The Board to consider revised terms of reference, drafted in response to the establishment of the Health and Wellbeing Partnership in 2022.
7.1 Siobhan Farmer, Director of Public Health, (Gloucestershire), outlined proposals for the alignment of the membership of the Health and Wellbeing Partnership with the Health and Wellbeing Board. It was explained that to fulfil the proposals required a review of the terms of reference, (including membership), of both committees.
7.2 As noted at the earlier Health and Wellbeing Partnership meeting, the Health and Care Act 2022 introduced significant changes to the structures and governance of local NHS bodies, including changes to the way local Health bodies work with Local Government. As a consequence of the changes, the Gloucestershire NHS Integrated Care Board was formed on 1 July 2022, taking on the responsibilities and functions formerly held by the Gloucestershire Clinical Commissioning Group.
7.3 It was explained that the Act did not impact on the statutory duties of Health and Wellbeing Boards, and that these must still be discharged. There remained, however, a potential overlap in the intended roles and responsibilities of Integrated Care Partnerships (ICP) and Health and Wellbeing Boards (HWB), particularly for areas that are coterminous.
7.4 One of changes introduced by the Act was a requirement for each Integrated Care Board (ICB) and each upper tier or unitary Local Authority within its geographical area to establish a joint committee, (an Integrated Care Partnership). In Gloucestershire’s case, since the County Council and the ICB are coterminous, this resulted in the establishment of a single Integrated Care Partnership for the County. Each Integrated Care Partnership can determine its own procedures and methods of working.
7.5 Reflecting on the Council’s co-terminosity with the ICB and the anomalies brought about by the pre-existing Health and Wellbeing Board and the new Integrated Care Partnership covering the same geographical area, serious consideration had been given to how the two bodies might align/develop complementary roles in order to add value to their respective functions and facilitate the delivery and improvement of local outcomes and services.
7.6 Referencing Health and Wellbeing Boards Guidance published by the Department of Health in November 2022, including guidance for localities affected by the issue of coterminous areas, members were informed that: ‘in the few areas where the ICP and HWB are coterminous, (covering the same geographical boundaries), it may be appropriate for the HWB and the ICP to have the same members. This can be done, for example, by one part of the meeting formally being of the HWB, and the other part of the ICP. However, both have different statutory functions which each will be required to fulfil.”
7.7 Members were advised that, following publication of the new guidance, comparisons were made between the membership of the Gloucestershire HWB and HWP. From the comparisons, it had become apparent that the HWP had a significant number of core officer members in common with the HWB, plus additional representation from the Voluntary, Community and Social Enterprise (VCSE) sector and a wider representation from the health and care sectors. The HWB included several ‘in common’ appointed members, (including the Chair), plus ‘elected’ cabinet portfolio leads from GCC, and the Deputy Police and Crime Commissioner.
7.8 To add value to the two committees, and hopefully achieve a more streamlined approach to meetings, it was proposed that the membership and future meetings of the HWB and HWP align. This would allow the members of the HWP to participate at both HWP and HWB meetings. The benefits of creating a consistent membership would hopefully reduce the potential for repetition at meetings brought about by the duplication of agenda items relevant to both groups, thus creating efficiencies in resource demands.
7.9 In order to achieve this, the following proposals were made: -
a) The Terms of Reference for both the HWP and the HWB to be updated to reflect the proposed changes.
b) The HWB to include elected representatives.
c) Continued oversight of the delivery of the JHWS, (for which the Local Authority is accountable), to be made via the HWB. Scrutiny of the JHWS to remain with the Adults and Social Care Scrutiny Committee.
d) All other aspects of the HWB Terms of Reference to be maintained, including the arrangements for voting.
e) Meetings to be scheduled so that the HWP meet six times a year. Every other meeting of the HWP to take the form of a reduced session for the HWP, for which HWB members would join part or all of the meeting. The sessions to focus on Pillar 1 of the Interim Integrated Care strategy.
f) Additional development sessions to be arranged periodically to review developments to the JHWS.
7.10 If agreed by the HWB and the HWP, virtual consultation of the proposals to be made prior for consideration by the Gloucestershire County Council’s Constitution Committee.
7.11 The draft terms of reference were noted, with a request that the HWP and the HWB submit any views to the Chair of the Board/Partnership for inclusion in the report/recommendations to the GCC Constitution Committee meeting in March. The Constitution Committee to then make recommendations to Full Council at its meeting on 24 May 2023, seeking approval of the revised Terms of Reference for each committee.