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NHS England finds Wirral CCG structure ‘not fit for purpose’

An NHS England review has found that Wirral CCG has structures “not fit for purpose” and a dysfunctional relationship between two of its chief officers.

Serious concerns were raised about the CCG, which serves a population of about 330,000, in May. The governing body of the CCG requested support from NHS England and the national organisation began an investigation – the first time it has taken such action in relation to a CCG.

The CCG’s chair, Phil Jennings, and its chief clinical officer, Abhi Mantgani “stepped away” from their duties to make way for the review.

The findings of the ‘capability and governance review’ found that the “ongoing relationship between the Chair and the CCO has impacted the ability of the organisation to make progress.”

Other problems in the group were found to stem from an unusual governance structure. The CCG is made up of three consortia, which are themselves made up of “mosaics of like-minded practices rather than discrete population-based commissioning areas”, the review says.

The three groups had previously, during 2011 and 2012, proposed to form separate CCGs but merged when they were told they would not be authorised.

The governing body is made up of proportional representation from the consortia with no substantive membership forum across the whole CCG.

A briefing on the review findings said: “The increasingly challenging financial environment has exposed these characteristics as being problematic for the CCG in discharging its functions.”

NHS England also found evidence of a poor relationship between the CCG and Wirral University Teaching Hospital Foundation Trust. In particular, there was found to be a “challenging personal relationship between the trust’s chief executive and the CCG chief clinical officer”.

The review recommends reviewing the consortia structure, revising governance arrangements and developing governing body capability.

Wirral CCG said that it welcome the report and accepted all of its recommendations. It will develop a more detailed action plan to implement them.

NHS England’s regional director of operations and delivery in the north, Jon Develing, will continue to work as the CCG’s interim accountable officer, and NHS England will continue to provide it with support.

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