Accountable Care System
County Council Cabinet member says of NHS changes, ‘What we’re not going for in Devon is an Accountable Care Organisation’ – but can we take this assurance at face value?
At Devon County Council yesterday, I asked Cllr Andrew Leadbetter, Cabinet Member for Adult Care and Health, whether the Devon Accountable Care System (ACS) (which is being renamed the Integrated Care System!) is still due to start on April 1st. He replied that ‘What we’re not going for in Devon is an Accountable Care Organisation’ – only an Accountable Care System.
He said that the 1st April date was the one ‘on which the two CCGs [NEW Devon and South Devon & Torbay] are going to merge’ and that the ACS already existed in all but name. ‘It’s their plans, they don’t actually need our permission to go ahead with it’, he added – although DCC is ‘in partnership with them’. He didn’t answer Cllr Brian Greenslade’s point that DCC had glossed over it in a recent spotlight review.
You can WATCH THE EXCHANGES BY CLICKING HERE AND FORWARDING TO 2:57.
However I think there’s a confusion in Cllr Leadbetter’s response and in the joint statement with the CCGs which he issued as a written report at the meeting and previously emailed to councillors:
- No one has said that the Devon CCGs, through the Sustainability and Transformation Plan (STP), are currently introducing an Accountable Organisation (ACO), the new form of long-term NHS provider contract which has been developed by NHS England, could hand over large chunks of the NHS to private including American companies – and will shortly be judicially reviewed.
- However according to the CCGs, Phase 1 of the Accountable Care System in 2018-19 will develop an ‘integrated delivery system for Devon’ with a ‘single strategic commissioner’.
- And according to the report Designing the commissioning system in an accountable care environment: A route map for Sustainability and Transformation Partnerships which describes how the Devon STP has been working – and which Dr Tim Burke, Chair of NEW Devon CCG says is the ‘route map’ for the accountable care system – this integrated system is designed to lay the basis for Accountable Care Organisations.
- On page 18, the report says that the integrated delivery system, ‘Through bringing budgets together on a whole population and/or model of care basis, [will] provide signals to providers on how to organise. This will signal the number, shape and scope of accountable care organisations and how they will need to work together to deliver.’
SO – Cllr Leadbetter is right, the emerging ACS is not an ACO. But the ACS is designed to lead to the setting up of ACOs.
Unless, of course, they have changed their mind. Is the route map still the route map – or not? This is the question that the CCGs and Cllr Leadbetter need to answer, before his ‘assurances’ can be considered meaningful. As he mentioned yesterday, I and other councillors will be meeting with him and the CCGs to discuss these issues further.
(Other noteworthy point:
NOTE FOR BAFFLED READERS: I know this is an incredibly complicated subject, not helped by their tendency to change the name of what we’re talking about as soon as objections are raised – as though that makes it better! If you’re confused – you’re not alone. However it MATTERS A LOT to the future of the NHS. Read this report explaining the issues, which I submitted to the Health Scrutiny Committee last month.
Health Scrutiny agrees to my request to scrutinise controversial plan for Accountable Care System in Devon from 1st April – I tell them there is no public consensus for private companies running our NHS
After Sarah Wollaston calls for delay in introducing Accountable Care Organisations, I have submitted evidence about Devon’s Accountable Care System to the parliamentary enquiry
Sarah Wollaston, the chair of the Commons Health Committee, has written to the Health and Social Care Secretary urging him to delay a new contract for Accountable Care Organisations (ACOs), due to be implemented nationally later this year. She claims there is a “great deal of concern” over the plans which she considers “have not been well aired publicly up until now”.
This is precisely the point which I have made about Devon’s Accountable Care System -intended I believe as a precursor to Accountable Care Organisations – which is due to begin on 1st April. Neither Devon’s Health Scrutiny Committee nor the public has been made aware of this, and what it involves is still unclear.
I have submitted the paper – with 8 key questions – which I prepared for Health Scrutiny on Thursday to the parliamentary Health Committee’s Sustainability and Transformation Partnerships inquiry. Thanks to Mike Allen for drawing my attention to this just before last night’s deadline for submitting evidence.