/CKWCB.12.128_GH_CCE_minutes_22_Fe

NHS KIRKLEES

Minutes of the Greater Huddersfield Clinical Commissioning Executive (CCE) Meeting held on Wednesday 22nd February 2012, 2.00 – 5.00pm in the Board Room at Broad Lea House, Bradley Business Park, Huddersfield Present: Vanessa Stirum (VS) Mehboob Khan (MK) Rob Millington (RM) Dr Steve Ollerton (SO) Dr Judith Parker (JP) Dr David Hughes (DH) Dr Dil Ashraf (DA) Dr Anuj Handa (AH) Dr Karen Dean (KD) Dr Paul Wilding (PW) Steve Brennan (SB) Carol McKenna (CM) Sheila Dilks (SD)

Non-executive Associate and Chair Non-executive Director Non-executive Associate CCG Clinical Chair CCG member CCG member CCG member CCG member CCG member CCG member Deputy Director of Finance Chief Operating Officer Director of Transformation

In attendance: Jan Giles (JG) Vicky Dutchburn (VD) Kath Woodford (KW) David Boothroyd (DB) Rachel Carter (RC) Helen Severns (HS) Dasa Farmer (DF)

Assistant Director of Commissioning Assistant Director of Commissioning (Mental Health) Performance Reporting Manager Senior Contracts Manager Deputy Director of Commissioning/Head of Contracts Assistant Director of Commissioning (Children’s) Communications & Engagement Lead

Minutes: Kelly Chadwick (KC)

Personal Assistant to Greater Huddersfield CCE

EC/12/75

Apologies for Absence Apologies for absence were received from; Merran McRae Nicky Hoyle Dr Jane Ford

Director of Wellbeing, Kirklees Council Public Health Consultant CCG member

Declarations of Interest JP declared that her practice is currently in discussions with the PCT with respect to relocation of her practice.

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EC/12/76

Accuracy of Minutes – 25 January 2012 The minutes of the CCE meeting held on 25th January 2012 were ACCEPTED as a true and accurate record with the exception of one amendment as noted below.

SO requested his name to be added to page 7 regarding the Task & Finish Group for the non-recurrent money. SO attended this meeting.

Action: KC to add to previous notes.

Estates Strategy SB advised he had met with Keith Geldard and Mark Jenkins recently to discuss prioritisation of PCT estates and map out the existing structures. A further meeting is planned for 2 weeks to explore the next steps. An enquiry into the timescales was made and SB advised that it will take approximately 4 weeks for discussions then it will be progressed from May onwards.

Further discussion too place regarding the input from CCE members and SB agreed to keep the CCE informed and ask for input as/when required.

There is an agreed business case template and prioritisation tool that will be used. This will include relevant suitability of estates.

Mark Jenkins had suggested any new themes/locations are to be taken into consideration.

Action: KC to add to agenda for May CCE. Action Log EC/11/65 – Declarations of Interest. KC confirmed the amendments were in hand.

EC/11/66 – CCG Structures. Carol advised she has discussed the roles of external nurse/consultant with JP/SD. This has now also been issued publicly. Development work will continue over the coming weeks on these roles.

EC/11/66 – OD & Authorisation Subgroup. KC confirmed the action was ongoing. Information will be shared once received.

All other actions complete.

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EC/12/77

Clinical Chair/Chief Operating Officer update COO Update CM advised that she had put together a brief report of updates. The key point is that David Nicholson is planning to attend the CKW cluster area on Friday 20 April. The agenda for the day is currently being developed and will be issued nearer the date.

Clinical Chair Update SO advised that there had been further discussion around Information Governance and the new equipment ordered for members. Orders had now been submitted and a further update will be provided when available.

The CCE members NOTED the contents of the report and thanked CM/SO for the update.

EC/12/78

CQC/Ofsted Inspection Report HS was in attendance and explained the background to the report.

There has recently been an Ofsted inspection as part of a 3 year cycle. Two teams come into Kirklees for a joint inspection with the PCT and the Council. The two main areas of criticism were the Healthy Child Programme and Child & Adolescent Mental Health (CAMHs) Programme. A number of plans are in place to increase health visitors. We are also working on a CAMHs programme which will look at areas including fostering/adoption etc.

Action: Further report on CAMHS to be brought to April meeting. KC to add to agenda.

Discussions took place about the funding of the health visitors. It was confirmed that 23 health visitors are to be funded over 4 years and CQUINS will be used to help with funding. HS advised that the Quality & Safety Subgroup will take on board the implementation of the action plan and feedback to the CCE. The CCE are then required to oversee the implementation of the plan.

The CCE RECEIVED and NOTED the contents of the report and thanked HS for her attendance.

EC/12/79

Draft PPI Strategy Dasa Farmer was in attendance and explained the draft strategy to CCE members.

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The initial version of this document was agreed at the OD & Authorisation Subgroup in January and it will be taken to an OD session for further detailed discussions. The draft strategy is only shared for information purposes today but agreement is requested to move the strategy forward.

PW raised a question regarding how other CCGs are developing/implementing their strategies. DF advised that each CCG does this differently and for GHCCG in particular, getting view/thoughts of each member is important in helping to develop the strategy.

Discussion took place about patient participation groups in practices and their involvement in this. It was noted that Public Health has previously had a lot of input into PPI. DF advised that will be incorporated into the ongoing work. It was suggested that a working group could be established to develop/progress this strategy. This was agreed in principle and the details need to be discussed further.

The CCE RECEIVED and NOTED the contents of the report and thanked DF for her attendance.

EC/12/80

NHS Transition CCG Structures CM explained that the pools for the “Heads of� roles have now been agreed and staff have sent in their expressions of interest.

Discussions have taken place with respect to the roles and 4 roles have now been assigned on an interim basis. CM confirmed these as follows; Head of Practice Support is JG Head of Strategic Development is VD Head of Service Improvement is JC Head of Quality & Safety is Penny Woodhead. This will be a joint role shared with Calderdale CCG. It was noted that these transitional roles will take effect from 1st March 2012 and a formal announcement is expected on Friday 24th February 2012.

CM advised that discussions will be taking place shortly with the new SMT members with respect to the next tier of staff.

CM advised there was no further update at present regarding the roles of Accountable/Financial Officer. The assessment is not scheduled until the end of June but there has been some discussion about putting these roles in place on a transitional basis as soon as possible.

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CSS Update SO explained the draft Memorandum of Understanding. Discussion took place regarding the content of this document. Medicines Management and PPI are slightly different to the services incorporated in the document. SO suggested keeping these two particular services within the CCG rather than sourcing them from the CSS. Further discussion took place regarding the services that would be available from CSS and SD raised concerns regarding service redesign and transformation areas. It was agreed that SB/SO/CM would discuss further outside the CCE meeting and feedback as and when necessary.

Action: SO/SB/CM to discuss CSS services outside of CCE to agree content for financial submission.

Design of NHS Commissioning Board CM advised that a national office is to be based in Leeds. There will also be 4 regional offices and approximately 50 local offices.

OD & Authorisation update There has been a revision of the recently released DH “towards establishment” documents. These can be found on the DH website.

There was a national event held on January 31st to look at work for authorisation and how this will progress. Local events are to be organised shortly. Draft role outlines are now available.

The authorisation process has three stages – pre-assessment, formal application and main assessment. There are 2 options for application – July for a decision in October or October for a decision in December.

The OD & Authorisation Subgroup has developed a project plan which is progressing very well. The OD session planned for 29 February will be focussing on practices being part of a membership organisation and also on stakeholder mapping. SO advised he needs to draft a Personal Development Plan for each GP over the coming weeks.

EC/12/81

Specialist Commissioning Clinical Standards Stocktake CM advised that this report when to the Cluster Board for agreement and is shared with the CCE for information purposes. Appendix A sets out the list of services that are agreed by the SCG. Page 5 of 10

It was noted that the CCG needs to continue to link in with these conversations and receiving updates. CM agreed with this point. RC advised that contracts will be starting to separate as of April 2012 so keeping up to date with this is vital.

Discussion took place regarding the inclusion of other services such as mental health, specialised bone care and spinal cord injury. It was agreed that CM would raise this at Cluster level and feedback.

Action: CM to raise the issue of SCG/CCG communication at Cluster level and feedback to CCE. EC/12/82

2012/13 Operating Plan VD advised that the draft plan had been shared at the last meeting.

Comments had been received and incorporated. Peter Flynn has requested specific information and this will be discussed further with him.

VD advised that the next draft of the plan will be available w/c 27 February. Comments were to be sent to VD no later than 9 March to allow time to incorporate them into final version. It was agreed that the final sign off and agreement from CCE would be taken at the meeting scheduled for 14 March. VD would then submit the final version to Peter Flynn on 15 March.

EC/12/83

Calderdale & Huddersfield Clinical Strategy Refresh PW gave an update on the programme. This has quite tight timescales. The outline proposal for a programme manager is being developed. A refresh of the services provided by CHFT is on GHCCG’s agenda for the next 3-5 years so this is quite timely.

GHCCG needs to be heavily involved and able to lead the changes.

It was noted that this refresh would include the diabetes service redesign and ophthalmology work amongst others. A vision of 5-10 years for integrated healthcare is required and discussions need to take place regarding what services could proposed, discussed and redesigned, if appropriate.

CCE members were requested to send suggestions for 7-10 phrases for visions for the refresh. It was agreed that the discussions need to take place between clinician to clinician, not managers. JG advised we do need to ensure we have support from all practices regarding this programme.

PW advised he would be discussing the agenda for the next steps with CM/JC at the next Transformation Board. It was agreed PW would provide a further update next month.

Action: PW to provide further update regarding Calderdale & Huddersfield Clinical Strategy Refresh.

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EC/12/84

Performance Report KW was in attendance and explained the report. There is a single report showing the information as two separate views. It was agreed to discuss the information showing the current GHCCG position.

The information given is from Q3 as at December 2011.

The main issues this month are the over/under performing targets against national targets.

Cdiff: YTD forecast above Ambulance response for 8 minutes: 2 performance notices served on YAS. Money will be retained unless performance is improved. Next steps have been discussed and an action plan has been put in place.

Mixed sex accommodation: 17 breaches in November. These are now all rectified.

A&E 4 hour waiting time: slightly under target Stroke/TIA: actions are in place to support areas of concern.

NHS Dentists: underperforming due to a toolkit error.

Choose & Book and information for patients are other areas of concern.

KW advised that one practice has used the information for patients service so far.

Action: KW to source information on the practice and feedback to the CCE. KW advised that the figures on Healthchecks are really low.

Discussions took place on how to deal with this. SO advised he is scheduled to meet with Sarah Muckle to investigate this further.

DA suggested having a local CQUIN for the rural areas that YAS are underperforming on. RC advised this wouldn’t be possible as YAS actually covers 12 PCT’s.

The CCE RECEIVED and NOTED the contents of the Performance Report.

EC/12/85

Finance SB gave a brief update.

The key points are: Overall position improved.

DH baseline spend estimates discussed. No indication yet on CCG budgets.

Issues around public health allocations End of December 2012 before the CCG allocations are released.

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Access funding – the funding aimed for Local Authority expenditure has gone straight to them.

PCT overall position – the contingency fund hasn’t been fully spent so half of this will be used towards the future structures/running costs of restructuring process, with the other half going to MYHT. Work ongoing for 2012/13 QIPP It has been agreed that the Bolton Dashboard/Pathfinder programmes will be commissioned in the next financial year.

Non-recurrent money update The task and finish group established to discuss how to spend the access money have agreed on the following; 24 hour BP machines Psychotherapy interventions - £40k used for this Choose Well public campaign Predictive risk funding for another year Donor sperm IVF patients treatment funded at Care Manchester due to waiting times at CHFT Funding for local hospices Equipment for dermatology for the University Practice Discussions took place regarding the Choose Well campaign and suggestions were made to use radio/tv rather than poster advertisement. This option has worked well in the past. JG advised she would feed that back.

Action: JG to feed comments back to Comms team regarding Choose Well campaign.

The CCE RECEIVED and NOTED the contents of the Finance Report.

EC/12/86

Contracting Report DB gave advised of the key points; Huge undertrade at CHFT - £1.27 million Referrals still overtrading work ongoing regarding negotiating some reductions.

Demand planning ongoing Endoscopy pre-op assessments – CHFT now want to charge for this. It was noted that this will be picked up through the Planned Care Board.

Contract process for 2012/13 ongoing Deadline for signature of contracts is 15th March 2012 CHFT would like to have floor and ceiling limits again but this will need to be discussed further.

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Discussion took place regarding the over/undertrading in different specialities. It was agreed that DB would investigate this and feedback to the CCE. Action: DB to investigate the over/undertrading in different specialities at CHFT and feedback to the CCE. AQP Update RC briefly advised that the national specification for the Any Qualified Provider has been approved and it was agreed that this is the process that should be followed.

The CCE RECEIVED and NOTED the contents of the Contracting Report.

EC/12/87

Risk Report CM advised members to read the report for information. CM advised that the risk report currently reflects NHS Kirklees rather than GHCCG but this will change and it will need to become a regular item on the CCE agenda.

EC/12/88

Receipt of Minutes The CCE RECEIVED and NOTED the minutes of the following meetings; Cluster Board meeting Shadow Health & Wellbeing Board OD & Authorisation Subgroup Finance & Performance Subgroup Quality & Safety Subgroup Audit & Governance Subgroup Clinical Strategy Group

EC/12/89

Any Other Business 2012/13 Commissioning Readiness Scheme KD advised that this scheme is relatively simple in comparison with the current year. There will be in-house training. There will be 1 GP and the Practice Manager involved per practice and they will need to undertake a Training Needs Analysis by the end of April.

Practices will be given a choice of either participating in this scheme, or not. There will be no middle ground.

Discussions took place regarding the single handed practices and managing cover for absence of lead GP/Practice Manager. It was agreed that a nominated deputy would be used in this instance.

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Discussions took place regarding the financial costings of this scheme. SB confirmed this had been discussed and agreed previously.

The CCE RECEIVED and APPROVED the Commissioning Readiness Scheme.

Social Research Agencies JP advised she had been approached by a private firm and raised this as a general concern on how to deal with this appropriately. It was suggested that this could be fed into the PPI Strategy. JP agreed to discuss further with DF. Action: JP to discuss social research agencies with DF. Flu Epidemic DH highlighted that there is currently a flu epidemic in a care home in Holmfirth. It was noted that there are approximately 60 residents that are very ill which has resulted in a number of deaths over a period of a week.

EC/12/74

Date and time of the next meeting The date of the next scheduled meeting is Wednesday 28th March 2012, 2.00 – 5.00pm.

This concluded the content of the CCE meeting and the Chair declared the meeting closed at approximately 5.20pm.

Chair’s Signature: ........................................................ Date: ..................................

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