Agenda item

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 an open conversation around any potential impacts of the Long Term Plan on Local Government.

·         Chris acknowledged a concern that with S75 arrangements there is an assumption towards aggregation.

The Chairman expressed his thanks to Chris and Ben for joining the meeting of the Community Wellbeing Board.

Decision

The Community Wellbeing Board discussed and gave comments on the proposed set of tests to identify the implications for local government of the proposals outlined in the NHS England consultation document.