Enclosure Miii Market Management & Procurement Meeting Thursday 23 rd October 2014 Greenwich Park Street PRESENT Jim Wintour (JM) - Chair Alison Goodlad (AG) Leceia Gordon-Mackenzie (LG) Sam Jones (SJ) Jan Matthews (JM) Dr Krishna Subbarayan (KS) Vee Scott (VS) Nicola Moore (NM) Ed Humphreys () Emma Gennard (EG) Kirsty Price (KP) MINUTES Governing Body Lay Member Associate Director of Delivery & Service Re-design Greenwich Healthwatch Director of Delivery & Service Transformation Procurement & Delivery Manager GP Clinical Commissioner Associate Director of Communications & Engagement Director of Integrated Governance Joint Commissioning Manager Older People Interim Commissioner Children s ICES Contract Manager IN ATTENDANCE Naa Akle Noi (NAN) APOLOGIES Seelan Gunseelan (SG) Bridget Cameron (BC) Dr Ellen Wright (EW) Business Support Officer Associate Director of Finance Head of Joint Commissioning with LA GP Clinical Commissioner 1. WELCOME ACTION JW welcomed the group to the meeting 2. APOLOGIES As listed above. 3. CONFLICTS OF INTEREST a. To note declared interests The meeting noted the interests previously declared b. To add new interests EW declared that she is now on the pain service.
c. To identify potential conflicts of interests with the business on the agenda None 4. MINUTES AND MATTERS ARISING Minutes agreed. JW requested for conflict of interest register to be included in meeting papers. A request was made for an action log to be added to the minutes At the last meeting, the committee requested a written report in November on the progression of the CAMHS bids. JW asked for reaffirmation that the report will be presented at the next meeting At the previous meeting Irene volunteered to forward committee members a report on Citizen UK and the projects they are involved in; this action is still pending. NM will follow this up. NAN NAN NAN NM 5. ICCS UPDATE Presented by EG The advert for tender of ICCS (Integrated Community Children s Services) went out on Monday 20/10/14. There was a Market Management event held on Friday 17/10/14 where interested parties for the tender were invited and given an overview of the current services and advised of the vision to redesign and challenge the market. Thirteen organisations attended the event; over five of them have expressed interest in bidding. A Communication and Engagement plan has already been developed. There has also been a meeting with Healthwatch to share ideas and there is a good mechanism in place for keeping updates. There is contemplation on bringing in a specialist agency to communicate with some of the children with complex needs and long term conditions. Although there is no budget for it yet, there have been quite a few proposals presented that are been looked at to find out what is on offer and how it is going to enhance the procurement of the services the CCG commissions. There has been a liaison with Healthwatch on the subject. The committee will be updated as this progress. In answer to KS question on type of services and providers, EG explained that the plan is to take all the service lines that already exist and integrate them so that children do not have to go to several different places for assessments. The intension is to keep a single point of assess. EG pointed out that there are a few services that may be subjected to change or removal; continuing care is been looked in the same way adult continuing care responsibility is 2
adhered. In relation to Personal Health Budget (PHB), it will be conflicting and difficult for a provider to manage a child or family who want to make their own decision on their budget. A review is been done on how to manage this in the future. A working group has been set up for PHB; the group is to look in to questions on the management of budget. Currently there are two choices, commission as it goes or commission a certain amount of services from a provider within the contract. JW informed everyone that in the past the contract has included a clause stipulating that the value of the contract is subjected to reduction due to individuals choosing PHB. JW suggested doing something similar. School nursing are currently been managed on behalf of RBG who have requested this continue for another year. They have however stated that they will like to reserve the right pull out should they decide to do something different. KS pointed out that school nurses are often the first point of contact therefore it is important to consider how coordination will be maintained between the school nurses and other services when handling their contact. Action: The committee requested a report on PHB for both Adult and Children to be presented at the January or February meeting. Action: The committee requested a report on PQQ to be presented at the January or February meeting. 6. MEDEQUIP CONTRACT - Integrated Community Equipment Service (ICES) Presented by. Simon EG / BC The continence service is based around the procurement, storage and delivery of continence product. The current service agreement with Medequip is due end on 31 st March 2015. Continence has a big budget in the ICES with 20% increase in spend last year. A review was done on the continence to understand the reasons for the pressure on the budget. A QIPP target was then set to save 25,000 through tender. The vision for the continence service in Greenwich is to Commission a cost-effective Continence service where service users receive best value products on time while respected the dignity of the service user which is used efficiently by prescribers and deliverers. The options appraisal presented was split into six options, four around the future commissioning options and two around the management of the budget. Commission Options; Option A; Extend the existing contract variation with Medequip for up to two years. This option does not present any saving and therefore not recommended. Option B; Access the NHS Supply Chain Framework 3
Agreement. This is the favoured option. There are four different providers on this frame work agreement who have savings ranging from 80,000 to 150,000. The issue with this option is around the legal advice received so far; the frame work does not cover the scopes and service in Greenwich, it covers the procurement and supply of product but not delivery. There is negotiation with NHS Supply to include in the frame work agreement the delivery of the products. There has not yet been a satisfactory agreement to this. Option C; Go out to tender for individual outsourced Continence Product contract. In April the CCG went out to tender however it became clear that the data was not of adequate quality for providers to put in a good bid. Only three providers submitted a tender. This option gives the CCG total control along with the responsibility of tender. The Supply Chain option removes the responsibility of tender. Option D; Go out to tender under Any Qualified Provider. Providers will be pharmacy stores across the borough and prescription will be sent to them for supply. This option takes away bulk buying power and reduces the chance of making any savings. Management and Budget Options; Option E; Award a contract variation to Oxleas to commission the service. This will mirror what Bexley have done. The issue with this option is around the management of the budget; there will be little control over who is commissioned and this will makes it difficult to determine if the CCG is getting value for money. There is also not enough data to set the budget at the correct amount. Option F; Bring Continence Product services back in house on an individual health authority basis, either as an internal department or as a local authority trading company. This option will not be possible to implement in time for 1st April 2015, the option is also not cost effective and therefore not recommended. The recommendation was for the CCG to pursue option B and get definitive legal advice. Should the CCG need to go out to tender if the legal advice from Supply Chain is not preferable the recommendation was also made for the specification to be developed. JM stated that because notice has already been given, if the CCG is going out to tender, it has to be very soon without delay for a provider to be in place by 1 st April. KS asked about deliver delays with Supply Chain and how they are dealt with. explained that Oxleas are using the service and find it very reliable. KP informed everyone that if the CCG chooses to go with option B, there will be an agreement with NHS Supply Chain which will stipulate the CCG s requirements and monitor them 4
through KPI. The CCG can monitor how quickly products go out and stipulate that in the agreement. KP went on to explain that at the moment, complaints for the Supply Chain service are going in through Oxleas because they are the first point of contact for patients. There have been attempts to get information on the complaints Oxleas receive in the past with no luck. Action: The committee requested information on Bexley s experiences in using NHS Supply with a focus on delays and any other complaints with the service. Action: Include in the specification of the contact, a high standard of delivery on time with a clear statement that any failure to meet this will result in the termination of the contract. The committee has asked for an independent legal advice on the issues raised on NHS Supply before deciding whether to use that option or go to tender. Action: to get independent legal advice on NHS Supply The decision was made to negotiate a 3month extension with Mediquip. JW suggested getting 6 months extension instead. Action: Find out if extension from Mediquip is possible. The committee will like Oxleas to manage the contract. It was noted that medicines management are also working on continence and prescribing. Action: agreed to contact Rena Amin on drawing a linking in with medicines management. 7. AGREEMENT OF ALLIANCE PARTNERS FOLLOWING MARKET ANALYSIS - UPDATE Presented by AG. The first Alliance Partnership Board (APB) meeting took place on 12 th September. It was decided at the meeting that the board will be chaired by Greenwich CCG until the operational phase of the programme when a chair will be elected. The board made the decision to develop the service model in phases with services becoming operational at different times. Four clinical groups has been established, these groups will be supported by operational groups that will oversee the development of the clinical pathway, the referral routes, and criteria, among others. The four clinical projects are; COPD The clinic service should be operational by the end of January. Most of the pathway work is complete. Cardiology Potential significant expansion into the community via Eltham Hospital has been identified. A draft of the potential service pathway and structure will be presented by mid-november. Frailty A multi-agency frailty workshop was held on 2 nd October involving around 50 stakeholders to developed new pathways that will underpin the development of an overarching service model. A follow up section is due to take 5
place on 24 th October. MSK The first meeting for MSK will take place on 23 rd October, where there will be a review of new pathways. One of the sub groups of the Alliance is Finance/Information. This group is to look at sharing documents across organisations. A meeting has been arranged with an external company to explore methodologies around the costing of the clinical pathways. Key notes about the partnership; The next APB meeting is on 31 st October. Two project managers have been recruited, one more to be recruited. There are now CPL leads; they will link into the transformation group. JW ask what the annual cost of the contact will be. SJ informed the committee that the annual cost is about three million pounds. JW also expressed concern about the number of meetings to be generated from the alliance structure. SJ assured everyone that most of meetings took place prior to the alliance partnership; the only new parts of the structure are the APB and the four enabler groups. Eventually the enable groups will fall away leaving the partnership board. Action: SJ and AG to meeting with VS to discuss the partnership from a communication and engagement point of view. Action: SJ and AG to meeting with NM to discuss the partnership from a quality point of view. 8. GP OUT OF HOURS (OOH) Presented by AG. SJ/AG SJ/AG At the governing body in September, it was agreed that OOH and urgent care procurement will include satellite services at Eltham and Thamesmead covering 8am to 8pm seven days a week. The date of the ITM will be delayed by a week in order to allow the paper work to be updated to incorporate the new elements. Bidders are now putting their submissions together. The deadline for submission is 20 th November; evaluation takes place from 21 st November through to 18 th December. Everything is on target. Three independent GP s from OOH have been signed on with one independent nurse. KS request a copy of the specifications that was sent to the providers. Action: Keep RBG informed of what is going on. 9. ANY OTHER BUSINESS SJ announced that there is going to be a ceremony involving AG AG 6
Greenwich CCG, RBG and local MP in relation to the development of Eltham Hospital. VS explained that a VIP preview event has been organised for 13 th November. Due to health and safety on the work site only a small group of individuals have been invited. The people invited represent key people that occupy the building. The ceremony is part of a six months programme on promoting the hospital. JW asked for the procurement calendar to be present at every meeting. It was decided that meeting paper should be distributed at least 3 days prior to meeting date, any paper being presented to the committee has to be sent to the meeting coordinator before this deadline 10. DATES OF FUTURE MEETINGS 27 th November 2014 7