IN ACTION INTERVIEW
W
hen clinical senates were first announced, many were unclear about how exactly they would work. But the political who, whys and hows didn’t bother the people behind Chorley and South Ribble and Greater Preston CCGs. In
this collaborative locality, the concept of a ‘clinical senate’ was around long before any national directive. “At the beginning I was unclear about the national stuff and what it means, really,” admits Dr Gora Bangi when he speaks to Commissioning Success about his experience as chair of Chorley and South Ribble Clinical Commissioning Group. Arguably, whether he understands the details of the national directive or not matters little: he was already putting cross-clinical collaboration in motion while his CCG was in shadow form. For him, the responsibility of CCGs is not to dictate but rather to facilitate the appropriate transfer of funds to the right places as guided by a community of clinical experts. To see to this, his CCG teamed up with Greater Preston CCG to bring the major stakeholders in the local health economy together, forming what the Government would recognise as a clinical senate. This group includes the area’s major acute provider; the leading community provider; both foundation trusts; the top tier of Lancashire County Council; the two CCGs; North West Ambulance Service; and an NHS England area team (the latter two are recent additions). “So this is really high level stuff,” says Dr Bangi. “We have all the clinical leaders and managers working together.”
ON BOARD WITH THE BOARD Getting all the major players in a local health economy around a table is no small feat. Dr Bangi and the chair of Greater Preston, Dr Ann Bowman, first wrote to the stakeholders to call a meeting, then presented their vision to a divided group. They explained that they would be statutory from April and wanted to lay out a “very collaborative platform” from the start. It was an opportunity for them to explain how they envisaged commissioning developing and let everyone know they wanted to be very different from previous commissioning organisations. As part of their role facilitating the appropriate exchange of resources across the local health economy, the CCGs wanted to see a seamless journey for their patients, rather than what Dr Bangi calls “the very arbitrary way things were done before”. He explains further: “Rather than me commissioning a bit of community care, then commissioning a bit of acute care and so on, what we wanted to do was base care around the patients.” The idea was then to have discussions around what primary care could do in collaboration with secondary care to design a pathway to which everybody aligned. Then the CCGs could facilitate the movement of resource accordingly. This results in what Dr Bangi calls a more “empowered approach” to commissioning healthcare – not one in which the CCGs tell everybody what to do.
AN IDEAL BACKGROUND Dr Bangi’s path into commissioning was as a GP, but he hasn’t always been one. He trained later in life, after starting out in the world of business. “So this is quite in my area of expertise,” he
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