Finance woes hold up biggest CCG merger in England

Solihull, Birmingham South Central and Birmingham Cross City CCGs have delayed their plans due to a failure to agree on an “adequate” financial plan and the appointment of a single accountable officer.

Last year the three CCGs announced their intention to merge by April 2018, appointing a joint management team and single accountable officer to work in “shadow form” this year.

However the CCGs are not progressing as quickly as they intended.

A board paper, published by Solihull CCG on 2 February, said: “The BSol [Birmingham and Solihull] CCGs are currently unable to secure an agreed scheme of reservation and delegation (SORD), there is a delay in agreeing appointment of a single management team/shared AO and the submitted financial and operating plans are not adequate. These pose significant risk to Solihull CCG as well as to the future assurance and governance of BSol [health commissioning board].”

The board paper added that in December last year the three CCGs failed to sign off a financial plan that would commit to a shared control total for 2017-18.

However, a finance report from January said the three CCGs have agreed to work towards a combined control total for 2016-17 of £23.4m, with a planned over achievement of surplus from Birmingham Cross City and Birmingham South Central CCGs to offset Solihull CCG’s foretasted deficit.

In a statement to HSJ Patrick Brooke, accountable officer for Solihull CCG said, “The CCGs planned to work to a combined control total across Birmingham and Solihull, however the quality, innovation productivity and prevention gap across all organisations had not been closed at the date of submission; this led to NHS England not agreeing to the Solihull CCG element of the plan. Solihull CCG’s position remains challenging, with a QIPP requirement of £18m, or 6 per cent.”

“The financial plans have been through a process of refinement and we are now working closely with NHS England on reaching agreement for the Birmingham and Solihull financial plans.”   

“A prioritisation policy has been agreed across Birmingham and Solihull, which the CCGs plan to use to review services over the next 12 months.”

HSJ asked whether the CCGs whether the merger was still on track.

A spokeswoman for all three CCGs said: “The CCGs continue to work closely together towards the shared goal of a single management team. The timeline for this is challenging and there have been some delays, due to complexities around organisational structures and the processes that are already in place. A unified approach has now been agreed to shared governance and decision making, and this is now progressing.

”The existing management teams already share a single weekly senior management team meeting and are working closely to achieve a single commissioning voice for Birmingham and Solihull.”