NHS Reforms – How will they work in Warwickshire?

A really good turnout!

Yesterday was pretty busy around here – we held a partnership event for all of the major health organisations in Warwickshire, to try and work out how everyone will work together as a result of the NHS reforms. The event was co-hosted by Councillor Les Caborn (our Chair of the Adult Social Care and Health Scrutiny Committee) and Andrew Lawrence from the Centre for Public Scrutiny (CfPS).

At the event we had reps from (watch out for acronyms here) CCGsPCTs, HWBBCQC, LINk, NHSCfPSHealthwatch, and local Councils.

Locally, most of the unanswered questions are about how these agencies will work together, as people have new responsibilities, or find themselves working with different organisations. The idea behind the event was to get everyone in the same room, to try to provide answers to these questions, and build what will be important working relationships for the future.

Here are some of the things we learned:

Health is about patients and the public

I’m not saying that we didn’t all already know this, but it was kind of encouraging to affirm this as a lot of the debate on the reforms has been about structures and organisations, rather than improving care. It was really useful to try and map out all of the people and organisations involved – each table put patients and the public right at the centre of their ‘solar system’.

Note the Spaceship…

A lot of our work should focus on stopping people becoming patients, or sending them to the right people to get better.

I suppose this expands on the adage of “prevention is better than cure”, though is a bit more complicated than that. We heard from health professionals that in a lot of cases, people who have minor complaints either put off seeing their GP until their condition gets more serious (which is clearly bad for the patient, and more expensive for the NHS) – or even worse, wait until their condition is really advanced, when they present to A&E on a Saturday night, with a problem that should have been sorted long before then.

A focus on early intervention and preventative campaigns doesn’t just make sense from a health point of view; with budgets as constrained as they are, can we afford not to nip these problems in the bud?

GPs are getting on with the job they’ve been given

We had reps from 2 out of the 3 Clinical Commissioning Groups (CCGs) operating in Warwickshire at our event – the message from them was that, despite concerns expressed by the British Medical Association and others, they’ve been given the responsibility to commission healthcare services in their area, so they’re getting on with it.

The CCGs are going through the process of being authorised at the moment, with them taking over responsibility from the Arden Cluster (Primary Care Trust) in April 2013. As with any membership organisation, there is the problem of engagement, and they admit that not all GPs will want to be involved with commissioning. They say they are working to combat this though.

Health Scrutiny is like a spaceship (yes, really)

Continuing the solar system theme here – County and Unitary Councils have had the responsibility since 2001 for scrutinising local health services (i.e. Health Scrutiny) and have powers to require information from local health trusts, and to call in their Chief Executives if there are problems. Out of all of health bodies, Health Scrutiny hasn’t been really affected by the health reforms, and still has the powers to look at anything that Councillors and public want it to. This can range from the closure of a ward in Rugby, to a specific group to look at Mental Health services for young people, or even parking at University Hospital in Coventry. Scrutiny can go anywhere, and look at anything. Like a spaceship.

The next steps in Warwickshire

The event went really well – you can see some more of the debate and photos on Twitter (@WarksDemocracy). Quick feedback from most people was that it was useful to get around a table with everyone – even if we didn’t all agree all the time.

County Councillors will be working with District Councillors over the coming months to work out how local democracy and accountability can be promoted in the new health world. We’ll be looking to avoid duplication between councils and hopefully, by working together, get better results for local residents. This should then help how the councils work with the CCGs, Health and Wellbeing Board, and Health Scrutiny.

We’ll be holding another event in October – hopefully we can update you all further after that – things are moving pretty quickly, so who knows where we’ll be by then!

Improving Council services – have your say

The County Council provides a wide range of services for local residents, funded in part by your Council Tax. These cover social care, children’s services, roads and infrastructure, waste disposal, and fire and rescue.

Are these services working?

Could they be improved?

Are there hidden problems that need to be explored?

Most Council decisions are taken by the Cabinet, which is made up of 10 county councillors from the Conservative group. However, there are many other councillors, from across the political parties, whose role is to hold the Cabinet to account on those decisions.

This is done via something called “Overview & Scrutiny”. Councillors choose specific topics to examine and scrutinise in detail, and then try to form clear recommendations about how to improve them. The focus is on better outcomes for residents and service users – and it is a key element of the Council’s democratic process.

Councillors will soon be deciding what topics they’ll be looking at over the next 12 months – and they’d like to hear your views*.

What should the Council be scrutinising?

Please email your thoughts by 6 May 2012 to: democraticservices@warwickshire.gov.uk

*Scrutiny only has the capacity to look at certain issues. However, any requests that Councillors are unable to investigate will be passed on to the relevant Council department.

Scrutiny Bytes – our quarterly newsletter

Is the Council delivering on its promises? Is it working effectively with other public service providers? Are local people being properly involved in decision-making?

These are just some of the questions that the Council’s Overview & Scrutiny function seek to answer.

Take a look at our latest Scrutiny Bytes newsletter for a glimpse at some of the issues Councillors have been investigating recently.

New approach for pupils at risk of exclusion

At a scrutiny meeting on 14 December, Councillors received a presentation about the proposed closure of the Pupil Referral Unit (PRU).

Ofsted recently placed Warwickshire’s PRU in “special measures”, deeming the provision of education to be inadequate. As a result, the Council has been looking at how else these at-risk children could be educated.

A pilot scheme began in September whereby funding is devolved to groups of headteachers – known as Area Behaviour Partnerships (ABPs) – who work in partnership to arrange alternative education for pupils. So rather than be sent to the PRU, they could be enrolled at a nearby college, or receive specialist support at a Learning Support Unit. The aim is to improve pupils’ life chances by keeping them in mainstream education as long as possible.

Representatives from Warwickshire’s four ABPs attended the scrutiny meeting to share their progress to date. A very open discussion took place, and the following observations were noted:

  • While members endorsed the initial work of the ABPs, there were cross-party concerns over the proposed changes, particularly the speed at which the PRU will close
  • The amount of funding provided for LSUs is not enough for many schools, who are having to supplement this from within their own budget
  • While the Council will provide a list of quality-assured providers, there is no requirement for ABPs to select from this list
  • Close monitoring of the ABPs will therefore be needed, with regular reports brought to the scrutiny committee
For more detail, please see the minutes of the meeting.

Update: Cabinet approved the closure of the PRU on 15 December 

Our first ever post!

Welcome on board. This new blog is designed to keep you up-to-date with all that’s going on at Warwickshire County Council.

It’s a new initiative from the Democratic Services team, who will be posting on here with updates from a range of Council meetings and committees.

We’ll also be using the site to seek your views. Whether you’re a local resident, an elected councillor or someone from outside the county (all are welcome!), we want you to get involved.

So please, take a look around, leave some feedback, share anything of interest… and keep coming back. We’re in the early stages of development, so your input can really shape the future content and success of this site.

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