Agenda item

(To receive a report by the Director of Public Health, which invites the Committee to consider a report to the Executive which seek approval on Public Health Arrangements for Greater Lincolnshire, which is due to be presented to the Executive on 1 February 2022. The views of the Committee will be reported to the Executive as part of their consideration of this item)

Consideration was given to a report by the Executive Director – Adult Care and Community Wellbeing and The Director for Public Health, which invited the Committee to consider a report on Public Health Arrangements for Greater Lincolnshire, which was due to be presented to the Executive on the 8 February 2022.

The report sought the Executive’s approval for a pilot scheme of Public Health arrangements across Greater Lincolnshire which would see the Lincolnshire County Council (LCC) Director for Public Health to be formally seconded on a fixed term basis to both North Lincolnshire and North East Lincolnshire Councils as the Director for Public Health for each authority. A management structure would be put in place to ensure all other staff were in a position to be effectively managed. The Director for Public Health would undertake the statutory duties for each authority and put in place a governance structure to ensure political scrutiny and engagement in decision making.

The main aim of the pilot was to improve the offer to and health and wellbeing of the people of Greater Lincolnshire.

There were advantages and benefits of bringing the public health delivery mechanism together, including creating efficiencies and effectiveness in terms in having one approach to certain areas, such as substance abuse.

The Committee were referred to the proposed management structure and governance structure, as set out in Appendix A to the Executive report. It was proposed that a governance structure be established in which a single governance board comprising Executive Councillors and a senior lead officer from each authority to agree priorities and share decision making, with the Director for Public Health being made accountable to the governance board operationally and tactically. The DPH would be statutorily accountable to the three Leaders and Chief Executives of each Council for the discharge of all core public health functions and for the Public Health Grant allocation. It was noted that the Lead Consultants for Public Health at each authority would provide day to day management and contact within each local authority area.

It was proposed that the changes would provide a single management structure for Public Health within Greater Lincolnshire so expertise, knowledge, skills and efficiencies could be shared across the three authorities. The Director for Public Health for Greater Lincolnshire would be supported by a Lead Consultant in each of the upper tier areas, and the Lead Consultants would be the operational and tactical leads for each of the three authorities.

Each local authority would retain responsibility for the ring-fenced grant funding allocated to it by the Department of Health. However, where it makes sense to do so, grant funding would be used collectively to achieve greater efficiency or if mutually beneficial.

Consideration was given to the report and during the discussion the following points were noted:

• The Committee welcomed the proposal as a pilot scheme. It was recognised that it was a good initiative with the potential for collaboration and innovation between three local authorities. 
• It was suggested that a set of criteria be developed to include a comparison between the current discharge of public health functions in the three local authorities and the discharge of these functions as a result of the pilot, highlighting the benefits to the service.  The Committee also suggested that a further criterion be added, which would evaluate whether the pilot had supported opportunities to develop public health’s links with the NHS and adult social care. 
• It was requested that the Committee receive reports on the evaluation against the criteria as well as the criteria for progress reports during the eighteen-month pilot period. 
• Members recognised the challenges facing public health and indicated that some additional resources would be required to support the Director of Public Health to deliver the pilot scheme. 

·       The pilot scheme provided further opportunities for the public health service in each of the three local authorities to learn and share good practice with each other.  

·       The outcome of the evaluation of the pilot, which would report no earlier than twelve months into the pilot, could lead to one of three actions:

(i)             making the arrangement permanent;

(ii)            extending the pilot for a longer period; or

(iii)           discontinuing the pilot. 

·       The proposed management arrangement would include a lead consultant in each local authority, who would report to the Director of Public Health. 

·       The Director of Public Health would be available to provide briefings to the executive councillors in each local authority.

·       The governance arrangements would be confirmed as the pilot progressed, including the development of the priorities for the Director of Public Health and the senior management.

RESOLVED:

1. That the recommendations to the Executive be approved as a pilot scheme

That a summary of the comments made be reported to the Executive for their consideration of this item.