Health chief welcomes NHS shake-up plans as 'catching up with reality' despite criticisms over timing

The Government published its White Paper in February which details plans for regional Integrated Care Systems (ICSs) - bodies which link councils, the NHS and communities - to take over the budgets and commissioning powers currently held by Clinical Commissioning Groups (CCGs), such as Leeds CCG.

If approved, the plans could be implemented in 2022 and would also see the scrapping of the need for local NHS bodies to put contracts out to tender for many services.

Rob Webster, lead chief executive of West Yorkshire and Harrogate Health and Care Partnership ICS, which includes the areas NHS, councils, voluntary sector, Healthwatch, social enterprises and hospices, told the Yorkshire Evening Post that the new legislation simply “reflects the reality” of how the NHS currently works best.

“The legislation is to catch up with our reality. We have a system but the legislation underpinning that is from a time when the ideology was more about competition. The ideology now is about collaboration.”

The Government says the new proposals aim “to build on the successful NHS response to the pandemic” but some - including bosses at Leeds CCG - have previously criticised the timing as “poorly judged”.

In its response to NHS England during the consultation process over the proposals earlier this year, the Leeds CCG wrote: “We are unclear of the merits of these [legislative changes] being proposed at this stage of the pandemic when we are facing unprecedented pressure”.

But Rob Webster told the Yorkshire Evening Post it makes sense to him to harness the progress made on collaboration and partnership working during the pandemic.

While admitting there’s “probably never a good time” for major change within the NHS, he said: “I think it’s a good time in some ways because what we have seen in parts of the country is the kind of collaboration that we have worked on over the past few years has been accelerated during the pandemic.”

Rob praised the proposals for being as permissive as possible - setting very little in stone so as to allow for greater flexibility in meeting the differing needs of local populations.

And he cited three reasons behind the case for partnership working at a West Yorkshire and Harrogate level.

He said: “One is scale. For example, Leeds Teaching Hospitals was the first place to do a double hand transplant. You couldn’t organise that at a neighbourhood level, that has to be a system level.

“The second reason is good practice and we want to share it to benefit everyone living across the area.

“The third is because it’s a ‘wicked issue’. [For example] how do you deal with making sure childhood obesity is dealt with and where can we make the most progress together?

“There’s been a focus on these very specialist services, people’s mental health, support for carers, work around strokes, diabetes, around how we used tech and IT. That process has been really helpful to us in making a difference to local people.

“This was all in advance of the White Paper and all in advance of the pandemic,” he said, adding: “And then when the pandemic came along, because we have the relationships in place, we have been able to coordinate our response really well.”

Notable achievements of the ICS in Leeds in recent times include securing investment for two new hospitals - the £450m ‘Hospitals of the Future project to build a new children’s hospital and adult hospital - as well as a new CAMHS unit in the city to support children with mental illness.

Rob said the ICS is able to focus on things that “really matter to people” - on both a large and small scale.

“One of the things I’m most proud of is, during the pandemic as more people have sadly died and with the funerals of those people, the way people have been mourned has been deeply impacted. So we set up a grief and loss support service because we knew that they might need to talk to someone.

“What we have in our partnership is peppered by these small things as well as the really big things which are visible from space.

“I think that combination of looking into detail and overall environment is what will make us successful.”

He added he hopes the abolition of CCGs does not become a “distraction” from the overall plans.

“As I understand it it isn’t about redundancies or job losses, it’s about a continuation of the journey we have been on and focusing on that. We need the skills and capacity that exists in CCGs now.”

The plans, in the proposed Health and Social Care Bill, will now be subject to parliamentary approval over the coming months.

A spokesperson for Leeds CCG said: “Since we submitted our response to the proposals, the Government’s White Paper has been published and we have considered this carefully.

“The feedback we provided was strictly in relation to the proposals at the time, our current position is in line with the views shared by colleagues at the West Yorkshire and Harrogate Health and Care Partnership, who remain committed to integration including a Leeds-based resource.

“We remain committed to working with all our system partners to do the right thing for our patients, citizens and our colleagues.”

Coun Fiona Venner, Leeds City Council’s executive member for children, families and adult social care and chairwoman of the Health and Wellbeing Board said working in partnership will be key in tackling the post-Covid challenges.

She said: “In Leeds and West Yorkshire we have built really strong partnerships with our NHS colleagues and as such we welcome the move towards greater integration of health and care.

“This type of closer working reflects the approach that we’ve taken as a council in Leeds on the issues of health and wellbeing for a number of years.

“We have many challenges ahead of us as we recover from Covid, in particular the need to tackle health inequalities and the impact of the pandemic on mental health, employment and communities.

“We can only tackle these problems and improve health outcomes by placing the leadership in the public sector and by bringing public services together in partnership. The success of the vaccine programme shows what can be done when we all share leadership and operate as Team Leeds.

“Our Health and Wellbeing Board in Leeds will continue to bring together all our local NHS, council and third sector partners and together we will plan services for the city. In 2021 we will be designing a new health and wellbeing strategy that will outline how we plan to build back fairer through greater integration of our key services.”

**Rob on the Covid pandemic:

Health chief Rob Webster described the Covid-19 pandemic as “the most challenging time of our lifetimes” but praised the response of the NHS, councils, voluntary sector and communities across the region.

Rob, who is also chief executive of South West Yorkshire Partnership NHS Foundation Trust, which provides community mental health and learning disability services, said: “I have seen some things I couldn’t be more proud of, as a trust chief exec and as lead chief exec of this partnership.

“I’m proud of the work that’s gone on. It’s like that saying that people are like tea bags - you don’t know how strong they are until they are up to their necks in hot water. And I think everyone has been up to their necks in hot water.

“What I’m really proud of is the way communities have responded - and the way we have worked well alongside them.

“Whereas in a Hollywood film, when there’s a pandemic and society breaks down, we have seen an outbreak of altruism. People have been kind and supported their neighbours.

“Yorkshire folk have got together to look after each other and we have been part of that which has been magnificent really.”

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