Agenda item - Public Involvement

To consider the following matters raised by members of the public:

A deputation on Sustainability & Transformation Plans (STP) has been received from Mr Ken Kirk and Ms Madeleine Dickens. This is a revised version of a deputation originally submitted to Full Council in July 2016 and referred on to the HOSC. Since it is several months since the deputation was originally submitted, Mr Kirk and Ms Dickens were invited to revise their submission in light of more recent developments. A response to the revised deputation will be given at the 19 October HOSC meeting. (Copies of both the revised and the original deputations are included for information.)

30.1    A deputation on Sustainability & Transformation Plans (STP) was presented by Mr Ken Kirk and Ms Madeleine Dickens. A similar deputation was presented to the July 2016 meeting of Full Council and was referred on to the HOSC. Given the time that had elapsed between the July Full Council meeting and the HOSC meeting, and given recent developments in the STP process, Mr Kirk and Ms Dickens were invited to revise their deputation and to re-present it.

30.2    The Chair responded to the deputation requests for action:

In view of emerging information about wholly new NHS governance structures Councillors communicate their disquiet about the proposed STP arrangements to the STP Board and request the attendance of the Board Chair at a specially convened HOSC meeting.

HOSCs’ main statutory duty is to scrutinise NHS plans to make major changes or improvements to health services for local people, checking that they are not detrimental and that there is proper engagement and consultation with stakeholders and the public. The HOSC will certainly want to examine, at as early a date as possible, any STP plans to make substantial changes to local services. It is not possible to say precisely what the HOSC would do with these plans, since we do not yet know what they might contain, but should they involve large-scale service changes then the HOSC is likely to want to gather evidence about them and potentially to make recommendations to Full Council or to other bodies. 

Our understanding is that the ‘checkpoint update’ submitted on June 30 did not include detailed plans for service change.It consisted, rather, of high-level diagnostics of the quality, care and resource gaps facing the STP footprint, and outline proposals for better regional co-working. As such, this submission is not strictly relevant to the HOSC; the HOSC’s role is to respond to detailed proposals, not to engage with planning work in progress.

We acknowledge that there is public concern about the STP process. The council is involved in STP planning: HWB Chairs from across the STP footprint are part of the Central Sussex & East Surrey Alliance Programme Board, and council officers sit on various STP sub-groups. The Health & Wellbeing Board has already received a presentation from the Chair of the STP Board, and an STP update is a standing item on HWB agendas. At a regional level, HOSC Chairs are beginning to work together with the STP Board to plan the scrutiny of the detailed STP proposals when these become available.

We believe that these actions are appropriate at the current time, although we will continue to review this as the STP process evolves.

The full council recommended that the HWB call public consultation meetings on STP at the earliest opportunity. It has since become clear that councillors and officers will participate in the proposed new STP governance structures. The lack of any public consultation or engagement in decisions of this magnitude flies in the face of democratic and legal (see Gunning) principle. Urgent action should be taken to redress this. 

The city council and the CCG are committed to engaging with local people. We are still some way from being in a position to consult with residents about the STP, because consultation requires there to be concrete proposals to consult on.

It is important to recognise that there has been a commitment to date to ensure the STP plan will incorporateexisting local initiatives. The local initiative for better integration of local health and social care services, Brighton & Hove Caring Together, will provide the foundation for local STP planning and in many ways is formalising how we already work together and intend to develop our provision over the next 4-5 years. The council and the CCG have already begun engaging on B&H Caring Together, with more events planned in the next few weeks.

A recommendation be made back to full council to propose a delay in acceptance of the STPlan pending much fuller objective consideration of its consequences. 

We do not currently know what the detailed contents of the local STP will be. We do know that the city faces serious problems with health and care services which urgently need addressing. We also know that solutions for many of these problems will not solely be found in Brighton & Hove: for example, a significant proportion of patient-flow into the Royal Sussex County Hospital comes from outside the city. In addition many residents already use services outside the city. We are also committed to the continuing integration of local health and social care services.

The STP offers opportunities to step up our work on integration and to develop the kind of regional co-working relationships which are key to improving services at our hospital trust and elsewhere. It is not recommended that members seek to delay these developments when we don’t yet know what the full implications of the STP are.

 The most effective means of soliciting the opinion of city residents on the tendering out of local NHS services should be identified along the lines of the University of Brighton Citizens’ Health services survey examining attitudes to privatisation.  

It is clearly the case that a number of local people are unhappy with the prospect of services currently provided by NHS organisations being delivered by independent sector organisations following the re-tender of contracts. However, it is important to understand that NHS and local authority commissioners have to act in ways which accord with procurement law and best practice.

30.3    Cllr Mac Cafferty proposed an amendment to the recommendation: that, in addition to noting the deputation, the HOSC should agree to hold a special committee meeting to scrutinise STP plans to date. This amendment was seconded by Cllr Allen and agreed by the committee. The Chair confirmed to Mr Kirk that the special meeting will be held in public.