ARGYLL AND BUTE COUNCIL COUNCIL REPORT BY CHIEF EXECUTIVE 8 MAY 2003

NHS ARGYLL & CLYDE – CONSULTATION ON INTEGRATED HEALTH CARE SYSTEM

1. SUMMARY

NHS Argyll & Clyde have issued a consultation document with a closing date of 16 May 2003 on their proposals for single system working in their area. The document is available in the Members Lounge.

2. RECOMMENDATIONS

It is recommended that a response be submitted on the basis outlined in this report.

3. DETAIL

3.1 Within NHS Argyll and Clyde there are currently 4 separate statutory NHS organisations planning and providing health services.

NHS Argyll and Clyde Health Board are responsible for

* strategic leadership * governance * strategic planning and resource allocation * development and implementation of local health plan * performance management

3 NHS Trusts

Argyll & Clyde Acute NHS Trust Lomond and Argyll Primary Care NHS Trust and Inverclyde Primary Care NHS Trust responsible for:

* implementing the local health plan by organising and providing local healthcare services

3.2 The Argyll and Clyde Health Board area covers the Council areas of , (part), Inverclyde, Renfrewshire and (part).

3.3 The proposal is to establish:

* a single NHS organisation within NHS Argyll and Clyde * a single Chief Executive and Executive Team and a single Board of governance * Community Health Partnerships (4 incorporating the existing 7 LHCC’s) configured around Local Authorities to provide locally focused and empowered integrated health and social care services * Operational Divisions (3) responsible for the operational management of all health care services in the division and for leading and/or hosting a network of interdependent support and clinical services and integrating primary and secondary care in NHS Argyll & Clyde

3.4 This would mean that for the Argyll and Bute Council area and part of West Dumbarton the configuration and functions would be as follows.

NHS Argyll & Clyde Operating Division

* responsible for the implementation of strategy and the operational delivery of services * organising and providing healthcare services * managing and integrating Primary and Secondary care services in its area * leading and or hosting NHS Argyll & Clyde wide services e.g. IT etc. * devolving management to the front line as far as possible * facilitating the development of LHCCs into Community Health Partnerships

Argyll and Bute Community Health Partnership

* population approx. 91,000 * co-terminous with Argyll and Bute Local Authority * operational management arrangements between and within other CHP’s to reflect community patterns of accessing services from: Helensburgh to the Vale of Leven and Cowal and Bute to Inverclyde

Lomond Community Health Partnership

* population approx. 48,000 * co-terminous with West Dunbartonshire Local Authority * operational management arrangements between and within other CHP’s to reflect community patterns of accessing services from: Helensburgh to the Vale of Leven, Alexandria and Glasgow * taking lead in developing CHP into Glasgow catchment area

4. CONCLUSIONS

4.1 Partnership working – particularly with Health – is becoming increasingly important in delivering both central and local government objectives. The proposals are to be welcomed in principle.

4.2 The preference would have been for a Division of NHS Argyll and Clyde to have been established to cover Argyll and Bute. Given however, that this option is not canvassed in the Consultation paper, the proposal to establish a singe Community Health Partnership (CHP) contiguous with the Council’s boundaries should be particularly welcomed. Such a step would significantly increase the scope for effective joint planning and working between the Council and NHS Argyll and Clyde. Conversely, any suggestion to create more that one CHP to operate within Argyll and Bute’s boundaries should be (a) identified as inconsistent with the principles of the consultation paper; and (b) strongly opposed by the Council.

4.3 There is one additional feature I would like to see covered in the proposals.

The Lomond and Argyll Primary Care NHS Trust (and its predecessor) had their Headquarters at Aros, Lochgilphead. While this has officially remained as the Trust Headquarters, de facto they have operated out of Hartfield in Dumbarton. The vast majority of residents served by the new Division reside in the Argyll and Bute area. The area has distinct needs with the geography dictating a model of service delivery which is quite different from other Health/Local Government areas. To facilitate joint working and the move through community planning to Argyll and Bute Public Services the actual Headquarters presence should be re-established in Lochgilphead.

5. IMPLICATIONS

Policy: The recommendations in this report are in line with the developing partnership agenda between Health and Local Authorities.

Finance: } The recommendations should result in closer working, relationships Personnel: } being developed to the benefit of clients and staff. Equal Opportunities: }

James McLellan Chief Executive 28 April 2003 Rep1931