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JOINT FUTURE AGENDA: SHORT LIFE WORKING GROUP ON JOINT PREMISES DEVELOPMENT IN PRIMARY AND COMMUNITY CARE: FINAL REPORT
APPENDIX 4
COMMUNITY CARE AND HEALTH (SCOTLAND) ACT 2002 - FLEXIBILITIES
The SLWG report has identified the need for a wider strategic approach in respect of joint premises development with need for joint property and estates strategies to be developed between the NHS/LA.
During the consideration time of the SLWG, the Community Care and Health (Scotland) Act 2002 put in place mechanisms to enable the NHS/LA to transfer capital assets and resources as part of the development of better joint services. These flexibilities were designed to address immediate needs of partners undertaking ad-hoc joint development projects at the leading edge of joint premises development. These same flexibilities are expected to provide the tools for partners to implement their joint property and estates strategies.
The Community Care & Health (Scotland) Act 2002 ( http://www.scotland-legislation.hmso.gov.uk/legislation/scotland/acts2002/20020005.htm)
and the Community Care and Health (Joint Working etc) Regulations 2002 ( http://www.scotland-legislation.hmso.gov.uk/legislation/scotland/ssi2002/2002533.htm)
enable partners to transfer property or delegate functions to provide premises in support of joint working and achieve more effective use of resources. Current flexibilites set out in the Act are:
Payments by NHS bodies to local authorities
Section 13 of the Act allows an NHS body to make payments towards certain local authority functions. Payments can be made towards revenue or capital expenditure. It provides financial flexibility, enabling the NHS body to move resources to deliver joint objectives. The functions for which payments can be made are prescribed in Regulation 2(1) and Schedule 1 to the Regulations.
The NHS body must be satisfied, before making any payment towards local authority expenditure, that it:
- has an effect in relation to the health of individuals;
- has an effect in relation to, or is affected by, any function of the NHS body; or
- is connected with any function of the NHS body.
Payments by local authorities to NHS bodies
Section 14 of the Act allows local authorities to make payments to NHS bodies towards prescribed NHS functions. Payments can be made towards revenue or capital expenditure. Regulation 3(1) and Schedule 2 to the Regulations prescribe the functions for which payments can be made. Local authorities can only make payments towards expenditure by NHS bodies if they are satisfied that the service would be improved.
Delegation and pooled funding
Section 15 of the Act enables local authorities and NHS bodies to delegate functions to one another and to pool their resources in support of joint services. This is a significant change in the flexibilities enabling fuller integration and flexibility within the current organisational framework. This allows local authorities and NHS bodies to agree who is best placed to co-ordinate a joint service on a day to day basis to provide a seamless response and to use resources more efficiently.
Pooled budgets enable partners to use their resources more flexibly and to streamline the management and accounting for them. This cuts through separate schemes of financial delegation and financial instructions, and creates the circumstances for more streamlined audit arrangements for community care expenditure. The functions which local partners can delegate are prescribed in Regulation 4 and Schedule 3 to the Regulations (for local authority functions) and Regulation 5 and Schedule 2 to the Regulations (for NHS functions).
The Act requires the local authority or NHS body to satisfy themselves that any joint working arrangements would, in their opinion, be likely to lead to an improvement in the way in which the functions prescribed in the Regulations are exercised.
Once a partner has agreed to delegate functions to another body and satisfied itself on the pre-conditions referred to above, it can agree to enter into joint resourcing arrangements. These may comprise straightforward payments to sustain the delegation (and therefore operate on an aligned budget) or put resources into a pooled budget. This means that resources including staff, money, equipment, property and other resources from within the separate agencies can be brought together to provide a single point for the planning, commissioning and delivery of services. This should result in more flexible use of resources, quicker decision-making and more streamlined processes. Regulation 10 sets out all the criteria for a pooled budget. The arrangements must be specified in a written agreement in accordance with Regulation 9.
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