Agenda item

Purpose: To inform the Board where commissioning alignment is already taking place; what plans are for the coming year; where efforts could be improved; what the challenges are and how the Health and Wellbeing Board can help influence this work.

(Councillor Gordon Lundie declared a personal and prejudicial interest in Agenda item 13 by virtue of the fact that he was a member of the Board of Governors for Royal Berkshire Hospital. As his interest was personal and not prejudicial or a disclosable pecuniary interest, he determined to remain to take part in the debate and vote on the matters where appropriate.)

The Board considered a presentation (Agenda Item 13) concerning the alignment of commissioning plans.

Shairoz Claridge and Tandra Forster gave the presentation as attached on the agenda and invited the Board to comment of how they would like to see alignment of commissioning work progress in the future and whether there were any areas that officers had not already considered.

Councillor Hilary Cole commented that very good work had taken place around aligning commissioning plans. She further added that in a time of diminishing financial resources, no stone should be left unturned when it came to achieving economies of scale by better joint commissioning.

Councillor Lynne Doherty enquired upon the timelines for further commissioning work as the end of the current financial year was fast approaching. Shairoz Claridge responded that the work was ongoing and work to align the Voluntary Sector Prospectus would be undertaken in the following twelve months in anticipation of the 2017/18 financial year. Other timelines would be agreed by other commissioning groups.

Cathy Winfield sought to raise the same point as Councillor Cole regarding financial pressures and asked how this could link to the three local authorities (Reading, West Berkshire and Wokingham) in their joint commissioning. Tandra Forster described the example of the reprocurement of the NHS 111 and explained that the contract would allow for an extension in order to allow a new approach to be initiated. Rachael Wardell added that the business case had been completed and it was deemed that better value for money could not be achieved from a standalone commissioning unit but there was a case for a more collaborative approach. No contract would be renewed without consultation with the other two local authorities (Reading and Wokingham) and the Director for Adult Social Services would keep this under review.

Councillor Lundie advised that he was a member on the Board of Governors for Royal Berkshire Hospital and at its strategy board meeting had discussed integration funding for providers. In the context of accountable care organisations, he asked what the role of the Board was in these organisations as providers had signed letters of intent regarding integration with the Clinical Commissioning Groups. Cathy Winfield explained that discussion on this matter had been held at the Berkshire West 10 Integration Board which took a view that there was an Accountable Care System rather than organisation. There was a two year plan with integration in the CCGs the focus of year one and the plan was for local authorities and adult social care to have more involvement in year two of the integration project. Providers had received large amounts of funding towards deficits in their budgets and in the case of the Royal Berkshire Hospital a surplus budget was expected to be delivered.

Councillor Lundie commented that the Board of Governors for the Royal Berkshire Hospital might not have understood the need to clear the deficit and also deliver a surplus on its budget. He commented that the Council’s Executive members might need to hold a discussion on the matter.

Andrew Sharp commended the good commissioning work that had been completed by the local authority and CCG in collaboration and pressed the need to be mindful of what was and wasn’t working. He continued that at times the joint system worked very well and could think of a case example from Christmas Day where services had worked together excellently, however there were other times when the system was not quite as effective. More engagement with the public should be carried out and when there were issues they should be highlighted and addressed.

Councillor Jones asked Tandra Forster whether the Board had provided the influence that was required. Tandra Forster advised that further work on priorities would be undertaken. Councillor Cole agreed that as the Portfolio Holder for Adult Social Care, she would progress these discussions and report back to the Board.

RESOLVED that the presentation be noted. A report on Accountable Care would be brought to a future Board meeting.