To receive a presentation from NHS Outer North East London officers on the planned Commissioning Support Organisation for East and North London.
Minutes:
NHS officers explained that, with effect from 1 April 2012, primary care services were being provided by NHS North East London and the City (NHS NELC) covering all seven North East London boroughs. The Health and Social Care Act had now received Royal Assent however and all Primary Care Trusts, including NHS NELC would therefore be abolished from April 2013. The replacement structures including Clinical Commissioning Groups (CCGs) would operate in shadow for the 2012/13 year.
There would be one CCG in each borough and all CCGs had now appointed Chairs and Clinical Directors. CCGs were planning for full authorisation from April 2013. CCG managerial support costs (a separate budget from the cost of providing medical treatment) had been set at £25 per head of population.
An organisation called Commissioning Support Services had been set up to develop support for CCGs in North East and North Central London. This would be able to provide services efficiently to local CCGs by utilising economies of scale. The Commissioning Support Services organisation was however itself under development and it was planned to submit a full business plan for the organisation to the Department of Health in August 2012. Service level agreements with CCGs and performance indicators were also being developed. Engagement with other stakeholders including Local Authorities would continue throughout the 2012/13 period.
Officers explained that there was already a great deal of collaboration or joint commissioning taking place and discussions were ongoing to ensure that the £25 per head budget was sufficient. Officers agreed to hold discussions with Councillor Braham separately from the meeting regarding issues around the introduction of community matrons into a Waltham Forest health centre.
The issue of “ghost patients” – people who had moved away from an area but remained on a local GP’s list was presently under discussion with the British Medical Association. Members noted this but were concerned that this could impact negatively on services if GP lists were not up to date.
It was accepted by officers that CCGs could collaborate on certain issues for example recent changes to psychotherapy services, but this was not a cross-subsidy.
The Committee questioned why only some GP surgeries had patient participation groups and also how the Commissioning Support Organisation would engage with the public. Officers responded that each CCG was obliged to have a named lead for patient and public involvement. Issues around non-IT access were being considered but equally many young people preferred to respond by e-mail rather than for example attend a patients’ meeting. Members felt that many GPs in, for example Waltham Forest did not take these responsibilities seriously and officers responded that these were matters that could be taken up at practice level. A further problem was difficulties seen in some areas with attempts to cleanse GP lists which had in fact been postponed in Waltham Forest.
It was clarified that the NHS NELC Chief Executive – Alwen Willams and Board now covered seven PCT areas. Inner and Outer North East London were two of the smallest clusters in London and it was felt to combine these constituted the best use of resources. For this year, NHS NELC would retain accountability for health budgets even though the CCGs were now operating in a shadow form.
The Commissioning Support Organisation would not simply be the Primary Care Trusts in another form as it would not have a statutory role. Rather, its services would be provided as a business to the CCGs who could decide whether or not to purchase them.
Officers agreed to supply the current management support figure for PCTs but pointed out that a 40% cost saving had been made by bringing the clusters together.
The Committee noted the presentation and thanked the officer for her attendance and input to the meeting.