Item 8.2 South Gloucestershire Clinical Commissioning Group Membership Meeting Date: Tuesday, 8 th July 2014 Time: 13.30 15.30 Location: Bristol and Bath Science Park Minutes Attendees: Dr Jon Hayes (JH), Clinical Chair (Chair) Dr Martin Lockyer (ML), Almondsbury Surgery Dr Norman Douglas (ND), Bradley Stoke Surgery Dr Shahid Afzal (SA), Close Farm Surgery Dr Luke Parker (LP), Close Farm Surgery Linda Marshall (LM), Close Farm Surgery Dr Imran Hamid (IH), Concord Medical Centre Dr Ian Paul (IP), Coniston Medical Practice Dr Brian Tomlinson (BT), Courtside Surgery Janet Biard (JB), Courstide Surgery Dr Chris Boelling (CB), Emerson s Green Medical Centre Dr Raymond Finch (RF), Dr Foubister and Partners Dr Jane Goram (JG), Frome Valley Medical Centre Leigh Frost (LF), Frome Valley Medical Centre Dr Felicity Fay (FF), Hanham Health Dr Catherine Buckley (CB), Kennedy Way Surgery Dr Neil Kerfoot (NK), Kingswood Health Centre Dr Jon Evans (JE), Leap Valley Surgery Dr Amanda Ramshaw (AR), Northville Family Practice Dr Alison Wint (AW), Pilning Surgery Dr Rebecca Williams (RW), St Mary Street Surgery Dr James Bragg (JB), Stoke Gifford Medical Practice Dr Ann Sephton, The Oaks Medical Centre / Deputy Clinical Chair Dr Richard Berkeley (RB), The Orchard Medical Centre Dr Cheryl Atter (CA), The Park Medical Centre Dr Richard Greenway (RG), The Three Shires Dr Hannah Richmond (HR), The Willow Surgery Dr Mark Thompson (MT), Thornbury Health Centre Dr Kate Mansfield (KM), Wellington Road Family Practice Page 1 of 6
Dr Sam Davies (SD), West Walk Surgery Sharon Kingscott (SK), Chief Finance Officer, South Gloucestershire CCG Melanie Green (MG), Head of Medicines Management, South Glos CCG Dr Stephen Illingworth (SI), Clinical Lead for Projects, South Gloucestershire CCG Alison Ford (AF), Children s Commissioning Manager, South Gloucestershire CCG Dr Phil Yates (PY), Chairman, GP Care (for item 5 only) Alex Crawford (AC), Deputy Head of Commissioning and Planning, University Hospitals Bristol NHS Foundation Trust (for item 7 only) Maxwell Allen (MA), IM&T Project Lead, University Hospitals Bristol NHS Foundation Trust (for item 7 only) Eszter Kormendi (EK), PA, South Gloucestershire CCG [notes] 1. Welcome and Apologies JH welcomed everyone to the membership meeting and everybody introduced themselves. 1.1 Apologies were noted from: Jane Gibbs (JG), Chief Officer, South Gloucestershire CCG Dr Tharsha Sivayokan (TS), Christchurch Medical Centre Ann Magham (AM), Wellington Road Family Practice ACTION 2. Declaration of Interests None. 3. Minutes of the Previous Meeting JH confirmed that the Primary Care Strategy is being developed following the extended Membership meeting in May. The draft strategy will be presented to the Membership at the September meeting. Item 6 Share and agree the vision The CCG submitted its expression of interest to NHS England regarding the possibility of co-commissioning primary care. Both the CCG s letter and the response from NHS England were circulated to the Membership for information under agenda item 6 of today s meeting. The CCG does not have the staff resources to take up cocommissioning in its entirety, this is reflected in the CCG s expression of interest. The Membership commended the CCG s response. ML informed the group he had spoken to the Area Team about co- Page 2 of 6
commissioning. The question of out of area patient registrations was raised. It will start as of 1 st September 2015. NHS England will arrange such home visits. When the time comes, the CCG will have to agree a response to NHS England on behalf of South Gloucestershire practices with regards to the practicalities of out of area patient registration. The minutes were approved for accuracy. 4. Members Briefing New Board member JH welcomed Janet Biard who is the new Practice Manager Board member. JB replaces Martin Wilkes on the Governing Body. Simon Stevens visit 27 th June Simon Stevens, Chief Executive of NHS England, visited the South region on 27 th June. The visit was hosted by NBT. CCGs Chief Officers and Chairs were invited. South Gloucestershire CCG was represented by Jane Gibbs. JG appraised Simon Stevens of the CCG s financial situation and current challenges. Representatives from Bristol, North Somerset, Somerset CCGs, NHS England Area Team and NBT attended this visit. NBT NBT s hospital move from Frenchay to Southmead went well; patients were moved efficiently. However, NBT continues to face challenges in achieving its 4-hour A&E waiting targets. GPs have experienced difficulties with admitting patients via the Hub. There are problems around discharging patients. NBT s performance puts a lot of pressure on primary care services. A summit meeting to discuss NBT s performance will be called by the NHS England Area Team; Bristol and South Gloucestershire CCGs, NBT and the TDA will attend. ACTION: GPs are asked to send any feedback, examples of problems they encounter at NBT to the CCG s Quality Portal. GPs NBT has fallen behind schedule on elective care operations. Elective care backlog nationally has to be cleared by September. Some extra money has been made available to CCGs to help clear the backlog. The criteria for claiming money are very strict and the CCG will have to submit a detailed plan outlining how the funding would be used. Next meeting of the Membership Group The next meeting of the Membership Group on 10 th September will focus on the CCG s primary care and urgent care strategies. The meeting will run from 1.30-4.30pm. Practice Managers are invited to Page 3 of 6
attend along with the GP representatives. Members are asked to consider the Call to Action information and feedback to inform discussions at the next meeting. 5. Prime Minister s Challenge Fund PY attended the meeting to inform the Membership Group about the opportunity for practices to be involved in the Prime Minister s Challenge Fund project. One Care Consortium were awarded a 5 million funding for a 2-year project to pilot new ways of working within Bristol and South Gloucestershire GP practices. The pilot project is proposed to develop harmonised templates for GP practices to use and to make patient records available across local organisations. The aim is to take some pressure off GPs and to ensure continuity of care. NHS 111 would take part in the pilot too. Avon IM&T and Connecting Care would provide the necessary software and technological background. The project also proposes a telephony system which could lead to a shared visiting system and clinical advice system between GPs. The project is also looking into the possibility of registering nursing homes with GP Care or BrisDoc to proactively look after these patients. During wave 1 of the sign-up, 14 practices from South Gloucestershire and 23 from Bristol have signed up to take part in the pilot. The wave 2 sign-up process is expected to start in 4-5 months time. PY hopes that by the end of the project, some efficiencies in primary care service provision will have been made. The question whether this project could facilitate the federation of practices was raised. PY confirmed that collaboration between practices would certainly be helped but the exact details are to be determined. The Membership agreed that JH will write to Linda Prosser to inform her that several member practices expressed an interest in the possibility that the One Care Consortium project could support the activities of South Gloucestershire practices working together in federations. ACTION: JH to contact Linda Prosser JH 6. Primary care co-commissioning This item was discussed under item 3. Page 4 of 6
7. UH Bristol proposal to eliminate faxing of patient identifiable information AC and MA attended the meeting to give an update to the Membership Group on the initiative that UHB will cease faxing patient identifiable information as of 1 st September. Letters and discharge summaries will no longer be faxed out to practices. Bristol practices will receive this information via CDS. High volume practices in South Gloucestershire (i.e. at least 2500 documents a year) have been or will be contacted by Julie Marshall, Project Manager. It would be helpful if these practices could take up CDS. The majority of South Gloucestershire practices are low traffic practices. The Membership Group expressed clinical concerns around the potential delays in receiving the information from UHB after 1 st September, if practices do not wish to use CDS. An alternative solution could be the use of NHS.net but this would also require administrative staff to log in to check if there are any documents from UHB. A solution will have to be found. ACTION: JH will contact Andrew Appleton to take this forward with Julie Marshall. JH 8. Re-commissioning community health services for children KM informed the group that the current community health services contract for children is coming to an end in March 2016. The formal reprocurement process will start in the Autumn 2014. The CCG has a 6 million share in the contract. Although the re-procurement means a huge amount of work, it also presents the CCG with the opportunity to work with stakeholders and to improve service provision. South Gloucestershire s population is growing. Even though a demographic dip is currently affecting secondary schools, the number of primary school children is on the increase. The new Children and Families Bill will come into force from September 2014. This will result in some changes in the way services are provided. Under the 0-25 Children s Strategy, statements of special educational needs will be replaced by new birth to 25 education, health and care plans which will require joint working between child and adult services for all agencies. Various patient and public involvement opportunities have already taken place and are planned for the rest of the procurement process. These events have already provided the team with valuable feedback on current services and they have helped identify areas in need of improvement. Page 5 of 6
To help collect more information, clinicians who work with children and young people are invited to complete a survey before the end of July. The current GPwSI Paediatrics service works very well. The LIFT service for adults is a good service; the aim of the re-procurement process is to establish a similar service for children. CAMHS offers services in Tier 3, but service provision for in Tiers 1 and 2 will have to be established. Public Health works with School Nurses. Services for children on the autism spectrum are disjointed (primary care vs. school); there is usually a long wait before diagnosis. Safeguarding children training for GPs is underway. 9. Any other business Patient Participation DES Some problems have been reported around the payment of the Patient Participation DES in some Bristol GP practices. It is important to ensure the criteria that NHS England want are clear, so that practices do not spend a lot of wasted time and energy on the Patient Participation DES and then not get paid. ACTION: Charlie Record to work on this. CR 10. Date of next meeting 17 th September 13.30-16.30 BAWA Page 6 of 6