CHS Children s Programme Board Held on Tuesday 5th January 2016 12:00 to 13.30 CCG Conference Room, 5 th Floor, South Plaza Present Judith Brown (JB Chair) Operations Director Bristol CCG Fiona Butter (FB) Margaret Kemp (MK Minutes) Rebecca Cross (RC) Ian Chislett (IC) Chris Flook (CF) Mark Hemmings (MH) John Gibbs (JG) Richard Lyle (RL) Padma Ramanan (PR) Mark Pietroni (MPi) Joe McEvoy (JM) Mark Pietroni (MPi) Paula Williams (PW) Programme Director Community Services Re-commissioning Bristol CCG Project Manager Community Services Recommissioning Bristol CCG Service Manager: Joint Commissioning (Children) Bristol CC / CCG Deputy Chief Financial Officer Bristol CCG Deputy Chief Finance Officer South Gloucestershire CCG Commissioning Manager Maternity, Children & Young People s Services North Somerset CCG Senior Clinical Procurement Advisor NHS South, Central and West Commissioning Support Unit Programme Director for Community, Partnerships & PPI Bristol CCG Finance Lead Bristol CCG Director of Public Health South Gloucestershire Council Assistant Director of Specialised Commissioning NHSE Director of Public Health South Gloucestershire Council Healthwatch Bristol Representative Dialled In None Apologies Kirsty Alexander (KA) GP N and W Locality and clinical lead for Children s Community Services Bristol CCG Clinical representative for Programme Board Page 1 of 6
Niema Burns (NB) Becky Pollard (BP) Julie Kell (JK) Alison Moon (AM) Mike Pingstone (MP) Jon Shaw (JS) Equality & Diversity Lead Bristol CCG Director of Public Health Bristol City Council Head of Joint Commissioning (Adults and Children) North Somerset CCG (part of meeting) Director of Transformation and Quality Bristol CCG Senior Clinical Commissioning Manager Head of Commissioning, Partnerships and Performance South Gloucestershire Council Minutes 1 Welcome and Introductions JB welcomed everyone to the meeting and introductions were made. The meeting was quorate. 2 Apologies Please refer to apologies section above. 3 Declarations of Conflicts of Interest There were no new conflicts of interest declared. 4 Minutes of meeting held on 3 rd December 2015 The minutes of the meeting were agreed as accurate. 5 Matters arising and actions from last meeting Outstanding Actions Page 2 outstanding actions from the meeting on the 3 rd November: The adding IM&T risk and closing risk 24 had been completed on the 6 th November. The other two outstanding actions were agreed to be closed. The actions from the meeting from the 3 rd December had been completed and agreed to be closed. Sequential procurement of the Counselling lot this has been agreed by North Somerset and South Gloucestershire CCG however there had been some concern over the model that may result from this way of procuring the lots i.e. a medical model but the Commissioners could also see the benefits of procuring sequentially. The Commissioners were assured that this lot would be co commissioned and therefore they would Page 2 of 6
be able to influence how this service would be delivered. Tier 4 CAMHS Out of hours Provision RC has been in discussion with NHSE and they are considering a way forward. 6 Financial sign off for 16/17 and risk sharing agreement The paper tabled on the 3 rd of December had been circulated following the meeting however this had been subsequently revised on the 8 th December due to cuts in South Gloucestershire Council public health funding. Action: MK to circulate revised paper of the 8 th December MK All commissioners had signed up to the principle of either funding their own identified deficit or to find cost savings / service reductions. There are still on-going discussions as to the actual deficit and it is hoped to have an updated position by Friday 15 th January 2016. If a Commissioner decides that they are unable to fund their deficit and as a result there needs to be a service reduction, then this needs to be discussed with all the Commissioners so that the impact on other services can be assessed. Once a decision has been made on the level of service reduction, Sirona (the interim provider) will be informed of this. Action: FB to co-ordinate process for the agreement of service reduction(s) FB Collaborative commissioning agreement The CCA has been updated to reflect the change in activity and to reflect the change in commissioning responsibility for Health Visiting from the 1 st October. It will now be shown as months 1 6 (April to Sept) and months 7 12 (October to March). These changes had been discussed at the finance workstream group and the revised apportionment of costs will be signed off by this group and circulated to the Programme Board. It is the responsibility of the finance group members to inform their commissioners of the new costs. Financial Envelope Substantive Provider There are two outstanding pieces of information required in order to establish the value of the lots Disaggregation of the CCHP block contract value onto the services/lots Financial value for Tier 4 A base up costing template had been sent to commissioners for them to complete though RC questioned the value of this. Action: Chris Flook to supply the breakdown of the CCHP block contract value for South Gloucestershire CCG CF Page 3 of 6
Action: JM ask Alex Dibble to supply Tier 4 CAMHS financial value 7 Changes to Specifications following consultation period. JM The paper identified the high level changes to the specification. Although the specifications had not been part of the formal consultation people were given the opportunity to comment. Commissioners have reviewed these comments and are amending the specifications in light of this although the changes were not material, mainly factual corrections. With the CAMHS specification the response time to a crisis had been changed form 2 weeks to 1 week. The values, model and outcomes had been formally consulted on and these have been revised in light of the feedback. A common thread from the feedback was that there were too many values and outcomes and therefore they have been consolidated Action: MK to circulate amended values / model and outcomes to the Programme Board any comments to be sent by Wednesday 13 th January MK 8 Tier 4 CAMHS Interim provider the standstill period has now finished and the contract has been awarded to AWP and the Huntercombe Group. The Huntercombe Group is part of 4 Seasons and therefore NHS E undertook forensic accountancy on this company to provide assurance that they were financially stable. This company will be providing consultancy to AWP as they are a current provider of Tier 4 CAMHS. The Huntercombe element forms a very small part of the overall contract. AWP will be responsible for the running of the service. NHS E is currently working on communications for NBT and external partners. Commissioners have been informed. NHSE paper on CAMHS Tier 4 had been distributed with the papers for this meeting. Tony Jones (Patient and Public Involvement Programme Manager Bristol CCG) had reviewed the paper and provided feedback to FB. He did not feel that the paper gave the assurance necessary and that including Tier 4 in the procurement was a potential risk. NHSE have been advised that they do not have to undertake formal consultation as there will be no change to the service but they will engage with internal and external stakeholders. Any engagement needs to be local and NHSE is happy to take advice on what activities are needed to give assurance to the programme board. Advice to be sought from Tony Jones The Programme Board meeting on the 3 rd December had requested a plan by NHSE on engagement and this paper did not provide this. Page 4 of 6
The question was raised if there had been any consultation when the Tier 4 CAMHS specification was being developed. It was unclear how long the Tier 4 national specification had been used for and whether any previous lack of consultation would be considered an issue now. An understanding of this would determine the level of risk to the procurement. JB reminded the Board that the CCHS consultation had been on the values, model and outcomes and not the service specifications. However, the reason for the Board s decision to include Tier 4 CAMHS in the procurement process was to ensure close links / interface between Tier 3 and Tier 4 CAMHS. The paper did not show any reference on how to bring these together. It is important that the opportunities of the benefits of bring Tier 3 and 4 together and the joining in up of pathways are not lost. There needs to be dialogue as to how the national Tier 4 specification fits with local processes but there can be no material changes to the specification. JM to speak with Louise Farbus Head of Stakeholder Engagement Specialised Commissioning NHSE South re engagement. It was suggested that the CCHS PPI Lead may be available help with this work. It is important to understand how Tier 4 will fit with new CCHS model and how it will work with Tier 3 and how the opportunities can be achieved. However timing is a challenge as the specifications have to be ready for the 1 st February for the Invitation To Tender (ITT). Additional wording will need to be added to the specification stating the requirement for Tier 4 and Tier 3 to work together and that the new provider will need to undertake engagement work. Action: JM to seek advice on the level and type of engagement required to provide assurance to the Programme Board Action: JM to produce timetable of engagement to provide assurance to the Programme Board by 28 th January 2016 Action: Commissioners to agree wording for specification PW expressed concerns has to how Healthwatch North Somerset would be involved in the procurement process. Action: MH to link with PPI lead in North Somerset JM JM MH 9 Healthwatch Update No update. 10 Risk Register CCHP Interim Provider Page 5 of 6
The risk register had been revised following the last Programme Board meeting. CCHP20/15 Viability of Lifetime Service provision. Verbal assurance had been received from Chrissie Hardman (Head of Children Services Sirona CIC) but awaiting written assurance and then this action will be closed. Action: Please send any comments or new risks to MK 11 Risk Register CCHS Re-commissioning The risk registered had been revised following the last Programme Board meeting. 12 AOB Action: Please send any comments or new risks to MK RL informed the Board that Bristol CCG would become the lead commissioner for AWP MH contract from the 1 st April 2016 and would be writing to NHS E specialised commissioners about the development of a single process and aligning quality, governance and performance. JM there has been recent planning guidance on moving specialised commissioning to hub providers. Action: RL to write to JM 13 Date and time of next meeting; RL Thursday 4 th February, 12:00 13:30, CCG Conference Room, 5 th Floor, South Plaza. Page 6 of 6