Commissioners in north east London have told STP leaders they must remain sovereign organisations in wake of a new partnership agreement in the patch.
After seeking advice from lawyers, City and Hackney Clinical Commissioning Group has sent a letter to sustainability and transformation partnership leaders reminding them the agreement between providers and commissioners “does not create any new legal entity, and each organisation remains sovereign”.
The letter, sent on 7 June, was written in response to the East London Health and Care Partnership agreement, which was created in May and covers 20 organisations in the North East London STP patch.
City and Hackney and Waltham Forest CCGs are the only two NHS commissioners yet to sign the agreement.
In the letter, City and Hackney CCG makes clear the new partnership board must “talk to” individual CCG boards and adds “the governance at STP level needs to reflect the fact that organisations cannot be bound by majority vote”.
Although the partnership agreement said it does not intend to be legally binding it, it does propose that the board’s scope of authority includes “major system changes” such as the system control total and financial strategy, Whipps Cross Hospital redevelopment strategy and the system-wide estates strategy.
City and Hackney’s letter follows proposals for a single accountable offer to be appointed across the seven CCGs in north east London and raises concerns that commissioners will only have one representative on the partnership board.
It says: “In respect of the membership of the partnership board we note that this includes ‘nominated representative/s of east London commissioners.
“We assume that this means that the CCGs in east London collectively will be represented on the board by one person. This is at odds with the membership for providers and others, each of whom is represented by one person.”
A CCG spokeswoman said: “We are committed to delivering the best health and care services for the people of the City of London and Hackney – any changes to commissioning are always robustly scrutinised to ensure they enhance the CCGs ability to meet its statutory obligations.”
Rob Whiteman, chair of the East London Health and Care Partnership, said: “The partnership agreement is not, and is not intended to be, a legally binding commitment.
“Signed off by our partnership board, of which City and Hackney CCG is a member, it is essentially meant to support effective collaboration and trust between those involved to work together to deliver improved health and care outcomes and reduce health inequalities across east London. The agreement will be reviewed and updated regularly by the board to take account of any emerging good practice or development.
“City and Hackney CCG is yet to sign the agreement and we are in ongoing discussions with them about it.”
CCG governing body report and information provided to HSJ
7 June 2017 (letter)