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1. Summary and purpose of report

1.1. Members will be aware that late on Tuesday, 20 May the Department of Health finally published on the internet the long awaited guidance on local authorities' scrutiny of health. A printed copy is attached to this report.

1.2. The purpose of this report is to summarise some key points and assess whether arrangements made by the Committee conform with the Guidance.

2. Key points from the Guidance

· Focus should be on health improvement in the widest sense, not just scrutiny of NHS services

· Scrutiny is not the only (or even the main) form of engagement between local authorities and local NHS bodies

· There are powers for all local authorities to scrutinise issues affecting the health of their area but social services authorities have the extra power to require information and attendance of NHS officers

· Scrutiny will include action and decisions of the executives of local authorities as well as NHS bodies

· Patient and Public Involvement Forums (PPIFs) have the power to refer issues to local authority health scrutiny committees

· Reports should be from the scrutiny committee, not the Executive or full Council

· Non-voting Members representative of key stakeholders may be co-opted onto scrutiny committees but this is not the only means of involving stakeholders in reviews: non-executive District Councillors may be co-opted as full Members of the scrutiny committee

· County Councils should work closely with district councils: scrutiny powers may be delegated to them

· A joint scrutiny committee can be set up to undertake the functions which the appointing authorities give to it (e.g. a specific review)

3. Compliance of our arrangements with Guidance

3.1. There has been little time to assess completely the implications of the Guidance for the arrangements which the Committee has put in place. This section sets out a few significant points: the arrangements already made (and recommended to this meeting of the Committee) comply with advice in the Guidance.

3.2. Conflict of interest: Paragraph 1.9 states "Committees must take steps to avoid any conflict of interest arising from members' involvement in the bodies or decisions that they are scrutinising. Conflicts of interest may arise if scrutinising councillors are:

· an employee of an NHS body, or

· a non-executive director of an NHS body, or

· an executive member of another local organisation commissioned by an NHS body to provide goods or services.

These councillors are not excluded from membership of overview and scrutiny committees, but they must follow the local authority protocols regarding participation where there is a risk of conflict of interest. Where such a risk is identified, they should consult their monitoring officer for advice on their involvement."

3.3. Scrutiny plans: Paragraph 4.6.1 sets out the recommendation that there should be an annual scrutiny plan, discussed and shared with partner organisations, which identifies priority issues for review and builds in capacity for making response to NHS bodies on service reconfigurations and issues raised by Patient and Public Involvement Forums. Paragraph 4.6.2 goes on to set criteria for assessing priority. The consultation paper published last October sought views on the Committee's `priority reviews': it therefore complies with the recommendation that there should be a statement of priority for the coming year. The Committee will need to establish a programme or `scrutiny plan' later this year for 2004. The criteria agreed at the last meeting conform with the advice about criteria for setting priorities.

3.4. Approaches to reviews: the Guidance recognises that reviews may be reactive or proactive and may focus on a particular NHS Trust/PCT or be thematic, impacting on many organisations, both NHS and in other sectors. It suggests both working groups and formal `select committee' type hearings. This Committee has made arrangements which comply with all these suggested approaches.

3.5. Working with NHS bodies: the Guidance includes proposals about working with NHS bodies to determine the programme of reviews and to plan work on individual reviews. Proposals considered elsewhere on this agenda for protocols guiding the arrangements at formal `select committee' type sessions of this Committee comply with requirements in the Guidance for adequate notice to NHS bodies of issues for consideration at such sessions and for sufficient notice.

3.6. `Substantial variation and substantial development': neither Regulations nor Guidance define `substantial'. There is advice in the Guidance (section 10.6) which the Committee should take into account in discussions with NHS bodies about changes to health services.

3.7. Relationship to partnership working and local strategic partnerships (LSPs): the Guidance refers to the important links between local authorities and local NHS bodies. In Hampshire, District Councils are developing close arrangements with respective PCTs, often focussed on issues around improving the health of local communities. The County Council works in close partnership with PCTs in delivering health and social care services. The Guidance (paragraph 5.5.6) refers to the complementary roles of local community strategies and LSPs and health scrutiny work.

Recommendation

That the Committee notes publication of the Guidance, and that the arrangements made by the Committee conform with advice set out in the Guidance.