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Health and Social Care Bill

I am grateful for the opportunity to explain how the commission’s reviews will contribute to the new comprehensive area assessments of local areas that will be introduced from April next year. As described by the noble Baroness, the CAA forms part of the new local government performance framework, set out in the Government’s 2006 local government White Paper, Strong and Prosperous Communities. It will be an important new step in producing integrated assessments of local services against common goals. The assessment will be carried out against the outcomes of local area agreements and a national set of 200 cross-government indicators. I agree with the noble Baroness that it is essential that the commission’s reviews feed into that assessment. She is correct to say that the work of the CAA is very important—and in her comment on the fact that CSCI’s work is already integrated into that, which gives us an indication of how that is likely to continue. As my honourable friend the Minister clarified in another place when debating this Bill, where the indicators used in reviews under Clause 42 relate to local authorities working alone or in partnership with PCTs, other NHS bodies or other local service providers, they will form part of the single set of national indicators to be used in comprehensive area assessments. The commission will work closely with the Audit Commission to ensure that that happens. The national indicator set was announced in October as part of the Comprehensive Spending Review; the details of the indicators are being published by the Department for Communities and Local Government. There are 31 indicators covering health and well-being and adult social care which appear in the national indicator set and the NHS vital signs to support partnership working. The Government have also commissioned the seven current inspectorates with a role in local authority assessment to work together to develop and test a methodology for carrying out CAAs, and they carried out a joint consultation on their proposals in November last year. This methodology has been trialled in four local areas in order to work through in more detail how the CAA will need to operate on the ground. The learning from this process will be reflected in a second joint consultation this summer, which will set out more detailed methodologies for the CAA, along with more structured piloting in a further 10 authorities. The first joint CAA judgments are then expected to be published by the relevant inspectorates, which will include the Care Quality Commission, in the autumn of 2009. This will be a transition year, with full implementation the following year. I hope that the noble Baroness will be reassured from this that arrangements are being taken forward to ensure the Care Quality Commission’s assessments will be fully integrated into the CAA process and that she will therefore agree to withdraw the amendment. Under current legislation, the Healthcare Commission and Commission for Social Care Inspection are required to review NHS bodies and local authorities on an annual basis. We have altered this to allow more flexibility, precisely because we believe that the commission is best placed to decide on the frequency of periodic reviews and the periods they cover. Of course, the commission will also want to take into account the timing of comprehensive area assessments in making that decision.