Inadequate CCG moves to join with council

Somerset Clinical Commissioning Group, which was rated inadequate by NHS England last month, has approved a proposal to set up a “joint health and care board” with Somerset county council and NHS England.

The council and NHS England are yet to vote on the plans. If the plan is approved, health and council leaders hope to hold the new commissioning board’s first meeting by April next year.

The move is part of the push by Somerset Sustainability and Transformation Partnership to develop an accountable care system by 2019. The STP has said it needs to make savings of around £600m by 2021.

The intention is for the new board to commission all services covered by Somerset CCG’s budget, specialised services covered by NHS England, primary care, public health, and adult and children’s social care.

A detailed business case has not yet been written but it is planned that the organisations involved will retain their responsibilities, however they would take decisions at the same time through the new board.

This board would control a “significantly pooled budget”, CCG governing body papers said.

Some health services, such as surgery, radiotherapy, abortions and certain invasive treatments, cannot legally be commissioned through pooled budgets so the board will need to establish other arrangements – such as one organisation becoming the lead for commissioning those services.

Creating a single commissioning board would also open possibilities for making efficiency savings by reducing duplication in estate, travel and back office functions.

Leaders also believe there may be VAT benefits if the council becomes the accountable body for the entity.

The board would meet in public and need to comply with the governance of each of the organisations involved.

The CCG papers said: “The board would require robust governance structures to be established. It is important that the structures can operate within the complex legal framework of both organisations, preferably without having to have delegated authority for statutory responsibilities.”

If the plans are approved by the council and NHS England, a more detailed business case will be developed in consultation with staff from the county’s health, public health and social care system.

All three organisations would decide on the business case in November.

Approval would prompt the creation of a shadow board and the three organisations would start co-locating and joining up their IT systems to create the business unit where officers would work.