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CCG governance creaking under pressure

CCG governance creaking under pressure

It seems CCGs’ best-laid plans to merge are being thwarted but the death knell is sounding anyway

Earlier this year, Healthcare Leader wrote about how back-door restructuring through mergers and integrated care organisation could be sounding the death knell for clinical commissioning groups.

However, it seems CCGs’ best-laid plans to merge are being thwarted but the death knell is sounding anyway.

Ten CCGs in England have been having a particularly difficult time recently with votes of no confidence, financial issues and staff resignations.

Vote of ‘no confidence’ in Staffordshire

On Monday, Healthcare Leader reported that GPs in Staffordshire submitted a vote of no confidence in NHS Stoke-on-Trent and NHS North Staffordshire CCGs after it was proposed that all five CCGs in the area share an accountable officer.

According to the LMC the GPs voted against the decision because ‘they see themselves as a unique local health economy with its own needs and challenges and they want to address that amongst themselves and not be part of a large Staffordshire group’.

Dr Harald Van der Linden, medical secretary for the LMC, added: ‘There’s concern that the senior accountable officer will mean that we lose some of the decision making on a local level and autonomy.’

Staff exodus in Liverpool

Farther north, what was set to be England’s largest merger had to be halted when the MP for west Lancashire raised concerns about pay increases for the heads NHS Liverpool CCG.

The merger between NHS Liverpool, South Sefton and Southport and Formby CCGs was paused while NHS England conducted an investigation into the CCG, which found problems with governance and management of conflicts of interest.

This resulted in the resignation of NHS Liverpool CCG’s chair, vice-chair, chief officer and finance director.

Katherine Sheerin, the chief officer, said she decided to stand down as ‘it is the right time to move on’.

Tom Jackson, chief finance officer, said he decided to stand down ‘following Katherine Sheerin’s decision to resign’.

Governance review in London

NHS City and Hackney CCG, which had planned to fully integrate its £335m budget with Hackney council, is also under investigation for governance issues.

According to a board paper from Hackney’s health scrutiny committee, NHS England requested the integration be paused and commissioned Deloitte to conduct ‘a review of the governance, which led to the agreement of the integrated commissioning model’.

The board papers added that‘a further legal review of the model’ had been commissioned by NHS England.

Resignations in Crawley

While NHS Crawley CCG was not planning to merge, NHS England did also launch an investigation into its governance, leading to the resignation of both the chair and chief clinical officer.

Dr Amit Bhargava, chief clinical officer for NHS Crawley CCG and a GP at the Southgate Medical Practice, stepped down late last month along with CCG chair Alan Kennedy.

The CCG refused to comment on the investigation but a spokesperson for NHS England South told Healthcare Leader: ‘In line with our assurance role to ensure good governance within CCGs, we have commissioned an independent investigation by Verita in relation to NHS Crawley CCG. 

‘The investigation is underway and it would be inappropriate for us to comment further.’

In his resignation letter, Dr Bhargava said: ‘The NHS faces big challenges, with the need for new partnerships and collaborations, and it is right that the leadership is also new and takes charge of its destiny to create a great future.’


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