Agenda item

To receive an update on the current arrangements for Healthwatch in the City.

 

A briefing paper from Voluntary Action Leicester is attached at Appendix B. (Page )

 

Note: The following documents have been made available since the agenda was originally published.

 

A position statement from the former chair and members of the Healthwatch Leicester Board is attached at Appendix B1  (Page)

 

A statement from the Director Care Services and Commissioning, Adult Social Care, Leicester City Council is attached at Appendix B2 (Page)

Members received an update on the current arrangements for Healthwatch in the City.

 

Kevan Lyles, Chief Executive, Voluntary Action Leicester (VAL), presented a briefing paper from Voluntary Action Leicester which had previously been circulated with the agenda for the meeting.

 

In addition to the comments in the briefing paper, the following statements were noted:-

 

a)         VAL had been contracted by the City Council to deliver a successful transition from the previous LiNK to establish an independent Healthwatch for Leicester City.  VAL considered that the current Healthwatch Leicester were not as successful as the Healthwatch for Leicestershire, and the Chair of the Leicestershire Healthwatch was at the meeting if members wished to ask questions.

 

b)         VAL did not consider that there had been a breakdown between VAL and Healthwatch Leicester.  The recruitment process for new Board members was now underway, following the resignations of a number of Board members.

 

c)         Details of the current inspections being carried out by Healthwatch Leicester in conjunction with Healthwatch Leicestershire were outlined in the briefing paper previously circulated.

 

d)         Nationally, approximately 1/3 of Healthwatch were established on the model implemented in Leicestershire.  Approximately 1/3 of Healthwatch were organised on the independent stand-alone model requested by the City Council, but the vast majority were funded by a ‘grant process’ and not a tender process.

 

e)         It was envisaged to have a new Independent Healthwatch Board in place by 1 June 2015.

 

In response to members’ questions Mr Lyles stated:-

 

a)         The initial target of Healthwatch Leicester being established as an independent organisation from 1 April 2014 had not been achieved and VAL had assessed that the Leicestershire model was working well and should be looked at again as a model for the City.  VAL had not felt able to ‘novate’ the contract to Healthwatch Leicester as they felt that Healthwatch Leicester were not ready to become an independent body and that this was not in the best interests of the people in Leicester.  VAL took their contract responsibilities seriously and felt that patients and service users in the City required the best possible voice to represent them.

 

b)         VAL provided back office functions and systems to Healthwatch Leicester and when Healthwatch Leicester made arrangements to transfer its operations to Age Concern’s premises and for Age Concern to take over these functions, VAL were concerned that IT system would not be able to deliver the requirements for Healthwatch Leicester and that VAL had not been able to discuss issues fully with the lead on finance on the Board.  Consequently VAL had requested the City Council for a delay in establishing an independent Healthwatch Leicester under the terms of the contract.  This decision had been taken on the basis of best practice nationally and locally.

 

c)         VAL were also awarded the contract to establish an independent Healthwatch for Rutland and this had been achieved.  That contract was for one year and not three, as with the City Council, and with hindsight, it may have been better for VAL to have been offered a similar contract for the City.  It was also felt it would have been better to secure the type of Healthwatch required by the Council through a ‘grant’ rather than a contract tender process.

 

d)         A number of lessons had been learned from the process leading to the current situation, largely through hindsight.  VAL felt they had been totally focused on providing an excellent Healthwatch for Leicester and had acted accordingly.  They had however, been able to reflect upon recent events following the resignation of Board members.

 

e)         The reason for not agreeing to ‘novate’ the contract to Healthwatch Leicester had not been about finances but had been based upon the belief there were benefits and efficiencies to be achieved by combining the work of Healthwatch Leicester with that of Healthwatch Leicestershire in relation to their inspections of the Leicestershire Partnership NHS Trust.

 

f)          That the original tender, issued before the regulations were published, was to deliver a Healthwatch for the City and after the regulations it was clear that the City Council wished to move to an independent Healthwatch body in accordance with established timescales.

 

Members commented that:-

 

a)         They were disappointed that many people had been working hard for two years to establish an independent Healthwatch and this had not yet been achieved.

 

b)         It was not for VAL to consider what was in the best interests of the people of Leicester; Councillors were the elected democratic representatives to make those choices and the Council had entered into a contract with VAL for them to establish an independent Healthwatch for Leicester.  It was evident from VAL’s briefing paper that there was no acknowledgment that the decision to change the model of delivery for Healthwatch lay with the Council.

 

c)         It should have been patently apparent to VAL that the City Council’s Health and Wellbeing Scrutiny Commission and the County Council’s Health Overview and Scrutiny Committee were completely different in their operation and focused on differing health needs for their respective populations.  VAL should, therefore, have realised that if both the City and County Council’s felt there was a need for, and had a desire for, joint arrangements for health scrutiny the two Councils would have established combined health scrutiny arrangements.

 

d)         The 3 former Board members, present at the meeting, were highly respected for their work over a number of years in relation to health , and VAL were requested to issue individual apologies to them for the circumstances which had led to them resigning from the Board.

 

Following members comments, Mr Lyles stated:-

 

a)         That VAL were wrong to have overridden the right to establish an independent Healthwatch for Leicester, and were consequently working to establish this by 1 June 2015.  VAL however, felt that had they had acted validly under the contract.  VAL now accepted that they had overreached their position and that it was not their role to determine when due diligence was in place, that was rightly the role of the Contract Commissioners and the City Council.

 

b)         The previous Board members were at the meeting and had heard VAL’s apology for overreaching its position.  VAL had appointed the previous Board members and had confidence in them.  VAL had not made any detrimental comments about specific Board members in their briefing paper.

 

The Chair thanked the Chief Executive for his contribution to the discussion.

 

Karen Chouhan, Philip Parkinson and Surinder Sharma presented a position statement as the former chair and members of the Healthwatch Leicester Board which had previously been circulated with the agenda for the meeting.

 

In addition to the comments in the briefing paper, the following statements were noted:-

 

a)         The Board of Healthwatch had made arrangements in January 2014 for an independent Healthwatch to be accredited and set up as a separate company which had been discussed in public meetings with the Council.

 

b)         The Board had set a deadline for Healthwatch to be completely independent by September 2014.  The original target of April 2014 was known to be unrealistic and the extension to September had been agreed following discussions with the Director Care Services and Commissioning, Adult Social Care, Leicester City Council and the Chief Executive of VAL.

 

c)         VAL had written to the City Council to inform them of VAL’s concerns that the Board did not have the necessary competences for VAL to novate the contract the Board.

 

d)         Board members had subsequently met with VAL in October as the Board had not been given a copy of VAL’s letter to the Council.  At the meeting the Board members were informed that there would be commercial and public perception issues for VAL if the contract was novated, it would be better for staff to remain with VAL, patients would benefit and that the 3 year contract with VAL should remain.

 

e)         The Board had worked for nine months to ensure that arrangements were in place for an independent Healthwatch Leicester to be established.  This work had taken place in tandem with all of Healthwatch’s core work.

 

f)          When VAL decided not to novate the contract to the Board and then reiterated this view in subsequent meetings, 5 Board members felt that they had no option by to resign since Healthwatch could not operate independently of VAL if it had no control of its finances or priorities for staff support.  The Board members felt there had been a breakdown of trust and could not continue to work with VAL if Healthwatch was not an independent body.

 

g)         The three ex-Board members felt patients’ interests had been set aside and that it was a sad state of affairs to be in the current position.  They felt the Board had the experience and commitment to oversee an independent Healthwatch for the City, to say otherwise was misleading.

 

h)        The Vice-Chair had agreed to stay until new arrangements were in place.

 

i)          As a result of the decision not to novate the contract the public had been poorly served as some costs had been incurred in setting up a bank account, making arrangements for telephone lines, and securing IT arrangements.  These costs had been agreed at the time with the Council and VAL and VAL had now agreed to honour these abortive costs.

 

j)          The ex-Board members indicated that they would be prepared to carry on if the contract was novated.

 

Following members’ comments and questions, the three ex-Board members stated:-

 

a)         That numerous efforts had been made to remedy and salvage the situation but on each occasion VAL had reiterated that they would not novate the contract to the Board.

 

b)         The issues had subsequently been discussed with the Council to raise the Board’s concerns.

 

c)         It was vital for an independent Healthwatch for the City to have a strong voice in speaking on behalf of patient’s concerns, particularly as the health economy was undergoing considerable change in the City through the Better Care Together Programme and change in the provision of mental health services. 

 

d)         There would be a loss of impact between what the previous Board had achieved and what a new Board could achieve until they were fully assimilated with the issues and practices locally.

 

e)         It was felt that the Board had a good working relationship with the staff and the Board could have achieved more if it had not been dealing with arrangements to ensure that the Healthwatch could operate on an independent basis.  Large parts of that work would now have to be repeated to achieve the new target of independent Healthwatch by 1 June 2015.

 

Members commented that:-

 

a)         Every effort should be made to preserve the energy, commitment and money already spent in establishing an independent Healthwatch for the City.

 

b)         VAL should acknowledge the situation had been poorly handled and should reconsider their decision and novate the contract as quickly as possible to demonstrate its strong leadership role and restore public faith and confidence.

 

The Chair thanked the ex-Board members for their contribution to the discussion.

 

The Director Care Services and Commissioning, Adult Social Care, Leicester City Council presented a briefing paper which had been circulated to Members prior to meeting and had been published with the agenda. 

 

The Deputy City Mayor stated that:-

 

a)         A great deal of effort and energy had been spent by the Council to resolve the current situation, and it was unfortunate that it had taken the Commission’s intention to discuss the issue in public to make progress.  The Commission’s questions had reflected his own concerns as to why the issue had taken so long to make progress.

 

b)         The events since October had not been in the best interests of Healthwatch, the public, VAL or the Council.

 

c)         He welcomed VAL’s statement at the meeting that they would now novate the contract and were working to a new deadline of 1 June 2015.  It was disappointing that the Council had to resort to seeking a formal address through the contract process to achieve that.

 

d)         He had held various meeting meetings with VAL and other parties and had welcomed the steps that were in hand to recruit a new Board.  He acknowledged the former Board members indication that they were prepared to carry on if the contract was novated, but would need to seek further clarity now that the recruitment process for a new Board was underway.

 

e)         He was disappointed that it taken so long for VAL to indicate their concerns when so much work had been undertaken and arrangements made to establish an independent Healthwatch.

 

The Assistant City Mayor, Adult Social Care echoed the Deputy City Mayor’s concerns and supported efforts to bring this issue to speedy conclusion.  She indicated that she had not been involved in the details of recent discussions in view of her close working relationship with all three ex-members of the Board.

 

The Director Care Services and Commissioning, Adult Social Care stated:-

 

a)         The original tender was issued prior to the full guidance and regulations being received, but it had been clear in the tender documents that the development of Healthwatch would be subject to further guidance once these had been published.

 

b)         The contract was awarded to VAL in early 2013 and VAL had subsequently agreed in May 2103 to the transition arrangements for Healthwatch to become an independent body by 1 April 2014.  During the discussions on this it had been made clear that the City Council wished to have independent Healthwatch because the health needs for the City were different to that of the County.

 

c)         The contact was originally issued for a three year period as it was not known at the outset how long it would take to make the transition from LiNK to a fully independent Healthwatch, particularly as it was not known when the detailed Regulations and guidance would be issued.

 

Members commented that there appeared to be goodwill on behalf of all parties to reach a position whereby the contract could be novated n a short period of time.  It would be unfortunate and time consuming to incur more expenditure to re-start the work already undertaken by the Board to achieve an independent status for Healthwatch.

 

In response to Members comments the Chief Executive of VAL stated that Val would be willing to enter into further discussions after the meeting to resolve the issue and indicated that VAL would not object in principle to suspending the recruitment process, reinstating the previous Board members and supporting the accelerated process to achieve an independent Healthwatch for the City.

 

RESOLVED:

 

1)         That everyone be thanked for their contribution to move this issue forward to get back on track to establish an independent Healthwatch for the City and not lose the continuity of experience of those that had been involved prior to the current situation.

 

2)         That the executive continue to show leadership in getting all parties together to resolve the issues as soon as possible.

 

3)         That all other parties be encouraged to demonstrate their leadership roles in seeking a speedy resolution to the current unsatisfactory situation in the best interest of the people they serve.

 

4)         The VAL Chief Executive’s apology in public be noted but the Commission would welcome a gesture by VAL to issue personal apologies to the ex-Board members.

 

Councillors Bajaj, Sangster and Palmer left the meeting at this point.