Further integration of NHS Portsmouth Clinical Commissioning Group and Portsmouth City Council

Plans have been developed which propose new ways for the city’s council and NHS to work more closely together in future.

The plans set out options for further integration of the leadership of Portsmouth City Council and NHS Portsmouth Clinical Commissioning Group (CCG). This marks a continuation of a process of closer partnership which has involved senior joint appointments, and resulted in a range of positive changes such as targeted early health and social care support for children and families, a shared clinical record available to frontline NHS and social care staff, and integrated domiciliary care teams to help people return home after a hospital stay.

There are three key recommendations:

  • More decision-making to the Health and Care Portsmouth joint commissioning committee
  • Integrating the council and CCG approach to finance, including the creation of a joint role
  • Proposing future arrangements for the CCG’s accountable officer role.

In terms of the third point, the recommended course of action is that the CCG’s accountable officer functions are incorporated into the function of the Portsmouth City Council Chief Executive. The CCG will continue with its strong clinical leadership model, including clinical leadership for Health and Care Portsmouth and having a clinical chair for its governing board.

A paper containing these recommendations was considered by Portsmouth City Council’s cabinet on 9 July, and will go to the CCG’s Governing Board on 17 July. It will then be considered by the city’s Health and Wellbeing Board. If agreed by all three bodies, approval would then be sought from NHS England with regards the proposed changes to delivery of the CCG’s accountable officer role functions.

Dr Linda Collie, the CCG’s clinical leader and current accountable officer, said: “For many years now, our ambition has been to bring health and social care together, because we feel that would bring valuable, tangible benefits to people living in our city. Ultimately, our total focus must be on meeting the needs of people using services in Portsmouth, and the changes we have been making, and are now proposing, are designed to do just that.

“The CCG has always maintained a strong clinical voice at the heart of the decision-making process, and we believe these recommendations will continue that and enhance our effectiveness.”

David Williams, Chief Executive of Portsmouth City Council, said: “A huge amount has already been achieved through our integrated working with the NHS, and these recommendations are a natural progression in Portsmouth’s journey to truly integrated health and social care. We now have much closer working between the council and the CCG, and have positive relationships with the voluntary, community and social enterprise sector. These proposals mark an important next step on that journey.

“Increasingly, NHS and council teams are working together under the Health and Care Portsmouth banner, and it feels right that we should now try to make sure that the leadership arrangements reflect that progress and Portsmouth has a clearer voice within the wider health system.”

Cllr Matthew Winnington, the council’s Cabinet Member for Health, Wellbeing and Social Care said: “This paper is a statement of intent – it sets out a clear vision for how the council and the CCG can continue to work together to deliver joined up services.

“Local authorities play a unique role in the lives of our residents. Bringing together the council and the CCG means we can work together to tackle those wider issues that impact the health and wellbeing of people in Portsmouth – things like improved air quality, housing and economic development. I’m excited to be delivering on our mission to make sure we’re providing the right services for the people in our city so they are supported to live full, healthy and independent lives.”


Why is the proposal being made?

The proposals are a natural development of work between the council and the CCG over a number of years.  They stem from requests made by both the council’s Cabinet and the CCG’s governing board to get broader and deeper integration between the two organisations. There are a number of factors involved: there are pressures on the health and social care system as a whole, and key documents (the NHS Long Term Plan and the Hampshire and Isle of Wight Strategic Transformation Plan) have set out how the NHS, local authorities and the voluntary, community and social enterprise sector can and should work together to address those pressures.

The proposals are about making sure there are structures and attitudes in place – in terms of resources, decision-making and people – to make sure the city can fulfil its desire to provide joined-up care for people in Portsmouth, delivered in the right place and at the right time.

Local authorities are uniquely placed to engage with residents on a number of factors that contribute to people’s overall health and well-being – like education, housing, leisure and transport. Bringing the council and CCG closer together means that resources, knowledge and expertise can be better combined for the benefit of the people of Portsmouth.  Together, the council and the CCG will work with the wider health and care system to influence the delivery of better, more cost effective services across the Hampshire and Isle of Wight area.

What has happened so far?

The two organisations have worked together for a number of years as part of the Health and Care Portsmouth programme, and already share a number of statutory posts – including in Adult Social Care, Children, Families and Education; and in Public Health. There are also shared commissioning functions and teams.

By sharing knowledge, expertise and resources we have been able to achieve much, including:

  • Health visitors and children’s social workers have been co-located since 2016; in addition a diverse range of health and social care professionals has been brought together to deliver a Targeted Early Help and Prevention service for children and families.
  • Adult community health, social care and therapies have been co-located to deliver multiagency care and co-ordination.
  • From June 2018 the CCG has commissioned an Integrated Primary Care Service incorporating the provision of three interconnected services: Out of Hours (OOHs), the AVS, and GP Enhanced Access. This will ensure safe, effective delivery of primary medical care services 24 hours a day, 7 days a week, and improve access to primary care.
  • A specific Blueprint for Adult Social Care in Portsmouth has been launched, with a cross-organisation programme board to ensure its delivery.
  • A joint health and care domiciliary care service specifically to enable people to return home as quickly and safely as possible after a hospital stay.
  • A collaborative approach has been taken to include the voluntary sector as an equal partner in the provision of health and care to Portsmouth residents. Through the signposting service, an easy access route for GPs has been available to access non-medical support from the voluntary sector for their patients.
  • A single clinical record across health and care providers in the city to improve communication between health and social care professionals. All GP practices within the city, Solent NHS Trust, and Adult Social Care use ‘TPP SystmOne’ as their primary clinical system – better for patients, and for the clinical staff.