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Page 1: Oxfordshire Clinical Commissioning Group - NHS … · Oxfordshire Clinical Commissioning Group ... struggling with 20-40 minute registration processes and overtime ... SA said that

1 Last Updated: Thursday, 11 May 2017 File Name: C:\Users\Ed.Browning\Downloads\nelg-notes-12-10-16.docx Author: Julie Dandridge

Oxfordshire

Clinical Commissioning Group

MINUTES:

TITLE: Locality Commissioning – North East

Held on: 12 October 2016, 13:00 – 15:00PM

Venue: Montgomery House Surgery, Bicester

STANDING ITEMS Action

1. Welcome: Diane Hedges

2. Apologies: Rosie Rowe

3. Declarations of interest + AOB – No new declarations of interest

4. Minutes of the Meeting Held on 14 September 2016 They were accepted as correct. North Bicester patients A request was again made for the remaining patients on the North Bicester list to be allocated to the Bicester practices. JD to check the number on the residual list and whether it was possible to bulk allocate. JD reported that there was often about 20% of the list who did not re register as the patients had either moved away or passed away. The remainder were those that did not visit their GP. Feedback to be provided before the next meeting. VHS also requested response to previous correspondence to JD regarding up front funding for patient registrations, as staff were struggling with 20-40 minute registration processes and overtime/ costs incurred due to shear volume – 50/60 per day. JD to respond. The CCG has allocated more funding to the hub to increase the capacity during October to December but it was felt that this was too little too late. Diabetes Evening meeting around Diabetes is planned 2.11.16 in Oxford. All to check for interest. SA to check details and send round.

JD

JD

SA ALL

5. Matters Arising

a. PPG Forum Chair Update: HVO provided an update. Health fair in Bicester planned for Friday 14 October in John Paul Centre. There will be a focus on encouraging people to join their PPG.

b. The aim will be to also try and identify any themes that we can

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2 Last Updated: Thursday, 11 May 2017 File Name: C:\Users\Ed.Browning\Downloads\nelg-notes-12-10-16.docx Author: Julie Dandridge

see if we can address. Norman Ruby has decided to stand down and there is no one else imminently who can step forward but HVO will keep looking.

c. Bicester Healthy New Town Update: SA attended a recent stakeholder workshop for the Bicester Healthy New Town and reported that there was discussion around cycling, voluntary groups and schools. Three work streams formed part of the outline including built environments; community activation and creating care closer to home.

HVO was concerned that little discussion on how health with be supported by Healthy new town. Kingsmere population example with young families – as they age fitter youngsters move on. Other practices advised a mix of older grandparents also move in so does even out. There was some discussion as to whether practices were happy to display leaflets from active groups - if displayed in practices then it would give the impression that they are being endorsed by the practice. Need to be careful on what needs to be displayed. It was agreed that practices need to be a bit selective but MW suggested that some could be displayed under the Generations game banner.

HVO

All

ITEMS REQUIRING CLINICAL FEEDBACK

6. NE Transformation a. November Locality meeting focus:

SA said that next month’s locality meeting will be focussing on the transformation plan. This will show the financial gap and how over next 5 years we will manage. The plan will include movement to more community based care and how the Horton and JR will have services reconfigured. Currently obstetric unit at Horton is closed as a result of a lack of medical staff but this will also need to be considered going forward. A midwife led unit is now operating. However it was felt that if the numbers of deliveries at the Horton were too low to justify an obstetric unit then there may be no options for the commissioners. It is planned that there will be a series of options with which the CCG will go out to consultation after which a decision will be made. Community hospital reconfiguration will also be part of the debate and how we use the 152 beds currently available. SA posed the question on what locality based services should be provided - ? EMU type services. Key that we utilise space in community hospital. This will need to be articulated locally at practice, neighbourhood and locality level. Kidlington will support some things but not all and some will need to be provided at both Kidlington and Bicester hubs. A suggestion was made

JAH/SA

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3 Last Updated: Thursday, 11 May 2017 File Name: C:\Users\Ed.Browning\Downloads\nelg-notes-12-10-16.docx Author: Julie Dandridge

that a list needed to be pulled together with the possible different services. It was noted that it was Important to involve the public. Diane Hedges reported that it is important that all parties input into this so can shape the way forward and we can consider NELG views on continuing obstetrics and alongside paediatrics. What info do practices need to make that decision? Should Paediatrics be an ambulatory service –to be discussed at the next meeting A Slide deck will be shared at the November meeting. GPAF update: AE reported that PML has shared with the practices how they think they can deliver the GP AF national criteria. This proposes a hybrid mode – need to deliver 1.5hrs hours by GP and ANP in the evening with administrator M- F and this could be done by willing practices. The Federation will run the service on Sat and Sun. Federations would manage the practice rota and sort the IT and other issues. This liberates 18hrs for in hour capability to help support the in hours system. A rough rule would be that Big practices would do 1 session a week and smaller practices one a fortnight – but it would depend on the willingness from practices. Any queries to Andrew Elphick.

b. ONEMed briefing: A clinical pharmacist for the Federation had been considered but was deemed too expensive.

c. Neighbourhood groupings: These are mentioned in some of the plans – suggestion that 2 neighbourhoods one Kidlington and surrounds and then Bicester. All to be happy with the groupings as the CCG will look more and more towards planning on this level. Islip and Woodstock agreed they aligned more with Kidlington than Bicester.

It was agreed that the NE locality would want to consider how primary care might be delivered across the NE Locality and that should consider mapping out future health provision across the patch. A possible protected learning time event was considered with other stakeholders also invited. Agreed to have Kidlington and Bicester meeting and then to bring together.

All

JAH

All

Note

SA/JAH

ITEMS FOR INFORMATION AND DECISION

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4 Last Updated: Thursday, 11 May 2017 File Name: C:\Users\Ed.Browning\Downloads\nelg-notes-12-10-16.docx Author: Julie Dandridge

7. Locality Community Services Group Update: WO’G reported that the group is looking at ways of configuring community services across in the localities. In NE 4 areas discussed

1) IT- ensuring shared access between practices and DNs similar to OOH in other areas of the county;

2) registering as carers with Carers Oxfordshire as this will give you support in areas of need and if people are struggling

3) Organising a bank of carers so if a social situation becomes untenable OH/social care will have a carer’s bank and this will be accessible through the SPA. Carers bank will only be accessible through the GP.

4) Combine training of all care staff. OHFT organising training in care homes and will ensure that all can access including PN, care home nurses and DN. This should lead to more co-operative working.

Next meeting planned for Nov 16.

8. New models of care update – Diabetes: SA reported that this was going on at a pace. Project group is looking at what skills primary care has to deliver more diabetes care in the community with important primary /secondary care interaction so that it is possible to book a slot to speak to the diabetologist for advice etc. Currently looking for IT solutions that can extract information from pt. record into a dashboard so could see at an instant the risks to pts. Plan would be to have an outcome based contract with the CCG. Garry Tan and Rustam Rea have been approaching practices to look for space so that they can see pts. nearer their home. Practices should consider offering a room to consultants for free in the short term and try joint consultations. A question was raised on how long the project will run before it is deemed a success. Initially looking for some pilot funding for 6months to 1 yr. and then try and contractualise.

ALL

9. Commissioning Intentions 2017/18: JAH advised this is a strategic level document without much Locality or primary care detail. The detail is within the NE Locality Plan document.

All

FORWARD PLANNING

10 Primary Care Dataset project – Todd Davidson, CSCSU Change Manager & Mike Bernstein, Project Manager: Mike and Todd were welcomed to NELG and presented this item. The Project brief has been shared. The plan would be to use EMIS

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enterprise to publish documents and referral forms etc . It was thought that this should strip out burden from practices of having to upload new templates as all would be done centrally. Users will set the standards for what the template will look like and have alpha and beta feedback. Update will be seamless and require no input for practice - although it will be necessary to consider how you allow practice specific adaptions. Mike /Todd to consider Practice specific issues. There was a request for GPs to work on design groups and to advise how local variants could be added in. All to consider A number of questions were raised by NELG

What would be the clinical governance of the templates

How would it interface or not with QOF master

Important to link with the LMC

The PC Services template is very good and if that can be replicated then will be good. Plan to make life easier for practices.

Todd and Mike stated that they were hoping to get the green light next Wednesday through IMT Board to provide the go ahead.

MB /TD

ALL

WHITE SPACE/ANY OTHER BUSINESS

11 12 13

Education events Happening at VHS on a Friday lunchtime. Few attending so the meeting was asked if they want to continue? Many reported that there is difficultly attending due to weight of workload and travelling time. Suggested it would be better to have protected time for education. Protected afternoon – would individuals pay for this? Concern that all too busy. – Whole afternoon twice a year with focused idea of what we are doing. With PML to cover. JAH advised c£5k for the cover from PML and lunch / venue etc. Could open it up to other practices across the county. Ideas and suggestion to Steve Sharpe PM at Montgomery House. AKI Pathways have been produced. Education events run by Horton 19/ Oct - contact Meenu. Further dates in GP bulletin. Flags going live on November 2nd. Pharmacy support to practices Looks more expensive than a GP so will need to consider this. Much of proposals were quality improvements. Thinks c£250 / for a locum session. Things that address emergency admissions would be premium to do.

All

ALL

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14

Evidence for help and support of pharmacy helping out in practice – what evidence is there?. JD to send to DF information on CCG pilot – suggestion was that could look at pharmacy technician? Global diagnostics A concern was raised that Woodstock were not permitted to use Global diagnostics services at Witney – JAH to check.

JD

JAH

ITEMS FOR INFORMATION

Paper 8 – Combat Stress – MH charity for Veterans Paper 9 – Mazar report (more on this in December) Paper 10 – General Practice Finance Guide Paper 11 – OCC – “Responsible Localities” – A new model for Adult Social Care Paper 12 – OCCG Board paper 29 September 2016 Paper 12 – EMIS template for weight management services

Date of Next Meeting 9 November 2016, 1-3pm Montgomery House

Attending: 12.10.16

Practice

Representative

Present / Apologies

Bicester Health Centre Dr Stephen Attwood (SA) Dr Jonathan Holt Paul Netherton, (PN) - P.Mgrs rep Sandy D’Amon, H/Visitors (SD’A)

Y Y

Gosford Hill Medical Centre Dr Mark Wallace (MW) Sally Mackie (SM)

Y

Islip Medical Practice Dr Meenu Paul (MP) Beverley Turner (BT) Jenny Hoare, D/Nurse (JH) or Helen Mayes (HM)

Y

Kidlington, Exeter, Yarnton MP (KEYS)

Dr Finnigan (DF) Annie Owen (AO)

Y Y

Langford Medical Practice Victoria House Surgery Now Alchester Medical Group

Dr Tom Anderson (TA) Dr Damian Hannon (DH) Dr Toby Quartley George Thomas (GT)

Y Y

Montgomery House Surgery Dr Will O’Gorman (WO) Steve Sharpe (SS)

Y

Woodstock Surgery Dr Helen Roskell (HR) Sue Kavanagh (SK)

Y

Others: Dr Helen VanOss, Public & Patient Forum Chair Julie Dandridge (JD) Locality Sponsor Julie-Anne Howe, (JAH) Locality Co-ordinator Julia Stackhouse – (JS) CSU Communications Ian Davies, (ID) Dir Community & Environment CDC or Rosie Rowe OCCG Exec Team rep – Diane Hedges – Director of Deliveries & Localities Speakers as listed Laura Spurs, PML, or Andrew Elphick

Y Y Y A A A Y