Cornwall Council and NHS Kernow are having to go through mediation to resolve an almost year-long dispute over who should pay for services.

The two organisations are set to go to formal mediation to resolve a dispute, which involves more than £4million.

NHS Kernow, as the clinical commissioning group (CCG) for Cornwall, and Cornwall Council are responsible for jointly commissioning some services including mental health, children’s services and adult social care.

However since November there has been a disagreement about which organisation should be paying for which services and liable for overspends on budgets.

This first occurred when Cornwall Council presented an “unexpected” invoice to NHS Kernow for £1.8m last year.

And Cornwall Council has indicated in a new report that the figure for 2020/21 is £2.3m.

The schemes included are part of the Better Care Fund and due to the dispute NHS Kernow and the council have been unable to agree an outturn position.

Both organisations say that most aspects of the dispute have now been resolved but the council says that there is one “significant” issue which needs to be resolved and so the organisations are going to formal mediation.

While the dispute remains unresolved the council has been unable to set a way forward for the Better Care Fund (BCF) for the current financial year.

A report, which will go to the Health and Wellbeing Board next week, states: “A small number of schemes within the s.75 BCF agreement are currently subject to dispute. This has meant that the council and NHS Kernow have been unable to agree an outturn position for previous financial years.

“There remains one significant outstanding issue which is subject to escalation under the terms of the BCF s.75 agreement through formal mediation planned for October 2021.

“The principal scheme subject to a dispute process is the Support Living Scheme (SLS) and the liability for spend over budget.

“The differential between outturn position and total contributions made is £1.8m (2019/20) and £2.3m (2020/21) with trajectories indicating similar levels in future years. Until this matter has been resolved it is unlikely that the Council will be able to agree a revised BCF plan for 2021-22 or formally report an agreed outturn position.”

Cornwall is set to have an Integrated Care System which will bring together NHS and council services with works ongoing to set it up and the council’s Cabinet this week approving proposals for its governance.

The Local Democracy Service went to NHS Kernow with a number of questions about the issue.

We asked how the dispute occurred; why it has taken so long to resolve; why mediation is needed; whether NHS Kernow and Cornwall Council believe that mediation will resolve the issue.

In addition we asked the financial value of the outstanding dispute; and also asked whether there were any concerns about whether this could indicate possible issues with the Integrated Care System.

An initial joint statement from NHS Kernow and Cornwall Council stated: “NHS Kernow and Cornwall Council jointly commission a number of services including mental health, children’s services, and adult social care. Some of the contracts are now coming to an end, and we are working together to agree how they will be paid for and delivered in the future.”

When it was noted that this did not answer the questions, an additional statement was provided from NHS Kernow chairman Dr Paul Cook, who said: “NHS Kernow and Cornwall Council are meeting to resolve the long-standing dispute. Some solutions have been shared and NHS Kernow and Cornwall Council are currently considering these before any next steps are taken.

“We are absolutely committed to working closely with all partners in Cornwall and the Isles of Scilly to achieve the best health and care outcomes. To do that effectively we must resolve any outstanding issues.”