Agenda item

The Committee received a report and presentation from the Chief Officer, North Durham and Durham Dales, Easington and Sedgefield Clinical Commissioning Groups that advised of a Clinical Commissioning Group (CCG) merger proposal (for copy see file of Minutes).

The presentation highlighted the following:-

·        Current arrangements – 5 CCGs covering Teesside, Darlington & Durham

·        Plan, buy and monitor NHS services for over 1.2 million people

·        What CCGs do

·        Why do we want to make the changes?

·        Proposals – 4 options

·        What was not covered by the change

·        Principles

·        Expected benefits

·        Option 4 preferred

·        What this would mean for patients and the public

·        What happens next

·        Opportunity to feedback and further engagement

The Chief Officer added that the CCGs were a good organisation carrying out fantastic work locally but that it was important for everyone to work together, and he thanked Healthwatch for their continued support and involvement with the engagement.

Mrs Hassoon asked if the patient reference groups would continue and was advised that the CCG would not want to change any of these arrangement as they worked well.

Councillor Hopgood was concerned that this was another re-organisation in the past 20 years, and she asked how much it would cost.  She queried that the savings of 20% would surely be spent on the re-organisation and there was chance that arrangements could change again with a further merger.  The Chief Officer said that there would also be a cost with re-organisation but not necessarily in financial terms but in staff time and the disruption to staff.  He assured members that the CCG were not expecting to see a bill following this re-organisation.

As the consultation was due to close, Councillor Bell recommended that the committee support option 4 for the shared management structure and then look at options for a further merger when they were proposed.

Councillor Crute commented that the correct governance arrangements needed to be in place with the feedback given from the patient reference groups.  However, he was concerned how scrutiny would fit in to these new arrangements especially with the Integrated Care Partnerships (ICP) and the Integrated Care System (ICS)  to ensure that the organisations were subject to accountability.  The Chief Officer assured members that they would ensure the governance arrangements were in place.

The Corporate Director of Adult and Health Services said that Durham should be looked at as a place and should be protected especially in terms of the local authority and social care perspective.  She added that it would make more sense to have one CCG and that the relationship was already in place so she would support the merger.  In terms of the wider ICP/ICS issue this would be monitored closely.  The Chair agreed that having one CCG would add value and may be beneficial to protect the acute trust in Durham.

Councillor Temple asked for some assurance that the merger would not affect the proposals for Shotley Bridge Hospital.  He also asked if there were any plans to merge Durham and Darlington CCGs as thought this would make more sense in terms of the foundation trust.  He referred to the likelihood future merger with Sunderland and South Tyneside and felt that that the geography would not be helped by a single Durham CCG. The Chair said that some services had already started merging care with Sunderland and South Tyneside.

In response the Chief Officer said that the CCG would continue to support the Shotley Bridge proposals however there was some concerns around the capital funding.  They were seeking assurances from NHS England regarding the short-term funding.  In terms of Durham and Darlington he advised that a merger was considered as the CCG work closely with Darlington as they shared a border and some patients were just as likely to go to Darlington as they were Durham for their care needs.  However, GPs in the Darlington area felt that they worked more closely with Tees and they were aligned to the southern ICP.  There needed to be a greater understanding of what would work in each ICP area as hospitals could not provide a service alone.  He advised that there would be a need for some staff to work together as one team serving different areas under the ICP.

The Chair of the North Durham Clinical Commissioning Group explained that representatives from GPs in North Durham CCG consulted on the proposed merger and that no concerns were raised.  The shared management operation may cause some difficulties for future financial sustainability, but assurance had been given that funding for Durham CCGs would be used for practices in the Durham area.

The Chief Officer confirmed that the function of the governing body that resources allocated for Durham would be distributed in Durham.  The two Durham CCGs manged their finances well and would continue to use the resources as best as they could for the population of Durham abiding by the formula for the funding criteria.

Resolved:

That the report be received and that option 4 be supported.