Archived decisions
Item 6
MEETING: HAMPSHIRE, SOUTHAMPTON, PORTSMOUTH AND ISLE OF WIGHT HEALTH SCRUTINY JOINT COMMITTEE
DATE: 19 MARCH 2007
SUBJECT: ESTABLISHING LOCAL INFORMATION NETWORKS (LINks)
AUTHOR: DAVE SHIELDS
1. Proposals for Local Involvement Networks (LINks) are set out in the Local Government and Public Involvement in Health Bill and it is anticipated that these will replace the former Patient & Public Involvement Forums. They will form part of move towards greater transparency and integration of health and social care services. There is also an increased focus on wellbeing in Local Area Agreements (LAAs).
2. LINks will be able to refer health and social care matters affecting their area to overview and scrutiny committees. The Bill will allow for external scrutiny of council social care services by patients and the public (via LINks) for the first time. The scope of scrutiny is explicitly extended to cover the activities of partners contributing to the development or delivery of Local Area Agreements and scrutiny committees will be given powers to require evidence from such partners and to respond to scrutiny recommendations.
3. The DoH proposes to publish a model specification for LINks for council procurement officers and this will involve identification of organisations to host the LINks service.
4. Host organisations and LINks will be independent of councils and health bodies. They will be locally-focused and locally-derived bodies, without prescribed structures, and they will have the potential to provide the best avenue for local people's involvement at all stages of the commissioning cycle - strategic needs assessment, service planning, contracting and monitoring. Powers to visit premises and ask for information will also support local people's input to the regulatory process.
5. Councils are increasingly devolving service provision externally, e.g. to voluntary and community organisations through `compacts', and it will be important to release the potential of these organisations to develop social enterprises and build social capital. It will be important to avoid any blurring of roles between providers, the LINk host or LINk members within any single organisation in order to inspire community confidence in these new structures.
6. The Bill also seeks to strengthen the provisions of section 11 of the Health and Social Care Act 2001 (as amended) by placing a new duty on NHS bodies to consult service users (or their representatives) about proposals that would have a substantial impact on the manner in which services are delivered or the range of health services available as experienced by the user. Primary Care Trusts will now be required to give information on consultations it has carried out before making commissioning decisions and how influential the results of the consultation were on those decisions.
7. Greater responsiveness to local people is designed to give people power to drive service improvement and value for money and to hold all local public service leaders to account for their performance. The creation and fostering of active citizens' groups, voluntary and community organisations, and social enterprises are key to improving services, reducing health inequalities and building strong communities. Local councils are well placed to promote community development models where participatory democracy is not seen as a threat to or substitute for, but a vital component of representative democracy.
8. Currently £28m is spent by the DoH on the Commission for Patient and Public Involvement in Health (CPPIH), forum support organisations and Patients' Forums. Although LINks will be fewer in number than Patients' Forums it is possible that the wider remit of LINks and the need reach out to the full diversity of communities will increase costs, However the amount of money to be provided to councils to carry out this new duty has yet to be confirmed.
Local Involvement Networks (LINKs)
What are they?
LINKs are networks which will be established to facilitate greater community engagement in Health and Social Care services. The LINKs will replace existing Patient Public Involvement (PPI) forums following the recent Local Government and Public Involvement in Health Bill. Legislation to dissolve the PPI forums and allow for LINKs to be established will be passed in 2007 with the likely timescale for LINKs to be active from early 2008.
The fact that LINKs are a network rather than a forum is mentioned a lot by the DoH as an important change in these bodies. LINKs are very much seen to be a mechanism to engage more widely with an entire geographic community unlike PPI forums which had a limited engagement dimension. The exact way in which the LINKs are to be constituted has been left open for local determination as long as the LINKs meet the criteria set out in part 11 of the bill. They will be assessed on this in their annual report and through inspection by the Audit Commission.
What will they do?
As set out in Part 11 153 (1) of the Bill, each local authority must arrange for means to carry out the following activities -
153 (2)
(a) Promoting and supporting, the involvement of people in the commissioning, provision and scrutiny of local care services*;
(b) Obtaining the views of people about their needs for, and their experiences of, local cares services; and
(c) Making -
(i)Views such as are mentioned in paragraph (b) known, and
(ii)Reports and recommendations about how local care services might be improved
To persons responsible for commissioning, providing, managing or scrutinising local care services.
(* In this section of the Bill, care services means services provided as part of the health service in England or services provided as part of the social services functions of a local authority. Local care services in relation to a local authority means -
(a) care services provided in the authority's area; and
(b) care services provided in any place for people from the area)
Section 154 of the Bill sets out the criteria for how the local authority ("A") will arrange to undertake the activities specified under section 153 (2).
154 (2) In this section, a reference to a `local involvement network' is to -
(a) a person who, in pursuance of the arrangements, is to carry on in A's area activities specified in section 153 (2) for that area: or
(b) any other means put in place under the arrangements for the carrying on in A's area of activities so specified for that area.
As set out in the bill, the following bodies cannot be a LINK in any given area:
The host organisation
Any local authority in that area
A National Health Service trust
An NHS foundation trust
A Primary Care Trust
A Strategic Health Authority
`What will LINKS do?
Their function will be:
· Promoting and supporting the involvement of local groups and individuals from across the community to influence the commissioning, provision and scrutiny of health and social care services;
· Obtaining the views of local groups and individuals about their health and social care needs;
· Gathering the views of local groups and individuals about their experiences of health and social care services;
· Conveying these views to organisations responsible for commissioning, providing, managing and scrutinising health and social care services;
· Enabling local groups and individuals to share their skills and experience in order to influence the development and improvement of local health services;
· Supporting people within the community to make their voices heard, including people who find it hard to participate in traditional ways or do not choose to;
· Supporting the commissioners and providers of health and social care services to engage with the local community, and in particular those groups and individuals who find the services they need difficult to access;
· Act as a hub within a network of user-led and community based groups in the area covered by the host local authority, providing a channel of views and information between these groups and the local health and social care organisations;
· LINKs will set their own agenda and focus on issues of concern to local people and seek to influence change; and,
· LINKs will be required to report on their activities and expenditure to the public, to health and social care bodies, the relevant local authority, the Secretary of State for Health, and other interested organisations
Taken from the Government response to `A stronger local voice' Dec 2006, p. 37
Powers of inspection - LINKs will have power to inspect NHS sites but it is expected that only a small group of members from each LINK will have that power of inspection.
Reporting mechanisms - LINKs need to produce an annual report each year setting out how they have achieved the activities set out in the Bill.
How will they be set up?
The host organisation - Local Authorities have a duty to commission a host organisation to start up the LINK in their area. The budget will be held by the host organisation for the LINK and the annual report that the LINK produces will need to set out how the LINK has achieved the criteria specified in the bill.
Membership organisation - The LINK will be a membership organisation formed from anyone who is interested in joining over the age of 18.
Local flexibility in how LINKs are to be developed - The exact criteria about how LINKs will be constituted has been left fairly loosely defined by the Secretary for State and according to the Democratic Health Network, this has been done deliberately to enable local LINKs to form in ways appropriate to their area.
Timescale for establishing LINKs - Current DoH timescales seem to suggest that Local Authorities should be setting up their broker agency to establish the LINK in late 2007 with LINKs starting to get underway in early 2008.
What might LINKs look like? - There has been some suggestion that LINKs could be a virtual network or they may contain a physical base e.g. in a shop. LINKs will cover the local authority area of the Authority responsible for Social Care provision so Counties and Unitaries will have LINKs.
The `early adopter' areas - There will be early pilot LINKs launched soon and these will be presented as good practice for other areas to follow. The pilots will be in the following areas:
South Dorset
Medway
London Borough of Kensington and Chelsea
Hertfordshire
Manchester
Doncaster
County Durham