Agenda and minutes

There were no declarations of interest made.

Dr Ranjit Gill, Chair of the Clinical Commissioning Executive Committee attended the meeting and invited the Scrutiny Committee to comment on proposals for the organisational form and draft constitution of Stockport’s Clinical Commissioning Group (CCG) (copies of the proposals had been circulated).

The following comments were made/ issues raised:-

·         It was important that the obligations of GP membership of the Commissioning Group were stringent and would be enforced, particularly around training and development for GPs.

·         There were a range of other health professionals, such as pharmacists, who were not represented on the Governing Body of the CCG and there was concern that their expertise and input would be missed. In particular the contribution that could be made by clinical scientists and optometrists was highlighted.

·         Often GPs lacked an understanding of the processes of decision making and corporate governance so ensuring the skills/understanding gap was closed was necessary to ensure that the new clinical commissioning decisions were not dominated by non-clinicians in the new Commissioning Support Service.

·         The role of local knowledge and relationships was vital in ensuring effective collaboration between partner agencies at a local level.

·         A key challenge for the new CCG would be to minimise unhelpful interference from outside bodies and new initiatives that impeded commissioning decisions to the detriment of local people.

RESOLVED – (1) That Dr Gill be thanked for his attendance.

(2) That the Democratic Service Manager be requested to respond to the consultation on the proposed organisational form and draft constitution of Stockport’s Clinical Commissioning Group on behalf of the Scrutiny Committee stating that its view was that:-

·         the overriding aim of both the architecture of the commissioning arrangements and the agreements underpinning them should be to improve health outcomes for residents;

·         the membership obligations for GP practices should include requirements for training and developments of staff at practices to facilitate better early interventions which will improve outcomes, reduce costs and ensure that GPs understood the process of GP led commissioning so they could take an active part in the new arrangements; and

·         further consideration be given to the composition and membership of the Governing Body and constituent bodies to ensure appropriate representation from specialist services such as pharmacists, optometrists,  dentists and clinical scientists.

A representative of the Democratic Services Manager submitted a report (copies of which had been circulated) providing background information on the role and remit of the Health Scrutiny Committee to facilitate discussion on the future direction of the Scrutiny Committee in light of ongoing reform of the NHS.

The Chair invited the Scrutiny Committee members and officers present to make suggestions on a set of principles that would inform and underpin the work of the Committee in the future.

The following comments were made/ issues raised:-

·                A key role for the Scrutiny Committee in the future would be to hold to account the Clinical Commissioning Group, Foundation Trust, Public Health and Council departments on the delivery of the Health & Wellbeing Strategy.

·                The transfer of Public Health functions to the Council would provide the Committee with a role in scrutinising the plans for this transfer and to ensure the more joined up service provided was appropriate. The Committee could have a role in promoting ‘wellbeing’ more generally.

·                The reforms were providing an opportunity for Stockport to shape its own arrangements, and Scrutiny had a key role in assisting this and in shaping its own role within this broader context.

·                Scrutiny reviews had a very valuable role in shaping service delivery. The Health and Wellbeing Strategy could be used to inform that programme of work. Scrutiny Reviews provided an opportunity for the Committee to promote innovation and an increased emphasis on prevention.

·                HealthWatch would provide both a challenge and an opportunity. It could provide a mechanism for public engagement, but would that be sufficiently independent? There had traditionally been a good relationship between LINk and the Committee and it was hoped this would continue with the new arrangements.

·                Local providers looked on the Committee as providing an element of local accountability, rather than through regional or national health bodies, which was valued by these organisations.

·                The Committee had a key role in supporting non-health services to improve the wider determinants of health and inequalities.

·                It was important that the work of the Committee did not become ‘politicised’ and the focus of its work remain on outcomes.

·                The Committee needed to have ‘teeth’ to ensure it could hold organisations and people to account. The Committee had traditionally sought to have constructive relationships with partners which had proven effective.

·                In light of discussions around the CCG and GP obligations, the Committee should try to ensure these obligations were being met.

·                It was important for the focus of scrutiny to be on outcomes, rather than structures.

RESOLVED – (1) That the report be noted.

(2) That the Democratic Services Manager, in consultation with the Chair, be requested to prepare a note on the discussion of the Committee on its future role with a view to the Committee agreeing a position at its next meeting on 13 December 2011.