Denise Holden: ext 7338

e-mail: [email protected]

1. Summary and Purpose

1.1. The government has issued directions to Local Authorities with health overview and scrutiny powers. These require that a joint committee with delegated powers is established to consider any proposal from the NHS for a substantial variation or development in the delivery of services that are provided across more than one overview and scrutiny committee area. This requirement is additional to the option for Local Authorities to establish joint committees to consider wider scrutiny issues that may be of interest.

1.2. This paper therefore:

_ sets out the protocol for joint working between Overview and Scrutiny Committees (OSCs) in Hampshire and the Isle of Wight, drawing on the Department of Health Guidance.

_ proposes arrangements for enabling Hampshire County Council to delegate health scrutiny powers as required by the Directions in order to respond to consultation by an NHS body (as set out in Local Authority (Overview and Scrutiny Committees Health Scrutiny Functions) Regulations 2002,
regulation 4).

1.3. The arrangements proposed will enable the Health Review Committee to respond flexibly and promptly to any proposal from an NHS body to substantially vary or develop services that extend beyond the area covered by the County Council.

1.4. The Directions relate solely to the discharge of health scrutiny responsibilities and do not extend to any response that Hampshire County Council make wish to make on behalf of Executive members.

2. Joint Committees

2.1. The Department of Health Guidance provides for significant flexibility in how an OSC discharges its responsibilities. Although the legislation for overview and scrutiny of health relates to the health services in the area of an OSCs local authority, Section 12 identifies the circumstances where arrangements can be made for a joint committee to scrutinise health services that cross more than one local authority boundary and section 8 sets out arrangements for establishing a joint committee.

2.2. As a joint committee is only able to undertake the functions which the appointing authorities allocate to it there needs to be clarity about its roles and responsibilities and the terms of reference that will apply to its work. This point applies whether the joint committee is convened to consider a proposal to substantially develop or vary NHS services or established to undertake a broader scrutiny function.

2.3. Where a Local Authority determines that it is appropriate to delegate health scrutiny powers to a joint committee, the full powers of the overview and scrutiny of health services are given to the delegated committee, but only in relation to that particular exercise or consultation.

3. Consultation of Local Authority Overview and Scrutiny Committees by NHS bodies

3.1. The directions issued by the Secretary of State in July 2003 require that `where a local NHS body consults more than one overview and scrutiny committee pursuant to regulation 4 of the Regulations on any proposal it has under consideration for a substantial development of the health service or a substantial variation in the provision of such service, the local authorities of those overview and scrutiny committees shall appoint a joint overview and scrutiny committee for the purposes of the consultation and only that joint overview and scrutiny committee may:

a) make comments on the proposal consulted on to the local NHS body under regulation 4(4) of the Regulations;

b) require the local NHS body to provide information about the proposal under regulation 5 of the Regulations; or

c) require an officer of the local NHS body to attend before it under regulation 6 of the Regulations to answer such questions as appear to it to be necessary for the discharge of its functions in connection with the consultation.'

3.2. This means that only the joint committee may comment to the NHS body on the proposals put forward. The Guidance clearly states that any joint committee established under these directions should aim to consider the proposal from the perspectives of all those affected by that proposal when formulating a response.

3.3. Any report or recommendations made by the joint committee should be responded to by the relevant NHS organisation. On receipt of the NHS body's response the joint committee may refer the matter to the Secretary of State if it is not satisfied

_ With the content of the of the consultation or that sufficient time has been allowed

_ That the reasons for not carrying out the consultation were adequate

3.4. The option remains for any of the OSCs originally consulted to refer the matter to the Secretary of State if it is considered that the proposal is not in the interests of the health service in its area. This power should however only be exercised once the joint committee has received a response from the NHS.

4. Action required

4.1. The Committee has already indicated its intention to work collaboratively with other overview and scrutiny committees that may be involved in considering proposals for substantial variation to health services provided to its population.

4.2. A protocol to support joint working across Hampshire and the Isle of Wight OSCs has been drafted to promote information sharing and improve understanding of issues affecting the health of local people. This is attached at Appendix One and includes provision for the appointment of five members from Hampshire County Council Health Review Committee.

4.3. NHS organisations have been advised of the need to alert the Committee to any formal consultations that may be pending in order to enable the Committee to consider how best to discharge its responsibilities. This prior notice is more pressing where there is a need for a joint committee to be established and appropriate arrangements for delegating authority to a joint committee need to be in place.

4.4. Hampshire County Council now needs to establish a mechanism to enable the delegation of scrutiny powers to a joint committee as required by the directions. This should be flexible enough to accommodate the increasingly complex arrangements for NHS provision in Hampshire and the wide range of health issues which may be referred for formal consultation.

4.5. It is therefore recommended that arrangements are put in place to amend the Constitution to authorise the Health Review Committee to delegate the health scrutiny function to a joint committee where there is an intention on the part of a local NHS organisation to consult on a substantial variation or development to health services that extends beyond the area covered by the Committee.

4.6. If the timescales are such that it is not possible for the this decision to be taken by the Committee then the Chief Executive, in consultation with the Chairman of the Health Review Committee, should be able to agree to the formation of such a joint committee, its membership and terms of reference, subject to the details subsequently being endorsed by the Health Review Committee.

4.7. The delegation of the health scrutiny function would be limited to the specific proposal to be consulted on and clear terms of reference would be agreed to guide the work of the joint committee. Regular reports and up-dates will be provided to the Chief Executive and the Health Review Committee by members or officers appointed to a joint committee so convened.

5. Principles and Conclusions

5.1 When responding to proposals from an NHS body to substantially vary or develop health services that extend beyond the boundaries of Hampshire County Council the following arrangements will apply:

· A joint committee will be established in accordance with the attached protocol when all member authorities are affected by the proposal.

· In all other cases a joint committee would be established to respond to a specific proposal from an NHS body. The membership of that joint committee will be agreed by the Local Authorities affected and convened solely for the consideration of, and agreeing a response to, that specific proposal.

.

Recommendations

Health Review Committee

1. The Committee endorses the joint working arrangements for Overview and Scrutiny Committees in Hampshire and Isle of Wight as set out in the protocol attached at Appendix One.

2. The Chief Executive be authorised to agree any changes to the protocol in consultation with the Chairman of the Health Review Committee.

3. The Committee formally appoints five members to the Hampshire and Isle of Wight joint committee, one of whom should be one of the district councillors appointed to the Committee.

4. The Committee recommends to the Standards Committee that:

_ the Health Review Committee is authorised to delegate health scrutiny powers to a joint committee and appoint members when there is an intention by an NHS body to consult on a substantial variation or development to health services that extend beyond the area covered by Hampshire County Council Health Review Committee and that Part 2, chapter 1, paragraph 1.3 of the Constitution be amended accordingly

_ the Chief Executive in consultation with the Chairman of the Health Review Committee may agree to the formation of such a committee, its membership and terms of reference if there is insufficient time for that decision to be taken by the Health Review Committee subject to the details being submitted for approval to the next meeting of the Health Review Committee

5. That any joint committee so convened will work to a specific proposal and with clear terms of reference. These will be restricted to consideration of and agreeing a response to, the proposal on which the Committee has been consulted.

6. Regular reports would be provided to the Committee and the Chief Executive of the progress made by any joint committee so convened

7. The Strategic Health Authority, NHS Trusts and PCTs providing health services to people living in the area of the Committee are advised of the Committee's decision and the need to alert the Committee to any proposals that may be considered a substantial variation or development at the earliest possible opportunity

Standards Committee

1. The Standards Committee, recommend to the Council, that Part 2, Chapter 1, paragraph 1.3 of the Constitution be amended to enable

_ the Health Review Committee to delegate health scrutiny powers to a joint committee and appoint members when there is an intention by an NHS body to consult on a substantial variation or development to health services that extend beyond the area covered by Hampshire County Council

_ the Chief Executive in consultation with the Chairman of the Health Review Committee may agree to the formation of such a committee, its membership and terms of reference if there is insufficient time for that decision to be taken by the Health Review Committee subject to the details being submitted for approval to the next meeting of the Health Review Committee

2. That any joint committee so convened will work to a specific proposal and with clear terms of reference. These will be restricted to consideration of and agreeing a response to, the proposal on which the Committee has been consulted.

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.

File Location

None

Appendix 1

HAMPSHIRE, SOUTHAMPTON, PORTSMOUTH AND ISLE OF WIGHT HEALTH SCRUTINY JOINT COMMITTEE PROTOCOL

1. Membership

(1) The Joint Committee shall be made up of 11 members comprising of :-

(1) 5 elected representatives from Hampshire County Council to include one District Councillor co-opted to that Authority's overview and scrutiny Committee dealing with Health;

(2) 2 elected representatives from Southampton City Council;

(3) 2 elected representatives from Portsmouth City Council;

(4) 2 elected representatives from Isle of Wight Council.

The appointment of such representatives shall be solely at the discretion of each Authority who shall also waive the requirements for the Joint Committee to be based upon political proportionality.

2. Role and Function of the Joint Committee

(1) To facilitate the exchange of information about planned health scrutiny work by each member authority and to share information and outcomes from local health scrutiny reviews.

(2) To undertake scrutiny reviews of regional health services where all member authorities are affected.

(3) To review regional or specialist services that impact on residents of the member authorities.

(4) To review health services provided for residents of member authorities outside the area covered.

(5) To work in partnership with other relevant organisations to improve the delivery of health services , improvement in the health of residents and to tackle health inequalities.

(6) The Joint Committee will not discuss individual complaints about health service provision but may scrutinise trends in complaints where these are believed to be a cause for concern.

3. Substantial Variations and Developments

A substantial variation or development is where any proposal by a NHS Body impacts on more than one of the constituent authorities area and relate to any amendment to health service delivery involving :-

(1) additional expenditure or a reduction in expenditure exceeding £250,000 in any one year on any individual element or function to which that decision relates; or

(2) if it is significant in terms of any individual service element provided for the patients, carers and public who use or have potential use of any service; or

(3) impacts on a vulnerable section of the community without adequate measures taken to assist with accessing alternative provision.

4. Co-optees

The Joint Committee shall be entitled to co-opt any non voting person as it thinks fit appropriate to assist in its debate on any relevant topic.

5. Meetings of the Joint Committee

The Joint Committee shall meet on a quarterly basis. In addition, extraordinary meetings may be called from time to time as and when appropriate. A meeting may be called by the Chairman of the Joint Committee, if he/she considers it necessary or appropriate after receiving advice from relevant officers.

Meetings shall be held at appropriate venues in the areas of the member authorities on a rotational basis.

Meetings shall be open to the public and press in accordance with the Access to Information requirements.

6. Quorum

The quorum for the Joint Committee shall be 6 voting members (This ensures that there will always be a minimum of two authorities represented).

7. Chairman and Vice Chairman

The Chairman and Vice Chairman of the Joint Committee shall be appointed by the Joint Committee at its initial meeting and then on an annual basis thereafter.

If the Chairman and Vice Chairman is not present, the remaining members of the Joint Committee shall elect a Chairman for that meeting.

8. Deputies

An Authority may appoint a named deputy to attend in the place of the named



member on the Joint Committee provided that the relevant officer is notified prior to the commencement of the meeting.

9. Agenda items

Any member of the Joint Committee shall be entitled to give notice to the relevant Officer that he/she wishes an item relevant to the functions of the Joint Committee to be included on the agenda for the next available meeting. On receipt of such a request the relevant Officer will ensure that it is included on the next available agenda.

10. Notice and Summons to Meetings

The relevant Officer will give notice to all members of meetings. At least 10 working days before a meeting the relevant officer will send a summons to every member specifying the date, time and place of each meeting and specify the business to be transacted, and will be accompanied by such reports as are available.

11. Reports from the Joint Committee

Once it has formed recommendations the Joint Committee will prepare a formal report and submit it to the Department of Health for consideration.

If consensus is not reached within the Joint Committee a minority report can be produced, on an alternative view to the majority of the Joint Committee, where a minimum of 4 voting members request this after the item has been debated.

12. Rights of Joint Committee members to documents

In addition to their rights as Councillors, members of the Joint Committee have the additional right to documents, and to notice of meetings.

13. Officers of Health Authorities attending meetings

(1) The Joint Committee may scrutinise and review decisions made or actions taken in connection with the discharge of Health functions falling within its remit. As well as reviewing documentation, in fulfilling the scrutiny role, it may require any officer of the relevant Health Authority to attend before it to explain in relation to matters within their remit :

(1) any particular decision or series of decisions;

(2) the extent to which the actions taken affect Council's policy; and/or

(3) their performance.

and it is the duty of those persons to attend if so required.

(2) Where any officer is required to attend a Joint Committee under this provision, the Chairman of that Joint Committee will inform the relevant Officer. The relevant Officer shall inform the officer in writing giving at least 10 working days notice of the meeting at which he/she is required to attend. The notice will state the nature of the item on which he/she is required to attend to give account and whether any papers are required to be produced for the Joint Committee. Where the account to be given to the Joint Committee will require the production of a report, then the officer concerned will be given 10 working days to allow for preparation of that documentation.

(3) Where, in exceptional circumstances, the officer is unable to attend on the required date, then the Joint Committee shall in consultation with the officer arrange an alternative date for attendance.

14. Attendance by others

The Joint Committee may invite people other than those people referred to in paragraph 1 above to address it, discuss issues of local concern and/or answer questions. It may for example wish to hear from residents, stakeholders and members and officers in other parts of the public sector and shall invite such people to attend.

The Joint Committee shall permit a representative of any other authority or organisation to attend meetings as an observer.

15. Procedure at Joint Committee meetings

(1) The Joint Committee shall consider the following business :

(1) minutes of the last meeting;

(2) declarations of interest;

(3) any urgent item of business which is not included on an agenda but the Chairman, after consultation with the relevant officer, agrees should be raised;

(4) the business otherwise set out on the agenda for the meeting;

(2) Where the Select Committee conducts investigations (eg with a view to policy development), the committee may also ask people to attend to give evidence at committee meetings which are to be conducted in accordance with the following principles:

(1) that the investigation be conducted fairly and all members of the committee be given the opportunity to ask questions of attendees, and to contribute and speak;

(2) that those assisting the committee by giving evidence be treated with respect and courtesy; and

(3) that the investigation be conducted so as to maximise the efficiency of the investigation or analysis.

(3) Following any investigation or review, the Committee shall prepare a report, for submission to the Department of Health and/or Council as appropriate and shall make its report and findings public.

16. Administration of the Joint Committee

Hampshire County Council will provide the lead administrative support to the Joint Committee. The costs associated with this shall be shared on an equal basis amongst the member authorities.

17. Voting

Any matter will be decided by a simple majority of those members voting and present in the room at the time the motion was put. This will be by a show of hands, or if no dissent, by the affirmation of the meeting.

If there are equal votes for and against, the Chairman will have a second or casting vote. There will be no restriction on how the Chairman chooses to exercise a casting vote.

18. Public and Press

All meetings of the Joint Committee shall be open to the public and press unless an appropriate resolution is passed in accordance with the provisions of Schedule 12A of the Local Government Act or Schedule 1 of the Health and Social Care Act 2001.

All agendas and papers considered by the Joint Committee shall be made available for inspection at all the constituent authorities offices, libraries and web sites.

19. Code of Conduct

Members of the Joint Committee must comply with the Code of Conduct applicable to Councillors under the Local Government Act 2000.