Agenda item

[Report of the Assistant Director for Commissioning . To be introduced by the Cabinet Member for Finance and Health.] Cabinet to consider an agreement between the Council and CCG,   which as drafted at appendix 1,  will act as a framework partnership agreement and set out shared outcomes and objectives, and contain detailed schedules enabling:

                                          i.    Lead commissioning for specified care groups

                                        ii.    Pooled budgets for specified care groups

The Cabinet Member for Finance and Health introduced the report which proposed taking forward a partnership agreement to allow the Council and Haringey CCG [Clinical Commissioning Group] to pool their relevant social care budgets and take forward a model of commissioning which would better support providing joined up care and, in turn, better outcomes for Adults with health and social care needs. The report included details of the framework to be followed and the areas which the Council or CCG would lead on commissioning activities.

Cabinet were asked to note that the pooling of budgets would formally start in April 2017 and, until then, there would be work on unifying budgets.

In response to Councillor Engert’s questions, the following information was noted:

·         The lead commissioning role for long term conditions and older people would be decided over the next month as the Council and CCG were awaiting the outcome of Better Care Fund allocations for the year.

·         There were a number of different mechanisms in place for Members to understand what will happen in the areas of social care spend. The Cabinet Member reported that: the Adults Scrutiny Panel will have specific session looking at detail of spend in Adults in October , the Overview and Scrutiny Committee will consider the draft Medium Term Financial Plan for 2017 -2222 as well as looking at budget performance of 2016/17.

·         In terms of monitoring the use of the pooled budgets, it was the Cabinet Member’s role and responsibility to relay information about the performance of the Council’s partnership with CCG to Cabinet and the Overview and Scrutiny Committee.

RESOLVED

1.    To approve the S. 75 Partnership Agreement between the Council and the CCG which provides for:

a)         Lead commissioning and the establishment and maintenance of pooled fund for the commissioning of learning disability services for eligible adults resident in Haringey;

b)         Lead commissioning and the establishment and maintenance of a pooled fund for the commissioning of mental health services for eligible adults resident in Haringey;

c)         Lead commissioning and the establishment and maintenance of a pooled fund for the commissioning of older people’s services, including those services identified in the Better Care Fund 2016/17, for eligible adults resident;

d)         Joint commissioning and the establishment and maintenance of a pooled fund for the commissioning of children and adolescent mental health services for the residents of the London Borough of Haringey;

e)         Lead commissioning and the establishment and maintenance of a pooled fund for thecommissioning of the Independent Domestic Violence Advocacy Service and the Identification and Referral to Increase Safety Service for eligible adults resident in Haringey.

2.    To delegate to the Deputy Chief Executive, in consultation with the Chief Operating Officer and the Cabinet Member for Finance and Health, the authority to finalise and agree the draft S.75 Partnership Agreement between the Council and the CCG which is attached as Appendix 1.   

Reasons for decision

There had been previous work on developing joint commissioning across the CCG and the Council and recently there has been an appetite for working up proposals for greater integration at pace and scale. To this end, the Council and the CCG were now proposing to implement strategic plans for more integrated commissioning through the establishment of a partnership agreement, under s. 75 of the National Health Services Act 2006.

The proposals support a shared vision for integration of the commissioning activities of the CCG and the Council through a transformational approach which enables the shared strategic objectives of a shift towards community based provision; greater involvement of residents in their care and treatment; a focus on enablement and person centred provision; and the active promotion of independence to be achieved within an efficient, value for money framework. 

Local residents have frequently called for greater integration of health and care arrangements locally to support a better experience and to improve outcomes. The proposals set out in this report and draft partnership agreement are designed to improve services to local residents but focus on arrangements for pooling funding and integrating commissioning. Whilst these arrangements will create greater efficiencies and a more joined up approach, they will not directly affect or change models of service delivery and consultation has not been undertaken on the detail of the s. 75 partnership agreements at this time.  

Alongside the work to develop more fully integrated partnership arrangements in Haringey, the wider health and care landscape has been undergoing significant reshaping in light of the development of the NHS led Sustainability and Transformation Plan for North Central London (a footprint covering Barnet, Enfield, Haringey, Camden and Islington). The Plan requires planning and transformation of the health and care landscape across the five borough area but also requires articulation of integrated models locally to ensure that arrangements for commissioning and budgets meet local need, based on local requirements and existing local plans. The draft s. 75 Partnership Agreement supports this approach.

By implementing the partnership agreement in a phased way, focusing on different care groups, the CCG and the Council together will have the flexibility to respond to changing need and to focus on areas of greatest need, demand and pressure.

Alternative options considered

Consideration was given by officers to containing the joint working between the CCG and the Council within the scope of the current arrangements for joint working, which are concentrated around the Better Care Fund. This approach, however, fails to respond to the changes in the wider health and care landscape and restricts fully joined up working to areas of provision largely for older people. 

Consideration was also given to immediate implementation of the approach across all adults’ services but this was felt to leave both the CCG and the Council open to uncertainty and some level of risk.