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Cheshire West and Chester’s health scrutiny committee has raised concerns over plans to merge NHS CCGs in Cheshire and Merseyside.

Clinical Commissioning Groups (CCGs) are clinically-led NHS bodies responsible for the planning and commissioning of healthcare services for their local area. These groups of GP practices have a statutory responsibility for commissioning most NHS services, including urgent and emergency care, acute care, mental health services and community services.

However, NHS England has outlined that Integrated Care Systems (ICSs) would cover the whole country by 2021 and that commissioning arrangements would be streamlined to support this, with typically one CCG covering each ICS area. This announcement has accelerated the pace of proposed CCG mergers, although the COVID-19 has caused some disruption to these plans.

ICSs are a new, closer form of collaboration in which the NHS and local authorities take on greater responsibility for managing resources and performance. These systems push for more joint-up working and streamlined commissioning across health and social care, with a focus on more person-centred care.

However, Cheshire councillors have raised concerns over the merger proposal for the CCGs in Cheshire and Merseyside and has suggested the creation of separate ICS bodies to manage commissioning, while keeping current local CCG structures in place.

If the merger plan was to go ahead in Cheshire, it would mean NHS Cheshire CCG could be scrapped — despite only being created in April 2020 — to make way for a Cheshire-Merseyside ICS.

Cheshire West and Chester Officer Phil Purvis told The Chester Standard: “It is quite clear that the committee recognises that the plans do show advantages in how NHS resources can be delivered in a more stable and efficient manner. This needs to be meaningful to local people and local communities. There are several areas of clarification members have raised.

“The theme seems to be a recognition of ‘yes, this has possibilities’ but ‘it needs to be balanced against robust local systems for that accountability and influence’ on commissioning at a local level.”

Councillors felt that the borough could lose its ‘loud voice’ in the governance of the NHS locally if it were to be paired with councils in the Liverpool City Region.

The spokesperson added: “Prior to this publication, work had started across the nine CCGs in Cheshire and Merseyside looking at what would need to be done to progress any possible future merger of the CCGs.

“NHS chiefs’ preferred option would see the creation of separate ICS bodies to manage commissioning, with the alternative to keep the existing structures in place and bolt-on an ICS board ‘with an accountable officer, working to a joint committee mechanism’.”

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