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London CCGs push ahead with merger to improve Covid response and reduce inequality

London CCGs push ahead with merger to improve Covid response and reduce inequality
By Awil Mohamoud Reporter
6 August 2020

Eight clinical commissioning groups (CCGs) in London are pushing ahead with a proposed merger for April 2021, in a bid to improve their Covid-19 response and recovery and reduce health inequalities among communities.

Brent, Central London, Ealing, Hammersmith and Fulham, Harrow, Hillingdon, Hounslow and West London CCGs have put forward plans to become the ‘North West London CCG’ next year, following year-long discussions.

The CCGs will now need to secure approval from each of the eight CCG governing bodies and local GP members, before they can send an application to NHS England and Improvement in September. 

Jo Ohlson, accountable officer for 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.’

‘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.’

Better pandemic response

A ‘Case for Change’ report, published by the London CCGs, said becoming a single entity would help them react ‘quickly and consistently to the continuing pandemic and recovery’ in what ‘has been one of the hardest hit parts of the country’.

It added that the merger would help to improve patient wellbeing and care and ‘level up additional primary care services’ across the area over the next five years, as well as ensuring ‘equity of access to services’.

The CCGs have also pledged to increase investment in out of hospital services. 

The report said: ‘In recognition of health inequalities across NW London, we will make substantial progress towards fair share allocations based on population need in the next five years, faster than the national timetable.’

Improve efficiency 

The report also said having a single CCG in the area would ‘reduce duplication in ways of working’, allowing ‘more time and money to be put into patient services’. 

The CCGs said: ‘We have made some savings by implementing joint arrangements across our CCGs. However, each CCG is a separate legal entity and it costs significantly more to service all eight organisations than it would a single body.’

They added: ‘One single CCG taking strategic decisions across the whole area and smaller primary care networks (PCNs) at local level would directly lend themselves to having an even closer local focus, whilst at the same time enabling more effective commissioning of services’.

Each local area will, however, maintain a borough committee following a merger. 

Opposition to mergers

The move follows the merging of 74 CCGs in April this year to form 18 new bodies, which cover wider geographical areas. This has taken the overall number of CCGs in England from 191 to 135. In London specifically, 17 CCGs merged to form three new organisations. 

Last month, four other CCGs – Dudley, Sandwell and West Birmingham, Walsall and Wolverhampton – also launched a proposal for an April 2021 merger.

The NHS Long Term Plan recommends mergers as a way for NHS organisations to align strategy and manage resources and assets better, but there has been widespread concern over the growing number of organisations opting to make the change.

Campaigners have said mergers are a ‘distraction’ to the Covid-19 response, and should generally be avoided as they ‘reduce local accountability and democracy’.

Local Medical Committees (LMCs) have also warned that this trend will lead to GPs having less input in local decision-making and ‘present a real challenge’ to having proportionate GP representation.

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