Concerns Persist Despite Restructure Changes in Buckinghamshire, Oxfordshire, and Berkshire West Integrated Care Board

Despite proposed changes aimed at addressing concerns, the Oxfordshire Joint Health Overview and Scrutiny Committee (HOSC) has reiterated its objections to the planned restructure of the Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board (BOB ICB). The committee's concerns continue to grow, with members calling on the government to conduct a thorough review of the restructuring proposals.

At a recent meeting, committee members reaffirmed their support for the "call in" request, which seeks government intervention, even after hearing about the adjustments made to the initial plans. These changes were intended to ease some of the concerns raised by local health authorities, but the committee is still not convinced that they adequately address the key issues.

Changes to the Restructure Plan

One of the central issues relates to the removal of dedicated "place directors" for each of the three areas covered by the BOB ICB. In response, the ICB has proposed the introduction of a "place-based convenor" to oversee these regions. However, this role would not be funded directly by the ICB, but rather by the county's Better Care Fund, which is jointly contributed to by both the NHS and Oxfordshire County Council.

While this new structure has sparked debate, some committee members remain uneasy, particularly regarding the potential lack of local control and oversight that the previous "place directors" provided. The committee has emphasized that more details are needed before any changes can be fully accepted.

Budget Management and Local Oversight

Another aspect of the planned restructure that has been amended involves the management of healthcare budgets. Initially, there were proposals to centralize certain budgetary controls. However, after discussions, it was agreed that these areas would now be subject to local oversight, ensuring that funds are managed in a way that better reflects the needs of each county under the BOB ICB's jurisdiction.

Stephen Chandler, the executive director of people and transformation at Oxfordshire County Council, delivered the update, stating, "A number of the areas of budget that were being proposed to be managed centrally, there's been agreement that they will be subject to local oversight." This shift has been welcomed by some, but there is still concern over how effectively this local oversight will be implemented.

Despite these adjustments, HOSC has not backed down from its request to have the restructure plans reviewed by the government. Jane Hanna, the chair of the committee, emphasized, "We are nowhere near at the moment taking that call in request off the table. And I know that's obviously something that is desired by the ICB."

Ongoing Discussions and Future Implications

While progress has been made on some fronts, such as budget management and staffing roles, HOSC remains wary of the broader implications of the proposed changes. There are still numerous ongoing discussions, particularly regarding the dedicated role for Oxfordshire, which remains a key sticking point for committee members.

As the process moves forward, it will be crucial for all stakeholders, including the government, local councils, and NHS representatives, to carefully evaluate the long-term effects of the proposed restructure on local healthcare delivery. Until then, the committee's concerns remain firmly on the table, and the future of the BOB ICB restructure hangs in the balance.