2nd March 2018
By Graham Smith
Cornwall Council appears to have backed down over “Kennally Care” and abandoned its plans to set up a new organisation to run the health service.
In a remarkable statement issued late yesterday (Thursday) the council said it was no longer pursuing its ambition to create an Accountable Care System.
The statement followed publication of NHS Kernow board papers, for a meeting next Tuesday, which continues to urge support for a new structure. It is not clear if the council consulted NHS Kernow before issuing its own statement. You can read those board papers here:Integrated Strategic Commissioning Function
Cornwall Reports understands that the council’s 10-member Liberal Democrat-led cabinet met, informally, on Monday to make the decision.
But because of the way the council and its NHS partners have repeatedly changed the title of their project – which started as an Accountable Care Organisation, and in its most recent manifestation was known as an Integrated Strategic Commissioning Function – Cornwall Reports is seeking clarification about precisely what the authority’s intentions are now.
The statement says the council still wants to work more closely with the NHS to integrate health and social care but gives no details of how this will be achieved, other than through the existing Health & Wellbeing Board.
It will require some imaginative stretching of normal English language to explain what appears to be a dramatic policy U-turn. As recently as January, the council and NHS Kernow prepared a brief for Exeter MP Ben Bradshaw, extolling the virtues of an Accountable Care System. Yet last night’s statement says clearly: “we don’t support the establishment of an ACS in Cornwall.”
The statement implies that the council has given up on its so-called “Option 6,” which had been recommended by its Health and Adult Social Care Scrutiny Committee, following a whistle-stop inquiry into setting up an ACS. Option 6 called for a “new governance arrangement” and this has now been ruled out.
The statement might explain why a special all-member briefing on the subject, due to have taken place on Wednesday, was cancelled at short notice, by council leader Adam Paynter, apparently without the knowledge of the council’s chief executive Kate Kennally.
The creation of an ACS would have led to Ms Kennally being in overall charge of strategic commissioning and gave rise to the tag “Kennally Care.” The all-member briefing was later rescheduled for 21st March, just seven days ahead of a cabinet meeting which had been expected to rubber-stamp the proposal.
It is not now clear if that 28th March cabinet meeting will even discuss the NHS at all. A debate over a £6 million bail-out for the Truro stadium project suddenly appears much more urgent.
Last night’s statement implies that the council’s political leadership has scored a rare, but very impressive, victory over senior officials, who had been pressing for the restructured health service to launch on 1st April.
NHS Kernow bosses, having been marched to the top of the hill, only to be marched back down again, will no longer have to persuade reluctant GPs that an ACS is a good idea.
One thing all sides agree on is that the officials had lost the battle for hearts and minds, and failed to win popular support for the idea of pooling budgets and setting up a new organisation. A series of protests outside County Hall culminated in the threat of legal action against the council. Health campaigners say they plan to remain vigilant, suspecting that the Accountable Care model might resurface in future.
Here is the council’s statement in full: “Following the recent Cornwall Council inquiry into integrated strategic commissioning and discussion by cabinet, a decision has been reached not to support an accountable care system (ACS) in Cornwall.
Cornwall Council Cabinet member for adults Rob Rotchell said: “Whilst we don’t support the establishment of an ACS in Cornwall, we do support the integration of health and care services.
“We want to develop integrated commissioning of health and care – joining up the way we work and ensuring we spend the resources of council and the NHS wisely.
“Our priority is to put residents first and organisations second, as well as bring together health and care practitioners to supply care in a person-centred way which is closer to home for our residents.
“We believe in the NHS, but this doesn’t mean we want to run the NHS services. We will jointly lobby for fair funding for Cornwall and we believe that we are stronger when we harness the clinical expertise of the NHS with local democratic leaders to improve local services.
“We don’t believe in creating a new organisation or committee for strategic commissioning, and will instead strengthen the existing Health and Wellbeing Board to become a more effective decision making body.
“We believe these arrangements will allow us to deliver better services, such as those as evidenced by the significant improvement in delayed transfer figures.”