• CCGs consult on splitting, with West Birmingham GPs joining neighbouring CCG
  • Birmingham councillors and LMC back option, but acute trust opposes, citing “financial consequences” for hospital build 
  • Will go to GPs for a vote in June

West Birmingham GPs are being encouraged to break away and join a new CCG, despite strong opposition from the local hospital trust, which has described the proposal as “perplexing”.

Sandwell and West Birmingham Clinical Commissioning Group is consulting on boundary changes in the city after Birmingham City councillors asked NHS England to urgently resolve the “West Birmingham question”.

One option proposed is shifting the CCG boundaries so West Birmingham GPs would join neighbouring Birmingham and Solihull CCG.

That option is backed by the Birmingham local medical committee but opposed by Sandwell and West Birmingham Hospitals Trust, which has said it would “imperil” work on the much-delayed Midland Metropolitan Hospital.

Sandwell and West Birmingham CCG is currently part of the Black Country and West Birmingham Sustainability Transformation Partnership with three other CCGs. The Birmingham and Solihull CCG has the same boundaries as its eponymous STP.

In November, Birmingham’s health and social care overview committee wrote to NHSE saying that, for integration to work, a single CCG was needed across the city.

It wrote: “An essential pre‐requisite for effective integration is that both NHS and the local authority can operate within a single integrated footprint… Failure to do this will mean that we are storing up serious problems for the future.”

In response, both CCGs agreed to consult on changes, with consultation on three different options running until 6 May. A final vote on a preferred option will go to GPs on 17 June.

The options are:

  • Sandwell and West Birmingham CCG keeps its boundaries and remains part of the Black Country and West Birmingham STP;
  • Sandwell and West Birmingham CCG would keep its boundaries but move into the Birmingham and Solihull STP; and
  • Sandwell and West Birmingham CCG would split and dissolve, with West Birmingham practices merging into Birmingham and Solihull CCG and the rest merging into a new single Black Country CCG. This option would be dependent on the other three Black Country CCGs merging.

In a letter to GP members this month, Birmingham LMC chair Bob Morley said the LMC supported West Birmingham GPs breaking away and the first of three options was “wholly unacceptable”.

It stated: “The view of Birmingham LMC is that there must be a single GP commissioning body for Birmingham and that it would be a disaster for West Birmingham GPs to be part of [the] Black Country.”

Dr Morley said moving the whole CCG into the Birmingham and Solihull STP was also undesirable because it would cause “enormous” upheaval among Sandwell GPs.

However, a Sandwell and West Birmingham Hospitals Trust spokeswoman said the West Birmingham breakaway option was “perplexing” and “inconsistent with the views put to us by local ward councillors in West Birmingham, and by community representatives”.

The trust had no view on which STP Sandwell and West Birmingham GPs should join but said splitting commissioning boundaries would have “financial consequences”, and ”imperil” construction work on its new £475m hospital, already delayed by Carillion’s collapse. 

The trust spokeswoman added: “The two CCGs have fundamentally different care and commissioning models. This introduces the risk that one single acute hospital is required to work 60 per cent in one way, and 40 per cent in another. This creates material risks to efficiency and effectiveness.”

A Sandwell and West Birmingham CCG spokeswoman said the boundary review was about ensuring the CCG could support “the relationships and networks” to bring together health and care in Birmingham and the Black Country. 

She added: “We are not doing this on our own but are working in partnership with our GP practices, health providers, local authorities, patient groups and neighbouring CCGs to enable us to make an informed decision.”