NHS Kernow - Disclosure Log Freedom of Information Requests September 2017
Contents Clinical Management... 3 FOI 62570 - First Contact Physiotherapy... 3 Continuing Healthcare... 4 FOI62530 Agency Staff... 4 FOI 62540 - Staffing and Assessments... 4 FOI 62680 - Spend... 5 FOI 62670 - Funding... 6 FOI 62730 Applications for funding... 7 FOI 62870 Operation and Staffing... 8 Contracts... 10 FOI 62890 Out of Hours GP Provision... 10 FOI 63030 Non-Emergency Patient Transport... 10 Information Governance... 11 FOI 63040 Subject Access Requests... 11 Mental Health and Learning Disabilities... 12 FOI 62900 Probation Service Clients... 12 Miscellaneous... 13 FOI 62610 - GP Systems... 13 Organisation... 13 FOI 62810 Staff WiFi... 13 FOI 62820 Shaping Our Future... 14 FOI 63010 Annual Report... 14 Prescribing and Pharmacies... 15 FOI 62520 Metrogel... 15 The information supplied to you continues to be protected by the Copyright, Designs and Patents Act 1988. You are free to use it for your own purposes, including any non-commercial research you are doing and for the purposes of news reporting. Any other re-use, for example commercial publication, would require the permission of the copyright holder. Most documents supplied by NHS Kernow Clinical Commissioning Group will have been produced by local officials and will be our copyright. Information you receive which is not subject to our copyright continues to be protected by the copyright of the person, or organisation, from which the information originated. You must ensure that you gain their permission before reproducing any third party information. All appendices for this disclosure log are available upon request by emailing KCCG.FOI@nhs.net with the appropriate FOI reference below. 2
Clinical Management FOI 62570 - First Contact Physiotherapy Please tell us about first contact physiotherapy roles in General Practice in the areas covered by NHS Kernow CCG by answering the following: 1(a) Please confirm/deny whether the areas covered by NHS Kernow CCG has any first contact physiotherapists in General Practice a) NHS Kernow does not have any first contact physiotherapists in General Practice yet but we will soon be running a pilot with two practices in East Cornwall. 1(b) If yes to Request 1(a) please confirm/deny whether this is a pilot b) This will be a pilot. 1(c) If yes to Request 1(a) please confirm/deny whether it is a permanent part of the service c) N/A 1(d) If yes to Request 1(b) please confirm/deny whether you have plans to roll out the pilot to other GP surgeries in the areas covered by NHS Kernow CCG d) We will review the results after 3 months to see if we will roll out the pilot. Please tell us about how first contact physiotherapy roles in General Practice in your area are funded by answering the following: 2(a) If yes to Request 1 (a) please confirm/deny whether this is funded all or in part by NHS Kernow CCG a) There is no additional funding for the period of the pilot. The evaluation will determine whether additional funding is required for this new way of working. 2(b) If yes to Request 1 (a) please confirm/deny whether this is funded all or in part by individual GP practice (s) a GP federation (s) or GP cluster (s) b) N/A 2(c) If yes to Request 1 (a) please confirm/deny whether this is funded all or in part from temporary funding c) N/A 2(d) If yes to Request 2 (c) please specify what this source of funding is (name of the fund) d) N/A 3. Please tell us more about which services are utilising first contact physiotherapists by answering the following: 3
3(a) If yes to Request 1 (a) please provide the name of GP practices, GP federations and GP clusters in the areas covered by NHS Kernow CCG, that have first contact physiotherapists working in General Practice a) The pilot will take place with 2 GP practices in East Cornwall Oak Tree Surgery and Tamar Valley Health 3(b) If yes to Request 1 (b) please provide the name of the physiotherapy provider who delivers a service that has a first contact physiotherapist working in General Practice b) The physiotherapy provider for the pilot is Cornwall Partnership Trust Continuing Healthcare FOI62530 Agency Staff 1. How much the organisation has spent on agency nursing staff to work within Continuing Healthcare? A. NHS Kernow does not use agency nursing staff for Continuing Healthcare, therefore our spend was 0. 2. If possible please can you break this down by financial year? I.e. 2015-2016, 2016-2017 A. N/A 3. Please can you also confirm which agencies have been used during this period? A. N/A FOI 62540 - Staffing and Assessments 1. Who is the service lead/manager responsible for CHC and NHS Funded Nursing Care assessments? A. The director for the service is Gordon Frame. 2. How many permanently contracted nurse assessors are employed by the CCG? A. 23.97 whole time equivalent 3. Has the CCG contracted external providers/staffing agencies to complete CHC and Funded Nursing Care assessments? A. No 4. How long was the contract for? A. N/A 5. What was the total value of this contract? 4
A. N/A 6. How many CHC or NHS Funded Nursing Care assessments were completed under this contract? A. N/A 7. How many CHC or NHS Funded Nursing Care Assessments were not completed within the advised 28 days from referral for 2017 so far and in total for 2016? A. NHS Kernow average 70% completion within 28 days, we are unable to give accurate numbers until our current data cleanse is complete. 8. How many Fast Track CHC or NHS Funded Nursing Care assessments have been completed for 2017 so far and in total for 2016? 2016 2017 (up to end of July Fast Track 1425 1024 Decision Support Tools requiring assessment 799 516 Please note that the figures above do not include FNC as this data is not currently captured. 9. How many CHC and NHS Funded Nursing Care assessments does the CCG currently have outstanding? A. The data currently held by NHS Kernow identifies 110 assessments which are outstanding for January to July 2017. However NHS Kernow is aware that this information may not be accurate due to current data cleansing which has identified errors in recording. 10. Does the CCG commission any other NHS or Local Authority bodies to undertake CHC or NHS Funded Nursing Care assessments? A. No 11. Does the CCG have any plans to engage external providers/staffing agencies to support with CHC and NHS Funded Nursing Care assessments? A. No FOI 62680 - Spend Please provide the following information: 1) The total spend on CHC for each CCG over the last 5 financial years. NHS Kernow was formed on 1 April 2013 and cannot provide information relating to the former primary care trust (2012 to 2013). Please contact the Department of 5
Health s legacy team to request this information: reviews&informationteam@dh.gsi.gov.uk. 1) Total CHC spend Financial year Total CHC spend 2013/14 41.413m 2014/15, 40.876m 2015/16, 45.475m 2016/17 51.170m 2017/18 (year to date) 24.050m September 2017 2) CHC spend split by the following for the last 5 financial years: Financial year CHC spend on - Mental Health CHC spend on - Learning Disability / Autism Spectrum Disorder CHC spend on - Acquired Brain Injury 2013/14 17.771m 7.324m Unknown 2014/15, 15.974m 6.237m Unknown 2015/16, 15.826m 7.910m Unknown 2016/17 15.613m 9.426m Unknown 2017/18 (year to date) September 2017 6.967m 4.230m Unknown NHS Kernow do not code spend relating to Acquired Brain Injury and therefore cannot provide the information you request. FOI 62670 - Funding How many people applied to your CCG for continuing healthcare funding between 2013 present 2014/15 2,655 2015/16 3,519 2016/17 3,773 6
1. Of these, how many are successful in being granted the funding between 2013 present 2014/15 2,417 2015/16 3,272 2016/17 3,419 2. Of these, how many were unsuccessful between 2013 present 2014/15 238 2015/16 247 2016/17 354 Due to a change in recording software NHS Kernow are unable to supply information for 2013/14 3. Of the cases that were unsuccessful, how many asked for the CCG to review their application for funding between 2013 present? How many of these reviews found in favour of the applicant? And 4. How many cases were transferred to an independent review panel between 2013- present? How many of the independent reviews found in favour of the applicant 1/4/13 to 31/03/14 1/4/14 to 31/03/15 01/04/15 to 31/03/16 01/04/16 to 31/03/17 number of appeals received 11 26 16 8 number successful 1 12 2 1 number to NHSE 5 1 6 3 number successful at NHSE 1 0 0 0 FOI 62730 Applications for funding 1. How many applications were made for Continuing Healthcare for people over 90 between 1-4-2013 and 1-8-2017? A. 2518 2. How many of these applications were successful? A. 1540 3. How many of these unsuccessful applications went to Local Appeal? A. 8 4. How many of these applications were successful at Local Appeal? A. Outcome not recorded 7
5. How many of the applications between 1-4-2013 and 1-8-2017 were retrospective applications? A. 50 6. How many of these retrospective applications were successful? A. Part of period= 11 Whole of period= 19 7. How many of those unsuccessful retrospective applications went to NHS England? A. 14 8. How many of those that went to Appeal at NHS England were successful? A. 0 9. What specific qualifications does the Nurse Assessor Samantha Sandercock have that qualifies her for her post? A. The information you have requested is personal to the individual and therefore NHS Kernow exempt the release of this information under Section 40(2) of the Freedom of Information Act; Personal Information: Someone else s personal data. However NHS Kernow can confirm that it ensures all members of staff receive appropriate training in order for them to carry out their duties effectively and within the regulations relating to their employment. 10. What is the structure of the Line Management supervising the Nurse Assessor Samantha Sandercock? A. The line management of the post is as follows CHC Senior Co-ordinator, CHC General Manager. The director with responsibility for this area of business is Gordon Frame, Director for Integrated Care Community. 11. What are the names and qualifications of those involved in the Line Management in charge of assessment. A. NHS Kernow does not release the names of individuals below director level. The director with responsibility for this area of business is Gordon Frame BSc Hons. MBA 12. How many appeals for Continuing Healthcare Funding commenced or continued after the death of the applicants? A. 22 FOI 62870 Operation and Staffing 1. Is your CHC process managed in-house? Or is part or all of the process outsourced to a 3rd party (e.g. CSU, Local Authority, Independent provider)? If outsourced, please state the name of the organisation and the services outsourced (all CHC, assessment, brokerage, invoice validation etc.) 8
A. NHS Kernow manage the CHC process in-house 2. Please provide the name and contact details for your head of CHC. A. The director with the responsibility for Continuing Healthcare is Gordon Frame 01726 627800 3. How many staff are engaged (including employees, contractors and agency staff) in managing your CHC process? Please indicate how many staff are involved with (a) managing patients and (b) managing finances. A. There are a total of 52.45 whole time equivalent (WTE) of which 11.8 WTE are administrative and 40.65 WTE are clinical. All employed by NHS Kernow. NHS Kernow Clinical staff support the eligibility process, they do not manage patients. B. In addition to the above, there is 1 wte Finance Manager and 3 wte finance officers 4. How many active CHC funding appeals are you currently processing? A. At present we have 14 active CHC appeals. 5. How many funding assessments are currently awaiting completion? A. 109 assessments are currently awaiting panel review. 6. In financial year 16/17 what was the average number of days from completion of DST assessment to commissioning active provision? A. NHS Kernow do not currently have the information you have requested, it is something which is in development. 7. In financial year 16/17 what was your total CHC spend? A. 51.170m 8. Does the CCG use any third party technology solutions to record patient information relating to CHC (Broadcare, Swift, Caretrack, QA Plus etc.)? If so, which solution(s)? If not how is this information recorded? (e.g. Excel) A. NHS Kernow uses Broadcare to record patient information 9. Does the CCG use any third party technology solutions to record financial information (Broadcare, Caretrack, QA Plus etc.)? If so, which product(s)? If not, please advise how are invoices validated against care package details? A. NHS Kernow uses Broadcare and Oracle to record financial information 9
10. What is the renewal date of your current third party technology solution? A. The renewal date is April 2018 Contracts FOI 62890 Out of Hours GP Provision If the NHS Kernow CCG is the lead commissioner for GP out of hours services provider, please respond to the following: 1) What is the geographical patch you commission GP out of hours services for and how many patients does this cover? A. NHS Kernow commissions out of hours GP services for the county of Cornwall with a population of 500,000. 2) What is the name of the current provider of GP out of hours services for this patch? A. Cornwall Health Ltd 3) How many errors and serious incidents (or equivalent) were reported to the CCG relating to GP out of hours services, in the following: a. 2015-0 b. 2016-1 c. 2017 to date (January to September) 2 4) Please provide copies of any reports on the service s safety that have been produced in this period. A. NHS Kernow does not hold the information you have requested. 5) If the CCG does not collect this information, please set out how it records and evaluates is the safety of the service, and provide any information collected that supports this. Within the Commissioned contract we have a quality schedule (attached); in addition we participate in end-to-end reviews and are members of the Out of Hours Clinical Governance meetings, this covers complaints, serious incidents, incidents, nearmisses. FOI 63030 Non-Emergency Patient Transport 10
1. Does the CCG operate a Non-Emergency Patient Transport Service (NEPTS) If not, is a NEPTS service currently being considered A. Yes, we currently commission this service. 2. Does the CCG operate the NEPTS service with other CCGs if so which CCGs? A. No the service is for Cornwall and Isles of Scilly patients only. 3. Is NEPTS Health Care Professional (HCP) or Patient Led Booking (PLB) or both: Please answer:- A. Both. There is a Centralised booking Service based at Royal Cornwall Hospitals Trust (RCHT) that arranges transport for those with a medical need. First Bookings are usually patient led, whilst subsequent bookings are HCP led. 4. If the NEPTS service is wholly or partly PLB: a. What date was this introduced? i. This has been in place since the beginning of the CCG in April 2013 b. Has PLB caused an increase in activity? (Yes/No) i. The CCG doesn t collect this information, you would need to contact the centralised booking service at RCHT rchtr.foi@nhs.net c. Which mobility categories have been most affected? i. The CCG doesn t collect this information, you would need to contact the centralised booking service at RCHT rchtr.foi@nhs.net Information Governance FOI 63040 Subject Access Requests 1. How many subject access requests did you receive the identifying paperwork for and process in 2014? A. For the year 2014/15 we received 8 requests 2. How many subject access requests did you receive the identifying paperwork for and process in 2015? A. For the year 2015/16 we received 8 requests 3. How many subject access requests did you receive the identifying paperwork for and process in 2016? A. For the year 2016/17 we received 4 requests 11
4. How many subject access requests you rejected in 2014? A. 0 5. How many subject access requests you rejected in 2015? A. 0 6. How many subject access requests you rejected in 2016? A. 0 7. What was the average cost for you to process a subject access request in 2014? 8. What was the average cost for you to process a subject access request in 2015? and 9. What was the average cost for you to process a subject access request in 2016? A. NHS Kernow does not hold the information you have requested for Questions 7-9 10. How much do you charge an individual to process a subject access request? A. NHS Kernow does not charge an individual to process a subject access request Mental Health and Learning Disabilities FOI 62900 Probation Service Clients 1. What health services does the CCG commission specifically for probation service clients (those seen by the National Probation Service, Community Rehabilitation Companies, or housed in probation Approved Premises) for: A) Mental health Mental health services are accessible to anyone who meets the relevant criteria in terms of a mental health conditions, irrespective of probation status. B) Physical health Physical health services are accessible to anyone who meets the relevant criteria in terms of a mental health conditions, irrespective of probation status. 2. Does the CCG facilitate access to mainstream (non-offender-specific) healthcare for probation service clients in any way (e.g. directly making probation staff aware of the services that it commissions and referral procedures)? If so, please could you describe how you do this? All services are accessible irrespective of probation status as above. Probation colleagues are invited to a number of multi-agency forums. Mental Health Commissioner and providers are working closely with the multi-agency Peninsula CLCJB Partnerships group to ensure that services are accessible and delivered in a timely fashion for all those who present with a Mental Health condition, and that 12
providers work in strong collaboration to meet the needs of those in the criminal justice system. Miscellaneous FOI 62610 - GP Systems 1. What Clinical system is used in your GP practices? (EMIS, SystemOne, Vision) etc. A. The clinical systems used by GP practices are Microtest, Emis and System one. Organisation FOI 62810 Staff WiFi 1. Wi-Fi Provider- Who is the contracted supplier for the Wi-Fi contract. A. The Wi-Fi provider for NHS Kernow is Cornwall IT Services, also known as CITS. 2. Average Annual Spend Please state the annual average spend over three years for each supplier. If this is a new contract please state the estimate annual average spends. If there is more than one Wi-Fi provider please split annual for each individual provider. A. NHS Kernow s annual spend is approximately 250,000 3. Number of Wi-Fi Users- Please state the number of users the Wi-Fi contract is in place for. An estimate number of users will also be acceptable. If there is more than one Wi-Fi provider please state the number of users for each individual provider. A. NHS Kernow do not hold this information as this forms part of a wider service level agreement. 4. What is the contract Type: 1. WiFi= WiFi contract, 2. Managed=Part of a larger contract, 3. In-house=is the Wi-Fi managed and maintained in-house. A. Managed=Part of a larger contract 5. Number of Locations/Site- I require the number of locations/sites the Wi-Fi contract is contracted for. If there is more than one Wi-Fi provider please state the number of sites for each individual provider. A. This is a corporate network 6. End User Offer- What the Wi-Fi offers to the end users e.g. Unlimited, Pay as you go, free 1 hour access or just free access. If there is more than one Wi-Fi provider please state the number of sites for each individual provider. A. Unlimited 7. Manufacturer Name/Brand- Please provides me with the brand names of the Wi-Fi equipment which many include manufacturers of the access points and 13
routers. If there is more than one Wi-Fi provider please state the Manufacturers Name for each individual provider. A. Cisco 8. Contract Description- Please provide me with a brief description of the solution in place for Wi-Fi and any other services provided under the contract. If there is more than one Wi-Fi provider please state the contract description for each individual provider. A. This is part of wider IT support service level agreement. 9. Actual Contract Start Date- Please can you state the Start date of the contract. If there is more than on Wi-Fi provider please split contract dates for each individual provider. A. This is part of a rolling contract as CITS is a preferred NHS provider 10. Actual Contract Renewal/Expiry Date- Please can you state the renewal/expiry date of the contract. If the contract is coming up for renewal if possible please state the likely outcome of the Wi-Fi contract. A. This is part of a rolling contract as CITS is a preferred NHS provider FOI 62820 Shaping Our Future 1. Please can I have a copy of the Shaping Our Future Transformation Board "Expression of Interest" to become a first wave Accountable Care System. This document was submitted to central government and is referenced in the minutes of the 24th May 2017 meeting of the board. A. In Cornwall and the Isles of Scilly, we expressed an interest to NHS England in May 2017 to become a first wave Accountable Care System in line with our aspirations to support integration and improvement in local services. A copy of our expression of interest to NHS England is attached. Whilst NHS England continue to support us in making progress towards establishing an Accountable Care System, in line with the intentions set out in the Expression of Interest, we were not selected as a first wave ACS. 2. Please can I also have a copy of central government's reply. A. We received positive feedback on our application verbally from NHS England, but we did not have a formal response from central government. FOI 63010 Annual Report 1. Please advise me what % of requests for copies annual reports you respond to within 28 days between 1/10/16 to 30/9/17 A. On 28 September 2017 NHS Kernow received an email from a member of the public requesting a printed copy of the CCG s latest annual report. 14
We have responded to inform the requestor that the CCG has never printed copies of the annual report as part of a drive to reduce costs and wastage. The annual report is published on the CCG s website. Since the CCG s formation in 2013, the organisation has never received any requests for a printed copy. Prescribing and Pharmacies FOI 62520 Metrogel 1) How many prescriptions have been written in the past 12 months within the CCG for Metrogel (metronidazole 0.75% w/w)? 2) How many of these prescriptions for Metrogel were for the licensed indication of the treatment of acute inflammatory exacerbation of rosacea? 3) How many of these prescriptions for Metrogel were for the licensed indication of the deodorisation of the smell associated with malodorous fungating tumours? 4) How many prescriptions have been written in the past 12 months within the CCG for a licensed indication of the treatment of acute inflammatory exacerbation of rosacea? 5) How many prescriptions have been written in the past 12 months within the CCG for a licensed indication of the smell associated with malodorous fungating tumours? A. NHS Kernow does not hold the information you are requesting above, please contact NHS Business Service Authority as follows: https://www.nhsbsa.nhs.uk/contact-us/freedom-information who may be able to assist. 15