NHSCL CCG Governing Body Minutes - Draft Date Wednesday 12 March 2014 Time 3.30 PM 5.30 PM Venue Boardroom, 5 th Floor, 15 Marylebone Road, London NW1 JD Present Ruth O Hare (Chair) (ROH) Governing Body Chair & GP Member, NHSCL CCG Jonathan Munday (JM) Governing Body Vice Chair & GP Member, NHSCL CCG Neville Purssell (NP) Governing Body Vice Chair & GP Member, NHSCL CCG Paul O Reilly (POR) Governing Body GP Member, NHSCL CCG Sheila Neogi (SN) Governing Body GP Member, NHSCL CCG Mona Vaidya (MV) Governing Body GP Member, NHSCL CCG Jonathan Levy (JL) Governing Body GP Member, NHSCL CCG Philip Young (PY) Governing Body Deputy Chair, NHSCL CCG Michael Morton (MM) Governing Body Lay Member, NHSCL CCG Nafsika Thalassis (NT) User Panel Chair, NHSCL CCG Daniel Elkeles (DE) Chief Officer, CWHHE CCG Collaborative Jonathan Webster (JW) Director of Patient Safety and Quality, CWHHE CCG Collaborative Alan Hakim (AH) Secondary Care Consultant, CWHHE CCG Collaborative Ben Westmancott (BW) Director of Compliance, CWHHE CCG Collaborative In Attendance Eva Hrobonova (EH) Consultant in Public Health, Tri-Borough Public Health Matthew Bazeley (MB) Managing Director, NHSCL CCG Rosalyn King (RK) Director of Health Outcomes, NHSCL CCG Kiran Chauhan (KC) Deputy Managing Director Neil Shadbolt (NS) Head of Finance, NHSCL CCG Alison Miller (AM) Delivery Manager, NHSCL CCG Chats Malalasena (CM) Business Manager to the Governing Body, NHSCL CCG Aoife Kirwan (AK) Senior Contracts Manager, NWL CSU Cath Attlee (CA) Whole Systems Lead, Tri Borough Adult Social Care Apologies Rachel Wigley (RW) Director, Tri Borough Adult Social Care Clare Parker (CP) Chief Finance Officer, CWHHE CCG Collaborative Page 1 of 8
1. Welcome, Introduction and Apologies ROH called the meeting to order. RW had sent her apologies. 2. Declarations of Interest There were no new declarations since the last meeting. 3. Minutes of the Previous Meeting Minutes were approved as an accurate record. 4. Matters Arising There were no matters arising. 5. Log There were no outstanding actions. 6. Ratification of Chair s s There were none. 7. Appraisal of Investment Committee Decisions There were none. Minutes of December 2013 and January 2014 Investment Committee meetings were available under agenda item A: For Noting. 8. Papers circulated for noting/information These were noted. 9. Report from the Chair ROH presented the written Chair s summary report and brought attention to the Annual General Meeting (AGM) being planned for the summer of 2014. ROH further updated the Governing Body members of the partnership work continuing in conjunction with external organisations such as the Westminster City Council and Tri Borough Councils through the Westminster Health & Wellbeing Board and Tri Borough Integrated Partnership Board. ROH has joined the process of appointment of a new Chair for Imperial College Health Partners which has not been announced publicly yet. ROH has also joined the process for appointment of a new Chief Executive Officer, namely Tracey Brittin, for Imperial College Healthcare NHS Trust (ICHT). ROH stated that this will lead to further opportunities for close liaisons with the ICHT closely as the Whole Systems Integrated Care GP led provider network for Central London CCG geography / most of Westminster develops. Page 2 of 8
10. Report from the Chief Officer There were no comments or questions arising from the Chief Officer s written report. 11. Report from the Managing Director MB presented the newly introduced written report by Managing Director to the Governing Body members. Whilst it will be an update on the CCG s operational work taken place since the previous meeting, it is also hoped the report would create an opportunity for the Governing Body members to raise operational or other queries back to MB. 12. BAF (Board Assurance Framework) BW drew attention of the Governing Body members to two main risks, which were related to: The proposed partnership between West Middlesex and Chelsea & Westminster Hospitals, which is not proceeding as originally anticipated causing potential instability to services at West Middlesex and leading to a detrimental effect on patient outcomes; Challenges faced in the establishment and development of the Commissioning Support Unit leading to reduced ability to deliver our commissioning objectives. Changes to the BAF since the last discussions were highlighted within the document in blue. BW focused on the BAF for 2014-15 financial year, a specific workshop on that regard has not taken place for CLCCG therefore BW asked Governing Body members for their input on what they think are the key issues and risks for the 2014-15 financial year. BW agreed to recommend a list of risks and issues depending on what CLCCG is planning to achieve during 2014-15 financial year for the Governing Body members to comment. MB said that all the CLCCG projects workbooks which, as part of each workbook contents highlight each project s risks, will be shared with BW. Governing Body members use the whiteboard in the CLCCG Chair s and MD s office to write their CCG business worries, ideas etc. 13. Early Adopter Status (EoI) of Whole Systems Integrated Care (WSIC) RK gave an update on the current status on development of the business case for WSIC GP provider network for the Central London CCG. Marina Muirhead has been recently appointed as the project lead for the development of the business case which is the next stage of the expression of interest declared for provision of a GB led provider network. Present stage of activities involve Marina meeting with the Governing Body members and other members of key stakeholders. Page 3 of 8
Presently, all the parties who expressed their interest are required to submit the business cases by middle of May 2014 however the exact date is not confirmed. 14. Shaping a Healthier Future (SaHF) Update DE presented the document pack SahF update & response to actions, Central London CCG GB 12 March 2014. Main highlights for CLCCG were: Primary care; Weekend opening across the CWHHE CCGs; In terms of major hospitals, rebuilding of St Mary s entire site; Primary care and community services, social care/social work incorporation in that redevelopment discussions and planning is being led by ROH on behalf of the CCGs and agreed by Imperial College Healthcare NHS Trust; Rebuild of Chelsea & Westminster Foundation NHS Trust s accident & emergency (A&E) unit; Closure of Hammersmith hospital s A&E which will have an impact on St Mary s A&E. Outside of the SaHF programme, two matters were highlighted: Chel West is in the process of acquiring West Middlesex hospital for which the business case is being developed, it is not anticipated that Westminster patients will have a significant impact from this, wherever they are affected, it would be pre- agreed by CLCCG. Patient transport facility will be considered for Westminster patients who may have to travel to West Middlesex; A Central Middlesex hospital site / building originally developed as a PFI scheme, has to be closed down due to financial deficit. A strategic service outline business case for the utilisation of the building is being agreed by all the stakeholders. One option proposed is that elective orthopaedic patients from Charing Cross hospital site be treated at this Central Middlesex site; RE presented further updates to the Governing Body, following their questions raised at the February 2014 Governing Body seminar, which covered: Assurance dimensions; engagement and equalities including transport updates which will be shared with other stakeholder groups; Finance contribution assessment including NHS England s financial contribution aspect which is in region of 30M to date. Given there are aspects proposed to deliver by General Practices, Governing Body GP members thought that there should be evidence of workforce planning involved and requested that results of work undertaken as part of the dedicated workforce work-stream be included into this document. Page 4 of 8
It was highlighted that more General Practitioners are required for SaHF initiative to be successful, there is a substantive piece of work taking place with Health Educations North West London which looks at how to engage more General Practices to become training practices, how to convince more medical undergraduates that taking up careers as General Practitioners is the right path, how are available resources best used etc. A piece of further work is being undertaken to arrive at a consistent transport model for whole of North West London; some actions being taken are conducting travel surveys, engaging with individual NHS Trusts. Transport of London (TfL) has agreed for the NHS Trusts and community healthcare to use their travel survey, so that the survey questions raised to the public are agreeable to TfL also. However they have not agreed to run the survey for the NHS. Local authorities are also involved in the conversations. 15. 2014-15 Contracting Update AK gave a brief verbal update on the current status of contracting round 2014-15. As per the conversations taking place, offers made to all the providers and counter offers made back by the provider, it is anticipated that contracts will be signed at end of this financial year. 16. Operating Plan for 2014-15 a. Submission to NHS England February 2014 KC presented the operating plan submission document to update the Governing Body members on what was submitted to NHS England as part of the NHS England s planning cycle. This captured the improvement trajectories for a range of indicators over either a two year or a five year trajectory periods; As part of the process of CCGs having to identify one local priority for improvement during 2014-15, CLCCG has identified care planning; Whilst the February 2014 submission was an initially submission, a full final submission is required to be made by early April 2014; Public health also have been consulted on this submission in order to ensure the priorities are of an appropriate level of ambition and are supported by public health commissioning priorities; Governing Body members recognised this as a valuable piece of work setting the framework for 2014-15. b. Feedback from Westminster Health & Wellbeing Board (HWB) February 2014 MB gave an update on the discussions from HWB; CLCCG s operating plan for 2014-15 has been discussed in detail, care planning and plans around dementia have been of particular interest to the HWB. More detail had been asked to be submitted for assurance of HWB, particularly to show that both the care planning outcome and quality are met; Page 5 of 8
Better Care Fund also had been discussed in detail, HWB are in support of the direction of its travel, further clarity on governance is sought; CLCCH received the 2014-15 Joint Strategic Needs Assessment (JSNA) programme and will be engaged in the JSNA development which will be mutually beneficial for CCG core business; Pharmacy Needs Assessment also has been received; Chelsea and Westminster Hospitals has submitted a health and wellbeing strategy which has been welcomed by the HWB; A paper on CLCCG workforce has been presented to the HWB; Discussions have taken place related to SaHF and a paper on Whole Systems Integrated Care will be presented at the next HWB meeting; MB thought that that Collaboratively the CCGs should think of how the HWB membership should be formed; whilst the CCG Chair and Westminster City Councillor form the leadership of Vice Chair and Chair positions respectively, whether other membership should consist of more appropriate health representatives. DE mentioned that, given valuable work taken place via the Tri Borough Integration Partnership Board, for implementation of Better Care Fund (BCF) piece of work that there should be BCF Implementation Partnership Board which consist of equal health and social care representation, reporting to Tri Borough HWBs, Cabinet offices and CCG Governing Bodies. 17. Project in the Pipeline: Empowerment and Equalities Update POR gave an update to the Governing Body on the key activities relating to engagement and equalities. The update highlighted some of the key activities related to training and development through User Panel seminars, engaging in commissioning, development of practice based Patient Participation Groups, cancer awareness events and NWL engagement forums. EH and Helena Stokes-CLCCG Engagement Lead has had discussions related to behavioural change. 18. Risk Management Strategy BW presented the risk management strategy for the Governing Body members approval. This has been approved by the CCG Audit Committee in January 2014 GB 13/14-25 The Governing Body resolved to approve the risk management strategy. Page 6 of 8
19. CWHHE Committee Reports for: Audit Committee (for joint CWHHE CCGs) Performance Committee (for CWHHE Collaborative) Members noted these reports. BW was commented on the succinct reports that he generates following the Thursdays Committees and CCG Chairs meetings. 20. Health & Safety Policies BW presented a suite of policies for the approval of Governing Body members. These policies, listed below, are required to be in place for organisations under the Health & Safety Act 1974. Display Screen Equipment Policy Fire Safety Policy First Aid Policy Health and Safety Policy Manual Handling Policy Personal Safety and Lone Working Policy Slips Trips and Falls Policy Work Equipment Policy GB 13/14-26 The Governing Body resolved to approve the above suite of policies. 21. Quality & Safety Committee Terms of Reference GB 13/14-27 The Governing Body resolved to approve the CLCCG Quality & Safety Committee Terms of Reference. 22. Information Strategy & Information Governance Committee Terms of Reference GB 13/14-28 The Governing Body resolved to approve the CWHHE Information Strategy & Information Governance Committee Terms of Reference. 23. Finance & Performance Committee Update a. Finance & Performance Committee Update Members noted the brief, arising from the CLCCG Finance & Performance Committee meeting dated 26 February 2014, which was presented by JM. b. M10 Financial Position NS presented the Month 10 CLCCG Governing Body finance summary report dated 5 March 2014. Members briefly discussed the financial aspects of 15 Marylebone building contract. Page 7 of 8
24. Transformational Redesign Group (TRG) Update MV who has chaired the TRG of 12 March 2014 gave an update on the discussions that had taken place, covering the subjects of: Villages; the first village workshops had taken place covering community nursing, environmental health, discharge coordinators, pharmacists, social services; Behavioural Change; Diabetes related to which a substantive amount of work has taken place at CWHHE CCG Collaborative level; Integrated allergy care for children (Itchy, Sneezy, Wheezy project); whilst this contract has been rolled however there funding issues exist. Ophthalmology 25. Quality and Safety Committee (QSC) Update Members noted the brief, arising from the CLCCG QSC meeting dated 12 March 2014, which was presented by NP. 26. AOB a. Better Care Fund Plan CA presented the near final version BCF plan, earlier versions of which was originally discussed in February 2014. Approval was sought from the Governing Body for the plan, subjected to detailed review of the plan by CLCCG Finance and Performance Committee. According to the BCF plan presented, Members thought that the governance of BCF management needs to be further clarified in the governance structure. Also members talked about the required change in the structure of the Health & Wellbeing Boards (HWB) in that health representation is more prominent in HWBs. Conversations in this regard will continue through the Tri Borough Integration Partnership Board which is attended by the Tri Borough Councillors. Where the expenditure will be applied needs to be further clarified at the time of this plan is presented to the CLCCG Finance & Performance Committee. 27. Questions from the Public No questions were raised. Next Meeting 14 May 2014, Conference Rooms 3 &4, 5 th Floor, 15 Marylebone Road, London NW1 5JD. Page 8 of 8