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Quality and Safety Committee Minutes Wednesday 03 February 2016 (0900-1100)

Perceval House: 3rd Floor; 14/16 Uxbridge Road, Ealing W5 2HL

In attendance: CHAIR: Philip Young (PY), Mohini Parmar (MP), Tessa Sandall (TS), Ann Coles (AC), Gordon Turner (GT), Sue Pascoe (SP), Ian Robinson (IR), Neha Unadkat (NU), Mohammad Alzarrad (MA), Vijay Tailor (VT), Serena Foo (SF), Philip Portwood (PP), Richard Christou (RC), Jyoti Lehal (JL)

Apologies: Kris Ogunkoya (KO)

Item Action 1 Welcome & Apologies (as above) 2 Declaration of Interests 3 3.1 Minutes of the Meeting 13 January 2016 agreed as accurate with the

following outstanding actions: TS to continue to chase GP Out of Hours feedback: Update -

outstanding

TS to discuss special school nurses paper with Maggie Wilson:Update - TS confirmed paper is not ready. Will need to go toFinance and Performance Committee.

SP to speak with JW regarding escalations feedback and action logof CWHHE meetings: Update - PY requested our escalations areformally discussed at new CWHHE Committee. No feedbackreceived for a single escalated item so far. SP will work with JW tocarry out a reflective audit. JL to send a copy of all escalationssince October 2015 to SP and to add as a standing item on theagenda from March onwards.

GT update on WLMHT 6 monthly IAPT suicide report: Update - GTagreed to a 6 monthly report to be presented at June committee.JL to add to June agenda.

GT to discuss benchmarking suicides with CNL: Update – GTrequested this item to be added to March/April agenda fordiscussion.

JB to address data discrepancy within IPR and maternity transitionreport: Update – outstanding.

GT to request AWOL data for WLMHT MHA patients to includerecurrent cases and period of absence: Update still outstanding GTis pushing for a response.

JB to address neo natal numbers query and high births numberoutside in Hillingdon: Update - outstanding.

JB to produce maternity positive message summary forstakeholders: Update – MP will ask the team to work on this.Someone from the committee will pick up and speak to JB.

JF/GT to review Ealing Hospital complaints: Update: GT requestedthis item is brought back to the committee in April. TS confirmedshe will also follow up.

On action log

Special school nurses paper to be presented at Finance & Performance Committee – remove action.

SP to liaise with JW regarding escalation feedback. JL to send copy of escalations since Oct 2015 to SP. Add as standing item on agenda from March onwards.

JL to add WLMHT 6 monthly IAPT suicide report to June committee agenda.

JL to add benchmarking suicides with CNL to March/April agenda.

On action log

On action log

On action log

On action log

JL to add Ealing Hospital complaints review to April meeting agenda

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3.2 Matters Arising None discussed

4 Quality and Performance Reports (inc CQG Report, NWL Maternity Transition and Quality Dashboard and Provider Reports)

GT presented the CQG report: WLMHT

o The Trust is significantly behind with completing and returning Serious Incidents (SI) reports. 41 outstanding which are being followed up by GT and patient safety team. 16 of these will be sent for final sign off and the rest happen in two weeks. TS requested formal review to document outcomes from CQG. TS expressed concerns as we do not know if WLMHT has taken action and changed their practices. MP requested a clinical meeting as well.

o The CCG is collaborating with the Trust to ensure NHS England Southern Health NHS Foundation Trust Report’s recommendations are reviewed and where applicable implemented. The Trust has assured the CCG the recommendations have been noted and actioned however the CCG still requires further reassurance and oversight of details behind these decisions. IR requested GT to check BHH.

o The WLMHT CQC Programme Board reported that although behind trajectory, the Trust was making good progress towards addressing the areas raised in the CQC Inspection report.

LNWHT Acute o The Trust are finding it difficult to recruit nursing staff to the

Ealing Hospital service, as potential candidates are reluctant to apply due to the forthcoming closure. GT confirmed the closure refers to the service and not the Trust. No CQC report received as yet. PY stated Jacqueline has informed him there are issues within CQC hence the delays.

Hillingdon Hospitals NHS Foundation Trust o PY would like to know why there is a business case in place for

midwife numbers. GT to speak to JB. PY would like assurance wards at Ealing Hospitals have safe staffing and appropriately placed temporary and permanent staff members. TS will write to Leigh and Amanda, cc in MP. Depending on the response will then highlight to Jacqueline. Possibility of extending a future committee meeting by an hour in order to accommodate update on this topic.

Ealing UCC o The UCC reports that the child clinical assessment target has

improved, and although it is still slightly below target it is expected to continue to improve as a result of reviewing the streaming guidelines and processes. GT advised the committee they will be reinstating regular meetings as part of this.

o TS asked if we have discussed 4 hours breach and correct reporting process with UCC. IR confirmed discussion has taken place.

London Ambulance Service (LAS) o MP confirmed LAS topic has been discussed at patient and

quality meeting. PY requested a deep dive to take place and if this is likely to be escalated back to their committee.

NHS 111 o PY confirmed this item is on the agenda for later discussion. PY

does not understand 111 minutes. The minutes do not reflect how we are progressing and if we there should be any reasons

GT to formally review processes in place and feedback on actions implemented by WLMHT. GT to discuss recommendations and gain further assurance these are being implemented. GT to speak to JB regarding business plan need for midwife numbers. TS to discuss safe staffing levels and appropriately placed temporary and permanent staff members at Ealing Hospital with JB.

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for concerns as not clear from document. SP advised they are currently trying to establish membership at the meeting. Have also discussed who should be attending quality & safety committee to discuss 111 on regular basis. TS requested this matter is escalated. PY would like LAS and 111 representation at Ealing level.

Provider Reports: WLMHT

o Exception Report - Delayed Transfers of Care: MP suggested benchmark data with Salford as they are performing considerably well. PY cannot see any figures regarding the number of patients staying. TS confirmed numbers have decreased. PY would like visibility of the number of beds compared to the number of patients admitted. IR further added the numbers for Ealing reported last week was 16.

o Exception Report – Readmissions within 30 days: MP noted numbers are increasing again.

o Exception Report – Serious Incidents: MP highlighted to the committee the number of SIs reported within 2 working days have drastically increased. PY confirmed there were 8 SIs in one month. SF advised many are from Hounslow and will be looking into this.

SF updated the committee on IAPT services and how they are still experiencing recovery issues. The discharge summaries to GPs are not working well and below target. TS confirmed the CCG will not meet targets for this year. Will work towards doing everything to catch-up for the coming year. LNWHT Community

o Exception Report – District Nursing: MP noted referrals responded to during the day, twilight or night service periods within 24 hours are less than 20%. This is a concern. TS will investigate. MP would like confirmation reporting issues for KPIs are SystmOne related and not a real issue. GT confirmed not all are due to SystmOne.

o Exception Report – Podiatry DNAs: MP pointed to the committee figures are now on the increase.

o Exception Report - Delayed Transfers of Care: MP would like to know if numbers relate to Jasmin or Magnolia wards. TS stated most likely Rosemary and not Jasmin.

o Exception Report – Falls Service: MP expressed concerns performance is below 80% target in M8. GT clarified actual figure should be 82%. PY advised staffing issues have now been going on for years and if there will be any resolutions. TS confirmed looking into ways to support LNWHT not just by funding. Mapping action plan with the committee’s involvement. Will be looking into the right measures to increase community nurse engagement.

LNWHT Acute

o Exception Report – 18 Weeks RTT: PY questioned why the backlog has increased since M8 and the measures taken place since. TS confirmed this is due to clock stops.

ICHT VT discussed CQG held last week. One concern raised were 18 Weeks RTT is worse in M9. Number of cancellations is due to bed availability. A number of patients have also been transferred elsewhere. Imperial is currently in its worst position. The current top 4 SIs themes are:

o Delays in treatment

JL to add to NHS 111 matter to escalation report. GT to provide number of beds compared to the number of patients admitted figures for WLMHT to the committee. TS to investigate low LNWHT Community district nursing referrals response times.

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o Pressure sores o Infection control o Surgical

Maternity transitions issues are cropping up within trusts and not just Imperial. PY raised concerns with the statement that they are significantly over performing in all hospitals with activity as does not sound correct. TS confirmed this refers to activity since April. Diagnostics – looking at external outsourcing however companies are asking for Tariff plus! Remains to be settled. This accounts for the delay in outsourcing. NWL Maternity Transition PY requested since this document will be in the public domain we will need to rephrase the statement stating ‘that close to a 100% of women receive their 1ST choice of provider’ if this figure is now 100%. GT will pick this up with JB.

GT to inform JB to amend wording under NWL maternity transition report.

5 Quality Reports • Patient Safety Report

GT presented the report. GT highlighted WLMH are experiencing consistent non-compliance with 48 hour reporting target. 41 RCA reports were late and not yet received. Average number of working days for investigation are 84 days.

6 Safeguarding • Safeguarding Childrens (by exception)

No exceptions • Safeguarding Adults Report (by exception)

RC discussed the transfer of care event last week was well attended and received. RC will submit paper next month.

JL to add Transfer of Care paper to March’s committee meeting.

7 NHS Out of Hours 111 – NHS England Report (William Mead) Report noted

8 Items for Noting: (a) Minutes from the CWHHE Quality & Patient Safety Committee (b) Minutes from the CWHHE Performance Committee (c) Minutes from 111 Clinical Governance meeting (d) Exception report from previous meeting (e) Feedback on items raised by CCG at CWHHE Quality Committee (f) WLMHT and LNWHT Contract Query Notices Reports noted

9 A.O.B. GT raised the timings of these committee meetings for discussion. GT proposed all future meetings are held on the third Wednesday of each month from April 2016 onwards to fall in line with CQG and other reports. MP suggested GT speaks Ben Westmancott to make sure in line with governing board meetings in case of impact other agree.

GT to liaise with Ben Westmancott regarding future committee meeting dates changes.

10 Date of Next Meeting – 02 March 2016

1

Information, Governance, Management and Technology Committee Thursday 28 January 2016, 10:00 – 12.30

Meeting Room 1 & 2, Perceval House

Item Discussion Action

1. Apologies and Declaration of Interest Members present: Arjun Dhillon (AD) Chair, Helen Simpson (HS), Neha Unadkat (NU) Invited Guests: Amanda Lucas (AL), Ian Riley (IR), Naseem Isaq, (NI) Bill Sturman (BS), Faisal Siddiqi (FS), Omesh Sharma (OS), Sonia Patel (SP), Paramjit Matharu (PM) (minute-taker) Apologies: Sally Armstrong, Piers Grace, Shanker Vijayadeva, Linda Williamson, Sue Clements, Keith Bird, David Ashby, Gordon Turner, Farid Fouladinejad

2. Minutes from previous meeting (26 November 2015) The draft minutes of 26 November were agreed. Matters arising not covered on agenda Action log – The committee went through the action log AD noted these meetings were now being held bi-monthly in line with the meeting in common with CHWWE members.

3. Projects and Operational Matters a) Hardware capital projects update The Chair gave a summary of the Hardware project which included switches. b)Practice migrations to SystmOne One surgery had recently agreed to migrate to SystmOne. Although the programme for SystmOne had closed, they would still need support and funding. c) 2016/17 Capital bids There was a discussion around why Ealing was previously under invested and why some CCGs had more funding than others. There is a bid for annual capitation and the deadline is at the end of month. Funding for practices was discussed. The Chair highlighted the work the IT team had carried out for practices ie all refreshed eg wires, routers, desktop and laptop.

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The Chair had assured the Committee that Ealing CCG has now got its fair share of funding. d) Utilisation dashboard and prioritisation The Chair displayed on screen, the dashboard via SystmOne which is part of our IT strategy. It is primary care focussed with various programmes and tabs like SMS, DNA tracking costs, Out of hospital spec, GP IT support, cases resolved hardware, clinical training received, my record element online appointment and summary access. e) Shared services IT support performance report The Chair summarised the IT support which had migrated into one. There is one help desk, which has improved, for all the 8 CCGs which previously for Ealing was the ICO. FS agreed to send a report for information.

4. Governance and IG a) WSIC ISA SP highlighted that health and social care and Multi-Disciplinary Teams were included in the WSIC ISA and explained that the difference between Information sharing agreement and MOU is the social care, direct and indirect care in the ISA. To date in NWL there are over 180 practices who have signed up. Other organisations included acute providers and Mental health trusts and seven local authorities. SP confirmed that S251 was not pursued. However if areas wish to proceed with a section 251 then there is a condition to write to all individual patients in North West London. Stakeholders and patient groups agreed it was not worth sending out. As part of the national engagement, the IGA (Information Governance Alliance) reviewed our IG arrangements and confirmed the IG was legal but had recommendation and consideration but there were no rules about proportionality. We have sought further legal assurance on the uses of National level datasets to populate the Data Warehouse from a QC, which came back satisfied with legal requirements and uses. Health and Social Care Act was updated in October and the Legislation further supports agreement to share between health and social care. Communication and fair processing has been looked into and there is a case study published in the public domain on the lay partners who were also involved in putting the communications together. Took part in an NHS England PMCF fair processing workshop and review and they have said the website was one of best set of communications for the whole system ie website and posters leaflets etc. There is a video of patients which can be put on the GP Screens surgeries. Some proof cards in pharmacies have been published. The London wide LMC got a joint statement saying ISA is legal and are satisfied with the

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provisions put in place. Indemnify clause mentioned legal cost and proceeding. If it’s not met there will be a cost or fine. This does not support damages for incidents or damages ie legal proceeding. SNT sits in. SP confirmed £60k has been set aside and there is a contingency fund. Updated data processing agreements and added clauses on activity which provides additional data. There are 4 providers in agreement; South CSU, Concentra and EMIS and TPP. There is a separate arrangement with Apollo for proof of concept. There was a discussion around the indemnity clause which the CCG will be providing. The ISA will be moving towards a provider provision. SP mentioned this information agreement is an enabler, looking at care information exchange for NWL being adopted into ISA, this is a programme hosted by Imperial which will be going through next month. There was a long discussion around data. IR said once GP data is received they are able to start to deploy the WSIC DWH and work is underway to develop options for deployment of the tool to primary care organisations across NWL. SP said there were two phases and documents to ISA agreement. ISA had a second legal opinion which SP was happy to share. There is an additional clause, looking at interim data set and methodology. The Chair had concerns as complex and filtered data may be used inappropriately. NU added the CCG wanted assurances to take to the Governing Body. SP added practices have signed up re gateway process. SP said she would look into this and report back. It would take six weeks for the ISA and pilot for capitated budget. BS suggested a road map. The following questions were asked - Clarification of what is being asked to sign - Assurance of version control of agreements - How much project cost? - Timeframe for delivery - Getting practices to sign up - Where procurement done on our behalf? - Who decided to buy Apollo? - Need separate project? - Need sub group? - Sign off process? SP assured the committee that there was a tight governance group and they do not deal with the commercial side. The Chair felt things were getting complicated with various programmes all related eg WSIC ISA, WHYSE and it is difficult to explain to members what they signing up to ie whole package. SP suggested explaining in simple language on one side of A4 but will need support from AD.

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b) WHYSE IR gave background and update and is now looking at local implementation plans. There are two new dashboards:- 1) Urgent care dashboard 2) NHS 111 dashboard IR explained the process for NHS 111 and being able to scrutinise and see activity which could be used widely. IR noted that WHYSE is intended as a Strategic Business Intelligence (BI) system for commissioning across the 8 NWL CCGs. The Chair commented that it was helpful to see activity within urgent care and 111 and the move towards shifting care close to home and reduce secondary care services. Users will be able to access and use data, making it a more beneficial data tool. This will include being able to see peaks of inactivity and triage of patients. As the activity is more complex for Ealing, there is a reliance on data flows and data tools to capture this information. NU felt it was a matter of timing for GPs ie when ready to use and commission, then start training. The information needs to be useful for GPs to use. Some practices are willing to use and pilot. The WHYSE Contract has one more year to run and the 78 practices still need to be trained. Need clarity on options eg re-procure or exit. There are three practices piloted in Ealing. AL mentioned that Hillingdon is proactive with tool and their GPs are engaged. NU further commented she would like to see the ‘shadow’ data before going live. This is to seek assurance that we are receiving one version of data as currently there are at least three potential sources of information (Whole Systems, WHYSE and warehouse collecting data). AD commented that a draft paper would be presented at the next F&P as they did not just want to switch to new system without the impact being understood.

AL to give an update including how Hillingdon are using this tool. There was a discussion relating to reports that did not correlate from CCG data analyst and CWHHE. The Chair commented that we have WHYSE and whole systems integrated care warehouse. We potentially have 2 different source of information. We need assurance of one source coming from data set. IR felt the issue is local use of data. IR stated that we are shadowing current BI platform (ERNI) and WHYSE and are looking at options to avoid duplication. BI are validating data to make sure it is the same. It has not been agreed to bring together the WSIC DWH and WHYSE as a decision has not been made yet. IR agreed to discuss the options with the CWHHE committee. Advance Programme Interface (API) was discussed. Work is progressing and there will be a road map. There are three levels, nationally locally and regionally.

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BS mentioned that with pilot in GP practices, it would be useful to see the outcome and recommendations if successful. The Chair mentioned that as a commissioner this is interesting but as a practitioner this might be nice to know but will not affect daily work. IR responded that this was a commissioning tool and is opened to the CCG. The idea was to deliver to GPs. AL said she was happy to show a demonstration. HS felt this was useful to look at. c) GP System of Choice – Practice Agreement JS gave an update. Agreements have been sent out. Christine Dunne is involved. This has been endorsed by the LMC Action – PM to check with Christine Dunne re number of Ealing practices who have signed up

PM

5. Any other business Health promotion screens – JS gave an update. This was discussed at the Practice Manager forum and is now moving forward. JS suggested having a health promotion screen at Perceval House. The process was explained ie products on show in each unit have scheduling. The master play list goes to all surgeries. Digital Road map – SP explained that the digital road map was via NHS England and was agreed for Ealing. Submission was end of March but now slipped to June. Idea is for the IT map to go paperless and will share outcomes. This is going through diagnostic phase. Providers have submitted interest. Timeline slippage was due to STP (Sustainability Transformation Plan). Assurance for local digital would be part of STP. Looking at 6 capability ie discharge, care records, population health, assistive care, decision support, assess and optimise. Can share Roadmap. Have some ideas for primary care. Got utilisation dashboard. SP would welcome information but due to sensitivity this cannot be shared. The Chair said this was raw data and waiting time not included. JS asked about future plans or funding. SP responded there were opportunity for funding. Both SP and Mike Davey are working on this across NWL CCGs. The Chair added the IT strategy road map should be same for all. NWL have forums where providers come together. This will bring all together. This is a helpful vehicle for alignment and flag gap nationally. Information comes from various providers eg HSIC and EE. IT toolkit being refreshed next week. SP plans for WIFI. The Chair stated that there was no strategic plan for Wi-Fi in Ealing practices. NEXT CHWHHE meeting 18 February to be confirmed at MBR.

6. Date of next meeting 31 March 2016 Meeting Room 1&2 10.00-12.30

Minutes of the Local Joint Primary Care Co-Commissioning (PCCC) Committee Meeting in Public

Wednesday 20th January 2016 Time: 10.30–11.30am

Location: Ealing Town Hall, Liz Cantrell Room

Present

Voting Members Ealing Clinical Commissioning Group (Ealing CCG)/Central London, West London, Hammersmith & Fulham, Hounslow and Ealing CCG Collaborative (CWHHE)

Philip Portwood (Chair of Local Joint Committee) Lay Member PP

Philip Young Lay Audit Committee Chair PY

Dr Mohini Parmar Governing Body Chair MP

Dr Shanker Vijayadeva Governing Body Sessional GP (additional GP) SV

Sally Armstrong Deputising for Jonathan Webster Governing Body Nurse, Director of Quality and Patient Safety

SA

Tessa Sandall Acting Managing Director TS

Peter Buckman Deputising for Keith Edmunds Chief Finance Officer (CWHHE) PB

NHS England (NHSE)

Dr Mark Spencer Deputy Medical Director (London) MS

Rachel Donovan Deputising for Julie Sands Head of Primary Care (NW London) RD

Non-Voting Advisors

Local Medical Committee (LMC)

Dr Adam Jenkins LMC Representative AJ

Ealing CCG/CWHHE/Health & Well Being Board (HWBB)

Christopher Cotton PCCC Lead (CWHHE) CC

Sue Hardy Head of Strategic Estate Development SH

Neha Unadkat Deputy Managing Director NU

Jane Sagoo Member Engagement and Extranet Manager JS

Vaishnavee Madden Deputising for Dr Jackie Chin – Health & Well Being Board representation

VM

Apologies

Voting Members Ealing CCG/CWHHE

Dr John Riordan Governing Body Secondary Care Consultant JR

Keith Edmunds Chief Finance Officer (CWHHE) KE

Clare Parker Accountable Officer (CWHHE) CP

Jonathan Webster Governing Body Nurse, Director of Quality and Patient Safety JW

NHSE

Liz Wise Director of Primary Care (London) LW

Jo Ohlson Acting Director of Commissioning Operations NW London JO

Julie Sands Head of Primary Care (NW London) JS

David Finch Medical Director (NW London) DF

Item Agenda item Action General Business

1 Welcome, Introduction & Apologies PP welcomed all the committee members and non-voting advisors to the meeting.

No questions had been received in advance from the public.

None

2 Apologies noted. None

3 Declarations of Interest

Committee members’ and non-voting advisors were asked to state any conflicts of interest in relation to the agenda items under discussion:

MP & SV declared member of a Personal Medical Services(PMS) practice.

AJ (non-voting advisor) declared Director of Ealing GPFederation.

Committee members’ and Non-voting advisors were reminded to complete the declaration of interest forms and return to JS.

Terms of Reference (ToR)

Functions and Duties Discussions took place regarding the functions and duties of the ToR regarding delegated duties. CC confirmed that it is his understanding that that the joint committee exercises decision-making powers delegated to it only by NHS England, the Ealing CCG Governing Body (GB) has not delegated any of it duties or functions to the joint committee. It was agreed that any local amendments to the ToR need to be agreed by the GB. MP and PY asked for this to be clarified and actioned.

JS to chase any outstanding declarations of interest forms.

CC to verify functions and duties of local joint meeting and local amendments.

MP to raise at next GB meeting.

CC to feedback agreed revisions to the meeting in common

4 Minutes and actions from previous meeting

Minutes of 16/12/2015 meeting accuracy agreed

Actions for 16/12/2015 meeting reported in the relevant agendaitems, updated and recorded in the action log.

Refer to action log

Items for Discussion

5 Personal Medical Services (PMS) Update NU gave an overview of the PMS review, reminded members of the 3 month extension and reported that Paper 5 be tabled at the GB meeting and LMC today:-

Overview In February 2014 NHS England’s area teams received national guidance setting out a requirement to review all PMS contracts by the end of March 2016 (now with a three-month extension).

The purpose of the review is to secure best value from future investment of the ‘premium’ element of PMS funding.

As a result of this review, any additional investment in general practice services that go beyond core national requirements (whether this is deployed through PMS or through other routes) should:

reflect joint NHS England and CCG strategic plans for primary care;

secure services or outcomes that go beyond what is expected of core general practice orimprove primary care premises;

help reduce health inequalities;

give equality of opportunity to all GP practices, i.e. PMS, General Medical Services(GMS) and Alternative Providers Medical Services (AMPS) (provided they are able tosatisfy locally determined requirements); and

support fairer distribution of funding at a locality level.

In September 2014, further guidance was issued clarifying that CCGs must be involved in commissioning decisions related to PMS funding. All funding released by the review will be reinvested into general practice.

The key principles underpinning the review process are:

Decisions on future use of PMS funding are agreed jointly with CCGs;

Patients should have access to the same range of services regardless of what type ofcontract the practice they are registered with holds;

There should be equality of opportunity to all GMS, PMS, and APMS practices to providethe same range of services; and

Proposals for reinvestment should take account of the overall net impact of any fundingchanges.

NU reported the following;-

London wide support the outcome of the strategiccommissioning framework, principles align to the transition ofprimary care

OOH needs to align to the strategic outcome to the populationdelivery

All services must be provided

Practices equalised.

Ealing have seven PMS practices of which four have sent in detailed information – NHSE have been chasing the other three practices.

Financial implications and cost pressures are still being discussed at both a CCG and practice level (dependent upon the final commissioning intentions).

NU reported that Ealing CCG could not agree with the premium calculations for the PMS component as they had not received details behind the calculations at practice level from NHSE.

NU highlighted the risks of retention of workforce if there was not a proper transition plan for the PMS practices. Having to re-attract staff a couple of years later would be difficult as staff were difficult to retain and attract in local practices already.

PY highlighted that the equalities impact assessment was not mentioned. TS confirmed valid point and further discussions will take place at the CCG to take this forward once there was clarity on what changes were likely in a practice due to this review..

AJ asked for clarification on the premium components and is it right that there is a mandatory component of the premium offer – Clarification was provided – there are separate parts to the premium offer, one part (KPI’s) is Mandatory and the rest are optional for the CCG to commission.

MP – CCG still need to think about what we commission for population coverage and equal across all practices. LMC have been involved with the KPIs and whatever is offered needs to be equal.

PY flagged that he has requested a legal opinion to allow delegated decision to GB

CC confirmed that NW London are completing the model for the financial analysis.

PY concerned about tight deadlines for submission of commissioning

intentions on 19th February.

NU confirmed that the GB will be asked to:-

• Note of background to and rationale for the PMS review;• Endorse the NWL principles for the PMS review;• Endorse the progress to date made on CCG commissioning

intentions; and• Approve the establishment of a special committee established

by the Governing Body to make a decision on commissioningintentions and any additional investment that may be required.

NU to feed back GB decision

6 Estates Strategy SH gave a verbal update on the following areas;-

Estates Strategy CCG met Department of Health deadline of 31st December

2015 with document in draft form based on the Strategic ServiceDelivery Plan (SSDP)

The development of the estates strategy is being overseen bythe Strategic Estates Group, which has representatives fromstakeholders across the borough including Ealing Council

Focus now on expanding to include other relevant stakeholdersestate.

Piece of work is now underway to develop a primary carepremises investment plan identifying where investment isrequired outside of the proposed Ealing Health andWellbeing Hubs.

Next step to transform the strategy into a strategic planning tool– work in process.

Note: draft estates strategy will be going to the ExecutiveCommittee and LMC today.

PY raised a concern that he has not seen the SSDP. TS confirmed that this was developed in 2013/14 and has been to the Executive Committee and GB for approval. TS will forward PY a copy.

SH reiterated that the strategy is in draft form and will need to be agreed by the GB. PY and MP raised concerns regarding delivery of the strategy – it was suggested that a workshop be planned with the GB members to maximise strategic delivery and vision.

Improvement Grants Practices applied in July 2015, still awaiting confirmation from

NHSE NHSE has contacted practices where further information is

required and due diligence process is taking place Work is required to be completed by end of March

MP asked if all practices had to give further clarification – SH confirmed only some.

TS recommended to formally review CCGs position in respect of the delayed notification to practices and possible escalation as practices may not be able to complete the works by end of March.

SV questioned the overlap between funds (improvement grant and PCTF). TS requested a matrix of which practices have applied for funding schemes – timelines need to be kept. SH to prepare.

TS/SH to send copy of Estates Strategy to PY

MP to action GB workshop on Estates Strategy

TS/MP to escalate completion end date to NHSE

SH – tracking matrix of practice funding applications

Primary Care Transformation Fund

NHSE circulated a letter to CCGs in early November 2015outlining the intentions for the 16/17 Primary CareTransformation Fund (previously known as the Primary CareInfrastructure Fund)

NHSE reported that further details on the governancearrangements and criteria for the 16/17 process would be issuedin December 2015 but this is still awaited.

NHSE provided some information to assist practices inpreparing bids while awaiting final governance arrangementsand criteria.

CCG communicated to all practices advising them to startpreparing their bids with the following information:-

The Bids must cover estates and technology schemes which support the following criteria:

o contribute to 7 day access to effective careo increase capacity of Primary Careo enable access to wider range of services to reduce

unplanned admissions to hospitalo increase training capacity in general practiceo support the delivery of the Out of Hospital Strategy and

delivery of community based services as part of theCCG commissioning intentions

NHSE have issued guidance for practices to procure somesupport with preparing bids and assistance

Deadline for CCGs to submit bids is the 4th March 2016

SV reiterated the focus for the 16/17 bidding included technology and not just premises.

MP concerned with time line of submission.

Post meeting note NHSE has now notified CCGs that the deadline for 2016/17 PCTF proposals has been pushed back to the end of April. The CCG has written to all practices requesting that bids be submitted by midday 21st March 2016 to enable the CCG to consider proposals and take through internal governance processes.

7 Recent Changes in local Primary Care provision (Terminations / Mergers / Relocations)

Nothing reported.

8 Primary Care Compliments, Concerns and Complaints TS informed RD that the Quality & Safety Committee would like to see regular updates on themes and numbers of complaints that NHSE receive from Primary Care.

RD confirmed to share what NHSE currently have within the next week and look into future feedback

PY noted that CWHHE's Audit Committee had received no assurance as to how the Counter Fraud team working for NHSE were operating as we had received no feedback. CWHHE had written to NHSE and had had an incomplete response. He said he would raise it of NHSE at the

RD to send information to TS

forthcoming joint PCCC meeting.

AOB

Future Local Joint PCCC meetings in public dates:- 2015/16

Date changed (via email) to Wednesday 10th February at Ealing Town Hall, Queens Hall from3.00-4.00pm (to fit in with PMS review timeline).

Wednesday 16th March 2016 at Ealing Town Hall, Queens Hall, from 09.00– 10.00am

2016/17

Wednesday13th April 2016 at Ealing Town Hall, Nelson Room, from 09.00-10.00am