Agenda item

In attendance for this item were:

Worcestershire NHS Clinical Commissioning Groups:

Mari Gay, Chief Operating Officer and Lead Executive for Quality and Performance and Tom Grove, Head of Communications, Engagement and Organisational Development

The Chief Operating Officer (COO) and Lead Executive for Quality and Performance summarised the journey of the three clinical commissioning groups in Worcestershire.  Over time this had become more co-ordinated, with a shared management team which designed pathways and made decisions for the whole of Worcestershire, taking into account the differences of the three areas. The NHS Long-term Plan and more integrated systems had brought on this way of working and a proposal was being put through the NHS governance system for one CCG to span the Herefordshire and Worcestershire STP area.  There was already one Accountable Officer for the 4 CCG’s. Maintaining a place-based structure, with joint commissioning, would be important.

Engagement with the public was taking place although the proposal was not about service change. Participation had been low, but regarding the options of whether to proceed with the merger now or take more time, the preference was to ‘get on with it’. The CCG representatives said that questions from the public had included querying whether local engagement would continue, which it would, and whether services would change, which they would not.  

The Chairman invited questions and the following main points were made:

·         A member queried the low number of responses (119) and the Head of Communications, Engagement and Organisational Development explained that consultation was still taking place using a combination of drop in meetings, online channels and posters – while more responses would be good the low numbers may reflect the lack of proposed service change where greater response would be expected. Derbyshire had only received 101 responses.

·         It was confirmed that the legal status of the proposed CCG model would be one statutory body from the current four.

·         A HOSC member asked whether this was another step to Integrated Care Organisations and the CCG COO advised that this would depend on central government but was debateable and would be challenging in her view. For now there were still individual organisations but they were all trying to integrate pathways and work as a network to use NHS services better and more efficiently.

·         A HOSC member asked how the local aspect would be retained under the proposed merger and whilst acknowledging this concern the CCG COO advised that staff could be assigned to work on specific areas and specific issues and local forums and networks would remain unchanged. She also referred to frustrations from service providers about working with different CCGs.

·         A HOSC member asked how the merger would affect lower levels of staff and was advised that director level was clear, while the next tier down was being looked at and the structure would be based on delivering the strategic function but also the operational one.

·         When asked about drug purchasing the CCG COO advised that procurement would be more cost effective across a larger system and she advised that best practice and NICE guidance was looked to.

·         A HOSC member commented that the low level of response to the engagement was to be expected since the issue at hand would not mean much to the public. He asked what had been learned from the engagement, and was advised that feedback had been valuable in highlighting the importance of maintaining local relationships and networks. The CCGs had considered including in the consultation a third option of not merging but it was important to only include options which were realistic to deliver.

·         The Wychavon District Council HOSC member asked why a drop-in meeting had not taken place in Wychavon, and issues of resources and director presence were referred to, although this feedback would be taken on board for the future. It was pointed out that the drop-in sessions had not included new presentations but were more for questions.

·         It was confirmed that there were no plans to change reporting arrangement to the Health Overview and Scrutiny functions for Worcestershire and Herefordshire.

·         The Chairman sought assurances that Worcestershire would not be ‘pushed out’ and the CCG COO pointed out current ways of working would not change in this respect, with a focus on maintaining and continuing to grow local structures, whilst coming together for decisions affecting both counties. She viewed the change as more administrative and the organisation would be a bit leaner but continue its work.

·         When asked whether economies would be sought from reducing leases on separate CCG buildings, members were advised that staff bases would still be needed and separate sites would facilitate the place-based focus.