Agenda item

Report of the Director of Communications and Engagement, SHIP PCT Cluster, providing an update on changes to local NHS commissioning organisations as a result of Government reforms, attached.

The Panel considered the report and received a presentation from the Director of Communications and Engagement, SHIP PCT Cluster, providing an update on the changes to local NHS commissioning organisations as a result of the Government reforms.  (Copy of the report circulated with the agenda and appended to the signed minutes).

The following points were noted:-

• the over-arching National Commissioning Board would be a single, nationwide organisation, with matrix-working at its heart to provide simplicity, aid and efficiency to ensure a consistent approach and would take up its full statutory duties and responsibilities on 1 April 2013;
• there would be 27 Local Area Teams,(LAT’s), each having the same core functions which would take on direct commissioning of GP services, dental services, pharmacy and certain optical services;
• there would be 4 regions providing clinical and professional leadership at a sub-national level and Southampton was part of the Wessex Local Area Team which included SHIP, Dorset Bournemouth and Poole.  This area comprised 7 Local Authorities, 9 CCGs and 6 Health & Wellbeing Boards;
• CCG’s were groups of GPs and other key health professionals responsible for 80% of the healthcare budget in their area and would buy in services.  All GPs would be a member of the  CCG in their area and each CCG would have a governing body and would be responsible for engaging with local people to ensure that services met their needs;
• authorisation would be the process by which CCGs would be assessed as ready to take on responsibility for health care budgets for their local communities and Southampton was timetabled in Wave 4, with the authorisation decision due in January 2013;
• CCG’s were public bodies/statutory NHS organisations under the umbrella of the National Commissioning Board.
• CCG members and the local care team were represented on the Health & Wellbeing Board, which was a statutory Board and was a crucial vehicle for setting the strategic direction of the new Health and Social Care Act;
• the Southampton CCG and Local  Area Team was based in Oakley Road;

The Chair had received a deputation from 38 Degrees who had asked that they be permitted to ask officers a few questions in relation to the above item.  The following questions were answered by officers.  Members of the organisation had also been given contact details for the Southampton CCG and Link who would be able to assist them if they had any further queries/questions:-

• Structure of Consultation  - the consultation structure being adopted by Southampton CCG to enable concerned individuals to engage with them would be the same consultation process as previously used and there were robust mechanisms in place to engage with the public.

• Election of Lay Members/CCG Board - Lay members/representatives had been appointed and were qualified persons who had applied for the positions.  The current 5 members of the CCG Board had been voted in by GP’s by way of an internal election.

• Externalisation/Privatisation - The proposed model constitution was set by statutory guidelines and would eventually become a public document.  This would be shared with the public and  published on the SHIP’s website.

• Dr Richard McDermott’s position - Dr Mcdermott was a member of Southampton’s CCG and also the managing director of a company called Solent Medical.  Officers confirmed that there was strict governance and guidelines around “conflict of interest” issues  and this was strictly scrutinised.

Panel members expressed concerns that the CCG commissioning support units may be fragmented, making them less efficient;  the private sector might “cherry pick” services that would provide them with more money;  and if delivery of services was dominated by cost due to lack of funding, this could lead to inadequate and less efficient services/supplies and subsequently endanger people’s lives, the large number of health bodies would require a good communication structure.  Officers conceded that there were financial issues but that their core vision and promise was to improve the quality and outcomes for their customers as well as driving costs down.