This QPARA Action Group monitors local health issues.
Clinical Commissioning two years on
It is now two years since the NHS Brent Clinical Commissioning Group (CCG) came into being. The CCG allocates about two-thirds of the NHS budget in Brent for routine hospital treatment and community healthcare provision. The rest comes from NHS England who commission GPs and hospital specialist services such as cancer care.
The CCG is comprised of the 67 GP Practices in Brent and is chaired by Dr Ethie Kong, a Harlesden GP, with Sarah Mansuralli as the Acting Chief Operating Officer. A Governing Body which meets mostly in public and has a majority of GPs on it directs the affairs of the CCG.
Two notable features of the new CCG were to have doctors in charge and to involve patients much more closely in governance through an Equality, Diversity and Engagement (EDEN) Committee. The EDEN Committee included 8 community representatives and 5 elected chairs of Locality Patient Participation Groups (PPGs). For governance purposes Brent CCG has been divided into 5 Localities, which are meant to include the GP practices within a recognised geographical area, though this concept has already been significantly eroded.
In Queen’s Park we are in the Kilburn Locality. The Kilburn PPG, chaired by Robin Sharp and with technical support from the CCG, has met bi-monthly with an attendance averaging around 20 people. There have been informative presentations both from CCG and Hospital Trust clinicians and administrators on unfolding plans. These have been met with probing and reasoned challenges from members. Several QPARA members take part. QPARA people have also been active in helping to revive the Practice PPG at Lonsdale Medical Centre.
How far have the new structures worked? As far as having GPs in charge is concerned the jury is still out. A major problem is that pressures on GPs are huge, so even where they have allocated time for CCG governance they are finding it hard to master the committee work and associated papers.
Sadly the initial enthusiasm of the CCG for involving patients has seemingly disappeared. The EDEN Committee has been abolished and there is now no commitment in the revised constitution to supporting the Locality PPGs, though in practice some help may still be extended.
In response to these moves leaders of the Locality PPGs and others have formed a new independent body to bring together the separate Locality and Practice PPGs and other patient groups and individuals to speak to the CCG, the hospitals, Brent and the GPs on behalf of patients. We are called Brent Patient Voice (BPV). For news and information about what we are up to please go to www.bpv.org.uk .
BPV members have played an active role in giving evidence to the Mansfield Commission set up by four local authorities including Brent to scrutinise the implementation of Shaping a Healthier Future, the NHS plan for re-organising hospital provision and community services in NW London. This has included the controversial closure of the A&E Departments at Central Middlesex and Hammersmith Hospitals, which was followed by poor performance against waiting time targets by Northwick Park Hospital in particular.
For most of us healthcare means treatment by GPs and hospitals.
However, for the last twenty years, decisions on how to allocate
NHS funds have been taken by
Primary Care Trusts (PCTs) under a process known as commissioning. From 1st April, PCTs are out and GP-led area-based Clinical Commissioning Groups (CCGs) take over
In Brent the CCG is made up of the 67 GP practices in the borough. It is chaired by Dr Ethie Kong, a Harlesden GP, and has as full-time
Chief Operating Officer Jo Ohlson, an NHS administrator. Key decisions are delegated to a Governing Body, most of whose members are local doctors elected by their peers. The CCG is required to
consult and involve patients in planning services which it will do through Patient Participation Groups (PPGs), one for each of the five Brent localities.
In Queen’s Park we are in the Kilburn Locality. The PPG, of which I am currently chair, is open to any patient registered with a practice in Kilburn. We meet every two months, with some twenty people attending our March meeting. We are consulted on health priorities and implementation plans by the CCG.
Brent Council is also now responsible for public health. They partner the CCG in supporting a Health and Wellbeing Board.
The Council is also charged with setting up an independent watchdog known as Healthwatch.
Will we notice any difference? We should see a trend towards more services located in the Community rather than in major hospitals and there should be better communication and consultation. Look out
for the new HUB scheme under which extra appointments and doctor capacity will be located at a selected practice in the Kilburn area.
In a few years’ time we may begin to know if the new doctor-led and patient-involving NHS can deliver better care and better
health than its predecessors. I believe that it is possible if it can be much more open about success and failure.
This article by Robin appeared in the May 2013 QPARA newsletter.