BROMLEY CLINICAL COMMISSIONING GROUP GOVERNING BODY MEETING THURSDAY 21 MAY 2015 PUBLIC QUESTIONS AND ANSWERS QUESTIONS RAISED AT THE PUBLIC FORUM PRIOR TO THE MEETING ON 21/5/15 The Chair welcomed members of the public and reminded them that questions to be taken all needed to relate to the agenda for the Governing Body meeting following the public forum. Questions on other issues had been and could be sent in, and written answers would be provided and posted on the CCG website. A) QUESTIONS RELATED TO AGENDA ITEMS From Paul Brown (present) Q 1 Is the CCG satisfied with its monitoring and performance management of King s NHS Foundation Trust and with the Trust s accountability to Bromley residents? Response: The CCG already has a number of processes in place to monitor the performance of Kings. The main meeting to monitor performance is through the Integrated Governance Committee, chaired by the lay member Harvey Guntrip and attended by all lay members, clinical leads, chief officer and directors. The minutes of these meetings are included in the Governing Body papers. The Committee receives performance information on King s through the integrated governance report as well as receiving information on the performance of other providers. The IGC meetings are also attended by the South East Commissioning Support Unit, who manage acute contracts on the CCG s behalf. They meet the providers regularly through the Contract Monitoring Board and can raise performance management issues on behalf of the CCG. Performance is also measured through the Clinical Quality Review Groups (one for each provider) and the Quality Assurance Sub-committee, chaired by Nurse Member Sara Nelson, which focuses on the quality and safety of services provided by King s and other providers. CCG officers and clinical leads attend meetings of some of King s internal committees, such as their Quality and Governance Committee and their Serious Incidents Committee. The CCG also regularly reviews specific performance indicators, on a weekly and monthly basis using a range of indicators that measure performance, quality and patient experience. Some indicators such as four- hour A&E waits are monitored on a daily basis. For GPs there is a system of quality alerts, enabling GPs to report concerns about any providers. The CCG responds to these alerts and passes them onto the appropriate provider for investigation, so that full feedback can subsequently be given to members. These alerts provide a useful source of intelligence about the quality of services, and may relate to an individual patient or highlight an emerging theme or trend.
Recently King s has been subject to a Care Quality Commission inspection and a full report on the outcome will be brought to the CCG Governing Body when available. Lastly, meetings of the King s Board of Governors are open to the public and questions can be put to the Board. Q2 What is the reason for the surprising statement (Enclosure 6) that there are savings relating to a reduction in adult and older people s inpatient beds in 2015/16? Response: The CCG previously commissioned a large number of beds from Oxleas Foundation Trust but these were not fully used in 2014/15 because of changes in the way services were provided, particularly with greater investment in community services. The budget for inpatient beds has therefore been reduced. This is being carefully monitored to ensure that the right number of beds have been commissioned for the needs of the Bromley population while increasing services in the community to provide better support closer to where patients live and to prevent avoidable admissions. Written question from Tom Williams (not present) Q3 At a meeting of the Health & Wellbeing Centre held in the village hall in Orpington to study the design of the layout presented by the architects I asked who was responsible for the maintenance of the Health & Wellbeing Centre. No body there could give me the answer. Who is responsible for the maintenance of the Orpington Health & Wellbeing Centre? Response: This will be the responsibility of NHS Property Services (NHSPS) who will hold the head lease for the centre with Berkeley Homes From the Co-Chair of Save our Local Hospitals (present) Q4 Is funding for the Health and Wellbeing Centre fully in place and what is the current position? Response: NHS Property Services (NHSPS) and NHS England are responsible for the capital funding for the building (ie the head lease from Berkeley Homes, and the fitting out costs), on the basis of the CCG s business case which NHS England has approved. The CCG will be responsible for funding the use of the building. As the building will accommodate services that already exist, this funding will be transferred and be available. Much of the design work for the Centre has already been done; the next stage is to firm up detailed room designs with the prospective users and this has already commenced. B) QUESTIONS RELATED TO TOPICS NOT ON THE AGENDA From Tom Williams
Q1 Re: Dermatology In the minutes of the meeting held on Thursday 19 th March I now learn that the Dermatology Services Procurement will now not go ahead in its present form. My Question: Would the CCG please explain in a manner that the public can understand why this is now so considering that it was passed even though two members of the Board voted against it when a vote was called for? I as a member of the public agreed fully with the two Board members who voted against due to the warnings given by the CCG infection control officer. Response: The approval to pass the procurement and award the contract was given by a majority of the voting and accountable members of the Governing Body. Subsequent to that approval, the CCG exercised its right to cancel the contract award before contract signature. This was due to matters arising outside the control of the CCG which impacted on its decision to award. B: QUESTIONS NOT RELATING TO AGENDA ITEMS From Tom Williams Q B1 Dr Bhan s salary In answer to the response to my question, Why is Dr Bahn paid 50k more than recommended by NHS England you reply, remuneration is determined by role, qualifications and experience and follows robust guidance set by NHS England. As your statement differs so much from the Daily Mail article which was, the approved salary by NHS England is a range from 95k to 135k depending on the size of the CCG; I will be sending your version to the Daily Mail and NHS England when I receive the answers to these questions. My supplementary questions about that 50k paid to Dr Bahn over and above the 135k are these. Q B2 Is the Daily Mail wrong about the 95k/ 135k? Response: The figure quoted by the Daily Mail includes remuneration for clinical roles Dr Bhan holds in addition to her CCG role. Dr Bhan s remuneration for her CCG role is within the approved salary range for CCG chief officers. NHS England has published guidance on pay for Chief Officers of CCGs. These guidelines are available on their website http://www.england.nhs.uk/wpcontent/uploads/2012/06/remuneration-guidance-final.pdf. The guidelines outline three suggested pay ranges for Chief Officers based on population sizes of CCGs. This is a useful guide but the agreed remuneration also takes into account the level of complexity a Chief Officer will face within a particular CCG such as the scale of the productivity challenge and the quality and outcomes challenges. Q B3 How and when did NHS England guide the remuneration committee at Bromley CCG that it was okay to pay Dr Bahn 50k above the 135k as recommended by NHS England that
Daily Mail wrote in their article on the March 10 th 2015. Please supply the written evidence or the name of the person who gave it if it was verbal? Response: The process for determining the salary and terms and conditions of senior staff in the CCG used by the remuneration committee follows robust guidance set by NHS England. This guidance is available on the NHS England website at http://www.england.nhs.uk/wp-content/uploads/2012/06/remuneration-guidancefinal.pdf. This guidance is used by the Bromley CCG remuneration committee, as well as other CCGs and NHS organisations across the country. Q B4 If as you write Dr Bahn holds clinical roles for Bromley Council, and health education England, in her capacity as a consultant in Public Health as well as her role as Head of School for Public Health London. My question is - Why does Bromley CCG pick up the tab for all these jobs? Response: The CCG recovers the salary for Dr Bhan s additional roles from her other employers. As Dr Bahn is the Accountable Officer for Bromley CCG. Holds Clinical roles for Bromley Council. Has a job/role, Health Education England. A job/role, consultant in Public Health. A job/role, Head of School for Public Health London. My questions are. Q B5 Is the Dr spreading herself too thinly in these numerous jobs she does to give the public proper value for money in all of them? Q B6 Will the CCG please issue for the public a guide of how much of her time the Dr spends at each job per year? Q B7 Does the Dr Claim expenses for any of these jobs? Response: Dr Bhan works many extra hours and manages her time carefully to ensure that she fully meets the commitments required in each of her roles. She also spends much of her free time voluntarily supporting the urgent care system in Bromley. Her clinical expertise has proven invaluable in supporting the local health and care system on a number of occasions, particularly during recent norovirus outbreaks. That same clinical knowledge and insight is of unique advantage to the CCG in a number of areas, particularly where issues of NHS commissioning and public health frequently overlap. She is a highly experienced, valued chief officer and public health consultant who has been leading the NHS in Bromley for many years. Dr Bhan is entitled to claim expenses within the framework of her employers relevant protocols and policies. Topic 4 Sara Nelson
Q B8 Who pays the wages of Sara Nelson the nurse on the Board? The reason I ask is because it states in the papers sent out to me that Sara is an employee of NHS England. Could an explanation be given please so that the public could fully understand who pays for who? Response: Sara Nelson is employed by NHS England who pay her a salary. Bromley CCG pays her an honorarium for her work as a member of its Governing Body.