Wednesday 24 April 2019

Big changes ahead for cash-strapped Brent Clinical Commissioning Group

Brent Clinical Commissioning Group (Brent CCG) which has an £11.2   deficit, is to move from Wembley Centre for Health and Care in Chaplin Road, Wembley to the Brent Civic Centre. In turn the social work team will be moved from the Civic Centre to the Willesden Centre for Health and Care.

Other nearby Clinical Commissioning Groups are also in deficit and so they, along with Brent will be moved into a ‘super’ CCG covering the whole of North West London to save costs.

The way each proposal interacts with the other is as yet not entirely clear. 

The Brent CCG move to the Civic Centre is premised both on saving money and improving working conditions and there is an additional justification based on the benefit  joint work with Brent council departments, although it is not clear why that does not also apply to the social work team.

One key element is the role of NHS Property Services (NHS PS). As covered previously on Wembley Matters as part of the gradual marketisation of the NHS they seek market rates for their properties and charge for ‘void’ (unused) spaces. Brent CCG will save on these charges but there is a risk that NHS PS will not accept the ‘hand back’ of the current space they occupy.

The Brent CCG is required to adopt the North West London ‘Agile Working Policy’ which doesn’t mean that they combine office work with yoga - it just means that they have no fixed personal desk and that there are more staff than there are seats available. I guess the agility comes in when they all leap over each other to try and bag a seat in the morning:

In addition to the rent  for accommodation on the 5th and 6th floor of the Civic Centre Brent CCG will have to pay Brent Council an additional, discounted, charge for use of the Boardrooms and Conference Hall. Staff will have to pay to park their cars at the Civic Centre if they wish to drive to work.

The rent paid by Brent CCG to Brent Council will be £299,000 annually, Brent Council will pay £180,000 annually for the Willesden Centre, but this will be reduced to £80,000 over the 10 year lease period because Brent will have to spend £800,000 to ‘kit out’ Willesden because at present it is a ‘shell.’

While all this is going on the move towards a single CCG to cover North West London has accelerated. This extract from yesterday’s Health and Wellbeing Board explains:

Single CCG Across North West London 

1.     The 10 Year Plan requires that there will be a shift to a CCG for every ICS area – in Brent’s case this would be a North West London CCG. This would mean a consolidation of existing CCGs, which will become leaner, more strategic organisations that support providers to partner with local government and other community organisations on population health, service redesign and long-term plan implementation. 

2.     The movement towards a single CCG may take place either via changes to the constitutions of the 8 individual CCGs in North West London or via a formal merger application to NHS England. In the latter scenario this would mean that Brent CCG would cease to exist as a legal entity and that commissioning responsibilities would be merged into a new organisation – North West London CCG. 

3.     A working group has been set up at North West London level to design the structure of the single CCG. Since North West London collaboration is currently in a significant deficit position, the movement towards a single CCG is being accelerated in order to achieve administration cost savings. Current plans are to finalise the new structure by the end of April 2019 and to approve a case for change in May 2019, with staff consultation progressing in June 2019. The plan is to have completed the move to a single CCG structure by April 2020. At the time of writing, it is anticipated that there will be a local ‘branch’ of the CCG that will be based locally within the borough. This local arm will be focused primarily upon primary and community care, and the development of the local ICP.

Will this mean that the super CCG will take up the accommodation at the Civic Centre or will it be allocated to a 'local branch'? 

What will be the extent of redundancies across the eight CCGs and how will those in the 'top jobs' be affected? 

What independent powers will a 'local branch' have?

How will both the 'super CCG' and the 'local branch; be democratically accountable to local residents?

Meanwhile a small but vital organisation, Brent Advocacy Concern, that has served disabled Brent residents for 30 years, have been caught up  in the new market rents policy and will have to find £16,000 in December for the annual payment for their space in the  Willesden Centre. A sum that they cannot afford and so they are faced with finding a cheaper alternative or closing down...

1 comment:

Philip Grant said...

CCG's were an invention of the Conservative-led government, not included in their 2010 manifesto, but brought by as a pet scheme of the then Health Minister under the Health and Social Care Act 2012.

One of the main purposes of CCG's was to work closely together with the local authority they shared their boundaries with (so Brent CCG and Brent Council), after responsibility for a number of health and well-being services were transferred from the NHS to local councils.

Now the local accountability which was supposed to underpin these changes is being sacrificed for more "cost efficiency" (i.e. cuts to public spending).

Once again, the NHS is being messed-about with for political reasons, causing more disruption, job losses and probably a poorer service. In time, perhaps the letters CCG will be remembered as Cock-up by Conservative Government.