BROMLEY CLINICAL COMMISSIONING GROUP - GOVERNING BODY MEETING THURSDAY 20 NOVEMBER 2014

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1 BROMLEY CLINICAL COMMISSIONING GROUP - GOVERNING BODY MEETING THURSDAY 20 NOVEMBER 2014 PUBLIC QUESTIONS AND ANSWERS QUESTIONS RAISED FOR THE PUBLIC FORUM PRIOR TO THE MEETING ON 20 NOVEMBER 2014 WRITTEN QUESTIONS FROM THOSE PRESENT From Tom Williams Q.1 How much money did Bromley CCG spend on consultants in its first year of office? : 70,000 was spent on consultants in the financial year 2013/14. I have a number of questions relating to the report on the Orpington Health and Wellbeing Centre (Enc. 6), para. 8 (Legal Considerations): Q.2a Who is the Responsible Officer for this project? : The Chief Finance Officer is the Responsible Officer for this project. Q.2b How much has been spent so far on legal advice and does this come from our local health budget? : To date there has been no expenditure on legal advice for the Orpington Health and Wellbeing Centre. The CCG receives two allocations of funds for healthcare and for running costs. Any expenditure on legal advice is funded from running costs. Q.2c The report states that the initial designs and floor layouts have been completed and discussed with prospective clinical services users and the CCG Project Team. Can members of the public have access to the design and floor layout? : The initial designs and floor plans have been completed but they will continue to change. The final designs and floor plans will be part of the Outline Business Case which should be completed after planning consent has been given by the London Borough of Bromley. Berkeley Homes consulted publicly on the proposed development and illustrations of these, including indicative floor layouts, are available on the following websites: Post_Submission_Version8_websitebig.pdf

2 2 Q.2d Is the Centre worth the money, considering how long it has taken so far? Initially it was needed because Orpington Hospital was going to close but Orpington Hospital is now up and running. King s has not got enough money for nurses, so why should a new building be opened? When the former Bromley PCT believed that Orpington Hospital would be closed, they planned a project that would bring health services closer to people s homes and would also re-house local general practices. Kings have since decided to keep Orpington Hospital open to provide an increasing number of hospital services, such as orthopaedics and rehabilitation. They are not however developing a community based asset and the rationale for opening a community Health & Wellbeing Centre has not changed: the CCG still wants to provide services in the centre of the Orpington community and general practices still need different premises. The Chief Executive of NHS England, Simon Stevens, has stated in his five-year plan that the future of the NHS is about transforming community services, so the Orpington Health and Wellbeing Centre will be needed more than ever to deliver and support community services. Beckenham Beacon provides a similar function for the Beckenham area and the two centres will help to transform NHS services in Bromley. Supplementary question Q.2e I and other members of the public do not believe there is money available to start new projects. Shouldn t the money be used to employ more nurses rather than start a project that may not work properly? The CCG is already funding the services concerned and the GPs are paid through their contracts with NHS England so this is not about additional money. By shifting services into a new centre there should be efficiency savings and the intention is to increase health prevention work in order to reduce patients need for hospital admission and further expensive treatments. From Peter Moore Q.1 My query concerns an entry in the Healthwatch booklet that lists various organisations and policies in Bromley. The bit on dentists interested and confused me. It seemed to suggest that all (Bromley) dentists had a requirement to offer their patients treatment under the NHS framework and listed different bands of cover. Is this correct? Are there caveats to this? : NHS dentistry is managed by NHS England and not by the CCG. If a dental practice is listed as an NHS dentist it should be offering NHS services. You can enquire about local dentists via the NHS England website or Tel:

3 WRITTEN QUESTIONS RECEIVED FROM THOSE NOT PRESENT From Paul Brown 3 Q.1 On the performance report for the meeting, why is clinical effectiveness at the PRUH still described as being monitored at Trust level with no figures given, unlike King s at Denmark Hill? The figure quoted against King s Denmark Hill is the whole Trust performance. The report will be amended to make this clear in future. Q.2 The performance, quality and financial reports submitted to the CCG contain a wealth of data important to members and managers but are difficult to understand and not helpful for the public. Would the CCG consider producing as a regular agenda item a report for the public containing selected indicators like standardised death rates, readmissions to hospital, cancelled operations, patients notes missing for outpatients, discharges after 6.00pm, doctor and nurse staffing ratios, hospital infections and waiting for appointments, test results and treatments and waiting times on the day for things like blood tests, x-rays, A&E, the hospital pharmacy and in outpatient clinics. The Patients Advisory Group would have views on what might be included and on the format. The CCG publishes the detail as a principle of transparency but we would like to develop a more public-facing scorecard with summarised information and would welcome feedback from the PAG for this. It may not be possible to provide all the items listed but the CCG should be able to provide something that is easier to understand than the full report. Q.3 Why is the CCG considering incentives in the new contract for the 111 service in SE London to encourage the call centre to get a high proportion of people to self-care (in other words not to refer to the service) when much recent commercial experience suggests that call handlers will be expected to follow the money and give advice designed to maximise the contractor s income. Any incentives are included in the basic specification for the service and do not involve extra payments for providers. Our specification for the NHS 111 service encourages more people to self-care and take responsibility for their own health, providing advice on managing long-term conditions and giving information about healthy lifestyles. From Susan Sulis ORPINGTON HEALTH & WELLBEING CENTRE PROJECT (Enc. 6, item 10) 1(a) What is the total budget allocation figure (from start to completion) for this project? : Bromley CCG has no access to information in relation to any expenditure incurred by Bromley PCT.

4 4 For 2014/15, the budget for the Orpington Health and Wellbeing centre project is 200k. The budget for 2015/16 onwards is yet to be finalised and discussions are taking place to confirm responsibilities between Bromley CCG and NHS Property Services and the associated costs for the remainder of the project. 1(b) What is the estimated total annual ongoing running cost (including all elements) following completion? : These are yet to be finalised and will be set out in the outline business case which will be published in the first part of The Senior Responsible Owner of the Project is identified in the report (6.3) as the BCCG s Chief Financial Officer, Mark Cheung. (a) What are Mr. Cheung s professional qualifications that demonstrate his suitability for the responsibility of managing such a project? : Mr Cheung is the Chief Finance Officer for Bromley CCG and qualified accountant. The role of the Senior Responsible Officer is to be the clear accountable officer at the Governing Body to ensure that the project meets its objectives. That role includes ensuring that there is the appropriate experience and expertise in the project team and its delivery partners to manage the project successfully. Mr Cheung has worked in the NHS for over fifteen years and has throughout his career gained experience on a number of capital and estates projects. He was a capital investment advisor as part of the former London Regional Office and also sat on the South East London Capital Strategy Group of the South East London PCTs as a finance lead. Mr Cheung is also the statutory accountable finance officer for Bromley CCG with responsibility for a budget of over 380m and ensuring that all statutory financial duties and targets are met. (b) Please list the projects of similar type; size and value that Mr Cheung has had responsibility for in the past, with dates; clients; etc, and his professional role/job title? : In addition to the experience outlined above Mr Cheung worked on a number of capital projects in South East London. These include financial and risk modelling for the capital equipment replacement at the Queen Elizabeth Hospital, Woolwich; Finance and economics advisor for two mental health units at South London and Maudsley NHS Trust; Finance lead as the assistant director of finance of Greenwich PCT for two similar schemes in Greenwich Heart of East Greenwich and Eltham Community Hospital. FURTHER QUESTIONS FROM THOSE PRESENT Q.1 How would the re-procured dermatology service and the two-week wait referral system for urgent cases be affected by Choose and Book?

5 5 The Choose and Book system makes it easier to arrange appointments on the spot which are convenient for the patient. It also allows the receiving consultant to review the details of the referral and if appropriate to pass it on immediately to a specialist consultant, thus avoiding a wasted appointment for the patient and the consultant. Therefore GPs and patients are being encouraged to use the system. There have been problems recently because of an upgrade of the computer system and a lack of available appointment slots in certain hospital specialties. This has resulted in GPs having to re-submit some referrals by post or fax which is not satisfactory because it can cause delays or mean not all the clinical information reaches the receiving consultant. These problems are being worked on with the hospital management at the PRUH. As far as dermatology services are concerned, the current contract expires on 31 March The new contract will be designed to provide services for patients in the most appropriate place, including the community. This should manage the demand for specialist consultant clinics better. Q.2 Would it not be a better trade-off to employ more staff rather than investing in new appointment systems? It is not a trade-off, as both new systems and additional staff are needed. Money is available to employ more staff, but there is a national problem of a lack of trained staff, particularly nurses. Q.3 How are Governing Body meetings advertised to the public? They are advertised in the Bromley News Shopper and on the CCG s website. GP practices are also informed through a regular bulletin although we do not know to what extent they advertise this within the surgery.