June 2016 will see two momentous events: the referendum on theEU and, to a lesser extent, the submission of local sustainability and transformation plans.
Brexit campaigners argue remaining in the EU involves an intolerable loss of sovereignty, while Bremainers believe shared sovereignty delivers greater net gains. Meanwhile, if STPs are going to work, both commissioners and providers need to decide whether the benefits of shared decision-making are worth the collective effort required to do so.
The latest clinical commissioning group barometer survey indicates CCG leaders are thinking about the future governance arrangements needed to make integrated care systems a reality. The most important design features the survey respondents are prioritising are:
shared ethos and values (92 per cent)
effective shared leadership (90 per cent)
shared governance structures (86 per cent).
Commissioners recognise that future governance systems must achieve better allocative efficiency than what we have now. In doing so, local systems will need to design their leadership and governance models with the objective of improving the liquidity of resources (both human and financial), greater congruity of incentives, and the alignment of purpose to system and person orientated outcomes.
All while resisting the temptation of short term gains for individual organisations and keeping focus on the longer term, collective good.
What is undeniable from this barometer is that CCGs are approaching this with collaboration and pragmatism. Sovereignty is simply not a priority.
John Rooke is a healthcare expert at PA Consulting Group