NHS SOLIHULL CLINICAL COMMISSIONING GROUP GOVERNING BODY (CCG) PUBLIC BOARD

Transcription

1 NHS SOLIHULL CLINICAL COMMISSIONING GROUP GOVERNING BODY (CCG) PUBLIC BOARD Minutes of the Meeting held on Wednesday 2 December 2015 The Board Room CCG Offices, Friar s Gate, Shirley, Solihull at 2.30pm until 5pm Attendees: Dr Anand Chitnis (AJC) Chair/GP NHS Solihull Clinical Commissioning Group Dr Mike Baker (MB) Governing Body GP NHS Solihull Clinical Commissioning Group Dr Patrick Brooke (PB) Chief Officer NHS Solihull Clinical Commissioning Group Steve Coathup (SC) Lay Advisor (Vice Chair) NHS Solihull Clinical Commissioning Group Dr John Davenport (JD) Governing Body GP NHS Solihull Clinical Commissioning Group Dr Sue Harrower (SF) Governing Body GP NHS Solihull Clinical Commissioning Group Rhod Mitchell (RM) Lay Advisor NHS Solihull Clinical Commissioning Group Dr Stephen Munday (SM) Governing Body Member NHS Solihull Clinical Commissioning Group Ian Woodall (IW) Chief Finance Officer NHS Solihull Clinical Commissioning Group In Attendance: Julie Bishop (JB) EA to Chief Officer (Minute Taker) NHS Solihull Clinical Commissioning Group Sue Byrne (Observer) (Sb) PA to Chair/Chief Nurse NHS Solihull Clinical Commissioning Group Chris Howell (CH) Chief Officer Organisation and NHS Solihull Clinical Commissioning Group Service Design Debbie King (DK) Deputy Chief Nurse NHS Solihull Clinical Commissioning Group Neil Walker (NW) Chief Contract and Performance NHS Solihull Clinical Commissioning Group Officer Doug Middleton (DM) Chief Operating Officer NHS Solihull Clinical Commissioning Group Apologies: Dr Charles Ashton (CA) Secondary Care Consultant NHS Solihull Clinical Commissioning Group Mark Ford (MF) Lay Advisor NHS Solihull Clinical Commissioning Group Karen Middlemas (KM) Chief Officer Organisation and NHS Solihull Clinical Commissioning Group Service Design Dr Geoff Naylor (GN) Governing Body GP NHS Solihull Clinical Commissioning Group Sue Nicholls (SN) Chief Nurse NHS Solihull Clinical Commissioning Group Ian James (IJ) Director of Adult Services Solihull Metropolitan Borough Council Minute No: Item: Introduction: 525/2015 Welcome & Apologies: Dr Anand Chitnis, the Chair welcomed everyone to the public session of the meeting. Apologies were received as recorded above. 526/2015 Declarations and Register of Interest: Dr Chitnis requested any declarations of interest. There were no other declarations pertinent to the agenda. The Register of Interest was approved by the Governing Body subject to amendments to be made to Dr Davenport and Dr Baker s register of interest. Action: Dr Baker and Dr Davenport to advise Clare Rippin, Assistant Governance Manager of the amendments to the register. Page 1 of 12

2 Dr Munday referenced his new declaration wife employed as a head of clinical services/matron at Spire Parkway'. The Governing Body noted there were no declarations of interest declared pertinent to the agenda. 527/2015 Public Questions: There were no questions raised by members of the public. 528/2015 Minutes of Previous Meetings & Matters Arising: The minutes of the meeting which took place 7 October 2015 were agreed as an accurate record of the meeting. There were no matters arising raised at the meeting. 529/2015 Schedule of Action Plan: The action sheet has been updated to reflect discussions from the meeting. 530/2015 Chairman s Report: Dr Chitnis presented his report to the Governing Body. The key highlights included: Right Care There is a clear message around the financial challenge and having to meet our statutory duties to live within our allocated resources. Emphasis was placed on the Right Care data and that CCGs should be working hard on where they are outliers in terms of their peers on the Right Care Website. This is the link to the specific Solihull CCG pack link. It shows areas that we do well for example significant improvements since the CCG approved the centralisation of acute stroke services to the HASU at Heartlands Hospital and areas we need to focus on such as length of stay following fracture neck of femur. Solar Birmingham and Solihull Mental Health NHS Foundation Trust, in collaboration with Barnardo's and Autism West Midlands, invited professionals and stakeholders to the launch of Solar - a new service for children and young people (Tuesday 1 December). The launch included presentations and information to announce their emotional health and well-being service for those aged 0-19 years in Solihull. Dr Chitnis attended the launch and was very impressed with the young people s passion and was invigorated by their energy. The Governing Body noted and received the report. 531/2015 Chief Officers Report: Dr Brooke presented his report to the Governing Body. He informed the Governing Body of the following good news items: End of Life The Care Quality Committee (CQC) is undertaking a number of end of life care themed reviews across the country. SCCG hosted the review for Solihull during 5-11 November. It was an opportunity for Solihull to highlight examples of good local practice that others can learn from and vice versa. The review will also identify the actions that need to happen nationally so that the inequalities in end of life care services can be addressed. The verbal feedback highlighted the compassion and commitment of staff supporting Page 2 of 12

3 patients at the end of their life. Dementia Diagnosis Rates October 2015 NHS England has advised that for people over 65 with dementia, Solihull CCG s actual dementia diagnosis rate for October 2015 is 66.8% which is a really good result for Solihull. Dr Chitnis advised that the Mental Health Pod has agreed to support GP Practices whose rate is slightly lower than others. Solihull pop-up Urgent Care Centre A pop-up Urgent Care Centre will be open at Chelmsley Wood Primary Care Centre, Crabtree Drive, Solihull 9am until 6pm on the following days: Friday 25 December (Christmas Day); Saturday 26 December (Boxing Day); Sunday 27 December; Monday 28 December (Bank Holiday); Friday 1 January (Bank Holiday); Saturday 2 January; Sunday 3 January. Consultant Connect This went live on Monday 2 December 2015 with two specialties (gynaecology and diabetes). To date one GP has used the service regarding a referral and an outpatient appointment was avoided which was pleasing. More specialties will be included shortly and GP Practices are being contacted by the CCG to ensure they have the information available to use the service. Dr Brooke highlighted the following items to the Governing Body from his report. Heart of England NHS Foundation Trust (HEFT) The Provider Regulation Executive, a committee of the health sector regulator Monitor, has confirmed that HEFT is in breach of its licence to provide NHS services and agreed to direct the trust board and governors to appoint a new interim leadership team. The trust board has agreed to the action required by the regulator. Dame Julie Moore University Hospitals Birmingham (UHB) Chief Executive has been appointed interim Chief Executive of HEFT and Jacqui Smith (UHB) chair has become the interim chair of the HEFT Board. Jacqui Smith will continue in her role as chair at UHB alongside her work at HEFT. Dame Julie Moore will spend the vast majority of her time at HEFT while fulfilling the Interim CEO role. In addition, the trust board has committed to Monitor that they will develop and implement short and long term financial plans to improve their finances. Quarter 1 Assurance Meeting The first quarterly assurance meeting of 2015/16 with NHS England took place on 12 October. The meeting focused on operational target delivery and the CCG s financial position. For 2014/15 the CCG was assured with support. The ratings scale for 2015/16 has changed slightly and the final assessment. However, Q1 does appear to represent a positive move in assessment from 2014/15 annual review. This is covered in more detail in the performance report agenda item 538/2015. CCG s Financial Position The CCG is in the third month of turnaround looking to develop its QIPP programme ambition of 9.5m. D Middleton added that the figures have been reviewed to include opportunities to maximise efficiencies around AECs and outpatient referrals. If realised, the plan is to deliver 8m. The focus is on delivery and Page 3 of 12

4 it is important to have engagement from both secondary and primary care. New builds in Solihull Dr Chitnis is anxious that approval is being given by the local authority planners for new homes (including nursing homes) without discussing the implications this may have on health services. Dr Davenport agreed pointing out that the impact on infrastructure and costs to services cannot be underestimated. Dr Brooke added that staffing capacity in nursing homes is also an issue. Dr Chitnis has raised these concerns with the Solihull Health and Wellbeing Board (SHWB) and added that he would raise it again at a future meeting. Action: Dr Chitnis to raise it at the SHWB. R Mitchell advised that the Joint Primary Care Committee (JPCC) at its last meeting discussed the estates plan which will feed into the Primary Care Strategy. The Local Estates Forum is now established and is meeting monthly and attended by both health and local authority representatives. Although it is focussed on health and social estates, the local authority representative does have links to the local authority planners. C Howell informed the Governing Body that the CCG is involved in the plans for the Powergen site. Dr Munday agreed that new housing developments/nursing homes impact on health and social care. Planners consult too late in the process and this is a piece of work being undertaken by Sangeeta Leahy, Senior Public Health Specialist to encourage planners to consult early on in the process. He would feedback to Sangeeta the Governing Body s support for this approach. The Governing Body noted and received the Chief Officer s report. Patient Experience: 532/2015 Your Health, Your Voice Panel: Dr Fazil presented the newsletter which summarised the last meeting of the panel which took place 17 November The panel s main focus was on the Procedures of Lower Clinical Value (PLCV). These procedures are considered to be only marginally clinically effective, or ineffective with limited clinical value in the majority of cases. Some are high cost for limited clinical benefit and some are considered to be clinically effective but only if particular clinical thresholds apply. There was good engagement and the panel made a number of useful recommendations which N Walker has noted. The panel is supportive of the approach being taken. The Governing Body noted and received the newsletter. Strategy & Policy Development: 533/2015 Urgent and Emergency Care Vanguard: Dr Brooke presented the report which provided and update on the Urgent and Emergency Care (UEC) Page 4 of 12

5 vanguard local site visit and value proposition development. Solihull together for better lives is a partnership of organisations who agreed the ambition. ICASS is the work programme and vanguard is the status which was awarded to Solihull in July The vanguard project will run until 31 March 2018 and it is not expected to carry on beyond this point. The local site visit was referenced which took place on 29 September which provides a useful assessment of areas which are well developed and areas that require more focus on. S Coathup questioned the nine areas listed for development on page 2 of the attached letter to the report in particular the urgent care centre. Dr Brooke advised that the vanguard team is keen to move at pace and advised that Solihull should not be reliant on capital investment. However, space at the site is a challenge. With regard to ambulance service contribution identified as a gap this has been addressed as the West Midlands Ambulance Service is now a member of the Solihull together for better partnership and is working with the CCG development of the high intensity user s project. A key deliverable is the vanguard proposition and a draft high level view that will develop into the full submission for 2016/17 was submitted to apply for funds from the national transformation fund which is critical to achieve the new care model. A detailed value proposition for 2016/17 and beyond is required by the end of the calendar year. Additional support from Provex Consultancy (healthcare planning and financial management consultancy, offering an in-depth range of expert services to NHS providers and commissioners, private healthcare providers and public private partnerships) to develop the granular financial model required for the value proposition was support by the Governing Body D Middleton added that one key area which is a concern is sharing data and information across systems. Dr Brooke advised that this will be strengthened in the next proposal. The Governing Body noted and received the report, site visit update and progress. 534/2015 Primary Care Estate: A decision to defer this item was taken prior to the Governing Body meeting. Public Accountability: 535/2015 Integrated Quality Report presented to the Quality Safeguarding and Experience (QSE) Committee D King presented the Quality Integrated report presented to QSE Committee 27 October 2015 to the Governing Body to provide assurance of the actions being taken in relation to reported quality issues. Assurance data in this report is. Highlights in the report included: The Care Quality Commission inspected Marie Curie Hospice in July The report was published at the end of September and the overall rating for the service is Outstanding. The Governing Body commended Marie Curie for an exceptional rating. The Governing Body is disappointed to note that there have been two reported never events during Page 5 of 12

6 October 2015 within Heart of England NHS Foundation Trust (HEFT). One was a Solihull patient and the other a Birmingham South Central patient. A Root Cause Analysis (RCA) will be undertaken for both events in accordance with the Serious Incident National Framework. The Nursing and Midwifery Council has confirmed the go-live date of April 2016 for nurse revalidation. The CCG Practice and Professional Development Nurse and the Chief Nurse are providing updates and support and have no concerns regarding the revalidation. Dr Chitnis acknowledged that HEFT is on track for its reduction of falls trajectory. However, he added that it is important to ensure that falls is kept high on the agenda. D King advised that NHS Birmingham CrossCity CCG undertook a falls themed review and there is evidence of good practice. The draft report is being presented to the Quality Safeguarding and Experience Committee meeting. There are a number of recommendations and these will be discussed with HEFT. The Governing Body commended Caroline Kelle, nurse from Hobs Moat practice who has been awarded Queens Nurse Status. This prestigious award is for individual nurses who have demonstrated a high level of commitment to patient care and nursing practice. She will receive her award alongside Sue Nightingale and Kirsty Millard who were awarded this prestigious status earlier in the year. The Governing Body noted and received the report. 536/2015 Solihull Safeguarding Adults Board Annual Report : This report provides a multi-agency overview through the Solihull Safeguarding Adults Board Membership and board activity. Whereas, the Solihull CCG Safeguarding Report tabled at the 3 June 2015 Governing Body meeting provided an internal and partnership overview from the perspective of Solihull CCG. It sets out the national, regional and local picture following the enactment of the Care Act 2014 and is a working document as organisations implement and embed the Care Act changes across the system. The Governing Body received and noted the annual report. 537/2015 Finance Report for the Period 1 April October 2015 (Month 7) Following discussion at the Finance and Performance (F&P) Committee the Governing Body was advised of the key issues. The month 7 highlights are: Year to date and forecast outturn consistent with plan of 0.081m surplus; 2.5m of the 3.0m Risk Share support has been factored into the forecast out-turn position; 1.0m of remaining risk offset by matching level of mitigations (remaining 0.5m from the Risk Share and 0.5m from in-year QIPP schemes); Underlying position of 4.2m deficit; QIPP delivery anticipated at 98.4%. The CCG has commenced an intensive three month work programme to identify the QIPP savings required to deliver a 3m surplus in 2016/17. It is expected that some of the schemes currently being implemented will generate a part year saving in 2015/16. We intend to quantify and report any such schemes from month 8. Page 6 of 12

7 The outpatient trajectory is a concern and is rising year on year. Dr Chitnis added that Consultant Connect may help reduce the number of GP referrals. Consultant Connect is one of six projects which sit under the Outpatient Activity Management Programme and all parts of the system need to contribute to address the increase in Outpatient referrals. D Middleton advised that the savings included in the QIPP plan for outpatient referrals is 1.2m, while this year we have not been successful in halting the growth of outpatients which is a concern. N Walker advised that one area where there has been an increase both locally and nationally in the number of GP urgent referrals is suspected cancer cases. The Governing Body noted the year to date position to the end of and forecast full year outturn position and performance against the QIPP target. (a) Finance and Performance Committee Approved Minutes January October 2015: The suite of minutes were presented to the Governing Body as it appears that for some web viewers there is an issue with viewing some (not all) of the Finance & Performance Committee minutes appended to the end of the Finance Report. For clarification, all the Finance & Performance Committee minutes from January 2015 until October 2015 were noted and received by the Governing Body. (b) Finance and Performance Committee Approved Minutes : The Governing Body noted and received the Finance and Performance Committee approved minutes of the meeting which took place 4 November /2015 Performance Report for the Period 1 April 31 October 2015 Month 7 Following discussion at the Finance and Performance (F&P) Committee the Governing Body was advised of the key issues. NHS Constitution breaches in: I. Solihull: RTT Incomplete Pathways M6 II. Solihull : RTT 52 weeks M7 III. Solihull: RTT diagnostic waits within 6 weeks M6 IV. HEFT: A&E 4 hour waits M7 V. Solihull: Cancer 2-Week Suspected Cancer referrals M6 VI. *Solihull: 31 day wait for subsequent treatment where treatment is surgery M6 VII. Solihull: Ambulance Category A Red 2 Responses M7 VIII. Solihull: Mixed sex accommodation M7 The following headlines were raised: Contract Performance Notices/Reviews in relation to HEFT; 2 Acute, 2 Community; Waiting list and KPI performance breach updates for HEFT Solihull Community Services. Overview of NHS England Assurance Framework Six Domains Annual 2014/15 CCG Assessment (Published 8 October 2015) The CCG was assured with support. This was driven by HEFT performance against national standards and the CCG s financial position. Page 7 of 12

8 Overview of NHS England Assurance Framework Domains 2015/16 Q1 CCG Assessment (detail to be published). The Q2 assurance meeting with NHS England is taking place 5 January Cancer two week wait suspected cancer referrals The trajectory was just missed and work is continuing with the GP practices to encourage patients to attend their appointment i.e. 10,000 leaflets have been pre-printed by the CCG for practices to use. 31 day wait for subsequent treatment where treatment is surgery The Governing Body acknowledged that the important target is the 31 day which is doing well. It is encouraging to see patients starting treatment early once a diagnosis of cancer had been made. * N Walker informed the Governing Body that he was pleased to report that the three Solihull patients waiting for surgery have now received their surgery during M06-September. The Governing Body noted the Month 7 national and local contract performance and remedial actions and trajectories where standards are breached. 539/2015 Governance & Risk Report: Dr Brooke presented the report for review and approval by the Governing Body. It updates the Governing Body on three keys issues: Section One -Risk via either the Board Assurance Framework or Corporate Risk Register The top CCG risks are: - 1. Risk 90 - Insufficient primary and community care capacity to enable further shift from secondary care (16E). 2. Risk 96 - Providers fail to deliver commissioned services to meet statutory duties (16E). 3. Risk 73 - Quality Related issues for HEFT (includes risk 159 re maternity) (16E). 4. Risk Delivery of 2016/17 Savings Plan (15E). 5. Risk 198 Reimbursement of fines (15E). Dr Chitnis asked the Governing Body how assured they were in terms of the risks and the appropriate mitigation being taken. I Woodall advised that the identified risks should be taken to the appropriate committee for review and assurance. This was confirmed by the appropriate Governing Body committee chairs/members at the Governing Body meeting. The ICASS risks are monitored via the ICASS Programme Board. With regard to the Board Assurance Framework (BAF) the CCC Governance Manager meets with the Senior Managers individually to review the framework. To assure the Governing Body the Governance Manager reviews the risks and robustly monitors on a regular basis. S Coathup referred to risk number 100 and his concerns around CCG staff capacity. Dr Brooke added that there is no ideal model across the CCGs. He pointed out that Solihull is a mid-size CCG. There is Page 8 of 12

9 pressure nationally for CCGs to reduce their management costs. D Middleton suggested that this is discussed at the Governing Body away development session in January 2016 i.e. review running costs and how they are used to deliver the CCG s Operational Plan. Dr Fazil proposed using a development session to consider ways of working. Action: Dr Chitnis noted the suggestions and would consider the best approach. Section Two - Governance and compliance The Constitutional amendments are a separate Governing Body agenda item 540/2015. Section Three - Update from the Audit Committee No further meeting of the Audit Committee since the last report. The Governing Body reviewed the Corporate Risk Register on a confirm or challenge basis to: i) endorse the risks and post-mitigation scores; ii) review the mitigating actions and iii) Identify any additional risks. 540/2015 NHS SCCG Constitution Update: Dr Brooke advised the Governing Body that the Constitution as currently drafted does not reflect the changes within the membership to stand down the locality boards and to incorporate the Clinical Cabinet. The proposed changes address these points and undertake a number of housekeeping updates throughout. There are only two opportunities per year to make Constitutional changes and the CCG is waiting for NHS England to confirm the timescale for the next submission which is due imminently. The member s forum considered and supported the proposed changes. The changes have been shared with the lay Audit Committee members and agreed by the Audit Chair. The Governing Body agreed to: Approve the proposed changes to the CCG Constitution as set out in the paper; Delegate authority to the Audit Chair and Accountable Officer to agree the incorporation of amended Terms of Reference of Governing Committees (where these have been agreed by committee) into the Constitution prior to the Constitution submission deadline to NHS England. Operational Achievement: 541/2015 Operating Plan Progress Report 2015/16: D Middleton presented the progress report. The report is in four sections: Section 1 CCG Ambitions This section provides information regarding in year progress against the ambitions set out in the Operating Plan: 1. *Ambition 1 - Securing additional years of life for the people of Solihull with treatable mental and physical health conditions - RAG status amber Page 9 of 12

10 2. Ambition 2 - Improving the health related quality of life of people with one or more long-term condition, including mental health conditions (proxy 2a & 2b) RAG Rating 2a green, 2b RAG Rating amber (No new data). 3. **Ambition 3 - Reducing the amount of time people spend avoidably in hospital through better and more integrated care in the community, outside of hospital (proxy 3a & 3b) 3a RAG Rating red, 3b RAG Rating red (No new data). 4. Ambition 4 - Increasing the proportion of older people living independently at home following discharge from hospital RAG Rating red. Moving in the right direction. 5. Ambition 5 - Increasing the number of people with mental and physical health conditions having a positive experience of hospital care RAG Rating amber. Data received for experience in hospital, just below target. 6. Ambition 6 - Increasing the number of people with mental and physical health conditions having a positive experience of care outside hospital, in general practice and in the community RAG Rating red. (No new data). 7. No national definition currently available. *Ambition 1 An action from the last Governing Body meeting was to identify what was driving the direction of travel the wrong way. Suggestions for the Developing Excellence in Primary Cate LiS are being collated and a proposal for the revised LiS for 2016/17 will be presented to the Joint Primary Care Commissioning committee at the January/March 2016 meeting. Dr Brooke added that it highlights a gap in systematic reviews in mortality and an option might be to review a particular age group of deaths as part of the 2016/17 Developing Excellence in Primary Care Local Improvement Scheme (LiS) to share learning and identify common themes. It was agreed that the Mortality Review Group will undertake a review of processes and report to the Quality, Safeguarding and Experience Committee. Action: D King to raise at the next Mortality Review Meeting. Healthy Start vitamins Dr Munday and Dr Chitnis have discussed why Healthy Start vitamins are below plan and how it could be done differently. Public Health England has written to CCGs to encourage primary care to promote the benefits of vitamins to parents in disadvantaged areas of the borough. Smoking in Pregnancy Dr Chitnis stressed the importance of primary care supporting mothers to be to stop smoking. Smoking in pregnancy has substantial adverse effects on the baby. There is help available to support them i.e. a specialist pregnancy stop smoking advisor. Public in year cuts to the Public Health Grant Dr Munday advised the Governing Body that Public Health is undertaking a review of commissioning intention due to the in-year cuts to the Public Health Grant. There is potential that this review may impact on some of the projects. Public Health is undergoing a prioritisation exercise which will feed into the review; this will be completed by December Page 10 of 12

11 The Governing Body recognises the difficult position and the importance of the prioritisation exercise **Ambition 3-Overall non electives are down by1.3%. The subset of information data included in ambition 3 shows Solihull is moving in the right direction. It is aligned to the BCF target. Section 2 Metrics This section provides the performance against the Operating Plan metrics for each of the programmes namely: Preventing Illness, Improving Health, High Quality General Practice, Joint Commissioning, Information and Early Intervention, Out of Hospital and Hospital Transformation. Section 3 Programme Narrative This section provides a narrative of the actions completed in the reporting period and the actions to be undertaken in the next period. Section 4 - Effectiveness Review Group The Effectiveness Review Group continues to be one of the CCG programmes for 2015/16, and the update of the programmes work is included in this report. The Governing Body: Noted the current position regarding CCG ambitions and operating plan metrics; Noted the current position for each programme (including ERG); Highlight any points of clarification or concern to be raised to the ICASS Board, Joint Commissioning Board, ERG, or Senior Management Team; Mortality Group tasked to undertake a review of processes and report to the Quality, Safeguarding and Experience Committee. 542/2015 Update from Clinical Cabinet): Dr Chitnis presented the update to the Governing Body on behalf of Dr Naylor the chair of the Clinical Cabinet. Mark Ford, lay advisor has agreed to be a member of the Clinical Cabinet. The Terms of Reference section 3.3 Only members of the committee have the right to attend committee meetings. However, other individuals, including external advisers, may be invited to attend for all or part of any meeting, as and when appropriate was queried by S Coathup as it is inconsistent with Finance and Performance Committee Terms of Reference whereby any voting Governing Body member has the right to attend. The Governing Body agreed that it should be consistent in all committee Terms of Reference that voting Governing Body members have the right to attend sub committees of the Governing Body with the exception of the Remuneration Committee and Joint Primary Care Committee. Attendance at these meeting would be determined by the chair. Action: Rebecca Hutchin, CCG Governance Manager to amend the wording in the sub committee s Terms of Reference to ensure a consistent approach. In terms of clarity Dr Chitnis and S Coathup offered to discuss it with R Hutchin, if required. The Pod summaries were referenced. Dr Chitnis informed the Governing Body that clinical lead vacancies have been advertised to the GP membership as it has become apparent that in a number of the pods Page 11 of 12

12 resource is challenging particularly mental health and primary care pods. Dr Saima Ali is no longer supporting the developing mental health services pod and the Governing Body acknowledged her commitment supporting the pod. The Governing Body was pleased to note the progress of the Clinical Cabinet. 543/2015 Joint Primary Care Commissioning (JPCC) Committee: D Middleton gave an update on the last meeting which took place 25 November Items covered at the meeting included: Primary Care Hub, draft Strategic Estates Plan and draft work plan. Dr Chitnis informed the Governing Body of a conflict of interest as a GP provider in relation to the leg ulcer service referenced in the approved JPCC minutes 23 September agenda item 30.PCCC He reiterated the importance of continuity of care and integration of social and family support and primary care was best placed to offer this service D Middleton advised that the leg ulcer service issues have now been resolved. To ensure a clear audit trail in terms of the procurement decision the appropriate paperwork is going to The CCG Audit Committee. The Governing Body received the minutes of the Joint Primary Care Commissioning Committee held on 23 September /2015 Any Other Business: There were no other items of additional business. The next meeting will take place Wednesday 3 February 2016 at2.30pm until 5pm in the Board Room, CCG Offices, Friars Gate, Shirley, Solihull. The public session closed at 4.50pm. Signed...Dr Anand Chitnis, Chair of the NHS Solihull Clinical Commissioning Group Dated... Page 12 of 12