CKWCB-12-198c_Wakefield_CCE_Public_Minutes_24_July_12

NHS Wakefield Clinical Commissioning Group CLINICAL COMMISSIONING EXECUTIVE Minutes of the meeting held on 24 July 2012 Boardroom, White Rose House Present

Dr Phil Earnshaw Dr Adam Sheppard Dr Clive Harries Dr David Brown Dr Avijit Biswas Dr Ann Carroll Stephen Bryan Elaine McHale Jan Power Jo Webster

Jim Hayburn

In Attendance

Sandra Cheseldine Adam Bassett Katie Lister Ruth Unwin

Michelle Ezro

Matt England Laura Elliott

Lee Beresford

Danny Alba

Julie Owen

Joanne Fitzpatrick Jo Hanlon

Chair, Wakefield Alliance GP, Lupset Health Centre GP, Chapelthorpe Surgery GP, Kings Medical Centre GP, Pinfold Surgery GP, Outwood Park Medical Centre Practice Manager, Stuart Road Surgery Wakefield Council LINks Representative Shadow Accountable Officer NHS Wakefield Clinical Commissioning Group (CCG) Chief Financial Officer, NHS Wakefield CCG Non Executive Director Corporate Risk Manager, NHS Wakefield District (NHSWD) Communications Officer, NHSWD Director of Development, Mid Yorkshire Hospitals NHS Trust (Minute 12/148 only) Assistant Chief Executive Mid Yorkshire Hospitals NHS Trust (Minute 12/148 only) Head of Contracting and Commercial Strategy, NHS Wakefield CCG Head of Quality and Engagement, NHS Wakefield CCG (Minute 12/151 and 12/154) Head of Strategy and Strategic Planning, NHS Wakefield Clinical Commissioning Group Senior Commissioning Manager, NHSWD (Minute 12/150 only) Older Peoples Programme Manager, NHSWD (Minute 12/153 only) Head of Medicines Management (Minute 12/153 only) Head of Public Health (Long Term Conditions)

Julie Thorpe Ruth Twiggins

Jez Mitchell

(Minute 12/154 only) Senior Commissioning Manager Head of Public Health (Vulnerable Adults), NHSWD (Minute 12/156 only) Substance Misuse Development Worker, NHSWD (Minute 12/158 only)

12/138 Apologies Apologies were received from Dr Hanney, Dr Dewhirst, Dr Andrew Furber, Rhod Mitchell, Sam Pratheepan and Sandra Greenwood.

12/139 Declarations of Interest Dr Earnshaw reminded members of the requirement to declare any interests which related to any items on the agenda. This could either be undertaken at this point or when the matter was considered on the agenda.

All GPs present at the meeting declared an interest in the item ‘Tackling Health Inequalities in Wakefield via Primary Care’ (12/154). It was agreed that during consideration of this matter Sandra Cheseldine would undertake the role of Chair.

12/140 Chair’s Update Dr Earnshaw highlighted that Jo Webster had been appointed as Chief Officer Designate of NHS Wakefield Clinical Commissioning Group (CCG) and he offered his congratulations to her on behalf of the NHS Wakefield CCG Board.

Dr Earnshaw noted that as part of the preparation for the Clinical Commissioning Executive to meet as a statutory board, a private session would be introduced at the end of the meeting.

Dr Earnshaw also noted that due to the issues of quoracy at the last meeting he would be grateful if members who were unable to attend meetings notified either Jo Webster or himself at the earliest opportunity.

12/141 Minutes of the meeting of the NHS Wakefield Clinical Commissioning Executive Meeting held on 28 June 2012 It was RESOLVED that i)

The minutes of the meeting of the NHS Wakefield Clinical Commissioning Executive Meeting held on 28 June 2012 were agreed as a correct record but be amended to record that the meeting had taken place King’s Medical Centre, Normanton.

12/142 Addendum to the minutes of the meeting of the Wakefield Alliance Clinical Commissioning Executive Meeting held on 27 March 2012

Sandra Cheseldine advised that the Pest Control Policy had been recommended for approval subject to confirmation that this was required.

This policy had then been reconsidered at the Audit and Governance Group meeting on 12 April 2012.

It was RESOLVED that i)

The addendum to the minutes of the meeting of the Wakefield Alliance Clinical Commissioning Executive Meeting held on 27 March 2012 were agreed as a correct record with one amendment: The pest control policy be approved subject to confirmation that this was required.

12/143 Addendum to the minutes of the meeting of the Wakefield Alliance Clinical Commissioning Executive Meeting held on 22 May 2012 It was noted that following confirmation that it was required, the pest control policy had been recommended for approval to the Clinical Commissioning Executive meeting on 22 May 2012 by the Audit and Governance Group on 12 April 2012.

It was RESOLVED that i)

The addendum to the minutes of the meeting of the Wakefield Alliance Clinical Commissioning Executive Meeting held on 22 May 2012 were agreed as a correct record.

12/144 Matters Arising from the Minutes of the Meeting of the Wakefield Alliance Clinical Commissioning Executive held on 28 June 2012 Adam Bassett updated the Clinical Commissioning Executive (CCE) on progress of the actions discussed at the meeting on 28 June 2012.

The following items were also discussed: 12/125

Hospital Standardised Mortality Ratio (HSMR)

Adam Bassett provided an update from Laura Elliott which advised that: The current HSMR has been reported by MYHT as 100 (April 2011 February 2012). It is estimated to rise following the 2011/12 national rebasing which is likely to flag the Mid Yorkshire Hospitals NHS Trust (MYHT) as an outlier. A progress report will now be presented to the MYHT Executive Contract Board on 26 July.

12/126

Preparing for Authorisation: Letter of Support for the Chair

It was noted that all but one member of the Clinical Commissioning Executive (CCE) had had the opportunity to confirm the decision made at the last meeting of the CCE to support for the Letter of Support for the Chair.

It was RESOLVED that i)

It was noted that the letter of Support for the Chair had been confirmed as supported by the Clinical Commissioning Executive.

12/145 Shadow Accountable Officer Update Jo Webster introduced this report noting the following: a) Policy and Guidance Update Code of Conduct The Clinical Commissioning Executive (CCE) was advised that the Code of Conduct: Managing Potential Conflicts of Interest where GP practices are potential providers of clinical commissioning group (CCG)-commissioned services had recently been published. Its stated aim was to protect the integrity of the NHS commissioning system and protect CCGs and GP practices from any perceptions of wrong doing. It was noted that members of the Practice Support Unit would be reviewing the implications of the Code of Conduct and will at the same time be discussing the implications with the Local Medical Committee and all relevant changes would be incorporated into the new NHS Wakefield CCG Constitution.

It was further highlighted that services would be commissioned using the NHS standard contract rather than the GP contract. Subject to transitional arrangements (to be confirmed) the resources currently associated with local enhanced services (with the exception of public health services) would form part of CCGs baseline allocations so that they could determine how best to use these resources. From 1 April 2013 the CCG would no longer use enhanced services as a contracting method for new services. b) Policy and Guidance Update: NHS Clinical Commissioning Group Regulations.

Jo Webster advised that the NHS (Clinical Commissioning Group) Regulations had been published at the end of June by the Department of Health and had been presented to Parliament for approval. c) NHS Care Objectives It was highlighted that Our NHS Care Objectives: a draft mandate to the NHS Commissioning Board had been published for consultation on 3 July 2012. The mandate would be at the heart of the accountability relationship between the Board and the Department of Health. The mandate set out 22 objectives for the NHS Commissioning Board which were outlined within the report. CCE members were asked to note that the Quality sub group would address this emerging challenge. d) Policy and Guidance Update: Functions of CCGs During June 2012: Functions of Clinical Commissioning Groups had been published which was an update to Functions of GP Commissioning Consortia: A Working Document. The document outlined the services which CCGs would be responsible for commissioning.

It was noted that health visiting was not included in the list of functions for CCGs to commission. It was therefore highlighted that there was an expectation that the CCG would work closely with both the Local Authority and the emerging West Yorkshire Local Area Team of the NHS Commissioning Board around the future management of local health visiting services. e) Policy and Guidance Update: Securing Excellence The CCE was advised that on 22 June 2012 the NHS Commissioning Board had published the single operating model for the commissioning of primary care services within the NHS. f) Authorisation Jo Webster reported that NHS Wakefield CCG’s application was successfully submitted on 2 July 2012 as planned. A communication had been received from the NHS Commissioning Board on 6 July confirming the application and indicating the intended issues of a high level assessment of compliance by 17 July 2012. It was expected that a finalised response to the application would be issued at the end of July. g) Introduction of Operational Divisions at the Mid Yorkshire Hospitals NHS Trust (MYHT) Jo Webster explained that from the beginning of July MYHT would be introducing new management arrangements for its clinical services to support the integration of acute and community services. The previous four clinical service groups would change to three divisions. The arrangements for this were outlined within the report. h) Winterbourne Review The CCE was informed that the Department of Health had published an interim report as part of a review of events at Winterbourne View Hospital and the wider investigation into the way health and social care supported people with learning difficulties. The report did not cover directly what occurred at Winterbourne View Hospital but detailed how the Department of Health and the NHS Commissioning Board would monitor progress; created the framework in which local action would take place; proposed actions and ensured that providers, commissioners and the workforce were clear on their roles and responsibilities and understood good models of care.

The report outlined the initial findings and the key objectives which had been identified. The final report would be published once criminal proceedings had concluded.

It was RESOLVED that i)

the report be noted.

12/146 Finance Report Jim Hayburn introduced a report which presented the financial position of NHS Wakefield Clinical Commissioning Group for June 2012 and the forecast year end position based on this position.

It was highlighted that NHS Wakefield Clinical Commissioning Group was on target to achieve each of its key financial performance indicators. The report advised that at the end of June NHS Wakefield Clinical Commissioning Group (CCG) had generated a surplus of £1,073K which was made up of a planned surplus of £774k and an underspend on revenue budgets of £299k.

Appendix 4 to the report outlined the 2012/13 capital planning position. It was reported that allocations had been received this month totalling £1,850k. Appendix 6 to the report outlined the financial position at month 3 on those budgets in relation to commissioned services which would be devolved to the NHS Wakefield Clinical Commissioning Group.

It was RESOLVED that i)

the revenue and capital financial positions at the end of June be noted;

12/147 Performance Report Matt England introduced a report which informed the Clinical Commissioning Executive (CCE) of performance against the 2012/13 NHS Operating Framework outcome measures together with other identified national and local priorities.

The appendix to the report outlined a summary position of key performance indicators for both NHS Wakefield Clinical Commissioning Group (CCG) and the Mid Yorkshire Hospitals NHS Trust (MYHT).

The CCE gave detailed consideration to the following performance issues and considered the actions which were being taken to address areas of under and over performance: • • • • • •

Eliminating mixed sex accommodation Ambulance response times A&E four hour wait 62 day cancer waits Transient Ischaemic Attack (TIA) Referral to Treatment Time

With regard to TIA, the CCE noted that MYHT had now implemented seven day consultant clinics and had recognised the need to ensure that they can measure the expected improvement. It was highlighted that data was normally available on a quarterly basis but from May 2012, MYHT had commenced monthly reporting to ensure that the service is monitored efficiently. It was anticipated that the improvement should be seen

immediately, however the invalidated monthly position is 26.3% against a target of 60%, It was further noted that NHS Wakefield CCG will be seeking assurances that this would improve through the Executive Contract Board.

It was RESOLVED that i)

the NHS Wakefield Clinical Commissioning Group performance against key national and local priority measures for 2012/13 be noted;

ii)

the additional actions outlined within the report required to address areas of under performance be agreed.

12/148 Mid Yorkshire Service Strategy Ruth Unwin and Michelle Ezro attended the meeting and updated the Clinical Commissioning Executive on the Mid Yorkshire Hospitals NHS Trust (MYHT) Clinical Services Strategy Option Appraisal Process. They also provided details of a report which outlined an appraisal of shortlisted options and a summary of results from an non financial workshop held on 10 July 2012.

The presentation covered the following areas • • • • • • • • • • •

The option appraisal process Non financial appraisal process Criteria What the clinical strategy consisted of Integrated care The two options Existing services at each site Opportunities for in year changes What each site would look like under each option Outcome of the option appraisal process so far Next steps

The CCE was advised that 44 people had attended an option appraisal workshop and the emerging view of consensus was for option 2. Dr Carroll noted that she had been NHS Wakefield CCG’s representative in this process and that she confirmed that option 2 was emerging as the preferred option.

Ruth Unwin advised that the preferred option would be derived from a quality score, financial appraisal and risk analysis. The outline business case would be available at the end of September and the MYHT, Calderdale, Kirklees and Wakefield District Cluster and the Clinical Commissioning Group Boards would be asked to consider this in October.

Formal consultation would take place from January 2013 in parallel to the production of the full business case.

Dr Earnshaw provided his thanks on behalf of the Clinical Commissioning Executive to Ruth Unwin and Michelle Ezro for the presentation and for attending the meeting.

It was RESOLVED that i)

the presentation be noted.

12/149 Optimizing Pontefract Hospital: Engagement Process Matt England introduced a report which provided the Clinical Commissioning Executive (CCE) with the Mid Yorkshire Hospitals NHS Trust’s (MYHT) report ‘Optimization of Pontefract Hospital’ and set out the process for engagement on the proposed changes and the involvement of the Overview and Scrutiny Committee (OSC).

The report advised that the Pontefract Optimization Project at MYHT had undertaken an assessment of the utilisation of the new hospital estate at Pontefract Hospital (PH). This review had identified that PH was underutilising clinic and theatre capacity and as a result had produced the document ‘Optimization of Pontefract Hospital’ which was attached as appendix 1 to the report. This report recommended service configurations to increase the utilisation of the hospital.

An engagement process was in place and was outlined in appendix 2 of the report. This commenced on 13 July 2012 and would run for four weeks. It was agreed that the outcome of this would be brought to the next meeting of the CCE in August.

It was RESOLVED that i)

the process be approved;

ii)

the planned optimization programme be supported;

iii)

The outcome of the engagement process be brought the August meeting of the Clinical Commissioning Executive.

12/150 Stanley Health Centre Capital Bid Danny Alba introduced a report which advised that following approval by the Clinical Commissioning Executive (CCE) in November 2011 additional work had been undertaken on an outline business case which was attached as appendix A to the report. The CCE was asked to confirm their approval to reflect the update on revenue costs (attached at appendix B) and completion of the outline business case (OBC) and to make a recommendation that the NHS Calderdale, Kirklees and Wakefield District Board approves its submission to NHS North of England (NHSNE) capital finance.

The CCE was advised that the initial business case did not include revenue consideration in terms of depreciation and capital charges that would be charged to revenue over the life of the asset, the value of the asset being

written off and impairment costs. Confirmation had also been requested that the providers would occupy the new accommodation and pay rent accordingly to operate services from the premises.

It was noted that details of the revenue considerations had been considered by the Finance and Performance Group on 14 June 2012.

The full financial implications were established within the report. It was highlighted that this was a publically funded business case submission to NHSNE Capital Finance with a value of £1,000,000. The recurrent revenue consequences were £26k per annum and there was a one off revenue charge in the first year of £508k.

The CCE considered the key risks to delivery of the project which were outlined within the report. It was noted that these would need to considered further as the project developed.

Jo Webster requested that the proposals contained within the report were supported by the Clinical Commissioning Executive (CCE).

It was RESOLVED that i)

approval of the outline business case for a capital bid for the refurbishment and development of Stanley Health Centre be confirmed to reflect the update on revenue costs and completion of the outline business case;

ii)

It be recommended to the Board of NHS Calderdale, Kirklees and Wakefield District to approve the outline business case for submission to NHS North of England Capital Finance;

iii)

It be noted that the risks and issues outlined within the report will require further consideration as the scheme progressed.

12/151 Transition: Quality Handover Laura Elliott introduced a report which shared the NHS Calderdale, Kirklees and Wakefield District Board’s plan to develop quality handover documents in line with the National Quality Board (NQB) guide ‘HOW TO: Maintain Quality during the Transition: Preparing for Handover’. This was attached to the report.

The Clinical Commissioning Executive (CCE) was advised that a Quality and Safety Summary had been produced on a quarterly basis since June 2011, as a legacy document. This was shared with the SHA, the Quality Group and was available on the intranet. The Wakefield interpretation of these documents reflected the Quality and Patient Safety reports which were presented to the CCE every other month.

It was highlighted that the national document stated that Chief Executive Officers of receiving organisations should nominate a transition lead responsible for the receipt of functions. The Medical and Nursing Directors, or equivalent, should share responsibility for receiving the quality handover

document and the document should be taken to the final board meeting of the sending organisation and the first public board meeting of the receiving organisation in April 2013.

Following discussion it was agreed that work would take place before the next meeting of the CCE to identify NHS Wakefield Clinical Commissioning Group’s transition Lead. This would then be considered further at the CCE meeting in August. It was agreed that whoever was the lead for this process would undertake a formal handover back to the Board of NHS Wakefield Clinical Commissioning Group.

It was RESOLVED that i)

the contents of the report and plans for the handover for information be noted;

ii)

the transition lead for NHS Wakefield Clinical Commissioning Group (CCG) be considered at the August meeting of the Clinical Commissioning Executive;

iii)

it be agreed that the quarterly Quality and Safety Legacy document continued to be discussed within the CCGs evolving governance structure;

iv)

the formal and informal handover arrangements with the cluster Nurse / Medical Director be noted;

v)

the quality handover document be added to the agenda for the CCG Board meeting in April 2013.

12/152 Transition: Contracts Transition Matt England introduced a report which updated the Clinical Commissioning Executive (CCE) on progress in relation to the contract transition process from the PCT to future commissioners. The report also outlined the key issues and next steps for the contract transition process.

The report advised that the Department of Health had set out arrangements to ensure that contracts with providers were safely transferred from PCTs to the various organisations responsible for commissioning services in the future. The process involved three stages; ‘stock take’, ‘stabilise’ and ‘shift’.

The CCE was advised that the stock take element had now been completed and the project was now in the stabilisation phase which required all currently commissioned services to be stabilised onto a standard contract to expire in March 2013 or the be decommissioned following a full impact assessment. As part of this process a Contract Transition Plan had been created.

The report outlined key issues which were emerging through the stabilisation process and provided details of the next steps in the Contract Transition Plan.

It was RESOLVED that i)

the progress and key risks be noted.

12/153 Enhanced Support to Care Homes Julie Owen and Joanne Fitzpatrick introduced a report which outlined a business case and related service specification for the proposed pilot of the Care Home Liaison and Support Service. It was highlighted that the business case was related to proposals developed in response to the additional resources which were made available to clinical commissioning groups in January 2012 to improve local services and reduce pressures on the NHS. The business case and service specification were attached to the report.

The report advised that the development of the service would be a six month pilot with a review of a number of outcome measures. As a pilot with a limited capacity it had been agreed at the Joint Strategic Commissioning Board meeting on 15 June 2012 it was concluded that the preferred approach would be to focus on care homes within a specific geographical area with future consideration to support Extra Care Housing facilities as determined by the phased implementation of the service.

The report also highlighted the main risks associated with the failure to implement the Care Home Support and Liaison Service.

The report outlined the financial implications of this scheme and highlighted that total staffing costs would be ÂŁ70,285.

The CCE considered the proposal for the pilot to focus upon a specific geographical area. It was agreed that this should be the case and the geographical area should be around those care homes identified in red in appendix 1 of the service specification.

Jo Webster requested that the proposals contained within the report were supported by the Clinical Commissioning Executive (CCE).

It was RESOLVED that i)

the implementation of the proposed Care Home Liaison and Support Service be approved;

ii)

the proposal to focus the pilot on those care homes within a specific geographical area be supported and this be based on those care homes highlighted in red in appendix 1 of the service specification.

12/154 Tackling Health Inequalities in Wakefield via Primary Care All GP members present at the meeting declared an interest in this item. It was agreed that during consideration of this item Sandra Cheseldine would undertake the role of Chair.

Jo Hanlon and Laura Elliott introduced a report which advised that following the introduction of the Personal Medical Services contract in 2010, which contained a portion of funding to tackle health inequalities, a project team led by the Public Health Directorate had been established. In addition how these funds were allocated to practices had been discussed by the Senior Management Team which had culminated in a model for allocating funds.

The report advised that the health inequalities funding was ÂŁ500,000 per annum recurrent. The additional funds required from the management allowance to fund the General Medical Services practices was ÂŁ75,894.

The Clinical Commissioning Executive (CCE) was advised that it had been agreed that the Index of Multiple Deprivation (IMD) 2010 score would be used to determine which practices received funding. The Wakefield IMD 2010 score was 25.87 and it had been agreed that those practices with a score higher than the Wakefield value would receive funding which made 22 practices eligible.

The CCE considered the proposals within the report and questions were raised regarding the use of the IMD 2010 score. It was also noted that following the abolition of PCTs the responsibility for this scheme would pass to the NHS Commissioning Board Local Area Team. It was also felt that prior to any payments for year two of this scheme an evaluation of the achievements of the first year should be undertaken.

Jo Webster requested that the proposals contained within the report were supported by the CCE. Following a vote to which GP members abstained the proposals were agreed. There were no votes against the proposal.

It was RESOLVED that i)

the project and the proposed approach to allocating the funding be supported;

ii)

the use of the Management Allowance as described within the report be approved;

iii)

An evaluation the achievements of the first year of the scheme be undertaken prior to the payment of any further monies.

12/155 Dermatology Contract Julie Thorpe introduced a report which advised that a formal tender process had been undertaken for the provision of the Community Dermatology

Services across the Wakefield district. This had followed NHS Wakefield District policy and the appropriate Tender regulations.

The Clinical Commissioning Executive was advised that the tender evaluation panel had put forward recommendations to award contracts to the three specified geographical lots within the tender and the recommendation was to award all three lots to the same bidder based upon the outcome of the Award system scores.

The total for the three year contract was ÂŁ4,063,437 which reflected a 30% cost below tariff.

Clinical Commissioning Executive members highlighted that they did not feel they were in a position to approve this tender as the report did not contain sufficient information. It was therefore agreed that an updated report would be brought back to the next meeting in August.

It was RESOLVED that i)

a more detailed report be brought to the August meeting of the Clinical Commissioning Executive.

12/156 Draft Health and Wellbeing Strategy Ruth Twiggins introduced a report which presented the draft Health and Wellbeing Strategy. She advised that the strategy had been developed based on the six key health and wellbeing priorities which had been identified within the Joint Strategic Needs Assessment.

The Clinical Commissioning Executive (CCE) was advised that an engagement plan had been developed to ensure that key stakeholders were involved in the development of the strategy. This report was therefore presented to the CCE to allow members to have the opportunity to contribute to and comment on the early draft of the strategy.

Jo Webster noted that the Health and Wellbeing Board would develop the strategy and the role of NHS Wakefield Clinical Commissioning Group would be to examine the priorities and to ensure that they linked with what it commissioned.

It was noted that CCE members were invited to comments on the strategy and feed back any comments by 9 August 2012.

It was RESOLVED that i)

the outcomes and objectives within the strategy be supported;

ii)

Clinical Commissioning Executive members to support the development of the strategy by providing any comments by the end of Thursday 9 August.

12/157 QIPP Report Lee Beresford introduced a report which had the purpose of providing assurance to the Clinical Commissioning Executive (CCE) regarding progress on the implementation of the NHS Wakefield Clinical Commissioning Group’s (CCG) QIPP Programme.

The report advised that the total target savings for 2012/13 QIPP was £12.567M made up of £11.023M, plus the running cost target of £1.459M and a Specialised Commissioning Group QIPP of £85K. It was noted that QIPP ‘tracker’ system had been developed which was overseen by the Finance and Performance Group.

The CCE was advised that a month 2 flex QIPP data showed that QIPP schemes were not performing to the levels anticipated. This was mainly in the areas of A&E attendances and emergency admissions which were higher than planned levels. It was noted that within the Finance report a nil value of QIPP had been recorded to date with an estimated forecast of break even, which was due to the fixed contract value with the Mid Yorkshire Hospitals NHS Trust. There was a however a financial risk around this is QIPP continued to under perform.

Jo Webster advised that a detailed analysis if the Primary Care Transformation Scheme would be brought to the August CCE meeting.

It was RESOLVED that i)

the content of the report be noted.

12/158 Alcohol Liaison Service Jez Mitchell introduced a report provided an update on the Alcohol Liaison Service.

The Clinical Commissioning Executive (CCE) was advised that the service will be based within the Gastroenterology Department at the Mid Yorkshire Hospitals NHS Trust. Through patient detection, assessment and specialist liaison it was anticipated that the service would prevent alcohol hospital admissions, re-admissions and the length of stay for the those who were admitted. Based on the potential savings assumed, cash savings would ensure the Alcohol Liaison Service could become self sufficient in year four.

It was noted that the Prevention Clinical Commissioning Unit had approved the service specification in June 2012 and requested that the paper be submitted to the CCE. Dr Brown noted that the specification outlined that that the service would operate on a Monday to Friday working hours basis. It was agreed by the CCE that this could severely detract on the success of this service and it was agreed that this matter would be clarified. Elaine McHale also noted that the service was intended for adults but highlighted the issue of alcohol misuse amongst 16-18 year olds which she advised needed to be addressed.

It was RESOLVED that i)

the report be noted.

12/159 What Makes a Good Practice Jan Power introduced a report which provided members with a summary of the recommendations made by Wakefield Local Improvement Network (LINk) following their survey and visits to GP practices last year. The report advised that through the work of LINk and its engagement with the public a number of concerns had been raised about aspects of services received at local GP practices and the LINk had decided that further work needed to be undertaken.

In 2010 the LINk Task Group surveyed all GP practices in the district with a 50% response rate. The Task Group also decided to visit a number of practices. Following this the LINk felt that some practices offered the very best of services but also that some were not so good and made a number of recommendations relating to the following: • • • • • • •

Well person checks Test results Access issues Patient panels Appointments Confidentiality Criminal Records Bureau checks

Overall the LINk team felt that on the whole practice staff worked very hard, with increasing patient lists, trying to develop services locally to increase choice and efficiency and dealing well with the changing landscape of health.

On behalf of the Clinical Commissioning Executive Dr Earnshaw thanked Jan Power for the work which she and the LINk had undertaken in this area and for her report.

It was RESOLVED that i)

the good practice and recommendations from the What Makes a Good Practice report published by Wakefield LINk for information be noted.

12/160 Individual Funding Request Report Jo Webster introduced a report which presented the Annual Report on Individual Funding Requests (IFR) for 2012 The Annual Report summarised the work completed during 2011/12 in relation to IFRs. The report also demonstrated how this process met the Individual Funding Request Terms of Reference and outlined the volument

of IFRs submitted to NHS Wakefield District during 2011/12 and the outcome of these requests. The report also highlighted the key issues and potential risks to the IFR process and identified actions to be undertaken in 2012/13 to mitigate risk and address issues.

It was highlighted that during 2011/12 710 requests had been submitted, a decrease of 28% on the previous year. 67% were approved at the triage stage. 79 of the cases received in 2011/212 were considered by an IFR panel reaching of total of 115 cases overall.

Dr Harries highlighted that he was aware of a number of potential IFRs relating to adults with Aspergers Syndrome and whether these cases were included within these figures. Jo Webster advised that she would check this.

It was RESOLVED that i)

The Annual Report on Individual Funding Requests for 2011/12 be noted;

ii)

The use of the submission form by referring clinicians be encouraged.

12/161 Minutes of the NHS Calderdale, Kirklees and Wakefield District Cluster Board meeting held on 12 June 2012 It was RESOLVED that i)

the Minutes of the NHS Calderdale, Kirklees and Wakefield District Cluster Board meeting held on 12 June 2012 be noted.

12/162 Minutes of the Finance and Performance Group meeting held on 12 July Jo Webster introduced these minutes and highlighted that the Finance and Performance Group had asked the Clinical Commissioning Executive to note the following items: • consideration of ambulance turnaround times • a detailed consideration of the QIPP transformation schemes which is to be undertaken that the next meeting of the Finance and Performance Group • a request for the Performance Improvement Manager to undertake a detailed examination of accident and emergency performance.

It was RESOLVED that i)

the Minutes of the Finance and Performance Group meeting held on 12 July 2012 be noted.

12/163

Clinical Commissioning Units Update It was RESOLVED that i)

The Clinical Commissioning Units Update be noted.

12/164 Clinical Commissioning Executive (CCE) decisions for Inclusion in the Legacy Document It was agreed that the following items would be included in the Legacy Document: •

Tackling Health Inequalities in the Wakefield District via Primary Care.

It was RESOLVED that i)

the above item be included in the legacy document.

12/165 Items for referral to the Cluster Board or any of the Sub Groups It was agreed that the following items be referred to the Board of NHS Calderdale, Kirklees and Wakefield District: • Performance regarding Transient Ischaemic Attacks • Stanley Health Centre Capital Bid • Tackling Health Inequalities It was RESOLVED that i)

the above items be referred to the Board of NHS Calderdale, Kirklees and Wakefield District

12/166 Any Other Business Improving Dignity and Respect in Care Dr Brown introduced a report which advised that NHS Wakefield District had been allocated £10-15,000 to spend on initiatives which improved dignity and respect in care. It was noted that these monies should be spent on addressing gaps in services for patients with sensory impairments.

It was recommended that a Task and Finish Group be formed to produce firm proposals to bring to the August Clinical Commissioning Executive for sign off.

It was highlighted that the Yorkshire and Humber Local Education and Training Board (YHLETB) had agreed to allocate £1.3m in non-recurrent monies of which £50k was allocated to Calderdale, Kirklees and Wakefield District to allocate to local clinical commissioning groups. The suggested approach that could be used was outlined in a letter from the YHLETB which was attached as appendix 1 to the report.

It was RESOLVED that i)

spending the ‘Improving Dignity and Respect in Care’ initiative money on addressing the service and training issues raised by the survey on sensory impairment be supported;

ii)

the development of a Task and Finish Group to firm up proposals to spend this resource be supported;

iii)

final details of this proposal be considered at the August Clinical Commissioning Executive meeting.

12/167 Date and Time of Next Meeting 1.00 pm on 21 August 2012 at White Rose House.