Agenda item

Councillor Cooke, Chair of the Leicester City Health and Wellbeing Scrutiny Commission to present a report on the outcomes of a ‘Fit for Purpose Review’ carried out on the Commission’s behalf by the Centre for Public Scrutiny with a view to improving health scrutiny.

The Board is requested to:

1.    Endorse the “Improving Health Scrutiny Arrangements following the ‘Fit for Purpose’ Review Report”.

2.    Endorse the “Implementation Plan’ of actions and the prescribed way forward as a means to drive and co-ordinate improvement to future health scrutiny arrangements.

3.    Support the need for mandatory training for all members of the Health & Wellbeing Scrutiny Commission.

Councillor Cooke, Chair of the Leicester City Health and Wellbeing Scrutiny Commission, presented a progress report on the outcomes of a ‘Fit for Purpose Review’ carried out on the Commission’s behalf by the Centre for Public Scrutiny (CfPS) with a view to improving health scrutiny.  Following the publication of the CfPS Review Report, the Scrutiny Commission had developed an Implementation Plan to address the recommendations that had been made. 

The CfPS concluded that there were four areas of work that needed to be improved.  These were:-

            Improved public and community involvement

Clarification of relationships

Effective prioritisation of issues to scrutinise

Member skills development

The Commission’s responses to each of the 20 recommendations in the CfPS Review Report and the progress made on them to date were detailed in the Improvement Plan.  Some improvements had been achieved by simply rearranging the seating layout for the meeting, which had made a big impact in changing the dynamics of the meeting and establishing a more forensic approach to scrutiny.   Others were more complex such as the protocols on joint working arrangements, which would have benefits in the long term.  The first protocol was signed in June 2014 with Healthwatch and two other protocols had been developed with NHS England and the Care Quality Commission. It was intended to sign these during April.  These protocols would help to maximise mutual knowledge and help each organisation to learn from each other.

Councillor Cooke hoped that his successor would be able to bring a further report back in 6-12 months to demonstrate that further progress had be made on the Implementation Plan.  He also felt that there had always been an issue of the competence of the Commission to carry out its functions and this had been reinforced recently by the publication of guidance on the function of health scrutiny.  Health scrutiny was a statutory responsibility of the Council and it was important that the Commission members understood the legal framework in which they were required to operate. It was therefore essential that there should be mandatory training for health scrutiny members similar to that already for provided for members of the Planning Committee and the Licensing and Public Safety Committee.  Both these had statutory regulatory responsibilities.  He felt that there was capacity to provide this training in-house and there was a real need to understand how the complex NHS system worked and how the Council’s scrutiny process fitted in with both the NHS  structure and, equally importantly, the relationship between the Scrutiny Commission and the Board.

The Commission had undertaken some joint working which had proved both interesting and challenging.  Joint scrutiny had taken place with the Adult Social Care Scrutiny Commission on topics of common interest; but it had not been possible to persuade the County Council to pursue joint scrutiny, as had happened in 2012/13, when the joint working secured a review of the Safe and Sustainable outcomes by the Minister of State in relation to the Congenital Heart Unit at Glenfield Hospital.

The Chair supported the approach taken by the Commission to strengthen the scrutiny function around health and commented that the relationship between the Board and Commission had been constantly evolving and would continue to do so in the future with new structures and responsibilities.  It was important to ensure that the governance arrangements kept pace with current and future changes and remained fit for purpose.

In response to the Chair’s question on whether there were any benefits that could be adopted across other parts of scrutiny and not just health; Councillor Cooke stated that he believed there were lessons learned from the review that could be applied equally across all scrutiny commissions.  He also firmly believed that member development and training was an essential part of being a councillor in order to carry out duties in a professional manner.  

Following a further question in relation to recommendation 13 in the Improvement Plan on whether sufficient progress had been made on establishing clear delineations between the various roles of bodies to establish a good fit so that everyone was clear about each other’s roles; Councillor Cooke commented that the protocols were not yet a finished product but would hopefully be developed further under his successor.  The important factor was firstly to establish which body to work with and then to identify if the other party also sees value in it.  Once signed it needs to be implemented and developed.  The benefits of the Healthwatch protocol had been hampered by recent events which had delayed work on agreeing joint working methods and annual reviews.  He would be leaving a legacy document for his successor who would need to build new relationships with the various bodies in order to continue the progress already made.

In response to a question from a member of the public on how the recommendations for enhanced scrutiny applied to the Better Care Together Programme; Councillor Cooke commented that the scrutiny of the programme was in its early stages and that the knowledge building stage was already underway.  He could not comment on how the scrutiny would continue under his successor, but he intended to meet with the questioner as soon as possible to better understand the issues and would leave comments on how he thought the scrutiny process should progress in his legacy document.

RESOLVED:

1)         That the “Improving Health Scrutiny Arrangements following the ‘Fit for Purpose’ Review Report” be endorsed.

2)         That the “Implementation Plan” of actions and the prescribed way forward as a means to drive and co-ordinate improvement to future health scrutiny arrangements be endorsed.

3)         That the need for mandatory training for all members of the Health & Wellbeing Scrutiny Commission be supported.

4)         That a further update report be submitted to the Board in 6-12 months to demonstrate the further progress that had been made on the Implementation Plan.