putting barnsley people first on thursday 9 june 2016, 9.30 am at the grimethorpe ......
TRANSCRIPT
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Putting Barnsley People First
A meeting of the NHS Barnsley Clinical Commissioning Group Governing Body will be held on Thursday 9 June 2016, 9.30 am at the Grimethorpe Pentecostal Church, Brierley Road, Grimethorpe, Barnsley S72 7EH
AGENDA (Public)
Item Session GB Requested
to
Enclosure Lead
Time
1. Apologies
09.30 am
2. Quoracy
3. Patient Story
09.30 am 10 mins
4. Declarations of Interest Relevant to the Agenda
GB/Pu/16/06/04 Nick Balac
09.40 am 5mins
5. Questions from the Public on Barnsley Clinical Commissioning Group Business
Nick Balac 09.45 am 10 mins
6. Minutes of the Meeting held on 12 May 2016 Approve GB/Pu/16/06/06 Nick Balac
09.55 am 5 mins
7. Minutes of the Extraordinary Meeting held on 26 May 2016.
Approve GB/Pu/16/06/07Nick Balac
10.00 am 5 mins
8. Matters Arising Report
Note GB/Pu/16/06/08 Nick Balac
10.05 am 5 mins
Strategy
9. Report of the Chief Officer
Information GB/Pu/16/06/09 Lesley Smith
10.10 am 10 mins
Quality Governance
10. Special Education Needs Update
Information
GB/Pu/16/06/10 Brigid Reid
10.20 am 10 mins
11. Quality Highlights Report
Assurance GB/Pu/16/06/11Brigid Reid
10.30 am 10 mins
12. Social Prescribing Information GB/Pu/16/06/12 Lesley Jane
Smith
10.40 am 10 mins
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Signed
Dr Nick Balac – Chairman Exclusion of the Public: The CCG Governing Body should consider the following resolution: “That representatives of the press and other members of the public be excluded from the remainder of this meeting due to the confidential nature of the business to be transacted - publicity on which would be prejudicial to the public interest” Section 1 (2) Public Bodies (Admission to meetings) Act 1960
13. CCG Committees Terms of Reference Approve GB/Pu/16/06/13 Vicky Peverelle
10.50 am 10 mins
14. Risk and Governance Exception Report Assurance & Approval
GB/Pu/16/06/14Vicky Peverelle
11.00 am 10 mins
Finance and Performance
15. Integrated Performance Report
Assurance GB/Pu/16/06/15 Heather Wells Vicky Peverelle
11.10 am 15 mins
16. Budgets 2016/17 Approve GB/Pu/16/06/16 Heather Wells
11.25 am 10 mins
Committee Reports and Minutes
17. Minutes of the Audit Committee held on 23 May 2016
Assurance GB/Pu/16/06/17 Chris Millington
11.35 am 5 mins
18. Minutes of the Finance and Performance Committee held on 5 May 2016
Assurance GB/Pu/16/06/18 Nick Balac
11.40 am 5 mins
19. Minutes of the Quality and Patient Safety Committee held on 31 March 2016
Assurance GB/Pu/16/06/19 Mehrban Ghani
11.45 am 5 mins
20. Minutes of the Equality Steering Group held on 18 February 2016
Assurance GB/Pu/16/06/20Brigid Reid
11.50 pm 5 mins
21. Primary Care Co-Commissioning Committee Assurance Report
Assurance GB/Pu/16/06/21Chris Millington
11.55 pm 5 mins
22. Date and Time of the Next Meeting: 14 July 2016 at 09.30 am at the Rockingham Centre, Sheffield Road, Hoyland, Barnsley S74 OPY.
12.00 pm Close
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GB/Pu/16/06/04
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Putting Barnsley People First
GOVERNING BODY
9 June 2016
Declarations of Interests Report
1. PURPOSE OF THE REPORT
To provide the Governing Body with all Governing Body members declarations of interest.
2. EXECUTIVE SUMMARY
This report details all Governing Body members declared interests for members to update and to enable the Chair and members to foresee any potential conflicts of interests.
3. THE GOVERNING BODY IS ASKED TO:
Review that their individual declared interests are up to date
Receive and note the Governing Body members declarations of interest
Agenda time allocation for report:
5 minutes
Report of: Vicky Peverelle
Designation: Chief of Corporate Affairs
Report Prepared by:
Lynne Richards
Designation: Governance, Assurance and Engagement Facilitator.
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1. SUPPORTING INFORMATION
1.1 Links to the Assurance Framework
The report is especially relevant to the following risks on the Governing Body Assurance Framework: 2.1 and 5.2.
1.2 Links to Objectives
To have the highest quality of governance and processes to support its business
To commission high quality health care that meets the needs of individuals and groups
Wherever it makes safe clinical sense to bring care closer to home
To support a safe and sustainable local hospital, supporting them to transform the way they provide services so that they are as efficient and effective as possible for the people of Barnsley
To develop services through real partnerships with mutual accountability and strong governance that improve health and health care and effectively use the Barnsley £.
1.3 Governance Arrangements Checklist
Financial Implications
Not relevant
Contracting Implications
Not relevant
Quality
Not relevant
Consultation / Engagement
Not relevant
Equality and Diversity
Not relevant
Information Governance
Not relevant
Environmental Sustainability
Not relevant
Human Resources
Not relevant
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Putting Barnsley People First
REGISTER OF INTERESTS
NHS Barnsley Clinical Commissioning Group
This register of interests includes all interests declared by members and employees of Barnsley Clinical Commissioning Group. In accordance
with the Clinical Commissioning Groups constitution and the Clinical Commissioning Groups Accountable Officer will be informed of any conflict
of interest that needs to be included in the register within not more than 28 days of any relevant event (e.g. appointment, change of
circumstances) and the register will be updated regularly (at no more than 3-monthly intervals)
Register: Governing Body
GOVERNING BODY
Name Position Details of interest
Nick Balac Chair of Barnsley Clinical Commissioning Group
Partner at St Georges Medical Practice (PMS)
Practice holds Barnsley Clinical Commissioning Group Vasectomy contract
Member Royal College General Practitioners
Member of the British Medical Association
Member Medical Protection Society
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GOVERNING BODY
Name Position Details of interest
The practice is a member of Barnsley Healthcare Federation which may provide services for Barnsley CCG
Mehrban Ghani Medical Director for Barnsley Clinical Commissioning Group
GP Partner at White Rose Medical Practice, Cudworth, Barnsley
Directorship at SAAG Ltd, 15 Newham Road, Rotherham
The practice is a member of Barnsley Healthcare Federation which may provide services for Barnsley CCG
Madhavi Guntamukkala
GP Member Barnsley Clinical Commissioning Group
GP partner at The Grove Medical Practice
Member of British Medical Association and member of Royal College of General Practitioners
The practice is a member of Barnsley Healthcare Federation which may provide services for Barnsley CCG
John Harban GP Member Barnsley Clinical Commissioning Group
GP Partner at Lundwood Medical Centre and The Kakoty Practice, Barnsley
AQP contracts with the Barnsley Clinical Commissioning Group to supply Vasectomy, Carpal Tunnels and Nerve Conduction Studies services
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GOVERNING BODY
Name Position Details of interest
Owner/Director Lundwood Surgical Services
Wife is Owner/Director of Lundwood Surgical Services
Member of the Royal College of General Practitioners
Member of the faculty of sports and exercise medicine (Edinburgh)
The practice is a member of Barnsley Healthcare Federation which may provide services for Barnsley CCG
Anne Marie Hoyle
Practice Manager Member Barnsley Clinical Commissioning Group
Business Manager at The Kakoty Practice, Barnsley
Cllr Alice Cave, BMBC Elected Councillor is related
Member of Yorkshire NAPC Steering Group
Director Barnsley Enterprise for Living Well (CIC)
Member of the Institute of Healthcare Management
The practice is a member of Barnsley Healthcare Federation which may provide services for Barnsley CCG
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GOVERNING BODY
Name Position Details of interest
Nick Luscombe GP Member Barnsley Clinical Commissioning Group
GP partner at Huddersfield Road Partnership
Practice lead for a small dispensing branch surgery
A fierce advocate of the adoption of first world standards of medical practice into Barnsley health care
Member of the British Medical Association but not actively
Medical student and F2 tutor for University of Sheffield
Lawrence King
GP Member Barnsley Clinical Commissioning Group
Salaried GP at Kingswell Surgery
Local Medical Committee Member
Sudhagar Krishnasamy
GP Member Barnsley Clinical Commissioning Group
GP Partner at Royston Group Practice, Barnsley
Member of the Royal College of General Practitioners
GP Appraiser for NHS England
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GOVERNING BODY
Name Position Details of interest
Executive member of Barnsley Local Medical Committee
Member of the Medical Defence Union
Director of SKSJ Medicals Ltd
The practice is a member of Barnsley Healthcare Federation which may provide services for Barnsley CCG
Chris Millington
Lay Member, Barnsley Clinical Commissioning Group
Partner Governor Barnsley Hospital NHS Foundation Trust
Vicky Peverelle Chief of Corporate Affairs, Barnsley Clinical Commissioning Group
No interests to declare
Brigid Reid Chief Nurse, Barnsley Clinical Commissioning Group
Volunteer registered Nurse, St Gemma’s Hospice, 329 Harrogate Road, Moortown, Leeds LS17 6QD
Partner works at Leeds Teaching Hospital NHS Trust which provides services to Barnsley patients via Specialised Commissioning and could tender to supply
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GOVERNING BODY
Name Position Details of interest
others.
Mark Smith
GP Member Barnsley Clinical Commissioning Group
Senior Partner at Victoria Medical Centre also undertaking training and minor surgery roles.
Lesley Smith Chief Officer, Barnsley Clinical Commissioning Group
Husband is Director of Ben Johnson Ltd a York based business offering office interiors solutions, furniture, equipment and supplies for private and public sector clients.
Board Member (Trustee), St Anne’s Community Services, Leeds
Member of the Regional Leadership Council (RLC), Yorkshire and Humber Leadership Academy, Health Education England
Chair, South Yorkshire Cancer Strategy Group
Chief Officer lead, Working Together o Living With and Beyond Cancer Programme (in conjunction with
McMillan Cancer Support) o CVD Stroke
Chair, Working Together, Programme Executive Group
Mike Simms Secondary Care Clinician, Barnsley Clinical Commissioning Group
No interests to declare
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GOVERNING BODY
Name Position Details of interest
Heather Wells Chief Finance Officer, Barnsley Clinical Commissioning Group
Partner holds a Senior Management position with BUPA –potential supplier of services to the NHS.
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GB/Pu/16/06/06
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Putting Barnsley People First
Minutes of the Meeting of the BARNSLEY CLINICAL COMMISSIONING GROUP GOVERNING BODY (PUBLIC SESSION) held on Thursday 12 May 2016 at 09.30 am in the Boardroom, Hillder House, 49/51 Gawber Road, Barnsley S75 2PY MEMBERS PRESENT: Dr Nick Balac (in the chair) Chair Dr Mehrban Ghani Medical Director Dr Madhavi Guntamukkala Member Dr John Harban Member Ms Marie Hoyle Member Dr Lawrence King Member Dr Sudhagar Krishnasamy Member Dr Nick Luscombe Member Mr Chris Millington Lay Member Ms Heather Wells Chief Finance Officer Mrs Lesley Smith Chief Officer Ms Brigid Reid Chief Nurse Mr Mike Simms Secondary Care Clinician IN ATTENDANCE: Mr Khawer Ashfaq Medicines Management Pharmacist (for minute
reference GB 16/107 only) Mrs Chris Lawson Head of Medicines Optimisation (for minute reference
GB 16/108 only) Mrs Susan Metcalf PTS Review Programme Lead (for minute reference GB
16/106 only) Ms Kay Morgan Governing Body Secretary Ms Hilary Mosley Health Improvement Nurse Principle (for minute
reference GB 16/109 only) Mrs Vicky Peverelle Chief of Corporate Affairs Ms Kirsty Waknell Communications Manager APOLOGIES: Dr Mark Smith Member MEMBERS OF THE PUBLIC: Miss Alison Edwards CCG Quality Co-ordinator (observing member of CCG
staff) Ms Nora Everitt Member of the Public Mrs Margaret Sheard Member of the Public
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The Chairman welcomed members of the public to the Governing Body meeting.
Agenda Item
Action
Deadline
GB 16/99 QUORACY
The Chairman declared that the meeting was quorate.
GB 16/100 PATIENT STORY
The Governing Body received a Patient Story which reflected a positive experience about the support that a patient and his family had received from Dementia services, in particular the Memory Team. The Chairman invited the views of the Governing Body in relation to the Patient Story. It was recognised that dementia patients were not necessarily aware of the impact of their illness on family members and interest from families was not always evident in every dementia case. The Story had provided a good example of service integration to provide holistic care and best outcomes for the patients and their families. It was important to maintain the level and flexibility of Dementia services in Barnsley to prevent hospital and care home admissions. An evaluation of the Memory Team will come to the Governing Body in June 2016. The Chief Nurse informed the meeting that 12 May 2016 was International Nurses Day. It was noted that a group of nurses from Primary Care were currently meeting to undertake work on infection control. The Chair commended the key contribution nurses were making to healthcare.
The Governing Body noted the Patient Story.
GB 16/101 DECLARATIONS OF INTEREST, SPONSORSHIP, HOSPITALITY AND GIFTS RELEVANT TO THE AGENDA
The Governing Body considered the Declarations of Interest Report. Dr N Luscombe commented that all GP elected members would have an interest in agenda item 11 Clinical Pharmacists. The Chairman indicated that the use of clinical
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Agenda Item
Action
Deadline
pharmacists in Primary Care was a national initiative. The CCG was investing in clinical pharmacists to improve outcomes for the people of Barnsley and address sustainability in Primary care in addition there would be no financial gain to Practices. Agreed Action: Dr J Harban’s declaration would to be updated to read: ‘AQP contracts with the Barnsley Clinical Commissioning Group to supply Vasectomy, Carpal Tunnels and Nerve Conduction Studies services’.
VP
09.06.16
GB 16/102 QUESTIONS FROM THE PUBLIC ON BARNSLEY CLINCIAL COMMISSIONING GROUP BUSINESS
The Chairman invited questions from the public. Availability of Care Home Placements for People with Dementia A member of the public referred to the Patient Story and her own personal experience of finding a care home placement for a relative with dementia. In response, the Chairman commented that there had been an increase in availability of dementia places within care homes. However, for more advanced cases of dementia placements were required in specialised care home secure units. There were however lesser numbers of these types of placements. The numbers of very severe dementia cases may decline due to support provided from the Memory Team and a focus on providing cognitive skill sets for people with dementia. It was noted that there was also a wealth of support within the local community for people with dementia, their families and carers. The Chief Nurses commented that she had requested Healthwatch and the Barnlsey Metropolitan Borough Council to assist with guidance to relatives choosing a care home. Public Involvement and Engagement A member of the public extended an invitation to Governing Body members to attend a Barnsley Save our
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Agenda Item
Action
Deadline
NHS Campaign Group public meeting on Saturday 14 May 2016. The member of the Public referred to the NHS England publication NHS Citizen and public and patient involvement tool and queried the involvement of the public and patients in the Sustainability Transformation Plan (STP) and vanguards. A meeting had been held on 25 April 2016 but wider promotion and engagement was required. The Chief Officer advised that there was a Communication and Engagement Strategy for the STP and if there were deficiencies with Public engagement then this would need to be addressed. The Chief Officer and the member of the public agreed to further discuss this issue outside of the meeting.
LS
12.05.16
GB 16/103 MINUTES OF THE PREVIOUS MEETING HELD ON 14 APRIL 2016
The Minutes of the meeting held on 14 April 2016 were verified as a correct record of the proceedings.
GB 16/104 MATTERS ARISING REPORT
The Governing Body considered the Matters Arising Report and the following main points were noted: Minute reference GB 15/96 - Patient X-rays It was reported that seven Practices could now access and view patient X-rays at Practice level. It was noted that GP NHS.net email addresses were required to access the system. The Chair of the Practice Managers Group was working to move this project at pace. Minute reference GB 15/185, 14/347 & 15/210 - Hospital Discharge Notifications (D1 letters) From a patient safety perspective it was agreed that a letter be sent to GPs, practice nurses, advanced nurse practitioners and Practice Managers as a matter of urgency to advise of the current difficulties with D1’s.
MG
31.05.16
The Governing Body noted the Matters Arising Report.
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Agenda Item
Action
Deadline
STRATEGY
GB 16/105 REPORT OF THE CHIEF OFFICER
The Chief Officer updated the Governing Body on key issues and developments relevant to the strategic direction of the CCG. The following key points were noted: Yorkshire Ambulance Service The Chief Officer referred members to the proposed changes to the way in which 999 and NHS 111 services will be commissioned and managed. From 1 April 2016 NHS Wakefield CCG will act as lead commissioner and contractor for 999 and the Greater Huddersfield CCG for NHS 111. Discussion took place. In response questions raised it was noted that:
Performance of the contract will be monitored and managed by the relevant lead commissioner and contractor. A contract performance floor level would be determined for all CCGs, with reference to quality and safety measures.
A hub and spoke type model of emergency services, linked to the Urgent and Emergency Care Network Strategy would be introduced.
The proposed changes formalised responsibilities in relation to the commissioning, contracting and performance management of 999 and NHS 111 Service.
The CCG had previously diverted management time to address poor performance. In future this would be handled by the lead commissioner and the new arrangements would bring economies of scale.
An explanation was provided regarding the terminologies of ‘hear and treat’ and ‘see and treat’. The role and use of Rightcare Barnsley by the ambulance and NHS 111
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Agenda Item
Action
Deadline
service in the provision of care for Barnsley people was highlighted. The Chairman concluded discussion indicating that the new arrangements demonstrated excellent principles of collaboration and would lead to a reduction in health inequalities. South Yorkshire and Bassetlaw Sustainability Transformation Plan (STP) The Chief Officer provided feedback from a meeting to discuss the STP held on 11 May 2016. It had been recognised that South Yorkshire and Bassetlaw had a long history of working successfully together and had established itself in terms of a collaborative. However the ability of the collaborative to deliver at scale and pace was questioned. The Chief Officer advised that an STP event will be held on 10 June 2016. She would raise comments received about the involvement of the public in the STP at the event. Barnsley Accountable Care Partnership Board It was noted that the Barnsley Hospital NHS Foundation Trust had confirmed their intention to become a partner of the Barnsley Accountable Care Partnership Board. The Barnsley Hospice will also be invited to attend the Board in a non-voting capacity.
The Governing Body approved the proposed changes to the way ambulance services are commissioned going forward including: i) The Strategic Approach to Commissioning
Ambulance 999 & NHS 111 Services in Yorkshire and the Humber 2015-2019
ii) The Memorandum of Understanding for the collaborative commissioning of 999 ambulance services between Clinical Commissioning Groups across Yorkshire and the Humber.
iii) The Memorandum of Understanding for the collaborative commissioning of NHS 111
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Agenda Item
Action
Deadline
services between Clinical Commissioning Groups across Yorkshire and the Humber.
And noted the report for Governing Bodies which sets out the proposal for the collaborative commissioning of 999 & NHS 111 services by Yorkshire and Humber CCGs, with a lead commissioner/contractor. Agreed actions: To query public engagement and involvement in development of the STP at an STP event on 10 June 2016 The Governing Body noted the contents of the Chief Officer Report.
LS
09.06.16
QUALITY AND GOVERNANCE
GB 16/106 PTS REVIEW PAPER
The PTS Review Programme Lead provided the Governing Body with the final report of the four South Yorkshire CCGs on the outcome of the South Yorkshire-wide Patient Transport Services. Members noted the project risks and the roles and responsibilities for the PTS Procurement Team. It was highlighted that there was a role for a clinical lead on the Procurement Team.
The Chairman highlighted that engagement in the review had predominantly been from the Sheffield area. In response the PTS Review Programme Lead clarified that wider representation would be acquired from all CCGs within the review.
It was noted that the review provided a real opportunity to commission a quality service for patients who regularly use and depend on the patient Transport service.
The Governing Body approved the following recommendations:
That patient transport services should be procured on a South Yorkshire CCG-wide basis (Sheffield, Rotherham, Doncaster and Barnsley
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Agenda Item
Action
Deadline
CCGs)
The procurement route should be the Competitive Dialogue procedure carried out in accordance with The Public Contracts Regulations 2015
That lot 2 for core PTS services should be procured on the basis of a Lead Provider Model
The length of contract should be 5 years plus an option to extend for a year and then a further year (5+1+1). This will enable providers to invest in the service, finance fleet, implement new technology and continually improve services.
There should be a separate Any Qualified Provider (AQP) procurement for a ‘Take, Go and Collect’ service for repatriations and transport to care homes out of area from hospital to put in place a framework of qualified providers who can undertake these journeys.
Agreed Actions The Practice Manager Member and Lay Member to be involved in development of services and public engagement approach. To request expressions of interest for the clinical lead role on the PTS Procurement Team and advise the PTS Review Programme Lead accordingly.
MH/CM/SM KM
09.06.16
09.06.16
GB 16/107 REVIEW OF THE “AUTOMATED DISPENSING – IN PATIENT AUTOMATION PROJECT” BUSINESS CASE
The Lead Medicines Management Pharmacist provided the Governing Body with an update on the “Automated Dispensing- inpatient automation program” at the Barnsley Hospital NHS Foundation Trust (BHNFT).
With regard to Patient Hospital Discharge Letters (D1’s) the Medical Director explained that inaccuracies in prescribing occurred before submission to the pharmacy. It was noted that ward based pharmacists and electronic prescribing could reduce medication errors. Cultural issues would also need to be addressed to improve the quality and timeliness of D1’s.
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Agenda Item
Action
Deadline
The original business case for the pharmacy automation project had indicated that there would be a release of manpower in pharmacy and a redeployment of pharmacists to work at ward level. The meeting was advised that a skill reassessment of pharmacists had been undertaken and there was an increased presence of pharmacists in ward areas.
The Chairman indicated that the CCG would not be complacent with regard to the return on investment.
The Governing Body noted the report. Agreed Actions To develop an action plan to acquire additional value for the CCGs investment in the Pharmacy automation scheme.
MG/KA
09.06.16
GB 16/108 CLINCIAL PHARMACISTS
The Head of Medicines Optimisation presented the Governing Body with an overview about the introduction of Clinical Pharmacists into Primary Care Settings across Barnsley. It was noted that the business case for the programme had been approved by the Governing Body and Membership Council.
The Head of Medicines Optimisation reported that the interviews for the clinical pharmacist posts would be on 18 and 19 May 2016 with pharmacists commencing in post from June to September 2016. The pharmacists would be inducted and supported by the Medicines Optimisation Team. It was noted that the Scheme would be monitored to quantify return of investment.
It was highlighted that the clinical pharmacist service would increase capacity in Primary Care and assist with the shortage of GPs. The service would be promoted to Practices and patients. The Chief Nurse commented that the ‘First Port of Call' Training would incorporate the clinical pharmacist and social prescribing schemes.
The Governing Body noted the report and that Clinical pharmacist into Primary Care was an invest to save scheme, would increase capacity in primary
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Agenda Item
Action
Deadline
Care.
GB 16/109 COMMUNITY SHOP
The Health Improvement Nurse Principle provided the Governing Body with an update on how the previous CCG grant to the Community Shop was facilitating and enhancing the health offer that they provide. The Chairman commented that the CCG’s investment had enabled empowerment of people to help themselves and others. It was noted that an additional Community Shop would be opened in Athersley by the Autumn 2016
As a social presence, it was recognised that the Community Shop and other similar organisations, in partnership with the CCG and local area council networks could help deliver the strategic local agenda for the people of Barnsley.
The Governing Body noted the Community Shop Update. Agreed Actions: The Health Improvement Nurse Principle and Mrs Margaret Sheard to further discuss partnership working between the company shop and area council networks,
HM
09.06.16
GB 16/110 RISK AND GOVERNANCE EXCEPTION REPORT
The Chief of Corporate Affair’s provided the Governing Body with the Risk and Governance Exception Report, including the full Register of Interests and an update on the process for appointing the CCG’s External Auditors from 2017/18.
Risk Register The Chairman commented that the score for risk reference CCG 14/10, ‘Capacity of Primary Care’, would decrease with the introduction of Clinical Pharmacists.
The Governing Body:
Agreed:
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Agenda Item
Action
Deadline
That the red (extreme) risks on the GBAF were appropriately scored and there is sufficient assurance that they are being effectively managed as at 12 May 2016
Reviewed and Noted
The risks rated as extreme on the Risk Register
The risks escalated from the Risk Register as gaps in control against risks on the Assurance Framework
The Registers of Interests, Sponsorship, Gifts and Hospitality
The update regarding the procurement of the External Audit service from 2017/18.
The Governing Body did not Identify any positive assurances relevant to the risks on the GBAF
FINANCE AND PERFORMANCE
GB 16/111 INTEGRATED PERFORMANCE REPORT
The Chief Finance Officer and Chief of Corporate Affairs introduced the Integrated Performance Report to the Governing Body. Finance The Chief Finance Officer informed the meeting that subject to audit , the CCG was reporting the achievement of all financial targets and duties , including a surplus £8,280,000 in line with NHS England expectations. No significant issues had been identified by the external auditors at this point. However, further work around third party assurances was required to complete the audit. The Audit Committee would consider the CCG’s Annual Report and Accounts, together with documentation from internal and external auditors on 23 May 2016, prior to making recommendations to the extraordinary meeting of the Governing Body on 26 May 2016.
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Agenda Item
Action
Deadline
Performance The Chief of Corporate Affairs presented the CCGs key performance indicators and exception report. It was noted that year to date performance against the A&E 4 hour indicator was at 93% for April 2016. This improved performance needed to be sustained and this was being monitored via the Systems Resilience Group. In response to questions raised about diagnostic tests the Chief of Corporate Affairs clarified that the dip in performance was linked to the industrial action by junior doctors and the impact of Easter bank holidays in March 2016. It was further confirmed that diagnostic tests were being undertaken at weekends.
The Governing Body noted the contents of the report including:
2015/16 performance to date
year end financial outturn
the delivery of all financial duties, subject to the findings and opinion of external audit.
COMMITTEE REPORTS AND MINUTES
GB 16/112 MINUTES OF THE MEMBERSHIP COUNCIL HELD ON 15 MARCH 2016
The Governing Body noted the minutes of the Membership Council held on 15 March 2016.
GB 16/113 MINUTES OF THE AUDIT COMMITTEE HELD ON 28 APRIL 2016
The Governing Body received the minutes of the Audit Committee held on 28 April 2016. It was noted that the Audit Committee had considered the NHS Barnsley CCG 2015/16 Annual Report and Accounts in detail and had proposed some amendments. The Committee had been assured on the quality, accuracy and robustness of the Annual Report and Accounts. Agreed Action
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Agenda Item
Action
Deadline
The Governing Body agreed to convey their appreciation to Ms Anne Arnold for her support to and chairing of the Audit Committee and to the Finance and Corporate Affairs Team for their work on the CCG’s Annual Report, Annual Governance Statement and Annual Accounts.
LS 09.06.16
GB 16/114 MINUTES OF THE FINANCE AND PERFORMANCE COMMITTEE HELD ON 7 APRIL 2016
The Governing Body received the minutes of the Finance and Performance Committee held on 7 April 2016. A typographical error was noted on page 4, first bullet point to read: ‘The majority of activity and finance proposals have been agreed’.
GB 16/115 MINUTES OF THE PATIENT AND PUBLIC ENGAGEMENT COMMITTEE HELD ON 24 MARCH 2016
The Committed considered the minutes of the Patient and Public Engagement Committee held on 24 March 2016. It was noted that:
All CCG commissioning managers were utilising the Engagement Toolkit and checklist.
The Patient Council were to review the CCG Engagement Strategy.
GB 16/116 PRIMARY CARE COMMISSIONING COMMITTEE ASSURANCE REPORT
Mr C Millington highlighted that the Primary Care Commissioning Committee had reviewed the prioritisation of the Primary Care Transformation Fund Bids and noted the year-end financial position in respect of the Primary Care Commissioning delegated budget. The Chairman commented that the CCG had made significant investment in Primary Care.
The Chief of Corporate Affairs advised that the Primary Care Transformation Fund was primarily to resource estates and technology proposals. It was noted that the portal for submission of proposals was between the 2 and 30 June 2016.
The Governing Body noted the Primary Care
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Agenda Item
Action
Deadline
Commissioning Committee Assurance Report. Agreed Action: To inform Practices regarding the outcome of the prioritisation of the Primary Care Transformation Fund Bids. To distribute the final guidance and template for Primary Care Transformations bids to practices when received by the CCG.
VP
VP
20.05.16
09.06.16
GB 16/117 CLINICAL TRANSFORMATION ASSURANCE REPORT
The Governing Body noted the Commissioning Assurance Transformation Board Clinical Transformation Assurance Report.
GB 16/118 MINUTES OF THE HEALTH AND WELLBEING BOARD HELD ON 5 APRIL 2016
The Governing Body noted the minutes of the Health and Wellbeing Board held on 5 April 2016.
GB 16/119 MINUTES OF THE COMMISSIONERS WORKING TOGETHER BOARD HELD ON 2 FEBRUARY 2016
The Governing Body noted the minutes of the Commissioners Working Together Board held on 2 February 2016.
GENERAL
GB 16/120 GOVERNING BODY ASSURANCE WORK PLAN AGENDA AND TIMETABLE
Members received the Governing Body Work Plan / Agenda Timetable 2016/17. The Chief Nurse indicated that she had submitted comments for updating of the work plan to the Governing Body Secretary.
GB 16/121
QUESTIONS FROM THE PUBLIC
The Chairman invited questions from the public.
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Agenda Item
Action
Deadline
Hospital Discharge Summary Letters (D1’s) A member of the public referred to problems previously discussed about D1’s and asked if the Governing Body intended to take action to resolve issues? In response it was advised that the quality and timeliness of D1’s had been a long standing concern of the CCG and Primary Care. The Chairman said that the public could be assured that the CCG had taken all necessary action and were supporting the Barnsley Hospital NHS Foundation Trust (BHNFT) to bring about the required improvement in D1’s. The CCG has received assurance from the BHNFT that action was being taken to improve D1’s. Patient Transport In response to a questions raised it was clarified that the safeguarding of patients would be a key quality element Patient Transport Service Specification. The Chief Nurse clarified that within the last three years there had been no Serious Incidents relating to Patient Transport Services. Community Pharmacists A member of the public highlighted that the public would not necessarily be aware about the differences between Community Pharmacists and Clinical Pharmacists and advised of intended budget cuts for Community Pharmacies. The Chairman indicated that unfortunately it was not with in the CCG’s power to influence nationally imposed budget reductions for Community Pharmacists. The CCG would however continue to provide support for Community Pharmacists. Agreed Action Mr C Millington and Ms Kirsty Waknell with the member of the public raising the question to consider the Comms messages to the public in respect of the Primary Care Clinical pharmacists Scheme.
/KW/NE
09.06.16
GB 16/122 DATE AND TIME OF THE NEXT MEETING
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GB/Pu/16/06/06
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Agenda Item
Action
Deadline
The next meeting of the Governing Body will be held on:
Thursday 9 June 2016 at 9.30 am, Grimethorpe Pentecostal Church, Brierley Road, Grimethorpe, Barnsley S72 7EH
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GB/Pu/16/06/07
Page 1 of 6
Putting Barnsley People First
Minutes of the Meeting of an Extraordinary Meeting of the BARNSLEY CLINICAL COMMISSIONING GROUP GOVERNING BODY held on Thursday 26 May 2016 at 09.30 am in the Boardroom, Hillder House, 49/51 Gawber Road, Barnsley S75 2PY MEMBERS PRESENT: Dr Nick Balac (in the chair) Chair Dr Mehrban Ghani Medical Director Dr Madhavi Guntamukkala Member Dr John Harban Member (from minute reference GBEO 16/03 03.1) Ms Marie Hoyle Member Dr Sudhagar Krishnasamy Member Dr Nick Luscombe Member Mr Chris Millington Lay Member (from minute reference GBEO 16/03 03.1) Dr Mark Smith Member Ms Heather Wells Chief Finance Officer Ms Brigid Reid Chief Nurse Mr Mike Simms Secondary Care Clinician IN ATTENDANCE: Ms Anne Arnold Interim Chair Audit Committee Ms Kay Morgan Governing Body Secretary Mr Richard Walker Head of Assurance Ms Linda Wild KPMG Audit Manager APOLOGIES: Dr Lawrence King Member Mrs Vicky Peverelle Chief of Corporate Affairs Mrs Lesley Smith Chief Officer
Agenda Item
Action
Deadline
GBEO 16/01
QUORACY
The Chairman declared that the meeting was quorate.
GBEO 16/02
DECLARATIONS OF INTEREST, SPONSORSHIP, HOSPITALITY AND GIFTS RELEVANT TO THE AGENDA
No declarations of interest, sponsorship, hospitality and gifts relevant to the agenda were received.
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Agenda Item
Action
Deadline
GBEO 16/03
NHS BARNSLEY CCG ANNUAL REPORT AND ACCOUNTS 2015/16
The Governing Body were presented with the CCG’s Annual Report, Governance Statement and Accounts and advised that the Audit Committee had reviewed the documents in detail. The Audit Committee recommended that Governing Body:
Approve and adopt the Annual Report and Accounts 2015/16
Authorise the Accountable Officer to sign and date the Performance Report, Accountability Report, the Governance Statement, the Statement of Accountable Officers Responsibilities and the Statement of Financial Position on the CCG’s behalf
Authorise the Chair and Accountable officer to sign and provide to KPMG the Management Representation Letter 2015/16.
The interim Chair of the Audit Committee commented that the production of the Annual Report and Accounts was a significant exercise undertaken each year to defined timescales. The Audit Committee had recognised that despite losing two key members of staff there had been a strong team effort in producing the year end accounts. The Audit Committee had undertaken scrutiny including a ‘page turner’ review of the draft Annual Report, Governance Statement and Accounts on 28 April 2016 and reviewed these documents again on 23 May 2016. All amendments proposed by the Audit Committee had been incorporated into the final documents presented before the Governing Body.
The Chief Finance Officer advised the Governing Body that subsequent to the Audit Committee meeting on 23 May 2016:
Two outstanding Service Auditors Reports had been received from NHS Business Services Authority regarding Prescription Services, and HSCIC regarding GP Payments Services. These had been reflected in the CCG’s Governance Statement.
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Agenda Item
Action
Deadline
At 4.00 pm on 25 May 2016 the External Auditors had advised the CCG of a mapping error in NHSE’s Accounts template. This has affected all CCGs with level 3 co-commissioning status but was a purely presentational error with no impact on the CCGs financial targets.
03.1 Annual Report & Governance Statement
The Head of Assurance presented the Annual Report to the Governing Body. It was noted that the draft Annual Report had been received by the Governing Body in April 2016. The Head of Assurance drew members attention to:
The Statement as to Disclosure from each individual member of the Governing Body. It was clarified that this confirmation would also be sought from Governing Body members who were absent from the meeting.
The proposed amendments to section 4.9.3, ‘Third Party Assurances’ in respect of a Service Auditor Report from PwC for HSCIC’s GP Payments Services. The CCG had determined that the issues identified in the HSCIC letter did not represent a significant risk to the CCG in terms of materiality and in the light of other compensating controls operated by the CCG.
The Governing Body noted and approved the revised text for section 4.9.3.
In response to a questions raised, it was clarified sections 5.2.1 (Salaries and Allowances) and 5.2.2 (Pension Benefits) were subject to Audit review and this was reflected in the KPMG Opinion. The figures recorded in these sections were also confirmed to be correct.
The Governing Body approved the Chief Officer as Accountable Officer to sign off the relevant sections of the Performance Report and Accountability Report.
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GB/Pu/16/06/07
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Agenda Item
Action
Deadline
03.2 Annual Accounts
The Chief Finance Officer presented the Governing Body with the CCG’s Annual Accounts 2015/16. It was noted that the CCG had met all its required financial targets.
The Governing Body considered the Annual Accounts and approved the Chief Officer as Accountable Officer to sign off the financial statements.
03.3 KMPG ISA 260 Summary of Audit Findings 2015/16
The KPMG Manager presented the Governing Body with the ISA 260 Summary of Audit Findings. The KPMG Manager reported that KPMG intended to issue an unqualified audit opinion on the accounts and an unqualified value for money conclusion, following the Governing Body adoption of them on 26 May 2016 and receipt of the signed accounts and Management Representation Letter. There were no recommendations in respect of the CCGs control environment. The KPMG Audit Manager reported that there had been a slight delay in preparation for the audit, unfortunately, the hard copy working papers provided for the audit were not cross referenced or provided en-bloc electronically as requested. It was recognised that despite losing two key members of staff from the Finance Team, there had been a strong team effort in producing the year end accounts. Looking ahead the learning from this year’s audit process would be incorporated into a revised year end timetable to ensure all required information was available at the specified time for year-end audits in future years. The KPMG Audit Manager drew members’ attention to the proposed fee for the audit £57,050 plus VAT. It was noted that the fee was £800
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GB/Pu/16/06/07
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Agenda Item
Action
Deadline
above that highlighted within the audit plan and this was due to additional audit resource required as a result of the working papers provided for the audit not being in line with agreed expectations. In addition as a result of carrying out additional audit procedures via NHSE to gain assurance on Co-commissioning expenditure extra fees will be charged. Approval would be sought from the Chief Finance Officer and Public Sector Audit Appointments Limited for the increase in audit fee.
03.4 Head of Internal Audit Opinion & Annual Report 2015/16
The Governing Body received and noted the Head of Internal Audit Opinion & Annual Report 2015/16.
03.5 Annual Report of the Local Counter Fraud Specialist 2015/16
The Governing Body received and noted the Annual Report of the Local Counter Fraud Specialist 2015/16
03.6 Management Representation Letter
The Governing Body received the Management Representation Letter and approved the letter for sign off by the Chairman and Chief Officer as Accountable Officer. The letter reflected the national template and no additional disclosures specific to Barnsley CCG were proposed or required.
03.7 Statement as to Disclosure to Auditors
It was noted that this item had been previously discussed under minute reference GB EO 16/03 3.1.
03.8 Approval and Adopt the Annual report and Accounts and approve the letter of Representation
The Governing Body:
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GB/Pu/16/06/07
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Agenda Item
Action
Deadline
Confirmed that the Statement as to Disclosure to Auditors is accurate
Approved and adopted the Annual Report and Accounts 2015/16
Authorised the Accountable Officer to sign and date the Performance Report, the Governance Statement, the Statement of Accountable Officer’s Responsibilities, the Accountability Report, and the Statement of Financial Position on the CCG’s behalf.
GBEO 16/04
DATE AND TIME OF THE NEXT MEETING
The next meeting of the Governing Body will be held on:
Thursday 9 June 2016 at 9.30 am, Grimethorpe Pentecostal Church, Brierley Road, Grimethorpe, Barnsley S72 7EH
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GB/Pu/16/06/08
Page 1 of 5
Putting Barnsley People First
GOVERNING BODY
9 June 2016
MATTERS ARISING REPORT
The table below provides an update on actions arising from the previous meeting of the Governing Body (public session) held on 12 May 2016.
Table 1
Minute ref Issue Action Outcome/Action
GB 16/101 Declarations of Interest, Sponsorship, Hospitality and Gifts Relevant to the Agenda To amend Dr J Harban’s declaration and update Register to read: AQP contracts with the Barnsley Clinical Commissioning Group to supply Vasectomy, Carpal Tunnels and Nerve Conduction Studies services.
VP
COMPLETE
GB 16/102 Questions from the Public – Public Involvement & Engagement STP The Chief Officer and the member of the public to further discuss Public Involvement & Engagement in the South Yorkshire and Bassetlaw Sustainability Transformation Plan outside of the meeting.
LS
COMPLETE
GB 16/105 Report of the Chief Officer – South Yorkshire and Bassetlaw Sustainability Transformation Plan To query public engagement and involvement in development of the STP at an STP event on 10 June 2016
LS
COMPLETE
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Page 2 of 5
Minute ref Issue Action Outcome/Action
GB 16/106 PTS Review Paper The Practice Manager Member and Lay Member to be involved in development of services and public engagement approach. To request expressions of interest for the clinical lead role on the PTS Procurement Team and advise the PTS Review Programme Lead accordingly.
MH CM SM KM
COMPLETE COMPLETE
GB 16/107 Review of the “Automated Dispensing – In Patient Automation Project” Business Case To develop an action plan to acquire additional value for the CCGs investment in the Pharmacy automation scheme.
MG KA
GB 16/109 Community Shop The Health Improvement Nurse Principle and Mrs Margaret Sheard to further discuss partnership working between the company shop and area council networks.
HM
GB 16/113 Minutes of The Audit Committee held on 28 April 2016 To convey their appreciation to Ms Anne Arnold for her support to and chairing of the Audit Committee and to the Finance and Corporate Affairs Team for their work on the CCG’s Annual Report, Annual Governance Statement and Annual Accounts.
LS
COMPLETE
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Page 3 of 5
Minute ref Issue Action Outcome/Action
GB 16/116 Primary Care Commissioning Committee Assurance Report To inform Practices regarding the outcome of the prioritisation of the Primary Care Transformation Fund Bids. To distribute the final guidance and template for Primary Care Transformations bids to practices when received by the CCG.
VP VP
COMPLETE COMPLETE
GB 16/121 Questions from the Public – Community Pharmacists Mr C Millington and Ms Kirsty Waknell with the member of the public who raised the original question to consider the Comms messages to the public in respect of the Primary Care Clinical pharmacists Scheme
CM KW NE
COMPLETE
1. ITEMS FROM PREVIOUS MEETINGS CARRIED FORWARD TO FUTURE MEETINGS
Table 2 provides an update/status indicator on actions arising from earlier Board meetings held in public.
Table 2
Minute Ref
Issue Action Outcome/Actions
GB 15/42 Terms of Reference Clinical Senate
The Chairman to ascertain interest in the membership of the Clinical Senate from GPs.
NB
Pending – Dr M Guntamukkula to attend Clinical Senate
GB 15/96 Summary of Lorenzo demonstration Pharmacy Robot Patient X-rays to be made available to respective GPs
VP
In Progress. Seven Practices can access & view Patient X-rays at Practice level. GP NHS.net email address required to access the system. The Chair of the Practice Managers Group
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Page 4 of 5
Minute Ref
Issue Action Outcome/Actions
is working at pace to move this project forward.
GB 15/155 Report of the Chief Officer – Establishment of Urgent and Emergency Care Networks To raise transfer of work from the District Nursing Service to Primary Care at the South West Yorkshire NHS Partnership Trust through Contracting arrangements.
HW/VP
To build into contract discussions after evidence provided through membership. No evidence provided as yet.
GB 15/185 14/347 & 15/210
Hospital Discharge Notifications To write to GPs, Practice Nurses, Advanced Nurse Practitioners and practice Managers advising of the current difficulties with D1’s and that information provided in D1’s should be where appropriate checked for accuracy.
MG
GB 15/193 Minutes of the Patient and Public Engagement Committee (16 July 2015) To provide updates on the Patient Partner Telephone System to the Governing Body
CM
Schedule completed detailing all participating Practices: RAG rated for clarity All work in line with action plans is ongoing to resolve issues around the Patient Partner Telephone System Patient Partner System to be promoted to Practices. Progress reported requested from Mike Austin
GB 15/182 Minutes of the Clinical Transformation Board 1 October 2015 To consider and proposed options for a consistent approach to the provision of minutes to the Governing Body on 10 December 2015.
NB/VP
Corporate processes being renewed 09.05.2016.
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Page 5 of 5
Minute Ref
Issue Action Outcome/Actions
GB 15/307 Integrated Performance Report To determine the commencement date for provision of primary care triage by i-Heart Barnsley in the A&E Department at BHNFT
VP
Bid included for Primary Care Transformation Fund
GB 16/67 The Chief Officer agreed to communicate to both providers the CCG’s frustration that the A & E Department were not diverting patients to the I HEART service and how these two providers could work together to benefit each other.
LS
COMPLETE
GB 16/76 QUARTERLY UPDATE ON CHILDRENS SERVICES The Chief Nurse to submit a report about Education, Health and Care Plans and the role of the Designated Clinical Officer to the next meeting of the Governing Body on 12 May 2016.
BR
COMPLETE - Scheduled for Governing Body Agenda 9 June 2016
GB 16/77 UPDATE ON CHILD SEXUAL EXPLOITATION The Chief Nurse agreed to acquire the detail of CSE training and report back to the next meeting of the Governing Body on 12 May 2016.
BR
327 Licensed drivers have received safeguarding training focussed on drivers coming into contact with vulnerable children and adults. All remaining 367 drivers will complete training by no later than end of July.
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GB/Pu/16/06/09
1
Putting Barnsley People First
GOVERNING BODY
9 June 2016
REPORT OF THE CHIEF OFFICER
1. PURPOSE OF THE REPORT
To update the Governing Body on key issues and developments relevant to the strategic direction of the CCG.
2. EXECUTIVE SUMMARY
This report provides an update on the following issues:
Stronger Communities Partnership
Medical Interoperability Gateway (MIG) Project Update
Year End Assurance Letter
Pre-consultation for children’s surgery and anaesthesia and hyper acute stroke services – to note the report
Communications and engagement strategy and the future plans for public consultation comments.
3. THE GOVERNING BODY IS ASKED TO:
Note the report and provide comment on the communications and engagement strategy and the future plans for public consultation for children’s surgery and anaesthesia and hyper acute stroke services.
Agenda Item – Allocation of Time
10 Minutes
Report Of
Lesley Smith
Designation Chief Officer
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GB/Pu/16/06/09
2
1. DISCUSSION / ISSUES
1.1 STRONGER COMMUNITIES PARTNERSHIP
The Stronger Communities Partnership Group met on the 24 May 2016. The key elements of the meeting were as follows: 1) The terms of reference were agreed which included the vision:
'Through collaborative working we aim to ensure a coordinated approach to prevention and early intervention, ensuring that individuals and families have easy access to all forms of early help, making best use of their own skills and resources and preventing needs escalating. Wherever possible we will work in a co-productive manner focusing on ‘what works’. We recognise that achievement of our vision will require a longer-term shift to focusing on the causes rather than symptoms of need but with the benefit of better outcomes and reduced demand on more costly, specialist services.'
2) There was a discussion regarding the development of the 4 delivery groups
for; early help (all ages), early help (children), resilient and healthy communities and anti-poverty and the progress these groups are making. Early Help (Children). Children's centres converted into family centres successfully. Early help for children booklet available. Explains offer to children. Early help (adults) - delivered 2 workshops - social prescribing and falls. It is also overseeing the universal information and advice work which is nearing completion. Anti-poverty. Teams have been brought together and co located at civic centre to assist with coordination of information and advice. Further efforts to review ways of working and self-serve methods.
3) Development of an All Age Early Help Plan for the Borough. The SCP have agreed the development of this which will be borough wide. Fundamental to this is an agreed set of definitions, principles and outcome measures which will be shared at a later date.
4) Housing and Health update. Berneslai Homes are the managing agent on behalf of BMBC responsible for the management and maintenance of 18,800 council houses. They deliver a range of core and added value services detailed below:
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GB/Pu/16/06/09
3
1.2 MEDICAL INTEROPERABILITY GATEWAY (MIG) PROJECT UPDATE
Of the 36 practices in Barnsley, 30 practices have switched on the MIG to date. A further 2 practices are expecting to switch the MIG on. The remaining 4 practices will be contacted individually to try and work through any outstanding issues. Work has commenced to rollout access to the MIG with the Barnsley Hospice, BHNFT and SWYPFT in the next phase.
1.3 YEAR END ASSURANCE LETTER
The CCG had its Annual Review Meeting for 2015/16 on 19 April 2016. A copy of the informal feedback letter is attached at Appendix A. NHS England’s assessment of the CCG against the five assurance components has been reported as GOOD, subject to regional and national moderation.
1.4 COMMISSIONERS WORKING TOGETHER PROGRAMME CHILDREN’S SURGERY AND ANAESTHESIA AND HYPER ACUTE STROKE SERVICES
Pre-consultation for children’s surgery and anaesthesia and hyper acute stroke services Between January and April 2016, the CWT Programme held an open pre-consultation for the review of children’s surgery and anaesthesia services and also hyper acute critical care services across the region. The purpose of the pre-consultation communications and engagement work was to gather views to inform plans and the development of the options for future service configuration. These options will inform the consultation that will be opening to the public in September 2016.
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GB/Pu/16/06/09
4
Complementing the overarching communications and engagement activity and support from the core team, local CCG based activity was also carried out. Each CCG followed similar methods and approaches for engaging with their respective stakeholders and local populations. A copy of the report is attached at Appendix B; page 4 of the report explains the methods and approaches for engaging with stakeholders and the local population in Barnsley. Communications and engagement strategy and the future plans for public consultation During the pre-consultation phase views were gathered from key stakeholders to inform plans for future service configuration and consultation. Preparations are now underway to enter a 12 week or 16 week public consultation (depending on guidance from the OSC) on the options for reconfiguring children’s surgery and anaesthesia and hyper acute stroke services across our commissioning and provider partners in the region. The draft Strategy is attached at Appendix C, and Governing Body is asked for comment.
-
Dr Nick Balac, Chair Lesley Smith, Accountable Officer Barnsley CCG
Dear Nick and Lesley RE: CCG 2015/16 ANNUAL REVIEW Thank you for meeting with us on 19 April for your Annual Review Meeting. The purpose of this letter is to provide informal feedback on the key issues we discussed, and to confirm next steps for the publication of the 2015/16 CCG Headline Assurance Assessment. We discussed the good work in 2015/16 on Rightcare Barnsley in establishing a single point of access, and on the development of primary care. The CCG has maintained a focus on health inequalities, through the HIT scheme, and implemented some innovative work in general practice workforce which we would like to share across Y&H. We also acknowledged the improved relationships between the CCG and the hospital Trust which has resulted in an agreed contract for 2016/17 within the nationally-required timescales. I congratulated the CCG on ensuring continued improvement through your commissioning for the people of Barnsley. The sustainability of local acute services remains an issue. You described the work in progress to develop a strategic solution to this, through the development of an Accountable Care Organisation (ACO) and the wider Sustainability and Transformation plan (STP) work on acute services. The CCG has started to consider what the STP and ACO will mean for the overall governance structure of the CCG. We acknowledged the work that is underway to develop the STP for South Yorkshire & Bassetlaw. I thanked Lesley for her significant contribution to date in drawing the STP together. Your continued leadership and clinical engagement from the wider CCG membership will be essential to the successful delivery of the plan. As part of the STP, we expect to see the successful completion of the work on hyper acute stroke and children’s services within 2016/17. As we discussed there is excellent work being undertaken collaboratively, but it is essential for the sustainability of services that the implementation of these plans moves at pace.
Direct 0113 82 47511 Date:26/05/16
NHS England – North (Yorkshire & the Humber)
3 Leeds City Office Park Meadow Lane
Leeds LS11 5BD
-
We discussed the achievement of NHS Constitution standards, and agreed that the necessary improvement in A&E performance in 2016/17 will require a step change in the service model, which is being led through the STP. It will be important for you to ensure that the STP addresses this within 2016/17 in order to secure improved emergency access for your population. Whilst there is still work to do, in order to finalise the Better Care Fund plan, we discussed the strength of the 2016/17 Operating Plan and the work the CCG has done to firmly embed the Right Care approach in their QIPP planning. We discussed the annual assurance assessment of the CCG, in the context of the 2015/16 CCG Assurance Framework. Our assessment of your CCG, against the five assurance components, is as follows:
Well Led Organisation
Delegated Functions
Financial Management
Performance Planning
Good Good Good Good Good It is important to note that this assessment is provisional, and subject to regional and national moderation. As you will be aware, NHS England is required in the 2016/16 Mandate for the NHS, to publish a Headline Assessment of the CCG by the end of June. The Headline Assessment will be determined by the lowest of the assessments across the five components. It is clear from our discussions that the CCG is continuing to improve and delivering well through your leadership and the hard work of the organisation. Thank you. I will write to you again at the end of June, with your finalised Headline Assurance Assessment. In the meantime, please do not hesitate to contact Alison Knowles or Mark Janvier should you require any further information. Yours sincerely
Moira Dumma Director of Commissioning Operations
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Communications and engagement report: pre-
consultation for children’s surgery and anaesthesia and
hyper acute stroke services
April 2016
1. Introduction
As Commissioners Working Together (CWT), we are a collaborative of eight clinical
commissioning groups (CCGs) across South and Mid Yorkshire, Bassetlaw and North
Derbyshire and NHS England.
Some people have better experiences, better outcomes and better access to services than
others – and to ensure that everyone experiences the highest quality and safest service
possible, we are working with all local hospitals and care providers, staff and patient groups
to understand how best to do this for the benefit of everyone in the region.
Over the last year, we have focused on four key areas – reviewing both hyper acute stroke
and children’s surgery and anaesthesia services, urgent and emergency care and have also
developed a partnership with Macmillan for people living with and beyond cancer.
Between January and April 2016, we held an open pre-consultation for the review of
children’s surgery and anaesthesia services and also hyper acute critical care services
across the region.
The purpose of the pre-consultation communications and engagement work was to gather
views and input to inform plans and the development of the options for future service
configuration. These options will inform our consultation that will be opening to the public in
September 2016.
2. Methods and approach
During pre-consultation, we focused our efforts on three key groups:
Patients, carers, families and the wider public
Clinicians and staff working in the services
Place-based stakeholders such as Overview and Scrutiny Committees (OSCs),
Health and Wellbeing Boards, MPs and other interested groups.
A comprehensive stakeholder map – developed with input from all CCGs – helped to shape
and inform the approach and develop appropriate methods and ways of connecting with our
identified audiences.
-
We followed the NHS England Planning, Assuring and Delivering Service Change for
Patients Guidance (November 2015) and had conversations with and learned from
colleagues in parts of the country where successful, large-scale engagement has already
taken place (eg Manchester and Wakefield).
Our approach was inclusive and included:
Overarching strategic communications and engagement from the Commissioners
Working Together team
CCG-led local conversations and awareness raising based on comprehensive, place-
based communications and engagement plans
Regionally-led clinical and managerial engagement
Clinically informed materials
Clinically led communications materials
Patient and public involvement in development of materials
Our methods have included:
Digital communications and engagement through our website, with background about
why changes are being considered and materials. This was the central point for
signposting and survey responses
An online survey, asking the questions:
What matters to you when accessing children’s surgery and anaesthesia services?
What matters to you when accessing critical care for people who have had a stroke?
Social media – Twitter and Facebook led
Events, supported by the same toolkit (presentation, topline messages and Q&A)
Broadcast and print media releases and conversations
One to one briefings and updates with place-based stakeholders, via regular chief
officer briefings
Briefings with Healthwatch
Setting up a Joint Health Overview and Scrutiny Committee
A working group with all communications and engagement leads from our eight CCG’s,
along with communications leads from the region’s acute provider organisations and NHS
England has been meeting regularly since June 2015. As well as helping to shape the
communications and engagement approach, the group has met to discuss what materials
were needed to support local conversations (which were subsequently developed by the
core team) and update on engagement progress.
-
As well as promoting the pre-consultation, each CCG has been leading on local
conversations with local groups and communities – ranging from established patient and
public participation groups to health ambassadors (representing community and interest
groups such as the homeless, asylum seekers and the deaf community), parent and carer
groups (including a group for parents with children who have autism), stroke groups,
disability networks and local employers. These have been complemented by regional events
with clinicians, staff involved in the services and patient and public representatives.
3. Overview of communications and engagement activity
The pre-consultation period started in January 2016 and since early February, the website
has seen a significant increase in traffic, with 6,756 page views between 1 February and 15
April. The top three page destinations throughout pre-consultation were:
/what-we-do/childrens-surgery/share-your-thoughts
/what-we-do/critical-care-stroke-patients
/what-we-do/children’s-surgery
Interest in the Commissioners Working Together Twitter and Facebook presence has also
grown – with Twitter followers increasing at a rate of around 50 a month and tweet
impressions averaging around 15,000. Profile visits reached almost 1,300 in February and
over 1,100 in March. Facebook has also helped raise awareness of the pre-consultations,
with videos of the clinical leads and patients reaching more than 700 users. A blog from the
clinical lead for children’s surgery services was read by 140 individual users with Twitter
being the main source of traffic.
For further awareness raising, contact was made with the region’s key media with briefings
given and a press release issued. This also resulted in an article in the Health Service
Journal (HSJ) – a national trade publication.
Collectively, as a core team and as individual CCG’s we have held, attended and shared
information at 22 events. This includes patient and public participation groups, parent and
carer forums and stroke support groups. Attendance at the events has varied from
audiences of 15 to over 200.
We have also been gathering views on a one-to-one basis in outpatient clinics, local
authority settings, sixth form colleges, stroke groups and parent and carer forums.
By the end of the pre-consultation phase, we received 247 online responses as well as
written feedback from each of the events. We estimate that more than 500 face to face
conversations have taken place; though the awareness of the need to look at changing the
two service areas has reached many thousands.
3.1 Overview of clinical engagement
-
In establishing the workstreams and subsequent pre-consultations, clinical spokespeople
were identified and have been involved in helping shape the messaging for our various
communications and engagement methods and materials.
At least five clinical workshops were held centrally throughout the pre-consultation phase
and Commissioners Working Together workstream leads continue to work with clinical
representatives from each commissioning and provider organisation in South and Mid
Yorkshire, Bassetlaw and North Derbyshire to ensure all plans and developments are
clinically-sound and sustainable.
We have also actively engaged with and worked alongside a number regional clinical
experts from the Yorkshire and Humber Strategic Clinical Network throughout this process,
where they have attended events, acted as spokespeople and been kept informed through
regular e-bulletins and face to face meetings.
3.2 Overview of MP engagement
Building on existing relationships, each individual clinical commissioning group held the
responsibility for communicating and engaging with their local MPs through regular briefings
with the respective Chief Officers.
4. Overview of communications and engagement activity by area
Complementing the overarching communications and engagement activity and support from
the core team, local CCG based activity was also carried out. Each CCG followed similar
methods and approaches for engaging with their respective stakeholders and local
populations.
4.1 NHS Barnsley Clinical Commissioning Group
NHS Barnsley Clinical Commissioning Group (Barnsley CCG) carried out various
communications and engagement activity for the two workstreams, alongside promoting the
pre-consultations, and how to get involved, via their website which was supported by social
media signposting from their Facebook and Twitter accounts (over 9,700 followers).
Quantitative communications included the promotion of the pre-consultations via e-bulletins
to various partner organisations and patient and public groups from across Barnsley. This
included information being distributed to their patient council, OPEN (a public engagement
network of around 200 members), GP patient reference groups (PRG’s) and to local partners
from across health and social care, as well as their local authority and voluntary sector
organisations.
Patient and public communications and engagement
Qualitative engagement in Barnsley with patients and the public included the pre-
consultations being discussed at the Barnsley Patient Council meeting on 24 February 2016.
The meeting was attended by members of local GP patient reference groups from across
Barnsley with a presentation given by a member of the CWT core team alongside open,
-
participatory discussion on the pre-consultations. Feedback from this meeting has been
incorporated into the overall themes.
Further qualitative engagement for the pre-consultation into hyper acute stroke services
included attendance at an Afternoon Tea Party and Dance held by the Rotary Clubs of
Barnsley, which provided an afternoon of company, discussions and entertainment for
lonely, elderly and socially isolated people from across the borough. Over 200 people were
in attendance and took part in a number of informal, face to face discussions. Again, the
feedback was then incorporated centrally.
Staff and partner communications and engagement
Qualitative engagement with partner organisations, which did also include some patient
groups and representatives, was the presentation of and discussions on the work of
Commissioners Working Together and the pre-consultations at Barnsley CCG’s
Commissioning Plans Event on 12 February 2016. As well as having a stand with
information to take away, round table discussions on the workstreams were had with the 50+
people in attendance.
Barnsley CCG built on their strong relationships with their partner and provider organisations
for further quantitative communications and engagement activity. Promotion of the pre-
consultations and the opportunities to get involved was included in:
Voluntary Action Barnsley’s weekly e-bulletin as well as through social and digital
media (their own website and Facebook and Twitter accounts)
South West Yorkshire Partnership NHS Foundation Trust circulated the information
to all practice governance coaches in Barnsley, including physical and community
services as well as mental health. Information was also sent widely to staff within
physical and community services, including district nurses.
Barnsley Hospital NHS Foundation Trust promoted the pre-consultations via their
own existing networks, including Barnsley Parents and Carers Forum.
Via their volunteering and engagement team, Barnsley Metropolitan Council
promoted the pre-consultations to their staff, area teams and through their Service
User and Carer Groups database (of which there are over 200 members).
Communications and engagement with seldom heard groups and those in protected
characteristics
As well as qualitative engagement at the Rotary Club event for elderly and socially isolated
people, Barnsley CCG targeted the following groups for promotion of and involvement in the
pre-consultations:
Barnsley BME Women and Children Forum
Healthwatch Children and Young People
Barnsley Maternity Service User Group
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4.2 NHS Bassetlaw Clinical Commissioning Group
NHS Bassetlaw Clinical Commissioning Group (Bassetlaw CCG) posted information on the
pre-consultations and the links to the central online surveys on their own website and
supported the awareness raising via their social media accounts (over 2,900 followers on
Twitter and 50 on Facebook).
Patient and public communications and engagement
Qualitative engagement by Bassetlaw CCG throughout the pre-consultation phase included
attendance at their Patient Experience Steering Group. The group, consisting of patient
representatives from across Bassetlaw, received a presentation on the two pre-consultations
with the opportunity for follow up, participatory discussion.
Quantitative communications and engagement included the dissemination of pre-
consultation information through various community and voluntary sector organisations in
the area. These included:
Bassetlaw Action Centre
Advice Bureau, and;
Bassetlaw Community Voluntary Services.
Staff and partner communications and engagement
Further awareness raising included the dissemination of information through Bassetlaw
CCG’s Working Voices project. This is an ongoing partnership project between the CCG and
the workforce of five local employers – Eatons Electrical, Ryton Park Primary School, BPL,
North Nottinghamshire College and Bassetlaw CAB.
Regular updates on the work of Commissioners Working Together and the pre-consultations
were also given at Bassetlaw CCG’s Governing Body meetings throughout the phase.
4.3 NHS Doncaster Clinical Commissioning Group
NHS Doncaster Clinical Commissioning Group (Doncaster CCG) actively promoted the pre-
consultations, engaging with a wide range of local communities for involvement in the two
pre-consultations. This was complemented by hosting locally tailored online surveys on their
website which was signposted to from their own Twitter account of over 9,500 followers
The former chair of Doncaster CCG also promoted the pre-consultations through his regular
comment piece in the Doncaster Star.
Patient and public communications and engagement
Qualitative engagement for the pre-consultation into children’s surgery and anaesthesia
services included attendance at seven participatory events with various patient and public
groups including; two local colleges, Doncaster Parent’s Voice, Doncaster’s patient and
participation group network and Happy Hands, Doncaster’s Deaf Parent Group.
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Similarly, qualitative engagement for the hyper acute stroke services pre-consultation
included attendance at three participatory events with a local stroke group, Doncaster
Speakability and the Doncaster Stroke Support Group.
Vox pop sessions were also carried out at the Civic Building in Doncaster, engaging
members of the public in 1:1 conversations about the two pre-consultations and feeding their
views into the overall feedback.
Quantitative engagement on the two workstreams included the distribution of information,
including how to get involved to targeted patient and public groups across Doncaster,
including children’s centres, parent partnerships, carers’ services and charities.
Staff and partner communications and engagement
Quantitative communications and engagement activity was carried out with Doncaster
CCG’s partner organisations through the distribution of information and survey questions for
all internal and external publications of the following:
Doncaster Metropolitan Borough Council
Public Health
Doncaster and Bassetlaw Hospitals NHS Foundation Trust
Rotherham, Doncaster and South Humber NHS Foundation Trust
The Doncaster Chamber of Commerce
St Leger Homes (who provide housing services for the 21,000 council-owned homes
in Doncaster)
The online survey was also distributed to a number of BME community groups and to the
CCG’s Health Ambassadors who represent a range of seldom heard community groups
such as the homeless and asylum seekers.
Communications and engagement with seldom heard groups and those in protected
characteristics
Through their various communications and engagement activity, Doncaster CCG also
targeted the below groups with information and opportunities to get involved:
Doncaster Men’s Group
Doncaster Age UK
Doncaster Mencap
Doncaster Mind
Doncaster Autistic Society
Doncaster Deaf Parent and Toddler Group
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The LADDER group (supporting young people across Doncaster with a range of
disabilities)
4.4 NHS Hardwick and NHS North Derbyshire Clinical Commissioning Groups
NHS Hardwick and NHS North Derbyshire Clinical Commissioning Groups (CCGs)
submitted joint communications and engagement activity plans and reports and worked
jointly to target their respective populations and audiences.
Information on the pre-consultations was posted on their individual websites and supported
by social media signposting through their respective Twitter accounts (over 3,700 combined
followers).
Patient and public communications and engagement
Qualitative engagement covering the two CCGs included attendance at two participatory
events and meetings where information was shared and discussions had on the two pre-
consultations. This included a focus group at the Derbyshire Stroke Centre on Thursday 17
March 2016. Feedback from this group has been incorporated into the central themes.
Quantitative communications and engagement by the two CCGs included the contacting of
and dissemination of information to at least ten specific patient and public groups relevant to
each service. The opportunity to have a face to face discussion with a member of either
Hardwick or North Derbyshire CCG was also offered to these groups, which included, the
North Derbyshire Stroke Club, Dales and High Peak Council for Voluntary Service, the
Derbyshire Parent forum and Cypress Parent Support Group.
Staff and partner communications and engagement
Quantitative communications and engagement across the two areas included the mass
communication of pre-consultation information through each CCG’s internal and external
publications, chief officer blogs, GP newsletters and information shared with the provider
organisations in the region, Chesterfield Royal Hospitals NHS Foundation Trust and
Derbyshire Community Health Services.
Due to the engagement with and by building on their relationships with partners, information
was then cascaded independently via the local Healthwatch and NVDA (a registered charity
supporting health related voluntary organisations across Derbyshire) to their own
stakeholders and audiences.
The executive teams of each CCG provided regular updates to the region’s Health and
Wellbeing Board and information was also shared amongst all Patient Participation Groups
(PPGs) and practice managers in the region.
4.5 NHS Rotherham Clinical Commissioning Group
Overarching communications and engagement methods carried out by NHS Rotherham
Clinical Commissioning Group (Rotherham CCG) included the publishing of the pre-
consultations on their website with links to the central feedback surveys on the
Commissioners Working Together site. This was supported by further digital and social
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media engagement with signposting from the CCG’s Twitter account (to over 7000
followers).
Quantitative communications also included the inclusion of the pre-consultations in emails
out to all 31 Rotherham GP practices as part of their regular GP e-bulletin, alongside articles
printed in internal and external partner publications and newsletters, for example, those of
The Rotherham NHS Foundation Trust and Rotherham Metropolitan Borough Council.
Patient and public communications and engagement
Rotherham CCG had a strong focus on qualitative engagement with various face to face
conversations having taken place throughout the pre-consultation phase. These
conversations included targeted engagement with local groups for stroke survivors and
those having suffered from other neurological conditions. Presentations on the two
workstreams were given to these individual groups in February and March 2016 with
discussions then feeding into the overall pre-consultation feedback.
For the children’s surgery and anaesthesia workstream, qualitative engagement was carried
out with the Rotherham Parent’s Forum. The forum is an active group of parents and carers
who work with health and care organisations who provide services for disabled children and
their families in Rotherham.
Further qualitative engagement with patients and the public included presentations to and
discussions with the Rotherham PPG network, made up of patient and public
representatives from across all GP practices in the area. Workstream leads from the central
Commissioners Working Together team also attended this participatory event and were able
to discuss the pre-consultations and also answer any questions the audience had.
Staff and partner communications and engagement
Information on the work of Commissioners Working Together and how to get involved with
the two pre-consultations was also shared via qualitative engagement with a number of
Rotherham CCG’s partner organisations. For example, the CCG had regular catch ups with
Healthwatch Rotherham throughout the pre-consultation period as well as chief officer and
chair conversations with the local health overview and scrutiny committee.
Communications and engagement with seldom heard groups and those in protected
characteristics
Communications and engagement targeted to groups as identified in the protected
char