Agenda item

To receive an update report on the Better Care Together Joint Leicester, Leicestershire and Rutland Five Year Strategy and to agree proposals with regard to comments on the drafts and a programme of wider engagement.

Geoff Rowbotham, Interim Programme Director and Michael Cawley, Finance Director will attend the meeting to present the report.

To receive an update report on the Better Care Together Joint Leicester, Leicestershire and Rutland Five Year Strategy and to agree proposals with regard to comments on the drafts and a programme of wider engagement.

Geoff Rowbotham, Interim Programme Director and Michael Cawley, Finance Director attended the meeting to present the report.

It was noted that:

·         The 5 year plan was reviewed in June and incorporated comments previously made by the Board.  This document was now publically available on the website.

·         Both the Strategic Outline Case (SOC), essentially the investment proposal to support the plan; and the Program Initiation Document (PID) setting out the governance arrangements for the programme, had been developed.  These documents had been submitted to the various partnership boards for development and approval.   It was intended to put these documents in the public arena during February and March 2015.  There would be a series of engagement events with the staff and the public to receive comments and feedback on the documents.

·         It was proposed to hold a voluntary sector summit in February to identify how and where the sector could support and interface with the programme.

·         Once all the documents were in a final form there would be a further opportunity for stakeholders to comment on the proposals. 

·         The programme contained a number of proposals that would require formal statutory and work was underway to identify to identify these and develop proposals for the consultation process.   When this was completed this would be presented to the Council’s Health and Wellbeing Scrutiny Commission for comment.

·         Work was progressing on developing the work that had previously been carried out under the Better Care Fund between health and social care partners to incorporate this into the Better Care Together Programme proposals.  It was recognised that there were challenges facing local authority partners in social care in relation to future budgets and to integrating the work of both health and social care workforces into the required outcomes for the programme.  Work was on-going through the Partnership Board to achieve this and to develop detailed implementation plans.

Following questions from members of the Board it was noted that:-

·         The concerns expressed about the ability of the local arrangements to have the capacity to change to meet the proposals within the suggested timescales for the proposals for the ‘beds programme and left shift’ in the report were noted.  However, one of the guiding principles in the programme was that there would be no intention to move capacity out of acute sector until the provision had been established in the community and this should not, therefore, put patient care a risk.  This principle had financial implications and this had been taken into account within the proposals.  Assurances were also being sought from the Adult Safeguarding Boards requesting them to examine the proposals and to confirm that individuals were not being put at risk.

·         The proposed reduction in children’s beds was based on a clinical view that if high quality and better community based services were provided there was an opportunity to care for the children out of a hospital setting.

·         As each part of the plan goes forward and each part begins to be implemented, it would have detailed proposals supported by an evidence base and would be subjected to detailed scrutiny.

·         It was accepted that there were challenges around the timescales for implementing the programme but at this stage there was confidence that the plan was the right plan for the circumstances and it had been tested externally for its robustness and its ability to be delivered.  As it moved into its operational phase the governance arrangements would take effect and various stakeholders, groups and individuals would be held to account to achieve the outcomes and milestones within the programme.

·         The Office of Government Commerce had commented upon the energy and commitment of all the stakeholders to make the programme work and this was seen as a reflection on the work and the co-operation of the local authority, health, social care and other partners and community groups in developing the proposals to the current stage.

·         The Partnership Board would receive the first performance report on the programme at its meeting in January which would be held in public.  The Board would then receive future regular monitoring reports.

In response to questions from the public, the Interim Director stated that:-

·         The proposals had not been submitted to the Council’s Health and Wellbeing Scrutiny Commission because the details of the proposals were still being developed through discussions with clinicians, Healthwatch, health professionals and key stakeholders.  Once these details were complete it would be made available for scrutiny by the Commission.

·         Public consultation was planned to start in February and March 2015, after which the proposals would be reviewed in the light of comments received.

·         In addition to the general public consultation, parts of the programme would require a statutory consultation process, but this would be unlikely to start until after the elections in May 2015.

·         The development of the programme was an ongoing and evolving process.

·         The programme set out a 5 year vision for the provision of services and did not present options as such.  Different options for delivering services had been considered in the early planning of putting the programme together and the proposals in the current programme were considered to be the best way forward within the requirements for producing the programme.

·         Both the Risk Register and the Board Assurance Framework were currently in draft and would be submitted through the clinical; reference groups and the PPI groups to the Partnership Board in January 2015.

·         The suggestion that the risks to delivering the programme should be highlighted would be taken on board and included in the public engagement and consultation processes.

The Chair suggested that a standing risk register should be prepared and published on the web-site to promote public confidence.  It should then be updated periodically.  He also commented that the Council’s Scrutiny Commission were looking at how they could engage in such a vast programme as this within their resources and how they effectively interact with the work of the Board.  This scrutiny was likely to be an ongoing process over a period of time.  It should be borne in mind that the local government scrutiny process had never been asked to deal with a programme of this magnitude before.

RESOLVED:

1)         That the progress made to date on the programme be noted.

2)         That it be noted that the Strategic Outline Case and the Programme Initiation Documents will be made available for comment in the week commencing 22 December 2014.

3)         That the proposal to provide initial comments on the drafts and the proposal to carry out a wider engagement of the 5 Year Plan, Strategic Outline Case and Programme Initiation Document during January and March be endorsed.