All is not well with N. Kirklees Clinical Commissioning Group Governing Body, to judge from their meeting on 1st March when there was an unprecedented breaking of ranks among the members.
Some key points.
Incredible shrinking Clinical Commissioning Groups
Dr Kelly, the N Kirklees Clinical Commissioning Group Chief Officer, said that they have already had conversations about:
- Clinical Commissioning Group ‘light’ functions (sorry, another crazy jargon word – explained right after these bullet points)
- Multispeciality Community Providers contracts and
- Accountable Care Organisations.
Clinical Commissioning Group ‘light’ functions are when the Clinical Commissioning Groups slim down and their commissioning duties are subsumed into an Accountable Care Organisation or Organisations, as these organisations have commissioning powers – as in closing the purchaser provider split.
This updates what was said at a previous N.Kirklees Clinical Commissioning Group Governing Body meeting, when mainly Dr Kelly and Deborah Turner (Head of Quality and Safety) were talking about Multispecialty Community Providers. They said the Clinical Commissioning Group had to change, slim down and lose some staff (and have reduced responsibilities).
Conflict of interest over Multispeciality Community Provider contract
David Kelly said Curo may be interested in bidding for the Multispecialty Community Provider contract.
Curo Ltd is a GP Federation. It is owned and run by the GP practices, and some GP members of North Kirklees Clinical Commissioning Group Governing Body belong to Curo GP practices.
For Curo to bid for the North Kirklees Clinical Commissioning Group’s Multispecialty Community Provider contract would seem to worsen the 2014 Conflict of interest, when N.Kirklees Clinical Commissioning Group (NKCCG) Governing Body approved Curo’s Business Cases for:
- a £514,049 12 month pilot (with scope for a 3 year roll out) to deliver the first wave of ‘Care Closer to Home’, through GP-led Care Coordination
- a Beyond Over 75 Enhanced Service, aimed at keeping over 75s out of hospital through early identification of health and social care issues
The ‘Care Closer to Home’ scheme aimed to replace acute and emergency hospital services that are being closed down at Dewsbury hospital, with health and social care services in the community, based on a private American healthcare system.
This has since morphed into a proposal for a Multispeciality Community Provider scheme.
When talking about Conflicts of Interest Policy, a Cleckheaton GP said he goes to other meetings as well as the Governing Body and there, alongside the GPs and officers, are providers round the table who obviously have pecuniary interests in what is being discussed but they never mention this at the beginning of the meeting. He challenges this regularly, most recently last week!
Later, speaking personally to our reporter, he said on a Sustainability and Transformation Plan-wide level, things are tight.
Already in London they are saying they cannot afford a big teaching hospital, so are thinking of closing it.
Fragile relationship between N. Kirklees Clinical Commissioning Group and the GP member practices
There was a great worry that there would be no GPs to fill places on the Governing Body when they fell vacant due to pressure of work and fewer GPs.
The Patient Safety Officer who also works for Calderdale and Huddersfield Foundation Trust and is advisor to the Care Quality Commission said how very fragile the relationship between N. Kirklees Clinical Commissioning Group and the GP member practices is (always robustly defended their relationship previously), because a couple of times the Clinical Commissioning Group has said something would happen, then has reneged on their promise.
(Wakefield Clinical Commissioning Group have had a public spat with their GP members, reported in the Health Service Journal.)