NHS DORSET CLINICAL COMMISSIONING GROUP JOINT PRIMARY CARE COMMISSIONING COMMITTEE. 3 February 2016 PART ONE PUBLIC MINUTES

Transcription

1 NHS DORSET CLINICAL COMMISSIONING GROUP JOINT PRIMARY CARE COMMISSIONING COMMITTEE 3 February 2016 PART ONE PUBLIC MINUTES Part 1 of the Joint Primary Care Commissioning Committee of NHS Dorset Clinical Commissioning Group was held at 14:00hrs on 3 February 2016 at Vespasian House, Barrack Road, Dorchester, Dorset, DT1 1TG. Present: In attendance: Jacqueline Swift, Chair of the Joint Primary Care Commissioning Committee (JS) Julia Bagshaw, Acting Director of Commissioning NHS England South (Wessex) (JB) Rob Childs, Clinical Chair Representative - Mid Dorset Cluster (RC) Jacqueline Cotgrove, Director of Assurance and Delivery (JC) Olivia Falgayrac-Jones, Interim Head of Primary Care (OFJ) Tim Goodson, Chief Officer (TG) David Jenkins, Vice Chair, Joint Primary Care Commissioning Committee (DHJ) Tom Knight, Clinical Chair Representative East Dorset Cluster (TK) Blair Millar, Clinical Chair Representative West Dorset Cluster (BM) Sue Richards, Practice Manager, Mid Dorset Cluster Representative (SR) Andy Rutland, Primary Care Lead (AR) Sally Shead, Director of Nursing and Quality (SSh) Melanie Smoker, Contracts Manager (Medical) NHS England South (Wessex) (MS) Mike Wood, Director of Service Delivery (MW) Judith Young, Practice Manager Representative East Dorset Cluster (JY) Anu Dhir, Primary Care Lead (AD) Margaret Guy, Vice Chair, Healthwatch Dorset (MG) Councillor Jill Haynes, Dorset Health and Wellbeing Board (JH) (Part) Chris Hickson, Head of Management Accounts, Financial Planning and Primary Care Conrad Lakeman, Governing Body Secretary (CGL) David Phillips, Director of Public Health (DP) Louise Trent, Personal Assistant (SL) Nigel Watson, Chief Executive (Wessex Local Medical Committees) (NW) 1

2 1. Apologies Action 2. Quorum 2.1 It was agreed that the meeting could proceed as there was a quorum of Committee members present. 3. Declarations of Interest 3.1 Members were reminded of the need to be scrupulous with regard to ensuring declarations of interest were up to date and complete. 3.2 All members who held a GMS or PMS contract declared an interest in item Minutes 4.1 The draft minutes of Part 1 of the meeting held on 2 December 2015 were approved for signature by the Chair as a true record. 5. Matters Arising 5.1 The Committee noted the Report of the Chair on matters arising from the Part 1 minutes of the previous meeting. 6. Chair s Update 6.1 The Chair introduced her update. 6.2 She said the meeting scheduled for 3 August 2016 would be cancelled. CGL 6.3 This was the last formal joint meeting with NHS England before becoming the Primary Care Commissioning Committee. The Chair thanked NHS England and confirmed that the Committee and NHS England would continue to work together. 6.4 Dr Rutland and Dr Dhir were introduced as Primary Care Leads for Co-Commissioning and Development respectively, each working two sessions a week. Dr Rutland confirmed he had resigned from his Locality Lead role. 6.5 The roles would develop as the Committee moved to full delegation. Discussions regarding the Committee structure had mooted a smaller Committee, retaining a non-gp majority and creating a Primary Care Reference Group. 2

3 6.6 The Primary Care Leads would be the GP representatives and the Reference Group would have representatives from different clusters and Practice Managers to offer a forum for meaningful discussion. Practice Nurses would be included in the Reference Group. 6.7 The creation of the Primary Care Lead roles highlighted the commitment of the CCG to Primary Care. 6.8 The Committee directed that comments on the proposed structure of the Committee and Reference Group should be made to the Primary Care Leads. All 6.9 The Committee noted the Chair s update. 7. NHS England South (Wessex) 7.1 Horizon Scanning The Acting Director of Commissioning (NHS England South (Wessex) introduced the report on Horizon Scanning and summarised the individual workstreams set out in the report Guidance was awaited from NHS England on the process for the adoption of primary schemes The schemes included core estates, vulnerable practices and support for recruitment. A vulnerable practices scheme had been launched to support the recruitment of GP registrars in hard to recruit areas An announcement was awaited on the recruitment support to attract candidates These had been discussed at a recent Health Education Wessex meeting and the Chair would forward a link to the papers to Dr Millar. JS A contract had been awarded to deliver a scheme to enable pharmacies to access Summary Care Records and would be progressed jointly with the CCG IT Team There was concern that without the Summary Care Records in place the system would be open to abuse with patients accessing medication they were not due The Committee noted the report on Horizon Scanning. 3

4 7.2. NHS England South (Wessex) Primary Care Finance report The Acting Director of Commissioning (NHS England South (Wessex) introduced the Finance report The Committee noted the NHS England South (Wessex) Finance report. 7.3 The Village Medical Practice, West Moors The Interim Head of Primary Care introduced the report on The Village Medical Practice, West Moors This was a single-handed surgery where the sole GP had been taken ill and would be unable to provide services for several months. Locum cover had been sourced and work was continuing with Castleman Ltd, a local GP Federation, to provide a caretaking arrangement. The work model from Castleman would be delivered to NHS England shortly The Governing Body Secretary and General Counsel received assurance from members that no members of the Committee were members of Castleman Ltd The Committee noted the report on The Village Medical Practice, West Moors. 8. Public Health 8.1 The Director of Public Health introduced his Public Health update. 8.2 There had been progress on the Drug and Alcohol strategy with the myriad structures in the clusters combining to form one commissioning strategy. 8.3 Childhood immunisation work had been ongoing, supported by NHS England working together with Public Health to develop a plan. 8.4 Two consultants from Public Health had been working with the CCG Design and Transformation Directorate as part of the Strategic Transformation Plan. This had highlighted the opportunity to work together across Local Authorities. 8.5 The Clinical Services Review had brought together thinking and had created an opportunity to concentrate on best outcomes for primary care incorporating sustainability and value for money. 4

5 8.6 The Public Health budget had been reduced by 6% which had not been transferred onto to existing contracts. However there would be a further reduction of 3% with a requirement to demonstrate best value for money, going forward. This would not be absorbed. 8.7 The Committee noted the Public Health update. 9. Local Medical Committees (LMC) 9.1 The Chief Executive (LMC) introduced the LMC update. 9.2 The Health Education Wessex meeting had highlighted pressures on general practice with a number of partners leaving. Practices had been struggling to recruit as younger doctors did not wish to become partners and locum numbers had been growing. The LMC had been contacted by GPs wishing to hand contracts back. The LMC had been working with practices regarding mergers. 9.3 The Clinical Services Review focused on acute hospital reconfiguration, however a robust system for general practice was also required. 9.4 Work with Colleges and Universities would also be needed to create an attractive career path for students to encourage recruits to domiciliary care. 9.5 The Committee noted the LMC update. 10. Dorset CCG 10.1 The Future Development of Primary Care The Director of Service Delivery introduced the report on The Future Development of Primary Care Workforce would be a priority as national guidance recognised the challenges for a sustainable primary care workforce. A draft Sustainability and Transformation plan would be brought to the Committee in April. MW/CGL The Committee noted the report on The Future Development of Primary Care Dorset Primary Care Development Plan The Director of Service Delivery introduced the report on the Dorset Primary Care Development Plan. 5

6 This was a one year plan but a five year plan and one year operational plan would be developed It was noted that patient experience had not been referenced. Services available to patients and positive experiences should be central to the work. MW The Committee noted the report on the Dorset Primary Care Development Plan Primary Care Finance Update The Head of Management Accounts introduced the Primary Care Finance Update He updated the Committee and said that since completion of the report, prescribing overspend had increased to 2.1 million and would represent a pressure for the CCG. There was a requirement in the planning guidance to create a 1% recurrent headroom as part of wider planning There had been a 4% allocation of funding nationally however the Dorset allocation was approximately at 1.8%-1.9% The Committee noted the Primary Care Finance Update Full Delegation Working Arrangements The Director of Service Delivery introduced the report on Full Delegation Working Arrangements A new draft staffing structure had been developed to take forward full delegation. Consultation with staff had begun. The team had been working well with NHS England on delegation arrangements. Internal audit had reviewed the system to ensure that arrangements and processes were sufficiently robust The Committee noted the report on Full Delegation Working Arrangements PMS Review investment proposals The Chair and the Governing Body Secretary and General Counsel directed that as the Committee was being asked to approve the methodology, all GPs with a PMS/GMS contract were ineligible to vote due to conflicts of interest. They would, however, not be required to withdraw due to the uncontentious nature and the recommendation. CGL 6

7 The Head of Management Accounts, Financial Planning and Primary Care then introduced the report on the PMS Review investment proposals A process had been undertaken with the GP investment group for NHS England and the LMC had been involved to identify core services. This had resulted in the recommendation of a Basket of Services for investment in primary care. This would grow with the reinvestment of the PMS premium every year, coupled with a review of the items included in the Basket The Committee recognised that the process had been well managed. As services identified as core and non-core were reviewed it would provide the opportunity to revise funding in the Basket so that services were not interrupted or stopped. The investment proposal had been well received at the GP Stakeholder meeting There was concern regarding dementia drugs management being placed back in Primary Care. GP Practices had not been informed in advance but patients had received direct notification from Dorset Healthcare The Director of Service Delivery would investigate and update the Committee. MW The Committee (excluding conflicted GPs) approved the PMS Review investment proposals Update on the Estates Strategy and Transformation Fund bids The Director of Service Delivery introduced the Update on the Estates Strategy and Transformation Fund bids Valuable transformation funding was available. Successful bids would put the CCG in a good position. The deadline for bids had been extended to April The Committee noted the Update on the Estates Strategy and Transformation Fund bids Primary Care Profiles The Director of Service Delivery introduced the report on Primary Care Profiles The profiles had been set up as an appropriate method to review referral rates and clinical resource utilisation. This was a local tool that went beyond the Quality and Outcome Frameworks 7

8 (QOF) Assurance was sought that the information would remain as relevant as possible. What was contractually required of GPs would be reviewed to ensure that an unnecessary burden of work would not be placed on GPs. The two Primary Care Lead GPs were members of the task and finish group and would ensure that this was so. AD/AR The Committee noted the report on Primary Care Profiles Medicines Optimisation Group (MOG) The Director of Nursing and Quality introduced the MOG report As part of antibiotic stewardship, the Department of Health had written to ten practices in Dorset that had been identified as being in the top 20% of prescribing for antibiotics. The CCG knew the practices and had been working with them to improve the position The Practice Manager Representative East Dorset Cluster confirmed that at the recent locality meeting it had been identified that this could be partly due to the rising use of telephone triage The Governing Body had discussed repeat dispensing through the Electronic Prescription Service (EPS). Work on software had been progressing. The Director of Quality and Nursing would report further to the Committee. SSh The Committee noted the report on the MOG. 11. Any Other Business Cllr J Haynes left the meeting The Director of Assurance and Delivery, NHS England, enquired whether the Primary Care Commissioning Committee would wish to have representation on the Local Health Resilience Partnership to meet the resilience requirements of primary care or if there was another way in which the CCG would wish to link to ensure overall assurance of primary care was represented. The Chair directed that a paper be prepared for the April meeting. JC 12. Date and Time of Next Meeting 12.1 The inaugural meeting of the Primary Care Commissioning Committee will be held at 2pm on Wednesday 6 April 2016 at 8

9 Vespasian House. 13. Exclusion of the Public 13.1 Resolved : that representatives of the Press and other members of the public, be excluded from the remainder of this meeting having regard to the confidential nature of the business transacted, publicity of which would be prejudicial to the public interest. 9