ADULT AND COMMUNITY SERVICES SELECT COMMITTEE – 29 MARCH
2005
RECOMMENDATIONS
AND UPDATE FROM THE PWC TASK GROUP
REASON FOR SELECT COMMITTEE CONSIDERATION
1. To identify:
§ Other Local Authorities and NHS PCT / Healthcare Trusts which have been involved in the establishment of a Care Trust
§ Other Local Authorities and NHS PCT / Healthcare Trusts which have considered and rejected a proposal to establish a Care Trust.
§ Any relevant lessons from the experience of those authorities in developing and/or delivering such a proposal.
2. To consult with stakeholders, building on the work already undertaken by the Select Committee in relation to the HealthFit exercise and the Isle of Wight HealthCare Strategy recommendations from the Select Committee.
3. In order to make recommendations to the Executive, the Transitional Steering Board the PCT, the Healthcare Trust and/or the Strategic Health Authority on:
§ Whether an application should be submitted.
§ The criteria which should be used by the Local Authority and NHS bodies to decide whether or not to submit an application to the Secretary of State.
§ The criteria to decide which services to include in any such application.
§ How the Select Committee should be involved in the development of proposals to form a new trust.
§ Corporate Governance and accountability arrangements, including the role of the Select Committee, should the new Trust be formed
§ The transition process in forming of a new trust
§ Any other features of the application which the Select Committee wishes to express a view upon (including the viability and sustainability of the Council after any transition).
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ACTION
REQUIRED BY THE SELECT COMMITTEE To endorse the recommendations made by the Task Group, to be forwarded to the Transitional Steering Board and IWC Executive. |
BACKGROUND
The
Statement of Intent was issued jointly by the Isle of Wight Primary Care Trust
(PCT), Isle of Wight Healthcare NHS Trust (IWHNHST) and the Isle of Wight
Council (IWC) in July 2003. The
statement set three aims:
1.
“That in future they
wish to see health and social care services delivered jointly with a view to
full integration of those services wherever that either improves services to
the people we serve, the working experience and development of our staff or
creates greater efficiencies.
2.
That services should be
driven by the needs of the service user and our wider community rather than
professional or organisational boundaries
3.
That all managers are
expected to apply this principle in the future design and delivery of
services”.
In
July 2004, the IWC, PCT and IWHNHST on the Isle of Wight commissioned a report
by PricewaterhouseCoopers in order to produce a range of options around
increased service integration. The
Island Strategy Group (comprising the chairs of the two NHS trust boards, the
portfolio holder for Adult and Community Services and the Chief Executives of
each of the three organisations) put forward a recommendation to the Executive
on 6 October 2004 that Option 5 is the preferred option. This option outlines the aim of setting up
of a joint service to provide Social Care and Health Services for the
Island. The exact form and range of
service delivery that this Trust will take is yet to be decided. A range of stakeholders have been consulted
jointly by the NHS and Local Authority, and in addition the Adult and Community
Services Select Committee, through the PwC Task Group will be scrutinising and
assisting in policy development in line with the responsibilities for both
Adult and Community Services and Health Scrutiny.
RECOMMENDATIONS
Following a series of meetings of the PwC Task Group, and now with the involvement of the whole committee, the following recommendations will be put forward to the project’s Transitional Steering Board and the IWC Executive. These proposals are based upon independent research, consulting with stakeholders and a meeting with the Independent Reconfiguration Panel (IRP).
The Select Committee recommends the following:
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Recommendation |
Action by |
Rationale |
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1. The Select Committee will support the integration programme, subject to an impact assessment with key milestones. |
By June 2005 |
To ensure that the aspirations of the Statement of Intent are met, resulting in viable public services on the Isle of Wight. |
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2. The appointment of a Director of Adult and Community Services on a fixed term contract, to add impetus, experience and fully represent the interests of the IWC during this integration period. |
With Immediate effect |
To represent the best professional, operational and organisational interests of IWC and in particular lead on the forthcoming Commission for Social Care Inspection in June 2005. To satisfy the criteria of having a statutory Director of Social Services. |
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3. That a shadow trust board be established, prior to the setting up of any new organisation in legislature. |
With Immediate effect |
Allows any new governance arrangements to be trailed as well as setting, testing and monitoring suitable performance targets. |
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4. That the new Trust includes as a key objective the promotion and development of ‘independent living’ and that a timetable to incorporate some leisure, transport and libraries services to be explored. |
By October 2005 |
The Committee consider all investment in preventative measures will bring down costs in future years. |
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5. That there be equal representation on the Transitional Steering Board in terms of Local Authority members and NHS representatives. Furthermore, a place should be reserved for a staff representative |
With Immediate effect |
Transparent and balanced corporate accountability. |
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6. That the Children’s Services Trust should not be included within a new organisation. |
With Immediate effect |
The Committee believes the Children’s Services agenda to improve attainment standards and reorganisation will over complicate an already busy restructure, and the IWC does not have sufficient resources at present. |
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7. That Housing should not be included within the new Trust |
N/A |
The Committee believes that including Housing at this time would not be of benefit to the integrity of the current service. Any dilution of the current arrangements would, from the evidence gathered by the Task Group, have a detrimental affect upon Housing. In order to keep Housing high on the agenda, it should remain as part of the Council. It is also important to bear in mind that part of the Audit Commission’s Comprehensive Performance Assessment (CPA) takes into account targets focussing upon housing and homelessness. The Committee recognises that Housing has close links to the health, but also believes that there are stronger ties with other Council services such as Planning, Economic regeneration strategy, Environmental Health, Highways and the Housing Benefits Section. The Task Group does however recognise the need for a review of this position after the new organisation has been put into operation. |
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8. That a Head of Housing be appointed at the earliest date |
With immediate effect |
To maintain a strategic focus on Housing and assist with forthcoming developments such as the Pan project. |
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9. That, recognising the importance of good industrial relations, the Select Committee recommends that a specialist team be established to integrate salaries and terms and conditions for personnel working within the new Trust with the expressed objective of achieving full integration of the above by April 2008. In addition any Section 31 agreement must address differentials in pay and conditions |
By January 2006 |
The Committee would expect to see the integration programme carried out on the principle of ‘levelling-up’ in line with guidance from the Department of Health on Developing Health Trusts. Members considered it important to resolve differences in pay and conditions prior to the organisation’s establishment to ensure that service delivery experiences as little disruption as possible and that staff are fully on board with any integration. |
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10. That a series of new performance indicators (PIs) be developed to measure service improvements for patients and the public by the establishment of a new Trust. These new targets will enable clear and concise scrutiny to be undertaken to determine how the new arrangements have performed in comparison to current performance levels. |
With immediate effect |
This is required for good Performance Management. The indicators will require recognition by statutory bodies to legitimise them and the service delivery. |
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11. The new targets are included within the new PSA targets (currently being devised during 2005). |
May 2005 |
Focus the new administration on the integration agenda. |
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12. That an ‘exit strategy’ be developed so that individual service elements can withdraw from the Trust in the form that they are currently if the needs and delivery of health services are not reaching predicted performance levels.
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By June 2005 |
Safeguard and maximise service delivery. |
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13. That the integration project incorporates all these recommendations within a timetable to provide a framework for delivery of the new trust’s objectives. |
With immediate effect |
To ensure clear accountability and sustainability of services. |
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14. That the work of the Task Group should continue post election, with particular focus on the issue of governance. |
After May 2005 |
On-going Health Scrutiny |
RELEVANT PLANS, POLICIES, STRATEGIES AND PERFORMANCE INDICATORS
1. Adult and Community Development Work Plan for Health Scrutiny, which is the basis for the work carried out by the Task Group.
2. Isle of Wight Council Corporate Plan, which outlines, “Improving Health, housing and the quality of life for all”.
3. Health and Social Care Act 2001, which contains the legislation relating to the responsibility of Local authority Overview and Scrutiny Committees for Health Scrutiny.
CONSULTATION PROCESS
The
Task Group have taken evidence from officers from both the PCT and IWC, and a
Public and Patient Involvement Forum representative has been present at the
majority of Task Group meetings.
The
Task Group have consulted with Elected Members of Camden Borough Council who
have been involved with the establishment of a Social Care and Mental Health
Care Trust covering Camden and Islington.
The
Select Committee met with the Chairman and Chief Executive of the Independent
Reconfiguration Panel (IRP) to discuss issues relating to the setting up of any
new organisation. The Task group also consulted with
representatives from the Isle of Wight Rural Community Council, UNISON and
Housing Associations.
FINANCIAL, LEGAL, CRIME AND DISORDER IMPLICATIONS
None.
APPENDICES ATTACHED
None
BACKGROUND PAPERS USED IN THE PREPARATION OF THIS REPORT
PricewaterhouseCooper, Organisational review, Phase 2 Report, October 2004.
IWC, IWPCT and IWHNHST, Statement of Intent 2003
Contact Point: Louise Biggs,
Research and Scrutiny Officer, available on 01983 823768 or
[email protected]
ALISTAIR DRAIN
HEAD OF SELECT COMMITTEE AND REVIEW TEAM