A City and Hackney Clinical Commissioning Group GP leader has accused the area’s sustainability and transformation plan process of being “not democratic”.

Governing body member Gary Marlowe expressed concern about rules for the North East London STP board, which would allow decisions to be made by only two CCG chief officers. There are seven CCGs in the patch.

Dr Marlowe raised the concerns during the CCG’s May governing body meeting.

Minutes of the governing body meeting in May said: “GM [Gary Marlowe] noted that under the proposals in the NEL STP, a quorum of the board would be two CCG chief executives, removing not only clinical control but also ensuring that City and Hackney could be outvoted by other CCGs.” 

In response, the CCG’s chair Clare Highton explained that STPs would not have access to transformation funding without the agreement of all member CCGs, but added: “While there was no statutory power to force membership of a STP, it may be impossible to continue financially outside of one.”

Dr Marlowe told HSJ this week: ”CCGs for all their faults are legal entities established under the Health and Social Care Act. The intention as far as I am aware was to have clinical leadership in decision making. STPs do not, as I understand it have the authority to trump the decision making of CCGs.

“My other concern is that a quorum of the STP board being two chief executives, and hence the ability to make a decision on behalf of all the NEL CCGs, is surely not democratic.”

The minutes also revealed a number of other concerns about the STP proposals being developed for the patch. They said the CCG “disagreed” with advice from NEL that plans should not be discussed in public.

The 44 STP footprints in England are required to submit their plans by the end of June.

Jane Milligan, chief officer for Tower Hamlets CCG and lead for NEL STP said:City and Hackney CCG is one of seven CCGs and five providers developing a sustainability and transformation plan for north east London.

All CCG governing bodies and provider trust boards have ongoing opportunities to review and comment on the STP as it develops. We are yet to receive a final submission date from NHE England and a sign off process will be agreed with all partners when this is confirmed.”