To receive an update for the Bedfordshire Clinical Commissioning Group Financial Plan.

Nick Robinson, Interim Accountable Officer at the Bedfordshire Clinical Commissioning Group (BCCG) introduced a report that focused on the £45m financial deficit, the reasons behind it and lessons learned.  From the investigation it was apparent that the BCCG had failed to see signs of the worsening financial deficit in 2013/14.  Other issues included poor core information systems, poor leadership and management structure, poor processes and a failure to meet planned savings.

NHS England exercised its powers to put the BCCG into special measures and a recovery plan had been developed to tackle the issues outlined. This plan had the support of GPs, along with support of a strengthened governing body.  With commissioning support from a unit in the South West of England, improved systems and processes had been implemented and the BCCG was confident it could target and start to address known weaknesses by the end of July 2015.  The development of the Plan for Patients 2015/17, which included consideration of Biggleswade Hospital, was fundamental to the BCCG’s recovery which had been paused whilst investigations took place.

In light of the update and clarification sought, Members raised the following concerns:-

·         Whether any fraudulent activity had taken place now that the extent of the deficit was known.  Nick Robinson assured the Committee that external forensic investigators had established that all monies had been spent on healthcare. He acknowledged that detailed quarterly monitoring of budgets had not raised any undue concerns.

·         Disappointment that the BCCG had not acted upon engagement with patient groups, stakeholders and partners.  Nick Robinson felt these groups had been let down by the BCCG and they would reassess and advise those concerned on the plan in a clear and transparent way with regards to delivery. That information provided to the Committee was light in content and made for uncomfortable reading, and whether the Interim Accountable Officer would remain with the BCCG to see the changes through. Nick Robinson advised that a permanent Accountable Officer would be recruited, however, he would stay in his position for as long as he was needed.

·         Whether work with the Health and Wellbeing Board over the past four years on new models of care would be progressed.  Nick Robinson advised there were no current plans to implement the new models as component parts were out of alignment.  In order to drive the initiatives forward, Members were advised to lobby the issue regarding the Hospitals which had hindered progress.

Cllr Jones thanked Nick Robinson for his openness and reminded Members of the difficulties this Council faced when it first started in 2009.  The Council would continue to support the BCCG during this difficult time.

RECOMMENDED

1.    The Committee expressed its grave concern over the financial situation in which the BCCG found itself, in particular the lack financial knowledge, the failure to recognise an underlying deficit and the subsequent ineffectual action take between July and December 2014 as the deficit grew.

2.    The Committee noted the key actions which had been taken, the demand led nature of the business and the quality of healthcare commissioned, but reiterated that the new executive management team might learn from the mistakes of its predecessors and commission services within budget by demonstrating a more efficient and effective organisation together with prudent financial controls.

3.    The Committee looked forward to renewed public confidence.