Archived decisions

                    Item 8

Health Overview and Scrutiny Committee

`A Stronger Local Voice; A framework for creating a stronger local voice in the development of health and social care. A document for information and comment.'

Briefing Note for Members: 24 July 2006

Changes to current arrangements

    · The Commission for Patient & Public Involvement in Health, and Patient Forums will be abolished

    · Local Involvement networks (LINks) will be set up in the place of the Forums, covering an area rather than being tied to a specific organisation

    · HOSCs will continue to scrutinise matters relating to health services but will be encouraged to focus on commissioning that reflects public priorities in communities

    · Section 11 will be strengthened to be more explicit and include a new duty to respond

    · The arrangements for the NHS complaints service will continue

    · No changes will be made to Patient Advice and Liaison Services

Principles underpinning the new arrangements

    · There is a need for more meaningful engagement by the NHS in planning service change

    · The NHS and social care colleagues need to be more effective and systematic in finding out what people want and need from services. Hard to reach groups need to be more fully involved

    · Four principles will underpin the new arrangements

      1. independence

      2. engagement

      3. accountability

      4. transparency

    · The LINks will be independent of commissioners and providers so that they can act in the interest of the local community

Arrangements for supporting LINks

    · Each Local Authority (LA) with social service responsibilities will be appropriately funded to carry out a new statutory duty to make arrangements for the establishment of a LINk in its area

    · These LINks will provide a flexible way for people and communities to engage with health and social care organisations and hold those commissioning and providing health and care services to account.

    · They will gather information about what people need from health and health services and their experiences of using these services. This will be analysed and passed on as the LINks sees fit, with any recommendations.

    · They will be a means through which commissioners, HOSCs and regulators access the views of the local population.

    · The LINk will set its own agenda within a statutory framework and will promote (not replace) wider involvement

    · It will have a specific relationship with the HOSC and the information it gather will help the HOSC carry out its duties

    · It will want to build an effective working relationship with the LPP

    · Membership will be drawn from user groups, local voluntary and community sector organisations and interested individuals.

    · Responsibility fro setting up and managing the LINks will be local as will decisions about how members are appointed

    · Hosting arrangements for the LINks need to be agreed locally, possibly in consultation with other stakeholders. A model contract will be provided to assist LAs in this process.

HOSCs and commissioning

    · HOSCs will continue to scrutinise local health & social care organisations

    · Whilst the will be emphasis on the role of commissioners, the HOSC role will not be limited to this area

    · Their contribution in terms of delivery of section 11 will be key

    · HOSCs will have a strong relationship with the LINks, which will be able to refer matters to the HOSC and receive a satisfactory response

National Networks

    · A single network will be established nationally to fed patients and user views into policy development

    · Additionally the national regulators will increase user involvement in the assessment of organisation performance and develop criteria for assessing the extent to which these organisations engage with uses and communities.

Discussion Points (NB comments are invited for 7 September)

    · The document talks about health and social care but does not acknowledge the fact that s11 does not currently apply to LA service provision

    · There is ambiguity about the extent to which LINks will gather their own intelligence or make sure health and social care do this in their own right

    · There is no recognition of the skills it takes to secure meaningful feedback from different communities and process this to provide meaningful information or evidence for action

    · Priorities around communities have already been set by LAAs & LSPs, LINks should not either duplicate this process, or undermine effective work that has already taken place in communities.

    · There are potential opportunities to move this forward locally by bringing the Hats and LINk role together, this will require some fairly immediate discussions with Members and lead officers.

    · Other areas of overlap to avoid include the work around community engagement that we and the districts are already doing.

    · HOSCs are already holding the NHS to account for decisions that affect local people. The role of LINks needs to be clear to ensure that they do not duplicate this. There is no understanding that HOSCs also look at the quality of service provision as well as commissioning issues

    · There is no reciprocal arrangement to allow the HOSC to refer issues of concern to the LINk

    · There is no acknowledgement that LAs cover wide area- a LINk for Hampshire for example would not achieve what is envisaged

    · It is not clear if the costs to LAs of running the LINk will be met- or if the funding will be ring fenced to go entirely to the LINk

    · The right to visit NHS premises has been removed

    · The membership broadly reflects that of the old CHCs, how will the problems of single issue or political interests be managed (an original reason for removing CHCs).

    · How will the LINk be held to account for its performance and issues to do with delivery of statutory requirements. Complaints and codes of conduct also need to be considered