NHS Greater Huddersfield Clinical Commissioning Group
Minutes of the NHS Greater Huddersfield Clinical Commissioning Executive (CCE) Meeting held on Wednesday 7th November 2012, 1.30 – 4.30pm, Seminar Room 1, The Textile Centre, Huddersfield Present: Dr Steve Ollerton (SO) Dr Dil Ashraf (DA) Dr Judith Parker (JP) Dr Paul Wilding (PaW) Dr Karen Dean (KD) Carol McKenna (CM) Julie Lawreniuk (JL) Penny Woodhead (PeW) Dr Irving Cobden (IC) Moira Wilson (MW) Tony Gerrard (TG) Alison O’Sullivan (AOS)
CCG Clinical Leader and Chair GP Practice Representative GP Practice Representative GP Practice Representative GP Practice Representative Designate Chief Officer Chief Financial Officer Head of Quality & Safety Consultant Advisor Lay Member Lay Member Director of Children & Young People, Kirklees Council
In attendance: Martin Pursey (MP) Jan Giles (JG) Vicky Dutchburn (VD) Kath Woodford (KW) Lynsey Warwick Giles (LWG) Sapphire Wright (SW) Rachel Spencer-Henshall (RSH) Christine Powell (CP)
Head of Contracting Head of Practice Support & Development Head of Strategic & Business Planning Business Reporting Manager Research Analyst Graduate Management Trainee Consultant in Public Health Choose & Book Programme Manager
Minutes: Kelly Chadwick (KC)
Personal Assistant to Greater Huddersfield CCG
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Welcome, Introductions and Apologies for Absence SO opened the meeting and welcomed the CCE members. Introductions were made for Moira Wilson, PPI lay member and Sapphire Wright, Graduate Management Trainee. Apologies for absence were received from; Angela Monaghan (AM) Nicky Hoyle (NH) Dr Jane Ford (JF) Dr David Hughes (DH) Dr Anuj Handa (AH) Mehboob Khan (MK)
Nurse Advisor Public Health Consultant GP Practice Representative GP Practice Representative GP Practice Representative Non-executive Director Page 1 of 12
Declarations of Interest TG declared an interest as he is still currently a lay member for North Kirklees CCG. EC/12/202
Accuracy of Minutes of 3 October 2012 The minutes were AGREED as accurate. Matters Arising Public Meetings Page 3 of the minutes states that the CCE will begin to hold public meetings from January. CM confirmed this will now start to happen with effect from the February meeting, due to the extension of the authorisation timetable. Mid Yorkshire update CM provided an update on the work recently undertaken in relation to the Mid Yorkshire NHS Trust and the development of options for future service configuration. CAMHS Tier 3 Specification CM advised that the specification had been signed off as described and this was now out to tender. Action Log EC/12/187 - 5 September Action Log - EC/12/165 - Any Other Business - Health Checks JL advised she is still awaiting further information from David Boothroyd relating to the Locala budgets for Health Checks and AGREED to keep it on the action log. Action: Keep open on action log. EC/12/187 - 5 September Action Log - EC/12/178 – Receipt of Minutes (A&G Subgroup) – Complaints Policy. PeW advised that the Complaints Policy was based on NHS Kirklees. This has been picked up via the Quality & Safety Subgroup but hasn’t progressed due to staffing issues at present. There is some work required to tailor the report for CCG use, however it will be a CSU function and will be picked up through that route. A draft specification is in place and a standard reporting template needs to be produced. It was AGREED that the Quality & Safety Subgroup should carry this forward and report back to CCE as and when relevant/available. Action: Complaints Policy to be developed through the Quality & Safety and reported into CCE when available. KC to agenda for February. EC/12/188 - Clinical Leader/ Designate Chief Officer Report - NHS 111 lead contractor update Page 2 of 12
JL advised that there is no further update available yet. It was AGREED to keep this on the action log. Action: Keep open on action log. EC/12/188 - Clinical Leader/ Designate Chief Officer Report – Referral Pathway Software. JL advised that Rhona Radley has a meeting booked with Anuj Handa to take this forward and this will come back to CCE as a business case. EC/12/190 - Developing our Strategic Objectives VD advised this action is complete and the Strategic Objectives have been included on practice visits forms. VD confirmed that a meeting has also been arranged with Dasa Farmer to look at broader engagement. All other actions were confirmed as complete. EC/12/203
Clinical Leader/Designate Chief Officer Report GHCCG email addresses CM explained to the CCE that new email addresses will be put in place from 1st April but these have to be agreed by NHSCB. NHSK Staff Awards CM invited CCE members to attend the staff awards on Friday 30 November. This will be an opportunity to thank all staff for their hard work for the PCT. CM asked CCE members to let Kelly Chadwick know if they wished to attend. Action: KC to collect tickets on behalf of GHCCG. The CCE RECEIVED and NOTED the contents of the report and thanked SO/CM.
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Draft Equality & Diversity Strategy PeW explained the background of the strategy and the appendices. The key leads for delivering the strategy are now confirmed with the exception of the Clinical Lead. Discussion took place about PaW being the clinical lead in this area and PaW AGREED. PeW explained the action plan and advised that this was included in the report at high level and is consistent with the order book from the CSU.
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PeW asked the CCE members for the comments and asked for approval of the strategy with a review in 12 months. A question was raised about the Equality Impact Assessment template and PeW confirmed that the Cluster one is the most recent and this will be adapted appropriately. MW asked if we would be responsible for performance monitoring. PeW advised that the strategy has been developed to embed systems and processes into it. We need to monitor the action plan and this will be carried out through the Quality & Safety Subgroup. It was AGREED to monitor this through the Quality & Safety Subgroup and review it in March 2013 prior to the NHS Kirklees closedown. The strategy will then be reviewed in Autumn 2013. TG informed the CCE that Imran Patel, one of the non-executive members of North Kirklees CCG, is involved in a piece of work to look at how the strategy is embedded. It was AGREED that TG would speak with Imran regarding sharing information and ideas and feedback to the CCE. Action: TG to speak to Imran Patel regarding the E&D strategies and feedback to CCE. The CCE APPROVED the strategy and thanked PeW. EC/12/205
Joint Health and Wellbeing Strategy Rachel Spencer-Henshall attended to provide an update on the Joint Health and Wellbeing Strategy (JHWS). RSH advised that this strategy was a statutory requirement of the Health and Wellbeing Board and it was signed of at the last meeting on 3 October. The key elements were noted to try and fit with all partners. There are 5 core principles and 5 actions to focus on. RSH went on to explain these to the CCE members. RSH explained the strategic thinking framework. It is a set of 21 questions that have been written to be used as a tool. RSH advised that the CCG need to think about how this framework will fit with their objectives. An exercise using the JSNA was undertaken and 4 priorities were picked that GHCCG could work with to make a greater impact within communities. RSH advised that there will be a governance session held as part of the Shadow Health and Wellbeing Board in December to look at accountability and legislation. This will also focus on how the strategy will be aligned via SHWBB.
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RSH informed the CCE that a workstream has been developed to look at integrated commissioning between the Local Authority and the NHS. VD informed the CCE that this is the final version of the JHWS but it has been developed over a number of months with the involvement of a number of CCE members. Discussion took place about various links the JHWS to areas such as Calderdale CCG and the Strategic Review/Carestreams work. CM noted that we need to be able to understand the governance loop and although the JHWS has been formally signed off by the HWBB, the CCE need to endorse the strategy. The CCE RECEIVED and NOTED the contents of the report and ENDORSED the strategy. The CCE thanked RSH for her attendance. EC/12/206
Choose & Book update Christine Powell attended to provide an update on Choose & Book. CP explained the report and explained about optimising electronic referrals. CB advised the team would like all clinics at all sites to be on C&B, which isn’t an easy process but changes are slowly taking place. Kirklees currently have a 61% uptake which is slowly increasing and this is positive to note. JG informed the CCE that up to February 2012 Kirklees was below the national average and thanks to the work by CP and her team, Kirklees are now much more engaged with the use of Choose & Book and performance is above national and Yorkshire and the Humber averages. CP advised that the C&B team are working with practices and contacting them via their practice managers to ask if they need help with the system. The C&B team then look at targeted areas and graphs showing data results. CP advised that the reports from SystmOne were much better output than EMIS reports. JP informed CP that she was encouraging the use of Choose & Book during practice visits and asked CP if she would be willing to contact those practices specifically to offer help. CP confirmed she would contact them. KD informed CP that her practice is using the Advice and Guidance tool as one of their QP pathways.
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JG requested that the CCE receive the report and endorse the actions included. JG highlighted that the target of 90% from the SHA is quite difficult to achieve but the C&B team are working hard to produce the best results for Kirklees. The CCE RECEIVED and NOTED the contents of the report and ENDORSED the actions. The CCE thanked CP for her attendance. EC/12/207
Authorisation Site Visit Report CM advised that a formal write up of the site visit on 19 October was included in this report. The OD & Authorisation subgroup will remain the lead group with responsibility for addressing the 2 remaining reds. PeW informed the CCE that Calderdale CCG had received their report on 6 November and now has a window of time available to provide further evidence to turn these red buttons to green. If this isn’t possible, they will be authorised with conditions, regardless of how big or small the work required is. VD advised that a number of pieces of work have begun to try and address the areas. DA informed the CCE that there will be a number of public engagement events scheduled over the next month or so for the Strategic Review and this will be very helpful for the CCG. CM advised that once the final moderation report is received, SMT will look at in detail and decide if any further work can be carried out between now and the 18 December. Suggestions were made about looking at the evidence already submitted to re-evaluate it to see if anything has been missed. Action: CM to discuss site visit report further in SMT and provide feedback at CCE next month. The CCE RECEIVED the report and thanked CM/JG.
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CSU SLA MP provided an update on the SLA for the WYCSU. The CCG have been working with CSU to look at a financial framework and some of the governing principles. The paper provides a framework in advance of the document becoming finalised. The details of the services are also included in the appendices.
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MP informed the CCE that endorsement is required by them, with the Finance & Performance Subgroup having oversight of this being developed and will finally sit with CM in her role as DCO to formally sign off. VD raised a question about some of the figures and asked JL to check if these had been amended as per discussions recently held with the CSU. JL AGREED to check this. Action: JL to look at figures and share detailed service specification with VD. MW asked how the detailed service specification had been written. JL confirmed that each of the Heads of Service has one line of responsibility to work with a team in the CSU going forward. MP advised that the NHS CB is pushing for sign off by the end of November and we are responding on this as much as we can. Discussion took place regarding the areas where benefit could be gained from integrated working with the local authority. AOS advised that we need to try and get the right collaboration between the CSU and Local Authority and we need to be flexible to avoid duplication. CM agreed and advised that as commissioners and providers, the CCG and the Local Authority need to be able to work with the CSU. It was AGREED that AOS would share some information regarding the Local Authority communications and engagement to CM. Action: AOS to share Comms and Engagement information with CM. IC asked how or why the CSU was developed on a West Yorkshire basis. JL explained that it was based on the Cluster footprint mainly, although West Yorkshire has 2 Clusters so we are a little different. PeW informed the CCE that she had recently met with CSU Governance leads to offer help with new staff from a customer perspective. It was AGREED that CM could formally sign off the document on behalf of the CCG after detailed discussion at Finance & Performance. The CCE RECEIVED and NOTED the contents of the report and AGREED that CM could formally sign off the SLA on behalf of the CCG.
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NHS Transition People Transition CM advised that the pooling and matching process is still going on and a number of panels have now met. There are some issues to resolve in a number of functions and further panels will need to be held as a result of this. There has been a delay in informing some staff. Once the results are complete, interviews will take place. CM informed the CCE that the Senior Programme Manager interviews will require clinical input and asked if any GP’s could be available. CM advised that a welcome event for new staff was planned for the end of November but this has been put on hold now until January.
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NHSK Major Incident Plan CM explained the report has been brought to CCE to gain an understanding of what the CCG will begin to take on from April. CM highlighted that the content of the report needs to be noted from an NHS Kirklees perspective. CM advised that the West Yorkshire Local Health Resilience Partnership will consist of a member of all West Yorkshire CCGs. It’s not clear yet who that will be for GHCCG, or whether CCGs will identify one or two organisations to attend on behalf of all. The categories and responsibilities were discussed. CM informed the CCE that a dedicated session on this area of work will need to be planned at some point in the future. Action: Major Incident Planning to be picked up through a future OD session. KC to note. CM suggested endorsing this but with caveats to note that the responsibilities of CCGs as Category 2 responders still need to be fully understood and that further discussion would be required on resources required to support the management of this function.. The CCE RECEIVED and NOTED the contents of the report and ENDORSED it.
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Strategic Review Update PaW provided an update. A framework report has now been produced by the Programme Office and adapted for informing CCGs.
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Joe Gibson, Programme Director, has reduced his hours to part time over the coming month and is then leaving the Programme. A procurement is underway for new staff including a new Programme Director. This will provide extra support for both the Programme Office and the Carestreams. MP advised he had sat on the procurement panel with PaW and that a consulting have been agreed with 2 people commencing in November. The DH gateway review has now taken place. The Programme Board invited them early to carry out this check/review to increase the skill and strength of the governance aspect of the programme. The cross-cutting themes groups are now being established and these will be undertaking some of the groundwork for each of the Carestreams. An additional cross cutting theme group has been developed for Medicines Management. The Children’s Carestream are currently developing 2 business cases. They also have more focussed work going on. JP questioned whether the JHWS and Equality & Diversity Strategy will be included in the business plan. DA/PaW confirmed the foundations have been incorporated. The Long Term Carestream didn’t get through their Gateway 2a review. The Steering Group have now agreed to move the dates for the Gateway 2b Reviews by 2 weeks but the Long Term Carestream will keep w/c 13 Nov to revisit Gateway 2a again. The CCE RECEIVED and NOTED the contents of the report and thanked PaW. EC/12/212
Finance Contracting and QIPP Report JL provided an update. JL informed the CCE that the F&P Subgroup have detailed discussions each month about Finance, Performance, Contracting and QIPP individually. A summary report is then provided to CCE. JL advised that there is a small underspend of £118k within the budgets. There is a financial risk share around the contract at CHFT, however we need to aware of the recurrent implications of any overtrades when planning for next year. . JL explained the current QIPP position and explained the spending plan for the £3 million non-recurrent money GHCCG have. A question was raised with regarding to using some of the nonrecurrent money to build a new health centre. JL advised this isn’t possible as this would be identified as capital and will need further funding recurrently. JL explained the estates strategy and advised that GHCCG are involved but not responsible for estates. Page 9 of 12
Further discussion took place about inviting Keith Geldard to a CSG for an update on estates within the GHCCG area. AOS suggested some resource may become available from the Local Authority and perhaps a conversation needs to be held with regard to sharing this resource. CM agreed. Discussions took place about possible smaller schemes if there should be any further non-recurrent money in the future. DA asked if the partner organisations had confirmed how they would be spending their share of the non-recurrent money. JL explained how it stands at present and that this would be monitored through the contract management processes.. JG will be responsible for designing a process for primary care investment, and decisions for this area will be managed in line with those set out in our Constitution in relation to conflicts of interest. The CCE RECEIVED and NOTED the contents of the report and thanked JL. EC/12/213
Performance Report KW attended to provide an update. KW informed the CCE that there were no major issues to note at present. CM asked about the output from the CSG on 24 October in relation to the non-elective pressures. JL explained that we will be using the commissioning value packs which will be broken down into sections. The outcomes were discussed and it was agreed that some of the areas could be reported into the Strategic Review. It was also agreed to ask Sue Baughan to carry out some detailed work on specific areas. Respiratory is an area that was agreed in order to link with Calderdale. VD highlighted that the QIPP dashboard will be viewed and discussed in detail at the next CSG. The CCE RECEIVED and NOTED the contents of the report and thanked KW for her attendance.
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Quality & Safety Report PeW advised that the report covers a number of areas received into the Quality & Safety Subgroup each month. The 2 main areas to highlight this month are;
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Section 7 – new project called the Friends and Family Test. PeW explained the implementation of this project and advised that this will be performance managed by the SHA and there will be monthly updates via Quality & Safety Subgroup. It commences from 1st April 2013.
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Section 8 – NHS Kirklees Quality Handover document. PeW explained this will be a full handover document from NHSK to the CCGs. It’s currently in development. JP/PeW met with Sue Cannon from the Cluster recently to discuss this document in detail. They will be public documents. The Quality & Safety Subgroup are managing this on behalf of GHCCG. In March there will be a formal handover assembly from the PCT to the CCG for all handover areas which will include Quality and Safety.
The CCE RECEIVED and NOTED the contents of the report and thanked PeW. EC/12/215
Receipt of Minutes The CCE RECEIVED and NOTED the minutes of the following meetings; • Cluster Board Minutes – 03/07/12 • Finance & Performance Subgroup – 15/08/12 and 19/09/12 • Audit & Governance Subgroup – 27/09/12 • Clinical Strategy Group – 11/07/12, 01/08/12 and 12/09/12 • PCT/LMC/CCG Interface Meeting – 11/09/12 • SCG Minutes – 28/09/12 Clinical Strategy Group It was noted that the CSG minutes from 12/09/12 still had draft on them. Action: KC to check if correct version of minutes and include in next month’s papers if necessary. Specialist Commissioning Group A discussion took place regarding the £11.6 million overspend noted in the SCG minutes.
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Any Other Business OD Days for 2013 Discussion took place regarding availability for the OD Days during 2013. It was AGREED that KC would draft a list of dates and share at SMT. Action: KC to draft list of important dates including potential OD sessions for 2013 and share at SMT. Page 11 of 12
Matters to escalate to Cluster Board No matters noted. EC/12/217
Date and time of the next meeting The date of the next scheduled meeting is Wednesday 5 December 2012, 1.30 – 4.30pm. It was confirmed that the December meeting will now be in the Board Room at Broad Lea House.
This concluded the content of the CCE meeting and the Chair declared the meeting closed at approximately 4.30pm.
Chair’s Signature: ........................................................ Date: ..................................
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