Agenda and minutes

Commissioning Partnership Board
Thursday, 25th March, 2021 1.00 pm

Venue: Virtual Meeting - Virtual address. View directions

Items
No. Item

1.

Election of Chair

The Panel is asked to elect a Chair for the duration of the meeting.

Minutes:

RESOLVED that Councillor Chauhan be elected Chair for the duration of this meeting.

 

Variation in Order – The Chair, with the consent of the Board, advised that consideration of agenda item 8, Approval of 2020/21 Revised Section 75 Agreement, would be given in advance of agenda item 7.

 

2.

Apologies For Absence

Minutes:

Apologies for absence were received from Councillor Shah, Dr. John Patterson, Carolyn Wilkins, Helen Lockwood, Dr Mudiyur Gopi and Nicola Hepburn.

 

3.

Urgent Business

Urgent business, if any, introduced by the Chair

Minutes:

There were no items of urgent business received.

 

4.

Declarations of Interest

To Receive Declarations of Interest in any Contract or matter to be discussed at the meeting.

Minutes:

There were no declarations of interest received.

 

5.

Minutes of Previous Meeting pdf icon PDF 210 KB

The Minutes of the meeting held on 25th February 2021 are attached for approval.

Minutes:

RESOLVED that the minutes of the meeting held on 25th February 2021 be approved as a correct record.

 

6.

Public Question Time

To receive Questions from the Public, in accordance with the Council’s Constitution.

Minutes:

There were no public questions received.

 

7.

Approval of 2020/21 Revised Section 75 Agreement pdf icon PDF 383 KB

The Director of Finance to report.

 

Additional documents:

Minutes:

The approval of the Board was sought to the final version of the 2020/21 Oldham Section 75 legal document, the schemes included and the financial contributions of the Oldham CCG and Oldham Council.  Included within the submitted papers were proposals for a new pooled fund for Hospital Discharge Funding and a one-off variation in the contributions of the CCG and the Council to the Section 75 Pooled Funds for 2020/21.

 

The Board considered the development of Section 75 agreements that exist to facilitate closer working between local authorities and NHS organisations, with specific reference to the history of joint working in Oldham and of organisations providing support where flexibility allowed.  The budget positions of both the CCG and the Council in 2020/21 was considered, the Board being advised that both Directors of Finance had worked together to set out the system wide challenges being faced. 

 

The Board was asked to consider a new pooled fund for Hospital discharges comprising funding made available from NHS England between 19th March 2020 and 31st March 2021 to support the costs of discharging patients as quickly as possible from hospital during the COVID pandemic.  Care packages had been directly commissioned by both the CCG and the Council accordingly and formal confirmation of the creation of a new Pooled Fund at Scheme D in the Section 75 Agreement was sought.

 

With regard to the identified budgetary issues relating to the pooled fund, the Board was advised that for a number of reasons the CCG had significant scope to contribute additional funds to the pooled budget to the sum of approximately £16.823m.  The CCG’s eternal auditors had specified a number of tests that must be met to confirm these additional funds, and the Board gave a detailed consideration as to whether these monies were allowable spend for the CCG, whether the CCG’s proposed actions were permissible under the Section 75 legal document, whether the spend related to 2020/21, and that the authority was given during 2020/21.  Board Members were advised that they should be satisfied that these criteria were met before giving their approval to the additional CCG contribution.  Relevant considerations were set out in the submitted report and were subject to further report by the CCG Director of Finance.  The Board also considered submitted advice from the CCG’s legal advisors that the increased contributions to the Pooled Funds represented a legitimate use of CCG funds and was consistent with the Section 75 legal framework. 

 

It was noted that Adult Social Care played a key role in the delivery of health care and alleviated some of the burden from Royal Oldham Hospital through pro-active and integrated support at home.  Notwithstanding COVID-19, the Council had been making increasing contributions into adult social care over recent years.  The accounting treatment and implications of the additional contributions were noted, including likely considerations by the Council’s external auditor and the impact on the Council’s final outturn position.

 

RESOLVED that

1.            the strong history of joint working and funding  ...  view the full minutes text for item 7.

8.

Section 75 Month 8 and 9 Budget Position 2020/21 pdf icon PDF 190 KB

The Director of Finance to report.

Additional documents:

Minutes:

The Board gave consideration to a report presenting the Oldham Cares Section 75 (s75) pooled fund forecast position at the end of Months 8 and 9 in 2020/21. The report advised of forecast expenditure at Month 9 of £183.038m (£182.069 at month 8) compared to a budget of £180.673m, an adverse variance of £2.365m at month 9 (£1.397m at month 8). It was noted that most of this variance related to Oldham Council services and included a significant amount for Covid-19 related costs.

 

The Board was informed that the report had been produced on the basis that the 2020/21 s.75 Agreement, presented at agenda item 8 on the meeting agenda, had been approved.  Oldham Council was reporting an adverse variance of £2.743m at month 9 (£4.920m at month 8) which would be offset by favourable variances from income generation and reduced salaries costs. The CCG was showing a pooled budget underspend of £0.378m at month 9 (£3.524m at month 8).

 

The additional cost of dealing with the Covid-19 pandemic for Community Health and Adult Social Care was also being pooled within this s75 Agreement. The total cost forecast for 2020/21 at month 9 for Oldham Council was £16.793m (£17.815m at month 8). Of this sum, £10.833m (£9.527m at month 8) was expected to be recouped from the NHS via Oldham CCG. The Council was therefore showing a month 9 Covid related spend of £5.910m (£8.288m at month 8).

 

RESOLVED that the report be noted.

 

9.

Transformation Fund 2020/21 Budget Update pdf icon PDF 634 KB

The Chief Finance Officer to report.

Minutes:

The Board was updated on work undertaken to evaluate the impact of schemes funded from the Greater Manchester (GM) Transformation Funds and was asked to agree the next steps on evaluation work.

 

The Board was reminded that Oldham had received an allocation of £21.3m of GM Transformation Funds in 2017 to support Health and Social Care Transformation that built on the work undertaken in Oldham to progress the vision around integrated care.  Through an investment framework agreement with the GM Health and Social Care Partnership the Transformation Fund had supported a range of schemes to deliver that vision.  Prior to the pandemic there had been pressure to ensure that funds were spent as allocated, meaning that a full set of metrics to measure performance had not been available and scheme sponsors advised that information to monitor the impact of investment decisions would be sought retrospectively.

 

This process was paused in March 2020 due to the Covid-19 pandemic and the placing of the Transformation Fund into national NHS command and control funding arrangements.  Block contract arrangements were put in place with providers for 2020/21 meaning that programmes of work continued to be funded but with no scope to introduce new schemes.  Transformation Funds were now available to cover existing commitments for 2021/22.  However, these were non-recurrent funds and alternative recurrent sources of funding would need to be identified should schemes be permanently required.  Funding arrangements for 2021/22 were still to be confirmed with NHS England and it was proposed that all on-going schemes be asked to submit impact statements and sustainability plans, including metric data if recurrent funding was being requested, which would be considered as part of the system wide budgeting and financial prioritisation process.

 

The approach proposed sought to ensure that those schemes viable for taking forward would be considered for funding in 2021/22 once funding arrangements were confirmed.  To continue with no assessment of the schemes for 2021/22 would result in ether all schemes ending, or funding needing to be found from existing budgets for commissioned services, or increasing the financial deficit of the Oldham system.

 

RESOLVED that

1.            the report be noted;

2.                  a review be undertaken for those schemes which require continued funding to be done as part of the system wide budgeting and financial prioritisation process, the outcome of this process being reported to this Board in due course.

 

10.

Thriving Communities Programme Funding pdf icon PDF 531 KB

The Strategic Director of Communities and Reform to report.

Minutes:

The Board was further updated on the Thriving Communities Transformation Programme and was asked to confirm approval to continue with expenditure for 2021/22.

 

While Thriving Communities was a three-year project funded from the Greater Manchester (GM) Transformation Fund to run from April 2018 to March 2021, there remained some grant funded and contracted activity still to be delivered in the financial year 2021/22.  In addition, an evaluation of Thriving Communities had also been commissioned to take place alongside the final year of funded activity.  The Board was also advised that the Thriving Communities programme team had also been supporting Covid-19 response, including the implementation and management of doorstep engagement teams and the development and implementation of the Community Champions Programme, the costs of which had been covered by government funding.  It had been agreed that Thriving Communities work would pause during this time with a view to programme budget funds being used to reactivate work which was paused or not undertaken once possible in 2021/22.

 

A detailed consideration of each element and the respective funding requirement was given, the requirement totalling £410k, meaning the overall programme would still be delivered within the originally approved financial envelope.  As had been noted in a previous item on the Board agenda, funding from the GM Transformation Fund was non-recurrent and considerations were being given as to the sustainability and/or development of schemes within the Programme, matters which would be the subject of further report to the Board in due course.

 

The Board considered options to either continue with the committed expenditure as approved previously by Commissioning Partnership Board and as described in the submitted report, or to cease funding Thriving Communities activity, giving notice on contracts and grant agreements with immediate effect to minimise payment of funds.  The Council had entered into contractual arrangements with providers; the Council would have to terminate the contracts on notice to comply with its legal obligations with consequential financial implications for the Council.  Not to secure funding for schemes had the potential to impact disproportionately on some of the most disadvantaged communities who were accessing funded activities.

 

RESOLVED that the committed expenditure on the Thriving Communities programme be continued.