Agenda item

To consider a report from the Head of Scrutiny and Member Development presenting a range of information associated with the Fundamental Review of NHS Allocations Policy.

Following the previous meetings held on 25 September 2013 and 30 October 2013, the Head of Scrutiny and Member Development submitted a report that introduced further information in relation to the Fundamental Review of NHS Allocations Policy and the potential implications for Leeds.

The following information was appended to the report.

-  An update / briefing note provided by NHS England, through the West Yorkshire Area Team (Appendix 1);

-  Summary of the action points arising from the ‘core cities’ Chief Finance Officer’s meeting – 4 October 2013 (Appendix 2);

-  A briefing note from the Director of Public Health regarding the Public Health budget in Leeds (Appendix 3)

The Chair of the Scrutiny Board outlined that from the written update prepared by the Director of Finance (NHS England (West Yorkshire)) there appeared to be a proposed shift in position from the initial methodology used to produce the draft allocations earlier in the year. 

The following representatives were in attendance to help the Scrutiny Board consider the information presented:

-  Ian Currell (Director of Finance – NHS England (West Yorkshire))

-  Visseh Pejhan-Sykes (Chief Finance Officer – Leeds West Clinical Commissioning Group)

-  Councillor Lisa Mulherin (Executive Board Member for Health and Wellbeing – Leeds City Council)

In addressing the Scrutiny Board, the following points were made:

Director of Finance – NHS England (West Yorkshire)

·  The NHSE Board would be considering NHS funding allocations at its meeting on 17 December 2013 – with papers for that meeting released 7 days beforehand.

·  The NHSE Board was likely to consider a range of options around NHS funding allocations.

·  Key issues were likely to include ‘unmet need’ and the ‘pace of change’.

·  A number of representations had been made following the release of draft proposals and the national team responsible for drawing this work together had met with Leeds’ Clinical Commissioning Groups.

Chief Finance Officer – Leeds West Clinical Commissioning Group

·  Pleased about the conversations with NHSE following the publication of draft allocations earlier in the year.

·  A number of specific matters affecting Leeds’ situation remained – including the move to GP registered populations rather than census population details.

·  CCGs remained unclear about the full impact of individual elements of the formula used to produce draft allocations published earlier in the year.

Executive Board Member for Health and Wellbeing

·  Some concerns regarding NHSE’s openness and transparency on this matter remained and the involvement and engagement with local authorities had fallen short of expectations.

·  The details available publically only provided a partial picture, with proposed allocations for Primary Care and Specialised Services unknown.

·  An engagement event to discuss NHSE direct commissioning role around Specialised Services was scheduled to take place in London on 9 December 2013.

·  The full impact of any changes in CCG funding on the plans for health and social care integration across Leeds remained unclear.

Members discussed the report and information presented to the Board, along with the details highlighted at the meeting.  Members raised a number of issues, including:

·  The definition of ‘unmet need’ and the potential implications for Leeds arising from the classification used as part of the proposed funding formula.

·  Levels of deprivation and the potential impact of changes in CCG funding allocations on health inequalities across the City.

·  The balance between more NHS resources being used to support older people and addressing unmet need, which can result in people dying at a younger age.

·  The full impact of a potential reduction of £84M for CCGs in Leeds was unclear, particularly in terms of how such reductions would be managed (given the low levels of growth expected across the NHS in the coming years).

·  The potential impact of different spending levels (per capita) across each of the 3 CCGs in Leeds.

The Chair thanked those in attendance for their contribution to the discussion at the meeting and looked forward to their input at future Scrutiny Board meetings, where appropriate.

RESOLVED –

(a)  To note the information presented and discussed at the meeting.

(b)  That the Principal Scrutiny Adviser draft a formal response to the NHS

Funding Allocation proposals published by NHS England, taking account of the information due to be published ahead of the NHS England Board meeting (scheduled for 17 December 2013).