Agenda item

12:35

An update on the development of BOB ICS / ICB.

The Committee received an update on development of the Integrated Care System and Integrated Care Board.  Catherine Mountford, Director of Governance, Oxfordshire Clinical Commissioning Group, summarised the report emphasising that many aspects were still subject to change as the legislation was still going through parliament.  The final guidance was expected early April with the system aimed to function from 1 July.

Members noted the new positions to be appointed and national reports of management consultants being engaged to work on elements of ICS’s and asked if this was introducing another layer of administration and costs.

Catherine Mountford responded that it was not expected that the running costs of the ICB (the new NHS statutory body) would be larger than the combined costs currently for the three separate organisations.  A number of the positions were required under the legislation.  Consultants were providing advice on governance which was helpful.  Any such contracts were subject to NHS approval and had to be within the budget envelope.

Dr Alan Cohen noted that there was to be engagement around local determination and asked who made the final decisions on that.  He also asked why there was no mention of scrutiny in the draft constitution.

Catherine Mountford responded that there were currently a Chief Executive designate and Chair designate who would make those decisions subject to approval by NHS England.  They would expect to have a review of Board membership within the first year.  The draft constitution used the NHSE template and there was a reference in that to compliance with local authority scrutiny arrangements but without any detail on that. 

The Chair noted that there was some anxiety around the situation where the ICB was going to be an NHS body dealing with social care.  Questions remained about how the local authorities were to be involved and how the cultural differences would be addressed.  There was also a lot of concern that many of the meetings were not to be held in public.  She asked if there was still scope to deal with these issues.

Catherine Mountford welcomed the points being raised.  She said that it was clear that care will remain managed at Place with local input.

Stephen Chandler, Chief Executive, Oxfordshire County Council, responded that he recognised and understood the concerns being expressed.  He believed that the Committee should look, not just at how the Board would work, but also how the local structures will operate.  He was aware of a recent report that was critical of the NHS culture but he had seen no evidence of it in the people he had dealt with on the ICS.

Councillor Freddie van Mierlo asked to focus on how services were going to change for the people of Oxfordshire.  He gave the example of differing policies on In Vitro Fertilization across the three counties and asked how that would be resolved.

Diane Hedges responded that work would have to be done to identify the differences in services across the region.  The priorities committee would be involved in advising on solutions.

Councillor Nick Leverton asked if this Committee was safe under the new structures.  Catherine Mountford responded that the local authorities decided on scrutiny and it was their decision to set up a HOSC at BOB level in addition to the local HOSCs.

Actions:
Members will engage with Catherine Mountford and OCC about the evolution of the ICS/ICB from a governance perspective and how/where democratic references can influence how the ICB/ICS operates in practice. 

The convergence of service offer across BOB is to be placed on the Committee’s work programme.