Bodies which plan and fund healthcare in west Berkshire, Buckinghamshire and Oxfordshire could now have just one accountable officer despite a "very low level of support" for the proposal.

Berkshire West and Buckinghamshire Clinical Commissioning Groups (CCG) have both backed the management merger which now just needs Oxfordshire CCG approval.

The Buckinghamshire, Oxfordshire and Berkshire West Integrated Care System (BOB ICS) held a public consultation from October 10 to December 1 on:

  • Proposal 1: Appointing a single accountable officer and designing a shared management team for the three CCGs
  • Proposal 2: Creating stronger Integrated Care Partnerships (ICPs) in the three areas
  • Proposal 3: Merging the three CCGs into one

Berkshire West CCG – which covers Reading, West Berkshire and Wokingham – backed the proposal at this morning’s governing body committee, subject to the shared management team designs being backed at a later date.

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Mr Burrows admitted, however : “There was a very low level of support for the proposal.”

Plans to merge the three CCGs and create stronger ICPs will be considered in the next financial year of 2020/2021, which starts in April.

What is the current situation and what happens next?

Buckinghamshire and Oxfordshire already share one accountable officer – Louise Patten – while Cathy Winfield is the chief officer at Berkshire West.

If approved by Oxfordshire, a single accountable officer will be appointed and a shared management team will be designed to oversee the three CCGs.

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Managing directors would also be appointed to each CCG and have “a very similar role” to the current chief officer role.

South Reading Patient Voice co-chair Jim Penn called for Ms Winfield to take the chief officer job at the three CCGs, praising her performance.

Too big a job?

Saby Shetcuti, a lay member on the board, raised concerns about the challenge of one person taking on the role of overseeing three CCGs.

She said: “It is a massive job. You just have to look at what our current accountable officer does. Is it feasible?”

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Sam Burrows, BOB ICS programme director, responded: “The role would be very different from the current one.

“The creation of the managing director role is crucial – they would have a very similar role to the current accountable officer.”

How people responded to the consultation

The strongest opposition to the shared accountable officer proposal was in Berkshire West, with almost 70 per cent opposing the plans.

There were 224 responses to the consultation, with 209 deemed countable and just 21 respondents backing proposal one.

The proposal to create stronger ICPs (think of them as local councils working with local NHS services to maximise their voice in the wider BOB area) received the strongest support.

“Fait accompli” and “back to front”: Other concerns raised at the meeting

GP representatives said “moving too fast will upset people” (Reading’s Andy Ciercierski) and “there is a realisation this will happen anyway” (Wokingham’s Debbie Millingan OBE).

Speaking after the meeting, South Reading Patient Voice co-chair Monica Morris agreed with Ms Milligan, calling the plans a ‘fait accompli’.

While Francis Brown, a Healthwatch Reading board member, called the decision to vote on the chief officer proposal “back to front” but received little explanation in response.