The Committee will be asked to consider a report that provides an update on progress with proposals to appoint a joint accountable officer and management team across the three Clinical Commissioning Groups (CCGs) in Leicester, Leicestershire and Rutland (LLR) – NHS West Leicestershire CCG, NHS East Leicestershire and Rutland CCG and NHS Leicester City CCG. The report includes a link to an additional paper that provides background information, and that additional paper is also attached for Members’ convenience.
Caroline Trevithick, the Interim Accountable Officer, West Leicestershire CCG presented a report that provided an update on the West Leicestershire CCG, the East Leicestershire CCG and the Rutland CCG Management Structure.
Members considered the report and the ensuring comments and queries included the following:
· Some Members commented that the plans for the management structure were very welcome as there was an overlap across the three CCG areas. It was noted that there was a trend for this happening across the country. Comments were made that new structure would lead to more efficient decision making.
· Some concerns were expressed as to how the new management structure would work and that the Joint Accountable Officer would have immense responsibility.
The Interim Accountable Officer responded that the individual appointed to the post of Joint Accountable Officer would be working to three governing bodies and would be supported by a joint management team.
A Member expressed a concern about the governance issues and that having three governing bodies would make it difficult to performance manage that individual.
The Interim Accountable Officer said that the appointment process was very important (as it would be across the country) and the job description for the post would be based on a national job description for Accountable Officers. A Member asked whether the Scrutiny Committee Members could be included in the interview process and heard that the process was not something that the CCGs could shape but this request would be reported back.
· A concern was raised as to whether Leicester would continue to have the same scope for development and resources, as the City had very different demands compared to Leicestershire and Rutland, Members heard that the discussions had started by considering how there could be a more unified commissioning view whilst also acknowledging that each area had different needs.
· It was noted that there was a requirement to reduce running costs by 20% by 2020/21 and a Member said that this need to save money should have been clearly set out. In response, Members heard that the process on the management structure had already started before the requirement to make that saving was known. The proposals therefore were not driven by the need to save money; however, the CCGs tried to ensure that resources were used in the best way. A Member commented that there was no indication as to how much the proposals would save; information which she would have expected for proposals such as this.
· Concern was expressed that limited progress was being made in the 13 Integrated locality teams across the LLR, and much more progress was needed if the whole process was going to work.
· Concerns were expressed about the impact on staff including churn and redundancies and the Interim Accountable Officer explained that each of the individual CCGs were working with their staff. They had not seen a wholesale movement of staff and were trying to ensure that staff were supported through what was acknowledged to be a difficult time.
· The Chair asked for the reasons for proposing this model as opposed to a merger model. Officers responded that the merger model had not been ruled out as the question about that model had not yet been put to the CCG, but they were still open to exploring that model. However, the NHS had given clear guidelines that there needed to be one clear commissioner per Sustainability and Transformation Partnership (STP). The CCGs were looking to deliver this by having one having one single management team.
· The Chair drew the debate to a close and said that she was pleased with this step forward. She was aware that there was general frustration that too much time was being taken up with discussions rather than delivering that change.
1) that the report be noted;
2) that the Commission request more information on the Integrated Locality Teams; and
3) that the Commission request information on the discussion relating to the merger model and on how the proposals to appoint a Joint Accountable Officer are progressing.