Baroness Brinton: ...and prison services access to a patient’s confidential medical data as part of their role to reduce and prevent serious violence. As originally drafted, that Bill would have required GPs, CCGs and their staff to hand over that data. This was not just about those under suspicion; it could have been anybody involved in serious violence. I had extreme concerns about this, and I tabled an...
Lord Kamall: ...is updated to reflect the new ICB structure. As my noble friend Lord Howe mentioned to me, we had a massive debate about this 10 years ago, but the provision seems to have worked effectively in the CCGs, and we wish to continue that with the ICBs. Amendments 143 and 144, in the name of the noble Baroness, Lady Finlay, are about NHS England directing ICBs. I understand the interest in...
Karin Smyth: ...years might not have experienced much difference in services, the world has changed quite considerably in those 20 years. A decade ago, I was a commissioner for a primary care trust—now they are CCGs—of a teledermatology service, encouraging GPs to use that service as a way of supporting them, providing better link-in to secondary specialist care, and ultimately providing a better,...
Gillian Keegan: ...Hospital who had developed a special interest in Tourette’s, I understand that the current level of support available in the area is different—we heard how that impacted on Emma’s son. Local CCGs have acknowledged the impact on families and are considering options to address the matter. We understand that Alder Hey Children’s Hospital has developed a proposal for a local tertiary...
Lord Kamall: ...primarily facilitate and enable research. But where it is appropriate for an ICB itself to play a more direct role in research, it will have the power to commission and conduct research, just as CCGs do currently. A requirement for ICBs to “co-produce with place-based partnerships research aims to meet the needs of their local communities and ensure diversity of participation”, risks...
Edward Argar: ...boards from 106 clinical commissioning group (CCG) boards to 42 ICBs. Although no formal assessment has been made, we do not expect additional long term management costs as a result of this change. CCGs have been merged in recent years and many already operate at a system level through joint appointments. Focus is already on systems by default and putting these policies onto a statutory...
Lord Kamall: ...for Care is due to make a visit to one of the schemes. I now turn to the amendments on primary care providers. I understand noble Lords’ interest and that it has been widely acknowledged that CCGs, for example, are dominated by trusts, particularly for acute care. I take the gentle encouragement of the noble Lord, Lord Scriven, to understand that more, and particularly to make sure that...
Lord Hunt of Kings Heath: ...right about how this system is meant to work, but there are far too many examples of clinicians seeking to prescribe medicines that have gone through the technology appraisal and then finding that CCGs have set up the various devices that the noble Baroness, Lady Brinton, mentioned to delay or stop it. Does he recognise that CCGs are engaged in a process of seeking to delay implementation...
Lord Kamall: ...resources as we try to get this Bill through and ensure that it is workable and leads to the integration that we all want to see. I will also add that NHS England intends to assess ICBs, as I does CCGs. This may not be reassuring, given some of the strength of feeling about NHS England’s drive behind the Bill. The CQC will also make assessments of ICSs and systems, and part of that will...
Lord Kamall: ...the hospice movement, as we need the right balance. As the Government see it, the integrated care boards should take on, and are taking on, the commissioning of palliative care once they replace CCGs. That is because palliative care is already part of the comprehensive health service under new Section 3 of the NHS Act 2006, which lists the services that ICBs will be required to commission....
Earl Howe: ...already comprehensive, and the amendment could unintentionally limit ICBs’ ability to form relationships with Healthwatch and other organisations appropriate for their area. As was the case for CCGs, ICBs will be required to make arrangements to involve patients in the planning of commissioning arrangements in areas that may impact the manner in which services are delivered, or the range...
Earl Howe: ...level, an ICB will cover a geographic area. We would expect ICBs to be closely linked to their places via bodies such as health and well-being boards, where they will sit as the successor bodies to CCGs, and local authorities. ICBs will sit on the integrated care partnership as well as the health and well-being boards. Both bodies are vital in bringing together health, social care, public...
Earl Howe: ...to create a more joined-up approach across the NHS. Further, it would also move us away from well-established approaches that, by and large, work well for other NHS bodies. For example, with CCGs, NHS England appoints the accountable officer and the members of the governing body are appointed by the CCG. We are proposing a similar approach for ICBs, through which NHS England appoints the...
Lord Hunt of Kings Heath: ...integrated care boards. As he said: “Organisations that provide the bulk of NHS services” are therefore brought into the work of commissioning. The current system is one where commissioners—CCGs—hold providers to account “objectively determining whether they are best placed to provide a service and assessing their performance” and, as he said, the question then arises as to how...
Lord Kamall: ...the feeling of the House in my conversations with the Secretary of State, and his subsequent conversations with NHS England. I will take that back and look at the consultation process and the CCGs consulting all the relevant local authorities. I understand the point made strongly by the noble Lord, Lord Scriven, that we have to be careful about prescribing in a top-down way how to work...
Baroness Wheeler: ...Bill’s implementation. It also emphasises the need for an annual report and debate in Parliament on the impact of changes, scrutinising, in the first year in particular, how the changeover from CCGs to ICBs is working in practice. Following last week’s debate on the appalling backlog of waiting lists and the NHS’s duties under the mandate and constitution, I remind the Committee that...
Maggie Throup: All existing child safeguarding responsibilities on clinical commissioning groups (CCGs) will transfer to the respective integrated care board, which must continue to have regard to the duties on safeguarding partners set out in the statutory guidance ‘Working together to safeguard children’. NHS England has a responsibility to safeguard all users of its services, including children. It...
Maggie Throup: Many local child safeguarding partnerships already work across the different geographical footprints of local authorities, clinical commissioning groups (CCGs) and police forces. ‘Working together to safeguard children’ sets out the expectations for how partnerships should work across geographical boundaries, including on appropriate delegation where a senior leader is responsible for...
Maggie Throup: The statutory guidance ‘Working together to safeguard children’ designates accountable officers or chief nurses of clinical commissioning groups (CCGs) and their counterparts in local authorities and police forces as representatives of the three safeguarding partners in an area. This provides an equal and joint responsibility for local child safeguarding arrangements. All existing child...
Baroness Bakewell: .... It is now the biggest single provider of GP surgeries in this country. It has further designs on the existing fabric of the NHS, seeking to have its representatives sitting on the boards of CCGs, making decisions about the deployment of NHS funding. This is a direction of travel that needs to be monitored and checked. Safeguards must be written into the Bill against this takeover. Why...
