The Panel considered the report and received a
presentation from the Director of Communications and Engagement,
SHIP PCT Cluster, providing an update on the changes to local NHS
commissioning organisations as a result of the Government
reforms. (Copy of the
report circulated with the agenda and appended to the signed
minutes).
The following points were noted:-
- the over-arching National
Commissioning Board would be a single, nationwide organisation,
with matrix-working at its heart to provide simplicity, aid and
efficiency to ensure a consistent approach and would take up its
full statutory duties and responsibilities on 1 April 2013;
- there would be 27 Local Area
Teams,(LAT’s), each having the
same core functions which would take on direct commissioning of GP
services, dental services, pharmacy and certain optical
services;
- there
would be 4 regions providing clinical and professional leadership
at a sub-national level and Southampton was part of the Wessex
Local Area Team which included SHIP, Dorset Bournemouth and
Poole. This area comprised
7 Local Authorities, 9 CCGs and 6
Health & Wellbeing Boards;
- CCG’s were groups of GPs and other key health
professionals responsible for 80% of the healthcare budget in their
area and would buy in services. All GPs would be a member of
the CCG in their area and each CCG
would have a governing body and would be responsible for engaging
with local people to ensure that services met their needs;
- authorisation would be the process
by which CCGs would be assessed as
ready to take on responsibility for health care budgets for their
local communities and Southampton was timetabled in Wave 4, with
the authorisation decision due in January 2013;
- CCG’s were public bodies/statutory NHS
organisations under the umbrella of the National Commissioning
Board.
- CCG members and the local care team
were represented on the Health & Wellbeing Board, which was a
statutory Board and was a crucial vehicle for setting the strategic
direction of the new Health and Social Care Act;
- the Southampton CCG and
Local Area Team was based in Oakley
Road;
The Chair had received a deputation from 38
Degrees who had asked that they be permitted to ask officers a few
questions in relation to the above item. The following questions were answered
by officers. Members of the
organisation had also been given contact details for the
Southampton CCG and Link who would be able to assist them if they
had any further queries/questions:-
- Structure of
Consultation
- the consultation structure being adopted by
Southampton CCG to enable concerned individuals to engage with them
would be the same consultation process as previously used and there
were robust mechanisms in place to engage with the public.
- Election of Lay
Members/CCG Board - Lay members/representatives had been
appointed and were qualified persons who had applied for the
positions. The current 5 members of the
CCG Board had been voted in by GP’s by way of an internal
election.
- Externalisation/Privatisation - The proposed model
constitution was set by statutory guidelines and would eventually
become a public document.
This would be shared with the public and published on the
SHIP’s website.
- Dr Richard
McDermott’s position - Dr Mcdermott was a member of Southampton’s CCG
and also the managing director of a company called Solent
Medical. Officers confirmed that
there was strict governance and guidelines around “conflict
of interest” issues and this was strictly scrutinised.
Panel members expressed concerns that the CCG
commissioning support units may be fragmented, making them less
efficient;
the private sector might “cherry pick” services
that would provide them with more money; and if delivery of services was dominated by
cost due to lack of funding, this could lead to inadequate and less
efficient services/supplies and subsequently endanger
people’s lives, the large number of health bodies would
require a good communication structure. Officers conceded that there
were financial issues but that their core vision and promise was to
improve the quality and outcomes for their customers as well as
driving costs down.