Archived decisions

Contact : Graham Linecar Ext: 7390

1. Summary and purpose of report

1.1. At its last meeting, the Committee agreed to ask the five Community Health Councils (CHCs) in Hampshire to continue to be the first point of contact for consultation by NHS bodies when considering proposals for substantial development or variation in health services. The CHCs have agreed.

1.2. At the same meeting, the Hampshire & Isle of Wight Health Authority (HIoWHA) offered to present at each meeting of the Committee a forward-look at issues under consideration which might result in reconfiguration proposals. This report sets out proposed procedures for responding to NHS bodies when consulted on reconfiguration proposals.

2. The role of local authority overview and scrutiny committees in the new arrangements

2.1. The Department of Health has announced that CHCs will cease to exist from 1 September 2003. An important part of their activities, those related to representation of public and patient interests in relation to NHS services, are to be taken up by Patients' Forums to be established for each Primary Care Trust (PCT) and NHS Trust. However, the Commission on Public Involvement in Health has yet to make the necessary arrangements for appointment of members to Patients' Forums and to resource their activities. Local authority overview and scrutiny committees (OSCs) will take on another part of the CHCs' role - in ensuring that NHS bodies undertake appropriate consultation on proposals to change the way NHS services are provided and to make representations if NHS bodies take inadequate account of the reasoned and reasonable views of local communities before making decisions to reconfigure the way services are provided.

2.2. In practical terms, the Committee must have in place arrangements:-

_ so NHS bodies can seek advice on whether the Committee believes a change it is considering represents a `substantial change' sufficient to require full public consultation, can discuss those ideas before formulating proposals for public consultation and can agree what would be appropriate arrangements for consultation


_ to respond on behalf of the community when the NHS body undertakes public consultation on reconfiguration proposals. This is a different role to that exercised by the Executive of the County Council. The appropriate Department and/or Cabinet may respond in relation to the County Council's interests as a service provider and in recognition of its regulatory responsibilities, particularly for the environment and planning. Other local authorities may also respond with a particular local viewpoint in addition to the representation made by the Health Review Committee.

2.3. At conclusion of formal consultation, the NHS body will make a decision whether to proceed with the proposal, whether to proceed with an amended proposal or whether to reconsider what has been proposed. If the NHS body proceeds with change, the appropriate local authority's overview and scrutiny committee will consider whether the NHS body has undertaken sufficient and appropriate consultation and taken sufficient account of the results of that consultation. If the Committee considers the proposed change would not be in the interests of the health service in its area it may refer the matter to the Secretary of State for Health who may make a final decision on the proposal and require the local NHS body to take such action as he may direct.

2.4. This puts a considerable responsibility into the hands of Committee and it is important the Committee work with the CHCs to benefit from their expertise and experience in dealing with such matters.

3. Proposed arrangements

3.1. The Chairman and Vice-Chairman have met with the Chairmen of the Hampshire CHCs and the CHCs have agreed to continue to act as initial point of contact for NHS bodies seeking to discuss possible future changes to services so a view can be reached on appropriate consultation. The CHC will inform County Council officers of such approaches.

3.2. NHS bodies are required to discuss proposals with the appropriate local authority's OSC at a formative stage. Whilst CHCs continue to exist, it is again proposed that the appropriate CHC should lead that discussion but that increasingly the lead should pass to this Committee. Officers will consult with the Chairman and Vice-Chairman and bring to the Committee for consideration and comment the content and conclusions from discussion with a NHS body which is formulating for public consultation proposals for a major reconfiguration of NHS services. The arrangement for the Assistant Chief Executive of the HIoWHA to report at each meeting of the Committee on issues under consideration by all NHS bodies in Hampshire should give early warning of major proposals. The Committee would, therefore, have the opportunity to set up a working group (with membership and terms of reference set by the Committee in the same way as it would for a working group carrying out a topic review) to consider the intended proposal and prepare a response for agreement by the Committee.

3.3. Responsibility for organising and undertaking public consultation on significant change proposals rests with the NHS body putting forward the proposal. Once Patients' Forums are established, it would be anticipated that they may play a part in advising and assisting the Trust on arrangements. The Health Review Committee would put forward views on behalf of the community of Hampshire. Depending on the scale, significance and community impact of the proposal, that response may be given following consideration at a Committee meeting or by officers following consultation with the Chairman, and comments reported to the next meeting of the Committee.

3.4. The NHS body will take account of all representations received and decide whether, and how, to proceed. The Health Review Committee has then to conclude whether, before making that decision, the Trust has undertaken adequate consultation and taken sufficient and proper account of views expressed by the community and that the change is in the interests of the health service in the County Council's area.

Recommendations

1. That the committee agrees arrangements set out in section 3 of this report to enable it to respond to NHS bodies considering and making proposals for substantial development of or a variation in health services in Hampshire.

2. That Community Health Councils be thanked for the assistance they have offered to effect interim arrangements.

3. That the Committee records and welcomes the offer of the Assistant Chief Executive of the Hampshire and Isle of Wight Health Authority to give regular overviews of issues being faced by the NHS in Hampshire as a way to early identification of possible proposals enabling appropriate Member arrangements to be considered.

Section 100 D - Local Government Act 1972 - background papers

The following documents disclose facts or matters on which this report, or an important part of it, is based and has been relied upon to a material extent in the preparation of this report.

NB the list excludes:

1. Published works

2. Documents which disclose exempt or confidential information as defined in the Act.

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