Meeting documents

Purpose:

In October, the Buckinghamshire, Oxfordshire and Berkshire West Integrated Care System published an engagement document around the future arrangements for NHS commissioning.

Attendees:

Ms L Patten, Accountable Officer, Buckinghamshire CCG and Oxfordshire CCG

Papers:

"The future arrangements for NHS commissioning in your area" – Engagement Document, October 2019

Intended outcome:

For Members to gain a greater understanding on the proposals contained in the engagement document and to provide feedback to help design future arrangements.

The Chairman welcomed Ms L Patten, Chief Accountable Officer for Buckinghamshire Clinical Commissioning Group and Oxfordshire Clinical Commissioning Group.

During the presentation and discussion, the following main points were made.

·         The way in which the NHS Clinical Commissioning Groups (CCG) in the Buckinghamshire, Oxfordshire and Berkshire West (BOB) Integrated Care System (ICS) would be changing.  An engagement document had been produced which sought the views on two new ways of working:

o   Local working in each of the three counties (the integrated care partnerships);

o   Wider, at-scale working across the three areas (the integrated care system).

·         The NHS long-term plan set an expectation that each ICS would be covered by a single CCG.

·         The engagement document outlined the proposals to:

o   Appoint a single Accountable Officer and Shared Management Team;

o   Design a stronger Integrated Care Partnerships, constituted using a set of common principles;

o   Create a single commissioning organisation across the BOB geography.

·         In order to become the delivery vehicles for more local care services, much more would be required of Primary Care Networks (PCNs) than could be delivered within the current commissioning arrangements.

·         There was a need for greater oversight and accountability for the ICS which did not currently have permanent leadership or statutory governance.

·         Greater collaborative working would provide the best opportunity to support each ICP with its work to improve healthcare, tackle health inequalities and ensure consistency of services in terms of quality and availability across BOB.

·         Through the new PCNs and ICPs, GPs and other healthcare providers would focus on developing and delivering services to meet healthcare needs in their local areas, whilst still being involved in strategic commissioning.

·         There were 12 PCNs across the County and the PCNs would be working closely with Community Boards as these develop to improve outcomes for each local population.

·         Ms Patten stressed that embedding services at the ICP level was important and services, such as 999 and 111 could be provided by the ICS in order to maximise efficiencies and maintain consistency across the 3 areas.

·         In response to timings around appointing a single accountable officer, should the proposal be approved, Ms Patten explained that the recruitment process would commence in January 2020 with the aim of appointing the single accountable officer by June and thereafter appoint a shared management team.

·         The proposed merger of the CCGs would take effect in April 2021.

·         In Bucks, care home admissions were around 9 months earlier than the national average.  Ms Patten explained that if effective multi-disciplinary working exists, then admittance would be later.  There was a need for closer working between health and social care in order to achieve this.  A pilot was being carried out in Aylesbury and Wycombe and progress was already being made.

·         The need for a scrutiny function across the ICS was recognised and the Chairman reported that informal meetings between the BOB ICS scrutiny Chairman was taking place.

·         A Member asked what was meant by "better outcomes" for local residents.  Ms Patten responded that the role of the PCNs was to deliver local GP services and wrap-around services and each PCN would respond to their local challenges.

·         A general comment was made about the engagement document and the need for the language to be understood by the public.  The use of acronyms was confusing and it was felt that there should be more public engagement about the proposed changes and what that means for local people.  Ms Patten agreed to feedback to the ICS communications team.

ACTION: Ms Patten

·         A Member commented that the PCNs should be mapped to Community Boards in order to create greater cohesion.

·         In response to a question about moving to 7 day working across the whole system, Ms Patten said that there was a move to develop 7 day working and there was already 24/7 access to GP services but there were still some services not operating across 7 days and this would be reviewed over the coming months.

The Chairman thanked Ms Patten for her presentation and Committee Members agreed to send a formal response to the CCGs on their proposals for future commissioning within the specified deadline (1^st December 2019).

ACTION: Chairman