Agenda item

Presentation by Stewart Findley, Chief Clinical Officer, Durham Dales, Easington and Sedgefield Clinical Commissioning Group

Stewart Findley, Chief Officer, North Durham, DDES, Darlington, Hartlepool and Stockton and South Tees CCGs gave members a presentation setting out proposals for increased collaborative working arrangements across Darlington; Durham Dales Easington and Sedgefield; Hartlepool and Stockton; North Durham and South Tees CCGs.

He reminded members that the Health and Social Care Act 2012 established the statutory role of the Clinical Commissioning Group and sets out the statutory duties and requirements including those roles which are considered ‘statutory’ requirements, namely, that appointment of a Chair of the Governing Body, a Chief Officer, a Chief Finance Officer and an Executive Nurse.

Dr Findley indicated that many CCGs around the country are now either merging or creating joint committees and collaborative arrangements with a single agreed leader/Accountable Officer. The annual leadership assessment of CCGs by NHS England now also includes a focus on collaborative working. As a result, he indicated that the 5 CCGs in Durham and the Tees Valley (NHS Darlington CCG, NHS Durham Dales, Easington and Sedgefield CCG, NHS Hartlepool and Stockton-on-Tees CCG, North Durham CCG and NHS South Tees CCG) had agreed to develop joint leadership and management arrangements. They appointed a single Accountable Officer from 1st October 2018 supported by two Chief Officers and a highly skilled Director team. He confirmed that the new accountable officer was Dr. Neil O’Brien.

Members were also advised that NHS Hambleton, Richmondshire and Whitby CCG would also work closely with the ‘collaborative’ on areas of mutual interest, such as acute services commissioning.

Dr Findley explained the relationships between proposed Integrated Care Partnership footprints and existing CCG boundaries.

The Committee was informed that the CCGs had indentified a number of benefits to be derived from working more collaboratively including:-

·         Working together to share expertise and capacity presents the opportunity to

learn quickly, shorten delivery timescales and achieve stretching ambitions.

·         Shared responsibility and delivery of the STP, working as key system leaders within a complex health and care system supporting the development of an

Integrated Care System and Integrated Care Partnerships.

·         Potential for greater overall clinical engagement and input.

·         Support for both clinical and managerial succession planning across all CCGs.

·         Greater potential for influence locally, regionally and nationally.

·         An opportunity to re-focus, re-energise and align the team to support both the local and wider complex and significant transformation agenda by working at

scale.

·         Reputational benefits for CCGs as joint working brings shared benefits for

delivery and improved performance.

·         Management efficiencies in preparation for any running cost allowance reductions.

Members were advised that under the collaborative arrangement, place based commissioning would continue. This would be important as CCGs further develop integrated working with local authority and provider partners; develop and extend primary care and community services and ensure that services are responsive to local need and reduce the reliance on hospital based care. Dr Findley confirmed that each CCG would retain a strong local clinical voice and leadership whilst also retaining their individual statutory status.

Dr Findley reported that a robust governance framework would be developed which addressed statutory requirements at CCG level and also reflected an integrated approach across CCG and other partners as new relationships and ways of working were embedded.  He stressed however that there would be no change to partnership working, existing governance and decision making, including the requirements for individual and joint consultation and engagement on service change proposals.

During the discussion which followed, Dr Findley reported that there were now requirements that 20% of CCG running costs needed to move into clinical improvement and/or transformation. This equated to around £4m across the collaborative.

Members noted that the collaborative proposals positioned the CCGs well to deal with finance and performance challenges and support transformation plans. Local place-based teams would be supported by more robust integrated and at sacle “support” functions which would free capacity for local engagement and shared working with partners.

Agreed that the report and information be noted.