Tuesday 6 th November Second Floor Hemel One Boundary Way Hemel Hempstead HP2 7YU

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1 Tuesday 6 th November 2018 Mr Seamus Quilty Chairman HCC Health Scrutiny Committee Dear Seamus Second Floor Hemel One Boundary Way Hemel Hempstead HP2 7YU Herts Valleys, NHS Clinical Commission Group: Nascot Lawn NHS Respite Care Centre I am writing to set out our own formal response to your letter to the Chief Executive of NHS England, dated 24 October At the outset, I acknowledge with thanks your comments about the improving relationships between your committee and Herts Valleys CCG and confirm that we wish to continue to build on these relationships in order to work with you in a close and productive way, as suggested in your letter. It is therefore disappointing that you have included in your letter comments about Herts Valleys that are inaccurate and unsubstantiated. Whilst respecting the political drivers and the decision to send a letter from the scrutiny panel meeting in July, it is the inaccuracies that we cannot allow to go uncorrected. We are also surprised that you have chosen to send the letter so many months later. In your letter, you have stated that HVCCG have acted without transparency, its governance procedures and processes have been weak at times. We don t agree with this statement, and you have not provided any information to substantiate it either in your letter or the report that your committee provided to the CCG under regulation 23(4) of the Local Authority (Public Health, Health and Wellbeing Boards and Health Scrutiny) Regulations In particular, you do not identify in your letter any procedures of ours that you consider have been weak. We regularly review our governance arrangements and take considerable effort to ensure we have the correct arrangements in place. We are satisfied that we have acted in accordance with the principles of good governance, and with the processes prescribed in our constitution and integrated governance protocol. External reviews are also undertaken and amongst these our auditors have reported on the CCG s strong governance. You have also stated that: there has been what can only be described as a wholly inadequate approach to engagement both with stakeholders and most importantly to the members of the public that both HVCCG and the County Council serve. This statement is inaccurate and does not reflect the extensive engagement that the CCG has carried out, and that was specifically acknowledged by the High Court in the judicial review judgment. We have met and

2 talked to families face-to-face throughout, including through our Chief Executive, Kathryn Magson and me, as Chair. Attached is a timeline listing all engagement with families and other organisations, all of which were regularly reported to members as part of the CCG papers for scrutiny on 19 July 2017, 21 March 2018, 3 July 2018, 21 August 2018 and 21 September In his judgment in the High Court, Mostyn J. acknowledged the considerable lengths that we had gone to in involving the public in our decision-making, stating that: I am satisfied that the defendant fully complied with its obligations, and its agreement. There had been much engagement with the public including meetings and correspondence with the parents, carers and community interest groups. These are fully set out in the evidence before the court. There was a very full public involvement in the proposal to withdraw funding. The defendant fully complied with its statutory obligations. You state that the timing of your letter - sent many months after the committee and council decisions - is deliberate and that the relationship, because it has improved, can withstand the criticism which you go on to outline. We have written this response to you, putting the record straight, not because the relationship between us isn t a strong one. In fact the teams on the ground, including senior officers, have been agreed on the way forward since the summer of 2017, and have been working day-to-day on really important issues such as the transfer of children to alternative respite centres. Our concern is that your letter to our regulator, which is also in the public domain, contains serious and material inaccuracies and it would be irresponsible of us not to address these. We would also like you to be aware that this correspondence between us will be discussed at our board meeting in public on Thursday of this week 8 November. We assume that our response and indeed the reply from NHS England, when it arrives, will be made public via your council meeting at the end of this month and will be included in full in any associated public communication. Yours sincerely Nicolas Small Chair Herts Valleys CCG

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4 Appendix: schedule of engagement meetings and phone call and subsequent meeting between HVCCG Accountable Officer and HCC Chief Executive, confirming CCG s inability to contribute following Investment Committee HVCCG, E and NHCCG and HCC meeting HVCCG and HCC operational meeting from HVCCG to HCC indicating the CCG will no longer fund respite services Phone call with HVCCG and HCC HVCCG letter to Hertfordshire Community Trust - confirming ceasing of funding for Nascot Lawn from (6 month contract notice period) HVCCG CEO letter to Director of Children s Services confirming ceasing of funding for Nascot Lawn HVCCG and HCC meeting HVCCG and HCT meeting HVCCG and HCC meeting HVCCG, E and NH CCG, HCT and HCC meeting HVCCG letter to parents using Nascot Lawn immediately following purdah HVCCG meeting with Carers in Herts , and HVCCG meeting families using Nascot Lawn HVCCG meeting with Hertfordshire Parent Carer Involvement (HPCI) Operational and Strategic meeting HVCCG, E and NHCCG, HCT and HCC July Joint health and social care assessments commence Operational meeting HVCCG, E and NH CCG, HCT and HCC Operational and Strategic meeting HVCCG, E and NHCCG, HCT and HCC Healthwatch update MP update Full Council meeting HVCCG in attendance Strategic meeting HVCCG, E and NHCCG and HCT and HCC HVCCG meeting with parents Parent/Carers meeting Healthwatch update Parent/Carers meeting MP meeting Parent/Carers meeting Parent/Carers meeting Parent/Carers meeting HVCCG issue letter to HCC informing HCC of formal consultation in line with Regulation 23 of the Local Authority (Pubic Health, Health and Wellbeing Boards and Health Scrutiny) Regulations HVCCG issue letter to parents requesting them to contact us with comments on the Council s feedback regarding the CCG proposal by 5pm on 18 April HCC and HVCCG face to face meeting to discuss consultation Nascot Lawn Strategic Meeting HVCCG letter to parents Nascot Lawn Operational Meeting HCC Health Scrutiny meeting

5 HCC to respond to HVCCG on consultation Nascot Lawn HCC and CCG parent evening meeting HVCCG communication to families and stakeholders of decision made by Finance and Performance Committee Nascot Lawn HCC and CCG parent evening meeting Nascot Lawn Operational meeting Nascot Lawn Operational meeting Nascot Lawn Strategic meeting Nascot Lawn Operational meeting Nascot Lawn HCC and CCG parent evening meeting Nascot Lawn operational meeting Nascot Lawn strategic meeting Nascot Lawn operational meeting