NHS Kernow Disclosure log Freedom of Information requests June 2015

Transcription

1 NHS Kernow Disclosure log Freedom of Information requests June 2015

2 Contents FOI Contracts - Children s tender...3 FOI Mental health & learning disabilities -Contact information...5 FOI Organisation - Databases...5 FOI Contracts - Patient transport...5 FOI Prescribing & pharmacies - Prescribing recommendations...6 FOI Contracts - MSK patients...6 FOI Prescribing & pharmacies - Declarations of interest...8 FOI Prescribing & pharmacies - Rebate schemes...8 FOI Prescribing & pharmacies - Prescribing schemes...9 FOI Finance & budgets - non-nhs healthcare FOI Finance & budgets - Non-NHS healthcare FOI Organisation - Locum GPs FOI Long term conditions - Diabetes FOI Organisation - Contact information FOI Prescribing & pharmacies - Work programmes FOI Contracts - Community equipment provision FOI Organisation - IT systems and training FOI Mental health & learning disabilities - Funding FOI Mental health & learning disabilities - Placements FOI Organisation - IT FOI Contracts - Procurements Appendix FOI The information supplied to you continues to be protected by the Copyright, Designs and Patents Act You are free to use it for your own purposes, including any non-commercial research you are doing and for the purposes of news reporting. Any other re-use, for example commercial publication, would require the permission of the copyright holder. Most documents supplied by NHS Kernow Clinical Commissioning Group will have been produced by local officials and will be our copyright. Information you receive which is not subject to our copyright continues to be protected by the copyright of the person, or organisation, from which the information originated. You must ensure that you gain their permission before reproducing any third party information.

3 FOI Contracts - Children s tender Date received 30/06/ What is the governance structure developed to decide whether to tender the service, and provide assurance regarding the process used, please? For example, is there a Programme Board that has been delegated the necessary authority by the KCCG Governing Body to decide on the most economically advantageous manner to commission the service - does this group report to a committee of your Governing Body? A. NHS Kernow s Governing Body signed off the decision to tender the services and will also oversee the assurance of the process. Additional assurance has been commissioned from the South West Commissioning Support Unit. 2. Can you please provide a list (detailing the time, date and representatives) of any meetings held between any employee or representative of KCCG and Virgin Care, during the past 2 years. These are meetings outside of the ongoing tender exercise. A. NHS Kernow has not concluded its procurement of children s services and is therefore neither able to confirm or deny if Virgin Care is participating in the procurement of children s services or provide details of any other bidders - and can therefore not confirm if any meetings any meetings have taken place with Virgin Care. We therefore exempt the release of any information, if held, relating to meetings held between NHS Kernow and any potential bidders under section 36 of the Freedom of Information Act, effective conduct of public affairs. In applying this exemption, a public interest test was carried out to consider if the public interest to disclose the information outweighed the exemption. It was agreed that as the procurement has not ended, the release of any such information, if held, would prejudice the procurement and have a detrimental effect on health and care services. 3. Have you performed an impact assessment regarding how a potential move to a private company may affect the existing staff and patients of the service? If so, can you kindly provide me with a copy? A. NHS Kernow can confirm an equality impact assessment has been produced and released but, as the procurement has not concluded we exempt the release of this information under Section 36 of the Freedom of Information Act, effective conduct of public affairs. In applying this exemption, a public interest test was carried out to consider if the public interest to disclose the information outweighed the exemption. It was agreed that as the procurement has not ended, the release of any such information, if held, would prejudice the procurement and have a detrimental effect on health and care services. 3

4 4. Do you expect any staff employed within the existing service to be made redundant as a result of this tender? A. NHS Kernow has not concluded its procurement of children s services and awarded a contract to a provider. We are therefore unable to speculate on the terms of a contract that has not yet been awarded and are therefore unable to provide the information you have requested. 5. Can you confirm that the NHS pension entitlement of existing staff will be protected? For example, if a private company was to win the tender will they be required to provide an NHS pension (under a directions status) for the staff? A. NHS Kernow has not concluded its procurement of children s services and awarded a contract to a provider. We are therefore unable to speculate on the terms of a contract that has not yet been awarded and are therefore unable to provide the information you have requested. 6. Can you confirm that it is your understanding that the transfer of any staff would result in TUPE applying? A. NHS Kernow has not concluded its procurement of children s services and awarded a contract to a provider. We are therefore unable to speculate on the terms of a contract that has not yet been awarded and are therefore unable to provide the information you have requested. 7. Can you guarantee that this tender will not compromise the quality of service provided to children? A. NHS Kernow is committed to ensuring children and young people in Cornwall and the Isles of Scilly have the best start in life and support they need to realise their ambitions. It is NHS Kernow s Triple Aim vision to improve people s health and wellbeing, their experience of care and support and reduce the cost of care. This procurement will ensure we achieve this. There has already been an extensive engagement and consultation process to give children, young people and their families and those that work for the services a chance to have their say about how the services are provided. Those views, together with the needs of the commissioners NHS Kernow, Cornwall Council, NHS England and the Council of the Isles of Scilly, and local and national strategies were used to help the commissioners to decide to put the services out to tender. Local clinicians, children, young people and their families will continue to be consulted during this process. 4

5 FOI Mental health & learning disabilities -Contact information Date received 26/06/ What is the name(s) of the lead mental health commissioning officer? A. Sue Smith, Programme Director, Delivery 2. Which other CCGs does the lead commission on behalf of? A. None. FOI Organisation - Databases Date received 25/06/ Please can I have a list of every database your authority holds alongside a description of what the database is. A. NHS Kernow as a matter of process updates its databases registration regularly. NHS Kernow is in the process of updating the full register and therefore exempts the release of this information under section 22 of the Freedom of Information Act, information intended for future publication. We aim to have the information available at the end of August 2015 and will be able to share our up-to-date list then. FOI Contracts - Patient transport Date received 24/06/ Please can you tell me the annual contract value awarded to NSL for Non- Emergency Patient Transport Services? A. The non-emergency patient transport contract was awarded to NSL by the former primary care trust in 2013/14. It was awarded on 31 March, 2013 and the contract ends on 30 September The contract value is 1.78 million a year. Year 1 1,737,199 Year 2 1,713,114 Year 3 1,690,038 Year 4 1,667,911 Year 5 1,629, Please can you tell me if there has been any increase in the contract value since the award of the contract? 1. Yes. 5

6 3. Please can you tell me the value of the increase in contract value since the award of the contract? A. 647,905 over the life of the contract 4. Please can you give a brief explanation for the rationale behind the increase in contract value? A. To mitigate against unforeseen variances in the demand profile across patient mobilities and increased operational pressures brought about by increased system-wide demand. FOI Prescribing & pharmacies - Prescribing recommendations Date received 23/06/ Please confirm the level of clinical evidence, cost effectiveness data and other supporting evidence the Medicines Management team require to consider recommending its adoption by the clinical commissioning programs or its incorporation into local guidelines for an ISO accredited Class IIA medical device? A. All medicines included in NHS Kernow s formulary are analysed by pharmacists from across Cornwall before they re approved for inclusion. Pharmacists will examine all available evidence, including trial data; effectiveness; the quality of the product; NICE recommendations; prescribing analysis; SIGN; Welsh guidance and safety data. Cornwall s formulary committee which is the Cornwall Area Prescribing Committee s technical working group - will consider application recommendations for approval to the formulary. Clinical decisions brought to either the technical working group or the Cornwall Area Prescribing Committee are agreed, minuted and ratified and prescribing decisions, guidelines and protocols are published on Cornwall s Eclipse formulary website: FOI Contracts - MSK patients Date received 22/06/ Please could you tell me where a GP send patients who present with an MSK problem? A. People in Cornwall and the Isles of Scilly can access two physiotherapy clinical pathway; the first is for lower back and neck pain (service specification is supplied) The map of medicine lays emphasis on primary care management via analgesics or manual therapy (via an Any Qualified Provider), before the GP makes a secondary care consultant referral, such as pain clinic, neurosurgery or rheumatology. 6

7 The second physiotherapy clinical pathway is for shoulder, (frozen shoulder, impingements etc.), knee (patella-femoral pain, patella tendinopathy, meniscal tears etc.) and hip and groin (sacro-iliac disorders, muscle tears etc.). The emphasis is on primary care management / self management via analgesics. If this doesn t work, the patient can access a range of other physiotherapy services that are commissioned by NHS Kernow. If the physiotherapy doesn t improve the patient s condition, a hip, knee and shoulder MSK Interface service is also available on Choose and Book. The remit of an interface service is to review the patient s symptoms in more detail than standard physiotherapy. The service is also staffed by physiotherapists, known as ESPs (extended scope practitioners). ESPs may also offer additional treatment such as a knee brace (which is a clinically proven alternative to surgery). They may also request MRIs etc, if their GP has not already requested this. If the MSK Interface doesn t work, an orthopaedic referral is invariably made by the GP. 7

8 FOI Prescribing & pharmacies - Declarations of interest Date received 17/06/ Please confirm all members of the CCG, including board and staff members, prescribing or medicines advisors and any members of prescribing committees and sub-committees for the last financial year to date where the interest relates to a pharmaceutical or device/dressings/medical equipment supply company. A. NHS Kernow can confirm none of its staff, including the heads of medicine management, have any declarations of interest to declare. FOI Prescribing & pharmacies - Rebate schemes Date received 17/06/ Which rebate schemes the/each CCG is currently engaged in (name of drug/treatment/product plus name of manufacturer and what type of rebate eg discount by prescribing volume, discount above threshold level) Name of Scheme Drug(s) covered Companies involved in the scheme Medicines rebate scheme Pradaxa. Boehringer Ingelheim Limited Medicines rebate Rivaroxaban (Xarelto) Bayer scheme Insulin rebate scheme Apidra Sanofi Insulin rebate scheme Insuman Sanofi Medicines rebate scheme Fentanyl Transdermal Matrix patch (Fencino) Queitapine prolonged release tablets (Ebesque) DB Ashbourne Ltd 2. When each contract was signed? A. Sanofi: July 2014 Boehringer: Februay 2015 Bayer: April 2014 DB Ashbourne: January Was each drug was in the local formulary when the contract was signed? A. Yes 8

9 4. Were savings from each rebate are included in the commissioning budget or are accounted for as "other income"? A. The rebate monies reduce the level of spend and are not shown as other income in the accounts. 5. Whether CCG employees receive any financial or other reward for achieving savings via PCRS? A. NHS Kernow employees received no financial awards for achieving savings. 6. Please let me have copies of any information or requests sent to GP practices in the 6 months since contract signature with respect to these rebates (eg informing them that the drugs under the scheme are now cheaper) A. NHS Kernow did not send any information to GPs regarding rebates. 7. Please send copies of the PCRS contracts, redacted as appropriate, and details of any other rebates or benefits obtained by the CCG arising from membership (either membership of the CCG itself or local GPs' membership) of other manufacturer discount schemes. A. NHS Kernow does not have the information you have requested. FOI Prescribing & pharmacies - Prescribing schemes Date received 15/06/ Please provide the following details for the GP prescribing budgets: Amount ( ) Details of NHS Kernow s prescribing budget are published in its annual accounts, which are available on its GP Prescribing Budget 2013/14 * website. We therefore exempt the release of this information under section 21 of the Freedom of Information Act, information accessible by other means. Details of NHS Kernow s prescribing budget are published in its annual accounts, which are available on its Spend (total actual cost) on GP website. We therefore exempt the release Prescribing 2013/14 of this information under section 21 of the Freedom of Information Act, information accessible by other means. Details of NHS Kernow s prescribing budget are published in its annual GP Prescribing Budget 2014/15 * accounts, which are available on its website. We therefore exempt the release 9

10 Spend (total actual cost) on GP Prescribing 2014/15 of this information under section 21 of the Freedom of Information Act, information accessible by other means. Details of NHS Kernow s prescribing budget are published in its annual accounts, which are available on its website. We therefore exempt the release of this information under section 21 of the Freedom of Information Act, information accessible by other means. * Please provide budget figure net of any expected QIPP savings. 2. Did the CCG have a Prescribing Incentive Scheme in place? Yes. Copies of the Yes. Copies of the incentive schemes incentive schemes 2013/ /15 are attached to are attached to this this If Yes, please provide a copy of the 2013/14 and 2014/15 Prescribing Incentive Schemes detailing (where possible) indicators, how each indicator is measured (metrics), associated incentive and anticipated benefit (e.g. total anticipated saving to be generated for prescribing budget). 3. Were GP practices automatically enrolled in the Prescribing Incentive Scheme (i.e. mandatory enrolment)? 2013/14 No 2014/15 No 3a. If participation was not mandatory, how many practices participated in the Prescribing Incentive Scheme each year? 2013/14 All 2014/15 All 4. What was the total incentive payment budget (i.e. total funding) available in the CCG for achievement of the Prescribing Incentive Scheme? ( total) 2013/14 560, /15 560, Please select the option that best describes how often practices were updated on their achievement against the Prescribing Incentive Scheme? Please tick. 2013/ /15 Monthly Yes Yes Quarterly Other (Please state) 6. Was there any restriction on how the recipient could spend the incentive money from the Prescribing Incentive Scheme? (If yes, please enter details in the box below.) 2013/14 Yes 2014/15 Yes 10

11 Use of GPPQS monies GPPQS monies can only be used: For the benefit of patients of the practice; To support the delivery of the CCG s strategic objectives; Having regard to the need to ensure value for money; According to the purposes specified below; Inclusion Criteria - Payments MAY be spent on the following: Direct patient care (not already funded by GMS or PMS Contracts) Initiatives to improve the quality or cost-effectiveness of prescribing (see Appendix 1 below) Invest to save or service redesign schemes Non-recurring staff costs to undertake a specific approved project The purchase of medical equipment to be used for the treatment of patients that is not funded by GMS The purchase of furniture or equipment for the comfort or convenience of patients Health Promotion initiatives (eg Waste Campaigns, Antibiotic Awareness) IT hardware not provided under the GP Systems of Choice hardware provision i.e. laptop/ipad (NB arrangements will need to be made to ensure that security measures including encryption are in place. The practice will also need to fund the cost of maintenance, support and any licenses) Exclusion Criteria - Payments MAY NOT be spent on the following: Purchase of land, buildings or vehicles External or internal structural changes to buildings Any work to increase the value of the premises - including redecorating, fixtures or fittings Furniture, equipment or IT services to support the office functions of the practice Any equipment or activity already covered under core GMS or Enhanced Service payments e.g. routine staff training Any services or equipment which are not directly connected with patient care To reduce a practice s contribution to the employment costs of existing practice staff To earn interest on savings or hold cash amounts in anticipation of demands in future years To pay off existing loans or mortgages taken out by members of the practice or third party landlords To fund a practice s contribution where a percentage reimbursement has already been made by the CCG To pay for maintenance and support of practice equipment. 7. Was the Prescribing QIPP Plan developed by or in conjunction with a pharmacist (e.g. Head of Prescribing or Chief Pharmacist)? By With 2013/14 Yes Yes 2014/15 Yes Yes 11

12 FOI Finance & budgets - non-nhs healthcare Date received 15/06/ Please can you tell me what the CCG and the PCT before it spent on non- NHS healthcare over the past five financial years. A. NHS Kernow was established on 1 April 2013 and can only provide information from this date. Please contact the Department of Health for details of the former Primary Care Trust s spend: reviews&informationteam@dh.gsi.gov.uk. Details of NHS Kernow s spend during 2013/14 is available in our annual accounts, which are published on our website. We therefore exempt this information under section 21 of the Freedom of Information Act, information accessible by other means. Details of NHS Kernow s spend during 2014/15 will be published in the annual accounts and these will be available later this year. We therefore exempt this information under section 22 of the Freedom of Information Act, information intended for future publication. FOI Finance & budgets - Non-NHS healthcare Date received 15/06/ How much the CCG spent on non NHS-providers last year and what each of the top 10 providers received? A. During the past financial year, NHS Kernow spent the following with non-nhs healthcare providers: 1 Peninsula Community Health 2 Cornwall Council 78,322, Community Services Supported Living Placements 15,430, Duchy Hospital 14,913, Acute care - elective operations 4 Serco Ltd 6,331, Out of hours GP services 5 Outlook Southwest 3,209, Counselling / Therapy Services 6 Bodmin NHS Treatment Centre 3,125, Acute care - elective operations 7 Millbrook Healthcare Ltd 2,113, Primary Care Services 8 Care UK Clinical Services 2,078, Acute care - elective operations 9 Probus Surgery Ltd 1,928, Minor surgical procedures 10 Dr Warren & Partners 1,518, Primary Care Services 12

13 FOI Organisation - Locum GPs Date received 12/06/ Please provide the total number of locum GPs the CCG has employed. Please provide a number for agency locum GPs and a number for bank locum GPs and provide these figures for each of the last five financial years. 2. Please provide the total number of shifts worked by locum GPs. Please provide a number for agency locum GPs and a number for bank locum GPs and provide these figures for each of the last five financial years. 3. Please provide the total amount of money spent on shift payments to locum GPs. Please provide a number for agency locum GPs and a number for bank locum GPs and provide these figures for each of the last five financial years. 4. Please provide the 10 highest amounts of money ever paid by the CCG to a locum GP for working a single shift. Please provide a number for agency locum GPs and a number for bank locum GPs and provide these figures for each of the last five financial years. 5. Please provide the name of the practice where each of the highest-paid shifts were worked by locum GPs. Please provide a number for agency locum GPs and a number for bank locum GPs and provide these figures for each of the last five financial years. 6. Please provide the number of agencies used by the CCG to provide locum GPs. Please provide these figures for each of the last five financial years. 7. Please provide the names of each agency used by the CCG to provide locum GPs in each of the last five financial years. Please provide these names for each of the last five financial years. 8. Please provide the total amount of money paid by the CCG to each of those agencies. Please provide these figures for each of the last five financial years. A. NHS Kernow does not employ locum GPs. You may wish to contact NHS England, which commissions GP services, to answer your questions: england.contactus@nhs.net. FOI Long term conditions - Diabetes Date received 11/06/ What structured education programmes for adult patients diagnosed with diabetes are currently commissioned and who are they provided by? Please state: the name of each programme (e.g. DAFNE, X-PERT, DESMOND) whether the programme is targeted at people with Type 1 or Type 2 diabetes (or both) whether the programme is targeted at people with newly diagnosed or established diabetes (or both) if applicable, whether the programme is targeted at specific groups of people (for example BME groups) the name of the provider that delivers the programme. 13

14 A. Structured education is commissioned only for people who access the insulin pump service, in line with NICE TA for insulin pumps for people with Type 1 diabetes. It is a locally developed course. The provider of the pump service is Royal Cornwall Hospitals NHS Trust (RCHT) and the course is delivered by Peninsula Community Health and RCHT. For all newly diagnosed Type 1 patients, the Diabetic Specialist Nurses (DSNs) provide a two-day group carbohydrate counting course (based on the BDAC course). The course is provided in Truro, in conjunction with RCHT dieticians. There is also a small pilot of structured education for people newly diagnosed with Type 2 diabetes in a specific geographical area. The pilot uses the Lilly conversation maps. This is not a fully-commissioned service. 2. Which of these programmes meet nationally agreed criteria for diabetes structured education set out by NICE[1] and/or are certified by QISMET (Quality Institute for Self Management Education and Training)[2]? A. The insulin pump programme meets the criteria for patient education for the NICE insulin pumps guidelines. The Type 2 education service covers all newly diagnosed Type 2 patients in the west of Cornwall, covering GP practices in Camborne, Redruth, Helston, Falmouth, Hayle, St Ives and Penzance. This education could now meet NICE guidance as audit and peer reviews are place. 3. For each structured diabetes education programme on offer, please state the length of the contract commissioned. For example, whether the contract is commissioned on a yearly basis, two yearly or three yearly basis. A. The programme for Type 1 is a requirement for the NICE TA and is part of the overall contract with the acute hospital trust. The DSN service is part of the Peninsula Community Health community services contract. 4. For each structured diabetes education programme on offer, please state the cost per patient of attending the whole programme, as agreed between the CCG and the provider. A. NHS Kernow does not have the information you have requested as it is provided as part of a block contract with Peninsula Community Health. The provider is not required to report this cost to the CCG as part of its reporting procedures. We have contacted the provider, Peninsula Community Health, to request this information but we have been told this information is commercially sensitive and could not be shared with either NHS Kernow or a third party organisation such as Diabetes UK. 14

15 5. For each structured diabetes education programme on offer, how many places were commissioned for: (i) 2016/17; (ii) 2015/16; (iii) 2014/15; and, (iv) 2013/14? A. NHS Kernow does not have the information you have requested as it does not commission this service by activity. 6. For each structured diabetes education programme on offer, how many people attended the programme in: (i) 2014/15; and (ii) 2013/14? A. NHS Kernow does not have the information you have requested. We have contacted Peninsula Community Health and have been told that during 2013/14, 224 face-to-face sessions were delivered. An additional 129 face-toface sessions were classed as Did Not Attend (DNA). During 2014/15, 410 face-to-face sessions were delivered and 310 DNAs. 7. For each structured diabetes education programme on offer, how many people completed the programme in: (i) 2014/15; and (ii) 2013/14? A. NHS Kernow does not have the information you have requested. We have contacted Peninsula Community Health and have been told that the education is delivered during two days and patients are expected to attend both sessions. As such, during 2013/14, 224 face-to-face sessions were delivered. An additional 129 face-to-face sessions were classed as Did Not Attend (DNA). During 2014/15, 410 face-to-face sessions were delivered and 310 DNAs. 8. Do any of the structured diabetes education programmes on offer currently have a waiting list? If so, approximately how long is the waiting list for each programme? A. NHS Kernow does not have the information you have requested. We have contacted Peninsula Community Health and have been told that it is unable to provide us with the information at this time as the person who is responsible is off work. 9. How are structured diabetes education programmes promoted to local people with diabetes? For example, through posters and/or leaflets in GP practices/pharmacies, patient champions, online. A. NHS Kernow does not have the information you have requested. We have contacted Peninsula Community Health and have been told that this is an ongoing pilot and not a commissioned service. The pilot is advertised in the surgeries that are included and they refer patients. 15

16 10. What processes are in place to ensure that healthcare professionals understand and promote the benefits of structured diabetes education programmes to their patients, in order to improve the quality of the referral process to programmes available locally? For example, encouraging GPs and practice nurses to attend diabetes structured education taster sessions, providing skills training in motivational interviewing. A. Structured education programmes are not commissioned for newly diagnosed adults with diabetes and as such GPs and healthcare professionals are unable to promote them. FOI Organisation - Contact information Date received 11/06/ Could you please provide the contact details of the lead commissioner responsible for Anticoagulation Management. A. Natalie Jones, Director of Clinical and Corporate Affairs. Natalie.jones9@nhs.net 2. Please can you also provide the contact details for the IT lead. A. Paul Jacka, IT lead. Paul.jacka@nhs.net FOI Prescribing & pharmacies - Work programmes Date received 11/06/ Do you have a work programme for cardiovascular disease? A. No, this is not a dedicated workstream for NHS Kernow. 2. Do you have a work programme for Familial Hypercholesterolaemia? A. No, this is not a dedicated workstream for NHS Kernow. 3. Within your organisation do you approve the use of Ezetimibe to treat Familial Hypercholesterolaemia? If Yes: a) Within your organisation when was the prescribing of Ezetimibe to treat Familial Hypercholesterolaemia approved? b) Do you have any shared care protocols in place for Ezetimibe? A. Ezetemibe is second line on our formulary. We have no shared care protocol. FOI Contracts - Community equipment provision Date received 10/06/ How many assessors do you have registered to access your community Equipment Service? 16

17 2. Is your Community equipment service operated under a section 75 arrangement? Please advise if you operate Integrated Commissioning, Integrated provision, Pooled budget or other? 3. What is your CES budget m total? 4. How is the budget split? Health Pool Local Authority Pool Education/Children s Telecare Health Non-pool Other 5. Who is the Lead agency for ICES NHS Provider NHS Commissioner Local Authority 6. Who is the CES Provider In-house Service Voluntary Sector Provider Commercial 7. What Finance Model do you use for community equipment? Credit Model Purchase Model Hire model/lease TCES retail Other 8. What was your Expenditure on Specials/Non-stock/new purchases in What is your Benchmark Population, Clients age What is your Total Population 11. What types of equipment do you issue out under the following headings? Bathing equipment Beds & accessories Bariatric Equipment Children s CHC adults Short term loan Wheelchairs Seating Cushions Household Moving & Handling Ramps & Steps Minor Adaptations Sensory Telecare Walking Aids Other 12. What is your eligibility criteria for provision of equipment? 17

18 A. NHS Kernow is unable to provide information for all your questions as it is not the lead commissioner for the equipment loan service. Please contact Cornwall Council to request this information: FOI Organisation - IT systems and training Date received 08/06/ What budget has been allocated for ICT technical training from 1 April 2015 to 31 March 2016? A. NHS Kernow has not allocated any budget for ICT training. 2. Can you please provide details of the ICT Managers/Mangers that will purchase ICT technical training? A. Paul Jacka: paul.jacka@nhs.net 3. Please can we have a list of RFQ (Request for Quotes) for any training that will be purchased within the coming 12 months? A. No quotes have been raised. 4. Is there ICT technical training required to be purchased within a certain timeframe? A. None has been identified. 5. Can I have a list of any ICT software Upgrades planned for the new financial year? A. None are in progress at this time. 6. Can I have a list of any hardware upgrades planned for the new financial year? A. Desktop and Server replacement program have been purchased. 7. Can you provide copies or details of any ICT projects? A. No formal projects have been identified at this time. 8. How much ICT technical training, has been purchased from QA Limited since first of April 2015? A. None. 9. Do you currently have any skills licences purchased with QA Limited? If so can you please provide a usage report? 18

19 A. Please cold you clarify what you mean by a skills licence, please. 10. Can you please provide details of the ICT Managers/Mangers that will purchased the licence? A. Paul Jacka: paul.jacka@nhs.net FOI Mental health & learning disabilities - Funding Date received 05/06/ In each of the financial years and how much did your clinical commissioning group spend on: 1) Adult mental health services 2) Children s mental health services 3) Learning disability care Please breakdown the figures by each year A. NHS Kernow does not hold the information in a format you have requested. Details of the contracts for adult mental health and learning disability services also contains the value of children s mental health services. NHS Kernow is unable to separate the costs for these three services as it is undertaking a procurement of its children s and adolescent services and to provide individual costs would allow bidders to know how much is spent on this service. We therefore exempt the release of this information under section 43 (2) of the Freedom of Information Act, commercial interests. In reaching this conclusion we have carried out a public interest test and, whilst recognising the need for being open and transparent, we believe this is outweighed by concerns that, as a commissioner of children s and adolescent services, the release of this information during a procurement will prejudice NHS Kernow s ability to conduct a fair procurement and compromise its ability to secure a high quality service which offer value for money for the population of Cornwall. This information will be available once the procurement has ended and a contract has been awarded. 2014/15: Information of NHS Kernow s spend for these services during 2014/15 will be available in its annual accounts. This will be published later this year. We therefore exempt this information under section 22 of the Freedom of Information Act, information intended for future publication. 2. Based on your budget plan for , how much is your clinical commissioning group planning to spend on: 1) Adult mental health services 2) Children s mental health services 3) Learning disability care 19

20 A. NHS Kernow has not set its budget for 2015/16 and is therefore unable to provide the information you have requested. We therefore exempt this information under section 22 of the Freedom of Information Act, information intended for future publication. 3. Which NHS mental health trusts do you commission to provide services? A. Cornwall Partnership NHS Foundation Trust 4. How much was the value of the block contracts for mental health care you agreed with each trust listed in question 4 in and ? (for trusts that also provide community health care such as sexual health services, please exclude this and only include mental health). Please breakdown the figures by each year. A. The mental health values within the block contract were: During 2013/14, NHS Kernow spent 45,802,000 on mental health care. During 2014/15, NHS Kernow spent 45,441,500 on mental health care. 5. What percentage uplift/change to each of the above block contracts have you agreed for ? For any contracts not agreed, please list your proposed uplift. A. NHS Kernow and its provider have not agreed its contract for 2015/16. We are therefore unable to provide this information and exempt this under section 22 of the Freedom of Information Act, information intended for future publication. 6. Please attach any correspondence your CCG received from former care minister Norman Lamb or former deputy prime minister Nick Clegg regarding mental health or mental health funding in A. NHS Kernow has not received any correspondence from either Norman Lamb or Nick Clegg about the funding of mental health and children s services. FOI Mental health & learning disabilities - Placements Date received 05/06/ How many times did you authorise out-of-area placements for mental health patients in , and ? A. NHS Kernow was formed on 1 April 2013 and cannot provide information relating to the former primary care trust (2012/13). Please contact the Department of Health s legacy team to request this information: reviews&informationteam@dh.gsi.gov.uk During 2013/14, NHS Kernow authorised 66 out of county placements for people with mental health needs. 20

21 During 2014/15, NHS Kernow authorised 156 out of county placements for people with mental health needs. Please note, this figure includes the seven month closure of Longreach inpatient unit in Bodmin; without the closure, we would expect the figure to be much lower. The unit has now reopened. 2. How many of these placements in each were requested due to bed pressures locally meaning the patient could not be admitted to local units? A. During 2013/14, 64 of the placements identified in the previous answer were requested due to a patient being unable to be admitted to a local unit. During 2014/15, 153 placements identified in the previous answer were requested due to a patient being unable to be admitted to a local unit. Please note, this figure includes the seven month closure of Longreach inpatient unit in Bodmin; without the closure, we would expect the figure to be much lower. The unit has now reopened. 3. How much did your CCG spend on the out-of-area placements for mental health patients in each year? A. NHS Kernow was established on 1 April 2013 and is unable to provide information from 2012/13/ Please contact the Department of Health s legacy team to request information about the former primary care trust: reviews&informationteam@dh.gsi.gov.uk Acute patients already out of county and admitted Acute patients unable to be admitted locally Pre-approved placements (specialist treatment) 2013/ /15 536, , ,516, , ,244, ,165, Please note this information may have been recorded differently between 2013/14 and 2014/15 following a review and additional analysis of the ledger and use of budget codes. A review was carried out during 2014/15 to reassess the coding used. FOI Organisation - IT Date received 02/06/ Please confirm the location of your computer room / data centre on your premises: A. We can confirm that our computer room and data centre is stored on NHS Kernow premises. Due to security issues, we are unable to confirm the exact location. 21

22 2. Please confirm the location of your computer room / data centre at a third party location: A. None 3. Please confirm the location of your computer room/data centre at another NHS provider location. A. We can confirm that a secondary computer room and data centre is at another NHS premises. Due to security issues, we are unable to confirm the exact location. 4. What is your annual budget for the following areas in the years? IT as a whole IT staff IT Hardware IT Software IT Licences IT Utilities (heating, aircon) 450, , ,000 20,000 30,000 This is included within the rent paid to NHS Property 630, , ,000 15,000 53,000 Services. Please contact information@property.nhs. 650, , ,000 25,000 15,000 uk to request these details. NHS Kernow was formed on 1 April 2013 and does not have the information you have requested. 5. Do you have any plans to move or re build your data centre facilities? A. No 6. Do you have any other IT projects planned with a budget of over 50,000 for the next 12 months? Please provide details (product, budget and expected project length) A. SharePoint Business Intelligence. This will cost 60,000 during a 12 month program. 7. Do you have any other IT projects planned with a budget of over 50,000 for the next two years? 8. Do you have any other IT projects planned with a budget of over 50,000 for the next three years? A. Single access to clinical record across the County, 500,000 per annum during four years. 9. If so please provide contact details (name, full address and direct telephone number) of the current /potential leads? A. Paul Jacka - paul.jacka@nhs.net / If your data centre /computer room is located with a third party of other NHS service supplier, please provide the contract start date? 22

23 A Contract end date? A Total contract cost? A. 8, Annual contract costs? A. 2, Service/project lead (name, full address and direct telephone number) A. Paul Jacka - paul.jacka@nhs.net / Name of supplier/contractor? A. Royal Cornwall Hospitals Trust. FOI Contracts - Procurements Date received 01/06/ Please provide a list of all contracts awarded by competitive procurement or tender by the CCG during 2014/15. A contract is considered to have been "awarded" at the point when the contract was signed. For each contract, please state which CCGs it covers and which CCG led the procurement. A. During 2014/15, NHS Kernow awarded a contract for the out of hours primary care service. 2. For each contract listed in response to question 1, please state which bidder was awarded the contract, the contract start and end dates, and the full-term value of the contract (an estimate will suffice). A. The contract was awarded to Devon Doctors Ltd. The contract began on 1 June 2015 and ends 30 November 2017, with an option to extend for a further 2.5 years. The contract value is 8 million a year (estimated 36,350,000 during five years). 3. Please list all bidders and provide the full tender evaluation and bid scoring for each bidder. This should include the score provided for each bidder for each question in each category in each tender. 23

24 A. Identity of all bidders: Devon Doctors Ltd. South West Ambulance NHS Foundation Trust (SWASFT). Bid score of each bidder: Scoring protocol: Scored questions were scored in accordance with the following matrix: Grade Definition of grade 0 No information or wholly inadequate response. Limited information provided or a response that is inadequate or only 1 partially addresses the question or that would adversely affect the potential service to a small extent. Acceptable response in terms of level of detail, accuracy and relevance. 2 Provision of the required service at satisfactory standards. Comprehensive response including all requested information that provides the Commissioner with a good level of comfort over the ability of the 3 Bidder to provide the service through the reliability or effectiveness of the delivery processes (including their support aspects) envisaged. Superior response. Additional value in healthcare provision through better access, greater capacity, improved quality or greater integration of the 4 service that will in some other way result in better outcomes than stipulated in the requirements. Overall scores Evaluation criteria Weightings SWASFT score Devon Doctors Ltd Legal and regulatory Pass / Fail Pass Pass Economic standing Pass / Fail Pass Pass Health and Safety Pass / Fail Pass Pass Risk assessment Pass / Fail Pass Pass Service requirements 25% 12.50% 17.2% Clinical 25% 12.50% 16.3% Patient focus, equality and diversity 10% 5.00% 6.0% Workforce 15% 8.13% 10.0% IM&T 5% 2.92% 2.9% Contract management 10% 5.00% 4.6% Financial (q1 5) 10% 4% 5% Financial (q6) Pass/ Fail Pass Pass Overall score 50.04% 61.94% Q No SWASFT Devon Doctors Ltd Potential bidder details and structure PB1 Not scored Not scored PB2 Not scored Not scored 24

25 PB3 Not scored Not scored PB4 Not scored Not scored PB5 Not scored Not scored PB6 Not scored Not scored PB7 Not scored Not scored PB8 Not scored Not scored PB9 Not scored Not scored PB10 Not scored Not scored PB11 Not scored Not scored PB12 Not scored Not scored PB13 Not scored Not scored PB14 Not scored Not scored PB14a Not scored Not scored PB14b Not scored Not scored PB14c Not scored Not scored PB14d Not scored Not scored PB14e Not scored Not scored PB14f Not scored Not scored PB14g Not scored Not scored PB14h Not scored Not scored PB15 Not scored Not scored PB16 Not scored Not scored PB17 Not scored Not scored PB18 Not scored Not scored PB19 Not scored Not scored PB20 Not scored Not scored PB21 Not scored Not scored Legal and regulatory LR Pass Pass LR1 Pass Pass LR1a Pass Pass LR1b Pass Pass LR1c Pass Pass LR1d Pass Pass LR1e Pass Pass LR1f Pass Pass LR1g Pass Pass LR1h Pass Pass LR1i Pass Pass LR1j Pass Pass LR1k Pass Pass LR1l Not scored Not scored LR2 Pass Pass LR2a Pass Pass LR2b Pass Pass LR2c Pass Pass LR2d Pass Pass LR2e Pass Pass 25

26 LR3 Pass Pass LR3a Pass Pass LR3b Pass Pass LR3c Pass Pass LR3d Pass Pass LR3e Pass Pass LR4 Pass Pass LR5 Pass Pass LR6 Pass Pass LR7 Pass Pass Economic standing ES1 Pass Pass ES2 Pass Pass ES3 Pass Pass ES4 Pass Pass ES4a Pass Pass ES5 Pass Pass ES5a Pass Pass ES6 Pass Pass ES6a Pass Pass ES6b Pass Pass ES6c Pass Pass ES6d Pass Pass ES6e Pass Pass ES7 Pass Pass Health and safety HS1 Pass Pass HS2 Pass Pass HS3 Pass Pass HS4 Pass Pass HS5 Pass Pass HS6 Pass Pass HS7 Pass Pass HS8 Pass Pass HS9 Pass Pass HS10 Pass Pass HS11 Pass Pass HS12 Pass Pass HS13 Pass Pass HS14 Pass Pass HS15 Pass Pass HS16 Pass Pass Risk Assessment R1 Pass Pass R2 Pass Pass R3 Pass Pass R4 Pass Pass R5 Pass Pass 26

27 R6 Pass Pass Financial F1 1 2 F1b F2 2 2 F3 1 2 F4 2 2 F5 2 2 F6 Pass Pass Service requirements SR1 2 3 SR2 1 3 SR3 2 3 SR4 2 3 SR5 2 3 SR6 2 3 SR7 2 3 SR8 3 3 SR9 2 2 SR SR SR Clinical C1 1 3 C2 2 3 C3 2 2 C4 2 3 C5 3 2 Patient focus, equality and diversity P1 2 3 P2 2 2 P3 2 2 P4 2 3 P5 2 2 IM&T IM1 3 3 IM2 2 2 IM3 3 3 IM4 2 2 IM5 2 2 IM6 2 2 IM7 2 3 IM8 3 2 IM9 2 2 Workforce W1 2 2 W2 3 3 W

28 W4 2 3 W5 2 3 W6 2 3 Contract management CM1 2 2 CM2 2 2 CM3 3 1 CM4 2 2 CM5 1 2 CM

29 Appendix FOI

30 Objectives: GP Prescribing Quality Scheme To support delivery of the identified Medicines Optimisation initiatives, and drive costeffective prescribing. 2. To balance the requirement to deliver savings with a requirement to recognise the qualit y of prescribing. 3. To offer achievable incentives to all practices, and be as transparent and as easy to understand as possible. Elements: 1 - Prescribing Budget Element: 2014/15 Prescribing Outturn GPPQS Payment 0 1% Underspent 10p per registered patient 1 2% Underspent 20p per registered patient 2 3% Underspent 30p per registered patient 3 4% Underspent 40p per registered patient 4 5% Underspent 50p per registered patient >5% Underspent 60p per registered patient 2 - Prescribing Cost Growth Element: Growth Rate (year to Mar 15) GPPQS Payment 0 1% Below England Rate 10p per registered patient 1 2% Below England Rate 20p per registered patient 2 3% Below England Rate 30p per registered patient 3 4% Below England Rate 40p per registered patient 4 5% Below England Rate 50p per registered patient >5% Below England Rate 60p per registered patient 3 - Prescribing Quality and Audit Element: Action Meet with CCG Team and agree a Practice Plan and prescribing support plan Implementing the TARGET Antibiotics Toolkit Discharge Review TARGET antibiotics pack v2 Amen GPPQS Payment 10p per registered patient 10p per registered patient 10p per registered patient Medication Safety Review: Novel Oral Anticoagulants Repeat Prescribing Process Review Discharge Med Review Protocol NOAC Prescribing Review p per registered patient 10p per registered patient Repeat Prescribing Review Kernow Clinical Commissioning Group

31 Report title Enablers Practices will meet with the CCG s Pharmaceutical Advisors and nominated Prescribing Support Technician in the spring/summer to discuss the priorities and opportunities at the practice for the year and develop a Practice Plan. The CCG will provide all practices with a detailed pack of prescribing information, identifying any areas where the practice are outliers and where there may be potential savings available. The CCG s Prescribing Support Technicians, Pharmaceutical Advisors, and Clinical Leads for Medicines Optimisation will be available to support practice-based work on prescribing throughout the year. The CCG Prescribing Team will develop a set of protocols and audit packs to support both quality improvement and cost saving prescribing projects. Practices may use any remaining monies from previous GPPQS payments to support prescribing work. The 150K Enabling fund support has been top-sliced from the prescribing budget to further support GPs to take protected time to work on prescribing. Equivalent to 1,800 per practice (6 GP sessions), this money is accessible on submission of an agreed workplan. The enabling fund should not be used to fund the GPPQS reviews/audit work but rather to support medicines optimisation initiatives in line with KCCG priorities including polypharmacy, frailty etc Administration In the event of an overall KCCG prescribing budget underspend, payments will be unlimited. In the event of an overall overspend; the payments under this scheme will be capped at 550K. In the event of a dispute e.g. if a practice s population had changed significantly in-year and they wished this to be taken into account a KCCG Panel will consider representations from practices and will have the power to adjust payments due. Please see document below for Guidelines on how monies secured under this scheme can be used/spent. Page 2/5

32 Report title GP Prescribing Quality Scheme The objectives of this scheme are: 4. To support delivery of the identified Medicines Optimisation initiatives, and drive costeffective prescribing. 5. To balance the requirement to deliver savings with a requirement to recognise the quality of prescribing. 6. To offer achievable incentives to all practices, and be as transparent and as easy to understand as possible. Financial Element GPs and the LMC in Cornwall have indicated that rather than being set specific target s, practices would prefer more freedom to reduce prescribing costs in the way that suits each individual practice. This scheme offers a simple incentive based on aggregate prescribing spend, that rewards practices for reducing their prescribing costs and/or maintaining an underspent position objectives that can be achieved by delivery of efficiency savings. The CCG Prescribing Team will be available to work closely with practices. In order to offer a meaningful incentive to all practices, there are two elements: Savings against 2012/13 Outturn Savings against 2013/14 Budget Practices who achieve a total prescribing spend in that is lower than the previous year will be eligible to claim 20% of the reduction This element means that practices starting from a significantly overspent position can achieve payments by reducing their spend, even if staying within their prescribing budget for the year may be unrealistic. Practices who achieve a total prescribing spend in that is lower than their allocated budget will be eligible to claim 10% of the underspend This element means that practices starting from a significantly underspent position can achieve payments by maintaining that position, even if achieving further savings proves difficult. Practices can achieve under either or both of these elements. Prescribing Efficiency Element All payments under this scheme are conditional on Practices implementing the following prescribing actions Meeting Practice Meeting with CCG Pharmaceutical Advisor and Prescribing Support Technician Agree one significant Medicines Optimisation project to implement during the year Evidence/Target Practice Plan Page 3/5

33 Report title Plus: Two of the following Five Quality Actions: PPI/C.Diff Review Evidence/Target Review Summary Good Practice Meeting Meeting Report Antibiotics Audit Audit Summary NSAIDs Review Review Summary Insulin Passport Review Review Summary Enablers Practices will meet with the CCG s Pharmaceutical Advisors and nominated Prescribing Support Technician in the spring/summer to discuss the priorities and opportunities at the practice for the year and develop a Practice Plan. The CCG will provide all practices with a detailed pack of prescribing information, identifying any areas where the practice are outliers and where there may be potential savings available. The CCG s Prescribing Support Technicians, Pharmaceutical Advisors, and Clinical Leads for Medicines Optimisation will be available to support practice-based work on prescribing throughout the year. The CCG Prescribing Team will develop a set of protocols and audit packs to support both quality improvement and cost saving prescribing projects. Practices will have received monies from previous PCT schemes in a lump sum. This can be used to support protected time and facilitate work on prescribing. A 150K budget has been top-sliced from the prescribing budget to further support GPs to take protected time to work on prescribing. Administration In the event of an overall KCCG prescribing budget underspend, payments will be unlimited. In the event of an overall overspend, the payments under this scheme will be capped to 550K (allocated on a pro-rata basis). In the event of a dispute e.g. if a practice s population had changed significantly in-year and they wished this to be taken into account a KCCG Panel will consider representations from practices and will have the power to adjust payments due. Please see document below for Guidelines on how monies secured under this scheme can be used/spent. Page 4/5