Agenda item - Formal Member Involvement

RESOLVED: That the Health and Wellbeing Board note the Letter from Councillor Taylor.

38(b) Written questions from members

38.1    The following question was submitted by Councillor Sykes to the Policy Resources and Growth Committee on the 6^th of December 2018 and referred to the Health and Wellbeing Board. Councillor page put the question to the Board:

          “Given the extraordinary pressure on local authority finances including those of our council, and the particular stresses in Adult Social Care budgets, can Cllr Yates advise on the council Administration’s response to apparent competition between BHCC and our local CCG for residential and nursing bed spaces in the city and the fact that this might be unnecessarily driving up prices, thereby impacting on budgets?”

38.2    The Chair thanked Councillor Page for his question and gave the following written response:

          “CCG colleagues face acute winter pressures, particularly in relation to nursing bed availability in the city. BHCC work in partnership with CCG colleagues to identify and secure provision during this difficult period. The high demand for placements in the city has driven up costs for CCG and BHCC. To support strategic planning and to gain greater control in the market, the HWB will today consider a proposal from Commissioners to explore the option of block contracting where it is deemed in the best interests of the Council. By entering into block contracts arrangements at an affordable capacity can be secured at more competitive rates, whilst maintaining good quality provision. Commissioners intend to undertake a small block contract pilot of 25 beds, based on a maximum of 5 beds with 5 different providers. This proposal has the full support of CCG”

38.3    Councillor Page asked if the Board could give a guarantee that gazumping of spot purchasing would not happen in future.

38.4    Lola Banjoko, Deputy Managing Director of Brighton and Hove CCG, responded that spot purchases were not a ‘business as usual’ or a preferable outcome for the CCG but a crisis solution when patient safety was compromised and should take precedents. She added that a sustainable and affordable model that we would co-develop was required to address volatile situations that occasionally occur.

38.5    Councillor Page stated that this response suggested that the hospital was at bursting point and the perception has been that the CCG has been paying high prices to reduce the Delayed Transfers of Care (DToC) particular performance indicator so the rest of the system was struggling to find beds, to clarify this was not to tweak the DToC statistic but when the hospital was at full capacity.

38.6    The Executive Director- Adult & Social Care stated that the CCG was working closely with the council on bed purchasing policy and that a tripartite business model that had to take into account the Care Act responsibilities, to provide a sustainable market and a fair charge for self-funders, was required from providers.

38.7    The Board considered the member’s letter submitted by Councillor Taylor.

38.8    Councillor Taylor stated that the motivation of the letter was not critical of individual councillors as there had been clear cross-party efforts to serve the city’s residents, however there were concerns over the question of the strategy, accountability and broader governance to make sure value for money and the best outcomes for residents were delivered. This council had a good history, particularly on the issue of rough sleeping and homelessness, of working in a cross-party approach which was evident in policy panels and cross-party working groups.

38.9    The Chair thanked Councillor Taylor for his letter and gave the following written response:

          “As you may be aware this issue has been raised and is going to the Constitutional Working Group already. I will happily ask that this letter to the meeting pack.

My understanding is that officers have already been drafting papers covering the issues that you have raised. These papers will go through the Constitutional Working Group and then if agreed to Policy, Resources and Growth.

The working group meet in early March and I hope to be able to provide an update to this Board at the next meeting.”

RESOLVED: That the Health and Wellbeing Board note the Letter from Councillor Taylor.