Minutes:
The Chair
invited the Democratic Services Officer to provide their update to members
regarding the Health and Care Bill and its implications for Health Scrutiny.
The Panel was
advised that a recent meeting of the National Scrutiny Officer Network a
discussion about the Health and Care Bill took place. It was understood there
would be reconfiguration for scrutiny. For example, currently any significant
alterations to health service provision required consultation with Health
Scrutiny. Should Health Scrutiny be unhappy with this change it had the power
to make a referral to the Secretary of State. This power was not used regularly
and only rarely in Middlesbrough.
However, the
changes proposed in the Bill meant this power would no longer exist in its
current format. Instead, it was proposed the Secretary of State will call the
decision in rather than Health Scrutiny. As such the department for health and
social care advised guidance would be issued to clarify this position.
A draft
scrutiny principle document had also been produced that aimed to reinforce the
importance of health scrutiny, and their envisaged role, during the transition
to Integrated Care Systems.
The Health
and Care Bill would be phased in, but would not commence at the same time as
the Integrated Care Systems, which were intended to be active in April 2022 but
have been delayed until July 2022. The power to refer issues to the Secretary
of State would likely take place approximately a year after Integrated Care
Systems were implemented.
One of the
main objectives within the Scrutiny Principles guidance document was leaders
from the health and social care sector should work cooperatively and with
openness and transparency. By doing this it was intended the importance of
health scrutiny’s role in improve patient outcomes would be reinforced. It was
intended that the Scrutiny Principles guidance document would be published in
the summer.
Some of the
main principles that were outlined in the document was that scrutiny should be
outcome focused with a strategic approach considering how scrutiny should be
best applied. The document also detailed how an inclusive approach should be
adopted which would enable Integrated Care Systems to add richness to their
understanding of local need.
Several
comments were made to the department of health and social care regarding the
scrutiny principles document. These included practical examples of what good
practice should look like and that the language used in the Principles document
should be fully understood by all stakeholders. Some participants at the
meeting felt there needed to be greater clarification on the role of health and
well-being boards within the new system.
The Panel
were shown a diagram of how the Integrated Care System would operate that had
been produced by the King’s Fund.
A member
raised a concern that many people who did not work in, or understand the
mechanics of the health system, would be confused by the proposals detailed in
the presentation. It was commented that this could lead to reduced transparency
and a potential lack of accountability.
The
Director of Commissioning Strategy and Delivery for the Tees Valley Clinical
Commissioning Group advised members that while the changes described were
significant, they were not occurring in the delivery arm of the health service,
where most people interacted with the NHS. Instead, the changes described
concerned the governance arrangements of the NHS. It was also commented that
the Tees Valley CCG had always had a strong and productive relationship with
Health Scrutiny and this would continue in the future.
The
Democratic Services Officer commented that the NHS had always been a complex
organization and scrutiny’s involvement in holding it to account had never been
easily explainable.
A member
commented that while they recognized the complexity of situation it was
nevertheless important that health scrutiny panels had a clear understanding of
their powers in light of the Health and Care Bill.
The Chair
thanked the Democratic Services Officer for their update.
NOTED