ICS appoints CCG chief as new lead

Mr Garratt will retain his existing roles as accountable officer of the ICS’ three clinical commissioning groups – Ipswich and East Suffolk, West Suffolk, and North East Essex CCGs – and the single leadership group which oversees them.

The long-time Suffolk commissioning chief takes on the system leadership role from East Suffolk and North Essex Foundation Trust chief Nick Hulme, who was the sustainability and transformation partnership’s accountable officer.

Mr Hulme has stepped back from the role to avoid conflicts of interest and to focus on running his newly-merged trust, which is also set to reconfigure services across its Ipswich and Colchester hospital sites and carry out a major capital programme.

The mid-sized ICS, which hopes to come out of shadow form later this year, covers a population of around a million residents. It has split itself into three “alliances” based around its existing CCG boundaries. Its next structural task is to appoint an independent chair this summer.

Setting out his priorities in an exclusive interview with HSJ, Mr Garratt paid tribute to Mr Hulme, adding he had done an “outstanding job” leading the ICS to date.

He cited workforce and health inequalities as the area’s two major priorities, said the system was aiming for a breakeven position by 2021, and set out how plans for the voluntary sector to play a key role in delivering on the ICS’ top targets.

The ICS’ workforce problems are laid bare by its 13 per cent vacancy rate, 3 per cent over the national average, and the fact that around 12 per cent of its nurses are over the age of 60.

He said the patch would be “increasingly looking at how the alliance systems [the three sub-systems which will sit beneath the overall ICS] will employ the workforce, so we can break down boundaries between teams, and also have more rotational models”.

He added that integrated care not only made sense for patients but also that “the more we integrate services the more attractive we will become [to prospective employees]”.

The ICS workforce plan is still in its formative stages, but Mr Garrett confirmed the patch would require international recruitment to plug gaps, especially in the short-term.

The ICS is also aiming to carve out a significant role for local voluntary organisations, which are currently bidding for a share of a £2m fund established by the ICS to finance a range of schemes designed to tackle health inequalities and deprivation.

“Rather than telling the voluntary sector what the answer is, we’re providing the funding and inviting them to come up with solutions. The voluntary sector is more agile than the statutory sector and it will also help us deliver [schemes tailor-made for our localities],” he said.

Announcements on successful schemes are due in September.

The ICS is also targeting financial balance by 2021 after cutting its deficit from £46m in 2017-18 to a planned £4.5m this financial year.

Mr Garratt said the use of guaranteed income contracts, increasingly integrated services, and other drives, such as cutting delayed discharges and stranded patients, had all contributed to the significant deficit reduction.

“We had three fewer admissions a week at Ipswich Hospital site in 2018 than we did the year before, which is a really great achievement [given that we have an aging population and in many similar areas demand is rising].

“[Meanwhile,] at West Suffolk FT we regularly saw over 200 patients stranded over seven days during 2017. The system recognised this was a key metric to change to ensure patient safety and operational performance and through close working between health and social care colleagues we regularly keep it below our operating standard of 160.”

Local leaders are also finalising which GP practices will join which primary care networks, with East Suffolk set to have 11, West Suffolk to have six and a further seven across north east Essex.