Leicester, Leicestershire and Rutland PCT Cluster Minutes of ... - NHS

Leicester, Leicestershire and Rutland PCT Cluster
Paper T
LLR PCT Cluster Board Meeting
12 January 2012
Minutes of the Sixth Meeting of the Leicester City Clinical
Commissioning Group Board
held on Tuesday 8 November 2011 at 1.00pm in the Conference Room,
3 rd Floor, St John’s House, 30 East Street, Leicester, LE1 6NB.
PRESENT: Professor A Farooqi Co-Chair (in the Chair)
Dr Avi Prasad
Co-Chair
Dr T Khong
Leicester City Central
Dr R Kapur
Leicester City Central (Locality
Lead)
Dr G Singh
Millennium
Dr D Jawahar
Millennium (Locality Lead)
Dr U Roy
LPCG (Locality Lead)
Dr P Danaher
Leicester Primary Care Group
Dr AJJ Bentley
North East Leicester (Locality
Lead)
Dr Simon Freeman CCG Managing Director
Ms Sue Lock
CCG Operating Officer
Mrs Sharon Robson Associate Director of Quality
Ms Michelle Iliffe Deputy Director of Finance
Dr Peter Rabey
Secondary Care Clinician member
Mr Fayyaz Suleman Lay member
Mr Ivan Browne
Consultant in Public Health
IN ATTENDANCE: Mrs Clare Mair
Mr Richard Morris
Ms Sarah Prema
Mr Hasmukh Jobanputra
Ms Mel Thwaites
Ian Scudamore
Dr Jo McKenna
Mr Jim Bosworth
Executive Assistant Corporate
Governance
Associate Director
Communications and
Engagement
Associate Director Developments
(item 11/146 onwards)
Leicester LINk
Assistant Director of Children and
Families (item 11/148 only)
Consultant Gynaecologist and
Obstetrician (item 11/148)
Senior Contracts and Provider
Performance Manager (Acute)
(item 11/149 only)
Assistant Director, Commissioning
(item 11/150 only)
ITEM DISCUSSION LEAD
LCCCG/11/131 Welcome and Introductions
LCCCG/11/132
Apologies for Absence
Dr Nitin Joshi, North East Leicester and Ms Deb
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Watson, Director of Public Health and Health
Improvement.
LCCCG/11/133
Declarations of Interest on Agenda Topics
GPs declared an interest on items pertaining to GP
practice.
Dr Jawahar made a declaration regarding his practice
now being a paid member of the full provider arm of the
LMC. He has added that to his written declaration.
Professor Farooqi reminded all GPs to make this
declaration as they join the provider arm.
Dr Rabey declared an interest specifically in Paper M,
Redesign of Maternity and Gynaecology Services within
UHL and generally for any secondary care business.
LCCCG/11/134
Notification of Any Other Business
No other items of business were requested.
MINUTES AND REPORTS
LCCCG/11/135 Minutes of Leicester City Clinical Commissioning
Group Board held on 13 September 2011
The minutes of the Leicester City Clinical
Commissioning Group Board held on 13 September
2011 were reviewed and accepted as an accurate
record (Paper A) subject to the following changes;
LCCCG/11/112 – Contract Performance Report
Second paragraph, page 10. Remove the sentence
‘e.g. formal escalation, notice and enforcement’.
LCCCG/11/118 – Extending Choice of Provider AQP
The seven priority services that were considered were;
• MSK
• Adult Hearing Services
• Continence Services
• Community Diagnostic Testing
• Wheelchair services for Children
• Venous leg ulcer and wound healing
• Primary Care Psychological Therapies
LCCCG/11/136 Action notes of Leicester City Clinical
Commissioning Group Board held on 13 September
2011
The action notes were reviewed (Paper B) and the
following noted:
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Matters Arising
LCCCG/11/113 – Finance Report
Dr Roy asked for an update on the transformation bids.
Of the five bids submitted by LCCCG three were
successful in being put forward to the Cluster for bids;
INR equipment, ultrasound and BP monitors. Ms Lock
advised that funding has been identified for INR and as
part of the project it will be agreed how to take that
forward. A transformation bid for the BP monitors has
been submitted.
Actions
11/06 - Secretarial support to the CCG Board
This has been sorted and the action can now be closed.
11/33 – SHACC
Dr Freeman advised a strategic review of sexual health
services is being proposed across LLR and will be
discussed at the CCG.
11/62 – Transformation Bids
Dr Bentley advised the use of agency staffing is still
being explored. He will provide an update next month.
TB
11/76 – Health Checks – Communications Work
Mr Morris reported this work is in progress but to ensure
it is done robustly and ensure the messages are
sustained it will not be ready until January 2012 at the
earliest. There has been particular interest from the
Leicester Mercury Patients Group.
CCG DEVELOPMENT AND GOVERNANCE
LCCCG/11/137 Feedback from Board to Board with PCT Cluster
Professor Azhar Farooqi presented the letter and
scoring matrix received from Catherine Griffiths giving
feedback on the recent Board to Board meeting (Paper
C). It was generally a good report from the Cluster with
regard to most aspects of development.
The Cluster asked for the following areas to be further
developed in time for the January 2012 Board to Board;
• AQR – being discussed on today’s agenda
• Commissioning Support Services – being discussed
on today’s agenda
• Developing Commissioning intentions – being
discussed on today’s agenda
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• Financial return – this will be done over the next
month and brought back to the CCG Board in
Confidential Session. There is opportunity to do
innovative work and look at a 2-3 year timescale for
this.
• Demonstration of performance target improvement.
• Authorisation plan – a paper on corporate
governance on today’s agenda.
• Out of Hours – this is not directly a CCG
responsibility but an important quality issue.
Professor Farooqi will write to the Cluster asking if
there are any quality issues and seeking assurance.
It was RESOLVED
- to receive the letter, scoring matrix and actions
arising from the Board to Board meeting.
- to take the actions forward.
MI
AF
LCCCG/11/138
Mission, Vision and Values for Leicester City CCG
Professor Azhar Farooqi reported that a workshop took
place for the CCG to develop their Mission, Vision and
Values (Paper D). Following that session Mr Morris
took the eight values away and further refined them into
four values with the aim of making them less corporate
and more owned by the CCG.
Mr Suleman asked if the values should include
something on the patient and putting them first. Mr
Morris said that alongside the mission and constitution
there will be a charter and that will come out in that
document.
It was RESOLVED
- to agree to the mission, vision and values.
LCCCG/11/139
Board Membership
Professor Farooqi reported that Dr Peter Rabey has
been appointed to the CCG Board as a secondary care
clinician and will continue in this role until further
guidance.
Mr Hasmukh Jobanputra, Chair of Leicester LINk will be
attending as a non-voting member.
The three lay member roles have been advertised and
will close tomorrow. There has been considerable
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interest. One of the lay member roles will become the
vice chair for the CCG Board. Interviews dates will be
arranged.
It was RESOLVED
- to note the new appointments and lay member
recruitment process.
LCCCG/11/140
A Constitution for Leicester City CCG
Dr Simon Freeman, CCG Managing Director presented
the final version of the Constitution for Leicester City
CCG (Paper E). Consultation has included the LMC
and constituent practices. Feedback was received from
12 practices and numerous individuals. Mr Morris
reported the feedback had been overwhelmingly
positive. However some people had not understood the
sections on leaving or opting out of the CCG and
paragraph 19 about when a member ceases to be a
member. It was agreed clarification is needed on some
of the wording.
The constitution needed to state that the maximum
number of GP board members is ten and the process
for selection, including the chair
The constitution refers to an AGM and that needs to be
planned for January or February 2012 linked to a PLT
session. Mr Morris advised that when the CCG is
formed in statute it would be required to hold an AGM
within six months of the end of the financial year. In the
meantime the meeting would be deemed an ‘extraordinary
AGM’ and will need to be held soon as the
current Board has only been elected for 12 months and
the membership will need to be decided at the AGM.
Mr Browne noted at paragraph 26 that Ms Watson
should be recognised as a joint appointment between
NHS Leicester City and Leicester City Council. This
will be amended.
The membership at Appendix 2 requires amendment.
Mr Suleman felt that paragraph 27 needed to refer to
the process for appointing lay members. Dr Freeman
advised that further guidance is awaited from the DH
but the current process could be included.
Paragraph 6 referred to Council or Members. This
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would be amended to refer to the Member Practices.
There is still some reconciling between the constitution
document and appendices such as the secondary care
clinician and title of nurse director/quality.
Dr Freeman advised the final amendments would be
done and then the constitution sent out to practices for
sign off. The final version will be received at the
January CCG Board.
SF
It was RESOLVED
- to make some further changes before sending to
all member practices fro sign off prior to
presenting to the January CCG Board.
LCGPC/11/141
Path to Authorisation Toolkit
Dr Freeman presented an update on the current
position of the CCG against the authorisation toolkit
(Paper F). The toolkit requires the CCG to self assess
its capability against a range of factors and forms the
basis of the Board to Board meetings with the Cluster
and the authorisation process to become a statutory
body. There are six categories and a range of criterion
within those. An initial score was done some months
ago and revisions done to show where the CCG
believes it is. The scores have been RAG rated to
show if the score is satisfactory or requires
improvement. Dr Kapur, Professor Farooqi, Ms Robson
and Ms Iliffe will be developing the commissioning
strategy and it is hoped to bring this to the development
session in December.
SP
Mr Suleman asked if the DH had issued guidance on
authorisation. Dr Freeman responded that the
authorisation process is not clear but guidance received
to date has been used to develop the plan. A number
of other guidance documents are expected early next
year.
It was RESOLVED
- to note the content of the report and the
assessment of scores.
- to approve further work on the Authorisation Plan
with a full plan to be presented to the December
CCG Board.
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LCCCG/11/142
Corporate Governance Framework
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LLR PCT Cluster Board Meeting
12 January 2012
Ms Sharon Robson, CCG Board Nurse presented a
report setting out the plans to develop corporate
governance within the CCG (Paper G).
The Corporate Governance Cluster lead held a
development session for the CCG Board focussing on
what good governance should look like and the steps
needed to achieve that. The paper set out the sub
committees to be established in shadow form in
readiness to take over Cluster responsibilities as and
when required. Corporate governance processes are a
very important part of the authorisation process. There
are three key drivers; the corporate framework, risk
management strategy and board assurance framework.
A risk register is already in place that reports up to the
Cluster.
There are many documents being issued on
governance but the scheme of delegation has not yet
been received. Ms Robson and Mr Iliffe therefore had
prepared a paper, looking at the gaps and the scheme
of delegation for the Cluster and the governance
requirements of the CCG.
Dr Freeman said the plan allows the transition from no
formal subcommittees of the CCG to the full
committees. The role of lay members and the vice chair
will migrate and the vice chair will become Chair of the
Corporate Governance Committee which would include
the audit function. To achieve early authorisation these
structures must be in place in shadow form. The
guidance states that the vice chair must have a financial
qualification.
The Quality and Corporate Governance Committee
remains with the Cluster but the Associate Directors
have been assigned to the CCGs and provide an
important link.
It was RESOLVED
- to note the content of the report.
- to agree the proposed Corporate Governance
Structure.
- to approve the Corporate Governance Transition
Plan and timeline.
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PERFORMANCE
LCCCG/11/143
Leicester City CCG specific Performance Report
including QIPP
Ms Sue Lock, CCG Operating Officer presented the
performance report for the Leicester City CCG specific
performance targets (Paper H) and reports at both city
level and locality level. Therefore the locality reports
were introduced with this item to supplement the report.
QIPP – with regard to out patient attendances the target
remains green for the city with a further small
improvement since last month. The target for
emergency spells is over target by 5.5% and is
attributed to short stay admissions.
NHS Health Checks – the Board has discussed a
revised approach to the incentives that are linked to the
outcomes the CCG is looking for. This has been
discussed with the LMC as part of their statutory role
and they are happy with the approach. There will be a
launch event in December for all practices. Further
work has been done to identify eligible recipients for the
LD health checks. This year GPs will be paid for
undertaking checks on patients as per their registers.
Practices will also be supported to validate their lists.
The LMC are happy with this and will support the
process. There will be templates that link onto the
clinical system for making the payment claims. The
CCG now has 100% practice sign up and has asked
practices to advise when they will undertake the checks
and if there is a deviation from plan to offer them
support. If practices are not going to do the checks
these will be offered via another practice through a
collective LES.
Choose and Book – the electronic booking LES has
been discussed with the LMC and they are happy with
the way that will be set. The CCG will be assessing
performance against attempted CAB referrals. Slot
availability at UHL will be monitored.
Extended opening hours – the CCG is working with a
few practices with whom there are queries but it is
expected that the numbers will be the same or higher
than last years target.
Dr Roy noted that the CCG would be using the practice
registers and not the local authority registers to
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determine the learning disability checks. He advised
that the university practices will have a lot of students
coded as having an LD due to varying degrees of
dyslexia. It was agreed that there needed to be some
checks and balances in ensuring people receive the
checks appropriately. The two university practices will
be written to separately regarding this anomaly. The
questionnaire will improve the list for next year.
The reports from the from Locality Chairs were then
presented (paper T);
North East Leicester
Dr Bentley reported there are three practices reporting
red for outpatient activity and it is hoped they will be
supported by the emergency admissions projects.
Good practice is being shared across the patch. All
practices have stated they will do the LD checks and
some have already commenced these. The CAB run
rate counting has been low in the past so it is hoped
that the reporting on attempted CAB bookings will help.
Some practices have been achieving QIPP targets
whilst others have not. Dr Freeman undertook to look
into that with Dr Prasad. The locality felt there was
tension between providers having a good RAG rating
but clinicians at times having concerns about quality
issues and how these are reported and fed into the
system. Professor Farooqi said it was important that
concerns be reported so that they can then be
discussed and acted upon.
SF/AP
Leicester City Central
Dr Kapur reported that emergency activity remains
green. Learning Disability and Health Checks are
making progress. 70% of practices in the locality have
been approved to provide extended hours services.
Inappropriate use of the emergency department
continues to be a problem. Practices are tackling
patients on an individual basis. A number of
attendances are alcohol related and it would be useful
to engage with public health and further build on their
work in that area.
Mr Morris advised that another piece of communications
work will focus on community groups and educating
them on the health system and the appropriate routes
for different health care requirements.
Leicester Primary Care Group
Dr Roy reported there was no change in the emergency
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activity data from previous months and the figures relate
to short stay admissions. The nursing home project has
been running in the locality since last year supporting
patients who typically are admitted for short stays. The
project is being rolled out city-wide. With regard to
emergency admissions the locality has informed the
commissioning sub group that it is setting up an early
discharge group and alcohol related admittance group.
The position on extended opening hours remains the
same. Four practices are undertaking a DES and have
not yet moved over to a LES due to the issue of
Thursday p.m. opening. The university practice is
writing a proposal to provide services and opening
times accordingly as their population swells and
reduces during term/holiday time.
Dr Freeman advised that public health will be doing a
strategic review of sexual health services. SHACC will
continue in the meantime but he felt SHACC would
remain a critical service going forward.
Millennium
Dr Jawahar advised that seven practices had improved
on the short term emergency admissions activity.
External peer reviews are taking place on out patient
activity. The position for routine patient referrals
remains green.
It was RESOLVED
- to note the locality reports.
- to note the progress against the CCG
performance at both city and locality level.
LCCCG/11/144
2011/2012 Operating Performance Framework for
the One Leicester CCG
Dr Simon Freeman, CCG Managing Director presented
a report on performance against the quality indicators
that the CCG and Cluster are being held to account for
the delivery of during 2011/12 (Paper I).
The 12 weeks maternity access target continues to be a
problem for the City. The issue is around patient
education. There is a programme of work to help with
this.
The level of achievement of EMAS Category A calls
within the City is a concern. Dr Freeman was confident
that the contractual arrangements are being properly
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managed but the EMAS contract is a block contract and
that is not sensitive to demand. The contract is
managed by Derbyshire County PCT on behalf of nine
other PCT commissioners. A contract meeting takes
place on 22 November.
Mortality rate targets continue to be unachievable for
the PCT. The rates require renegotiation.
The position on immunisation continues to report as
amber. It is likely that the responsibility for
immunisation targets will move to public health and the
local authority in due course.
It was RESOLVED
−
to note the delivery position for each area.
LCCCG/11/145
Contract Performance Report – August/September
2011 for the One Leicester CCG
Dr Simon Freeman, CCG Managing Director presented
a cluster-wide contracts performance report for acute
and non acute services (Paper J). He advised that the
budgets are managed by the Cluster but himself and Mr
Sanders have contract management bridging roles in
the CCGs; Dr Freeman for the UHL contract and Mr
Sanders for LPT.
At month 6, UHL were £642k under budget for city
activity. The underperformance is due to orthopaedic
work put out to the independent sector that has now
come back to UHL. The 18 week general surgery
backlog at UHL is due to capacity issues and the
Cluster has agreed to some funding to remove the
backlog. With this support UHL will still not achieve its
18 week target. A contract query has been issued to
UHL for MRSA bacteraemia cases. The 62 day cancer
wait non achievement of target is due to endoscopy
issues at UHL. A working party has been set up to look
at the whole of endoscopy screening in readiness for
meeting higher targets on bowel screening for next
year.
For the non acute contracts, LPT is largely based on a
block contract therefore minimising the degree of
financial risk.
Continuing Health Care (CHC) continues to be a risk
whereby patients whose primary needs are health
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rather than social care related are paid for by health.
The total budget for the City and County this year is
£65m. Dr Freeman believes that a cluster wide risk
sharing arrangement for CHC is required.
It was RESOLVED
LCCCG/11/146
− to receive the report.
Finance Report
Ms Michelle Iliffe, Chief Financial Officer presented a
report outlining the position for CCG delegated budgets
and for Leicester City budgets (Paper K).
At the Board to Board meeting the CCG advised there
was a year-to-date under spend of £1.1m. There are
two main risks; prescribing spend and transformation
funds. Detailed projects plans have been asked for so
that any underspend from the transformation fund will
be clear. Within the pharmacy contract there will be
some Category M price changes in October and this will
have an impact on prices and refunds. Money will need
to be moved between the budgets to meet this cost.
This will not affect the prescribing incentive schemes in
place.
Formal notification of the CCG running cost amount per
head of population is awaited with detail of what is
included within that figure.
The current uncommitted expenditure has increased to
£1.5m. The finance team is doing some work on the
underlying recurrent position to ensure it is driven by the
ledger. The outcome of that will inform financial
planning and resources going forward and to identify
how much can be committed recurrently. There will
again be the requirement to create a 2% transformation
fund. The CCG will be looking at the options on 6
December.
Professor Farooqi said the CCG was now in a position
to plan and identify areas for investment. The Cluster is
looking at ways the CCG can extend plans for at least
two years to realise longer term schemes and gains.
It was RESOLVED
- to note the financial position of the budgets
delegated to LCCCG.
- to note the financial position of NHS Leicester City
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COMMISSIONING DEVELOPMENT
LCCCG/11/147
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as extracted from the Cluster finance report.
- to commence work on recurrent schemes for
2012/13.
Report from CCG Commissioning Sub Group
including Transformation Bids
Dr Avi Prasad reported on the transformation bids that
had been discussed at the CCG Commissioning Sub
Group (Paper L). In August the CCG was made aware
of a further £1.5m to be used non-recurrently and rapid
work was done to come up with ideas which then went
through a shortlisting process. Most of the bids
submitted did support the mission and vision of the
organisation.
UCC bounce back scheme
This scheme would require putting Systmone into all
practices so that patients attending the UCC could be
registered with a practice and be given a GP
appointment there and then.
Respiratory Disease Outcomes
This would improve care in the community and prevent
admissions. The virtual ward is not part of this.
Community Dermatology
This requires the up-skill of GPs to diagnose and treat
and provide an OP service in the community.
Audio and Visual Communication
Information screens would give patients information
about health services and signpost them to the most
appropriate part of the NHS system.
Twinning
This would partner or cluster practices to share learning
and best practice.
Protected Learning Time
City wide and locality protected learning time for
practices is pivotal to deliver organisation wide changes
and developments.
24 hour blood pressure monitors
This is part of NICE guidelines and practices would be
assisted to fulfil the criteria.
All of the above schemes will be looked at by the
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Cluster for approval tomorrow. The outcome of the
Cluster decision would then be reported as soon as
possible. Blocks of management time will be needed to
support the implementation. Some schemes will not
require that support i.e. NHS Checks, Twinning, PLT
and the Community Dermatology project has
management time built in. There will be scope to jointly
manage some of the projects.
Dr Jawahar asked if unsuccessful practices would
receive written feedback. Dr Jawahar was asked to
take back the message to his locality that schemes
were only able to be approved if they were city-wide.
DJ
It was RESOLVED
- to ratify the decision of the sub group in approving
these bids.
- to receive a progress report in a few months
following Cluster approval and scheme
implementation.
- to note the update.
LCCCG/11/148
Redesign of Maternity and Gynaecology Services
within UHL
Dr Teck Khong, Ms Mel Thwaites, Assistant Director of
Children and Families (LLR Cluster) and Ian
Scudamore, Consultant Gynaecologist and Obstetrician
(UHL) attended for this item to present two papers
(Paper M); a briefing paper on the redesign and
reconfiguration of maternity and gynaecology services
within UHL and a response by Dr Khong setting out a
commissioner view to these proposals. The CCG
generally supported the proposals and will further
consider the paper. Dr Khong and Ms Thwaites will
formally respond to Mr Scudamore.
TK/MT
It was RESOLVED
LCCCG/11/149
- to consider the paper and provide UHL with a
written response.
LLR Commissioning Intentions for UHL
Dr Jo McKenna, Senior Contracts and Provider
Performance Manager (Acute) attended for this item to
present a framework for specifying commissioning
intentions for acute services in 2012/13 for Leicester,
Leicestershire and Rutland (Paper N). The main things
for the CCGs to consider are any service proposals for
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primary care transformation or AQP (any qualified
provider) procurement plans that will impact on UHL
and CQUINS for 2012/13 and to build that within the
contracts. Activity moved out to be delivered in the
community would take activity out of the acute provider.
The notice periods linked to each scheme will be
worked out.
CQUINs have been an important lever to drive quality.
The more specificity that can be given to the quality
issues that primary care is aware of, the better the
CQUIN will be formed. Caroline Trevithick will work
with the CCG on this. Ms Lock proposed that patient
medication changes from UHL could be included as a
Local 1 CQUIN. Dr Danaher will develop a CQUIN
around having a formal system for medication that is
prescribed by UHL but not supported in primary care.
Dr Prasad will work with Dr McKenna on the CQUINs.
Mr Morris will explore and come up with a proposal on
how a fund could be set up and used by PPGs for
issues such as public health.
PD
AP/JMc
RM
It was RESOLVED
- to note that commissioning intentions will need
further development.
LCCCG/11/150 Development of Non Acute Commissioning
Intentions 2012/13
Mr Jim Bosworth attended for this item (Paper O) to
propose the steps needed to give providers sufficient
notice of the intent from commissioners should changes
to current contracts be required.
The three CCGs will work collaboratively on a number
of contracts. Leicester City CCG has some specific
priorities. Non acute contracts are numerous and many
have a degree of sensitivity as they link to historic
partnership agreements. The CCGs will be developing
their commissioning intentions over the coming months.
Mr Suleman declared an interest as vice chair of the
Leicester Council of Faiths before stating that he felt the
third sector had a lot of potential to deliver changes for
the CCG. Dr Freeman will pick up with Mr Bosworth
about the process for the third sector.
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A process will be required to review contracts where the
financial cost and return is not currently clear and that
could take 6 months in which case the CCG will need to
do something in the short term as contracts are due to
renew in 2012/13.
It was RESOLVED
- to develop commissioning intentions on a
number of key priorities to ensure maximum
impact within the resources available.
LCCCG/11/151
Extending Patient Choice of Provider – AQP
Approach
Dr Simon Freeman presented a paper on the
government’s requirement to extend the choice of
providers in community services (Paper P). The Cluster
is required to identify three of more community or
mental health services and these were agreed in
discussion with the three CCGs at the October
Collaborative Commissioning Board (CCB). The
agreed services are MSK (physiotherapy), Community
Diagnostics (MRI and ultrasound) and Continence
Services (children and adults). The service
specifications will be ready by December 2011.
Procurement will be led in the Cluster by Jane French.
It was RESOLVED
- to note the paper and confirm the decision of the
CCB for the three identified services to move to
an AQP process.
COLLABORATIVE ARRANGEMENTS
LCCCG/11/152 Health and Wellbeing Board
Dr Simon Freeman reported that the Health and
Wellbeing Board for Leicester City has met and held a
development session to discuss its remit and purpose
and the steps to put that into practice. A further meeting
is planned for 24 November 2011.
It was RESOLVED
- to receive the verbal update.
LCCCG/11/153 LLR Commissioning Collaborative intentions for
capacity and capability
Dr Simon Freeman presented a paper proposing the
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alignment of current commissioning support staff into
CCGs (Paper R). It is envisaged that commissioning
support would include a range of functions including
finance, HR, procurement, informatics, business
intelligence, contracting but further guidance is awaited
to confirm that. Commissioning arrangements are being
split across the 3 CCGs with managerial and finance
support. That will ensure there is a link in from each of
the CCGs in a different capacity. The QIPP programme
leads will remain with the cluster for the present time.
Each CCG will need a lead for Strategy and Planning
and Ms Prema is leading on that for Leicester City CCG
at present. The Urgent Care Strategic Lead will move to
the City CCG from 1 April 2011.
Mr Suleman asked how the proportionality of costs would
be worked out e.g. UHL is a large service to lead on. Dr
Freeman believed the costs would be equitably split
based on registered population. That will need to be
reviewed in detail and included in the running costs work.
It was RESOLVED
- to approve the proposed collaborative
arrangements.
- to note the assignment of further staff to the CCG
on an interim basis.
- to move to a formal recruitment process for the
Head of Strategy and Planning role.
LCCCG/11/154 Report from Clinical Senate and Minutes – 27
September 2011
Professor Azhar Farooqi presented the minutes from the
LLR Clinical Senate held on 27 September 2011 (Paper
S).
It was RESOLVED
- to receive the minutes.
PRIMARY CARE DEVELOPMENT
LCCCG/11/155 GP Forum
Professor Azhar Farooqi reported that the GP Forum had
met on 13 October. It was agreed to withdraw the paper
which had captured comments and formulate it with
action points.
It was RESOLVED
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−
to note the verbal report.
Paper T
LLR PCT Cluster Board Meeting
12 January 2012
LCCCG/11/156 Annual Quality Review Process 2011/12 Progress
Report
Ms Sue Lock presented an update on the AQR process
which will run from October 2011 to July 2012 (Paper V).
The AQR process is now in its third year for the City.
Practices are visited and a wide range of issues
discussed within five key domain areas; patient safety,
clinical effectiveness, patient experience, governance
and practice culture and engagement. The review allows
a subjective assessment to be made of the practice’s
quality of service and level of governance. Practices are
rated within one of three levels. The next round of AQR
visits has commenced. A key role of the CCG is to
improve quality of services and Ms Lock undertook to
bring a report to the CCG Board each month to report on
trends, common themes that may need to be addressed
and good practice that can be shared. All information
presented to the board will be anonymous. The majority
of practices are doing very well. This process is about
supporting those practices that need extra help and
guidance and should be a positive experience and
process. Ms Lock will revisit and reissue the terms of
reference for the AQR visits.
SL
It was RESOLVED
- to note the progress made to date
- to revisit and reconfirm the terms of reference.
LCCCG/11/157 Prescribing and Medicines Management Update
Dr Paul Danaher presented a progress report on
resource, function, activity, achievements and next steps
for the prescribing and medicines management function
(Paper W).
The team went through a period of having some vacant
posts but recruitment is taking place and the team should
be strengthened shortly. It is expected that there will be
additional support for the Prescribing Incentive Scheme
in terms of getting the budget in place. Dr Khong and Dr
Bentley requested that should there be surplus
prescribing funds available, these be given to practices in
quarter 4 to undertake a review of their prescribing. They
believed there is now an increased range of prescribing
management software systems available and it would be
useful to trial these. Dr Danaher undertook to look into
PD
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that.
Paper T
LLR PCT Cluster Board Meeting
12 January 2012
The national guide prices have been released for a
number of specialist order products. Work will continue
to engage with UHL to extend the project for specialist
drugs and include some practices in a pilot.
It was RESOLVED
- to note the contents of the paper, the
achievements made and future steps.
TO RECEIVE FOR INFORMTION
LCCCG/11/158 Minutes of the Locality Group Meetings of Leicester
City Clinical Commissioning Group
The locality chairs presented the following minutes from
the Locality Meetings of Leicester City CCG (Paper Y);
Minutes of Leicester City Central Locality Meeting held
on 23 September 2011
Minutes of North East Leicester Locality Meeting held 28
September 2011
Minutes of Leicester Primary Care Group Locality
Meeting held on 28 September 2011
Minutes of the Millennium Locality Meeting held on 21
September 2011
It was RESOLVED
− to receive the minutes.
LCCCG/11/159 LMSG Terms of Reference
Dr Paul Danaher presented the Terms of Reference for
the Leicestershire Medicines Strategy Group (Paper Z)
as agreed by the group on 6 September 2011. The
Group will review the terms of reference in 12 months’
time.
It was RESOLVED
- to note the terms of reference.
LCCCG/11/160 Minutes of Health and Wellbeing Board
The minutes of the Health and Wellbeing Board held on
15 September 2011 were noted for information (Paper
Aa).
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Paper T
LLR PCT Cluster Board Meeting
12 January 2012
LCCCG/11/161 Minutes of the Commissioning Sub-Group held on 4
October 2011
The minutes of the Commissioning Sub-Group held on 4
October 2011 were noted for information (Paper Bb).
LCCCG/11/162 Minutes of the Commissioning Collaborative held on
25 August 2011
The minutes of the Commissioning Collaborative held on
25 August 2011 were noted for information (Paper Cc).
ANY OTHER BUSINESS
LCCCG/11/163 There were no other items of business.
DATE OF NEXT MEETING
LCCCG/11/164 The next scheduled meeting of Leicester City CCG
Board will take place on 13 December 2011 at 1.00 p.m.
20