Agenda West Lancashire Clinical Commissioning Group Membership Council Meeting Date & Time: Wednesday 17 June 2015, 1pm Venue: Ellerbrook Suite, Briars Hall, Lathom Meeting: Business Meeting / Membership Council No. Time Slot Item 1. 1.00pm Apologies for absence For: Action, Approval, Decision, Discussion Enclosure/ Verbal Item Presenter 2. 1.05pm Minutes of Last Meetings Approval Enclosure Dr Caine Membership Council: Thursday 14 May 2015 (5mins) 3. 1.10pm Matters Arising Approval Verbal Dr Caine (10mins) 4. 1.20pm Executive update Discussion Verbal Dr Caine Safeguarding Training (CH) (30mins) Finance/contracts/Performance update (JM) Update on Direct Access to MRI (BB) 5. 1.50pm SNOW WHITE Urgent Care Dashboard Discussion Verbal Dr Caine (10mins) 6. 2.00pm Direct Access to Diagnostics tests for GPs Possible offer to West Lancs CCG PDS Medical Discussion Verbal Mike Maguire PDS Medical Helen Fogg / Mark Spencer / Amanda Ardron (20mins) 2.20pm COFFEE BREAK 7. 2.40pm FtFT Preparing for outcome of June Gateway Page 1 Discussion Verbal JM/CH/KT/AS (40mins) 8. 3.20pm Dieticians Food 1st Discussion Verbal Lucy Haworth (10mins) 9. 3.30pm Medicines Optimisation Pan Mersey Guidance Discussion Verbal Michelle Spencer (10mins)
10. 3.40pm Open Q&A and AOB Discussion Verbal (5mins) 12. 3.45pm Date, time & place of next meeting: Thursday 9 July 2015, Briars Hall Hotel, Lathom Page 2
Minutes West Lancashire Clinical Commissioning Group Membership Council Date & Time: Thursday 17 June, 1pm Venue: Briars Hall, Ormskirk Meeting: West Lancashire CCG Membership Council Attendees: Aughton Surgery Dr Roberts Ashurst Primary Care Dr Saxena Beacon Primary Care Dr B Biswas Dr Ros Bonsor Apologies: Birleywood Practice Dr D Bisarya Matthew Ryder Clinic Dr Ryder Claire Derbyshire Drs A & A K Bisarya Dr A Bisarya Judie Rowlands (PM) Birleywood Practice Judie Rowlands (PM) Burscough Family Practice Dr Ganga Duddukuri County Road Surgery Dr Ray Phil McConnell (PM) Hall Green Surgery Dr Chang Dr Cusack Lathom House Surgery Dr Statham Dr Littler Dr Littler Manor Primary Care Dr Amit Sharma Matthew Ryder Clinic Elizabeth McGowan Page 3
Natalie Evans Skelmersdale Family Practice Dr Jaidka Susan Bunner (PN) North Meols Medical Centre Dr Dontula Ormskirk Medical Practice Jo Debacker (PM) Dr L Dean Parbold Surgery Dr J Caine Dr Mullen Dr Crossan Dr Gullick Dr Ravangave Parkgate Surgery Dr Gregory Debbie Dobson (PM) Stanley Court Surgery Dr G Simpson Dr Sur and Partners Dr Sur Dr Jaidka Karen Black (PM) Susan Bunner (PN) Tarlton group practice Dr Hudson Viran Medical Centre Dr Hindle In attendance Dr Mark Spencer (PDS Medical) Amanda Ardron (PDS Medical) Lucy Haworth CCG Support Staff Mike Maguire Chief Officer Claire Heneghan Chief Nurse Jackie Moran - Head of Quality Performance & Contracting Katie Wightman Head of Corporate Affairs Nicola Baxter - Head of Medicines Optimisation Michelle Spencer Medicines Optimisation Joanne Kane Administrative Assistant Page 4
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Agenda Summary of Discussion Action Lead Item 1. Apologies for absence Apologies for absence are noted above. 2. Minutes of last meeting The minutes from 14 May 2015 were agreed as a correct record. 3. Matters Arising The community interest company in Kirklees that could provide an insight into a new community model has been extended an invitation to attend a future Membership council meeting. Update Dr Bonsor to update at next meeting LARC Jackie Moran updated on this item which had been was deferred from 14 May. It has been suggested that it may be beneficial for a smaller group from Membership to attend a separate sexual health event where Paula Briggs could provide this update. It was agreed to further this. Separate sexual health training to be arranged. JM/RB CCNOT following the decision to discontinue funding this service will cease at the end of June. The new community paramedic will attend the July membership. 4. Exec Update Safeguarding Training Claire Heneghan presented slides on safeguarding training obligations following a query from Membership about who is responsible for provision of training. The Local Area Team response was that it is the responsibility of practices to train their staff to the required level. They suggested practices organise training sessions across neighbourhoods. The CCG already commissions some safeguarding support, so it was stated that training sessions could be provided to safeguarding leads, which could then be cascaded to all practice staff. Follow up arrangements for practice safeguarding training. CH Page 6
The guidance will be recirculated on what exactly counts towards fulfilling the requirements, as there was some confusion about this. There was also brief discussion around how safeguarding could be explored during MDTs. Finance/Contracts/Performance Update Jackie Moran presented slides on the assurance pack, presenting information on the current state of contracts, reporting that the majority are ready to be signed off. In order to promote quality improvements a number of contracts have been unbundled and are now Payment by Results (PBR), meaning that the CCG pays on a cost per case basis. Representatives from Whiston will attend a future Membership meeting to inform further on their system. Discussion followed on the new urine testing system which was generally agreed to be time consuming and not suitable for primary care use. Further discussion took place on lab tests and how an understanding of cost may be beneficial. Jackie will request consultants attend Membership with a view to inform further on the issues discussed. Update on direct access to MRI Mike Maguire updated on behalf of Bapi Biswas following on from a visit to Fairfield Hospital. Mike requested at least three practices to volunteer for involvement in a pilot for direct access to MRI. The following practices volunteered to be involved; Debbie Dobson - Parkgate Surgery Dr Littler -Sandy Lane Health Centre Dr Sharma - Manor Primary Care Dr Simpson - Stanley Court Surgery 5. SNOW WHITE Urgent Care Diagnostics John Caine presented slides on the SNOW WHITE dashboard. This dashboard originally presented data from 7 streams hence the name but this has now grown to include further data sets. There was some discussion on what the merits of this dashboard. Potentially this will further understanding by Page 7 Whiston to attend next membership council. Urology consultants to be invited to attend Membership council. JM JM
identifying trends, pinpointing pressures and could ultimately allow funding to be diverted accordingly in a timely manner. It was noted that the expectation is that only a short telephone call or simple form would be provided by practices and the advantage would be to gain a better understanding within the context of the bigger system. Mersey CSU are developing SNOW WHITE and continue to progress with this. The presentation is available on SharePoint. John Caine will continue to inform Membership on progress. 6. Direct Access to diagnostics tests for GPs Dr Mark Spencer and Amanda Ardron attended the Membership council to present information on Primary Diagnostic Services (PDS) Medical. Slides were shown to explain the proposed 12 month Pilot for Community Diagnostics. A brief explanation was given on the origins of PDS, which was then followed by slides looking at what diagnostic tests are currently available from the bespoke service, the referral pathway and clinical governance. The Membership council was asked to give a show of hands on whether they would be interested in commissioning such a service. The majority of the Members were very keen to proceed with this. 7. FtFT Preparing for outcome of June Gateway Jackie Moran presented slides on this item. The Membership was briefly reminded of the background of the Facing the Future Together Programme and then looked in detail at the pros and cons of re-procurement. The importance of the upcoming decision at the next Membership council was emphasised. Members will need to look at all the options available and then make the decision based upon the clinical gateway reviews. The Membership was also asked to consider the CCGs capacity to complete the process within three different timescales. It was agreed that all the information needs to be circulated in advance of the Membership Council on 9 July. Information pack to be provided to Membership prior to 9 July. JM Page 8
8. Dieticians Lucy Haworth from Southport and Ormskirk NHS Trust presented information regarding Food First. The aim of Food First is to promote an alternative to prescribing nutritional supplements. It was acknowledged that sometimes the prescribed supplements are appropriate but the option of food fortification should be considered first. It was noted that a formulary for prescribable first line oral nutritional supplements has been provided by the Medicines Optimisation team, this and the Food First guidelines are available to view on SharePoint. 9. Medicines Optimisation Pan Mersey Guidance Michelle Spencer presented information on the Malnutrition Universal Screening (MUST) Tool produced by Pan Mersey. This was followed by further slides with guidelines for managing malnutrition in adult in the community. This item linked into the previous item and the value of food fortification was re-iterated. It was also noted that training for practices HCA would be of benefit as they often weigh the patients and have more time spent with patients to discuss options. This also links in with community services, FtFT and should form part of the assessment process. This presentation is also accessible on SharePoint. 10. Any Other Business John Caine raised the Information Sharing agreement for EMIS Community, explaining that there are two levels to this and requesting that practices who have not yet responded please do so. E-referrals have reported some issues and had been down yesterday, this seems to be resolved now and the site is currently back up. 11. Date, time and place of next meeting Wednesday 17 June 2015, Briars Hall, Lathom Page 9