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Plans for single AO across three CCGs in doubt due to localism fears, but full merger still possible

Plans to create a single accountable officer (AO) for three major Leicestershire CCGs have been cast into doubt, as concerns were raised about a “loss of autonomy” and lack of governance for the bodies.

East Leicestershire and Rutland (ELR), West Leicestershire, and Leicester City CCGs initially agreed on proposals to create a single AO role earlier this year. Board papers from East Leicestershire and Rutland CCG noted that since a meeting in April, NHS England has made it clear that the move to a single AO was “the direction of travel.”

The board papers from July also noted that a possible full merger of the three CCGs was also discussed, but while it was seen to have “the greatest benefit to the overall system,” the move would cause a lot of disruption. However, the papers went on to say the full merger may be considered in “the longer-term direction.”

But during a general meeting of ELR members on 7 June, issues were raised about the amount of control CCGs would have under the new AO role, particularly the loss of a locality focus and possible loss of financial control.

“Concern was raised around the loss of autonomy and the lack of governance arrangements described in terms of the process. The loss of locality focus and possible loss of financial control were also of concern to members,” board papers said.

“All members present agreed that they supported greater collaboration across the organisations as the benefits of this can be clearly articulated.”

Alan Smith, an independent lay member of the board, also outlined his unease at the proposals. He noted the lack of governance arrangements described in the report and the fear of “losing localism” as a single team across the three organisations. Smith stated that “he could not see any benefit” for patients or practices in the proposals and could only see risk, and therefore he could not support the report.

A spokesperson for East Leicestershire and Rutland CCG told NHE: “In June 2018, ELR CCG’s governing body decided not to proceed with proposals to move to a single accountable officer and management team across the three CCGs in Leicester, Leicestershire and Rutland.

“The decision was based on concerns about the ability and capacity of a single AO and management team to ensure three separate statutory organisations can continue to meet the different and complex needs of patients across Leicester, Leicestershire and Rutland.”

The spokesperson noted that they are continuing discussions to “further strengthen the collaboration” between the organisations.

 West Leicestershire CCG and Leicester City CCG have been contacted for comment.

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Image credit: ilbusca, iStock images