Cabinet considered the report regarding the rationale for altering the current arrangements for public health across Slough, RBWM and Bracknell-Forest.

Deputy Chairman of Cabinet, Adult Social Care, Children’s Services, Health and Mental Health introduced the report and informed that the report sought new arrangements for the delivery of public health services and the statutory Director of Public Health (DPH) post. It sought in principle the approval for the new collaborative arrangement and confirm indicative funding allocations subject to the 2021-22 Budget being approved.

Since 2013 the Berkshire Public Health System had operated on a hub and spoke model with Public Health teams within in each of the six unitary authorities supported by a Shared Strategic Director of Public Health and a Shared Team hosted by Bracknell Forest Council. 

The overall aim of the Berkshire Public Health System is to deliver the core public health duty for local authorities which is to take steps to improve the health of residents and decrease health inequalities.  During the current pandemic we have seen the importance of public health and associated strategic aims for delivery. There were also the associated work to deliver our public health strategy supported by the Health and Wellbeing Board.  Public health had a wide remit and has been working collaboratively with a number of agencies. The strong relationship with the NHS has been important.

One of the challenges of the current arrangements is that the Director of Public Health has been supporting 6 local authorities and this reduces capacity due to responsibilities and demands.  Recruitment to this type of roles has been  challenging and the current postholder is leaving in the New Year. This provided a natural opportunity to change the role in Berkshire to make the system more efficient and attractive.

It was proposed is to dissolve the current arrangement between the six authorities and move to an arrangement between Slough Borough Council, RBWM and Bracknell Forest Council and the Frimley Integrated Care System.  This would have a shared Director of Public Health role for East Berkshire to lead the public health system, working closely with the local authorities and partners across the integrated care partnership.  There will also be a hub team providing health intelligence, health protection and commissioning support to support public health teams in each local authority.  This would enable a lot more focus and insight locally.

The shared team commissioning function would sit within Bracknell Forest commissioning team with a view to individual authorities taking on the commissioning of particular services in the future.

The Deputy Leader of the Council, Resident and Leisure Services, HR, IT, Legal, Performance Management and Windsor thanked officers for their hard work during the current pandemic crisis and said the proposals would strengthen public health.  She asked if west Berkshire authorities would combine and thus be two directors of public health within Berkshire.  She also asked if proposed changed to public health would impact on what we do.  In response Cabinet were informed that yes there would be two Berkshire positions and that public health had not changed but the Government had formed the National Institute for Public Protection that would look nationally at issues, remaining functions of public health were currently under consultation. Some functions mat be devolved to local authorities.

The Lead Member for Finance and Ascot supported the proposal and said that he had been a governor of Heatherwood Hospital when the new trust was formed with Frimley Health. This report made sense and locally there were proposals for two new GP hubs.  He asked if the new proposals would help the council provide support for residents within the borough.  Cabinet were informed that through the creation of the integrated care system there had been a communality of local planning and commissioning.  We had greater purchasing power and an opportunity to improve services to areas such as mental health.

Cllr C Da Costa said she welcomed any ways of reducing inequalities and that the poorest in society were the ones who needed the services the most but still had the poorest outcomes. She raised concerns about the different needs of the three authorities and if they would be served appropriately.  She was informed that a the highest level the proposal would provide more capacity to service our area and that each local authority received its own grant to use locally or collectively.  There would also be a local focus via the Health and Wellbeing Board.

Resolved unanimously: that Cabinet notes the report and:

i)          Approves the creation of the post of Director of Public Health for East Berkshire in collaboration with East Berkshire Clinical Commissioning Group and Bracknell Forest and Slough Borough Councils.

ii)         Delegates authority to the Managing Director in consultation with the Lead Member for Adult and Children’s Service, Health and Mental Health and the Director of Adult, Health and Commissioning, to finalise and approve the partnership arrangements with relevant organisations.

iii)        Notes the inclusion of an additional £65,000 per annum to fund the new arrangements is to be added to the 2021-22 base budget and funded from the public health grant.