The organisation that plans and funds NHS services in Reading, Wokingham and West Berkshire, has voted in favour of plans that will see it sharing senior leadership functions with Oxfordshire and Buckinghamshire.
The decision was taken by Berkshire West Clinical Commissioning Group’s governing body at a meeting in public on 14 January 2020, despite an engagement exercise that showed most respondents, including Healthwatch Reading, opposed or had concerns about the plans.
The vote explained
What was the vote about? To create a ‘single accountable officer’ for Berkshire West Clinical Commissioning Group (CCG), Oxfordshire CCG and Buckinghamshire CCG and to move towards a merged management team.
What do CCGs do? They plan and fund NHS services for local people.
Why was this proposed? NHS England wants CCGs to save 20% on running costs. Our area's plan to combine management, could pave the way for a CCG merger in 2021.
How many managers do our CCGs have? Berkshire West CCG has a chief officer, Cathy Winfield, and Oxfordshire and Buckinghamshire CCGs share a chief executive, Lou Patten. There are also around 15 chief officers or directors across the three CCGs, plus three/four ‘lay members’ and four/six local GPs per CCG.
Who is voting on the decision? Berkshire West CCG’s governing body voted on 14 January in favour. Buckinghamshire CCG has also voted in favour, and Oxfordshire CCG meets soon to decide.
Did they ask the public for views? Yes, engagement took place 10 Oct-1 Dec 2019.
What did respondents say? Out of 209 responses (from people or organisations including local Healthwatch), 51% indicated they had concerns, 31% opposed the plans and 10% expressed support.
What happens next? The CCGs will start to recruit a single joint accountable officer and to discuss shared management structures. Local Healthwatch will meet senior leaders next month to discuss how local voices will be heard in changed structures.
The CCGs' public engagement exercise did not ask outright whether people supported or opposed the plan to create a ‘single accountable officer’ across Berkshire West CCG, Oxfordshire CCG and Buckinghamshire CCG. But a paper submitted for consideration before the vote, included an analysis of the 209 responses, from people or local organisations, showing that 51% indicated they had concerns, 31% opposed the plans and 10% expressed support for the proposal.
Despite these figures, the paper, drawn up by Buckinghamshire, Oxfordshire and Berkshire West Integrated Care System (BOB ICS) concludes: ‘In summary, the quantitate analysis shows neither strong support nor outright rejection of the proposal.’
Local Healthwatch representatives challenged this statement at the governing body meeting where the vote took place and raised concerns about the message this sent to people who gave feedback. Local Healthwatch across Berkshire West also submitted a formal response ahead of the vote (available in full on our website) which raises concerns about loss of local voice if the CCGs formally merge in the future and how a larger structure or combined management team could fully take into account the different health needs of people across Berkshire, Oxfordshire and Buckinghamshire.
Fiona Wise, executive lead for BOB ICS, responded formally to the Healthwatch submission, stating: ‘You make some very important points in your response about addressing local needs and differences, the involvement of patients and the public, and the value of the local co-design of services….We do need to consider how best to involve patients and the public in work that spans the ICS and I look forward to continuing our discussions when we meet in early February.’