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Councillors refuse to endorse NHS regionalisation plans for north east London

08/09/2017

Hackney councillors have sided with patients by refusing to endorse a proposal for a single accountable officer (SAO) for seven clinical commissioning groups (CCGs) in north east London.

The Inner North East London Joint Health Overview and Scrutiny Committee on 6 September heard patient and campaigner concerns that the move would reduce local accountability and hadn’t been consulted on.

The restructure would see the current chief officers of the CCGs leave. The SAO would lead the 7 CCGs and the East London Health and Care Partnership (formerly the sustainability and transformation plan or STP).

“The move would centralise decision making in an area with disparate health and care needs,” Hackney GP and campaigner Coral Jones said. “The voices of local people will be lost.”

Hackney patient representative Michael Vidal raised concerns the proposal contravened a CCG’s legal duties to commission services only for residents in its area.

City and Hackney CCG Chair Clare Highton said the SAO was a consequence of the NHS moving to accountable care systems (ACS). Accountable care systems are where NHS organisations (commissioners and providers) take on collective responsibility for resources and population health in their area. She said an ACS for City and Hackney was an exciting opportunity and hoped it would have high public and patient involvement. She maintained accountability had to stay at the local level where it is more meaningful as accountability at STP level has been a problem.

Hackney Councillor Ben Hayhurst said: “I’m concerned about putting power and control upwards. I’m deeply sceptical of the power an ACS will have if we move power up now.” He questioned whether the proposal was undoing the 2012 Health and Social Care Act via the backdoor without public consultation or democratic scrutiny. Legal advice from NHS England is that CCGs don’t need to consult on the changes.

Other councillors were concerned about losing the current CCG chiefs’ knowledge and relationships with local authorities and residents. They also doubted whether one individual could effectively attend seven health scrutiny committees and CCG boards.

The chairs of City and Hackney, Newham and Tower Hamlets CCGs claimed the move was necessary because “there’s no money” in the NHS. CCGs have been told by NHS England that they need to move to a SAO in order to access new transformation funding.

The joint scrutiny committee is now writing to the CCGs to express its concerns. The governing bodies of the seven CCGs will decide on the proposal this month, with City and Hackney CCG meeting on 29 September. If agreed, the SAO is expected to be in post by 1 January 2018.

North East London Save Our NHS said the committee decision was a success for campaigners but there was still a risk of NHS privatisation that needed to be publicly discussed.

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