NDCCG Primary Care Co-Commissioning Committee
Thursday 25th June 2015
NDCCG Primary Care Co-Commissioning Committee
Robert Robinson Room, Scarsdale
Thursday 25th 2015
Public Session
MINUTES
Present
Gary Apsley (Chair)
Lay Representative (PPI Lead)
Ben Milton Dr
Darren Green
Hannah Belcher
Ian Gibbard
John Grenville
Marie Scouse
Mark Smith
Jackie Pendleton
Jayne Stringfellow
Richard Bull
NDCCG, Lead Clinician
NDCCG, Head of Finance
NHS England, Contracts Manager
Lay Representative (Audit)
Derby & Derbyshire LMC, LMC Chair
NDCCG, Assistant Chief Nurse (Primary Care)
NDCCG, Director of Finance
NDCCG, Chief Officer
NDCCG, Chief Nurse
NDCCG, GP
Apologies
Beverley Smith
Andrew Milroy
Jonathan Rycroft
Joanne Winfield
NDCCG, Chief Transformation Officer
Derbyshire County Council, Head of Adult Social Care
NHS England, Head of General Practice
Lay Representative
In Attendance
Christy Herbert
Mark Roome
Jayne Bouch
NDCCG, Clinical Quality Administrator
GEM & Arden CSU Informatics
NHS England, Contracts Officer
Item
PCC.0027.15
Item
Welcome, Introductions and Apologies
The Chair of the meeting Mr Apsley welcomed the group, introductions
were given and apologies recorded as above.
PCC.0028.15
Declaration of Interests
Both the Chair Mr Apsley and Dr Ben Milton declared an interest in agenda
item 6 Premise Update.
PCC.0029.15
Minutes of the previous Primary Care Co-Commissioning Committee
The minutes of the previous Primary Care Co-Commissioning Committee
held on Thursday 25th May 2015 were agreed as a true and accurate
record.
Action
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NDCCG Primary Care Co-Commissioning Committee
Thursday 25th June 2015
Matters Arising
PCC.0018 & PCC.0026.15 – Miss Herbert has now arranged future
monthly meeting dates and venues. This information has been circulated
out to the Committee.
PCC.0021.15 – Mrs Scouse informed the committee that the Clinical
Quality Team have capacity issues in relation to managing some of the
Co-Commissioning contractual management requirements. In order to
undertake this role the team have looked at its structure and work streams
and the CCG intends to secure an additional resource. Mrs Scouse will
provide the Committee with a report in three months’ time.
Mrs Pendleton suggested that in the interim the CCG should build on its
relationships with the District Council and embed relationships in
preparation for future section 106 funding opportunities. Mrs Scouse will
take this forward.
Marie
Scouse
Marie
Scouse
The Committee briefly discussed the housing development currently in
process along the A61, Chesterfield. It is believed that this development is
not of a considerable size.
The Chair Mr Apsley suggested that Section 106 Monies should be
discussed outside of the meeting looking at what is already being done
and what other work can be done in preparation for future developments.
PCC.0021.15 – Miss Belcher informed the committee that Mr Rycroft is in
the process of collecting each CCGs responses in relation to the Guiding
Principles. Mr Rycroft intends to bring a paper to the August Primary Care
Co-Commissioning Committee.
PCC.0030.15
Marie
Scouse/
Darren
Green
Jonathan
Rycroft
Terms of Reference
Mrs Scouse informed the committee that since the last meeting the terms
of reference have been updated with the suggested changes.
At the previous meeting the committee queried if the names of members in
attendance should be included within the terms of reference.
The committee agreed that names are not necessary and only
positions should be listed.
The committee then discussed the vice' Chair of the Primary Care CoCommissioning Committee. It was agreed that the vice chair should be
formalised within the terms of reference so efforts can be made to attend
the meeting.
Action:
Mr Apsley agreed to approach Isabella Stone regarding the Vice Chair
responsibility to see if she has capacity to take this role on.
Mr Apsley
The committee agreed that the terms of reference can be amended
post meeting to reflect the changes made to the terms of reference
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NDCCG Primary Care Co-Commissioning Committee
Thursday 25th June 2015
Vice Chair.
It was noted by the committee that the quorum of five members, to include
two directors, one clinical representative and two lay representatives is a
requirement taken straight from the delegation agreement.
Clarity was sought by the committee on the ‘Clinical Representation’ within
the terms of reference. Mrs Stringfellow agreed that at future meetings she
will attend the committee as the Executive Lead for Primary Care rather
than Clinical Lead.
POST-MEETING NOTE: it was agreed that this consideration applied
equally to Mrs Scouse, and that Mrs Scouse would therefore also
attend Committee meetings as an executive officer rather than as a
clinician.
Mrs Stringfellow bought to the committee’s attention Section 8.6 – 8.8
reporting arrangements within the Terms of Reference. The committee
were informed that at the next Primary Care Development Group (PCDG)
Meeting on Monday 29th June 2015 it will be proposed that the Open
Public Minutes from this Primary Care Co-Commissioning Committee are
routinely circulated out to all NDCCG member practices for openness and
transparency of business discussed and they are fully informed of the
decision making process.
Miss
Herbert
The committee noted that the Primary Care Co-Commissioning Committee
is responsible for looking at how and where Primary Care funding is spent.
The Governing Body Assurance Committee (GBAC) then ratifies this
decision from an affordability point of view. This being the reason the
minutes of this committee are then taken to GBAC.
A further discussion was then held by the committee around GPs chairing
the PCDG Meetings and if this is appropriate. Mrs Stringfellow informed
the committee that moving forward she plans to attend future PCDG
Meetings with the possibility of chairing once the current chair retires in
August if the attendees of the group agree.
PCC.0031.15
Quality and Assurance Reports
Unfortunately the attendee who planned to present the Quality and
Assurance Dashboard Report to the committee was unavailable. A paper
example screenshot of the monthly Practice Dashboard was tabled at the
meeting.
The paper is an example dashboard of what has been developed in
Lincolnshire showing practice activity in prescribing, KPIs, Plans Vs
actuals in tariffs, activity data and admissions.
Mr Roome has been working with Mrs Derricott Clinical Quality Manager
using this dashboard as a comparative against the areas NDCCG are
interested in reporting. Mrs Scouse informed the group that it has been
suggested to also add in the monitoring information collected for NHS
England from the Primary Care Web tool, combining this information into
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NDCCG Primary Care Co-Commissioning Committee
Thursday 25th June 2015
one dashboard creates one sensible mechanism for reporting. This would
provide the Primary Care Co-Commissioning Committee with a report of all
the contractual elements that need reporting into the CCG.
The CCG Primary Care Team are reviewing the individual serious incident
and complaints data on a monthly basis and will bring this information to
the committee on a three monthly basis with exceptions being reported to
the committee when necessary. Mrs Scouse will take this forward.
The committee recommended that the dashboard report also include
Procedures of Limited Clinical Value (PLCV), 111 and Out of Hours. Mr
Roome noted this recommendation.
A further discussion was had by the committee around the harshness of
using the Red, Amber Green (RAG) status on performance and whether
this should be replaced with bronze, silver and gold. The CCG needs to
identify which practices they are actively working with so the focus should
not be on the RAG status but more around the discussions with practices
and how this element is recorded. Mrs Scouse will take this forward.
Mrs
Scouse
Mr Roome
Mrs
Scouse
Dr Milton highlighted that practices need comparative data in order to see
the value of data that is collected.
The Committee requested that a presentation of the dashboard be given at
the next meeting in July by Arden & GEM CSU Informatics.
Agenda
Mr Smith who is part of the GEMIMA Steering Group asked the committee
to be mindful that GEMIMA which is the platform for this dashboard has
lots of potential but is still in the process of being rolled out to practices.
PCC.0032.15
Premise Update
Mr Green informed the committee that there has been very little progress
since the last meeting in May.
Mrs Belcher highlighted that there has been a number of regional and
national meetings happening in order to try and get the schemes moving.
The concerns raised in Derbyshire and in other areas have been shared
and escalated.
The committee raised concerns that if there is no slippage in the NHS
England Infrastructure funding this leaves practices with a limited amount
of time for development. Practices now need full assurance of the
commitment agreed. The CCG is supporting the successful practises to
receive the funding and they have had an agreement in principle from NHS
England.
Mrs Pendleton informed the committee that NHS England has recently
sent out a letter to all four CCGs outlining the requirements to develop an
Estates Strategy. NDCCG plan to incorporate this into the 21st Century
estates Workstream which includes primary care.
PCC.0033.15
Violent Patient Scheme
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NDCCG Primary Care Co-Commissioning Committee
Thursday 25th June 2015
Mrs Scouse gave the committee an overview of Direct Enhanced Service
(DES) Violent Patient Scheme (VPS). The VPS is a service that provides
Primary Medical Services for patients who have been removed from a
practice list due to a breakdown in Patient / GP relationship or by them
exhibiting violent behaviour in a GP practice.
Further to the NHS Co- Commissioning delegated arrangements the
commissioning of this service is a North Derbyshire Clinical
Commissioning Group (ND CCG) and Hardwick Clinical Commissioning
Group (HCCG) responsibility.
Mrs Scouse further explained that this service is currently delivered by
Avenue House Surgery, Chesterfield. The Practice has given notice to
withdraw from this contract and have accepted to terminate this from
December 2015.
Currently the VPS has 10 patients registered on the scheme, all are
NDCCG patients, initial discussions have been held with HCCG and it is
the intention to continually jointly commission this service.
The committee were informed that in order to gain an understanding of
potential new provider interest for future delivery of this service for its
patient population the CCG will send out an expression of interest request
to its member practices.
The committee were made aware of the potential financial risk which
comes with the re-procurement of the VPS service. There is currently no
national specification or funding agreement for the VPS therefore the price
to deliver this varies across the Country.
Miss Belcher highlighted that this service can only be delivered by a
Practice and there is no such scheme for community pharmacy and
dentists etc.
The committee raised points around the duty of care towards other
patients and the violent patients themselves. Mrs Stringfellow advised the
committee that as part of the MAPPA Public Protection Officers Duty the
police are obliged to individually communicate with practices regarding
potentially or previously violent patients who have been released from
HMP.
Dr Bull question what currently happens to violent patients during the out
of hour’s period and why this is different to the VPS. Mrs Stringfellow
agreed to discuss this with DR Bull outside of the meeting.
Miss Belcher and Mrs Scouse plan to put together an options
appraisal along with a position statement on the risks and threats
which will be bought back to the next meeting and discussed under
matters arising.
PCC.0034.15
Dr R Bull
Jayne
Stringfellow
Mrs Scouse
Mrs Belcher
Primary Care Hub Development
This item was moved to the confidential section of the meeting for
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NDCCG Primary Care Co-Commissioning Committee
Thursday 25th June 2015
discussion.
PCC.0035.15
Minutes of the Primary Care Development Group Meeting
The committee noted for information the final minutes from the Primary
Care Development Group meeting dated Monday 30th March 2015.
Mrs Scouse asked the group to note the Basket of Services decision
making information within the minutes.
Mrs Stringfellow pointed out to the committee that a number of queries
have been raised by various sources around the decisions made and sign
off of the BOS specification. The process for ratifying the BOS and
contract arrangements will be shared with all member practices. It has
been identified that currently a number of practices are not delivering all
the services within the BOS, the BOS is commissioned and funded as a
whole and is inclusive.
Dr Bull highlighted that the purpose of the PCDG Meeting is not solely to
discuss the BOS and that this is only one element of the meeting. The
discussions on the BOS have been open, transparent and have gone
through an engaging interactive process for a number of months.
Mr Grenville informed the CCG that the Chesterfield Locality have
arranged an evening meeting on Monday June 29th to discuss the BOS. Mr
Grenville recommended that a member of the CCG attend the meeting. It
has been made clear by the locality that they are having difficulties
providing the essential and additional services they are contracted to
deliver.
Mrs Stringfellow agreed that she is happy to send the response to Mr
Grenville prior to the meeting on June 29th so that this can be shared with
the practices ahead of the meeting. Mrs Stringfellow reaffirmed that the
CCG has a duty to look at the measures and monitoring aspects of the
BOS. A representative from the CCG will attempt to attend the evening
meeting on June 29th.
PCC.0036.15
Minutes of the Chesterfield and North East Clinical Governance
Leads Meeting
The committee noted for information the final minutes from the
Chesterfield and North East Clinical Governance Leads Meeting dated
January 14th 2015.
PCC.0037.15
Any other business
Mrs Pendleton asked the committee to note that the CCG has formally
received the signed scheme of delegation agreement from NHS England.
Mrs
Stringfellow
The Committee had no other business to discuss.
PCC.0038.15
Date, time & venue of the next meeting
Thursday 23rd July 2015, 11am, Robert Robinson Room, Scarsdale
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NDCCG Primary Care Co-Commissioning Committee
Thursday 25th June 2015
Moving forward the administrative support for this committee will be
provided by Rosalind Combes. Please can agenda items and apologies be
forwarded to Rosalind.Combes@northderbyshireccg.nhs.uk
Signed by……………………………….
Chair
Date……………………………………..
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