Agenda item

Surrey County Council is playing an important role in the three Sustainability and

Transformation Partnerships across Surrey.  On 31 October 2017 the Cabinet considered a report regarding the Sustainability and Transformation Partnerships in Surrey with a focus on the work that had begun to implement the devolution agreement for Surrey Heartlands.

This report provides a further update on the progress that has been made in implementing the Surrey Heartlands devolution agreement and asks the Cabinet to endorse the next steps, including the pooling of budgets with NHS partners in an agreement under s75 of the National Health Service Act 2006 (s75 agreement) as part of a more joined up and integrated health and social care system.

[The decisions on this item can be called in by the Health Integration & Commissioning Select Committee]

RESOLVED:

1. That the progress made between the Council and health partners in Surrey Heartlands be noted and the direction of travel towards a devolved health and care system noted.

2. That the following Council budgets be pooled with the Surrey Heartlands CCG budgets under a 3 years.75 agreement:

·         The Surrey Heartlands proportion of the Council’s budget for adult social care and public health

·         The Surrey Heartlands proportion of the Council’s budgets relating to children’s community health services and Child and Adolescent Mental Health Services.

3. That the phased approach being proposed to creating a devolved health and care system by entering in to a s75 agreement but with appropriate safeguards in year one of the agreement including no transfer of additional financial risk to (or from) the Council and with the Council hosting the pooled budgets was noted.

4. That the intention to delegate within the agreement authority to the Surrey Heartlands Joint Committee to take commissioning decisions in relation to the functional areas included was noted, and that the Leader of the Council approve the final detailed delegations before the agreement was completed.

5. That authority be delegated to the Executive Director for Children, Families and Learning and Executive Director for Health, Wellbeing and Social Care, in consultation with the Cabinet Members for People, Adults and Children, to approve a ‘section 75’ agreement with the Surrey Heartlands Clinical Commissioning Groups.

6. To continue to develop plans with local government being at the centre of the delivery model which would ensure the wider determinants of health and wellbeing were met, truly changing the life outcomes of some of our most vulnerable residents and to call upon the Secretary of State to devolve all necessary powers to this Council to ensure that ambition was delivered.

Reason for decisions:

Sustainability and Transformation Partnerships played a pivotal role in shaping the future health and care priorities and landscape. In the eight months since the last Surrey Heartlands update to the Cabinet, significant progress has been made in the development of the devolution arrangements for Surrey Heartlands.

Devolution and the integration of health and social care were key mechanisms for enabling the Surrey Heartlands Health and Care Partnership to achieve its aims and ambitions, and were aligned to the draft vision for Surrey in 2030 endorsed by the County Council at its meeting on 22 May 2018.

[The decisions on this item can be called in by the Health Integration & Commissioning Select Committee]

The Cabinet Lead Member for People presented this report that described how the Council was playing an important role in the three Sustainability and

Transformation Partnerships (STPs) across Surrey.  It also provided a further update on the progress that had been made in implementing the Surrey Heartlands (SH) devolution agreement and asked the Cabinet to endorse the next steps, including the pooling of budgets with NHS partners in an agreement under s75 of the National Health Service Act 2006 (section 75 agreement) as part of a more joined up and integrated health and social care system.

He stated that the Secretary of State was to consider devolving responsibility and resources in order that there could be greater freedom on how services were delivered.  He also pointed out that the finer detail of the S75 agreements would be reported at a future meeting.

Mr Jonathan Essex, Member for Redhill East sought assurances and an update for the other STPs that were not part of Surrey Heartlands.  The Leader and Cabinet Members gave brief updates on the position in relation to the STPs and how they were progressing.  The Leader also reported that he and the Chief Executive met with Jeremy Hunt MP, before he changed roles, who was enthusiastic about Surrey Heartlands becoming a joint commissioning authority and he had been asked to bring back a plan to the new Health Secretary.

RESOLVED:

1. That the progress made between the Council and health partners in Surrey Heartlands and the direction of travel towards a devolved health and care system be noted.

2. That the following Council budgets be pooled with the Surrey Heartlands CCG budgets under a 3 years.75 agreement:

·         The Surrey Heartlands proportion of the Council’s budget for adult social care and public health

·         The Surrey Heartlands proportion of the Council’s budgets relating to children’s community health services and Child and Adolescent Mental Health Services.

3. That the phased approach being proposed to creating a devolved health and care system by entering in to a s75 agreement but with appropriate safeguards in year one of the agreement including no transfer of additional financial risk to (or from) the Council and with the Council hosting the pooled budgets was noted.

4. That the intention to delegate within the agreement authority to the Surrey Heartlands Joint Committee to take commissioning decisions in relation to the functional areas included was noted, and that the Leader of the Council approve the final detailed delegations before the agreement was completed.

5. That authority be delegated to the Executive Director for Children, Families and Learning and Executive Director for Health, Wellbeing and Social Care, in consultation with the Cabinet Members for People, Adults and Children, to approve a ‘section 75’ agreement with the Surrey Heartlands Clinical Commissioning Groups.

6. To continue to develop plans with local government being at the centre of the delivery model which would ensure the wider determinants of health and wellbeing were met, truly changing the life outcomes of some of our most vulnerable residents and to call upon the Secretary of State to devolve all necessary powers to this Council to ensure that ambition was delivered.

Reason for decisions:

Sustainability and Transformation Partnerships played a pivotal role in shaping the future health and care priorities and landscape. In the eight months since the last Surrey Heartlands update to the Cabinet, significant progress has been made in the development of the devolution arrangements for Surrey Heartlands.

Devolution and the integration of health and social care were key mechanisms for enabling the Surrey Heartlands Health and Care Partnership to achieve its aims and ambitions, and were aligned to the draft vision for Surrey in 2030 endorsed by the County Council at its meeting on 22 May 2018.