St Helens health trust looks to merger with neighbours

The CCGs have been in talks with NHS regulators over a merger with Cheshire and Mersey CCGs for some time, in response to NHS’s Long Term Plan.

This week, a report on a potential merger was presented to the governing bodies of St Helens, Halton and Warrington CCGs.

The report says there is a “growing appetite for formal CCG mergers”.

It also notes that there are “challenging financial pressures” and a requirement for CCGs to achieve a 20 per cent reduction in running costs.

St Helens CCG’s clinical accountable officer, Sarah O’Brien, said merging with other commissioners is in-line with NHS policy, as set out in the Long Term Plan.

“This is a policy direction,” said Prof O’Brien, who is also the executive director for people’s services at St Helens Council.

“I think it’s really important to remind ourselves that this discussion about, do we start to embark now on discussions with neighbouring CCGs about becoming bigger entities, it was laid out in the Long Term Plan, which is policy around the future of the health service, that CCGs would become more strategic.”

The NHS’s LongTerm Plan, which was published in January 2019, states that CCGs will become “leaner, more strategic organisations that support providers to partner with local government and other community organisations on population health, service redesign and Long Term Plan implementation”.

Prof O’Brien said it is recognised that one CCG for the whole of Cheshire and Mersey would be too “complex and too big at this stage”.

The current proposals are to establish a Mid-Mersey CCG featuring St Helens, Halton and Warrington; and a North Mersey CCG made up Liverpool, Knowsley, South Sefton, and Southport and Formby.

After getting the nod from their respective governing bodies on Wednesday, St Helens, Halton and Warrington will now develop a “case for change” on why they should merge to a single CCG.

During the meeting, Dr James Catania questioned whether St Helens CCG’s voice would be “weakened” if it did not proceed with the merger.

Prof O’Brien responded by saying one of the reasons the CCG is embracing the merger is to make sure it is a “key part of the change”.

“For me it’s about, lead the change, not have the change done to you,” she said.

Prof O’Brien said one of the biggest reasons to move ahead with the merger would be to tackle “fractured commissioning” in relation to St Helens and Knowsley Teaching Hospitals NHS Trust.

Prof O’Brien said: “A single commissioner around that system should help to have less fractured pathways into that acute trust.

“Which in the long turn will not only improve outcomes for the populations of all three boroughs but should help us take costs out and bring the system back into financial balance.

“It may also help us take some costs out that we can reinvest in the boroughs, in terms of community and primary care.

“So, for me the benefits are about being more cohesive, having a bigger strategic approach to some of our more challenging issues.”

Prof O’Brien insisted increasing the size of the CCG will not be at the expense of St Helens Cares, the borough’s integrated healthcare system.

St Helens Council leader David Baines was invited to the meeting and reiterated the local authority’s commitment to integration.

Cllr Baines said: “When I’m asked to name the one thing I’m most proud of that the council has done – certainly in the last ten years – I say St Helens Cares.

“I think it’s an incredible, unique, transformative system and with it we are the envy of CCGs and local authorities around the country, and rightly so.

“No matter what the future brings, that integration’s got to stay in place. It’s got to grow, got to improve.

“If we do merge, go into partnership with other authorities, with other CCGs, the one thing that cannot happen is our standards fall.

“Their standards have got to rise to our level.”