REPORT TO CROYDON CLINICAL COMMISSIONING GROUP GOVERNING BODY Meeting in Public. 30 October 2012

Transcription

1 REPORT TO CROYDON CLINICAL COMMISSIONING GROUP GOVERNING BODY Meeting in Public 30 October 2012 Title: CROYDON CCG AND CROYDON PUBLIC HEALTH MEMORANDUM OF UNDERSTANDING Lead Director Report Author Contact details Committees which have previously discussed/agreed the report. Committees that will be required to receive/approve the report Purpose of Report Dr Mike Robinson Kate Woollcombe Croydon Clinical Commissioning Group (CCG) Se Management Team CCG Governing Body Approval Recommendation: The CCG Governing Body is asked to: consider the draft document and propose any amendments agree that the CCG Chair and Accountable Officer may sign off the final version Executive Summary: Following the implementation of the Health and Social Care Act 2012, under which the majority of the public health function transfers into local government, there is a requirement that local authority public health teams provide expert public health advice to support delivery of the CCG s commissioning responsibilities. The Memorandum of Understanding (MoU) sets out the basis on which this support will be provided and describes the nature of the working arrangements and mutual interests between the two organisations. Key Messages and Issues: The MoU sets out principles and values rather than explicit detail of the work to be undertaken, in order to allow maximum flexibility within a defined framework. Page 1 of 11

2 The current draft MoU is provided at Appendix A for further comments and suggestions. Governance: PEC Comments where appropriate Financial Implications Implications for other CCGs Equality Impact Assessment Information Privacy Issues Reputational Issues Communication Plan n/a There may be additional costs for the CCG, attached to ensuring that the PH team has access, via the CSU, to the data required for delivery of the PH function. Other costs of providing the PH service will fall to the local authority and will be covered by the ring-fenced allocation (figures for to be confirmed). None A key focus of public health work is to reduce inequalities and to track, where possible/practicable, the experience of and outcomes for individuals with protected characteristics. This document formalises that responsibility with regard to the CCG. None Failure to have an agreed Memorandum of Understanding between the Council PH Team and the CCG will adversely affect the CCG s authorisation prospects. A dissemination process will be agreed. Page 2 of 11

3 Croydon CCG and Croydon Public Health Memorandum of Understanding 1. Background and purpose Consequent upon the Health and Social Care Act 2012 entering into statute, most of the public health function currently delivered by PCTs transfers into local government from 1 April Under the legislation, local authorities are mandated to ensure that their local CCG is provided with the specialist public health advice and support necessary to discharge their commissioning responsibilities effectively. There is a requirement that this relationship between local government and the CCG is captured in a Memorandum of Understanding signed off by both parties. 2. The Memorandum of Understanding The draft MoU, attached at Appendix A, sets out principles and values rather than explicit detail of the work to be undertaken, in order to allow maximum flexibility within a defined framework. 3. Recommendation The CCG Governing Body is asked to: consider the draft document and propose any amendments agree that the CCG Chair and Accountable Officer may sign off the final version 4. Next Steps In the light of feedback from stakeholders, the final document will be prepared for sign off by both Council and CCG. It is intended that this should have been completed by mid-november. Author: Kate Woollcombe Title: Deputy Director of Public Health Date: 24 October 2012 Page 3 of 11

4 Appendix A Attachment 05A Insert logos Croydon Council and Croydon CCG MEMORANDUM OF UNDERSTANDING between Croydon Council and CROYDON CLINICAL COMMISSIONING GROUP for the provision of Public Health Commissioning Support Version Control Version Author Date Comments v1.0 Kate Woollcombe First Draft circulated for comment to: Tony Brzezicki, Agnelo Fernandes, Paula Swann, Jon Rouse, Hannah Miller, Fouzia Harrington, Steve Morton, Jenny Phaure, Mike Robinson v2.0 Kate Woollcombe Reflects comments received to date v3.0 Kate Woollcombe Reflects further discussion at CCG Management Team 23 October 2012 Page 4 of 11

5 Purpose of the Document This document sets out a framework describing the nature and extent of the developing relationship between the Croydon Clinical Commissioning Group ( the CCG ) and the Public Health ( PH ) team currently based within the NHS, and due to transfer to Croydon Council on 1 April Context Under the Health and Social Care Act 2012, much of the public health function currently delivered within the NHS becomes the responsibility of local government. This means that councils will be taking on responsibilities across the three domains of public health: health improvement, achieved through coherent inter-agency action tackling lifestyle and other factors ( the wider determinants of health ) that influence health and wellbeing health protection, eg by preventing the spread of communicable disease, managing the public health response to major incidents, and monitoring the delivery and effectiveness of local screening and immunisation programmes as commissioned by the NHS Commissioning Board healthcare public health, providing specialist advice to support and inform the commissioning of effective and safe healthcare services to meet population need Local government has been mandated to ensure that Clinical Commissioning Groups are provided with the necessary public health advice and input to support effective delivery of their statutory responsibilities. Aims and Objectives The CCG s vision is to achieve Longer, healthier lives for all the people in Croydon. To that end, the partnership between the CCG and the PH team will have the following objectives: to develop a shared understanding of the nature and extent of the issues affecting the health of Croydon residents to develop effective strategies and interventions that will o secure health improvement and reduce inequalities in the population o have a positive impact on quality of life and healthy life expectancy Working Arrangements 1. The PH team will expect to develop close working relationships with the Joint Commissioning Unit and the Commissioning Support Service for South London, in order to be able to effectively advise and support the CCG in its commissioning decisions. 2. The CCG and PH team will formally agree an annual work programme that is informed by, and consistent with: local goals and priorities as set out in the Health and Wellbeing Strategy (HWS) and the CCG s Integrated Strategic Operating Plan (ISOP) national requirements and expectations, established and emerging the resources available The work programme will include core work, such as the JSNA, Annual Public Health Report, Health and Wellbeing Strategy, and task and finish projects in line with agreed priorities. An early draft is provided at Appendix The PH team will be active and consistent members of a range of groups in which the CCG has an interest, to be agreed as part of the annual work programme. 4. The PH team will support all member practices in delivering health improvement by assigning a named consultant lead to each GP network. 5. It is expected that there will be some areas of work which are best tackled across a number of CCGs, and that in such cases PH support to commissioning will need to be provided at scale. Page 5 of 11

6 This means that some Croydon PH staff will have SW London-wide responsibilities, and in return that Croydon CCG will receive PH support from other borough teams. 6. As a statutory partner in the production of the local JSNA, the CCG will ensure active representation from the Governing Body and/or Clinical Leadership group, actively participating in the prioritisation and action-planning processes. 7. The CCG will actively contribute to the development of the Health and Wellbeing Strategy. Domain Specific Activities Health Improvement 8. In line with priorities agreed by the Health and Wellbeing Board, the PH team will advise on and support the development of action plans to improve health and reduce health inequalities the design and delivery of local public health campaigns and related health improvement activities 9. The CCG will contribute to the development and implementation of strategies and action plans to improve health and reduce health inequalities, eg through all member practices addressing smoking, alcohol misuse, and obesity in their patients by actively supporting local PH campaigns and other preventative activities, including opportunistic health promotion with individual patients by ensuring that prevention and the principle of proportionate universalism (ie, actions must be proportionate to the degree of disadvantage, hence applied in some measure to all people rather than only the most disadvantaged) underpins their commissioning decisions 10. The CCG Governing Body and Clinical Leadership Group (CLG) will ensure that their member practices play their full part in achieving key public health targets (eg immunisations, screening, smoking, health checks) Health Protection 11. The PH team will ensure that local strategic plans are in place for responding to a range of emergencies, including pandemic flu, major incidents, and adverse/extreme weather conditions capacity and skills are in place to co-ordinate an emergency response (this may be managed on a SW London-wide basis) specialist health protection advice, including but not limited to advice on screening and immunisations, is available to primary care clinicians; this may be provided from local, sector, or London-wide resources 12. The CCG will ensure that they have the necessary policies and procedures in place to deliver their role as a Category 2 responder under the Civil Contingencies Act, and participate in major incident exercises where relevant. 13. As commissioners, the CCG will ensure that all providers of their commissioned services have major incident and business continuity arrangements in place, appropriate to the nature and extent of the service provided. 14. The CCG will ensure that all member practices have tested business continuity plans in place, and that resources can be made available in the event of a major incident to assist with the response, including participation in local command and control arrangements. Page 6 of 11

7 Healthcare Public Health 15. The public health team will lead the annual joint strategic needs assessment (JSNA) process, with particular emphasis on identifying the nature and extent of health inequalities in the borough undertake ad hoc needs assessments/service reviews/service evaluations in line with the agreed priorities for the year advise on and support the design and delivery of evidence-based care pathways advise on and support the delivery of evidence-based commissioning and procurement decisions advise on and support the design and delivery of strategies to reduce health inequalities and unwarranted variation in health outcomes assist the CCG with determining priorities and identifying areas for investment/disinvestment using appropriate methodologies support the CCG in ensuring the clinical effectiveness and quality of commissioned services through participation in governance and clinical quality review groups contribute to the development and revision of evidence-based criteria for the commissioning of services, including referral and demand management criteria provide specialist public health input to the Individual Funding Request process lead the development and publication of the Pharmaceutical Needs Assessment 16. The CCG and (where appropriate) member practices will support the development and publication of the Pharmaceutical Needs Assessment by ensuring that the PH team has access to appropriate levels of specialist advice to enable delivery of this statutory responsibility engage with and support the implementation of NICE and other best practice guidance relevant to Croydon work together with PH to implement agreed commissioning priorities and programmes, and demand management strategies Resources The PH team in Croydon comprises the Joint Director of Public Health (DPH), supported by 5.00 wte consultants (one of whom is the designated Deputy Director of Public Health (DDPH), one assistant director, and their teams. From time to time, specialist trainees are placed with the PH team. The total PH team establishment and skill mix as at 31 March 2013 is shown at Appendix 1. The pay budget and associated non-pay costs for the PH team will be fully covered by the allocation received by Croydon Council. If not co-located, hot desk facilities for visiting members of the PH team will be required. Access to Data To enable the PH team to discharge its responsibilities, appropriate individuals will require continued and free access to raw and aggregated NHS data through the Data Management Information Centre. The CCG will be responsible for ensuring that this access is maintained, where the data are held by their commissioning support organisation/s. Page 7 of 11

8 Appendix 3 contains a schedule of the data required by the PH team. These requirements may change over time. Governance The DPH will ensure that the work programme is delivered by staff with appropriate levels of knowledge, skills, and experience for the task in hand. Systems will be in place to ensure that staff have current registration, where this is a pre-requisite for appointment to, and continuing in, their role. All staff will be expected to participate in ongoing professional development, and to comply with the CPD requirements of their professional bodies as applicable. The DPH will ensure that the department meets the required criteria for accreditation as an approved training location for specialist public health trainees. Appointments to consultant posts within the PH team will be subject to the prevailing Faculty of Public Health guidance and procedures, including the establishment of an Appointments Advisory Committee whose membership includes Faculty representatives. The DPH will meet regularly with the CCG Chair and Accountable Officer to review progress with delivery of the agreed work programme, amend/update it as necessary in the light of developing or changing priorities, and to agree any remedial action that may be necessary. Date of Review April 2013 Appendices 1. Croydon Council PH Team: funded establishment and skill mix 2. Specimen Work Programme 3. Data Requirements Page 8 of 11

9 Appendix 1: Public Health Department: Funded Establishment as at 31 March 2013 [to be added] Page 9 of 11

10 Appendix 2 Draft Work Programme Core Work Annual Public Health Report JSNA Overview Chapter JSNA Deep Dives as agreed by the Health and Wellbeing Board Public Health contribution to the Integrated Strategic Operating Plan GP Practice Profiles Co-ordination, planning and monitoring of the implementation of NICE and other best practice guidance in Croydon The public health team will provide a consistent presence at the following meetings: o CCG Management Team (DPH or deputy) o CCG Governing Body (DPH or deputy) o CCG Clinical Leadership Group (Deputy DPH) o CHS CQR (nominated consultant in public health) o Primary Care CQR (nominated consultant in public health or agreed deputy) o Croydon Prescribing Committee and its subgroups (NICE; New Drugs) (DPH or deputy) o QIPP Operational Board (nominated consultant or agreed deputy) Knowledge management support, including response to ad hoc small-scale data requests Task and Finish Projects supporting specific aspects of the service transformation programme etc etc Page 10 of 11

11 Appendix 3 Data Requirements Access to pseudonymised 1 records from the following datasets will be required: 1. GP data for public health intelligence purposes 2. SUS data (A&E, inpatient, outpatient) 3. Breastfeeding prevalence data 4. Births data from maternity units/health visitors 5. ONS births and mortality files 6. Exeter flag 4s data 7. Terminations of pregnancy data 1 Pseudonymised in this context is used as a general term for data from which information that identifies individuals has been removed. Page 11 of 11