Agenda item

Ms Caroline Morison, Managing Director of Hillingdon Clinical Commissioning Group (HCCG), noted that the report set out system wide working and some reforms in Hillingdon.  The 2019 NHS Long Term Plan had set out the future direction at three population levels:

1.    Integrated Care System (ICS) – North West London (NWL) wide;

2.    Integrated Care Partnership (ICP) – place based model, Hillingdon wide; and

3.    Neighbourhood level – six coterminous neighbourhoods/primary care networks had been identified within Hillingdon that incorporated community mental health services and links to social care.

It was anticipated that the merger of the eight NWL CCGs would bring about strategic alignment.  In the week commencing 7 September 2020, a vote had been taken across the eight practice memberships and Hillingdon and six of the other seven CCGs agreed to move to a single NWL CCG.  Hillingdon’s Governing Body would be meeting on 23 September 2020 to talk about the proposal. 

There would continue to be a Borough team and a Borough Committee was being set up at commissioning level to include GPs and the Director of Public Health.  It would effectively be a formal sub committee of the NWL CCG and would retain a level of local accountability. 

Hillingdon’s ICP had already made specific agreements with regard to functional delivery and emergency care fed into this.  The governance of the Hillingdon Health and Care Partnership (HHCP), the Borough-based partnership for Hillingdon, had been formalised to take joint working to the next level.  The Board was advised that Central and North West London NHS Foundation Trust (CNWL) would be the lead organisation on the HHCP Health and Care Delivery Board.  Going forward, the winter would bring additional pressures that would need to be addressed alongside the impact of a second wave of COVID-19. 

The development of a new local integrated system was working well and progress had included local authority services to ensure that residents received the full benefit.  It was suggested that the merger of the NWL CCGs was often nudged into the ICS conversation but this was thought to be a separate and different matter.  Across NWL, the health sector was facing a financial deficit of more than £200m.  Until evidence had been provided of how this deficit would be addressed, the Council was not looking to become a formal partner of the ICS.

Although the London Borough of Hillingdon was not a member of the NWL ICS, the Council was still involved, officers worked closely with those partners on the ICS to ensure that services were aligned and the Chairman of the Hillingdon Health and Wellbeing Board now attended NWL ICS meetings.  Mr Graeme Caul, CNWL Managing Director, recognised Hillingdon’s concerns and advised that consideration was being given to the creation of an associate member status so that there was no risk for the Council but so that the local authority still had a seat at the table.  

Mr Tony Zaman, the Council’s Director of Social Care, commended Ms Morison on her performance as Managing Director at Hillingdon CCG.  Concern was expressed that the current congruence experienced in Hillingdon would be lost with the merger of the eight NWL CCGs.  This harmony had been partly facilitated as a result of more than 80% of hospital patients being local residents, and the coterminosity of the local authority and CCG.  As such, the Council’s view was that it made sense to leave Hillingdon as more of a standalone entity. 

RESOLVED: That the governance structure set out with the HHCP Health and Care Delivery Board working to ensure that care is integrated at an operational level across the Borough, reporting to the Health and Wellbeing Board (and to sovereign governing bodies) be supported.