Primary Care Co Commissioning Committee Minutes of Meeting held in Public on Wednesday 22 nd June 2016 14.00-16.00 Boardroom, SRCCG Offices, Town Hall, Scarborough Chair: Andy Hudson Present Greg Black GB GP, Governing Body member Sally Brown SB Associate Director of Corporate Affairs Kath Halloran KH GP, Governing Body member Philip Hewitson PH Lay Member, Audit and Governance Committee Andy Hudson AH Lay Member, Patient and Public Engagement Richard Mellor RM Chief Finance Officer Sarah Rigg SR Primary Care Nurse Simon Cox SC Chief Officer Phil Garnett PG SRCCG Chair Nigel Ayres Carolyn Liddle DI CL Healthwatch Representative Primary Care Manager Apologies Clare Beard CB NYCC Representative Dougy Lumb Chris Clarke Carrie Wollerton DL CC CW LMC Representative NHS England Executive Nurse In attendance: Clive Diggory Martin Braidwood Vanessa Burns Helen Phillips CD MB VB HP GP Governing Body Primary Care Manager Deputy Chief Finance Officer NHS England Item PCCC/16/20 Welcome and Apologies The Chair welcomed members and noted the above apologies. No members of the public were in attendance. No questions had been received from members of the public. Action Noted PCCC/16/21 Declarations of Interest Dr Diggory, Dr Black and C.Liddle asked that their interest in agenda item PCCC/16/29 Physician Associate scheme be noted. Dr Black and Dr Diggory asked that their interest in agenda item PCCC/16/26 ETTF bids be noted 1 P a g e
PCCC/16/22 Minutes of the Previous Meeting and Matters Arising The committee approved the minutes of the meeting on 27 April 2016. Matters Arising Tier 2 Weight Management GB confirmed that the template has been circulated. Practice Visits to be discussed as an agenda item. Responsive Safe and Sustainable paper to follow. ACTION: SB to liaise with NHS England. Health Education England opportunities for recruitment and funding for newly qualified staff circulars have been distributed. SB PCCC/16/23 NHSE Co-Commissioning Report NHS England to review all ETTF bids by the end of August 2016 when the outcome of NHSE assessments will be notified to the CCG. A query was raised regarding contact details with NHS England as no responses have been received from PCSE Enquiries with regard to business services and important information and actions regarding changes to practice partnerships have not been actioned. ACTION: HP to circulate contact details and to request that Clare Streeter confirm the correct reporting process. HP The Committee noted the comments and action above. PCCC/16/24 Update on National Policy and Issues in Primary Care from Local Medical Committee No report available. PCCC/16/25 Co-Commissioning Transition Plan Quarter 4 contract management meeting has been held with Castle Health Centre (CHC); attended by SB, CG and CC. Assurance was gained for the Homeless service with monitoring of the activity levels and assessment of value for money being undertaken. A quality and performance dashboard is being developed with the new provider embed. When the national Data Sharing agreement is in place then a decision will be made with regard to using RAIDR and/or Dr Foster for provision of risk stratification data. The Committee noted the comments and action above. Facilities and IM&T Report PCCC/16/26 Estates and Technology Transformation Fund (ETTF) Guidance Those members who are involved in practices declared their interest in this item The Deputy CFO gave an update following a review of the guidance and it was reported that there were a few additional items that SRCCG had not included in their assessment criteria. Additional criteria reflecting population growth were included. Further information is still required from practices. Clarification has now been received regarding 2 P a g e
the criteria for IT bids It was noted the submissions are timetabled to be made by the end of June 2016 with feedback from NHS England by the end of August 2016. PCCC/16/27 SRCCG ETTF Submissions As above. PCCC/16/28 Strategic Estates Plan The Governing Body approved the Strategic Estates Plan ( SEP) at the private meeting in December 2015 which contained commercially sensitive information about estates and practices. The public version of the SEP provided to the PCCC is available on the website Workforce PCCC/16/29 Physicians Associates Dr Black, Dr Diggory and C.Liddle declared their interest in this item but remained for the discussion of the agenda item as no decision was required. Three Practice Managers had attended a teleconference to discuss the scheme. Funding was discussed and possible training funds for practices. A draft scheme is being compiled and a formal commitment is required from practices. The next meeting with HYMS will be mid- July or earlier if possible. It was deemed a positive meeting and attendees confirmed their willingness to take forward the scheme. PCCC/16/30 CCG Primary Care Co-commissioning Officers Martin Braidwood has joined the CCG as Primary Care Business Manager and Mark Lagowski has joined the CCG as Service Improvement Manager for primary care Finance and Contracting Report PCCC/16/31 Finance Report Allocation is > 16m with a 50k QIPP expectation - 587k to be transacted in month 3 as an additional allocation to the primary care budget. The risks remain with the APMS contract at Castle Health Centre (CHC) associated with list growth. However, this is being monitored and discussed at contract management meetings. The growth has not been as anticipated and deductions have been made each quarter. It was noted that the sustainability of the service needs to be monitored to ensure adequate provision of primary care in the locality. Attendance at appointments has been monitored by CHC during the weekend period, and it was noted there is a 15% of DNAs reported. PCCC/16/32 Contracting Update Short form contracts with the enhanced services and specifications have been sent to practices and a summary paper will be discussed at the next meeting with regard to which practices have signed up to which services as we are aware that some practices have not signed 3 P a g e
up to some of the services including smoking cessation. A complete summary report was requested to include Local Authority services. ACTION: complete report for all enhanced services to be included on the agenda at the next meeting. SB Quality and Performance PCCC/16/33 Quality and Performance Dashboard Progress Due to national issues between NHSE and HSCIC around data sharing agreements there continue to be delays in embed being able to process data on behalf of CCGs. A steering group has been established and a representative from VoY CCG represents SRCCG and an update will be requested. It is hoped that a risk stratification tool will be available by August 2016 ACTION: SB to provide clarification regarding the metrix. SB PCCC/16/34 GP Patient Satisfaction Survey Practice Review It was previously agreed that PG and SB would visit those practices: Hunmanby Surgery, Prospect Road Surgery and Derwent Surgery, with regard to the lower than the CCG and national average satisfaction levels reported through the national survey undertaken in January 2016. It was noted that all three practices have made changes to make improvements within their practice processes. It was noted there was a 45% response rate from patients across the CCG ACCEPTED: assurance has been received that all practices are making improvements within their processes to improve the patient experience and that the CCG will continue to monitor survey results. Practices have received written notification from SRCCG that this assurance has been received but practices should continue to encourage FFT and monitor patient feedback PCCC/16/35 Progress and Exceptions Report from Primary Care Development Group Protected Time for Learning events had taken place in May 2016 and thanks were offered to the SRCCG teams involved. Additional events are taking place in September and November 2016. Recruitment and training of primary care staff remains a risk to service delivery and consideration is being given to a recruitment plan for clinical staff within primary care. The majority of practices will have nurse mentors in place by the end of December with most practices taking student nurses. Newly qualified nurses are being recruited with support by a preceptorship framework. Physician Associates as above. Seven practices have worked collaboratively and employ 4 pharmacists which is improving the joint working and embedding a standardised way of working across 7 practices. Feedback on progress was requested for the next meeting on the benefits of having a pharmacist in the practice and the types of roles they are undertaking. 4 P a g e
HP confirmed that an announcement is due to be made by NHS England with regard to the recruitment of additional Pharmacists in the area. A network approach is in train to work across the locality. To be included on the agenda for Council of Clinical Representatives (CoCR). ACTION: CL to provide feedback as regards the progress of the newly employed Pharmacists. CL 14 practices have now submitted workforce data via Y&H HEE portal and SRCCG have requested a report with practices identified. Eastfield has committed to submitting data at the next quarter. The remaining practice has now submitted their data and it is anticipated that all SRCCG practices will be included in the next report. The information will be used to develop a 5-year recruitment plan and will work alongside capacity planning for both primary and secondary care. Discussions took place regarding the structure of practice staff. Primary Care at Scale to be discussed within the private meeting agenda Risks remain in primary care regarding the number of GP vacancies. It was noted that there was no interest received from potential candidates in response to advertisements for GPs either on NHS jobs or in journals. Discussions took place regarding multi-role working across primary and secondary care and the committee supported the approach of joint working with GP and specialist roles being offered at the time of recruitment. Training requirements were discussed and the implications for the employee and career options at the end of the training. Capital bids as discussed above. CL reported back from the SystmOne National User Group Conference. Useful topics were discussed including the Frailty model, summary care record information for other providers and GPs to access the information as required. The information and feedback will inform the PCDG IM&T work stream. The Committee noted the comments and actions above. PCCC/16/36 Risk Register See appended document. New risk A risk has been identified with regard ETTF practice bids not being successful. PCCC/16/37 Progress and Exception Report to the Governing Body ACTION: AH to compile the report as required. AH PCCC/16/38 Any Other Business CL requested assurance on the process and responsibility for Contract Management of services from Public Health, in particular the smoking cessation service, Tier 2 weight management service and life style services. Concerns have been raised by PM about the criteria for delivery of these services and the checks that are in place for 5 P a g e
monitoring delivery and effectiveness of services. JL reported that Aoife Healy and Jenny Loggie are the contacts for these services and for smoking cessation it would be Emma Davis. Should Practice Managers have a query then they could contact the above. Work is ongoing with Scarborough residents with these services and the outreach programmes. JL will report back to NYCC issues as discussed. It was noted that there could be improvements in how practices and NYCC can work more closely JL confirmed that there is a toolkit which links with SystmOne although it was considered onerous and it was noted there has been some duplication of patient reporting. A suggestion was made for a Public Health representative to attend the Practice Managers group. Date and time of next meeting: 24 August 2016 6 P a g e
Meeting attendee list 2016-17 Job title April June Aug Oct Dec Feb Chair- Lay member for Patient and Public Engagement AH AH Vice Chair- Lay member for Audit and Governance PH PH GP PG PG GP Scarborough KH KH GP Ryedale GB GB Primary Care Manager and Lead CL CL Chief Officer SC SC Chief Finance Officer RM VB Executive Nurse CW X Associate Director of Corporate Affairs SB SB Nurse Primary Care representative X SR Healthwatch representative X NA NYCC representative CB JL LMC representative DL X 7 P a g e