Agenda item

6.1  Susanna White shared a paper outlining future primary care trust arrangements in Southwark, as well as South-East London. Jane Fryer and Andrew Bland joined with Susanna White in adding some further detail to the paper. In particular, the paper outlined some keys issues arising from the current Health and Social Care Bill, focusing on new Board arrangements, including GP commissioning and how it may impact in Southwark.

6.2  GP commissioning arrangements are due to come into operation in April 2013. A main focus for GP commissioners will be the need to get a firm grip on quality and costs.

6.3  Currently, Primary Care Trusts (PCTs) will merge into small groups or clusters. In South-East London, arrangements for the cluster PCT are underway, and it will cover six PCT areas. The ‘statutory body’ remains NHS Southwark, and each former PCT area will continue to have a ‘business support unit’ managing local commissioning and other ancillary services. The South-East London arrangements, including the new business support units, come into operation on 4 April 2011. Andrew Bland will be the Managing Director for the Southwark Business Unit, and Malcolm Hines will be the Finance Director. Jane Fryer will be the Medical Director across the South-East London cluster. Over the next two years, general practitioners (GPs) will take on commissioning roles, though responsibility rests with NHS Southwark until April 2013.

6.4  In Southwark, there will be one GP commissioning consortium covering all GP practices.  Following a formal recruitment process, eight GPs, two from each of four localities across Southwark, have been appointed to lead the consortium. The new GP board will be functional from 1 April 2011, though no commissioning arrangements have been delegated to the board yet. A main priority is to draft and agree a constitution, through involvement with all Southwark GP practices.

6.5  Historically, locally there has been a lot of involvement by GPs in health scrutiny, and that is expected to continue in the future. The key contacts will be the eight GP leads. In particular, Drs Patrick Holden (north of the Borough) and Mark Ashworth (south of the Borough) will have links into the social care agenda.

6.6  Susannah White and Andrew Bland answered a number of members’ enquires:

6.7  Given the potential for overlap between the planned Health and Well-being Board (under the Health and Social Care Bill) and Southwark’s existing Health and Well-Being Board, discussions are taking place between senior Council managers as to future arrangements for the existing Board.

6.8  The GP commissioning consortium’s decision-making committee meetings will be held in pubic. Initially, this committee will exist as a NHS Southwark sub-committee.

6.9  Andrew Bland, as Managing Director of the Southwark Business Support Unit will continue to attend the Health and Social Care Scrutiny Sub-Committee meetings.

6.10  The Southwark Business Support Unit will continue to provide a commissioning framework, for example using the NHS commissioning cycle and Joint Strategic Needs Assessment.

6.11  The new PCT configuration is designed to reduce management costs by up to 50% – though it will be up to GPs as what they want to ‘buy’. During the transition period to April 2013, a Transition Board led by the Chief Executive of NHS Lewisham will oversee progress.

6.12  The GP new commissioning system is about harnessing GPs skills and experience in terms of a patient’s gateway to accessing health services. The eight GPs in the leadership group will have a strategic overview, but for others their focus will be on normal day-to-day surgeries.