Agenda item

To consider a report of the Director of Public Health.

This report outlines the outcome of the recent consultation on the Public Health Staffing Restructure and presents the Final Business Case (Appendix A).  Health and Well Being Scrutiny Members previously considered the Draft Business Case on the 5th April 2016. The report was noted with an acknowledgement that an update will be provided to the Scrutiny Committee upon conclusion of the consultation.

The responses to the consultation have indicated a high level of staff engagement in the proposed Public Health Staffing Business Case and staff have indicated that they have felt listened to in the process and their amendments have been, in the majority of cases, reflected in the new structure.

The Scrutiny Committee is asked to comment on the Final Business Case prior to it being presented to the Executive on the 19 July 2016, and note that the Business Case proposes changes in terms and conditions of a number of staff.

Officer contact: Donna Sager, 0161 474 2436, donna.sager@stockport.gov.uk

The Deputy Director of Public Health submitted a report (copies of which had been circulated) inviting the Scrutiny Committee to consider the final Business Case for the restructure of the Public Health Service. The Business Case, which was considered by the Scrutiny Committee in April, had been subject to extensive consultation and discussion with staff, trade unions, and the Royal College of Nursing, and was being submitted for consideration prior to submission to the Executive in July 2016. The Business Case had been developed in response to reductions in the Public Health Grant from the Department of Health announced in February 2016.

The Executive Councillor (Health) (Councillor Tom McGee) attended the meeting to respond to questions from the Scrutiny Committee.

The followings questions were asked/ issues raised:-

·         Clarification was sought on the protection period for staff moving from NHS to Local Authority Terms and Conditions. It was stated that this would last for two years.

·         Clarification was sought on whether staff could remain within the NHS pension scheme following transfer. It was stated that an application had been made and it was anticipated that this would be accepted.

·         Was there confidence that desired outcomes could be delivered with the new structure? In response it was stated that the new structure would give priority to the preventative agenda. It was acknowledged that the future would be challenging, but there was confidence that the Service could continue to deliver improvements in outcomes.

·         Given that much of the Public Health work was targeted at population level, staffing numbers were important. In response it was acknowledged that delivering the public health agenda would be challenging. It was important to work with partners, such as pharmacies, to access the wider population.

·         Had staff been engaged with the consultation and been constructive? In response it was stated that Managers in the service had an open door policy, but that the team was relatively small which had meant everyone had engaged in the process, including the Union Representative. Every effort had been made to respond to and act upon the feedback received. .

·         What had been the effect on staff moral? In response it was stated that staff moral had been negatively impacted, although they recognised the need for changes. They also had concerns about the future of their work, roles and terms and conditions. There was recognition of the benefits of the new model, although there was understandable anxiety about change.

·         There were references in the Business Case to reductions in activity and further clarification was sought. In response it was stated that because most of the Public Health budget was committed through contracts, savings had to be sought from non-contractual activity and by prioritising those areas of work where the most impact can be demonstrated. It was also important to ensure that as many partners and front line staff elsewhere in the Council were engaged with and furthering the Public Health agenda.

·         Was the current round of reductions sustainable given future reductions? In response it was stated that the service had worked on a three year financial plan and every opportunity to generate income or make savings would be explored, including working with partners, or commissioning and providing services with other local authorities.

·         The importance of reducing inequalities was stressed, as was the long term challenge this represented, and the need for nuanced programmes to effect behavioural change. The comments were acknowledged, but it was stressed that tackling the disparity in ill-health life expectancy should also be a priority gap. It was also commented that there was often a geographical clustering of inequalities across a range of health indicators.

·         Given the scale of the reductions in staffing, where were the pressures on the service likely to be? In response it was acknowledged that there would be pressures, but there was confidence that the new structure and the dedication of staff would be able to absorb those. Until the new structure was in place it was difficult to identify where particular pressures would be, although the uncertainty over recruitment until the business case was adopted. Challenges with the children’s public health agenda had been identified in the consultation and changes made to the business case to ensure additional focus.

·         Was there sufficient administration support capacity in the new structure to allow for operational activity to be maximised? In response it was stated that the current support would be subsumed within the Corporate and Support Service, meaning that there was now greater resilience in support available to Public Health

RESOLVED – (1) That the final Public Health Business Case be noted.

(2) That the Deputy Director of Public Health be requested to circulate further information in relation to the ‘Stop Before Your Op’ campaign