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Significance of rejection of accountable care system played down

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The council’s decision to reject plans for an accountable care system will not affect Cornwall’s progress towards integrated health and social care, the chair of Kernow Clinical Commissioning Group has said.



Health Service Journal reported earlier this month how Cornwall Council announced it did not support an ACS in the county.

The decision followed an inquiry by the council into ACSs earlier this year. The inquiry was set up amid plans by Kernow CCG and the council to work closer together with a view to establishing an “integrated strategic commissioner”.

In the council’s statement, Rob Rotchell (Lib Dem), the cabinet member responsible for health and social care, said the council did not believe in creating a new organisation or committee for strategic commissioning.

In response, CCG chair Iain Chorlton told HSJ the decision “doesn’t change any of the plans”.

He said the council had wanted to distance itself from a “local, politically led campaign” that had “misunderstood” what is meant by “accountable care”, which some people feared would lead to privatisation of NHS services through the formation of a new organisation that would control the whole area’s health and social care budget. 

“They wanted to distance themselves from a notion that we were all going to have one single budget,” Dr Chorlton said. “The council still support the plans to work closer together.”

The term ACS was dropped by NHS England in its planning guidance last month and replaced by integrated care systems.

Under the plans, the four commissioners of health and social care in Cornwall – Kernow CCG, Cornwall and Isles of Scilly councils, and NHS England – would align budgets, which “increases the potential for single contracts” but each organisation would retain their accountability.

Among the presumed benefits of the scheme are better information sharing, a “whole population approach” to health and wellbeing, and the creation of a “whole system view” that could improve quality.

There would also be financial advantages of working as a single team, according to CCG governing body papers. These include potential VAT advantages from “integrated purchasing through pooled budgets”.

Dr Chorlton said the closer work between the CCG and the council to develop the integrated strategic commissioner would take time, but would start to operate “in shadow” this spring. Work will be carried out to explore the potential for co-location.

Cornwall Council did not respond in time for publication.

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