Agenda item - Formal Member Involvement

            Written Questions from Members

18.1    The Chair noted that two questions and a letter had been received and invited Councillor Page to ask his question:

            “There have been recent local press releases concerning significant saving having to be made by our local CCG in health care services in this financial year. Are these total proposed savings not more or less cancelled out by the prime minister’s announcement this week of extra funding for the NHS?”

18.2    The Chair responded on behalf of Brighton & Hove CCG:

            “Brighton and Hove CCG welcomes the news of a proposed new long-term funding agreement with the NHS and we await the details of what this will mean for our local population. However, as the proposal is due to start in 2019-20, any new funding agreement will not change our financial obligations for the current financial year.

“Last week we set out the need for the five CCGs across the Alliance to collectively save £50m by next April and we remain committed to achieving this. We have a duty to ensure local services are being commissioned in a sustainable and affordable way and that we do not carry on spending more money than is available to us. This will involve some difficult decisions having to be made and will need us to be open and honest with our patients, public and stakeholders about the services that we can no longer afford.

“As part of this, clinicians are currently reviewing all health and care services that have limited or no clinical benefit to patients to identify any areas where money is not being spent as effectively as it should be. Any decisions proposed as a result of this review will be based on whether a service is clinically effective and is a clinical priority, as well as input and feedback we have received from our local population.”

18.3    Councillor Page asked if the CCG could provide assurance that any future proposed reductions in services would be made public and be subject to a full consultation process.

18.4    The Chair stated that she would ask the CCG to provide a formal written response and that the Board’s priority was always ensuring the best outcomes for residents

18.5    The Chair invited Councillor Mac Cafferty to ask his question:

            “Can the Chair of the Health and Wellbeing Board tell me if they believe this Council practices effective partnership work with the Clinical Commissioning Group when funding was suddenly cut to the counselling services at the Brighton Women’s Centre. Shouldn’t effective partnership working mean such cuts to contracts won’t come as a surprise to important providers, this council or our city?”

18.6    The Chair responded:

            “As you are aware the Council and CCG agreed to a period of shadow working together prior to integrating services. The reason for the shadow period was because health and social care are very different in many areas. There are different governance and decision making structures and as your question demonstrates very different budget setting timelines. While a council has to set a balanced budget by the end of each February, NHS bodies often do not know what their financial position is and can, have in year cuts as well as in year increases.  The very issue you have raised are the reasons effort is being made to integrate key commissioned areas within the city to provide stability. However the shadow period only formally started in April this year and joint working does require working through difficult decisions made by one or other partner before a robust partnership can be formalised as well as having agreed ways of working to prevent or minimise these issues in future and there is a Caring Together standing item on the board.

With regard to the particular service you mentioned in your question, the Brighton Women’s Centre, it is particularly important to note that the CCG did not ‘cut’ funding to this service. The decision was made independently by HERE, the contracted provider.”    

18.7    Councillor Mac Cafferty stated that research from the Women’s Budget Group suggested that the burden of austerity had fallen disproportionately on women and that services such as those provided at the women’s centre had seen an increase in demand. He asked how the Board would be supporting the women’s centre given that the budget was unlikely to increase next year.

18.8    The Chair stated that she was in agreement with Councillor Mac Cafferty that these services did need to be protected and would provide a formal written response to him.

            Members Letters

18.9    The Chair invited Councillor Janio to speak to his letter. He stated that he felt residents of Hove and Portslade currently suffered from under-resourced health infrastructure and had done since the closure of the Hospital in Hove. Cancer diagnostics was the most important evolving issue in health care and GP services in North West Hove were inadequate. An urgent treatment facility in Brighton & Hove had been mandated by the Government and Toad’s Hole Valley was the ideal location for this as there was already a lot of development in the area which would mean access to s106 and Community Infrastructure Levy funds. Councillor Janio called on the Board to commission a feasibility study to push forward with locating a new facility in Hove and provide the services which residents desperately needed.

18.9    The Chair responded to Councillor Janio’s letter: “As you are aware the HWB have had queries about the numbers of GPs within the city and access to some services. These are referred to HOSC as part of their ongoing scrutiny of primary care within the city. Their next report is due in October.

“In September we will be having a presentation about the Brighton General site from Sussex Community Trust.  We will be happy to take this letter and give this to the CCG as I understand that the CCG will be presenting their vision of primary care in the city including services across the city as part of the Health and Wellbeing Board normal reporting under Caring Together.

“Toad Hole Valley is a large development and infrastructure would have to part of the build. Again we would ask the CCG to address this in their September update.”

18.10  RESOVED:

            That the Health and Wellbeing Board:

1)         Agrees that this letter is referred to the CCG and be addressed as part of the presentation at the September Board

2)         Notes the letter