Decision details

Lancashire and South Cumbria Integrated Care System - Update on the five year strategy

Decision Maker: Health Scrutiny Committee

Decision status: Recommendations Approved

Is Key decision?: No


High-level overview of the partnership in Lancashire and South Cumbria which is working as an Integrated Care System (ICS) and the progress towards developing a five year strategy for the system in response to the NHS Long Term Plan.


The Chair welcomed the following officers from the Healthier Lancashire and South Cumbria Integrated Care System (ICS): Andrew Bennett, Executive Director for Commissioning, Peter Tinson, Chief Operating Officer for Fylde Coast Clinical Commissioning Groups (CCGs) and Neil Greaves, Head of Communication and Engagement.


Andrew Bennett presented a report proving a high-level overview of the partnerships in the Lancashire and South Cumbria Integrated Care System and the progress toward developing a five year strategy in response to the NHS Long Term Plan.


Jenny Hurley, representing Protect Chorley and South Ribble Hospital from Cuts and Privatisation campaign group made deputations to the committee in response to the report. The deputations raised concerns expressed by the campaign group regarding the potential merger of eight Clinical Commissioning Groups (CCGs) to one and requested that detailed plans and the result of a public consultation be presented to a future meeting of the committee.


Mary Whitby, representing Save Ormskirk and Southport Hospital campaign group also made deputations to the committee in response to the report. The deputation requested that the committee rejected the five year plan and merger of the eight CCGs in favour of a public consultation.


Members requested clarification on a number of issues as detailed below:


·  Concerns were expressed regarding the wide ranging implications of the plan and lack of specific detail regarding the direction of the strategy and its local impact.


In response NHS colleagues stated that a series of NHS reforms from 2012, had highlighted the requirement for NHS bodies to work closer together. In addition ongoing feedback from patients had described that they received fragmented care. The strategy aimed to form partnerships and working relationships to improve the patient experience. It was emphasised that the strategy was not designed to centralise services, but to support the planning of healthcare at a neighbourhood level and high level expenditure at a strategic level. It was emphasised that 41 primary care networks had been successfully established and were engaging with the strategy.


·  With regard to the proposed merger of eight Clinical Commissioning Groups (CCGs) into one, members raised the issue of the practicality of addressing constituents' concerns to one single commissioning body for 1.7 million people in the ICS and asked how local accountability could be assured. It was maintained that this was already difficult with the current arrangement. Members also suggested that NHS reforms had frequently changed direction and it would be beneficial for the residents of Lancashire if decision making remained closer to home to allow for the specific priorities for individual areas to be developed.


NHS officers stated that there would be a plan to develop a case for change that was likely to recommend a single CCG, which would support work in the neighbourhoods/primary care networks to engage local people and address individual needs. This process included the submission of a formal request and a consultation to identify and address risks. The case for change had yet to be set out and local voice and representations would have to be answered at this stage. The consultation around CCGs would address at what level specific decisions would be taken and this would depend on the level of impact, i.e. if it was at local level or ICS wide.


·  In response to queries raised regarding the democratic deficiency of the NHS decision making process, it was confirmed that there were strong opportunities for councillors to work closely with the neighbourhoods. GPs were already working closely with councillors in some areas and there was an expectation that nationally appointed GPs would lead the board of local partnerships and involve councillors. This collaboration would be designed in to the model.


·  In response to comments it was clarified that the ICS was sensitive to the nuanced relationships in the partnerships with voluntary community, faith and social enterprise sector networks and was working on building these collaborations. A leadership group had been developed to include representatives from this sector in partnership meetings to ensure their involvement and so that they can contribute to decisions.


·  Members highlighted the recurring problem of a shortage of suitable staff being trained and how this would be addressed to ensure deficits in service provision were diminished, rather than relying on volunteers who provided additional support and should not be a replacement for NHS services.


·  In response to a question, Andrew Bennett stated that there were a number inaccuracies in the deputations and clarity regarding these could be provided.


·  Members commented that it was clear that the public needed better and more sustainable healthcare and acknowledged that the plans were currently at the strategic level.


It was moved by County Councillor Eddie Pope and seconded by County Councillor Alan Schofield that the published five year strategy be presented to the Health Scrutiny Committee at its next scheduled meeting on 5 November 2019.


The following amendment was proposed by County Councillor John Fillis and seconded by County Councillor David Whipp:


Due to lack of clarity regarding public accountability and the questions/concerns that have not been addressed, the committee was unable to support the five year strategy at the present time until further detail and more information was included. The committee would be prepared to consider future proposals and additions to the plans at its meeting on 5 November 2019.


On being put to the vote the amendment was LOST. Whereupon it was;

Resolved: That


The published five year strategy be presented to the Health Scrutiny Committee at its next scheduled meeting on 5 November 2019.


Report author: Gary Halsall

Date of decision: 24/09/2019

Decided at meeting: 24/09/2019 - Health Scrutiny Committee

Accompanying Documents: