Agenda item

On the 7th September 2017 the Health and Wellbeing Board considered a report requesting that the Board formally sign off Bromley’s Local Plan for the Better Care Fund. The Health and Wellbeing Board’s authorisation and the Chairman’s signature on the plan was a formal requirement by NHS England.  The Board resolved “that (subject to final adjustments) the HWB agree the BCF Local Plan, and consent to its submission to NHS England”.  Following approval from the Health and Wellbeing Board and final adjustments to the plan, the Local Plan had been submitted to NHS England on 11th September 2017, although to date NHS England had not confirmed whether the Local Plan had been approved.  For completeness and in line with the Council’s local governance the final Local Plan was presented to Executive to note.

In response to a question from the Leader, the Executive Assistant, Chief Executives confirmed that it was a statutory function of the Health and Wellbeing Board to sign off the Local Plan for the Better Care Fund.  Prior to sign off the Local Plan had not been scrutinised by any of the Council’s Policy Development and Scrutiny (PDS) Committees.  The Leader noted that whilst he was broadly supportive of the content of the Local Plan in future he hoped the sign off process would include scrutiny and consider input by the relevant PDS Committee.

The Portfolio Holder for Resources, Councillor Arthur, highlighted that when the Health and Wellbeing Board was established it had been clear that it did not have the authority to commit to expenditure on behalf of the Local Authority.  Councillor Arthur expressed concern that the Local Plan had been submitted to NHS England before being considered by the Council’s Executive, stressing that any decision requiring expenditure by the Local Authority should be considered by the Executive.

In response Chief Executive confirmed that the points that had been raised would be taken on board for the future.  The Director of Corporate Services reminded Members that whilst the governance process could incorporate consideration by PDS Committees and the Executive, a decision could not be imposed on the Health and Wellbeing Board.

In response to a further issue raised by the Portfolio Holder for Resources concerning the need to ensure that the funding was directed to patients who were being supported in the community, the Director of Adult Social Care explained that the purpose of the Local Plan was to enable consideration of new and more appropriate ways to support people in the community and prevent them from spending longer periods of time in acute care.

The Chairman of the Executive and Resources PDS Committee highlighted that it appeared that there were already delays in the process as the timeline included within the report indicated that Bromley should be at a more advanced stage of the submission and assistance process.  In response the Executive Assistance highlighted that the timetable within the report was indicative of national timescales and Bromley could not progress any further until its Local Plan had been approved by NHS England.

Councillor Kate Lymer queried whether any rejection of the Local Plan would be on the basis of not enough integration of services.  In response the Executive Assistant reported that integration could be an element of the need to review the Local Plan however, there were four conditions attached to approval to spend the Better Care Fund which all had to be met.  The Director of Finance highlighted that in recent months the Government had changed its stance in relation to integration.  Previously the stance taken by the Government had been full integration by 2020 however, in a recent speech by the Chancellor of the Exchequer reference had been made to further integration by 2018. 

The Director of Finance also highlighted that the issue of financial risk share would be a key issue requiring detailed consideration as the future integration of health and social care was being reviewed.  The further development of Accountable Care Organisations would require detailed scrutiny prior to any decisions being taken.  The Leader stressed that in relation to integration, Members would not take any decision before issues surrounding financial liability had been resolved.

RESOLVED: That

1. The report to the Health & Wellbeing Board and the Board’s decision to approve Bromley’s Local Plan for 2017-19 be noted.

2. The Local Plan submission to NHS England on 11th September 2017 be noted.