Agenda item

To consider any requests received in accordance with Part 4, Section B, Paragraph 29 of the Council’s Constitution.

The Chair informed the Board that a request had been received from Mr Alan Morton,

on behalf of Haringey KONP, to put forward some issues in relation to item 9 of the

agenda pack, Haringey Borough Partnership Update.

Mr Morton was invited by the Chair to put forward his representations to the Board.

Mr Morton highlighted that the question that needed to be asked was how the Health and Wellbeing Board would fit with the Borough Partnership proposed by the new structure of the CCG. Mr Morton was supportive of collaboration between health and social care as long as it was constructive. It was recognised that the Borough Partnership was still a work in progress, and Mr Morton was optimistic that this was an opportunity for improvements to be made.

Regarding the long-term outcome of the proposed changes, Mr Morton referenced a diagram at page 54 of the agenda pack which showed the Health and Wellbeing Board at the top of the organisation structure; and also referenced another diagram that was presented by the CCG at a recent meeting, which had similar content but had the NCL’s Strategic Commissioner as an important part of the diagram, with the Health and Wellbeing Board put on one side. Mr Morton highlighted that the difference in diagrams summed up the issue at hand, which was whether the Health and Wellbeing Board was in control of finance and policy, or whether it was only observing on the side lines. 

Mr Morton questioned whether the proposed changes would result in a take-over of social care by the NHS. Mr Morton stressed that the developments showed an extremely top down structure, starting from the NHS and extended down to the single North Central London (NCL) CCG. It was noted that the budget for health and social care in North Central London was around £4 billion, £3.2 billion came from NHS sources and only £800 million from social care budgets. Based on the budgetary figures presented, it was highlighted that the NHS were major funders and had more control in relation to decision-making.  It was mentioned that the outcome would be a greater squeeze to the funding for social care, which would be detrimental to social services. 

Mr Morton urged the Councillors and the Health and Wellbeing Board to strive for different and better outcomes. Mr Morton pointed to Osborne Grove as a positive example of co-production involving residents and service users. Mr Morton further urged Councillor to press the case for further public and councillor involvement in decision-making as part of the NCL CCG plans due to significant short term and long-term implications.

The following was noted in discussion of this deputation:

1. In response to a request for further clarification regarding the political deficit and the role of Councillors mentioned in the deputation, Mr Morton stressed that there should be more Councillor and community involvement. Mr Morton pointed out that there was inadequate Councillor representation in the NCL CCG structure, thus there was scope for improvement. Mr Morton mentioned that the CCG had met in public and queried whether the Borough Partnership would similarly meet in public.  Mr Morton highlighted that a public meeting of the Borough Partnership would allow Councillor to make important representations to sustain public and Council involvement in respect of the proposed changes.
2. A Board Member supported Mr Morton in terms of the need for democratic accountability of the NHS and stressed that there were opportunities to engage local residents to ensure there was some local democratic oversight on the decision-making process. It was recognised that there were many issues around the governance of the Borough Partnership, which were yet to be resolved.

The Chair invited officers to respond to the representations.

Tony Hoolaghan, Haringey and Islington CCG – Chief Operating Officer, thanked Mr Morton for his representations. In response to the representations, the Chief Operating Officer firstly noted that he had met with Mr Morton before Christmas to discuss some of the complexity of the changes, which he found was a useful discussion. The Chief Operating Officer recognised that the NCL CCG plans involved both major and complex changes, he understood the concerns raised in the deputation. It was noted that there was not a one size fits all blueprint, and the Borough Partnership had a level of flexibility and ability to co-create work, for instance the work undertaken on the Integrated Care System in the Borough Partnership. The Chief Operating Officer referenced the integrate event in North Central London and the integrate event at Borough level last year whereby efforts were made to subsidise the architecture for the integrated care system.

The Chief Operating Officer assured that the Borough Partnership were committed to community engagement and involvement, for example senior members of the Borough Partnership had agreed to commence a strategy for communication engagement and involvement that is currently in development.  Furthermore, it was noted that the new constitution for the single CCG allowed for decision-making at Borough level, such as primary care, community health services and mental health. It had been agreed that the North Central London (NCL) CCG would take on some of the NHS Commissioning decision-making at Borough level.

The Chief Operating Officer advised Mr Morton that he would be happy to discuss any of his concerns further outside of the meeting.

The Chair thanked the Chief Operating Officer for his response, and thanked Mr Morton for his representations.