17 Dec 2019

Dietitians make a difference to patients’ lives – their health and quality of life. Our services are also cost effective. Dietitians know this but do the people who are responsible for making decisions about health services in your area know? In the current health system, it’s now more important than ever to engage locally with key decision makers.

What is health scrutiny?

Local authorities are responsible for scrutinising local health organisations to ensure they are providing effective, efficient services and encourage improvement. The primary aim of health scrutiny is to strengthen the voice of local people, ensuring that their needs and experiences are considered as an integral part of the commissioning and delivery of health services and that those services are effective and safe.

If a local service is cut or changed it may be possible for anyone concerned about this, including dietitians, to ask whoever is responsible for health scrutiny at the council to intervene.

How do local authorities carry out health scrutiny?

Most authorities will have a ‘Health Scrutiny Committee’ on which elected councillors will sit. Each Committee has a Chairman and Vice Chairman. The councillors on the Committee will serve for a year and then have to reapply to be members. There is usually a place on the committee for a representative from an external body such as the local Healthwatch.

In essence, the scrutiny process connects decision makers to the local people and involves the community whenever possible. However, the powers of scrutiny cannot overrule decisions by NHS providers and bodies, but they are influential. Both groups include patient and public representatives.

Health Scrutiny Committees usually pick a number of topics to scrutinise and set up inquiries. Examples of topics include closure of wards, mergers of NHS Trusts, proposal for community stroke rehabilitation services and so on. Inquiries are held in public so patients and professionals working in healthcare may be invited to give evidence. They have the power to require representatives of all NHS bodies and health service providers to attend inquiries, give information and answer questions.

It is important to note that all NHS bodies and health service providers must consult with the local authority on proposals for any substantial variations to health services.

Local authorities can make recommendations to health bodies and where there is disagreement, they can refer matters to the Secretary of State for Health.

Why do dietitians need to influence Clinical Senates?

They influence and advise CCGs on service developments and care pathways and so it is important that they are aware of the role and valuable contribution of dietitians. If we don’t ‘stand up for dietetics’ they may never know about us!

What can I do?

  • Find how your local authority carries out its health scrutiny by visiting your council website.
  • If the council has a Health Scrutiny Committee find out who the individual members of the committee are. (Note the names and contact details will be available on the Council website.)
  • Network with individual councillors on the Health Scrutiny Committee, in particular the Chair and Vice Chair. This will help raise the awareness of dietetics with the committee members and for them to have a better understanding of your role in providing healthcare thus making them more likely to contact you and seek your opinion. (Find out more about influencing politically here).
  • Raise the profile of dietetics with your local Healthwatch Representatives on the Health Scrutiny Committee.
    • Healthwatch is an independent consumer champion for the public, patients and users of health and social care services in the local area. They may support you if you wish to take a case to the Health Scrutiny Committee as an individual. (NB if you wish to represent your employer you must seek advice from your manager).
  • Dates for committee meetings (held in public) are detailed on the council website as are the forward plans and minutes of previous meetings. You may attend a meeting as an observer. Attending meetings demonstrates that you are interested in local affairs and also provides an opportunity for you to better understand the key priorities for the councillors and raise your profile.
  • If you wish to participate in a meeting, notify the committee in advance by email or letter, stating the nature of the topics or issues you might want to raise. You may be invited to give evidence formally.
  • If you want the local authority to use its powers of scrutiny to investigate / intervene then link up with others to have a louder voice – e.g. other allied health professionals locally or local patients’ groups.
  • Talk to the BDA about any concerns you have about plans for your service. Working together helps us all to learn from each other.