Issue - meetings

To consider a joint report of the Leader of the Council and the Cabinet Member for Reform & Governance

This report reprises the purpose and objectives of a place-based approach to commissioning that have been outlined in previous Cabinet reports and updates on recent developments to deliver such an approach, working both internally within the Council and with wider partners.

Due to the pressure on health and social care this report further outlines the Cabinet’s position on the consideration and development of a new Single Commissioning Function (SCF) for health and care in Stockport.  Across Greater Manchester the ambition is for single commissioning functions for health and social care and it is the view of the Cabinet that a SCF in Stockport is key to delivering the shared ambition of the Council and wider health and care system partners. This aims to create a more sustainable health & care system driven by improved health outcomes, reduced health inequalities and less reliance on bed-based care.

The Cabinet is invited to:

·         agree to  the potential for an SCF on health and care to enable prevention-focussed, whole population commissioning that will reduce health inequalities, and improve healthy life expectancy and health outcomes for people in Stockport and engage in Cabinet workshops that considers the options and implications of single commissioning on the Council.

·         agree the position on SCF governance arrangements, directing the Deputy Chief Executive to progress joint working to advance this position, as outlined above in a phased approach, keeping the cabinet updated and ensuring appropriate decision making at critical points.

·         note that these arrangements do not infer on Councillors any new or additional responsibilities or duties in respect of the management or governance of health services in Stockport; nor do they infringe in any way the unity of the National Health Service.

Officer contact: Laureen Donnan, 0161 474 3180, Laureen.donnan@stockport.gov.uk

A joint report of the Leader of the Council and of the Cabinet Member for Reform & Governance was submitted (copies of which had been circulated) reprising the Cabinet of its agreed aspiration for a place-based approach to commissioning, particularly in relation to health and social care, and setting out the Council’s position on a preferred model for a single commissioning function. The report provided an update on recent development to deliver this preferred approach.

The Cabinet Member for Health outlined the background to the report, including the signing of the section 75 agreement between the Council and Clinical Commissioning Group (CCG) to allow for joint commissioning of services from a pooled budget. Both organisations had aspired toward a single commissioning arrangement, similar to the model adopted in Tameside, with a single Chief Executive / Chief Accountable Officer for both organisations. The CCG had now begun the process for appointing a Chief Accountable Officer with a health background.

The Cabinet Member stated that the Council would not be embarking on an expansion of the pooled budget through the Section 75 agreement unless it could be satisfied that it would retain democratic oversight over its resources raised through taxation. The Council was currently bearing the risk for its own resources within the existing pool and it was the expectation that the CCG would do the same.

The Cabinet Member also reported that the Council, CCG and the Greater Manchester Health & Social Care Partnership had agreed to undertake a review of Stockport Together Governance that may provide greater certainty on the way forward.

Cabinet members stressed that while the aim remained a single commissioning function this may be a long term aspiration until the Council’s governance concerns could be resolved and all groups on the Council were supportive.

Specific comment was made of the recent SEND Review and the highlighted weaknesses in joint commissioning, that both organisations had accepted and made progress in addressing. It was suggested that in the short term there needed to be a wider review of our existing joint commissioning arrangements.

Cabinet members stressed that under the proposals set out in the report that the Council’s statutory duties would remain the same, and that it would not be bearing any further responsibilities for the functioning of the wider health and social care system.

RESOLVED – That in relation to a single commissioning function:-

·         the potential for a single commissioning function for health and care to enable prevention-focussed, whole population commissioning that would reduce health inequalities, and improve healthy life expectancy and health outcomes for people in Stockport be agreed, and engagement in Cabinet workshops to consider the options and implications of single commissioning on the Council be supported;

·         the position on single commissioning function governance arrangements be agreed, and the Deputy Chief Executive be requested to progress joint working to advance this position, as outlined in the report, in a phased approach, ensuring the Cabinet was updated and ensuring appropriate decision making at critical points;

·         note that these arrangements do not confer on councillors any new or additional responsibilities or duties in respect of the management or governance of health services in Stockport; nor do they infringe in any way on the unity of the National Health Service.

·         current joint commissioning arrangements be reviewed to ensure they were operating as effectively as possible within the agreements in place with partners.

To consider a joint report of the Leader of the Council and the Cabinet Member for Reform & Governance

This report reprises the purpose and objectives of a place-based approach to commissioning that have been outlined in previous Cabinet reports and updates on recent developments to deliver such an approach, working both internally within the Council and with wider partners.

Due to the pressure on health and social care this report further outlines the Cabinet’s position on the consideration and development of a new Single Commissioning Function (SCF) for health and care in Stockport.  Across Greater Manchester the ambition is for single commissioning functions for health and social care and it is the view of the Cabinet that a SCF in Stockport is key to delivering the shared ambition of the Council and wider health and care system partners. This aims to create a more sustainable health & care system driven by improved health outcomes, reduced health inequalities and less reliance on bed-based care.

The Scrutiny Committee is invited to consider the report and the recommendation being proposed for the Cabinet and to comment on them prior to submission to the Cabinet.

Officer contact: Laureen Donnan, 0161 474 3180, Laureen.donnan@stockport.gov.uk

A joint report of the Leader of the Council and the Cabinet Member for Reform & Governance was submitted (copies of which had been circulated) inviting the Scrutiny Committee to consider proposals to further the Cabinet’s aspirations for place-based commissioning, and in particular a single commissioning function for health and care in Stockport. While Stockport already undertook joint commissioning there was an aspiration from Greater Manchester Health & Social Care Partnership to develop single commissioning arrangements as a means of improving outcomes for residents.

The following comments were made/ issues raised:-

·         Joint commissioning was a key element in the recent SEND Review and this needed to be pursued.

·         There was a need to ensure that any approach adopted would not mean the Council taking on responsibility for activity that was not within its purview while also ensuring its duties were discharged properly.

·         Clarity on the terminology and language being used was also important as this would change the nature of the risks for the Council.

·         While the overall direction may be a positive one, there was a need for greater clarity about the risks involved. The report identified a number of benefits of differing approaches but lacked balance in presenting potential risks.

·         Clarification and further information was sought in relation to references in the report to ‘leadership grip’ of the Neighbourhood Care approach. In response it was stated that there had been some significant changes in the personnel in all partner organisations and so a review of governance had been started. There was a preference form the GM Partnership for localities to move toward a local care organisation. The Council was satisfied that the Director for Adult Social Care had appropriate delegation to make these decisions to move the neighbourhood models forward, and the other partner organisations were similarly satisfied with their delegations.

·         The importance of ensuring democratic accountability over the use of Council Tax resources was emphasised.

·         Proposals contained in the report in relation to member workshops and briefings were welcomed.

RESOLVED – That the report be noted.

To consider a joint report of the Leader of the Council and the Cabinet Member for Reform & Governance

This report reprises the purpose and objectives of a place-based approach to commissioning that have been outlined in previous Cabinet reports and updates on recent developments to deliver such an approach, working both internally within the Council and with wider partners.

Due to the pressure on health and social care this report further outlines the Cabinet’s position on the consideration and development of a new Single Commissioning Function (SCF) for health and care in Stockport.  Across Greater Manchester the ambition is for single commissioning functions for health and social care and it is the view of the Cabinet that a SCF in Stockport is key to delivering the shared ambition of the Council and wider health and care system partners. This aims to create a more sustainable health & care system driven by improved health outcomes, reduced health inequalities and less reliance on bed-based care.

The Scrutiny Committee is invited to consider the report and the recommendation being proposed for the Cabinet and to comment on them prior to submission to the Cabinet.

Officer contact: Laureen Donnan, 0161 474 3180, Laureen.donnan@stockport.gov.uk

The Cabinet Member for Health submitted a report (copies of which had been circulated) inviting the Scrutiny Committee to consider proposals to further the Cabinet’s aspirations for place-based commissioning, and in particular a single commissioning function for health and care in Stockport. While Stockport already undertook joint commissioning there was an aspiration from Greater Manchester Health & Social Care Partnership to develop single commissioning arrangements as a means of improving outcomes for residents.

Councillors discussed whether the Council was seeking to emulate the Tameside model. In response it was suggested that there were aspects of their arrangements that could be learned from. The Cabinet wanted to ensure that all councillors had the opportunity to discuss and assure themselves that this was the correct approach.

The Chair stated that the Scrutiny Committee understood the arguments for pursuing this commissioning model but that more detail would be welcomed.

RESOLVED – That the report be noted.