Agenda item

Clinical Commissioning Group (CCG) merger




















21.1.     The Committee considered a report providing an update on the proposals to merge the three East Sussex CCGs. The Committee then asked the witnesses present a number of questions.

21.2.     The Committee asked how local representatives will be appointed to the East Sussex CCG Governing Body

21.3.     Terry Willows explained that localities, such as Hastings, High Weald, Eastbourne, etc., will be represented by a GP who is elected by the GP membership for that locality to the CCG’s Governing Body.

21.4.     In addition to the Governing Body meetings, locality meetings are expected to involve the broader GP membership and local residents interested in being involved. Healthwatch and Patient Participation Groups representation is also being considered for CCG committees that, once established, will exercise powers delegated from the Governing Body.

21.5.     The Committee asked whether the local authority representatives on the CCG board will have voting rights

21.6.     Terry Willows explained that local authority representatives cannot be voting members due to the Health and Social Care Act 2012 only permitting employees or appointees of the statutory body, the CCG, a vote. He added that the current local authority representative of the existing CCG Boards, the Director of Public Health, plays a very full role in deliberations and discussions.

21.7.     The Committee questioned whether there was sufficient engagement by the CCGs of district and borough councils.

21.8.     Terry Willows said that he would reflect on the feedback that the district and boroughs were not sufficiently involved in CCG decision making. He said the core reason to merge the CCGs was to improve commissioning of the wider determinants in relation to health, such as housing, and district and boroughs have an important role to play in delivering in these areas, for example, in their role as housing authorities. Jessica Britton added that the CCGs work closely on a range of projects with district and borough councils, including prevention and health improvement programmes like Healthy Hastings and Rother. She said the locality structure of the new East Sussex CCG will provide opportunities for additional engagement with stakeholders like the district and borough councils at a locality level.

21.9.     The Committee asked what difference the public would see once the new CCG was in place

21.10.  Terry Willows said the aim is for the East Sussex CCG to engage with patients and public in an improved and consistent way. He hoped, therefore, that the public would notice they are being listened to more by the new CCG and that it was commissioning new services that better meet the public’s needs.

21.11.  Terry Willows explained the new operating structure of the CCG will include additional capacity in the communications and engagement team, which will help take information from the localities and use it to help inform decision making at an East Sussex level.  The CCG is also looking at improving public engagement with the CCG decision-making process, as currently few people attend governing body meetings. This could include looking at technologies to make meetings more accessible, such as webcasting.

21.12.  The Committee asked how the new CCG would be different to the old Primary Care Trusts

21.13.  Terry Willows and Jessica Britton explained that it was different for a number of reasons, including the fact it was working towards integration with ESCC; the change in commissioning focus towards prevention and the wider determinants of health; and having GP leadership rooted in local neighbourhoods. 

21.14.  The Committee asked what efficiencies would come from the new CCG and whether they enable the delivery of the 20% back office savings required by NHS England

21.15.  Terry Willows explained that modelling had been undertaken of the impact of the merger and it had made the CCGs confident the efficiency target will be achieved. The 20% savings would be made by reducing the cost of running three statutory organisations with three separate statutory legal processes, such as producing three sets of annual accounts reports, three governing bodies and various sub-committees; reducing overheads across the three CCGs, such as support services commissioned from the commissioning support units; and potentially rationalising the CCG’s estate in the future. He said the CCGs are being restructured in a way that does not require redundancies and that any interim and agency bill staff  will be reduced and replaced by existing staff.

21.16.  The Committee asked where the East Sussex CCG will be based

21.17.  Terry Willows said that staff are currently primarily based at Friars Walk in Lewes with smaller teams in Bexhill and Eastbourne. There are no plans to change any of these office locations. The Friars Walk office is in need of renovation, so if the CCG does look to move it will be within Lewes. 

21.18.  The Committee asked whether NHS England need to sign off the merger, when this would be, and whether there a risk they would require a single CCG in Sussex.

21.19.  Terry Willows confirmed that NHS England had provided conditional approval of the merger subject to the due diligence process, for example, evidence that the existing CCGs are closed in an effective way. NHS England is also in the process of signing off the constitution of the East Sussex CCG. The constitution is based on a national template, so there are not expected to be any issues with it. Terry Willows added that the constitution sets out how decisions will take place at an East Sussex level, but the joint committee for the whole of Sussex is not included. The joint committee’s terms of reference will be agreed by the three CCGs in the Sussex Health and Care Partnership (SHCP) once they are all established.

21.20.  The Committee asked what plans are in place to ensure that the High Weald Lewes Havens CCG area of the new CCG will be fully on board, given the previous separation of earlier integration plans

21.21.  Jessica Britton said that recently the three CCGs had been working closely together and this  collaboration is reflected in the East Sussex transformation programme for 19/20 that has been agreed by all three of the CCGs and ESCC. The localities of the new East Sussex CCG will also ensure local views and concerns are fed in to the decision-making process.

21.22.  The Committee asked whether people would still be able to see how money was being spent within different areas of East Sussex by the combined CCG

21.23.  Terry Willows confirmed that the new CCG would be transparent about how the money is spent within the individual localities. Localities will need to explain their population’s need to the CCG and in return will be able to see how the money was spent in their area. The East Sussex CCG budget will also be broken down into the three previous CCGs’ areas so people can compare the old and new budgets for their area. 

21.24.  The committee RESOLVED to:

1) Note the report

2) Request the structure of East Sussex CCG to be circulated by email once it has been completed at the end of March


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