Health Overview and Scrutiny – How far have we got?

Presented at our conference in September 2002

Patient and Public Involvement 2002

Legislative Framework

Health Act 1999

Duty of partnership introduced

Local Authority and NHS must develop an agreed Local Health Improvement Programme (HImP) now known as the “Health Improvement & Modernisation Programme”

Ability to pool budgets / integrate services

Local Government Act 2000 introduces for local authorities a statutory duty to produce a “community strategy”, a power to “advance the social, economic and environmental well being of the communities they serve”, and the concept of Executive / Scrutiny divide in decision making for local authority.

The Health & Social Care Act 2001 provides for local authorities and the NHS the joint ability to create “Care Trusts”. It amends the 2000 Act: confers power to “review and scrutinise” health service issues, and includes scrutiny of social care commissioned by NHS within remit of the local authority. It lays on the PCT a duty to consult health scrutiny on “substantial developments and variations in services”, requires Trust Executives to attend Health Scrutiny meetings and requires NHS to provide information to health scrutiny and respond to any recommendations made.

NHS Reform and Health Care Professions Act 2002 gives local authority the power for Health Scrutiny to refer contested issues to the Secretary of State. It creates “Commission for Patient and Public Involvement in Health”, creates “Patient Forums” for all NHS Trusts with power to refer to OSCs, prescribes that PCT Patient Forums must work with other Patient Forums, gives Patient Forums power to propose NED to Trust Boards, and abolishes CHCs & ACHCEW.


    • Informal testing of concept by Local Authorities
    • Consultation on Regulations
    • proposed 1st Jan 2003 start


  • No additional resources to support new structures
  • Large no of LAs not ready to start (could be May 2003)
  • Single v two tier authority areas
  • Joint scrutiny – working across LA boundaries (eg Mental Health)
  • Training programmes just starting LGIU / DHN Toolkit ACHCEW / I&DeA / Universities