Agenda item

6.1  Annie Shepperd, Southwark Chief Executive, introduced the cabinet report of 23 November – Changes in the NHS and Implications for Southwark Council.

6.2  Members queried the reference in paragraph 22 of the report to the possibility of transferring some functions to the council to manage.  Annie Shepperd clarified that there might be areas, most likely back office functions, where it would make sense to create a joint service but that no detailed discussions had taken place.  In response to further questions she confirmed that nothing would be transferred which would put the council at a disadvantage.

6.3  Members were concerned about how decisions would be made about the transfer of functions to the GP consortia and the need to ensure that no services were put at risk.  Annie Shepperd stated that a clear business plan was essential in the transfer of services and that it would be more prudent to have interim arrangements which were subsequently transferred to the consortium.  It was important to continue discussions with GPs as to how they saw the new arrangements working, particularly in respect of commissioning.  Annie Shepperd commented that taking such a large amount of money out of the system would unavoidably and radically change the type of service available and it was her duty to protect the most vulnerable of Southwark’s citizens.

6.4  Members asked who would be represented on the team leading work on considering al the implications of changes taking place in the health system (recommendation 8 of the cabinet report).  Annie Shepperd explained that it was her job to protect and promote the interests of the council solely and that the council’s representatives would be officers without any conflict of interest.  Members asked about the level of staff morale in the council and the PCT.  Annie Shepperd replied that people were uncertain about the future but still focussing on their duty to serve the public.

6.5  Members asked the chief executive how she was going to protect and limit the risk to citizens.  Annie Shepperd stressed the importance of providing accurate information and involving citizens in decision making.  Her aim was to ensure that those people who were more dependent were prioritised.  She believed that people were looking for transparency and debate about choices.

6.6  Members asked whether any staff would transfer into the council from NHS London or NHS Southwark.  Annie Shepperd clarified that there was no automatic provision for this.  At the same time there was a possibility that, taking account of due diligence, some staff might be employed by the council.  In response to further questions she stated that currently there was no additional cost to the council in undertaking the due diligence exercise.  Officers were being moved from less urgent duties to take part in the exercise.

6.7  Members were concerned about any risks that would arise out of the proposals to link the safeguarding of adults and children.  Annie Shepperd believed that issues for adults were different to those for children.  Careful consideration needed to be given to the frameworks under which safeguarding operated.  The state had a responsibility to ensure protection and to ensure it continued to play the right role.  Members referred to paragraph 24, page 39 and asked what arrangements would be in place to safeguard vulnerable adults.  Annie Shepperd commented that the new legislative framework would lay down requirements for GPs and consortia to undertake certain duties.  GPs were already involved in the safeguarding system and discussions were taking place as to how they would become involved in commissioning to support the system.  Jane Fryer confirmed that GP consortia would be statutory NHS bodies with statutory responsibilities around commissioning and, as leaders of the commissioning body, a duty for safeguarding.

6.8  Members were also concerned that, as structures and processes changed, the council would continue to honour its commitment to involve citizens.  Annie Shepperd said that, as far as possible, this would continue but emphasised that the changes were being led by a system which the council did not directly manage or have accountability for.  Members asked whether the council was making any representations at a national level as to the future direction of services.  Annie Shepperd stated that representations had been made about some managerial arrangements and that the council had drawn NHS London’s attention to the local agreement in Southwark.

6.9  The sub-committee agreed to invite the chief executive back to a meeting in January 2011 to provide an update, particularly on the transfer of any functions from the PCT to the council.