relationships with the new players in the NHS at local level.  It will be helpful if members can encourage their local NHS counterparts to attend, and use it as an opportunity for developing local liaison.

4.            Recommendations:

4.1              That this report be noted

4.2       That a response be made to the Department of Health concerning the paper entitled Local Authority Health Overview and Scrutiny.

4.3       That member authorities be urged to support the conference on 26 April and to encourage their local health counterparts to attend.

4.4       That arrangements be made as soon as possible for a meeting with the Chairs and Chief Executives of the three new Strategic Health Authorities.

APPENDIX A

EXTACT FROM DEPARTMENT OF HEALTH PRESS RELEASE:
STATEGIC HEALTH AUTHORITIES

The Government has announced the appointment of the Chairs and Chief Executives of the three new Health Authorities in the region, which will become Strategic Health Authorities later in the 2002 subject to legislation. 

The new Chair of the Cumbria and Lancashire Health Authority is Mrs Kath Reade, who is 53 and lives in Burnley. She is currently serving as Chair of East Lancashire Health Authority. Mrs Reade is vice chair at the East Lancashire Regeneration Partnership and served for 14 years, until 1998, as Leader of Burnley Borough Council, Labour party. She is a lecturer in Health and Social Care by profession. Mrs Reade has declared political activity on behalf of the Labour party. She holds other Ministerial appointments on the North West Development Agency and the Lancashire Learning and Skills Council.

The Chief Executive of this Health Authority is Pearse Butler, currently Chief Executive of the Royal Liverpool and Broadgreen University Hospitals NHS Trust. 

The new Chair of the Greater Manchester Health Authority is Mr Philip Smith, who is 54 and lives in Stockport. He is currently serving as Chair of Stockport Health Authority with previous non-executive director experience. He has also served as director and or secretary of various companies over the last 20 years. He is a solicitor by profession. Mr Smith has declared no political activity in the past five years and holds no other Ministerial appointments. 

The Chief Executive of this Health Authority is Neil Goodwin, currently Chief Executive of Manchester Health Authority.  

The new Chair of the Cheshire and Merseyside Health Authority is Mrs Judith Greensmith DL, who is 47 and lives in Caldy on the Wirral. She is currently serving as Chair of Liverpool Health Authority. She has previous NHS experience chairing the North West Regional Training Panel for non-executive directors and judges for North West Health Challenge Awards. She is currently a member of various boards in Liverpool and is a freelance management consultant by profession. Mrs Greensmith has declared no political activity in the past five years and holds no other Ministerial appointments.

The Chief Executive of this Health Authority is Christine Hannah, currently Director of Strategic Development at North West Regional Office, Department of Health.