A 26-page DH consultation, Local Authority Health Scrutiny focuses on how disputes over service reconfiguration plans are handled by councils once they take over public health budgets in England from 1 April next year.
Under the proposals, local authorities could be required to consider the financial implications of any service changes, and to publish a timescale for deciding whether to refer a proposal for service reconfiguration they disagree with to the health secretary.
The consultation also proposes an 'intermediate' mechanism that would allow local authorities to refer a disputed proposal to the NHS Commissioning Board (NCB), and asks whether the consent of the full council should be required before any commissioning decision is referred either to the health secretary or NCB.
The consultation reads: ‘It would not be right for a local authority to refer a reconfiguration proposal to the secretary of state without considering whether the proposal is both clinically and financially sustainable, within the existing resources available locally. We believe health scrutiny would be improved if it was specifically asked to look at the opportunities the change offered to save money for use elsewhere in improving health services.’
Under the plans, local authorities will be able to draw up their own proposals for service reconfiguration, if they believe the existing ones are not in ‘the best interests of the local health services’.
Althought respondents to the consultation are asked if the first referral stage of a dispute should go to the NCB before it reaches the health secretary, the DH says it does not intend to remove a local authority’s power of referral to the secretary of state.
The consultation adds that it 'may be difficult for the NCB to both support clinical commissioning group (CCGs) with the early development of reconfiguration proposals (where CCGs request this support) and also to be able to act sufficiently independently if asked at a later date by a local authority to review those same plans'.
The NCB could instead have a 'more informal role', with local authorities able to approach it to raise concerns and seek advice before deciding whether to refer a decision to the health secretary, the consultation adds.
The consultation is due to close on 7 September.