Second NHS ‘devolution’ deal aims for 2018 launch

The Surrey Heartlands clinical commissioning groups signed an agreement with NHS England, NHS Improvement and Surrey County Council in June, but this is a high level document, HSJ understands.

It includes an agreement to provide the area with a share of transformation funding. This is expected to be worth £80m over four years from 2017-18, though the figure is not finalised, HSJ was told.

However, the delegation of budgets and responsibilities by NHS England and NHS Improvement is still subject to formal agreement of governance and other details.

This is being led nationally by NHS England chief financial officer Paul Baumann and is due to be in place to go live in April 2018. Delegated responsibilities and budgets being explored include elements of primary care, specialised commissioning and public health.

In return for its delegated functions there will be arrangements like in Greater Manchester, but not exactly the same, to ensure there is still reporting and assurance to the national bodies.

The newly appointed joint chief officer of the three Surrey Heartlands CCGs, Matthew Tait, will be substantively employed locally by the three CCGs and seconded to NHS England in order to take on delegated responsibilities from it, HSJ was told.

There will be a “director of delivery, assurance and oversight” for Surrey Heartlands who will report to NHS England and NHS Improvement, with the aim of giving the patch tailored and joined up oversight and regulation.

Claire Fuller, a GP and Surrey Downs CCG clinical chair, who is becoming the STP lead, said in a statement when the deal was announced last month: “We have to move towards a more joined up system, and devolution will help accelerate the good work that is already going on in Surrey Heartlands.”

Surrey County Council chief executive David McNulty, who chairs the Surrey Heartlands transformation board, said the development would “give fresh impetus to our efforts to work as one team to make devolution a reality for the benefit of local residents”.

The area includes Surrey Downs, North West Surrey, and Guildford and Waverley CCGs. Surrey Heartlands is the first area to receive a similar deal to the one in Greater Manchester, whose delegation arrangements went live last April. There are some “devolution” arrangements in Greater London but these do not involve significant delegation of powers or budgets.