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East Midlands Improvement & Transformation Board
24th November 2015, 10.00am Pera Business Park, Melton Mowbray, LE13 0PB
2. Declarations of Interest
3. Minutes of meeting held on 9th September 2015
4. The Regional Health Review
5. Regional Chair Networks
6. Member Development Programme
East Midlands Improvement and Transformation Board meeting 9th September 2015
In attendance Cllr Roger Begy OBE (Chair) Rutland County Council Cllr John Boyce (Vice Chair) Oadby & Wigston Borough Council Cllr Roger Blaney Newark & Sherwood District Council Cllr Robin Brown Northamptonshire County Council Cllr Cheryl Butler Ashfield District Council Cllr John Clarke Gedling Borough Council Cllr Tony Howard East Lindsey District Council Cllr Martin Rawson Derby City Council Cllr Russell Roberts Kettering Borough Council Cllr Tracey Taylor Bassetlaw District Council Cllr Mike Tebbutt Kettering Borough Council Mark Edgell LGA Juliet Whitworth LGA
Officers Stuart Young East Midlands Councils Lisa Hopkins East Midlands Councils
1. ApologiesMayor Kate Allsop Mansfield District Council Cllr Ranjit Banwait Derby City Council Cllr Marion Brighton OBE North Kesteven District Council Cllr Philip Hickson Derby City Council Cllr Alan Rhodes Nottinghamshire County Council
2. Declarations of InterestNone
3. Minutes of meeting held 2nd March 2015The minutes were approved as an accurate record of the meeting.
4. Performance Benchmarking – LG InformStuart Young introduced this report and informed members that this is voluntary for authorities, currently working with the LGA on this and any further refinements that authorities would like can work on with the LGA.
Members received a presentation from Juliet Whitworth on this and how the data can be used. All authorities can access the open-part of the data, however there is a closed part which members need to sign-in for.
Certain areas of data capture are kept back for a year before being made public, however this is not subject to Freedom of Information as the information will be made available in due course. Stuart Young stated the need to be clear on the tangible benefits for users. Members held a discussion around the benefits of this. It was suggested highlighting at Councillor events and a possible launch event. Would want to present to Councillors so that they are aware of this. Juliet Whitworth informed members that currently cannot sign-in on tablets to use this only laptops. Website address is www.lginform.local.gov.uk
Resolution Members of the Improvement and Transformation Board noted the report and considered how they could further promote and inform the effective use of LGInform in the region.
5. LGA Consultation – the future of Sector-led Improvement and Proposed Approach Mark Edgell introduced this report and informed members the future of Sector-led Improvement report has now been published. Local councils are now responsible for their own inspections. The future role for the LGA in this is to provide support. Corporate Peer challenges are no longer mandatory. There is an openness to publish peer challenge report and action plans can be agreed on the back of a corporate peer challenge. Resolution Members of the Improvement and Transformation Board considered and discussed the likely shape of LGA sector-led improvement offer.
6. Regional Chair Networks Cllr Roger Begy introduced this report.
Cllr Martin Rawson enquired whether Networks which are supported can be extended to other areas.
Stuart Young confirmed that member networks have been agreed and should continue as long as useful. Other networks can be established if there is a need.
Cllr Robin Brown commented that Health and WellBeing and Adult Social care are now closely linked especially with the Better Care Fund. Stuart Young informed members of the joint meeting with Adults, Childrens and Health and WellBeing Board Chairs on 9th November. At this meeting it will be discussed at what these Boards should collectively be looking at. Cllr Roger Begy informed members he will be working on governance arrangements and will keep members informed. Resolution
Members of the Improvement and Transformation Board: Noted the report and update on the regional scrutiny network. Supported proposals for firming up the governance arrangements in
support of the regional networks, in consultation with the respective chairs.
7. East Midlands Member Development Programme 2015/16 Stuart Young introduced this report and stated to members the need to make the current Councillor development programme as effective as possible. He continued the need to have a mix of larger events and smaller more focused events. Cllr John Clarke stated the need for members to become actively engaged. Members discussed what topics they would like covered in future events: Housing and Planning. Budgets and Financial Challenges. Implications of Autumn Statement. Health and Social Care. Stuart Young informed members of the importance of Midlands Engine, Midlands Connect and HS2. Resolution Members of the Improvement and Transformation Board: Considered subject matter and content for the final three events in the
Regional Programme of Policy Events. Considered board members role in increasing engagement with councils. Considered the issues highlighted in the evaluation analysis of the 2014/15
programme to inform the successful implementation of the programme in 2015/16.
Considered the key themes and actions for the successful delivery of the 2015/16 Councillor Development programme.
Agreed to aid in the promotion of the Councillor Development promotion, by encouraging Councillors to subscribe to events.
8. Regional Health Review – Next Steps
Cllr Roger Begy introduced this report and stressed to members the most important issue is to improve retention of health workers. Also, how do we attract workers into the area. Cllr John Boyce felt the East Midlands needs to be more attractive to encourage people here. Agency nurses tend to get paid more which can cause problems. Members felt that need to relook at training of nurses with ‘on the job’ training and also the need to ensure that staff stay at the end of their training. Members agreed the following as areas which need to be targeted: Recruitment and retention. Eliminating inequalities in funding. Stuart Young asked members what could potentially be done by local authorities and partners. Cllr John Clarke stated that Gedling BC have the CCG in their building now which helps with partnership working. Resolution
Members of the Improvement and Transformation Board: Noted initial progress in working with partners to deliver against the
agreed recommendations of the final report. Endorsed the principles of the ‘Partnership Agreement’ that EMC has been
invited to be a signatory to.
9. Housing Pressures in the East Midlands Cllr Roger Begy introduced this report and informed members work is currently ongoing which is being led by Cllr Chris Millar and a final report on this will be presented at the EMC Meeting in February 2016.
Members expressed the following concerns which should be taken into account:
Shortage of building materials/skills. Building houses fit for purpose, i.e. respite homes.
A letter is being sent to authorities and members are asked to support a response to this.
Members of the Improvement and Transformation Board: Noted the scope for an EMC Housing Review. Offered comments and advice in support of this review.
Improvement and Transformation Board
24th November 2015
Regional Health Review – Next Steps Summary In February 2015, members of East Midlands Councils endorsed the final report of the review into the key health challenges for the region. The focus is now on how to make progress against the agreed recommendations. Recommendations Members of the Improvement and Transformation Board are invited to: Identify issues that should be considered as part of the review into Sustainable Health
Services and nominate a representative of the Board to attend the event on its behalf. Identify issues that should be considered as part of the review into the Public Health
Workforce and nominate a representative of the Board to attend the event on its behalf.
Note progress in working with partners to deliver against the agreed recommendations
of the final report.
1. Background 1.1 The regional review into health was endorsed at the EMC meeting on 13th February
2015. The review, intended to complement the work already undertaken by health and wellbeing boards and local health scrutiny committees, identified four priority outcomes: Reducing inequalities in health outcomes. Eliminating inequalities in funding for healthcare. Improving the recruitment and retention of the health workforce. Effective cross sector, collective leadership.
1.2 Since this date, EMC has worked with partners in order to make progress against the agreed recommendations. Members are reminded that it is not within EMC’s influence alone to deliver these recommendations – but as the review highlighted – the key to securing improved health outcomes for communities in the East Midlands is to improve the effectiveness of collective work, particularly between sectors.
1.3 As part of this approach, Members endorsed proposals for EMC to join the ‘East
Midlands Partner Organisations’ to support joint work between the local government and health/academic sectors.
2. Progress against Recommendations 2.1 For the purposes of this report, a focus will be on a key recommendation of ‘effective
cross sector, collective leadership’.
“Council and NHS leaders should together develop a new model of collective leadership to improve health outcomes which requires: Greater local autonomy for policy setting and integration of funding. A collaborative approach with other parts of the public sector including police,
universities and LEPs.”
a) Working with LEPs and DsPH
2.2 EMC has been working with PHE and Directors of Public Health in promoting better
collective leadership, including with the LEPs on health/economy matters. Further work has been undertaken with BIS and PHE; with LEPs to be invited to provide further indication of how health will be reflected in their priorities going forward. Informed by the work of Health Education East Midlands, further activity is planned to incorporate the local/regional ‘economic and tourism offer’ into the professional training and career offer to students and practitioners.
2.3 Directors of Public Health have an important role as an interface between health and the local government sector. EMC has been supporting the consideration by DsPH of how to establish a collective approach with LEPs on health/economy matters and to inform progress, the following ‘think-piece’ was developed as the basis for further work, attached as Appendix 4(a).
b) Sustainable Health Services
2.4 Following a request from the East Midlands CCG Congress and with support from the
Acute Chief Executives group, EMC has agreed to support a mapping exercise as part of a collaborative review of services across the East Midlands. A number of recent issues (e.g. dermatology, spinal and breast cancer services) have highlighted that, despite significant transformational and QIPP1 plans within each area, there are some services where there is a significant risk to quality and sustainability and where the impact extends beyond a single CCG, provider or unit of planning.
2.5 It is also recognised that we, as a system, usually have the information about current
and future service pressures, but that we do not always bring this together to enable a planned, proactive, timely response. This review, therefore, aims to bring this intelligence together from across multiple perspectives (within and across our organisations) to inform the agreement of appropriate joint solutions to ensure the continued delivery of affordable, high quality care.
2.6 The results of the mapping exercise will be analysed for presentation and discussion
at a facilitated event on Tuesday 26th January 2016 (venue to be confirmed). The event is intended to confirm and challenge the intelligence generated in order to: Generate a shared view across the health system of those areas where there are
challenges to current or future sustainability Secure consensus on the priorities for action at local, unit of planning and system
level Initiate the development of a road map for action.
2.7 EMC, as a member of East Midlands Partner Organisations (including Clinical Networks,
Clinical Senate, Health Education East Midlands, East Midlands Academic Health Science Network, Public health England East Midlands, East Midlands Leadership Academy and the East Midlands CLAHRC) is committed to facilitate and contribute to the collaborative review.
1 QIPP stands for Quality, Innovation, Productivity and Prevention. It is a national, regional and local level programme designed to support clinical teams and NHS organisations to improve the quality of care they deliver while making efficiency savings that can be reinvested into the NHS.
2.8 Information on these proposals is attached as appendices 4(b) and 4(c). Members are invited to identify issues that should be considered as part of this review and nominate a representative of the Board to attend the event on Tuesday 26th January 2016 on its behalf.
c) Fit for the Future: A Review of the Public Health Workforce
2.9 Public Health England is currently undertaking a review of the public health workforce
to inform national and local workforce planning and strategy development. Given the opportunities for greater devolution, integration of our public services to provide more person-centred care, including helping people to stay healthier, and new technologies, it is the objective of PHE to ensure that the workforce remains equipped to meet future challenges of improving and protecting the public’s health. It is important that this is informed by local councils given their public health responsibilities.
2.10 To support this review, an event will take place on 21st January 2016 at Holywell
Conference Centre, Ashby Road, Loughborough LE11 3AJ. 2.11 The day will provide an opportunity for local leaders to:
Gain an early insight into emerging findings from this nation review. Input into national strategic commentary on options for intervention/action to
address skills gaps and knowledge/capability, to influence PHE and DH workforce development policy.
Develop thinking around future scenarios that challenge the health of our population, and the ways in which public health is currently delivered.
Share local intelligence about key skills gaps, and knowledge/capability in the current and future public health workforce.
Shape local action and share innovative practice in workforce development. Raise local challenges/concerns.
2.12 Members are invited to identify issues that should be considered as part of this review
and nominate a representative of the Board to attend the event on its behalf. 3. Health and Devolution Proposals 3.1 The Cities and Local Government Devolution Bill reached the committee stage in the
House of Commons on Tuesday 17th November 2015. 3.2 The Bill includes a clause specifically about the NHS, which if enacted would enable
ministers to transfer NHS functions to combined authorities made up of two or more councils or ‘other public bodies’. While the Secretary of State for Health would retain ultimate accountability to Parliament, the Bill’s provision allows for the complete integration of health and local government functions and funding.
3.3 Transferring functions from an NHS body to local government would be a significant
step beyond the joint decision making and budget pooling being established under the Greater Manchester devolution deal. At its most extreme, all responsibilities of a clinical commissioning group could be taken on by a combined authority under the proposals.
3.4 The bill also contains provisions for ministers to order property, rights and liabilities to
be transferred from any public authority – including NHS England, trusts or foundation trusts – to a combined authority.
3.5 The combined authority would remain answerable to regulators such as NHS
Improvement and the Care Quality Commission, and regulatory functions could not be transferred.
3.6 An amendment approved by the House of Lords in the summer said councils should
still adhere to national NHS service standards and accountability obligations. However, this was weakened last month by a government amendment that stated the combined authority should only ‘have regard’ to national standards.
Members of the Improvement and Transformation Board are invited to: 4.1 Identify issues that should be considered as part of the review into Sustainable Health
Services and nominate a representative of the Board to attend the event on its behalf. 4.2 Identify issues that should be considered as part of the review into the Public Health
Workforce and nominate a representative of the Board to attend the event on its behalf.
4.3 Note progress in working with partners to deliver against the agreed recommendations
of the final report.
Stuart Young Executive Director East Midlands Councils
Item 4, Appendix (a)
Collective Leadership - a ‘Think-Piece’ for East Midlands Directors of Public Health 1. Background 1.1 At a previous meeting of DsPH (10th July 2015), a discussion considered potential benefits
of increased collaboration and leadership on health matters. 1.2 While it was acknowledged that at the regional level, there is a generally a good
geographical fit between local government and NHS organisations that cover, commission or provide services across the East Midlands region, e.g. Public Health England, NHS England Area Teams, East Midlands Ambulance Service and Clinical Commissioning Groups – there needs to be clear benefits and objectives for greater collaborative work and associated leadership on these matters.
1.3 The following report reflects on a number of issues highlighted by the recent EMC report
on health (as agreed by council leaders), feedback from the meeting of 10th July and subsequent DsPH feedback to Meng Khaw, in addition to recent discussion with East Midlands MPs.
2. Common Issues? 2.1 The central question is, perhaps, ‘what is the potential for improving health outcomes,
unity of purpose and collective leadership through collaboration between health agencies, councils, MPs and wider health partners?’
2.2 Collective work should focus on those issues of common concern where such an approach
is likely to deliver greater value-added. Such issues may include (but not limited to) the following four priority outcomes: Reducing inequalities in health outcomes. Eliminating inequalities in funding for healthcare. Improving the recruitment and retention of the health workforce. Effective cross sector, collective leadership.
a) Collective Leadership
2.3 The scale of the challenges facing health are not solely ensuring adequate levels of funding
to meet future demand for health and social care – they are also about reform of decision-making and resource allocation to deliver better health outcomes at reduced cost.
2.4 So…what potential is there for a new sense of collective leadership and unity of purpose;
bringing together leaders from the NHS, universities, LEPs, industry and local councils to
Item 4, Appendix (a)
develop strong and powerful partnerships in order to drive improvements in healthcare across our region?
2.5 In recent discussions with the All-Party Parliamentary Group with MPs (16th September),
there is interest from MPs in holding a summit at Westminster on the key health issues and challenges for the region. Aside from the intent of MPs on this matter, the key issue for regional partners is ‘what are those issues that would benefit from greater engagement and leadership from MPs?
b) Collective Work – does it ever work?
2.6 Yes – but pick your battles! The following is a list of issues where focused, collective work
has made a significant impact: Upgrade and Electrification of Midland Mainline (including current work to ‘unpause’
investment). Midlands Engine for Growth – this area’s response to the ‘Northern Powerhouse’. Agreement of 5 regional investment schemes, including road and rail. HS2 - in agreeing line of route and preference for station location. Affordable housing allocations in conjunction with the Homes and Communities
Agency Management and delivery of ERDF funding programmes. Climate change, including first region to sign-up (all councils) to the Nottingham
Declaration on Climate Change. International Migration and joint work against agreed priorities that include cost shift
to local government (e.g. no recourse to public funds), migrant health profiles, and agreed regional position of settlement of asylum seekers.
2.7 The experience is that it works if the issue is clear, rather than approaching this from any
‘philosophical perspective’. Pragmatism works – so think about a) the issue, b) the benefits.
c) Questions on Collective Leadership on Health
2.8 From the recent health review undertaken, the lack of collective leadership was
highlighted as a priority area by the majority of consultees. So is the response to merely acknowledge this, or to consider how to address it? What collective work is actually being undertaken between local councils, DsPH,
academic schools and NHS in focusing resources against the challenges that are clearly identified, e.g. inequalities, recruitment?
Is it a lack (or perceptions of a lack) of political/organisational mandate holding us back? If so, the challenge is to refresh this, and how?
Item 4, Appendix (a)
One potential area is to clearly articulate the links between health and wealth; health, housing/heating and productivity and jobs – should this be from a hard-edged economic growth perspective rather than the more public good of public health? Is there potential for DsPH to seize the initiative here and offer specific proposals for LEPs to respond to?
How should DsPH collectively linking in with the Chairs of Health and Wellbeing Boards – that do meet collectively with a programme of work?
Is the context clear? Could we identify the size of the health economy and respective discretionary budgets?
d) Feedback from DsPH on the Potential Focus for Collective Work
2.9 What are the 2 or 3 issues that all DsPH focus on that would benefit from collective work?
Inequalities How do we persuade people that not only do they think prevention is essential but
consistently invest in it too; and matching up skills development with good quality work opportunities?
Reducing health inequalities in a local authority environment, recapping and revising some of the principles of the Marmot review in the context of local government.
Behavioural change interventions to improve public health.
Spatial Footprint The political and administrative alliances that exist in/across the region are a key
determinant of the approach. Need to work mainly on the footprints of devolved power in addition to collaborating
on a wider spatial basis on some issues.
Economy and Health Health and social care transformation - developing a view and consensus on the best
direction of travel across the East Midlands. Good growth and public health: optimising public health outcomes through economic
regeneration. Social value and public health: how can we use the Social Value Act to promote public
health outcomes? The health impact of use of retail units – including fast food/ licensed venues,
gambling/pay day lenders/ cheque cashing premises etc. Developing an evidence based position on the balance between ensuring utilisation
of units against the impact on health and wealth.
Item 4, Appendix (a)
Asylum resettlement - a shared understanding of the health needs/ feeding in to the contract management for G4S (holder of Home Office contract for dispersal), including joining up with the planning for Primary Care capacity etc.
3. Summary 3.1 Collective work does work – if the issue warrants it – specifically, if the ‘issue’ is relevant
to a number of areas, is of common and significant concern, and offers a basis for organisational/political lobbying/action.
3.2 If applying this to the health sector – what are the small number of key priorities that the
‘health system’ could work collectively on across the East Midlands? 3.3 Does this warrant exploring the establishment of a ‘health leadership group’ to action the
delivery on the agreed priorities?
Stuart Young Executive Director East Midlands Councils
Item 4, Appendix (b)
East Midlands Sustainable Services Review Introduction This paper sets out a proposed approach for a joint East Midlands Sustainable Services Review to identify, assess and agree appropriate actions in relation to those services where there are significant risks – or current and ongoing performance issues pertaining to, the delivery of high quality and sustainability care within the East Midlands. Background A number of recent issues (e.g. dermatology, spinal and breast cancer services) have highlighted that, despite significant transformational and QIPP plans within each area, there are some areas services that represent potential significant risk to quality and sustainability and where solutions may be required and have implications beyond a single CCG or unit of planning. It is also recognised that:
the challenges associated with these services and associated pathways of care may be compounded by the lack of a coherent clinical model, agreed by all relevant commissioners and providers within the health system, or significant capacity / workforce issues
even operating at “ Unit of Planning” Health economies do not have the scale to deliver a resilient service especially where there are national workforce shortages
there is scope both to improve the sharing of intelligence and the contribution of clinical leadership across the system to identify more proactively where services are at risk of significant performance issues
the dissemination of new care models, new roles and new technologies that might offer resilience locally is often not effective, with local economies sometimes unaware of best practice solutions that are available
There is a clear opportunity and need to identify, discuss and agree appropriate, commissioner-led solutions to these areas of service challenge during 2015/16 in order to:
inform planning and timely response in the event of regulatory measures and provider failure including where there are requirements for a continuity of services regime
inform the requirement for CCGs to define their commissioner requested services (for Foundation Trusts) and essential services (for non-Foundation Trusts) by the end of March 2016, including agreement with the relevant providers
ensure transformational plans are consistent and maximise opportunities to address the financial challenge facing local health services, whilst countering fragmentation and dislocation of services across complex pathways of care which have implications across multiple units of planning
inform CCG, collaborative and workforce commissioning plans, including informing innovative and effective solutions in the short, medium and long term
identify where future improvement support may be required to inform commissioning decisions and support sustainable service delivery, including reconfiguration of services where appropriate
Proposed Approach The EM CCG Congress has approach and secured the commitment in principle from the East Midlands Partnership Organisations, including the Clinical Networks, Clinical Senate, Health Education East Midlands and the Academic Health Science Network to facilitate and contribute to the joint review. With leadership from a small working group and participation from each CCG and specialised commissioners, it is proposed to take a risk stratified approach to identify services at three levels of consideration, mapping and defining action plans to:
1. address immediate issues 2. respond proactively to provider failure through the establishment of a framework setting
our which services must remain, transfer to a different site/Trust or transfer to a different setting
3. plan for system sustainability, developing a road map for further rationalisation and reconfiguration of services
It is proposed that the review would follow the phases outlined below: Phase Timescale Lead Initiation Scoping Secure commitment in principle from:
o CCGs o East Midlands Partner Organisations o East Midlands Collaborative
By end September 2015
Working Group CCG Accountable Officers
CCGs and local partners identify their understanding of ‘fragile’ services from their perspective
By early November 2015
CCGs Clinical Networks Clinical Senate HEEM NHS England, including specialised commissioning
Collation of information gathering By end November 2015
Facilitated event for clinical and commissioning leadership
December 2015 CCGs East Midlands Partnership Organisations NHS England, including specialised commissioning
Report including recommendations for commissioners
January 2016 Working Group
Actions The East Midlands CCG Congress is asked to:
Endorse the proposed approach to the joint review of quality and sustainable services for the East Midlands
Secure commitment to the review from individual CCGs
Roz Lindridge / Allan Kitt / Vicky Bailey / Andy Hall / Amanda Sullivan
Item 4, Appendix (c)
EAST MIDLANDS SUSTAINABLE SERVICES REVIEW - INFORMATION REQUESTOctober / November 2015
Following a request from the East Midlands CCG Congress and with support from the Acute Chief Executives, we are co-ordinating a mapping exercise to identify health services where there are significant risks or current and ongoing performance issues, which could affect high quality delivery and sustainability of the services. Please complete the spreadsheet on the next tab so that appropriate actions can be developed and agreed in order identify innovative and effective solutions. Once we have recieved completed spreadsheets, we will collate and present the information to colleagues at a facilitative event to take place in late January/early February 2016. A report will follow that will include recommendations for commissioners and providers.
Please see below on a short guide as to what we are looking for from each question:Question 1: Please identify similar services that pose a current issue or future risk to performance, quality and sustainability and where you consider that solutions are required. Question 2: Please list the providers of the service for the NHS, whether an NHS Trust or proviate provider. Question 3: Please state who commission the service. If you are the lead commissioner, please confirm the organsation/s that you commission a service on behalf of. Question 4: Please bear in mind your service may cover more than one geographical area. Question 5: When considering who else could be affected by any potential changes to the service; please consider providers across the surrounding geographical patch when responding to this question. Question 6: When identifying your rationale for highlighting the service in question, please provide specific, quanitfiable information where possible. Please use the criteria identified as a guide but these are intended as indicators and should not restrict your response.Question 7: When considering timescales that affect the service, please bear in mind current/short term refers to within 1 year, medium term refers to within 1-3 years and long term is 3 years plus. Question 8: Please state any other factors that relate to the service and pose a risk to quality and sustainability, e.g. workforce shortages both regionally and nationally that could mean other areas are vunerable.
If you have any problems or queries regarding the spreadsheet, please contact Vishal Gorecha on 0113 8249589 or [email protected]
Thank you for your contribution to the Review.The East Midlands Partner Organisations (East Midlands Strategic Clinical Networks, East Midlands Clinical Senate, East Midlands Academic Health Science Network, Health Education East Midlands, Public Health England, East Midlands CLAHRC, East Midlands Leadership Academy, East Midlands Clinical Research Network, East Midlands Councils)
Click here to complete the information request
Item 4, Appendix (c)
Q1. Please state the service area/speciality where you consider there are significant risks or current and ongoing performance issues, which could affect high quality delivery and sustainability of the services in the boxes below: e.g. dermatology, breast cancer surgery
Q2. Who provides the service? E.g. X NHS Trust & Y Health Services Ltd
Q3. Who commissions the service if not your organisation?If you commission the service, please identify which other commissioners you commission on behalf of
Q4. What geographical area does the service cover?E.g. Nottinghamshire and Derbyshire
Q5. Apart from patients, who else could be affected (e.g. providers) if the service was no longer provided in its current form/location? E.g. Surrounding providers e.g Derby, Leicester, Lincoln, Sherwood Forest
Q6. What is your rationale for identifying this service? Please provide specific, quanitfiable information where possibleE.g. Financial viability, workforce shortages, anticipated retirements/ loss of staff, unable to meet Royal College guidelines, unable to meet NICE guidelines, derogation from commissioning standards / activity requirements
Q7. Do you forsee these issues affecting the service in the:- current/short (within 1 year), - medium (1-3 years) or - long term (3+ years)?
Q8. Are there any other factors you want to highlight relating to the service?E.g. Workforce shortages regionally and nationally so other areas could be vulnerable
Please continue to add more if necessary
Role: Organisation:Email Address:
INFORMATION REQUEST FOR EAST MIDLANDS SUSTAINABLE SERVICES REVIEWPlease complete the spreadsheet and return to Vishal Gorecha at [email protected] no later than 25th November 2015If you have any queries, please call Vishal on 01138249589Please provide the following information. Please note that the information that you provide will be non-attributable within the analysis; however, providing your contact details here will enable us to contact you if there are any points of clarification and ensure that we can keep you updated on next stepsName:
Improvement and Transformation Board
24th November 2015
Regional Chairs Network Report Summary The following report updates the Regional Improvement and Transformation Board on the developments relating to the regional networks on adults, children’s, scrutiny and health and well-being. Recommendations Members of the Improvement and Transformation Board are invited to: Note the development of a more co-ordinated approach between Regional Chairs’
1. Key Points 1.1 The LGA and EMC provide support for a number of lead member/chair networks on
matters of key responsibility for the sector, specifically Health and Wellbeing, Children’s Services, Scrutiny and Adult Social Care.
1.2 In the co-ordination of activity of common interest and to support learning and the
sharing of best practice, it was agreed that the Board should bring together the Chairs of these networks on a regular basis. This would also link in to the wider activity of the sector that relates to improvement and transformation across both tiers of local government across the region.
1.3 To better support coordination on these matters, the Chairman of the Improvement
and Transformation Board, in conjunction with Cllr Sue Woolley, as the Chair of the Health and Wellbeing Board Chairs Network, invited the chairs of regional networks (children’s, adults and scrutiny) to a meeting in order to explore the potential for a more focused, collaborative approach – that includes shared learning - between these networks within the political governance provided by the Improvement and Transformation Board.
1.4 The respective chairs of the regional networks:
Children’s Lead Members Network – Cllr Patricia Bradwell Adult’s Lead Members Network – Cllr Robin Brown Scrutiny Network – Cllr Alan Walters Health and Wellbeing Board Chairs’ Network – Cllr Sue Woolley
2. Joint Meeting - Adult Social Care, Children’s and Health and Wellbeing Board
Chairs 2.1 The Portfolio Holders for Adult Social Care, Children’s and Health and Wellbeing Boards
held a joint meeting on Monday 9th November 2015. The session was based on “All age approaches to disability, including transition” and its purpose was to support political/leadership thinking about the changing policy landscape and to consider some of the issues that arise when SEND is considered from all age perspective and options that might be under consideration.
2.2 Aside from specific issues relating to disability and transition, the following was agreed
as a basis for moving forward: a) As a region, we will have greater influence if we articulate the identified blocks,
barriers and issues in a joint communication to central government b) Case studies that reference improved outcomes and/or cost savings would be
beneficial. c) There is a range of practice across the region that we should learn from and
councils should jointly develop a regional statement of ‘good outcomes for disabled people’.
d) Undertake regional data collection showing: The use of out of county placements into specialist units, e.g. St Andrews in
Northants. The number of young people going through transition for each LA over a
period of 5 years. Develop compelling arguments to support and challenge in-region and
central policy makers.
2.3 In order to further support the progress made by members at their recent joint meeting, lead officers from East Midlands children’s and adult’s improvement programme will develop a programme of work with EMC for consideration by respective boards.
2.4 A subsequent meeting was held by Chairs of Health and Wellbeing Boards. In agreeing its programme of work, the following 3 issues were agreed as priority areas for consideration: a) Integration of health servicesb) Workforce challenges (recruitment and retention)c) Reconfiguration of NHS healthcare services.
2.5 It was agreed that the March 2016 LGA summit offered a valuable opportunity to highlight the specific concerns and/or priorities for this region’s Health and Wellbeing Boards. In order to ensure adequate preparation, it was agreed that the next meeting of chairs should be held in January 2016.
3. Regional Scrutiny Network
3.1 The last Scrutiny Network meeting took place on 9th October and was hosted byBlaby District Council. The agenda for the meeting covered Commercialism andfeatured a presentation from Nottingham City Council, along with a presentation onBudget Scrutiny from Northamptonshire County Council. Both presentationsenabled delegates to discuss their own approaches and learn from others.
3.2 The next network meeting will take place on 11th December 2015 and is to be hostedby City of Lincoln Council. The agenda for the meeting will focus on devolution andwill provide an opportunity for network members to share devolution plans acrossthe region, consider responsibilities for scrutiny vis-à-vis combined authorities anda further presentation on new ways of working from a local authority.
4.1 Members of the Improvement and Transformation Board are invited to note thedevelopment of a more co-ordinated approach between Regional Chairs’ Networks.
Cllr Roger Begy OBE Chairman Improvement and Transformation Board
Improvement and Transformation Board
24 November 2015
Member Development Programme 2015/16 Update
Summary The following report updates the Regional Improvement and Transformation Board on the 2015/16 Councillor Development programme. Recommendations Members of the Improvement and Transformation Board are invited to: To note the report. To aid in the promotion of the Councillor Development promotion, by encouraging
Councillors to subscribe to events. Consider board members role in increasing engagement with councils.
Councillor Development Programme 2015/16
1.1 EMC launched its 2015/16 Councillor Development programme in May 2015, the programme has been designed to support local authorities and Councillors in the post-election period, supporting both new and existing Councillors with changes in Government and associated policy developments. In addition, the programme offers a broad range of skills development sessions, designed to complement in house induction programmes for Councillors.
2. Events and Attendance Update
2.1 EMC has delivered fourteen Councillor Development events this financial year, seven skills sessions, three policy event and two network meetings. These events were:
Delivering Services in the Age of Devolution, 6 November 2015, 47 Councillors Key Issues for Local Government, Housing, Planning, Welfare Reform and
Devolution, 23 September 2015, 42 Councillors The Future of Local Government and Public Services Event, 22 June 2015, 65
Councillors and 15 officers.
Raising the Bar in Scrutiny, 14 October 2015, 14 Councillors and 8 Officers Scrutiny and Effective Challenge, 17 September 2015, 21 Councillors and 3
Officers Chairing and Facilitation Skills, 16 September 2015, 35 Councillors New Councillor Event (evening session in Kettering), 14 July 2015, 11
Councillors. New Councillor Event, 24 June 2015, 8 Councillors attended. Mentoring Skills for Councillors, 19 June 2015, 9 Councillors. Civic Head and the Civic Team, 27 May 2015, 9 Councillors and 10 Officers and
Scrutiny Network, 9 October 2015, 8 Councillors and 13 Officers. Scrutiny Network, 10 July 2015, 12 Councillors attended, 13 Officers. Councillor Development Network, 8 July 2015, 3 Councillors and 14 Officers.
2.2 In total 284 Councillors from across 42 authorities in the East Midlands have attended the 14 events held by EMC the first two quarters of this year. This is an increase of 7 authorities compared with the same period in 2014/15 (35 in first quarter 2014/15).
3. Comparative Analysis of Attendance and Engagement
3.1 To provide context and comparative analysis of the attendance and engagement figures above, the figures have been compared against the same period in 2014/15. The below table provides the comparative figures.
2014/15 2015/16 April, May, June, July,
August, September, October, November to date
Number of Events held in period 17 14 Numbers of Councillors attended during period 232 284 Number of authorities that have participated during period 29 42
3.2 The total number of events in the 2015/16 period is slightly less than the same period in 2014/15, however engagement within these sessions has increased. It is encouraging that the number of participating authorities is higher, as EMC is keen to engage with all of its member authorities on Councillor Development. At present there are only two authorities in membership that haven’t participated in one of the Councillor events.
4. Future Skills Events for Councillors
4.1 The remaining skills sessions in the programme include:
New Role of a Councillor, 19 November 2015 Local Government Finance, 10 December 2015 Strengthening and Sustaining Personal Resilience, 20 January 2016 Being and Effective Councillor, 4 February 2016 Speed Reading, 10 February 2016 Making Progress on Problems, 26 February 2016 Conflict Resolution and Mediation, 11 March 2016
5. Increasing Engagement and Attendance
5.1 East Midlands Councils is keen to maintain the current high level of engagement with Councillors and authorities in the region. At present two events in the current programme have been postponed due to low numbers and EMC staff are exploring how best to meet customer’s needs.
5.2 EMC would welcome continued support from Improvement Board members in the promotion of the Councillor Development promotion, by encouraging Councillors to subscribe to events.
6. Regional Programme of Policy Briefing Events 2015-16
6.1 The 2015-16 Regional Programme of Policy Briefing events for Councillors has been designed specifically to support local authorities in the post General Election period. The first event in the programme took place on Monday 22nd June and provided analysis of what the outcomes of the General Election mean for policy affecting local government and the public sector.
6.2 The first three events in this programme have now been delivered, with an underlying theme of devolution featuring in all of the events. To date 154 Councillors have attended the three sessions, from across 39 authorities. At present there are 21 authorities signed up to the programme, therefore an additional 18 authorities have participated.
6.3 The next event in the programme is on 8th December 2015 and will explore Infrastructure requirements and developments of the region. The event will include presentations from;
Network Rail, Spencer Gibbens Institution of Civil Engineers – State of the Nation Report on Infrastructure Maria Willis, Construction Coach on the development of East Midlands
Infrastructure Pipeline Cllr Roger Blaney, Leader of Newark and Sherwood District Council on Newark
Growth Point Andrew Prichard, East Midlands Council on HS2 and Midlands Connect
6.4 Informed by previous discussions by Members, future events in the programme are proposed to include:
28th January 2016 – Housing and Planning Reforms, and the Potential Impact on Local Housing Provision
9th March 2016 – Innovations in Health and Social Care; or Local Government Finance/the Impact of Spending Review Settlement on Councils in the East Midlands.
6.5 There are currently 21 authorities subscribed to the programme. The current list of subscribing authorities are:
1. Ashfield District Council 2. Bassetlaw District Council
3. Blaby District Council 4. Bolsover District Council 5. Charnwood Borough Council 6. Chesterfield Borough Council 7. Corby Borough Council 8. Derby City Council 9. Erewash Borough Council 10. East Lindsey District Council 11. Gedling Borough Council 12. Kettering Borough Council 13. Mansfield District Council 14. Melton Borough Council 15. Newark & Sherwood District Council 16. North East Derbyshire District Council 17. North Kesteven District Council 18. North West Leicestershire District Council 19. Rutland County Council 20. South Holland District Council 21. Wellingborough Borough Council
6.6 EMC is keen to encourage additional authorities to subscribe to the programme, which offers value for money, with participating authorities offered 12 free places across all events in the programme.
7. In-House Member Development 7.1 A key area of support that East Midland Councils provides, is to support authorities
with their own in house member development programmes. Through the regional perspective and extensive experience of working with Councillor Development, East Midlands Councils is able to support authorities to identify development providers to meet their internal needs. Since May 2015 East Midlands Councils has supported the below authorities with in house development sessions:
Ashfield District Council with Chairing skills, Scrutiny, Community Leadership and Mentoring Skills
South Kesteven District Council with Scrutiny training Boston Borough Council with Chairing skills Nottingham City Council with ‘Being an Effective Councillor’ Rushcliffe Borough Council with Community Leadership and Chairing skills
8. Member Development Charter 8.1 There are currently 14 local authorities in the East Midlands region that have the
Member Development Charter. EMC are keen to grow this number and are currently supporting a County Council in the region with their work towards the charter.
9. Networks 9.1 East Midlands Councils leads the Councillor Development Network.
9.2 The next Councillor Development network meeting will take place on 1st December 2015 and is to be hosted by Rushcliffe Borough Council. The agenda for this network meeting will cover the different Leadership Academy options open to Councillors and will include a presentation from Cllr Neil Clarke, Leader of Rushcliffe Borough Council and Vice Chair of EMC. Along with information from the LGA, who are looking to fund a small pilot project on “Be a Councillor”.
Members of the Improvement and Transformation Board are invited to: 10.1 To note the report 10.2 To aid in the promotion of the Councillor Development promotion, by encouraging
Councillors to subscribe to events. 10.3 Consider board members role in increasing engagement with councils.
Kirsty Lowe Learning and Development Adviser East Midlands Councils