Agenda item

Report attached.

Janet Soo-Chung presented the report and explained that the Health and Social Care Act was passed on 27 March 2012.  The Key legislative changes of the act are:

• Clinically led commissioning
• Provider regulation to support innovative services
• A greater voice for patients
• A new focus for Public Health
• Greater accountability locally and nationally
• Streamlined arms-length bodies

Janet stated that there are eight CCG's that cover Lancashire, with six within the Lancashire County Council footprint.  The Act is moving through the authorisation process, there are four phases to the authorisation process, phase one is to be completed in June, with the final phase to be completed in January 2013 with the new Health and Social Care system to be in place by 1 April 2013.

The content of authorisation is built around six domains and has been developed through a wide range of stakeholder involvement including patients, carers, clinicians and partner organisations.

The six domains are:

In order to become a statutory organisation in their own right and to assume full accountability each CCG has to go through a nationally managed authorisation process between  now and March 2013. 

The NHS Commissioning Board

Janet explained that the Board will be organised into nine national Directorates, four slim sub-national regions and a national network of local offices.  This means that the local office for Lancashire will sit within the North of England region and is similar to the current configuration of the PCT Cluster (NHS Lancashire) and SHA North.  The bulk of the staff employed by the NHSCB will be based in the local office and their key functions will include oversight of the CCGs, be members of local Health and Well Being Boards and the direct commissioning of primary care services, specialised NHS services, military health services, offender health services and a range of public health services. It was noted that Richard Barker has been appointed as Regional Director for North of England.

Commissioning Support

Janet also explained that a key feature of both the eight CCGs and the NHSCB local office is that the staffing structures will be kept to a minimum and they will be expected to acquire additional services from Commissioning Support Organisations.  These CSOs whilst initially hosted by the NHSCB are expected to be outsourced by 2016.  The Lancashire and Cumbria joint venture is developing well and robustly and will offer services in areas such as contract management, service redesign, analytical support and other professional services.

The Lancashire and Cumbria unit has already successfully passed the first checkpoint and is well regarded on a national level.  It is required to go through a similar authorisation process to CCGs designed to test its marketing strategy, business plan, commercial acumen and ability to deliver high quality services locally on a sustainable basis.  The success of this operation is critical to the viability of CCGs as the CSO will provide much of the information and analysis to enable the CCGs to challenge local providers and meet their aspirations on outcomes and against national targets.

In responding to questions from fellow Board members, Janet confirmed that existing staff will transfer to the new setup, it is anticipated that that the new setup will see a 50% reduction in management costs.

Every GP practice in the country will come under a CCG National Commissioning Board and the structures are well advanced.

Board members emphasised the need to be clear about roles and responsibilities.

Resolved: The Shadow Health and Wellbeing Board noted the report and update regarding the NHS reform.