SKM_C364e pdf

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1 DRAFT PRIMARY CARE OPERATIONAL GROUP MINUTES 2pm on Thursday, 21 st September 2017 Rooms A&B, 1829 Building, Chester. Attendance: SKM_C364e pdf Agenda Welcome and Apologies Speaker Laura Marsh The Chair welcomed everyone to the meeting and noted the following apologies received from; Claire Baker, Lynn Suckley, Sarah Murray, Andy McAlavey, Julia Riley Notes of previous meeting held on 20 th July 2017 Laura Marsh The previous minutes were approved, however it was noted that Sara Smith and Ken Salter did not appear on the attendance list but were both present at the last meeting. No further amendments were requested. Action: Lorraine Maughan to update last set of notes to reflect attendance of Sara Smith and Ken Salter. Action: to amend terms of reference to have quoracy with 1 GP only. Action tracker Previous action : Barbara Perry and Julia Riley will meet to review the issues and decide which cases should be brought to the group and also to determine the content of the first stage response and/or letter. Julia Riley and Barbara Perry to look at cases open and determine whether dealing with patients with long term conditions / chronic non-malignant pain where there are sole prescribers should be raised at the Regional Quality and Safety forum meeting run by NHS England. This action is ongoing and has not been completed as of yet, Barbara Perry to give an update later in the meeting. Minutes of Primary Care Operational Group 21 st September

2 Agenda Speaker Declarations of interest Practice Managers declared general interests due to some of the issues on the agenda Health Checks for people with Learning Disabilities (LD) Sean gave the group an update of the changes to the Learning Disability DES and developments for patients within this area. This information has already been shared with Practices via the e-bulletin. All Sean Donnelly West Cheshire is underperforming in terms of uptake of LD health checks. Work is being done in order to support practices to increase uptake as well as trying to support patients and carers to attend appointments; this work has involved direct contact with services. Sean advised that he has already attended a previous Practice Manager s Forum to inform practices about the new materials and that these can be sent out to patients again. Sean advised that he plans on setting up a meeting with CWP Community Learning Disability team who are able to support Health Check in Practices. Laura Marsh felt that there is more work to be done around understanding why patients are not attending their appointments and how we can improve this. Pauline Finlay advised that she would be happy to attend the steering group in place of Andy McAlavey in order to gather intelligence about what service users are saying and then share this with practices. Sean advised he will be presenting at the Practice Nurse Forum in December. Tim Goldsbrough advised that Hope Farm offer appointments in the afternoon rather than in the morning which seems preferable and also have spent a lot of time engaging with carers. He added that cross referencing the CWP LD list with the practice LD list is required in order to ensure the list of LD patients is accurate and up to date. Action: Sean Donnelly to send guidance and support materials out to practices to support the uptake of annual health checks and also liaise with Pauline Finlay to share information with Practice Nurses. Action: Sean Donnelly to report back at next meeting in November with a progress update on LD health checks CD monitoring report Barbara Perry advised that work has not progressed significantly since the last meeting in part due to Julia Riley s absence. It was noted that St Werburgh s practice for the homeless feature on the final graph however they are not normally included. Barbara Perry Concerns had been raised about the inclusion of St Werburgh s due to their unusual patient population. Barbara stated that she believes all practices should be included. A response has already been shared with practices providing assurance that oxycodone prescribing was appropriate for palliative patients Primary Care Estates update Jill Baker All projects submitted as part of the Estates and Technology Transformation Fund have been successful in progressing to the next stage of the process. WCCCG will be submitting updated Project Initiation Documents by November 2017 Minutes of Primary Care Operational Group 21 st September

3 Agenda with support from GB partnerships (GB partnerships provides a comprehensive range of development, investment and property services) for cost information. The funding being sought for the above projects that are progressing is 13.08m. Cheshire West and Chester Council and Sanctuary have agreed to partner on a revised scheme to complete the Blacon Parade development. It is proposed to maintain a health facility on the ground floor for the Elms branch and provide a mix of residential (16 units) on the first and second floors. The One Public Estate Project in Ellesmere Port envisages bringing all the public sector organisations in the town, including Health, to be located on one site. The schedules of accommodation are being reviewed currently and will be issued for further review mid-october. There will be long term revenue consequence for the Clinical Commissioning Group post April 2018 once they take on fully delegated responsibility for commissioning primary care, the new build revenue costs need to be managed through the PID and business case process. Speaker Primary Care Quality Report Several issues have been raised via the primary care quality report: Patient notes not being correctly transferred between practices. No response has been received from Capita (Primary Care Services) following the deep dive investigation. The group discussed whether this should be escalated and agreed this should be. Tim Goldsbrough gave feedback that there have been improvements. However, notes of deceased patients are still being sent back to the practice. Hayley Pashley added that Garden Lane still have approximately 80 new notes outstanding. The group agreed that both of these issues presented a risk and should be escalated to PCSE. Action: Jefcoate to escalate the issues regarding Capita raised and the fact that no response has been received from Capita to previous correspondence. Coroner s report: after an incident in the midlands re pneumococcal vaccines recommendations for primary care now need to be implemented. The recommendations were included in the quality report. requested feedback from practices. Action: to ensure Practices to receive a reminder of the recommendations via a central alert and to build these into the administrative training from the GPFV. The address supplied within the letter relates to the immunisation and vaccination team within the Midlands. Therefore, when this is circulated via a central alert, the local address should be included. Action: Laura Jones to request that EMIS training relating to call and recall to go on the agenda for the ICT ops meeting. An outbreak of Hep A has been confirmed in a West Cheshire Care Home, the GP practice felt they did not have the capacity or were required to vaccinate the patients affected. This potentially holds a patient safety risk, and brings to the fore the need to have a service in place for all prophylaxis treatments. Conversations with out of hours are currently taking place around prophylaxis flu antivirals with the CCG accepting that Minutes of Primary Care Operational Group 21 st September

4 Agenda this may need to be a financial risk in the absence of NHS England funding being issued in advance. Action: to chase Julie Kelly for an answer on financial risk regarding provision of Hep A vaccines. Action: Loraine Maughan to ensure flu update is on the agenda for the next meeting. Speaker Primary Care Monitoring Report gave an update on which practices that the CCG are working with throughout the support and escalation process. She also updated the group that a new practice, City Walls has entered the process within the Planned Care thematic area for the first time. fed-back that work around the Planned Care thematic area is achieving positive results, with practices using alternative care pathways for appropriate patients, resulting in a reduction of patients attending secondary care outpatient clinics. The Primary Care team have now moved their focus onto emergency admissions, and use of out of area providers. For the former, a specific Emergency Activity data pack has been produced for Ellesmere Port and Neston, and this information has provided a real focus for these clusters. Work is continuing to look at usage of out of area providers. A discussion took place around directing patients to the Countess of Chester where possible and appropriate as West Cheshire patients have underutilised the potential activity within the agreed block contract so there would be further support for the local health economy if this provider is chosen. This is being tackled jointly with discussions with Practices and patients, as well as via the Choice Team. It was acknowledged that patient choice must remain an important consideration when decisions are made. The indicators used in the escalation process were discussed including whether now was a good time to move Practices to a comparison with ONS comparator CCGs. It was felt that due to this being a new process and progress not yet fully being made to move the CCG average, this would be too early to change. It was also discussed that the medicines management indicators may need to change to ensure these are still relevant. A meeting will be arranged to discuss Willaston Contract Mobilisation Sara Smith Sara Smith updated that the contract has been awarded for Willaston GP practice to CWP. 13th November 2017 will be the start of new contract. Fortnightly mobilisation meetings have been scheduled. The new provider will take on patient communications Primary Care Programme Update gave an update on the following projects on behalf of Sarah Murray: Medicines Management Repeat Prescribing Project Highest weekly total to date Week 18: 28,067 Current Gross Total stands at 484,896 Minutes of Primary Care Operational Group 21 st September

5 Agenda Average weekly savings now stands at 21,082. (23 weeks data see graph below) Require 23,076 to reach target of 1.2 m GPFV Practice Clinical Pharmacist advised that following a hiatus over the summer the CCG will be progressing this work, arrangements will be finalised in the next month. GP Resilience Programme It was noted that Cheshire & Merseyside s GP Resilience Programme allocation for 2017/18 is approx. 290,000 (full allocation of 350,000, minus 60,000 allocated to schemes from 2016/17 that had funding agreed over 2 years). This year s received applications totalled 2.9m. A panel made up of those CCGs whose practices have applied and NHSE local team met in July to agree which practices will get funding - Fountains and St Werburghs were both funded approx. 10k each. Training and Development Administrative staff gave feedback that 73 Staff will be undertaking Medical Correspondence Training in September. Other courses booked for 2017/18 are as follows: Call handling HR for managers and supervisors Signposting Dealing with difficult patients EMIS bespoke in-house training (individual practices) Practice Managers The Practice Manager Training and Development Programme has started, the second session was held this week. This is a series of 9 sessions which will be delivered over the rest of the year. Releasing Time For Care It was noted that the CCG are providing 18,000 funding backfill for GPs to attend the programme. 10 Practices are taking part: Boughton, Bunbury, Helsby, Hope Farm, Kelsall, Malpas, Tarporley Adey, Tarporley Campbell, Village Surgeries Group, York Road The first session is on 28 September NHSIQ are also offering us a 2 day course on the Fundamentals of Quality Improvement on 14 and 28 November. Each day is a full day and will be held locally. Enhanced Extended Hours Service Task and Finish group created with reps from PPG chairs to agree approach to marketing the extended hours service widely, but also to look at the broader Speaker Minutes of Primary Care Operational Group 21 st September

6 Agenda awareness raising and promotion of other services such as online access, econsult, minor ailments services, and using the NHS wisely. Marketing material is about to be finalised. Will launch at AGM next week. Plan to have a separate telephone number which can be used for extended hours service rather than having to use SPA telephone number with option 3 (confusing for patients). Separate telephone number will make it much clearer. Will be a divert from current number to new number for those using the old number Speaker GP Forward View Nursing Feedback Pauline advised that across Cheshire and Merseyside we have developed a CCG PN Lead collaborative forum which is looking at the Nursing 10 point plan from the GPFV from a strategic perspective rather than doing this in individual CCGs. We are meeting six weekly and have developed task and finish groups for each item. Pauline advised that she plans to feedback on developments to Paula Wedd after the meetings have taken place Re-design of Nursing Homes LES Victoria Hough, GP and CCG Clinical Lead for Care Homes gave an update on a piece of work that she is leading on around updating the Nursing Home LES. The current Primary Care (Care Home) LES specification was agreed in This specification only applies to nursing homes and is in need of review. As part of a wider review of the Primary Care CQUIN, the specification is being reviewed in order that the CCG has an opportunity to explore how enhanced primary care services can be provided more equitably to vulnerable people, regardless of their care setting. A Task and Finish Group made up of colleagues from primary care, the clinical commissioning group, care homes, Cheshire West and Chester Council, the Countess of Chester Hospital and the community was established to review the specification and to develop a new specification which takes into account the needs of frail patients in nursing and residential homes. The revised LES specifies some improvements in the provision and recording of palliative and end of life care and clarifies the need for more robust monitoring of the service and outcomes. The final KPIs are yet to be agreed until feedback has been collated from all 3 GP Networks. There were some positive comments about the KPIs which were felt to be robust. Tim Goldsbrough from Hope Farm Medical Centre gave feedback that he was concerned over the amount of workload being requested as compared to the funding available. Victoria gave an explanation of the work involved and what is expected from GP Practices as she was also keen to ensure the workload was not too onerous. The group felt more assured following this discussion. It was also mentioned that there was no reference to EMI (Elderly Mentally Ill) in the LES specification. This feedback would be reviewed and taken on board. Action: Laura Jones to ask Lesley Hilton to share information on the additional support available to Care Homes that would support practices to deliver the new Nursing Homes LES. Pauline Finlay Victoria Hough Minutes of Primary Care Operational Group 21 st September

7 Agenda Dressings Provision Options Paper Speaker Laura Jones Laura Jones has written a dressings options paper that attempts to address the inequity of dressing s provision across West Cheshire. Claire Baker has been the clinical lead for this piece of work and has chaired a task and finish group that had representation from across all three localities, CWP, CoCH and patient representation. The recommended option will be to include dressings care within next year s CQUIN. This would however, be a transitional solution only, as a first step to a more wideranging pathway redesign, linking to the Accountable Care Organisation, using the evidence within the Right Care Model as a basis for sound development. This holistic pathway would include the following: a) self-care b) enabling more rapid progression to compression for those with non-healing wounds c) equity of service. Although the group were generally in favour of this proposal, they felt that more work would need to take place to the paper before Practices and the Primary Care Commissioning Committee could give approval. The following information was requested: A clearer breakdown of what funding will be available next year to fund this activity A definitive list of what work will be specified within the CQUIN An understanding of what CWP would do to support Practices with this work. The patient leader, Ken Salter, fed-back that there were concerns that some simple dressings could not be accommodated within the GP Practice, and that waiting times for the dressings clinic were too long. fed-back that by commissioning this through the Primary Care CQUIN will enable quality standards for patients who require dressings to be agreed. Practices would then be responsible for meeting these outcomes and standards, however how they wish to deliver this (e.g. via a centralised dressings clinic model) will be down to the localities and clusters to determine. Action: Laura Jones to follow up on the group s request for more detailed breakdown of the finances and also specifics around what dressing s procedures are being proposed to be commissioned within the CQUIN ONS Comparator CCG Update Report Diane Taska Diane Taska provided an update on the current work taking place to understand the work of other Office of National Stastic (ONS) CCGs to determine what they are doing to reduce inappropriate hospital referrals and commission alternatives for patients within the community.. It was noted that West Cheshire CCG is an outlier in Outpatient referrals compared to these CCGs. Overall, this research has found that there is no one consistent theme to alternatives to outpatient referrals across these ONS CCGs, however the vast majority have implemented dashboards and similar support and escalation processes. However, areas of best practices include: a) Out of the nine CCGs who responded five either have a dashboard or are currently scoping one. Three of these CCGs have an equivalent support & escalation process, reported via their Primary Care Commissioning Committees. Although some are contacted on an individual practice basis, others are dealt with at the Primary Care Commissioning Committee and also at practice visit level. b) Six CCGs commission LES s, however, most CCGs starting to consolidate them into larger and less disease specific schemes. Commissioning of services such as dressings, wound management is variable across the CCGs. c) The majority of CCGs have not commissioned additional community services. However, North East Essex CCG has commissioned a more co-ordinated community provision, work collaboratively between community trusts and GP Minutes of Primary Care Operational Group 21 st September

8 Agenda Federations. d) All CCGs contacted had a GP Provider Federation at differing levels of development. Some are linking this to plans around ACO or STP development. e) The CCG has received example copies of primary care dashboards as well as funding amounts for Locally Enhanced Services and these have been viewed for comparison. The majority of these have not included the additional 5.00 per head invested into primary care in West Cheshire. In addition examples of newly procured and holistic community/primary care contracts have been received and shared with the relevant CCG programmes. It was noted this information has been utilised by West Cheshire to share best practice and form a network to share ideas around primary care and community care development. This information will now be shared at Primary Care LDS meetings to further spread best practices across Cheshire and Wirral. Information around community services that may lead to a reduction in Outpatient referrals has been shared with the Planned Care team. Speaker Any Other Business (to be notified to the Chair in advance) Patient Engagement Ken Salter gave a brief update. Ken discussed a specific patient experience story. advised Ken that examples of where care provided has been not as we should expect should be directed to the PALS team. October Meeting the October meeting has been cancelled in order to support an additional Primary Care Commissioning Committee. The next meeting will take place in November Date and Time of the next meeting: 2:00pm 4:00pm on 16 th November 2017, Conference Room A, 1829 Building Laura Marsh Minutes of Primary Care Operational Group 21 st September

9 Primary Care Operational Group Meeting Action Tracker Agenda Action By Whom Feedback Received Item 20 th July 2017 meeting Controlled Drugs (CD) Monitoring Report Concerns raised for discussion - Barbara Perry and Julia Riley will meet to review the issues and decide which cases should be brought to the group and also to determine the content of the first stage response and/or letter. Julia Riley and Barbara Perry to look at cases open and determine whether dealing with patients with long term conditions / chronic non-malignant pain where there are sole prescribers should be raised at the Regional Quality and Safety forum meeting run by NHS England. Barbara Perry Julia Riley 21 st September 2017 meeting Lorraine Maughan to update last set of notes to reflect attendance of Sara Smith and Ken Salter. Lorraine Maughan to amend terms of reference to have quoracy with 1 GP only Sean Donnelly to send guidance and support materials out to practices to support the uptake of annual LD health checks and also liaise with Pauline Finlay to share information with Practice Nurses. Sean Donnelly Action: Sean Donnelly to report back at next meeting in November with a progress update on LD health checks. Sean Donnelly Jefcoate to escalate the issues raised regarding Capita and follow up on the fact that no response has been received from Capita to previous correspondence. Action Tracker Primary Care Operational Group 20 th July / 2

10 Agenda Item Action By Whom Feedback Received Jefcoate to ensure Practices to receive a reminder of the recommendations via a central alert and to build these into the administrative training from the GPFV Laura Jones to request that EMIS training relating to call and recall to go on the agenda for the ICT ops meeting. Laura Jones to chase Julie Kelly for an answer on financial risk regarding provision of Hep A vaccines Lorraine Maughan to ensure flu update is on the agenda for the next meeting. Laura Jones Laura Jones to ask Lesley Hilton to share information on the additional support available to Care Homes that would support practices to deliver the new Nursing Homes LES Laura Jones to follow up on the groups request for more detailed breakdown of the finances and also specifics around what dressing s procedures are being proposed to be commissioned within the CQUIN. Laura Jones Laura Jones On Agenda/Complete On-going Overdue For future meeting Action Tracker Primary Care Operational Group 2/2

11 : 17-33a PRIMARY CARE OPERATIONAL GROUP Thursday 20 th July 2017 Room D, 1829 Building PRESENT: Laura Marsh (LM) Chair Director of Commissioning, NHS West Cheshire CCG Dr. Andy McAlavey (AMcA) Deputy Chair Medical Director for NHS West Cheshire CCG, GP Great Sutton Medical Centre Sarah Murray (SM) Head of Primary Care, NHS West Cheshire CCG (TJM) Deputy Head of Primary Care, NHS West Cheshire CCG Jonathan Gregson GP, Primary Care Cheshire Tim Goldsbrough (TG) Practice Manager, Hope Farm Medical Centre & Ellesmere Port and Neston Practice Manager Quality Lead Dr. Julia Riley (JR) Clinical Lead Quality and Safety, NHS West Cheshire CCG Barbara Perry (BP) Senior Medicines Optimisation Pharmacist, NHS Midlands and Lancashire Commission Support Unit Ken Salter (KS) Patient Representative Lynn Suckley (LS) Managing Partner, Malpas Surgery & Rural Practice Manager Quality Lead Hayley Pashley (HP) Practice Manager, Garden Lane Medical Centre & City Practice Manager Quality Lead Debra Alexander (DA) Note Taker Corporate Business Administrator, NHS West Cheshire CCG Agenda Welcome and Apologies Action by The Chair welcomed everyone to the meeting and noted the following apologies received from; Pauline Finlay Claire Baker Brian Green a. Previous notes of Primary Care Operational Group 18 th June 2017 The minutes of the meeting on 18 th June 2017 were accepted and agreed as an accurate record with no amendments. b. Action Tracker and Matters Arising Support and Escalation Process Changes to the supplementary guidance were done last month and the best practice guide is included within the papers Primary Care Programme Update including Procurement Ongoing Action Training is being coordinated and dealt with centrally within NHS England. Minutes of Primary Care Operational Group 20 th July 2017 ONGOING 1

12 : 17-33a Agenda Sarah Murray provided further update within Action by Terms of Reference Primary Care Quality Update This refers to the Hope Farm audit, no action/update required Primary Care Programme Update including Procurement Re: issues at the Knoll Pharmacy First Amendments to Specification COMPLETE COMPLETE COMPLETE COMPLETE Declarations of Interest No Declarations noted Controlled Drugs (CD) Monitoring Report Barbara Perry circulated the CD Monitoring Report in advance of the meeting for consideration and review. Barbara gave a brief summary on key issues within the report and requested advice and feedback from the Group on which issues attendees would like to be brought to their attention going forward. Concerns raised for discussion - Further understanding on what the risk factors associated with controlled drug prescribing needs to be assessed and which of these should be escalated to the group It was agreed that some issues need to be raised as patient safety concerns requiring a response within a specific time frame It was also agreed that recommendations that have not been actioned will require further discussion by the group e.g. where the medicines optimisation team has challenged the prescribing but not received a sufficient response or actions not implemented. ACTION: Barbara P and Julia R will meet, to review the issues and decide which cases should be brought to the group, also to determine the content of the first stage response and/or letter. Recommendation sought from the group on dealing with patients with long term conditions / chronic non-malignant pain where there are sole prescribers ACTION: Julia R and Barbara P to look at cases open and determine whether this issue should be raised at the Regional Quality and Safety forum meeting run by NHS England. BP/JR BP/JR At this stage, a number of specific cases were discussed. These included: Minutes of Primary Care Operational Group 20 th July

13 : 17-33a Agenda Matrifen patch - the practices have given a partial explanation, but the patient may require follow up by Julia R or Andy Dunbavand. Secondary care issues will be raised at the Meds Management Strategy Group for further assurance. Pethidine (including excessive dosages) - it is felt this is not appropriate for prescribing and requires monitoring. Contact has been made via the practice pharmacists and a proforma is in place that can be sent to practices requesting review / explanation / responses / actions. The group also requested further discussion about potential for diversion. Methadone example of GPs prescribing 150 tablets. The potential for diversion is there. A message has been sent from the Practice Pharmacist highlighting the dosage and that methadone should only be prescribed as part of a shared care agreement. Jonathan G also queried what appropriate doses of dexamfetamine and lisdexamfetamine are. If the group have any further questions on the paper, please direct them to Barbara Perry. Action by Primary Care Monitoring gave a brief update on the progress of Practices within the process to date and the key messages within the report were noted. It was explained that this month, as scheduled, the CCG have provided a shortened update report only, and will provide a more extensive report at the next meeting. It was noted that the only Practice within formal escalation currently is Westminster Practice. The CCG has been working with the Practice, however, there have been some feelings of frustration on behalf of the Practice due to the time required to complete the actions identified. Also, the Practice feels that a lack of administrative support within the Practice is hampering some efforts. ACTION: Sara Smith to review the TUPE list for Westminster practice to understand required staffing levels within the contract. In addition, Laura Marsh will raise this issue at the CWP contract meeting SS LM/TJM It was noted that the data or activity for the Practices within the informal process seem to be changing quite rapidly due to the constantly updating data within the Primary Care Dashboard. It was therefore agreed that a Practice would need to be above average by the required amount within the correct number of indicators for at least two months before contact is made. The Primary Care Operational Group was asked to review the best practice guide within the appendix and feedback any comments. The group then moved on to look at the final sections of the report Minutes of Primary Care Operational Group 20 th July

14 : 17-33a Agenda relating to vaccinations and screening and GP survey results. fed-back that the indicators relating to Primary Care are regularly monitored via the Primary Care Dashboard and brought up with relevant Practices. ACTION: A couple of the vaccination / screening indicators for Primary Care were low in a quarter. was asked to contact the data provider to understand whether this is a data inaccuracy or an issue for further investigation with the Practices. Action by TJM Primary Care Quality Update As agreed at last month s meeting, Julia carried out further research with the following points for noting:- An audit of written communications received from Acute and Community providers at Hope Farm was carried out on the 15 th June, 2017, there appeared to be a general themes with lack of consistent communication from different providers. Each discharge letter was set out in different formats, and were not always clear where GP action was required. These were discussed across partners at a joint CQUIN meeting. The group recommended that letters from providers should be standardised and this was due to be discussed at senate meeting. In addition, Julia attended the PPG Chairs Meeting on the13 th July, her presentation on Patient Empowerment and Patient Safety was very well received and this work will continue to be progressed Primary Care Programme Update Sarah advised the group that to date as of week 14 the gross savings made in the medicines management repeat prescribing project is 281,928 which equates to 20,022 per week. GPFV Practice Clinical Pharmacist Sarah reported that NHSE have advised that we have been successful in our bid for one Band 8a and 3 Band 7 clinical practice pharmacists to work across 17 practices covering a population of 122, The pharmacists will work across 9 practices in Ellesmere Port and Neston, 4 in the City area and 4 Rural. Sarah has ed all practices to advise them of this as well as the cost of the CSU for recruiting and employing the pharmacists. GP Resilience Programme Sarah reported that Cheshire & Merseyside s GP Resilience Programme allocation for 2017/18 is approx. 290,000 this equates to the (full allocation of 350,000, minus 60,000 allocated to schemes from 2016/17 that had funding agreed over 2 years). The current total of all Minutes of Primary Care Operational Group 20 th July

15 : 17-33a Agenda received applications is 2.9m. A panel made up of those CCGs whose practices have applied and NHSE local team will meet on Monday 24 July to agree funding. Four practices in our area have applied for funding namely Kelsall, Old Hall, Fountains and St Werburghs. econsult Sarah confirmed that an order is being processed for 27 practices. However within the discussion of E-Consult, positives and disadvantages were discussed including: This system allows administrative tasks to be dealt with without clinical appointment and helps to support demand JR raised that there have been a number of incidents recently where patients have used routine comms via the website to request support around urgent requests Training and Development Administration staff It was reported that training is still being provided and that we are now looking at Coding of Medical Correspondence training for administration staff working with Tim from Hope Farm and Atiya from The Elms to progress this. Practice Managers Sarah reported that The Practice Manager Training and Development Programme had started with the first session being held last week. She notified the group that this is a series of 9 sessions which will be delivered over the rest of the year. Sarah confirmed she has also passed on to NHSE who are providing the training centrally details Tim had shared with her regarding training he had accessed and also details of the Diploma in Advanced Primary Care Management to see if they are able commission a number of places across Cheshire & Merseyside. Releasing Time For Care Sarah updated that we now have dates for the delivery of the programme locally in West Cheshire on the 28 th September, 24 th October and 22 nd November. The sessions will take place in the afternoon with the final 3 dates to be agreed. It was noted that NHSIQ are also offering us a 2 day course on the Fundamentals of Quality Improvement on 14 th and 28 th November to be held locally. It was noted that the course is open to anyone working in practices, including the wider health care team. Practice staff are asked to bring a problem or an issue with them that they can work on over the two days to find a solution that can then be implemented back in practice. NHS IQ requires a minimum of 25 delegates for them to run the course. Sarah asked the group to let her know whether they would like to send people and how many places they would like. Sarah thought this course would Action by Minutes of Primary Care Operational Group 20 th July

16 : 17-33a Agenda be good for those practices which were interested in the Releasing Time For Care programme but couldn t commit to the full 6 sessions. ACTION: Notify SM of attendees for the Fundamentals of Quality Improvement course International GP Recruitment Sarah updated the group that a bid to be put forward in November will now be produced at a Cheshire and Merseyside level. Each CCG is now required to produce their Workforce Strategy to play in and to demonstrate the need in that health economy. Sarah will be producing this during August and will take it to the Practice Manager meetings in September to test out. If the group feel it would be useful it can be taken to Clinical Leads and Nurses forum. Sarah hopes to bring the strategy to the next meeting before sign off at Primary Care Commissioning Committee. Enhanced Extended Hours Service A task and finish group has been created with representatives from PPG chairs to agree an approach to marketing the extended hours service widely. It will also look at the broader awareness and promotion of other services such as online access, econsult, minor ailments services and using the NHS more wisely. PPG Chairs Sarah updated that she now attends this quarterly meeting to update on all aspects of general practice. The last session focused on access/making an appointment and she will be taking some of their recommendations to the Practice Managers meeting in September. LDS GPFV Group Sarah reported that she is the Cheshire and Wirral Local Delivery System representative on the GPFV Programme Board covering the STP footprint of Cheshire and Merseyside. A group has been set up that allows her to formally report back to LDS colleagues and in return take their views to the GPFV Programme Board. The meetings will be structured with half focussing on GPFV and transformation and half focussing on primary care commissioning and contracting. This will be a very useful forum for us as we move to full delegation. The group met yesterday and it was a very useful meeting. Action by ALL Any Other Business Laura M proposed an item to be discussed at the next meeting. Health checks for people with learning disabilities are not reaching target which should be at least 50% of those people within that criteria. Andy McAlavey was asked to attend a group to encourage and share with practices what the benefits of health checks are in particular to adults with learning disabilities. Minutes of Primary Care Operational Group 20 th July

17 : 17-33a Agenda ACTION: Laura M to circulate this information to the Group. Tim would like to request that a message is needed to go out to other practices regarding their need to check and update EMIS business continuity on a regular basis. EMIS are suggested this is done daily where possible. Ken Salter requested that an update from the dressings task and finish group is provided at the next meeting. Ken Salter raised the issue that his Practice has had to close their list due to increasing demand and a reduction in clinical capacity. The CCG focusing on late medication requests in their publicity and education to patients would be a big help for Practices. Action by LM Date and Time of the next meeting 2:00pm 3:30pm Thursday 21 st September, 2017 Conference Room A, 1829 Building Note: August Meeting has been cancelled Minutes of Primary Care Operational Group 20 th July

18 Primary Care Operational Group Meeting Action Tracker updated from July 2017 meeting Agenda Action By Whom Feedback Received Item 20 th July 2017 meeting Controlled Drugs (CD) Monitoring Report Concerns raised for discussion - Barbara Perry and Julia Riley will meet to review the issues and decide which cases should be brought to the group and also to determine the content of the first stage response and/or letter. Julia Riley and Barbara Perry to look at cases open and determine whether dealing with patients with long term conditions / chronic non-malignant pain where there are sole prescribers should be raised at the Regional Quality and Safety forum meeting run by NHS England. Barbara Perry Julie Riley 21 st September 2017 meeting Sean Donnelly to send guidance and support materials out to practices to support the uptake of annual LD health checks and also liaise with Pauline Finlay to share information with Practice Nurses Action: Sean Donnelly to report back at next meeting in November with a progress update on LD health checks. Sean Donnelly Sean Donnelly Jefcoate to escalate the issues raised regarding Capita and follow up on the fact that no response has been received from Capita to previous correspondence Jefcoate to ensure Practices to receive a reminder of the recommendations via a central alert and to build these into the administrative training Action Tracker Primary Care Operational Group 20 th July / 2

19 17-033b Agenda Item from the GPFV Action By Whom Feedback Received Laura Jones to request that EMIS training relating to call and recall to go on the agenda for the ICT ops meeting. Laura Jones to chase Julie Kelly for an answer on financial risk regarding provision of Hep A vaccines Laura Jones to ensure flu update is on the agenda for the next meeting. Laura Jones Barbara Perry and to meet to discuss the development of the prescribing indicators and involve Andy McAlavey and Andy Dunbavand Laura Jones to ask Lesley Hilton to share information on the additional support available to Care Homes that would support practices to deliver the new Nursing Homes LES Laura Jones to follow up on the groups request for more detailed breakdown of the finances and also specifics around what dressing s procedures are being proposed to be commissioned within the CQUIN. Barbara Perry Laura Jones Laura Jones On Agenda/Complete On-going Overdue For future meeting Action Tracker Primary Care Operational Group 20 th July /2