By Anne North

The NHS Cornwall and Isles of Scilly Integrated Care Board has confirmed that it is in merger talks with Devon.

The Cornwall ICB is not yet three years old.  Another round of expensive rebranding, logo-design and administrative musical chairs is now on the horizon.

A merger with Devon has profound implications for the role of any Cornwall-based director of Public Health, currently a local council job which chief executive Kate Kennally wants to combine with that a “neighbourhoods” strategic director.

Some councillors predict serious “conflict of interest” problems with recruitment to this role, as the Public Health director has to demonstrate robust independence.

But once merged with Devon, health commissioning – and its annual budget of nearly £1 billion - should be safely beyond the grasp of Cornwall Council even if the new Liberal Democrat-led administration revives its former enthusiasm for “Kennally Care.”

In 2015 the council’s previous Lib Dem-Independent administration launched an attack on Cornwall’s 13 community hospitals, complaining they were not used “efficiently.”

That administration’s so-called “Sustainability and Transformation Plan” went through several re-brands, eventually becoming an “Accountable Care System,” before it was eventually abandoned.

The merger between Cornwall and Devon ICBs is likely, eventually, to lead to a new South West regional NHS commissioning body which will also include Dorset, Somerset, Bristol, Swindon and Wiltshire.  In some respects it heralds a return to the period prior to 1974 when the NHS had a South West regional hospitals board.

The move is intended to refocus the NHS and direct attention to the frontline, reversing more than 10 years of “small is beautiful” ideology established by the Conservative-Liberal Democrat government in 2012.

That ideology claimed that no component part of the NHS was too small to have its own chief executive and board of directors who should all be encouraged to deal wherever possible with private-sector providers.  There was no improvement in service.

Instead, the Labour government now wants a return to “strategic commissioning” – which Labour sees as a productivity gain - as a price for increased NHS funding.

A statement from the Cornwall ICB said the merger talks were “at an early stage.”  Cornwall Reports understands that in fact a deal is all but done.  A formal confirmation is expected within months.

“This proposal is part of a wider reform of the NHS operating model across England, which will involve the integration of the Department of Health and Social Care and NHS England, and a changed role for NHS regions, ICBs and providers,” said the statement.

“As part of this, NHS England and the Department of Health and Social Care are aiming to create a new, leaner and simpler way of working in which each part of the NHS is clear on its purpose, what it is accountable for, and to whom.

“The aim also is to lay the foundations for longer-term reform to shift resources into prevention, wellbeing and care closer to people’s homes, as part of the government’s emerging 10-Year Health Plan.

“The absolute priority for the NHS this year is to continue providing high-quality patient care and reduce waits whether that is waits for surgery, waits for an ambulance, waits to be seen in the Emergency Department or waits to be discharged from hospital.

“We are now in the process of redesigning how our ICB could work to best meet the needs of our local population within a mandated reduction in organisational running costs and under the proposal to form a wider ICB ‘cluster’ with neighbouring colleagues at NHS Devon.

“Draft NHS England guidance on ICBs’ future role and purpose outlines the need for ICBs to build strong strategic commissioning skills to improve population health and reduce inequalities.

“We are therefore looking at what functions we can keep, grow or reduce, and what might need to transfer elsewhere or to stop altogether.

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In 2017 the prospect of "Kennally Care" drew protests at County Hall as the Lib Dem-led council attempted to take over the NHS.  A merger with Devon should ensure that Cornwall's £1 billion per year NHS commissioning budget remains beyond the council's grasp.

Time for another logo...this one's nearly three years old already...

“Design discussions have been taking into account a range of considerations such as population size and needs, patient flows, the need to discharge statutory duties, partnership arrangements and the imperative for maintaining strong ‘place’ based geography to support development of neighbourhood health in the future.

“Our priority remains to serve the population of Cornwall and the Isles of Scilly in the best possible way, working closely with, and remaining accountable to, all local health and care partners.”

annenorth@cornwallreports.co.uk