Details

09.Feb.2011

Three London boroughs have set out radical proposals for combining back office and management services, claiming the shake-up could deliver up to £35m in savings a year.

The plans unveiled by Hammersmith & Fulham Council, the Royal Borough of Kensington & Chelsea and Westminster City Council include legal services.

If given the green light, it is thought likely that Hammersmith & Fulham and Kensington & Chelsea – which already share a monitoring officer – would combine their legal departments first.

Between them, the three authorities employ 70 lawyers, 19 legal assistants and 31 support staff. Their current legal spend is more than £10.8m, divided as follows:

• WCC: £4.8m (includes internal, external spend and counsel fees)
• LBHF: £3m (in-house plus counsel)
• RBKC: £3m (in-house plus counsel)

“Key areas for potential savings are in combining legal advice, rationalising external suppliers and creating a stronger intelligent client function,” the report said, adding that a 10% saving would equate to £1m and a 20% saving to £2-3m.

“Further work is required on the structure that will best optimize the opportunities for savings, looking at both internal and external options,” the report suggested.

The package of proposals, which will be discussed at the councils’ respective cabinets over the next 12 days, would see the number of chief executive posts reduced from three to two.

Children’s and education services would meanwhile be combined under a single director. Assessment of children at risk will still be done on a borough basis, but specialist functions and management will be combined.

Adult social care will also be combined with a single director in charge of commissioning services. The councils said discussions were also underway with Central London Community Healthcare NHS Trust “about working closely with GPs in providing integrated community health and adult social care services across the three areas".

Staff involved in the provision of social care services could transfer into one or more new joint units alongside NHS staff with similar responsibilities, the report said. It added: “This will promote closer working; providing opportunities for smarter procurement and the delivery of more co-ordinated and less wasteful service to those in need.”

A tri-borough library service – but with individual council branding – has been suggested, with a future option of transferring the service to external management (“perhaps through a charitable trust”).

A number of other services will be operated on a tri-borough basis, including IT, HR, facilities management and insurance. Some environmental services will initially be combined only across two boroughs, including leisure, highways, transport and parking correspondence. A recommendation has been made to the three cabinets that they look at moving towards a single management team for the “environment family of services” in the future.

Six other services are under consideration for future integration. They are: customer services, waste management, street cleaning, contingency planning, CCTV, environmental health and parks management. The three councils believe there is an opportunity for a future joint procurement in waste management, the largest area of spend in environmental services, but this will not be “until some years hence”.

The following services are viewed as unsuitable for integration:

• Planning
• Licensing
• Housing and regeneration
• Culture
• Policy/communications
• Governance
• Housing benefit services.

The plans envisage major savings in management costs. According to the report, the aims are to: reduce the number of middle and senior managers overall by 50%; reduce overheads on direct services by 50%; and ensure that by 2014/15 the costs of overheads and middle and senior management are a smaller proportion of total spend than in 2010/11.

A so-called “Sovereignty Guarantee” has been signed by the three councils and is intended to safeguard local autonomy, responsiveness and identity. The three authorities will also retain their own councillors and decision making processes.

Detailed implementation proposals will be drawn up if the councils’ respective cabinets give the plans the go-ahead. Consultation will then take place with staff, unions, residents and community leaders.

The proposed timetable would see the changes phased in from May 2011, “with long-term interim appointments in key areas to provide continuity during a period of change”.

Cllr Sir Merrick Cockell, Leader of Kensington & Chelsea, insisted that the councils were committed to localism. Combining services would increase their ability to respond and engage on local issues and ensure a greater share of resources going to the frontline, he said. “These proposals offer significant opportunities to save many millions of pounds for our taxpayers.”

Cllr Stephen Greenhalgh, Leader of Hammersmith & Fulham, rejected the suggestion that the authorities were setting up a ‘super council’. “We are creating three slimmer councils with combined resources and expertise,” he argued. “Our residents should not notice the difference except in areas such as adult social care where there will be a marked improvement because we are able to fully integrate health and social care.”

Philip Hoult

Details

08.Feb.2011

The legal services department at Manchester City Council appears to have survived the local authority’s severe cutbacks relatively unscathed, it has emerged.

A report to be considered by Manchester’s Executive on 16 February says: “There is good evidence that our Legal Service is more cost effective than external provision and externalising this service would, therefore, only increase costs. In light of the settlement £50k efficiency savings have been identified and the service will work with directorates to consider opportunities for further savings, for example, reducing external legal costs.”

It adds: “We are actively assessing whether collaborative working with other AGMA councils has the potential to deliver longer term improvements, as well as further efficiencies.”

Last month Manchester and Salford City Council confirmed to Local Government Lawyer they were reviewing their legal teams, with a shared service one option under consideration.

Manchester’s budget proposals set out how it will make £109m of savings over the next financial year, rising to £170m in 2012/13. The council said it needed to make 25% savings overall over the next two years, adding that it had needed to find £60m more savings than anticipated as a result of the local government financial settlement.

Key proposals in the budget include:

• The loss of 2,000 posts, 41% of which will be managers. “We aim to do this through a programme of voluntary severance and voluntary early retirement,” the council said. This will be funded primarily through reserves set aside for major capital programmes
• Cutting the adults budget by 21% or £39.5m. “The service will have to stop providing some things, charge more for others or ask partner agencies or community groups to provide the service”
• Closure of Manchester Advice “in recognition of the availability of new city-wide legal advice provision” and concentration on those deemed most in need
• Reduction of the Supporting People grant by £12.6m or 35%, although the council said it would top this up by £4m
• Less care will provided to people, eligibility criteria will be more strictly defined and charges for services will be reassessed
• Children’s services will deliver savings of £45.1m or 26% of its budget. Safeguarding of vulnerable children “remains paramount” and the number of social workers employed by the authority will be increased. The budget for looked after children will be increased by £6m
• Many youth services will no longer be provided directly. Responsibility for running youth centres will be transferred to partner agencies, but the council will still have a commissioning budget of more than £1m. Centres will be closed if they are not taken over by other organisations
• The universal provision of early years activities will be transferred, and a more targeted family offer will be commissioned
• Savings of £31.2m will be made from neighbourhood services (29% of its budget). These will be achieved by changing waste and recycling activities, and reviewing library services and parking controls
• Three leisure centres and a sailing centre will close but the council will seek alternative management arrangements
• Local neighbourhood teams – such as Street Management and Manchester Contracts – will be consolidated
• The “corporate core” will provide £33.9m in savings. At 35% of budget, this is higher than “frontline” departments. The IT, HR and research and policy teams will be restructured, while the council’s property will be reviewed
• Events such as the annual Lord’s Mayor reception will be cancelled. Council publications will no longer be distributed to every home in the city
• A 22% reduction in grant funding to voluntary sector organsiations, leaving a commissioning budget of £31m
• A freeze in council tax for the second year running
• The creation of a Manchester Investment Fund, with £37m of ringfenced funding.

Sir Richard Leese, leader of Manchester City Council, said: "Putting this budget together has involved the most difficult, and in many ways most unpalatable, process I have been involved in since I was first elected to the Council.

"I cannot and will not pretend that the financial position in which we have  been placed is anything other than bad news. Manchester is the fourth most deprived local authority area in the country but is among the top five hardest hit local authorities. But we are doing everything we can to protect and maintain the services which people need and make sure funding is targeted where it will make the most positive difference."

Philip Hoult

Details

07.Feb.2011

There has been a “sea change” in local authority attitudes towards merging front line services, it has been claimed.

A survey by law firm Browne Jacobson of 150 senior local authority managers in England revealed that nine out of ten councils are looking to share front line and back office functions within the next two years.

Key findings from the report include:

• Some 89% of local authorities are already sharing services, whether back office functions, front line services or a combination of the two. One in nine authorities (11%) has no shared services arrangements in place.
• 68% of respondents are looking for more sharing of front line services in the next year, with 91% targeting front line services within the next two years
• 65% are looking for more sharing of back office functions within the next 12 months with 89% considering sharing back office functions within the next two years
• 70% of senior managers identified environmental services and 34% social care as the two service areas most likely to be shared by their authority in the future. These are also the two areas most likely to be shared already.
• 63% of respondents plan to save up to 10% of their total budget savings by sharing services in the financial year ending April 2012
• 98% of authorities said they would be comfortable sharing services with another public sector partner, but 78% would also consider working in partnership with the private sector in the future delivery of services
• More than eight out of ten managers (85%) would consider outsourcing services on a service-by-service basis. One third would be prepared to sign up to a large scale outsourcing project
• Political and public opposition is seen by 28% of senior managers interviewed as the biggest barrier to delivering shared services in the local government sector
• 84% of senior managers believe the long term rewards from shared services justify the short term pain
• 77% of respondents said shared services arrangements between public organisations are “attractive but hard to deliver”.

A similar survey conducted by Browne Jacobson three years ago revealed that less than half of public sector managers saw the potential to merge front line services. Just 5% said they saw opportunities of working with the private sector.

The law firm’s head of shared services, Dominic Swift, said: “The government’s austerity bombshell is clearly forcing authorities to look at innovative and radical ways in which to deliver their services. We can also see a noticeable sea change in attitudes towards merging front line services.

“Councils are starting to think outside the box and previous no-go areas such as the private sector and large scale outsourcing are also back on the agenda. With local authorities up and down the country already feeling the financial pinch the next step is to turn the shared services rhetoric into action.”

The Browne Jacobson report can be downloaded here.

A paper on shared services by a working group of the Procurement Lawyers Association recently warned of a number of misconceptions about how procurement rules apply to these arrangements.

The paper addressed the eight most common misconceptions. It said, for example, that the correct position was that UK government policy did not overrule European law and cannot be used to justify circumvention of EU procurement rules.

Philip Hoult

Details

03.Feb.2011

The return of public health to a position of prominence as part of the government's NHS reforms is welcome but the financial freeze could cause difficulties with delivery, says Nicholas Dobson.

Despite much opposition (including loud “noises off”), on 31 January 2011 the Health and Social Care Bill cleared its first Parliamentary hurdle. For after a lively debate the House of Commons gave the Bill its Second Reading and sent it to a Public Bill Committee for scrutiny. The Health and Social Care Bill Committee is now accepting written evidence.

There was certainly political polarisation in Parliament. Whilst Conservative and Liberal Democrat MPs (with the exception of Liberal Democrat Andrew George who abstained) backed the Bill at second reading by 321 to 235, Labour members were not shy in voicing their opposition. Shadow Health Secretary John Healey for instance, said that the changes will “break up the NHS” and “open up all areas of the NHS to price-cutting competition from private health companies”. Predictably though, Health Secretary Andrew Lansley saw things differently. “The purpose of the Bill,” he said, “can be expressed in one sentence – to improve the health of the people of this country and the health of the poorest fastest.”

Well, you pays the money and they takes the choice. But however the national health debate turns out, local public health is making something of a return. This is after an absence of some 37 years following its 1974 move from local authorities to a reorganised NHS. Amongst the new local authority responsibilities will be the establishment of new Health and Wellbeing Boards and (in double act with the Secretary of State) the appointment of local authority Directors of Public Health. Presumably a case of come back Medical Officers of Health, most (if not all) is forgiven. This article takes a look at some of the new local authority health functions, many of which take the form of insertions into the National Health Service Act 2006 (the NHS Act). References to clauses are to those in the Bill as introduced into Parliament on 19 January 2011.

Some of the New Local Authority Health Functions

Local Health Improvement

A new section 2B is to be inserted into the NHS Act by clause 8 of the Bill. This will require every local authority to take such steps as it considers appropriate for improving the health of the people in its area. Section 2B(4) optimistically provides that these steps may include “providing grants or loans (on such terms as the local authority considers appropriate)”. Local authorities for these purposes (per a new section 2B(5)) are English counties and non-county districts, London boroughs and the Council of the Isles of Scilly and the Common Council of the City of London. These are also the authorities for the purposes of “public health functions” of local authorities (per clause 1(3) of the Bill).

Regulations re Public Health Functions

Clause 14 inserts a new section 6C into the NHS Act which enables regulations to require a local authority to exercise its own or any of the Secretary of State’s public health functions by taking “such steps as may be required” (as old war films might have had it, ‘ve have vays of making you make your people healthy). The Secretary of State may also (per a new section 7A of the NHS Act, inserted by clause 18 of the Bill) arrange for a local authority (amongst others) to exercise any of his or her public health functions.

NHS Commissioning Board

Clause 5 inserts a new section 1D into the NHS Act creating a new corporate non-departmental public body to be known as the NHS Commissioning Board, accountable to the Secretary of State. As the Explanatory Notes indicate, this “will have broad overarching duties to promote the comprehensive health service (other than in relation to public health) and to exercise its functions with a view to securing the provision of services for the purposes of that service”. A new section 13J of the NHS Act (inserted by clause 19 of the Bill and headed “Duty to encourage integrated working”) will require the Board to “exercise its functions with a view to encouraging commissioning consortia [clause 6] to work closely with local authorities in arranging for the provision of services”.

Directors of Public Health

Local Authority Directors of Public Health step into the spotlight in clause 26 of the Bill which inserts a new section 73A into the NHS Act. As noted, these officers are to be appointed jointly by the local authority and the Secretary of State and will conduct the public health functions specified in section 73A(1). Directors must also “prepare an annual report on the health of the people in the area of the local authority” which the local authority must publish (section 73B(4) & (5). The Secretary of State is given various oversight powers concerning the performance of directors, and whilst a local authority may terminate a director’s appointment, it must firstly consult the Secretary of State.

Hello Local Healthwatch Organisations, Goodbye Local Involvement Networks

Part 5 of the Bill provides for the creation of a new national body, Healthwatch England, to be established as a statutory committee within the Care Quality Commission with functions prescribed in a new section 45A (1) to (4) of the NHS Act (see clause 166). It also provides for local Healthwatch organisations (LHOs) to be established as bodies corporate in each local authority area and (bad news in the present financial climate) funded by local authorities. These will (amongst other things) replace and continue the work of Local Involvement Networks under Part 14 of the Local Government and Public Involvement in Health Act 2007 as well as having additional functions. An LHO may do anything which appears to it to be necessary or expedient for the purpose of, or in connection with, the exercise of its functions (Para 4 of Schedule 16A inserted by Schedule 13 to the Bill). Additional LHO functions include (per clause 168(3)): the provision of advice and information about access to local care services (i.e. local NHS and local authority social services) and about potential choices concerning aspects of those services. The Secretary of State may make a transfer scheme in respect of transfer from the previous local involvement network body to the LHO of relevant property, rights and liabilities (clause 174(2)).

Independent Advocacy Services

Clause 170 inserts a new section 223A (Independent advocacy services) into the Local Government and Public Involvement in Health Act 2007. The effect of this is to transfer this duty in relation to complaints concerning the provision of health services from the Secretary of State to local authorities. Authorities will be able to commission either an LHO or other provider to deliver these services. In making these arrangements a local authority must have regard to the principle that service provision should so far as practicable be independent of any person who is either the subject of a relevant complaint or involved in investigating or adjudicating on such a complaint. In other words authorities must act consistently with the public law duty of fairness.

Health Scrutiny

Clause 175 of the Bill deals with health scrutiny functions of local authorities by amending section 244 of the NHS Act. As the Explanatory Notes indicate: “Local authorities will no longer be required to have health overview and scrutiny committees, but will continue to have oversight and scrutiny powers, which they may discharge how they see fit. For example, local authorities may choose to continue to operate their existing overview and scrutiny committees, or may choose to put in place other arrangements such as appointing committees involving members of the public.”

Joint Strategic Needs Assessments and Strategies

According to the Department of Health Joint Strategic Needs Guidance issued in 2007, such an assessment is “a process to identify the current and future health and wellbeing needs of a population in a local authority area”. Clause 176 amends section 116 of the Local Government and Public Involvement in Health Act 2007, so that a local authority and commissioning consortia having a boundary within, overlapping or coinciding with that local authority’s, have a duty to prepare a joint strategic needs assessment.

Section 177 inserts new sections 116A (Health and social care: joint health and wellbeing strategies) and section 116B (Duty to have regard to assessments and strategies) into the 2007 Act. New section 116A will require local authorities and their partner commissioning consortia to produce a joint health and well-being strategy to meet the needs identified in the joint strategic needs assessment. New section 116B will impose a duty on consortia, the local authority and the NHS Commissioning Board to have regard to the joint strategic needs assessment and joint health and wellbeing strategy when carrying out their commissioning functions. Section 116B(1) therefore will require a local authority, and each partner commissioning consortium to have regard to the most recent needs assessment and strategy when exercising relevant functions. A function is relevant for these purposes if it could be exercised in a way that meets, or affects, to a significant extent a need included in the most recent joint strategic needs assessment conducted under section 116 of the 2007 Act.

Health and Wellbeing Boards

Clause 178 requires local authorities (defined in effect as above by clause 178(14)) to establish Health and Wellbeing Boards for their areas. A Board will be a committee of the local authority and treated as if it were appointed under section 102 of the Local Government Act 1972 (clause 178(11)). The Board must consist of at least one councillor (although the executive leader may be a member instead or in addition to such councillor); the Directors of Adult Social Services, Children's Services and Public Health; a representative of the LHO, a representative of each relevant commissioning consortium and such other persons or their representatives as the local authority thinks appropriate. The Health and Wellbeing Board may also appoint such additional persons to be members of the Board as it considers appropriate.

Clauses 179 and 180 of the Bill deal with the functions of Health and Wellbeing Boards. Amongst these, a Board must, for the purpose of advancing the health and wellbeing of the people in its area, encourage persons who arrange for the provision of any health or social care services in that area to work in an integrated manner (clause 179(1)). A Board must also in particular provide such advice, assistance or other support as it thinks appropriate for the purpose of encouraging the making of arrangements under section 75 of the NHS Act (arrangements between NHS bodies and local authorities) in connection with the provision of such services (clause 179(2)). By clause 180(2) a local authority may arrange for its Health and Wellbeing Board to exercise any other functions of the authority. Clause 181 deals with the participation of the NHS Commissioning Board in the Health and Wellbeing Board and clause 182 enables joint discharge of functions by two or more Boards.

Care Trusts

As to Care Trusts, clause 184 amends Section 77 of the NHS Act to enable NHS foundation trusts or commissioning consortia and local authorities to form Care Trusts, if they decide locally that this is the best way to meet the needs of their local populations. The clause also makes amendments abolishing the direct role of the Secretary of State in the process of forming or disbanding a Care Trust.

Comment

Whilst the return of health functions to local government after a long absence is clearly welcome, two handholding spectres haunt the feast. One is financial famine and the other is consequently diminishing staffing resources. For whilst many authorities are shedding more expensive senior staff to help cut costs, the downside is that many such staff carry away with them substantial assets of knowledge, instinct and experience. And these are invaluable foundations for effective change. For there will be much new organisational infrastructure to assemble and wire up into sound corporate governance arrangements. And this will place obvious strain where there is a lower spec officer corps.

But on the plus side the return of public health responsibilities will clearly help with more holistic and effective local governance. For health and wellbeing issues affect us all and integrating these with strategic local government functions should help align the expectations of local people with what their councils are able to deliver. For it tends to be the local authority that is the ‘They’ in the “They should be doing something about this”. It’s just a shame that these health functions will be returning as local government copes with the throes of a financial ice-age.

© Nicholas Dobson

Dr. Nicholas Dobson is a Senior Consultant with Pannone LLP specialising in local and public law. He is also Communications Officer for the Association of Council Secretaries and Solicitors.

Details

03.Feb.2011

A recent High Court judgement sends a powerful message about the need to adhere to the Mental Capacity Act and to provide staff with adequate training, write Alex Ruck Keene and Victoria Butler-Cole.

The long-running case of G v E [2010] EWHC 3385 (Fam) continues, this time with a decision by Baker J concerning costs. After the naming and shaming of Manchester City Council in a previous hearing, it will come as no surprise that the Council was made the subject of a costs order in favour of the Official Solicitor, G, and E’s carer, F.

The hearing concerned the costs of the initial phases of the proceedings, up until the point at which G was returned to F’s care by order of the court. In deciding to depart from the general rule in welfare applications that there should be no order as to costs, Baker J observed that “local authorities and others who carry out their work professionally have no reason to fear that a costs order will be made...The Court is not going to impose a costs burden on a local authority simply because hindsight demonstrates that it got [difficult] judgments wrong.”

However, in the present case, there had been a “blatant disregard of the processes of the MCA and their obligation to respect E’s rights under the ECHR” which amounted to misconduct sufficient to justify imposing a costs order.

Baker J rejected the Council’s reliance on the ignorance of its staff, stating that notwithstanding the complexity of the MCA and the Deprivation of Liberty Safeguards (DOLS), “Given the enormous responsibilities put upon local authorities under the MCA, it was surely incumbent on the management team to ensure that their staff were fully trained and properly informed about the new provisions.”

Importantly, Baker J confirmed that: “If a local authority is uncertain whether its proposed actions amount to a deprivation of liberty, it must apply to the Court.”

The same applies where not only staff but also assessors under the DOLS regime conclude that there is no deprivation of liberty but where doubt or disagreement remains.

The Council was duly ordered to pay the costs of G, F and the Official Solicitor, and for part of the time period in question on an indemnity basis.

Comment

Perhaps the only mildly surprising element of the judgment was the imposition of costs on an indemnity basis for a period of time; in light of his previous findings as to the conduct of the Council, though, such an approach was, perhaps, all but inevitable. The judgment does provide a salutary lesson in the importance both of adherence to the statutory provisions of the Act and also of adequate training.

Passing reference is made to the problem which the authors know has arisen in numerous other cases, caused by the operation of the statutory charge in respect of publicly funded litigants. Baker J expressed the view that it could not be a proper reading of the relevant legislation that a litigant might have to use his damages to pay the statutory charge in a case where not all of his costs were recovered from the other side, but he heard no argument on the issue and the issue remains.

Alex Ruck Keene and Victoria Butler-Cole are barristers at 39 Essex Street (www.39essex.co.uk).

Details

03.Feb.2011

People in contact with the criminal justice system will have improved access to mental health services by 2014, the government has promised as it unveiled its mental health strategy.

The No health without mental health strategy is intended to tackle the underlying causes of mental ill-health. It includes the provision of around £400m to improve access to modern psychological therapies over the next four years.

This additional investment will help offer personalised support to 3.2m people across the country, the government said. It will also see one million people recover from their condition by 2014 and 75,000 people get their lives back on track by returning to work, education, training or volunteering.

The cross-government strategy has six key aims to be achieved over the next three years:

• “more people will have good mental health
• more people with mental health problems will recover
• more people with mental health problems will have good physical health
• more people with mental health problems will have a positive experience of care and support
• fewer people will suffer avoidable harm, and
• fewer people will experience stigma and discrimination.”

Deputy Prime Minister Nick Clegg said: “The evidence is clear: mental health needs to be addressed with the same urgency as physical health. We need to end the stigma attached to mental illness, to set an example by talking about the issue openly and candidly and ensure everyone can access the support and information they need.

“The strategy today shows how we will put people at the heart of everything we do, from a new focus on early intervention to increased funding for psychological therapy, so that everyone has a fair opportunity to get their lives back on track.”

Care Services Minister Paul Burstow suggested that mental health had for too long been the poor relation in the NHS. “Yet we know that good mental health and resilience are fundamental to our physical health, our relationships, our education, our work and to achieving our potential,” he said.

“What this strategy does is ensure that modern, evidence-based therapies are available for all who need them. Working with others, the government is determined to promote good mental health and wellbeing and challenge the stigma and discrimination that still affects so many people with mental health problems today.

One of the key elements of the government’s strategy is to bring together – through the Early Intervention Grant – funding (£2.2bn in 2011-12) for early intervention and preventative services for children, young people and families. This can also be used for Targeted Mental Health in Schools (TaMHS).

“Local authorities will have greater freedom and flexibility to put in place programmes that can reduce conduct disorder, improve family relationships and reduce costs to social care, youth justice, education and health systems,” the government said.

This coincides with the establishment of community budgets in 16 local areas for families with complex needs, including mental health problems.

Other notable initiatives in the strategy include:

• Launching the Health Visitors Implementation plan following its announcement last October for 4,200 additional health visitors
• Providing additional investment of up to £7.2m for the treatment of veterans with mental health problems
• Working in partnership with the Time to Change programme to challenge stigma and discrimination
• Ensuring that all psychological therapy sites have an employment co-ordinator whose role is to help get people back to work
• Launching a consultation to extend to all employees the right to request flexible working, which the government believes could help carers manage their caring role alongside work, and
• Publishing a new cross-Government suicide prevention strategy in the spring of 2011.