Agenda item

The Committee have requested an update on progress around Transforming Community Services whereby NHS North Yorkshire and York (the PCT) divests itself of the provider side of the organization. This provider side includes community nursing services and mental health services, including inpatient and community based services. The Committee previously received information on the process around the future provision of mental health care at its meeting on 23rd September 2009. Representatives of NHS North Yorkshire & York will be in attendance at the meeting to give a PowerPoint presentation on this subject.

Representations were received from John Yates on behalf of the Older Peoples Assembly. He referred to the transfer of these services to yet another provider with what appeared to be little or no public/patient consultation. He questioned how and when the PCT intended to remedy this situation.

Graham Purdy, Assistant Director of North Yorkshire and York NHS gave a presentation, which updated the Committee on proposals for Transforming Community Services (TCS). This related to the separation from NHS North Yorkshire and York of the provider side of the organisation, which included community nursing and mental health services, including inpatient and community based services. He confirmed that the PCT Board were to meet the following day to sign off a letter, which outlined the current situation in relation to the changes.

The presentation related to the following areas:

Policy and Context

• Policy opportunity to focus on improving community services;
• Milestones achieved in 2009 - contractual separation required by April, business ready by October and Community Services Strategy by November;
• National timetable – December 2009 operational plan, PCTs to have determined the future organisational model for PCT provided services by October 2010, at the latest, and have implemented where possible by March 2011;
• NHS NYY timescales – Board agreement for Community & Mental Health Services to be hosted by the PCT until March 2011, organisational model determined by October 2010 and implementation plans in place through 2011;

Organisational form – the options

• 15 suggested options for Organisational Model;
• Shortlist for Community & Mental Health Services – vertical integration, horizontal integration, integrated health and social care and Social Enterprises but with rigorous assurances required.

NHS NYY Process and Timeline

• March 2010, confirm with Strategic Health Authority, organisational models that are discounted;
• Agree organisational form, March-September 2010;
• Board approval by October 2010;
• 5 Locality Boards established March 2010 to agree transformation of community services of which York was one. These would be multi agency including the PCT, Local Authority, Providers and local stakeholder;
• Mental Health Project Board established to manage mental health transfer;
• Finalise details which included separate approaches for the transfer of community services and mental health services;
• Proceed to tender Mental Health services
• NHS NYY Programme Board to oversee transition.

Members questioned various details of the presentation including:

• Confirmation that no new NHS organisations were to be formed as part of this plan;
• The status quo which had previously mentioned as an option now appeared to have been discounted and which raised concerns;
• There appeared to be no dialogue between the Authority and the PCT in relation to these changes;
• How would the PCT engage with Local Authorities in the later stages of the process?
• Details of the link Officer between the Localities Board and the Authority;
• Details of transfer costs.

Officers provided some reassurances around the local structure in that York would be considered in its own right as each PCT area had its differing local needs. It was also confirmed that the York region was one of the last to be agreed with there being a further six months until final agreement was reached. Reference was also made to Officer links with the Locality Board.

Following further discussion it was

RESOLVED:             That a further update on progress on the Transforming of Community Services be arranged for the Committees second meeting in July. The update to include details of how the PCT will consult users, carers and members of the public on these changes to the service, together with a timeline of their future intentions. ^1.

REASON:                  To continue to update the Committee on progress around Transforming Community Services.