SOCIAL SERVICES NORTH WEST

MEETING ON 21 JUNE 2002 AT BURY

REPORT OF THE CO-ORDINATOR

WORKING WITH THE NATIONAL HEALTH SERVICE

1.         Matter for Consideration:

To report on the Social Services North West conference on Modernising Health and Social Care, the response to the Department of Health consultation on Local Authority Health Overview and Scrutiny, the survey of member authorities on PCT membership, and future arrangements for liaison between Social Services North West and the three Strategic Health Authorities in the region

3.         Information:

3.1       120 people gathered at the Reebok Stadium, Bolton on Friday 26 April 2002 for the Social Services North West conference on Modernising Health and Social Care.  The event proved particularly topical because the three new Strategic Health Authorities for the North West region had just been established, together with Primary Care Trusts in every locality.  The Government's commitments in the 2002 budget to increased long-term funding for both health and social care also helped to make this the beginning of a new era in these two vital public services, which need to work ever more closely together.

3.2       In opening the conference, Social Services North West Chair Councillor Cliff Morris (Bolton) welcomed the strong representation from NHS organizations, as well as many members and officers from Social Services Departments across the North West. He referred to the NHS Plan and the massive programme of reform which followed.  With the Budget last week they had matched their ambitions with tangible long-term resources.  He noted the promise of a significant increase in resources for the personal social services, and welcomed the Government’s recognition that its aims for the NHS will not be fulfilled unless social care is adequately funded.  Councillor Morris went on: "As the new organisational pattern has come into place, with Primary Care Trusts right across the region, we in local government have drawn even closer to the NHS, and have more and more aims in common.  We accept completely that health and social care must work together as a single system.  But we believe the best means of achieving this is through voluntary local agreements which suit local needs.  Progress is achieved by winning hearts and minds, and we believe the evidence on the ground shows continuous improvement at the interface between health and social care across the North West."

3.3       The first keynote speaker, Peter Garland, Director of Health and Social Care - North in the Department of Health, who spoke on Modernising the NHS.  He began by referring to the step change in health and social care investment in the 2002 budget: NHS average of 7.5% real terms growth over 5 years and PSS average 6.0% real terms growth over 3 years.  He then reviewed the four key components of the regeneration of public services: high national standards and clear accountability; devolution of power and resources to the front line; increased flexibility between services and between staff; and diversity of providers and choice for consumers.  He praised the developments already taking place in the North West and particularly the joint work taking place between health and social care.  In conclusion, he said that although there was now big money available, we faced big changes and big challenges.  “We mustn’t miss this opportunity,” he concluded.

3.4       There followed a presentation from four key managers in Knowsley, who are all now jointly employed by Knowsley MBC and Knowsley Primary Care Trust.  Their presentation was entitled Breaking down the barriers in Knowsley - Building the Future.  Anita Marsland, Chief Executive of Health and Social Care outlined the history and demography of Knowsley and how the Council was addressing the key issues for the community's well being.  Diana Forrest, Director of Public Health then outlined the history and role of Directors of Public Health in addressing health inequalities, and the work done through the Knowsley Health Plan and the Health Action Zone to address these.  Jan Coulter, Deputy Director, Health and Social Care spoke about Knowsley's performance against key social and health care indicators, and how the problematic areas were being tackled through integrated and innovative schemes.  Moya Sutton, Assistant Director, Children and Families then spoke from her perspective as manager of integrated children's services, about the needs of children, the strategic context in which they were being addressed, and operational developments in Knowsley.

3.5       The afternoon session was based on the Government's initiatives in Involving Patients and the Public in Health Care.  Hazel Blears MP, Parliamentary Under Secretary at the Department of Health, was the keynote speaker.  In introducing her, Chair Councillor Cliff Morris said that Social Services North West had welcomed the scrutiny role for local authorities in relation to health, but there was widespread concern about the abolition of CHCs. We have been pleased however to be involved in the consultations on the new arrangements, and welcome several significant improvements which have been introduced over recent months.

3.6       Hazel Blears welcomed the opportunity to speak to an excellent organisation which gave people the opportunity to discuss ideas and share good practice.  She went on "It is absolutely clear to me that if you want a patient focused NHS, and if you want public services to improve the public’s health, you need to make sure that patients and the public are placed at the heart of decisions about matters that impact on health.  The Government is absolutely determined to shift the balance of power – and I don’t just mean in terms of shifting power to the frontline of health services. Today I want to talk through shifting the balance of power to patients and the public – giving real clout to users of health services, and real clout to citizens – the people who pay for health services."  She then outlined the radical changes the Government is making to the ways in which patients and the public can not only get involved in decisions affecting health services – but ways in which they can really shape the planning, development and nature of services – locally, regionally and at the national level. 

3.7       Then followed a presentation entitled Involving Salford People.  It was introduced by Peter Connor, Lead Member for Community and Social Services, Salford City Council and  Dr Eileen Fairhurst, Chair, Salford Primary Care Trust.  They described how in Salford, many groups and individuals had been enabled and encouraged to make their own contribution to improving their own health and well being, and that of others.  Speeches were then made by Jacqui Pollock on ‘From Pain to Power', Cath Saunders and Sue Hinder on ‘Real Time Community Change’, and Caroline Brown and Justine Fairbrother on ‘Breast Mates’.  These were followed by questions and discussion from the floor.

3.8       The Department of Health paper Local Authority Health Overview and Scrutiny, published earlier this year, set 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.

3.9       Social Services maintained liaison with the LGA in resp[onding to the Department of Health’s consultation, and key points made included:

·        The need to support the development of Overview and Scrutiny processes within two tier areas of local government. The work of district councils has an important impact on the health of communities and most district councils have forged active relationships with health partners.

·        That the role of district councils is strengthened in the forthcoming guidance to ensure their involvement, and that district councils members co opted to participate in OSCs are empowered with an equal voting capacity to other representatives.

·        The need for training to support capacity building for overview and scrutiny and public involvement in local government and the NHS.

·        The need for additional resources for local government to support this activity.

·        That more detailed guidance is developed on the linkages between the agencies supporting the implementation of public and patient involvement in health and OSCs to avoid any duplication in supporting work programmes, and to ensure effective use of collective resources at local level.

It was also recommended that there should be a national definition of what is meant by “substantial change to local services“, and clarity regarding responsibility for consultation on changes should be provided and seek to promote inclusiveness and involvement in decision-making.  Detailed comments were also made on the planning of the overview and scrutiny process, the need for joint activity between neighbouring authorities in relation to certain services, member training and the vital issue of resources.  Also mentioned were the relationship between overview and scrutiny and the new arrangements for Public and Patient Involvement, and the new Commission for Healthcare Audit and Inspection.

3.10     At the last meeting, it was agreed that arrangements should be made for senior members of Social Services North West to meet with the Chairs and Chief Executives of the three Strategic Health Authorities, to continue the region-wide overview of the health and social care interface which this organisation has long maintained with the NHS at regional level.  Two of the three StHA chairs have agreed in principle to a meeting, and a date will be sought as soon as the appropriate representatives have been identified in this meeting. 

3.11     It was also decided to undertake a survey of member authorities, to ascertain the extent of local authority member involvement in the governance of Primary Care Trusts.  Replies received to date suggest that the extent of this involvement is now much greater than would have been the case a few years ago, and that local authority members are well placed to develop the interface between the two major services of local government and the NHS.  Members may wish to consider how to maximise the benefits of this situation.

4.            Recommendations:

4.1              That this report be noted

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