NHS Berkshire West Clinical Commissioning Group Governing Body Meeting in Private: Tuesday 10 July 2018

Transcription

1 NHS Berkshire West Clinical Commissioning Group Governing Body Meeting in Private: Tuesday 10 July 2018 Minutes of the meeting of the NHS Berkshire West CCG Governing Body Meeting in Private, 10 July 2018 Present: Abid Irfan Wendy Bower Geoffrey Braham Sam Burrows Andy Ciecierski Shairoz Claridge Rebecca Clegg Maureen McCartney Kajal Patel Dr Raju Reddy Debbie Simmons Cathy Winfield (CCG Chair) Newbury & District GP Locality Lead Lay Member, PPE Lay Member, Governance Director of Strategy GP Locality Lead, North & West Reading Operations Director, (Newbury & District) (Acting) Chief Finance Officer Operations Director (North & West Reading) GP Locality Lead, South Reading Secondary Care Consultant Nurse Director Chief Officer AI WB GB SB AC SC RC MM KP RR DS CW In attendance: Lynn Casey-Sturt Johan Zylstra Governing Body Secretary (Minutes) (Deputy) GP Locality Lead (Wokingham) Item Agenda No. 1 Welcome and Apologies The CCG Chair, Abid Irfan welcomed everyone to the Berkshire West Clinical Commissioning Group (BW CCG) Governing Body meeting. 2 Apologies for Absence Apologies were received from: Debbie Milligan, GP Locality Lead, Wokingham Sarah Garner, (Interim) Director of Joint Commissioning Saby chetcuti, Lay Member Governance Katie Summers, Operations Director (Wokingham) 3 Declaration of Interest AI reminded Governing Body members of their obligation to declare any interest they may have on any issue arising at governing body meetings that might conflict with the business of Berkshire West CCGs. None declared. Declaration of Gifts & Hospitality AI reminded Governing Body members of their obligation to declare any offer of gifts and hospitality whether accepted or declined and the reason for accepting or declining such offers. None declared. 4 Minutes of the meetings held on 12 June 2018 (Part A and Part B) The minutes of the meetings held on 12 June 2018 were agreed as a true record of that meeting. 4a Matters Arising/Action Log: June 2018 Action log from the meeting on 10 June 2018: Updated.

2 5 Chief Officer s Report (June 2018) The Chief Officer provided an update on key areas of work and assurance on matters of constitution reserved to the CO. Key points as summarised: Integrated Care System This ICS has now completed its work on defining its Strategic Priorities for 2018/19 and agreeing the projects which will be established to ensure these deliver. The ICS Unified Executive met in June 2018, with a further meeting scheduled to take place on 12 July A refreshed Memorandum of Understanding (MoU) will be presented to the Governing Body for discussion and approval following the July meeting of the Unified Executive. Buckinghamshire, Oxfordshire and Berkshire West (BOB) STP BW has now submitted its STP request for large capital schemes; this includes a request for estates re-development at Berkshire Healthcare and Royal Berkshire Foundation Trusts. Chief Executives from all STP organisations met with Matthew Swindells (NHS E) on 15 June 2018; the meeting focused on working arrangements and proposed future collaborations. Members were advised that the current thinking in this area focuses on four clearly defined levels of delivery: Neighbourhood (30k 50k Pop.); Place (Up to 500k Pop.); STP / ICS (at least 1m Pop.); Region (to cover multiple STPs / ICSs). BW10 integration programme The Berkshire West 10 Integration Board met on 6 June 2018 and included discussion on the significant improvement in performance by RBH in hitting the national target for no more than 3.5% bed days lost to DToC. It was noted that Maureen McCartney, Operations Director for North & West Reading is the Chair of a weekly DToC meeting to review and sign off DToC. Members also noted that following a meeting attended by Nick Carter (CEO West Berks Council and Chair of the BW10 Integration Board at the Ministry for Housing, Communities and Local Government) in June to discuss how Local Authorities can work most effectively with Integrated Care Systems; a report from this meeting will be presented at the Chief Officers Group on 31 July GP Provider Alliance (PCA) The Berkshire West Primary Care Alliance (BWPCA) continues to play an active role within the Berkshire West ICS to support the delivery of the ICS priorities. The BWPCA and each of its four constituent alliances have presented their business plans to the CCG Finance Committee and received its approval for how the primary care funding allocations will be used during 2018/19. Staff Survey BW CCG has conducted its second staff survey. Although the overall participation rate has dropped (still well above the NHS average), positive responses to individual questions have either held steady or slightly increased. Following on from the CO s update, members raised the following points for discussion: Reading Health & Wellbeing Board: Initial thoughts requiring clarification by a new Council member in relation to the ICS.

3 The proposed public health cuts to Smoking Cessation services, Eat for Health and NHS Health Checks. Locality Management Team (LMT): 7-day access and concerns around IT connectivity (EMIS, Vision and TPP Practices). Staff Survey (Internal Communications): Action: Managers to assure staff within their Teams on the changes within the CCG and its priorities. Action: All The Governing Body received the Chief Officer s Report and noted the updates provided 6 Risk Management and Assurance To provide for review and agreement the updated May Governing Body Assurance Framework (GBAF), the related Summary Risk Profile, and the red-rated risks from the corporate risk register. After one rise and four falls last month, the profile is static this month. In June, the total number of risks on the register remained the same, and the risks reported as red fell by two. Changes to red-rated risks from last month are: Newly downgraded from red: PrC2ciii Special measure practices PrC5 Practice engagement with re-design of same-day access Members highlighted Risk PrC5 (SO4): the requirement for Practices to engage with the re-design of same-day access and meet national requirements to expand sevenday provision. It was considered that risks relating to ongoing IT issues (interoperability, access to results, appointment booking arrangements) are properly captured within the Risk, as well as identified inherent risks around procurement. Action: It was agreed that in addition to current reporting, the addition of a position paper on the key Risks is provided and discussed at BW CCGS Commissioning Committee. Action: CW The Governing Body noted the level of compliance with quality and performance targets and supported the actions being taken to improve performance where necessary 7 M1 Quality and Performance Report To inform the Governing Body of the performance against CCG Clinical Indicators for Governing Body s information. DS summarised key areas of note as follows: Patient Safety Falls: RBFT reported two falls in April. Mixed sex accommodation: RBFT has reported a total of 220: 197 for Acute Medical Unit and 23 for emergency Department Observation (figures going forward will no longer include the observation bay). The Trust has been invited to join a national improvement collaborative Starting in June Clinical Effectiveness Fractured neck or femur: BHFT reporting 67.7% against a target of 85%. A deep dive review has now been completed with the report being presented within ICS Quality in March. Safeguarding training (Children Level 1): RBFT reporting 90.3% against a target of 95%.

4 Safeguarding Adults (All Staff): RBFT reporting 89.6% against a target of 90%. Independent providers Safeguarding training (Children and Adults): Circle reporting 88%, which is below target for both elements. Circle has questioned the validity of the results and these are being challenged. RBFT Maternity dashboard summary MLU: Retained 20% delivery rates with no diversion. Caesarean rates are continuing to increase reporting 30.31% for April. SCAS Clinical concerns: Reporting 46.0% against a target of 95%. A Recovery Action Plan has been requested. Number of serious incidents: Two cases reported in April. Falls (as Sis): Two 999 Sis reported in April (one Sub-optimal care of the deteriorating patient and one Treatment delay). SCAS 999 Asthma Care bundles: Reporting 78.8% against a target of 95%. Falls: Performance is still an issue. Reporting 51.8% against a target of 95%. Conveyance of patients detained under a Section 136: Reporting 66.1% against a target of 90%. Urgent Care Performance A&E (4 hour target): The performance in April has improved considerably as compared to March. RBFT reporting 92.5% against a target of 95%. New category standards. Ambulance Response Programme (ARP). Performance for SCAS 999 has improved in all areas as compared to March with all indicators achieving the national target at CCG and Thames Valley contract level. MM advised that an audit has taken place in respect of Cat 3 & Cat 4 arrivals in ED over a 16 hour period. 111 Calls answered: Reporting 79.12% against a target of 95% for BW Abandoned 111 Calls: Reporting3.24% against a target of 5% for BW. DToC: Performance has slightly deteriorated as compared to March reporting 4.5% against a target of 3.5%. Planned Care GP referrals, consultant follow up attendance and elective admissions are above plan for April. Planned care Performance The 62 day cancer standard was achieved for RBFT. RTT: There were two 52 week breaches for Berkshire West CCG; there were no 52 week waits at RBFT for April. Discussion pointed to the increase in Planned Care GP referral rates compared to the national picture which is thought to be coming down. To gain further clarity it was felt that members would need to see all of the data for Q1 (April June) by locality and specialty. Action: Although data is available through the South, Central and West Commissioning Support Unit (SCWCSU) Intelligent Point portal, it was agreed that SC request the data directly, and if necessary, CW would request same from the Chief Information Officer (Catherine Dampney). Action: SC/CW The Governing Body discussed and Approved the Quality Report 8 M2 Finance Report The (Acting) Chief Finance Officer gave an update on M2 Finance reporting. At Month

5 2 the CCG has reported an in year YTD and Forecast breakeven position, and has consequently achieved its required cumulative surplus positions of 2m (YTD) and 12.5m (FOT). Key points to note: Acute Services: No significant variances against plan have been identified. RBFT: The contractual form of the Contract is still being worked through by the CFO/DF group. Running Costs: Corporate underspend largely related to QIPP target for running costs for the year of 750k. Risks & Mitigations: The risk related to achieving our efficiency target is estimated at 8.2m. Going forward, risks will be shared more widely as a system. BCF Budgets: Budgets have been increased for the year in line with national guidance, and is expected to manage within its allocated funding. Cost Improvement and Efficiency Schemes: A review is underway looking at business cases that have not gone forward, and whether these would work in our new system. The Planning and Transformation Team are currently working on the effect of projects the CCG implemented last year. The Governing Body noted the financial plan summary paper 9 Thames Valley Priorities committee Policy Proposal To gain approval from the Governing Body to adopt the following recommendation. TVPC78 Smoking cessation before planned surgery New policy Raju Reddy, Secondary Care Consultant guided members through the policy outlining the key areas of note. Members attention was drawn to the proposed Public Health cuts to Local Authority funded Smoking Cessation services following cuts to public health budgets and the implications this would have on the service provided in Reading, with the possibility of the service ceasing from April In respect of this policy and all future policies, members felt that a system needed to be put in place whereby all agreed policies can be communicated to surgeries and displayed openly in clinics so that GP s, Practices and patients can remain informed. Action: It was agreed that SC would put together a process for disseminating communications within Primary Care; and also that SB would discuss the matter with the Medical Director at RBH in respect of Secondary Care. Action: SC/SB The Governing Body: Discussed the policy recommendations and associated equality analysis Agreed the adoption TVPC78 CCG implementation 10 Locality Update To update the Governing Body on matters arising in the Berkshire West CCG localities (South Reading, North & West Reading, Wokingham and Newbury & District). Members from the four Berkshire West CCG localities provided a brief verbal update on the key points of note. Newbury & District Quality Premium data 2017/18: The CCG has improved the number of patients

6 newly diagnosed with diabetes. This is expected to continue to rise now that coding practices have been changed. Planning Developments: Planning permission for the site at Sandleford that had previously been refused has recently been re-submitted and is likely to be approved. Health & Wellbeing Board: A draft strategy for improving outcomes achieved by children and young people aged 0-15 with special educational needs and/or disabilities ( ) has been well received and is out for public consultation for a six week period ending 20 July Matthew Chilcott has been appointed the new Primary Care Commissioning Manager, replacing Lisa Briggs as of the 19 September North & West Reading Craig Barlow, Paramedic Practitioner for SCAS, attended Council to share his experience of SCAS & GPs working together to support the role of paramedics in general practice. Council Members had a good discussion about what the CCG can do to help support practices increase dementia diagnosis rates and these actions will now be taken forward. Mortimer Surgery shared the success of their recent PPG Healthy Heart event that took place on 27 th June. Dr Will Orr was a speaker at the event. Balmore Park and Emmer Green announced that they had successfully registered all Priory Avenue patients in time before the practice s closure. The refreshed version of North & West Reading Locality s Plan on a Page was shared with Members and changes/additions to the plan were approved. South Reading TB: SR received a commendation from Public Health England on all the work around tackling TB in Berkshire West, and with our neighbours in Berkshire East. Cancer Project: The 15 cancer champions came together for their first meeting on 5 July 2018 and agreed to meet every month to share learning. Diabetic eye screening: The diabetic eye screening uptake rates are below the yearly target (85% achievable and 75% acceptable) with most practices only achieving 60%. Wokingham Health and Wellbeing Board 14 June 2018: A presentation from Bicester Health New Town programme on their Healthy New Town initiative. This is an NHS E funded demonstrator programme (one of ten sites across the country) and is a three year programme. GP Consultant Model: New models of care employed at Brookside Group Practice, Wokingham Medical centre and Woodley Centre Surgery, where some on the day acute care can be delivered by other health professionals; e.g. nurse practitioners, paramedics or pharmacists with supervision by GPs. The Governing Body received the Locality Reports 11 Delegated Committees Chairs Report To provide the Governing Body with an update on matters considered, decisions made and assurance that the Committee is discharging its responsibilities in line with the Terms of Reference and CCG Constitution.

7 Finance Committee Remuneration Committee PCCC The Governing Body received and noted the Chairs Reports 12 Terms of Reference The Governing Body were asked to approve the Terms of Reference. Finance Committee Remuneration Committee The Governing Body received and Approved the Terms of Reference 13 Annual Reports The Governing Body were asked to approve the Annual Reports. Audit Committee Finance Committee Remuneration Committee PCCC The Governing Body received and Approved the Annual Reports 14 Public & Patient Engagement/Communications Report To update Governing Body members on engagement activities by the CCG. WB gave a verbal update on the key points to note: Cancer Champions: SR Patient Voice are helping raise the awareness of the signs and symptoms of cancer and promote patient education amongst our seldom-heard groups. PPG Healthy Heart Event 27 June 2018: A good presentation was given on how primary care and secondary care are working together. Patient Voice: The Reading and West Berkshire Carers Hub gave a presentation (assisted by Dr Rupert Woolley) on Carers and the need for carers to be recognised. NHS 70 th Birthday: Several North and West Reading Patient Participation Groups (PPGs) and GP Practices have been busy organising events to celebrate the NHS s 70 th birthday including: Balmore Park PPG (open event): 8 July 2018; Western Elms (afternoon tea): 25 July 2018; Balmore Park (party): 18 September 2018; Pangbourne PPG (coffee morning): 8 September The Governing Body noted the PPE Communications Report 14 Any Other Business Governing Body AGM: The AGM is scheduled to take place on Tuesday, 11 September 2018; the venue has yet to be confirmed. Members agreed to discuss the Agenda at the next CCG Management Meeting. Action: All Meeting Closed: 11:15