NHS Kernow - Disclosure log Freedom of Information requests June 2017

Similar documents
NHS Kernow - Disclosure Log Freedom of Information Requests September 2017

NHS Kernow Disclosure Log Freedom of Information Requests May 2015

NHS continuing health care joint dispute resolution procedure

Performance and Quality Committee

Lincolnshire CCGs. Non-Emergency Patient Transport. Eligibility Criteria Policy

NHS Kernow FOI Disclosure Log December NHS Kernow - Disclosure log Freedom of Information requests December 2015

Briefing on Shaping Our Future urgent care work stream progress

JOB DESCRIPTION. Joint Commissioning Manager for Older People s Residential Care and Nursing Homes

Personal Budgets and Direct Payments

SPONSORSHIP AND JOINT WORKING WITH THE PHARMACEUTICAL INDUSTRY

Responding to a risk or priority in an area 1. London Borough of Sutton

WOLVERHAMPTON CCG. Governing Body Meeting 9 th September 2014

PLYMOUTH MULTI-AGENCY ADULT SAFEGUARDING PATHWAY PROTOCOL

NHS Bradford Districts CCG Commissioning Intentions 2016/17

Hospital Discharge and Transfer Guidance. Choice, Responsiveness, Integration & Shared Care

SAFEGUARDING CHILDREN POLICY

From April 2017 NHS Kernow aims to have in place a new NHS funded transport policy which will clearly outline:

NHS Kernow - Disclosure log Freedom of Information requests November 2016

5. Does this paper provide evidence of assurance against the Governing Body Assurance Framework?

Title: Replacement of the Commissioning Advisory Forum Agenda Item: 9

Draft Commissioning Intentions

Any Qualified Provider: your questions answered

Resource impact report: End of life care for infants, children and young people with life-limiting conditions: planning and management (NG61)

You said We did. Care Closer to home Acute and Community Care services. Commissioning Intentions Engagement for 2017/18

IUC and Vanguard. Greater Nottingham Integrated Urgent Care 1

21 March NHS Providers ON THE DAY BRIEFING Page 1

ALLOCATION OF RESOURCES POLICY FOR CONTINUING HEALTHCARE FUNDED INDIVIDUALS

This paper explains the way in which part of the system is changing to become clearer and more accessible, beginning with NHS 111.

TERMS OF REFERENCE. Transformation and Sustainability Committee. One per month (Second Thursday) GP Board Member (Quality) Director of Commissioning

CCG Policy for Working with the Pharmaceutical Industry

NHS Kernow - Disclosure Log Freedom of Information Requests November 2017

Job Description. CNS Clinical Lead

Your Care, Your Future

General Practice Models & Ownership FOI FOI request Definitions:

Continuing Healthcare Policy

NHS Kernow FOI Disclosure Log January NHS Kernow - Disclosure log Freedom of Information requests January 2016

Marginal Rate Emergency Threshold. Executive Summary

NHS DORSET CLINICAL COMMISSIONING GROUP GOVERNING BODY MEETING FINANCIAL POSITION AS AT 30TH NOVEMBER C Hickson, Head of Management Accounts

Policy for Non- Emergency Patient Transport (NEPTS) October 2017

JOB DESCRIPTION. Pharmacy Technician

WOLVERHAMPTON CCG GOVERNING BODY MEETING 12 JULY 2016

Update on NHS Central London CCG QIPP schemes

Date of publication:june Date of inspection visit:18 March 2014

STANDARD OPERATING PROCEDURE. Delayed Transfer of Care Northamptonshire

Requesting Ambulance Transport (999 or Urgent) A Guide for Healthcare Professionals

Bristol CCG North Somerset CGG South Gloucestershire CCG. Draft Commissioning Intentions for 2017/2018 and 2018/2019

Monthly Delayed Transfer of Care Situation Reports. Definitions and Guidance

Guidance for organisations applying for both registration and licensing as a new service provider

A meeting of Bromley CCG Primary Care Commissioning Committee 22 March 2018

GOVERNING BODY REPORT

QUALITY STRATEGY

End of Life Care. LONDON: The Stationery Office Ordered by the House of Commons to be printed on 24 November 2008

GOVERNING BODY REPORT

Job Title: Head of Patient &Public Engagement and Patient Services Directorate: Corporate Affairs Department: Patient and Public Engagement

Looked After Children Annual Report

Islington CCG Commissioning Statement in relation to the commissioning of health services for children and young people 0-18 years

15. UNPLANNED CARE PLANNING FRAMEWORK Analysis of Local Position

Guidelines for the Management of Patients who are End of Life

GP Cover of Nursing, Residential, Extra Care and Intermediate Care Homes. Camden Clinical Commissioning Group. Care Home LES Spec v1

Integrated Care Systems. Phil Richardson NHS Dorset CCG

Westminster Partnership Board for Health and Care. 21 February pm pm Room 5.3 at 15 Marylebone Road

NHS ENGLAND BOARD PAPER

Delegated Commissioning of Primary Medical Services Briefing Paper

Primary Care Commissioning Next Steps to Delegated Commissioning September Board Paper. 2.0 Delegated Opportunities, Benefits and Risks

Policy for Children s Continuing Healthcare

Integrated Health and Care in Ipswich and East Suffolk and West Suffolk. Service Model Version 1.0

NHS DORSET CLINICAL COMMISSIONING GROUP GOVERNING BODY MEETING ADULT AND CHILDREN CONTINUING HEALTHCARE ANNUAL REPORT

Westminster Partnership Board for Health and Care. 17 January pm pm Room 5.3 at 15 Marylebone Road

Please find below the response to your recent Freedom of Information request regarding Continence Services within NHS South Sefton CCG.

Engagement Summary. North London Partners Urgent and Emergency Care Programme. Camden Barnet Enfield Haringey Islington

Calderdale and Huddersfield NHS Foundation Trust End of Life Care Strategy

Sara Barrington Acting Head of CHC

NHS East and North Hertfordshire Clinical Commissioning Group. Quality Committee. Terms of Reference Version 4.0

CCG: CO01 Access and Choice Policy

Vision 3. The Strategy 6. Contracts 12. Governance and Reporting 12. Conclusion 14. BCCG 2020 Strategy 15

Seven Day Services Clinical Standards September 2017

Wandsworth CCG. Continuing Healthcare Commissioning Policy

COMMISSIONING FOR QUALITY FRAMEWORK

ANEURIN BEVAN HEALTH BOARD DELIVERING END OF LIFE CARE

Safeguarding Adults & Mental Capacity Act (2005) Annual Report 2016/17

England. Questions and Answers. Draft Integrated Care Provider (ICP) Contract - consultation package

Appendix 1: Integrated Urgent Care Service Update. 1. Purpose

CCG authorisation: the role of medicines management

CHC Operational Guidelines. 31 January 2017 Performance and Quality Committee

The Newcastle upon Tyne Hospitals NHS Foundation Trust. Procedure for Monitoring of Delayed Transfers of Care

Dementia End of Life Facilitation Team Admiral Nurse Band 6 Job Description

DRAFT - NHS CHC and Complex Care Commissioning Policy.

Care and Treatment Review: Policy and Guidance

Council of Members. 20 January 2016

Reservation of Powers to the Board & Delegation of Powers

SCOTTISH BORDERS HEALTH & SOCIAL CARE INTEGRATED JOINT BOARD UPDATE ON THE DRAFT COMMISSIONING & IMPLEMENTATION PLAN

Birmingham, Sandwell and Solihull Eligibility Criteria Policy for NHS Non-Emergency Patient Transport (NEPT)

Main body of report Integrating health and care services in Norfolk and Waveney

Delegated Commissioning Updated following latest NHS England Guidance

DRAFT Service Specification GP-led Urgent Treatment Centre (UTC) Service

Making every moment count

Welcome. PPG Conference North and South Norfolk CCGs June 14 th 2018

Quality Accounts: Corroborative Statements from Commissioning Groups. Nottingham NHS Treatment Centre - Corroborative Statement

JOB DESCRIPTION. The post holder will take a key role in leading and developing the Stroke specialist nursing service across the organisation.

Policies, Procedures, Guidelines and Protocols

Transcription:

NHS Kernow - Disclosure log Freedom of Information requests June 2017

Contents Children s health... 3 FOI60500 Palliative care... 3 Clinical management... 14 FOI61060 Launceston Community Hospital referrals... 14 Continuing healthcare... 14 FOI61020 Fast track applications... 15 Contracts... 15 FOI60590 GP contracts... 15 FOI60620 GP practices... 16 FOI60720 Out of hours provider... 17 FOI60730 Out of hours provider... 18 FOI60760 - Chiropractors... 18 FOI61130 Patient transport contract... 19 Finance and budgets... 22 FOI60490 Annual report and accounts... 22 FOI61140 : Vaccination programme costs... 22 Organisation... 23 FOI60640 Contact details... 23 FOI60740 FOI request information... 23 FOI61050 Cyber attacks... 25 Patient safety and experience... 26 FOI60630 Never events and serious incidents... 26 Prescribing and pharmacies... 27 FOI60510 Community pharmacy commissioning... 27 FOI60770 Care home services... 28 FOI60950 - QIPP... 28 FOI60960 Rebate agreements... 30 Properties and estates... 31 FOI60980 Car parking... 31 Urgent care... 32 FOI60970 Urgent care contracts... 32 Women's health... 32 2

FOI61100 Abortion referrals... 32 Appendix June FOI attachments... 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. Children s health FOI60500 Palliative care Date received: 01/06/2017 1. Do you commission palliative care for children and young people with lifelimiting and life-threatening conditions between the ages of 0 and 25? A. Yes. a) If yes, how much did you spend on children s palliative care in 2016/17? A. Adult (over 18): NHS Kernow commissions St Luke s Hospice and Cornwall Hospice Care for the provision of in-patient services, community specialist palliative nursing team and acute specialist palliative care services. The total spend on these services is below (excluding acute and community specialist palliative care as these services sit within block contracts) Cornwall Hospice Care: 1,017,324 St Luke s Hospice: 175,641 Children s Hospice South West: 109,224 From the ages of 18-25, continuing healthcare packages of care are available for individuals with life limiting/threatening conditions. NHS Kernow does not hold the information in the format you have requested. The cost of care per week ranges. There is not one specific agency/service we use to support this cohort of individuals. 3

Acute and community specialist palliative care services are contained within block contracts with Cornwall Partnership NHS Foundation Trust and Royal Cornwall Hospitals NHS Trust and therefore, NHS Kernow does not hold the information you have requested regarding spend. Please redirect your request to providers direct to cpn-tr.freedomofinformation@nhs.net and rch-tr.foi@nhs.net to request this information. Children (under 18): Palliative care services are contained within a block contract with Cornwall Partnership NHS Foundation Trust and therefore, NHS Kernow does not hold the information you have requested. Please redirect your request to providers direct to cpn-tr.freedomofinformation@nhs.net to request this information. Children s continuing care also commissions palliative care through individual providers on an individual needs basis. NHS Kernow s spend on children s continuing care in 2016/17 was 1.575m. 2. Do you have a published strategy or care pathway for children with lifelimiting and life-threatening conditions? If so, please provide a link or an attachment. A. Adults (over 18): No. NHS Kernow has a local service/pathway self-assessment and implementation priority plan against the National Ambitions for Palliative Care and End of Life that have been agreed by our multi-agency EOL Strategy Board. This has not been formally ratified and published. Children (under 18): No. NHS Kernow leads the children s and young people s palliative care network (CIOSPCN) where the development of a new strategy is currently underway. NHS Kernow is also working closely with the Parent Carer Council and the CIOSPCN to update the strategy for publication. 3. Did you ask for your local sustainability and transformation plan (STP) to include palliative care for children with life-limiting and life-threatening conditions? A. Adults (over 18): Yes. More information on the Cornwall and Isles of Scilly STP can be found here: http://www.cornwall.gov.uk/shapethefuture Children (under 18): Children s community services have developed their own plan, supporting which supports the STP, called One Vision, the strategy for which is publicly available online: https://www.cornwall.gov.uk/health-and-social-care/childrens-services/cornwallchildrens-trust/working-together/one-vision/ 4

The joint commissioning plan will include a review of all community nursing provision and will consider the new NICE guidance relating to children s palliative care. 4. Do you assess numbers and needs of children and young people with lifelimiting and life-threatening conditions between the ages of 0 and 25 among the population you serve? If yes, please tell us how. A. Adults (over 18): Adult continuing healthcare uses the national framework on continuing healthcare to assess the health and social care needs of patients. The Decision Support Tool is used to collate this information and indicates eligibility. In terms of how many children or young people, we record their specific diagnosis. In terms of end of life, the term Fast track is used. Children (under 18): Yes. The numbers and needs are collected through a number of sources including the local children s hospice, the disabled children s charter group and register, the CLIC and CCN teams. a) Please also tell us how many children and young people with life-limiting and life-threatening conditions there are in your area. A. Adults (over 18): NHS Kernow does not hold the information in the format you have requested. The breakdown you have requested is not routinely reported in the format you have requested. Children (under 18): NHS Kernow does not hold the information in the format you have requested. The CIOSPCN are currently developing methods for collecting this information in a central source. 5. Do you jointly commission palliative care for children and young people with life-limiting and life-threatening conditions between the ages of 0 and 25 with your local authorities in a way which is consistent with the Children and Families Act 2014? A. Yes, there is joint commissioning around children s continuing care and short breaks. There are also some good examples of tripartite funding for children needing additional support in an educational setting or receiving educational support at home but requiring extensive health care input to allow their EHC outcomes to be achieved. 6. Do you commission palliative care which enables a child or young person to receive end of life care at home if they wish to do so? A. Yes. 5

7. Do you commission a rapid transfer process for children and young people with life-limiting conditions to allow urgent transfer to the preferred place (for example from the intensive care unit to their home or to a children's hospice)? A. Adults: NHS Kernow encourages all continuing healthcare eligible patients that have a life limiting/threatening condition to work with their MDT members, family members to create a TEP (Treatment escalation plan) form that would indicate their wishes. This form would set out the process and teams needed for when the individual is nearing the end of their life. Children (under 18): NHS Kernow encourages all professionals to work with children and family members to create an advanced care plan that would indicate their wishes. This form would set out the process and teams needed for when the individual is nearing the end of their life. There is a rapid transfer process in place which allows the urgent transfer of a child between settings. There are also clear processes in place to alert the ambulance service should a call be made from that address. As the numbers are extremely low within the county, some care is commissioned on an individual basis as and when required. 8. Do you take steps to integrate assessments, plans and services for children and young people with life-limiting and life-threatening conditions between the ages of 0 and 25, including those without a special educational need and disability? If yes, please tell us how (For example, using education, health and care plans). A. Adults (over 18): NHS Kernow would expect that local health and social care teams take proactive steps to sharing information and aligning care plans through developing integrated community teams however, at this time, we do not have robust and consistent integrated care across the county. Children (under 18): In terms of commissioning, children s continuing care assessments are completed jointly with health colleagues, the local authority and voluntary organisations. Provider forums, multi-disciplinary team and child in need meetings also provide an opportunity for sharing of plans and policies across organisations. There is also a process in place to ensure that fast track applications for continuing healthcare for end of life, which includes joint assessments, are completed within agreed timescales. 9. Do you offer personal budgets to children and young people with lifelimiting and life-threatening conditions? A. Yes, all children and adults are offered a personal budget if they meet the criteria for continuing health care. 6

a) If yes, how many children and young people with life-limiting and lifethreatening conditions in your area have a personal budget? A. Less than five. 10. Do you take steps to make sure that young people with life-limiting and lifethreatening conditions can access palliative care services which are appropriate to their age and developmental stage? If yes, please tell us how. A. Where possible, at continuing care assessments, the views of children and young people are ascertained. NHS Kernow works closely with the Parent Carer Council to ensure that the views of children and young people are obtained through representation on groups and interview panels. NHS Kernow is also made aware of provider satisfaction surveys relating to these services, which include areas of transition and age appropriate environments. 11. Do you take steps to make sure that young people with life-limiting and lifethreatening conditions experience smooth transitions from children s to adults palliative care services? If yes, please tell us how. A. Yes, NHS Kernow s children s and adult teams work closely and have a transition commissioner within the CCG. There are clear processes in place to ensure the commissioning arrangements are in place for a child with palliative care needs during transition. Transition is a standing agenda item on the children s continuing care agenda and a live database of transition, mental capacity assessments and Deprivation of Liberty Safeguards are maintained. 12. Do you commission any of the following services for children with lifelimiting or life-threatening conditions? If yes, please state which outcomes you ask service providers to achieve and how much you spent on them in 2016/17: a) A level 4 paediatric palliative care consultant? A. No. NHS Kernow does not commission a level 4 paediatric palliative care consultant. NHS Kernow does contribute to this role via a block contract with Children s Hospice South West. b) Consistent with the NICE clinical guideline End of Life Care for Infants, Children and Young people, a multidisciplinary team that includes the following as a minimum? a paediatric palliative care consultant A. There is a team of acute and community paediatricians and a designated paediatrician with an interest and expertise in palliative care. The acute and 7

community paediatricians also work as hospice doctors across different care settings.. NHS Kernow does not hold the information you have requested regarding spend. The provision of acute and community paediatricians are contained within a block contract with Royal Cornwall Hospitals NHS Trust. Please redirect your request to providers direct to rch-tr.foi@nhs.net to request this information. a nurse with expertise in paediatric palliative care a pharmacist with expertise in specialist paediatric palliative care experts in child and family support who have experience in end of life care (for example in providing social, practical, emotional, psychological and spiritual support). A. Yes. Palliative care services are contained within block contracts with Cornwall Partnership NHS Foundation Trust and Royal Cornwall Hospitals NHS Trust and therefore, NHS Kernow does not hold the information you have requested regarding spend. Please redirect your request to providers direct to cpntr.freedomofinformation@nhs.net and rch-tr.foi@nhs.net to request this information. c) Acute children s palliative care nurses which provide children s palliative care? A. No. d) Community children s nurses which provide children s palliative care? A. Yes. Palliative care services are contained within a block contract with Cornwall Partnership NHS Foundation Trust and therefore, NHS Kernow does not hold the information you have requested. Please redirect your request to providers direct to cpn-tr.freedomofinformation@nhs.net to request this information. The outcomes for the block contract are below: All children and young people to have care plans for each stage of the ACT pathway including: o Breaking news through supporting the parents with expert nursing information and advice planning for going home o The Diana Nurse role is to act as the Lead Professional/Care Coordinator responsible for ensuring that the discharge plan is fulfilled prior to the child returning home o Multi-agency assessment of family s needs o Multi-agency care plan o End of life plan Improved quality of life (measured NI54) 8

Improved care co-ordination with continuity of care (Operating Plan minimum requirement) Engagement with statutory, voluntary and independent health providers to achieve best practice through providers forum (attendance at developing Palliative Care Clinical Provider Forum) Prevent inappropriate admissions to acute hospital services (feedback to be requested from acute providers) Enhance the opportunities for social inclusion, through working in partnership with statutory, voluntary and independent providers of children s services Develop local teaching and resource materials in partnership with Paediatric Community Services and other multi agency staff To contribute to an end of life training/rotational activity with Children s Hospice South West and BUPA e) Voluntary sector children s palliative care services (including children s hospice? If yes, which voluntary sector services do you commission and how much did you spend on them in 2016/17? A. Voluntary sector palliative care services are contained within block contracts with Children s Hospice Care and Bereavement Support. The block contract totals are as follows: Children s Hospice Care: 109,224 Penhaligon s Friends Bereavement Support: 10,000 The Children s Hospice Care outcomes are currently in draft format and are not available at this time. The outcomes for the Penhaligon s Friends contract are: Advice and guidance Home visit with family School visit interventions Memory day Peer bereavement support groups f) Community paediatricians which provide children s palliative care? Emotional and psychological support for children and their families? Bereavement care - to families before a child under the age of 1 has died? Bereavement care - to families after a child under the age of 1 has died? Bereavement care - to families before a child or young person aged 1 25 has died? Bereavement care - to families after a child or young person aged 1 25 has died? 9

A. Yes, there is a team of community paediatricians and a designated paediatrician with an interest and expertise in palliative care. The community paediatricians also work as hospice doctors across different care settings. Bereavement services are also offered by hospices. NHS Kernow does not hold the information you have requested regarding spend. The provision of community paediatricians are contained within a block contract with Royal Cornwall Hospitals NHS Trust. Please redirect your request to providers direct to rch-tr.foi@nhs.net to request this information. Equipment - including services which provide wheelchairs and services to maintain and repair equipment? A. Yes. Some items of equipment form large block contracts with providers, some come through the process of Individual Funding Reviews (IFR s) or specialist beds through the Children s commissioning team. There are clear processes and panels for the application for equipment and subsequent funding. There is Integrated Health Guidance for the Assessment and Provision of Community Health Funded Electric Profiling Beds for children and young people (0-18yrs) including a fast track process. NHS Kernow. The total annual budget for specialist beds and equipment was 137,096 in 2016/17. Servicing of specialist equipment such as ventilators and cough assists is done on individual maintenance contracts. 13. Do you commission any of the following services to provide care out of hours and at weekends for children with life-limiting or life-threatening conditions? We define out of hours and at weekends as 6:30pm 8am on weekdays and all day on Saturdays, Sundays and Bank Holidays. a) A level 4 paediatric palliative care consultant A. These services are not commissioned by NHS Kernow. b) Consistent with the NICE clinical guideline End of Life Care for Infants, Children and Young people, a multidisciplinary team that includes as a minimum: o a paediatric palliative care consultant A. There is a team of acute and community paediatricians and a designated paediatrician with an interest and expertise in palliative care. The acute and community paediatricians also work as hospice doctors across different care settings.. NHS Kernow does not hold the information you have requested regarding spend. The provision of acute and community paediatricians are contained within a block 10

contract with Royal Cornwall Hospitals NHS Trust. Please redirect your request to providers direct to rch-tr.foi@nhs.net to request this information. o a nurse with expertise in paediatric palliative care o a pharmacist with expertise in specialist paediatric palliative care o experts in child and family support who have experience in end of life care (for example in providing social, practical, emotional, psychological and spiritual support) A. Palliative care services are contained within block contracts with Cornwall Partnership NHS Foundation Trust and Royal Cornwall Hospitals NHS Trust and therefore, NHS Kernow does not hold the information you have requested. Please redirect your request to providers direct to cpntr.freedomofinformation@nhs.net and rch-tr.foi@nhs.net to request this information. c) Acute children s palliative care nurses which provide children s palliative care? A. No. d) Community children s nurses which provide children s palliative care? A. Community children s nurses for palliative care are currently commissioned on an individual spot purchasing basis. e) Voluntary sector children s palliative care services (including children s hospice services)? If yes, which voluntary sector services do you commission and how much did you spend on them in 2016/17? A. Yes. NHS Kernow does not hold the information you have requested regarding spend. Voluntary sector palliative care services are contained within block contracts with Children s Hospice Care and Bereavement Support. We can however confirm that the block contract totals are as follows: Children s Hospice Care: 109,224 Penhaligon s Friends Bereavement Support: 10,000 f) Community paediatricians which provide children s palliative care? A. Community paediatricians are currently commissioned on an individual spot purchasing basis. g) Emotional and psychological support for children and their families? h) Bereavement care - to families before a child under the age of 1 has died? 11

i) Bereavement care - to families after a child under the age of 1 has died? j) Bereavement care - to families before a child or young person aged 1 25 has died? k) Bereavement care - to families after a child or young person aged 1 25 has died? A. Yes, there is a team of community paediatricians and a designated paediatrician with an interest and expertise in palliative care. The community paediatricians also work as hospice doctors across different care settings. Bereavement services are also offered by hospices. l) Equipment - including services which provide wheelchairs and services to maintain and repair equipment? A. Yes. Some items of equipment form large block contracts with providers, some come through the process of Individual Funding Reviews (IFR s) or specialist beds through the Children s commissioning team. There are clear processes and panels for the application for equipment and subsequent funding. There is Integrated Health Guidance for the Assessment and Provision of Community Health Funded Electric Profiling Beds for children and young people (0-18yrs) including a fast track process. NHS Kernow. The total annual budget for specialist beds and equipment was 137,096 in 2016/17. Servicing of specialist equipment such as ventilators and cough assists is done on individual maintenance contracts. 14. Do you commission the following services to children and young people with life-limiting and life-threatening conditions between the ages of 0 and 25 (yes/no)? If yes, please state how much you spent on them in 2016/17: a) short breaks (respite). If yes, please state how much you spent on them in 2016/17: A. Adults (over 18): Yes. NHS Kernow does not hold the information in the format you have requested. The cost of care per week ranges. There is not one specific agency/service we use to support this cohort of individuals. Children (under 18): Yes, children can access residential short breaks at three locations throughout the county. If assessed as requiring a registered nurse to facilitate short breaks at home, this is jointly commissioned by NHS Kernow through the Children s Continuing process. These services are contained within a block contract with Cornwall Partnership NHS Foundation Trust and therefore, NHS Kernow does not hold the information 12

you have requested regarding spend. Please redirect your request to providers direct to cpn-tr.freedomofinformation@nhs.net to request this information. b) Step-down care:if yes, please state how much you spent on them in 2016/17: A. Adults (over 18): Yes. NHS Kernow does not hold the information in the format you have requested. The cost of care per week ranges. There is not one specific agency/service we use to support this cohort of individuals. Children (under 18): Step down care is currently commissioned on an individual spot purchasing basis. We therefore cannot confirm the total spend on this service. c) End of life care: If yes, please state how much you spent on them in 2016/17: A. Adults (over 18): Yes. NHS Kernow does not hold the information in the format you have requested regarding spend. The cost of care per week ranges. There is not one specific agency/service we use to support this cohort of individuals. Children (under 18): End of life care is currently commissioned on an individual spot purchasing basis. We therefore cannot confirm the total spend on this service. The children s continuing care spend on EOL care/fast track packages was 104,745. 15. Are you implementing the NICE clinical guideline End of Life Care for Infants, Children and Young People: Planning and Management (yes/no)? If yes, please tell us about the steps you are taking. A. Yes, the NICE clinical guidelines are being used by the children s commissioning team as the focus for the Cornwall and Isles of Scilly Children s Palliative Care Network. At the last meeting, the network used a Rag rating system against the guideline. This is being used to inform future meetings, work streams and commissioning intentions. The providers inform the commissioners through the CIOSPCN meeting of their implementation of the guidelines due to the clinical component of the guidelines. 16. Are you implementing Our Commitment to you for end of life care: The Government Response to the Review of Choice for children and young people with life-limiting and life-threatening condition? (yes/no). If yes, please tell us about the steps you are taking. A. Yes. NHS Kernow is using the ambitions for palliative and end of life care. We are using the two documents and specifically the building blocks outlined as a framework for assessing the services we have in place and inform us what is 13

working well and what needs further development. We are using the statement The offer of choice is only real when there is universal access to high quality services in all settings, when care is coordinated well, and where staff, services and infrastructure combine to enable effective discussion and implementation of people s preferences (DOH 2016:12) to lead the development of the palliative care strategy. Clinical management FOI61060 Launceston Community Hospital referrals Date received: 28/06/2017 We ask that you disclose the following information strictly in respect of Launceston Community Hospital. We also ask that the information you disclose is relevant to the period of time in question; namely 2011 and 2012. 1. What are the most common conditions / circumstances which necessitate referral to Launceston Community Hospital? 2. Is a risk assessment carried out before a patient is admitted to Launceston Community Hospital? 3. If so, which organisation carries out that risk assessment? For example, the referring NHS Trust or Launceston Community Hospital as the accepting hospital. a) If Launceston Community Hospital, what is the position of the person who carries out the risk assessment? 4. Who makes the decision as to whether an incoming patient is to be accepted by Launceston Community Hospital? 5. Please provide the policy document and/or statements regarding the type of patient Launceston Community Hospital is permitted to accept. 6. Please confirm when this policy/statement was put in place and whether there were any similar preceding policies/statements. a) If there were previous editions, did they materially differ from the current policies/statements. A. 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 Health s legacy team to request this information: reviews&informationteam@dh.gsi.gov.uk. Continuing healthcare 14

FOI61020 Fast track applications Date received: 27/06/2017 1. How many people in all the hospitals within your CCG have died in hospital awaiting the start of a package of fast-track continuing healthcare. 2. What is the average time period in your CCG in hours/days from the point at which a fast-track CHC application is made to the care package being provided for the 12 month period to the end of March 2017? 3. What is the average time period in your CCG in hours/days from the point at which a fast-track CHC application is approved to the care package being provided for the 12 month period to the end of March 2017? A. NHS Kernow does not hold the information you have requested. Please redirect your request to providers to request this information: Cornwall Partnership Foundation Trust: cpn-tr.freedomofinformation@nhs.net Royal Hospitals NHS Trust: rch-tr.foi@nhs.net Contracts FOI60590 GP contracts Date received: 05/06/2017 1. A copy of the contract to provide NHS Patient Healthcare between NHS Kernow and St Austell Healthcare. A. NHS Kernow does not hold the information you have requested. The main contract for General Medical Services is with NHS England. Please redirect your response to NHS England (England.contactus@nhs.net) to obtain this information. NHS Kernow commissions a small number of Local Enhanced Services from the surgery (as with most other practices in Cornwall). 2. A copy of the agreed procedures between NHS Kernow and St Austell Healthcare allowing St Austell Healthcare to refuse treatment of a patient. A. NHS Kernow does not hold the information you have requested. The main contract for General Medical Services is with NHS England. Please redirect your response to NHS England (England.contactus@nhs.net) to obtain this information. For the Local Enhanced Services that we commission, the practice will offer these services where possible but could refer a patient onto secondary care for a 15

similar treatment if they are unable to perform it themselves e.g. a 24 hour blood pressure test. 3. The number of patients removed by St Austell Healthcare for the years 2014, 2015, 2016 and from 1 January 2017 to 5 June 2017. A. NHS Kernow does not hold the information you have requested. The main contract for General Medical Services is with NHS England. Please redirect your response to NHS England (England.contactus@nhs.net) to obtain this information. 4. The number of people currently registered as St Austell Healthcare patients. A. NHS Kernow does not hold the information you have requested. The main contract for General Medical Services is with NHS England. Please redirect your response to NHS England (England.contactus@nhs.net) to obtain this information. FOI60620 GP practices Date received: 07/06/2017 1. I am writing to you under the Freedom of Information Act 2000 to request the following information from your CCG: 'General Practice Model & Ownership FOI'. Please provide information for the below for each General Practice: Practice code: Unique practice ID code Practice name A. NHS Kernow does not hold the information you have requested. GP services in Cornwall and the Isles of Scilly are not commissioned by NHS Kernow. Please redirect your request to NHS England at England.contactus@nhs.net or telephone 0300 311 2233. CCG code and name A. 11N. CCG name A. NHS Kernow. Federation name: If they don't belong to a federation please put '-'. If you don't have this data please put ' no data' 16

A. This request for information has previously been disclosed in an FOI request in January 2017 (FOI 57180) and is available to view on our FOI Disclosure Log: www.kernowccg.nhs.uk/get-info/information-governance/freedom-of-information- (foi)-requests/foi-disclosure-log/ We therefore exempt the release of this information under section 21 of the Freedom of Information Act, information accessible by other means. Vanguard name: If they don't belong to a vanguard please put '-'. If you don't have this data please put 'no data' Vanguard model: Type of vanguard (either 'PACS' (Integrated primary and acute care systems), 'MCP' (Multispecialty community providers), 'EHCH' (Enhanced health in care homes), 'UEC' (Urgent and emergency care), 'ACC' (Acute care collaborations)). If they don't belong to a vanguard please put '-'. If you don't have this data please put 'no data' Ownership: Please provide the name of the provider/brand that owns GP clinic e.g. Virgin Healthcare. If you don't have this data please put ' no data' Type of provider: (either 'Public - Company', 'Private - Company', 'Private - GP Owned', 'Social Enterprise', 'Charity', 'Other'). If you don't have this data please put ' no data' Contract type: (either 'GMS', 'PMS', 'SPMS', 'PMS PLUS', 'APMS'). If you don't have this data please put ' no data' Pharmacy on site: Does GP clinic own an on-site pharmacy? Yes or No. If you don't have this data please put ' no data' A. NHS Kernow does not hold the information you have requested. GP services in Cornwall and the Isles of Scilly are not commissioned by NHS Kernow. Please redirect your request to NHS England at England.contactus@nhs.net or telephone 0300 311 2233. FOI60720 Out of hours provider Date received: 09/06/2017 1. Please can you supply details on the commissioned out of hours provider in your CCG. Name of provider and provider representative if available. A. Information on contracts for out of hours providers are published on our website: https://www.kernowccg.nhs.uk/about-us/what-we-spend-and-how-we-spend-it/ via this link: http://policies.kernowccg.nhs.uk/documentslibrary/kernowccg/ourfinances/str ategicreportsandplans/contractlist.pdf 17

We therefore exempt the release of this information under section 21 of the Freedom of Information Act, information accessible by other means. FOI60730 Out of hours provider Date received: 09/06/2017 1. Please can you supply details on the commissioned out of hours provider in your CCG. Name of provider and provider representative if available. A. Information on contracts for out of hours providers are published on our website: https://www.kernowccg.nhs.uk/about-us/what-we-spend-and-how-we-spend-it/ via this link: http://policies.kernowccg.nhs.uk/documentslibrary/kernowccg/ourfinances/str ategicreportsandplans/contractlist.pdf We therefore exempt the release of this information under section 21 of the Freedom of Information Act, information accessible by other means. FOI60760 - Chiropractors Date received: 14/06/2017 1. Please provide a summary of health services that NHS Kernow CCG currently commissions from: a) Chiropractors/chiropractic clinics or any service provider where a chiropractor is involved in delivering the commissioned service b) Osteopaths/osteopathic clinics or any service provider where an osteopath is involved in delivering the commissioned service A. Information on contracts for AQP musculoskeletal services are published on our website: https://www.kernowccg.nhs.uk/about-us/what-we-spend-and-how-wespend-it/ via this link: http://policies.kernowccg.nhs.uk/documentslibrary/kernowccg/ourfinances/str ategicreportsandplans/contractlist.pdf We therefore exempt the release of this information under section 21 of the Freedom of Information Act, information accessible by other means. 2. Please provide a summary of health services that NHS Kernow CCG previously commissioned, but no longer commissions, from: a) Chiropractors/chiropractic clinics or any service provider where a chiropractor is involved in delivering the commissioned service b) Osteopaths/osteopathic clinics or any service provider where an osteopath is involved in delivering the commissioned service 18

A. NHS Kernow has not decommissioned any chiropractors/chiropractic or osteopaths/osteopathic clinics. FOI61130 Patient transport contract Date received: 30/06/2017 1. Who is your current and previous NEPTS operator (spanning the last three years or existing contract- whichever is longer? 2. What is the current contract (s) end date (s) and are there any provision for extensions? Information on contracts for non-emergency patient transport services are published on our website: www.kernowccg.nhs.uk/about-us/what-we-spend-andhow-we-spend-it/ via this link: http://policies.kernowccg.nhs.uk/documentslibrary/kernowccg/ourfinances/st rategicreportsandplans/contractlist.pdf We therefore exempt the release of this information under section 21 of the Freedom of Information Act, information accessible by other means. 3. Who or which body would the procurement of your future contract be made by? NHS Kernow will be undertaking the procurement of any future NEPTS contract. 4. Please provide the name, address, email and telephone number of the person responsible for the commissioning of services and the same for the person responsible for reviewing contract performance. We are unable to provide contact details for staff below director level. The director responsible for this area of work is Simon Bell Chief Finance Officer Email: simonbell@nhs.net Telephone Number: 01726 627800 5. Please provide the current service specification s in place across the contract (s). Please see attachment entitled Service Specification. 6. How is your current contract operated (in lots or as a whole)? What are the different budgets for these? 19

Our current contract for Non-emergency patient transport is operated in two lots. The transport is provided by EZEC and the booking office function is provided by Royal Cornwall Hospital Trust. Both covered by the standard NHS contract which can be found at: https://www.england.nhs.uk/nhs-standard-contract/ The 2017/18 budget for EZEC is 3,339,429 this figure includes CQUIN which is a payments framework which encourages improvements. The booking office function is provided by RCHT and is part of a larger block contract and is not separately identifiable. 7. What is your forecast spend in the following years (please break this down by service: scheduled patient journeys excl. renal, renal patient journeys, high dependency, secure and staff (if this is not available then please provide the total spend) a. 2017/18? As at the end of June 2017 forecast spend is 3,397,479. Activity is not broken down by service so we are unable to provide more detail. b. 2018/19? c. 2019/20? NHS Kernow will be entering in a procurement process within this financial year for the years 2018/19 and 2019/20, this information will be published as part of that process, at a later date. We therefore exempt the release of this information under section 22 of the Freedom of Information Act, information intended for future publication. 8. Please provide KPI and Penalties measure in place across this contract and the most recent performance review of the same. Please see the two attachments entitled KPI NEPTS and NEPTS Provider KPI Performance 9. Please provide the current Patient Transport Eligibility policy and what are your provisions for revision to this? Our policy has been reviewed and is in the process of being updated. It is due for publication 1st August 2017 and will be available on our website shortly. We therefore exempt the release of this information under section 22 of the Freedom of Information Act, information intended for future publication. 10. What is your policy on transporting escorts? Do you currently make payment provisions for this? 20

NHS Kernow policy is in line with national guidance: Medically eligible patients: Only healthcare professionals will normally be carried as patient escorts on NHS funded patient transport vehicles. Family members and friends may be authorised to travel in exceptional circumstances if they are able to provide the necessary skills or services that the patient requires on the journey that cannot be supplied by the transport staff. A patient can travel with an escort if one of the following applies: the patient's medical condition is such that he/she requires constant supervision for safety (the escort must be able to meet the medical need and it should be established whether a healthcare professional would not be the preferred option); or the patient has mental health problems that prevents them travelling alone; or the patient is under 16 years of age; or the patient has significant communication difficulties, including learning difficulties, impaired sight or is hard of hearing (where a patient has communication difficulties the escort should be able to provide a positive benefit in ensuring the patient can understand anything being said to them by the ambulance crew; for example, through the use of sign language where the patient is hard of hearing). Reimbursement of escort costs for Healthcare Travel Costs Scheme: Where deemed medically necessary by the patient s referring consultant, GP or another health care professional involved in the patient s care, the travelling expenses of an escort (or escorts) may also be claimed as part of the patient s travel expenses. Additionally, in cases where a child under 16 attends an appointment the travel costs of a parent or guardian escorting the child to its appointment may be paid. Such payments are made on the basis of the patient s eligibility for the scheme irrespective of the escort s eligibility. The actual travel costs should be assessed on the same basis as those of the patient. Eligibility for provision of escorts should be determined by either a healthcare professional of by the Centralised Booking Service at Royal Cornwall Hospitals NHS Trust who are: Clinically supervised and/or working within locally agreed protocols or guidelines, Employed by the NHS or working under contract for the NHS, and Must be agreed in advance of the journey. Payments are made on the basis of the patient s eligibility for the scheme irrespective of the escort s eligibility. The actual travel costs should be assessed 21

on the same basis as those of the patient and assessed in the same way as all other Healthcare Travel Costs Scheme claims. Only one relative escort will be permitted for children under 16 years and for adults who require constant attention and/or need an advocate during their hospital visit. Finance and budgets FOI60490 Annual report and accounts Date received: 01/06/2017 1. I understand that a meeting was held yesterday and the accounts should have been released. Why were the most recent accounts not released? I further understand that it was decided that the accounts would not be released until after the election. If this is so, who made this decision? Was this a decision imposed on you from central Government? A. Following formal approval of the Annual Report and Accounts by the Governing Body the Clinical Commissioning Group was required to submit its audited 2016/17 Annual Report and Accounts to NHS England by 31 May 2017. NHS Kernow planned to hold a single item, public, extraordinary Governing Body meeting on 30 May to ensure the Annual Report and Accounts were approved prior to submission. Due to Purdah, we were asked by NHS England to hold the meeting in private but ensure the documents were published on our website by 16 June. We can therefore confirm the meeting took place and the Annual Report and Accounts will be published by 16 June. They will also be published as part of the July Governing Body meeting papers. A note to this effect is included in the Chair s Report at Tuesday s Governing Body meeting. FOI61140 : Vaccination programme costs Date received: 30/06/2017 1. Could you please provide a figure for overall spending by your Clinical Commissioning Group or its predecessor Primary Care Trust(s) on the Healthy Individuals (21x) category as defined in the NHS Programme Budgeting Guidance for each of the past five financial years. 2011/12 2012/13 22

2013/14 2014/15 2015/16 2. Additionally, could you please provide a figure for your CCG s total spending on vaccination programmes for each of the past three years: 2013/14 2014/15 2015/16 A. 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 Health s legacy team to request this information: reviews&informationteam@dh.gsi.gov.uk. For information relating to 1 April 2013 to date, NHS Kernow does not hold the information you have requested. These services are not commissioned by NHS Kernow. Please redirect your response to NHS England (England.contactus@nhs.net) to obtain this information. Organisation FOI60640 Contact details Date received: 08/06/2017 1. Please could you let me know the names and email addresses for your: Head of Research A. NHS Kernow does not hold the information you have requested. NHS Kernow does not have a research department. Head of Analysis Head of Intelligence Head of Performance: A. We are unable to provide contact details for staff below director level. The director responsible for this area of work is Simon Bell Chief Finance Officer Email: simonbell@nhs.net FOI60740 FOI request information Date received: 12/06/2017 23

1. Please can you confirm who is the "qualified person" who gave opinion authorising the withholding of information requested in FOI 60030 under section 36 of the Freedom of Information Act (FOIA)? 2. On what date was their opinion sought regarding FOI 60030 and possible exemption? 3. What was the date that the "qualified person' gave their opinion that FOI 60030 IS exempt under section 36? 4. Under which subsection of section 36 did the "qualified person" deem that FOI 60030 IS exempt and why? A. NHS Kernow did not apply the Section 36 exemption regarding FOI 60030 and has therefore not withheld any information. 5. Can you please provide me with the papers relating to the seeking of the "qualified person's" opinion. 6. Can you please provide me with the "qualified person's" opinion itself. 7. Can you please provide me with information relating to the reasoning that informed the "qualified person's" opinion/decision. 8. Can you please provide me with any other papers related to the handling of FOI 60030. A. Under law, NHS Kernow is allowed to consider what exemptions apply. In this case, and as with other FOI requests, whilst exemptions were considered, they were not applied. The information you are requesting is not covered by the Freedom of Information Act 2000. Should you wish to see this information, please consider submitting a subject access request. More information on subject access requests is available here: https://www.kernowccg.nhs.uk/get-info/information-governance/subjectaccess-requests/ 9. Please can you provide copies of any internal policies or guidance issued to Departmental staff concerning the use of section 36 of the FOIA. A. NHS Kernow relies on its FOI policy and procedure as well as national guidance from the Information Commissioner. Our FOI Policy is published in our Document Library: http://policies.kernowccg.nhs.uk/documentslibrary/kernowccg/ourorganisation /Policies/FOIPolicyAndProcedure.pdf We therefore exempt the release of this information under section 21 of the Freedom of Information Act, information accessible by other means. 10. Please can you provide a list of all FOIA requests made since April 2013 where information was withheld under section 36. 24

A. NHS Kernow routinely publishes requests for information under the Freedom of Information Act on our website. It includes where exemptions have been applied to all or part of each FOI request: https://www.kernowccg.nhs.uk/getinfo/information-governance/freedom-of-information-(foi)-requests/foi-disclosurelog/ We therefore exempt the release of this information under section 21 of the Freedom of Information Act, information accessible by other means. NHS Kernow has received over 1,000 requests under the Freedom of Information Act since 1 April 2013 and apart from the actual response produced does not separately log where exemptions have been applied. We have estimated that it will cost more than the appropriate limit to breakdown this information. The appropriate limit, specified in regulations, is set at 450. We therefore exempt the release of this information under Section 12 of the Freedom of Information Act. 11. For each of these, please can you indicate a) who made the decision to withhold the information A. Where Section 36 exemptions are applied and a public interest test is required, NHS Kernow s Accountable Officer makes the overall decision to withhold the information. b) where available, which subsection of section 36 was considered relevant A. Please see our response to question 10, which is also relevant to any sub sections contained within Section 36. c) whether an internal review was requested of the decision d) for those where there was an internal review: a. who conducted that internal review b. what was the outcome of the review. e) whether the decision was appealed to the Information Commissioner, and if so, what his decision was A. Since 1 April 2013, NHS Kernow has carried out five internal reviews. None of those internal reviews contained requests for reviews of decisions relating to Section 36 of the Freedom of Information Act 2000. FOI61050 Cyber attacks Date received: 27/06/2017 1. For 2012, 2013, 2014, 2015, 2016 and 2017 (to date): 25

a) The number of cyber-attacks that you have been a target of, with the date of each attack b) For each attack, please state whether data was compromised and if so what was compromised c) For each attack, please state how many devices were affected d) For each attack, if known, the technique used i.e. DDoS (Direct Denial of Service), Adware, Phishing, Tampering, Spoofing, Bluejacking, Password attacks e) For each attack, whether it was reported to the police f) For each attack, whether it was reported to the Information Commissioner s Office A. 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 Health s legacy team to request this information: reviews&informationteam@dh.gsi.gov.uk. NHS Kernow has not been impacted upon by cyber-attacks since 1 April 2013. Patient safety and experience FOI60630 Never events and serious incidents Date received: 07/06/2017 1. Please send the full Never Events and Serious Incidents report which was presented to Kernow Clinical Commissioning Group s Quality and Performance Committee on April 25 at Trevithick meeting room, Sedgemoor. Reference of the report can be found by reading action point QP2017/088 on page 5 of the minutes of the Quality and Performance Committee which met on April 25 A. NHS Kernow can confirm that it does hold the information you have requested. However, we exempt the release of this information under the following exemptions: Section 31 - Law Enforcement Section 36 - Prejudicial to Effective Conduct of Public Affairs 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 the release of this information may unfairly expose the voluntary supplier of information for this investigation. The never event mentioned in the report is still under investigation and releasing information before an investigation has concluded may also prejudice the outcome. 26

We would expect to share details of learning and general findings relating to all never events to our Governing Body once an investigation has concluded. Providers are also expected to report similar information to their boards once their own investigations have ended. Prescribing and pharmacies FOI60510 Community pharmacy commissioning Date received: 02/06/2017 1. What services does NHS Kernow CCG-currently commission from community pharmacies in your area? (Please note, services may include minor ailments, smoking cessation, homeopathy, gluten-free prescriptions, vascular risk checks, Chlamydia screening, vaccinations etc) A. NHS Kernow commissions a minor ailments scheme, an emergency supply scheme and a palliative care drugs list scheme. 2. Has NHS Kernow CCG-decommissioned any health services provided by community pharmacies in your area in the last two years? (April 2015 April 2017)? A. Yes, NHS Kernow decommissioned the supply of gluten free foods on prescription. More information on this decision is available on our website: https://www.kernowccg.nhs.uk/about-us/what-we-spend-and-how-we-spendit/services-review-update/gluten-free-prescribing/ We therefore exempt the release of this information under section 21 of the Freedom of Information Act, information accessible by other means. 3. Where a meeting was held to discuss stopping funding any community pharmacy services, please could you give me the following details: a) The date of the meeting b) A full list of the services discussed c) A full list of the attendees d) A copy of the minutes of the meetings A. The decision to decommission the supply of gluten free foods on prescription was discussed at NHS Kernow s October 2016 Governing Body meeting. NHS Kernow routinely publishes Governing Body meeting papers on our website: https://www.kernowccg.nhs.uk/get-info/governing-body-meetings/ 27

Information on the decision to decommission the supply of gluten free foods on prescription is also available on our website: https://www.kernowccg.nhs.uk/about-us/what-we-spend-and-how-we-spendit/services-review-update/gluten-free-prescribing/ We therefore exempt the release of this information under section 21 of the Freedom of Information Act, information accessible by other means. A meeting took place on Thursday 9 June regarding the commissioning of community pharmacy services. A redacted copy of these minutes are attached. 4. Have there been any discussions around future plans to decommission health services currently provided by community pharmacies in NHS Kernow CCG s area? A. No. 5. Where such a discussion has been held, please could you give me the following details: a) The date of the meeting b) A full list of the services discussed c) A full list of the attendees d) A copy of the minutes of the meetings A. N/A. FOI60770 Care home services Date received: 14/06/2017 1. Are Medicines Optimisation services in Care Homes delivered by: CCG GP Practice Care Home independently Community Pharmacy Other (please state) A. Medicines optimisation services in care homes in Cornwall and the Isles of Scilly are provided by NHS Kernow and GP practices. Community pharmacies also supply medicines and support to care homes. FOI60950 - QIPP Date received: 20/06/2017 28

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 2016/17? 2. Could you please provide me with the details of any prescribing rebate schemes and QIPP/efficiency saving prescribing schemes active within your CCG for the current financial year 2017-18 (as they currently stand)? A. Primary care prescribing rebate schemes for 2016/17 and 2017/18: Rebated drug(s) Company Contract and period of agreement Apidra Sanofi 01/04/2014 to 31/03/2018 Axalid (Pregabalin) GlucoRx 01/04/2017 to 31/03/2018 Capsules BD Viva BD (Becton Dickinson UK 12/06/2017 to 12/06/2019 Ltd) Biquelle XL Aspire 01/04/2017 to 31/03/2019 Ebesque XL Ethypharm UK Ltd (DB Withdrawn January 2017 Ashbourne) Enteral Feeds Fresenius Kabi Ltd Sept 2013 to March 2017 Fencino Ethypharm UK Ltd (DB Initial fixed term of eight Firmagon (Degaralix) Ashbourne) months - ongoing Ferring 01/09/2016 to 01/08/2019 (superseded previous contract) Insuman Sanofi 01/04/2014 to 31/03/2018 Seretide GSK 01/09/2016 to 31/08/2018 Spiolto Boehringer-Ingleheim September 2016 for a term of three years Wavesense Jazz AgaMatrix Europe 01/10/2015 to 30/09/2020 NHS Kernow s QIPP prescribing schemes in 2016/17 were: CV - Promote Atorvastatin over Rosuvastatin CV - Promote Monomil 60mg XL over other Isosorbide Mononitrate 60mg MR DM - Alogliptin DM - BGTS Type 2 Diabetes DM - Insulins (Biphasic Analogues to Biphasic NPH) DM - Needles DM - Metformin SR to Sukkarto (Branded Alternative) MO - Axalid, Alzain or Rewisca from Pregabalin MO - Promote Ebesque, Biquelle or Sondate XL over all other Quetiapine XL (including generic) MO - Promote Generic Levetiracetam Tablet Prescribing 29

MO - Promote generic Sildenafil over other oral PDi5 inhibitors MO - Promote Longtec/Reltebon over other Oxycodone MR (including generic) MO - Promote Shortec/Lynlor over other Oxycodone immediate release (including generic) Promote Zapain Caplets from other forms of Co-Codamol 30/500 [Target 95.00%] MO - Butec from Butrans 2016/17 Respiratory - Use Of Duoresp Sipromax and Fostair Nexthaler over Symbicort Respiratory - Use Of Formeterol over Sameterol Respiratory - Use Of Fostair, Flutiform or Sirdupla over Seretide Respiratory - Use Of Seebri or Eklira over Spiriva NHS Kernow s QIPP prescribing schemes for 2017/18 are still being finalised. 3. What was the total income for the CCG from rebates during 2016/17? A. 476k ( 280k of this was non-recurrent). FOI60960 Rebate agreements Date received: 21/06/2017 1. I would like to request the list of pharmaceutical products/medicines/drugs that Kernow CCG currently holds rebate agreements for. If possible, can you also provide the corresponding rebate start dates please? A. NHS Kernow s current prescribing rebate schemes are: Rebated drug(s) Company Contract and period of agreement Apidra Sanofi 01/04/2014 to 31/03/2018 Axalid (Pregabalin) GlucoRx 01/04/2017 to 31/03/2018 Capsules BD Viva BD (Becton Dickinson UK 12/06/2017 to 12/06/2019 Ltd) Biquelle XL Aspire 01/04/2017 to 31/03/2019 Fencino Ethypharm UK Ltd (DB Ashbourne) Initial fixed term of eight months - ongoing Firmagon Ferring 01/09/2016 to 01/08/2019 (Degaralix) Insuman Sanofi 01/04/2014 to 31/03/2018 Seretide GSK 01/09/2016 to 31/08/2018 Spiolto Boehringer-Ingleheim September 2016 for a term 30

Rebated drug(s) Company Contract and period of agreement of three years Wavesense Jazz AgaMatrix Europe 01/10/2015 to 30/09/2020 Properties and estates FOI60980 Car parking Date received: 26/06/2017 1. How many car parking sites fall under the remit of the NHS Kernow CCG? 2. Roughly how many spaces do they provide in total across all sites? 3. Does the organisation manage their Car Parks directly (go to Q5) or via a Third Party (go to Q4)? 4. If managed by a Third Party: a) Who is the provider b) Dates of the contract duration (from/to)? c) What is the basis of the contract (build/operate; land lease; management only etc)? d) Any pros/cons of this arrangement? 5. How is parking currently controlled, e.g. POF, P&D, Permit, parking officers, barrier control, in/out global counting, bay occupancy? 6. Are you currently able to readily identify any patterns of use of particular zones/bay types/long or short term stays etc and collate this data to address specific problems areas on certain days/time periods? 7. What existing customer service focused measures are in place, e.g. information provided at entry points, visual guidance to zones/bays with available spaces, on-site support staff? 8. What are the key challenges that the NHS Kernow CCG face in regards to the provision of parking for patients/carers/visitors? 9. What are the key challenges that the NHS Kernow CCG face in regards to the provision of parking for staff? 10. Do you attend any conferences/events that focus on best practice in the management of parking/land use which you would recommend as good networking opportunities? 11. Who is the person responsible for Car Parks in your organisation (Name, Title, telephone and direct email) A. NHS Kernow does not hold the information you have requested. NHS Kernow s properties are managed by NHS Property Services and Community Health Partnerships, which includes the provision of car parking. Please redirect your request to information@property.nhs.uk and foi@communityhealthpartnerships.co.uk to request this information. 31

Urgent care FOI60970 Urgent care contracts Date received: 22/06/2017 1. Please send the full names of all bidders for Kernow CCG s contract for a functionally integrated urgent care access, treatment, and clinical access service incorporating NHS 111 and primary care out-of-hours services. Details of the contract was published on January 11, 2017, and closed on February 23, 2017. A. The above contract has not yet been finalised and agreed and therefore no formal Award Notice has been issued. 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 the release of this information at this stage of the tender 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. This information will be available once the procurement has ended and a contract has been awarded. Women's health FOI61100 Abortion referrals Date received: 29/06/2017 1. The average length of waiting time (in days) for women choosing to have an abortion from and to, including the date of their initial referral appointment to the date of abortion, for NHS-funded surgical abortions for 2012, 2013, 2014, 2015, 2016. 2. The average length of waiting time (in days) for women choosing to have an abortion from and to, including the date of their initial referral appointment to the date of abortion for NHS-funded medical abortions for 2012, 2013, 2014, 2015, 2016. 3. If you cannot provide this data, I instead request: a) The percentage and number of women having to wait more than 2 weeks for an abortion, from the date of their initial referral appointment/selfreferral date to their procedure, in 2012, 2013, 2014, 2015, 2016. 32

b) The percentage and number of women having to wait more than 4 weeks for an abortion, from the date of their initial referral appointment/selfreferral date to their procedure, in 2012, 2013, 2014, 2015, 2016. c) The percentage and number of women having to wait more than 6 weeks for an abortion, from the date of their initial referral appointment/selfreferral date to their procedure, in 2012, 2013, 2014, 2015, 2016. d) The percentage and number of women having to wait more than 8 weeks for an abortion, from the date of their initial referral appointment/selfreferral date to their procedure, in 2012, 2013, 2014, 2015, 2016. e) The percentage and number of women having to wait more than 12 weeks for an abortion, from the date of their initial referral appointment/self-referral date to their procedure, in 2012, 2013, 2014, 2015, 2016. A. NHS Kernow was formed on 1 April 2013 and cannot provide information relating to the former primary care trust (2010 to 2013). Please contact the Department of Health s legacy team to request this information: reviews&informationteam@dh.gsi.gov.uk. For information relating to 1 April 2013 to date, NHS Kernow does not hold the information you have requested. Please redirect your response to the following providers to request this information: Plymouth Hospitals NHS Trust (plh-tr.foi-requests@nhs.net) Royal Cornwall Hospital NHS Trust (rch-tr.foi@nhs.net) 33

Appendix FOI 60510 CPG Minutes Kernow Clinical Commissioning Group Minutes of the Commissioning Priorities Group Meeting held at 11.00 am on Thursday 9 th June 2016 at Trevithick Meeting Room, Sedgemoor Centre, St Austell Present: Chris Blong Chair Turnaround Director Francis Old GB GP Member Alison Flanagan GB GP Member Maggie Scott GB Member Nurse Lead Deputy Director of Corporate Governance Communications Manager (via Conference call) In attendance: Project Manager (Elective Care) Programme Manager (Elective Care Programme) Deputy Head of Prescribing Apologies: Simon Bell Chief Finance Officer Judy Duckworth GB GP Member Tamsyn Anderson Medical Director Rob White GB GP Member Exceptional Treatments Manager Karen Kay Director of Commissioning Deputy Director, Informatics, Performance & Contract Management Kathryn Hudson Director of Integrated Commissioning Rev Jeff James Lay Member for Public and Patient Involvement Minutes: PA to Chief Finance Officer CPG2016/098 CPG2016/099 Apologies and Welcome Declaration Conflicts of Interest CPG2016/100 Review CPG Minutes and Action Grid CPG2016/101 Review of Commissioning Budget Proposals.

GP presented 2 services for review: Emergency Supply Service-Pharmacy Enhanced Service ( 139k). Decision: No FIA, retain, reduce scope of drugs offered, continue to improve vfm. Minor Ailments Service-Pharmacy Enhanced Services ( 56k). Decision: No FIA, retain. To be included in Urgent Care Review under FRP. CPG2016/102 Summary LES Review CPG2016/103 CPG2016/104 Agree a List of Disinvestment/Decommissioning Recommendations to GB: Update on GB Directions/On-Going Impact Assessments CPG2016/105 Review of Interim Decommissioning Policy and Procedure: CPG2016/106 Communications Strategy Update CPG2016/107 Key Timelines/Activity Review: CPG2016/108 AOB: Date and time of Next Meeting: Thursday 16 th June 2016 @ 10.30 am in Print Room. FINAL COPY FOR RATIFICATION Signed by the Chair Dated

Appendix FOI 60630 Meeting of the Quality and Performance Committee Summary Sheet Date of Meeting: 25/04/2017 For: Information QP2017/088 Agenda Item and title: Author(s): Presented by: Lead Director: Clinical Lead: Serious incidents and never events Redacted Redacted Natalie Jones Alison Flanagan Executive summary: Numbers and trends in serious incidents Increased reporting from RCHT and improvements in responsiveness and submission of 72 hour reports. Continuing to track trend re delays in reporting but too early to demonstrate improvement yet. Recommendations and specific action the Committee needs to take at the meeting? Evidence in support of arguments: Who has been involved/contributed: Cross Reference to Strategic Objectives: