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Hampshire Partnership CCGPartnership Primary Care Commissioning Committees in
CommonBoard Room 6, The Middle Brook Centre, Middle Brook Street, Winchester
9 January 2020 13:00 - 9 January 2020 14:00
Overall Page 1 of 24
INDEX
1. Agenda- PCCC- 9 Jan 2020 v3.doc...........................................................................................3
2. Register of Interests- PCCC- Jan 2020.pdf................................................................................5
3. PCCC Draft Minutes- 7 Nov 2019- Publicv2.docx......................................................................9
4. PCCC Action Tracker Jan 2020.docx.........................................................................................15
6.1 Primary Care Resilience- Cover Sheet.docx............................................................................17
6.2 Nicola Decker Joint approach to Primary Care Resillience 191212.pdf...................................19
7. January 2020 combined PCCC Quality Report FINAL.docx......................................................21
Overall Page 2 of 24
Hampshire and Isle of Wight Partnership of Clinical Commissioning Groups
Page 1 of 1
Primary Care Commissioning Committees in CommonMeeting in Public
NHS FAREHAM AND GOSPORT CCGNHS ISLE OF WIGHT CCG
NHS NORTH HAMPSHIRE CCGNHS SOUTH EASTERN HAMPSHIRE CCG
Thursday, 9th January 2020 from 13.00- 14.00Board Room 6, The Middle Brook Centre, Middle Brook Street, Winchester, SO23
8DQ
Item Title Lead Delivery Action Time1. Welcome and Introductions Chair Verbal
2. Declarations of Interest All Paper
13.00
Items for Decision3. Minutes of the meeting on 7th
November 2019 Chair Paper Decision
4. Action Tracker from the meeting on 7th November 2019 and Matters Arising
All Paper Note
13.05
Items for Noting5. Primary Care Networks Update Primary Care
LeadsVerbal Note 13.15
6. Update on Primary Care Resilience Workshop
Nicola Decker/ Kirsten Lawrence
Paper Note 13.25
7. Quality Report Julia Barton Paper Note 13.35
8. Any Other Business 13.50
9. Evaluation of Meeting and Meeting Close 14.00
1. Agenda- PCCC- 9 Jan 2020 v3.docOverall Page 3 of 24
Overall Page 4 of 24
Partnership Delegated Primary Care Commissioning
02 January 2020
First Name Surname CCG Declared Interest - Name and Nature of Business
Jessamy Baird Sanofi Pharmaceuticals - Director of Market Access
CCG
North Hampshire
Jessamy Baird Benefactor of Treloars School through regular donations
CCG
North Hampshire
Jessamy Baird Sister works at Treloars School as Head of Music
CCG
North Hampshire
Jessamy Baird Sister works as Deputy Director of Public Health at Bedford, Luton and Milton Keynes STP
CCG
North Hampshire
Jessamy Baird Sanofi Pharmaceuticals - Shares OwnedCCG
North Hampshire
Julia Barton Friends with the family of contractor, Marcus Pullen, director of Blue Donut Studios
CCG
All Partnership CCGs
Julia Barton Patient at the Bosmere Medical PracticeCCG
All Partnership CCGs
Julia Booth No interests to declareCCG
Other
Normi Cadavieco No interests to declareCCG
North Hampshire
David Chilvers Section 12 GP for Social ServicesCCG
Fareham & Gosport CCG
David Chilvers GP with Willow GroupCCG
Fareham & Gosport CCG
Nicola Decker Partner GP at Watership HealthCCG
North Hampshire
Nicola Decker Husband is an orthopaedic surgeon at Hampshire Hospitals NHS Foundation Trust
CCG
North Hampshire
Nicola Decker Partner in GP Practice that is a shareholder in North Hampshire Alliance GP Commissioning Collaborative
CCG
North Hampshire
Nicola Decker Husband is a member of the Board of Governors, Hampshire Hospitals NHS Foundation Trust
CCG
North Hampshire
Nicola Decker NICE - FellowCCG
North Hampshire
Lisa Harding No interests to declareCCG
Other
2. Register of Interests- PCCC- Jan 2020.pdfOverall Page 5 of 24
First Name Surname CCG Declared Interest - Name and Nature of Business
Paul Jones Healthcare Financial Management Association (HFMA) - Member
CCG
North Hampshire
Paul Jones Hampshire Hospitals NHS Foundation Trust - Member
CCG
North Hampshire
Alma Kilgarriff No interests to declareCCG
North Hampshire
Kirsten Lawrence Daughter works for NHS mental health provider in Essex
CCG
All Partnership CCGs
Michele Legg Partner undertakes work in the spinal triage clinic at St Marys Hospital and the EAS
CCG
Isle of Wight CCG
Michele Legg Shares held in Company Island Clinical Academic Services
CCG
Isle of Wight CCG
Michele Legg Partner, Tower House SurgeryCCG
Isle of Wight CCG
Michele Legg School Governor at Ryde SchoolCCG
Isle of Wight CCG
Michele Legg President of IOW Osteoporosis SocietyCCG
Isle of Wight CCG
Sharon Martin No interests to declareCCG
North Hampshire
Roshan Patel No interests to declareCCG
All Partnership CCGs
Barbara Rushton GP LocumCCG
South Eastern Hampshire CCG
Barbara Rushton CCG Clinical Chair South East Hants CCGCCG
South Eastern Hampshire CCG
Barbara Rushton Co-Chair of NHS Clinical CommissionersCCG
South Eastern Hampshire CCG
Tracey Savage Husband is an employee of IOW NHS Trust
CCG
Isle of Wight CCG
Tracey Savage Visiting Lecturer, Keele University School of Pharmacy (no payment)
CCG
Isle of Wight CCG
Margaret Scott Patient at the Grange SurgeryCCG
All Partnership CCGs
Margaret Scott North East Hampshire CCG Primary Care Commissioning Committee
CCG
All Partnership CCGs
Sophie Sitch No interests to be declaredCCG
South Eastern Hampshire CCG
Sara Tiller Working closely with South Hampshire GP Allicance, Southern Health NHS Foundation Trust and GP practices on the development of new care models
CCG
South Eastern Hampshire CCG
2. Register of Interests- PCCC- Jan 2020.pdfOverall Page 6 of 24
First Name Surname CCG Declared Interest - Name and Nature of Business
Carole Truman Patient at South Wight Medical Practice.CCG
All Partnership CCGs
Carole Truman Chair of the 1st Brighstone Sea Scouts Group Exec
CCG
All Partnership CCGs
Carole Truman Magistrate on the Isle of WightCCG
All Partnership CCGs
Andy Whitfield GP Partner Voyager Family Health GMS Practice, Farnborough
CCG
All Partnership CCGs
Andy Whitfield Son works for South Central Ambulance Service
CCG
All Partnership CCGs
2. Register of Interests- PCCC- Jan 2020.pdfOverall Page 7 of 24
Overall Page 8 of 24
Minutes of the Meeting in Public of the Primary Care Commissioning Committees in Common at 10.00 on Thursday, 7th November 2019 in Board Room 6, The Middle
Brook Centre, Middle Brook Street, Winchester, SO23 8DQ
PresentName RoleMargaret Scott Non-Executive Director, HIOW CCG Partnership (Chair)Jessamy Baird Non-Executive Adviser, North Hampshire CCGJulia Barton Executive Director of Quality & Nursing, HIOW CCG
PartnershipDavid Chilvers Clinical Chair, Fareham & Gosport CCGNicola Decker Clinical Chair, North Hampshire CCGPaul Jones Deputy Director of Finance- North Hampshire CCG (deputy
for Roshan Patel)Michele Legg Clinical Chair, Isle of Wight CCGSara Tiller Managing Director and Executive Lead for Primary Care-
Fareham & Gosport and South Eastern HampshireCarole Truman Non-Executive Director, HIOW CCG PartnershipAndy Whitfield Medical Director and GP, HIOW CCG Partnership
In attendanceName RoleNormi Cadavieco Senior Governance Manager, HIOW CCG PartnershipLisa Harding Director of Primary Care, Wessex LMCAlma Kilgarriff Deputy Director of Primary Care Transformation &
Medicine Management, North Hampshire CCGEmma McKinney Director of Comms and Engagement, HIOW CCG
PartnershipLisa Medway Estates Project Manager, Fareham & Gosport and South
Eastern Hampshire CCGsTracy Savage Associate Director of Primary Care, Isle of Wight CCGSophie Sitch Senior Contracts Lead- Primary Care Transformation &
Contracting, Fareham & Gosport and South Eastern Hampshire CCGs
Alison Smith Managing Director, Isle of Wight CCGHeather Smith Head of Finance Transformation, Fareham & Gosport and
South Eastern Hampshire CCGs
ApologiesName RoleRos Hartley Executive Director of Strategy and Transformation, HIOW
CCG PartnershipRoshan Patel Chief Finance Officer, HIOW CCG PartnershipBarbara Rushton Clinical Chair, South Eastern Hampshire CCG
1. Welcome and Apologies
The Chair welcomed members to the meeting. Apologies for absence were received as noted above.
3. PCCC Draft Minutes- 7 Nov 2019- Publicv2.docxOverall Page 9 of 24
2. Declarations of Interest
The register of interests was presented and members were asked to declare any changes or amendments. They were also advised to raise any interests relating to agenda items being considered at the meeting as each item was discussed.
3. Minutes of the Previous Meeting
The minutes of the meeting held on 5th September 2019 were presented to the Committee and were agreed as an accurate record.
4. Summary of Actions and Matters Arising
See attached Action Log.
Action 22- CQC Outcomes Summary- Action complete. Action 24- Bramblys Grange Medical Practice- Boundary Change- Action Complete.
The Committee noted the update.
5. Isle of Wight Practice Closure
The Committee was previously notified of the potential closure of Beech Grove Surgery at the October 2019 meeting. The decision on the practice closure will be taken in private in order to allow impacted patients to be notified before the decision is made public. Following the decision and notification of impacted patients, wider communication of the decision will be made.
There has been a considerable amount of engagement with patients, including a survey. The feedback from this survey has been included within the options appraisal. Drop-in sessions have been arranged with patients at accessible times.
The Committee noted the importance of considering the potential travel impact on patients, particularly due to the limited public transport options available in the area. The Committee was assured that travel has been considered and will continue to be assessed during the transition period.
The Committee thanked the team on the Isle of Wight for their hard work in managing this situation.
The Committee noted the update.
6. Primary Care Network (PCN) Update
There is now an engagement programme in place across Fareham & Gosport and South Eastern Hampshire which includes monthly meetings with PCNs to support the development of integrated care. The senior leadership team at the CCGs has been restructured to better
3. PCCC Draft Minutes- 7 Nov 2019- Publicv2.docxOverall Page 10 of 24
support PCNs and to enable to the transformation team to support the programme of work. The CCG is reviewing existing LCS and LIS agreements to ensure that money is invested in a way that supports the PCN DES. Any proposed changes will come to the Committee for a decision.
The Isle of Wight CCG has similarly undergone a restructure to better support the established PCNs and a Head of PCN Support has been recruited to lead on this programme of work. The programme has been developed via STP development funding, with each area currently focussing on a specific area of speciality or need.
North Hampshire CCG has a support programme in place and the first meeting to discuss how the PCNs and CCG can work together is scheduled later in November. Work is ongoing to develop relationships with the PCNs in the ‘mid’ locality, with ‘North and mid’ coming together as an ICP in the near future.
LH noted that Wessex is generally well placed for the transition to PCNs because there is a history of working in localities. The LMC is looking at ways to best support the PCNs, specifically at management level as there has been significant focus on supporting Clinical Directors.
The Committee noted the update.
7. Section 96 Guidance
A process for allocating Section 96 funding was developed for use by Fareham & Gosport and South Eastern Hampshire CCGs following the delegation of Primary Care Commissioning from NHS England (NHSE). The process is presented to the Committee for consideration on adopting the process across the patch in order to ensure consistency of the application of Section 96 funding.
The Committee considered whether the process was fit to use as it was presented, noting that each situation would need to be considered on a case by case basis as all practices are different. However, a consistent process will promote fairness and transparency for all practices within the geography.
The guidance needs to be updated to include the latest data on funding caps, reference to any relevant case law and requirement for an open book process to review use of funds. The updated guidance should also be shared with NHSE for feedback. Once updated, the guidance will return to the Committee for approval. Action: SS
The Committee noted the guidance.
8. Managing Practice IssuesA flowchart for supporting practices was presented to the Committee which was developed in Fareham & Gosport and South Eastern Hampshire based on the policy & guidance manual. This flowchart has been reviewed and is supported by the Fareham & Gosport and
3. PCCC Draft Minutes- 7 Nov 2019- Publicv2.docxOverall Page 11 of 24
South Eastern Hampshire Primary Care Operational Group (PCOG). It is proposed that other CCGs consider adopting a similar process.
The Committee noted that the process was helpful, but it needed a policy or procedural document to support its consistent application and capture the nuance of each individual situation. Following discussion, the Committee proposed that a Policy or Framework on Managing Quality in Primary Care be developed. Action: JB/SS/AK/TS/KL
The Committee noted the paper.
9. Quality Report
An update on primary care quality was presented to the Committee, noting the following updates related to CQC outcomes:
South Eastern Hampshire CCG- Bridgemary remains rated ‘inadequate’ following a follow-up inspection in August 2019; however, the warning notice around governance that was issued in June 2019 during the initial inspection has been changed to a requirement notice. Significant issues remain related to training, use of policies, care planning and QOF monitoring. CQC will reinspect the practice within 6 months and the CCG will continue to support the practice to make improvements throughout this time.
South Eastern Hampshire CCG- Pine Hill Surgery underwent a comprehensive inspection in September 2019 following a previous ‘inadequate’ rating. The report from CQC has not yet been published, however, there have been indications that the practice is improving.
South Eastern Hampshire CCG- Southern Hants Primary Care Alliance, which provides all extended access primary care services across the locality, has been inspected and received a rating of ‘good.’ This is a testament to the hard work of the Quality team at the CCG.
North Hampshire CCG- Cedar Medical- Rooksdown surgery is now part of Bramblys Grange and therefore falls under their overall rating of ‘requires improvement.’ Primary Care for Beggarwood is now provided by North Hampshire Urgent Care (NHUC) which has not yet been inspected by CQC. The team at the CCG has been proactively visiting and supporting both practices given the number of outstanding actions at the point of transition, but there have been positive changes since then.
A risk related to staffing challenges at the Out of Hours provider Partnering Health Ltd was noted. The provider is now on enhanced monitoring by the CCG.
The team continues to work with NHS England to develop a primary care quality data portal to streamline the monitoring process. A demonstration of the portal to the Committee was proposed to be held once the portal has been completed. Action: JB
The Committee noted the update.
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10. Finance Report
An update on Primary Care finances for each of the CCGs was presented to the Committee, noting that financial performance is in line with budgets with the exception of £700k pressure for North Hampshire CCG. The reports for each CCG have been completed using a common template to allow for a look across the patch. However, there are minor variations in how budgets are broken down within each CCG.
The Committee considered whether prescribing should remain in the report as this budget is handled differently at each CCG and the medicines management budgets are monitored via other processes. It was agreed that the reports should continue to be presented as they currently are with the prescribing budget added as a separate line not included within the primary care subtotal.
The Committee noted the update.
11. Any Other Business
No additional items of business were raised.
Next Scheduled MeetingDate: 9th January 2020Time: 13.00Venue: Board Room 6, The Middle Brook Centre, Middle Brook Street, Winchester, SO23 8DQ
The meeting was closed at 11.15.
I confirm the minutes of the meeting were agreed as an accurate record
Signed by Chair: ………………………… Date:………………………
3. PCCC Draft Minutes- 7 Nov 2019- Publicv2.docxOverall Page 13 of 24
Overall Page 14 of 24
Page 1 of 1Rag Rating: Overdue In Progress Complete
Primary Care Commissioning Committees in Common Action Tracker 9 January 2020
Ref No
Date of Meeting/ Issue Originally Raised Title Summary of Action / Issue Update Due Assigned To
Progress report / Update from previous meeting
RAG
25 7 Nov 2019
Section 96 Guidance
Updated guidance to return to the Committee for approval. March 2020 SS
26 7 Nov 2019
Managing Practice Issues
Policy or Framework on Managing Quality in Primary Care to be developed. March 2020 JB/SS/AK/TS/KL
27 7 Nov 2019 Quality Report The Committee to receive a demonstration of
the primary care quality data portal. January 2020 JBThis demonstration is on the agenda for the meeting in private.
Previously completed actions have been archived.
4. PCCC Action Tracker Jan 2020.docxOverall Page 15 of 24
Overall Page 16 of 24
Page 1 of 1
Primary Care Commissioning Committees in Common1
Coversheet
Title of Paper Primary Care Resilience- Follow up summary from Meeting on 12th December 2019
Agenda Item 6 Date of meeting 9th January 2020Author Nicola Decker, Clinical Chair- North Hampshire CCGExec Lead Nicola Decker, Clinical Chair- North Hampshire CCG
To ApproveTo RatifyTo Discuss
Purpose
To Note
Executive SummaryA group was convened on 12 December 2019 to discuss ways to improve primary care resilience and support practices to provide the best services for patients. Attendees included clinical and commissioning leaders from across the Partnership and the Wessex Local Medical Committees.
The attached paper summarises the key points discussed at the meeting as well as ideas on how to work better together and next steps for bringing some of these ideas into practice.
Recommendations The Committee is asked to NOTE the report.
1 The Committees in Common comprise: North Hampshire CCG; Fareham & Gosport CCG; South Eastern Hampshire CCG and Isle of Wight CCG Primary Care Committees.
6.1 Primary Care Resilience- Cover Sheet.docxOverall Page 17 of 24
Overall Page 18 of 24
Primary Care Resilience Follow up summary from Meeting on 12th December 2019
Who was there? Jessamy Baird, Julia Barton, David Chilvers, Steven Clarke, Nicola Decker, Harriet Dewhurst, Keith Douglas, Ros Hartley, Tiffany Joby, Mark Kelsey, Alma Kilgarriff, Liz Kite, Kirsten Lawrence, Robert McCartney, Emma McKinney, Lauren Pennington, Roxanne Ransome, Matthew Richardson, Tracy Savage, Margaret Scott, Sophie Sitch, Beccie Van Oostrum, Nigel Watson, Adrian Wheeler.
What did we agree?
1. We are committed to working together to support primary care at this time. 2. Primary care needs support for the changing business model and we want to facilitate that support
(building on good relationships that already exist ) 3. We want to share the resilience support that already exists and make sure it is used to help 4. We will start a focus group to describe and deliver the business support offer.
Ideas on how can we get better at picking up early warning signs and how do we join up better? (summary of table discussions)
1. Opel system in Cambridgeshire (run by LMC there) to give an indication on pressure on individual practices. GP supporter scheme for individual practices to help them work through solutions (funding to backfill GPs), leadership development etc.
2. Build a Primary Care business support team. Support offer tailored depending on the issues, built on use of the diagnostic tool already in place from LMC.
3. Build a Primary Care Support Team. Early and regular engagement based on positive relationships. Confidentiality important. Utilise PCN development plans to plan proactive support. Use personal files/ soft-intel to identify gaps. Develop legal, financial, HR, and OD support access.
6.2 Nicola Decker Joint approach to Primary Care Resillience 191212.pdfOverall Page 19 of 24
Questions from Audience?
Next steps: Send notes out to people who were there and those that could not make it (Nicola).
Set up a date for a focus group to discuss the Business Support Team offer in early February based on a PDSA - Plan Do Study Act model (Nicola and Ros).
Involve Keeley Ellis who is already pulling together intelligence and information on how we can help including asking each of the primary care leads about what they are already sharing
Build on PCN development plans… so we make use of this time in the journey to better integrated care.
Set up a new date for us all to gather in the spring and get it in their diaries early (Nicola)
How big should General Practice be? Are PCNs a stepping stone to larger scale working?
How do we make the most of the GMS contract?
How big should General Practice be? Are PCNs a stepping stone to larger scale working?
We know that some practices/localities are working really well. Why don’t we articulate what they are doing and use it to help others?
Assuming Partnership model is required in the future how do we incentivise salaried and locum GPs to join us?
When you say what could PCNs do … what are you expecting them to do?!
Positive: CCG secondment into GP Federation with great results … right skills to the right place
Is NHSE going to solve the premises or workforce crisis? Can there be more flexible use of Primary Care premises?
Could we get a more joined up digital support?
Could we create a modified early warning score? Dashboards?
Does taking services like home visiting and extended hours out if practice just lead to fragmentation?
We know that some practices/localities are working really well. Why don’t we articulate what they are doing and use it to help others?
Could we set up a ‘business / professional support’ consultancy that brings the different perspectives together with no threats at an early stage?
6.2 Nicola Decker Joint approach to Primary Care Resillience 191212.pdfOverall Page 20 of 24
December 2019 I Primary Care quality exception report I 1
Primary Care Commissioning Committee
Title of Paper Primary Care Quality Exception Report(Covering North Hampshire, Fareham and Gosport, South Eastern Hampshire and Isle of Wight CCGs)
Agenda Item 7 Date of meeting 9th January 2020Exec Lead Julia Barton, Executive Director of Quality and NursingAuthors CCG Primary Care Quality Leads
For DecisionTo RatifyTo Discuss
Purpose
To Note X
Executive SummaryThis report details primary care quality risks, issues and exceptions from the following CCGs:
Fareham and Gosport CCG South Eastern Hampshire CCG Isle of Wight CCG North Hampshire CCG
Items for the committee to consider include a theme around resilience with the potential to impact on quality and outcomes for patients:
North Hampshire CCG: 4 practices have been identified as requiring resilience support. Specific themes draw on workforce with the potential for leadership instability with a potential impact on quality.
South Eastern Hampshire CCG: Havant primary care resilience concerns – Homewell, Bosmere and Park Lane resilience concerns and current list closure.
Fareham and Gosport CCG: Gosport primary care resilience concerns – Brockhurst, Bridgemary and Bury Road practices
Isle of Wight CCG: Practice closure (Beech Grove Surgery, Brading) and two mergers (Sandown/Shanklin practices and Grove House/Ventnor practices in Ventnor) mean that quality and support to the practices is needing to be closely monitored.
The CCG quality teams continue to work collaboratively with primary care commissioning team members to monitor practice position/status and the controls in place, as well as to provide practical advice and support to practices.
Recommendations
Members are asked to:
1) Note the report and the risks, issues and challenges and improvements being made by respective CCGs.
2) Request any further information or assurance required on the content of the report.
7. January 2020 combined PCCC Quality Report FINAL.docxOverall Page 21 of 24
December 2019 I Primary Care quality exception report I 2
CQC Regulatory Compliance - EXCEPTIONS
GP Practice Name
Inspection Date
Published date
CQC rating Comments
FGSEH CCGs practices (rated Requires Improvement or Inadequate)Staunton Surgery Dec 18 Jan 19 Requires
ImprovementVine Medical Group
Nov 18 Jan 19 Requires Improvement
The Grange Surgery
Oct 18 Dec 18 Requires Improvement
Bury Road Surgery
Nov 18 Jan 19 Requires Improvement
Brockhurst Medical Centre
Feb 19 June 19 Requires Improvement
Bridgemary Medical Centre
24 June Aug 19 Inadequate
CCG quality concerns escalated following each providers CQC inspections and publication of reports. CCGs provide support visits and remain vigilant, monitoring for quality assurance. CQC will re-inspect these providers within twelve months of report publication.
Pinehill Surgery Sept 19 Nov 19 Requires Improvement
CQC report published 21.11.19 overall rating Requires Improvement with Safe-RI, Effective-RI, Caring-Good, Responsive-Good, Well led-RI. Improvements must be made in relation to Reg17 and Reg20 including establishing effective systems and processes to ensure good governance in accordance with fundamental standards of care. CCG Quality remains vigilant and support continues
Remaining FGSEH CCGs practices (rated Good or Outstanding)30 practices &Southern Hampshire Primary Care Alliance
Good
Isle of Wight CCG practices (rated Requires Improvement or Inadequate)NoneRemaining Isle of Wight CCG practices (rated Good or Outstanding)100% (15) Remaining practices
Good
NHCCG practices (rated Requires Improvement or Inadequate)
7. January 2020 combined PCCC Quality Report FINAL.docxOverall Page 22 of 24
December 2019 I Primary Care quality exception report I 3
GP Practice Name
Inspection Date
Published date
CQC rating Comments
Watership Down Health
Jan 19 Apr 19 Requires Improvement
Overall rating RI with good in caring and responsive.Requirement notice under Regulation 17 (good governance); Regulation 18 (staffing) of the Health and Social Care Act.
These notices related to the governance in relation to medicine management and the oversight of staff training appropriate to their role.
Acorn Health Partnership
Mar 2019
May 2019 Requires Improvement
Overall rating RI with good in effective and caring.Requirement notices under Regulation 12 (safe care and treatment; Regulation 17 (good governance) of the Health and Social Care Act.These notices related to: not mitigating risks around fire safety, patient group directions and lack of systems and processes established and operated effectively to ensure compliance with requirements to demonstrate good governance.
Rooksdown and Beggarwood Sites
With the splitting of the Cedar Medical practice, the following CQC position is reported:
The Rooksdown site is now a branch surgery of Bramblys Grange, and falls under their overall CQC rating (Good), until re-inspection occurs.
The Beggarwood site is now provided by NHUC, and as yet has not been subject to CQC inspection, which is awaited.
Quality team support to both continues.
Remaining NHCCG CCGs practices (rated Good or Outstanding)80% (12) Remaining practices
Good As the remaining practices are rated Good overall with Good in each domain this invokes the new CQC methodology of an annual regulatory review (extended telephone review).
Primary Care Quality RisksRisk description Risk rating
Fareham and Gosport/ South Eastern Hampshire CCG IUC/111 Pathway Quality Risk: if there is unmitigated fragmentation
through the delivery of services by multiple providers for the integrated urgent care/111 pathway this may result in quality and safety risks that may cause patient harm.
9
Pinehill Surgery CQC quality concerns Southern Hants PC Alliance Quality capacity and governance
arrangements PHL staffing concerns Gosport primary care resilience concerns – Brockhurst, Bridgemary and
Enhanced Monitoring
7. January 2020 combined PCCC Quality Report FINAL.docxOverall Page 23 of 24
December 2019 I Primary Care quality exception report I 4
Risk description Risk rating
Bury Road practices Havant primary care resilience concerns – Homewell, Bosmere and
Park Lane Resilience concerns and current list closure
Enhanced Monitoring
Isle of Wight CCG Practice closure (Beech Grove Surgery, Brading) and two mergers
(Sandown/Shanklin practices and Grove House/Ventnor practices in Ventnor) mean that quality and support to the practices is being closely monitored.
Enhanced Monitoring
North Hampshire CCG Risk rating Capacity for the CCG to review the community acquired E.coli RCAs 9 Care Homes - early recognition of deteriorating residents 9
Estates issues in primary care (where quality is affected) Fareham and Gosport & South Eastern Hampshire CCGs, Isle of Wight CCG and North
Hampshire CCGo There are no specific quality issues regards estates to report. The CCG quality teams continue to
support practices that have estates issues highlighted during CQC inspections.
Progress with Quasar Primary reporting Fareham and Gosport & South Eastern Hampshire CCGs
o Quasar HCP feedback (Sept) continues to be consistent across F&G and SEH - 94% from GPs. Top three concerns identified are reporting, follow-up and medicines management.
o South Hampshire Primary Care Alliance (SHPCA) are live on Quasar and reporting regularly, providing surveillance data across GP extended access and IPCAS services. Quasar team supporting practices where less reporting is identified and all feedback shared with providers via quality portal monthly for awareness and learning.
Isle of Wight CCGo No update for this report - the approach to be taken will be discussed in Quarter 4.
North Hampshire CCGo Primary care commissioning team have developed a draft primary care dashboard, Quality CCG
team are collaborating and sharing QUASAR reporting of key metrics.
NHSE Primary Care Quality Data Portalo This is being hosted on the Quasar platform and is now live to CCG staff, bringing in a wide
range of data. Agreed HIOW data set is in place to standardise and benchmark. Plans now bein developed to design a route to share this information with practices, which was not included in original NHSE spec for the module.
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