30 April 2008

To All Health Overview & Scrutiny Chairs in the South West

Adult Social Care Overview & Scrutiny Chairs in the South West

LINks in the South West

cc. PCT Chief Executives in the South West

Dear Colleague

RE: Improving Joint Working in Health Scrutiny

I am writing as Chair of the South West Health Scrutiny Network Project Board to advise you of work that the Board is progressing to consult with Health Overview and Scrutiny Committees (HOSCs) and Adult Social Care Overview Committees regarding joint working between local authorities.

The South West Health Scrutiny Network was formed in 2007 as a result of a successful bid for £10,000 funding to the Centre for Public Scrutiny (CfPS). A Project Board was established with representatives from local authorities across the South West and stakeholder organisations such as NHS South West. The remit of the Project Board is to identify issues that would benefit from a regional approach, to share best practice and to organise events to improve the effectiveness of health scrutiny.

The Project Board has identified that there may be a need to explore how to simplify the process for joint working between HOSCs, particularly when there is a requirement to form a Joint Committee to consider and respond to proposals to develop or change health services that affect more than one local authority area, and are considered to be ‘substantial’ by the HOSCs for the areas affected by the proposals. Although this is an issue primarily relating to Health Overview and scrutiny Committees, the Project Board feels that it is important that Adult social Care Overview Committees are also made aware of this issue and have the opportunity to feed into this work if they wish to do so.

Many local authorities have experienced joint working with other health overview and scrutiny committees (HOSCs), from informal exchanges of information to establishing a formal Joint Committee. Joint working has many benefits, such as pooling resources and expertise, but can also bring practical difficulties.

This issue was highlighted at a recent CfPS regional workshop in relation to Specialised Commissioning that was attended by representatives from many HOSCs. The implications for HOSCs in relation to proposals by the Specialised Commissioning Group (SCG), to vary specialist services were discussed at the workshop.

The SCG is a formal joint committee comprising of the 14 Primary Care Trusts in the South West and is responsible for the collaborative commissioning of specialised services. It intends to consult with all HOSCs over the next 12 months regarding up to 14 specialist services.

Specialised services are services provided in a small number of specialist centres to catchment areas of more than a million people e.g. bone marrow transplants. They are high cost, low volume interventions and treatments

One of the main outcomes of the workshop was the need to identify a consistent process for the SCG to consult with HOSCs and for HOSCs to respond to proposals that they consider to be a ‘substantial variation’ in a timely manner. HOSCs will need to determine how to carry out joint working with other local authorities that also consider proposals to be ‘substantial’.

The Project Board is exploring options to simplify how HOSCs carry out joint working. We intend to circulate a briefing paper to the Chairs of all HOSCs and Adult Social care Overview Committees in May 2008 outlining:

  • A summary of legalisation and guidance in relation to joint working between HOSCs
  • The implications of proposals to vary or develop services that affect more than one local authority area, such as with services commissioned by the SCG
  • Options to simplify the process for responding to consultations that affect more than 1 local authority area, for example the development of a common template that commissioners are expected to complete and forward to all HOSCs

We would encourage all HOSCs to consider the options outlined in the briefing paper early in the new municipal year. We will be asking for your comments by the end of July 2008. Feedback from other stakeholders would also be much appreciated.

If there is a desire for the South West Health Scrutiny Network to work with HOSCs to progress this issue, the Project Board intends to arrange several sub-regional workshops to which HOSC members and officers will be invited to agree what steps they will take to be better prepared for the establishment of formal joint working arrangements, in the event that they are required.

Proposals to vary or develop services also have implications for Local Involvement Networks (LINks) and the Project Board intends to invite LINks across the South West to participate in this scoping work. PCTs will also be kept informed of progress and a copy of this letter and the briefing paper will be sent to PCT Chief Executives and LINks.

I hope that HOSCs welcome the input of the Project Board in relation to this issue. Remember that the Network exists to support HOSCs and to ultimately improve the effectiveness of health scrutiny. If you have any suggestions for issues that could be considered by the Network, or if you or a representative from your Committee would like to joint the Project Board, please do not hesitate to contact me.

Yours faithfully


Dr Pamela Akerman

Chair, South West Health Scrutiny Network Project Board