• Move emphasises shared nature of challenges in East Kent
  • Local acute provider is also in financial special measures
  • Accountable officer hopes to make progress before reconfiguration of some services

Four CCGs placed into special measures by NHS England won’t be able to solve all the area’s problems until a decision is made on a reconfiguration of acute and specialist services, the accountable officer has warned.

Glenn Douglas, the accountable officer for the clinical commissioning groups across Kent and Medway, said the four East Kent CCGs were working better together after a “sea change” in approach.

Three of the East Kent CCGs were rated as “inadequate” in the annual NHS England assessment of CCGs performance last month and have been placed in special measures by NHS England along with Thanet CCG which was rated “requires improvement.”

Canterbury and Coastal CCG ended the last financial year with a £9.5m deficit. Ashford CCG reported a £13m deficit and South East Coast CCG had a £7.3m deficit.

NHS Thanet CCG broke even.

It is thought to be the first case where NHS England has acted across a whole health economy in this way and placed the four CCGs in special measures. The main acute provider East Kent Hospitals University Foundation Trust, which has a deficit of £21m, is also in financial special measures.

Mr Douglas, who was appointed in March and also leads the Kent and Medway STP, said the four East Kent CCGs were very much part of the same health economy based around East Kent Hospitals University FT – and so it made sense for NHS England to treat them equally.

He said special measures “would focus people’s minds” and was a “warning shot across people’s bows.” Unlike, legal directions special measures does not give NHS England power over senior appointments.

“Individual CCGs will look firstly to their own situation but this is bigger than that,” he added, saying the emphasis on collective working validated what had been done in the area over the last few months and the development of a shared vision between partners.

“There is no doubt that there has been a degree of antagonism between some of the commissioners and the hospital,” he said. However, he added there had been “a little bit of a sea change” in developing a wider perspective among the CCGs. “The leadership of the GP community are absolutely bought in and it is growing among the membership.”

And he said there was a lot of work which could be done before decisions were made about the reconfiguration of emergency and specialist services in the area. Consultation on this – which is likely to see some services centralised wither in Ashford or in Canterbury – had been expected this spring but has been pushed back until next year.

“We can’t solve all of the problems until there is a strategic decision but there is a lot that we can do,” he said. “Moving forward we need to generate the confidence in the system that makes it an investible proposition.”

Key areas of work will include care for frail older people and for those with complex conditions, as well as more joined up care.