Councillors, NHS leaders and Healthwatch Reading have debated a management change that affects how spending decisions are made about the NHS in our area.
At a meeting held in public on 17 January 2020, members of the Reading Health and Wellbeing Board considered a decision taken on 14 January 2020 by the governing body of the Berkshire West Clinical Commissioning Group (CCG). The CCG is the statutory NHS budget holder for our area and had agreed to appoint a single accountable officer to also oversee the CCGs in Oxfordshire and Buckinghamshire, and to create a shared management team.
Council leader Jason Brock, a Southcote councillor, said: “As leader of the council representing residents, I find the tendency to greater centralisation and removal from local areas of decision-making to be highly concerning.” He also thought it was conceptually flawed, as councils had been required by government to make greater efficiencies via joint working with other councils, “but at the end of the day local accountability has remained”.
Councillor Graham Hoskin, chair of the Health and Wellbeing Board and councillor for Norcot ward, said: “In all my experience, the person who holds the purse strings, holds the power.” He called for transparency about the NHS funding coming to Reading, not to get lost under new structures.
Mandeep Kaur Bains, chief executive of Healthwatch Reading, said: “It came across strongly in the feedback [to a public engagement exercise on the plans] that there was quite a lot of negative feeling towards this sort of structure….Is there anything further you can say to reassure local people that their voices won’t get lost?”
Cathy Winfield, chief officer of Berkshire West CCG, responded that she expected there to be an 80/20 split in NHS decision-making, with the majority being done at the Berkshire West level for Reading, Wokingham and West Berkshire, and the remainder being strategic decisions made at the Buckinghamshire, Oxfordshire and Berkshire West (BOB) level. This meant that engagement with local Healthwatch, patient participation groups and the public would “carry on in the same as we do now, if anything, improving”.
Ms Winfield added that she felt the advent of primary care networks (groups of GPs getting new government funding to spend on new roles like social prescribers to support their neighbourhoods) were “game changers” and one way of mitigating the risk of centralisation.
Francis Brown, a member of the public (and a board member of Healthwatch Reading) submitted a question to the board, asking if the council was satisfied that a proposed merger of the three CCGs (which will be decided upon at a later date) "will really lead onto even better ways of working together [with the NHS]".
The board's chair, Councillor Hoskin, replied that the council would continue to work together with the NHS via the Berkshire West Integrated Care Partnership and through the Health and Wellbeing Board.
Emmer Green GP Dr Andy Ciecierski, a GP locality lead at the CCG and vice-chair of the Health and Wellbeing Board, said the proposal to create three new CCG managing directors, including one for Berkshire West, offered some reassurance against the concerns.
Reading Health and Wellbeing Board meetings are webcast and can be watched in full via the council website.