CCGs are running to stand still at the moment as they take part in one of four waves of ‘authorisation’ that will transform commissioning across the NHS.
The majority of us become very self-focused under pressure without realising that many of our challenges are shared if we take the time to look around us.
A problem shared...
I believe a problem shared is often a problem solved and one of the most influential partners CCGs can work with is their local council.
I can hear some GPs groan in despair citing a lack of time, understanding and the odd parking ticket as reason enough not to get too pally with their local authority.
However, if you look closer there are numerous shared opportunities from dementia and drug and alcohol services to social care and obesity.
I speak from personal experience having spent more than a decade as a local councillor and then as MP for Dartford North in Kent.
My twin involvement in politics and medicine has also given me the opportunity to see issues from both sides of the fence and realise the value of helping other people meet their needs as well as your own.
This means taking the time to meet your counterparts in local authority, understand their concerns and finding common ground where you can help one another.
I think there is a lot of misunderstanding between the organisations with councils not understanding how complex healthcare can be.
Healthcare isn’t the same as managing refuse collection because it can affect people’s lives in the most profound way. After all, no-one has died because their recycling bin wasn’t emptied on a Friday morning or chewing gum steamed off the pavement.
Community engagement
However, local authorities have been around a lot longer than the NHS and have a wealth of expertise in areas CCGs will find invaluable.
They can open a lot of doors and have systems in place that can be invaluable in helping us reach a wider audience.
A good example is community engagement where councils can effortlessly tap into extensive databases and specific communities. They have established distribution channels, strong community contacts and in-depth experience of lobbying, cross-partner funding and planning.
Councils are also a powerful driving force in encouraging people to lead healthier lives through their education, leisure and soon-to-be public health departments.
Local authorities face the same challenges as the NHS including reduced workforces struggling with increasing workloads, budget cuts and a population that is living longer but beset with a host of medical conditions that put greater demand on social care.
Working with local authorities
I think CCGs will be surprised at how receptive local authorities are to partnership working in the current climate although we have to take an active role in cultivating this relationship and avoid the pitfall of making assumptions about what we think councils know about our business and vice versa.
The chief executive and council leader of most local authorities are perfectly approachable and open to suggestions on how to improve service delivery and customer satisfaction and my advice is to arrange a face-to-face meeting and lay out your stall.
We live in a world where stand-alone public organisations are being forced through social and economic necessity to co-locate staff and integrate budgets and services and can see a time when they are largely indivisible.
A good example of doing away with this ‘them and us’ attitude is the financial tug-of-war that exists between local authorities and the NHS depending on whether or not a patient is being cared for in hospital or the community.
A hospital stay costs the NHS more (and the council less) while the local authority generally picks up the tab once a patient returns to the community.
An integrated care pathway and, dare I say it, integrated budgets would do away with this push-pull attitude and put patients’ needs first.
Reducing admissions, improving rehabilitation and aligning community services across health and social care could all take a big step forward with this approach.
Communication channels
Another key element of CCGs' relationship with councils is with local politicians.
Councils are made up of officers and elected members or councillors. The councillors veto decisions based on the advice and findings of officers.
It’s important to have a good relationship with both groups but it is worth being on good terms with members as they can hold a lot of influence. This needn’t take a lot of time and it is worth keeping them up-to-date with what is happening instead of reading about it in the newspaper.
Here are some examples of what you can do to nurture that relationship:
- Find out who your local ward councillors are and schedule a meeting to get to know them. They are on your side but need to know what your health priorities for their wards are
- Keep councillors informed about what is happening, especially if you are planning a surgery move/closure etc.
- If you are launching a health initiative, such as targeting diabetes awareness among the Asian community, use them to champion your cause and open community doors.
- Find out if members are interested in health or have strong views on a particular issue
- People like to feel valued so share relevant information
- Councillors have influence in a lot of health-related areas, such as leisure facilities, schools, regeneration projects etc.
- Share publicity/promotional events to foster goodwill
- Remember, politicians are always looking for an opportunity to raise their profile so be mindful of this around sensitive issues and make sure they know what is happening and when.
- Invite your local MP in for a chat about local issues. They can raise issues with the health secretary if it is relevant and put you on the radar to pilot possible initiatives
- Don’t be afraid to use the above to promote your work and make any suggestions about improvement to health services.
Dr Howard Stoate is chairman of Bexley Clinical Commissioning Group in south east London which serves a population of more than 220,000 people. He is also the former MP for Dartford and served as a local councillor for nine years.
Read our Inside Commissioning blog for the latest thinking on redesigning healthcare.
GP magazine is a media partner for Commissioning 2012, an event in London on 27-28 June featuring over 700 GPs and primary care managers. Speakers are expected to include health secretary Andrew Lansley and NHS chief executive Sir David Nicholson.
