Agenda item

CCGs Merger Update

[To receive a verbal update from the Chief Executive Officer of Black Country and West Birmingham CCGs - Mr Paul Maubach and the Managing Director of Wolverhampton CCG - Mr Paul Tulley on the CCGs merger]. 

Minutes:

The Chief Executive Officer of the Black Country and West Birmingham CCGs gave a verbal update on the CCGs merger.  In attendance for the item there was also the Managing Director of Wolverhampton CCG.

 

He stated that the CCG was a membership organisation, which was made up of the GP practices.  In October in the previous year, GP Members across the four CCGs across the Black Country and West Birmingham had voted in support of a merger of the four CCGs.  90% of practices across the four CCGs had supported the merger, which he considered to be an outstanding endorsement for the merger to proceed.

 

He commented that they were expecting the merger to be completed by 1 April 2021.  As part of the new arrangements there would be a local Commissioning Board, which would have Paul Tulley as a member and local GPs.  In addition invitations would be extended to the Director of Public Health and the Director of Adult Services to participate as and when they saw appropriate.  The trajectory which they were on, was to as much as possible, to transfer and devolve as much work into the new Integrated Care Partnership arrangements.  These arrangements were being developed by the Royal Wolverhampton NHS Trust.  They believed that the main emphasis in terms of the way they developed service delivery across Primary, Secondary Care and Community Services in Wolverhampton would be by supporting the partnership between the Royal Wolverhampton NHS Trust, the GP Practices and the Council. 

 

The Chairman had submitted the following questions in advance of the meeting to the Chief Executive Officer of the Black Country and West Birmingham CCGs :-   

 

1.     How will the Black Country CCGs Senior Management Team ensure that Wolverhampton does not suffer financially as a consequence of the merger? Will there be ring fenced budgets for the Wolverhampton area and will there be extra investment to help improve health inequalities, which have been even more marked by Covid-19? 

 

2.      Wolverhampton CCG has returned a surplus in recent years, in contrast to some neighbouring areas; can we be assured that surplus funds in the future will be re-allocated to improve health outcomes for Wolverhampton citizens?         

 

3.     Can you demonstrate how the merger will accelerate plans to ensure an improved and consistent quality of care in Primary Care across Wolverhampton.  Have you identified within Wolverhampton the areas which you will be looking at to improve Primary Care?    

 

The Chief Executive Officer of the Black Country and West Birmingham CCGs responded that when he was first appointed at Dudley CCG, they had actually given financial support to Wolverhampton CCG in his first two years.  More recently he rectified Walsall’s CCG deficit within a year as the turnaround Chief Executive.  He added that over the CCGs history across the Black Country all four CCGs had good financial stewardship including Wolverhampton.  It was his intention to maintain good financial stewardship and also to maintain investment in each of the places.  They would approach this by increasingly supporting the development of the Integrated Care Partnership locally in Wolverhampton.  As this developed it would be the CCGs intention to allocate resources to the Partnership enabling the Partnership to manage the resources.  The issues about maintaining the finances in Wolverhampton could be managed by the Integrated Care Partnership.  His recommendation to the Scrutiny Panel was to encourage health partners to all work together with the Royal Wolverhampton NHS Trust and the GP Practices to develop the Integrated Care Partnership.  The partnership would be the main vehicle to manage the resources locally going forwards.

 

In response to the question on how he could demonstrate how the merger would accelerate plans to ensure an improved and consistent quality of care in Primary Care across Wolverhampton, he stated that one of the benefits of merging the CCGs was that it enabled him to establish a much stronger, robust and dedicated Primary Care function.  He now had a Director of Primary Care who was very experienced, and he would lead the work on how they oversaw and ensured the quality of care in Primary Care Services.  The main focus at the moment was in supporting the development of the Primary Care Networks.  He had been most impressed with the Primary Care Networks work to date on the arrangements surrounding the roll out of the Covid-19 vaccine.  The Primary Care Networks were working well together and in working with the Royal Wolverhampton NHS Trust on the development of the Integrated Care Partnership.  He added that they would always continue to monitor access as consistency of access to GP services was an issue across the country and not just in Wolverhampton. 

 

The Vice-Chair of the Panel had submitted the following advanced questions to the Chief Executive Officer of the Black Country and West Birmingham CCGs :-

 

1.     How will the Black Country CCGs Senior Management Team, help to deliver proposed local Wolverhampton plans and place agenda set by Wolverhampton health partners working together?  

 

2.     How will the Black Country CCG Senior Management Team work with local health partners to find new and innovative ways to improve the health of the people of Wolverhampton, with a particular focus on the preventative agenda?

 

3.     Will the Black Country CCGs Senior Management Team be supportive of digital innovation in the health system in Wolverhampton including attracting the collaboration of high-profile technological companies and appropriate data sharing and use?

 

The Chief Executive Officer of the Black Country and West Birmingham CCGs responded that it was important to work with local health partners in Wolverhampton.  They would continue to be a partner to the Council through all the forums and shared statutory duties.  A key vehicle to be able to support the local Wolverhampton plans and place agenda was by supporting the development of the Integrated Care Delivery model across Primary, Community and Council services.  They would be maintaining a local team within Wolverhampton.  He had also, that week, signed a lease agreement for the CCG’s headquarters to be based at the Civic Centre in Wolverhampton.  He hoped this would help cement the relationship with the CCG and the City of Wolverhampton Council as two organisations moving forwards. 

 

The Chief Executive Officer of the Black Country and West Birmingham CCGs stated that the Black Country CCGs Senior Management Team would be supportive of digital innovation in the health system in Wolverhampton. This included attracting the collaboration of high-profile technological companies and appropriate data sharing and use.  Data sharing was extremely important because, as demonstrated by Covid-19, health partners could work far better together by having open data sharing arrangements.  This was because it enabled information to get to the right people at the appropriate time.  He praised the work taking place in Wolverhampton around the development of digital technologies.  The management team were fully supportive of the work taking place locally and highlighted the work taking place at the Royal Wolverhampton NHS Trust. 

 

A Panel Member commented that she was aware of a vaccination centre opening at Telford and there was soon to be one at Dudley.  There was also the mass vaccination site at Millennium point in Birmingham, to which some Wolverhampton residents had been invited to receive their vaccination and experienced great difficulty in being able to make the journey.  She understood that there were plans to open two dedicated centres in Wolverhampton.   She asked when it was intended for these two centres to open as she was being asked by local residents when a  dedicated vaccination centre would be opening within Wolverhampton.          

 

The Chief Executive Officer of the Black Country and West Birmingham CCGs responded that there were seven vaccination centres already in Wolverhampton including the New Cross Hospital running their own as a Hospital hub.  Each of the Primary Care Networks had already opened up a centre.  One of the Wolverhampton Centres had to date delivered the most vaccine out of all the centres in the Black Country and West Birmingham CCGs area, aside from the Walsall Hospital Hub site.  The feedback they had been receiving from the general public was that they far preferred to go to their local GP centre than a mass vaccination site, such as the one in Birmingham.  Their priority at the moment was to support the over 80s in having their vaccine.  The existing centres were more than capable of providing the existing vaccines to the people of Wolverhampton.  The pace of the supply of the vaccines was the biggest issue they were facing.

 

The Panel Member responded that nationally there was a target of vaccinating all over 70s by mid-February, she asked if this would be possible in the Wolverhampton area.  The Chief Executive Officer of the Black Country and West Birmingham CCGs responded that as long as there was sufficient supply, the target would be met.  Now there were three vaccines approved, the supply would start to increase.

 

The Chief Innovation, Integration and Research Officer of the Royal Wolverhampton NHS Trust commented that the Chief Executive Officer of the Black Country and West Birmingham CCGs had been in discussions with the Trust about how new model arrangements would work in the future, which were digitally driven.  The CCG had been very helpful in the planning of this work.  He felt they had a unique valued proposition in Wolverhampton in terms of the connectiveness of the relationships and data to drive a new deal for the patients and citizens they served.  He personally thanked the Chief Executive Officer of the Black Country and West Birmingham CCGs and his team including the Managing Director of the current Wolverhampton CCG.     

 

The Chief Innovation, Integration and Research Officer of the Royal Wolverhampton NHS Trust commented on the importance of the next phase and referred to the work taking place known as “Digital Wolverhampton.”  He thought now was the time to come together as a community of providers including Social Care to make proposals happen that had often been spoken about in the past.  The “Place” was absolutely critical to which they had received nothing but support from the Chief Executive Officer of the Black Country and West Birmingham CCGs and his team, and he hoped that would continue.  He hoped they would be given the flexibility that was needed in Wolverhampton due to the very unique set of circumstances and a unique leadership.  The Chief Executive of the Royal Wolverhampton NHS Trust , over the preceding years had led the Trust and Community Services closer and closer to GPs.  It was important that the “Place” agenda retained primacy.     

 

The Chief Executive Officer of the Black Country and West Birmingham CCG spoke positively about the work outlined by the Chief Innovation, Integration and Research Officer of the Royal Wolverhampton NHS Trust.  He commented on the excellent relationships in Wolverhampton and how it was his intention to support and develop them.  

 

The Chair thanked the Chief Executive Officer of the Black Country and West Birmingham CCG and The Chief Innovation, Integration and Research Officer of the Royal Wolverhampton NHS Trust for their contribution to the item.