Report to: Leader and Lead Member for Strategic Management and Economic Development
Date of meeting: 16 February 2024
By: Director of Adult Social Care and Health
Title: Sussex Health and Care Assembly Terms of Reference and Membership
Purpose: To consider and approve the revised terms of reference and membership of the Sussex Health and Care Assembly (“the Assembly”).
RECOMMENDATIONS: On behalf of the County Council as one of the four statutory members of the Assembly, the Leader and Lead Member for Strategic Management and Economic Development is recommended to consider the proposed changes to the Sussex Health and Care Assembly, as set out in paragraphs 2.1 – 2.4 of this report, and approve the draft refreshed terms of reference contained in Appendix 2.
1.1 East Sussex County Council (“ESCC”) is a statutory joint partner in the Assembly which is established as a joint committee between ESCC West Sussex County Council (“WSCC”), Brighton & Hove City Council (“B&HCC”), and the NHS Sussex Integrated Care Board (“ICB”). This is driven by the statutory requirement in the Health and Care Act 2022 to establish an ‘integrated care partnership’ as part of the new Integrated Care System (“ICS”) arrangements.
1.2 The Assembly has met five times since September 2022 and achieved the ambition of approving a five-year integrated care strategy, Improving Lives Together, in December 2022. This builds on the East Sussex Health and Wellbeing Strategy Health Lives, Healthy People (2022 – 2027), and sets out the ambition for a healthier future for everyone in Sussex over the next five years. The shared arrangement for delivering the Strategy was presented to the meeting of the Leader and Lead Member for Strategic Management and Economic Development on 20 June 2023.
1.3 At the end of its first year of operation a review was undertaken of the effectiveness and governance arrangements of the Assembly, which led to the Assembly Members holding a workshop session to discuss this on 11 October 2023 and enabled all partner Assembly Members to be actively consulted. The Leader and Lead Member for Strategic Management and Economic Development took part in these discussions in his role as the Chair of the Health and Wellbeing Board and statutory partner of the Assembly for ESCC.
1.4 This report brings the proposed changes to the Assembly role, membership and arrangements that resulted from the review exercise, for formal approval.
2. Supporting information
Evolution of the Assembly
2.1 A full description of the proposals arising from partner discussions that will help the Assembly evolve, and the rationale behind them is set out in Appendix 1. The changes are intended to enable and accelerate delivery of Improving Lives Together. In summary the main changes are as follows:
Chairing and secretariat arrangements
· Agreement that a new Independent Assembly Chair will be engaged by one of the Local Authorities on behalf of all four statutory partner members through a competitive selection process. The Chair will work closely with the ICB and all three Local Authorities to plan meetings and agendas in advance of meetings.
· Organisation and administration will be a shared responsibility of all four partners who will agree funding and timings, overseen by the Independent Chair. Support will be provided by one of the four statutory partners on a full cost recovery basis and managed through a Service Level Agreement.
· The four statutory partners will make equal contributions to the cost of the Assembly and the ICB will continue to publish the agendas, papers and meeting recordings on the Sussex Health and Care website.
Assembly membership
· Assembly membership will be reduced from the current twenty-four members to eighteen to ensure better balance and voice. This will include moving to one Higher Education representative and ensuring there are three Healthwatch representatives who can talk to the diversity of public experiences across the three places and life stages.
· A Leisure Services provider representative will be invited to become a member of the Assembly.
· Each statutory partner will retain the option to invite an executive officer to support or advise them during Assembly meetings.
· Subject matter experts can also be invited to attend and participate in specific agenda items at Assembly meetings, with the agreement of the Independent Chair and four statutory partners.
2.2 The terms of reference for the Assembly have been amended to reflect these proposed changes, so that the four statutory partner organisations can approve them through their organisation governance processes, prior to presentation to the Assembly itself for final approval. The refreshed draft terms of reference are attached in Appendix 2.
Role of Place
2.3 A core principle for this joint work is that the primary building blocks are the three “Places” (East Sussex, West Sussex and Brighton and Hove). At the inception of the ICS there was local agreement that “Place” is key to strategic leadership, local commissioning and delivery within the ICS, in order to get the best value out of the full range of collective resources available to meet needs and improve the health, care and wellbeing of populations.
2.4 A refreshed approach to the way the four statutory partners work across activity that is complementary to the Assembly was also agreed, to enable better alignment based on shared priorities driven by the three Joint Strategic Needs Assessments (JSNAs) and Health and Wellbeing Board (HWB) Strategies. In summary this includes:
· Further strengthening the alignment of shared priorities for populations across Sussex and Place, through the ongoing role and appropriate attendance of the ICB at the three statutory HWB Board meetings.
· Ensuring ongoing local democratic scrutiny of healthcare services through appropriate ICB attendance at Health Overview and Scrutiny Committee meetings.
· Working to align JSNA and HWB Strategy activity across the three Local Authorities, whilst acknowledging the need to retain a strong focus specific to each population.
3. Conclusion and reasons for recommendations
3.1 In its first year of operating the Assembly has strengthened partnership working required to provide the focus for shared priorities of improving health and integrating care for the populationacross Sussex. This is reflected in the bringing together and agreement of the integrated care strategy Improving Lives Together in December 2022, and the subsequent shared delivery arrangements.
3.2 To build on this strong start and better enable ongoing delivery of the strategy, the suggested changes to the Assembly’s role, membership and arrangements have been proposed following a collective review and feedback from the wider Assembly membership, and the views of the four statutory partners.
3.3 Within this report there are no changes to ESCC’s statutory role and responsibilities for services and budgets. ESCC remains responsible for setting its priorities and budgets through the Reconciling Policy Performance and Resources (RPPR) process. The work undertaken through the Assembly will add value through helping partner organisations focus on the things that can only be achieved well by working together.
MARK STAINTON
Director of Adult Social Care and Health
Contact Officer: Vicky Smith Email: Vicky.smith@eastsussex.gov.uk
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BACKGROUND DOCUMENTS
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