Agenda item

To receive a verbal update from the Director of Adult and Community

Services and the Managing Director of NHS South West London

Richmond Branch on the latest changes to local health services.

Apologies were received from Dominic Wright, Director of Service Transformation at NHS Richmond PCT.

Cathy Kerr, Director of Adult and Community Services at LBRuT and Dagmar Zeuner, Director of Public Health for Richmond were in attendance to address the Committee.  They reported the recent changes to local health services in particular they drew the attention of the committee to the following:

(i)      That a JSNA update had been produced and would be followed up in order to ensure members received it as part of the next briefing pack.

(ii)    [In response to the query raised by Councillor Mathias minute 115] The report by Ernst and Young regarding the financial position at Croydon PCT had not yet been released.  The previous evaluation that there would be no negative implications for Richmond in the findings remained unchanged at the present time.

(iii)   That GP’s locally had taken steps to organise further in preparation for becoming commissioners.  The election and selection process for the shadow board would be in place by April 2012.  This Board would need to demonstrate a sound constitution and clinical commissioning support in order to be authorised.

(iv)  Arrangements around commissioning continued to be clarified.  It was likely that out of hospital commissioning would remain with local GP’s but that commissioning for acute care could rest with a commissioning support service arranged at S or SW London level.

(v)    That a Public Health Outcomes Framework had been produced and would be brought to the Committee for consideration as part of a more detailed report at the March meeting.  The financial details of such provision had not yet been released but it was hoped that these could also be reported in March.

(vi)  The development of the Health and Wellbeing Board continued and it had been meeting regularly in the form of a shadow board. One recent session had been held to consider commissioning groups and commissioning support.

(vii)Mental health issues and commissioning had also been considered in anticipation of the upcoming consultation for which agreement would be sought from Cabinet in March and considered by the committee in June. [Sue Denby, Kim Goddard and Peter Molyneux were all in attendance from SWL and St George’s mental health trust] 

(viii)                       The next meeting of the Health and Well-being board would consider patient involvement.  Bonnie Green of Link  would introduce this item and, as well as regular members, Cllr Jaeger has been invited to this meeting. ,

(ix)  A formal announcement had been made by the government that the establishment of Healthwatch had been postponed until April 2013, therefore work would continue with Richmond LINk until that time.

The item was discussed and the following themes were explored by councillors and information provided by officers:

(i)      That reported increases to GP salaries to cover additional responsibilities for commissioning and related loss of provider work were not unfounded but often exaggerated.  In London Borough of Richmond GP salaries were moderate in comparison to national benchmarks.

(ii)    That the intention of the government reforms was to relieve the health service of some the inherent bureaucracy associated with it in the past.  However it was yet to be seen whether this would be achieved.  Caps on spending per head of the population were intended to maintain a focus on efficiency and economies of scale but organising regionally to achieve these economies was often complicated and costly in itself.

(iii)   That work between LBRuT HWB and those of other authorities had been conducted and would continue.

(iv)  That the Health and Wellbeing Boards did not meet in public and although there was no requirement to do so until they were formally established in April 2013, Richmond intended to meet in public before that time.

That a link to the HWB Terms of Reference should be provided for members [LINK]

It was RESOLVED:

1. That the information received be NOTED

2. That SWL and St Georges Mental Health Trust provide information for inclusion in the briefing pack relating to wards, nature of treatment provided, staffing and locations.