Windsor, Ascot and Maidenhead Clinical Commissioning Group Minutes of the Governing Body Meeting held in public held on Wednesday 3rd June 2015 at the Holiday Inn Maidenhead MINUTES Present: Adrian Hayter Chair AH Arthur Ferry Deputy Chair and Lay Member Governance AF Dr Judith Kinder GP Member JK Dr Kirstin Ostle GP Member KO Carolyn Robertshaw GP Member CR Matthew Tait Chief Officer MT Nigel Foster Chief Finance Officer NF Robert Cooper Lay Member Patient and Public Involvement RC Alan Mackay Practice Manager Member AM Anne Stebbing Secondary Care Member AS Sarah Bellars Director of Nursing SB Karen Stevens Christabel Shawcross (part) arrived 1450 Local nurse Local Authority Member In attendance: Viki Wadd CCG Head of Operations VW Anna Pardoe CCG PA (Minutes) AP Elika Saidi Communications and Engagement Manager ES Item Discussion Actions 1 Introduction 1.1 Chairman s introduction and apologies for absence. 1.1.1 No apologies had been received. CS 1.2 Conflicts of Interest to declare in relation to the agenda. In terms of working in individual practices, conflicts of interests were noted from Alan Mackay, Kirstin Ostle, Judith Kinder, Carolyn Robertshaw and Adrian Hayter. 1.3.1 Minutes of the last meeting in public and matters arising. Robert Cooper queried wording of 2.1.8. Matthew Tait explained that it meant the WAM financial position was more challenged. It was agreed that the wording be amended to state: Financial position showed a differential from a number of partners within the system. Accepted: With the exception of the amendment above, the Governing Body accepted the minutes of the last meeting as an AP
accurate record. Matters arising Outstanding actions: 1.4 (1.4 from December): This was still outstanding and Sarah Bellars will take this up with Caroline Tack. 2.2.1 Communications and Engagement Strategy: this could be taken off as this was on the agenda for this meeting. 2.2.2 Use of social media: this was on the plan for a future Governing Body development session. 4.5 Complete had been added to the beginning of the Terms of Reference for the Co-commissioning committee and could be removed. 10.3 The wording on the revised assurance framework had been changed in the latest version. 10.4 The Assurance Framework is currently being redesigned. 1.4 (6.5 from December): SB updated re messages to practices about quality at Royal Berkshire Hospital, this action no longer appropriate. 1.3.2 Minutes of the May Governing Body Workshop meeting. Confirmation of renewal of office. Viki Wadd clarified that Adrian Hayter had been voted in as Chair of WAM CCG for another 2 years at the last WAM Assembly meeting. 2 Chief Officer Report 2.1 Matthew Tait introduced the Chief Officer Report and briefly noted the highlights which included: Organisational development: A joint GB workshop was taking place in July. Lead Provider Framework for Commissioning Support Service Quarter 3 Assurance Process CCG Assurance Framework Urgent and Emergency Care Non-Emergency Patient Transport Service (NEPTS) Operational Plans 2015/16 Collaborative Care for Older Citizens 2.2 Report from the CCG Head of Operations Viki Wadd explained some brief points from the CCG Head of Operations report which included: New appointments. The Governing Body and management teams are now complete. Go to WAM, new member website which was going live in July and was well supported by clinical leads. Caroline Yeoman and Chris Allen had been nominated for a patient safety award for dementia and care homes work plus the Harm Free Care Programme. Primary Care Co-commissioning, the first public meeting is to be held in July. Changes to Public Health support, interim arrangements had not yet been confirmed. 3 Federated Quality Committee Chairs Report including Scorecard 3.1 Sarah Bellars introduced the report and explained that there had been a significant improvement in the Trust within a short space of VW/SB
time. The Chairs Report including scorecard was talked through and areas noted for improvement in quality and performance which included: 18 weeks RTT Frimley North A&E Frimley North Cancer 31 and 62 Day Waits Frimley North 6 Week Diagnostic Breaches Frimley North/ASPH Stroke Frimley North Cancelled Operations Frimley North Maternity Frimley North Falls Frimley South MRSA ASPH CDiff Never Event Frimley South 3.2 Anne Stebbing commented positively on the style of the new paper. Sarah Bellars noted that the Quality team were now attending meetings around contract monitoring. 4 Communications Update Elika Saedi was attending on behalf of Ally Green who had sent her apologies. The report provided highlights of the communications and engagement activity during March May 2015 which included: Collaborative Care for Older Citizens (CCOC) was a significant project for the CCG and would be covered as an item later on in the agenda. Re-procurement of NHS 111 contracts for both due to expire at end of March 2016. There would be some key patient engagement to help put the bid together that would be going out to tender. Primary Care Transformation was noted as a large piece of work which would bring together CCOC, PMCF and BCF. There would be individual plans to support each. Resilience planning and communications Community Partnership Forum Wasted Medicines - Tim Langran has been instrumental in making links and information was being shared in local media including BBC Radio Berkshire and local newspapers. Patient Online Improving online communications PPG network Annual report and AGM the Annual Report had been submitted the previous week and the AGM date of 16 th September was noted, final timings and venue to be decided. 8 Operational Plan 2015/2016 8.1 Viki Wadd introduced the Operational Plan and asked for Governing Body approval. This version had been refreshed to take into account the Five Year Strategy. Viki Wadd explained the highlights of the report and questions were invited from the Governing Body. 8.2 Anne Stebbing queried how the delayed transfer of care would be tackled and whether the focus was just on Secondary Care. Viki Wadd explained that there needed to be a whole system approach,
although acute trusts have a role to play. 8.3 Christabel Shawcross noted the good joint work done with the CCG particularly the work done around winter pressures and that it was important to ensure that people had the right support. 8.4 Robert Cooper raised a query on ageing well from page 19 regarding supporting overweight adults but with no proactive approach to obesity. Viki Wadd explained that one of the reasons for this was that wasn t highlighted as part of the joint strategic needs assessment, but was still recognised as an important issue. Viki Wadd would need to go back to colleagues in Public Health to discuss how this could be reflected in their workplans. Judith Kinder noted that there had been working taking place within local schools tackling obesity in children specifically. 8.5 Arthur Ferry commented generally on the transformational change programme and noted that it was extensive list of work and wondered to what extent timelines had been established for these along with an assessment of budgets and costs of the programmes. All QIPP plans had timelines, project leads and seniors responsible although capacity to deliver was tight. 8.6 Anne Stebbing queried what the management team would be asked to stop doing. Matthew Tait replied that the answer to this would be to stop duplicating as much possible and there was certainly room for significant efficiencies to be had on the collaborative model with duplication across the 3 CCGs. 5 Prime Ministers Challenge Fund update 5.1 Caroline Yeoman gave an update on the Prime Ministers Challenge Fund. The PMCF had been won on 27 March 2015 and a letter of intent was still awaited from NHS England. 5.2 The team was in place and working through the details; prescribing, referrals these would not replicate existing systems. 5.3 Caroline Yeoman noted that they were very mindful of the amount of work that might go back into surgeries and was working with Alan Mackay on how to minimise this. 5.4 The campaign would need a huge amount of engagement work. For example, to demonstrate what was an appropriate GP appointment, due to a large percentage of inappropriate use of GP Time. Education in schools would be needed and it was critical that the message be sent out to all sectors. There would be some internal PR around this also. 5.5 Caroline Yeoman invited questions from the Governing Body. 5.6 Sarah Bellars thought it would be useful to look at other areas where there were not so many appointment cancellations. Carolyn Yeoman replied that she was doing an analysis the costs for WAM over the last year of missed appointments. 5.7 Adrian Hayter asked how geared up the project was to be aligned with the strategic priorities of the CCG and commented that the Governing Body would be looking for governance processes of the programme board to be sighted onto objectives. 7 Better Care Fund Marianne Hiley introduced the Better Care Fund Performance update and explained some challenges on delivery of the BCF. The report was noted and support given to prioritising the transformation of community services. 6 Collaborative Care for Older Citizens update
6.1 Adrian Hayter welcomed Anshu Varma as the programme lead for this. Anshu Varma provided an update on the programme which had started in February and was sponsored by 4 CCGs, 3 Local Authorities and Frimley Health and BHFT. The population covered was 575,000, 89,000 of which were over 65. The Steering Group was described which held meetings every 2 weeks along with the 3 workshops that had already taken place and talked through her presentation. 6.2 Anne Stebbing commented that the project did not feel new and felt there needed to be more focus on what was going to be delivered. She noted concerns about the lack of resource being used following discussions earlier in the meeting. The importance of outputs from the meetings was noted. 6.3 The programme director was partly funded by Frimley and partly by the CCG. Viki Wadd asked whether the programme could cover how Secondary Care should respond to the complexity of the older population. Anshu Varma noted assessments and identifying those patients and flagging up to the GPs. 9 Finance Report Month 12 Nigel Foster introduced the Month 12 Finance Report and noted that the auditors had recently been in and documentation was a key point for all Berkshire East Governing Bodies. The final implications of the final outturn would be highlighted in due course to the Governing Body. Nigel Foster suggested that any further questions could be asked after the meeting. 10 Audit Committee Annual Report Any questions on the item could be put to Arthur Ferry. Nigel Foster made the observation that as part of good governance, all committees should be producing an annual report, the Audit and Remuneration committees had, but others had not. Anne Stebbing asked if there was a quality section within the annual report. Nigel Foster explained that some of it should be covered in the annual governance statement of the annual report. There was a brief discussion around when having a sub-committee working it needs to be ensured that the correct people are attending those committees the Governing Body would want assurance that those committees were doing what they are being relied upon to do. The meeting was closed.