GPs reject merger ‘driven by NHS England’ | HSJ Local | Health Service Journal

  • GP members have rejected proposals for six-way merger of clinical commissioning groups in Staffordshire
  • LMC had warned benefits of merger were “speculative” and claimed NHSE had driven proposals

GPs have voted against proposals to merge six clinical commissioning groups in Staffordshire, after being told the plans were “driven by NHS England”, HSJ has learned.

The CCGs’ shared management team outlined the intention to merge last year, but various concerns have been raised among the GP members.

The outcome of the vote is due to be formally announced after an extraordinary meeting this evening, but HSJ understands members in a clear majority of the CCGs have voted against the proposals.

The CCGs, which share an accountable officer and several other senior posts, declined to comment on the vote ahead of the meeting, and it is not clear whether they will now pursue the plans.

As reported in the Healthcare Leader, prior to the vote Paul Scott, chair of the North Staffordshire Local Medical Committee, advised his members to reject the merger.

He wrote in an email, seen by HSJ: “Much has been made of the potential benefits of having a single CCG in Staffordshire, yet few if any of these arguments hold true or are at best speculative.


Source: GPs reject merger ‘driven by NHS England’ | HSJ Local | Health Service Journal

Sexual health commissioning in local government

Original post from Local Government Association


These nine case studies showcase local government experience of commissioning sexual health services since taking over this responsibility in April 2013. The studies demonstrate how commissioners have grasped the opportunities of having a local government base. They outline the steps taken to collaborate not only within and between local authorities but also with NHS England and Clinical Commissioning Groups.

Supplier Details

Price For Non-Members: FREE
Price For Members: FREE
Reference Code: L15-227


– See more at:,3EGVU,JBZ5CO,C63R5,1#sthash.vuQcjfWJ.dpuf  ………’

Options for integrated commissioning: beyond Barker

Reposted from The King’s Fund


With around 400 separate local organisations each responsible for commissioning different health and social care services, the current organisational landscape is fragmented and unsustainable. Support is growing for a new settlement based on a single ring-fenced budget and a single local commissioner – as recommended by the Independent Commission on the Future of Health and Social Care in England, chaired by Kate Barker. This report explores the options for implementing that recommendation. It assesses evidence of past joint commissioning attempts, studies the current policy framework and local innovations in integrated budgets and commissioning, and considers which organisation is best place to take on the role of single local commissioner. It draws together findings from a body of work including a survey of existing joint arrangements, current evidence and examples, a seminar with pioneers of integration developments, and a national conference on integrated commissioning.



The King’s Fund publications


Council to commission out child protection in the biggest outsourcing ‘in a generation’

How a council is reacting to Government austerity cuts.

Original post from Community Care

‘Northamptonshire County Council will retain 150 of its 4,000 staff members in a £68m budget cut


Northamptonshire council open for business. Photo: John Martinez Pavliga/ flickr

Northamptonshire County Council has approved plans to outsource all services and make £68m of cuts in what it has termed “the most fundamental transformation… in a generation”.

‘Skeleton staff’

The council will be reduced to a 150-member skeleton staff. The rest of its 4,000 staff members will be moved into four bodies set up by the council.

A Northamptonshire council spokeswoman said it was not outsourcing in the literal sense, and the council would not commission out to private companies.

Instead, it planned to set up the organisations which would take on statutory responsibility for services like child protection and elder care in a system she termed “right sourcing”.

The "Next generation model". Image: Northamptonshire County Council

‘Private businesses’

However, drafts plans stated the council will “right source” through a federation of bodies which may include private businesses, out of direct council control.

These bodies, including one for child protection services, will be a mix of mutuals, social enterprises and community interest companies. They will be free to win business from other organisations.


Leader of the council Cllr Jim Harker said: “The traditional model for the council and local service delivery is unsustainable.

“The method of largely paying for local services through government grants no longer stacks up and in Northamptonshire our demand is far outstripping our income.”

Cllr Harker said: “This is all about setting these services free from direct council control. Free to find new income streams and new markets which will help not only protect these services from spending cuts but also by using this income to offset their cost to the council taxpayer.”  ‘

Why councils risk breaching the Care Act and failing people entitled to independent advocacy

View original article from Community Care



‘………..From 1 April 2015, a number of people will be entitled to the support of an independent advocate as a result of the Care Act 2014. Long fought for by disabled people’s groups, this right to support is vital, if limited in scope.

In his introduction to the Social Care Institute for Excellence’s guide to commissioning independent advocacy, its chair, Michael Bichard, states that: “Access to independent advocacy lies at the very heart of the Care Act”.  …………’

‘………….There is alsostatutory guidance on implementing the Care Act,also  published in October 2014, with one chapter on implementing the advocacy provisions. Furthermore, the impact assessment for the act, released at the same time, not only clarifies the ways in which advocacy is useful, it even includes a clear methodology for assessing likely need and costing advocacy provision for the Care Act. …………’

‘……….The role of the Care Act Advocate includes making a formal report of times when a local authority is not operating within the Care Act. Some have argued that this makes it in the best interests of local authorities to under-commission and under-refer. From a good practice point of view, this is nonsense. When even the Department of Health impact assessment praises advocacy for maintaining and supporting relationships, delivering greater control, supporting safeguarding processes and making social care spending more effective, under-provision cannot be in anyone’s interest. And from a personal level, most people I come across are definitely not against increasing people’s abilities to be heard and in control of their care and support.  …………..’

‘…………It’s important that we learn lessons from what’s happened in this commissioning round, and countless others. It’s important that a mechanism is put in place to ensure that commissioners are accountable, and that funding for statutory advocacy is demonstrably related to eligibility and need. However, most pressing of all is the need to make sure that adequately-resourced, high-quality advocacy provision is in place for those who need it to deal with assessment, care planning, review and safeguarding processes. That is their right. People with a right to advocacy should not be placed in a situation where decisions feel out of their control, confused, frightened or frustrated; seeing red, but not seeing their advocate.’