Agenda item

11:20

System leaders will provide a response to questions raised at the last meeting in relation to the Health & Wellbeing Board’s membership and its Integrated System Delivery Board (ISDB). The draft HWB Strategy is also attached for feedback (JHO8)

Prior to consideration of this item the Committee was addressed by Councillor Cathy Augustine. She thanked the Committee for challenging the lack of transparency and accountability of the Integrated Systems Delivery Board (ISDB), with some success. In terms of the Health & Wellbeing (HWB) Strategy, however, it was her view that consultation had been poorly publicised, causing participation to be low. She asked how input to the online survey was being encouraged and how could Didcot residents participate? Who has been invited to the stakeholder meeting on 28 February and could the list be shared?

Councillor Jane Hanna requested that the Committee take a further look at what was constitutionally commercial. It was her view that all was of a confidential nature, which was not in keeping with the openness and transparency which local government endeavoured to capture. She also spoke about the need for contingency planning in the face of Brexit and the possibility of losing care workers.

The Chairman welcomed Councillor Ian Hudspeth and Kate Terroni, OCC; Catherine Mountford and Dr Kiren Collison, OCCG, up to the table. He clarified that the Committee was interested in two particular areas,namely, the question of how many elected members were on the Health & Wellbeing Board and the openness of the ISDB.

Councillor Hudspeth stated that the consultation in relation to the Board’s membership began in November 2017. All were given the opportunity to put forward their views including the voluntary organisations of which there are 200 within the county, and providers also. It was felt that, in light of the new Long-Term Plan, the NHS needed to be in a position to influence local solutions. It was now felt that the Board had the appropriate balance of county/district councillors, NHS and OCC Chief Executives and the statutory representatives (eg. Directors of Adult Social Care, Public Health, Children’s Services, Chief Officer and Clinical Chair of CCG, Chair of Healthwatch Oxfordshire, etc).

Catherine Mountford reported that a paper would be taken to the 14 March Health & Wellbeing Board on the use of different approaches to engage public and wider stakeholders, particularly in relation to the HWB Strategy. Healthwatch had agreed to provide the support for the development of a Stakeholder Reference Group, using people previously involved in the preparation of the HWB Strategy and then widening it to include the social media and online tools etc.

Kate Terroni stated that following the last system review on 20 November 2017, consideration was given to where the’ engine’  to deliver the work of the HWB was to come from. The recent CQC inspection had then given the impetus to go ahead with this in the form of the Integrated Strategic Delivery Board (ISDB). She pointed out that this is not a decision - making group, nor is it in a position of authority. Its views are fed into the HWB, or the respective organisations such as the Cabinet or a Trust Board(s) for those to decide the way forward. She added that in light of the concerns expressed about its transparency it had been decided to make available each month, a list of the discussions which the Board had been engaged in, if the Committee should wish it.

Questions from members of the Committee and responses received, were as follows:

-       The voluntary sector comprised of many organisations which varied in size. Some were large providers of health care, some not. The very large providers were not actively involved in decision making in the same way as the Trusts. If the ISDB was to meet every 6 months, the voluntary organisations would have already met to consider their views. Therefore, what could they offer? Councillor Hudspeth responded that however large or small/local/national they were, it was all about trying to reach a compromise. The paper outlined the outcomes of the conversation which had taken place with them. Catherine Mountford pointed out that discussions had taken place with Healthwatch Oxfordshire about how it would apply different means of gaining opinion for different issues, as part of the Stakeholder Reference Group. The Group could also meet at different times with different groups, depending on the issue;

-       With regard to questions concerning the ‘top heavy’ membership of officers in relation to elected members on the HWB, Councillor Hudspeth compared the Board to that of the Growth Board which had grown organically from 2009. The key issue of difference was that the Growth Board comprised all elected members and the HWB did not. The HWB was set up as a statutory body with membership from key leading officers. He added, however, that the officers sitting on the Board would be fully aware of the views of the Council and would be representing members’ views, thus giving a balance. He added that it was originally felt that the Board was too OCC ‘top heavy’ and this was an opportunity to try to get the best, seamless services for residents, the best for Health care, and the best democratic representation;

Draft Health & Wellbeing Board Strategy

The Committee had before them, for consideration, the draft Health & Wellbeing Strategy prior to its submission to the Health & Wellbeing Board on 14 March 2019 (JHO8).

Questions submitted and responses received were as follows:

-       In the face of a lack of funding for public health and prevention, could it meet its targets? could it keep apace with rising need? And how would it be delivered?  - Kate Terroni responded that the CQC inspectors had reflected that the Board had now got the right people around the table to tackle inequalities, the prevention agenda etc. The system leaders, pulling together, could direct the monies where needed and would be held to account by this Committee. Councillor Hudspeth agreed that cuts to public health (£531m nationally) were stringent and Oxfordshire was campaigning for this to be reversed. It was important to be lobbying hard in the spending review for Oxfordshire. The business rates outcome was unknown at present. He added that as far as district councils were concerned, all needed to be delivering on inequalities, not just Oxford City;

-       Kate Terroni undertook to take back a comment about the ‘close type’ in the document making it difficult to read when imparting a lot of information;

-       The issue of the need for a strategy for affordable housing for health workers was also taken back;

-       In response to a question asking whether the lobby against cuts was also lobbying to keep these services ring-fenced, Councillor Hudspeth stated that he saw no change in the current ring-fence, the key was to stop the cuts in public health which had been taking place since 2013;

-       A member commented that there was a need to await the result of Brexit to see what the business rate threshold was before it is jumped to conclusions about the shift of services across Oxfordshire. Councillor Hudspeth responded that it was the goal of all of the Oxfordshire Councils to ensure a vibrant economy in Oxfordshire. Oxfordshire had a growth economy. Catherine Mountford commented that the NHS had been given national guidelines on planning for the EU. Moreover, workshops were being held, which was part of the usual business continuity. This was being addressed nationally.

All were thanked for their attendance and for responding to questions.