APPENDIX
1
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.
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
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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.
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BACKGROUND
PAPERS
None
ADDITIONAL
INFORMATION
PricewaterhouseCoopers
report
Contact
Point : Mike Fisher, Chief
Executive Officer
John Lawson,
Head of Legal and Democratic Services
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MIKE
FISHER
Chief
Executive Officer
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GORDON
KENDALL
Portfolio
Holder for Adult and Community Services
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JOHN
LAWSON
Head of Legal and Democratic Services
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JILL
WAREHAM
Portfolio
Holder for Children’s Services
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