Concerns key Calderdale health changes will limit borough's solutions

A “scrutiny in a day” session into changes the Health and Social Care Bill 2021 will bring, featuring a number of guest speakers from a range of health orgainsations, was hosted by Calderdale Council’s Adults, Health and Social Care Scrutiny Board.

Neil Smurthwaite, Chief Operating Officer of Calderdale Clincical Commissioning Group (CCG) said the legislation would bring in an integrated care system (ICS).

This would bring together NHS functions ranging from the voluntary sector to CCGs, the aim being to break down barriers to health care, take advantage of economises of scale and emphasise importance on “place” – delivering services close to patients’ communities.

Powers from groups like Calderdale’s CCG would be transferred to the West Yorkshire ICS but in future some of these could be delegated back to places like Calderdale.

It is expected the changes will be implemented from April 2022, with a “shadow year” to move responsibilities into place, and there would be some continuity of leadership, said Mr Smurthwaite.

Councillors questioned aspects of how the new system would be structured and particularly about what accountability it would have – as well as making a plea for it to be explained clearly to people rather than be full of acronyms and jargon.

Mr Smurthwaite said there would be the ability to influence the new system’s operation.

Programme Director of West Yorkshire Health and Care Partnership, Stephen Gregg, said the intention was to delegate much to place-based arrangements.

Coun Mike Barnes (Lab, Skircoat) wanted to know if Calderdale wanted to go in one direction on an issue, for example piloting a dentistry project, and West Yorkshire did not agree, who would have the deciding say?

Director of West Yorkshire Health and Care Partnership, Ian Holmes, said the system already worked as a federal model and if the ICS was saying it wanted things done at a “place” level it would not say no to something like that.

West Yorkshire was in a unique situation in that for five years it had operated as a close partnership and changes in the bill were catching up what it had been doing in practice.

Coun Barnes said the ICS’s constitution should have a section setting out how issues would be resolved.

Coun Megan Swift (Lab, Town) summed up what some were feeling: “What difference is it going to make to the average person in Calderdale?

“It will be great if it works, if it doesn’t we are in a mess folks,” she said.