Issue - meetings

From April 2013 there is a statutory transfer of public health functions to local authorities. A ring-fenced grant will be received to discharge the new responsibilities, and staff carrying out these functions will transfer into the local authorities from the PCTs.

The recommendations in the report attached as Appendix A were agreed by the Cabinet at its meeting on 15 October 2012.

Dr Melanie Smith presented the report in respect of the statutory transfer of public health functions to local authorities from April 2013.  The Cabinets of the three boroughs (Hammersmith & Fulham, Kensington & Chelsea and Westminster) had agreed the establishment  of a single tri-borough public health service, with the retention of individual borough sovereignty in relation to public health decision making and priorities, and with Westminster City Council as the lead authority.

Dr Smith stated that, during 2013/14, it was planned to focus on maximising the opportunities of an in-house public health function. Staff and contract liabilities would transfer into the local authorities from the PCTs. The transfer of staff from the PCT to Councils was a TUPE-like PCT owned process. The new organisational structure would be in place prior to transfer.

A register of all contract liabilities had been completed by the PCT. The three councils had procured an external forensic examination of the number and values of contracts to provide assurance as to which contracts and their values would transfer to the councils.

A ring-fenced grant would be received. However, on the basis of prudent financial planning assumptions at this point, it was believed that there would be a funding shortfall of £6.2 million, of which  £2.8 million had been  identified to Hammersmith & Fulham. There had been an unfavourable movement since the paper was written due to the identification of an additional cost of £300,000 to adult social care, and a decision to plan on the basis of no inflationary uplift.

Councillor Coleman queried the options to meet the funding gap. Dr Smith responded that the planned tri-borough structure achieved10 – 15% efficiencies and there was scope for savings in the contract portfolio. Displaced staff would be supported through the NHS redeployment pool, but it was possible that there might be  compulsory redundancies.

Councillor Craig queried the funding shortfall for a full year. Dr Smith responded that the allocation would be based on historic spend and, for the three boroughs, was above the national average. However, historic spend was over capitation for public health, and there was an issue in respect of whether the borough would continue to receive growth money. There were concerns in respect of sexual health funding as this was an open access services, and demand was increasing each year.

Prior to the forensic audit, contracts worth £53 million had been split approximately equally between NHS and external contracts. Most external contracts would have been negotiated locally and inflationary uplifts would be unusual. The key NHS contracts would be CLCH and genitourinary medicine with the larger trusts, and these would contain inflationary uplifts. The three councils would be responsible for any shortfall; the worse case scenario was £6.2 million.

Dr Smith stated that the biggest concern was in respect of the increase in activity generally.

Councillor Carlebach noted the indisputable value of the Community Champions.

Councillor Vaughan queried the accountability of the new structure and the portfolios of the Deputy Directors of Public Health. Dr  ...  view the full minutes text for item 26

1.                  That the statutory transfer of public health functions to local authorities from 1 April 2013 be noted, and that the establishment of a single tri-borough Public Health service with Westminster City Council as lead authority be agreed.

2.                  That, subject to the PCT engagement process, the organisational structure for the tri-borough Public Health Service be agreed.

3.                  That officers be authorised to continue discussions with NHS bodies on the details of transition arrangements, particularly with respect to finance, staffing and contracts, and to report back to Cabinet later this year after the formal notification of funding allocation from the Department of Health.

4.                  That officers be authorised to begin discussions on the terms of a Section 113 Agreement between the three authorities relating to the new tri-borough service.

5.                  That the planned overspend on transitional costs is met from the Corporate Contingency in 2012/13 in H&F’s accounts, to be returned in 2013/14 be approved.