PAPER B

Purpose : for Decision

REPORT TO THE EXECUTIVE

Date : 28 JULY 2004

Title : ORGANISATIONAL REVIEW – SHORTLISTING OF OPTIONS

JOINT REPORT OF THE PORTFOLIO HOLDER FOR ADULT AND COMMUNITY SERVICES AND THE PORTFOLIO HOLDER FOR CHILDREN’S SERVICES

IMPLEMENTATION DATE : 9 AUGUST 2004

SUMMARY/PURPOSE

1. To receive a report from PricewaterhouseCoopers, that short-lists two alternative organisational reconfigurations that require further clarification and work, to agree future steps in developing these models; to make a commitment to continue to explore as a long-term aspiration the development of a single public service organisation for the Isle of Wight.

BACKGROUND

2. The context to this report will be familiar, and is analysed in some detail in a report by PricewaterhouseCoopers (PwC) published on 20 July 2004.

3. An executive summary of that report is attached as Appendix 1 to this report. Copies of the full report can be obtained from iwight.com from Wednesday 21 July 2004.

4. The context of this report referred to above includes the imperative to move quickly. The need to obtain financial stability without compromising standards of care is an absolute requirement by the Strategic Health Authority. Any interim step proposed must, therefore, demonstrably improve the quality of the decision-making process. A short period of reflection, including engagement with stakeholders (particularly staff) will satisfy this criteria.

5. The review conducted by PwC was commissioned as a product of the Statement of Intent of July 2003 agreed by the Primary Care Trust, the IOW Healthcare Trust and the Isle of Wight Council and the Island's response to Healthfit. The PwC review takes account of both national and local policy imperatives, including achieving financial stability, increasing leadership capacity, Choice and Payment by Results. Some of these objectives are discrete from the organisational configuration review and will require solutions in advance of and separate from any organisational reconfiguration. The PwC report makes recommendations about organisational change which are consistent with achieving these objectives and which are designed to enable sustainable delivery of them.

6. This report is being considered by boards of the PCT and the Healthcare Trust and by the Isle of Wight Council Executive.

STRATEGIC CONTEXT/PWC Report

7. The executive summary, and substantive report, set out the process by which a long list of possible alternative organisational configurations were identified, developed and evaluated.

8. The analysis of nine alternative configurations by PwC has led to a clear recommendation that a short-list of two, labelled option 5 and option 6, should be pursued. These are:

(a) Establishment of a Health and Social Care Trust on the Isle of Wight that includes commissioning functions; and

(b) The establishment of a Health and Social Care Trust on the Isle of Wight that does not include commissioning functions but that commissioning is undertaken in a separate organisation.

These options require further detailed work and development.

9. Option 8 in the long list identified by PWC refers to the establishment of one public service organisation. The report does not recommend this option for further development at this stage but organisations may wish to affirm that they will continue to explore this concept.

10. The two short listed options are differentiated only by the inclusion, or exclusion, of the commissioning function. The significance of this in differentiating between the two options is not made sufficiently clear by the current report. A further issue is determining what is to be included in terms of health and social care and housing within these two options. Further work is therefore proposed to be commissioned from PwC to:

· Determine how commissioning would be delivered in either option

· Provide clarity on the next steps which need to be taken, including the establishment of a transitional steering group to lead this work.

This work would be undertaken during the next few weeks with a view to being reported back to the Trust Boards/Executive during September 2004.

CHILDRENS SERVICES

11. The development of Children’s Services is covered in some detail in the PWC report, which recommends that a Childrens Trust be developed in parallel with the establishment of a Health and Social Care Trust.

FINANCIAL/BUDGET IMPLICATIONS

12. The cost of additional work by PwC will be met from the funds already allocated by the three partner bodies and the Strategic Health Authority for the purpose of commissioning consultancy advice.

LEGAL IMPLICATIONS

13. The statutory context for the development of a Care Trust is principally the Health Act 1999. Each partner is governed by their own statutory regime, in the case of the local authority Pt 1 of the Local Government Act 2000 is the most significant statutory provision.

OPTIONS

14. The following options exist:

1. To receive the PricewaterhouseCoopers report.

2. To receive the PricewaterhouseCoopers report and agree the additional work that is required to enable a decision on the two options.

3. To reject the work of PricewaterhouseCoopers and/or to commission further development and evaluation of long listed options

RECOMMENDATIONS

i. To receive the Price Waterhouse Cooper report and accept the principle of establishing a Care Trust, and agree the additional work that is required to enable a decision on the two options.

ii. To use August and the early part of September as an opportunity to involve stakeholders, including staff, in an exchange of information and views about the short-listed options.

iii. To receive a further report in September 2004 to determine which, if any, of the short-listed options the Executive wishes to be pursued.

iv. To continue to explore, as a long term aspiration, the development of a single public service organization for the Isle of Wight.

BACKGROUND PAPERS

None

ADDITIONAL INFORMATION

PricewaterhouseCoopers report

Contact Point : Mike Fisher, Chief Executive Officer

John Lawson, Head of Legal and Democratic Services

MIKE FISHER Chief Executive Officer	GORDON KENDALL Portfolio Holder for Adult and Community Services
JOHN LAWSON Head of Legal and Democratic Services	JILL WAREHAM Portfolio Holder for Children’s Services