Agenda item

To receive an overview of the programme of CCG and system reform across south east London and in each borough.

Andrew Bland, Accountable officer for NHS Southwark CCG gave a presentation to the board on the Clinical Commissioning Group System reform across south east London.

Andrew Bland informed the board that the system reform arose out of national policy and local ambition in January 2019.  He advised that the NHS long term plan made over 130 commitments, and also invited the opportunity to look at the shape and scope of CCGs, and to develop a multi layered approach to how commissioning decisions are made with partners.  There was a programme of work that would seek to merge CCGs across the six parts of southeast London into one CCG from 1 April 2020.  That same piece of work was happening in the other parts of London with the areas divided as follows - south west, north west, north central and north east.

Andrew Bland explained that if there was a merger of the southeast London CCGs into one CCG, then at the same time there would be a need to create place based boards.  He explained that nationally a ‘place’ is regarded as a population between 150,000 and 500,000.  This was similar to the size of the various boroughs in south east London.

He informed the board that CCGs had been asked to look at the reform from a system level, how pathways across many boroughs get managed appropriately and decisions made in a coherent way both at borough and neighbourhood level.  He reported that Southwark had opted for two primary care networks which were quite sizeable.  Across south east London, there would be 34 primary care networks in total.

Andrew Bland reported that there would be tiers of the system of which to make decisions which was welcomed, because there were parts of Southwark residents care that needed coherence and decision making across south east London as someone’s care might start in one part of the region and end in another.  However the vast majority of decisions for local people would need to happen with the local authority and local partners.  He welcomed the idea of taking a very localised view at ward level and neighbourhood level as to what people needed, as the wider areas of Southwark, i.e. Dulwich, Peckham and Camberwell and up into the north of the borough were not similar.

He indicated that the SELCCG wanted to delegate a significant part of its budget to each borough’s place based board to take local decisions, but importantly to take them with a board that had health and social care representation rather than just health.  He reported that as a minimum the SELCCG would like to delegate the hospital spend to that board, with formal delegation of decision making powers, but to be populated by its partnership of health and social care. 

Andrew Bland advised that an application to have a southeast London CCG would have to be made at the end of September for it to come into force on the 1 April 2020. Also as a CCG for south east London there would be one governing body so there would be a need to have place based boards for each borough.

He informed the meeting that from 1 April 2020, every borough in southeast London must adopt one of the three areas for the delegation to work, Level 1, Greater Involvement, Level 2 Aligned Commissioning, Level 3, Joint Commissioning (see page 61 of the agenda for detail).

It was signalled by the chair of the board during the discussion that Level 3 would be the preferred option for Southwark.

RESOLVED:

That the contents of the report be noted.