• Eight CCGs consider merger across STP
  • Creating single ‘strategic commissioner’
  • Moving to shared accountable officer

Kent and Medway’s eight clinical commissioning groups are developing a “single strategic commissioner” and could potentially merge from next year.

Governing body papers show the CCGs are discussing appointing a single accountable officer within months and forming a joint committee.

A governing body paper says: “The strategic commissioner will over time take forward the strategic work and assurance undertaken currently by the Sustainability and Transformation Partnership, and has the potential to become a single CCG in the future (no earlier than April 2019).”

A merger would create a CCG covering a population of around 2 million and two top tier local authorities – Kent County Council and Medway Council.

The plans are in the process of being discussed by the CCGs’ governing bodies.

In a joint statement, they said: “It has become clear to us collectively that there is a need for the commissioning of some aspects of NHS care to be more joined-up.

“We need a strategic commissioner with the authority to:

  • establish strategic priorities and plans to improve the health and wellbeing for the population of Kent and Medway
  • commission services from a small number of health and care partnerships, which would join up the delivery of frontline services
  • directly commission some services (both specialised services and services provided at scale) for the whole of Kent and Medway.”

West Kent CCG governing body papers explain a plan under which the health and care partnerships would bring together providers in each area to take collective responsibility for achieving outcomes, the CCGs said.

The Kent and Medway STP would act as a single regulator, with delegated responsibility to assure providers and commissioners. There would be a single control total covering commissioners and providers for the area.

Ultimately, the STP’s programme responsibilities would move to the single strategic commissioner.

A proposed interim structure would see a single accountable officer for all CCGs, two managing directors, a director of acute strategy, director of strategic commissioning partnerships, director of corporate services, director of nursing and quality, and two directors of finance. Other roles – such as a medical director and programme director – would be STP roles.

Some of the CCGs already have some shared posts, including at accountable officer level. The West Kent papers suggest that efforts would be made to find suitable alternative employment for any “displaced” staff. During the transition period “the viability of CCGs to discharge their duties will remain a priority” with the majority of functions still sitting at individual CCG level.