AN NHS merger has been described as “highly concerning” amid complaints that the changes are not properly being scrutinised.
The reorganisation will see three clinical commissioning groups (CCGs) — responsible for planning, designing and paying for NHS services in the community — merged into one.
A council leader has said it will make it harder to hold the NHS to account; councillors elsewhere have said the changes need to be looked at in more detail; and the head of a local watchdog has said the plans “aren’t logical”.
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Berkshire West CCG covers Reading, West Berkshire and Wokingham, and serves 550,000 people. The plan is to merge it with Buckinghamshire and Oxfordshire CCGs, to form one ‘super-CCG’.
The plans were described as ‘concerning’ and ‘flawed’ by the leader of Reading Borough Council, Jason Brock, at a health and wellbeing board meeting on January 17, where he commented on the potential lack of decreasing democratic accountability.
Cllr Brock said: “I find the tendency towards greater centralisation and removal from local areas of decision-making to be highly concerning. I also find it to be conceptually flawed.”
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He compared how councils recently collaborate more and share services, but “the local accountability has remained”. He said it seems the ways the NHS merger is designed to keep local accountability could be “very easily unpicked”.
He added: “I’m concerned by the implications in terms of our ability to hold the NHS to account. I think we should approach it, as a council, with a great degree of caution.”
At West Berkshire Council, Cllr Martha Vickers raised concerns about the lack of scrutiny of the merger. She told the overview and scrutiny commission, on January 14, that they should look into the changes.
But council leader Lynne Doherty (Con, Speen) told her that work was already being done by the health and wellbeing board, and does not need to be duplicated.
However, at West Berkshire’s health and wellbeing board meeting on January 30, when the merger was due to be discussed, the chairman reminded the board to be “conscious of time”.
Cllr Vickers later said she heard one member joke that there was only “two minutes to cover this matter”. She added: “I was extremely disappointed at the cursory way the health and wellbeing board addressed the matter of the reorganisation of the CCG.”
Andrew Sharp, chief executive of Healthwatch West Berkshire, said it was “really frustrating” how little time was given to discussing the merger at the health and wellbeing board.
In an interview, he said: “One of the key problems is that local authorities often feel powerless.”
Mr Sharp said NHS England should consider having two CCGs: one for Buckinghamshire and Oxfordshire, and a separate one for Berkshire West. Buckinghamshire and Oxfordshire “already work together quite a lot”, but Berkshire West is too different an area to include.
He complained about the lack of engagement and listening to the views of local people. While there was a public consultation, Mr Sharp said: “A lot of people aren’t being listened to.”
He added: “Residents, patients and doctors are saying this doesn’t make sense. [The NHS] should listen because otherwise it’s a tokenistic exercise. But there’s a possibility that common sense will come through.”
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