PRIMARY CARE COMMISSIONING COMMITTEE PART 1 MEETING IN PUBLIC

Transcription

1 PRIMARY CARE COMMISSIONING COMMITTEE PART 1 MEETING IN PUBLIC 24 January 2018 The Gallery, The Woolwich Centre Enclosure xii PRESENT: Richard Rice (RR) CHAIR, Governing Body lay member Ellen Wright (EW) GCCG Clinical Chair Neil Kennett Brown (NKB) Managing Director David Maloney (DM) Chief Finance Officer Virginia Morley (VM) Director of Commissioning Strategy Irene Grayson () AD Primary Care Jan Matthews (Jan M) Primary Care Contract and Performance Simon James (SJ) Primary Care Delivery Manager Jill Prescott (JP) Primary Care Commissioning Manager Dr Ranil Perera (RP) GP Governing Body Member Rikki Garcia (RG) Healthwatch Jackie Davidson (JD) Royal Borough of Greenwich Tuan Tran (TT) Local Medical Committee Jill Webb (JW) Head of Primary Care, NHS England IN ATTENDANCE: Toni Meyers (TM) Lorna Duhaney-Riley Business Manager (Minutes) Primary Care Administrator APOLOGIES: Andrew Bland (AB) Accountable Officer Maggie Buckell (MB) Lay Member Dr Inyga Vanniasegaram (IV) Secondary Care Doctor Dr Sabah Salman (SS) GP Governing Body Member Greg Ussher (GU) Lay member Item 2. Conflicts of interest EW noted a possible conflict of interest with Item 6 and agreed to leave the room for that discussion. TT is a shareholder in GPCC who are involved with Clover Healthcare for item 7. The Committee considered that this was not a conflict as the discussion under item 7 was only concerning patient engagement rather than commercial matters. Action 3. Minutes of previous meeting on 29 November 2017 The minutes were agreed as an accurate record. Chair: Dr Ellen Wright Interim Managing Director, Neil Kenneth-Brown

2 4. Urgent Business None Primary Care budget allocations DM presented figures up to month 9. Against an annual budget of 37.2m he reported an underspend of 242k which was due to net increases in list size being less than planned for. He noted that the budget was expected to break even in the last quarter. 6. Vanburgh Park additional room EW left the room for this item. JW noted that the practice had asked for an additional room to provide space for a GP registrar/gp in final year of training. Against a boroughwide shortage of training places and the need to increase GP numbers, the Committee AGREED to the proposal on an indicative vote. ACTION: To contact remaining members of the Committee for their opinion before proceeding. 7. APMS Procurement presented this item, which was an update on Greenwich CCG s decision to extend the contract with Malling Health for 2 years and reprocure Clover Health Care APMS contract. Patient letters were due to be sent out on 15 January, but will now go out on 29 January, alongside an electronic survey (which would be open for 1 month) and would be available on the website. There had been some slippage in the timelines but Greenwich CCG was working with the London team to mitigate delays. Clover Health Care had agreed to extend their current contract to the end of September, with the new contract in force from 1 October The new contract would include 3 nursing homes its their remit. RG queried the difference between PMS and APMS. JW responded: GMS General Medical Services: a general, standard, nationally negotiated contract in perpetuity. PMS Personal Medical Services: follows GMS terms and pricing but can add additional services and more organisational types can hold it. APMS Alternative Provider Medical Services: the widest range of providers can bid to hold this contract, which is time limited. Local commissioning intentions can be added in. NKB noted that Greenwich had 3 APMS contracts extant, including this one. RG gave his opinion that the timescales for patient engagement were rather short. JW assured him that anyone bidding for the contract would be required to take patient feedback into consideration. The Chair invited members of the public to comment on this item. 2

3 Questions included: Should Greenwich have APMS contracts and how would they be monitored? RR stressed that the existing contract must be re-procured. JW pointed out that NHS England set the requirements for contracts and this was something Greenwich CCG had limited power over. She emphasised that eligibility criteria were clearly identified in the NHS regulations and that due diligence was undertaken in evaluating new providers which included close financial scrutiny, and that this was managed on a pass/fail system. She confirmed that APMS contracts were monitored in the same way as GMS/PMS contracts. Why was the patient reference group not sighted on the detail of the procurement or content of the letters going out to patients? JW reminded the Committee that the contract had come to its natural end and a decision had to be made to either re-procure or to ask patients to register elsewhere. The decision to re-procure was taken in Part 2 to avoid any commercial advantage to the market. noted that Greenwich CCG was constrained by a London-wide timeline in this matter, but she pointed out that patient groups had already agreed the content of the standard letters which were going to Clover patients. ACTION: To share the standard letters with the Patient Reference Group for their views and feedback. Is the CCG following Gunning principles in this matter? NKB confirmed that that was the case. The CCG was acting alongside the rest of London in bringing these contracts into line, which would save the NHS money on procurement costs. RG confirmed that Health Watch had been contacted. 8. PMS Review update of offer letters to practices JM presented this update. Following the agreement on PMS previously reported, letters would be received by practices within the next few days setting out their options. Individual practices could choose Wave 1 (whereby contracts would be backdated to 1 Jan 2018), Wave 2 (whereby contracts would begin on 1 April 2018), to revert to a GMS contract or they could hand their contracts back altogether. JM noted that the latter two options were not expected to be exercised. A launch workshop had been held in December Practices would be offered a meeting with Greenwich CCG, Local Medical Council and SEL Primary Care to discuss their offer letters. EW confirmed that this contract meant that Greenwich CCG can commission extra services to support primary care, and that it meant access to funding not previously available to practices. NKB thanked the Primary Care team for their work in bringing this review to a conclusion. 3

4 9. Update on GP At Hand SJ explained the GP At Hand business model and noted that NHS England had paused the further expansion of the service. GP At Hand currently had 16,000 patients registered and was rated Good by CQC. 90% of people registered were between 20-45yrs old (age group not normally seen by GP). He noted that the app which hosted it would automatically de-register patients from their local GPs which some patients had been unaware of. It was felt that this should be an additional service, and should not cause patients to be de-registered. This seemed to have an unplanned impact and may be unsafe to patients. Further figures were expected shortly detailing the impact on primary care across London. JW noted that the CCG still has a responsibility to residents to provide urgent and emergency care along with other support services, no matter which GP they are registered with. ACTION: To write to Hammersmith & Fulham CCG and Greenwich CCG Governing Body to express concern at the possible impact of GP At Hand. RR 10. AOB None. Questions from the public. Members of the public raised the following: 1. Could the committee comment on Communitas and dermatology awareness? RR confirmed that a response would be available at the following meeting which is a Governing Body Meeting. 2. Given that Capita s handling of patient records remains poor, can the committee advise what needs to happen to terminate the contract? JW agreed that concerns on Capita had been well reported and that there were now performance management arrangements in place for turnaround. KPIs and performance measures were in place and JW highlighted the ongoing transformation plans and new arrangements for transfer of medical records. NHS England Heads of Primary Care meet with Capita bi-monthly. ACTION: To add an update item to the next Committee meeting s agenda. 4

5 Next meeting: 28 March 2018 at 10.00am The Gallery, Woolwich Centre, 35 Wellington Street, Woolwich SE18 6HQ 5