ITEM 22 Joint Commissioning Board Minutes 1
JOINT COMMISSIONING BOARD Kinetic, Francis Crick House, Moulton Park, Northampton, NN3 6BF 14 th June 2013, 09.00-11.00 Present : Cllr Robin Brown (RB), Cabinet Member for Adult and Public Health, Northamptonshire County Council (Chair) Richard Alsop (RA), Chief Commissioning Officer, Nene CCG Carole Dehghani (CD), Interim Accountable Officer, Corby CCG Andrew Jepps (AJ), Assistant Commissioning Director, Northamptonshire County Council Akeem Ali (AA), Director of Public Health & Wellbeing, Northamptonshire County Council Pat McCarthy (PM), Head of Joint Commissioning, NHS Nene CCG Catherine O Rourke (COR), Programme Lead Mental Health, NHS Nene CCG Sian Heale (SH), Continuing and Complex Care Manager, NHS Nene CCG Roddy Thomson (RT), Head of Financial Reporting and Analysis, Commissioning Support, MK & Northants Cluster Andrew Bailey (AB), Carer Representative Brendan Macken (BM), Northamptonshire Mental Health Service User Reference Group Yalini Gunarajah (YG), Strategic Finance Manager, Northamptonshire County Council Gordon King (GK), Commissioning Manager Mental health, NHS Nene CCG In attendance: Gerry McMurdie (GM), Commissioning Manager Dementia, NHS Nene CCG Ralph Beresford (RaB), Commissioning Manager, Northamptonshire County Council Julie Egginton (JE), Minute Taker, Nene CCG ITEM ACTIONS 1.1 APOLOGIES Matthew Davies, Judith Cattermole 1.2 DECLARATIONS OF INTEREST None at present The Board were asked to advise JE so these could be registered in advance of the next meeting. AB advised he was also a carer governor of NHFT. All 2. MINUTES OF THE LAST MEETING The Minutes of the previous meeting were agreed. 3. MATTERS ARISING Page 1 - not yet spoken to Dom Cox about coming to a future meeting. It was suggested a paper be prepared to outline how the interface with NHS England should work. 4. ORGANISATION UPDATE RA provided an update on the CCGs plans for this year and the next 4 years. PMcC 2
Contracting will be moving from GEM back into Nene. Key area for focus is to develop the contract portfolio. CD confirmed teams are being embedded to facilitate county working. There were discussions around Borderline and concern raised around the impact for the County if services move into Borderline. There was also challenge as to why these services are not delivered in Northamptonshire. AA updated on NCC, advising of budget pressures which would necessitate a different way of joint working. 5. CHILDRENS COMMISSIONING BUSINESS 5.1 SH summarised the Childrens Joint Commissioner report and responded to questions raised. The Board noted the report. 5.2 AJ presented a brief report regarding future integration opportunities and the possible integration of children s commissioning across NCC and CCGs. The Board supported further work to set out how the integration of children s services commissioning could be implemented in advance of the September Board, including consideration of potential governance arrangements. Work on integration in this area could then inform a wider programme of work on health and social care integration. 6. MENTAL HEALTH COMMISSIONING BUSINESS 6.1 COR summarised the Month 2 report which forecast an un underspend on the pooled budget of 64k comprising a forecast 134k overspend in the health element of the pool and a 197k under spend in social care. The 650k QIPPs target activity is yet to impact. There were discussions around management of beds and it was acknowledged that a full view would be taken to mitigate overspend, to ensure activity to mitigate did not produce pressures elsewhere in the system. 6.2 PMcC provided an update on the implementation of payment by Results (PbR) which is a major change and risk for CCGs and providers. He confirmed that the commissioning team is now resourced to manage this programme following a gap in team earlier in year. The reference costs in Appendix 1 will be revised for future years to reflect the impact of QIPP schemes. There were discussions around programme budget information on local costs vs national, regional and comparator costs and the extent to which PbR will address variances. PMcC advised that whilst the focus on PbR has been around the financial aspects the real benefits are around specifying outcomes, interventions and pathways in mental health services. PMcC outlined that the PbR programme is now being taken forward via 3 workstreams on Activity and Cost, Data and Information and Care Pathways PMcC confirmed carers have & will continue to be involved. The Board noted that implementation activity is on track. 6.3 GMcC updated the Board on the proposed approach to the continued implementation of the National Dementia Strategy in Northants and the particular focus on improving diagnosis rates and the introduction of a Directed Enhanced 3
Service (DES) for dementia in primary care. There were discussions regarding the level of support for these initiatives in primary care and it was noted that Dr Tom Howseman is acting as clinical lead in this area. AB noted that there may be an increased workload on carers and the strategy will need to consider how extra resource can be developed to support carers. A wider discussion ensued regarding support in the community and the mobilisation of 3 rd sector and wider community services to support vulnerable groups as part of the Health and Wellbeing Strategy. RB advised there will be 4 Health and Wellbeing Board development days annually to help facilitate consideration of such issues with a wider group of stakeholders. 7. LEARNING DISABILITIES COMMISSIONING BUSINESS 7.1 COR summarised the report confirming that QIPP schemes in learning disability are on track. The QIPP programme is delivering a significant change in the way that health commissioned services for people with learning disability are being commissioned and delivered. COR reported on the Winterbourne action plan which is RAG rated green for all actions due for completion by end of July and a further report will be provided to the JCB in September. The CCG is working in partnership with NCC which is leading the Winterbourne Stocktake exercise. The joint report will go the the Adult Safeguarding Committee in the summer and the Health and Wellbeing Board in September. AB asked what will happen to Vale beds once they are de-commissioned as LD assessment and treatment beds and requested assurance that they would be utilised in an economically effective way. PMcc confirmed that the vale resource is being considered as part of broader strategic thinking about use of beds eg CAMHs. 8 COMMUNITY HEALTH SERVICES COMMISSIONING BUSINESS 8.1 AJ provided an update on community equipment which included a discussion around finance and contract renewal. AJ advised that joint tender with Peterborough and Cambs is not possible and that work to prepare for reletting of the contract is about to be initiated via the ICES group with enhanced customer and partner engagement. AJ reported that there is still pressure on the Pooled Budget mainly due to the pressure care CQIN. Further detailed work on the financial position is planned involving AJ/ GR/SLR with a further report to the Board in September to include a report on financial position. The Board agreed the recommendations regarding the proposed approach to procurement and the need to support reinvigoration of the ICES group. 9. PUBLIC HEALTH COMMISSIONING Nothing to report 10. CARERS STRATEGY Nothing to report 4
11. FUTURE JCB STRUCTURE AND TERMS OF REFERENCE PMcC summarised the report. There were discussions around responsibility, reporting line for conflict and membership. The Board were agreed that the JCB should be a force for facilitating a different way of joint working. RB advised the HWB saw the JCB as a vehicle for discussion and agreement who would then look to the HWB for approval, providing clear evidence based improvements and outcomes for the County. It was suggested there be a core membership of the JCB and others be called in as agenda items require it. In particular the budget holder for any agenda items to ensure collaboration, as well as clinicians, those involved in the service and those commissioning the service. The JCB considered the proposed structure and terms of reference and the issues posed in the last paragraph of the report. It was confirmed that the CCG clinical leadership would be represented in the membership, that the Board will meet in private recognising that the statutory bodies and the HWB Board to which the JCB reports meet in public. The structure and terms of reference were agreed with the caveat that further refinement may be needed with partners in the context of the changing strategic commissioning landscape. 12. FRAIL ELDERLY STRATEGY Deferred 13. HEALTH & SOCIAL CARE INTEGRATION DH INVITATION FOR PIONEER SITES There were discussions around resource and beneficial outcomes of applying to become a pioneer site as well as the activity that would be chosen to be a pioneer. It was agreed that as work had already been done on children, if it showed benefit with minimal resource required, it would be supported. 14. ANY OTHER BUSINESS None DATE OF NEXT MEETING: 13 th September 2013, 13.00-15.00, Kinetic, Francis Crick House, Moulton Park 20 th December 2013, 10.00-12.00, Kinetic, Francis Crick House, Moulton Park 5