Scrutinising for Health: Health Scrutiny Evaluative Research Project

01 January 2009

This report details the findings from the health scrutiny evaluation research carried out by the University of Manchester, commissioned by the CFPS. It focuses on the progress made in the development of health scrutiny within eight case studies.

Health scrutiny was implemented in 2003, and operates as an extension to local government scrutiny. The scrutiny of health services focuses on external scrutiny although internal scrutiny of the local authorities role is also important. Overall, research has suggested that scrutiny has developed fairly well in both contexts, and has provided a number of core findings that have relevance for this study. One positive aspect is that politics has adversely affected only a few Overview and Scrutiny Committees (OSCs). Nevertheless, local scrutiny is not without its problems: there is a lack of resources, indeed more recently the CFPS’s yearly survey has shown a reduction in financial resources for scrutiny; OSCs exercise a weak ‘holding to account’ function, evidenced in part by the rare use of the call-in procedure; and the existence of many statutory consultations.

The case study research reported here has sought to build on prior work through investigating the approaches used by Health Overview and Scrutiny Committees (HOSCs). Eight cases were chosen to reflect the diversity of local authorities; a geographical spread and also on the basis of factors concerning the health scrutiny activities of HOSCs and their associated NHS organisations. This data was taken from earlier research and has provided a range of sites with different approaches and in different stages of development. On this basis, it was expected that cases would demonstrate varying degrees of effectiveness.

Case study methodology was adopted as the basic approach to the research. Within this a variety of methods were used to collect the data, including observation material, semistructured interviews and documentary sources. The data was analysed in relation to a number of research questions and also in relation to an evaluation framework, which focuses on the democratic accountability functions that are used in health scrutiny. The framework utilises the concepts of collaborative, corporate, challenging and campaigning functions and therefore the report contains both empirical and analytical results.