Agenda item

(To receive a report from the Richard Childs, Chairman of Lincolnshire West Clinical Commissioning Group and the Lincolnshire (Shadow) Joint Commissioning Committee, which advises the Committee of the Clinical Commissioning Groups arrangements to support the Lincolnshire Sustainability and Transformation Partnership)

The Chairman welcomed to the meeting Richard Childs, Chair, Lincolnshire West Clinical Commissioning Group and Sarah-Jane Mills, Chief Operating Officer, Lincolnshire West Clinical Commissioning.

Consideration was given to a report which updated the Committee on the Clinical Commissioning Group arrangements to support the Lincolnshire Sustainability and Transformation Partnership.

The Committee received an overview of why there was need to look at current Clinical Commissioning Group arrangements.  It was noted that the way the four Lincolnshire Clinical Commissioning Groups interacted with themselves and other stakeholders was not as streamlined, or as quick as the changing health environment required.  As a consequence, the view was that changes were necessary.

It was highlighted that the Legislative Reform (Clinical Commissioning Groups) Order 2014 allowed for CCGs to form joint committees for the purpose of exercising their commissioning functions.  It was reported that since their establishment the Lincolnshire CCGs had worked together to support the commissioning of health care provision for people in Lincolnshire.  The Committee noted that since May 2017 South Lincolnshire and South West Lincolnshire CCGs had shared an Accountable Officer, but were still constituted as two CCGs.  Overall, arrangements had worked well, but the statutory responsibility of each organisation required that decisions had to be considered by each organisation, which had resulted in a slowing down of decision making; and resulted in delays in delivering improvements.

Looking forward, the four CCGs were looking to develop a framework that would support strategic commissioning for Lincolnshire, whilst protecting and retaining local clinical engagement and a focus on the needs of the different localities across the county.  Page 73 of the report identified the framework for discussion.

The Committee was advised that the current priority was to establish a joint executive function to lead and manage the strategic commissioning issues across the county; and to have one Accountable Officer, and to retain Lead Officers in each of the four CCGs.  The purpose of the one Accountable Officer was to streamline activity to ensure that there was effective patient care. 

During discussion, the Committee raised the following issues:-

·         The benefits of one Accountable Officer - The Committee was advised that a single Accountable Officer would be able to deal with strategic issues; and would have oversight of the whole system.  This would then ensure better equity of services across the county.  The Committee also noted that the appointment of such an officer would help accelerate the STP and help ensure that national initiatives were workable for Lincolnshire;

·         Some members expressed their support for the report and its proposals; and for the frankness of the two presenters.  The Committee was advised that the purpose of the changes was not to create an additional layer, but to ensure that processes were more effective to ensure that patients received a better service in a timely fashion;

·         The need for working closely with district councils, the County Council and MPs was stressed to build up relationships and trust; and to ensure that lobbying continued to ensure that Lincolnshire's voice was heard;

·         The need to promote the NHS as being preventative healthcare; and that a culture shift was needed, to ensure that the health service was to be retained.  Particular reference was also made for the need for individuals to take responsibility for their personal health, and for the Council to consider public health preventative measures when setting its budget; and

·         GP joint working arrangements – The Committee was advised that some GP practices were currently working together; and that there were also three GP Federations in Lincolnshire West.  The joint working arrangements allowed for better and extended GP service provision; and

·         A question was asked as to whether the CCG Joint Commissioning Committee would be open to the public.  The Committee was advised that the meetings would be open to the public.

In conclusion, the Committee extended their support for the review of CCG arrangements proposed; and agreed that a letter should be sent to the four CCGs.

RESOLVED

That the Chairman on behalf of the Committee be given authority to write to all four CCGs, expressing the Committee's disappointment at the lack of progress being made with delegated approval arrangements for the Shadow Joint Committee and to the consequences of this lack of progress on commissioning decisions.