APPENDIX
2
45/06
Purpose:
for Decision
DECISION
UNDER DELEGATED POWERS
DECISION
CANNOT BE TAKEN BEFORE FRIDAY, 15 SEPTEMBER 2006
Title: BUSINESS CASE FOR THE INTEGRATION OF HEALTH AND SOCIAL CARE VOLUME 2
- EXTENDED SUMMARY
REPORT TO THE CABINET MEMBER FOR ISLAND HEALTH, HOUSING AND COMMUNITY
WELLBEING
SUMMARY/PURPOSE
1.
For the Cabinet Member to approve the conclusions and
recommendations of the Business Case.
2.
For the Cabinet Member to confirm continued commitment
to the integration process during the reorganisation of the local NHS.
CONFIDENTIAL/EXEMPT
ITEMS
3.
Not applicable
BACKGROUND
4.
NHS
organisations and the Local Authority on the Isle of Wight have a long history
of working closely together. In 2003
and 2004 formal Statements of Intent were agreed by the Isle of Wight
Council, Primary Care Trust (PCT) and Healthcare Trust. Following the
development of a joint healthcare strategy by the PCT and Healthcare Trust in
2003/04 all three organisations (the partners) along with the Hampshire and
Isle of Wight Strategic Health Authority (SHA) commissioned
PricewaterhouseCoopers to undertake a review of organisational
configuration. The PwC review
recommended a Care Trust which both commissions and provides services and in
Autumn 2004 all three organisations supported this as the future direction.
5.
The
Transitional Steering Group and Board were set up in 2004 to oversee the
Transition Project and a Business Case was developed to evaluate the options
for integration. It presents seven options representing increasing
levels of integration, from the current position of partnership agreements in
some small service areas, through integration of major service areas to full
integration by either an overarching partnership agreement or the establishment
of a single organisation for health and adult social care.
6.
The
centrally-led reorganisation of the NHS (Commissioning
a Patient-led NHS) will result in the merger of the Isle of Wight
Healthcare Trust and the Isle of Wight Primary Care Trust into a single
organisation to commission and provide all NHS care on the Island from October
2006. The main focus of the
7.
9.
The integration of adult social care and health
services on the island is a manifesto commitment by the current administration
and continues the direction of travel set out in previous organisational,
corporate and service plans.
10.
Integration and closer working between Health and
Social Care organisations is a national policy driver as evidenced by the
recent White Paper, Our Health, Our
Care, Our Say, National Service Frameworks and the Valuing People White
Paper.
CONSULTATION
11.
Consultation was undertaken with the Island public as
part of the local healthcare strategy (the Island response to Healthfit) in
2003/04, the starting point for the current integration agenda, which
demonstrated support for an integrated health and social care organisation.
12.
Further consultation with stakeholders was also
undertaken in relation to Commissioning
a Patient-led NHS and with regard to individual partnership agreements.
Consultation will be undertaken with stakeholders on the planned partnership
agreement for Intermediate Care Services.
13.
A full consultation process will be undertaken once
plans for further integration are formulated.
FINANCIAL/BUDGET
IMPLICATIONS
14.
Budget Accountants and Heads of Finance from NHS and
Local Authority have worked closely with the Transition Project Accountant in
preparing financial information for the Business Case.
15.
There are no immediate financial implications attached
to the recommendations in this report and the decision to be made by the
Cabinet Member at this stage.
LEGAL
IMPLICATIONS
16.
Health Act flexibilities through a Section 31
Agreement enable pooling of health and social care budgets and the transfer of
functions between health and local authority organisations. The work of the
Transition team has been supported by the Councils Legal Services Department
and by the procurement of independent legal advice from specialist law firm
Bevan Brittan.
OPTIONS
17.
The Business Case makes four recommendations to the
Council and Healthcare Services for actions to be pursued, pending the review
of further integration. The Cabinet Member for Island Health, Housing and
Community Wellbeing has the following options:
1. To
accept any or all the recommendations.
2. To
reject any or all of the recommendations.
RISK MANAGEMENT
18.
Principal risks are outlined below with actions currently in place or
proposed to be taken which will address the risk:
|
RISK
|
SCORE
(Probability
x Impact) High,Medium,Low
|
ACTION
|
|
1. Insufficient support from partner
organisations for proposed direction
|
LxM=M
|
To seek a reaffirmation of high-level commitment on
presentation of the Business Case to TSB
|
|
2. Insufficient
public support for proposed direction
|
LxH=M
|
Broad and effective consultation to focus on
outcomes rather than organisational details
|
|
3. Commissioning
Governance:
The proposed
model for single organisation including commissioning and provision runs
counter to the national direction
|
LxM=M
|
The special circumstances have been recognised by
DoH in the proposal for a single healthcare organisation. The proposal has
received broad support at local and regional level.
|
|
4. Financial
Risks agreement on balanced budgets and financial rules.
|
MxH=H
|
NHS Financial Recovery plan and agreed financial
principles under preparation.
|
|
5. Organisational Risks:
Lack of engagement of staff
Loss of staff morale / increased staff anxieties
Key personnel changes may impact on plans
for integration.
|
MxM=M
|
A communications strategy for the Transition Project
has been agreed to keep staff informed, promote dialogue and understanding of
anticipated outcomes and benefits and different organisational cultures.
New appointments to be briefed on history and scope
of Transition Project
|
RECOMMENDATIONS
|
19.
That
the Cabinet Member note the Business Case and the context in which it is
received and accept the four recommendations made by the Business Case.
|
BACKGROUND
PAPERS
19. Commissioning
a Patient-led NHS Department of Health, July 2005.
An
Island Response Transition Project Team, September 2005.
These and further background
information and documents are available on the Transition Team website www.shapingthefutureiow.org.uk
, also accessible via the link on www.iwight.com
.
APPENDICES
20.
Business
Case for the Integration of Health and Adult Social Care Volume 2 Extended
Summary
CONTACT
DETAILS
Contact
Point: Mark Price, Transition Project Director, tel 01983 550942,
email
[email protected]
|
ANDREW
WILLIAMSON
Interim Director of Adult and Community Services
|
CLLR
DAWN COUSINS
Cabinet Member for Island Health,
Housing and Community Wellbeing
|
Decision:
..
.
Signed
:
Date:
.