GM ASSOCIATION OF CCGs: Association Governing Group (AGG) TUESDAY, 19 JANUARY 2016 13:00-16:45 Conference Suite, Level 2, Manchester Town Hall Attendance: Steve Allinson (SA) NHS Tameside & Glossop CCG Alan Dow (Arrived 13:55) (AD) NHS Tameside & Glossop CCG Chris Duffy (CD) NHS HMR CCG Ranjit Gill (Arrived 14:00) (RG) NHS Stockport CCG Denis Gizzi (Arrived 13:15) (DG) NHS Oldham CCG Nigel Guest (Arrived 13:40) (NG) NHS Trafford CCG Caroline Kurzeja (CK) NHS South Manchester CCG Stuart North (SN) NHS Bury CCG Hamish Stedman (HS) NHS Salford CCG (Chair) Bill Tamkin (BT) NHS South Manchester CCG Martin Whiting (Left 16:15) (MW) NHS North Manchester CCG Gaynor Mullins (GMu) NHS Stockport CCG Apologies: Trish Anderson (TA) NHS Wigan Borough CCG Wirin Bhatiani (WB) NHS Bolton CCG Tim Dalton (TD) NHS Wigan Borough CCG Ed Dyson (ED) NHS Central Manchester CCG Michael Eeckelaers (ME) NHS Central Manchester CCG Anthony Hassall (AH) NHS Salford CG Gina Lawrence (GL) NHS Trafford CCG Su Long (SL) NHS Bolton CCG Kiran Patel (KP) NHS Bury CCG Ian Wilkinson (IW) NHS Oldham CCG Simon Wootton (SW) NHS HMR CCG In Attendance: Kate Ardern (Agenda item 10 only) (KA) Director Public Health Wigan Council Rob Bellingham (Arrived 14:25) (RB) NHSE - GM & Lancs Sub Region Team Sandy Bering (Agenda item 10 only) (SB) NHS Trafford CCG Andrea Dayson (ADa) GM Association of CCGs Warren Heppolette (WH) Health & Social Care Reform Sophie Hargreaves (Agenda item 5 only) (SH) Healthier Together Jonathan Kerry (Agenda item 6 only) (JR) NHS Wigan Borough CCG Stephanie Pearson (SP) GM Association of CCGs (Minutes) Annette Walker (Arrived 13:55/ Left 16:30 (AW) NHS Bolton CCG (CFO Chair) Ian Williamson (Agenda item 4 & 5 only) (IWi) GM Devolution Kath Wynne Jones (KWJ) NHS Oldham CCG (HoC Chair) 1.WELCOME & APOLOGIES FOR ABSENCE The chair welcomed all members and noted apologies. MW & CK are representing all three Manchester CCGs. Page 1 of 6
2. DECLARATION OF INTEREST None noted. 3. MINUTES OF THE LAST MEETING 15.12.15 Noted and agreed All actions completed. 4. DEVOLUTION UPDATE IW and WH attended to give a brief description of the current position of devolution:- Main pieces of work going forward o Design the implementation framework of the Strategic Plan. o Transformation fund the rules and criteria have been drafted. o #Taking charge agenda. o Detailed paper around the accountability arrangements described at the SPB Executive. o Need to agree management arrangements and a firm foundation for responsibilities. Implementation Working Group was established to oversee all elements of the Strategic Plan. Implementation Working Group (IWG) met last week with RG in attendance for the CCGs. Operational Management Team to focus on BAU - transfer of functions from NHS England. Need to develop a programme risk register. Transformation fund criteria; AGG to schedule time in February to co-ordinate discussion. IW confirmed the AGG Executive has provided consistent representation which is working well. As we move towards implementation we need to continue discussions with the CCGs. Transformation Fund paper scheduled for February AGG for discussion ADa 5. HEALTHIER TOGETHER IMPLEMENTATION IW and SH attended to provide on update on HT:- 12 CCGs will remain accountable with a reporting route into the JCB to ensure oversight into HT. Programme plan programme board 5 th Feb to look at the first plan. Sequencing some sectors might take longer to go through all the stages due to capital build. Programme plan take a baseline in March and then take an assessment every 6 months. Capital funding is an issue and the main priority with no timescales as yet. NWAS flagged as a risk as timeline still not received; Pathfinder is crucial element. Best possible result from the judicial review noted thanks to everyone for their support. Thanks also formally minuted to the HT team from the CCGs. There is a right appeal within 21 days of the decision which would be the 28 th January. Work with the CFOS and report into the financial framework will report into the programme board Governance discussed and agreed that this could be routed through CFOs. CK/ED wanted to alert members to a communications paper to request funding support. GM recruitment process had started to ensure that spread is even across GM. Jane Eddleston appointed as chief medical advisor. Interviews on going for clinical champions. Page 2 of 6
Recover of legal costs to go to COOs and CFOs to discuss further COOs to discuss the recovery of legal costs form the Judicial Review. 6. DIGITAL ROADMAP Jonathan Kerry presented a paper on the update on progress:- Assurance that this is being dealt with in terms of how it fits into the locality plans. Lot of direction from NHSE how they will review road maps and the 7 key areas. Need to link with locality plans and devolution. Pull together a working group deadline to complete is April 16. Progress to date locality plans to pick up key themes to understand and progress forward. Engagement event last week with IMT leads. Data service for commissioner ask for analysis to show the pathways. Could be quick wins to link organisations together. AD noted that point 4.2.5 needs to include Glossop. The digital roadmap is a CCG agenda and NHSE have delegated responsibly to CCGs to devise. Will link into the strategy/assurance group that Joe McGuigan chairs. AGG noted progress and await further review in a few months 7.3 GOVERNANCE Primary Care standards SL previously highlighted a need for GM social care standards. Governance group meets on a weekly basis current focus on JCB. JCB paper re; accountability and delegation of budgets input from Claire Wilson. Paper about delegation and NHSE governance going to Operational Management Team. JCB Working Group chaired by RB had its first meeting CCG representation from Andrea Dayson, Steve Dixon, Kath WJ, Melissa L and Melissa S. Work needs to be done to look at AGG and how this supports the JCB agenda. 7.4 DMT DMT now transitioned to the Operational Management Team (OMT) Establishment of an Implementation Working Group (IWG) RG attended the first meeting Need to work though the approach on poor A&E targets different approach moving forward. From April will be judge as GM will be judge on all failures not just local failures. IW in discussions with regulators to be a part of the OMT. OMT and IWG relying on the AGG Executives to support due time commitments required. RB interim chair of the OMT until the GM CO is appointed. WH will be pulling together a paper as accountability needs to be properly agreed. Need to steer clear of micromanagement but needs to move towards brokerage. Page 3 of 6
AGG agreed AGG Executive to support OMT and IWG 7.5 DEVOLUTION PROGRAMME BOARD Transformation fund from PWC and Carnall Farrer needs to be reviewed at a future AGG. Need to be aware what is included in the Transformation Fund. Need to make sure that papers are presented in a timely manner but understand this is difficult. Accountability framework document reference the sustainability budget. Regulators wrote to all providers to confirm what funds they will receive we need to ensure all conditions come through the transformational team. Comms need to be highlighted to ensure that they include CCGs in communications. GM Transformation Fund document circulated to AGG - complete ADDITIONAL ITEM: PRIMARY CARE A draft refresh of the primary care strategy requires AGG approval. GMu proposed to establish a small task and finish group to review the strategy further. Work shop took place on Thursday strong attendance and regarded as a positive event. There is funding potentially available for this slippage money available. Non recurrent funding for implementation and legal costs available. Looking to put forward further details in the next 4 days full details to COOS on Friday. AGG agree to the proposal to establish a task and finish group to review the refresh of the Primary Care Strategy. 8. SPECIALISED COMMISSIONING RB was thanked for his contribution to the paper:- Describes the governance and what needs to be done from April 17. 4 main recommendations has been viewed previously. 3 rd option NG and GL as Trafford CCG Lead with RB, transformation team and specialised commissioning team. Developing an MOU with the specialised commissioning to access resources/expertise. Suggesting for the first year to work alongside NHSE in a delegated role. Proposing work under the delegated authority for 12 months then move to full devolution financial risk sits with NHSE along with accountability. AGG to work with NHSE to understand further how the services are to be commissioned. Not a great deal of transformation of services has progressed more BAU. Paper will be discussed at the JCB has already been to the SPB exec. Further details will be received regarding the Mental Health Vanguard. Page 4 of 6
AGG approved the paper and the option for Trafford CCG to lead specialised services on behalf of the AGG. 9. LD FAST TRACK CK presented a paper that details significant changes: Focus on ensuring early wins set the foundation for the long-term transforming care agenda. Talked previously about why GM was selected as a fast track with approximately 150 of GM patients in Calderstones or similar settings. Key risk cultivating the market place. Time frame for closure is over 3 years expectation is to move the patients faster to manage risks with staffing. 4 key areas with high numbers are Bolton, Manchester, Wigan and Trafford. Standardise the best practice around LD Tameside have a good LD commissioner and Salford have long standing commissioning arrangements that we can use in the learning. Areas of concern have been unclear re: dowry arrangements; work on going with Mike Tate. Consultation process; GM is our locality with a plan to bring people back into GM as a whole. Need to be certain that the new arrangements will deliver improved key community care. Originating CCG will fund the patient to go through CFOs to make sure this makes sense. AGG endorsed the paper and agreed GM as the locality footprint 10. MENTAL HEALTH 10.1 MH PROGRAMME UPDATE MW presented the MH strategy which was a piece of work identified as an early priority: MH Partnership Board meeting established and chaired by Jim Battle from the GM police. Work area updates have been through HoCs by SB status is still in draft form. Substantive document is proposed for the SPB in February. All agreed MH strategy is a priority. Strengthening the GP role empowerment of the practitioners who can be part of the front line. Connect to system management, areas that will reduce A&E targets. Clear evidence of potential benefits that we need to integrate and align to the Strategic Plan. Need to be clear on how we reshape the market. Excellent document needs further scrutiny around the costs. The MH Partnership Board and AGG need to review which areas of work need to be prioritised. Great appetite for this piece of work aspiration for GM to be transformational. MH wellbeing needs to be included in the locality plans from 16/17. Will come back to AGG in March with the implementation plan and priorities testing of the system on how we implement into locality plans for GM. AGG noted the progress of the MH Strategy To further review in March to assess the implementation plan and priorities. Page 5 of 6
Confirmation of RADAR support for 3 years CFOs to agree funding options. 10.2 GM ALCOHOL / SUBSTANCE MISUSE / RADAR Professor Kate Ardern attended to provide an update on the GM alcohol Strategy: GM alcohol strategy 14/17 strategy started off as a part of the home office initiatives. Partnership arrangement set up to look at a multi-agency approach. H&SC devolution strategy exploration of regulatory compliance. 4 key areas o Common licence across GM o Enforcement hubs across GM o Possibly having a single licencing authority o Devolution mandatory licensing conditions. Identified as a key priority for the Prevention Board for devolution. Potential of introducing a levy on late night licencing. Responsible student drinking Salford, Manchester student union and MMU adopted as pilots. Also embracing further education areas. Asset based approach working with local communities culture of responsible drinking. Building on good work with the development of Community Health Champions. Reviewing the potential of joint commissioning with alcohol/drugs/legal highs. Working on a set of principles to set out the framework and then review options on how to streamline funding. Work is being aligned with SB and the work on RADAR. Contribution from NHSE will link in with A&E and front end care linked to RAID and RADAR. Delegated the authority through to the CFOs more details in the reports. Paper will go to the WLT, police and crime team. Other work on going with the drink drive limits GM lead across the North on England. Agreed that a future discussion with clinicians to endorse the alcohol unit price can be arranged. Evidence is clear that minimum unit pricing makes a different. Everything in the license is based on evidence based strategy. Also working closely with the leisure services providers. 11. ANY OTHER BUSINESS 12.1 PROPOSAL TO MOVE ALL AGG MEETINGS TO THE AFTERNOON Move to afternoon all agreed. Discussions still needed re venue and JCB dates going forward 12.2 HS RETIREMENT HS retiring from GP in June 2016 and Chair of Salford CCG from July 16 Chair for the AGG needs to considered incorporate into away day. NEXT MEETING DATE: AGG/HOC/CFO JOINT AWAY DAY 2 FEBRUARY 2016 TIME: 09:30 14:30 VENUE: AJ Bell Stadium, 1 Stadium Way, Barton-upon-Irwell, Salford, M307EY Page 6 of 6