Agenda and minutes

There were no declarations of interest.

Apologies were received from Cllr Wayne Fitzgerald(Con), Cllr Sue Woolley (Con), and Cllr Jonathan Owen (Con).

Chris Gormley, Deputy Director of Mandate, Legislation and Accountability from NHS England, and Ben Dyson, Executive Director of Strategy from NHS Improvement were welcomed to the meeting to discuss the implementation of the NHS Long Term Plan and Community Wellbeing Board member views on a proposed set of tests to assess the impact of the proposals on local government powers and duties.

Ben emphasised five themes that would be crucial throughout implementing the Long Term Plan;

·         The role of CMA regarding the NHS;

·         Enabling NHS organisations to better collaborate through loosening procurement requirements;

·         It would be beneficial to enable NHS commissioners and providers to form joint committees, which would include local authorities;

·         The need for greater flexibility for commissioning between NHS bodies, equivalent to the S75 flexibilities for joint working between NHS and Local Authorities; and

·         For NHSE and NHSI to become one body.

Chris also raised that there would be pre-legislative scrutiny led by Central Government on this. He acknowledged that it was unusual NHSE and NHSI were making the proposals and emphasised this was as requested by the Prime Minister.

In the discussion that followed, the following points were raised;

·         Concern was raised that it was unclear how Health and Wellbeing Boards would fit into new structures.

·         Regarding a query raised as to why bringing NHSE and NHSI closer together will be more effective Chris explained that they would be working far more closely with the seven regions.

·         The Chairman brought Members attention to the four tests proposed by the LGA and detailed in the report for NHSE, DHSC and the Ministry of Housing Communities and Local Government to adopt.

·         Chris emphasised that it is intended to move to a more outcomes based focus on commissioning, he brought particular attention to the proposals made in the long term plan around adjusting the tariff to commission for outcomes rather than activity.

·         Chris also responded to concerns around culture in the NHS by emphasising they were aware this needed working on.

·        A concern was raised that without the Adult Social Care Green Paper there was a risk the NHS Long Term Plan would be out of step with changes in Adult Social Care. In response Chris emphasised that none of the proposed changes alter the fundamental structures and accountabilities within the NHS, they shouldn't have a negative impact on Adult Social Care. 

·        Regarding how the NHS would be engaging with local government at a local level going forwards Chris emphasised that their focus would be on enabling more collaboration and shared decision making. He also raised there would be engagement events that Local Authority members and officers would be welcome to attend.

·         Regarding a concern raised around NHS property services, and where it forces the NHS to sell off property because they can't afford the rents,  Chris confirmed this couldn’t be removed without legislation.

·        Chris confirmed that ICSs partnership boards won't be statutory, which should make collaboration easier across the sector. 

·        Chris emphasised that they were keen to continue  ...  view the full minutes text for item 2.

A supplementary agenda will be circulated to the Community Wellbeing Board ahead of the meeting.

Paul Ogden, Senior Adviser, introduced this item regarding the progress on the Business Rates Retention work in respect of public health. He emphasised this work had been seen and agreed by both the LGA Leadership Board and Executive.

He informed the Community Wellbeing Board that 75 per cent of Business Rates would be retained by local authorities. He also emphasised that Directors of Public Health still had concerns. In particular Paul brought Members attention to the fact that should the transfer of public health funding into the business rates system not happen, the Government would potentially be looking to reduce the share of funding retained to 63 per cent.

The Chairman emphasised concerns that including the ringfenced public health grant into the business rates retention arrangements going forwards could have implications for the whole sector.

Decision

The Community Wellbeing Board noted the report.

Action

Officers to proceed with delivery of the LGA work programme on Business Rates Retention and the Fair Funding Review taking account of any steers about how to respond to concerns about removal of the public health ring-fence.

Simon Williams, Director of Sector Led Improvement at the Care and Health Improvement Programme, introduced the report detailing a draft approach to measuring value for money in Adult Social Care. He informed Members this approach has been developed collaboratively by the LGA and ADASS working with DHSC, MHCLG, and consultancies/contractors with expertise in this area. Simon emphasised this was about how to best use the resources available to Adult Social Care and not about creating a league table. He described the approach to measuring value for money as a new improvement tool and that that had been shared with all nine ADASS regions, which had all responded positively.

Simon raised the following three risks;

·         That this could be seen as creating league tables.

·         The assumption that cheapest is best but that it was clear further investment was needed.

·         That so far the approach was more around how money is spent rather than understanding outcomes of spend and that more work would be needed to bring this back to value for money.

In the discussion that followed, the following points were made;

·         Simon emphasised that a more collaborative way of working with providers was needed in future. He also raised that there had been issues around data consistency.

·         Regarding points made around prevention and early intervention data Simon agreed this data could be used to identify the contribution of prevention to reduce costs.

·         Regarding a query on outcomes, and a concern that the approach was currently too focused on money, Simon explained that not a lot of nationally collected data focuses on outcomes and that this needed to be addressed. Simon emphasised that this will be published by ADASS and that it would be important this approach come soon. He also raised there wasn’t time to develop this to incorporate outcomes prior to it being launched.

Decision

The Community Wellbeing Board endorsed the approach but agreed more ways to measure outcomes would need to be developed.

Mark Norris, Principal Policy Adviser, introduced the report setting out proposals for the children and young people’s mental health work programme for the LGA.

Decision

The Community Wellbeing Board agreed the proposed objectives to raise the profile of, and set out the case for, local government’s role within children and young people’s mental health, in advance of the next spending review, with a launch date at NCASC 2019. This included the set-up of a joint Steering Group between the Children and Young People Board, Safer & Stronger Communities Board and the Community Wellbeing Board consisting of two Members from each Board.

The Chairman updated the Community Wellbeing Board on activities in which he had represented the LGA since the previous meeting.

It was also suggested that a discussion around air quality and its impact on health, potentially across Boards, would be valuable.

Cllr Jackie Meldrum requested an addition in the minutes to state that the Autism Task Group had asked Councillors to contribute to their work.

The minutes from the previous meeting were agreed with this amendment.

The Community Wellbeing Board received a confidential update from Jim McManus, ADPH Vice-President and Director of Public Health Hertfordshire County Council.

This item was confidential as it referred to survey results that had not yet been published.

There followed a confidential discussion with the Community Wellbeing Board.

Decision

The Community Wellbeing Board:

1.1. Noted the update on the suicide prevention self-assessment;

1.2. Gave a steer on key messages to be reflected in the national and

regional reports about the self-assessment; and

1.3. Gave a steer on suicide prevention support that would be helpful to

councillors responsible for public health.