Borderline & Peterborough LCGs Joint Board Meeting
Friday 1st November 2013, 2:00 pm - 4:00 pm
Sorrento Room, The Fleet, Fleet Way,
High Street, Fletton, Peterborough, PE2 8DL
MINUTES
Attendees:
Borderline LCG Board
Dr Gary Howsam (GH)
Dr Mark Attah (MA)
Dr Cosmas Nnochiri (CN)
Karen McNally (KM)
Mary Bryce (MB)
Michael Bacon (MB)
Vice Chair
Co-opted Member
PDMA Lead
Practice Manager Representation
Healthwatch Representative
Patient Participation Group Lead
Peterborough LCG Board
Dr Michael Caskey (MC) (Chair)
Dr Paul van den Bent (PvdB)
Dr Harshad Mistry (HM)
Dr Neil Sanders (NS)
Rob Bristow (RB)
Brian Parsons (BP)
Barbara Cork (BC)
Gill Metcalf (GM)
Chair of Peterborough LCG Board
Vice Chair
GP Lead Peterborough LCG
GP Lead Peterborough LCG
Nurse Representative
Patient Representative
Patient Representative
Healthwatch Representative
Borderline and Peterborough
Alan Sadler (AS)
Business Manager, Borderline & Peterborough LCGs
Kyle Cliff (KC)
Assistant Director Commissioning & Contracts,
Borderline & Peterborough LCGs
Louise Jinks (LJ)
Finance Manager
Simon Pitts (SP)
Programme Manager, Borderline & Peterborough LCGs
Cathy Mitchell (CM)
Local Chief Officer, Borderline & Peterborough LCGs
Margaret Osibowale (MO)
System Finance Lead, Borderline & Peterborough LCGs
In Attendance:
Tina Almond (TA)
Teresa Johnson (TJ)
Sarah Shuttlewood (SS)
for item 1.1,1.2 & 1.3
Chris Gillings (CG)
for item 1.1 & 1.2
Borderline Administration Support Officer
Peterborough Administration Support Officer
Acting Director Performance & Delivery & SIRO
Head of Information Management
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Apologies for Borderline LCG Board:
Dr Richard Withers (RW)
Chair
Dr Andrew Anderson (AA)
Community Services Lead
Belinda Fraser (BF)
Nurse Representative
Dr Oliver Stovin (OS)
Referral Lead
Apologies for Peterborough LCG Board:
Dr Mohsin Laliwala (ML)
GP Lead Peterborough LCG
Andy Slater (AS)
Practice Manager Representative
ACTION
1.
Agenda Item 1 - Joint Meeting:
Borderline and Peterborough LCG Business
The Chair recommended that a separate joint action log is created for this
section of the meeting.
1.1
•
Urgent Care and winter pressures - MIIU
Sarah Shuttlewood, Acting Director of Performance and Delivery attended
to feedback to the Board the progress of the MIIU following the first month
of operation.
SS reported some operational challenges with regard to medical cover and
some minor performance issues which have been resolved. The public
have responded well to using the new service.
Since MIIU commenced there has been evidence of a reduction in minor
injuries attending the A&E.
HM suggested that a message is sent via the gateway to GP practices to
enable all GPs and health professionals to have access to a generic
mailbox to feedback issues or concerns relating to the MIIU. SS agreed
this would be of benefit and suggested utilising the contracts email
address.
It was noted by 2 GPs present that the quality of patient information
recorded back to the GP was not very detailed. CM was aware of a few
issues that have been raised and has been in contact with Simon Temple,
the Lead of the MIIU.
HM, Urgent Care Clinical Lead will be meeting with the providers of the
MIIU service in the near future to discuss progress and issues.
Healthwatch representative, GM raised point that as the facility had taken
over from the previous walk-in-centre based at the same location at the
CCC the change of closing time had not been made clear to all in the
advertising.
LCG Boards requested refreshed communications to the
public to clearly indicate the service is 8am – 8pm. Action: Sarah SS
Shuttlewood.
GH raised the following:
• include CCG logo on the MIIU branding
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• Interpretation of the “45 minutes to be seen” message, patients are
being delayed. Patients expect to be seen and treated in 45 minutes.
• lack of clinical leadership of the MIIU staff.
• suggest MIIU staff are given access to out of Hours (OOH) GP
contact details.
Patient representatives raised that the local bus service no longer stopped
close to the entrance. The nearest bus stop was on Thorpe Road. The
Patient reps asked if there any plans to review bus route to stop closer to
the MIIU.
HM commented a higher calibre of medical input was required. SS to feed
comments through and confirmed there was a need to look at how best to
maximise medical cover in each service during the 12 hours of operation
and streamline OOH support.
CM informed the Board that she had suggested to staff at LCHS a better
interface between OOH and the MIIU was required.
Actions:
1. SS to check with communications Team/patient engagement team
for any issues raised with regard to public transport to the MIIU.
2. Refreshed communications to the Public to clearly indicate the
opening times of the MIIU as 8am – 8pm.
3. CM and KC agreed to take forward actions for the MIIU
1.2
Information Governance Update
Sarah Shuttlewood and Chris Gillings attended for this item.
SS outlined from the accompanying paper the following:
The CCG is required to meet the national standards around information
governance as set out in the Information Governance Toolkit (IGT). The
IGT is a framework covering Information Governance Management, Data
Protection and Confidentiality, IT Security, Secondary User Service,
Clinical Information and Corporate Information.
The Board were reminded that LCGs need to engage IG/IM&T at project
idea stage so any issues can be built into the project timeline and potential
barriers to implementation can be worked through as early as possible. All
of these initiatives have a great deal in common in respect of data
handling. They are all multidisciplinary in function, and require a reliable
central data resource as a key component of their operation. The IG team
need to ensure they provide responsive feedback on issues that need
addressing to support project implementation.
Education and training is being planned for all LCG project and support
managers and will take priority for the IG Team from the beginning of
November.
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SS
SS
KC/CM
The Borderline and Peterborough LCG Boards were asked to note the
Information Governance update and comment on any issues that were
outstanding as concern had been expressed by Peterborough and
Borderline LCGs that timescales were being significantly affected, and as a
consequence, the chance of the CCG achieving QIPP savings and Living
within our Means (LWOM) projects were being compromised.
SS advised that weekly task and finish group discussions regarding IG
have been set up to resolve IG issues for LCGs.
Comments and questions from the Board:
Regarding the current IG delays and issues (ie Ophthalmology) the Board
asked for assurance that this will be progressed and resolved in a timely
manner. Suggestion for commissioner and providers IG checklist. SS
advised that a process for escalations, inclusions and timeframes was to
be agreed in the form of an SLA between CSU and LCGs.
CM informed the Boards there was an SLA agreement meeting next week.
CM to raise issue at that SLA agreement meeting.
CM
SS agreed to write to the Board to outline process and revisit the Board at
the December meeting.
SS
Future Privacy Impact Assessment (PIA) will need to be clear on
• How to manage any complications
• How financial risk will be managed
• How to mitigate risks
Actions:
1. SS to develop SLA style agreement between CSU and LCGs.
2. SS to attend Joint Board session December 2013.
3. LCGs asked for resolution on the Evolutia (Ophthalmology) issue
within the next week. SS to feedback to the Board by 8th
November.
1.3
SS
TA/TJ
SS
Review LWOM Plans
Notification of letter received from Dr N Modha - Further issues relating to
LWOM. MC outlined as follows:
Area Team have made recommendation for turnaround officer to be
appointed to the CCG. LCGs are asked for their thoughts and feedback
on the recommendation. CCG current financial position is £8.6m deficit.
The Chair, MC, suggested a joint LCG wide approach across the whole
CCG would offer a smoother approach. Borderline and Peterborough LCGs
agreed that further individual Board debate was required.
It was commented that the detail and figures shared via the email from Dr
Modha may not be the most accurate information.
The letter from Dr Modha has a directive for the LCG leaders to lead.
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ALL
CM asked for clarification from SS and Dr Modha regarding the LWOM
action plans that have been developed for each of the LCGs. Have these
now been replaced by the more recent detail requested via Dr Modha’s
email? CM advised that the Boards were previously kept aware of
information via the action plans. SS to respond.
SS also advised that Rob Murphy will be collating the responses on behalf
of the CCG.
The work on the medium term financial plan will review the top quartile
performance and activity for Borderline and Peterborough LCGs.
GH asked for clarification on the future of the decision making regarding
funding streams for the LES and the PDMA. Clear messages will need to
be given to the GP Practices.
SS responded advising that all financial work streams will be under review
by the Turnaround Director.
HM asked to formally note that both LCGs were working hard to reduce
referrals with already limited resources. The GP Practices in Borderline &
Peterborough need to be encouraged to continue strong engagement and
maintain investment in primary care.
MO advised that Borderline & Peterborough LCGs were over-performing
on referrals by 511.
Debate followed;
•
•
•
•
regarding the accuracy of the data
the demands by the Area Team and how the Boards can assure the
Area Team that work is in progress and need to find ways to
evidence this.
engagement is the best way forward. The LCGs should not use old
PCT solutions to address the new GP Commissioning world.
dispute between the LCG Boards regarding the disjointed
approach.
GH and CN voiced that future GP commissioning management needs to
see the bigger picture. They felt strongly that it was not the role of the LCG
to manage the deficit.
MC suggested that the Borderline & Peterborough LCGs manage and
review the top 5 groups of the referrals for their LCGs.
SS agreed to forward a summary to the Board after the Governing Body
meeting scheduled on 5th November.
SS
Next meeting CM to bring Recovery Plans for sharing in December.
CM
Actions:
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1. SS agreed to forward a summary to the Board after the Governing
Body meeting scheduled on 5th November.
2. CM to bring Recovery Plans for sharing to 6th December meeting.
SS
CM
3. LCGs are asked for their thoughts and feedback on the
recommendation for Turnaround Officer.
1.4
ALL
Refreshed Business Plan – Alan Sadler
AS gave a brief overview of the refreshed Joint Business Plan asking the
Board for their comments on the content and format.
The finance section showed the current position but future document will
show Financial Plans for the next 3 years. MO suggested she may be
able to work into the document the assumptions of the Medium Term
Finance Plan.
Working in parallel with the business plan AS has developed an action plan
which will record LCG priorities. AS asked for comments on the priorities
and the measurable of the action plan. The Borderline & Peterborough
LCG Board to review the document that was circulated 31/10/13.
Comments back to AS by 08/11/13
CM added that previously the LCGs had been tasked with evidencing the
one year plan. The CCG had requested the refreshed Business Plan be
extended to include activity planning until end of financial year 2017. The
Boards were reminded that clinical input will be required.
The CCG have requested final draft of the Business Plan by end of
November 2013.
AS suggested Task and Finish Group to include Borderline & Peterborough
representation to review the final draft before submission to the CCG.
Item 1.8 – Medium Term Finance Plan followed this item.
1.5
Section 75 Update
CM advised that this item was outlined in the Joint Commissioning Forum
held earlier this morning.
Borderline & Peterborough Boards were invited to make comment on the
draft Section 75 document within a timeframe.
The Joint Commissioning Forum nominated Dr Bishop to review the final
document prior to submission to the CCG by 18 November 2013.
1.6
Early Supported Discharge Outcomes
This item was discussed at the Joint Commissioning Forum earlier in the
day. The Board members were made aware of suggestion for the
organisation to make investment with the Stroke Association to commission
service of rehabilitation for people post-stroke. CM advised further update
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ALL
would be available next month.
1.7
QP Initiatives Update
Simon Pitts, Programme Manager will be developing short 1 page briefings
around each project which will outline the criteria for pathways. The detail
will be available by 8th November 2013.
1.8
Standing joint Item: Medium Term Finance Plan (M Osibowale)
MO made reference to the monthly report. The CCG had published the
first draft of the Medium Term Finance Plan for 2013/14 to 2016/17.
A timeline had been set by the CCG for taking forward the updating of the
MTFP which will become the CCG’s MTFP and Financial Delivery plan.
The timeline is set out in Appendix 2 of the report.
Local Timeline
• review the B&P LCGs allocation of the proposed savings split by the
ten change programmes
• validate and review the original source data used in collating the MTFP
and confirming the savings opportunities.
• undertake further diagnostic work for potential new schemes that will
deliver savings.
• monthly progress updates to the Joint Board
The MTFP includes a review of each LCG to identify top three areas for
potential savings. For future reporting MO will include the top quartile
information for reference. MO added that further work was required on the
figures used in reporting. The data requires putting into context and needs
narrative for the Board.
MC added that there was pressure from the Area Team for all LCGs to
focus on the MTFP and a need for all to focus more on reducing referrals.
The Boards want to reflect to the Area Team the reasons why the referrals
are high.
GH confirmed the Boards need accurate information and inclusion from the
relevant expert to ensure the CCG and Area Team get a true reflection and
assurance from the LCG Boards.
CM reiterated on behalf of the CCG that the MTFP work is a priority for the
Borderline & Peterborough LCG Boards and all members need to be
involved with reviewing the information. MO and OS will be working on the
detail.
1.9
CQUINS
KC advised the Board that discussion was in progress regarding CQUIN for
2014/15.
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Proposed schemes to be checked and agreed by the LCG Boards. KC
asked the LCG Boards to review proposed list to see if there was anything
on the list that should not be and whether there was anything missing.
LCG Boards to feed back comments to KC.
KC confirmed the final document will be circulated once it had been
reviewed.
Query to include
Frail elderly ambulatory pathways/hot clinics. The LCG Boards suggested
hot clinics would be acceptable but not specifically for frail elderly.
NS suggested adding a column to indicate the benefits to the health
economy and to the LCG.
KC assured the LCG Boards that this is taken into account but is not part of
the final document.
1.10 Standing Joint Item:
Steering Group
Feedback from the Peterborough Region
CM fed back from information shared on email via Andy Vowles.
• focus will be on individual projects.
• need to revisit the ToR to focus on PSHFT Savings Plan and
procurements.
CM and the Board Chairs to review the terms of reference for the PRSG.
There being no further business, the Joint LCG meeting closed at
3.35 pm.
Contact Details:
Borderline LCG
Name: Tina Almond
Email: [email protected]
Telephone: 01733 704452
Peterborough LCG
Name: Teresa Johnson
Email: [email protected]
Telephone: 01733 758518
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CM/MC/
RW