Agenda item

To consider a joint report of the Interim Provider Director; Director of Services for People (SMBC); Deputy Chief Executive (SFT); Medical Director (Pennine NHS FT); Interim Chief Executive (Viaduct)

The four Providers of Health and Social Care in Stockport have reached a milestone in the Joint commissioner led procurement process to identify the potential organisational form of a Multi-speciality Community Provider (MCP) in Stockport. The purpose of this document is to present the options that have been considered by Providers, including the relevant information required to support members of each partner provider organisation (Stockport NHS Foundation Trust, Stockport MBC, Viaduct Health and Pennine NHS Foundation Trust) in identifying a preferred option.

This document provides an overview of the strategic context in the development of a MCP in Stockport and outlines the appraisal undertaken by providers leading to a recommendation of a preferred option for the MCP form.

The Scrutiny Committee be recommended to consider the proposed recommendations to the Council’s Executive:-

(1) It is the recommendation of this options appraisal that the option to form A New Neighbourhood Led Accountable Care Trust should be considered by all providers for approval to progress to a Full Business Case (FBC) including  legal agreements, regulatory and financial due diligence.

(2) It is important to stress that the completion of the FBC is part of the much larger procurement and regulatory process described above, the timescales for completion of which have yet to be confirmed.  Once approved by Provider governance processes, the FBC would therefore also be subject to the final outcome of the Joint Commissioning Procurement process and would require regulatory approval by NHS England and NHS Improvement.

(3) In addition, as outlined in section 4 in relation to support services, it is recommended that Stockport MBC and Stockport NHS FT:

·                Develop a specification for a structured programme that results in an option for an integrated support services;

·                Adopt the design principles and next steps identified in section 4 above to inform this programme;

·                Focus in the first instance upon support services in Stockport Foundation Trust and Stockport MBC;

·                Adopt a public sector led arrangement either through a partnership or public to public transfer in the first instance to enable effective support services to meet critical transformation requirements in the development of the care model; and,

·                Develop a detailed report for consideration by the Stockport Together Board and appropriate organisational governance along with a proposed approach to programme investment, governance, accountability arrangements and requisite third-party support.

Officer contact: Keith Spencer / Holly Rae, 0161 474 3014, keith.spencer@stockport.gov.uk / holly.rae@stockport.gov.uk 

A joint report of the Interim Provider Director, Director of Peoples Services (Stockport Council), Deputy Chief Executive (Stockport NHS Foundation Trust, Medical Director (Pennine NHS Foundation Trust ) and the Interim Chief Executive (Viaduct Health) was submitted (copies of which had been circulated) providing the an update on the process for identifying the preferred organisation form for the new Multi-speciality Community Provider (MCP) in Stockport, including an assessment of the options available.

Keith Spencer (Interim Provider Director) Dr Stephen Watkins (Director of Public Health) Dr Donna Sager (Deputy Director of Public Health) and Councillor Tom McGee (Executive Councillor (Health)) attended the meeting to respond to questions from the Scrutiny Committee.

A presentation was also made to the Scrutiny Committee, summarising the background to the development of the MCP and highlighting the key issues to have arisen through the Options Appraisal process.

The Executive Councillor (Health) emphasised that the Executive and partners unanimously were of the view that the MCP arrangements should avoid, as far as possible, any private sector involvement. He further stated that, with the exception of Viaduct Health, all other partners would be considering and deciding upon these proposals in public, although no date had yet been fixed for a final decision on the MCP form as each partner organisation needed to seek separate legal advice.

The following comments were made/ issues raised:-

·         On page 45 of the document (58 of the agenda pack) there was reference to ‘market opportunities’ and assurances were sought that this was in accord with previous assurances given about the MCP remaining a public sector body. In response, the Executive Councillor (Health) restated the commitment of partners to ensure the MCP remained a publically owned form, although he could not give a categorical assurance as future government policy may impact on this. It was further commented that the Health & Social Care Act prevented a distinction being made between public and private organisation in tendering process, supported by European Procurement rules, which prevented the possibility of private sector involvement ever being ruled out. However, given the nature of the services being tendered for, it was unlikely a private provider could successfully tender for this contract.

·         Clarification was sought on when the delivery of new models of care would begin. In response it was acknowledged that the delivery of care was the area of real importance. Investment from the Greater Manchester Transformation Fund was enabling changes to be made to services to deliver these new models, and from November the neighbourhood model would begin to be rolled out over the following 12 months. There had been a desire to ensure that the process of change and improvement in delivery was not dependent on progress with organisational change.

·         The report made little reference to the impact on wider health and care workforce of the options, but the turbulence of change was likely to negatively impact staff morale. In response it was accepted that the discussion of organisation form would cause worry for some staff, but the model being proposed would have the least impact on staff of all the options. It was further commented that consideration was being given to seconding staff into the MCP, rather than transferring staff via TUPE, as this would allow partner organisations to maintain control over their staffing.

·         Concerns were expressed that within the model being proposed, there was a danger of dominance by GPs. What was being done to ensure that there was a balance between different groups to ensure input was equally valued. In response, it was stated that as part of the development of the governance arrangements for MCP, consideration would be given to ensure wider engagement of stakeholders. It was commented that Foundation Trust status required involvement of others non-doctors in the governance arrangements. Comment was made that as part of the preventative work stream within Stockport Together, a lot of effort has been made to engage the third sector and to model new services collaboratively. It was also emphasised that in addition to the strategic governance arrangements being considered, further thought would be given to how to develop neighbourhood governance arrangements with a democratic element.

RESOLVED – That the report be noted.