NHS Kernow - Disclosure Log Freedom of Information Requests November 2017

NHS Kernow - Disclosure Log Freedom of Information Requests November 2017

Contents Prescribing and pharmacies... 3 FOI 63600 Growth hormones... 3 FOI 63750 UTI treatment... 5 FOI 64180 Gallstone treatment... 6 Contracts... 6 FOI 63720 GP at hand... 6 FOI 64050 Non-emergency patient transport... 6 FOI 63830 Health apps... 7 FOI 63770 AQP audiology... 8 Individual funding requests... 10 FOI 63810 Positional plagiocephaly... 10 Information governance... 11 FOI 63760 Information governance... 11 Organisation... 12 FOI 63870 Public relations... 12 Women s health... 13 FOI 63820 IVF... 13 Long term conditions... 14 FOI 63970 Diabetic wounds... 14 FOI 63730 Wheelchair services... 15 Referral management... 17 FOI 63930 Smokers and BMI over 30... 17 FOI 63920 Smokers and BMI over 30... 18 FOI 63640 Hernia guidelines... 19 Finance and budgets... 20 FOI 63940 Mental health spend... 20 FOI 64170 Capped expenditure process... 21 Continuing healthcare... 22 FOI 63980 Continuing healthcare... 22 Children s health... 23 FOI 63880 Paediatric audiology... 23 Public Health... 28 FOI 63960 GP federations... 28 Patient safety and experience... 28 FOI 64060 Red bag scheme... 28 2

Mental health and learning disabilities... 29 FOI 64190 CAMHS... 29 The information supplied to you continues to be protected by the Copyright, Designs and Patents Act 1988. You are free to use it for your own purposes, including any non-commercial research you are doing and for the purposes of news reporting. Any other re-use, for example commercial publication, would require the permission of the copyright holder. Most documents supplied by NHS Kernow Clinical Commissioning Group will have been produced by local officials and will be our copyright. Information you receive which is not subject to our copyright continues to be protected by the copyright of the person, or organisation, from which the information originated. You must ensure that you gain their permission before reproducing any third party information. All appendices for this disclosure log are available upon request by emailing KCCG.FOI@nhs.net with the appropriate FOI reference below. Prescribing and pharmacies FOI 63600 Growth hormones 01/11/2017 FOI ref: 63600 Growth Hormone use and policies within your organisation. 1. For each of the listed licensed Somatropin preparations in the table below (Table 1.1 Somatropin Table) please provide information on: (Please provide answers in the table provided) Restrictions i) Are there any restrictions to the prescribing of each preparation? IF YES - Please state, where possible, the reason for the restriction and if the restriction applies to children (patients aged 18 or under) ii) Are there any planned changes to these restrictions over the period of the rest of this financial year (2017/18) and 2018/19? IF YES - please provide details of planned changes. Restrictions Are there any Planned changes to Restricted status? Restricted? Yes/No Yes/No If restricted, please state reason given. Does this restriction apply to children (patients aged 18 or under)? If yes please provide details 3

Genotropin Humatrope Nordiflex Norditropin Nutropin Omnitrope Saizen Zomacton Table 1.1. Somatropin Table 2. Please provide a copy of the latest written policy, protocol, pathways, shared care agreement or other literature outlining your organisation s recommendations for the use of licensed Somatropin preparations in children (patients aged 18 or under) in line with NICE TA 188? If the information is already in the public domain could you please provide the direct URL to where this information is located 3. Are local policies for the use or restriction of licensed Somatropin preparations in patients aged 18 or under led by specialists in hospital or medicines optimisation/medicines management pharmacists within your organisation? 4. Does your organisation monitor adherence or have internal audits in place to monitor adherence in patients who have been prescribed a Somatropin product? IF YES please provide details: 1. i) The only restriction for prescribing each preparation is to promote use of cost effective option, whilst recognising patient preferences ii) There are no planned changes to these restrictions over the period of the rest of this financial year (2017/18) and 2018/19 2. A copy of the latest written policy, protocol pathways, shared care agreement or other literature outlining the organisations recommendations for the use of licensed Somatropin preparations in children (patients aged 18 or under) in line with NICE TA 188 can be found at; http://intranet.cornwall.nhs.uk/documentslibrary/royalcornwallhospitalstrust /Clinical/Pharmacy/SomatropinPaediatricSCG.pdf 3. Local policies for the use or restriction of licensed Somatropin preparations in patients aged 18 or younger are developed in conjunction with provider trust and medicines optimisation team 4. CCG does not monitor adherence or have internal audits in place to monitor adherence in patients who have been prescribed a Somatropin product. 4

03/11/2017 FOI 63750 UTI treatment 07/11/17 FOI ref: 63750 5. Do you have a formulary used by primary care prescribers? 6. If so, what is the current status of nitrofurantoin and trimethoprim with respect to urinary tract infections (e.g. first line, second line, etc) 7. Has the status of either nitrofurantoin or trimethoprim changed in the formulary since November 2014? If so, can you please provide the previous status(es) and details of the date(s) of change. 8. Have you had any work plans in place with respect to nitrofurantoin and trimethoprim prescribing since 2014? If so, can you please provide documents and start date. 9. Have you had any GP prescribing incentive schemes or similar which relate to trimethoprim or nitrofurantoin prescribing since November 2014? If so, can you please provide the documents. 1. NHS Kernow has a formulary used by primary care prescribers, it is available at https://www.eclipsesolutions.org/cornwall/. 2. NHS Kernow s formulary is available at https://www.eclipsesolutions.org/cornwall/ and includes the statuses of nitrofurantoin and trimethoprim with respect to urinary tract infections. 3. NHS Kernow s guidelines are reviewed annually. Prior to 2016 nitrofurantoin and trimethoprim were both options for the treatment of uncomplicated urinary tract infections. In 2015 nitrofurantoin became first line treatment for uncomplicated urinary tract infections. 4. In line with antimicrobial resistance five year strategy NHS Kernow carries out audits on the prescribing of antibiotics in line with guidance. 5. NHS Kernow has not had any GP prescribing incentive schemes that relate to trimethoprim or nitrofurantoin with November 2014. 5

17/11/2017 FOI 64180 Gallstone treatment 28/11/2017 FOI ref: 64180 1. Does Kernow CCG currently have a guideline in place for the use of Ursodeoxycholic acid 250mg TABLETS? 2. If the answer is yes to request 1, could you send me details of this guideline. 1. NHS Kernow does not have a guideline in place for the use of Urodeoxycholic acid 250mg tablets, however it is on our formulary; www.eclipsesolutions.org/cornwall 30/11/2017 Contracts FOI 63720 GP at hand 06/11/2017 FOI ref: 63720 Could you please provide me figures under the Freedom of Information Act of how much each CCG is paying to GP at hand 2017 to provide this service - https://www.gpathand.nhs.uk/our-nhs-service NHS Kernow does not commission the services of GP at Hand 08/11/2017 FOI 64050 Non-emergency patient transport 23/11/17 FOI ref: 64050 1. Do you hold the budget for Mental Health Transport or is it held by the Trusts 6

in your area? 2. Who currently provides your NEPTS (Non-Emergency Patient Transport Services)? 3. When is your NEPTS contract up for renewal? 4. Are your mental health services commissioned within a wider Patient Transport Service? 5. Do you make use of providers other than your main contracts for Adhoc journeys or repatriations? 6. Do you use caged vehicles for your mental health journeys? 7. Do you commission a courier services and if so when does the contract expire? 1. NHS Kernow holds the budget for mental health transport 2. E-Zec Medical Transport currently provides our non-emergency patient transport services 3. NHS Kernow s contract with E-Zec Medical Transport is up for renewal on 1 st April 2019 4. NHS Kernow s mental health services are not commissioned within a wider patient transport service. 5. NHS Kernow does make use of providers other than our main contract for adhoc journeys and repatriations 6. Caged vehicles are not used for mental health journeys 7. The courier service is an in-house shared service provided by Royal Cornwall Hospitals Trust on behalf of the health community in Cornwall 28/11/17 FOI 63830 Health apps 10/11/2017 FOI ref: 63830 1. Does your CCG have a policy on the use of health apps? 2. If yes, please provide the policy (or policies) and contact details. 3. Do you currently have specific budgets for the use of health apps within your CCG? 4. If yes, please provide a contact for any budgets related to the use of health apps. 5. Are there individual health apps specified for patient use? Please provide a list of these. 6. If yes, please specify which of these health apps is paid for by the CCG. 7. Please specify who is responsible for the funding of each app that is paid for by the CCG and provide contact details? 1. NHS Kernow does not have a policy on the use of health apps 2. Not applicable 7

3. NHS Kernow does not have specific budgets related to the use of health apps 4. Not applicable 5. One of our GP practice localities has secured 500 licenses for mycopd 6. The 500 licenses for mycopd were made available to our patients by NHS England, at no cost to NHS Kernow 7. Not applicable 29/11/2017 FOI 63770 AQP audiology 08/11/2017 FOI ref: 63770 1. Regarding the CCG: * Are adult hearing services currently being delivered through Any Qualified Provider (AQP) within the CCG? * Does the CCG use AQP for any other services provided? If so, what services? 2. Regarding the CCG IF currently using AQP in the audiology service (IF NOT, please move to part 6): The audiology services provided by AQP: * When did the CCG begin using AQP? * Who are the current providers for audiology services? * How many AQP providers does the CCG have? * What percentage of provision is provided by private sector companies and NHS services within the CCG? 3. Type of AQP service provided: * Are they a Consultant led service? * What are the current appointment waiting times for the Audiology service? * What percentage of patients are fitted with bilateral hearing aids? * Are the type of hearing aid that providers fit audited? If so, what make and model of Hearing Aids are used? * Does the AQP service provide balance/diagnostic services? * Does the AQP service offer appointments for repairs or open clinics? 4. Referral to the audiology service: * Is a Choose and Book system used for audiology referrals? * Can patients be directly referred to an AQP audiology service by their GP? * From what age of patient do they accept Direct Referrals? 8

* What percentage of referrals are a direct referral to an AQP audiology service? 5. Cost of the service: * What is the current contract value of the Audiology service provided by AQP? * Is the Audiology service being operated within the current contract value? * What is the current contract length for the Audiology service? * When is the current contract due to expire? * Does the CCG have plans to continue using AQP for the audiology service after the current contract ends? 6. Regarding the CCG IF NOT currently using AQP in audiology: * Has the CCG used AQP to provide audiology services before? * When did the CCG stop using AQP in audiology? 1. - NHS Kernow has an AQP audiology service specification for individuals over the age of 55 years requiring assessment for routine hearing loss and contracts being put in place for this service, following a recent procurement exercise - NHS Kernow is using the AQP process for non-obstetric ultrasound, musculoskeletal services (MSK), physiotherapy and MRI 2. - NHS Kernow has had AQP audiology contracts in place since its formation on 1 st April 2013 - Information on NHS Kernow s AQP providers are available on our website; https://www.kernowccg.nhs.uk/ - All NHS Kernow s AQP audiology providers are commissioned to deliver AQP audiology services on behalf on the NHS. In the financial year 2016/17 sector providers conducted on average 60% of the AQP activity with the remaining 40% undertaken by NHS organisations 3. - The nature of the AQP audiology service is that they can be undertaken by qualified audiologists, there is no requirement for this to be undertaken by a consultant - Information on waiting times for audiology services is published on NHS England s website; https://www.england.nhs.uk/statistics/category/statistics/audiology-waitingtimes/ - In the last financial year 2016/17 93% of patients were fitted with bilateral hearing aids - The make and model of hearing aids vary across our providers. Provision of NHS-funded hearing aid(s) will be of a minimum technical specification as designated by the NHS. Commissioners recommend the use of NHS Supply Chain approved products or equivalent. - Balance/diagnostic services are not part of the audiology AQP specification - The service specification includes repairs, though is not prescriptive as to how aftercare and repairs should be delivered allowing this to be done via 9

4. a number of mechanisms (face to face, postal service, drop in clinics). The majority of our providers however prefer to operate on an open clinic basis. - Under the new contract, all new audiology referrals are directed through NHS Kernow s Referral management service (RMS) who then offer appointments via a choose and book system. The only exception to this if for domiciliary visits where the providers make direct contact with the patient to book their appointments from the referrals passed to them from the RMS - GP referral is the access criteria for AQP audiology services - The age criteria for AQP audiology 55 years and over - Under the new contract, all referrals to the AQP audiology service must be made via the GP except if they are part of another patient pathway 5. - The nature of an AQP contract is that there is no guaranteed activity. Consequently there is a 0 contract value for the AQP audiology service. However for all providers NHS Kernow has a budget of 2.2m - The spend on AQP audiology is expected to exceed the budget - The AQP audiology contract was recently procured for 20 months and is due to expire on 30 th June 2019 - It is not known at this time if NHS Kernow plans to keep using AQP for audiology services after the current contract ends 6. N/A 30/11/2017 Individual funding requests FOI 63810 Positional plagiocephaly 09/11/2017 FOI ref: 63810 Please could you provide me the number of funding requests for positional plagiocephaly treatment in the last 5 years. NHS Kernow has not received any funding requests for positional plagiocephaly treatment since April 2013. NHS Kernow was formed on 1 st 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 10

13/11/2017 Information governance FOI 63760 Information governance 02/11/2017 FOI ref: 63760 Pursuant to the Freedom of Information Act we are requesting details of the structure and chain of command for the Information Governance Department up to the most senior management including names and contact details. We await hearing from you in accordance with the Data Protection Act 1998 and the Freedom of Information Act. The NHS Kernow structure/chain of command for the Information Governance Department is as follows; Senior Information Risk Owner (SIRO)/Chief Operating Officer Helen Childs, Executive Director Caldicott Guardian/ Chief Nursing Officer Natalie Jones, Executive Director Deputy Director of Corporate Governance Information Governance Lead Head of Information Governance Records Management Team/Subject Access Request Team, Cornwall Partnership Foundation Trust on behalf of NHS Kernow The director with responsibility for this area of work is Helen Childs, who can be contacted on 01726 627800. As per NHS Kernow s policies and procedures we do not release names of employees below director level. 17/11/2017 11

Organisation FOI 63870 Public relations 13/11/2017 FOI ref: 63870 1. Does your Trust/CCT currently use a private company to undertake any of the following services: - Public Relations - Social Media Communications - External Stakeholder Communications - Internal Stakeholder Communications 2. If yes, can you please confirm: - When the current contract(s) was/were last let - When the current contract(s) expires/expire - Whether the current contract(s) has/have options to extend its length - When you expect to retender the contract(s) 3. If no (to question 1 above), are you considering letting such a contract (s) in the future and if so, do you have an approximate timetable for engaging the market? Part 2 4. Have you used a private company to help you with any other marketing or public information campaigns in the past two years? 5. If so, could you please provide a brief overview of what those campaigns were about approximately how long your contract with the company was for to support the campaign(s)? 1. NHS Kernow does not currently use a private company to undertake any public relations, social media communication, external stakeholder communications or internal stakeholder communications 2. Not applicable 3. NHS Kernow are not considering letting such a contract with a private company 4. NHS Kernow has not used a private company to help with any other marketing or public information campaigns in the past two years 5. Not applicable 12

21/11/2017 Women s health FOI 63820 IVF 10/11/2017 FOI ref: 63820 1. How many cycles of IVF has the authority funded in each of the financial years: (a) 2014/15 (b) 2015/16 (c) 2016/17 2. What was the total amount paid by the authority in each of these years to providers in payment for IVF services? (a) 2014/15 (b) 2015/16 (c) 2016/17 3. How many of the cycles stated in each year in answer to question 1 above were provided by NHS providers, and how many were provided by private or third sector providers? (a) 2014/15 (b) 2015/16 (c) 2016/17 4. Are individuals for whom the authority funds IVF services given any choice of provider? For example, does the authority procure a list of qualified providers and allow individuals eligible for IVF to choose from this list, or does the authority require individuals to use a provider nominated by the authority? 5. How, if at all have the authorities funding criteria for IVF services changed between the financial year 2014/15 and 01/11/2017. For example a. Has the number of cycles funded changed (if so, from what to what) b. Has the minimum age changed (if so, from what to what) c. Has the maximum age changed (if so, from what to what) d. Has the time trying to conceive criteria changed (if so, from what to what) e. Have criteria relating to previous children changed (if so, from what to 13

what) f. Have any other criteria changed or been introduced in this period, e.g. BMI The information you have requested in questions 1a, 1b, 2a, 2b, 3a, 3b, 4 and 5 has previously been released and can be found on our disclosure log https://www.kernowccg.nhs.uk/get-info/information-governance/freedom-ofinformation-(foi)-requests/foi-disclosure-log/. We therefore withhold this information under Section 21 of the Freedom of Information Act 2000; information accessible by other means. 1c. 58 2c. 240,410 3c. All are NHS Providers 21/11/2017 Long term conditions FOI 63970 Diabetic wounds 20/11/2017 FOI ref: 63970 1. How much money was spent in total on the management of diabetic wounds (A: clinician hourly rates, B: cost of materials) effecting the sole of the foot between January 2015 and January 2017? 2. How much money was spent on offloading orthoses (insoles that reduce high pressure points of the foot) for patients with diabetes between January 2015 and January 2017? 3. How much money was spent on TTCs (Total Contact Casts) used in the management of foot wounds in diabetic patients between January 2015 and January 2017? 4. How much money was spent on bespoke footwear (customised shoes) made for patients with diabetes-related foot complications between January 2015 and January 2017? 5. How many home visits were there related to the care for patients with diabetic neuropathic ulcers in 2015-2017 by: 14

a) District nurses; and b) Podiatrists? 6. What is the total cost of routine podiatry appointments for patients with diabetic neuropathic ulcers? NHS Kernow does not hold this information in this format. We only have total costs around the orthotic service equipment supplied. For details around diagnoses and patient care please contact Royal Cornwall Hospitals Trust rch-tr.foi@nhs.net and Cornwall Partnership Foundation Trust cpn-tr.freedomofinformation@nhs.net 21/11/2017 FOI 63730 Wheelchair services 06/11/2017 FOI ref: 63730 1. Who provides your current Wheelchair Service a. Is your provider an NHS organisation or a contracted-out, non-nhs organisation? b. What is the name of your current provider? c. What is the name of the Wheelchair Service Manager? 2. How your wheelchair services are provided a. Do you combine your Wheelchair Service with any other service, such as Prosthetics or Community Equipment? If so, please provide a list of the other services. b. Is your Wheelchair Service exclusive to your CCG? c. If you service is combined with another please provide a list of the CCGs that share this Wheelchair Service and confirm who is the lead CCG? d. Is the Repair and Maintenance element of the service integrated or contracted out to a 3rd party Approved Repairer? e. If you have an externally provided Approved Repairer, what is the name of your current provider? 3. About your wheelchair service a. What is the size of the population covered by your Wheelchair Service? b. How many registered service users are served by the Wheelchair Service? 4. About the Integrated (Combined service and Repair & Maintenance) contract with your provider a. What is the contract spend in the last financial year for the Integrated Wheelchair Service? 15

b. Please state the dates of your last financial year. c. When was the Integrated Wheelchair Service last tendered? d. When does the current contract expire? Please provide details of any potential contract extension? e. Please provide the date this Wheelchair Service will be next tendered 5. About the Repair and Maintenance (R&M) sub-contract with your wheelchair provider (where appropriate) a. What is the contract spend in the last financial year for the R&M Wheelchair Service? b. Please state the dates of your last financial year. c. When was the R&M Wheelchair Service last tendered? d. When does the current R&M sub-contract expire? Please provide details of any potential contract extension e. Please provide the date that R&M Wheelchair Service sub-contract will be next tendered 1.The assessment service is provided by Cornwall Partnership Foundation Trust with Royal Cornwall Hospitals Trust providing some paediatric assessments via the paediatric community therapy team. Millbrook industries provide the standard and non-standard wheelchairs supply, maintenance and repairs service. Ottobock provide bespoke seating systems. a. NHS Kernow operates with a mixture of both NHS providers and contracted out non-nhs organisations, Millbrook and Ottobock are non NHS organisations and contracts are in place for these companies. b. The names of NHS Kernow s current non-nhs providers are Millbrook and Ottobock. c. NHS Kernow does not release names of employees below Director level; the director with commissioning responsibility for this service is Helen Childs. Please contact Cornwall Partnership Foundation Trust cpntr.freedomofinformation@nhs.net for information on the service they provide. 2a. Prosthetics are commissioned by NHS England. Community equipment is commissioned through Cornwall Council, for further advise on their providers Freedom of Information requests can be submitted through their website https://www.cornwall.gov.uk/ b. The wheelchair service is exclusive to NHS Kernow c. Not applicable d. The repairs and maintenance service is part of the contract with the equipment supplier, Millbrook Industries. e. Not applicable 3a. Our wheelchair service covers a population of 534000 residents across Cornwall and the Isles of Scilly. b. NHS Kernow has 5112 adults and 574 children registered users served by the Wheelchair Service (numbers taken from quarter one of 2017/18) 4a. NHS Kernow s contract spend for Integrated Wheelchair Service for the last financial year 2016/17 was 2,401,000 16

b. The last financial year was 01/04/2016-31/03/2017 c. Information regarding when NHS Kernow s Integrated Wheelchair service contract was last tendered is available on our website; https://www.kernowccg.nhs.uk/about-us/what-we-spend-and-how-we-spendit/ d. Information on when NHS Kernow s current Integrated Wheelchair Service contract expires is available on our website; https://www.kernowccg.nhs.uk/about-us/what-we-spend-and-how-we-spendit/ e. Information on when NHS Kernow s Wheelchair Service contract will next be tendered is available on our website; https://www.kernowccg.nhs.uk/aboutus/what-we-spend-and-how-we-spend-it/ 5a. NHS Kernow does not have a separate repairs and maintenance contract, therefore we are unable to provide a breakdown of what was spent on repairs and maintenance from the total Integrated Wheelchair Service contract spend for the last financial year 2016/17 of 2,401,000 b. The last financial year was 01/04/2016-31/03/2017 c. Information of when NHS Kernow s contracts are tendered is available on our website; https://www.kernowccg.nhs.uk/about-us/what-we-spend-andhow-we-spend-it/ d. Information of when NHS Kernow s contracts are tendered is available on our website; https://www.kernowccg.nhs.uk/about-us/what-we-spend-andhow-we-spend-it/ e. Information of when NHS Kernow s contracts are tendered is available on our website; https://www.kernowccg.nhs.uk/about-us/what-we-spend-andhow-we-spend-it/ 27/11/2017 Referral management FOI 63930 Smokers and BMI over 30 16/11/2017 FOI ref: 63930 How many patients have been referred by their GP for elective care but have been unable to receive treatment because of a) being a smoker, and b) having a BMI over 30 for each of the following periods: - 2014/15; - 2015/16; - 2016/17; - and the first two quarters of 2017/18. Please ensure you provide answers for a) and b) in each period separately, where possible. Many thanks indeed for your assistance on this. 17

NHS Kernow does not have referral guidelines in place that prevents referral of patients who smoke or have a BMI of over 30. Please note that some of our providers of elective care services may have exclusions to access their services for patients with a BMI over a certain point due to equipment issues. 22/11/2017 FOI 63920 Smokers and BMI over 30 14/11/2017 FOI ref: 63920 1. Have referral policies changed for elective procedures for patients who are obese (with a BMI of 30 or above)? 2. Have referral policies changed for elective procedures for patients who smoke? 3. Are you considering changing referral policies for elective procedures for patients who are obese? 4. Are you considering changing referral policies for elective procedures for patients who smoke? 5. If yes to any of the above what has the change been or what change are you considering? 6. What is the current average wait from referral to treatment for elective hip replacements for patients who are obese or smoke? 7. What is the current average wait from referral to treatment for elective hip replacements for patients who are not obese and do not smoke? 1. NHS Kernow has not changed referral policies for elective procedures for patients who are obese (with a BMI of 30 or above) 2. NHS Kernow has not changed referral policies for elective procedures for patients who smoke 3. NHS Kernow is not considering changing referral policies for elective procedures for patients who are obese 4. NHS Kernow is not considering changing referral policies for elective 18

procedures for patients who are smoke 5. Not applicable 6. NHS Kernow does not have this information, we do not receive any data on obese patients or patients that smoke 7. NHS Kernow does not have this information, we do not receive any data on obese patients or patients that smoke 22/11/2017 FOI 63640 Hernia guidelines 01/11/2017 FOI ref: 63640 1. Provide a copy of the CCGs hernia commissioning guidance. 2. Provide a list of names of those who contributed to the guidance, and their email addresses. 3. Who is the lead clinical advisor for hernia (if application) at your CCG? What is their email address? 1. NHS Kernow s hernia commissioning guidance is available online; http://rms.kernowccg.nhs.uk/primary_care_clinical_referral_criteria/general_s urgery/hernias 2. The director with responsibility for this area of work is Gordon Frame, who can be contacted on 01726 627800. As per NHS Kernow s policies and procedures we do not release names of employees below director level. 3. The Elective Care Clinical Lead is Dr Robert White, Robert.white7@nhs.net. 22/11/2017 19

Finance and budgets FOI 63940 Mental health spend 16/11/2017 FOI ref: 63940 1. What was your total CCG 2015/16 outturn? 2. What was your total CCG 2016/17 outturn? 3. What was your planned spend as a proportion of overall CCG allocation in 2015/16 on mental health? 4. What was your planned spend as a proportion of overall CCG allocation in 2016/17 on mental health? 5. What was your total planned spending for mental health 2016/17? 6. What was your total planned spending for mental health 2015/16? 7. What was your mental health 2015/16 outturn? 8. What was your mental health 2016/17 outturn? 1. NHS Kernow s total 2015/16 outturn is published in our annual report, available on our website; https://www.kernowccg.nhs.uk/about-us/annual-report/ 2. NHS Kernow s total 2016/17 outturn is published in our annual report, available on our website; https://www.kernowccg.nhs.uk/about-us/annual-report/ 3. NHS Kernow s planned spend as a proportion of overall CCG allocation in 2015/16 on mental health can be calculated from our annual report 4. NHS Kernow s planned spend as a proportion of overall CCG allocation in 2016/17 on mental health can be calculated from our annual report 5. NHS Kernow s total planned spending for mental health in 2016/17 was 124,099,000 6. NHS Kernow s total planned spending for mental health in 2015/16 was 125,839,000 7. NHS Kernow s mental health 2015/16 outturn was 122,206,000 8. NHS Kernow s mental health 2016/17 outturn was 126,218,000 24/11/2017 20

FOI 64170 Capped expenditure process 27/11/2017 FOI ref: 64170 1. Please state the progress to date against the financial targets set by Capped Expenditure Process in Cornwall. 2. Please state how savings through the Capped Expenditure Process have been achieved to date. 3. Please state how further savings through the Capped Expenditure Process will be achieved before the end of 2017-18. 4. Please provide minutes of all internal meetings between 1 July 2017 and November 27 2017 in which the Capped Expenditure Process has been discussed. 5. Please provide a copy of all internal correspondence between the CCG and NHS England and/or NHS Improvement between 1 July 2017 and November 27 2017 in which the capped expenditure is discussed. 1. Although invited to take part in the Capped Expenditure Process (CEP), NHS Kernow was unable to agree with NHS England any improvement on its initial Plan of an in-year deficit of 37.6m. NHS England had set a control total deficit for the CCG of 19.9m, leaving a gap of 17.7m. NHS Kernow s financial position is regularly reported at the Governing Body. This reports our position against both NHS Kernow s original plan and the control total set by NHS England. The papers for this are available on our website; https://www.kernowccg.nhs.uk/ 2. NHS Kernow does not have a separate savings programme associated with the Capped Expenditure Initiative. 3. NHS Kernow does not have a separate savings programme associated with the Capped Expenditure Initiative. 4. As noted above, NHS Kernow does not have a distinct programme of work for the CEP but broader financial recovery is a core part of NHS Kernow s business, given its current financial over commitment. As such, we would not have distinct meetings to discuss the CEP as a separate programme. 5. As noted above, NHS Kernow does not have a distinct programme of work for the CEP. Overall financial recovery is a regular part of NHS Kernow s discussions with NHS England, given the current financial over commitment. In view of this, we would not have distinct correspondence to discuss the CEP as a separate programme.. 22/12/2017 21

Continuing healthcare FOI 63980 Continuing healthcare 20/11/2017 FOI ref: 63980 1. How many patients within your CCG were deemed eligible for NHS Continuing Healthcare packages in the financial years 2016/17, 2015/16 and 2014/15? Please could I have this information broken down by year? 2. How many patients within your CCG died in hospital while awaiting the start of a NHS Continuing Healthcare care and support package in the financial years 2016/17, 2015/16 and 2014/15? Please could I have this information broken down by year? 3. How many patients in the last four financial years have waited more than a) one week b) one month c) one year to receive a care and support package after being found eligible for NHS Continuing Healthcare? Please could I have this information broken down by year? 4. What was the longest wait between a patient being found eligible for NHS Continuing Healthcare and receiving a care and support package in the financial years 2016/17, 2015/16 and 2014/15? Please could I have this information broken down by year? 1. The following patients with deemed eligible for continuing healthcare packages by NHS Kernow in the last three financial years; - 2014/15 2310 patients - 2015/16 2380 patients - 2016/17 2279 patients 2. NHS Kernow does not hold the information as requested 3. NHS Kernow does not hold the information as requested 4. NHS Kernow does not hold the information as requested 28/11/17 22

Children s health FOI 63880 Paediatric audiology 13/11/2017 FOI ref: 63880 1. Please state the name, job title and contact details of the person completing this form. We will only use these details if we have queries about your responses and will not share your details with anyone outside the National Deaf Children s Society. Name: Job title: Email address: Phone number: 2. Please list the locations where secondary tier paediatric audiology services, commissioned by your CCG, are carried out (services which carry out hearing assessments but do not carry out any treatment or re/habilitation services. Children found to have a hearing loss would be referred to the ENT clinic or tertiary paediatric audiology service for hearing aid fitting). Please use full names, with no abbreviations and add further rows or continue on a further sheet of paper if necessary. Name of NHS Trust or Provider Hospital or Clinic or site name Address Postcode 23

3. Please list the locations where tertiary paediatric audiology services, commissioned by your CCG, are carried out (services which carry out both hearing assessments and re/habilitation services, including hearing aid fitting). Please use full names, with no abbreviations and add further rows or continue on a further sheet of paper if necessary. Name of NHS Trust or Provider Hospital or Clinic or site name Address Postcode Are hearing assessments carried out at this site? Y/N Is hearing aid fitting carried out at this site? Y/N Does this site provide tinnitus and balance services? Y/N 24

4. Is there anything else you d like to tell us about the sites where paediatric audiology services are commissioned or details of the commissioning arrangements? 5. Do you use the Commissioning Services for People with Hearing Loss: A framework for clinical commissioning groups? when commissioning services for deaf children in your area? Please put a cross next to the most relevant option. Yes No Not sure Not aware of it 6. Do you use the model service specification for children s audiology services that forms part of the Commissioning Services for People with Hearing Loss: A framework for clinical commissioning groups? (section 8.5)? Please put a cross next to the most relevant option. Yes No Not sure 7. When commissioning paediatric audiology services (via a contract or service specification etc.) do you require them to: (Please put a cross next to the most relevant option) Have gained IQIPS (Improving Quality in Physiological Services) accreditation for paediatric audiology Be working towards IQIPS accreditation for paediatric audiology Neither of these options 8. Is there anything else you d like to tell us about the paediatric audiology services that you commission? 25

1. Name: NHS Kernow does not release the names of employees below director level Job title: Freedom of Information Officer Email address: kkcg.foi@nhs.net Phone number: 01726 627800 2. Please see below list of locations where secondary tier paediatric audiology services commissioned by NHS Kernow are carried out; Name of NHS Trust or Provider Royal Cornwall Hospitals Trust Royal Cornwall Hospitals Trust Royal Cornwall Hospitals Trust Royal Cornwall Hospitals Trust Royal Cornwall Hospitals Trust Royal Cornwall Hospitals Trust Royal Cornwall Hospitals Trust Royal Cornwall Hospitals Trust Royal Cornwall Hospitals Trust Royal Cornwall Hospitals Trust Royal Cornwall Hospitals Trust Royal Cornwall Hospitals Trust Royal Cornwall Hospitals Trust Hospital or Clinic or site name West Cornwall Hospital Camborne and Redruth Community Hospital Falmouth Health Centre Truro Health Park Newquay Health Centre Educational Audiology Centre Bodmin Health Centre Wadebridge Health Office Launceston Hospital Stratton Hospital Liskeard Hospital Callington Health Centre Saltash Children Centre Address St Clare Street, Penzance Barncoose Terrace, Redruth Trescobeas Road, Falmouth Infirmary Hill, Truro St Thomas Road, Newquay Priory Road, St Austell Bodmin Road, Bodmin Brooklyn, Wadebridge Link Road, Launceston Hospital Road, Stratton, Bude Clemo Road, Liskeard Haye Road, Callington Plougastal Drive, Saltash Postcode TR18 2PF TR15 3ER TR11 2JA TR1 2JA TR7 1RU PL25 5AB PL31 2LB PL27 7AT PL15 9JD EX9BR PL14 3XD PL17 7AW PL12 6DL 26

Royal Cornwall Hospitals Trust Plymouth Hospital NHS Trust Plymouth Hospital NHS Trust Plymouth Hospital NHS Trust Plymouth Hospital NHS Trust Plymouth Hospital NHS Trust Plymouth Hospital NHS Trust Torpoint Community Centre Derriford Hospital Mount Gould Local Care Centre Ivy Bridge Health Centre South Hams Hospital Tavistock Hospital Clinic Plymouth Child Development Centre Macey Street, Torpoint Derriford Road. Crownhill, Plymouth, Devon 200 Mount Gould Road, Plymouth Station Road, Ivybridge, Devon South Hams Community Hospital, Plymouth Road, Kingsbridge, Devon Spring Hill, Tavistock Scott Business Park, Beacon Park Road, Plymouth PL11 2AJ PL6 8DH PL4 7PY PL21 0AJ TQ7 1AT PL19 8LD PL2 2PQ 3. Tertiary paediatric audiology services are not commissioned by NHS Kernow and are commissioned by NHS England, for further information please email england.contactus@nhs.net 4. Not applicable 5. NHS Kernow uses the Commissioning Services for People with Hearing Loss: A framework for clinical commissioning groups. 6. NHS Kernow does not use the model service specification for children s audiology services. 7. When commissioning paediatric audiology services NHS Kernow requires neither Have gained IQIPS (Improving Quality in Physiological Services) accreditation for paediatric audiology or Be working towards IQIPS accreditation for paediatric audiology 8. Not applicable 01/12/2017 27

Public Health FOI 63960 GP federations 19/11/2017 FOI ref: 63960 1) A list of all GP Federations (alliance, network, social enterprise, collaboration or any other associative name) etc. that operate through your CCG. The list will include: -Name of the Federation -Number and list of names of practices -Structure of each Federation (whether a LTD company, LLP, coop, CIC etc.) -Main point of contact for each Federation -Population covered Kernow Health CIC is the GP federation that operates through NHS Kernow, all the information requested is available on their website; http://www.kernowhealthcic.org.uk/ 05/12/2017 Patient safety and experience FOI 64060 Red bag scheme 23/11/2017 FOI ref: 64060 Please could you tell me the name of the person who would be responsible for improving care in care homes for residents as well as email addresses wherever possible, Based on recent Vanguards being selected as pilots for the Red Bag Scheme we are looking to share our products that might assist your organisation s lead for the transfer of patients from care homes into Hospital. It could be a Nursing and Quality Manager, please advise. The director with responsibility for Quality is Natalie Jones who can be contacted at natalie.jones9@nhs.net. Please note that NHS Kernow does not commission Care Homes, these are private 28

companies and you may wish to contact them direct. 07/12/2017 Mental health and learning disabilities FOI 64190 CAMHS 27/11/2017 FOI ref: 64190 1. For each of the last 3 years, what was the average waiting time for patients in your CCG from referral to assessment in a Tier 2 CAMHS service? 2. For each of the last 3 years, what was the average waiting time for patients in your CCG from referral to first point of treatment in a Tier 2 CAMHS service? 3. For each of the last 3 years, what was the average waiting time for patients in your CCG from referral to assessment in a Tier 3 CAMHS service? 4. For each of the last 3 years, what was the average waiting time for patients in your CCG from referral to first point of treatment in a Tier 3 CAMHS service? If differentiation between Tier 2 and Tier 3 services proves difficult, please feel free to collate the numbers into a single statistic. Tier 2 Average waiting time from referral to assessment Average waiting time from referral to first point of treatment 2015 2016 2017 Tier 3 Average waiting time from referral to assessment Average waiting time from referral to first point of treatment NHS Kernow does not hold the information you have requested, for more information please contact Cornwall Partnership NHS Foundation Trust cpn- 29

tr.freedomofinformation@nhs.net. 12/12/2017 30