Removing local authority representation from integrated care boards (ICB) will ‘undermine’ government efforts to shift care to the community, a committee of MPs has warned.
The Health and Social Care Select Committee also said that taking away council members from boards was a ‘damaging move’.
In a report on the NHS Modernisation Bill, the committee urged the government to reconsider its decision to remove local authority representation on ICBs.
It said: ‘We remain convinced that removing their representation from ICBs is a damaging move that will undermine the government’s efforts to shift treatment into the community and deliver a more integrated health and care system.’
The bill proposes replacing the requirement for ICBs to appoint at least one primary care and local authority board member with appointing a member nominated by each mayor of a mayoral strategic authority within their areas.
The cross-party committee recommended that the statutory requirement for ICBs to have at least one member jointly nominated by local authorities is retained.
This echoes the committee’s previous call for the government to retain local authority membership of ICBs, with its report on palliative care in March also urging the government to reconsider its plans.
The new report, published last week, also said the committee had heard concerns from multiple witnesses about the proposed changes to ICB membership, with Health Foundation policy and research director Dr Hugh Alderwick warning there was a risk of losing the local-level connection with social care and public health.
‘That [connection] is critical for things like managing multimorbidity, and it might make things like pooling budgets more distant or difficult just because the planning together is not as effective,’ Dr Alderwick said.
The report also said that chair of the Local Government Association’s Health and Wellbeing Committee, Dr Wendy Taylor, had branded the change ‘a backward step’, with local authorities needing to be at the centre for neighbourhoods to work.
The committee said that the importance of close and integrated working between the NHS and local authorities to meet the three shifts – set out in the 10-Year Health Plan – has been a ‘recurring theme’ during parliament.
The plan, published last summer, sets out how the NHS will achieve the government’s reform ambitions, including shifting from treating sickness to prevention, moving care out of hospitals into communities and transferring from analogue to digital.
Parliamentary scrutiny of the NHS Modernisation Bill is under way, with the first session of the committee stage beginning on Tuesday.
Under the bill, NHS England will be abolished and its functions transferred to the Department of Health and Social Care (DHSC), a single patient record will be created, and ICBs will be given legal responsibility for primary care commissioning.
The Health Committee report sets out a number of proposed amendments to the bill, including making ICBs legally required to comply with recommendations from SEND tribunals and greater consideration to health inequalities across government.
Committee chair Layla Moran said: ‘The health bill will herald the most far-reaching changes to the health service in nearly 15 years.
‘This is the opportunity to rewire parts of the NHS to tackle chronic problems affecting every area of the country, from SEND and mental health services to better prevention of obesity and frailty.
‘It should be about more than just reshuffling bureaucracy and handing power to the Secretary of State.’
Healthcare Leader has contacted the DHSC for comment.
