Agenda item

Report of the Director of Corporate and Support Services- Ship Cluster, requesting that the Panel note the establishment of cluster working across PCTs in Southampton, Hampshire, Isle of Wight and Portsmouth, attached.

The Panel considered the report of the Director of Corporate and Support Services - Southampton, Hampshire, Isle of Wight and Portsmouth (SHIP).  Cluster, requesting that the Panel note the establishment of cluster working across Primary Care Trusts (PCTs) in SHIP area. (Copy of the report circulated with the agenda and appended to the signed minutes).

The Panel received a presentation from Debbie Fleming, Chief Executive of the NHS Southampton, NHS Hampshire, NHS Isle of Wight and NHS Portsmouth (SHIP) Cluster.

Main themes of the presentation included:

-  PCTs were due to be abolished on 31 March 2013 and the aim of the clustering was to ensure PCTs continued to be resilient during the transition, as well as aid the establishment of GP consortia, Health and Well Being Boards and future arrangements for public health

-  there was no choice to making changes – this was mandated following legislative changes set out in the White Paper ‘Equity and Excellence: Liberating the NHS’, and its associated policy documents ‘Operating Framework for the NHS in England 2011/12’, PCT Cluster Implementation Guidance’

-  there was however a choice for PCTs on which other PCTs they could cluster with -  there had been a great deal of successful joint working previously between the four local PCTs which had agreed to work as a cluster during the transition to the new GP-led commissioning system

-  SHIP was the third largest cluster in the country and would have a combined allocation of £2.9 billion commissioning health care for nearly two million people across the four local authority areas

-  that the previously robust arrangements in Southampton were recognised and valued.  The cluster headquarters had been established in Southampton in a deliberate move to switch the emphasis from Hampshire.

-  Sandy Hogg, Nominated Director/Executive Lead for Southampton City at NHS Southampton City had been appointed as the representative for Southampton on the cluster board

-  There were many developments moving the cluster and associated governance arrangements forward and much had already been done following the appointment of the cluster board and Chief Executive earlier this year, work on delivery was progressing.  However, further guidance was expected from the Department of Health

-  A cluster HQ executive team and the 4 PCTs would increasingly work together under the joint Board, supported by a single management team.  The first meeting of the cluster board had taken place on 6^th June.  The priorities for the SHIP Cluster were:

o  Focusing on delivery, so that financial and operational performance is maintained, along with safe, high quality services. Work must continue to drive out unnecessary duplication and waste, so that all patients receive the right care, in the right place at the right time, thus delivering savings for the local health system

o  Facilitating the establishment of the new GP Clinical Commissioners (GPCCs), including all the support services that they will need in the future

o  Supporting the development of the new Health and Well-being Boards and the transfer of the Public Health function into each of the local authorities

o  Working with local NHS Trusts so they all achieve Foundation Trust status by 2014

o  Continuing to commission services that will in future become the responsibility of the National Commissioning Board (for example, primary care commissioning and specialised commissioning).

The Panel discussed issues arising from the presentation, including that of adequate representation for the interests of Southampton on the cluster board.  The Panel highlighted their concern at the apparent lack of representation for Southampton on the board having only 1 in 13 places whereas Hampshire and Portsmouth had 8 and 3 respectively.  It was clarified that executive appointments had been made on the basis of ability and appropriate skills set rather than location / PCT representation.  There were 3 non-executive appointments per Trust on the cluster board, representing a 25% share.  A detailed breakdown of the appointments to other posts was given. 

The Panel also questioned the method of consultation used.  It was explained that the cluster were enacting national policy and that there whilst there had been no consultation as such, there had been a great deal of joint working and internal staff consultation / sharing of information although there was no obligation to do so.

The challenge of bringing together three disparate areas and dealing with issues such as deprivation were acknowledged.

The mechanism for dealing with disputes and problems that might arise and decisions made by the cluster board was discussed in detail. The panel agreed they would write formally to the Cluster Board to seek re-assurance on dispute resolution between the Cluster and Local Authorities, specifically regarding the mechanism to be applied for resolving disputes regarding the eligibility of a service user for continuing care.

RESOLVED that the report and presentation be noted.