Issue - items at meetings - Integrated Community Equipment Service

Extract from the proceedings of the Health & Wellbeing Board meeting held on 9 September (copy attached); together with a report of the of the Executive Director for Adult Services (copy attached) and the report to the Health & Wellbeing Board (appended).

That the Committee agree that the Council can enter into a contract, in partnership with the CCG, with the equipment provider selected by West Sussex County Council (WSCC) as set out in Option 1 in 2.6 in Appendix 1, and delegates authority to the Executive Director Adult Care and Health to take all steps necessary to award the contract.

64.1    The Chair noted there was a deputation associated with this item from UNISON and called forward the lead representative, Mr Alex Knutson, to present for up to five minutes.

64.2    Mr Knutson explained that the recommendation in the report was for the Integrated Community Equipment Service (ICES) contract to be procured with West Sussex County Council (WSCC) in October 2015. Reference was made to the makeup of the Health & Wellbeing Board, and it was felt the report before the Committee was inadequate as it gave two options, but did not give any details of the option to use the ‘in-house’ staff to commission the service. It was noted that Sussex Community Trust had not provided detailed financial information  to Officers and the Health & Wellbeing Board and commissioners, and whilst commissioners had supplied a summary of the specification there was not enough information for  UNISON and GMB toto put together an ‘in-house’ bid.. It was noted that this placed any private bidder in the same position, but without this information it was felt the decision of the Health & Wellbeing Board had been taken without all the necessary information. The representatives called on the Trust to give all the necessary information for the service, and it was felt the Committee should have asked for this information before taking a decision.

64.3    The representatives giving the deputation went on to state that the Committee had a responsibility to local residents; the staff in the service and the service users, and it was noted that there was a 98% approval rating for the service. The Committee were requested to refer the report back to the Health & Wellbeing Board, and allow the trade unions to submit a bid on behalf of the current staff. It was noted that the service was not in any sort of crises, and there would be an impact for the service as a preferred bidder would likely be seeking to maximise profits. It was stated that the Chair had offered to help facilitate an in-house bid, but it was noted that information was not provided at the meeting as had been proposed. The representatives asked that the matter be deferred to explore the other options for the future of the service, and it was felt the ‘in-house’ option could deliver a better service in view of the wider budget cuts of the organisation.

64.4    The Committee noted the deputation.

64.5    The Committee considered a report of the Executive Director for Adult Services in relation to the Integrated Community Equipment Service (ICES). The report had been referred from the Health & Wellbeing Board for decision as it related to matters that involved externalising a service that the Council jointly funded and commissioned. The Health & Wellbeing Board had agreed to recommend to the Committee that the CCG enter into a contract with the equipment provider selected by WSCC.

64.6    The Chair noted there was a proposed amendment from the Labour & Co-Operative Group and invited Councillor Morgan to propose the amendment.

64.7    Councillor Morgan stated that the speakers on the deputation had made an excellent case to the Committee; he reiterated the 98% satisfaction rate with the current service provision. The service had a dedicated team, and whilst the building itself was no longer fit for purpose, it was important to pause to see if the existing providers could come forward with a workable bid. Councillor Morgan queried if the capital receipts from sales could be used for investment, and went on to add that it was vital there be an excellent local health service employing local people. The Committee were urged to support the proposed amendment.

64.8    Councillor Lepper seconded the amendment.

64.9    The Chair stated that he had offered to facilitate the meeting, as suggested in the deputation; however, getting hold of the information had proved difficult. It was noted that Sussex Community Trust had given notice on the existing service and the decision was one which in the Council had been forced to take. The Committee had already agreed to the principle of this direction of travel, and the level of pressure in the social care budget was emphasised.

64.10  Councillor G. Theobald noted that like the previous item this had been considered at the Health & Wellbeing Board, and it had been the view of the health professionals that this was the best way forward, and there were arguments that Councils should be doing more of the type of joint working that was being suggested in the report. He noted that the funds were not available to invest, and this option was considered to be the best outcome for residents; for these reasons he could not support the amendment. The Chair added there was no question in relation to the quality of the existing service provision.

64.11  Councillor Shanks queried if the Council could make a request to WSCC that the provider not be a private company. In response the Chair explained that the provider had served notice, and if this option were not approved then the provision of a replacement service could be severely jeopardised.

64.12  Councillor Hamilton noted his own experience of the excellent service that was currently provided, and explained the issues he had found in dealing with WSCC Social Services.

64.13  Councillor A. Norman noted that Sussex Community Trust had decided that the service was not part of their core business and the local authority did not have the capital to invest in the service. It was noted that at the Health & Wellbeing Board the decision had been made unanimously by the health professionals.

64.14  In response to Councillor Peltzer Dunn it was explained that without a replacement service there was an expectation that individuals would have to stay in hospital longer as the required equipment could not be provided to them.

64.15  Councillor Bowden noted he was sympathetic to the Labour amendment; he would welcome a bid from the staff currently providing the service, and he felt there was adequate time to allow them to do this.

64.16  Councillor Sykes noted his sympathy with the deputation, and stated that the current service had been widely praised and he felt the position of the trade unions needed to be heard.

64.17  In response to some of the points raised Officers explained that it was important to join the West Sussex tendering process at the earliest opportunity to achieve economies of scale. The CCG had been very clear of their position to go with the tendering process, and it was noted that this approach had been approved by the Health & Wellbeing Board. The Monitoring Officer clarified that the amendment had been drafted in view to exploring other options or an ‘in-house’ bid; any procurement exercise would need to be fair and transparent without giving preference to any single provider. It was added that the view of CCG, who were the majority partnership, and the recommendation of the Health & Wellbeing Board needed to be carefully considered. The Council should seek to avoid a situation of uncertainty, and if the proposed option were not agreed then this could lead to a gap in the service – such a decision could be deemed unreasonable.

64.18  The Chair responded to further points in the debate and stated that the recommendations as listed in the report would provide for a fair and transparent procurement; he reiterated that the Council was the minority funder of the service.

64.19  Councillor Morgan expressed his concern that the final provider would be chosen by WSCC. In response the Monitoring Officer stated that the WSCC procurement would be open and transparent and compliant with EU procurement rules.

64.20  In response to Councillor Peltzer Dunn it was estimated by the Executive Director for Adult Services that it could take up to a year to consider any options coming forward on the basis set out in the proposed amendment. It would be necessary to get the data from Sussex Community Trust to put together a detailed specification. The report had dismissed the option of the service coming in-house due to the associated costs, and it was felt that to go through a procurement process as suggested in the amendment would go beyond the September deadline for the expiration of the current service.

64.21  Councillor A. Norman noted that the Health & Wellbeing Board had made its professional view on the matter clear, and that this was in the best interests of the service users.

64.22  The Chair then put the Labour & Co-Operative amendment to the recommendation (as set out below) to the vote:

            “That Policy and Resources Committee defer the decision on awarding the contract and request that the Executive Director Adult Social Care and Health investigate on an urgent basis the possibility of establishing a viable option around a local NHS or voluntary sector service employing existing staff, working in co-operation with other NHS Trusts in the city, and using capital receipts from the disposal of the current site to establish a new centre under local public or voluntary sector management.”

64.23  The amendment was carried.

64.24  At this point in the proceedings the Chair called for an adjournment to allow Officers to consider the legal position of the agreed amendment.

64.25  Following the adjournment the Monitoring Officer explained that, whilst the amendment had been carried, the legal and financial consequences of the decision were not clear to the Committee. The service was jointly commissioned by the Council and the CCG – who were the majority provider of the service. Neither the CCG nor the Health & Wellbeing Board had been consulted in relation to the amendment. The Committee had not taken into account all relevant issues, in line with principles of administrative law, and the Monitoring Officer was of the view that to take a decision on the amended recommendation would be unlawful. It was recommended that the Committee defer the final decision to allow further legal and financial information to be considered; as well as the timescales for the WSCC procurement process. Both the Executive Director for Finance & Resources and the Executive Director for Adult Services agreed with this position.

64.26  RESOLVED: That the Committee defer the report.