A note of caution from the Clinical Commissioning Group, with final decision postponed
By Graham Smith
The prospect of Kennally Care taking over Cornwall’s National Health Service on 1st April has suffered a setback after the Clinical Commissioning Group, one of the key “partners,” pulled back from endorsing the idea immediately.
The board of NHS Kernow had been expected to follow the example of Cornwall Council’s Health & Adult Social Care scrutiny committee, which had earlier voted unanimously in favour of creating a “new vehicle” to administer a single, place-based budget for all aspects of healthcare.
The “Integrated Strategic Commissioner” who would be in overall charge would be the council’s chief executive, Kate Kennally – leading to the tag “Kennally Care.” The council scrutiny committee recommended proceeding in line with the original timetable which will see the new structure effective from 1st April, subject to a cabinet meeting on 28th March.
But instead of following County Hall, NHS Kernow bosses decided they needed more time – with some voices raised in support of an alternative approach to improved integration. Concerns were expressed in language such as the need for “maturity” and “greater trust.” A growing number of Cornwall’s doctors are known to have doubts about the new structure.
The NHS Kernow board is torn between the Kennally Care option (known as Option 6) and a greater use of pooled budgets under existing co-operating arrangements (known as Option 2.)
Option 6 remains an “ambition” but the decision to take what some fear will be an irreversible step has now been postponed until March. Option 2 is seen as less risky because it keeps the NHS in overall charge of general health commissioning, while still encouraging more integration where sensible.
In a statement, NHS Kernow said: “Our governing body met to consider the options around integrated strategic commissioning. There was a good debate and we are clear that no final or formal decision has been taken; rather an ambition identified in terms of moving forwards. The governing body was keen to set an ambition to reach Option 6.
Many of Cornwall’s doctors remain to be convinced about proposals which would end the 70-year-old NHS of Nye Bevan and create a new, untested model of healthcare led by council boss Kate Kennally
“Option 6 sets out working with our three other commissioning partners (Council of the Isles of Scilly, Cornwall Council and NHS England) in a truly joint way. This is likely to involve the setting up of a joint committee to oversee the commissioning functions, with the potential in time to have delegated authorities from the four commissioning organisations.
“It was felt that we would need to demonstrate maturity as we progress this with greater trust between partners, with the greater use of section 75 pooled budget arrangements, which is described in Option 2.
“The governing board supported that there should be a series of gateways, covering governance, finance and leadership including culture. This will provide a means of testing our progress along a journey to Option 6, ensuring we are ready and that it is safe to move forward towards integrating commissioning.
“This recommended ambition will now be discussed and tested with our membership practices as well as our continuing conversations with colleagues within the CCG.”