Towards systemness: Blithering takes the lead

Towards systemness Blithering takes the lead_primary care training_NHS

In what many see as a landmark moment for integrated care, the NHS Blithering Care Partnership has announced the appointment of Sir Trevor Longstay as chief executive of both the area’s CCG and its acute trust.

Dismissing objections to his appointment from patient groups, regulators and his own staff, Sir Trevor said he was “not prepared to let theoretical questions of legality stand in the way of progress”. He promised to address the concerns of stakeholders “in the fullness of time”.

The combined role, Sir Trevor said, would “resolve the ridiculous situation where one organisation makes decisions and another, quite separate organisation, often with its own agenda, holds it to account”. This, Sir Trevor said, often resulted in “watered-down decisions and needless scrutiny”.

NHS Blithering spokesman Martin Plackard hailed the development as “a decisive step towards systemness” adding that “a single appointment to the top jobs in the local commissioning and delivery system removes all doubt about our commitment to full integration and signals a welcome and long-overdue end to silo working”.

“The number of parties involved in key decisions is a source of frustration, delay and waste of resources. By collaborating with himself, Sir Trevor will be able to kickstart the rollout of the high-quality system thinking our patients deserve,” Plackard said.

Asked how conflicts of interest would be managed in future, Sir Trevor said that he would “step out of the room whenever a potential conflict arose and take the decision somewhere else”.

“In the highly unlikely event that I am unable to reach agreement with myself, I will have the casting vote,” he added.

Stressing that “world-class governance is a first principle of the new arrangements”, Sir Trevor said that he had agreed to chair a committee in common tasked with ensuring that “probity and transparency are never far from our thoughts”.

The two organisations’ current executive teams would remain in what Sir Trevor described as “an advisory and largely decorative capacity”.

Plackard acknowledged that some details of the new arrangement remained to be worked out, such as how the combined post would continue to function if one party were to lose to their job.

“It would be within the power of the chief executive to reappoint himself, subject to approval by the joint appointments and remuneration committee,” he said. “Otherwise we anticipate that deputy chief executive Dr David Rummage would fill the role on an interim basis until a suitable replacement could be found.”

His comments were echoed by Sir Trevor, who said: “As independent chair of the appointments committee, my role is simply to ensure that members are mindful of the potential implications of failing to arrive at the correct decision. My own preferences do not come into it.”

Asked how the new unitary board would work with other parts of the local health and care system, Sir Trevor said: “There will of course be a seat at the table for social care, mental health, community services and primary care. They can take it in turns.”

He added that other stakeholders already had their own forum in the shape of the Blithering Assembly, “where they can get together, have a chat about things and make occasional suggestions.”

Sir Trevor confirmed that he is to step aside from his other role as executive chair of the WasteAway PLC clinical waste disposal conglomerate to “give my full attention” to his new three-day-a-week strategic role. “There’s only so much one man can do,” he said, with characteristic modesty.

Strategy editor: Julian Patterson


Reproduced at by kind permission of Julian Patterson.