Agenda item

In September 2019 CCG Governing Bodies across NW London agreed to move towards the creation of a single CCG by 1 April 2021.  This report informs the Board of the proposals for integration and the single CCG.

Sheik Auladin (Managing Director, Brent CCG) introduced the report, providing further background to the decision to move to a single CCG. Initially there were plans for integration of the CCGs in 2020-21, but the model had reverted back to individual CCGs and would remain as one unit until April 2021 where there would be 1 CCG moving forward. From April 2020 onwards there would be a transition year, then a North West London wide approach from 2021-22. It was expressed that the reason for the push back was that there had not been full support from CCGs and local boroughs. They were currently looking at governance, and Mark Easton (Chief Accountable Officer, Brent CCG) had written to all Chief Executives of Councils and explained the need to begin moving ahead with local councils. Sheik Auladin highlighted the opportunity to pitch where the HWB wanted Brent CCG and the Council to work together more strongly.

As a result of the restructure there was a need to save money, so individual CCGs were undergoing a restructure process that would reduce operating costs. It was not known whether there would be further restructure once they had merged into a single CCG. As part of the merger there was a shift from eight Managing Directors to four Managing Directors. This would be revisited. The interim arrangements for Mark Easton’s cover would act up for 3 months until recruited.

The Chair thanked Sheik Auladin for the update and invited the Board to ask questions. The following issues were raised:

·         It was highlighted that there was uncertainty as to what an Integrated Care System was or how it would operate. Carolyn Downs (Chief Executive, Brent Council) expressed that it was hard to engage constructively without understanding the concept fully, and, with the threat of the same proposals that had been rejected, it was essential for the CCG and the Council to push integration as much as possible. Sheik Auladin agreed that it was jargonistic terminology, and highlighted that there were upcoming workshops about the Integrated Care System, which Chief Executives had been invited to.

·         The CCG was not aware what apportionment of the £33.9b year on year NHS funding bill would be allocated locally, but advised that most investment would go to acute care and hospitals and revamping new sites. There was a push to have more hospitals and improve the set up at Hillingdon and Northwick Park but no other investment came to CCG other than year on year allocation. Sheik Auladin highlighted that there was a lot of investment into the Primary Care Network and GP contracts, which was promising but did not feel like enough. Councillor McLennan added that £4.5m was being allocated to community services.

·         Regarding how the Health and Wellbeing Board could be confident that community services needed were delivered in areas of growth, Sheik Auladin highlighted that the GP registered population in Brent was a substantial 400,000 so they were trying to invest as much as possible into Primary Care Networks and Community Services. Jonathan Turner (Deputy Managing Director, Brent CCG) added that the planning assumptions for the following year showed a substantial gap needing to be covered through savings programmes, as demand could outstrip the investment going into services. It was believed that this would impact estates programmes in the Borough. Councillor Tatler (Lead Member for Regeneration and Environment) asked what the CCG were doing to secure more revenue to deliver the promise of medical centres made 2 years ago to residents. Sheik Auladin advised that they lobbied NHS England on a regular basis and were looking at new premises. The only way they could manage the current system was to work closely with the Local Authority. The CCG were in discussions with the Council to resolve the need in South Kilburn.

As no further issues were raised, the Board RESOLVED to note the report.