(a)   that plans and strategies of both the CCG and HWB sought to reconfirm that people were at the centre of services;

(b)  the current economic climate was forcing all public sector organisations to look at the system in a different way;

(c)   the CCG was the largest in the country, had clear clinical leadership and was on course to be established in April;

(d)  the HWB had developed a clear vision of what it wanted to see for all the people of Plymouth, supported and framed by its own definition of health and wellbeing. The board’s vision is to see “Happy Healthy Aspiring Communities” throughout Plymouth;

(e)  the developing Joint Health and Wellbeing Strategy (JHWBS) provided three core strategic approaches which were to ensure shared ownership of the sustainability agenda, ensure that systems were developed and used that made the best use of resources and to move the focus of work to the promotion of health and wellbeing. The three core strategic approaches were aligned with those of the CCG;

(f)    the HWBwould evidence alignment with the core approaches and constantly ensure that resources were focused toward prevention and hence the promotion of health and wellbeing;

(g)   in developing their definition of health and wellbeing the HWB had used four cornerstones Body, Mind, Heart and Spirit.  The balance between these ingredients was thought to be central to an individual’s health and wellbeing and framed the recommendations of the Marmott Report 2010;

(h)  Plymouth’s Shadow Health and Wellbeing Board would shortly launch a public consultation about how best to improve health and wellbeing across the City.  The consultation would not be on a finished strategy, but  a conversation with the City about health and wellbeing.

(i)    it was difficult to see how the system would run in the future, there would be a big role for voluntary and community sector, community interest companies and social enterprise. The alignment of existing providers was critical;

(j)    annual performance measurements were a problem in the NHS and that performance needed to measured over  5-10 years. An improved life expectancy measurement would indicate that plans were working;

(k)  in its current form the NHS  was unsustainable,  to ensure a sustainable service people must be prevented from being patients;

(l)    there was a need to create a value based system where informed decisions were made. Currently the  information nor the technical expertise existed to deal with the current problems in the NHS;

(m)the new system would require huge culture change and staff would need to be prepared to make that journey. The CCG was now fully staffed and staff had job security. The biggest risk to the CCG was maintaining the membership organization;

(n)  the cooperative values of equality, self-responsibility and solidarity were clear in the document prepared by the board;

(o)  clinical engagement in commissioning had been around for some time although previously without adequate leverage. The CCG had both elected and employed clinicians making commissioning decisions, managers working in partnership with clinicians;

(p)  NHS rationing, where a NHS Commissioner refused to fund a medical treatment which had been requested by a patient and recommended by an NHS treating clinician, would be a sign of failure for the CCG.

(1)  that the City Council, through the Health and Wellbeing Board, develop and implement a Health and Wellbeing impact assessment for all council reports;

(2)  that the Health and Wellbeing Board ensure that the consultation document is available in formats accessible to people with a range of abilities;

(3)  the Cabinet Member for Cooperatives and Community Development is invited to a meeting of the Health and Wellbeing Board to discuss the cooperative council;

(4)  scrutiny panel members use their community networks to discuss and collect consultation response to the questions posed in the health and wellbeing consultation document to be fed back through the formal consultation route of the Democratic Support Officer for the panel.