Joint ICB/trust committee given binding powers to improve system’s care quality

Cornwall Integrated Care System is pushing ahead with the creation of a joint committee for quality and improvement after a delay of several months. The committee will take responsibility for issues such as pathway redesign and improving avoidable mortality related to NHS services. It will meet at least six times a year.

The ICS, which has previously been criticised by external bodies for poor collaboration, believes its committee of 18 local leaders is the first of its kind to be rolled out in England under the 2022 health reforms.

However, the ICS has also abandoned similar plans to form a joint finance and performance committee.

Plans for the two committees were initially announced last August, with Cornwall Integrated Care Board stating decision-making power would be ceded from the ICB and Cornwall’s two NHS providers’ boards. The creation of the committees was paused a month later as chiefs waited for clarity on national policy around procurement and choice.  

An ICB board paper  has now confirmed the establishment of the quality and improvement committee. The ICB said it had dropped plans for the finance and performance committee following legal advice. 

The decisions reached by the new quality and improvement committee would be binding on the system’s ICBs and its two provider trusts: Royal Cornwall Hospitals Trust and Cornwall Partnership Foundation Trust.

The committee’s membership comprises six representatives from each of the three organisations. These include their chief executives, medical directors, chief nurses and three non-executive directors. All have voting rights.

Where there is no clear majority for a decision or where one CEO does not agree, the decision will revert back to the three organisations’ boards according to the committee’s terms of reference.

The CEOs will also have the power to request that a decision be referred back to their organisation’s board rather than be considered by the committee, if they believe it poses a “significant and not sufficiently mitigated risk to the delivery of their organisation’s statutory responsibilities”.

This would only happen in “exceptional circumstances”, the paper says.

The chairs and company secretaries of the three bodies will also be invited to meetings as non-voting members, along with representatives from Cornwall Council, South West Ambulance Trust, University Hospitals Plymouth, the VCSE sector and primary care.

The committee will be chaired by Nick Kaye, an ICB board member who also chairs the National Pharmacy Association.