Agenda item

To consider a joint report of the Corporate Directors for Services to People and Corporate and Support Services.

The report provides a further update on progress relating to the Stockport Together programme for integrating health and social care and describes and seeks approval to the steps that need to be taken to formalise important aspects of the integrated arrangements. These include areas such as governance, leadership, management and finances.

The Scrutiny Committee is recommended to comment on and note the report.

Officer contact: Steve Houston on 0161 474 4000 or email: steve.houston@stockport.gov.uk

The Corporate Director for Corporate and Support Services submitted a report (copies of which had been circulated) providing an update on progress towards the Stockport Together programme for integrating health and social care and outlining the steps that need to be taken to formalise important aspects of the integrated arrangements, including governance, leadership, management and finances.

The Chair welcomed members of the Adult Care Services & Housing; and Health & Wellbeing Scrutiny Committees to the meeting and invited those members to participate fully in its proceedings.

The Deputy Leader of the Council and Portfolio holder for Support & Governance (Councillor Iain Roberts) and the Executive Councillor for Supporting Adults (Councillor Keith Holloway) attended the meeting to respond to questions from the Scrutiny Committee.

The following comments were made/ issues raised:-

Draft Section 75 Partnership Agreement

·         It was explained that the new agreement sought to build on the current arrangements but recognise that the scale of the pooled budget was now more significant.  This was reflected in the proposals around the governance arrangements.

·         While during the first year of operation, there was a recognition that risk would continue to be borne individually by each contributing party, moving forwards agreement would need to be found to move to a different risk sharing arrangement.

·         As the Section 75 Agreement was revised, the revisions would continue to be shared with members including the submission of the final version to the meeting of the Scrutiny Committee on 12 April 2016.

·         Further clarity was requested on the hosting by the CCG of the Integrated Commissioning Function and the role and responsibilities of the Director of Integrated Commissioning.

·         There were constitutional implications arising from the implementation of the Agreement which would need to be processed through the Council’s decision-making apparatus and which would include consultation with both the Constitution Working Party and this scrutiny committee.

·         While there had been a significant rationalisation of the structures surrounding the Agreement, the complexity of the relationships between the various parties was such that the structure remained necessarily complex.

·         In response to a question around non-financial contributions made by the parties under the Agreement, it was explained that this would account for the work of corporate and support services which supported the Agreement but which was not a direct monetary contribution.

·         Concern was expressed that the arrangements for the auditing of the pooled budget would be complex by virtue of the requirement to segregate the budget at the end of the year by contributing party for audit purposes.  In response it was commented that both the CCG and the Council used the same external auditors which should simplify this process and that work continued towards securing the necessary agreement to treat the fund as a single integrated budget for audit purposes which would obviate this requirement in future years.

·         In response to concerns about democratic accountability in the administration of the pooled budget, it was stated that the intention was not to diminish the involvement of elected members and that the Agreement would continue to the subject to accountability in the same way as the current agreement through the Executive, individual portfolio holders and the scrutiny arrangements within the Council.

Governance Specification

·         A discussion took place around the omission of the word ‘social’ from within the proposed title of the Health and Care Integrated Commissioning Board.  While members acknowledged the rationale behind the decision not to include specific reference to social care, it was requested whether the Executive could give further consideration to this matter.

·         Additional clarity was requested in relation to the proposed composition of the Board; the frequency, timing and location of its meetings; and the proposed publication scheme for agendas, minutes and reports of the Board.  In response it was stated that further consideration would be given to these matters, however meetings of the Board would be webcast would introduce an increased element of transparency to its proceedings.

·         It was suggested that the proposed period of notice by which public questions should be submitted in advance of meetings of the Board should be aligned to the Council’s Code of Practice for asking public questions.

·         The principle of members’ attendance at meetings of the Board during which confidential items were being discussed was raised.

·         The importance of ‘pre-scrutiny’ being factored into the decision-making process was emphasised.

Memorandum of Understanding

·         It was suggested that a review should be undertaken on the progress towards putting in place a formal alliance contract resulting from the memorandum well in advance of its terminal date.

·         It was suggested that the Memorandum could be more outcome focussed and be clearer as to its objectives.

·         Work was ongoing with regard to the undertaking of a review of the integration of various support services that could provide support to health and social care.  Further details of the services in scope would be circulated to members.

·         Stockport was working closely and in collaboration with its partners throughout Greater Manchester to ensure that model being adopted in Stockport was consistent with what was happening elsewhere.

Pooled Budget Tables (Appendices 1 and 2)

·         It was commented that the reporting mechanisms by which the pooled budget statements and associated performance were provided to members in a standard, consistent and understandable format.  It was also stated it was important that such data was provided in a timely fashion to facilitate prompt analysis and scrutiny.

RESOLVED – (1) That the report be noted.

(2) That the Executive be recommended to give consideration to the comments of the Scrutiny Committee in advance of any approval of the proposed approach to the integrated commissioning of health and social care.