Meeting: Joint Commissioning Management Board Date: 30th August 2018 Time: 10am – 11.30amLocation: Room 009, Civic Building, Waterdale, Doncaster, DN1 3BU

AttendeesJackie Pederson (chair) – Chief Officer Doncaster CCG

Anthony Fitzgerald – Director of Strategy & Delivery Doncaster CCG

Denise Bann – Strategic Lead Commissioning DMBC

Andrew Russell – Chief Nurse Doncaster CCG

Steve Mawson – Chief Financial Officer and Assistant Director for Finance DMBC

Hayley Tingle – Chief Financial Officer Doncaster CCG

Paul Stewart from NHS England – Shadowing Jackie Pederson

Cath Doman – Director of Health & Social Care Transformation

Dr David Crichton – Clinical Chair Doncaster CCG

Linda Tully – Lay Person, CCG Rupert Suckling – Director of Public Health

Damian Allen – Director of People DMBC

Gill Parker – note takerApologiesJo Miller – Chief Exec DMBC

Cllr Nigel Ball – Portfolio Holder DMBC

Cllr Rachael Blake – Portfolio Holder DMBC

Item Discussion/Comments Action

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Welcome, introductions and apologies

Introductions around the room.

Apologies noted above

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Minutes of the previous meeting and matters arising

Accepted as a true account of the meeting

Rolling Action Plan updated with following items to be closed down: 1, 5, 6, 7, 9, 11, 13, 14, 15, 17, 18, 19, 21 & 22. All closed items to be moved to a closed log.

Action log item 12 – Anthony still to look at mechanism for BCF recommendation of cases through JGOG – keep open.

Jackie requested any future items coming to JCMB must have cover sheets detailing what is required.

Action log item 13 – Rupert clarified the cost increases were for the care homes price lifts.

Action log item 15 – this item to be closed, but a new item to be logged re joint planning/setting milestones for next meeting – Anthony.

GP

AF

All

AF

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Inefficiencies in the system and refreshed savings challenges to be made by 2021

Two years ago, the challenge in Doncaster was £139 M funding gap – what is the latest position? It has been a struggle to engage with providers on this, and only one provider has given a response. Steve proposed a simple approach as it was not expected for the pressures to have changed much.

ACTIONS:

i. Tracy Wyatt to send the CCG figures to Steve.ii. JCMB agreed to take the refreshed overarching position for the next 5 years

to the ACPLT.

TW

JP

4

Update following Section 75 discussion (from rolling action log)

Following previous advice from Gary Andrews of NHS England, a call to West Berkshire CCG, with Fay, Hayley and Cath has taken place. West Berkshire are seen by NHS England as being quite far ahead with their ways of working, however, their local authority doesn’t form part of their system. Doncaster is in a different position to West Berkshire, as we have some organisations in financial difficulties.

The Directors of Finance need to progress this work and Debbie Hogg needs to be involved. At the working group in September we should get the position on Intermediate Care. Our ambition is to have the Section 75 and joint contract in place for intermediate care services by 1st April 2019.

ACTION: Hayley to ensure Intermediate Care leads are invited to the next Directors of Finance meeting and to agree a plan to deliver these milestones.

It was felt there was more financial risk on the CCG than the Council.

HT

5 Terms of Reference – decision re what is quorate

JCMB noted that clarification on its decision-making powers was needed following uncertainty at the last meeting regarding the status of the decision made on programme funding. Quoracy of the meeting is an important enabler of this.

SM noted that the Council cannot delegate decisions to a non-constituted body such as JCMB but can delegate to an officer (DA in JCMB’s case). JCMB is the consulting body. The key is to plan ahead as much as possible, with Damian having preview of any spending decisions to be made. ODRs (if required) should run in parallel to decision on spend, and should go in draft form to JGOG as part of the proposal.

Jackie and Hayley are designated decision makers for the CCG, and therefore one of them must be present for a decision to be made.

David commented there should be equal representation from the Council and CCG at JCMB meetings – it sometimes feels quite light on the Council side. He suggested quorate should be 3 members from each body, but with at least one decision maker from each. Jackie (or Hayley if not available) or Jo (or Damian if not available) to chair. Clinical

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input is required and this is covered by existing members (DC, AR, CD, RS).

Other points noted:

- The process for business cases and other recommendations to JCMB needs to be improved, to include the ODR process.

- JCMB needs to take more of an investment-led approach. JCOG’s Forward Plan needs to reflect this. AF and CD to develop and bring to JCMB

ACTIONS:

i. Gill and Cath to update the TORS to address quoracy and decision-making powers.

ii. CD, AF and DB to develop JCOG Forward Planiii. CD to clarify process and documentation required to support decision-

making process

GP/CDCD/AF/DB

CD

6 Messages from JCOG (in written format)

6.1 Tier 3 Weight Management Business Case for approval

This business case has been considered by JCOG, which recommends that JCMB approve it subject to a clear exit plan and funding arrangements being set out once non-recurrent BCF funding ceases. JCMB agreed this in principle, with regular updates / progress reports to be brought here – Rupert to ensure this is done.

ACTION: RS to brief JCMB on progress.

6.2 Social Prescribing Business Case for Approval

This business case has been through JCOG and several recommendations were made. The business case is transformational and funding is requested for 2 years – there is also a clear exit strategy. An onward referral fee of £15 per case is recommended for non-contracted VCF organisations who provide services as a result of social prescribing. The successful bidder is to provide guidance and development, for which a fee will be charged. A mechanism is to be built in to ensure clients do not drop off the radar if no further funding is available.

There is much evidence to show the value of Social Prescribing.

Questions were raised as follows:

Money granted to other organisations – this was clarified as grants to organisations who don’t have a contractual relationship

What is the overhead of £14 K for? – Accommodation, management, performance, talent match etc.

RS

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Confirmation of project timeframes? 1st April 2019 – 31st March 2021 – Fay to amend the business case to reflect this

Social Prescribing is seen nationally as an area to explore, and is well received by the Primary Care Trust. We need to ensure enough time has been built in to do the navigation, planning and joint working.

Social Prescribing will link into a piece of work Denise Bann leading on - £200 K community investment programme –managing the demand for services coming in to the front door. And also £200 K for a social isolation and loneliness piece of work which Debbie John-Lewis is leading on.

Damian is supportive of this business case.

DECISION: Business case approved by JCMB

ACTION: FW to clarify project milestones.

FW

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Working in partnership with the Voluntary, Community and Faith Sector to deliver outcomes for Health and Wellbeing – Katy Turner

Anthony updated this was discussed at JGOG last week and well supported. The CCG and Council and commissioned the Innovation Unit to support the VCF to develop how they work together as a sector to support improved joint working with the health and care system statutory partners. . A series of workshops have been held with the VCF sector. Not all the VCF sector were represented, however the process has been open to all

The funding request is for £60 K to fund internal resourcing / back filling of staff to release capacity from within the VCF to work up a proposal.

JCMB supported the proposal subject to:a. Tightening up the outputs from the process (i.e. what specific things will emerge

as a result) and the timeline.b. To consider the best way to remunerate the sector for the work – probably for

the funding to go through one organisation on behalf of the others and that organisation then remunerates the others

c. To keep the funding less than £50k to avoid the need for a Cabinet decision and to support the sector in-kind with things like access to rooms and so on

Team Doncaster has also agreed that this work be used as an exemplar for how the statutory sector works with the wider (beyond H&SC) VCF. The Place Plan programme will lead this work.

Jackie reminded this is BCF non-recurrent funding – we need to be open and transparent with specific outcomes, products, timeframes and an exit strategy.

DECISION: Business case approved by JCMB

ACTION: KT to action the recommendations above.

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8 AOB

8.1 Developing a Long Term Plan for the NHS

The following document / questionnaire has come from the ICS network:

There is a 10 year plan for the NHS, however it contains big implications for social care. The ICS wants to coordinate a response on specific topics. JCMB agreed to submit a response as a Place. The response needs to be submitted to the SYB ICS 21st September.

ACTION: JP and CD to coordinate the response on behalf of the ACP.

8.2 Population Health Management

NHS England is benchmarking the maturity of local health and care systems in terms of the maturity of their approach on Population Health Management. Local leads are Victor Joseph and Nabeel Alsindi. A quick turnaround regarding information governance, data flows, strategic planning and maturing the system is required.

Rupert and Anthony to hold further discussion on this, so that clarity can be provided to JCMB.

Rupert also to:

Circulate the original Population Health slides

Speak to Anthony about where the approach is best worked up Respond to the maturity matrix

There is national support available for this work.

8.3 Place Plan resources and arrangements for managing future funding proposals.

CD briefed JCMB on the Place Plan resources agreed following consideration at JCMB last month and having gone through the Council ODR process. The spread sheet detailing what has been agreed and what remains outstanding in terms of resourcing has been circulated to JCMB with the papers.

The ACPLT is considering how accountability and resourcing can be spread across the partnership. Initial discussions have been had at the ACPLT in August and will be

JP/CD

RS/AF

RS

AF

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continued at the September meeting.

9 Shared / Integrated Business Intelligence business case

Healthtrak is funded by the BCF as a 2 year project, which is halfway through. An exit strategy needs to be built in to it.

Due to time constraints today, it was suggested this be tabled at our next JCMB meeting. Anthony to speak to Michael and Jon about this.

ACTION: GP to note for the Forward Plan.

10 Standing Agenda Item – High level financial report showing running totals of the 3 BCF elements

We need to see running totals to enable future decision making. We need to plan ahead for the totality of the programme. The level of detail needs to be worked out that JCOG will require and what will be required at JCMB. This will help with forward planning and ensure funding is prioritised and used in the right way. It will link to our joint delivery plans and set out our investment-led approach for the year.

GP

SM/HT/CD/AF/DB

Date and time of next meeting: Thursday 11th October 2018 at 9am

Civic Office Meeting Room 413

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