Clinical commissioning groups could be morphed into the operational arms of the health and wellbeing boards, which will take on the role of “signing off” health plans, Andy Burnham has suggested.

The shadow health secretary said CCGs could function “more as an executive to the health and wellbeing board’s non-executive” role in an interview, giving the greatest detail to date about how commissioners could operate under his ambitious plans to integrate health with social care services.

In an exclusive interview with HSJ, Mr Burnham said: “The end point for me is very clear… I envisage a world where the health and wellbeing board is signing off proposals.

“I think there has been a serious loss of public accountability that has come with the [coalition government’s] reorganisation.

“It needs to be restored and I think you can much more safely devolve the primary care budget back to local levels where the health and wellbeing board has that sign off.”

Asked where the infrastructure would come from to support health and wellbeing boards, he said: “Well, it could be the CCG, couldn’t it?

Andy Burnham

‘The longer people stick in the silos… that will increase not diminish the funding problem,’ said Andy Burnham

“The CCG could function more as an executive to the health and wellbeing board’s non-executive.

“You could just put these things together, so they are basically functioning as an executive with a board. These are matters to be further debated.

“There is also the status of the [commissioning support units] in this.

“They are limbo, to be honest, as much of the system is.”

The former health secretary said Labour would “not mandate this and say ‘by this time you must have done this’”

He added: “Integration is a journey. People should embrace it at a pace that feels right given the nature of the arrangements that they have at a local level.

“The message I will send out is the quicker you embrace the notion of a single service and single budget, the quicker you will be placing your health economy on a path to sustainability.

“The longer people stick in the silos, and argue, I would guess that will increase not diminish the funding problem.”

He added that he would “repatriate” the CSUs “back to support CCGs and health and wellbeing boards”.

Placing the health and wellbeing boards centre stage stems from Mr Burnham’s desire to align health policy with other areas of public policy.

“That ability to align health policy with housing, planning, leisure, education policy… In the end 21st century health policy has to have that focus or… we are all doomed to fail.

“If we have a narrow model of commissioning, which is what we have at the moment, where we have health service professionals commissioning health services from other health service professionals, in the end I don’t think it gets ahead of the huge challenges that we face.

“We need, at local level, to have a policy where the new homes that we are building are built with care in mind, to facilitate older people staying there as long as they can, where services can be moved in to support them.

“This is the kind of change that we need to see in terms of the way people are thinking and working at local level.”