Source · Select Committees · Public Accounts Committee
Recommendation 9
9
Acknowledged
NHS England unable to clarify application of 50% headcount reduction across ICBs.
Conclusion
We asked how the 50% headcount reduction will be applied to ICBs, noting that some were already working efficiently and the importance of the place–based approach in ensuring effective working between local councils, directors of public health and local GPs. The Department expected that the changes to ICBs would not lead to more centralisation. However, NHS England was unable to clarify whether the 50% reduction in ICBs represented a 50% reduction for each ICB individually or across system as a whole. NHS England explained that the detail of the expectations on ICBs would become clear as the 10–year plan for the NHS was finalised.12
Government Response Summary
The government agrees with the observation, reiterating principles of empowering local leaders and strong partnerships. However, specific details on how the headcount reduction will apply to ICBs remain linked to the forthcoming 10 Year Health Plan and are subject to future primary legislation.
Government Response
Acknowledged
HM Government
Acknowledged
1.6 The government agrees with the Committee’s recommendation. Target implementation date: to be confirmed, subject to Primary Legislation 1.7 These reforms focus on empowering frontline staff and local leaders to drive improvements in patient care, by reducing duplication and improving services for patients through a more efficient, less bureaucratic system. 1.8 Strong partnership working at place will be an essential enabler to neighbourhood health; delivering joined up care closer to people’s home and proactively supporting people in the community to avoid deterioration of health. This is as much about integration within the NHS – between primary care, community and acute services – as it is about integration between the NHS and wider public sector partners. 1.9 NHS England has already clarified through the model Integrated Care Board blueprint that Integrated Care Boards should continue to foster strong relationships with local government in their places, so that they build a shared understanding of their populations and work together to commission neighbourhood services to improve outcomes and tackle inequalities. NHS England and the department will work closely with the Local Government Association to take this forward throughout the organisational change programme. 1.10 The 10 Year Health Plan will set out an agenda to deliver on the three big shifts needed to move healthcare from hospital to the community, analogue to digital, sickness to prevention. In line with the shift from hospital to the community, preserving and improving effective working relationships with local government and further enabling local systems are core principles that will remain central in the department’s ongoing organisational design work.