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City quits leading care system due to 'lack of democratic oversight'

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A major council has pulled out of a leading integrated care system because of a lack of “democratic oversight”.

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The Health Service Journal reports Nottingham City Council has suspended its involvement in the Nottingham and Nottinghamshire ICS for six months due to concerns over the project’s transparency.

The council quit in late November and said it will review its involvement in spring 2019. It will continue to work with the NHS on day to day work, including winter planning.

David Pearson, who chairs the ICS and is director of adult social care, health and public protection at neighbouring Notts County Council, said it was with “regret” that the city council was reviewing its membership. He said the ICS leadership “will… make every effort to resolve” the council’s concerns.

Sam Webster, the city council’s cabinet member for adult social care and health, said: “Too many decisions about our local health and social care services have been taken without democratic oversight. There needs to be greater accountability to the public and that requires greater democratic involvement and more engagement with people who use local health services.

“While we support the principle of integration of health and social care services, this process cannot be a cover for cuts or for privatisation of public services, therefore proper oversight and scrutiny is required locally.”

The council is run by a Labour majority.

Notts County Council, the other local authority in the ICS, has confirmed it will continue its involvement in system.

The Nottinghamshire ICS was established in the first wave of ICS announced in August 2016. It is seen as one of the more advanced health economies as it accepted a whole system financial control total for 2018-19.

The six clinical commissioning groups in the area announced they had appointed a single accountable officer last month.

The council is not the first to express concerns about how local authorities are involved in new integration systems. Three out of the four councils involved in the Bedfordshire, Milton Keynes and Luton sustainability and transformation partnership threatened to quit the system in June this year over concerns health organisations were prioritised over local councils.

The long-term plan from NHS England and NHS Improvement is likely to outline how integrated care systems should develop nationally, but it is not clear if it will include how, and to what extent, local authorities should be involved.

The Nottingham and Nottinghamshire ICS consists of Nottingham City Council, Notts County Council, Nottingham University Hospitals Trust, Greater Nottingham Clinical Commissioning Partnership, Mid Notts Alliance, Sherwood Forest Hospitals Foundation Trust, CityCare Partnership, Nottinghamshire Healthcare and Circle.

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