DH 'impressed' with West Midlands clusters but 'worried' about QIPP

A note from Denise McLellan, chief executive of Birmingham and Solihull PCT cluster, contains the following key messages taken from an assurance process carried out by the DH.

Key points:

• Impressed with the changes made over the last 15-16 months since the last assurance process. Recognised the issues raised then have been taken on board and that systems and processes are stronger than previous.
• The early establishment of clusters has paid dividends in terms of relationships and agreement on boundaries.
• They recognised that the bottom up approach to QIPP and the development of system plans may well be the right one - as opposed to the top down approach in some areas.
• Great GPs - without exception - their contribution and level of involvement and engagement is as good as any.
• West Mids does have one of the highest number of emerging GP commissioners per capita and there are issues around co-terminosity with local authorities.
• Delivery on QIPP for 11/12 - some worries in some areas ( including Birmingham & Solihull) and will be closely monitoring.
• FT pipeline is working well and impressed with the tripartite agreements. However some -non Birmingham and Solihull - providers have further to go.
• Positive messages about working with local government and west mids is perceived to be improved and strong local govt relationships.
• Strengthened systems and processes around governance and quality and perceived to be leading the pack on workforce planning.
• Very convinced by the SHA performance management model and now looking at situations where Clusters should take over and the situations in which it will lie with the SHA- increasing shift to cluster.

Areas to address:

1. Emerging GPC boundaries - need to look at how this works and support effective relationships with the Local Authorities and the hospitals
2. FT trajectory for specific providers - ensuring we have strong risk management
3. Delivery of QIPP to focus more on future years, esp Birmingham
4. Not prepared to let 18 week and A&E targets slip. (issue for Heart of England Foundation Trust for Birmingham and Solihull)

The note adds: “On Birmingham and Solihull, the personal feedback is very positive and better than anticipated by the top team, particularly regarding provider relationships. There is a recognition that there is more to do on the longer term and ensuring we facilitate QIPP delivery this year and for future years.

“There was also a note made (this was more of a comment than an overall concern) re the children’s safeguarding and the issues in Birmingham.”

• Sign up to health news in your region straight to your inbox: choose your HSJ Local newsletters now