EC-12-65-_1_-GHCCE_mins_23.11.11-RATIFIED-25.01.12-kjc

NHS KIRKLEES

Minutes of the Greater Huddersfield Clinical Commissioning Executive (CCE) Meeting held on Wednesday 23rd November 2011, 2.00 – 4.30pm in the Board Room at Broad Lea House, Bradley Business Park, Huddersfield Present: Vanessa Stirum (VS) Rob Millington (RM) Dr Steve Ollerton (SO) Dr Judith Parker (JP) Dr David Hughes (DH) Dr Jane Ford (JF) Dr Dil Ashraf (DA) Dr Anuj Handa (AH) Dr Karen Dean (KD) Steve Brennan (SB) Carol McKenna (CM)

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

In attendance: Angela Monaghan (AM) Jan Giles (JG) Nicky Hoyle (NH) Rachel Carter (RC) Kath Woodford (KW)

Chair, Calderdale, Kirklees & Wakefield District Cluster Assistant Director of Commissioning Public Health Consultant Deputy Director of Commissioning - Head of Contracts Performance Reporting Manager

Minutes: Kelly Chadwick (KC)

Personal Assistant to Greater Huddersfield CCE

EC/11/50

Apologies for Absence Apologies for absence were received from; Sheila Dilks (SD) Mehboob Khan (MK) Dr Paul Wilding (PW)

EC/11/51

Director of Transformation Non-executive Director CCG member

Accuracy of Minutes 26 October 2011 The minutes of the CCE meeting held on 26th October 2011 were ACCEPTED as a true and accurate record with amendments as recorded.

EC/11/52

Action Log AQP – the three services agreed are Diagnostics and Adult Hearing across the Cluster and IAPT in Calderdale only.

Page 1 of 7

EC/11/53

Final TORs for sign off GHCCE Terms of Reference CM confirmed that these terms of reference are set by the Cluster Board and that the CCE members can only formally accept them.

Section 8 – membership.

CM advised that the Local Authority member for both CCG’s would Merran Mcrae, Director of Adult Services at Kirklees Council.

Merran will be a non voting CCE member.

Section 12 - conflicts of interest 12.3 – standing item on agenda for declarations of interest.

Action: KC to include on agenda as standing item.

Section 14 – quoracy.

CM confirmed the wording had changed slightly.

The CCE members formally accepted the revised TORs. CM advised that the Cluster Board will approve them for sign off at their next meeting.

SUBGROUPS Audit & Governance Group Terms of Reference Section 2 – membership.

CM advised this should read 2 representatives from each CCE. SO/PW are the GHCCE members.

The CCE members formally APPROVED the Audit & Governance Terms of Reference.

Finance & Performance Group Terms of Reference CM advised that there are still some typing errors and wording to be amended. Membership has also been amended as there is a need to differentiate between members and attendees.

Section 2 – membership.

The Chair and Vice-Chair of this group are yet to be agreed. The only members of this group from the PCT are SB, SD, CM and NH. Any other managers will be recorded as “in attendance”.

SO/DA are the GHCCE members.

The CCE members formally APPROVED the Finance & Performance Terms of Reference.

Page 2 of 7

Quality Group Terms of Reference Section 2 – membership amended slightly.

JP/JF are the GHCCE members.

The CCE members formally APPROVED the Quality & Safety Terms of Reference.

EC/11/54

Standing Financial Instructions (SFI's) SB briefly introduced the three different documents and explained that there are training sessions planned on the subjects. The PCT managers will receive training first, the SFIs will also be taken to DDAD, then brought back to a CCE meeting to be explained in detail.

The CCE RECEIVED and NOTED the contents of SFI’s.

EC/11/55

Self Assessment OD Plan Karen Gallagher (KG) was in attendance to present the final version of the plan.

KG explained the background of the plan, which is an introduction to GHCCG and the approach taken to get to the final version. KG explained the model of authorisation. This captures the work that the CCE members have been undertaking. The next steps are to start thinking about structures and how this will work with the practices.

RM suggested using various tools and techniques to help the CCE members to deliver on the goals, both collectively and individually.

KG reminded the CCE members of the future OD sessions that are planned and how best to use the sessions.

It was agreed that some of the wording in the plan would be amended and that key strengths would be noted.

Action: KG to email amended version out to all CCE members.

KG confirmed that there are 6 key areas/domains and that 5 workshops are planned so far. A formal review will take place in April 2012 but ongoing timescales need to be discussed.

Action: KG to devise 3 monthly timescales for further discussion.

The plan will be a live action document with reviews continuously throughout the year. A small working group has been set up and will be called the OD & Authorisation Group. Future dates are currently being planned. The membership was confirmed as follows; Page 3 of 7

Karen Gallagher Jan Giles Carol McKenna Steve Ollerton Paul Wilding Karen Dean Nicky Hoyle Rob Millington Andrew Parker JG confirmed that a monthly report will be submitted to the CCE for update on progress but the subgroup will take on all other functions.

EC/11/56

Commissioning Support and CCG Structures CM advised she has been working with SO/SB regarding the local structures. CM informed the CCE members that she and others had also been working with Jonathan Molyneux to ensure a shared understanding of costings cross the Cluster.

There is a requirement for a business case to be produced by January for the Commissioning Support Office.

Equality & Diversity Act October 2010 JG explained the background of the Act and what areas it covers.

There are four goals covering nine different areas. This will be reviewed in April 2012 and every four years thereafter.

EC/11/57

111 Specification Pat Andrewartha (PA) was in attendance to present the business case and draft service specification.

PA explained the 111 service. The service will be supported by a Directory of Services. The advert for procurement is going out in January 2012. The service itself will be going live from April 2013.

One issue raised was about how much information will actually be transferred back to practices. PA explained that there will be Key Performance Indicators (KPI’s) around certain areas.

PA asked the CCE for endorsement of the business case and draft specification. It will be going to Cluster Board in December for final sign off. PA advised she would take all comments/questions and feedback to the Cluster Board.

The CCE AGREED to endorse the business case and draft service specification as it currently stands.

Page 4 of 7

EC/11/58

Performance Report KW advised of the key points; MRSA – above in-month projector for NHS Kirklees so no issues.

Cdiff – above in-month projector for NHS Kirklees so no issues.

Ambulatory response times – in-month problem for Kirklees, mainly in Spen/Kirkburton/Denby Dale. A meeting has recently taken place with Paul Mudd at YAS to look at the variances. The full position has now been reported and the figures are now showing as green.

Action: KW to send out full updated report on ambulatory response times.

YAS performance notice been served.

Mixed sex accommodation doesn’t affect CHFT 18 weeks – breaches on diagnostics A&E waits/MRI/Neurophysiology for diagnostics all noted as problem areas.

Stroke/TIA – going to be a relaunch of the referral pathway over the next few weeks.

Action: KW to retrieve further detail on stroke figures to see if there is any other explanation other than patient choice.

Dentistry – discussions took place about the use if NHS dentists.

Figures are showing an issue but this is still undetermined as yet.

Mental Health – Vicky Dutchburn will attend the next F&P meeting to discuss figures.

Smoking quitters – action plan requested, normal seasonal variance on this. NH advised she has a paper detailing further information about this service and will feedback to the CCE members at a later date.

The CCE RECEIVED and NOTED the contents of the performance report.

EC/11/59

Finance Report SB advised of the key points; £2.4 million improvement overall. Two main reasons are acute trading positions in-month and a slight improvement in year for QIPP. There is an issue around paediatrics HDV at Mid Yorkshire which is relative to GHCCG as the budgets are still aligned with NKHA this year.

PBC – budgets are being looked at on schemes relating to PBC (e.g. University – sexual health), clinical engagement and the incentive scheme.

Page 5 of 7

Discussion took place regarding how QIPP plans are going to be formulated next year.

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

EC/11/60

Contracting Report DB gave advised of the key points; The overall position contractually is showing an undertrade of £927k at month 6 for CHFT. There is a large overtrade on day cases due to the elective movement to day case.

Emergency short/long stay – more patients moving to short.

Each month a challenge is submitted on case mix.

MSK – stand out area – detailed piece of work being undertaken by the Information team.

Discussion took place regarding the incomplete pathway for dermatology, urology and trauma & orthopaedics. DB advised that the under performance does not always relate directly to the waiting list issues.

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

EC/11/61

Any Other Business Shadow Health and Wellbeing Board - minutes of last meeting included for information purposes.

It was agreed that minutes of all subgroups will be reported back to the CCE for information purposes. This will include Clinical Strategy, Audit & Governance, Quality & Safety and Finance & Performance.

Action: KC to include copies of minutes for each meeting.

EC/11/62

Date and time of the next meeting The CCE members were reminded that December’s meeting was cancelled due to the Christmas break.

The date of the next scheduled meeting is Wednesday 25th January 2012, 2.00 – 4.00pm.

This concluded the content of the CCE meeting and the Chair declared the meeting closed at approximately 4.30pm.

Page 6 of 7

Chair’s Signature:

Date: 23/11/11

Page 7 of 7