NHS Kernow Disclosure Log Freedom of Information Requests May 2015

NHS Kernow Disclosure Log Freedom of Information Requests May 2015

Contents FOI47250 - Contracts - Pathology services... 3 FOI47260 - Organisation - ICT documents... 3 FOI47280 - Prescribing & pharmacies - Rebate schemes... 4 FOI47300 - Contracts - GP services... 6 FOI47330 - Long term conditions - Diabetes foot problems... 6 FOI47340 - Contracts - Wound therapy devices... 6 FOI47390 - Prescribing & pharmacies - Rebate schemes... 7 FOI47420 - Mental health & learning disabilities - Budget and referrals... 9 FOI47470 - Mental health and learning disabilities - Personal Health Budgets... 11 FOI47480 - Contracts - End of life care services... 12 FOI47490 - Finance & budgets - Organisational spend... 13 FOI47500 - Finance & budgets Reminder services... 18 FOI47510 - Long term conditions - Pain services... 19 Appendix - FOI47330... 21 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.

FOI47250 - Contracts - Pathology services Date received: 05/05/2015 1. The total CCG budget for the financial year 2014-2015. A. NHS Kernow s budget for 2014/15 will be published in its annual report in June. We therefore exempt the release of this information under section 22 of the Freedom of Information Act, information intended for future publication. 2. The total spent on Pathology services during 2014-2015 (primary care only). If you are in a position to supply this - the total unit activity of Pathology services in the financial year 2014-2015 (primary care only). A. Provider Activity Value ( ) Unit Prices ( ) Plymouth Hospitals NHS Trust (PHNT) 797830 987993.491 1.24 Royal Devon and Exeter NHS Foundation Trust (RDE) Northern Devon Healthcare Trust (NDHT) 233373 322997 1.38 North Bristol NHS Trust (NBT) 103 371.32 3.61 University Hospitals Bristol NHS Trust (UHBT) Total 3207385 7204905.94 2.25 Please note that data for Royal Devon and Exeter NHS Foundation Trust and University Hospitals Bristol NHS Trust has been excluded as there is not a direct access to pathology. With regards to Royal Cornwall Hospital information, Cornwall s pathology service is being re-procured. Due to this timing, the release of this information would prejudice the provider s commercial interests. We therefore exempt the release of this information under section 43 (1), trade secrets and 43 (2) of the Freedom of Information Act, commercial interests In reaching this conclusion we have carried out a public interest test and, whilst recognising the need for being open and transparent, we believe this is outweighed by concerns that, as the provider of pathology services in Cornwall, the release of this information we will prejudice Royal Cornwall Hospital Trust s ability to conduct a fair procurement and compromise NHS Kernow s ability to secure a high quality service which offer value for money for the population of Cornwall. FOI47260 - Organisation - ICT documents Date received: 05/05/2015 1. Please supply NHS Kernow s ICT Strategy, including the future plan and strategy of the organisation s ICT department. 3

A. NHS Kernow is developing its strategy, which is currently in draft format after the recent NHS five year plan release. We are unable to share a draft strategy and exempt this information under Section 22 of the Freedom of Information Act, information intended for future publication. 2. Please supply NHS Kernow s ICT Departmental Business Plan 3. Please supply NHS Kernow s ICT Technical Strategy. A. NHS Kernow is developing its departmental business plan, which is currently in draft format after the recent NHS five year plan release. We are unable to share a draft business plan and exempt this information under Section 22 of the Freedom of Information Act, information intended for future publication. 4. Please supply NHS Kernow s ICT structure A. NHS Kernow s ICT team comprises of six employees, who are managed by Simon Gittoe Davies, Chief Finance Officer. 5. Please supply NHS Kernow s ICT capital budgets and programmes. If you feel that your organisation or the department hold other documents that relate to my request or the document above please send them accordingly. A. NHS Kernow is developing its capital budget and programmes schedule. We are unable to share a draft budget and programme and exempt this information under Section 22 of the Freedom of Information Act, information intended for future publication. 6. Lead member: Cabinet Member for ICT and Telecommunications come under? Please can you provide me with their direct contact details including their Full Name, Actual Job Title, Contact Number and Direct Email Address? A. NHS Kernow s ICT and telecommunications team is managed by Simon Gittoe Davies, Chief Finance Officer. His email is simon.gittoesdavies@nhs.net and the telephone number is 01726 627966 FOI47280 - Prescribing & pharmacies - Rebate schemes Date received: 06/05/2015 1. Please confirm or deny that the CCG/ Health Board has primary care rebate contracts for a) Medicines b) ACBS products c) Devices A. We can confirm NHS Kernow has primary care rebate contracts in place for medicines. 4

2. Please confirm or deny that the CCG/Health Board is in receipt or has rebate agreement or discounts for anticoagulants A. Yes. 3. Please confirm which products the CCG/ Health Board has rebate agreements or discounts for. A. We can confirm that NHS Kernow has pricing agreements in place with: Boehringer Ingelheim Limited for Pradaxa. Bayer for ivaroxaban (Xarelto) NHS Kernow also has a pricing agreement in place with DB Ashbourne Ltd for one or more of its products. We have contacted the provider about releasing details of its products and we are unable to confirm these details as DB Ashbourne has confirmed these details are commercially sensitive and would prejudice its ability to compete in a commercial environment. We therefore exempt the release of this information under section 42 (2) of the Freedom of Information Act, commercial interests. In reaching this conclusion we have carried out a public interest test and, whilst recognising the need for being open and transparent, we believe this is outweighed by concerns that by releasing this information we will damage DB Ashbourne s ability to operate in a competitive market and NHS Kernow s ability to get value-for-money for these specific products. 4. Please confirm or deny if the CCG/Health Board has a policy that refers to PrescQIPP or LPP or any other body to review of a rebate scheme in order to enter into a rebate contract. Please specify which body or organisation. A. NHS Kernow does not have a policy that refers to PrescQIPP or LPP or any other body to review of a rebate scheme in order to enter into a rebate contract 5. Please confirm or deny the availability of a rebate policy for the CCG/Health Board and where this can be accessed or whether a policy is in development. A. NHS Kernow does not have a policy that refers to PrescQIPP or LPP or any other body to review of a rebate scheme in order to enter into a rebate contract 6. Please confirm the number of rebate or discount contracts that the CCG/Health board has entered into in the last 12 months for: a) Medicines b) ACBS products c) Devices A. NHS Kernow has four rebate contracts in place for medicines. 5

FOI47300 - Contracts - GP services Date received: 07/05/2015 1. Please note that there was an error in the FOI request I submitted to NHS Kernow CCG on Tuesday 28 April. Please may I make the following FOI Act request for information: What was the total Personal Medical Services (PMS) budget spent on GP practice members in 2013/14 and 2014/15 respectively? What is the total PMS budget for 2015/16 for GP practices that are members of NHS Kernow CCG? How many PMS contracted GP practices were members of NHS Kernow CCG on 31 March 2013; 31 March 2014; and 31 March 2015 respectively? Over how many years is premium PMS funding being phased out in NHS Kernow CCG area? A. NHS Kernow does not commission personal medical services and does not have the information you have requested. Please contact NHS England, which commissions GP services. Please email england.contactus@nhs.net. FOI47330 - Long term conditions - Diabetes foot problems Date received: 13/05/2015 1. In the financial year 2015/16, does NHS Kernow have an established pathway for referral to a designated Foot Protection Service for all people with diabetes who are defined as being at increased risk of foot ulcers during annual foot risk surveillance? A. Yes, NHS Kernow does have an established pathway for podiatry. Please find attached a copy of the pathway. FOI47340 - Contracts - Wound therapy devices Date received: 13/05/2015 1. How many Negative Pressure Wound Therapy Devices did the Trust use in 2014? 2. Do you currently have a contract for Negative Pressure Wound Therapy Devices? 3. If the answer is yes for the above: 4. Who is this contract with? 5. What was the contract start date? 6. What is the contract due to expire? 7. With reference to the above question, are these devices owned or rented? 8. If rented, please specify the amount the Trust spent on renting Negative Pressure Wound Therapy Devices in 2014? 9. What was the Trust spend on Negative Pressure Wound Therapy Consumables for the period of 2014? 6

10. How much did the Trust spend on replacing lost Negative Pressure Wound Therapy Devices in 2014? 11. How much did the Trust spend on warranty and servicing of Negative Pressure Wound Therapy Devices in 2014? 12. In 2014, how many patients were reported as delayed discharge and can you supply this data at department level with the total number of days delayed discharge? A. NHS Kernow does not have the information you have requested. Please consider contacting Royal Cornwall Hospital NHS Trust (foi.rcht@cornwall.nhs.uk) or Peninsula Community Health (pch.foi@pch-cic.nhs.uk), which may have the information you have requested. FOI47390 - Prescribing & pharmacies - Rebate schemes Date received: 19/05/2015 1. Could you please provide me with the details of any prescribing rebate schemes and QIPP prescribing schemes active within your CCG during the financial year 2014/15 for Primary Care Prescribing Rebate Schemes Name of Scheme Drug(s) covered Companies involved in the scheme Medicines rebate scheme Pradaxa. Boehringer Ingelheim Limited Medicines rebate Rivaroxaban (Xarelto) scheme Insulin rebate scheme Apidra Insulin rebate scheme Insuman Bayer Sanofi Sanofi Medicines rebate scheme We have contacted the provider about releasing details of its products and we are unable to confirm these details as the provider has confirmed these details are commercially sensitive and would prejudice its ability to compete in a commercial environment. We therefore exempt the release of this information under section 42 (2) of the Freedom of Information Act, commercial interests. NHS Kernow has a pricing agreement with DB Ashbourne Ltd for one or more of its products. 7

Name of Scheme Drug(s) covered Companies involved in the scheme In reaching this conclusion we have carried out a public interest test and, whilst recognising the need for being open and transparent, we believe this is outweighed by concerns that by releasing this information we will damage DB Ashbourne s ability to operate in a competitive market and NHS Kernow s ability to get value-for-money for these specific products. 2. What was the total income for the CCG from rebates during 2014/15? A. NHS Kernow is unable to provide this information as rebates are still being claimed. We therefore exempt this information under section 22 of the Freedom of Information Act, information intended for future publication. 3. Could you please provide me with the details of any prescribing rebate schemes and QIPP prescribing schemes active within your CCG during the financial year 2014/15 for QIPP Prescribing Schemes Name of Scheme Medicines rebate scheme Medicines rebate scheme Medicines rebate scheme Drug(s) covered Pradaxa. Rivaroxaban (Xarelto) NHS Kernow also has a pricing agreement in place with DB Ashbourne Ltd for one or more of its products. We have contacted the provider about releasing details of its products and we are unable to confirm these details as DB Ashbourne has confirmed these details are commercially sensitive and would prejudice its ability to compete in a commercial environment. 8

Name of Scheme Drug(s) covered We therefore exempt the release of this information under section 42 (2) of the Freedom of Information Act, commercial interests. In reaching this conclusion we have carried out a public interest test and, whilst recognising the need for being open and transparent, we believe this is outweighed by concerns that by releasing this information we will damage DB Ashbourne s ability to operate in a competitive market and NHS Kernow s ability to get value-for-money for these specific products. FOI47420 - Mental health & learning disabilities - Budget and referrals Date received: 21/05/2015 1. The name of your Clinical Commissioning Group? A. NHS Kernow Clinical Commissioning Group. 2. In the following financial years how much money has your CCG allocated to mental health services NOT including services for dementia? a) 2013/14 b) 2014/15 c) Projected budget for 2015/16 A. NHS Kernow is unable to provide this information as we do not record it in the format you have requested. Dementia care is an important component of a holistic mental health service for our population and we do not routinely attempt to differentiate the costs of this element from the overall delivery of mental health services. 3. What percentage of the total annual budget of the CCG went to mental health services NOT including services for dementia in the following years? a) 2013/14 b) 2014/15 c) Projected budget for 2015/16 A. NHS Kernow is unable to provide this information as we do not record it in the format you have requested. Dementia care is an important component of a holistic mental health service for our population and we do not routinely attempt to differentiate the costs of this element from the overall delivery of mental health services. 9

4. How many adult patient referrals for mental health did your CCG commission treatment for in the following years (not including dementia treatment) a) 2013/14 b) 2014/15 c) Projected number for 2015/16 A. NHS Kernow does not hold the information you have requested. Please contact Cornwall Partnership NHS Foundation Trust, which we commission to provide mental health services, to request this information: cpntr.freedomofinformation@nhs.net. 5. In the following financial years how much money has your CCG allocated to child and adolescent mental health services? a) 2013/14 b) 2014/15 c) Projected budget for 2015/16 A. NHS Kernow is undertaking a procurement of its children s and adolescent services and is therefore unable to provide details of how much is spent on these services. We therefore exempt the release of this information under section 43 (2) of the Freedom of Information Act, commercial interests. In reaching this conclusion we have carried out a public interest test and, whilst recognising the need for being open and transparent, we believe this is outweighed by concerns that, as a commissioner of children s and adolescent services, the release of this information during a procurement will prejudice NHS Kernow s ability to conduct a fair procurement and compromise its ability to secure a high quality service which offer value for money for the population of Cornwall. 6. What percentage of the total annual budget of the CCG went to child and adolescent mental health services in the following years? a) 2013/14 b) 2014/15 c) Projected budget for 2015/16 A. NHS Kernow is undertaking a procurement of its children s and adolescent services and is therefore unable to provide details of how much is spent on these services during 2013/14. We therefore exempt the release of this information under section 43 (2) of the Freedom of Information Act, commercial interests. In reaching this conclusion we have carried out a public interest test and, whilst recognising the need for being open and transparent, we believe this is outweighed by concerns that, as a commissioner of children s and adolescent services, the release of this information during a procurement will prejudice NHS Kernow s ability to conduct a fair procurement and compromise its ability to secure a high quality service which offer value for money for the population of Cornwall. 10

7. How many child and adolescent patient referrals for mental health did your CCG commission treatment for in the following years? a) 2013/14 b) 2014/15 c) Projected number for 2015/16 A. NHS Kernow does not have the information you have requested. Please contact Cornwall Partnership NHS Foundation Trust, which we commission to provide mental health services, to request this information: cpntr.freedomofinformation@nhs.net. FOI47470 - Mental health and learning disabilities - Personal Health Budgets Date received: 22/05/2015 1. Who is NHS Kernow s lead for Personal Health Budgets for Kernow CCG? A. Sue Smith, Programme Director for Delivery. 2. I also request who is in charge of Personal Health Budgets for people with Mental Health Disabilities? A. Sue Smith, Programme Director for Delivery. 3. I would like to know if records are kept of meetings held by commissioners at Kernow CCG about a particular patient, and if so is this information then recorded as part of the patients NHS medical record? If so, how does a patient access this information such as who attended the meeting and how decisions were made? A. Minutes of meetings where a patient s needs are discussed are not recorded on their NHS medical record. Anyone can request to see their NHS medical record or request a specific organisation to release information held about them by requesting a subject access request. This may include, for example, information recorded in the minutes of a meeting. Information may be redacted if it contains personal information that relates to another person. Under the right of subject access, anyone is entitles only to their own personal data, and not to information relating to other people (unless they are acting on behalf of that person). Neither are they entitled to information simply because they may be interested in it. Subject access provides a right to see the information contained in personal data, rather than a right to see the documents that include that information. The organisation has 40 calendar days to respond to your request. 11

To request a subject access request from NHS Kernow, please contact Peninsula Community Health pch.subjectaccessrequests@pch-cic.nhs.uk for details. Requests cannot be made by telephone. Details about what information you are entitled to is published on the Information Commissioner s website at https://ico.org.uk/for-organisations/guide-to-dataprotection/principle-6-rights/subject-access-request/. FOI47480 - Contracts - End of life care services Date received: 27/05/2015 1. What is the name of the CCG/CCGs you will provide information for? A. NHS Kernow. 2. In the following financial years how much of the CCG budget has been allocated/commissioned to palliative/end of life care services? a) 2013/14 b) 2014/15 c) Projected budget for 2015/16 a) 2013/14: 4.5 million. b) 2014/15: 5.5 million. c) Projected budget for 2015/16. NHS Kernow has not finalised its budget for 2015/16 and is therefore unable to provide you with this information. 3. What percentage of the total annual budget of the CCG went to palliative/end of life care services in the following years? a) 2013/14 b) 2014/15 c) Projected budget for 2015/16 a) 2013/14: 0.65 per cent b) 2014/15: 0.78 per cent c) Projected budget for 2015/16. NHS Kernow has not finalised its budget for 2015/16 and is therefore unable to provide you with this information. 4. If possible, please outline briefly what services the CCG has commissioned for end of life/palliative care with the projected budget for 2015/16? A. NHS Kernow has not finalised its budget for 2015/16 and is therefore unable to provide you with this information. 5. How much money in the following years did the CCG provide to hospices in their area? a) 2013/14 b) 2014/15 c) Projected for 2015/16 12

a) 2013/14: 1.4 million b) 2014/15: 1.4 million c) Projected for 2015/16: NHS Kernow has not finalised its budget for 2015/16 and is therefore unable to provide you with this information. 6. How many complaints in the following years has the CCG received relating to the end of life care/palliative care of a patient it commissions? a) 2013 b) 2014 c) So far 2015 a) 2013/2014: No formal complaints received. b) 2014-15: No formal complaints received. c) 2015-16: No complains received as of 10 June 2015. FOI47490 - Finance & budgets - Organisational spend Date received: 27/05/2015 1. What was the total spend on primary care services in 2014/15. What is the projected primary care spend in 2015/16? A. Details of NHS Kernow s spend on primary care services is published in its annual report, which is available on its website. We therefore exempt this information under section 21 of the Freedom of Information Act, information accessible by other means. Details of NHS Kernow s budget of 2015/16 has not yet been set. We therefore exempt this information under section 22 of the Freedom of Information Act, information intended for future publication. Please note the majority of primary care spent is met by NHS England. You may wish to contact them for details. Please email: england.contactus@nhs.net. 2. How much of the 2014/15 budget was attributed to organisational costs described in this request as monies for administration, salary, utilities, and rent? Is this figure set to change in 2015/16? What is the projected figure for 2015/16? A. Details of NHS Kernow s spend on organisational costs during 2014/15 is published in its annual report, which is available on its website. Please note these are reported as admin costs and NHS Kernow is subject to a cap on costs set by NHS England. We therefore exempt this information under section 21 of the Freedom of Information Act, information accessible by other means. For 2015/16, NHS Kernow has been set a cap of 12.183 million on admin expenditure by NHS England, a reduction by 10 per cent on the previous financial year. 13

3. How much of your total budget for 2014/15 was pooled with local authorities? What local authorities do you work with? Is the amount of pooled budgets set to increase in 2015/16? How much money will be pooled with local authorities in 2015/16? A. Details of NHS Kernow s spend on pooled budgets is published in its annual report, which is available on its website. We therefore exempt this information under section 21 of the Freedom of Information Act, information accessible by other means. Details of NHS Kernow s budget of 2015/16 has not yet been finalised. We therefore exempt this information under section 22 of the Freedom of Information Act, information intended for future publication. 4. What amount of monies were allocated to co-commissioning primary care services alongside NHS England in 2014/15? Is this figure set to change in 2015/16 and if so, what amount of monies allocated to co-commissioning is projected? A. NHS Kernow does not co-commission primary care services with NHS England. 5. What is your population size? A. NHS Kernow s population size during 2014/15 was 566,967. 6. How much money was allocated per individual in your population in 2014/15? What is the projected money per head in 2015/16? A. The per capita NHS allocation during 2014/15 was 1, 212. During 2015/16 it will be 1,221. 7. How much of your total budget will be spent on patient education for 2015/16? How much was spent on patient education in 2014/15? A. NHS Kernow does not record its spent in a format you have requested and is therefore unable to provide this information. 8. How much of your total budget will be spent on training for NHS workers and clinical professionals in 2015/16? How much was spent on training for NHS workers and clinical professionals in 2014/15? A. NHS Kernow spent 155,000 on staff training and development and has set aside a budget of 100,000 in 2015/16. 9. How much of your total budget will be spent on primary care property maintenance for 2015/16? How much was spent on primary care property maintenance in 2014/15? A. NHS Kernow does not have the information you have requested. Please contact NHS England for these details: Please email: england.contactus@nhs.net. 14

10. How much of your total budget will be spent on clinical research for 2015/16? How much was spent on clinical research in 2014/15? A. NHS Kernow is a commissioning organisation and has not spent any money on clinical research during 2014/15 and does not expect any spend during 2015/16. 11. How much of your total budget will be spent on children s services for 2015/16? How much was spent on children s services in 2014/15? A. Details of NHS Kernow s spend on children s services it commissions will be published in its annual accounts, which will be available later in the year. We therefore exempt this information under section 22 of the Freedom of Information Act, information intended for future publication. Details of NHS Kernow s budget of 2015/16 has not yet been set. We therefore exempt this information under section 22 of the Freedom of Information Act, information intended for future publication. 12. How much of your total budget will be spent on GP services for 2015/16? How much was spent on GP services in 2014/15? A. Details of NHS Kernow s spend on enhanced services will be published in its annual accounts, which will be available later in the year. We therefore exempt this information under section 22 of the Freedom of Information Act, information intended for future publication. Details of NHS Kernow s budget of 2015/16 has not yet been set. We therefore exempt this information under section 22 of the Freedom of Information Act, information intended for future publication. 13. How much of your total budget will be spent on pharmacy and pharmacy services for 2015/16? How much was spent on pharmacy and pharmacy services in 2014/15? A. NHS Kernow does not commission pharmacy services. Please contact NHS England, which commissions these services: Please email: england.contactus@nhs.net. 14. How much of your total budget will be spent on out-of-hours services for 2015/16? How much was spent on out-of-hours services in 2014/15? A. Details of NHS Kernow s spend on out of hours service during 2014/15 will be published in its annual accounts, which will be available later in 2015. We therefore exempt this information under section 22 of the Freedom of Information Act, information intended for future publication. On 1 June, 2015, NHS Kernow s new contract for GP out of hours services with Devon Doctors Ltd began. The contract value is 8 million a year. 15

15. How much of your total budget will be spent on optometry for 2015/16? How much was spent on optometry in 2014/15? A. Details of NHS Kernow s spend on optometry during 2014/15 will be included in its programme budget. This information is being prepared and will be published on NHS England s website, once approved. We therefore exempt this information under section 22 of the Freedom of Information Act, information intended for future publication. NHS Kernow s budget for 2015/16 has not yet been set. We therefore exempt this information under section 22 of the Freedom of Information Act, information intended for future publication. 16. How much of your total budget will be spent on dentistry for 2015/16? How much was spent on dentistry in 2014/15? A. NHS Kernow does not commission dental services. Please contact NHS England, which commissions this service: Please email: england.contactus@nhs.net. 17. How much of your total budget will be spent on physiotherapy for 2015/16? How much was spent on physiotherapy in 2014/15? A. NHS Kernow does not have the information you have requested. It commissions Peninsula Community Health to provide physiotherapy as part of a block contract to provide community services and is therefore unable to split this cost from the overall contract. Peninsula Community Health may be able to answer your question: email pch.foi@pch-cic.nhs.uk. 18. How much of your total budget will be spent on telehealth for 2015/16? How much was spent on telehealth in 2014/15? A. NHS Kernow does not have the information you have requested. It commissions Peninsula Community Health to provide telehealth as part of a block contract to provide community services and is therefore unable to split this cost from the overall contract. Peninsula Community Health may be able to answer your question: email pch.foi@pch-cic.nhs.uk. 19. How much of your total budget will be spent on cancer services for 2015/16? How much was spent on cancer treatment in 2014/15? A. Details of NHS Kernow s spend on cancer services during 2014/15 will be included in its programme budget information, which is being prepared and will be published on NHS England s website once approved. We therefore exempt this information under section 22 of the Freedom of Information Act, information intended for future publication. Details of NHS Kernow s budget of 2015/16 has not yet been set. We therefore exempt this information under section 22 of the Freedom of Information Act, information intended for future publication. 16

20. How much of your total budget will be spent on diabetes services for 2015/16? How much was spent on diabetes services in 2014/15? A. Details of NHS Kernow s spend on diabetes services during 2014/15 will be included in its programme budget information, which is being prepared and will be published on NHS England s website once approved. We therefore exempt this information under section 22 of the Freedom of Information Act, information intended for future publication. Details of NHS Kernow s budget of 2015/16 has not yet been set. We therefore exempt this information under section 22 of the Freedom of Information Act, information intended for future publication. 21. How much of your total budget will be spent on respiratory services for 2015/16? How much was spent on respiratory services in 2014/15? A. Details of NHS Kernow s spend on respiratory services during 2014/15 will be included in its programme budget information, which is being prepared and will be published on NHS England s website once approved. We therefore exempt this information under section 22 of the Freedom of Information Act, information intended for future publication. Details of NHS Kernow s budget of 2015/16 has not yet been set. We therefore exempt this information under section 22 of the Freedom of Information Act, information intended for future publication. 22. How much of your total budget will be spent on eye services for 2015/16? How much was spent on eye services in 2014/15? A. Details of NHS Kernow s spend on eye services during 2014/15 will be included in its programme budget information, which is being prepared and will be published on NHS England s website once approved. We therefore exempt this information under section 22 of the Freedom of Information Act, information intended for future publication. Details of NHS Kernow s budget of 2015/16 has not yet been set. We therefore exempt this information under section 22 of the Freedom of Information Act, information intended for future publication. 23. How much of your total budget will be spent on cardiovascular disease services for 2015/16? How much was spent on cardiovascular disease services in 2014/15? A. Details of NHS Kernow s spend on cardiovascular disease during 2014/15 will be included in its programme budget information, which is being prepared and will be published on NHS England s website once approved. We therefore exempt this information under section 22 of the Freedom of Information Act, information intended for future publication. 17

Details of NHS Kernow s budget of 2015/16 has not yet been set. We therefore exempt this information under section 22 of the Freedom of Information Act, information intended for future publication. 24. How much of your total budget will be spent on chronic kidney disease services for 2015/16? How much was spent on chronic kidney disease services in 2014/15? A. Details of NHS Kernow s spend on chronic kidney disease services during 2014/15 will be included in its programme budget information, which is being prepared and will be published on NHS England s website once approved. We therefore exempt this information under section 22 of the Freedom of Information Act, information intended for future publication. Details of NHS Kernow s budget of 2015/16 has not yet been set. We therefore exempt this information under section 22 of the Freedom of Information Act, information intended for future publication. 25. How much of your total budget will be spent on mental health services for 2015/16? How much was spent on mental health services in 2014/15? A. Details of NHS Kernow s spend on mental health services during 2014/15 will be included in its programme budget information, which is being prepared and will be published on NHS England s website once approved. We therefore exempt this information under section 22 of the Freedom of Information Act, information intended for future publication. Details of NHS Kernow s budget of 2015/16 has not yet been set. We therefore exempt this information under section 22 of the Freedom of Information Act, information intended for future publication. FOI47500 - Finance & budgets Reminder services Date received: 28/05/2015 1. How much does the Trust spend on sending text message or email reminders of appointments for treatment to patients during 2013, 2014 & 2015 to date? A. NHS Kernow commissions healthcare services and does not provide direct patient appointments and its spend on appointment reminders is therefore zero. You may wish to contact NHS England, which commissions GP services and dentists to obtain these figures: england.contactus@nhs.net. Royal Cornwall Hospital NHS Trust for hospital appointments: foi.rcht@cornwall.nhs.uk. Peninsula Community Health for community health appointments: pch.foi@pchcic.nhs.uk. 18

FOI47510 - Long term conditions - Pain services Date received: 29/05/2015 1. Does your Clinical Commissioning Group fund a pain service? A. Yes, in secondary care. 2. Do you think it is important that pain services continue to be delivered in your region? A. NHS Kernow is unable to answer this question as a response would be based on personal opinion and not face, which is contrary to the Freedom of Information Act, however commissioning services that support people manage their pain is central to our ethos to improve people s health and wellbeing and improve people s experience of care and support. 3. Do you anticipate that there will be a change in the budget dedicated to providing a pain service in the next five years? A. NHS Kernow is unable to answer this question as a response we anticipating something would be based on speculation and not fact, which is contrary to the Freedom of Information Act. 4. Do you believe that the current budget that is set aside for delivery of pain services in your CCG is sufficient? A. NHS Kernow is unable to answer this question as a response would be based on personal opinion and not fact, which is contrary to the Freedom of Information Act. 5. Does your CCG have a pathway that GPs have to follow prior to referring into a secondary care pain clinic? A. Yes. 6. How many new patient referrals were funded in the last financial year? A. During 2014/15, 1538 referrals were funded. 7. How many follow up patient episodes were funded in the last financial year? A. NHS Kernow does not have the information you have requested, however it is being looked into as part of the Orthopaedic Services Review. 8. Does your local pain service provide specialist pain physiotherapy? A. Yes. 19

9. Does your local pain service provide acupuncture clinics? A. No. 10. Does your local pain service provide psychological therapy? A. No, but this is being looked into as part of the wider Orthopaedic Services Review. 11. Does your local pain service provide pain intervention procedures eg spinal injections? A. Yes. 12. Does your local pain service provide pain management programmes? A. Yes. 20

Appendix - FOI47330 21

Cornwall & IoS Diabetic foot check & referral pathway Jan 2014 Contact with patient with diabetes. Inspect feetremove patients shoes, socks and any dressings YES Are any of these present? New ulceration Known ulceration with cellulites or infection Known ulceration with deterioration in condition Suspected osteomyelitis/ulcer probing to bone Suspected acute Charcot foot Critical limb ischaemia, necrosis or gangrene Evidence of foot problems Are any of these present? Neglected feet Corns or Callus Toe nail problems* Peripheral vascular disease Peripheral neuropathy Structural foot deformity Painful feet/abnormal sensations NO * diabetic patients do not automatically qualify for routine toe nail cutting Patients at low risk of foot ulceration should receive annual foot checks provided by their GP practice All patients should be referred, on diagnosis of diabetes, to podiatry for an initial assessment then on-going follow up as below. If this is not happening please arrange Patients at increased risk of foot ulceration should receive foot checks every 6 months provided by podiatry Patients at high risk of foot ulceration should receive foot checks every 1-3 months provided by podiatry Refer to Community Podiatry clinic listing patient s current foot problem. Patient will be contacted for appropriate appointment (18 week RTT, 13 week av wait) Emergency admission Refer to Hotline for urgent podiatry appointment 01579 373550 Triaged phone line 5 days a week, office hours District hot foot clinic (access within 72 hours max ) specialist podiatrist in 1of 3 area centres with informal access to M.D.T. Specialist podiatry clinic at RCHT (access within 72 hours max) with informal access to M.D.T. Diabetic foot clinic weekly M.D.T @RCHT to stabilise & prevent emergency foot