• The two accountable officers for eight CCGs are not applying for joint role across north west London
  • Clare Parker says she is not applying because she did not need “distraction” of organisational changes
  • Four other senior staff have left over past two months
  • CCG cluster had capital plan knocked back by NHS Improvement

Six directors have left or not reapplied for their jobs at a troubled clinical commissioning group collaboration, HSJ can reveal.

Four directors have left the North West London Collaboration of CCGs since September and the two accountable officers for the eight CCGs in the cluster have said they will not apply for the joint role across all of them.

North west London’s capital case for an ambitious reconfiguration plan was knocked back by NHS Improvement in September. The regulator expressed scepticism over the plan’s activity forecasts.

In a letter to staff at the five inner London CCGs – covering Hammersmith and Fulham, Kensington and Chelsea, Westminster, Ealing and Hounslow – accountable officer Clare Parker said she would not be applying for the role covering these boroughs plus Harrow, Brent and Hillingdon.

She said: “After serious consideration I have chosen not to exercise my right to apply through the internal process at this time. I believe that the CCGs need a strong delivery focus over the next few months given the financial and performance challenges we are facing, and that is what I need to concentrate on without being distracted by the organisational changes.”

She said these challenges were: “Delivering the 2017-18 financial position, robust 2018-19 planning including QIPP planning, clarifying and implementing our urgent care strategy to drive improved A&E performance, completing the assurance process for the Shaping a Healthier Future capital business case, strategic outline case one and supporting staff through this period of change,”

In September, the CCGs voted to have a single accountable officer and finance director across the eight groups.

Ms Parker’s letter, seen by HSJ, said she would not be applying via the internal process but could still apply as an external candidate.

A spokesman for the collaboration said the expanded role would be externally advertised as the accountable officer for Brent, Harrow and Hillingdon, Rob Larkman, was also not applying.

HSJ understands inner north west London interim finance director Caroline Boswell left on 17 November as did programme director of mental health Fiona Myers. Her predecessor, Jane Wheeler, left in September.

Strategy and transformation director Alasdair Ramage left in September at the end of his six month contract.

Earlier this month, HSJ reported the CCGs had spent £36m with consultancy firms over the past four years.

The spokesman said: “The eight CCG governing bodies in north west London have agreed to appoint a single shared accountable officer as part of our programme of developing further collaborative working. A full, open and transparent competition will shortly take place for that role. The successful candidate will then be the single AO for all eight CCGs. Both Clare Parker and Rob Larkman remain the AOs for [their CCGs] until a single AO is in post.

“Alasdair Ramage was initially appointed for six months. Following a review at that six month point we agreed that the changes to commissioning that we are bringing forward will impact on the role and that this is an appropriate opportunity to rethink and reframe the job in the new context. Both the mental health director and the head of finance roles were being filled by interims. We have made a permanent appointment to the finance role and they will start in the new year. The mental health role is being covered internally while we look at how the role will fit into the new collaborative commissioning arrangements.”

“As we move from the design to the delivery of our STP, and a change in the way we collaborate to commission our services, it’s no great surprise that when interims leave we look again at the roles and review whether they need to change. Like many parts of the NHS we have a deliberate policy of trying to limit the use of interims and so we would always expect them to move on fairly quickly.”