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‘Crazy’ loss of clinical leadership with the move to ICSs, report finds


By Jess Hacker
19 July 2022

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More than a third (36%) of CCG leaders will not move into an integrated care system (ICS) leadership role, Healthcare Leader can reveal, with many concerned by the loss of clinical leadership.

The survey of more than 140 CCG leaders and staff also highlighted that only 27% expect to continue working in a leadership position in their ICS, with more than a fifth (22%) left unsure.

It comes two weeks after Integrated Care Boards (ICBs) became statutory bodies, marking the formal end of CCGs and the gradual transfer of commissioning responsibilities.

Healthcare leader’s report – CCGs: A post-mortem – also reveals that 68% of CCG staff felt there will be a loss of clinical leadership as a result of the massive shake-up within the NHS.

Dr Hasan Chowhan, chair of North East Essex CCG, said: ‘Whenever you have an
organisation change from one form to another, you have to think who are the people who will take that change forwards? There isn’t a mass of people with this level of experience, be it clinical or non-clinical.

He added that he ‘fears for clinical leadership’, suggesting that there was never ‘any thought about what happens to those experienced’ leaders, with many colleagues unsure where they will fit into the new system.

Each of the 42 new ICBs is required to have at least one primary care and one trust representative on their board, however the recently published constitutions suggest there will be far greater representation for secondary care.

Dr Agnelo Fernandes, South West London CCG borough lead for Croydon, suggested the lack of directly transferrable roles for CCG chairs onto the ICB will bring about the loss of clinical leadership.

He said: ‘There is no role for a CCG chair in the new system, so two of our last CCG chairs have already resigned and I finish in July.

‘There isn’t a role on the ICS board or anything like that for any of the CCG chairs which means we are a lost resource.’

Where are leaders going?

The survey also highlighted that most departing CCG staff will look for roles in an ICS (28%), a PCN (19%) or a GP practice (21%).

As many as 15% will retire when their time at their CCG comes to an end, with 8% moving into the private sector.

Dr Neel Gupta, former chair of Camden CCG in north London, who is moving into the private sector, said: ‘No effort was made to try to retain people like me. I don’t think any other sector would do that. It’s crazy really’

Out-going clinical leaders recently expressed major misgivings about how the NHS is being run, in light of the shift to ICSs.

Last week, MPs launched a new inquiry into Integrated Care Systems (ICSs), days after their official launch.

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