CCGs in Mid & South Essex Under Threat

On Friday I attended the Mid & South Essex CCGs STP Joint Committee meeting that had been hastily moved, at short notice, from Rayleigh to Purfleet. I have serious concerns about the plans to combine the decision making powers of the five Clinical Commissioning Groups (CCGs) in Mid & South Essex, forcing each CCG to abide by a majority decision, even if it is not in the best interests of the people it represents.

This is a purely financially driven move, instigated by the publicly unaccountable Essex Success Regime, to make over £400 million of government cuts to the NHS in our area of Essex in the next few years. Despite the ‘spin’ that health authorities put on this, it is not driven by a desire to see patient care improved.
The five CCGs of Basildon & Brentwood, Castle Point & Rochford, Mid Essex (Maldon, Braintree & Chelmsford), Southend and Thurrock will meet again this coming Friday, 15th September, to sign up to an agreement where they will combine to commission clinical services as one. It is highly questionable whether they are even legally entitled to enter such a binding agreement under the Health and Social Care Act 2012 which created CCGs, by which they are duty bound to act in the best interests of the populations that they represent. By signing up to the Terms of Reference (link below) of this constitution they are obviously putting themselves at odds with this duty.
When I questioned the committee about this move, I was told that “a lot of soul-searching” had been done before coming to a decision. Personally, I think legal advice would have been more appropriate – that’s what City & Hackney CCG did recently when confronted by a similar proposal. I have contacted City & Hackney CCG and am told the concerns were over their statutory responsibilities. Following that legal advice, last week the Inner North East London Joint Health Overview & Scrutiny Commission (INEL JHOSC) voted by 6 to 1 to reject proposals to appoint a Single Accountable Officer across East London Health & Care Partnership (ELHCP).

The autonomy of each CCG is under threat from this agreement.

Here is the text of the full question that I submitted to the committee:

“From the NHS commissioning fact sheet of July 2012, it states of CCGs :
Your commissioning responsibilities will include: planning services, based on assessing the needs of your local population; securing services that meet those needs; and monitoring the quality of care provided.

Whereas Mid & South Essex STP Joint Committee Terms of Reference from July 2017 requires that CCGs:
4 – Principles
In performing their respective obligations under this Agreement and the Commissioning Contracts, the CCGs must:
4.1.6 Make decisions on behalf of the 1.2 million STP population, not upon CCG populations.

Are not CCGs, by agreeing to this term, acting against their duties as laid down in the Health & Social Care Act 2012 to base their decisions on the best interests of the populations that they specifically represent?

In order for any CCG to agree to this condition would it not be necessary for further primary legislation to be passed in the UK Parliament?”

The full Terms of Reference that all five CCGs plan to sign up to this coming Friday, 15th September, can be found here.

Much discussion ensued about financial savings, but nothing to convince me that the CCGs would not find themselves acting in opposition to their duties as set out under the Health & Social Care Act 2012, and therefore illegally. I am awaiting a full written response from the committee Chair to these questions.

Like the attempts to downgrade Southend & Chelmsford A&E departments, it would appear that this is yet another huge change to the way our local health care is managed and delivered, being surreptitiously brought in by Essex Success Regime to cut costs and endanger patient care.

We have very little time to act in order to put a halt to this move. With such huge, detrimental ramifications, potentially affecting up to 1.2 million residents of Essex, it would seem prudent to at least clarify the legality of this move before then consulting properly with people of Mid & South Essex about giving away their rights.

If you are concerned about this plan to join up all five CCGs then I would urge you to write to the Chair and the Accountable Officer of your own CCG, before Friday 15th September, and let them know of your objections.

For your convenience, the contact details are as follows:

Chair: Dr José Garcia Lobera
Interim Accountable Officer: Ian Stidston –

Chair: Dr Arv Guniyangodage –
Accountable Officer: John Leslie –

MID ESSEX (Maldon, Braintree & Chelmsford) CCG
Chair: Dr Caroline Dollery –
Accountable Officer: Caroline Rassell –

Chair: Dr Anand Deshpande – 
Accountable Officer: Mandy Ansell –

Chair: Dr Kashif Siddiqui –
Accountable Officer: Ian Stidston –

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