• Deloitte review finds “lack of strategy” and “joined up commissioning” between Walsall CCG and local authority
  • CCG, which is under legal directions, “disintegrates” joint commissioning unit with council as result of review
  • CCG’s interests “not always met” by joint commissioning arrangement

A West Midlands clinical commissioning group, currently under NHS England legal directions, has dissolved the joint commissioning unit it had with its local authority.

Walsall Clinical Commissioning Group said it would “disintegrate” the joint commissioning arrangements with Walsall Council after a review from Deloitte found a “lack of joined up commissioning intentions” and evidence that the CCG’s interests had not always benefited from the set-up.

Last June, the CCG was put under legal directions after being rated inadequate.It has since been taken out of special measures following improvements made to its health and social care integration programme called “Walsall Together.”

As part of the CCG’s legal directions it was required to commission an external review of the joint commissioning unit, better care fund and continuing healthcare arrangements. The review was carried out by Deloitte.

The joint commissioning unit was set up by the CCG and council leads for commissioning mental health, learning disabilities, older people’s and continuing healthcare services. The two organisations also pooled their budgets for learning disability services.

The review, published in the CCG’s governing body papers last week, found:

  • a lack of strategy for learning disability and mental health services shared by the council and CCG;
  • a lack of “joined up commissioning” between the CCG and the council;
  • high spending on learning disability and continuing healthcare clients compared to other NHS organisations;
  • the CCG’s “interests have not always been met” by the joint commissioning arrangement, and;
  • better care fund arrangements are “unclear and funding measures require a review”.

The report also said it is “not clear that there is a shared position across all staff that focuses on maximising independence, minimising risk and providing sufficient support with housing, social care and nursing to keep clients out of inpatient care”.

In response to the review Walsall CCG said it would “disintegrate” the joint commissioning unit by 1 April. All CCG and council staff will return to their respective organisations.

According to the document, the CCG’s own joint commissioning committee is also set to be “stood down” following a review, however an option to re-establish it may be discussed in October.

An “escalation of [the] dispute relating to learning disability pooled budget arrangements under way”, the document added.

Paul Maubach accountable officer for Walsall CCG said: ”I am pleased that we have made such good progress in the nine months that I have been at the CCG.

”There are still many challenges ahead; this improvement is thanks to the dedication of our staff and partners; and we are fully committed to improving the way we commission services to achieve better results for the people of Walsall.”

Walsall Council had not responded to HSJ in time for publication.

This story was updated 14:00 on 24 April following comment receieved from the CCG.