Agenda, decisions and minutes

Stella Jeffrey was elected as Chair of the working group.

1.1       RESOLVED: That Councillor Stella Jeffrey be elected as Chair of the working group.

The following non-pecuniary declarations of interest were made:

Cllr Muldoon: Elected governor of the SLAM NHS Foundation Trust.

Cllr Hall: Elected governor of King’s College NHS Foundation Trust

2.1       The following non-pecuniary declarations of interest were made:

Cllr Muldoon: Lead governor of the SLAM NHS Foundation Trust.

Cllr Hall: Elected governor of King’s College NHS Foundation Trust

It was agreed that the following information would be supplied to the working group for inclusion in its final report:

·                Detailed information on the public health budget; its constraints and flexibilities in terms of funding positive public health outcomes; and the requirement to submit an annual statement to Public Health England demonstrating that public health outcomes have been met.

·                A copy of the latest annual statement and annual public health report.

·                Finance information quantifying the headroom and tolerances within the public health budget to ensure that mandatory health protection activity in response to emergencies could always be carried out.

·                Information on actual spend to date in terms of the public health budget.

·                Information on the level of funding provided by Lewisham to the advice sector compared to other London boroughs.

·                Information on how people will get advice, including specialist debt advice, from April 2015.

·                Results of the consultation with the Lewisham Clinical Commissioning Group on the savings proposals.

3.1       Aileen Buckton introduced the report, covering:

·           How the budget was currently structured.

·           The split between mandatory and discretionary public health services.

·           The upcoming restructure and the harmonisation in terms and conditions between local authority staff and staff who transferred to the local authority when public health responsibilities were transferred.

·           The savings proposals – decommissioning some services and spending the savings in areas of budget reductions where the reductions could result in a negative public health outcome.

·           The previous use of public health money to retain free swimming for the over 60s and young people.

3.2      The working group discussed the public health budget and the proposed savings and Aileen Buckton commented that the first set of proposals (A6 - £1.5m) would have a minimal impact on outcomes; and whilst the second set of proposals (A8 - £1.154m) might have a more significant impact, this would be mitigated by a reconfiguration of services at a neighbourhood level, in alignment with the development of integrated services.

3.3      One of the aims of the working group was, in relation to the savings being proposed, to consider any alternative services that exist or would be put in place to replace reduced or stopped services. The working group considered the table in the report that listed the risks and mitigation associated with each element of the savings proposals. In response to questions from Members the following points were noted:

·           Savings proposals relating to breastfeeding services had the potential to affect the achievement of UNICEF/WHO baby friendly status in 2015, so steps would be taken to ensure the renegotiation of contracts relating to breastfeeding cafes would not jeopardise the Council’s chances of achieving the status.

·           The new neighbourhood model was largely in place in terms of management infrastructure, although geographic co-location was still to be achieved. Further integration was also required in terms of integrating more services and extending networks (with mental health, the voluntary and community sector, pharmacies etc.). However, the Community Connections programme was now firmly established in the neighbourhoods.

·           South East London had chosen to retain infection control nurses rather than devolve the relevant budgets to NHS England and this had given the boroughs an advantage in terms of ensuring adequate health protection activity.

·           In terms of work with specific communities, such communities would now only receive specific targeted interventions if there was clinical need (e.g. if a particular illness was prevalent in a certain community); and that in terms of access to services, a broader picture would be considered and efforts made to ensure everyone had access to services.

3.4      In response to a question from Cllr Walsh about measuring the impact of public health services (and cuts to them), Danny Ruta spoke about the difficulties in quantifying benefits and reported that academic research indicated that the most sensible way of measuring the success of services was probably to list the different types of benefits they brought in words (and numbers where possible), compare these to the costs and make  ...  view the full minutes text for item 3.

None.

4.1       None.