(Verbal update)
Minutes:
The Executive Director for Health, Wellbeing and Adults informed the Board that the consultations were a national exercise and every local authority across the country was in a different position, Croydon’s being good. He stated that the proposals in the consultation were endorsing some of the practices that Croydon already had in place for a while. He informed the Board that they wanted to respond as the One Croydon Alliance because they were in agreement that the ICS would continue to enhance the work that the council were already doing.
The Vice Chair informed the Board that the reorganisation proposed by the ICS consultation was a huge project. As a result, there had been a lot of concerns about these changes being conducted during the pandemic because many people were busy, such as clinicians. Whilst these changes had been planned for some time, there had been a lack of consideration in regards to the lessons that had been learnt during the pandemic of integrated working. The fact that it was an engagement rather than a consultation had not given the opportunity for clinicians to provide feedback because they had been preoccupied.
Concerns had been raised by clinicians, such as GP’s, of the removal of Clinical Commissioning Groups (CCG) and the resulting loss of influence and involvement of GP’s and hospital clinicians to the system. The plans discuss clinical leadership, however in practice that would be on the periphery and not centred to decision making.
The British Medical Association (BMA) and the Local Medical Committee (LMC) raised serious concerns about the future of general practice in these plans, and that Primary Care Networks (PCN) were not representative organisations or statutory bodies. This would lead to the voice of General Practice being reduced even further. While this could be mitigated in Croydon through several different means, the face of General Practice would still change and there were associated risks. Without the involvement of clinicians in the decision making process, there may be a rise in the costs of healthcare, as well as the inefficiencies and the quality of care also decreasing.
There were real concerns fed back by the LMC’s and by the BMA, however it was uncertain whether they would be taken into account due to the engagement in place of a consultation. He stated that from a Croydon perspective, they could mitigate some of the issues because integrated care already harboured strong relationships within the borough that could be built upon further.
The Chair of Croydon Health Services NHS Trust informed the Board that one of the strengths in Croydon was that clinicians have taken the lead in the planning of services and that they worked across the divide between acute physicians and those who work in primary care and general practice. He stated that despite whichever system would be implemented nationally, they would mitigate that within Croydon and provide reassurance to the public that acute physicians and those that work in primary care would continue to work together to deepen the partnership. They would continue to help develop the appropriate pathways to different services for the local population in order to improve their health and well-being in future.
The Healthwatch Croydon CEO informed the Board that they were concerned about the patient and resident voices being heard throughout the changes, as Healthwatch and the voluntary sector references were missing at sector level, and the potential to regress their involvement to that of the past.
The Croydon Voluntary Action (CVA) CEO informed the Board that while he was chairing a London wide call for the Social Prescribing Advisory Group, one of the issues that was discussed was the pressure on link workers and community builders. There had been difficulties such as referring people to activities during lockdown and also having to manage more complex cases. He believed that the Healthy Communities Together Project would enable them to support coordinated voluntary and community provision through the localities model in Croydon.