Agenda item

Report by the Director of Adults and Health.

The Chairman of the Health and Adult Social Care Scrutiny Committee will be invited to speak for up to three minutes on the Proposals for Integrated Care System arrangements report.

Each of the main Minority Group Leaders will be invited to speak for up to three minutes on the Proposals for Integrated Care System arrangements report.

The Cabinet will then discuss the report prior to taking any decision.

Following consideration of the report, Cabinet resolved to:

1.   Approve the appointment to the Sussex Health and Care Assembly of the Cabinet Member for Public Health and Wellbeing as the County Council’s representative for the remainder of the County Council term to May 2025 and the addition of the Assembly to the list of outside bodies.

2.   Approve the proposals for appointments to the NHS Sussex Integrated Care Board set out in paragraph 2.1.

3.   Agree that the detail of governance arrangements for the Assembly and the Board be settled by the Director of Law and Assurance in liaison with the other local authorities and NHS agencies involved together with any consequential changes from the legislation referred to in the report that may be needed to the constitution and terms of reference of the Health and Adults Social Care Scrutiny Committee and the Health and Wellbeing Board.

The call-in deadline is 26 May 2022.

4.1         Cabinet considered a report by the Director of Adults and Health. The report was introduced by Cllr Bob Lanzer, Cabinet Member for Public Health and Wellbeing who outlined the provisions of the Health and Care Act 2022 and the implications for the governance of NHS and social care partnership arrangements. He said the Act reinforces opportunities for the NHS and councils across Sussex (East, West and Brighton and Hove) to work together. The integration provisions comprise an Integrated Care Board (ICB) with local authority representation and a Sussex Health and Care Assembly with Chairs of the Health and Wellbeing Boards. For West Sussex this will be the Cabinet Member for Public Health and Wellbeing.

4.2         Cllr Garry Wall, Chairman of the Health and Adult Social Care Scrutiny Committee welcomed the opportunities for closer planning and improved partnership working. He said the needs of residents should remain front and centre and continue to be underpinned by the corporate council plan. The partnerships would need to provide value for money. The Committee noted changes may be required to its terms of reference and the proposed operational arrangements at Board level. The Committee supported and welcomed the proposals.

4.3         Cllr Kirsty Lord, Leader of the Liberal Democrat Group welcomed the representation of the 3 local authorities and that of public health but said that assurance was needed that differing needs across rural parts of Sussex were adequately represented to ensure place-based issues were not lost under the ICB. Cllr Lord had concerns about the financials of the new arrangements alongside existing pressures on services and said that the adult social care element of council tax did not cover the costs.

4.4         Cllr Caroline Baxter, Leader of the Labour Group broadly supported the proposed changes to governance and welcomed the collaborative aspirations. She said it was a challenging time for local authorities and for health and social care services and that the Act did not address some key issues, such as staff shortages and lack of funding and was concerned about the increased powers of the Secretary of State. Cllr Baxter asked to see scrutiny of contract awards to private providers and an all-member briefing on the process.

4.5         The following points were made by Cabinet Members in discussion:

Ø  Cllr Jacquie Russell, Cabinet Member for Children and Young People advised there would be representation to meet the needs of children through these new arrangements, and highlighted the close working relationship of the three Directors of Children’s Services across Sussex which would continue through the ICB.

Ø  Cllr Amanda Jupp, Cabinet Member for Adults Services welcomed the report and recommendations and said that partnerships had improved and strengthened since the discussions about new governance arrangements began.

Ø  Cllr Paul Marshall, Leader of the Council advised the Health and Care Act set the context to strengthen the position around place based needs. The council would retain its sovereignty and the ICB should better reflect the local place. The Leader highlighted the duty to collaborate with the new arrangements and the opportunities to influence health provision across Sussex in terms of population need.

4.6         Cllr Lanzer appreciated the broad support on a cross-party basis and advised any changes to terms of reference would be communicated to members prior to implementation. He advised the paper did not include the emerging complexities of adult social care reform but was confident that officers and Cabinet colleagues would look strategically at the whole piece, including the diversity of the West Sussex landscape. He said the report did not identify any risks and was confident in the appointments to the ICB. He summarised that a pragmatic approach to funding, resources skillsets and capabilities was needed in the public sector for the ICB to be effective, and that there was no reason to exclude the private sector if it could make a positive contribution to the Integrated Care System. The Director of Adults and Health advised there would be challenges across the whole piece, but the report dealt with governance arrangements and core planning processes. He added that member engagement was scheduled for the Autumn.

4.7        Resolved – that Cabinet:

1.   Approve the appointment to the Sussex Health and Care Assembly of the Cabinet Member for Public Health and Wellbeing as the County Council’s representative for the remainder of the County Council term to May 2025 and the addition of the Assembly to the list of outside bodies.

2.   Approve the proposals for appointments to the NHS Sussex Integrated Care Board set out in paragraph 2.1.

3.   Agree that the detail of governance arrangements for the Assembly and the Board be settled by the Director of Law and Assurance in liaison with the other local authorities and NHS agencies involved together with any consequential changes from the legislation referred to in the report that may be needed to the constitution and terms of reference of the Health and Adults Social Care Scrutiny Committee and the Health and Wellbeing Board.