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?
