CCGs: A merging mindset

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The merger agenda has been a prominent one for Clinical Commissioning Groups across the country for over a year now.

A number of which went ahead in April this year with more on the horizon. In the past month a further mergers have been proposed while some jobs have been lost due to merger duplications.

Merger proposals:

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Following internal and external consultation, the eight NHS Clinical Commissioning Groups (CCGs) in North West London have put forward a proposal to merge into a single CCG. The eight CCGs involved comprise Brent, Central London, Ealing, Hammersmith and Fulham, Harrow, Hillingdon, Hounslow and West London.

A release by the groups informed locals that all groups have been discussing the proposal of a merger for over a year, with plans now in place for this to take effect in April 2021.

Engagement with the public took place last year and the CCGs will be discussing further with local people and organisations over the next six weeks. The next steps will be to consult with the local councils in the area, all eight CCG governing bodies and local GP members. If the CCGs and GPs approve the proposal, an application will be sent to NHS England and Improvement at the end of September 2020.

Jo Ohlson, accountable officer for the North West London CCGs said: “All eight CCG governing bodies agreed last year that this was the right direction of travel. Going forward we will retain a focus on managing key relationships locally, working closely with our GPs, hospitals, local councils, Healthwatch and voluntary organisations.”

Adding: “Each borough will continue to have its own team to ensure that the right services are provided for local needs. We have learned a great deal from the Covid-19 pandemic, notably about how we function better as one organisation as joint working across all parts of the NHS, in partnership with social care, has been critical to our response.”

Elsewhere and further north, the four Clinical Commissioning Groups in the Black Country and West Birmingham – Dudley, Sandwell & West Birmingham, Walsall and Wolverhampton – are also proposing to merge to create one CCG.

To ensure that all stakeholders can feedback on the proposals, it has launched a series of formal conversations to allow people to share views about the plans. The CCGs have already started working together and aligning teams and committees and now share a senior leadership team, headed up by a single Chief Executive, Paul Maubach.

The statement announcing the news, reads: “We are proposing this merger as we believe it is the best way for the CCGs to deliver on its commitments to improve the health and wellbeing of the people of the Black Country and West Birmingham.

“Local relationships and clinical leadership are central components to the way in which the CCGs work and this will be retained through place based teams in Dudley, Sandwell, Walsall, West Birmingham and Wolverhampton. A merge would also reduce organisational running costs, which would be better spent on supporting local healthcare services.”

Currently, four Governing Bodies oversee the work of the CCGs which include representation from GPs, nurses, secondary care doctors, managers and system partners.

The statement continued: “After much discussion, and two listening exercises, the Governing Bodies have indicated a preference to merge fully because they believe that the benefits of doing so would be much greater than staying as we are today.

“However, we want to assure you that no decisions have been taken and all four CCGs are keen to listen to the views of member practice GPs, partners, patient representatives and other key stakeholders.”

A decision about future commissioning arrangements will be determined by a vote of the GP Members after all feedback has been considered. If there is support then an application would be submitted to NHS England and Improvement for a final decision and if successful, means the merger would be effective from April 1, 2021.

Paul Maubach, chief accountable officer, said: “Our Governing Bodies recognise the benefits of a single team and a single merged CCG to improve our ability to support the health and wellbeing of people in the Black Country and West Birmingham.”

Concluding: “I want to reassure you that whatever a future commissioning organisation might look like, our decision-making will continue to be clinically-led and we will remain committed to the relationships which we hold in each of the five places we serve.”

Job duplication:

NHS bosses have confirmed that they are expecting that there will be more job losses at the Kent and Medway CCG, although they are not coronavirus related. The Kent and Medway CCG has recently gone through a merger which saw eight of the county’s CCG’s merge into one body and according to a report in the Isle of Thanet News, this reshuffle will cause further job disruption.

Becca Bradd, executive director of people and organisational development at NHS Kent and Medway CCG, told the local news source that a “small number” of voluntary lay-offs have been made at senior level due to “duplication” of the role.

Bradd explained: “As this process is not yet complete and we continue to support our colleagues, it would be inappropriate to comment further.”

Last week, councillors questioned NHS bosses about the merger as part of a scrutiny committee.

The report detailed how Rochester Cllr Teresa Murray, who is the deputy leader of Medway Council’s Labour Group, questioned whether any job losses had taken place in the “streamlined” organisation and whether more were likely in the future.

Wilf Williams, who heads up the organisation as the accountable officer, said a “small number of redundancies” had been made since April and indicated there would likely be “further” ones.

He continued: “We don’t expect significant redundancies, more than the few that we have had so far.

“Our new structure has more positions than currently people in post, although that does mask some areas where there may be some reductions and people cannot necessarily transfer from those areas.”

Concluding, Ms Bradd said: “An essential part of establishing our new organisation is bringing together our teams, including a single leadership team, to collectively manage the planning and development of healthcare services for people across Kent and Medway.

“We have worked hard to retain as many of our people, their knowledge, experience and skills as possible.

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Alex Douglas

The author Alex Douglas

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