Rebecca Stephens, Chair welcomed everyone to the first public meeting of the Primary Care Commissioning Committee.

Transcription

1 Minutes of the NHS England and Cambridgeshire & Peterborough Clinical Commissioning Group Primary Care Commissioning Committee meeting held on Tuesday 25 April 2017 in the Cedar Room, Lockton House, Clarendon Road, Cambridge Present: Rebecca Stephens, Chair Tracy Dowling, CCG Chief Officer Jonathan Dunk, CCG Chief Finance Officer Sue Watkinson, Director of Planned and Primary Care Karen Handscomb, CCG Deputy Chief Nurse (On behalf of Jill Houghton) In Attendance: Dr Gary Howsam, CCG GP GB Chair and Chief Clinical Officer: Alice Benton, CCG Head of Primary Care Sharon Fox, CCG Secretary & Deputy Director of Corporate Affairs Diane Siddle, NHSE Primary Care Contracts Manager Sandie Smith, Healthwatch Cambridgeshire Cllr Tony Orgee, Cambridgeshire Health and Wellbeing Board Dr Guy Watkins, Cambridgeshire Local Medical Committee Diane Siddle NHSE Tracey Lewis, NHSE NHSE Staff and Members of the Public PC17/11 Welcome and Introductions Rebecca Stephens, Chair welcomed everyone to the first public meeting of the Primary Care Commissioning Committee. PC17/12 Apologies for Absence Apologies for absence were received from Jill Houghton and Jessica Bawden. PC17/13 Declarations of Interest Dr Gary Howsam declared an interest as a GP Partner at Queen Street Surgery, Whittlesey. This interest was set out in the CCG s Register of Interest. PC17/14 Notification of Any Other Business There were no additional items of business raised. PC17/15 Minutes of the Last Meeting The minutes of the former Joint Committee meeting held on 21 March 2017 were agreed as a true record. Page 1 of 5

2 PC17/16 Matters Arising PC17/17 Actions List The Committee noted the actions that had been undertaken and those that were in progress. The Actions List was updated and is appended to the minutes. PC17/18 Delegation Agreement Sharon Fox presented the signed Delegation Agreement between NHSE and the CCG in relation to the responsibilities now delegated including the commissioning, procurement and management of Primary Care Medical Services Contracts. The Committee noted the Delegation Agreement. PC17/19 Terms of Reference Sharon Fox presented the Terms of Reference for the Primary Care Commissioning Committee which had previously been approved in draft by the Governing Body as part of the Delegated Commissioning Committee. The Committee approved the Terms of Reference. PC17/20 Draft Cycle of Business Sharon Fox presented the draft Cycle of Committee Business which had been circulated prior to the meeting. She advised the Committee that this would be developed further to reflect the Delegation Agreement and the Primary Care Work Plan. The Committee noted the Draft Cycle of Business. PC17/21 Primary Care Update Alice Benton presented the Primary Care Update which had been circulated prior to the meeting. In relation to Delegated Commissioning Transition, she advised the Committee that the transfer of responsibility for primary medical services commissioning from NHS England to the CCG was underway. The CCG had undertaken the first contractual payment run to practices. Tracy Dowling advised the Committee that details of staff being assigned to the CCG from NHS England had now been confirmed and formal notification would be received shortly. Alice Benton confirmed that the CCG was undertaking the process to appoint the additional staff that were agreed as part of the decision to take on delegated commissioning. These staff would support corporate, contracting, estates and quality functions that would be impacted by the additional workload. The CCG s primary care team was aligned to ensure capacity for the workload associated with delegated commissioning as well as the General Practice Forward View (GPFV) implementation requirements and transformation activities. In relation to the GPFV Plan / Primary Care Strategy update, Alice Benton advised the Committee that the CCG had now received feedback from NHSE on the second submission of the CCG s GPFV Plan. NHSE had assessed the Plan overall as green indicating that it satisfied the requirements set out in the GPFV Planning Guidance and that it Page 2 of 5

3 demonstrated that all key elements had been carefully considered. Focus now shifts to implementation and the primary care team was developing the delivery plans which underpinned the achievement of the key ambitions of the plan. Turning to Time to Care Testbeds, Alice Benton confirmed that the Testbed Workshops would be completed by the 27 April The focus of the workshops was to bring all the practices together in each testbed group to determine the activities and outcomes they were seeking to achieve through the process. The workshops would be followed up with practices working in smaller, facilitated groups, to test different ideas on behalf of their testbed. The intention in the first phase of the testbed programme was for the participating practices to identify different ways that they can improve the capacity and efficiency of their own service provision, and strengthening this through testing solutions that were possible through working differently together. The Committee would receive details of the areas of focus for each testbed at its next meeting. In relation to Clinical Pharmacists Pilots, Alice Benton advised the Committee that that no bids from Cambridgeshire and Peterborough had been successful in the next wave of the Clinical Pharmacists pilot. Detailed feedback was being sought to inform future applications, however, initial feedback that consideration was only being give to bids that cover a population of 30k to 50k. The Chair thanked Alice Benton for her report. She congratulated the Team on the Green rating provided by NHSE on the GPFV Plan. The Committee noted the Primary Care Update. PC17/22 Primary Care Investment Plan Alice Benton presented a paper providing details of the commissioning intentions for general practice in 2017/18. This included the plans for local enhanced services and the reinvestment of the resources transferred to the CCG from NHS England as a result of the PMS contract rebasing process. She advised the Committee that the investment plan had been developed in the context of the CCG s decision to no longer invest in Practice Development and Management Agreement. The investment which had been available to practices for a number of years represented an important income stream for which an alternative solution was being proposed within the primary care budget. She confirmed that engagement with the Local Medical Committee had been undertaken in the development of these plans. The Committee discussed the Report. Sandie Smith thanked Alice Benton for ensuring that the feedback from Healthwatch on wax removal was incorporated into the Plan. She asked for clarification on what was happening in relation to the Alternative Medical Scheme. Alice Benton confirmed that this remained a Direct Enhanced Service and was subject to wider review by NHSE on behalf of the East. Dr Gary Howsam commented that the CCG was fully sighted on the local issues and was feeding into the review process. The Chair thanked Sue Watkinson and Alice Benton for their report. She Page 3 of 5

4 said that the Committee acknowledged that investment in primary care was essential in maintaining the stability of provision in general practice, as well as establishing the platform for longer term transformation to support the achievement of wider system objectives. The Committee supported the Primary Care Investment Plan for This would be presented to the Governing Body for approval on 9 May 2017, following approval of the funding element of the Remuneration and Terms of Service Committee Sub-Group 2. PC17/23 Practice Merger Granta Medical Practice with Barley Surgery The Committee received a paper describing the arrangements for the merger of Granta Medical Practices (D81043) and Barley Surgery (E82011) from 1 April Diane Siddle advised the Committee that the new entity intends to retain the practice code (D81043) and the contract held by Barley Surgery (E82011) would terminate. She confirmed that both practices operate a General Medical Services contract. Patient records and the computer systems would merge between 1pm Wednesday 26th April and 1pm Thursday 27 April Diane Siddle confirmed that the merger plan indicated no reduction in sites or services. Diane Siddle advised the Committee that the practices wished to develop a Primary Care Home model in line with the wider national vanguard programme which was testing this new model of care, and Cambridge University were looking to study the impact of its development and implementation. The Committee discussed the merger. Dr Guy Watkins confirmed that the CCG should note the merger of the practices which was consistent with the regulations. The contractual change required the CCG s approval. Jonathan Dunk said that he would like to see a financial impact assessment prepared for future reports so that the impact of efficiency measures in the system could be monitored. Dr Guy Watkins said that there may be potential shifts in QOF achievement. Tracey Lewis confirmed that the global sum pay change slightly on the Carhill formula however she anticipated that this would be marginal. Sandie Smith asked about the impact on patients. Alice Benton confirmed that patients would have access to more services at Sawston Medical Centre. Sandie Smith added that she was satisfied with the level of engagement and no concerns had been raised. The Chair said it would be helpful to provide more detail around the engagement process in future reports. The Chair thanked Diane Siddle for her report. The Committee noted the merger of Granta Medical Practice with Barley Surgery. The Committee approved the contractual arrangements associated with the merger. The Committee requested clarity in future reports regarding the regulations and the role of the Committee in either noting or approving this type of change. PC17/24 NHSE Summary of Hot Topics Diane Siddle presented a short report updating the Committee on the work of the Primary Care Team at NHSE. The Committee discussed the Report. In relation to the GP Resilience Fund, Dr Guy Watkins expressed his concerns regarding the late announcement on funding last year and that there had not been time to Page 4 of 5

5 invest. He would ensure that fair shares on the funding were implemented across the East. Diane Siddle confirmed that the QOF process was on hold as there had been an error in the new year aspirations and achievements in Jonathan Dunk expressed his concern regarding the consequences in and requested confirmation that the impact would be borne by NHSE. He asked that prior year adjustments were assured. Dr Gary Howsam reaffirmed his interest as a GP partner at Queen Street Surgery which was within Cohort 2. He asked when bids would be approved. Jonathan Dunk said that he anticipated that capital bids would be approved by the end of May. Alice Benton confirmed that there was a clear process on Improvement Grants. Dr Guy Watkins said it was important to distinguish between the capital available to primary care and the wider system. Jonathan Dunk confirmed that the STP was looking at capital in its entirety. Alice Benton suggested that this was discussed outside the meeting to provide clarity on the number of schemes that were available. The Chair thanked Diane Siddle for her report. The Committee noted the Report. PC17/25 Finance Report Tracey Lewis presented the Month 12 Finance Report. She advised the Committee that the practices within the CCG were reporting a 167k year to date underspend. She added that the CCG had been allocated shares of budgets not held at practice level, earmarked reserves and contingencies. These budgets were currently not included within the year to date position. Jonathan Dunk said he sought reassurances from NHSE on the impact on the budgets for and requested further detail to be brought back to the Committee at the next meeting. The Chair thanked Tracey Lewis for her report. The Committee noted the Month 12 Finance Report. PC17/26 Questions from the Public There were no questions from the public. PC17/27 Date of Next Meeting Sharon Fox CCG Secretary 28 April 2017 The date of the next meeting was confirmed as Tuesday 30 May 2017 at 9.30 am in the Cedar Room, Lockton House, Clarendon Road, Cambridge, CB2 8FH Page 5 of 5