Agenda item

CCG SYSTEM REFORM - PRESENTATION

Minutes:

Christina Windle, Director of Commissioning Operation (DoCO), SEL Commissioning Alliance and Neil Kennet-Brown, Managing Director (MD) of GCCG presented this item.

 

In response to a number of questions from Councillor Muldoon, the DoCO said that the STP was not a legal organisation, but was a partnership to ensure the plan was delivered effectively.  The SEL CCG would have the legal status and all Boroughs would be represented at this Governing Body.  The place based boards would have delegated authority to make local decisions particularly around primary and community care and they would all meet in public for part of the agenda.  The CCG would still adhere to the 2012 Act that required clinical representation at decision making boards. 

 

In response to a question about the business case for this change, officers responded that it was to enable better integration at different levels with efficiency savings being made in respect of management costs. 

 

Close working would continue as previously and would mean continuity of leadership at a local level.  Local voice would be represented at the SEL Board and the place based director would continue to come to Council meetings.  Relationships with the Health and Wellbeing Boards and Overview and Scrutiny Committees would continue at a local level.

 

The SEL CCG Governing Body would comprise of approximately 22 Members and would include  Director of Public Health and Adult Social Care positions; place based Boards would have the local representation and Council Care partnership representation that local CCG Governing Bodies had now.

 

In response to questions about risk, the DoCO stated that multiple systems had to work together effectively, and responded that the risk based approach was being adopted to mitigate disruption to services.

 

In response to Cllr Mcilveen’s and other Members’ questions about recognising the diverse nature of each borough to ensure local need was recognised when sharing cost and allocations, the DoCO responded that relationships that currently stand would be built on.  The management cost envelope had reduced and the savings had gone into frontline services. 

 

Members were advised that not everything needed to be addressed at the centre and that risk share arrangements already operated.  Allocation of monies would be made to the SEL Governing body based on a needs assessment. The details needed to be worked through and delegation levels also needed to be drawn up based on need.  Large scale collective decisions based on high level principles would be made at SEL Governing Body level.

 

Delegation to place based boards would be made to address local need.  If place based boards required additional resources, they would be received by the SEL Governing Body for consideration.

 

Challenges in the entire geography of the SEL footprint and the health inequalities this represented were recognised.  These reforms would enable even greater collaborations to address this, but still have the ability with delegated budgets to address economies of scale and work with providers to deliver the best services.

 

In response to a question from Cllr Lloyd on the determination of Better Care Funds (BCF) to boroughs, the MD, GCCG responded that his assumption was that if the BCF continued, it was better to be place based.

 

It was noted that it was considered that public consultation was not required as this was not a service change, and also that merger approval would be sought from Governing Bodies and membership in September and submitted by the end of the same month.

 

In response to a question about timescales and information on place based board budgets, the DoCO replied that it was hoped to appoint a shadow governing body by November 2019, who will then look at delegation levels.  The details of this would be in the application being presented to NSH England in September.  Officers agreed to share further details in September.

ACTION: MD GCCG and DoCO.

 

Members asked for an OHSEL JHOSC Committee to be arranged for late September so that they strengthen the view of the OHSEL JHOSC to be included in the application.

 

Supporting documents: