REPORT TO MERTON CLINICAL COMMISSIONING GROUP GOVERNING BODY Date of Meeting: 26 th January 2106 Agenda No: 5 Attachment: 04 Title of Document: Clinical Chair and Chief Officer Report Report Author: Adam Doyle, Chief Officer Purpose of Report: To note Lead: Adam Doyle, Chief Officer Contact details: andrew.murray@mertonccg.nhs.uk; adam.doyle@mertonccg.nhs.uk Executive Summary: This report covers the main updates and activities undertaken by the Clinical Chair and Chief Officer in a number of strategic and operational areas. Key sections for particular note (paragraph/page), areas of concern etc: Governing Body recruitment, delegated commissioning of primary care and assurance meetings Recommendation(s): The Governing Body is asked to note this paper and to ask any questions relevant to the content Committees which have previously discussed/agreed the report: Nil this report is provided for the Governing Body Financial Implications: Each of the areas discussed within the paper have a financial element to some extent. However, there is nothing extraordinary for noting in relation to finance. Implications for CCG Governing Body: For note and discussion How has the Patient voice been considered in development of this paper: The patient voice has been considered particularly in the following areas: Patient Engagement Group visit Other Implications: Nil of note Equality Assessment: Each of the areas discussed within the paper have an equalities element to some extent. However, there is nothing extraordinary for noting in relation to equalities. Information Privacy Issues: Nil of note Communication Plan: (including any implications under the Freedom of Information Act or NHS Constitution) Aspects of the report are communicated through the appropriate internal and external communications channels.
Merton Clinical Commissioning Group Clinical Chair and Chief Officer Report January 2016 1 Introduction This is the report for the Clinical Chair and Chief Officer to the Governing Body of Merton CCG. It covers the strategic developments and operational matters since the last Clinical Chair and Chief Officer s update to the Governing Body in January. 2 Clinical Chair Update 2.1 Governance changes Our new Governance arrangements are now starting to take effect and we held our first Clinical Transformation Committee on 7 th January 2016 where we discussed the new ways of working for the CCG. 2.2 Delegated commissioning of Primary Care As the Governing Body is aware, we submitted our application/expression of interest to NHS England on 6 th November 2015, to take on the delegated commissioning of primary care from 1 st April 2016. We have agreed to go forward with the application but have caveated it subject to the due diligence work that is currently underway. It is also important to note that until the CCG is aware of the 2016/17 financial allocations we receive, it is difficult to financially model the financial impact that this may cause. We are still awaiting elements of this assurance and until then we do not have the full position to make a further decision on this pressing matter. The Chief Officer and I are pushing for the full information to ensure we can make an informed decision on this matter. 2.3 Simon Stevens visit Along with other CCG s in South London, the Chief Officer and I attended a meeting with Simon Stevens, Chief Executive of NHs England to discuss a number of matters. We had a lengthy discussion on a wide range of topics including primary care and the planning guidance. 2.4 Planning guidance and financial allocations We received the planning guidance just before Christmas for the 2016/17 planning round and subsequently we were sent the accompanying financial allocations at the beginning of January. The Chief Officer will be taking us through the high level elements of the planning round at today s Governing Body, but our initial assessment is that our allocations are not where we would have expected them to be and, as such, we have a stretch to deliver a significant transformational QIPP programmes for next year. These will be particularly in the area of outpatient s services and long term conditions within the community.
More in Merton We launched More in Merton an initiative to ensure that our referring GPs were using all the community assets in Merton for referrals for patient care particularly the Nelson Health Care Centre. We are encouraged by the number of referrals that we are seeing, but we need to do much more to ensure we fully use this community asset. 2.5 Joint Overview and Scrutiny Committee I attended the first Joint Overview and Scrutiny Committee to discuss our collaborative plans across south west London on behalf of the 6 CCGs. During the meeting, we reiterated the current issues as described in our issues paper about how we can collectively find a clinical and financially sustainable plan for healthcare in south west London. 2.6 Strategy As part of our programme to deliver our plan for strategy, I went to meet Dr Sam Everington, Chair of Tower Hamlets CCGS to discuss the Bromley by Bow Centre in Tower Hamlets. I found this to be an incredibly helpful way of seeing how we could enact our vision in the east of our Borough. We held an East Merton design session on 16 th December 2015 where I discussed how we could move our model into one focussed on the social determinants of health and how we can engage our communities around that vision. We are holding a session with our Health and Wellbeing Board this afternoon and I will update on progress at our seminar in February. 3 Chief Officer Update 3.1 Staffing changes I am pleased to announce the following new members of staff: Sue Hillyard, Director of Commissioning Operations - Sue will cover the vacant Director of Commissioning post for the next six months and I will be working to establish the role of Director of Transformation in due course Liz Royle, Designated Nurse Children s Safeguarding - Liz joined us on 5 th January 2016 in this role. Liz was previously worked for Central London Community Healthcare and comes with significant experience in this area. Senior Commissioning Manager (Mental Health) I am pleased to announce that we have successfully recruited to this role. We are currently undergoing pre-employment checks and will announce who the successful candidate is in due course 3.2 CCG Assurance Framework 2015/16 Merton CCG has undergone a number of assurance meetings with NHS England since the last Governing Body meeting.
2015/16 Assurance Meeting We are still awaiting the regional moderation process to be given our assurance rating. I will ensure that this is communicated to the Governing Body when I receive it. Mental Health Stocktake I attended a mental health stock take meeting with South West London and George's Mental Health NHS Trust at NHS England on 30 th November 2015 where we discussed the south west London plans for mental health services. At this meeting there was a particular focus on Children and Adolescent Mental Health Services (CAMHS) and we presented the position across SWL. We have also been notified that our CAMHS Transformation plan has also been formally signed off. Statutory Obligations Report Merton CCG has received feedback from NHSE on the Annual Statutory Obligations Report for 2014-15 along with the information provided during the 2014/15 Q4 assurance deep dive on PPI. NHSE assessment of Merton CCG s delivery of its statutory obligations is consistent with an assurance level for patient and public participation activity of outstanding based on the following: The report built on the comprehensive information from the Q4 deep dive and provided some excellent examples of engagement activities. The detailed vision of engagement was linked to the organisation s vision. The report clearly demonstrated an awareness of the population including those defined by protected characteristics and the prevalent health conditions. It highlighted the structure and resource allocated to PPI and senior staff involvement. The CCG is able to demonstrate partnership working with a range of organisations and networks and made reference to their stakeholder database as well as various communication and dissemination methods. The explanation of the use of the BCF demonstrated committed partnership working with the LA and the use of patient stories at CQRG meetings to hold providers to account. Excellent examples were provided within the report to demonstrate detailed engagement activities, including faith groups. The inclusion of measurable improvements from these activities would have further enhanced the report to evidence outcomes. The report demonstrated the use of feedback highlighting how sources of patient feedback such as NHS choices are monitored. The report provided details of self-management courses, highlighting the vision for other particular groups to be involved in future. The case study demonstrated its benefits. Details of how success will be measured in relation to care planning with patients were included.
The report ably demonstrated current activity and successes but also highlighted particular areas to be improved on. This includes brief mention of PHBs and the identification of a group it would benefit. I would like to thank the team and particularly Lynn Street, Director of Quality and Performance, for this excellent piece of work. Regional Tripartite I attended a Regional Tripartite meeting to discuss the plans for winter for SGH and we now have a clear understanding of the drivers that are needed to be addressed to relieve the ED performance and constitutional standard for our population. We are now in the implementation phase of the appropriate schemes to improve operational performance in Q1. I would also like to take this opportunity to thank the work of the local providers who managed the very Christmas and New Year period. We had really good plan for the Christmas period that we feel worked well. The included Merton putting in place additional community resource to Community services, 111 call handlers and to our out of hours Primary Care provider to manage the increase in demand. Area Tripartite As part of our on-going monitoring of our providers along with colleagues from Wandsworth CCG, I attended an area meeting to agree the cancer recovery plan for St Georges Hospital (SGH) NHS Foundation Trust. I am pleased to say that in November SGH we achieved the 62 day cancer target and narrowly failed the 14 day cancer target. This shows that the performance for our local population is moving in the right direction. We are confident that the changes the Trust is making will began to see a sustained recovery in this very important clinical area. 3.3 Local service changes PMS Review As co-commissioners of Primary Care services with NHS England, we are currently working to conduct a review of Personal Medical Services (PMS) contracts with practices in Merton. We discussed this with our practices at our Practice Leads Forum on 13 th January and aim to work with each practice to develop our commissioning intentions for general practice. We will then work with the Local Medical Committee about our plans to negotiate the new contract. 3.4 Emergency Preparedness Resilience and Response (EPPR) and Industrial Action EPPR In light of the recent tragic events in Paris, NHS England together with the Department of Health and other national agencies, are reviewing and learning from
the incidents that occurred and will ensure that this is then reflected fully in their established EPPR procedures. The threat assessment to the UK from international terrorism in the UK remains Severe. Severe means an attack is highly likely. NHS Trusts have been asked to give assurance to their public Boards to provide assurance that: They have reviewed and tested their cascade systems to ensure that they can activate support from all staff groups, including doctors in training posts, in a timely manner including in the event of a loss the primary communications system; They have arrangements in place to ensure that staff can still gain access to sites in circumstances where there may be disruption to the transport infrastructure, including public transport where appropriate, in an emergency; Plans are in place to significantly increase critical care capacity and capability over a protracted period of time in response to an incident, including where patients may need to be supported for a period of time prior to transfer for definitive care; They have given due consideration as to how the Trust can gain specialist advice in relation to the management of a significant number of patients with traumatic blast and ballistic injuries. Merton CCG CO and Directors have recently undertaken Business Continuity training which is also being rolled out to staff. When this is complete, I will ensure the Governing Body is informed. Industrial Action On the 4 th January 2016 following a breakdown in negotiation regarding junior doctor s contracts, the British Medical Association announced that there would be industrial action undertaken on three occasions: Tuesday 12 th January - 08:00 to Wednesday 13th January 08:00 Junior doctors will provide emergency cover only which is the same as they would provide in their specialty, hospital or GP practice on Christmas Day, clinics, non-emergency surgery or other nonemergency work will not be covered. Tuesday 26 th January 2016 08:00 to Thursday 28th January 2016 08:00 Junior doctors will provide emergency cover only which is the same as they would provide in their specialty, hospital or GP practice on Christmas Day, clinics, non-emergency surgery or other nonemergency work will not be covered. Wednesday 10 th February 2016 08:00 to 17:00 Full withdrawal of junior doctor s labour. This means that junior doctors will not attend work, or provide emergency cover for that time period
The industrial action on the 12 th January 2016 proceeded as planned and Merton CCG monitored the impact in the local Trusts. We will continue to monitor plans for the next two proposed days of industrial action. 3.6 Key Chief Officer Meetings NHS Leaders meetings 4th December I attended this event on 4th December 2015 and Simon Stevens inform us about the subsequent plans and the outcome of the comprehensive spending review. Patient Engagement Group I attended the Patient Engagement Group on 16 th December 2015 and discussed our vision for PPI. I found the feedback incredibly helpful and have fed back the group s thoughts to the Director of Quality. Meeting with Richard Milner and Peter Coles I had a productive meeting with Peter Coles, Interim Chief Executive for Central London Community Healthcare and Richard Milner, Deputy Chief Executive for Central London Community Healthcare on 12 th January 2016 about the mobilisation of community services. Meeting with David Bradley I met with David Bradley, Chief Executive for South West London and St George s Mental Health Trust regarding the SWL Parity of Esteem Investment for 2015/16 and the contracting round for 2016/17. I feel that we are in a good place for these negotiations and I will keep the Governing Body updated on these areas over the next few months.