CKWCB-12-198c Wakefield CCE Public Minutes 24 ... - NHS Kirklees

NHS Wakefield Clinical Commissioning Group
CLINICAL COMMISSIONING EXECUTIVE
Minutes of the meeting held on 24 July 2012
Boardroom, White Rose House
Present Dr Phil Earnshaw Chair, Wakefield Alliance
Dr Adam Sheppard GP, Lupset Health Centre
Dr Clive Harries GP, Chapelthorpe Surgery
Dr David Brown GP, Kings Medical Centre
Dr Avijit Biswas GP, Pinfold Surgery
Dr Ann Carroll GP, Outwood Park Medical Centre
Stephen Bryan Practice Manager, Stuart Road
Surgery
Elaine McHale Wakefield Council
Jan Power
LINks Representative
Jo Webster
Shadow Accountable Officer NHS
Wakefield Clinical Commissioning
Group (CCG)
Jim Hayburn
Chief Financial Officer, NHS Wakefield
CCG
Sandra Cheseldine Non Executive Director
In Attendance Adam Bassett Corporate Risk Manager, NHS
Wakefield District (NHSWD)
Katie Lister
Communications Officer, NHSWD
Ruth Unwin
Director of Development, Mid
Yorkshire Hospitals NHS Trust
(Minute 12/148 only)
Michelle Ezro
Assistant Chief Executive Mid
Yorkshire Hospitals NHS Trust
(Minute 12/148 only)
Matt England
Head of Contracting and Commercial
Strategy, NHS Wakefield CCG
Laura Elliott
Head of Quality and Engagement,
NHS Wakefield CCG
(Minute 12/151 and 12/154)
Lee Beresford Head of Strategy and Strategic
Planning, NHS Wakefield Clinical
Commissioning Group
Danny Alba
Senior Commissioning Manager,
NHSWD
(Minute 12/150 only)
Julie Owen
Older Peoples Programme Manager,
NHSWD
(Minute 12/153 only)
Joanne Fitzpatrick Head of Medicines Management
(Minute 12/153 only)
Jo Hanlon
Head of Public Health (Long Term
Conditions)

Julie Thorpe
Ruth Twiggins
Jez Mitchell
(Minute 12/154 only)
Senior Commissioning Manager
Head of Public Health (Vulnerable
Adults), NHSWD
(Minute 12/156 only)
Substance Misuse Development
Worker, NHSWD
(Minute 12/158 only)
12/138 Apologies
Apologies were received from Dr Hanney, Dr Dewhirst, Dr Andrew Furber,
Rhod Mitchell, Sam Pratheepan and Sandra Greenwood.
12/139 Declarations of Interest
Dr Earnshaw reminded members of the requirement to declare any
interests which related to any items on the agenda. This could either be
undertaken at this point or when the matter was considered on the agenda.
All GPs present at the meeting declared an interest in the item ‘Tackling
Health Inequalities in Wakefield via Primary Care’ (12/154). It was agreed
that during consideration of this matter Sandra Cheseldine would undertake
the role of Chair.
12/140 Chair’s Update
Dr Earnshaw highlighted that Jo Webster had been appointed as Chief
Officer Designate of NHS Wakefield Clinical Commissioning Group (CCG)
and he offered his congratulations to her on behalf of the NHS Wakefield
CCG Board.
Dr Earnshaw noted that as part of the preparation for the Clinical
Commissioning Executive to meet as a statutory board, a private session
would be introduced at the end of the meeting.
Dr Earnshaw also noted that due to the issues of quoracy at the last
meeting he would be grateful if members who were unable to attend
meetings notified either Jo Webster or himself at the earliest opportunity.
12/141 Minutes of the meeting of the NHS Wakefield Clinical Commissioning
Executive Meeting held on 28 June 2012
It was RESOLVED that
i) The minutes of the meeting of the NHS Wakefield Clinical
Commissioning Executive Meeting held on 28 June 2012 were
agreed as a correct record but be amended to record that the
meeting had taken place King’s Medical Centre, Normanton.
12/142 Addendum to the minutes of the meeting of the Wakefield Alliance
Clinical Commissioning Executive Meeting held on 27 March 2012

Sandra Cheseldine advised that the Pest Control Policy had been
recommended for approval subject to confirmation that this was required.
This policy had then been reconsidered at the Audit and Governance
Group meeting on 12 April 2012.
It was RESOLVED that
i) The addendum to the minutes of the meeting of the Wakefield
Alliance Clinical Commissioning Executive Meeting held on 27
March 2012 were agreed as a correct record with one
amendment:
The pest control policy be approved subject to confirmation that
this was required.
12/143 Addendum to the minutes of the meeting of the Wakefield Alliance
Clinical Commissioning Executive Meeting held on 22 May 2012
It was noted that following confirmation that it was required, the pest control
policy had been recommended for approval to the Clinical Commissioning
Executive meeting on 22 May 2012 by the Audit and Governance Group on
12 April 2012.
It was RESOLVED that
i) The addendum to the minutes of the meeting of the Wakefield
Alliance Clinical Commissioning Executive Meeting held on 22
May 2012 were agreed as a correct record.
12/144 Matters Arising from the Minutes of the Meeting of the Wakefield
Alliance Clinical Commissioning Executive held on 28 June 2012
Adam Bassett updated the Clinical Commissioning Executive (CCE) on
progress of the actions discussed at the meeting on 28 June 2012.
The following items were also discussed:
12/125 Hospital Standardised Mortality Ratio (HSMR)
Adam Bassett provided an update from Laura Elliott which advised that:
The current HSMR has been reported by MYHT as 100 (April 2011 -
February 2012). It is estimated to rise following the 2011/12 national
rebasing which is likely to flag the Mid Yorkshire Hospitals NHS Trust
(MYHT) as an outlier. A progress report will now be presented to the
MYHT Executive Contract Board on 26 July.
12/126 Preparing for Authorisation: Letter of Support for the Chair
It was noted that all but one member of the Clinical Commissioning
Executive (CCE) had had the opportunity to confirm the decision made at
the last meeting of the CCE to support for the Letter of Support for the
Chair.

It was RESOLVED that
i) It was noted that the letter of Support for the Chair had been confirmed
as supported by the Clinical Commissioning Executive.
12/145 Shadow Accountable Officer Update
Jo Webster introduced this report noting the following:
a) Policy and Guidance Update Code of Conduct
The Clinical Commissioning Executive (CCE) was advised that the Code of
Conduct: Managing Potential Conflicts of Interest where GP practices are
potential providers of clinical commissioning group (CCG)-commissioned
services had recently been published. Its stated aim was to protect the
integrity of the NHS commissioning system and protect CCGs and GP
practices from any perceptions of wrong doing. It was noted that members
of the Practice Support Unit would be reviewing the implications of the
Code of Conduct and will at the same time be discussing the implications
with the Local Medical Committee and all relevant changes would be
incorporated into the new NHS Wakefield CCG Constitution.
It was further highlighted that services would be commissioned using the
NHS standard contract rather than the GP contract. Subject to transitional
arrangements (to be confirmed) the resources currently associated with
local enhanced services (with the exception of public health services) would
form part of CCGs baseline allocations so that they could determine how
best to use these resources. From 1 April 2013 the CCG would no longer
use enhanced services as a contracting method for new services.
b) Policy and Guidance Update: NHS Clinical Commissioning Group
Regulations.
Jo Webster advised that the NHS (Clinical Commissioning Group)
Regulations had been published at the end of June by the Department of
Health and had been presented to Parliament for approval.
c) NHS Care Objectives
It was highlighted that Our NHS Care Objectives: a draft mandate to the
NHS Commissioning Board had been published for consultation on 3 July
2012. The mandate would be at the heart of the accountability relationship
between the Board and the Department of Health. The mandate set out 22
objectives for the NHS Commissioning Board which were outlined within
the report. CCE members were asked to note that the Quality sub group
would address this emerging challenge.
d) Policy and Guidance Update: Functions of CCGs
During June 2012: Functions of Clinical Commissioning Groups had been
published which was an update to Functions of GP Commissioning
Consortia: A Working Document. The document outlined the services
which CCGs would be responsible for commissioning.

It was noted that health visiting was not included in the list of functions for
CCGs to commission. It was therefore highlighted that there was an
expectation that the CCG would work closely with both the Local Authority
and the emerging West Yorkshire Local Area Team of the NHS
Commissioning Board around the future management of local health
visiting services.
e) Policy and Guidance Update: Securing Excellence
The CCE was advised that on 22 June 2012 the NHS Commissioning
Board had published the single operating model for the commissioning of
primary care services within the NHS.
f) Authorisation
Jo Webster reported that NHS Wakefield CCG’s application was
successfully submitted on 2 July 2012 as planned. A communication had
been received from the NHS Commissioning Board on 6 July confirming
the application and indicating the intended issues of a high level
assessment of compliance by 17 July 2012. It was expected that a
finalised response to the application would be issued at the end of July.
g) Introduction of Operational Divisions at the Mid Yorkshire
Hospitals NHS Trust (MYHT)
Jo Webster explained that from the beginning of July MYHT would be
introducing new management arrangements for its clinical services to
support the integration of acute and community services. The previous
four clinical service groups would change to three divisions. The
arrangements for this were outlined within the report.
h) Winterbourne Review
The CCE was informed that the Department of Health had published an
interim report as part of a review of events at Winterbourne View Hospital
and the wider investigation into the way health and social care supported
people with learning difficulties. The report did not cover directly what
occurred at Winterbourne View Hospital but detailed how the Department of
Health and the NHS Commissioning Board would monitor progress;
created the framework in which local action would take place; proposed
actions and ensured that providers, commissioners and the workforce were
clear on their roles and responsibilities and understood good models of
care.
The report outlined the initial findings and the key objectives which had
been identified. The final report would be published once criminal
proceedings had concluded.
It was RESOLVED that
i) the report be noted.

12/146 Finance Report
Jim Hayburn introduced a report which presented the financial position of
NHS Wakefield Clinical Commissioning Group for June 2012 and the
forecast year end position based on this position.
It was highlighted that NHS Wakefield Clinical Commissioning Group was
on target to achieve each of its key financial performance indicators. The
report advised that at the end of June NHS Wakefield Clinical
Commissioning Group (CCG) had generated a surplus of £1,073K which
was made up of a planned surplus of £774k and an underspend on
revenue budgets of £299k.
Appendix 4 to the report outlined the 2012/13 capital planning position. It
was reported that allocations had been received this month totalling
£1,850k. Appendix 6 to the report outlined the financial position at month 3
on those budgets in relation to commissioned services which would be
devolved to the NHS Wakefield Clinical Commissioning Group.
It was RESOLVED that
i) the revenue and capital financial positions at the end of June be
noted;
12/147 Performance Report
Matt England introduced a report which informed the Clinical
Commissioning Executive (CCE) of performance against the 2012/13 NHS
Operating Framework outcome measures together with other identified
national and local priorities.
The appendix to the report outlined a summary position of key performance
indicators for both NHS Wakefield Clinical Commissioning Group (CCG)
and the Mid Yorkshire Hospitals NHS Trust (MYHT).
The CCE gave detailed consideration to the following performance issues
and considered the actions which were being taken to address areas of
under and over performance:
• Eliminating mixed sex accommodation
• Ambulance response times
• A&E four hour wait
• 62 day cancer waits
• Transient Ischaemic Attack (TIA)
• Referral to Treatment Time
With regard to TIA, the CCE noted that MYHT had now implemented seven
day consultant clinics and had recognised the need to ensure that they can
measure the expected improvement. It was highlighted that data was
normally available on a quarterly basis but from May 2012, MYHT had
commenced monthly reporting to ensure that the service is monitored
efficiently. It was anticipated that the improvement should be seen

immediately, however the invalidated monthly position is 26.3% against a
target of 60%, It was further noted that NHS Wakefield CCG will be seeking
assurances that this would improve through the Executive Contract Board.
It was RESOLVED that
i) the NHS Wakefield Clinical Commissioning Group performance
against key national and local priority measures for 2012/13 be
noted;
ii)
the additional actions outlined within the report required to
address areas of under performance be agreed.
12/148 Mid Yorkshire Service Strategy
Ruth Unwin and Michelle Ezro attended the meeting and updated the
Clinical Commissioning Executive on the Mid Yorkshire Hospitals NHS
Trust (MYHT) Clinical Services Strategy Option Appraisal Process. They
also provided details of a report which outlined an appraisal of shortlisted
options and a summary of results from an non financial workshop held on
10 July 2012.
The presentation covered the following areas
• The option appraisal process
• Non financial appraisal process
• Criteria
• What the clinical strategy consisted of
• Integrated care
• The two options
• Existing services at each site
• Opportunities for in year changes
• What each site would look like under each option
• Outcome of the option appraisal process so far
• Next steps
The CCE was advised that 44 people had attended an option appraisal
workshop and the emerging view of consensus was for option 2. Dr Carroll
noted that she had been NHS Wakefield CCG’s representative in this
process and that she confirmed that option 2 was emerging as the
preferred option.
Ruth Unwin advised that the preferred option would be derived from a
quality score, financial appraisal and risk analysis. The outline business
case would be available at the end of September and the MYHT,
Calderdale, Kirklees and Wakefield District Cluster and the Clinical
Commissioning Group Boards would be asked to consider this in October.
Formal consultation would take place from January 2013 in parallel to the
production of the full business case.

Dr Earnshaw provided his thanks on behalf of the Clinical Commissioning
Executive to Ruth Unwin and Michelle Ezro for the presentation and for
attending the meeting.
It was RESOLVED that
i) the presentation be noted.
12/149 Optimizing Pontefract Hospital: Engagement Process
Matt England introduced a report which provided the Clinical
Commissioning Executive (CCE) with the Mid Yorkshire Hospitals NHS
Trust’s (MYHT) report ‘Optimization of Pontefract Hospital’ and set out the
process for engagement on the proposed changes and the involvement of
the Overview and Scrutiny Committee (OSC).
The report advised that the Pontefract Optimization Project at MYHT had
undertaken an assessment of the utilisation of the new hospital estate at
Pontefract Hospital (PH). This review had identified that PH was
underutilising clinic and theatre capacity and as a result had produced the
document ‘Optimization of Pontefract Hospital’ which was attached as
appendix 1 to the report. This report recommended service configurations
to increase the utilisation of the hospital.
An engagement process was in place and was outlined in appendix 2 of the
report. This commenced on 13 July 2012 and would run for four weeks. It
was agreed that the outcome of this would be brought to the next meeting
of the CCE in August.
It was RESOLVED that
i) the process be approved;
ii)
iii)
the planned optimization programme be supported;
The outcome of the engagement process be brought the August
meeting of the Clinical Commissioning Executive.
12/150 Stanley Health Centre Capital Bid
Danny Alba introduced a report which advised that following approval by
the Clinical Commissioning Executive (CCE) in November 2011 additional
work had been undertaken on an outline business case which was attached
as appendix A to the report. The CCE was asked to confirm their approval
to reflect the update on revenue costs (attached at appendix B) and
completion of the outline business case (OBC) and to make a
recommendation that the NHS Calderdale, Kirklees and Wakefield District
Board approves its submission to NHS North of England (NHSNE) capital
finance.
The CCE was advised that the initial business case did not include revenue
consideration in terms of depreciation and capital charges that would be
charged to revenue over the life of the asset, the value of the asset being

written off and impairment costs. Confirmation had also been requested
that the providers would occupy the new accommodation and pay rent
accordingly to operate services from the premises.
It was noted that details of the revenue considerations had been
considered by the Finance and Performance Group on 14 June 2012.
The full financial implications were established within the report. It was
highlighted that this was a publically funded business case submission to
NHSNE Capital Finance with a value of £1,000,000. The recurrent revenue
consequences were £26k per annum and there was a one off revenue
charge in the first year of £508k.
The CCE considered the key risks to delivery of the project which were
outlined within the report. It was noted that these would need to considered
further as the project developed.
Jo Webster requested that the proposals contained within the report were
supported by the Clinical Commissioning Executive (CCE).
It was RESOLVED that
i) approval of the outline business case for a capital bid for the
refurbishment and development of Stanley Health Centre be
confirmed to reflect the update on revenue costs and completion
of the outline business case;
ii)
iii)
It be recommended to the Board of NHS Calderdale, Kirklees
and Wakefield District to approve the outline business case for
submission to NHS North of England Capital Finance;
It be noted that the risks and issues outlined within the report
will require further consideration as the scheme progressed.
12/151 Transition: Quality Handover
Laura Elliott introduced a report which shared the NHS Calderdale, Kirklees
and Wakefield District Board’s plan to develop quality handover documents
in line with the National Quality Board (NQB) guide ‘HOW TO: Maintain
Quality during the Transition: Preparing for Handover’. This was attached
to the report.
The Clinical Commissioning Executive (CCE) was advised that a Quality
and Safety Summary had been produced on a quarterly basis since June
2011, as a legacy document. This was shared with the SHA, the Quality
Group and was available on the intranet. The Wakefield interpretation of
these documents reflected the Quality and Patient Safety reports which
were presented to the CCE every other month.
It was highlighted that the national document stated that Chief Executive
Officers of receiving organisations should nominate a transition lead
responsible for the receipt of functions. The Medical and Nursing Directors,
or equivalent, should share responsibility for receiving the quality handover

document and the document should be taken to the final board meeting of
the sending organisation and the first public board meeting of the receiving
organisation in April 2013.
Following discussion it was agreed that work would take place before the
next meeting of the CCE to identify NHS Wakefield Clinical Commissioning
Group’s transition Lead. This would then be considered further at the CCE
meeting in August. It was agreed that whoever was the lead for this
process would undertake a formal handover back to the Board of NHS
Wakefield Clinical Commissioning Group.
It was RESOLVED that
i) the contents of the report and plans for the handover for
information be noted;
ii)
iii)
iv)
the transition lead for NHS Wakefield Clinical Commissioning
Group (CCG) be considered at the August meeting of the
Clinical Commissioning Executive;
it be agreed that the quarterly Quality and Safety Legacy
document continued to be discussed within the CCGs evolving
governance structure;
the formal and informal handover arrangements with the cluster
Nurse / Medical Director be noted;
v) the quality handover document be added to the agenda for the
CCG Board meeting in April 2013.
12/152 Transition: Contracts Transition
Matt England introduced a report which updated the Clinical
Commissioning Executive (CCE) on progress in relation to the contract
transition process from the PCT to future commissioners. The report also
outlined the key issues and next steps for the contract transition process.
The report advised that the Department of Health had set out arrangements
to ensure that contracts with providers were safely transferred from PCTs
to the various organisations responsible for commissioning services in the
future. The process involved three stages; ‘stock take’, ‘stabilise’ and
‘shift’.
The CCE was advised that the stock take element had now been
completed and the project was now in the stabilisation phase which
required all currently commissioned services to be stabilised onto a
standard contract to expire in March 2013 or the be decommissioned
following a full impact assessment. As part of this process a Contract
Transition Plan had been created.
The report outlined key issues which were emerging through the
stabilisation process and provided details of the next steps in the Contract
Transition Plan.

It was RESOLVED that
i) the progress and key risks be noted.
12/153 Enhanced Support to Care Homes
Julie Owen and Joanne Fitzpatrick introduced a report which outlined a
business case and related service specification for the proposed pilot of the
Care Home Liaison and Support Service. It was highlighted that the
business case was related to proposals developed in response to the
additional resources which were made available to clinical commissioning
groups in January 2012 to improve local services and reduce pressures on
the NHS.
The business case and service specification were attached to the report.
The report advised that the development of the service would be a six
month pilot with a review of a number of outcome measures. As a pilot with
a limited capacity it had been agreed at the Joint Strategic Commissioning
Board meeting on 15 June 2012 it was concluded that the preferred
approach would be to focus on care homes within a specific geographical
area with future consideration to support Extra Care Housing facilities as
determined by the phased implementation of the service.
The report also highlighted the main risks associated with the failure to
implement the Care Home Support and Liaison Service.
The report outlined the financial implications of this scheme and highlighted
that total staffing costs would be £70,285.
The CCE considered the proposal for the pilot to focus upon a specific
geographical area. It was agreed that this should be the case and the
geographical area should be around those care homes identified in red in
appendix 1 of the service specification.
Jo Webster requested that the proposals contained within the report were
supported by the Clinical Commissioning Executive (CCE).
It was RESOLVED that
i) the implementation of the proposed Care Home Liaison and
Support Service be approved;
ii)
the proposal to focus the pilot on those care homes within a
specific geographical area be supported and this be based on
those care homes highlighted in red in appendix 1 of the service
specification.

12/154 Tackling Health Inequalities in Wakefield via Primary Care
All GP members present at the meeting declared an interest in this item. It
was agreed that during consideration of this item Sandra Cheseldine would
undertake the role of Chair.
Jo Hanlon and Laura Elliott introduced a report which advised that following
the introduction of the Personal Medical Services contract in 2010, which
contained a portion of funding to tackle health inequalities, a project team
led by the Public Health Directorate had been established. In addition how
these funds were allocated to practices had been discussed by the Senior
Management Team which had culminated in a model for allocating funds.
The report advised that the health inequalities funding was £500,000 per
annum recurrent. The additional funds required from the management
allowance to fund the General Medical Services practices was £75,894.
The Clinical Commissioning Executive (CCE) was advised that it had been
agreed that the Index of Multiple Deprivation (IMD) 2010 score would be
used to determine which practices received funding. The Wakefield IMD
2010 score was 25.87 and it had been agreed that those practices with a
score higher than the Wakefield value would receive funding which made
22 practices eligible.
The CCE considered the proposals within the report and questions were
raised regarding the use of the IMD 2010 score. It was also noted that
following the abolition of PCTs the responsibility for this scheme would
pass to the NHS Commissioning Board Local Area Team. It was also felt
that prior to any payments for year two of this scheme an evaluation of the
achievements of the first year should be undertaken.
Jo Webster requested that the proposals contained within the report were
supported by the CCE.
Following a vote to which GP members abstained the proposals were
agreed. There were no votes against the proposal.
It was RESOLVED that
i) the project and the proposed approach to allocating the funding
be supported;
ii)
iii)
the use of the Management Allowance as described within the
report be approved;
An evaluation the achievements of the first year of the scheme
be undertaken prior to the payment of any further monies.
12/155 Dermatology Contract
Julie Thorpe introduced a report which advised that a formal tender process
had been undertaken for the provision of the Community Dermatology

Services across the Wakefield district. This had followed NHS Wakefield
District policy and the appropriate Tender regulations.
The Clinical Commissioning Executive was advised that the tender
evaluation panel had put forward recommendations to award contracts to
the three specified geographical lots within the tender and the
recommendation was to award all three lots to the same bidder based upon
the outcome of the Award system scores.
The total for the three year contract was £4,063,437 which reflected a 30%
cost below tariff.
Clinical Commissioning Executive members highlighted that they did not
feel they were in a position to approve this tender as the report did not
contain sufficient information. It was therefore agreed that an updated
report would be brought back to the next meeting in August.
It was RESOLVED that
i) a more detailed report be brought to the August meeting of the
Clinical Commissioning Executive.
12/156 Draft Health and Wellbeing Strategy
Ruth Twiggins introduced a report which presented the draft Health and
Wellbeing Strategy. She advised that the strategy had been developed
based on the six key health and wellbeing priorities which had been
identified within the Joint Strategic Needs Assessment.
The Clinical Commissioning Executive (CCE) was advised that an
engagement plan had been developed to ensure that key stakeholders
were involved in the development of the strategy. This report was therefore
presented to the CCE to allow members to have the opportunity to
contribute to and comment on the early draft of the strategy.
Jo Webster noted that the Health and Wellbeing Board would develop the
strategy and the role of NHS Wakefield Clinical Commissioning Group
would be to examine the priorities and to ensure that they linked with what
it commissioned.
It was noted that CCE members were invited to comments on the strategy
and feed back any comments by 9 August 2012.
It was RESOLVED that
i) the outcomes and objectives within the strategy be supported;
ii)
Clinical Commissioning Executive members to support the
development of the strategy by providing any comments by the
end of Thursday 9 August.

12/157 QIPP Report
Lee Beresford introduced a report which had the purpose of providing
assurance to the Clinical Commissioning Executive (CCE) regarding
progress on the implementation of the NHS Wakefield Clinical
Commissioning Group’s (CCG) QIPP Programme.
The report advised that the total target savings for 2012/13 QIPP was
£12.567M made up of £11.023M, plus the running cost target of £1.459M
and a Specialised Commissioning Group QIPP of £85K. It was noted that
QIPP ‘tracker’ system had been developed which was overseen by the
Finance and Performance Group.
The CCE was advised that a month 2 flex QIPP data showed that QIPP
schemes were not performing to the levels anticipated. This was mainly in
the areas of A&E attendances and emergency admissions which were
higher than planned levels. It was noted that within the Finance report a nil
value of QIPP had been recorded to date with an estimated forecast of
break even, which was due to the fixed contract value with the Mid
Yorkshire Hospitals NHS Trust. There was a however a financial risk
around this is QIPP continued to under perform.
Jo Webster advised that a detailed analysis if the Primary Care
Transformation Scheme would be brought to the August CCE meeting.
It was RESOLVED that
i) the content of the report be noted.
12/158 Alcohol Liaison Service
Jez Mitchell introduced a report provided an update on the Alcohol Liaison
Service.
The Clinical Commissioning Executive (CCE) was advised that the service
will be based within the Gastroenterology Department at the Mid Yorkshire
Hospitals NHS Trust. Through patient detection, assessment and specialist
liaison it was anticipated that the service would prevent alcohol hospital
admissions, re-admissions and the length of stay for the those who were
admitted. Based on the potential savings assumed, cash savings would
ensure the Alcohol Liaison Service could become self sufficient in year four.
It was noted that the Prevention Clinical Commissioning Unit had approved
the service specification in June 2012 and requested that the paper be
submitted to the CCE.
Dr Brown noted that the specification outlined that that the service would
operate on a Monday to Friday working hours basis. It was agreed by the
CCE that this could severely detract on the success of this service and it
was agreed that this matter would be clarified. Elaine McHale also noted
that the service was intended for adults but highlighted the issue of alcohol
misuse amongst 16-18 year olds which she advised needed to be
addressed.

It was RESOLVED that
i) the report be noted.
12/159 What Makes a Good Practice
Jan Power introduced a report which provided members with a summary of
the recommendations made by Wakefield Local Improvement Network
(LINk) following their survey and visits to GP practices last year. The report
advised that through the work of LINk and its engagement with the public a
number of concerns had been raised about aspects of services received at
local GP practices and the LINk had decided that further work needed to be
undertaken.
In 2010 the LINk Task Group surveyed all GP practices in the district with a
50% response rate. The Task Group also decided to visit a number of
practices. Following this the LINk felt that some practices offered the very
best of services but also that some were not so good and made a number
of recommendations relating to the following:
• Well person checks
• Test results
• Access issues
• Patient panels
• Appointments
• Confidentiality
• Criminal Records Bureau checks
Overall the LINk team felt that on the whole practice staff worked very hard,
with increasing patient lists, trying to develop services locally to increase
choice and efficiency and dealing well with the changing landscape of
health.
On behalf of the Clinical Commissioning Executive Dr Earnshaw thanked
Jan Power for the work which she and the LINk had undertaken in this area
and for her report.
It was RESOLVED that
i) the good practice and recommendations from the What Makes a
Good Practice report published by Wakefield LINk for
information be noted.
12/160 Individual Funding Request Report
Jo Webster introduced a report which presented the Annual Report on
Individual Funding Requests (IFR) for 2012
The Annual Report summarised the work completed during 2011/12 in
relation to IFRs. The report also demonstrated how this process met the
Individual Funding Request Terms of Reference and outlined the volument

of IFRs submitted to NHS Wakefield District during 2011/12 and the
outcome of these requests. The report also highlighted the key issues and
potential risks to the IFR process and identified actions to be undertaken in
2012/13 to mitigate risk and address issues.
It was highlighted that during 2011/12 710 requests had been submitted, a
decrease of 28% on the previous year. 67% were approved at the triage
stage. 79 of the cases received in 2011/212 were considered by an IFR
panel reaching of total of 115 cases overall.
Dr Harries highlighted that he was aware of a number of potential IFRs
relating to adults with Aspergers Syndrome and whether these cases were
included within these figures. Jo Webster advised that she would check
this.
It was RESOLVED that
i) The Annual Report on Individual Funding Requests for 2011/12
be noted;
ii)
The use of the submission form by referring clinicians be
encouraged.
12/161 Minutes of the NHS Calderdale, Kirklees and Wakefield District Cluster
Board meeting held on 12 June 2012
It was RESOLVED that
i) the Minutes of the NHS Calderdale, Kirklees and Wakefield
District Cluster Board meeting held on 12 June 2012 be noted.
12/162 Minutes of the Finance and Performance Group meeting held on 12
July
Jo Webster introduced these minutes and highlighted that the Finance and
Performance Group had asked the Clinical Commissioning Executive to
note the following items:
• consideration of ambulance turnaround times
• a detailed consideration of the QIPP transformation schemes which is to
be undertaken that the next meeting of the Finance and Performance
Group
• a request for the Performance Improvement Manager to undertake a
detailed examination of accident and emergency performance.
It was RESOLVED that
i) the Minutes of the Finance and Performance Group meeting
held on 12 July 2012 be noted.

12/163 Clinical Commissioning Units Update
It was RESOLVED that
i) The Clinical Commissioning Units Update be noted.
12/164 Clinical Commissioning Executive (CCE) decisions for Inclusion in the
Legacy Document
It was agreed that the following items would be included in the Legacy
Document:
• Tackling Health Inequalities in the Wakefield District via Primary Care.
It was RESOLVED that
i) the above item be included in the legacy document.
12/165 Items for referral to the Cluster Board or any of the Sub Groups
It was agreed that the following items be referred to the Board of NHS
Calderdale, Kirklees and Wakefield District:
• Performance regarding Transient Ischaemic Attacks
• Stanley Health Centre Capital Bid
• Tackling Health Inequalities
It was RESOLVED that
i) the above items be referred to the Board of NHS Calderdale,
Kirklees and Wakefield District
12/166 Any Other Business
Improving Dignity and Respect in Care
Dr Brown introduced a report which advised that NHS Wakefield District
had been allocated £10-15,000 to spend on initiatives which improved
dignity and respect in care. It was noted that these monies should be spent
on addressing gaps in services for patients with sensory impairments.
It was recommended that a Task and Finish Group be formed to produce
firm proposals to bring to the August Clinical Commissioning Executive for
sign off.
It was highlighted that the Yorkshire and Humber Local Education and
Training Board (YHLETB) had agreed to allocate £1.3m in non-recurrent
monies of which £50k was allocated to Calderdale, Kirklees and Wakefield
District to allocate to local clinical commissioning groups. The suggested
approach that could be used was outlined in a letter from the YHLETB
which was attached as appendix 1 to the report.

It was RESOLVED that
i) spending the ‘Improving Dignity and Respect in Care’ initiative
money on addressing the service and training issues raised by
the survey on sensory impairment be supported;
ii)
iii)
the development of a Task and Finish Group to firm up
proposals to spend this resource be supported;
final details of this proposal be considered at the August Clinical
Commissioning Executive meeting.
12/167 Date and Time of Next Meeting
1.00 pm on 21 August 2012 at White Rose House.