Governing Body meeting in public

Transcription

1 Present Minutes Name Role/ organisation Initials Dr Fiona Butler GP member, Chair FB Clare Parker Chief Officer CP Dr Oisin Brannick GP member OB Cynthia Folarin Public Health representative CF Yvonne Fraser Practice Manager/ Nurse representative YF Dr Rachael Garner GP member, Vice Chair, chair of Commissioning Learning Sets and Quality & Performance Committee Dr Richard Hooker GP member RH Dr Naomi Katz GP member, Vice Chair, clinical lead for primary care NK Louise Proctor Managing Director LP Dr Puvana Rajakulendran GP member, chair of Patient & Public Engagement Committee Sonia Richardson Patient representative SR Karen Rydings Practice Manager/ Nurse representative KR Dr Imran Sajid GP member IS Simon Tucker Lay member, Deputy Chair ST Jonathan Webster Director of Nursing, Quality & Patient Safety JW Philip Young Lay member PY RG PR In attendance Name Role/ organisation Initials Samira Ben Omar CWHHE Assistant Director of Patient Experience and Equalities (item 6.2) Simon Carney CWHHE Head of Governance SC David Cox Estates Support to CWHHE (item 10.1) DC Kerry Doyle Head of Corporate Services (minutes) KD Judy Durrant Assistant Director, Safeguarding JD Julie Fuller CWHHE Complaints Manager (item 6.2) JF Chloe Hardcastle Transformation PMO Manager CH Simon Hope Deputy Managing Director SH Prodine Kubalalika Lead Nurse for Infection Prevention and Control, CWHHE CCGs (item 6.1) SBO PK Page 1 of 17

2 Breac Macleod Head of Finance BMc David Matthews Head of Strategic Planning (interim) DM Michael Roach Assistant Director, Quality & Safety (interim) MR Apologies Name Role/ organisation Initials Keith Edmunds Chief Financial Officer KE Dr Alan Hakim Secondary care consultant AH Dr Philip Mackney GP member PM Sarah McBride Local Authority representative SMc Victoria Stark Lay member VS Dr Andrew Steeden GP member AS Ben Westmancott Director of Compliance BW Note regarding agenda The agenda items were taken in the following order: 1; 2; 3; 4; 5.2; 5.1; ; 6; 7; 8; 9; 10 1 Introduction 1.1 Welcome and apologies The Chair welcomed members and attendees to the meeting. The Assistant Director, Quality & Safety, who was on secondment to the role, was introduced to the Governing Body. The apologies were noted as above. 1.2 Declarations of Interest It was noted that the Chair would have an interest in the South Locality Options Appraisal for a locality primary care hub. 2 Minutes of the previous meeting 2.1 Minutes of the meeting held on 1 November 2016 The minutes were agreed to be an accurate record of the meeting. 2.2 log It was confirmed that there were no outstanding actions. 2.3 Matters arising There were no matters arising. Page 2 of 17

3 3 Reports from the Chair and the Chief Officer 3.1 Chair The Chair gave a verbal report on recent developments in the CCG, which included forthcoming engagement events: 31 January 2017: joint event with Royal Borough of Kensington & Chelsea Your Health, Your Care, 6pm pm, Kensington & Chelsea Town Hall; A joint event between the NHS and the council, symbolising how health and social care are being brought closer together in our plans; Opportunity for residents to be directly involved with the process of improving the health and social care services in the CCG, and to find out more about what we are already doing to improve them; The event would include: stalls; advice on staying well from health and social care experts; talks from local NHS and social care leaders; Q&A panel. Annual Joint Commissioning Learning Sets meeting, 7 February 2017 Including review of the work of our members over 2016/17; education and training for primary care, referral reviews and primary care transformation Members would be participating in a ballot at the meeting to decide if they wish to progress to delegated commissioning from April The Governing Body noted the report. 3.2 Chief Officer The Chief Officer presented the report, which outlined progress in CWHHE CCGs. The report included: Shaping a Healthier Future - Strategic Outline Case (SOC) Part 1 On 13 and 14 December 2016, North West London CCG Governing Bodies held meetings in public to consider a business case seeking over 500m investment in local NHS services; They approved the Strategic Outline Case (Part 1) and its subsequent submission to NHS England and NHS Improvement for approval. Contracts CCGs and provider trusts met the national deadline for agreeing contracts by 23 December 2016; The contracting process saw a move towards greater consistency across the sector, with key areas being: reduction in length of stay and an increased focus on seven day working. North West London Director of Strategy and Transformation Page 3 of 17

4 Matt Hannant, Director of Strategy and Transformation left the CCGs at the end of December to emigrate to New Zealand; The Chief Office and Governing Body thanked him for his leadership; The process to identify a successor would resume in the New Year. Appointment of External Auditors The CCG Chairs and Chief Officer approved the recommendation of the Governing Bodies Audit Panels to appoint BDO LLP as the new external auditors from 1 April 2017; The Chief Officer thanked the outgoing auditors, KPMG, for all of their work to date and for their work to come with the year-end activities to make the transition to BDO seamless. Election of CCG Chair Following the call for applications/ nominations by the Director of Compliance, one application for the role of Chair was received (from Dr Butler); Process for election of Vice-Chairs would be announced shortly; The Governing Body congratulated Dr Butler on her appointment. The Governing body noted the report. 4 Achieving strategic objectives 4.1 Delivery of Corporate Objectives Quarter / 17 The Head of Strategic Planning presented the report, which outlined progress up to 31 December The following point were highlighted: Primary Care Following a six month review of Out of Hospital services, delivered by the West London GP Federation, new key performance indicators, minimum data sets and improved IT template were agreed in order to support better delivery of services for patients; The CCG was holding engagement events with members regarding taking on delegated commissioning from 1 April Better care, closer to home: planned care The new community musculoskeletal service was successfully commissioned and went live on 1 December 2016; The community provider of dermatology services had improved waiting plans, but had recently been unable to recruit into key consultant posts. An interim solution was being discussed with the provider, while a longer term commissioning strategy was developed. Better care, closer to home: unplanned Page 4 of 17

5 The CCG s urgent care review had moved to is three month patient and resident engagement process; The new Community Independence Service went live on 1 November 2016; work was ongoing to increase appropriate referrals to the rapid response service. My Care, My Way (Whole Systems Integrated Care) Joint meetings with Case Managers and the Community Independence Service were taking place to streamline and integrate patient support; Ongoing discussions to broaden the range of services at Violet Melchett Integrated Care Centre. Activity reporting was underway and the reports were being used to monitor usage; Eight new members of staff were recruited to the service, bringing the total number of staff to 51. Mental Health Community Living Well, the new wrap-round offer for those with stable, long-term mental health needs, began mobilisation; Core Improving Access to Psychological Therapies (IAPT) targets continued to deliver above national standard; Dementia diagnosis amongst the highest in the country; dementia/ Learning Disability care plans below national average. Dementia was focus of work by clinical leads via Commissioning Learning Sets; Waiting times/ access to secondary mental health care via the Single Point of Access (SPA) remained below expectation and were being addressed with the provider. Enablers All practices engaged with their Practice Link Pharmacist and agreed QIPP action plans. Pharmacists had continued to support practices with hands-on implementation, and overall delivery was on target; A primary care SystmOne needs analysis had been completed and the GP IT register had been completed; The CCG held its Annual General Meeting in October, with a presentation on its Patient & Public Engagement Small Grants Programme; The CCG management team reviewed the North West London Sustainability & Transformation Plan and aligned it to existing priorities. The Governing Body noted and discussed the delivery of the CCG s Corporate Objectives for the nine months to 31 December North West London Sustainability & Transformation Plan The Chief Officer presented the report. Page 5 of 17

6 The Governing Body was reminded that the plan, which set out the five year plan for health and social care transformation in North West London, had been presented and discussed several times prior to submission to NHS England in June and October It was noted that the Governing Body ratified the plan at its meeting in public in November Stakeholder representation was discussed, and the Governing Body was advised that there was Health & Wellbeing Board/ Local Authority representation on the North West London group. It was noted that representatives on the group were expected to take feedback from and to colleagues to support the plan s development. The Governing Body discussed patient engagement, and supported having links from practice website to the North West London STP website, as well as developing an accessible narrative that could be sued in a range of engagement materials. Working at scale was discussed, and the Governing Body noted the importance of collaborative/ shared arrangements across organisations to support delivery of the plan. It was confirmed that Public Health was involved in the plan, particularly Delivery Area 1: radically upgrading prevention and wellbeing. The Governing Body: Noted the version of the STP submitted to NHS England on 21 October 2016; Ratified the Sustainability & Transformation Plan as the shared vision and strategic plan for health and care in North West London, based on the agreed set of priorities and assumptions; and Committed: - The CCG and its staff to working as part of the local health and social care system on the development of detailed financial modelling, delivery plans and business cases where appropriate; - To engaging with patients, the public and stakeholders on the further development and delivery of the plan. 4.3 Delegated Primary Care Commissioning: Update for Governing Bodies (January 2017) The Transformation PMO Manager was welcomed to the meeting, and presented an update on delegation, whereby CCGs would take on responsibility for commissioning General Practice services in response to the needs and circumstance of their registered populations. The Governing Body was advised that if members voted against delegation, the CCG would rescind its application. It was confirmed that the outcomes of the due diligence exercise were expected on 31 January The proposed terms of reference for the Delegation Executive Steering Group were discussed, and the Governing Body noted that the Group would be responsible for overseeing the work streams relating to the due diligence process and member engagement, including making recommendations based on the outcomes of the due diligence process. Primary care representation on decision making groups was considered, and the Governing Body acknowledged that managing conflicts of interest, perceived or real, was important. Using primary care colleagues from a different area of London was suggested as an approach to retaining knowledge of primary care, while ensuring decisions were made by non-conflicted members. Page 6 of 17

7 It was noted that strategic leadership would remain at Governing Body level, with clinical leads and the management team working to ensure that decisions were made in the best interest of patients. The Governing Body: Noted progress with the application, and due diligence updates for governance, resourcing and finance; Noted the programme management process that was employed in North West London, including the set-up of a (non-decision making) Delegation Executive Steering Group (the Terms of Reference for which were appended to this document in Appendix 4); Endorsed the Terms of Reference for the Delegation Executive Steering Group (Appendix 4); Discussed the proposed governance arrangements in relation to the future composition of primary care commissioning committees at Level 3, noting that from 1 April 2017, if CCGs moved to delegated commission, these would replace the co-commissioning committees currently in place, which were operating at Level 2 (joint arrangements with NHS England); Discussed the proposed approach to the effective management of conflicts of interest and the recommendations of the North West London CCGs conflicts of interest reference group; Noted the voting procedure required in order to give effect to the decision to move to Level 3 (subject to voting outcomes) by naming the required committee in each CCG s constitution, as a committee of the Governing Body; Noted the intention for the final terms of reference for the primary care commissioning committees to be ratified at the CCG s Governing Body meeting in March, subject to each CCG s voting outcomes; Noted that each CCG s decision would have effect from 1 April 2017 and that in the event of one of more CCGs members voting against delegated arrangements, existing joint commissioning arrangements ( co-commissioning ) would continue. 5 Assurance and finance reports 5.1 Transformation Board The Practice Manager representative presented the report. Areas of progress in the CCG s transformation programmes were highlighted: Better care, closer to home Musculoskeletal service mobilisation completed and new service commenced 1 December 2016; CWHHE Right Care Diabetes redesign programme started. A stakeholder workshop was held, with input from specialists, patients, commissioners, providers and the third sector. Primary Care Engagement with members to support understanding of primary care delegated commissioning, and to respond to member feedback head of ballot in February 2017; Approach to supporting development of estates in the south of the CCG considered. Page 7 of 17

8 My Care, My Way: Whole Systems Integrated Care (older people) Funding has been agreed to support an Organisational Programme (OD) Programme for Whole Systems Integrated Care; Training Programme for Health & Social Care Assistants and Case Managers is being refreshed, and overseen by the Whole Systems Steering Group. Mental Health Agreement to incorporate all existing core services under a single Community Living Well integrated service has been reached; Recruitment to the Head of Well-Being Services, and the Navigators commenced and posts being filled. Enablers Young adults joint strategic needs assessment was discussed; Joint working between Federation and CCG colleagues via IT working group to improve IT and templates for all services. The Governing Body noted the report. 5.2 Patient and Public Engagement feedback The Chair of the Patient & Public Engagement Committee presented the report, which outlined achievements since the last meeting in public: Adult, Specialist and Intermediate Care The CCG held two patient workshops to get the views and opinions of service users and patients regarding existing services; The workshops fed into writing service specifications. Urgent care Following the Governing Body s approval of the Urgent Care Review strategy, the team began its engagement in late December, and would continue until late February; Over 1,200 completed feedback forms had been received; A steering group comprising patient representatives, CCG staff, and voluntary sector colleagues was set up to oversee the implementation of the strategy; Events being held in January for local residents. Patient & Public Engagement Small Grants 2016/17 Page 8 of 17

9 Grant recipients that were unable to present at the CCG s Annual General Meeting were invited to present at the patient Reference Group meeting in December 2016; The 2016/17 projects included: - Abundance Arts, Wow wellbeing inter-generational community arts and wellbeing project ; - Central London Youth Development Trust, Men s Health Improvement & Empowerment ; Dalgarno Trust, VIP Project (Very Important People) ; - Equal People Mencap, Healthy Living Project ; - French African Welfare Association, African Men Health Initiative ; - Hear Women/GarGar Foundation, Know Your Health ; - MSH Health & Wellbeing Community Interest Company, MSH@Home Companionship Programme ; - Woman s Trust, Self-Development Domestic Violence Workshops ; - Youth Projects International, Linking African Young People to Services. The Governing Body noted the report. 5.3 Finance & Activity report The Head of Finance presented the report. The Governing Body was advised that the CCG had met all statutory financial duties to month 7. Commissioning was discussed, and it was noted that the Committee had reviewed and approved a number of business cases, which were included in the report. It was confirmed that the Committee had also scrutinised the South Hub options appraisal, which would be discussed later in the agenda. The Governing Body was informed that risk share arrangements across CCGs had been discussed by the Committee, and that there would be an adjustment at month 9. The Governing Body: Noted the highlights from the Finance & Quality, Innovation, Productivity and Prevention (QIPP) reports and the month 7 finance and activity report; Noted that at all statutory financial duties had been achieved by West London CCG to month 7; Noted the highlights from discussions on commissioning and services, including the following: - Shaping a Healthier Future implementation business case; - Child & Adolescent Mental Health Services Out of Hours Pilot Update; - Estates: South Hub; - Governance Framework for 2017/19 Operational Plan; - AQP Termination of Pregnancy Service: Specification and Central Booking Services Approval; - Whole Systems Integrated Care; Page 9 of 17

10 - 2016/17 Three Borough Better Care Fund (BCF) Q2 Update. 5.4 Commissioning Learning Sets report The Chair of the Commissioning Learning Sets presented the report, which described the progress made by CCG members in developing the CCG s commissioning. The following points were highlighted: Gynaecology audit Advice (38%) followed by a procedure (34%) were the main reasons for referrals; Practices attempted to manage the patient in primary care mainly with advice in (52%) of the cases, followed by medication (34%); In 93% of attendances an advice line was not used before referrals were sent, showing potential under-utilisation of the Gynaecology /advice line; Most practices felt a community service would be beneficial for patients. The Commissioning Commissioning Learning Set sessions also focused on: delegated commissioning, quality premium, QIPP, emergency admissions, the new musculoskeletal (MSK) and Community Independence Services (CIS), the National Diabetes prevention programme and Childhood Immunisation. The Governing Body noted the report, and progress made with: Prescribing Standardisation Scheme (PSS) ; National Diabetes Prevention Programme (NDPP); Primary Care Commissioning Delegation; Community Independence Service; Launch of new MSK service; Emergency Admissions Audit; Older People s Mental Health; Quality Premium Update; GP Five Year Forward View; Patient Experience Feedback; GP Federation Update. 5.5 Quality & Performance report The Chair of the Quality & Performance Committee presented the report. The following areas were outlined: Chelsea and Westminster NHS Foundation Trust A&E 4 hours target had not been achieved due to deterioration; Significant investment is being made to support improvement Page 10 of 17

11 Cancer wait 62 days target was not met, mainly due to five breaches. Marie Stopes International Following recent visit by the Care Quality Commission, CQC where the services were temporarily suspended, the suspension had now been lifted and services resumed. Annual Patient Experience and Complaints Report 2015/16 The Committee reviewed the executive summary and the recommendations set out in the report. A&E performance across London and England was discussed by the Governing Body, and it was noted that the experience at Chelsea & Westminster Hospital in quarter 3 had resembled performance at other Trusts. The Governing Body noted the report. 5.6 Operational Group report The Managing Director presented the report. The Governing Body noted that the Group was responsible for time-critical decisions, as well as steering strategic direction for the initial scoping of work. It was noted that key achievements since the Governing Body last met included: Steering the leadership team s preparation for member engagement and Plenary meetings; Discussing the approach to delegation of primary care commissioning; Supporting colleagues in the CCG to develop approach to commissioning and contracting services commissioned across multiple CCGs, such as community health services; Developing the CCG s approach to aligning services across neighbouring CCGs, balancing against the need to ensuring services meet local needs, with a particular focus on the Central London Community Healthcare NHS Trust range of services, and contract requirements for 2017/18; Reviewing a proposal to build on, align and optimise current practice and address gaps in end of life provision and consideration of a tele-health service for care and residential homes. The Governing Body presented the report. 5.7 Board Assurance Framework 2016/17 The CWHHE Head of Governance presented the framework The Governing Body was advised that the key risks for 2017/18 were in development, and would be presented to the Governing Body for review in a development session. The Governing Body: Noted the latest iteration of the Board Assurance Framework (top level RAG ratings at Annex Page 11 of 17

12 A, and CWHHE Board Assurance Framework at Annex B); Provided comments regarding further assurances or clarification needed, and on how this information was best presented to enable effective discussion to the CWHHE Governance team, with a view to approving; Noted that the relevant Committees of the Governing Body, and CWHHE Senior Team would subject the BAF to scrutiny and further development before bringing it back to Governing Bodies in March for scrutiny; and Noted that following discussion at management level regarding Risk 8, the Chief Officer, Clare Parker, had been assigned as the director lead. 5.8 Shaping a Healthier Future finance report month 7 The Chief Officer presented the report. The Governing Body was advised that, following previously reported areas of overspend in the North West London Strategy & Transformation team, mitigations for these risks had been identified, including Balance sheet flexibilities; NHSE additional contribution; Internal efficiencies; Primary care headroom. It was noted that there was a need to ensure appropriate controls were in place for 2017/18. The Governing Body approved: The overspend of 2m; The expenditure for the underlying funding pressures on the S&T budget, which would be shared evenly between all 8 CCGs. The Governing Body noted: The total budget had increased slightly from month 6, and Health Education England North West London (HEENWL) had approved a further 0.3m of funding, taking the total HEENWL support to 2.4m; That Hammersmith & Fulham CCG Finance & Performance Committee recommended for approval their final contribution to the overall strategy, which was expected to be ratified by the Governing Body in January; There was an overall overspend across the work streams for M7 YTD of ( 1.7m), and that the team was continuing to explore mitigations to reduce the overall funding pressure in order to minimise the risk to CCGs; The majority of the overspend to date was due to budget phasing and was, in the main, recoverable; That the extension of the STP and the SOC1 assurance process had led to pressures which were no longer manageable within the existing budget; That the remaining cost pressures of 2m remain as reported in month 6, and there was on- Page 12 of 17

13 going work to find alternative sources of funding for this; The final Month 7 position. 6 Operational objectives 6.1 Annual report on healthcare associated infections 2015/16 The Lead Nurse for Infection Prevention and Control, CWHHE CCGs was welcomed to the meeting. The key points from the report were summarised: MRSA During 2015/16, all 20 CWHHE CCG-attributed cases were investigated by the CCGs Lead Nurse for Infection Prevention. Clostridium difficile (C diff) Detailed case reviews, while identifying areas for improvement did not reveal significant lapses in care; Further work would be carried out during 2016/17 to explore the thresholds for sending stool specimens, which appear to vary between Trusts. Carbapenemase-producing Enterobacteriaceae (CPE) Seven of the outbreaks or clusters of infection were caused by Carbapenemase-producing Enterobacteriaceae (CPE) at Imperial College Healthcare NHS Trust; One outbreak in particular affected 40 patients, although only nine patients had clinical infections; The outbreak prompted focused work with the Trust, including regular teleconference meetings and two clinical visits to affected wards; All Trusts commissioned by CWHHE CCGs would be monitored on their implementation of the CPE toolkits in 2016/17, as a Quality Schedule indicator. Supporting best practice was discussed, and the Governing Body noted that learning was shared across clinical networks. The Governing Body approved the annual report following review and subsequent recommendation of the CCG Quality & Performance Committee. 6.2 CWHHE Collaborative Complaints and Patient Experience Report (2015/16) The CWHHE Assistant Director of Patient Experience and Equalities, and the CWHHE Complaints Manager were welcomed to the meeting. The Governing Body was advised that CWHHE CCGs Complaints Policy reflected legislation outlined in the NHS Complaints Regulations It was noted that there was a statutory requirement to acknowledge complaints within three working days, and respond within a mutually agreed timeframe. It was confirmed that quarterly reports were presented to the CCG s Quality & Performance Committee, and that in 2015/16 there were 349 complaints received by the CWHHE CCGs about the services they commission, with recurrent themes relating to poor communication, staff attitude, and Page 13 of 17

14 waiting times for appointment or referral to treatment to be acted upon. The Governing Body discussed patient experience, and noted the importance of environment and communication. Ways of capturing patient experience data to support learning and training were considered, and it was noted that the team had produced a short film that was available online for colleagues to use. The Governing Body: Approved the Annual Complaints Report Section; Noted the Annual Patient Experience Section set out in the report. 6.3 CWHHE Safeguarding annual report 2015/16 The Assistant Director for Safeguarding presented the report. The Governing Body was advised that all statutory requirements were being met, and that key achievements in 2015/16 included: Substantive posts across the Tri-Borough CCGs had been recruited to; The Safeguarding Policy for Adults which was produced and implemented during 2015/16; The CCG Safeguarding Policy for Children was also reviewed and revised in 2015/16; NHS England (NHSE) undertook a Safeguarding Deep Dive in November 2015, and reported that there was good assurance of safeguarding processes. The CWHHE CCGs were assured as outstanding in the following areas: - Engagement around Female Genital Mutilation (FGM); - The work undertaken with Buckinghamshire New University to develop an educational tool to support practitioners in the application of The Mental Capacity Act (2005). The team undertook a piece of work focusing specifically on CCG responsibilities, landscape and what we knew about the quality care provided in care homes was presented to the West London CCG Quality, Patient Safety & Risk Committee in December 2015 It was noted that: The CCG could be assured that its safeguarding arrangements are in place or, where there were gaps, mitigating actions had been taken; The CCG could be assured that the trusts from which it commissions its main services had their safeguarding arrangements in place. The Governing Body approved the annual report following review and subsequent recommendation of the CCG s Quality & Performance Committee. 6.4 Conflicts of interest: new Guidance for CCG Governing Body members and Staff The CWHHE Head of Governance presented the report. The Governing Body was advised that NHS England was reviewing its statutory guidance, and Governing Body members were advised to declare all interests to ensure transparency in the CCG s decision making. Page 14 of 17

15 It was noted that the register of interests would be refreshed before the end of the financial year. The Governing Body: Noted the attached short-form guidance, which had been developed for dissemination amongst staff and Governing Body members alike; Agreed that each Governing Body member should review their entry in the Register of Interest and satisfy themselves that, in light of the guidance, it reflected accurately all of their interests. 6.5 Health and Safety report: 1 April 30 November 2016 The CWHHE Head of Governance presented the report. The Governing Body was reminded that all CCG Governing Body members and staff were responsible for staff and visitor health and safety. It was noted that priority areas of work for 2016/17 were: Communication: to continue to promote health and safety to ensure all staff understand their health and safety responsibilities; All managers to be able to monitor and review the health and safety within their departments and identify any hazards and risks to staff; DSE (Display Screen Equipment) assessments; A seminar or Health and Safety Awareness and Responsibility training for the Governing Body members to be introduced; Mandatory training; and Development of the Health & Safety Dashboard. The Governing Body: Noted the report, which was put forward for the Governing Body s information on behalf of the Health and Safety Committee; Approved that the Health and Safety Committee be given delegated authority to approve Health and Safety policies on behalf of the Governing Body. 6.6 Tri-Borough Public Health memorandum of understanding: update The Head of Corporate Services presented the report. The Governing Body was advised that the memorandum of understanding supported the working arrangements in place in 2016/17, and was reminded that the ring-fence, which had maintained resources until 2016/17, was being removed in April It was noted that in 2017/18 there would be a need to focus on prevention, wellbeing and using strong Public Health data to support the five delivery areas of the Sustainability & Transformation Plan, particularly Delivery Area 1: radically upgrading prevention and wellbeing. The Governing Body supported strengthening working relationships with Public Health, and considered ways of bringing it closer to commissioning. It was suggested that CCG and Public Health colleagues should identify what resources were needed, and what was available. Page 15 of 17

16 The Governing Body approved the memorandum of understanding. 7 Questions from the public : To confirm what will resources would be available from Public Health in 2017/18 (CF/ KD) There were no questions from the public 8 Information to note 8.1 Report of the North West London CCGs collaboration board The Governing Body noted the report. 9 Minutes of Committees of the Governing Body To provide a Public Health work programme for CCGs to draw on (CF/ KD) 9.1 CWHHE Investment Committee, September & November 2016 The Governing Body noted the minutes. 9.2 CWHHE Quality & Performance Transition Committee, July 2016 The Governing Body noted the minutes. 10 Achieving strategic objectives 10.1 South Locality Options Appraisal for a locality primary care hub The Deputy Chair chaired the discussion, and the CCG Chair left the meeting. The Estates Support to CWHHE was welcomed to the meeting, and gave a verbal update on progress with the project, which was part of the wider strategic delivery plan to support delivery of Shaping a Healthier Future. Progress to date was outlined: Developing the case for capital funding; Engagement to date has involved all the practices in the south and attendance at the Patient Reference Group and the Patient Participation Forums across all localities. The Governing Body noted the importance of engaging with patients and stakeholders. It was confirmed that the Option Appraisal was structured in line with the Treasury Five Case Model: Strategic Case; Economic Case; Financial Case; Commercial Case; Management Case. The Governing Body noted the update. Page 16 of 17

17 11 Any other business There was no other business. 12 Date of next meeting in public of the Governing Body 21 March Future meetings Meetings in public 2017/ 18 meeting cycle to be published Page 17 of 17