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

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Paper A LLR PCT Cluster Board meeting 14 June 2012 and the LMC who are acting as the authorised agent of the “GP providers” in their capacity as LMC members. The LMC has signed the APMS contract with CNCS on behalf of the individual GPs and has a responsibility to performance manage the contract in place with CNCS on behalf of the GPs. The SHA have requested that the PCT undertake quarterly monitoring visits of the OOHs service. Due to our commissioning arrangements these visits are led by the LMC with PCT attendance, an SHA representative may join the meetings. After collecting information on the number of unfilled shifts in OOH providers from PCTs across the region the SHA has written asking the PCT how it will be tackling the issue. The issue has been placed on the Corporate Risk Register. The PCT are closely monitoring the service given the gaps (Q3 106 GP shifts were not filled and 65 GP shifts were covered by a nurse). CNCS have been asked to put forward a plan to address, approximately 25 GP posts were appointed to in Q4, a further 30 posts out to advert in April. The PCT will assess the impact of these recruitments. Mr Wilson said that he found the report difficult to support; the National Quality Requirements (NQR) for face to face clinical assessments and consultations are not meeting the standard which could have serious consequences. Ms Griffiths said that the Cluster Board needed assurance that there is a remedial action plan to address these issues. Ms Taylor said that she was working with the LMC to monitor the NQR. Mr Wilson noted that there were a lot of shifts that were not manned. Ms Taylor said that she and Dr Rashid had undertaken a site visit and found that about 70 shifts out of 2,900 had not been manned. Dr Rashid said they were assured that shifts were not being manned by tired doctors. Ms Griffiths said that there were performance issues and noted the plan to have an external review of the contractual arrangements. Mrs Rowbotham said that the Quality Group had been strengthened; the LMC attend as they formally manage the contract. CNCS have not currently been invited. It was noted that although the GPs are the accountable people, the Cluster commissions the service. Mrs Ellis asked that there is an update report regarding the management of the contract and the non-compliance with some of the NQR. Action: Dr Rashid 32
Paper A LLR PCT Cluster Board meeting 14 June 2012 It was RESOLVED - to note with concern the non-compliance with the contract. CB/12/159 The Leicester City Assist Practice Contractual Review of the new APMS Contract Ms Vikki Taylor, Director of Commissioning Development presented a report on The Leicester City Assist Practice Contractual Review of the new APMS Contract (as attached in Minute Book – Appendix Number CB/05/10/X). Ms Taylor said that this was a primary care contract which would devolve to the National Commissioning Board in April 2013 and would therefore remain as part of the Cluster core business. This is a separate primary care contract report for although it is a small contract it is high risk. This contract is specifically for those many individuals, some of whom reside in Leicester, who are going through the asylum application process which takes many years to complete and the length of stay within Leicester can vary from weeks to many years. Asylum Seekers are entitled to primary care during their asylum application. Primary care for failed asylum seekers is provided at the discretion of GP practices, but all are eligible to ‘immediately necessary’ treatment. The needs of the asylum seekers are complex and varied. The Leicester City Assist Service was developed in 2009 to provide primary medical care to the estimated 3,000 asylum seekers living within Leicester City, although many patients do travel from across East Midlands to access services. Until April 2011 the service was provided as a PCT Cluster Managed Service and following an open procurement process, Assura Leicestershire LLP was appointed as the new provider. They commenced services under a five year Alternative Personal Medical Services (APMS) Agreement on 2nd October 2011. The first contractual review took place in February 2012. Ms Taylor said that because of the level of Board concern regarding this service there was extensive Cluster representation on the panel. The site was visited and there were significant improvements in the willingness of the provider and in their collaborative approach. 33
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Minutes of the Leicester, Leicestershire and Rutland PCT ... - NHS

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