Agenda item

To consider a report of the Corporate Director for People.

The report will update the Scrutiny Committee on the procurement for the Multi-speciality Community Provider.

Officer contact: Andrew Webb, 0161 474 3808, Andrew.webb@stockport.gov.uk

The Corporate Director for People submitted a report (copies of which had been circulated) providing the Scrutiny Committee with an update on the development of the Multi-speciality Community Provider (MCP) for health and social care and providing an opportunity for the Scrutiny Committee to comment on the possible models of the organisational form of that provider.

James Sumner, Deputy Chief Executive of Stockport NHS Foundation Trust, and Keith Spencer, Provider Director, also attended the meeting to answer questions from councillors.

The report set out the approach partners were taking to determining the best organisational form to support innovative, integrated, wrap-around provision to meet the needs of older adults with complex needs, and to do so within the context of increasing demand outstripping resources. Progress had already been made in improving service delivery through innovation and further improvements would come to fruition without any need for changes to the organisational form. Partners were committed to the development of an MCP as they believed this was the best way to address cost and demographic pressures, and realign resources.

The options set out in the report had been developed based on an assessment of the services in view of the Stockport Together programme. All services, regardless of the final organisational configuration, would remain subject to external oversight and inspection through NHS Improvement, the CQC and others. Each partner organisation would also be seeking legal advice to inform the discussions on what the preferred option would be.

The Executive Councillor (Health) (Councillor Tom McGee) stated that these proposals were the result of lot of work from all partners, and within a challenging financial context. The Council, as a democratic organisation, created an added level of complexity in the process but it was important to engage councillors and other stakeholders in these discussions and final decision given the scale of the proposals. He stated that no decisions had been taken, and that all the options would be considered, although he would not favour options that could lead to a loss of public ownership of the services in question.

The following comments were made/ issues raised:-

·           Clarification was sought about the risk of the provider eventually leaving public ownership, and assurances were sought about the there being appropriate governance arrangements to provide oversight and control over service delivery and financing. In response, it was stated that partners working on the MCP had no mandate to change the public nature of the services in question. Each model would have its own governance arrangements and implications, and these would be a part of the considerations in developing the proposal further.

·           Stockport Together and the current proposals were the result of hard work by all organisations over a number of years, and that had been recognised by the interest from NHS England and others, as well as through the success in accessing funding to support the programme. It was commented that partners in Stockport had shown good leadership in putting the wider public interest ahead of individual organisational interests in developing the programme. The various regulators involved with individual partners had also indicated they were supportive of the programme.

·           Further information was requested about patient input, and ensuring the correct balance between the views of professionals and those of patients. In response it was stated that the current consultation with stakeholders related to organisational form, whereas there had been greater drive to involve patients and service users in the development of the models of care. Depending on which model emerged as the preferred model, this may trigger a further formal consultation stage as a NHS service change. Whatever the future organisational form, there would continue to be mechanisms for public and patient engagement in service improvement. It was further commented that many members of the public were more likely to engage with consultation about care and services than organisational issues.

·           Was there wider public consultation, and consultation with other stakeholders such as GPs? In response it was stated that the consultation being undertaken was an open process and there was nothing to prevent wider engagement. Many of the wider service changes had been subject to extensive consultations through each organisation’s budget processes. GPs had also signed up to this process through their member organisation Viaduct Health that represented all the GP practices in Stockport. GPs themselves would be central to neighbourhood centred models of care being developed.

·           What could be learnt from experience elsewhere, in particular Tameside? In response it was stated that partners in Tameside were not as far advanced as those in Stockport, but it was unlikely their approach would be very different from that under consideration here.

·           Concerns were expressed about the potential impact of sub-contracting activity out of the public sector, and the need for scrutiny and accountability of those arrangements. In response it was commented that this should not be source of concerns as there would inevitably be some sub-contracting, some of which would be to other public sector providers, but also to care home providers. In the latter example, the new arrangements would facilitate a different relationship with these providers to ensure the needs of service users could be better met.

·           Public health and prevention needed to be at the heart of the care model as it was vital if more expensive demand was to be reduced. In response an assurance was given that while the budgeting for the programme may be dominated by NHS spending, that was simply reflective of where the spending occurred, but prevention was central to the new care models being developed.

·           It was queried how do any disagreement between the four organisations on the final form would be resolved.

·           Members of the public were concerned about the possibility of privatisation of the NHS. In response it was commented that partners had been clear from the outset that they wished to ensure as much resource was kept within Stockport, with as many services delivered locally through local providers. The commitment of the Council’s Executive to maintaining public ownership and pubic delivery wherever possible was also restated. Members welcomed that assurance.

·           Once the options appraisal was complete and a further report submitted to the Scrutiny Committee, more would be needed to identify clearly the risks associated with each option, including an analysis of the potential impact of Greater Manchester developments on the options.

RESOLVED – That the report be noted and Andrew Webb, James Sumner and Keith Spencer be thanked for their attendance.