The Monitoring Officer to report on the receipt of any questions, or representations in accordance with the Council’s procedures.
The following questions have been received:
From Steve Score
Q1 Will the public be consulted on the draft Integrated Care Board constitution before it is finalised?
From Kathryn Jones
Q1 I have been trying unsuccessfully to find the papers taken by the shadow Integrated Care Board meetings in the papers for the CCG governing body meetings and am concerned about the lack of transparency. Please could you tell me where they can be found?
From Kathy Reynolds
Q1 At a previous meeting the LLR ICS explained that councillors were explicitly banned from sitting on integrated care boards. In the House of Lords on 9th February Health Minister Lord Kamall, announced that NHS England will revise its draft guidance to remove the proposed blanket exclusion of councillors sitting on integrated care boards. What does this mean for the membership of the LLR ICS Board?
Q2 We know that the Designate CEO and Designate Chair have been appointed, have any other Designate Members been appointed and how will the selection process for board members change to allow selection of councillors?
From Jean Burbridge:
Q1 At the January meeting of the Leicester City Health Overview and Scrutiny Committee, I asked the question whether social enterprises would sit on the Integrated Care Board and/or ICS Partnership. I have since discovered that there is already a social enterprise (namely DHU Health Care) represented on the shadow Integrated Care Board, but I was not given this information in the response to my question. Please could you let me know if there are plans to include other social enterprises or “independent organisations” on the Integrated Care Board in either shadow or full form?
From Sally Ruane
Q1 Will the ICS Chair guarantee that the Integrated Care Board or any other local commissioner will pay for the emergency health care, including ambulance services, required by all people in its geographical area even if some of those individuals are visiting from other parts of the country?
Q2 The Health and Care Bill makes reference to “the group of people for whom each [Integrated Care Board] has core responsibility” (emphasis added). Will the ICS Chair pledge that the Integrated Care System in Leicester, Leicestershire and Rutland will abide by the principles of comprehensive and universal health care?
From Godfrey Jennings
Q1 Please could you tell me why the draft Integrated Care Board Constitution has not been to the joint health overview and scrutiny committee as is happening in several other parts of the country where good practice is being observed. When will the draft be brought to this committee before it is finalised?
Minutes:
The Chair explained the procedure to be followed and took public questions as follows:
From Steve Score: Will the public be consulted on the draft integrated care board constitution before it is finalised?
From Sally Ruane on behalf of Kathryn Jones: I have been trying unsuccessfully to find the papers taken by the shadow Integrated Care Board meetings in the papers for the CCG governing body meetings and am concerned about the lack of transparency. Please could you tell me where they can be found?
From Sally Ruane: Will the ICS Chair guarantee that the Integrated Care Board or any other local commissioner will pay for the emergency health care, including ambulance services, required by all people in its geographical area even if some of those individuals are visiting from other parts of the country?
The Health and Care Bill makes reference to the group of people for whom each integrated Care Board has core responsibility. Will the ICS Chair pledge that the Integrated Care System in Leicester Leicestershire and Rutland will abide by the principles of comprehensive and universal health care?
From Kathy Reynolds (read by the Chair on her behalf): At a previous meeting the LLR ICS explained that councillors were explicitly banned from sitting on integrated care boards. In the House of Lords on 9th February Health Minister Lord Kamall, announced that NHS England will revise its draft guidance to remove the proposed blanket exclusion of councillors sitting on integrated care boards. What does this mean for the membership of the LLR ICS Board?
We know that the Designate CEO and Designate Chair have been appointed, have any other Designate Members been appointed and how will the selection process for board members change to allow selection of councillors?
From Godfrey Jennings: Please could you tell me why the draft integrated care board Constitution has not been to the joint health overview and scrutiny committee as is happening in several other parts of the country where good practice is being observed. When will the draft be brought to this committee before it is finalised?
From Jean Burbridge: At the January meeting of the Leicester City Health & wellbeing Scrutiny Committee, I asked the question whether social enterprises would sit on the Integrated Care Board and/or ICS Partnership. I have since discovered that there is already a social enterprise (namely DHU Health Care) represented on the shadow integrated care board, but I was not given this information in the response to my question. Please could you let me know if there are plans to include other social enterprises or “independent organisations” on the Integrated Care Board in either shadow or full form?
Andy Williams Designate CEO, ICS responded to the public questions as follows:
The LLR ICB constitution was based upon the national model and was still being developed. The national model was available on the NHS website and the only substantive change suggested to that was to broaden membership so it could include availability for local government representatives and local partners.
From April 2022 the board meetings would take place in public. ICS was not proposing to consult beyond what they had done already as they were following the national consultation and its outcomes. In relation to the shadow ICB meetings, minutes of those were taken through the LLR CCG and were available to the public.
Regarding councillors being included in the membership, the regulations had changed to enable this, and the selection process would be up to the local authorities/partner organisations to appoint their representees and further guidance was awaited around this.
In addition to the Designate CEO and Designate Chair appointments the ICS had appointed non-executive Directors and chosen their preferred candidates for remaining executive roles. The ICS were still awaiting government legislation before making partners.
Regarding social enterprises, DHU Health Care were a partner in the original CCG and shadow ICS arrangements however, that would not formally continue once the board was established. It was noted that whilst they would not be part of the board when it went live, organisations like DHU Health Care were an important part of the system and positive engagement with them was necessary.
In terms of who paid for emergency health care, including ambulance services, required by people in a geographical area, there was already clear guidance around that; as a general rule the ICB would pay regardless of where persons were treated, however there were some exceptions. Core comprehensive and universal health care would be bound by the Bill and the ICS would work within that.
David Sissling, Chair of ICS then addressed a couple of points and commented that interest in the ICB’s constitution was understandable, but it was a work in progress and subject to national guidance, however the ICS would be happy to share the template and invite observations in due course.
As to meetings, so far, the ICS had met as a partnership not as a board and were trying to progress as much as possible in shadow form with membership, structure etc before convening as a board from April 2022. ICS were already demonstrating that the quality of work was enhanced by collaboration and relationships were strong.
The Chair invited any supplementary comments/questions which included the following:
From Steve Score: the ICS/ICB was a major change to the way the NHS is run and making details public about board meetings was not the same as a full public consultation. It was suggested that wider involvement of the public would be better from the point of transparency.
Sally Ruane on behalf of Kathryn Jones noted frustration that Leicester City Health & Wellbeing scrutiny was informed papers of the shadow ICB meetings were in public domain and noted the clarification that the public could access minutes through CCG but not papers.
Sally Ruane expressed concerns around emergency care not being covered by the Bill and other possible gaps and sought to have categoric assurance that emergency care and ambulances would be fully covered by the Bill and that the ICB would pay. There was also concern about new core responsibilities, what that meant and whether it pointed towards core services and shrinkage if some services were not defined as core.
Andy Williams responded to the supplementary points that the ICS had tried hard locally to engage with people in the description and discussion of changes taking place, however this was totally driven by the national statutory agenda over which ICS has no discretion and where there has been any discretion and the ICS were minded to exercise that they have engaged on that before making initial submission e.g., more representation on the board.
Regarding access to papers, it was confirmed the minutes of the shadow board meetings are available through the LLR CCG and from April 2022 all papers will be made available as the ICB meetings will be held in public.
In relation to emergency care the scope and remit of ICB will be determined in the final analysis of legislation. There was no reason to believe there was any intent to be unclear on budgets or funding for emergency care and there was no intention for ambiguity. The core responsibilities were a matter of drafting and for government to determine the remits of ICB, but the ICS was not aware currently of any attempt to use this to restrict access to services.
The Chair expressed concern that this committee was being taken up with question/answer sessions that should really be de facto fulfilled by the ICB and queried whether there would be facility at the ICB meetings to include a mechanism for public questions. David Sissling, Chair of ICS confirmed that intention was one of the first matters for board to facilitate public question and answers or appropriate arrangements at meetings and during the preparatory period the board would discuss that point. The Chair welcomed that transition moving forward and thanked representatives of ICS for their responses.