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Independents' Day

GPs submit vote of 'no confidence' in CCGs

Exclusive GPs have presented NHS Stoke-on-Trent and NHS North Staffordshire CCGs with a vote of no confidence following plans to create a larger commissioning group in the area. 

An email sent to practices within North Staffordshire LMC, seen by Pulse says, the vote taken at the beginning of the month found that 23 out of 42 practices in the area don’t have confidence, after fears that commissioners plan to combine the debts of the CCGs.

Dr Harald Van der Linden, medical secretary for the LMC, said that the vote arose because GPs are concerned about a proposal that has been put forward to appoint one accountable officer for all CCGs in the Staffordshire area.

Dr Van der Linden said GPs in NHS Stoke-on-Trent and NHS North Staffordshire CCGs are against the move because 'they see themselves as a unique local health economy with its own needs and challenges and they want to address that amongst themselves and not be part of a large Staffordshire group.’

He added: ‘There’s concern that the senior accountable officer will mean that we lose some of the decision making on a local level and autonomy. 

The email added that clear financial boundaries are needed between the north and south CCGs in order to ‘deliver a patient orientated service, that supports general practice’.

Dr Paul Scott, chair of North Staffordshire LMC, said that part of the problem lies in the fact that the joint accountable officer could see NHS Stoke-on-Trent and NHS North Staffordshire CCGs, which are already merged, take on the debt of NHS East Staffordshire, NHS Stafford & Surrounds, NHS Cannock Chase and NHS South East Staffordshire and Seisdon Peninsula CCGs. 

He said the two north Staffordshire CCGs have a deficit of £10m, while the CCGs in the south have a combined deficit of £150m and combining the deficits would be ‘hugely punitive to the more deprived north’. 

Dr Van der Linden added: ‘One of the big anxieties have been is we don’t want to be part of the bigger organisation and then be asked to share the debt.

‘We have enough challenges as it is, if we have to carry their debt as well, that would make life even more complicated for us.’

Both NHS Stoke-on-Trent and NHS North Staffordshire CCGs were rated as 'requires improvement' by NHS England.

Of the other Staffordshire CCGs only NHS East Staffordshire was rated as good, with the rest requiring improvement.

Dr Scott said that LMC leaders fed back the results of the vote to the joint CCGs board, which has triggered another CCG ballot on Tuesday with caveats that the LMC on now supports.

A spokesperson for NHS Stoke on Trent and NHS Staffordshire CCGs said the CCGs 'are still engaging with their membership regarding a potential move to appoint one AO for all of the county’s CCGs'.

He added: 'Currently North Staffordshire and Stoke-on-Trent have a joint AO who is substantive with North Staffordshire and interim with Stoke-on-Trent, while Staffords & Surrounds, Cannock Chase, and South East Staffordshire & Seisdon Peninsula have a single interim AO.'

Readers' comments (9)

  • Well done and a lesson to learn for everyone.

    CCGs are membership organisations and we should not forget that. If the membership does not like the decisions being made, they should take appropriate action, like this.

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  • I do not understand why this is not happening everywhere. I can only suppose that GPs have forgotten that CCGs are membership organisations, or that they have become apathetic. Talk to each other in CCGs and exercise the power you have before it is too late

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  • Vinci Ho

    Yes, vote of no confidence is a good 'nuclear' weapon but it must be 'meaningful' depending on the circumstances.

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  • I think the take home message is
    1 - be willing to pull the trigger on the nuclear option
    2 - be willing to follow through by challenging the incumbents at re-election to change things.

    1 is perhaps a lot easier than 2 - but there is a mechanism to change as long as you are willing to step up to the plate.

    P.s. not all CCGs are struggling - I think ours do an amazing job (i am not on it).

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  • North Staffs CCGs seem to forget that Stoke hospital has a 100million pound debt and is in special measures

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  • CCG ...awful idea ..breeding ground for fat cats and favours to friends in their previous practices and closing smaller practices.
    These guys are driving blindfold with learner drivers from the old pct.
    They were designed by Andrew Lansley to bring care into the community . He went on about ..nothing without my voice ...ran by doctors who know their patients best. Just my views on the mess.

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  • Plus DrDr's 100k makes a total DEFICIT of £260,000.
    How, When and Who is going to clear it?
    The current Governing Bodies and Trust managers who created this phenomenal deficit in the first place?
    Interesting to know the management budgets of these organisations I did try to look them up, but failed. Perhaps Carolyn could investigate and tell us what the annual salaries of those managers and GPs are.

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  • Votes like this often achieve relatively little. If the CCG officers concerned do fall on their swords (and there is no guarantee that they will) then either there needs to be a group of GPs in the area prepared to take on the poisoned chalices concerned (and agree to behave in a "corporate way" as employees of NHS England) or NHS England imposes external management on the organisation. Either way, local GPs remain in dager of being ridden roughshod over. The whole CCG experiment has been a piece of nonsense from the outset I'm afraid.

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  • sceptic | GP Partner/Principal15 Aug 2017 11:49am

    I'm not connected with Stoke on Trent or Staffordshire CCG in anyway but I must say your comment shows worrying lack of understanding.

    NHS runs on rules set by DoH. Budget book has to be submitted before start of he year (try making spending plans of 300mil to balance in 12 months). This is constrained by naionally set tarrif on hospital activities (unless block contract), need for 1% reserve + 1% headroom, certain funding attached with specific requirements (e.g. must be spent in out of hours access), required shared resource with LA (Better Care Fund), statutory requirements to be full filled as well as in year changes forced by DoH.

    Granted some areas such as Manchester has had extra extra extra funding (I wonder how much more money per capita they've had in the last 7 years) but most CCG's budget are less then what is required to balance the book. CCGs try to address the funding shortage by making "innovations" - obviously this cannot succeed every year. If CCG execs can suddenly save 3% budget (circa 5-10mil) year on year, they should be managing bigger companies with much better pay then 170k (about average take home for Accountable Officer).

    So the reality is, DoH is setting CCGs to fail. It's with regret I'm seeing colleagues like you dancing to their tune.

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