Cllr. Ketan Sheth
There was a lot of national media commentary and coverage about the role of the NHS at the recent General Election, which was unsurprising given all the commitments major political parties were making: boosting NHS funding, more doctors and extra GP appointments, rebuilding hospitals, and so on.
However, I think that members of overview and scrutiny committees – of all political parties – know that the NHS in particular and health in general are always a major issue in their areas regardless, not just because of the casework we receive from constituents or because health and the NHS tend to fill up a lot of the space on the work plans of our scrutiny committees.
Firstly, local government is part and parcel of the structure of the NHS in many localities, with Directors of Public Health and Directors of Adult Social Care sitting on the executives of Clinical Commissioning Groups. And, let’s not forget that many elected councillors are involved outside the local authority in the governance structures at a Board level of many of their local NHS providers (I will declare an interest as I am a Lead Governor of Central and North West London NHS Foundation Trust). In local government, we have a view of the NHS from the root up and dare I say probably a more detailed picture than those operating at a national level or, to use today’s jargon, a ‘granular’ picture, which shows that every area has its own strengths and weaknesses that may or may not align to the national picture.
So, now we are settling back into the business of ordinary scrutiny committees there are three areas which, drawing on my own experiences, I think many healthy overview and scrutiny committees will be focusing on in 2020. They look a little different to the recent national debate.
Firstly, the quality of services, particularly of primary care, is a growing area of importance alongside access to services. The Care Quality Commission publishes ratings for each of the primary care providers in each area; it’s always worth keeping up to date with the local picture, in particular how ratings change. What you will want to see is an improvement in these ratings, and fewer GP providers being placed in special measures as a result of an inadequate CQC rating. If it’s heading in the opposite direction in your area, it might be time to ask why.
Secondly, working at scale is increasingly the big challenge for the NHS. On the commissioning side in north-west London there are plans to merge eight separate CCGs into one body by April 2021. That will mean a single operating model, and I assume some commissioning arrangements, operating at scale, commissioning services across many different boroughs. That’s something we will be tracking with care.
Finally, workforce is an issue which is frequently raised at health overview and scrutiny meetings. We’ve heard a lot about problems nationally of recruiting to specialist posts, as well as vacancy rates for nurses. But is it time to ask about the local pressures on recruitment and retention in the hospitals for the big provider trusts in your area?
So, now the national political tremors have settled let’s re-focus on local health scrutiny issues for 2020. Who knows, they may be very different to the national picture.
Cllr. Ketan Sheth is a Councillor for Tokyngton, Wembley in the London Borough of Brent. Ketan has been a councillor since 2010 and was appointed as Brent Council’s Chair of the Community and Wellbeing Scrutiny Committee in May 2016. Before his current appointment in 2016, he was the Chair of Planning, of Standards, and of the Licensing Committees.