LGA Governance


Agenda and minutes

Agenda and minutes

Venue: Room D&E, Ground Floor, Layden House, 76-86 Turnmill Street, London, EC1M 5LG. View directions

Contact: Alexander Saul  0207 664 3232 / Email: alexander.saul@local.gov.uk

Items
No. Item

1.

Apologies and Declarations of Interest

Minutes:

The Board noted Cllr Liz Mallinson, Cllr Lynn Travis, Cllr Jackie Meldrum’s and Cllr Carole Burdis’ apologies.

 

Cllr Robin Moss declared an interest in item 4 as he runs a service for young people.

 

2.

Presentation from Duncan Selbie, Chief Executive of Public Health England

Duncan Selbie, Chief Executive of Public Health England, will attend to speak on Public Health England and its work with Local Government. Duncan will then engage in discussion with the Board.

Minutes:

The Chairman introduced Duncan Selbie, Chief Executive of Public Health England, who had been invited to attend the Board to discuss Public Health England and its work with Local Government.

 

Duncan expressed that he would like to pursue greater visibility in the work of local authorities in improving public health. He also emphasised Public Health England’s goal was not only to improve length of life, but the length of life in good health.

 

He highlighted the challenges faced by Public Health England and local government in improving public health; in particular that their two biggest restraints in improving public health is obesity and tobacco, one in four hospital beds are occupied by a smoker and there hasn’t been enough interest in hospitals becoming smoke free. Further to this he emphasised that addressing these issues was not a political issue, but an economic one. He also highlighted the importance of employment for good health; which has been evidenced and that getting people back into work will be a priority going forward. Creating jobs people can get and access from where they live will be beneficial for public health. He also emphasised the importance of a decent place to live, friendship and affection in an individual’s health.

 

Duncan stated that it was their duty to improve the public health of the people as direct health care could only provide a small fraction of these things.

 

Further to this Duncan gave praise to the role of local government in public health. He stated that local authorities have applied both rigour and discipline, as well as having made savings and improved outcomes. He also highlighted that sector led improvement would remain critical. Duncan expressed his pride in local government and that he looked forward to continuing to work with the Local Government Association to demonstrate the impact councils had on health.

 

In the discussion with Duncan which followed Members raised the following points:

 

·         A Member asked what could be done to improve joint work regarding Sustainability and Transformation Plans (STPs).

·         A concern was raised regarding the public health funding formula. A Member asked how Duncan would ensure there will not be errors in how the funding is divided between local authorities.

·         A Member asked how we can demonstrate the value of parks and pools in decreasing obesity, in particular in areas of deprivation.

·         In response to the question on STPs Duncan explained that more leadership from local authorities would be critical in joint work going forward as only local authorities have the necessary focus on place.

·         In response to the concern raised on the public health funding formula Duncan explained that he would not forget the previous error in the funding formula and that establishing the new formula would be a very thoughtful process.

·         It was highlighted regarding the value of parks and pools that showing connection to outcome would be important in demonstrating their importance to central government.

·         A Member asked what Councils can do to address inequalities in health between localities.

·         A  ...  view the full minutes text for item 2.

3.

Presentation from Richard Humphries, Senior Fellow at the King's Fund

Richard Humphries, Senior Fellow at the King’s Fund, to give a presentation on the current issues facing care and health, how they might be impacted by the forthcoming General Election, and what opportunities and risks this period presents for the sector. Richard will then engage in a discussion with the Board.

 

Minutes:

The Chairman welcomed and introduced Richard Humphries, Senior Fellow of the King’s Fund, to give a presentation on the current issues facing care and health, how they might be impacted by the forthcoming General Election, and what opportunities and risks this period presents for the sector. The Chairman also expressed the gratitude of the Board to Richard for having agreed to give his presentation at such short notice.

 

Richard gave an overview of the King’s Fundand the key challenges to adult social care in coming years. In particular he identified funding, and workforce pressures, and the need for service transformation and better public awareness and engagement on social care. Regarding workforce issues he highlighted a concern that, for the most part, working in adult social care is not seen as high status work. He also emphasised the importance of making the best use of technology and developing the right kind of integrated care.

 

As a part of his presentation he detailed the previous efforts over the last two decades of governments to tackle the question of adult social care sustainability for the long-term. He also raised the options for sustainable funding, breaking these down broadly to ‘public’ (taxation and/or redirection of existing spending on older and disable people) and ‘private’ (charges, insurance, means testing and equity release). Richard emphasised that there are no examples abroad where social care has relied on one sole source of funding. He explained that public opinion is very divided on how social care should be paid for.

 

Richard highlighted opportunities for future work on the adult social care agenda including; the potential for social care to be a key campaign issue, to promote public awareness on social care and to explore different funding options. He emphasised the importance of maintaining momentum on the agenda as there will likely be strong media interest given political parties’ different approaches to adult social care.

 

Richard also highlighted risks to the adult social care agenda, in particular; he raised a concern that the political focus on Brexit could force out key domestic issues, the momentum behind reform and the green paper could slow, and heightened political fault lines post-Election could damage cross-party consensus for change.

 

Richard explained to the Board that the fundamental challenges facing adult social care will not have changed following the general election. He identified post-election issues in the effect on key policies and of NHS pressures, STPs and the emergence of accountable care systems on the future of adult social care. He also expressed concern as to the uncertainty around the implications of Brexit on the social care workforce, effect on economy and public finances as well as in distracting from domestic issues.

 

In the discussion which followed Members raised the following points;

 

·         A Member raised a query as to what the role of local authorities in STPs would be going forward.

·         A concern was also raised regarding the challenge faced by local authorities in creating a sustainable workforce and sustainable social care.

·         A  ...  view the full minutes text for item 3.

4.

Update on lead members' special meeting on children and young people's mental health and wellbeing pdf icon PDF 221 KB

Additional documents:

Minutes:

Deepa Patel, Adviser, introduced the report updating the Board on the lead members' special meeting on children and young people's mental health and wellbeing and seeking the Boards views on resulting actions and next steps. She informed the Board that, based on the issues identified by lead members at the special meeting, suggested actions had been detailed in the report. Deepa advised that this update had also been reported to the Children and Young Peoples Board meeting on 23 March 2017. Members were asked whether they would like to suggest any additional actions or identify if any should be prioritised.

 

Lead members expressed a view that the lead members’ special meeting on children and young people’s mental health and wellbeing had been very useful piece of work.

 

In the discussion that followed, the Board raised the following points:

 

·         Members emphasised the key role of schools in identifying and responding to children and young people’s mental health and wellbeing, but also noted those not attending school needed to be considered.

·         A view was expressed that the LGA should seek clarity as to how the future Government intends to improve the transition from Children’s and Young People’s Services to Adult Services.

·         A concern was raised that in a Members constituency many of the teenagers who have committed suicide were home educated and as a consequence could not be referred to children and adult mental health services by a teacher.

·         A Member suggested that it would be useful to share this work with the Royal College of Nursing going forward.

·         Members emphasised that a greater focus on supporting families and parents would be beneficial going forward.

·         A Member expressed we needed to continue to be mindful of the impact of Cyber Bullying on the mental health of young people.

 

The Chairman explained that in her own local authority they were pursuing commissioning services with their local partners with the aim to redesign their children and adolescent mental health service. She expressed a concern that they had found the market to not be responding to this need and that they were limited in the amount of providers available. 

 

Decision

 

The Board noted the report and provided their views on the suggested actions.

 

Action

 

Officers to incorporate the Boards views in forthcoming work as detailed in the report, with priority given to the suggested round table discussion.

 

5.

The Future of Local Commissioning project with NHS Confed and NHSCC pdf icon PDF 129 KB

Minutes:

Alyson Morley, Senior Adviser, introduced the report outlining to the Board proposals for a joint initiative with NHS Confederation, NHS Clinical Commissioners (NHSCC) and other key partners to influence the policy agenda on the future of local commissioning. She explained to Members that as a result of the recent announcement of the June 2017 general election the outlined proposals in section 7 of the report would all change and the timelines indicated would no longer be achievable. Alyson emphasised that despite this it would be valuable to discuss how the Board would like to approach the purpose, process and governance arrangements for future joint work on the Future of Local Commissioning. Alyson explained that it would be important to emphasise the value of a place based approach, to stress the importance of local accountability and ensuring the new government would receive our key asks as early as possible.

 

In the discussion which followed Members raised the following points;

 

·         A view was expressed that we need to concentrate on outcomes and responsibility.

·         A view was expressed that we need to ensure our vision for health and social care is a medium to long term one.

·         A member raised the importance of local government being at the table to discuss the future of health devolution.

·         Concerns were raised that further integration could be difficult to achieve.

·         The Chairman expressed a view that local Health and Wellbeing Boards should not have been excluded from the STP process.

·         A concern was raised that the NHS was remaining cautious in how they work in partnership with local government.

·         Members emphasised that the LGA should not be holding back and should drive forward with our key asks to the new government quickly.

 

Decision

 

The Board noted and provided comments on the report.

 

Action

 

Officers to incorporate the Boards views in approaching the purpose, process and governance arrangements for future joint work on the Future of Local Commissioning.

 

 

6.

Update on Other Board Business pdf icon PDF 170 KB

Minutes:

Mark Norris, Principal Policy Adviser, introduced the report, which presented updates on various areas of the Board’s work which were not included as part of other items on the agenda.

  

Decision

 

The Board noted the updates contained in the report.

 

7.

Minutes of the last meeting pdf icon PDF 189 KB

Minutes:

The Boardagreed the minutes of the previous meeting held on 16 February 2017.