Agenda item

Cllr Izzi Seccombe, Chair of the Community Wellbeing Portfolio, introduced the report and highlighted that the LGA had consistently campaigned for a democratically accountable, place-based approach for health and wellbeing, and therefore welcomed the place-based approach that sustainability and transformation plans (STPs) were intended to introduce which had been announced by the NHS.

Integration was fundamentally important for local government and the NHS for a sustainable future for health services. The CWB Portfolio policy group on the future vision for health and social care was currently examining what has been learnt from approaches to integration so far, and how the integration agenda could be influenced in the future.

NHS planning guidance for 2016/17 required the development of sub-regional footprints, which had been welcomed by the LGA as they worked well with the Five Year Forward View and were intended to help improve financial efficiency, the health and wellbeing gap and the equality gap. However, there were some areas of concern; there was a very tight timescale for establishing the footprints, with draft plans required to be submitted by early April and full plans by early June, and guidance had been issued at a very late stage; and each area was required to identify a Chief Executive from the NHS or local government to oversee and develop the footprint, which could potentially draw accountability away from Health and Wellbeing Boards and local authorities and not help with integration.

In the discussion which followed Members made a number of comments, including:

·         Members supported the view that Health and Wellbeing Boards (HWBs) should have oversight of the emerging footprints to provide democratic accountability. HWBs were a strong integration point and if they were not engaged in the process it could not be seen as accountable. Sub-regional footprint geography should match with that of HWBs where possible.

·         Concern was raised that the NHS was not engaging in meaningful consultation on the sub-regional footprints. In some areas these did not match with combined authority footprints. Guidance from the NHS stressed that the plans should be for the whole system, with full involvement of local government and in some areas this had not been the case. Local authorities wanted to bring budgets together with the NHS to innovate and transform services.

·         Local authorities had previously been informed that the announcements on the Better Care Fund (BCF) in the Local Government Finance Settlement would help those areas with a smaller tax base. If the BCF was used for the transformation agenda this would begin to move away from the principles outlined in the Settlement.

·         Local authorities were currently unable to create sustainable solutions for the prevention agenda. There should be a much stronger, clearer and funded commitment from the government for Public Health, so local public health issues could be addressed and councils could work on longer term transformational issues.

·         Members supported the suggestion that a letter should be written to Jeremy Hunt, the Secretary of State for Health, to address issues which had been raised by members around sustainability and transformation plans and sub-regional footprints.

Decision

The LGA Executive:

i.              noted the action taken so far by the LGA in representing the views of councils in relation to health and care integration and transformation work; and

ii.             agreed that a letter be written to the Secretary of State for Health to address issues which had been raised by members around sustainability and transformation plans and sub-regional footprints.

Action

Letter to the Secretary of State to be drafted as agreed by members. (Sally Burlington)