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City will rejoin ICS subject to ‘privatisation’ veto

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A city council which suspended involvement in its area’s integrated care system has said it will rejoin, subject to agreement it will be able to veto “proposals that may result in privatisation or outsourcing”.

Nottingham City Council’s provisional decision to rejoin also follows the ICS deciding there will be an “integrated care provider” matching the boundaries of the local authority, and including more councillors on its board, Health Service Journal reports.

In December it announced it would suspend membership for six months, citing, among other issues, “lack of democratic oversight”. It is a Labour run council and will be holding local elections next month.

At a meeting on Wednesday, the council agreed to “rejoin as a full member of the ICS, with immediate effect, subject to an agreement for unanimous voting on proposals which could lead to outsourcing or privatisation of NHS services at ICS and ICP level”.

An ICS spokesman said it would make a decision on whether to move to unanimous voting on these issues at its board meeting next month, which the city council is expected to take part in.

The paper to the council’s executive board on Wednesday acknowledged that procurement rules mean “it is currently not legally possible for the city council to prevent any organisation from tendering for services”, and “it is not possible to have an absolute veto on privatisation”.

Although the ICS has not explored any major private involvement in services, it has in recent years worked with Centene, the international managed care and insurance firm based in the US, on population health analysis and interventions, which was controversial with some.

The area had previously planned to have two ICPs covering its area – one for “Greater Nottingham”, an area stretching beyond the city council’s boundaries, and one for mid Notts, to the north. In February, it decided that instead it would have three – one for the city of Nottingham, one for southern Notts (covering Broxtowe, Gedling and Rushcliffe); and one for mid Notts (Ashfield, Mansfield, Newark and Sherwood).

The paper to the council’s meeting stated: “An agreement on how to proceed has now been reached with substantial changes made by the ICS partnership that resolve the primary issues raised…

“[They] include the creation of a dedicated City Integrated Care Partnership that matches the boundary of the city council, inclusion of democratic representation on the ICS board, enhanced engagement activities and the incorporation of enhancements to procurement as far as is possible within the legal constraints.”

The ICS held its first public board meeting last week.

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