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Briefing on potential North Mersey CCG merger

09 Jan 2020

A paper setting out a case for change for a potential merger of the four North Mersey Clinical Commissioning Groups – NHS Knowsley CCG, NHS Liverpool CCG, NHS Southport and Formby CCG and NHS South Sefton CCG – will be presented to NHS Liverpool CCG’s governing body next week (14 January 2020).

The paper recommends that engagement about the potential merger now gets underway to inform a final decision in spring 2020.

The potential North Mersey CCG is a response to the NHS Long Term Plan which states that CCGs will become leaner, more strategic organisations that support providers to partner with local government and other community organisations on population health and service redesign.

The four North Mersey CCGs have a long history of collaboration, with the majority of services they commission provided by the same NHS Trusts for their combined population. The area the CCGs cover is one of the most deprived in the country, with more than 4 out of 10 residents living in the 10% most deprived neighbourhoods in England. Despite the best efforts of the health and care system, health outcomes for the North Mersey population are not improving and the inequalities gap is widening. Partners across commissioning and provision are committed to greater collaboration, including joining-up commissioning to address the huge challenges we face.

Although there are currently three senior leadership teams across the four CCGs, recent staffing challenges have led to opportunities to share skills and capacity, including a shared Chief Finance Officer and collaborative contracting arrangements between Liverpool and Knowsley CCGs, as well as a shared Lead Nurse between Liverpool and the two Sefton CCGs.

The four CCG governing bodies and GP memberships have been involved in a process to identify and appraise options for how the organisations could look in the future. This considered how best to:

  • Improve health outcomes and reflect patient flows
  • Improve quality of care and patient experience
  • Optimise our ability to engage and involve the population
  • Support health and care commissioning integration with local authorities
  • Improve operational utilisation and reduce workforce duplication
  • Improve the financial position and deliver value for money
  • Support wider system collaboration at place (local authority level), North Mersey and Cheshire and Mersey level.

A merger of the four North Mersey CCGs is considered to be the best way of meeting this criteria by reducing duplication and inconsistency in commissioning approaches and reflecting patient flows. It would create the environment for a strong strategic commissioner to drive integration and better population health. A single CCG would provide the opportunity, through the establishment of single strategic commissioning functions and a single board and membership, to meet 20% running cost reductions required of CCGs, and for this to be implemented equitably as a single employer. Governance and decision-making would be streamlined, with clinical representation from each place. A single organisation would enable joined-up engagement with and involvement from the North Mersey population, while also influencing Cheshire and Merseyside Health and Care Partnership strategy and plans.

A merger would be implemented in a way that balances the benefits of strategic commissioning across a bigger footprint, where appropriate, with more focus on joining-up commissioning with local authorities to better integrate health and care.

The engagement process will now seek wider views on this proposal from CCG staff, GP practice membership, local authorities, Healthwatch and other stakeholders in each of the four areas. This feedback will be compiled as part of a report which will be used in final decision-making about a merger.

NHS England guidance states that CCG mergers may only take effect from the beginning of a new financial year (1 April). Subject to approval, a merger application for North Mersey would be made by September 2020 for a single North Mersey CCG to be established in April 2021.

It is proposed that, subject to approval of a merger, the CCGs would put in place transitional arrangements in 2020/21 that would enable the establishment of a single Accountable Officer and senior management team in advance of the establishment of a North Mersey CCG from April 2021.

The full governing body paper is available on NHS Liverpool CCG’s website: https://www.liverpoolccg.nhs.uk/about-us/governing-body-meetings/2020/

If you have any queries about the potential merger, please get in touch with us:

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