London NHS organisations call for ‘whole system’ regulation

The North East London sustainability and transformation plan asks that national regulators move to a “single system” approach for areas planning to implement accountable care systems.

The document, published last week, sets out plans for an accountable care system to go live in Barking, Dagenham, Havering and Redbridge by April 2018. Outlining changes the footprint “asks” for, the plan says: “Accountable care systems and integrated care require whole system collaboration and a shared commitment to patient outcomes.

“As such, they need consistent regulatory responses that treat the underlying partners in care as a single system. We request that where plans exist for accountable systems, the system be regulated as a whole, despite the fact that there are distinct underlying organisations.”

A year ago, Barking and Dagenham, Havering and Redbridge clinical commissioning groups were named as one of NHS England’s devolution pilot sites with the aim that the area would create an accountable care organisation. According to the plan, a business case is being written and will include plans for the “pooling of health and social care budgets” and a “single leadership team” responsible for both the development of the accountable care system and business as usual activities.

City and Hackney CCG is also planning to expand its devolution pilot to an ACS, which will develop a “fully integrated commissioning function” across the CCG and two local authorities.

Included in the STP “asks” is “flexibility on health and social care funding arrangements and freedom to break from existing regulation”.

The plan also sets out a case for capital investment of £500m-£600m and asks that organisations can retain capital receipts and for “central support to cover PFI costs above normal levels”.

Full story in The HSJ 16 November 2016