Consultation on local NHS Services - 16th July

 A local GP writes:

The NHS Long Term Plan was published last January 2019. One of many suggested changes was that each Sustianability and Transformation Partnership(STP) should become an Integrated Care System (ICS). To help achieve this, NHS England (NHSE) would like there to be one Clinical Commissioing Group (CCG) for each STP area. It is not explained, but the reason is to give the STP/ICS legal footing.  The CCGs are set up in law by the Health and Social Care Act 2012. The STP/ICS are a later idea, and currently only have legitimacy insofar as it is shared by their constituent CCGs. 


The changes would mean moving from the current 191 CCGs to just 44, one per STP "footprint".  The Plan suggests that should be achieved by April 2021, but in SE London they want achieve it by 2020.  


CCGs are important because they commission most of your local services. A few are commissioned by the local council. NHSE and Public Health England commission services nationally. The commissioners  decide what work they want to be done, and contract with providers to provide these services. The providers are GPs, hospitals, community health services, mental health trusts etc. The providers have some choices about how they provide the services, but little choice over what services they provide.


In Lewisham, the opposition of Lewisham CCG was a significant factor in throwing out the plans to close the A&E and maternity services at Lewisham hospital. If we had a CCG covering the whole of SE London would we have had such support?


The consultation period is now!  There is one consultation event for each of the 6 boroughs/CCGs (Currently boroughs and CCGs are co-terminus). It does not give you the date until you click on the Eventbrite link, but the Lewisham one is on Tuesday 16th July, 16.30-19.30 St Laurence Centre, Bromley Road SE6 2YS

https://www.ourhealthiersel.nhs.uk/get-involved/help-us-to-shape-the-future-of-the-nhs-in-south-east-london.htm

Some of the issues you may wish to consider:

• Will mergers on this scale cause a loss of accountability?  
• Local accountability was a big feature of the 2012 Health and Social Care Act.  They may say that there will be sub-committees at borough level, but will these have decision-making powers?
  
• Will meetings still be held in public? 
• The Act says that CCG Governing Body and certain other meetings must be held in public. If the CCG is at SE London level, you may have to travel a long way to attend meetings, and much may be about other parts of SE London in which you have little interest/knowledge.  They may say local meetings could still be held in public, but there will be no statutory responsibility to do this.
  
• Will clinicians still have the same influence? 
• This was another big feature of the 2012 Act - more clinical involvement, less managerial.
  
• Has it really been made clear what is proposed? 
• The website does not say anything about mergers!
• What will happen if local GPs vote against merger?