Agenda item

Brent Council recently commissioned external consultants EY LLP to work with Brent Council and Brent Clinical Commissioning Group to: Develop a high-level framework for integrating commissioning functions; and Identify options for integrating commissioning in two specific areas, children’s therapies and Continuing Health Care (CHC, brokerage element of the service). This report provides the proposals for integration of commissioning between the Council and CCG.

Phil Porter (Strategic Director of Community Wellbeing, Brent Council) introduced the item and flagged to Members of the Board that there had been a number of changes to the executive summary of the Ernst and Young (EY) report since the agenda pack had been published (addendum viewable here).

He explained that the Council had commissioned EY to develop a framework in order to bring together strategic commissioning functions of both the Council and Clinical Commissioning Group (CCG). EY’s work had an initial focus on two specific areas: residential/nursing placements and children’s therapies. He outlined that both organisations shared the same vision of improved outcomes for residents via integrated commissioning, but that a joint language and approach for this was required. He highlighted that that there were an array of complexities to be addressed across North West London but that the report began to set out how these could be managed - beginning at a local level. He emphasised the significant level of overlap identified between the Council and CCG when services were commissioned and that this could often be problematic in sending competing messages to market service providers. He also specified some of the practical formative proposals for the integrated commissioning model and the benefits that these could bring going forward.

Gail Tolley (Strategic Director of Children and Young People, Brent Council) added that joint commissioning formed part of the discussion on the local area’s Written Statement of Action (WSOA) to Ofsted/CQC at the last meeting and this had contributed in part to children’s therapies being one of EY’s focus areas. She mentioned that this topic had also been discussed further at a meeting of Brent Children’s Trust (BCT) on 23 January 2018 and that positive discussions were ongoing about the arrangements and vision for integrating commissioning. Sheikh Auladin (Chief Operating Officer, Brent CCG) agreed that there had been a lot of progress on the WSOA and it was felt that the aims within the report would be achievable with time and effort. He spoke about instances where integrated teams between the CCG had Council had worked closely together in urgent care scenarios and felt that a similar proactive, joined-up approach would be needed to successfully drive integrated commissioning across the board.

It was questioned whether there would be any risk of cutting across the alignment of CCGs in North West London and whether there was potential for further engagement with additional local authorities and CCGs on establishing joint commissioning arrangements. Members agreed that this was a priority area across North West London and it was pleasing that Brent had been leading the way in working collaboratively to integrate commissioning functions. It was noted that the accountable care model had been mandated by NHS England and that CCGs would need to plan locally accordingly to move forward within this model. It was emphasised that the report was a starting point for the local area, but noted that Phil Porter had also undertaken work with Diane Jones (Director of Quality & Safety - ?NHS Brent, NHS Harrow, NHS Hillingdon CCGs) and Dr Tim Spicer (Chair of NHS Hammersmith and Fulham CCG) to also look at commissioning and contract alignment across London in the future.

It was RESOLVED that the report and proposals for the integration of commissioning between the Council and CCG be noted.