Issue - items at meetings - Adults Section 75 Review

Report of Director of Adult Social Services (copy attached).

(1)          That the requirement to revise the Section 75 Agreement to reflect changes in the law be noted.

(2)                     That the revisions to the Section 75 Agreement be agreed in order to comply with the changes in the law.

(3)                     That the proposals for amendments to the arrangements for future meetings of the Joint Commissioning Board be noted.

50.1    The Committee considered a report of the Chief Operating Officer, Clinical Commissioning Group which outlined revisions to the Adults Section 75 Agreement between the Council and the Clinical Commissioning Group which need to come into effect on 1 April 2013 in order to reflect the changes in law. 

50.2    The report explained that from 1 April 2013 the Clinical Commissioning Group would become the accountable body for commissioning the majority of healthcare provision in the City.  Joint Commissioning agreements with the Council therefore needed to be revised in order to reflect the new commissioning landscape and changes to legal responsibility for Public Health functions that transfer solely to the Council.

50.3    The Chief Operating Officer stated that paragraph 3.3.1 of the report set out the changes to service areas to be jointly commissioned.  The intention was to have an agreement for a three year period.  There would be a non pooled budget.  A detailed schedule would be submitted to the Joint Commissioning Board which would be updated annually.

50.4    The Senior Lawyer explained the proposals for new governance arrangements for the Joint Commissioning Board.  It was proposed to have the Joint Commissioning Board on the same day as Adult Care & Health Committee, immediately prior to the committee.  There would be one vote for the CCG and one vote for the Council.  There was a question as to whether to involve the whole of the Adult Care and Health Committee or whether to have a Sub-Committee to sit on the Joint Commissioning Board.  

50.5    Councillor Meadows expressed concern that the proposal was to maintain a separate Joint Commissioning Board, now that the section 75 business had decreased.  She considered that the section 75 business should be considered within the Adult Care and Health Committee. 

50.6    Councillor Meadows noted that there was still a health element to a number of the Section 75 functions.  She considered that health money should be attached to these services.  She stated that she would like to know how much health money was being used to support the council’s budget.  Councillor Meadows asked how staff were affected by the arrangements.    

50.7    The Chief Operating Officer replied that the support grant for HIV/AIDS would need to be used by the Public Health Team led by Tom Scanlon.  HIV/AIDs was now solely commissioned by the Council.  However, there were a range of services that had a duel aspect.  There were no proposals to make changes to staffing. 

50.8    The Chair stated that £18 million would come across to the Council with the public health functions. 

50.9    Councillor Mears welcomed the revisions in the Section 75 agreement but had areas of concern.  She considered that the Section 75 budget should be submitted to the Adult Care & Health Committee. It needed to be a regular report.  Councillor Mears referred to paragraph 5.1 (financial comments) and asked for more information on the respective contributions. With regard to the JCB, Councillor Mears agreed that changes needed to be made around saving time and cost cutting.  She considered that it would be more practical to have one meeting which would add to clarity and make decision making simpler.  It did not make sense to have the JCB before Adult Care & Health Committee.    

50.10  The Head of Business Engagement informed Members that £16m of the Adult Social Care budget related to Section 75.  She confirmed that it would be possible to identify the Section 75 budget in the finance report submitted to the Committee.  

50.11  The Chair stated that there was a need to talk to the Opposition Spokespersons as to what they wanted to see happen with the review of Section 75.    These views would be fed into the constitutional review. 

50.12  The Chair thanked the Chief Operational Officer for her work with the Joint Commissioning Board and stated that he was pleased that she was continuing to work with the CCG. 

50.13  RESOLVED - (1)      That the requirement to revise the Section 75 Agreement to reflect changes in the law be noted.

(2)               That the revisions to the Section 75 Agreement be agreed in order to comply with the changes in the law.

(3)               That the proposals for amendments to the arrangements for future meetings of the Joint Commissioning Board be noted.

Report of the Chief Operating Officer, Brighton and Hove CCG (copy attached).

(1)               That the revisions to the Section 75 Agreement and review the draft documentation be noted.

29.1    The Board considered a report of the Director of Adult Social Services which outlined revisions to the Adults Section 75 Agreement between the Council and the Clinical Commissioning Group which will come into effect on 1 April 2013.

29.2    Members were informed that the CCG and Council were committed to maintaining both formal joint commissioning arrangements, namely the section 75 for Children’s Services and the Section 75 for Adults’ Services.  In preparation for the CCG becoming the accountable body for commissioning healthcare in the City on 1 April 2013, both agreements needed to be updated to reflect the new commissioning landscape.  All significant elements of the revised Agreement were summarised in the report and a full version of the draft document was attached as an appendix.

29.3    The Chief Operating Officer informed the Board that it was timely that the documentation was updated.  It was last revised several years ago and some services were no longer jointly commissioned.  The duration of the Section 75 agreement would be three years from April 2013.  The Joint Commissioning Board would remain for the time being; however there would be further thought about the longer term governance.  A joint commissioning plan would be submitted to the Board annually.  The documentation had been drawn up using a national template.

29.4    Councillor Norman referred to the consultation paragraph in the report.  He asked if the decision not to consult on the revised documentation could be disputed.  The Chief Operating Officer replied that if there were any major changes there would be a consultation process.  However, no major changes were currently proposed.  She did not think anyone would challenge the decision not to consult.

29.5    The Senior Lawyer stated that when deciding whether to consult or not, it was necessary to consider whether there were proposals for delivery of the service or commissioning arrangements to be .  As this was not the case and that the proposed changes are necessary to reflect  changes in law, there was no need to consult.

29.6    The Chief Operating Officer stated that the report would be submitted to the Adult Care & Health Committee.  She drew attention to paragraph 5 of the report which explained that the revised Section 75 arrangement would maintain the previous funding arrangement whereby respective financial contributions were not pooled, but instead were separately managed and reported on by the Lead Commissioner on behalf of both organisations.  

29.7    RESOLVED - That the revisions to the Section 75 Agreement and the draft documentation be noted.