Exclusive: Councils threaten to quit leading STP

The comments were made by the leaders of three upper tier councils within the Bedford, Luton and Milton Keynes STP, in a letter shared with HSJ.

The letter, dated 14 June, said Milton Keynes, Luton and Bedford councils “are prepared to disengage with the BLMK STP and withdraw our resources from the process” after becoming “increasingly frustrated” that the views of local government are being “overlooked”.

It said this approach “runs the risk of simply redesigning NHS services rather than remodelling the health and care system”.

It also criticised NHS England’s STP timeframes as “often unacceptable and counterproductive”.

BLMK STP is one of 14 health economies described as an “integrated care system” by NHS England, because it is deemed to be more advanced than other areas. It is led by Richard Carr who is also chief executive of Central Bedfordshire Council, a fourth council in the STP which did not sign the letter.

The letter was sent to clinical comissioning group leaders in response to commissioners’ refusal to jointly appoint chief operational officers between the CCGs and councils.

It said: “We feel that the current capacity being expended by our authorities on the BLMK STP is not having any impact on the services we deliver or could not have been achieved faster by deploying those resources at a local level.

“Unless the culture of engagement and decision making changes, the BLMK STP cannot legitimately claim to be working towards an integrated health and social care system…

“We are prepared to disengage with the BLMK STP and withdraw our resources from the process. We strongly feel that from a local authority prospective this would simply reflect the de facto current position in regards to a lack of strategic role.”

The three council leaders make five demands from the CCGs to stop them from pulling out of the STP, including a meeting with NHS England about “unacceptable” STP timeframes; jointly funding an integration post in each local authority area; and future decisions on services to be taken “only after reaching agreement with local authorities”.

In some regions of England, particularly Greater Manchester, the CCG accountable officer role is now filled on a dual basis by the local authority chief executive.

BLMK STP includes Bedfordshire, Luton and Milton Keynes CCGs, as well as Milton Keynes University Hospital, Bedford Hospital Trust and Luton and Dunstable University Hospital Trust.

The letter also comes after it was revealed that MKUH is looking at closer collaboration with Buckinghamshire Healthcare Foundation Trust, which is in a neighbouring STP.

The letter was sent by Pete Marlan, leader of Milton Keynes Council; Hazel Simmons, leader of Luton Borough Council; and Dave Hodgson, mayor of Bedford Borough Council.

The chairs of the three CCGs that received the letter said: “As a first wave integrated care system there are a number of issues that are revealing differences of expectation that need to be worked through. Robust challenge is a necessary part of the process. All partners, however, remain committed to working together.”