Cornwall Council to launch shadow Accountable Care System on 1st April

Cornwall Council to launch shadow Accountable Care System on 1st April

5th February 2018

By Graham Smith

Cornwall councillors today (Monday) cleared the way for Kennally Care to launch, in shadow form, on 1st April – without a business case or risk assessment.

As expected, the Conservative-Liberal Democrat dominated Health & Adult Social Care scrutiny committee endorsed the recommendation of a six-member Inquiry Panel which called for the creation of a “new vehicle” to integrate strategic commissioning of healthcare.  All six members of the panel, which included one Mebyon Kernow councillor and one Independent, supported its recommendation.

Despite continuing confusion over precisely what the proposed Accountable Care System is designed to do, or how it will be funded, the council’s cabinet can formally approve the restructure of Cornwall’s health services when it meets on 28th March.  The board of NHS Kernow meets tomorrow (Tuesday) and is expected to make a similar decision, launching the ACS on 1st April.

The ACS will stay in “shadow” form until at least September, when some constitutional changes might be necessary to alter or transfer the various statutory responsibilities which current attach to the council, NHS Kernow, the Royal Cornwall Hospital Trust and the Cornwall Partnership NHS Foundation Trust.  This will require a full council vote.

Today’s decision means the council’s chief executive, Kate Kennally, will become the “shadow” single Integrated Strategic Commissioner on 1st April and will have the various chief executives of the three NHS organisations reporting to her.  This has led to the new structure being known as Kennally Care.

She told today’s meeting that she did not expect the new organisation to become fully operational on its own statutory footing until 2020.  She said a draft business case would be brought to the cabinet meeting on 28th March and a full business case would be published in the autumn.


Some details of the draft business case are already known.  They describe a five-year place-based capitated budget for Cornwall, controlled from County Hall.  It marks a significant milestone in the 2015 Devolution Deal, transferring some government powers from Whitehall to Truro.

Councillors said there would be public consultation but the scope of that consultation exercise remains obscure.

Today’s decision also means the only realistic prospect of now slowing the creation of an ACS rests with the courts, and the growing likelihood of a legal challenge.  Campaigners have threatened to either issue an injunction against the council, or to join the council to the two existing Judicial Reviews as what looks like becoming an extremely high profile class action.

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