Agenda item

Integrated Care Systems and Working with Scrutiny

To receive a presentation by Mark Wilkinson, Cheshire East Place Director.




Mark Wilkinson, Cheshire East Place Director, attended the Committee meeting and provided a presentation on Integrated Care Systems (ICS) and Working with Scrutiny. Committee Members noted the following:

An overview was provided on the NHS structures in England since 1 July 2022. Historically, a single Cheshire CCG served the Cheshire area. CCGs were abolished and replaced with Integrated Care Boards (ICBs) – statutory organisations commissioned to meet the health needs of Cheshire and Merseyside residents.

Another key element of the ICS was the Integrated Care Partnership (ICP) which brought together key organisations (Local Authorities, NHS, Healthwatch etc) to look at effective partnership working.

Members received an update on plans to return maternity services to Macclesfield District General Hospital. Services at Macclesfield were suspended at the start of the COVID pandemic. It was highlighted that whilst there had been a clear focus to return services, there were four factors that needed to be achieved before this could be done:

  • The Trust needed a partner to work with and this had been identified in the form of Stockport NHS Foundation Trust.
  • Funding was needed – higher staffing standards and levels were required as a result of several maternity scandals across the NHS. There was a reasonable expectation of additional investment.
  • Additional staffing would be needed – additional recruitment of midwives, consultants, and anaesthetists would be required in order to safely bring back maternity services. There were concerns around the ability to recruit sufficient anaesthetists as there was a general shortage across the NHS.
  • Beds on the Macclesfield site would need to be made available as maternity beds had been reused for those attending A&E. Work was underway to resolve this.


Committee Members were invited to ask questions.

  • Members queried why the staff from Macclesfield Maternity Unit couldn’t return to Macclesfield hospital.


It was confirmed that staff would return to Macclesfield Hospital, when the services returned.  Additional staff were needed to meet higher NHS wide standards on staffing maternity units.  No decision had yet been made as to whether it would be possible for maternity services to return – the current suspension remained in place and would expire in April 2023. A decision would need to be taken before this date to determine if the suspension needed to be extended further or another option identified The NHS were fully committed to returning maternity services to Macclesfield however there was key criteria that needed to be met before services could safely return. It was noted that those members of staff who worked within the Maternity Unit pre-COVID had been temporarily relocated to other hospitals.

Cllr M Simon left the meeting at 12.33pm.

  • Members queried at what point the issue of maternity services at Macclesfield hospital became a significant variation and require full consultation and formal discussion at Scrutiny Committee.


It was confirmed that the next stage of decision making on maternity services would be early in the New Year. It was suggested that should the NHS make a decision to not return maternity services to Macclesfield Hospital, there would need to be a formal briefing to Scrutiny, but that stage had not yet been reached.


a)    An update on Maternity Services at Macclesfield Hospital to be added to the Committee Work Programme.

b)    Underlying delivery of the new ICS from a local point of view / update on success of Winter Plan to be added to the Work Programme.

c)    That the Integrated Care Systems and Working with Scrutiny presentation be received and noted.


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