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Scrutiny & Assurance

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Since we began developing our proposals and plans for consultation, we have undergone rigorous scrutiny and a process of assurance with the CCGs’ Governing Bodies, Local Authorities, the West Midlands Clinical Senate and NHS England.

Below are the organisations and bodies that provide scrutiny and assurance including any reports and letters they have provided as part of their role.

Governing Bodies

The Governing Bodies received and considered regular updates on the development of the pre-consultation business case and will continue to receive and consider the progress of the consultation. Public papers are on the CCGs' websites.

On 4 December, the Governing Bodies met in common in a meeting in public (view minutes) and approved the Pre-Consultation Business Case and agreed go to consultation. These minutes are unconfirmed and will be discussed at the next Governing Body meeting.

Dates of future meetings are available on the CCG websites:

Health Overview and Scrutiny Committees

Any proposals for substantial changes to NHS services are required to be referred to the Local Authority Health Overview and Scrutiny Committee. Both the Stoke-on-Trent City Council Adults and Neighbourhoods Overview and Scrutiny Committee and the Healthy Staffordshire Select Committee have received regular updates on the proposals.

West Midlands Clinical Senate

In 2017, the CCGs approached the West Midlands Clinical Senate to request independent clinical advice on the Community Hospitals and Discharge to Assess model of care - see Stage 1 feedback (July 2017).

The CCGs met again with the Independent Clinical Review Panel in early 2018 and the Senate’s report was published on 30 July 2018.

The Consultation Institute

We have sought advice and worked closely with the Consultation Institute to develop our consultation plan. The Consultation Institute are the leading independent experts on best practice in public consultations.

NHS England Assurance

In July 2017, the draft Case for Change was presented to NHS England’s Regional Sense Check Panel. It was determined that the scope of the work be extended beyond just Discharge to Assess (D2A) and Community Hospital beds to include the broader picture of the delivery of local health services. In November 2018, NHS England provided further assurance with a letter supporting going to consultation. Both letters are below:

Joint Health Overview and Scrutiny

As these proposals affect five Community Hospitals in more than one local authority area and in order that Overview and Scrutiny Committees are able to exercise their important scrutiny function, on 7 December 2017, a letter was sent to each separate body to advise that in accordance with the Local Authority (Public Health, Health and Wellbeing Boards and Health Scrutiny) Regulations 2013, the Governing Body in Common on 5 December 2017 agreed that under Part 4 Health Scrutiny by Local Authorities, regulation 30 (5), local authorities must appoint a joint health scrutiny committee where a ‘responsible person’ (in our case the CCG) informs affected local authorities that it has under consideration a proposal which would affect more than one local authority area. The regulations require the relevant local authorities to form a joint scrutiny panel known as a mandatory joint scrutiny panel.

The CCGs sent a letter in December 2017 to request that Staffordshire County Council and Stoke-on-Trent City Council establish a mandatory joint scrutiny panel as the best way of obtaining a view on the proposals being consulted on. Since then, the JHOSC was formed and the CCGs sent a further letter to advise the JHOSC that the Governing Bodies agreed to go to consultation.

The CCGs will now work with the JHOSC to agree meetings and how to proceed during the consultation.

Independent Reconfiguration Panel

Local Authority Health Overview and Scrutiny Committees have the power to make a referral to the Secretary of State for Health to make a final decision. The power to make a referral is given to local authorities by regulations issued by the Secretary of State. A local authority (or group of local authorities under section 30 of the regulations) can make referrals on three grounds:

  • It is not satisfied with the adequacy of content or time allowed for consultation with itself (not wider consultation with patients, the public and stakeholders).
  • It has not been consulted, and it is not satisfied that the reasons given for not carrying out consultation are adequate.
  • It considers that the proposal would not be in the interests of the health service in its area.

Staffordshire County Council made a referral on 11 January 2017 - see the letter in the Healthy Staffordshire Select Committee public papers (31.01.2017) (pages 91-94).

Stoke-on-Trent City Council made a referral on 26 January 2017 - see the letter in the City Council Meeting public papers (26.01.2017) (pages 93-94).

The Secretary of State for Health receives the referral and passes it to the Independent Reconfiguration Panel (IRP), which is appointed to review each case and advise the Secretary of State. The panel is made up of experts in the area of health service reconfiguration and representatives of the public. See the findings in IRP Stoke-on-Trent initial assessment.

In response to the findings, the CCGs acknowledged that the process could have been better managed and that lessons had been learned. These lessons and subsequent process that were to be put in place from October 2017 led to no recommendations being made by the IRP.

On 27 April 2018, Stoke-on-Trent City Council Adults and Neighbourhoods Overview and Scrutiny Committee acknowledged that the CCGs had implemented improved processes to involve local stakeholders. They formally responded to the IRP and agreed to ‘draw a line and move forwards’ - Minutes of Meeting (27.04.2018).