Agenda item

(indicative timing: 2:50pm to 3:20pm)

The Strategic Director referred the Panel to the Agenda Report, highlighting that the new Care Quality Commission (CQC) assurance framework for adult social care was part of the Health and Care Bill, published 6 July 2021, which set out key legislative proposals to reform the delivery and organisation of health and care services in England, building on the existing Integrated Care Systems (ICS) model.

Little was known about the new framework, however, the CQC was planning stakeholder engagement workshops to help establish a baseline for assessing local authorities and was working closely with Directors of Adult Social Services.  It was anticipated that CQC inspection of local authority adult social care would begin from April 2023.   

Since 2010, Councils had worked together to support their own performance through ‘Peer Reviews’.  The West Midlands network was active and Worcestershire had benefitted from this approach in January 2020.  In addition, to prepare for CQC assurance, several self-assessment tools had been developed by Worcestershire Officers and shared regionally.  Feedback received was good, which added to the progress made since the 2020 Peer Review.

The Government’s Integration White Paper was published on 9 February 2022.  It focussed on integration at place level and aligned with the Health and Social Care Bill, however, it was noted that children’s services were not included and questions on governance, leadership and digital transformation remained unanswered.

In the ensuing discussion, the following main points were made:

·         When asked in what areas the Council was weakest, the Strategic Director suggested that more evidence of co-production would likely be required.  In addition, long term funding of adult social care, however, this was an area of concern for all Councils.  It was anticipated that comparisons would be made with similar local authorities and the use of the Council Tax Levy would be a contributing factor

·         The Cabinet Member with Responsibility added his concern about the budget, especially the introduction of the cap on care costs.  In Worcestershire, 60% of residents were self funders and this would result in a considerable challenge.  It was noted that other authorities, such as Nottinghamshire, had a higher Council Tax

·         Concern was raised around the proposals of measuring shared outcomes across the ICS, rather than outputs, which would come into force from April 2023.  The notion of the right healthcare and the right care at the right time would focus partners to collaborate

·         The White Paper included, under Leadership, the appointment of a single person accountable for the delivery of a shared plan and outcomes in each place or area, agreed by relevant local authorities and Integrated Care Board.  The Strategic Director commented that there was no further detail, nor whether the position would be executive or non-executive

·         When asked whether the relationship between the CQC and the Council would change, it was reported that it would likely evolve and become more of a partnership model, especially as the CQC workforce would change due to the inspection regime

·         The ICS was a long term initiative, with the ability to align budgets and share resources.  The Panel noted that any consideration of organisation reform would be a massive distraction to service improvement

·         Clarification was given about plans for shared digital records and the benefits and safeguards of such systems.  Data protection would not change and information sharing protocols would be in place.  Furthermore, digital technology could assist in remote monitoring of patients and remote consultations and the potential for further improvement was huge

·         A Member asked about the key line of enquiry in relation to leadership capability, to be informed that it would likely be wide, to include Senior Leaders in the Directorate, relationships with Directors of Finance and Chief Executives and Members involved in decision making and scrutiny.