Issue - meetings
To consider the decision taken by the Joint Strategic Commissioning Board (Cabinet Committee) on 16 October, 2018 relating to ‘Wirral Health and Care Commissioning Pooled Fund Arrangements’ which has been called-in in accordance with Council Procedure Rule / Standing Order 35.
The following papers are attached:
· Call-in meeting procedure;
· The Call-in Notice;
· Minute Extract – JSCB, 16 October, 2018;
· The report considered by the decision maker.
- Call in 05.11.18, item 32 PDF 515 KB
- JSCB MINUTE EXTRACT, item 32 PDF 61 KB
- Pooled Funds 161018, item 32 PDF 158 KB
- Pooled Funds 161018 App1, item 32 PDF 106 KB
- Pooled Funds 161018 App2, item 32 PDF 323 KB
- Pooled Funds 161018 App3, item 32 PDF 345 KB
- Pooled Funds 161018 App3a, item 32 PDF 64 KB
- Pooled Funds 161018 App4, item 32 PDF 823 KB
- Pooled Funds 161018 App5, item 32 PDF 78 KB
- Webcast for CALLED-IN BUSINESS - Wirral Health and Care Commissioning Pooled Fund Arrangements
Chair’s Opening Remarks.
Prior to the commencement of business, the Chair informed the Adult Care and Health Overview and Scrutiny Committee, visiting Members of the Children and Families Overview and Scrutiny Committee, Officers and members of the public on the reason for the meeting, and how the meeting’s business would be conducted.
The Chair further informed that a series of speakers would be given set amounts of time to present information and evidence on the subject of the Wirral Health and Care Commissioning Pooled Fund Arrangements and that witness statements would be taken in the order detailed in the agenda papers. Time would also be allowed for questions and responses, and once final statements had been delivered, the Adult Care and Health Overview and Scrutiny Committee would debate the matter.
For clarity, the Chair also advised the Adult Care and Health Overview and Scrutiny Committee that any points of order raised by Members during the meeting would require reference to the relevant supporting Standing Order within the Council’s Constitution.
Explanation of Call-In by the Lead Signatory.
Councillor Kate Cannon set out the reasons for bringing this matter before the Adult Care and Health Overview and Scrutiny Committee. She informed that it was her view that inadequate, limited or no consultation had taken place with the electorate, and questioned why proposals for the Pooled Fund Arrangements were judged to be in the best interests of the Wirral residents.
Councillor Cannon believed that the decision taken was undemocratic - stating that the Clinical Commissioning Group (CCG) was not an elected body - and requested that the matter also be referred to the Children and Families Overview and Scrutiny Committee and/or referred to experts to look at the contract in detail. Councillor Cannon requested that she be allowed to share a document containing information relevant to the matter under consideration, and with the consent of the Chair and Members of the Committee this was agreed. The Chair suspended proceedings for five minutes to allow Members opportunity to review the document contents.
Overview and explanation of the decision taken by the relevant Cabinet Member.
Councillor Chris Jones, Cabinet Member Adult Care and Health set out the background to the decision, taken by Members of the Cabinet Committee and the CCG Board, sitting in common as the Wirral Joint Strategic Commissioning Board (JSCB).
Councillor Jones explained that the decision was planned for to deliver the best possible services for residents, given the budgetary restraints imposed from Central Government. The associated service redesign would allow patients / service users to tell their story once - enabling money to go further i.e. a better return on investments, and how suggestions that the plan supported privatisation of the NHS was ludicrous. She added that NHS and Social Care Staff agreed that the integration of care (and joined-up funding) was needed, particularly when it came to those with disabilities.
Members of the Committee questioned Councillor Jones, in particular regarding the absence of opportunity to scrutinise the documentation relating to ... view the full minutes text for item 32
The report of the Chief Finance Officer, NHS Wirral CCG and Wirral Health and Care Commissioning is attached.
- Pooled Funds 161018 App1, item 22 PDF 106 KB
- Pooled Funds 161018 App2, item 22 PDF 323 KB
- Pooled Funds 161018 App3, item 22 PDF 345 KB
- Pooled Funds 161018 App3a, item 22 PDF 64 KB
- Pooled Funds 161018 App4, item 22 PDF 823 KB
- Pooled Funds 161018 App5, item 22 PDF 78 KB
- Webcast for Wirral Health and Care Commissioning Pooled Fund Arrangements
Graham Hodkinson, Director for Adult Care and Health, introduced a report on Wirral Health and Care Commissioning Pooled Funding Arrangements. The report was about the joining up of services to enable people to navigate what was a very complicated system; so that people told their stories only once, potential delays were reduced and people didn’t get lost in the system.
Wirral Health and Care Commissioning (WHaCC) had been in operation since May 2018. This was the contemporary name for the Integrated Commissioning Hub referred to in reports dated before May 2018. WHaCC was a formal strategic partnership created on behalf of Wirral Council and Wirral CCG. The partnership was created following agreement to progress into a formal partnership by Wirral Council Cabinet in November 2017 (minute 62 (27/11/17) refers) and NHS Wirral CCG’s Governing Body in December 2017.
This report presented the detail of how the agreement to create a single care and health commissioner for Wirral had been taken forward in terms of financial governance and decision making. The Section 75 pooled fund agreement (Appendix 3 to the report) set out the budget areas that were being pooled in 2018. It also referred to a shadow pool which referred to budgets that were not being pooled in 2018, in order to minimise exposure to financial risk. Financial and governance arrangements were included within the Section 75 agreement.
Importantly the key risks and mitigations had been considered and responded to by WHaCC in setting up pooled fund and financial governance arrangements.
He acknowledged that concerns had been expressed from a number of sources and further scrutiny of the risks as well as the benefits would need to happen before any further pooling was considered. The Board were being asked to agree to the pooled arrangements for 2018/19 only after which he proposed that there would be a pause whilst further scrutiny took place on any proposed expansion of the pooled fund.
In September 2017 a due diligence exercise was undertaken by Price Waterhouse Cooper (PWC). The report illustrated the benefits of integrated commissioning and set out their view of potential risks and mitigations on behalf of Wirral Council and Wirral CCG. The report was considered in advance of the decision to create WHaCC, but had not previously been in the public domain. At this stage the report could be read in conjunction with the arrangements that had been put in place to respond to the highlighted risks. He stated that some of the language used in the PWC report in relation to ‘accountable care organisations and accountable care systems’ was something which had not been adopted in Wirral. Wirral’s focus was on integrated care, collaboration and NHS providers working together and was not on the creation of an Accountable Care Organisation.
Mike Treharne, Chief Financial Officer, Wirral NHS CCG then spoke to the report and expanded further on some of its details. He referred to the key risks and mitigations appendix in the report and stated that the risks were ... view the full minutes text for item 22