Shake-up of health service could see a reduced role for Beds, Luton and Milton Keynes CCG

A planned shake-up of the health service after the Covid-19 pandemic could see a reduced role for Bedfordshire, Luton and Milton Keynes clinical commissioning group (CCG), despite their recent merger.

Tuesday, 19th January 2021, 8:17 pm
Updated Tuesday, 19th January 2021, 8:20 pm
NHS (stock image)

Clinical commissioning groups (CCGs) are responsible for the commissioning of health services in their local area.

A newly reformed 'BLMK CCG' has been emerging from the remnants of the Bedfordshire, Luton and MK CCGs.

But CCG responsibilities could soon be swallowed up by integrated care systems (ICSs), according to a report to Luton Borough Council's health and social care review group.

ICSs were first set up in 2016 and work in partnership with local councils and other authorities, taking collective responsibility for managing resources.

ICSs are currently fewer in number than CCGs, although they typically cover larger areas.

NHS England published a consultation document in November, which was considered by Luton Borough Council's health and well-being board.

Labour South councillor David Agbley, chairman of the review group, asked for an extra meeting to consider its response.

NHS finance will increasingly be organised at ICS level and be allocated by local leaders, said the report.

The aim is for each ICS "to invest in and deliver joined-up, more preventative care, tailored to local people’s needs".

The plan is to set up "an ICS board or committee model with an accountable officer".

"We're clear that we want ICSs to be key bodies for financial accountability and financial governance arrangements will need to reflect that," it added.

"Current CCG commissioning budgets, primary care budgets, the majority of specialised commissioning spend, central support or sustainability funding and nationally-held transformation funding will be brought together."

"We need to understand the changes which are going to come," Labour South councillor David Agbley told the review group.

"We started with the sustainability and transformation partnership (STP) over this uproar about who's doing what and who's in charge of finance.

"And there was this disquiet about taking money from front line and it going into administration.

"That question hasn't been answered. It takes away the public responsibility and oversight from us."

A shared integrated care service for Beds, Luton and Milton Keynes (BLMK ICS) has existed since 2016.

Independent chair of BLMK ICS, Dr Rima Makarem, said the short consultation time is to meet deadlines in order to pass through Parliament this year.

"We're all asking the same questions, so hopefully the paper coming out this month will give us more idea of what's being proposed.

"NHS England is currently devolving a lot of assurance and oversight to the ICSs, so it remains local rather than being done at a regional level.

"Local authorities remain full members of the ICSs, so you retain your responsibilities and oversight."

Councillor Agbley asked: "Can you tell us what the changes will be if you go for option two?"

Dr Makarem added: "With option two you wouldn't have a formal CCG any more, but the functions, those individuals, would be employed by the ICS.

"The CCG will no longer be commissioning in the traditional way.

"It will be 'here's the money for you to deliver better outcomes, for example, in cancer'.

"The providers work out between them how to deliver better services."