Decision details

Following on from the previous presentation from the ELHCP the Board received a briefing from Henry Black, Chief Finance Officer, North-East London Commissioning Alliance (NELCA) on the development of the Integrated Care System for NEL.

The plan is that by April 2021 the ICS will be supported by a single CCG, three local systems (BHR, City and Hackney and WEL) and seven place-based partnerships to maintain focus at a local level. The CFO explained that the streamlining of the CCG’s should result in a reduction in the overall management structures and costs with a target saving of 20%. Some specialist services will be devolved down to the regions (NEL).

The Board, whilst acknowledging that the government is committed to these structural changes, expressed its concerns that it will make decision making more problematic, given the difficulties of reaching consensus under the current CCG arrangements, let alone moving to a regional structure.

Dr John, Deputy Chair and in his new capacity as Chair of the ICS stated that there had been a number of positives for the Borough operating under the current arrangements, adding that whilst the ICS will hold the overall budgets they will be channelled locally and in that respect Barking and Dagenham will have a voice through representation at Board level.  He had also received assurances that under the new structural arrangements the Borough would not lose out financially and that recognising the good work already achieved through the BHRCCG, he was confident that local residents will not lose out.

The Independent Chair of the Local Safeguarding Adults Board asked that given the new body will hold all the funds allocated for adult and children safeguarding, how will they get access to monies?  The CFO understands that up to 95% of allocated monies will be devolved locally and it was his understanding that the Chair of this Board and the Council’s Chief Executive are pushing for the Borough Partnership to be made responsible. 

Finally, it appeared to the Board that the new structures would be moving away from the current commissioner/provider financial split, and how would this operate?  The CFO responded that he did not support the commissioner/provider split to deliver health and care services as in his view it did not encourage collaborative working.