Proposed Merger of CCGs in County Durham and the Tees Valley Dr Neil O’Brien, Chief Clinical Officer Darlington Clinical Commissioning Group Durham Dales, Easington and Sedgefield Clinical Commissioning Group Hartlepool and Stockton-on-Tees Clinical Commissioning Group County Durham and the Tees Valley North Durham Clinical Commissioning Group Clinical Commissioning Groups South Tees Clinical Commissioning Group
About us County Durham and the Tees Valley Clinical Commissioning Groups
Case for change – maximizing our combined potential • Natural next steps to our collaboration • Supports nascent ICP and ICS • Delivery of streamlined clinical pathways and improve health outcomes • Right direction of travel (LTP) – single strategic commissioning voice • Gain further financial and administrative efficiencies • Opportunity for sharing best practice and learning – accelerate improvement • Longer term financial and workforce (clinical input) sustainability County Durham and the Tees Valley Clinical Commissioning Groups
Benefits - interdependency map Darlington Clinical Commissioning Group Durham Dales, Easington and Sedgefield Clinical Commissioning Group Hartlepool and Stockton-on-Tees Clinical Commissioning Group County Durham and the Tees Valley North Durham Clinical Commissioning Group Clinical Commissioning Groups South Tees Clinical Commissioning Group
Feedback from engagement Healthwatch engaged for independent Full feedback report to Governing Bodies to support feedback decision making Letters to partners and stakeholders FAQs to be developed for ongoing communication Presentations to HWBBs and OSC and engagement Continued and strengthened engagement, Positive from all partners, stakeholders, staff and public, recognise required providing feedback on how efficiencies used to efficiencies, want to see resource support patient care, strong benefits realisation directed towards patient care process Continued local focus critical; documentation Support 2 CCG option as balances ability developed that describes local approach; to achieve efficiencies with keeping a Constitution and make up of Governing Bodies to local focus reflect local communities Clear approach to financial delivery within Members expect opportunities for each CCG financial sustainability and security Benefits of risk share strengthened Reinforcing local working and local management Clarity on how local focus retained resource; strengthening clinical leadership through decision making process; developing local engagement approaches County Durham and the Tees Valley Clinical Commissioning Groups
Challenges and Response Continued engagement with members and partners Management and decision making will be key to ensuring this is mitigated as well as may feel more remote from the strong engagement with PCNs and LAs progressing membership and local partners integration Clinical Leadership may become Representation from the GPs serving the less aware of very local issues if populations across the whole geography will be drawn from a wider membership critical to retaining that local focus Mitigated by good engagement, equity impact Ensure needs of diverse assessment, population health management populations are addressed approaches, sound financial planning Continued engagement, limited further structure Staff uncertainty and disruption changes required Financial challenges in Tees Valley Better able to manage risks across the wider population, good engagement with ICP partners Agreed project team and plan with additional Insufficient management capacity to capacity resourced from effective RCA reductions effect the changes County Durham and the Tees Valley Clinical Commissioning Groups
Maintaining a local focus • Continued and developing integration work with local authority partners • Continued voice of members throughout our decision making processes and greater devolvement of decisions to local primary and community teams • Greater support for clinical leadership development and particularly PCNs • Local, visible and accessible team including: – Chief Officer – CFO – Locality Commissioning Development and Delivery Director (s) – Locality Commissioning Development and Delivery Director for primary care – Medical Director(s) – Director of Nursing and Quality – Additional Directors for Children and Young Peoples services and for Mental Health and Learning Disability (working at scale) County Durham and the Tees Valley Clinical Commissioning Groups
Clinical Leadership Response: Clinical leadership review findings: • Strengthened senior clinical • All GBs have significant leadership representation from • Portfolio roles rationalised, focused membership on statutory functions and priority • Mixed engagement through areas CCOM • Clear focus in quality, safety and • Difficulty recruiting clinicians to service redesign GBs or taking on leadership • Developing relationship with PCN roles impacting on governance Clinical Directors to align work and and succession planning ensure clinical input into key • Portfolio Clinicians often poorly developments and decisions supported; work not always • New constitutions to be developed focused on priorities; varying through Member engagement levels of impact despite significant resource County Durham and the Tees Valley Clinical Commissioning Groups
Progress • Significant efficiencies already achieved (£1.5m with further £0.5m expected) • Governing Body meetings ‘in common’ and joint committee for shared decisions (49+ meetings stopped) • Shared lay membership in place • Senior management team working to support both potential CCGs • Strong project team to deliver • Application documentation ready County Durham and the Tees Valley Clinical Commissioning Groups
CCG Merger Programme Governance (RACI) CCG Governing CCG Governing CCG Governing Body CCG Governing Body Body CCG Governing Body Body Joint Committee Combined Combined Management Group Working Group CCG Merger Programme Leads Meeting CCG Merger Programme Governance RACI Richard Henderson/Graeme Niven/Mark Pickering Tees Valley Commissioning Leads / Duham Commissioning Tees Valley Primary Care Lead /Durham Primary Care Lead HR & Workforce Lead / Organisational Development Lead Tees Valley Clinical Quality Lead /Durham Clinical Quality Tees Valley Project Sponsor / Durham Project Sponsor Craig Blair & Michael Houghton/Sarah Burns y Programme Manager / Governance Lead d n a y h y a Programme Sponsor / Clinical Lead C a n l y d l i e d k h n l n l p Financial Accounting / Control i a i a i PMO CCG Merger Programme F e F D Comms & Engagement Lead B Estates / Procurement Lead s t l r o e l e Benefits Realisation Lead i a J G i i r w / u l a / e s y J g M t r n e / n y S o y t i e n i l / n c k s r Digital / ICT Lead e t / e n h e w o r t e l t n r a o t r g t i y i o k e D a e o o i o r e o R c i l B e H K i r o i l s p l i l ' i m l l P B l O a l i e S E G E i m n u B W h k e e q i a n a l a k r k i c r r c i a a Lead i e i g a c a c l i Lead l i l a i u M M e u N N A o V r K J R J J J P STANDING MEMBERS STANDING MEMBERS CCG Merger Programme Items/Activities in the meeting I I R I C I I I I I I C I C Agenda setting I I C I I I I I I I I I I R Actions log: Update and manage A R R I I I I I I I I I I I Decisions/Recommendations A A R R R R R R R R R R R I Development of strategies / plans R R I I A C C C C C C C C C Programme Progress (monitoring) (monitoring) A R R C C C C C C C C C C R Programme Risk & Issue Escalations Key Operational Support Kate Sutherland - Corporate Governance Jill Mathewson - Corporate Governance Nicola Murray - IT Digital Daniel Blagdon - Comms & Engagement Marie Dalkin - PMO County Durham and the Tees Valley Clinical Commissioning Groups
CCGs Governing Body sign off NHSE Decision Merger Staff New expected Application constitution consultation Submission submitted begins to NHSE to NHSE Staff TUPE 2019 2020 Aug Sep Oct Nov Dec Jan Feb Mar Apr Today ledger process commences with link to Finance national team. Comms & Website development, social media etc engagement NHSmail migration, ODS codes etc Informatics Corporate Work with CCOMs re constitution through nov/dec. New Governance constitution agreed Jan and submitted to NHSE for approval. NHSE Processes Application feedback and merger decision. HR Staff Consultation and TUPE County Durham and the Tees Valley Clinical Commissioning Groups
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