North Central London Primary Care Committee in Common ... · Ian Bretman Lay Member (Patient and Public Involvement) Citizens Advice Bureau,Barnet No No Yes Indirect Chair 1.4.2017

Section Lead Paper Pages Time

Pre-meet to be held for committee members from 1430-1500

PART 1 AGENDA

1 Welcome and Apologies

Chair

3pm to 3:15pm

2 Declarations of interest Register Item 2 3-6

3 Minutes from the previous meeting on 21 February 2019 Item 3 7-14

4 Actions from the previous meeting on 21 February 2019 Item 4 15-20

5 Matters Arising

6 Questions from the public (These must relate to items on the agenda for this meeting. Can ask up to three questions per person.)

Items for discussion

7

Finance Report - 2018/19

Tracey Lewis Item 7

21-33

3:15pm to 3:45pm

8 NCL Quality & Performance Report Paul Sinden Item 8 34-55

Items for decision

Contract Variations:

9

All Boroughs

PMS Contract Changes

Enfield

(Medicus Health Partnership)

Forest Road Group Practice (MHP)

Riley House Surgery (MHP)

Freezywater PCC (MHP)

Southbury Surgery (MHP)

Green Street Surgery (MHP)

Lincoln Road Medical Practice (MHP)

Enfield Island Surgery (MHP)

Dean House Surgery(MHP)

Enfield

Boundary House Surgery

Vanessa Piper / CCG Lead Item 9

56-64

3:45pm to 4:15pm

North Central London Primary Care Committee in Common (Meeting Held in Public) – AGENDA

Date: Thursday 18 April 2019 Time: 15:00-16:30 Venue: Barnet CCG – Hendon Town Hall, Committee Rm 1, The Burroughs, London NW4

4AX.

Page 1 of 83

Page 2 of 2

Camden

Regents Park Practice

Prince of Wales Practice

Haringey

Myddelton Road

Barnet

None

10 Barnet

Cricklewood Health Centre – APMSContract Centre

Vanessa Piper / CCG Lead

Item 10 65-68

11 Haringey

Tottenham Hale Medical Centre - PMSContract Centre


Item 11 69-72

12 Haringey

Federation4 Health – caretaking APMScontract extension


Item 12 73-74

Items to Note – Urgent Decisions Taken Since 26 February 2019 Meeting

13 None

Items to Note and information

14 PCCC Risk Register Paul Sinden Item 14 75-814:20pm to 4:30pm 15 Committee Forward Planner Chair Item 15 82-83

16 Any other Business Chair Verbal

17 Date of Next Meeting: 20 June 2019, Clerkenwell Room, Islington CCG

Resolution to exclude observers, the public and members of the press from the remainder of the meeting. By reason of the confidential nature of the business to be transacted in accordance with Section 1, Subsection 2 of the Public Bodies (Admissions to Meetings) Act 1960 and clause 22 of the Terms of Reference of this Committee and clauses 9 and 10 of the Standing Orders of this Committee.

Page 2 of 83

Report Title Declaration of Interests Register – NCL Primary Care Committee in Common

Agenda Item: 2

Governing Body

Sponsor

N/A Tel/Email

Lead Director /

Manager

Paul Sinden, NCL Director of Performance, Planning and Primary Care

Tel/Email [email protected]

Report Author Vivienne Ahmad, Board Secretary, Islington CCG


Report Summary The Committee Members and attendees are asked to review the agenda and consider whether any of the topics might present a conflict of interest, whether those interests are already included within the Register of Interests, or need to be considered for the first time due to the specific subject matter of the agenda item.

A conflict of interest would arise if decisions or recommendations made by the Committee could be perceived to advantage the individual holding the interest, their family, or their workplace or business interests. Such advantage might be financial or in another form, such as the ability to exert undue influence.

Any such interests should be declared either before or during the meeting so that they can be managed appropriately. Effective handling of conflicts of interest is crucial to give confidence to patients, tax payers, healthcare providers and Parliament that CCG commissioning decisions are robust, fair and transparent and offer value for money.

If attendees are unsure of whether or not individual interests represent a conflict, they should be declared anyway.

Recommendation To NOTE the Declaration of Interests Register and invite members to inspect their entry and advise the meeting / Board Secretary of any changes.

Identified Risks

and Risk

Management

Actions

The risk of failing to declare an interest may affect the validity of a decision / discussion made at this meeting and could potentially result in reputational and financial costs against the CCG.

Conflicts of Interest The purpose of the Register is to list interests, perceived and actual, of members that may relate to the meeting.

Resource

Implications

Not Applicable

North Central London Primary Care

Committee in Common Meeting

18 April 2019

Page 3 of 83

mailto:[email protected]


Engagement

Not Applicable

Equality Impact

Analysis

Not Applicable

Report History and

Key Decisions

The Declaration of Interests Register is a standing item presented to every Committee Meeting.

Next Steps The Declaration of Interests Register is being presented to every Committee Meeting and regularly monitored.

Appendices

The Declaration of Interest Register.

Page 4 of 83

Register of Interests - NCL Primary Care Committee in Common - April 2019

From To

Fin

anci

al In

tere

sts

No

n-F

inan

cial

P

rofe

ssio

nal

Inte

rest

s

No

n-F

inan

cial

P

erso

nal

Inte

rest

s

Representatives from Haringey CCG

Dina Dhorajiwala GP Partner, Vale Practice Vale Practice Yes No No Direct Practice Partner 15.3.2018 8.11.2018

West GP Member, Governing Body Vale Practice is a member of Federated4Health,the pan-Haringey federation of GPPractices

Yes No No Direct Practice Partner 15.3.2018 8.11.2018

Member, Strategy and Finance Committee The Vale Practice is a memberof WISH,the Urgent Care CentreProvider at Whittington Health

Yes No No Direct Practice Patner 15.3.2018 8.11.2018

Member, Clinical Cabinet WISH, the Urgent Care Centre Provider at Whittington Health.

Yes No No Direct Director

Primary Care Lead, Governing Body NHS England Yes No No Direct GP Appraiser 15.3.2018 8.11.2018

Member, NCL Primary Care Committee in CommonVale Practice

No No Yes IndirectHusband is a practice partner and GP Principal. 1.3.2018 8.11.2018

Member, Primary Care Steering Group

Member, Primary Care Transformation Group

Member, Health and Wellbeing BoardMember, NCL Clinical Leads Reference Group

Cathy Herman Lay Member, Governing Body No No No N/A 15.3.2018 8.10.2018Chair, NCL Primary Care Committee in Common

Member, Health and Well Being Board

Chair, Investment Committee

Member, Audit Committee

Member, Quality and Performance Committee

Member, Primary Care Transformation Group and Organisational DevelopmentChair, Engagement Network

Representatives from Islington CCG

Sorrel Brookes Lay Vice Chair Help on Your Doorstep No No Yes Direct Trustee 23.08.2018

Member of Governing Body

Member,Strategy & Finance

Member, Quality & Performance Committee

Member,PPP Committee

Member, Audit Committee

Member of Remuneration Committee

Member,NCL Primary Care Committee in Common

Clare Henderson Director of Commissioning for Haringey & Islington CCGs No 5.3.2018 22.10.2018

Attendee of CCG Governing Body

Attendee, Strategy and Finance Committee

Member, Clinical Cabinet

Dominic Roberts Clinical Director, Islington CCGMember of the Executive Management Team

Greenland Passage, a residential association.

No No Yes Direct Chair & Board Member 7.11.2018

Lead on conflict of interest issues for the Governing Body and CCG.

1-12 Royal Court Ltd, Freehold Company

No No Yes Direct Secretary & Director

Caldicott Guardian for Islington & Haringey

Freedom to Speak up Guardian for Islington & Haringey

Chair of the Individual Funding Request Panel

Chair of the Locally Commissioned Services Working Group

Chair of Care Homes Working groupClinical representative for Islington & Haringey on the NCL Primary Care Joint Committee

Supporting and managing the Clinical Leads (including Darzi fellow) - recruitment, bi-monthly network meetings, appraisals, finance.

Medicines and devices Safety Officer (MSO & MDSO)Chair of the MSO/MDSO network for local CCGs andProvidersControlled drugs safety lead and Antimicrobialstewardship lead.

Member of the Whittington Care Quality Review Group

Clinical leadership for Map of medicine teamClinical leadership for serious incident reviews & patient safety

Clinical leadership for GP Practice Quality

Clinical leadership for pressure ulcer task and finish group.

Clinical leadership for Federation Working Group

Chair board Link visits

Chair of the NLP IG Working Group

Representatives from Barnet CCG

Dr Charlotte Benjamin Elected GP Representative St. George's Medical Centre Yes Yes Yes Direct GP Partner 1.3.2017 30.10.2017

JFS Brent No No No Indirect School Governor 1.3.2017 30.10.2017Chelsea and Westminster NHS FT

No No Yes Indirect Husband is a clinical lead for ENT 1.3.2017 30.10.2017

Ian Bretman Lay Member (Patient and Public Involvement) Citizens Advice Bureau,Barnet No No Yes Indirect Chair 1.4.2017 14.9.2017The company is a potentialsupplier to the NHS

No No Yes IndirectSon is a senior technical managerin a company offering an App for people to manage prescription requests and long term medication programmes

1.4.2017 14.9.2017

Colette Wood Director,Care Closer to Home No Interests Declared No No No No Nil Return 27.10.2017

Representatives from Enfield CCGJohn Piesse Head of Primary Care Referral to Improve Safety(IRIS)

a charitable organisation focusing domestic violence and abuse

Yes No No Indirect Consultancy Work Nov-17 Current 22.03.2018 23.10.2018

Karen Trew Governing Body Member and Lay member for Audit and Governance and Vice Chair

Barnet CCG, CCG Audit Committee

Yes Yes No Direct Member of Barnet CCG Audit Committee and NCL ACIC

Jul-18 Current 31.10.2018

NHS England Performer List Decision Panel (outside of North Central London)

Yes Yes No Indirect Chair of Panel Apr-13 Current 31.10.2018

Broxbourne School Hertfordshire No No Yes N/A Chair of the Governing Body (previously Governing Body membersince Nov. 2004)

Jun-15 Current 31.10.2018

Wormley C of E Primary SchoolHertfordshire

No No Yes N/A Chair of the Governing Body Jun-06 31.10.2018

Lloyds Pharmacy Clinical Homecare

No No Yes Indirect Son employed in operational role Apr-17 31.10.2018

Dr Mateen Jiwari Medical Director Royal College of GPs Yes Yes No Indirect Education Lead Oct-16 Current 29.10.2018

Imperial College No Yes Yes Indirect Honorary Senior Clinical Lecturer Mar-18 Current 29.10.2018

GDPQ Yes Yes No Indirect Clinical Director and Shareholder Mar-16 Current 29.10.2018

Digital GP Ltd Yes Yes No Indirect Director and Shareholder via PDQ Technologies

May-16 Current 29.10.2018

Barking, Havering and Redbridge

No No Yes Indirect Wife is a locum GP Aug-15 Current 29.10.2018

Deborah McBeal Deputy Director of Primary Care and Deputy ChiefOperating Officer

We are Pareto No No No N/A Director of company, dormant, non-trading

2013 Present 28.03.2018 15.10.2018

Date of InterestDate declared

Update

Is the interest direct or indirect?

First Name Second NameCurrent position (s) held- i.e. Governing Body,

Member practice, Employee or other

Declared Interest- (Name of the organisation and nature of business)

Type of Interest

Nature of Interest

Page 5 of 83

Charlotte Hampstead Group Practice Yes Yes No Direct Part Time Nurse Practitioner 18.0.2017 current 11.09.2018

Haverstock Healthcare Limited Yes Yes No Direct Works at out of hours hub at weekend 18.07/2017 current 11.09.2018

Grays Inn Road Practice Yes Yes No Direct Part Time Practice Nurse 11.09.2018 current 11.09.2018

Islington GP Federation Yes Yes No Direct Part Time Senior Nurse 11.09.2018 current 11.09.2018

Daleham Gardens Practice Yes Yes No Direct Part Time Practice Nurse 11.09.2018 current 11.09.2018

Royal College of Nursing No Yes No Direct Member 18.07.2017 current 11.09.2018

City University Yes Yes No Direct Honourary lecturer for nursing and midwif29.09.2017 current 11.09.2018

Royal College of GPs Yes Yes No Direct Education Assessor 11.04.2018 current 11.09.2018

Sarah McDonnell-Davis Director of Primary Care and Commissioning & Deputy Chief Operating Officer

PA Consulting Yes No No Direct Shareholder PA Consulting 15.06.2018 current 20.06.2018

Dr Kevan UCLH Council of Governors No Yes No Indirect Camden CCG representative on the UCL 01.03.2018 current 02.11.2018

Bloomsbury Surgery Yes Yes No Direct GP Partner 13.06.2017 current 02.11.2018

Central Health Evolution Limited Yes Yes No Direct GP Practice is a Member 13.06.2017 current 02.11.2018

Haverstock Health Care Yes Yes No Direct Shareholder in GP Federation 01.11.2016 current 02.11.2018

CCAS Assessor Yes Yes No Direct 2-4 sessions per month 13.06.2017 current 02.11.2018

Neeshma Shah Director of Quality and Clinical Effectiveness Independent consultant Yes Yes No Direct Occasional ad hoc consultancy work on sole trader basis on subject matter relating to medicine, the pharmacy profession and the health and social care landscape

24.04.2013 current 24.0.2018

Glenys The Young Foundation No Yes Yes Direct Senior Fellow 18.05.2018 current 02.11.2018

Member of the House of Lords No Yes No Direct Baroness Thornton - Labour and Co-operative Member From 1.11.2017: Opposition spokesperson for Health

09.08.2017 current 02.11.2018

London School of Economics No Yes Yes Direct Emeritus Governor 09.08.2017 current 02.11.2018

Social Enterprise UK No Yes Yes Direct Patron 09.08/2017 current 02.11.2018

Healthcare and Assistive Technology Society

No Yes Yes Direct Chair of the Advisory Panel and Patron 09.08.2017 current 02.11.2018

Phone Coop Foundation for Co-Operative Innovation

Yes Yes No Direct Chair until 1 June 2018 as the Coop merged with Mid Counties cooperative

18.05.2018 01.06.2018 02.11.2018

Power of Empathy No Yes Yes Direct Board Member 09/01/2019 current 31/01/2019

Social Business International No Yes Yes Direct Senior Associate - Group Leader of Social Enterprises who provide public services and supporting 'Bold Commissioners' Group of public sector commissioners

31.10.2018 current 02.10.2018

Rebecca Booker Deputy Chief Finance Officer No No No None 18.10.2017 7.11.2018

Tracey Lewis Interim Head of Finance TBC

Representatives from NCL

Simon Goodwin Chief Finance OfficerMember, NCL CCG Governing Bodies

East London Foundation Trust No No Yes Indirect Wife is Senior Manager at the Trust 14.6.2017 12.10.2018

Member of all five CCG Finance Committees

Attendee, CCG Audit Committees and NCL Audit Committee in Common Attendee, NCL Joint Commissioning Committee

Attendee, NCL Primary Care Co Commissioning in Common

Paul Sinden NCL Director of Performance, Planning & Primary Care No No No N/A 30.4.2018

Attendance at Governing Body for all 5 CCGs in NCL

Attendance of NCL Committees - Primary Care and Joint Committee

Vanessa Piper Head of Primary Care, NC London No No No N/A 31.10.2018Attendee of NCL Primary Care Committee in Commonand other committees when required

Stakeholders

Emma Whitby Chief Executive at Healthwatch Islington Age UK East London Direct Trustee 1.7.2015

Greg Cairns Director of Primary Care StrategyLondonwide LMCs

No No No N/A 18.12.2018

Representatives from Camden CCG

Ritchie Elected GP Representative

Thornton Lay Member

Cooley Elected Practice Nurse

Page 6 of 83

Item 3:

Page 1 of 8

2

NORTH CENTRAL LONDON PRIMARY CARE COMMITTEE IN COMMON

(Meeting held in public)

Draft Minutes of the Meeting held on Thursday 21 February 2019 between 3pm and 4:30pm

Haringey Civic Centre, Committee Rooms 1&2, 1st Floor, Civic Centre, High Road, Wood Green, N22 9SB

Present: Voting Members: Ms Cathy Herman (Chair) Governing Body Lay Member, Haringey CCG Ms Sorrel Brookes Governing Body Lay Member, Islington CCG Mr Ian Bretman Governing Body Lay Member, Barnet CCG Ms Glenys Thornton Governing Body Lay Member, Camden CCG Ms Karen Trew Governing Body Lay Member, Enfield CCG GP Representatives Dr Dina Dhorajiwala Governing Body GP Member, Haringey CCG Dr Dominic Roberts Clinical Director, Islington CCG (and also representing Camden

CCG and Enfield CCG) Dr Nick Mistry GP Clinical Lead, Barnet CCG Officer Representatives Ms Clare Henderson Director of Commissioning, Haringey CCG & Islington CCGs Ms Deborah McBeal

Director of Primary Care Commissioning and Deputy Chief Operating Officer, Enfield CCG

Ms Sarah McDonnell-Davies

Deputy Chief Operating Officer and Director of Primary and Community Care, Camden CCG

Ms Colette Wood Director of Care Closer to Home, Barnet CCG Ms Neeshma Shah Director of Quality & Clinical Effectiveness, Camden CCG Mr Paul Sinden NCL Director of Performance, Planning and Primary Care Non-Voting Members Mr Greg Cairns Director of Primary Care Strategy, London wide LMCs In attendance Mr John Piesse Head of Primary Care Commissioning, Enfield CCG Ms Tracey Lewis NCL Primary Care Finance Lead, Camden CCG Ms Vanessa Piper Head of Primary Care, NCL Primary Care Team Mr Chris Hanson Governance and Risk Lead, NCL CCGs Ms Vivienne Ahmad (Minutes)

Board Secretary, Islington CCG

Apologies: Dr Charlotte Benjamin Governing Body GP Member, Barnet CCG Dr Mateen Jiwani Governing Body GP Member, Enfield CCG Dr Kevan Richie Governing Body GP Member, Camden CCG Ms Charlotte Cooley Governing Body Practice Nurse, Camden CCG Mr Simon Goodwin Chief Finance Officer, NCL CCGs Ms Rebecca Booker Deputy Chief Finance Officer, Camden CCG Ms Emma Whitby Chief Executive of Healthwatch Islington

Page 7 of 83

Item 3:

Page 2 of 8

1. Welcome & Apologies

1.1 The Chair welcomed members and attendees to the meeting.

1.2 Apologies were recorded as above. 2a

Declarations of Interests Register

2a.1 The Declarations of Interest Register was considered. There were no changes / updates declared.

2b Declarations of Interest Relating to Items on the Agenda

2b.1 Dr Mistry declared his conflicts of interests in item 12.3 and 12.5 in regards to St Andrews Medical Practice and Derwent Medical Centre and therefore would leave the room for these items.

3 Minutes of the of the previous meeting held on 20 December 2018

3.1

The minutes of the meeting held on 20 December were APPROVED as an accurate record.

4 Actions from the previous meeting held on 20 December 2018

4.1

The action log was reviewed and updated.

5 Matters Arising – To provide clarity on the governance of the process by which GP Practice space may be declared surplus to requirements

5.1

Following discussion at the Committee in December 2018 further clarification was provided on the governance process to declare any GP practice space as being surplus. It was suggested that the NCL Primary and Community Estates Board (with representation from all five CCGs) would be the best forum to identify surplus capacity for sign off by the Committee. Agreed surplus capacity would then be declared to NHS Property Services. The Committee asked that a protocol be developed to ensure all necessary work had been undertaken prior to any space being declared as surplus. Governance for the decision-making process above between the Primary and Community Estates Board and the Committee would be agreed with the NCL Head of Governance and Risk.

5.2 Action:

To agree the governance process for declaring GP Practice space as being declared surplus to requirements (Paul Sinden and Andrew Spicer)

5.3 The Committee NOTED the verbal report.

6 Questions from the public

6.1 The Chair invited members of the public to ask any questions relating to the agenda. Written questions had been submitted in advance and an overview provided at the Committee. It was confirmed that formal responses would be appended to the minutes and published on the CCG website.

ITEMS FOR DISCUSSION

7 PCCC Terms of Reference

6.1 Chris Hanson presented an updated PCCC Terms of Reference (TORs) with only minor changes being made to: Simplify the Committee title to fully reflect delegated arrangements; Simplify wording to make the Terms of Reference an easier read;

Page 8 of 83

Item 3:

Page 3 of 8

Strengthened the ability to amend the membership list without the need to formally change the Terms of Reference.

On approval by the Committee the updated Terms of Reference would then go to all five CCG Governing Bodies for approval.

6.2 In response to the report the Committee requested: The addition of an NCL CCG Director of Quality as a non-voting member (8.3); Clarity on the roles, and recruitment to the external clinical posts over and above the

current practice nurse member. 6.3 Action:

To amend the terms of reference as above. (Chris Hanson) 6.4

Action:

To include the revised Committee Terms of Reference in the Accountable Officer's report for the five CCG Governing Bodies. (Vivienne Ahmad & Karl Thompson)

6.5

The Committee APPROVED the revised Committee Terms of Reference subject to the above amendment.

8 Finance Report – Month 9 of 2018/19

8.1 Tracey Lewis provided an overview of the month 9 finance report that covered both delegated primary care medical services budgets and CCG expenditure in primary care: Delegated budgets were forecast to overspend by £2.3m accruing from the £2.6m

pressure on Camden budgets; For overall primary care budgets (delegated and CCG held) there was an underspend

of £2.2m, this was predominately on prescribing and primary care other which then offset the overspend on delegated budgets;

The report itemised spend across CCGs in a standard way to allow comparisons across CCGs, and included the use of GP Forward View monies (£1.6m for NCL), spend on locally commissioned services, and CCG £1.5 per head investment (£2.8m for NCL);

The Committee received an additional paper on 2019/20 allocations for delegated budgets that had just been received from NHS England. The uplift across NCL was 6.74% for 2019/20 and would need to cover the global sum uplift, population changes, cost pressures and investments. A more detailed report would on sources and application of funding in 2019/20 would be received by the Committee in April 2019.

8.2 In response to the report the Committee:

Asked for a breakdown of primary care “other” expenditure in the next report to help answer questions being asked at CCG strategy and finance committees;

Requested an update on the list cleansing process being undertaken by Capita in the context of registered populations being 15-20% in excess of resident populations across the five CCGs;

Requested an update in April 2019 as to whether the allocations uplift to delegated budgets in 2019/20 would help offset some of the cost pressures experienced by Camden CCG in 2018/19. Work was on-going in CCGs to establish budgets for next year and identify risks and contingencies.

8.3 Action:

To update the finance report for April 2019 to include a breakdown of primary care “other” expenditure. (Tracey Lewis)

8.4

Action:

To provide an overview of budgets for 2019/20. (Tracey Lewis) 8.5 The Committee NOTED the report. 9 NCL Quality & Performance Report

9.1 The Committee received an overview of the report with the baseline information remaining unchanged from the report to the Committee in December 2018. The Committee were asked to note:

Page 9 of 83

Item 3:

Page 4 of 8

NHS England were compiling themes from complaints escalated to them (those not resolved at practice level);

Evidence on the impact of deprivation on on-line access to general practice would be fed into plans for enhancing digital access to general practice;

An update on managing serious incidents would be provided to the Committee in June 2019 once guidance from NHSE has been finalised. .

9.2 In response to the report the Committee: Requested that the Committee receive a future report on workforce, in particular on

mitigating risks related to an ageing workforce in general practice. A report on workforce was scheduled to come to the Committee in June 2019.

9.3 Action:

To provide an update on workforce in June 2019. (Paul Sinden) 9.4 The Committee NOTED the report. 10 NHS Long Term and National GP Contract

9.1 The Committee received an overview of the priorities for primary care set out NHS Long Term Plan published in January 2019, and an overview of the new five-year GP contract to be introduced from April 2019. The Committee were asked to note: Many changes to the GP contract were designed to support implementation of the

NHS Long Term Plan including the establishment of primary care networks supported by multi-disciplinary teams;

The consistency of the NCL strategy for general practice (approved in November 2018) with the priorities set out in the NHS Long Term Plan;

The new GP contract introduced changes for the alignment of practices to networks, a greater quality improvement focus in the Quality Outcomes Framework, and the introduction of on-line access;

Full technical guidance to support the introduction of the new GP contract was yet to be published;

A meeting with the Local Medical Committee (LMC) had been set up to discuss the introduction of the new GP contract;

A new national scheme for indemnity was to be introduced removing the cost pressure of rising indemnity costs from practices.

9.2 In response to the report the Committee: Welcomed the opportunity to discuss the NHS Long Term Plan and new GP contract

at the Committee Seminar to be held in May 2019.

9.3 The Committee NOTED the report.

11 Finchley Memorial Update – Barnet CCG

11.1 The Committee received an update on the relocation of Ravenscroft Medical Centre into Finchley Memorial Hospital. Greg Cairns the Local Medical Committee (LMC) representative declared an interest for this item. It was noted: The practice was selected to relocate following an expression of interest process

open to all practices in Barnet; Consultation on the decision started on 1 February 2019 and scheduled to finish on

25 April 2019; Alongside the consultation an equalities impact assessment and quality impact

assessment were being undertaken; Once the consultation and impact assessments were complete a report with

recommendations would come to the Committee for approval.

11.2 In response to the report the Committee: Asked that the embedded report be circulated to the Committee separately.

Page 10 of 83

Item 3:

Page 5 of 8

11.3 Action:

To circulate to the embedded report to the Committee. (Vivienne Ahmad) 11.4 The Committee NOTED the report.

ITEMS FOR DECISIONS

Contract Variations

12 All Boroughs - PMS Contract Changes

BARNET

12.1 Torrington Park Group Practice –The Committee was asked to approve the removal of a GP partner from the contract from 31 March 2019, with the capacity replaced by the practice recruiting two salaried GPs.

12.2 The Committee APPROVED the recommendation. 12.3 Dr Mistry of Barnet CCG declared a conflict of interest for the next two items and

left the room. Dominic Roberts was co-opted to cover for Barnet. St Andrews Medical Practice – The Committee was asked to approve an additional GP partner joining the PMS Agreement, with the new partner being an existing salaried GP at the practice. The new partner would help cover anticipated list size growth from nearby housing developments and improve access to benchmark levels.

12.4 The Committee APPROVED the recommendation on condition that the practice improved access to benchmark levels.

12.5 Derwent Medical Centre – The Committee was asked to approve the removal of a GP partner from the contract. The practice was in discussion with a local practice to either become joint signatories on both contracts or merge.

12.6 The Committee APPROVED the recommendation. 12.7 Dr Mistry came back into the room.

Mountfield Surgery - The Committee was asked to approve one GP taking 24-hour retirement on 2 March 2019. Current level of GP sessions would be maintained across the GP partners.

12.8 The Committee APPROVED the recommendation. 12.9 Greenfield Medical Practice - The Committee was asked to approve a contract

variation for new practice opening hours, with no half-day closer from April 2019.

12.10 The Committee APPROVED the recommendation. CAMDEN

12.11 James Wigg Practice – The Committee was asked to approve the addition of a GP partner to the PMS Agreement. The new partner was currently a salaried GP at the practice.

12.12 The Committee APPROVED the recommendation. 12.13 Holborn Medical Centre – The Committee was asked to approve the addition of a GP

partner to the contract to change GP portfolios to improve same day access and access for patients with complex needs.

12.14 The Committee APPROVED the recommendation. 12.15 Keats Group Practice - The Committee was asked to approve the removal of two

retiring GP partners and addition of a new GP partner to the contract. Additional salaried GP appointments would be put in place to improve access to benchmark levels, with progress to this monitored locally.

Page 11 of 83

Item 3:

Page 6 of 8

12.16 The Committee APPROVED the recommendation. 12.17 Daleham Gardens Health Centre - The Committee was asked to approve the issue of

a contract variation with the new practice opening hours.

12.18 The Committee APPROVED the recommendation. 12.19 Rosslyn Hill Surgery - The Committee was asked to approve a contract variation for

new practice opening hours removing half-day closure from 1 September 2018.

12.20 The Committee APPROVED the recommendation. ENFIELD

12.21 Forest Road Group Practice, Riley House Surgery, Freezywater PCC, Southbury Surgery, Green Street Surgery, Lincoln Road Medical Centre, Enfield Island Surgery and Dean House Surgery (Medicus Health Partnership) - The Committee was asked to approve the addition of a GP signatory to the 8 PMS contracts from 1 April 2019.The new partner would do 5 sessions per week at Connaught Surgery and work across the Medicus Health Partnership sites.

12.22 The Committee APPROVED the recommendation. HARINGEY

12.23 Myddleton Road Surgery - The Committee was asked to approve an additional GP partner joining the PMS Agreement to help the practice extend access to remove half-day closure and move appointments to benchmark levels.

12.24 The Committee APPROVED the recommendation. 12.25 Bridge House Medical Practice - The Committee was now asked to approve two

variations - (a) to remove the non-clinical signatory and (b) to remove the GP partner. The Committee had approved the removal and recruitment of a new GP partner in August 2018 but the new partner then did not join the practice. The practice would seek to find a new GP partner, possibly from the current salaried GP cohort.

12.26 The Committee APPROVED the recommendation. 13 Camden - Brunswick Medical Centre Contract Extension

13.1 The Committee was asked to approve extending the current contract until 31 December 2019, with an option to extend to April 2020 to enable re-procurement of the contract through Tranche 7 of the London-wide Alternative Personal Medical Services (APMS) procurements. The new contract would commence in January 2020. It was noted that in December 2018 the Committee approved extending the current contract until 30 September 2019 and re-procurement of the APMS contract on a 5-year term (with option to extend for up to 5 further years). However, this extension did not fit with the Tranche 7 process hence the request for the further extension above.

13.2 The Committee APPROVED the recommendation to extend the contract until 31 December 2019, with an option to extend to April 2020.

14 Camden - Camden Health Improvement Practice Extension

14.1 The Committee was asked to approve extending the current contract until 31 December 2019, with an option to extend to April 2020 to enable re-procurement of the contract through Tranche 7 of the London-wide Alternative Personal Medical Services (APMS) procurements. The new contract would commence in January 2020. It was noted that in October 2018 the Committee approved extending the current contract until 30 September 2019 and re-procurement of the APMS contract on a 5-year term (with option to extend for up to 5 further years). However, this extension did not fit with the Tranche 7 process hence the request for the further extension above.

Page 12 of 83

Item 3:

Page 7 of 8

14.2 The Committee APPROVED the recommendation to extend the contract until 31

December 2019, with an option to extend to April 2020. 15 Barnet - East Barnet Merger

15.1 The Committee was asked to approve the merger of three PMS contracts from 1 April 2019. The merged practices would continue to operate from East Barnet Health Centre, and would operate as 'East Barnet Group of Doctors'. The practices had undertaken informal consultation with patients on the 3 lists, and notified the CCG and Barnet GP Federation of the intentions to merge. The Committee was being asked to approve the merger and site closure subject to the following conditions: Patient and wider stakeholder engagement would be under taken in March 2019 and

feedback used to inform service changes Satisfactory submission of a signed liability agreement. A financial statement which assures that practice accounts have been reviewed. Assurances that a lease agreement is in place prior to full merger on 1 April 2019.

15.2 The Committee APPROVED the recommendation of the merger of three PMS contracts from 1 April 2019 subject to fulfilment of the conditions listed above.

16 Management of practices who close half day

16.1 The Committee was asked to approve the next steps in the process to ensure that practices closing for half-a-day had adequate sub-contracting arrangements in place. The GP contract did not include a clear definition of the required sub-contracting arrangements so NHS England had undertaken a national consultation exercise to provide national criteria as to how “reasonable needs of patients could be met”. In October 2018 a report to the Committee identified 37 practices that closed for half-a-day without providing adequate sub-contracting arrangements, and a process was underway with these practices to align their arrangements with the national criteria The Committee was therefore asked to approve the following: 1. Practices who have confirmed that they will now open for the half-day - issue a

contract variation notice citing the new opening hours. This related to 11 of the 37 practices

2. Practices who have failed to respond - issue a formal contract request for information. Failure to respond to the contract request for information would place the practice in breach of contract. This related to 6 of the 37 practices.

3. Practices who have responded again by stating that their current sub- contracting arrangements were satisfactory - issue a formal contract request for information. Failure to respond to the contract request for information would place the practice in breach of contract. This related to 7 of the 37 practices.

4. Practices who had commenced active discussion with their subcontractors to deliver the list of reasonable needs – the Committee would receive an update for these practices in 18 April 2019.

16.2 In response to the report the Committee:

Agreed to the approach to the four categories of practices above, but requested that those practices not yet meeting the requirements be further supported to do so by providing responses that would meet the national criteria;

Noted that delivery of cover for half day closure may change as primary care networks were developed.

16.3 Action:

Update report to be received by the Committee in April 2019. (Vanessa Piper)

16.4 Action:

Page 13 of 83

Item 3:

Page 8 of 8

Guidance provided to practices not yet compliant with cover arrangements (Vanessa Piper)

16.5

The Committee APPROVED the recommendation of the next steps to be taken.

ITEMS TO NOTE - URGENT DECISIONS TAKEN SINCE THE DECEMBER MEETING

17 Enfield: Arnos Grove Medical Centre's request to increase rent

17.1 The Committee was asked to note that the urgent decision process was used in January 2019 to approve the practice request for an additional clinical room to meet the demands of a growing list size. The urgent decision was required to secure the room, because the landlord intended to lease the room to another provider if agreement for use by the practice was not concluded in January 2019. The additional room would increase the current market rent by £4,124 per annum. To assist with this the practice had cleared all outstanding rent arrears and signed the tenancy at will, signature of the lease was to follow.

17.2 The Committee NOTED the decision taken.

ITEMS TO NOTE AND INFORMATION

18 PCCC Risk Register

18.1 Paul Sinden presented the paper summarising the risks falling within the remit of the Committee, with the register having been updated in line with Committee approval in December 2018. The report was now supported by a risk tracker and heat map. PCCC Risk 12 - Managing variation in primary care quality and performance across NCL – a meeting would be set up to help develop this was about CCGs develop an early warning system to identify struggling practices and enhance current levels of support before regulatory action was required. PCCC Risk 18 - Primary Care Support England - Capita contract delivery – Capita had restarted the patient list cleansing process in agreement with NHS England, but further information was required on the timing (by geography) and scheduling of the work across population cohorts.

18.2 The Committee NOTED the risk report. 19 Committee Forward Planner

19.1 The Committee Seminar would now be held in May 2019 rather than March 2019 to maximise attendance.

19.2 Action:

To update the forward planner with the PCCC seminar on 16 May 2016. (Vivienne Ahmad)

19.3 The Committee NOTED the forward planner. 20 Any other Business

20.1 Committee effectiveness was scheduled for review. Questionnaires would be given to members at the April meeting and the results would be drawn together for a report to be discussed at the Seminar in May 2019.

20.2 Action:

Committee effectiveness questionnaires to be given to Committee members at the next meeting on 18 April 2019. ( Paul Sinden & Vivienne Ahmad)

21 Date of next meeting

21.1 Thursday 18 April 2019, 3pm to 4:30pm in Committee Room 1, Hendon Town Hall, The Burroughs, Barnet, London, NW4 4BG.

Page 14 of 83

Item 4 - NCL Primary Care Joint Committee - Action Log

Action Log – Part 1 Meeting Date

Action No.

Minutes Ref

Action Action lead Deadline Status update Date closed

16/08/18 2 6.3 Request from NHSE Complaints Team whether they report on the themes by practice and CCG on complaints received

Vanessa Piper 18.04.19 10.04.19 - The NHS England Complaints team have confirmed that a report can be produced on the themes of concern by practice for 2018/19 financial year. The report will be ready by 15 April 2019. This can be shared initially with the CCG leads and then incorporated into the PCCC performance report for June 2019. 21.02.19 – agreed to keep this action open until report received - estimate for April 19 meeting .

20.12.18 1 1.3 Introduction - To organise a seminar in March 2019 to discuss the strategic impact on primary care services arising from the 10 year plan.

Vivienne Ahmad / Paul

Sinden

21.02.19 12.03.19 - The Seminar will now take place on 16 May 2019 instead of March 2019. Recommend to close this action. 14.02.19 – PCCC Seminar is in the process of being booked for March.

Page 15 of 83

Page 2 of 6

20.12.18 2 1.4 Introduction - To contact Emma Whitby to thank her for her support to date and encourage Healthwatch representation in the future.

Paul Sinden 18.04.19 18.04.19 – Deborah Fowler from Enfield Healthwatch has agreed to join the Committee from April 2019. Recommend to close this action.

21.02.18 - It was agreed to keep this action open. 14.02.19 - Emma Whitby contacted and other Healthwatch teams asked for nominations.

20.12.18 3 1.5 Introduction - To explore the option of appointing patient representative(s) to preserve the overall balance on this committee.

Paul Sinden / Cathy Herman

18.04.19 18.04.19 – Deborah Fowler from Enfield Healthwatch has agreed to join the Committee from April 2019. Recommend to close this action.

21.02.18 - It was agreed to keep this action open. 14.02.19 - CCGs asked to identify potential patient reps from respective primary care committees.

20.12.18 6 7.3 Performance & Quality Report - to agree with NCL CCGs’ Directors of Quality the proposal that QISTs would support practices re SI and sharing the learning; a paper summarising the implementation of incidents in general practice, teasing out the role of CCG Quality and Safety teams, GP practices, Federations and QISTs.

Paul Sinden / Neeshma

Shah / Dominic Roberts

20.06.19 18.04.19 – February 2019 Committee agreed to receive a report in June 2019.

20.12.18 7 8.3 London Strategic Framework for Primary Care - To assess the degree of alignment of Healthy London Partnership (HLP) initiatives

Paul Sinden 18.04.19 21.02.19 - It was agreed to keep this action open.

Page 16 of 83

Page 3 of 6

with those of the CCGs to help determine the level of synergy that exists.

14.02.19 - A review of Health London Partnerships and London Levies support for CCGs underway for 2019/20. Results will be shared once review complete.

21.02.19 1 5.2 Matters Arising: GP Practice space declared surplus to requirements – To agree the governance process for declaring GP Practice space as being declared surplus to requirements.

Paul Sinden and Andrew

Spicer

18.04.19 Recommendations from NCL Primary and Community Estates Board will come to the Committee for approval. Recommend close this action.

21.02.19 2 6.3 PCCC TORs - To amend the PCCC Terms of Reference.

Chris Hanson 28.02.19 22.02.19 - The TORs were updated with the amendments. Recommend to close this action.

21.02.19 3 6.4 PCCC TORs – To include the revised Committee Terms of Reference in the Accountable Officer’s Report for the 5 CCGs Governing Bodies.

Vivienne Ahmad & Karl

Thompson

01.03.19 01.03.19 - The revised PCCC TORs were added to the AO Report for all five CCGs. Recommend to close this action.

21.02.19 4 8.3 Finance Report – To update the finance report for April 2019 to include a breakdown of primary care ‘other’ expenditure.

Tracey Lewis 18.04.19 Included in April 2019 Finance Report Recommend close this action.

21.02.19 5 8.4 Finance Report - To provide an overview of 2019/20 budgets at the April 2019 Committee.

Tracey Lewis 18.04.19 Included in April 2019 Finance Report Recommend close this action.

Page 17 of 83

Page 4 of 6

21.02.19 6 9.3 NCL Quality & Performance Report- To provide an update on workforce in August 2019.

Paul Sinden 22.08.19 09.04.19 – Update on workforce has been added to the forward planner. Recommend close this action.

21.02.19 7 11.3 Finchley Memorial Update – To circulate the embedded report attached to the Finchley Memorial Update.

Vivienne Ahmad

20.03.19 20.03.19 – This was duly circulated to the Committee members. Recommend to close this action.

21.02.19 8 16.3 Management of practices who close half a day - An update report to be received by the Committee in April 2019.

Vanessa Piper 18.04.19 10.04.19 - There has been a hold on writing out to the remaining 24 practices who continue to close ½ day with a contractual Request for Information until the guidance was released for the Primary Care Network DES. The publication of the Primary Care Network was released on 29 March 2019 and stated ‘Unless a GP practice has prior written approval from the commissioner, no PCN member GP practice will be closed half day on a weekly basis and all patients must be able to access essential services, which meet the reasonable needs of patients during core hours,

Page 18 of 83

Page 5 of 6

from their own practice or from any sub-contractor. This means that unless a GP practice has prior written approval from the commissioner, all PCN GP member practices will not close for half a day on a weekly basis’. (4.6.8 page 27) Therefore in light of the PCN DES it has been agreed across NCL that for the 24 remaining practices a revised letter will be sent focusing on the benefits of the PCN DES, requirements for sign up to a network in relation to a ½ day closure. An update will then be brought to the June 2019 PCCC in conjunction with the PCN network agreements.

21.02.19 9 16.4 Management of practices who close half a day - Guidance provided to practices not yet compliant with cover arrangements.

Vanessa Piper 18.04.19 Update in Committee papers for April 2019.

21.02.19 10 19.2 Committee Forward Planner - To update the forward planner with the PCCC seminar on 16 May 2016.

Vivienne Ahmad

18.04.19 18.03.19 - The Forward Planner has been amended so the next PCCC seminar is on 16 May 2019.

Page 19 of 83

Page 6 of 6

Recommend to close this action.

21.02.19 11 20.2 AOB - Committee effectiveness questionnaire to be given to Committee members at the next meeting on 18 April 2019.

Vivienne Ahmad & Paul

Sinden

18.04.19 Questionnaire distributed to Committee members at April 2019 meeting. Recommend close this action.

Page 20 of 83

Central London Primary Care Committee in Common Meeting – 18 April 2019

Report Title Primary Care Finance Report (Month 11 2018/19)

Date of report

10th April 2019

Agenda Item

Leave blank

for

Committee

Secretary

Lead Director /

Manager



GB Member Sponsor

N/A

Report Author

Tracey Lewis – Interim Head of Finance for NCL Primary Care


Name of

Authorising

Finance Lead

Rebecca Booker Camden CCG Deputy Director of Finance

Summary of Financial Implications

Review of Primary Care expenditure versus budget across the five North Central London CCGs.

Report Summary

This report presents the Month 11 Primary Care financial position across the five North Central London CCGs.

Recommendation The Primary Care Committee in Common is asked to NOTE the contents of this report.

Identified Risks

and Risk

Management

Actions

This report is one element used to monitor the Clinical Commissioning Group’s financial and other performance in terms of adherence to core statutory duties.

Conflicts of Interest

Resource

Implications

There are no resource implications arising from this report.

Engagement

This report is being presented to the Committee which includes lay members, clinicians and key stakeholders.

Equality Impact

Analysis

This report was written in accordance with the provisions of the Equality Act 2010.

Report History

and Key

Decisions

N/A

Next Steps N/A Appendices None

Page 21 of 83


Primary Care Finance Report 2018/19

Month 11 February 2019

1Page 22 of 83

2

Executive Summary 3

Total Primary Care Budget 4

Year to Date Spend by Service Area 5

General Practice Delegated Commissioning 8-9

Prescribing 10

Locally Commissioned Services 11

GP Forward View Investment 12

Page 23 of 83

Executive Summary

3

• This report presents the 2018/19 Primary Care financial position across the five North Central London

(NCL) CCGs (Barnet, Camden, Enfield, Haringey and Islington CCG) as at Month 11, February 2019

• The report summarises the Month 11 expenditure against budgets. Previously the committee have

received the finance report detailing 2018/19 Primary Care budgets for the NCL CCGs as at Month 9,

December 2018

• As at Month 11, the NCL Primary Care budget is forecasting a net under-performance of £0.29m against

a budget of circa £424m.

• A key message in 2018/19 is that NCL continues to face significant financial pressures across the wider

health and care arena and Primary Care expenditure is managed within each individual CCG control

totals.

Page 24 of 83

NCL Primary Care Budgets

4

• Table 1 details the total NCL Primary Care budget and forecast outturn for the financial year 2018/19 as at Month 11, February 2019

• The NCL Primary care budgets are forecast to under perform by £0.29m. Within this forecast there are a number of variances, including under performance in Prescribing, £3.3m.. This under performance is offset by over-performance in other services, including £2m in General Practice (GP) Delegated Commissioning and £2m in Primary Care Other.

• The total under performance of 0.29m at Month 11, represents an adverse movement of £1.91m from the reported Month 9 position of £2.2m.

Table 1: Primary Care Budgets

2018/19 BUDGET vs FOTMonth

9

Budget FoT Var

Fav/(Adv) Budget FoT Var





Fav/(Adv)

Var Fav/(Adv)

GP Delegated Commissioning

GP Delegated Commissioning 50,841 50,841 0 37,526 40,165 (2,639) 42,881 42,881 0 42,731 42,431 300 37,065 36,717 348 211,044 213,035 (1,991) (2,339)Total Spend on the GP DC budget 50,841 50,841 0 37,526 40,165 (2,639) 42,881 42,881 0 42,731 42,431 300 37,065 36,717 348 211,044 213,035 (1,991) (2,339)

Primary Care services

Prescribing 49,223 46,814 2,409 24,743 24,818 (75) 37,689 38,014 (325) 29,819 29,205 614 25,011 24,334 677 166,485 163,185 3,300 3,312Locally commissioned services 744 0 744 3,124 3,149 (25) 987 987 0 310 275 35 2,019 2,018 1 7,183 6,428 755 1Out of Hours 4,035 3,755 280 2,744 2,744 (0) 3,682 4,216 (534) 2,450 2,271 179 3,903 3,576 327 16,813 16,562 252 84Practice Transformation Support £3p/h 711 711 0 432 432 0 513 513 0 682 685 (3) 595 595 (0) 2,932 2,936 (3) (103)PC - Other* 2,130 2,130 (0) 2,645 2,557 88 4,603 4,603 0 3,114 5,408 (2,294) 815 670 145 13,307 15,368 (2,061) 1,470GP IT Costs 1,494 1,494 0 2,543 2,434 109 1,054 1,054 0 804 804 0 667 738 (71) 6,562 6,524 38 (186)Total Spend on the GP DC Budget 50,841 50,841 0 37,526 40,165 (2,639) 42,881 42,881 0 42,731 42,431 300 37,065 36,717 348 211,044 213,035 (1,991) (2,339)

Total spend All Primary Care Services 109,178 105,745 3,433 73,757 76,299 (2,542) 91,408 92,266 (859) 79,909 81,078 (1,169) 70,074 68,648 1,427 424,326 424,036 290 2,238

Number of Practices 61 61 0 34 34 0 48 48 0 39 39 0 33 33 0 215 215 0 215

Registered Patients 422,598 427,762 (5,164) 281,291 292,438 (11,147) 337,160 343,132 (5,972) 317,923 322,032 (4,109) 251,627 257,212 (5,585) 1,610,599 1,642,576 (31,977) 0

Total Spend per Practice (£000) £1,790 £1,734 £56 £2,169 £2,244 -£75 £1,904 £1,922 -£18 £2,049 £2,079 -£30 £2,123 £2,080 £43 £1,974 £1,972 £1 £1,971

Total Spend per Regd Patient (£) £258 £247 £11 £262 £261 £1 £271 £269 £2 £251 £252 -£0 £278 £267 £12 £263 £258 £5 £253

Total

£'000

NHS Barnet CCG

£'000

NHS Camden CCG

£'000

NHS Enfield CCG

£'000 NHS Haringey CCG £'000 NHS Islington CCG £'000

Page 25 of 83

5

Year To Date Spend By Service AreaGraph 1, Spend by service details the year to date expenditure by service area for each CCG.

Page 26 of 83

General Practice Delegated Commissioning

• Table 2 summarises the budget, year to date (YTD) and the 18/19 forecast outturn (FOT) position as at Month 11, February 2019 for the NCL CCGs

• The GP Delegated Commissioning budget consists of the core Primary Care contracts. The budget represents 51% of the total Primary Care budget and is split into the main contracts General Medical Services (GMS), Personal Medical Services (PMS) and Alternative Provider Medical Services (APMS)

• The delegated budget is £211m and is forecast to overspend by £2m across the five NCL CCGs. The following slides 3 to 7 details GP Delegated Commissioning budgets for each NCL CCG

6

Table 2: NCL GP Delegated Budgets

£000's £000's £000's £000's £000's £000's

PMS 92,074 82,513 82,945 432 92,834 (760)

GMS 94,008 85,016 83,122 (1,894) 91,904 2,105

APMS 10,239 9,172 9,364 192 10,130 109

Other Medical Services 7,169 6,389 13,621 7,232 10,147 (2,978)

Surplus/Deficit inc Contingency & NR 7,554 3,692 0 (3,692) 8,021 (467)

Total Primary Care Medical Services 211,044 186,783 189,052 2,269 213,035 (1,991)

Forecast

Variance

Fav/(Adv)

Forecast

OutturnService

Annual

BudgetYTD Budget

YTD Actual

Expenditure

YTD

Variance

Fav/(Adv)

Page 27 of 83


7

Camden CCG is forecasting an over-performance of £2.6m, this is due to the actual contract costs being higher than the allocation.

Barnet CCG is forecasting to break-even at Month 11 on the Delegated Commissioning Budget.

Table 4: Camden CCG Delegated Budget

Table 3: Barnet CCG Delegated Budget

Barnet CCG £000's £000's £000's £000's £000's £000's

PMS 22,317 20,457 20,478 21 22,592 (275)

GMS 24,658 22,603 21,874 (730) 24,317 341

APMS 447 410 404 (6) 448 (1)


Surplus/Deficit inc Contingency & NR 1,534 1,406 0 (1,406) 0 1,534

Total Primary Care Medical Services 50,841 46,605 46,605 (0) 50,841 (0)

Annual

BudgetYTD Budget

YTD Actual

Expenditure

YTD

Variance

Fav/(Adv)

Forecast

Variance

Fav/(Adv)

Forecast

Outturn

Camden CCG £000's £000's £000's £000's £000's £000's

PMS 20,044 18,374 18,717 342 20,155 (110)

GMS 14,999 13,749 13,768 19 15,127 (128)

APMS 3,324 3,047 2,974 (73) 3,378 (54)

Other Medical Services 1,373 1,259 1,189 (70) 1,505 (132)

Surplus/Deficit inc Contingency & NR (2,214) (2,030) 0 2,030 0 (2,214)

Total Primary Care Medical Services 37,526 34,399 36,648 2,248 40,165 (2,639)

Annual

BudgetYTD Budget

YTD Actual

Expenditure

YTD

Variance

Fav/(Adv)

Forecast

Outturn

Forecast

Variance

Fav/(Adv)

Page 28 of 83


8

As at month 11, Enfield CCG continues to show a balanced position against the 2018/19 budget, with both Haringey and Islington CCGs showing minor savings against the 2018/19 budget.

Table 6: Haringey CCG Delegated Budget

Table 5: Enfield CCG Delegated Budget

Enfield CCG £000's £000's £000's £000's £000's £000's

PMS 25,571 23,439 23,513 74 26,303 (732)

GMS 12,326 11,298 10,896 (402) 11,067 1,259

APMS 2,194 2,011 1,895 (115) 1,932 261


Surplus/Deficit inc Contingency & NR 1,440 1,320 0 (1,320) 1,227 213

Total Primary Care Medical Services 42,881 39,305 39,305 (0) 42,881 0

YTD Actual

Expenditure

YTD

Variance

Fav/(Adv)

Forecast

Variance

Fav/(Adv)

Forecast

Outturn

Annual

BudgetYTD Budget

Haringey CCG £000's £000's £000's £000's £000's £000's

PMS 22,633 18,860 18,854 (6) 22,580 53

GMS 13,896 11,579 11,150 (429) 13,896 0

APMS 2,558 2,132 2,493 361 2,612 (53)

Other Medical Services 1,392 1,093 1,167 74 1,092 300

Surplus/Deficit inc Contingency & NR 2,252 0 0 0 2,252 0

Total Primary Care Medical Services 42,731 33,664 33,664 0 42,431 300

Forecast

Variance

Fav/(Adv)

Forecast

Outturn

Annual

BudgetYTD Budget

YTD Actual

Expenditure

YTD

Variance

Fav/(Adv)

Page 29 of 83


9

• Other Medical Services

Included in ‘Other Medical Services’ is:

• Other Medical Funds - (locum costs for maternity/paternity/sickness cover) • CQC & Indemnity Costs • Occupational Health and DBS Checks• Sterile Product Costs • Personally Administered Drugs • Seniority Payments (phasing out after 2019/20)

Table 7: Islington CCG Delegated Budget

Islington CCG £000's £000's £000's £000's £000's £000's

PMS 1,509 1,383 1,383 (0) 1,457 52

GMS 28,130 25,786 25,434 (352) 27,951 179

APMS 1,716 1,573 1,598 25 1,768 (52)

Other Medical Services 1,169 1,072 4,415 3,344 1,000 169

Surplus/Deficit inc Contingency & NR 4,541 2,996 0 (2,996) 4,541 0

Total Primary Care Medical Services 37,065 32,809 32,830 21 36,717 348

Annual

BudgetYTD Budget

YTD Actual

Expenditure

YTD

Variance

Fav/(Adv)

Forecast

Variance

Fav/(Adv)

Forecast

Outturn

Page 30 of 83

Prescribing• The Prescribing budget relates to the budget allocated to GP practices to spend on pharmaceuticals for registered patients.

• Table 8 details the budget and forecast prescribing costs at Month 11 and average cost per patient.

• At Month 11, the prescribing budgets across all NCL CCGs are forecast to underspend by £3.3m, predominantly at Barnet CCG.

• With the exception of Enfield CCG the NCL CCGs have excluded Short Stock Drug costs from the forecast and are reported as a risk for the CCGs.

10

Table 8 : Prescribing costs

Budget Forecast

Variance

Fav/(Adv) Budget Forecast

Variance


Variance


Variance


Variance


Variance

Fav/(Adv)

Prescribing

Total Prescribing £'000 49,223 46,814 2,409 24,743 24,818 (75) 37,689 38,014 (325) 29,819 29,205 614 25,011 24,334 677 166,485 163,185 3,300

Registered Patients 422,598 422,598 0 281,291 281,291 0 337,160 337,160 0 317,923 317,923 0 251,627 251,627 0 1,610,599 1,610,599 0Number of Practices 61 61 0 34 34 0 48 48 0 39 39 0 33 33 0 215 215 0

Average GP Prescribing spend per patient (£) 116 111 6 88 88 (0) 112 113 (1) 94 92 2 99 97 3 103 101 2

Average Total costs spend per practice (£) 807 767 39 728 730 (2) 785 792 (7) 765 749 16 758 737 21 774 759 15

Total £'000NHS Barnet CCG £'000 NHS Camden CCG £'000 NHS Enfield CCG £'000 NHS Haringey CCG £'000 NHS Islington CCG £'000

Page 31 of 83

Locally Commissioned Services (LCS)

• Locally Commissioned Services (LCS) are discretionary contracts for additional local GP services to meet local health needs

• LCSs are discretionary and are additional to the GP core contracts. They will vary between CCGs depending on local commissioning plans

• Table 9 summarises the Month 11 budget and forecast per CCG

• At Month 11, the LCS budget is almost forecast to breakeven.

11

Table 9: LCS Budget vs FOT

Locally Commissioned Services

2018/19 Annual

Budget £'000

2018/19 Forecast

£'000

Variance Fav/(Adv)

£'000

Barnet CCG 744 - -Camden CCG 3,124 3,149 (25)Enfield CCG 987 987 -Haringey CCG 310 275 35Islington CCG 2,019 2,018 1NCL Total 7,183 6,428 11

Page 32 of 83

GP Forward View Investment • In April 2016 the GP Forward View was published by NHSE to commit an extra £2.4 billion a year to support

general practice services by 2020/21. The fund is ring-fenced for improving patient care and access, additionally to invest in new ways of providing Primary Care.

• For 2018/19 NHSE has confirmed that NCL will be allocated £1.6m from the GP Forward view monies.

• NCL CCGs are also receiving additional GP Access Funding (GPAF).

• £3 per head

• CCGs are required to invest £3 per head of registered population over two years for primary care transformation. The budget allocated to each CCG is detailed below for 2018/19. All NCL CCGs are forecasting to spend their allocated budget

12

Table 10: £3 Per Head

Table 9: GP FV Investment

Page 33 of 83

North Central London Primary Care Committee in Common Seminar 18 April 2019

Report Title Performance and Quality Report Date of report 11 April 2019

Agenda Item

Lead Director / Manager



GB Member Sponsor


Report Author



Report Summary

1. Introduction This report sets out: The latest Quality Report for comment. The source report was

prepared for February 2019 by NHS England; A summary of actions accruing from the quality report; An overview of comparative performance across Boroughs, as

previously requested by the Committee.

2. Quality Report The report is a consolidation of publicly available information on individual practice performance, and is therefore included in Part I of the Committee (a meeting in public). This report aims to highlight practice sustainability through an aggregation of national indicators and local knowledge. The table draws together a multitude of indicators from an array of sources, including data from Care Quality Commission (CQC) ratings, GP Patient Survey (GPPS) results and practice demographics. The metrics in this report have been used to identify and support practices in difficulty through the resilience programme. Local teams were asked to identify those practices which were considered in difficulty and those which would benefit from Resilience Programme support.

Page 34 of 83



2

National criteria in this report were created for use as a screening tool by local commissioners to guide their assessment with local stakeholders on offers of support to improve sustainability and resilience. Hard copies of the report for each CCG, setting out performance by practice, will be provided at the meeting. 2.1. Report construct The report sets out: Contract type held by each practice – General Medical Services /

Personal Medical Services / Alternative Personal Medical Services; Practice demographics including deprivation in a range of 1-5, with

1 being the most deprived and 5 the least deprived; percentage of patients aged over 75; and ethnicity;

An overview of quality through Care Quality Commission ratings and written complaints received;

Workforce including a focus on succession (percentage of GPs and nurses aged over 55); the degree of reliance on locum GPs and coverage (number of patients per full-time GP and full-time nurse;

Efficiency as measured through Quality Outcomes Framework achievement and exception rate, list size, and annual list size change;

Patient experience measures from the Friends and Family Test (recommending the practice); and GP patient survey measures ( not recommending the practice, ease of telephone contact, ease of making an appointment);

Payment per weighted patient; Utilisation of Patients Online as measured through use of online

appointments and ordering repeat prescriptions online; The offer of extended access. Appendices to the report include references for the information contained and a glossary of terms.

Recommendation The Committee is asked to: NOTE and COMMENT on the performance and quality report; NOTE CCG responsibilities for responding to serious incidents in

general practices.

Identified Risks and Risk Management Actions

The report outlines areas where support to practices is required, and where formal action requiring remedial actions plans are required.


Conflicts of interest are managed robustly and in accordance with the CCG’s conflict of interest policy.

Page 35 of 83

3

Resource Implications

The report helps to identify practices in need of resilience funding. Local primary care development plans, including the GP Forward View and developing primary care at scale seek to address variations in care and access described in the report.

Engagement

The report includes patient experience measures from the Friends and Family Test and GP Patient Survey carried out by Ipsos MORI.

Equality Impact Analysis

This report was written in accordance with the provisions of the Equality Act 2010.

Report History and Key Decisions

Development of a London-wide approach to the reporting of primary care quality is underway, and this report will be developed in accordance with the London-wide work. The Quality Report relates to the shared responsibilities of Barnet, Camden, Enfield, Haringey and Islington CCGs for jointly commissioning primary care services in North Central London.

Next Steps Development of a London-wide approach to the reporting of primary care quality is underway, and this report will be developed in accordance with the London-wide work. Local reporting will be further extended through work with the Care Closer to Home workstream and CCGs. Agree and NCL-wide approach to delivering CCG responsibilities for responding to serious incidents in general practices.

Appendices

Quality Report to the NCL Primary Care Committee-in-Common; Supporting performance scorecard for each CCG

Page 36 of 83

4

NCL CCG Primary Care Committee-in-Common Quality Report

1. Introduction This report sets out: The latest Quality Report for comment. The source report was prepared for February 2019 by

NHS England. The previous report was provided for October 2018; A summary of actions accruing from the quality report; An overview of comparative performance across Boroughs, as previously requested by the

Committee.

2. Quality Report The report is a consolidation of publicly available information on individual practice performance, and is therefore included in Part I of the Committee (a meeting in public). This report aims to highlight practice sustainability through an aggregation of national indicators and local knowledge. The table draws together a multitude of indicators from an array of sources, including data from Care Quality Commission (CQC) ratings, GP Patient Survey (GPPS) results and practice demographics. The metrics in this report have been used to identify and support practices in difficulty through the resilience programme. Local teams were asked to identify those practices which were considered in difficulty and those which would benefit from Resilience Programme support. National criteria in this report were created for use as a screening tool by local commissioners to guide their assessment with local stakeholders on offers of support to improve sustainability and resilience. Hard copies of the report for each CCG will be provided at the meeting. Appendices to the report include references for the information contained and a glossary of terms.

3. Actions accruing from the report This section summarises how the report is used to make commissioning decisions and apply primary care medical contracts where applicable. The table below summarises commissioning actions undertaken against the performance domains in the report:

Domain Indicator Description of action taken

Quality Care Quality Commission (CQC) ratings; Complaints

1. Informal remedial action - Number of practices under improvement plan review

2. Formal remedial action - number of practices issued a remedial notice

3. Practice mergers 4. Infection control audits

Efficiency Quality Outcomes Framework (QOF);

1. Performance improvement plans

Page 37 of 83

5

List size changes; Friends and Family Test (FFT)

2. Quality Improvement Support Teams (QISTs) to reduce unwarranted variations

3. Care Closer to Home Integrated Networks (CHINs) / Neighbourhoods development

4. Resilience funding 5. Financial assistance (Section 96)

Workforce Age profile; Full-time equivalents (FTE) for GPs and Nurses

1. Pharmacists in Practice 2. GP retention scheme 3. Medical Assistance Programme 4. Training programmes

Patient Experience

GP Patient Survey 1. National access programme 2. GP access Hubs 3. Performance improvement plans

Patient Online

Online appointments; Repeat Prescriptions

1. Differential access linked to deprivation levels in some CCGs – ensure digital inclusion part of roll-out.

Extended Access

Extended access days; Direct Enhanced Service (DES) sign up

1. GP Hubs 2. DES sign up 3. National access programme

Premises New schemes; Relocation into compliant buildings; Void space

1. Improvement grant awards 2. Capital funding awards 3. Service charge financial assistance applications

The report will also be used to provide as a source of information to help develop and early warning system to identify struggling practices and enhance current levels of support prior to any regulatory action being taken. The early warning system will be developed across North Central London.

4. Overview of performance This section sets out an overview of performance across CCGs from the quality report. The report sets out performance by CCG and an overview of practice outliers in performance compared to CCG averages. Performance for practices, and across CCGs, should be assessed against the range of indicators provided (Care Quality Commission ratings, patient experience responses, Quality Outcomes Framework achievement, and written complaints received) to arrive at a rounded view of performance rather than using single measures of performance. Demographic, finance, and workforce information is then provided as context. 4.1 Demographics This section provides a summary of population profiles for practices including: Deprivation in a range of 1-5, with 1 being the most deprived and 5 the least deprived;

percentage of patients aged over 75; Average list size per practice and list size change over the 12 months to February 2019; Average payment per weighted patient

Page 38 of 83

6

Barnet Camden Enfield Haringey Islington

Contract type GMS 29/54 PMS 25/54 APMS 0/55

GMS 15/34 PMS 16/34 APMS 3/34

GMS 18/47 PMS 27/47 APMS 2/47

GMS 15/37 PMS 22/37 APMS 0/37

GMS 29/33 PMS 2/33 APMS 2/33

Deprivation: 1 = most deprived 2 3 4 5 = least deprived Null

1 3

14 31 5 0

6

12 8 5 2 1

22 4

12 6 3 0

15 10 6 4 0 2

16 16 1 0 0 0

Patients aged > 75 on list 6% 4% 6% 4% 4% % list non-black & ethnic minority 63% 65% 60% 58% 67% Average list size 7,896 8,620 7,310 8,713 7,805 Annual list size change -4% -3% -2% -2% -3% Average payment per weighted patient

2017/18 £138 2016/17 £133

2017/18 £150 2016/17 £153

2017/18 £136 2016/17 £139

2017/18 £133 2016/17 £128

2017/18 £138 2016/17 £136

To note: The relatively high rates of deprivation in Enfield, Haringey and Islington; The higher rate of over 75s in Barnet and Enfield; Average list sizes per practice highest in Camden and Haringey and lowest in Enfield; List size changes are for the 12 months to February 2019. Unlike in previous reports CCGs

have experienced a recorded reduction in list size over the 12 months, and this is under investigation with NHS England;

Payment per weighted patient is based on 2017/18 figures with previous reports based on 2016/17 figures. All CCGs show an increase in weighted payment per patient except Camden CCG and Enfield CCG. The headline figures need further analysis to isolate cost differentials across CCGs in particular for estates costs;

Changes in practice numbers from October 2018 to February 2019 in Barnet (55 to 54) and Enfield (48 to 47).

4.2 Care Quality Commission The Care Quality Commission (CQC) rates general practices to give an overall judgement of the quality of care. The CQC applies four ratings to practices, as is the case for other health and social care services. Practices are assessed across five key areas for quality of care (caring, effectiveness, responsiveness, safety, being well-led). The table below summarises Care Quality Commission (CQC) ratings for practices within each CCG as at February 2019. The previous ratings from October 2018 are shown in red:

CQC ratings Barnet Camden Enfield Haringey Islington

Overall rating:

Outstanding Good Requires Improvement Inadequate Yet to be rated

0 0

51 52 0 0

1 0 3 2

0 0

29 33 2 0 0 1 3 0

0 0

44 46 2 1 0 0 2 0

0 0

32 33 1 1 2 2 2 1

0 0

29 28 1 1 1 1 2 3

Rating for caring:


1 0

51 52 0 0 0 0 3 2

0 0

30 33 1 1 0 0

3 0

0 0

46 47 0 0 0 0 2 0

0 0

32 34 1 0 2 2 2 1

0 0

31 30 0 0 0 0 2 3

Page 39 of 83

7

CQC ratings Barnet Camden Enfield Haringey Islington

Rating for effectiveness:


0 0

51 52 0 0 0 0 3 2

1 1

27 31 3 1 0 1 3 0

0 0

44 45 2 2 0 0 2 0

0 0

32 33 1 1 2 2 2 1

0 0

30 29 0 0 1 1 2 3

Rating for responsiveness:


0

50 50 2 2 0 0 3 2

0 0

31 34 0 0 0 0 3 0

0 0

45 47 1 0 0 0 2 0

0 0

33 33 0 0 1 2 3 2

1 0

29 29 1 1 0 0 2 3

Rating for safety


0 0

49 50 2 2 1 0 3 2

0 0

30 33 1 0 0 1 3 0

0 0

43 46 3 1 0 0 2 0

0 0

33 33 0 1 2 2 2 1

0 0

29 28 2 2 0 0 2 3

Rating for being well-led:


1 1

50 51 0 0 1 0 3 2

0 0

29 33 2 0 0 1

3 0

0 0

44 46 2 1 0 0 2 0

1 1

31 32 1 1 2 2 2 1

0 0

29 28 1 1 1 1 2 3

To note from the above: The majority of practices assessed to date ( by October 2018) have received a good rating; Four practices, as at February 2019, have received an overall inadequate rating to date.

These practices will be subject to formal remedial action through the primary care medical services contract, as well as being required to complete an action plan to address concerns raised by the Care Quality Commission (CQC). Three practices (previously six in October 2018) across NCL have received a requires improvement rating;

Six (previously twelve) practices across North Central London have yet to receive a visit from CQC and/or are yet to receive their report. All practices have inspections scheduled with the CQC;

An early warning system is going to be developed to identify struggling practices, and enhance existing support mechanisms, prior to regulatory action being required. Once developed the early warning system will be applied to all practices that have yet to receive their Care Quality Commission (CQC) inspection.

4.3 Quality Outcomes Framework The Quality Outcomes Framework (QOF) was introduced as part of the new General Medical Services contract in April 2014, with the intention to improve the quality of care patients are given by rewarding practices for the quality of care they provide to patients. The table below summarises performance for each CCG area, and for comparison the national achievement was 94.7%. Note the data is now available for 2017/18 as well as 2016/17 and 2015/16.

Quality Outcomes Framework Barnet Camden Enfield Haringey Islington

% achievement in 2017/18 96.8% 96.3% 95.3% 95.8% 96.4% % achievement in 2016/17 96.7% 96.3% 95.2% 95.8% 96.4% % achievement in 2015/16 95.8% 96.3% 95.2% 96.1% 96.4%

Page 40 of 83

8

Practices with less than 70% 0 0 0 0 1 Practices with less than 80% 0 1 0 0 0 Practices with 80% to 90% 2 2 6 2 1

Aggregate performance for each CCG is above the national average. The table reports by exception the number of practices in each CCG with achievement materially below CCG average scores. Quality Outcomes Framework (QOF) outcomes for those practices achieving less than 90% when cross-referenced to Care Quality Commission ratings show: For the 2 Barnet practices both practices have an overall good CQC rating; For the 3 Camden practices 2 practices have an overall good CQC rating, and 1 practice has

an overall inadequate rating; For the 6 Enfield practices all have received an overall good CQC rating; For the 2 Haringey practices both practices have an overall good CQC rating; For the 2 Islington practices 1 practice has an overall good CQC rating and 1 practice has an

overall inadequate rating.

4.4 Patient experience The GP patient survey is an independent survey run by Ipsos MORI on behalf of NHS England, with the survey being sent to over one million people nationally. The survey results presented were published in August 2018 and cover the period from January to March 2018. The Friends and Family Test asks patients how likely they are to recommend their GP service to friends and family based on their most recent experience of service use, with the results showing those likely or extremely likely to recommend their practice. Results are from December 2018.

Patient Experience Barnet Camden Enfield Haringey Islington

GP patient survey – good overall experience of the practice

81% 82% 79% 79% 81%

GP patient survey – easy getting through by phone

67% 80% 66% 74% 76%

GP patient survey – satisfied with type of appointment offered

70% 74% 69% 68% 70%

Friends and family test:

Average recommendation % Practices with results Range of recommendation %

85%

27/54 62% - 100%

88%

18/34 29% - 100%

87%

32/47 40% - 100%

84%

17/37 35% - 100%

81%

15/33 47% - 100%

The friends and family test does not provide an outcome for each practice, so the average is shown for those practice with a patient response recorded. A broad range of recommendation across practices is shown within each CCG area. 4.5 Complaints The NHS Complaints procedure is the statutorily based mechanism for dealing with complaints about NHS care and treatment and all NHS organisations in England are required to operate the procedure. The table shows the average number of written complaints made by patients and/or their carers during 2017/18 per practice and in total, previous figures for 2016/17 are in red.

Written complaints received Barnet Camden Enfield Haringey Islington

Number of complaints received in 2017/18 and 2016/17

582 610

430 416

530 527

411 394

346 377

Page 41 of 83

9

Complaints escalated to NHSE 31/582 8/430 39/530 36/411 18/346 Average received per practice 10 11 12 13 11 11 11 11 11 11 Average per 1000 people on list 1.4 1.4 1.5 1.5 1.5 1.5 1.2 1.3 1.5 1.4 Range received per practice per 1000 people on the list

0 – 4.8 0 – 6.7

0 – 5.9 0 – 7.4

0 – 4.9 0 – 5.7

0 – 3.4 0.2 – 3.1

0 – 4.8 0 – 4.0

The number of complaints received by per head of population, and by practice, is consistent across the five CCGs. Within each CCG there is a broad range of complaints received across practices. This report adds in the complaints escalated to NHS England as they have not been resolved locally by the practice. In response to the Committee request to have a view of complaints themes and trends – the national team at NHS England have been asked to check the granularity of the information available through reporting on the governance portal. 4.6 Access The table below shows that all practice lists have extended access to general practice services seven days per week through primary care hubs, and where individual practices provided extended access through the Direct Enhanced Service.

Access to general practice Barnet Camden Enfield Haringey Islington

Seven-day extended access to general practice though primary care hubs

100% 100% 100% 100% 100%

Practices participating in Direct Enhanced Service for practice-based extended access

50/54 24/34 41/47 34/37 27/33

4.7 Workforce The table below provides on overview of workforce information for each CCG. The information is sourced from the workforce minimum data set collected by NHS Digital. The information is experimental and needs to be treated with caution. The information is based on the position as at March 2018 and was published in September 2018.

Workforce Barnet Camden Enfield Haringey Islington

% of GPs aged over 55 32% 19% 32% 40% 27% % locum GPs 2% 5% 11% 7% 6% % of nurses aged 55 and over 46% 21% 55% 53% 52% Number of patients per full-time GP 2,288 2,021 2,455 2,661 2,183

The information shows the need for succession planning for the GP and nurse workforce, some of which will be provided through the use of new skill-mix in general practice including pharmacists, physicians, physiotherapists and mental health professionals. 4.8 Deprivation Impact This section of the report responds to the Committee request to cross-reference the quality indicators to provide a rounded view of practice performance. This starts with looking at any impact of deprivation on patient experience and access.

Page 42 of 83

10

The quality report includes a deprivation score for each practice based on national indices (although the indices are form 2015). Deprivation is shown in a range of 1-5, with 1 being the most deprived and 5 the least deprived. The table below summarises the deprivation index for practices within each CCG. To note is the relatively high rates of deprivation in Enfield, Haringey and Islington;

Barnet Camden Enfield Haringey Islington

Contract type GMS 29/54 PMS 25/54 APMS 0/55

GMS 15/34 PMS 16/34 APMS 3/34

GMS 18/47 PMS 27/47 APMS 2/47

GMS 15/37 PMS 22/37 APMS 0/37

GMS 29/33 PMS 2/33 APMS 2/33

Deprivation: 1 = most deprived 2 3 4 5 = least deprived Null

1 3

14 31 5 0

6

12 8 5 2 1

22 4

12 6 3 0

15 10 6 4 0 2

16 16 1 0 0 0

Each graph below shows results for a range of indicators split across the 5 levels of deprivation. 4.8.1 Deprivation link to age profile Practices with higher proportion of over 75s generally have lower overall deprivation scores (most marked for Barnet and Enfield).

4.8.2 Deprivation link to ethnicity A general trend of reducing levels of deprivation, as the proportion of black and ethnic minority (BAME) people on the practice list falls.

0

0.2

0.4

0.6

0.8

1

1.2

po

pu

lati

on

age

d 7

5+

Deprivation index : 1 = most deprived 5 = least deprived

Deprivation link to Age profile ( % 75+)

Series1

Series2

Series3

Series4

Series5

Page 43 of 83

11

4.8.3 Deprivation link to complaints Differential pattern across CCGs on rate of complaints according to practice deprivation score.

4.8.4 Deprivation link to overall patient experience Differential pattern across CCGs (other influencing factors). Some improvement in reported experience as deprivation falls in Camden and Haringey, but trend not repeated in Barnet and Islington.

30%

40%

50%

60%

70%

80%

90%

1 2 3 4 5

% o

f lis

t th

at is

no

n-B

AM

E


Deprivation link to ethnicity - % of list non-BAME

Barnet

Camden

Enfield

Haringey

Islington

0.0

0.5

1.0

1.5

2.0

2.5

1 2 3 4 5

Nu

mb

er o

f co

mp

lain

ts p

er 1

00

0 p

eop

le

on

list

Deprivation index: 1= most deprived 5 = least deprived

Deprivation - link to rate of complaints

Barnet

Camden

Enfield

Haringey

Islington

Page 44 of 83

12

4.8.5 Deprivation link to patient experience of telephone access Some trend for easier access by telephone as practice deprivation scores fall in Barnet, Camden and Haringey, but not repeated in Enfield. Look into further determinants of access.

4.8.6 Deprivation link to patient satisfaction with type of appointment Some trend for improved satisfaction with type of appointment as practice deprivation scores fall in Barnet, Camden, Enfield and Haringey. Look into further determinants of satisfaction.

0

0.2

0.4

0.6

0.8

1

1.2

1

% o

f lis

t st

aisf

ied

wit

h o

vera

ll ex

per

ien

ce


Deprivation - link to overall patient experience

Series1

Series2

Series3

Series4

Series5

40%

50%

60%

70%

80%

90%

100%

1 2 3 4 5

% o

f lis

t sa

tisf

ied

wit

h t

elep

ho

ne

acce

ss


Deprivation - link to patient experience of telephone access

Barnet

Camden

Enfield

Haringey

Islington

Page 45 of 83

13

4.8.7 Deprivation link to access to making on-line appointments Some trend for higher uptake of on-line booking of appointments as practice deprivation scores fall in Barnet, Camden, Enfield and Haringey.

4.8.8 Deprivation link to access to requesting repeat prescriptions on-line Some trend for higher uptake of on-line ordering of repeat prescriptions as practice deprivation scores fall in Barnet, Camden, Enfield and Haringey.

0.5

0.6

0.7

0.8

0.9

1

1.1

1

% o

f lis

t sa

tisf

ied

wit

h t

ype

of

app

oin

tmen

t o

ffer

ed


Deprivation - link to patient experience of appointment

Series1

Series2

Series3

Series4

Series5

0

0.2

0.4

0.6

0.8

1

1.2

1% o

f lis

t w

ith

on

-lin

e ap

po

intm

ents

en

able

d


Deprivation - link to access to on-line appointments

Series1

Series2

Series3

Series4

Series5

Page 46 of 83

14

0%

10%

20%

30%

40%

50%

1 2 3 4 5

% o

f lis

t w

ith

on

-lin

e o

rder

ing

of

rep

eat

pre

scri

pti

on

s en

able

d


Deprivation link to enabled repeat prescription ordering

Barnet

Camden

Enfield

Haringey

Islington

Page 47 of 83

15

5. CCG Role in Responding to Serious Incidents in GP Practices

In London, all CCGs have delegated responsibility for functions relating to commissioning primary medical services. In relation to serious incidents the delegation Agreement from 2015 delegated responsibility for incidents and serious incidents from NHS England to CCGs. NHS England are in the process of providing more guidance to GPs on the whole subject of managing incidents, including Serious Incidents. The guidance (draft) has been recently circulated to patient safety leads in CCGs for feedback, and a discussion is due to take place at the London Patient Safety leads meeting in February 2019. An update on management of serious incidents in GP practices will therefore now come to the Committee in April 2019 rather than February 2019.

Page 48 of 83

Page 49 of 83

Page 50 of 83

Finance

Practi

ce

Code

Practice Name

Co‐commissioning model

Contract Type

Dispensing Practice

Practice Linked IMD

(National Quintiles)

% Patients Aged 75+

% Patients Non‐BME

CQC Rating ‐ Overall

CQC ‐ C

aring

CQC ‐ E

ffectiv

e

CQC ‐ R

espo

nsive

CQC ‐ Safe

CQC ‐ W

ell led

Written complaints (total)

Written complaints (via NHS E)

Practice Size

(Based on FTE

GPs)

% GPs aged 55 years an

d over

% Locum GPs

% Nurses aged 55 years an

d over

Number of patients per FTE GP

Number of patients per FTE

Nurse

QOF Achievement

QOF Exception Rate

List size

Annual List Size Chan

ge

FFT: % likely to recommend GP

service to friends & fam

ily

(* = nos <6; NA = zero re

turn)

GPPS ‐ Good overall experience of

GP practice

GPPS – Easy to get through

by

phone

( ~ = nos <10

; * = < 0.5%

)

GPPS ‐ Satisfied with the type of

appointm

ent offered

( ~ = nos <10

; * = < 0.5%

)

Average

payment per weighted

patient

Online Appointm

ents Enab

led

% Of Reg Pop with online

appointm

ent enab

led

Total n

o. pt tran

sactions using

online appointm

ents service

Order Repeat Prescriptions Online

Enab

led

% Of Reg Pop with order repeat

prescriptions online enab

led

Total n

o. prescriptions ordered via

online pt tran

saction service

Category

Full / Partial / No

No. of extended access days

Directed Enhan

ced Services

(Extended Access payment)

E83003 Oakleigh Road Health Centre Del GMS 4 7% 70% 8 Medium‐large 20% 0% 100% 1,797 6,683 99.3% 4.7 8,905 ‐4% 100% 92% 90% 82% £141 16% 151 15% 158 FULL 7 ✔E83005 Lichfield Grove Surgery Del PMS 4 6% 64% 0 Small‐medium 15% 0% 100% 2,358 7,780 99.2% 7.4 6,255 ‐1% 87% 71% 81% £139 48% 187 47% 174 FULL 7 ✔E83006 Greenfield Medical Centre Del PMS 2 6% 58% 6 1 Medium‐large 17% 0% 58% 2,207 6,221 98.8% 4.1 6,868 0% 100% 85% 72% 64% £149 36% 321 36% 123 FULL 7 ✔E83007 Squires Lane Medical Practice Del GMS 3 7% 59% 19 1 Medium‐large 0% 20% 1,712 0 98.8% 6.5 5,766 ‐1% 68% 66% 53% 49% £132 31% 263 30% 146 FULL 7 ✔E83008 Heathfielde Medical Centre Del PMS 5 ‐ Least Deprived 7% 78% 17 Medium‐large 50% 0% 15% 2,489 4,422 99.9% 2.7 8,171 ‐4% 81% 87% 60% £153 43% 186 43% 269 FULL 7 ✔E83009 Phgh Doctors Del PMS 5 ‐ Least Deprived 8% 75% 30 1 Medium‐large 25% 3% 100% 2,749 10,822 92.5% 5.7 10,967 ‐1% 93% 78% 68% 61% £154 34% 249 34% 474 FULL 7 ✔E83010 The Speedwell Practice Del PMS 4 7% 63% 29 Medium‐large 13% 0% 36% 2,300 6,337 95.7% 4.2 11,502 0% 74% 39% 63% £141 28% 462 27% 276 FULL 7E83011 The Everglade Medical Practice Del GMS 1 ‐ Most deprived 3% 42% 0 Medium‐large 21% 1% 0% 1,630 8,226 99.9% 11.6 8,267 ‐2% 72% 87% 57% 63% £118 12% 17 12% 46 FULL 7 ✔E83012 The Old Court House Surgery Del GMS 4 9% 77% 11 1 Medium‐large 0% 0% 0% 2,052 7,840 99.6% 7.1 8,350 ‐3% 96% 91% 78% 88% £119 21% 37 21% 29 PARTIAL 6 ✔E83013 Cornwall House Surgery Del GMS 4 8% 63% 11 0 Medium‐large 33% 0% 0% 1,807 22,176 99.4% 8.1 6,360 1% NA 68% 49% 63% £123 18% 15 17% 63 FULL 7 ✔E83016 Millway Medical Practice Del PMS 4 7% 65% 53 1 Large 2% 0% 12% 2,065 5,909 98.7% 4.0 18,486 ‐1% 87% 35% 56% £157 100% 1155 100% 1022 FULL 7 ✔E83017 Longrove Surgery Del PMS 4 8% 79% 21 1 Medium‐large 29% 0% 53% 1,954 5,848 97.4% 4.5 11,325 0% 81% 64% 69% £154 25% 54 25% 467 FULL 7 ✔E83018 Watling Medical Centre Del GMS 3 6% 51% 21 2 Large 7% 0% 0% 1,483 5,990 96.8% 5.6 16,270 ‐2% 100% 85% 58% 73% £117 30% 517 29% 712 FULL 7 ✔E83020 St. Georges Medical Centre Del PMS 4 6% 60% 27 Medium‐large 0% 0% 0% 3,231 4,473 96.5% 4.4 11,183 ‐6% 100% 81% 53% 72% £154 75% 880 75% 371 FULL 7 ✔E83021 Torrington Park Group Practice Del PMS 4 9% 63% 10 1 Medium‐large 27% 0% 55% 2,120 10,698 93.9% 7.9 12,605 ‐1% 100% 89% 52% 79% £138 32% 300 32% 193 FULL 7 ✔E83024 St Andrews Medical Practice. Del PMS 5 ‐ Least Deprived 9% 72% 11 Large 15% 0% 48% 1,745 6,921 99.3% 4.0 10,907 ‐3% 82% 60% 77% £161 44% 231 44% 286 FULL 7 ✔E83025 Pennine Drive Practice Del GMS 3 6% 55% 1 1 Medium‐large 24% 0% 0% 2,437 7,879 100.0% 7.8 8,975 ‐1% 79% 67% 57% £128 9% 48 9% 103 FULL 7 ✔E83026 Supreme Medical Centre Del GMS 4 8% 65% 5 Small‐medium 76% 0% 0% 1,636 5,900 91.6% 7.0 4,351 ‐3% 80% 74% 72% £137 30% 74 30% 105 FULL 7 ✔E83027 188 The Practice Del PMS 4 9% 69% 11 Small‐medium 7% 16% 0% 3,149 10,866 98.3% 7.3 7,647 ‐2% 95% 79% 79% 74% £141 19% 55 19% 78 FULL 7 ✔E83028 Parkview Surgery Del PMS 2 3% 47% 1 1 Small‐medium 40% 15% 100% 2,854 7,624 99.6% 9.9 6,563 ‐1% 73% 82% 71% 76% £139 14% 37 14% 36 FULL 7 ✔E83030 Penshurst Gardens Surgery Del GMS 4 10% 61% 0 Medium‐large 0% 0% 0% 2,116 7,157 97.3% 5.4 6,646 ‐3% 73% 32% 51% £128 67% 358 67% 501 no data ‐ ✔E83031 The Village Surgery Del PMS 4 9% 76% 3 Medium‐large 42% 0% 100% 1,683 7,315 89.4% 2.7 5,220 ‐4% 100% 95% 98% 82% £136 13% 33 13% 136 FULL 7E83032 Oak Lodge Medical Centre Del GMS 3 4% 43% 25 1 Large 0% 0% 11% 1,965 5,078 100.0% 9.9 18,511 0% 62% 76% 41% 61% £153 50% 904 50% 499 FULL 7 ✔E83034 Mulkis Hb‐The Surgery Del GMS 3 6% 69% 8 1 Small‐medium 100% 0% 100% 2,735 7,647 93.5% 4.8 5,414 1% 88% 79% 67% £120 21% 132 21% 182 FULL 7 ✔E83035 Wentworth Medical Practice. Del PMS 4 7% 59% 12 2 0% 12,399 96.3% 3.0 11,401 ‐14% 89% 66% 49% 64% £198 27% 232 27% 186 FULL 7 ✔E83036 Vale Drive Medical Practice Del GMS 3 7% 73% 0 Small‐medium 100% 0% 0% 2,633 6,253 95.6% 3.6 5,569 ‐7% 88% 75% 70% 69% £122 21% 68 21% 63 FULL 7 ✔E83037 Derwent Crescent Medical Centre Del PMS 4 9% 68% 12 Small‐medium 41% 0% 52% 1,852 4,894 99.4% 4.9 5,588 ‐2% 92% 92% 85% 80% £155 86% 264 86% 252 FULL 7 ✔E83038 Jai Medical Centre Del GMS 3 9% 50% 10 0 Small‐medium 31% 0% 76% 5,246 6,350 98.0% 4.8 8,294 1% 80% 60% 74% £124 17% 68 17% 67 FULL 7 ✔E83039 Ravenscroft Medical Centre Del PMS 4 4% 62% 0 100% 5,323 96.9% 4.0 7,333 1% 88% 74% 78% £163 5% 40 5% 49 FULL 7 ✔E83041 The Surgery Del GMS 3 5% 40% 3 Small‐medium 0% 17% 0% 2,790 6,391 97.1% 9.3 4,656 ‐1% 78% 75% 71% £119 13% 0 13% 23 FULL 7 ✔E83044 Addington Medical Centre Del GMS 4 8% 76% 12 3 Medium‐large 50% 0% 76% 1,797 6,602 98.6% 4.1 9,090 ‐4% 85% 89% 83% 82% £120 28% 240 28% 262 FULL 7 ✔E83045 Friern Barnet Medical Centre Del GMS 3 6% 63% 13 Medium‐large 42% 0% 100% 2,633 8,670 97.2% 4.4 9,098 ‐12% 83% 66% 67% £108 18% 102 18% 99 PARTIAL 5 ✔E83046 Mulberry Medical Practice Del GMS 3 5% 53% 18 Medium‐large 23% 0% 26% 2,559 2,386 85.1% 3.2 9,949 ‐27% 73% 65% 64% £139 23% 221 23% 160 no data ‐ ✔E83049 Langstone Way Surgery Del PMS 4 5% 59% 19 1 Medium‐large 30% 0% 34% 2,313 2,610 91.2% 8.6 8,002 ‐7% 89% 76% 54% 62% £160 17% 43 17% 89 FULL 7 ✔E83050 East Finchley Medical Centre Del GMS 5 ‐ Least Deprived 6% 77% 6 Small‐medium 0% 0% 0% 3,027 17,972 90.4% 3.4 7,821 ‐9% 71% 54% 68% £113 15% 29 16% 234 no data ‐ ✔E83053 Lane End Medical Group Del GMS 4 8% 60% 15 Large 18% 0% 1,413 0 96.7% 7.4 13,140 ‐1% 82% 84% 40% 64% £142 47% 478 37% 501 FULL 7 ✔E83600 Adler Js‐The Surgery Del GMS 4 5% 73% 3 Small‐medium 50% 0% 0% 2,661 10,011 97.2% 1.8 5,858 ‐6% 100% 100% 91% 94% £126 24% 12 24% 231 FULL 7 ✔E83613 Ebhc Dr D Monkman Del PMS 4 8% 76% 1 40% 7,360 99.5% : 3,108 ‐6% * 96% 72% 86% £156 31% 60 31% 66 FULL 7 ✔E83621 Brunswick Park Medical Centre Del GMS 4 9% 68% 33 1 100% 5,382 98.4% 2.9 8,529 ‐3% 40% 70% 56% 64% £118 36% 249 35% 431 FULL 7 ✔E83622 Temple Fortune Medical Group Del GMS 5 ‐ Least Deprived 8% 74% 8 Small‐medium 51% 0% 55% 2,381 8,008 99.4% 7.5 7,292 ‐4% 84% 79% 79% £123 16% 79 15% 115 no data ‐ ✔E83629 Ebhc Dr P Weston Del PMS 4 7% 76% 2 40% 8,823 99.9% 0.2 3,647 ‐1% * 86% 68% 85% £167 0 0 FULL 7 ✔E83632 Ebhc Dr Cj Peskin Del PMS 4 7% 76% 3 1 40% 10,838 99.5% : 4,507 ‐5% * 77% 68% 70% £157 0 0 FULL 7 ✔E83637 Colindale Medical Centre Lp Del PMS 3 3% 41% 3 Small‐medium 47% 0% 65% 3,240 13,384 98.6% 3.0 8,934 ‐9% 80% 72% 69% 60% £134 18% 27 18% 107 FULL 7 ✔E83638 The Mountfield Surgery Del PMS 4 7% 66% 5 4 Small‐medium 93% 0% 100% 2,060 4,120 95.3% 3.1 5,021 ‐1% 100% 95% 95% 89% £160 11% 11 11% 52 FULL 7 ✔E83639 Rosemary Surgery Del GMS 4 4% 62% 1 1 Small‐medium 15% 0% 1,664 0 93.2% 2.4 5,346 ‐15% 98% 79% 63% 64% £121 38% 157 38% 101 FULL 7 ✔E83649 The Hodford Road Practice Del PMS 4 5% 67% 8 Small‐medium 100% 0% 0% 2,088 14,850 93.6% 2.2 3,681 ‐2% 90% 86% 92% 81% £145 84% 88 84% 110 FULL 7 ✔E83650 Gloucester Road Surgery Del GMS 4 12% 75% 0 Single‐handed 100% 0% 100% 1,771 4,178 95.5% 2.6 1,830 ‐8% 88% 91% 71% £121 24% 6 24% 30 FULL 7E83653 The Phoenix Practice Del GMS 3 6% 61% 11 2 Medium‐large 13% 0% 42% 2,311 5,317 93.9% 2.8 9,967 ‐3% 86% 77% 76% £116 20% 116 20% 240 FULL 7 ✔E83657 The Hillview Surgery Del GMS 4 6% 62% 0 Small‐medium 100% 0% 100% 1,855 7,833 95.0% 7.8 1,888 ‐1% 90% 98% 86% £146 6% 0 6% 7 NO 0 ✔E83668 Dr Sp Talpahewa Del GMS 4 3% 52% 2 Small‐medium 0% 0% 100% 2,307 5,767 96.7% 3.3 4,287 ‐1% 84% 91% 68% £133 15% 8 15% 26 FULL 7 ✔Y00316 Woodlands Medical Practice Del PMS 4 6% 68% 21 1 Small‐medium 0% 0% 0% 2,223 10,968 96.2% 4.0 4,381 ‐1% 50% 58% 34% 53% £144 44% 79 44% 127 FULL 7 ✔Y02986 Cricklewood Health Centre Del PMS 2 0% 54% 6 0 Small‐medium 0% 0% 100% 2,164 23,186 4,905 ‐10% 69% 72% 74% £129 11% 59 11% 22 no data ‐Y03663 Hendon Way Surgery Del GMS 3 3% 53% 13 1 0 99.6% 8.8 8,577 1% 67% 67% 30% 53% £147 26% 118 26% 100 no data ‐ ✔Y03664 Dr Azim & Partners Del GMS 3 4% 55% 14 1 0 98.6% 5.4 9,162 ‐7% 65% 48% 59% £130 59% 57 59% 166 FULL 7 ✔Y05258 Barnet Federated Gps Limited Del no data ‐

Patients Online Extended AccessBarnet CCG

PracticePractice

DemographicsQuality Workforce Efficiency Patient Experience

Page 51 of 83

Finance

Practi

ce

Code

Practice Name


Contract Typ

e

Dispensing Practice

Practice Linked IM

D

(National Q

uintiles)

% Patien

ts Aged 75+

% Patien

ts Non‐BME


CQC ‐ C

aring

CQC ‐ Effe

ctive

CQC ‐ R

espo

nsive

CQC ‐ Safe

CQC ‐ W

ell led

Written

complaints (total)

Written

complaints (via NHS E)

Practice Size

(Based on FTE

GPs)

% GPs aged 55 years and over

% Locum GPs

% Nurses aged 55 years and over

Number of patien

ts per FTE

GP

Number of patien

ts per FTE

Nurse

QOF Achievemen

t

QOF Exception Rate

List size

Annual List Size Change

FFT: % likely to recommen

d GP

service to frien

ds & family


turn)


GP practice


by

phone

( ~ = nos <10; * = < 0.5%

)


appointm

ent offered

( ~ = nos <10; * = < 0.5%

)

Average

paymen

t per weigh

ted

patient

Onlin

e Appointm

ents Enabled

% Of Reg

Pop with onlin

e

appointm

ent en

abled

Total no. p

t transactions using

onlin

e appointm

ents service

Order Rep

eat Prescriptions

Onlin

e En

abled

% Of Reg

Pop with order rep

eat

prescriptions onlin

e en

abled

Total no. p

rescriptions ordered

via onlin

e pt transaction service

Catego

ry

Full / P

artia

l / No

No. o

f extended

access days

Directed Enhan

ced Services

(Exten

ded

Access paymen

t)

F83003 Park End Surgery Del PMS 4 9% 79% 13 Medium‐large 14% 0% 0% 1,259 8,813 98.6% 3.6 7,106 0% 90% 87% 89% £168 62% 179 62% 265 FULL 7 ✔F83005 Gower Street Practice Del GMS 3 1% 61% 3 Medium‐large 55% 0% 0% 2,354 22,783 95.7% 3.1 9,023 3% * 68% 100% 85% £108 17% 102 17% 48 FULL 7F83006 Ampthill Practice Del GMS 1 ‐ Most deprived 5% 55% 16 Large 25% 7% 0% 1,153 8,423 96.9% 3.7 8,314 2% 83% 87% 85% 82% £134 15% 71 11% 101 FULL 7 ✔F83011 Primrose Hill Surgery Del GMS 4 7% 79% 5 0% 96.9% 2.2 6,476 ‐2% 81% 90% 69% £136 22% 82 22% 130 FULL 7 ✔F83017 Hampstead Group Practice Del PMS 3 5% 73% 20 Large 7% 9% 0% 1,361 8,484 98.1% 3.3 15,871 ‐1% 91% 87% 88% 78% £168 28% 232 28% 307 FULL 7 ✔F83018 Prince Of Wales Group Surgery Del PMS 1 ‐ Most deprived 5% 63% 7 Medium‐large 22% 0% 55% 1,611 5,324 98.6% 4.0 8,967 2% 83% 83% 57% 79% £166 33% 25 33% 114 FULL 7 ✔F83019 Abbey Medical Centre Del GMS 2 5% 62% 32 Large 11% 0% 0% 1,660 12,087 99.2% 3.5 11,970 0% 100% 84% 56% 68% £140 30% 75 29% 119 PARTIAL 1 ✔F83020 Adelaide Medical Centre Del GMS 3 7% 71% 18 Large 12% 12% 60% 1,722 4,555 97.9% 3.7 11,509 1% 92% 84% 73% 69% £139 49% 186 49% 233 FULL 7 ✔F83022 Caversham Group Practice Del GMS 2 4% 70% 38 Large 46% 8% 0% 2,295 9,293 94.0% 3.3 15,522 ‐2% 84% 71% 70% £135 22% 440 21% 439 PARTIAL 2 ✔F83023 James Wigg Practice Del PMS 2 4% 67% 116 1 Large 13% 0% 17% 1,701 5,683 96.4% 4.5 21,611 ‐2% 100% 75% 45% 48% £185 19% 134 19% 372 FULL 7 ✔F83025 The Regents Park Practice Del PMS 2 5% 52% 4 Medium‐large 0% 0% 35% 1,762 4,091 95.9% 3.3 6,256 0% 81% 64% 70% £168 8% 11 6% 35 FULL 7F83042 Gray's Inn Road Medical Centre Del PMS 2 2% 58% 7 Medium‐large 30% 0% 100% 1,216 12,371 93.4% 4.9 6,470 ‐15% 100% 79% 80% 69% £132 6% 14 6% 20 FULL 7 ✔F83043 Ridgmount Practice Del GMS 2 0% 59% 4 Large 29% 13% 2,421 99.7% 8.5 18,871 ‐3% 87% 89% 100% 85% £122 49% 475 49% 54 FULL 7F83044 The Bloomsbury Surgery Del GMS 2 4% 52% 3 Medium‐large 0% 0% 0% 1,476 2,412 93.3% 2.9 4,499 ‐1% 100% 85% 89% 76% £145 38% 64 34% 29 PARTIAL 6 ✔F83048 Brunswick Medical Centre Uhpc Del APMS 2 3% 56% 13 1 Single‐handed 0% 0% 0% 8,990 12,838 98.8% 7.3 6,913 ‐2% 76% 60% 91% 60% £166 35% 29 35% 41 FULL 7F83050 Fortune Green Road Surgery Del GMS 4 6% 69% 1 Small‐medium 0% 19% 0% 2,396 26,653 97.4% 5.7 2,819 2% * 89% 96% 75% £129 21% 33 21% 61 FULL 7F83052 Brookfield Park Surgery Del GMS 3 6% 77% 6 1 Small‐medium 35% 0% 0% 2,960 6,788 98.7% 3.8 3,514 ‐4% 76% 84% 68% £135 24% 15 24% 59 FULL 7 ✔F83055 West Hampstead Medical Centre Del PMS 3 3% 72% 0 Large 13% 0% 53% 1,989 9,944 98.3% 4.2 14,541 ‐12% 83% 85% 56% 73% £136 93% 878 93% 381 FULL 7 ✔F83057 Parliament Hill Surgery Del PMS 3 4% 78% 2 Medium‐large 3% 0% 100% 1,747 18,972 99.9% 3.1 7,377 ‐4% 98% 98% 81% £158 39% 177 39% 88 FULL 7 ✔F83058 Holborn Medical Centre Del PMS 2 2% 57% 10 Large 24% 0% 0% 1,556 8,022 98.0% 4.5 11,523 ‐1% 98% 94% 83% £150 15% 47 15% 62 FULL 7 ✔F83059 Brondesbury Medical Centre Del PMS 2 3% 63% 22 Large 10% 0% 31% 1,015 11,838 97.9% 5.1 17,714 ‐4% 29% 88% 82% 82% £179 32% 433 28% 234 FULL 7 ✔F83061 Museum Practice Del PMS 2 4% 63% 3 Medium‐large 0% 0% 901 98.1% 3.4 5,027 ‐4% 100% 96% 100% 92% £138 35% 131 35% 24 FULL 7 ✔F83615 Cholmley Gardens Surgery Del PMS 4 4% 73% 10 Medium‐large 40% 10% 0% 1,727 6,435 96.9% 3.4 8,143 ‐5% * 94% 87% 77% £125 14% 3 14% 53 FULL 7 ✔F83623 Keats Group Practice Del PMS 5 ‐ Least Deprived 6% 79% 5 1 Large 12% 7% 0% 1,473 3,928 99.6% 2.8 12,198 ‐4% 100% 90% 78% 83% £198 35% 111 35% 351 FULL 7 ✔F83632 Queens Crescent Practice Del GMS 1 ‐ Most deprived 4% 61% 10 Medium‐large 5% 0% 0% 1,062 6,404 98.0% 6.2 5,603 0% 94% 73% 76% 67% £121 9% 46 9% 69 FULL 7 ✔F83633 Daleham Gardens Health Centre Del PMS 4 6% 73% 4 1 Small‐medium 0% 0% 0% 1,393 6,180 98.6% 3.9 2,919 ‐12% 88% 92% 84% £193 31% 54 30% 43 FULL 7F83635 Kings Cross Surgery Del APMS 1 ‐ Most deprived 1% 51% 8 1 Small‐medium 6% 6% 0% 3,694 7,995 99.1% 10.3 5,598 ‐12% 94% 61% 80% 59% £155 28% 134 28% 85 FULL 7F83658 Belsize Priory Medical Practice (Group) Del GMS 2 5% 62% 8 Small‐medium 76% 40% 2,472 93.4% 3.1 4,372 1% 53% 51% 44% £132 32% 42 32% 27 FULL 7 ✔F83665 Swiss Cottage Surgery Del GMS 3 3% 66% 16 1 Medium‐large 0% 0% 40% 3,280 7,980 99.2% 2.8 13,892 ‐5% * 81% 83% 69% £149 42% 0 42% 128 FULL 7 ✔F83672 St Philips Medical Centre Del GMS 3 0% 63% 4 Medium‐large 0% 0% 2,674 10,166 ‐7% 100% 83% 85% 82% £105 17% 199 17% 24 PARTIAL 6F83677 The Matthewman Practice Del GMS 1 ‐ Most deprived 4% 65% 0 0 Single‐handed 100% 0% 2,043 76.1% 2.8 1,931 4% 92% 97% 91% £121 21% 0 21% 7 FULL 7 ✔F83682 Rosslyn Hill Surgery Del PMS 5 ‐ Least Deprived 4% 76% 4 Small‐medium 59% 41% 735 98.7% 2.3 1,810 1% 85% 84% 72% £233 32% 41 31% 72 FULL 7 ✔F83683 Somers Town Medical Centre Del PMS 1 ‐ Most deprived 3% 48% 13 1 0% 88.4% 3.8 3,717 ‐13% 65% 66% 40% 60% £173 6% 6 6% 11 FULL 7Y02674 Camden Health Improvement Practice Del APMS 0% 5 Small‐medium 0% 0% 50% 589 402 87.5% 9.4 841 ‐7% 72% 92% ~ £992 4% 1 0% 0 no data ‐

Patients Online Extended AccessCamden CCG

Practice Practice Demographics Quality Workforce Efficiency Patient Experience

Page 52 of 83

Finance

Practi

ce

Code

Practice Name


Contract Typ

e

Dispensing Practice

Practice Linked IM

D

(National Q

uintiles)

% Patien

ts Aged 75+

% Patien

ts Non‐BME


CQC ‐ C

aring

CQC ‐ Effe

ctive

CQC ‐ R

espo

nsive

CQC ‐ Safe

CQC ‐ W

ell led

Written

complaints (total)

Written


Practice Size

(Based on FTE

GPs)


% Locum GPs


Number of patien

ts per FTE

GP

Number of patien

ts per FTE

Nurse

QOF Achievemen

t

QOF Exception Rate

List size



d GP

service to frien

ds & family


turn)


GP practice


by

phone

( ~ = nos <10; * = < 0.5%

)


appointm

ent offered

( ~ = nos <10; * = < 0.5%

)

Average

paymen

t per weigh

ted

patient

Onlin

e Appointm

ents Enabled

% Of Reg

Pop with onlin

e

appointm

ent en

abled

Total no. p


onlin

e appointm

ents service

Order Rep

eat Prescriptions

Onlin

e En

abled

% Of Reg

Pop with order rep

eat

prescriptions onlin

e en

abled

Total no. p


via onlin


Catego

ry

Full / P

artia

l / No

No. o

f extended

access days

Directed Enhan

ced Services

(Exten

ded

Access paymen

t)

F85002 Forest Rd Group Practice Del PMS 1 ‐ Most deprived 5% 44% 14 1 Large 21% 4% 23% 1,275 4,681 97.6% 3.5 12,397 0% 40% 77% 33% 59% £176 44% 548 44% 725 FULL 7 ✔F85003 Riley House Surgery Del PMS 1 ‐ Most deprived 6% 60% 40 3 Medium‐large 55% 0% 27% 2,783 7,338 93.7% 5.0 8,529 1% 75% 70% 63% 53% £150 0 0 PARTIAL 1 ✔F85004 Eagle House Surgery Del PMS 1 ‐ Most deprived 6% 53% 19 Medium‐large 29% 0% 100% 3,012 4,418 96.9% 4.8 13,249 1% 81% 66% 30% 57% £151 20% 76 19% 204 PARTIAL 4 ✔F85010 Keats Surgery Del GMS 2 7% 52% 3 Small‐medium 100% 0% 100% 2,370 14,616 89.0% 2.9 4,908 ‐6% 86% 83% 83% 68% £122 16% 20 16% 52 PARTIAL 6 ✔F85016 Cockfosters Medical Ctre Del GMS 5 ‐ Least Deprived 11% 76% 12 3 Medium‐large 67% 0% 100% 1,759 7,887 87.7% 2.1 6,612 ‐2% 100% 85% 77% 83% £121 13% 7 13% 84 FULL 7 ✔F85020 The Woodberry Practice Del PMS 4 7% 74% 14 0 Medium‐large 3% 0% 50% 2,150 6,519 97.8% 4.4 8,798 ‐2% 88% 71% 76% £145 18% 55 18% 120 FULL 7 ✔F85023 The Ordnance Unity Centre For Health Del GMS 1 ‐ Most deprived 3% 57% 46 2 Small‐medium 0% 0% 0% 6,586 6,155 92.4% 5.5 9,459 ‐10% 67% 70% 45% 55% £126 15% 153 15% 80 no data ‐F85024 Dean House Surgery Del PMS 1 ‐ Most deprived 5% 51% 0 Single‐handed 100% 0% 2,586 97.1% 4.0 2,315 ‐1% 63% 86% 76% £149 25% 13 25% 27 NO 0 ✔F85025 White Lodge Medical Practice Del PMS 3 9% 78% 18 4 Large 18% 6% 13% 1,210 3,705 95.9% 3.0 11,203 1% 88% 84% 85% 76% £156 27% 259 27% 472 FULL 7 ✔F85027 Carlton House Surgery Del GMS 3 8% 80% 43 2 Large 11% 0% 0% 1,863 5,866 97.2% 5.4 11,680 2% 78% 39% 59% £128 0 0 PARTIAL 4 ✔F85029 Abernethy House Surgery Del PMS 4 10% 79% 18 1 Large 27% 0% 51% 1,633 4,284 99.3% 5.1 13,247 ‐2% 91% 88% 84% 82% £145 22% 187 22% 550 FULL 7 ✔F85032 Southgate Del PMS 4 8% 69% 6 Medium‐large 44% 0% 0% 1,604 9,894 91.3% 3.8 9,600 ‐2% 92% 84% 59% 75% £136 24% 279 24% 333 no data ‐ ✔F85033 Winchmore Hill Practice Del PMS 5 ‐ Least Deprived 9% 76% 20 1 Medium‐large 0% 0% 58% 3,227 10,007 95.7% 3.2 17,204 ‐2% 91% 78% 43% 71% £154 45% 624 44% 781 FULL 7 ✔F85035 Highlands Practice Del GMS 5 ‐ Least Deprived 10% 73% 1 1 83.5% 2.7 10,329 ‐4% 79% 46% 76% £121 40% 343 40% 319 PARTIAL 5F85036 Willow House Surgery Del GMS 3 7% 74% 3 Small‐medium 38% 0% 0% 1,536 5,762 95.0% 3.4 4,373 ‐2% 93% 92% 97% 91% £125 0 0 FULL 7 ✔F85039 Rainbow Practice Del PMS 1 ‐ Most deprived 4% 43% 8 Small‐medium 29% 42% 0% 3,270 11,548 97.6% 4.0 4,999 ‐2% 87% 75% 66% £131 25% 50 25% 52 PARTIAL 6 ✔F85043 Boundary Court Surgery Del APMS 1 ‐ Most deprived 4% 42% 2 Small‐medium 0% 38% 0% 2,238 7,853 96.3% 5.8 3,821 6% 100% 85% 81% 70% £130 13% 10 13% 21 FULL 7 ✔F85044 The Bounces Road Surgery Del GMS 1 ‐ Most deprived 4% 44% 6 Medium‐large 0% 0% 0% 1,290 9,152 98.4% 4.3 5,419 ‐6% 100% 80% 60% 73% £133 23% 15 23% 27 FULL 7 ✔F85048 Moorfield Road Health Ctr Del GMS 1 ‐ Most deprived 5% 59% 6 1 Small‐medium 70% 0% 0% 3,164 11,273 81.2% 2.8 5,106 ‐7% * 86% 77% 78% £107 0 0 PARTIAL 2 ✔F85053 Park Lodge Medical Centre Del GMS 4 6% 71% 22 Medium‐large 25% 36% 0% 1,692 4,816 94.8% 3.3 5,813 20% 92% 54% 34% 65% £129 0 0 no data ‐ ✔F85055 Connaught Surgery Del GMS 3 8% 63% 22 2 Small‐medium 0% 0% 0% 3,145 7,047 96.0% 2.3 5,055 ‐4% 73% 75% 79% 59% £130 18% 36 17% 89 PARTIAL 6 ✔F85058 Nightingale House Surgery Del PMS 2 6% 49% 21 Small‐medium 20% 0% 100% 3,053 6,105 98.2% 4.6 6,620 ‐2% 89% 81% 69% 67% £151 18% 75 17% 76 PARTIAL 4 ✔F85072 Grovelands Medical Centre Del PMS 3 7% 64% 1 Small‐medium 40% 42% 100% 3,291 12,121 98.9% 3.8 10,075 ‐4% 80% 75% 73% £150 13% 32 13% 107 FULL 7 ✔F85076 Freezywater Primary Care Centre Del PMS 1 ‐ Most deprived 6% 62% 27 3 Large 16% 0% 58% 1,930 5,221 97.7% 4.2 12,892 0% 67% 54% 27% 56% £150 0% 0 0% 0 PARTIAL 2 ✔F85625 Bincote Surgery Del PMS 4 8% 77% 4 0 Small‐medium 69% 9% 0% 2,138 58,781 95.7% 3.2 6,397 ‐2% 90% 93% 75% 83% £141 29% 44 28% 201 PARTIAL 2 ✔F85634 East Enfield Practice Del PMS 1 ‐ Most deprived 2% 51% 1 1 Small‐medium 0% 0% 100% 2,083 5,936 99.6% 8.3 3,191 ‐2% 100% 85% 64% 70% £150 31% 23 31% 25 PARTIAL 1 ✔F85642 The North London Health Centre Del GMS 3 7% 67% 6 1 Medium‐large 0% 0% 35% 2,448 3,743 95.0% 3.3 8,796 ‐3% 89% 86% 62% 69% £111 23% 152 23% 310 no data ‐ ✔F85650 Morecambe Surgery Del GMS 2 7% 51% 6 1 100% 10,285 96.9% 3.9 5,008 ‐3% 100% 73% 63% 56% £114 22% 68 22% 146 FULL 7 ✔F85652 Southbury Surgery Del PMS 3 5% 73% 4 Small‐medium 100% 0% 100% 3,034 9,860 93.7% 4.8 4,751 0% * 92% 95% 81% £138 0 0 FULL 7 ✔F85654 Brick Lane Surgery Del GMS 1 ‐ Most deprived 7% 59% 1 Single‐handed 30% 0% 100% 5,060 14,959 99.4% 5.5 3,992 0% 82% 67% 59% £114 36% 47 35% 46 PARTIAL 1 ✔F85656 Bush Hill Park Med Centre Del GMS 3 6% 68% 10 1 Small‐medium 50% 0% 1,852 89.8% 3.1 2,181 3% 93% 86% 98% 71% £122 14% 11 14% 87 FULL 7 ✔F85663 Latymer Road Surgery Del GMS 1 ‐ Most deprived 7% 47% 11 1 Small‐medium 34% 0% 0% 1,897 6,246 97.2% 4.2 4,621 6% 64% 44% 54% £124 11% 43 11% 65 FULL 7F85666 Dr Me Silver's Practice Del PMS 1 ‐ Most deprived 6% 43% 5 Small‐medium 0% 47% 100% 1,858 11,411 97.4% 10.7 3,826 11% 98% 87% 56% 73% £146 14% 26 14% 25 FULL 7F85676 Boundary House Surgery Del PMS 1 ‐ Most deprived 5% 46% 11 Small‐medium 19% 19% 100% 2,335 5,357 91.4% 3.5 4,956 ‐2% 76% 80% 67% 70% £162 19% 35 19% 39 PARTIAL 2 ✔F85678 Town Surgery Del PMS 3 3% 71% 5 1 Small‐medium 31% 0% 100% 2,756 8,641 99.2% 5.3 4,282 ‐1% 88% 93% 81% £141 22% 72 22% 72 FULL 7 ✔F85681 Green Street Surgery Del PMS 1 ‐ Most deprived 6% 57% 2 Single‐handed 100% 0% 100% 2,934 7,653 88.1% 4.7 2,357 0% 73% 72% 53% 79% £135 25% 22 25% 43 PARTIAL 1 ✔F85682 Chalfont Road Surgery Del APMS 1 ‐ Most deprived 3% 46% 10 2 Small‐medium 0% 100% 100% 2,656 8,852 95.8% 5.2 4,555 4% 91% 87% 79% 63% £135 16% 14 16% 63 FULL 7F85684 Curzon Avenue Surgery Del GMS 1 ‐ Most deprived 4% 50% 7 1 Small‐medium 40% 0% 0% 2,319 17,082 99.5% 5.5 5,618 2% 74% 51% 64% £120 0 0 PARTIAL 3 ✔F85686 Trinity Avenue Surgery Del PMS 3 7% 66% 2 Small‐medium 0% 0% 1,934 96.1% 2.7 2,712 ‐4% 100% 84% 85% 84% £147 16% 20 16% 43 PARTIAL 4 ✔F85687 Oakwood Medical Centre Del PMS 4 7% 71% 15 Small‐medium 19% 0% 0% 2,528 8,071 99.3% 6.3 7,454 3% 86% 75% 44% 55% £152 10% 95 10% 90 FULL 7 ✔F85700 Arnos Grove Medical Centr Del PMS 3 4% 61% 2 1 Small‐medium 43% 94% 100% 3,057 2,812 97.0% 9.9 5,809 ‐13% 61% 77% 54% £125 20% 4 19% 57 FULL 7 ✔F85701 Gillan House Surgery Del GMS 3 5% 66% 3 Medium‐large 41% 8% 100% 1,890 9,275 99.6% 5.5 10,606 ‐7% 91% 88% 69% 77% £116 19% 183 19% 218 FULL 7 ✔F85703 Lincoln Road Med Practice Del PMS 2 3% 61% 7 1 Medium‐large 23% 0% 100% 1,705 9,290 96.2% 2.4 7,978 ‐9% 71% 58% 76% £149 0 0 PARTIAL 2 ✔F85707 Enfield Island Surgery Del PMS 1 ‐ Most deprived 2% 49% 2 2 Small‐medium 50% 0% 100% 1,571 7,226 91.9% 3.1 3,778 1% * 84% 88% 78% £150 0 0 FULL 7 ✔Y00057 Angel Surgery Del PMS 1 ‐ Most deprived 4% 42% 5 1 Small‐medium 57% 0% 100% 2,246 11,559 98.0% 3.6 10,377 ‐51% 83% 75% 89% 71% £134 12% 54 12% 22 FULL 7 ✔Y00612 Green Cedars Medical Centre Del GMS 1 ‐ Most deprived 3% 44% 5 Small‐medium 16% 36% 100% 2,555 16,350 97.3% 8.6 6,506 1% 85% 75% 70% 65% £114 10% 6 10% 19 FULL 7Y03402 Evergreen Primary Care Centre Del PMS 1 ‐ Most deprived 3% 42% 34 1 Large 9% 10% 58% 2,962 11,650 96.2% 5.7 20,112 ‐1% 93% 66% 27% 57% £131 33% 181 33% 204 FULL 7 ✔

Patients Online Extended AccessEnfield CCG


Page 53 of 83

Finance

Practi

ce

Code

Practice Name


Contract Typ

e

Dispen

sing Practice

Practice Linked IM

D

(National Q

uintiles)

% Patien

ts Aged 75+

% Patien

ts Non‐BME


CQC ‐ C

aring

CQC ‐ E

ffective

CQC ‐ R

espo

nsive

CQC ‐ Safe

CQC ‐ W

ell led

Written

complaints (total)

Written


Practice Size

(Based on FTE

GPs)

% GPs aged

55 years and over

% Locum GPs


Number of patien

ts per FTE

GP

Number of patien

ts per FTE

Nurse

QOF Achievement

QOF Exception Rate

List size


FFT: % likely to recommend GP

service to frien

ds & family


turn)


GP practice


by

phone

( ~ = nos <10; * = < 0.5%

)


appointm

ent offered

( ~ = nos <10; * = < 0.5%

)

Average

paymen

t per weigh

ted

patient

Online Appointm

ents Enabled

% Of Reg Pop with online

appointm

ent en

abled

Total n

o. p

t tran

sactions us ing

online ap

pointm

ents service

Order Repeat Prescriptions Online

Enabled

% Of Reg Pop with order repeat

prescriptions online en

abled

Total n

o. p


via online pt tran

saction service

Catego

ry

Full / P

artia

l / No

No. o

f extended

access days

Directed Enhan

ced Services

(Exten

ded

Access paym

ent)

F85007 Lawrence House Surgery Del PMS 1 ‐ Most deprived 3% 49% 29 1 Large 25% 5% 82% 2,070 6,189 99.7% 7.9 16,745 1% 82% 85% 72% 66% £136 59% 376 58% 436 FULL 7 ✔F85008 Staunton Group Practice Del GMS 2 4% 57% 4 4 Medium‐large 39% 0% 27% 2,893 10,673 92.5% 6.5 14,272 4% 82% 61% 35% 42% £138 7% 223 7% 123 no data ‐ ✔F85013 Tynemouth Medical Practice Del PMS 1 ‐ Most deprived 3% 44% 32 3 Medium‐large 8% 0% 26% 1,918 3,101 10,145 6% 80% 52% 38% 39% £122 0 0 no data ‐ ✔F85014 Highgate Group Practice Del PMS 4 7% 81% 7 1 Large 0% 0% 0% 2,042 4,969 98.0% 4.1 15,833 ‐1% 67% 92% 75% 79% £145 70% 254 70% 567 FULL 7 ✔F85017 Charlton House Medical Centre Del GMS 1 ‐ Most deprived 4% 43% 19 3 Small‐medium 50% 0% 76% 4,165 8,463 99.8% 11.7 6,998 4% 75% 64% 71% £116 35% 372 35% 136 PARTIAL 1 ✔F85019 Morris House Group Practice Del GMS 1 ‐ Most deprived 4% 47% 42 Large 15% 0% 0% 1,910 15,583 95.8% 11.1 13,202 0% 76% 78% 36% 62% £136 30% 20 30% 253 FULL 7 ✔F85028 Bruce Grove Primary Health Care Ctr Del GMS 5% 10 3 Small‐medium 65% 0% 100% 2,730 14,739 94.6% 5.7 7,863 2% 65% 73% 72% £104 8% 27 8% 24 no data ‐ ✔F85030 Somerset Gardens Family Health Centre Del PMS 1 ‐ Most deprived 5% 42% 0 0 42% 5,791 99.3% 10.7 13,775 ‐1% 72% 50% 65% £151 11% 14 11% 208 FULL 7 ✔F85031 Westbury Medical Centre Del PMS 1 ‐ Most deprived 4% 54% 24 1 Small‐medium 0% 0% 100% 3,572 11,430 100.0% 6.0 10,730 ‐2% 76% 74% 61% £140 29% 161 29% 192 FULL 7 ✔F85034 Arcadian Gardens Surgery Del GMS 2 6% 60% 6 1 Small‐medium 7% 13% 100% 3,338 8,355 93.5% 3.1 3,807 ‐4% 76% 84% 66% £124 25% 64 25% 91 FULL 7 ✔F85045 Queens Avenue Practice Del GMS 4 7% 80% 4 Small‐medium 100% 0% 100% 2,291 17,411 94.7% 0.7 4,628 ‐1% 92% 91% 88% £114 19% 17 19% 167 FULL 7F85046 Hornsey Park Surgery Del GMS 2 3% 59% 9 2 Small‐medium 100% 0% 0% 4,108 6,847 95.7% 5.6 4,489 ‐2% 75% 91% 76% £112 17% 34 17% 33 FULL 7 ✔F85052 Spur Road Surgery Del GMS 1 ‐ Most deprived 7% 50% 5 1 Small‐medium 87% 0% 100% 1,323 15,216 96.9% 7.1 1,696 ‐7% 67% 88% 96% 65% £106 19% 14 19% 22 FULL 7F85060 Havergal Surgery Del PMS 2 5% 58% 7 1 Medium‐large 10% 37% 90% 1,912 5,597 86.6% 3.5 6,088 0% 76% 46% 63% £138 27% 100 23% 60 FULL 7 ✔F85061 Christchurch Hall Surgery Del GMS 3 4% 73% 5 1 Small‐medium 92% 26% 0% 2,201 9,040 91.7% 2.0 3,668 6% 91% 85% 93% 64% £125 3% 1 3% 4 FULL 7 ✔F85063 The Muswell Hill Practice Del PMS 4 5% 82% 9 Large 21% 0% 0% 2,049 7,016 98.9% 5.5 14,363 ‐3% NA 91% 79% 76% £134 43% 413 43% 429 FULL 7 ✔F85064 Stuart Crescent Health Centre Del PMS 2 6% 57% 3 0 Small‐medium 0% 0% 2,929 98.5% 6.9 4,978 ‐7% 100% 88% 79% 81% £130 19% 50 19% 59 FULL 7 ✔F85065 Stuart Crescent Medical Practice Del GMS 1 ‐ Most deprived 5% 56% 2 Small‐medium 50% 0% 0% 1,348 8,090 94.0% 5.9 3,235 ‐1% 69% 66% 66% £124 9% 18 9% 12 FULL 7 ✔F85066 Bounds Green Group Practice Del PMS 3 5% 65% 59 1 Large 12% 13% 37% 1,816 11,216 97.3% 6.1 17,427 ‐4% 91% 72% 81% £140 48% 1042 48% 848 PARTIAL 6 ✔F85067 The 157 Medical Practice Del PMS 2 7% 65% 0 Small‐medium 60% 20% 100% 1,704 8,116 85.0% 3.2 4,454 2% 81% 76% 58% £148 4% 11 4% 22 NO 0 ✔F85069 Crouch Hall Road Surgery Del PMS 3 4% 77% 6 Medium‐large 73% 0% 54% 2,314 8,443 99.9% 4.4 8,402 ‐2% 92% 90% 97% 80% £146 99% 259 99% 230 FULL 7 ✔F85071 Fernlea Surgery Del PMS 1 ‐ Most deprived 3% 57% 13 Small‐medium 32% 0% 100% 3,802 6,497 99.3% 6.1 9,419 ‐6% 97% 76% 76% 64% £138 23% 0 23% 74 FULL 7 ✔F85615 Tottenham Health Centre Del PMS 1 ‐ Most deprived 4% 43% 1 Small‐medium 98% 0% 0% 2,390 5,137 95.8% 2.7 5,478 ‐2% 68% 71% 58% £153 27% 29 25% 61 FULL 7 ✔F85623 Grove Road Surgery Del PMS 1 ‐ Most deprived 3% 48% 1 1 Small‐medium 44% 0% 100% 1,710 19,233 93.9% 6.3 4,394 ‐7% 100% 85% 91% 74% £146 13% 8 13% 27 FULL 7 ✔F85628 Dowsett Road Surgery Del GMS 1 ‐ Most deprived 4% 44% 6 Small‐medium 0% 31% 100% 1,782 6,090 99.4% 6.0 4,720 ‐7% 83% 77% 75% £108 24% 14 25% 37 FULL 7 ✔F85640 Evergreen House Surgery Del PMS 2 4% 61% 0 Small‐medium 0% 0% 0% 2,573 5,226 94.5% 2.6 6,816 ‐3% 83% 80% 64% £130 47% 59 47% 51 FULL 7 ✔F85645 Myddleton Road Surgery Del PMS 2 2% 60% 5 Single‐handed 100% 0% 0% 3,061 6,292 93.7% 3.2 3,083 ‐2% 35% 69% 77% 69% £143 41% 4 41% 42 FULL 7 ✔F85669 West Green Road Surgery Del GMS 1 ‐ Most deprived 1% 54% 15 5 Medium‐large 19% 17% 100% 2,710 47,547 97.1% 5.3 14,729 ‐6% 82% 90% 94% 81% £105 6% 1 6% 30 FULL 7 ✔F85675 The Alexandra Surgery Del PMS 3 6% 70% 4 Small‐medium 58% 17% 3,073 99.6% 4.8 5,709 4% 69% 73% 70% £137 46% 186 45% 264 no data ‐ ✔F85688 Rutland House Surgery Del PMS 4 5% 74% 10 3 Small‐medium 24% 0% 100% 2,488 8,295 99.5% 5.8 6,804 ‐4% 84% 76% 74% £133 26% 131 24% 134 FULL 7 ✔F85697 The Old Surgery Del GMS 2 7% 61% 1 Small‐medium 43% 0% 100% 1,899 10,289 96.6% 2.9 2,106 6% 83% 84% 73% £110 5% 0 5% 2 FULL 7 ✔F85705 Js Medical Practice Del PMS 1 ‐ Most deprived 3% 49% 4 1 Small‐medium 50% 0% 40% 5,247 7,472 83.3% 3.7 12,604 ‐1% 100% 83% 79% 68% £134 49% 146 49% 192 FULL 7 ✔Y01655 The Vale Practice Del GMS 3 1% 74% 2 Medium‐large 55% 0% 66% 1,889 7,590 98.2% 4.3 11,174 ‐1% 90% 87% 87% 70% £133 41% 161 41% 231 FULL 7 ✔Y02117 The Laurels Medical Practice Del PMS 1 ‐ Most deprived 3% 50% 21 2 Small‐medium 19% 56% 0% 5,449 21,176 99.4% 7.9 12,924 ‐2% 91% 74% 53% 51% £119 8% 101 8% 113 FULL 7 ✔Y03035 Queenswood Medical Practice Del GMS 3 4% 75% 22 1 Large 6% 0% 0% 2,035 8,906 100.0% 5.6 22,516 ‐3% 91% 93% 86% 85% £153 41% 605 41% 476 FULL 7 ✔Y03135 Bridge House Medical Practice Del PMS 2 4% 64% 20 Small‐medium 50% 0% 0% 5,135 7,131 90.9% 4.2 10,402 ‐2% 71% 42% 57% £134 11% 59 11% 75 FULL 7 ✔Y05330 Tottenham Hale Medical Practice Del PMS 1% 0% 4 Small‐medium 40% 0% 100% 1,927 7,706 2,720 ‐31% 72% 87% 60% £199 27% 68 27% 42 FULL 7

Patients Online Extended AccessHaringey CCG

PracticePractice

DemographicsQuality Workforce Efficiency Patient Experience

Page 54 of 83

Finance

Practi

ce

Code

Practice Name


Contract Typ

e

Dispen

sing Practice

Practice Linked IMD

(National Q

uintiles)

% Patients Aged 75+

% Patients Non‐BME


CQC ‐ C

aring

CQC ‐ E

ffective

CQC ‐ R

espo

nsive

CQC ‐ Safe

CQC ‐ W

ell led

Written complaints (total)

Written complaints (via NHS E)

Practice Size

(Based on FTE

GPs)


% Locum GPs



GP


Nurse

QOF Achievemen

t

QOF Exception Rate

List size



d GP

service to frien

ds & family


turn)


GP practice


by

phone

( ~ = nos <10; * = < 0.5%

)


appointm

ent offered

( ~ = nos <10; * = < 0.5%

)

Average

paymen

t per weigh

ted

patient

Onlin

e Appointm

ents Enabled

% Of Reg

Pop with onlin

e

appointm

ent en

abled

Total n

o. p


onlin

e ap

pointm

ents service

Order Rep

eat Prescriptions Onlin

e

Enabled

% Of Reg

Pop with order repeat

prescriptions onlin

e en

abled

Total n

o. p


via onlin


Catego

ry

Full / P

artia

l / No

No. o

f extended

access days

Directed Enhan

ced Services

(Exten

ded

Access paymen

t)

F83002 River Place Health Centre Del GMS 1 ‐ Most deprived 4% 72% 6 1 Large 0% 5% 83% 1,276 4,530 100.0% 7.2 10,050 1% 91% 92% 77% 77% £147 20% 70 18% 119 FULL 7 ✔F83004 Archway Medical Centre Del PMS 1 ‐ Most deprived 4% 66% 7 1 Small‐medium 44% 0% 73% 2,632 4,370 98.1% 5.4 6,311 ‐7% 82% 85% 64% £156 27% 65 26% 76 FULL 7 ✔F83007 Roman Way Medical Centre Del GMS 1 ‐ Most deprived 6% 66% 14 1 Medium‐large 35% 30% 0% 1,418 10,873 92.0% 3.1 3,599 21% 84% 86% 64% £130 18% 0 17% 15 FULL 7F83008 The Goodinge Group Practice Del GMS 1 ‐ Most deprived 4% 66% 0 Large 21% 0% 0% 1,329 8,849 94.6% 3.9 12,366 1% 88% 86% 83% £130 26% 139 26% 228 FULL 7 ✔F83010 Islington Central Medical Centre Del GMS 2 3% 73% 31 1 Medium‐large 41% 0% 100% 4,285 22,321 99.1% 4.3 18,776 ‐2% 74% 46% 72% £137 57% 199 57% 227 FULL 7 ✔F83012 Elizabeth Avenue Group Practice Del GMS 2 5% 73% 12 Large 0% 0% 0% 1,111 2,830 99.7% 6.5 7,400 ‐2% * 84% 85% 70% £149 37% 42 37% 150 FULL 7 ✔F83015 St Johns Way Medical Centre Del GMS 1 ‐ Most deprived 5% 67% 26 1 Large 22% 6% 27% 1,465 3,585 98.4% 8.9 12,894 0% 75% 93% 84% 69% £134 24% 190 24% 336 FULL 7 ✔F83021 Ritchie Street Group Practice Del GMS 2 3% 73% 32 Large 25% 0% 31% 1,962 11,412 97.7% 5.5 17,342 ‐10% 69% 65% 65% £125 38% 491 37% 341 FULL 7 ✔F83027 Drs Bowry & Bowry's Practice Del GMS 1 ‐ Most deprived 5% 66% 2 Medium‐large 47% 0% 1,569 0 96.2% 5.6 5,413 0% 93% 71% 57% £120 11% 34 11% 64 FULL 7 ✔F83032 St Peter's Street Medical Practice Del GMS 2 3% 74% 11 Large 49% 0% 0% 1,885 12,218 99.7% 5.2 12,032 2% 63% 87% 84% 68% £129 18% 128 1% 3 FULL 7 ✔F83033 Dr Haffiz Del GMS 1 ‐ Most deprived 7% 61% 3 1 Small‐medium 0% 0% 100% 2,850 14,250 64.5% 11.1 3,083 0% 71% 70% 57% 57% £113 8% 5 8% 12 no data ‐F83034 New North Health Centre Del GMS 2 9% 70% 2 1 Single‐handed 100% 0% 1,771 0 95.4% 5.7 1,678 3% 78% 92% 92% £147 12% 4 12% 7 FULL 7 ✔F83039 The Rise Group Practice Del GMS 1 ‐ Most deprived 5% 64% 11 Small‐medium 54% 6% 100% 1,890 4,083 87.1% 4.2 5,249 3% 80% 77% 71% 63% £135 20% 50 20% 102 FULL 7 ✔F83045 The Miller Practice Del GMS 2 4% 73% 16 Large 33% 0% 100% 1,598 7,991 98.9% 4.7 10,667 ‐5% 92% 95% 80% £148 36% 264 36% 278 FULL 7 ✔F83051 Dr Ko & Partner Del GMS 2 0% 73% 6 Small‐medium 0% 19% 100% 3,407 8,140 95.3% 3.5 0 74% 80% 59% £120 0 0 FULL 7 ✔F83053 Mildmay Medical Practice Del GMS 2 4% 65% 30 1 Medium‐large 32% 39% 100% 1,932 7,259 99.8% 6.0 6,210 3% 96% 80% 66% 67% £160 27% 0 27% 94 FULL 7 ✔F83056 The Mitchison Road Surgery Del APMS 1 ‐ Most deprived 3% 67% 5 Small‐medium 44% 0% 0% 3,715 12,737 100.0% 6.4 5,121 ‐5% 91% 78% 71% 75% £157 30% 43 30% 63 FULL 7F83060 The Northern Medical Centre Del GMS 2 4% 67% 6 1 Medium‐large 17% 0% 59% 1,893 6,384 97.3% 5.6 8,961 ‐4% 73% 59% 59% £130 12% 60 12% 38 FULL 7 ✔F83063 Killick Street Health Centre Del GMS 1 ‐ Most deprived 3% 62% 18 Large 20% 0% 21% 1,829 2,548 100.0% 6.2 12,067 ‐1% 87% 86% 74% 70% £156 19% 7 19% 186 FULL 7 ✔F83064 City Road Medical Centre Del GMS 2 4% 64% 7 Medium‐large 0% 0% 1,730 0 95.6% 6.3 7,607 ‐6% 81% 81% 77% 81% £170 33% 0 33% 73 FULL 7 ✔F83624 Clerkenwell Medical Practice Del GMS 2 1% 68% 16 1 Medium‐large 13% 0% 7% 2,414 8,293 99.9% 6.0 13,469 ‐6% 85% 90% 94% 76% £108 36% 207 36% 183 FULL 7F83652 Amwell Group Practice Del GMS 2 2% 69% 24 1 Large 0% 5% 52% 1,187 5,627 99.8% 7.4 11,115 ‐1% 83% 88% 60% £168 30% 25 29% 65 FULL 7 ✔F83660 Dr Trosser Del GMS 3 4% 72% 8 Medium‐large 59% 11% 0% 2,681 8,479 94.0% 3.6 9,079 0% 79% 73% 70% £120 19% 103 19% 132 FULL 7 ✔F83664 The Village Practice Del GMS 1 ‐ Most deprived 2% 57% 7 1 Small‐medium 0% 0% 0% 3,342 6,184 96.8% 5.0 8,962 ‐3% 66% 74% 61% £125 36% 88 36% 95 FULL 7 ✔F83666 Andover Medical Centre Del GMS 1 ‐ Most deprived 5% 58% 10 3 Medium‐large 0% 11% 30% 1,247 4,392 98.1% 8.8 6,462 ‐3% 73% 73% 64% 73% £142 21% 51 19% 55 FULL 7 ✔F83671 The Beaumont Practice Del GMS 1 ‐ Most deprived 3% 63% 3 Small‐medium 80% 0% 100% 2,769 5,275 98.5% 7.7 2,972 ‐1% 75% 77% 71% £149 33% 9 33% 37 FULL 7 ✔F83673 Dr Edoman Del PMS 2 3% 65% 11 1 Small‐medium 100% 0% 16% 1,981 4,142 100.0% 3.5 5,056 ‐7% 85% 76% 77% £161 17% 43 17% 36 FULL 7 ✔F83674 The Tufnell Surgery Del GMS 2 5% 71% 5 Small‐medium 0% 54% 100% 2,757 4,243 99.4% 6.5 9,598 ‐39% 83% 86% 75% £158 13% 57 13% 119 FULL 7 ✔F83678 Dr Segarajasinghe Del GMS 2 7% 67% 0 Small‐medium 0% 0% 0% 1,094 5,252 90.5% 13.5 2,559 3% 88% 71% 78% £110 16% 31 16% 16 no data ‐ ✔F83680 Dr Gupta Del GMS 1 ‐ Most deprived 4% 63% 5 1 Small‐medium 57% 3% 100% 1,579 4,816 96.0% 2.7 4,136 ‐5% 80% 77% 70% £120 18% 42 17% 40 FULL 7 ✔F83681 Partnership Primary Care Centre Del GMS 1 ‐ Most deprived 5% 68% 2 Small‐medium 10% 10% 100% 2,985 3,283 99.5% 8.8 3,523 ‐8% 80% 75% 74% 64% £127 10% 36 10% 33 FULL 7F83686 Stroud Green Medical Centre Del GMS 2 2% 67% 2 Small‐medium 0% 0% 100% 3,374 9,841 98.6% 6.9 6,672 ‐6% 92% 88% 83% 69% £125 21% 109 20% 88 FULL 7 ✔Y01066 Hanley Primary Care Centre Del PMS 1 ‐ Most deprived 3% 61% 8 1 Small‐medium 0% 0% 3,071 0 99.5% 5.8 7,137 ‐8% 92% 77% 62% 70% £148 32% 88 31% 213 FULL 7

Patients Online Extended AccessIslington CCG


Page 55 of 83

OFFICIAL

1

North Central London Primary Care Committee in Common –

Report Title REPORT TO THE NORTH CENTRAL

LONDON PRIMARY CARE COMMISSIONING COMMITTEE (PCCC)

Date of report

Agenda Item

Considered at Part 1☒ Part 2 ☐ Urgent decision ☐

9



Tel/Email

GB Member Sponsor

Not Applicable

Report Author

NHS England Primary Care Commissioning

Tel/Email

0203 688 1993 [email protected]

Report Summary

Detail of the request to vary PMS Agreements and any conditions to be applied

Recommendation Approval of the proposed changes outlined below and any conditions


Not maintaining the stability of the agreement. The risk can be mitigated by approving the variations with appropriate conditions.


Not Applicable


Not Applicable

Engagement

Not Applicable


Not Applicable


Not Applicable

Next Steps Issue appropriate variations with conditions where applicable

Appendices

Not Applicable

Which CCG does this relate to:

Enfield

Page 56 of 83

OFFICIAL

2

Contents

1 Executive summary ............................................................................................. 3

2 Background ......................................................................................................... 3

3 Table of requested PMS Agreement changes ..................................................... 4

Page 57 of 83

OFFICIAL

3

1 Executive summary The below table summarises the Agreement Changes requested by PMS Practices in NCL.

The corresponding CCG is asked to make determination for the PMS Agreement Changes in

their area.

2 Background PMS practices are required to submit agreement change requests with 28 days’ notice to allow

the commissioner to consider the appropriateness of the request. The Commissioner should

be satisfied that the arrangements for continuity of service provision to the registered

population covered within the agreement are robust and may wish to seek written assurances

of the post-variation individuals ability and capacity to fulfil the obligations of the agreement

and their proposals for the future of the service.

Page 58 of 83

OFFICIAL

4

3 Table of requested PMS Agreement Changes

Practice CCG approver

List Size 1/1/19

Agreement Change Comment Recommended guide based on: 72 GP appointments per 1000 patients

Apps x 10 min (app) / 180 (3 hour session)

Recommendation to committee

Forest Road Group Practice (MHP) Riley House Surgery (MHP) Freezywater PCC (MHP) Southbury Surgery (MHP) Green Street Surgery (MHP) Lincoln Road Medical Practice (MHP) Enfield Island Surgery (MHP) Dean House Surgery(MHP)

Enfield Total of 13 Practices - 86,875

Dr P Keating - Retirement of an individual signatory to the 8 PMS agreements

Recommended Guide

342 GP appt per week 18 Sessions per week

The 8 PMS practices, which form part the Medicus Health Partnership (made up of 5 GMS & 8 PMS practices) have requested the removal Dr P Keating with effect 31st March 2019 due to retirement. Dr T Sadhu will take over as Lead GP at the practice with effect 1 April 2019 and will offer 9 sessions a week. Dr Keating was offering 4.5 sessions a week at the Southbury Surgery and services at the other MHP Practices. The practice will be offering:

Regular 18.5 sessions a week at Southbury Surgery - Dr T Sadhu (9 sessions)

Dr S Datta (1 session) 1 Salaried GP (4.5 sessions) 1 Nurse – 4 sessions (practice are

recruiting to offer 8/9 sessions by mid-April)

Additional GP cover across MHP multiple sites. Offering 387 GP appointment per week. Practice Manager working at the practice. Dr Keating will commence as Salaried GP from

1st April 2019 – offering 4 sessions a week for at

To approve

Page 59 of 83

OFFICIAL

5

least 6 months. This will ensure a smooth transition for patient services at this site.

It is recommended that the committee approves the removal of Dr P Keating as a signatory to the PMS agreement.

Boundary House Surgery

Enfield 4,968 Dr R Olowookere Recommended Guide

359 GP appt per week 19 Sessions per week

There are 2 signatories on the to the PMS agreement - Dr R Olowookere & Dr D Samuels. Dr Olowookere has requested to be removed with effect 29/1/19 and was offering 5 sessions a week. The practice will be offering:

Dr Olowookere’s sessions covered by locums (5 sessions) Dr D Samuels (8 sessions) Locums – 2 sessions 2 full time HCA's who assist the Nursing staff, as well as a part-time Nurse Manager.

There is a shortfall of 4 GP sessions per week. Practices has stated in relation to the shortfall they:

Currently use the Hubs for additional appointments.

Locums used based on demand, to cover our busy periods.

Back Pain clinic which is a local initiative, this helps to reduce the demand for appointments.

To approve

Page 60 of 83

OFFICIAL

6

Commissioners will work with Boundary House Surgery to ensure that they work towards increasing the number of sessions and appointments.

It is recommended that the committee approves the removal of Dr Olowookere as a signatory from the PMS agreement.


Camden 6,277 Removal of Dr P Elphinstone as a signatory from PMS agreement

Recommended Guide

452 GP app per week 24 Sessions per week

Regents Park Practice - F83025 works in partnership with Ampthill Practice – F83006 which is a GMS practice. All partners are signatories on both the PMS and GMS contracts, but perform all of their clinical sessions at only one of the two sites. The practice currently offers the following number of appointments/sessions. The practice has assured they will continue to offer the following:

615 GP appointments 53 GP sessions

Dr P Elphinstone only provides her appointments at the (GMS) Ampthill Practice. As the service provision would remain unchanged at the (PMS) Regents Park Practice and they offer substantially more than the recommended amount of appointments, it is recommended that the committee approves the removal of Dr P Elphinstone as a signatory from the PMS agreement.

To approve

Page 61 of 83

OFFICIAL

7


Camden 6,277 Addition of Dr A Flynn as a signatory to the PMS agreement.

Recommended Guide


Regents Park Practice - F83025 works in partnership with Ampthill Practice – F83006 which is a GMS practice. All partners are signatories on both the PMS and GMS contracts, but perform all of their clinical sessions at only one of the two sites. The practice currently offers the following number of appointments/sessions. The practice has assured they will continue to offer the following:

615 GP appointments 53 GP sessions

Dr Flynn would perform all of his clinical sessions at the GMS) Ampthill Practice and the service provision at the (PMS) Regents Park Practice would remain unchanged. It is recommended that the committee approves the addition of Dr A Flynn as a signatory to the PMS agreement.

To approve

F83018 Prince of Wales Group Practice

Camden 8969 Removal of Dr N Ashworth, Dr S Palmer and Dr R Walthew Addition of Dr K Pealing and Dr T Postgate

Background This is a retrospective signatory changes. 3 doctors left the Agreement and 2 doctors were added on to the Agreement Name of GP Action taken Effective date of

action Dr N Ashworth Removed from

the Agreement 03/05/18

F83018 Prince of Wales Group Practice

Page 62 of 83

OFFICIAL

8

Dr R Walthew Removed from the Agreement

31/07/16

Dr S Palmer Removed from the Agreement due to retirement

31/08/17

Dr K Pealing Added on to the Agreement

11/10/18

Dr T Postgate Added on to the Agreement

01/10/16

Clinical Sessions provided

Recommended Guide


What the practice state they are providing following their change:


F85645 Myddelton Road Surgery

Haringey 3069 Addition of GP Signatory

Background It was approved during the February Committee for Dr S. Begum to be added to the PMS Agreement from 1 April 2019. Dr Begum withdrew the application before the agreement was signed. Practice is in the process of recruiting another partner. A new partner added to the PMS Agreement will enable the following:-

To Approve

Page 63 of 83

OFFICIAL

9

Practice opening on the half day on Wednesdays when they were closed. This will provide more appointments.

The additional GP will also enable the practice to provide more appointments and sessions for patients to access through telephone and face to face consultations.

Clinical Sessions provided

Recommended Guide


What the practice state they are providing following this change:

151 GP appointments per week 9 Sessions per week

There is a shortfall of 70 GP sessions and 3 GP sessions per week. Commissioners will work with The Myddleton Road Practice to ensure that they work towards increasing the number of sessions and appointments.

Page 64 of 83

OFFICIAL

1

North Central London Primary Care Committee in Common – 18 April 2019

Report Title Contract extension for Cricklewood

Health Centre (APMS) Date of report

Agenda Item 10

Considered at Part 1☒ Part 2 ☐ Urgent decision ☐

April 2018


Paul Sinden Tel/Email

GB Member Sponsor

Colette Wood

Report Author

Angela Kindrat Tel/Email [email protected]

Report Summary

This report sets out the case for a further contract extension for Cricklewood Health Centre APMS beyond the current 30th September contract. This is to align with the CCG timelines for finalising the consultation process and developing an options appraisal for the Walk in Centre. (WIC) A joint consultation is planned to commence in April 2019 for the registered list and walk in centre, with an aim to bring the outcome and recommendation to the August PCCC.

Recommendation i) To APPROVE the extension of the current contract to 30 November 2019 in the first instance. ii) To APPROVE a proviso which would further extend the contract to 31st March 2020 on basis that there is further slippage in timelines beyond commissioners’ control.


The legal team has advised that the patient list cannot be extended however, the viability of the WIC contract is dependent on the patient list contract remaining part of the arrangement. Both services are being delivered by Barndoc from the same premises.

Legal advice suggests there is a potential risk in further extension of the contract as challenge could be made with regard to procurement rules. Therefore commissioner should be clear on the mitigating circumstances which require an extension


Not Applicable


Not Applicable

Engagement

Wider stakeholder engagement will commence in April 2019 regarding the options of either a procurement or dispersal.


An equality impact assessment will be carried out during the consultation stage.

Page 65 of 83


OFFICIAL

2


Decision to extend the Cricklewood Health Centre APMS contract was most recently taken at the Primary Care Commissioning Committee in December 2019. PCCC approved an extension of the contract to end of September 2019. In terms of background and chronology of the Cricklewood contract, the Committee should note the following; ii) Initial contract- 1st April 2015 – 31st December 2015. The contract was varied to enable disaggregation of the WIC and registered list and was permissible under the terms of the contract which allowed an extension clause of 2 years (e.g. from 1st April 2015-31st March 2017) ii) 1st extension-1st January 2015 to 31st March 2017-contract extended iii) 2nd extension -1st April 2017 to 31st October 2018 (6 months beyond the extension term of the varied contract)

- iii) 3rd extension-1st November 2018 to 31st March 2019 (12 months beyond the extension term of the varied contract) iv) 4th extension-1st April 2019-30th September 2019 (17 months beyond the extension term of the varied contract). v) 5th extension-(proposed) 1st October 2019-31st November (19 months beyond the extension term of the varied contract). In the event that a proviso to extend to March 2020 is approved and utilised, this would represent 23 months of the contract running beyond the extension term of the varied contract.

Next Steps Issue appropriate variations with conditions where applicable

Appendices

Not Applicable


Barnet

Recommendation The Committee is asked to approve a further extension of the patient list APMS contract for the Cricklewood Health Centre to 30 November 2019 in the first instance. This is in order that the contract end date aligns with the Walk in Centre (WIC) contract commissioned by Barnet CCG which is due to expire on 30 September 2019. Both contracts are delivered by Barndoc Limited. The current expiry date is 30 September 2019, this is insufficient time to complete a patient engagement and options appraisal for the future of the contract.

Page 66 of 83

OFFICIAL

3

The Committee is asked to approve the recommendation to extend the contract to November 2019 in addition to further approval of a proviso to extend the contract to 31 March 2020 if required. 1. Background Barnet CCG have extended the WIC contract to 30 November 2019 in order for them to finalise their commissioning options appraisal for the WIC contract. As advised previously, if the patient list contract is not operational, it would destabilise the WIC contract because the viability of the WIC is dependent on the patient list contract remaining part of the arrangement. Commissioners are in the process of finalising the engagement plan and propose to commence engagement with stakeholders during April. There will be a 12-week consultation period again, aligned to the WIC consultation process. This will inform the decision of whether to re-procure the contract or disperse the list. List size-growth Commissioners have reviewed annual growth in list size (table 1). While there is a not insignificant increase since 2015, the most recent list size of 4,739 does not pose a risk in terms of the outcome of the options appraisal e.g. dispersal or re-procurement. A significant proportion of patients reside within Brent’s catchment area and Brent CCG has provided assurances that surrounding practices have sufficient capacity to absorb patients in the event of a dispersal. Table 1

Date Raw list size

% Increase Weighted list size

% Increase

1 January 2015

1,318 1,081.62

1 January 2016

2,404 82% 2,129.06 97%

1 January 2017

3,456 44% 2,941.15 38%

1 January 2018

4,246 23% 3,495.22 18.8%

1 January 2019

4739

12% 3,811.04 9%

Current contract value

Based on the current Londonwide APMS contract price of £108.02 inclusive of KPI Band A and B and without OOH deductions, the current value of the contract based on the weighted list size of 3,811 is £411, 669. 2. Next Steps If committee members approve the extension of the contract, commissioners will:

Page 67 of 83

OFFICIAL

4

i) Issue contract variation to extend the contract on the same terms until 30 November 2019.

ii) Work with task and finish group to develop a detailed timeline of activity and monitoring process to address further slippage

iii) Complete the options appraisal on the future of the contract and bring this back to committee once stakeholder engagement has been concluded. It is anticipated that this will now be in August 2019.

Page 68 of 83


Report Title Tottenham Hale Medical Centre – contract extension

Date of report April 2019

Agenda Item

11

Considered at Part 1 ☒ Part 2 ☐ Urgent decision ☐

Lead Director /

Manager

Owen Sloman Tel/Email [email protected]

GB Member Sponsor

Clare Henderson

Report Author

Anthony Marks Tel/Email [email protected]

Report Summary

The report sets out the case for the extension of the Tottenham Hale Medical Centre contract until 25 June 2020

Recommendation The committee is asked to APPROVE the extension of the Tottenham Hale Medical Centre contract until 25 June 2020

Identified Risks

and Risk

Management

Actions

Failure to extend the contract will result in termination and dispersal of 2247 patients in an area with identified access issues, or a costly care taking period whilst the contract is re-procured Risk can be avoided by extension of the current contract


Not Applicable

Resource

Implications

The contract will continue to be funded at the current agreed rate

Engagement

Not Applicable

Equality Impact

Analysis

Not Applicable

Report History and

Key Decisions

Not Applicable

Next Steps Issue contract variation Appendices

Not Applicable


Haringey

Page 69 of 83



Recommendation The committee is asked to approve the extension of the Tottenham Hale Medical Centre Alternative Primary Medical Services (APMS) contract until 25 June 2020 in line with the provision in the contract. At this time it is expected that building work for the new site the practice will relocate to will be well advanced and a move-in date in 2021 will be confirmed. The recommendation is made given the continued list growth, local regeneration and the need to continue to address local access issues. GP access has proved challenging in Haringey as recognised by a published Haringey Healthwatch report especially within the Tottenham Hale area. The case for a new practice here was supported by Haringey CCG, London Borough of Haringey and Healthwatch Haringey. The introduction of Tottenham Hale Medical Centre as a new practice, based on a zero list, was to address a deficit in the primary care provision and the anticipated needs associated with significant projected population growth within the regeneration area. From a zero list in July 2016, the practice now has 2666 patients. The practice is registered with the Care Quality Commission who inspected 10 September 2018 and rated the practice as overall Good in a report published 15 November 2018. Quality Outcome Framework (QOF) performance is has increased from 367.52 in 2017/18 to 536.35 in 2018/19 (46% increase). The contract has Key Performance Indicators (KPI) on which the contractual performance can be assessed however a full dataset is not available. Some data on the Primary Care Web Tool is also unavailable. The current contract is delivered from a temporary building (demountable) placed on a carpark with a lease in place until 28 July 2021, with 6 month break clause. The contract represents lower value for money when compared to the London APMS price however without secure premises re-procurement of the contract may fail and incur a costly caretaking period.

List growth From a zero list in July 2016 the list has grown to 2666 as at 1 January 2019

Page 70 of 83

List growth in the past year has been between 190 and 228 patients per quarter. The total registered population in Haringey has grown 1.6% over the last 12 months, Tottenham Hale Medical Centre’s

registered list has grown 45.8% over the same period.

Case for establishing a zero list practice at Tottenham Hale The Strategic Premises Development Plan for Haringey recognised that the borough faces issues of poor quality estate and high levels of deprivation. Access has also proved challenging as recognised by a published Haringey Healthwatch report especially within the Tottenham Hale area. The case for a new practice within the particular area was supported by Haringey CCG, London Borough of Haringey and Healthwatch Haringey. The introduction of Tottenham Hale Medical Centre, based on a zero list, would address a deficit in the current primary care provision and the anticipated needs associated with significant projected population growth within the regeneration area. The Tottenham Hale scheme was highlighted as a priority in Haringey CCG’s Premises Strategy Plan (March 2015) that was endorsed by

London FIPA in September 2015.

Performance The practice is registered with the CQC and was inspected on 10 September 2018. The report published on 15 November 2018 rated the practice as Good in all areas with an overall rating of Good. QOF achievement for 2017/18 was below the CCG and national average however the practice increased achievement in 2018/19 by 46% achieving 536.35 The practice has 8 ratings on NHS Choices achieving an overall score of three stars out of five. Satisfaction on the national GP survey is summarised below.

Page 71 of 83

Value for money The Tottenham Hale Medical Centre contract has atypical funding. It has a four phase initial annual funding model. The triggering of phases is based on the registered list size and the contract is currently in the second phase due to list growth. This means that the surgery is now open full core hours of 0800 – 1830 Monday to Friday. The contract holder is also paid a fixed management fee. The contract was commissioned as a pilot and has a higher remuneration than standard APMS contracts. It does not however attract a Price Support Supplement nor rent reimbursement due to the nature of the temporary building. Taking this into account and the monthly management fee the contractor is paid the contract represents less value for money than the standard APMS contract. As it is the intention to re-locate the practice into a new development value for money can be increased by re-procuring the contract on a standard APMS contract once premises are secured. Without longer term premises any re-procurement is likely to attract fewer bidders and may fail.

Recommendation Given the continued list growth, local regeneration, contractor performance and value for money, and the risk of failure for a re-procurement the recommendation to the committee is to extend the contract until 25 June 2020 as per the extension clause in the contract.

Page 72 of 83


Report Title Staunton Group Practice – caretaking contract extension

Date of report April 2019

Agenda Item

12

Considered at Part 1 ☒ Part 2 ☐ Urgent decision ☐

Lead Director /

Manager

Owen Sloman Tel/Email [email protected]

GB Member Sponsor

Clare Henderson

Report Author

Anthony Marks Tel/Email [email protected]

Report Summary

The report sets out the case for the extension of the current caretaking arrangements in place at Staunton Group Practice until 24 July 2019

Recommendation The committee is asked to APPROVE the extension of the caretaking contract provided by Federated4Health at Staunton Group Practice until 24 July 2019

Identified Risks

and Risk

Management

Actions

Failure to extend the contract will result in lack of Primary Care access for 14,254 patients which would have a significant impact on local practices if patients re-registered. Risk can be avoided by extension of the current contract


Not Applicable

Resource

Implications

The contract will continue to be funded at the current agreed rate

Engagement

Not Applicable

Equality Impact

Analysis

Not Applicable

Report History and

Key Decisions

Not Applicable

Next Steps Issue contract variation Appendices

Not Applicable


Haringey

Page 73 of 83



Recommendation The committee is asked to approve the extension of the caretaking contract for the patients at Staunton Group Practice which is provided by Federated4Health. This will provide continuity of care for patients registered at the Practice whilst Commissioners plan for the long term future of the Practice. As the contract has provision for three month extensions, the committee is asked to approve the contract extension to 24 July 2019.

Background Following CQC inspections on 2 May 2018 and 4 May 2018, and the suspension of the GP partners at the practice from 0001 on 9 May 2018, caretaking arrangements were put in place to provide continuity of service to 14,254 patients and to address any immediate patient safety concerns. Caretaking was initially provided by Forest Road Group Practice (9 May 2018 – 31 October 2018) and is currently provided by Federated4Health, the Pan Haringey GP Federation (1 November 2018 – 24 April 2019) under an Alternative Provider Medical Services (APMS) contract. The current caretaking contract is due to expire on 24 April 2019. Since the publication of CQC reports in 2017 there has been a marked reduction in list size, however patient numbers have been growing again since the start of 2019. The table below show the trend in patients registered at the practice.

It is reasonable to suppose that once the practice achieves a sustained period of stability the patient list will grow to 16/17 levels.

Page 74 of 83

North Central London Primary Care Committee in Common Thursday 18th April 2019

Report Title North Central London Primary Care

Committee in Common Risk Register Date of report 11th April 2019

Agenda Item




GB Member Sponsor

Not applicable.

Report Author



Report Summary

North Central London Primary Care Committee in Common Risk Register

1. Introduction This paper provides an overview of the risk register for the North Central London Primary Care Committee-in-Common (NCL PCCC) for scrutiny and oversight. The risk register includes the key risks within the remit of the Committee. The paper sets out strategic updates on risks held within the Committee risk register for April 2019.

2. Risks The Committee is asked to note the most material risks, with current risk ratings of 12 and above. There are 9 risks on the Committee risk register with 6 risks having a current risk score of 12 or higher. Key highlights: PCCC12: Managing variation in primary care quality and performance across NCL (Threat): Following sign-off of the NCL Strategy for General Practice CCG action plans to deliver the strategy are being developed and will include a focus on primary care at scale and the use of Quality Improvement Support Teams (QISTs) to help reduce unwarranted variation. The direction of the strategy is confirmed

Page 75 of 83



2

by the NHS Long Term Plan published in January 2019. The introduction of the new GP contract from April 2019 includes practice alignment to primary care networks supported by the introduction of a Direct Enhanced Service to help practices sign-up to joining the networks. This work is supported by securing funds from NHS England (for integrated care) to support the development of primary care networks, and support for the development of GP Federations by each CCG. The new GP contract also introduces a greater quality improvement focus in the Quality Outcomes Framework. PCCC13: Developing primary care workforce to support delivery of local strategies (Threat): Development of primary care workforce is included within the approved strategy for general practice. The Committee will focus on workforce in August 2019. The local response to the NHS Long Term Plan, scheduled for autumn 2019, will include workforce plans that are aligned to finance and activity plans. The NCL Strategy for General Practice, approved in November 2018, focuses on workforce development through primary care networks (with pharmacists, physicians and social prescribers supporting practice staff) and the benefits of working at scale. The new GP contract allows core funding to be used to extend skill-mix in practices in this way. PCCC14: Ensuring service continuity of Alternative Primary Medical Service (Special Allocation Service) (Threat): In February 2019 the Committee approved the service specification and business case for the re-procurement of the service across North Central London (NCL). The procurement will be carried out through Tranche 7 of the London-wide Alternative Personal Medical Services (APMS) procurement. The new NCL-wide service is scheduled to start in November 2019, with a paper to the Committee in April 2019 asking that existing services are extended to run until October 2019 (with an option to run until March 2020 if the procurement is delayed). PCCC18: Primary Care Support England – capita contract delivery (Threat): Capita have recommenced the patient list cleansing process in agreement with NHS England. The process will begin with checks on people aged over 100 on practice lists, with the second phase focusing on patients from overseas and homes with high multiple occupancy which will consider higher volumes of patients. The London process will start in North Central London. NHS England are using active contract management particularly in the areas of concern raised by the National Audit Office - pensions, optometry payments and performer’s list management. This includes

Page 76 of 83

3

fining with service credits as appropriate and utilising external expertise to strengthen contract management. PCCC22: Ensuring early warning system in place to support practices prior to regulatory actions (Threat): This risk has been added to the risk register as regulatory action has been taken with a series of practices recently following “inadequate” or “requires improvement” ratings following Care Quality Commission (CQC) inspections. Action in some cases has included having to put in place caretaking arrangements at practices at very short notice. The aim of the risk is to promote earlier recognition of struggling practices, and ensure that support is provided before regulatory action is required. This risk continues the work to address the now closed risk PCCC9 relating to “Loss of service provider at short notice due to regulatory intervention”. A meeting has been set up for CCG primary care teams to consider the development of an early warning system to identify struggling practices and enhance current levels of support before regulatory action is required. The existing quality report provides an overview of performance and variation across a range of indicators alongside local intelligence. The meeting will identify other sources of information to help NCL CCGs develop an early warning system to identify struggling practices and enhance current levels of support before regulatory action is required. PCCC23: Ensuring capacity and resources in place to delivering the Standard Operating Procedure for Primary Medical Services: This risk focuses on the need to ensure on-going capacity is in place to deliver the delegated responsibilities (from April 2017) for Primary Care Medical Services. This risk continues the work to address the now closed risk PCCC2 relating to “Delegation risks (resources, finances, practice member relationships)” established to monitor the initial delegation from NHS England in April 2017. This risk will cover any changes to the existing Standard Operating Procedure for delegated duties between NHS England and CCGs and any new requirement for the commissioning of Primary Medical Services such as work on half-day closures with relevant practices. A Standing Operating Procedure (SOP) is in place between NHS England and NCL CCGs to support the delegated function, with any changes to the balance of responsibilities set out in the Standard Operating Procedure subject to Committee approval. Delivery of the Standard Operating Procedure will be further supported by the transfer of the Primary Care Commissioning Team into NCL CCG structures from NHS England on 1 April 2019. The team has transferred into NCL structures with current funding plus an additional £50k support

Page 77 of 83

4

for non-pay costs. The team will retain current support from functions retained by NHS England including the Medical Directorate and Legal.

Recommendation The Committee is asked to: NOTE the report and updates to the Committee risk register; Provide feedback on the risks included; Identify if there are any new or additional strategic risks falling within

the remit of the Committee.


The risk register will be a standing item for each meeting of the NCL Primary Care Committee-in-Common.


Conflicts of interest are managed robustly and in accordance with the CCG’s conflict of interest policy.


The risk register focuses on risks relating to delivery of the strategic objectives of the five CCGs in North Central London delegated to the NCL Primary Care Committee-in-Common: Commission the delivery of NHS constitutional rights and pledges; Improve the quality and safety of commissioned services; Improve health outcomes, address inequalities and achieve parity of

esteem; Maintain financial stability and ensure sustainability through robust

planning and commissioning of value-for- money services.

Engagement

The risk register fully considers public engagement and partnership working as part of the risk mitigation/control process.


The report was written in accordance with the provisions of the Equality Act 2010.


The initial risk register for the Committee has been developed with reference to existing risk registers from individual CCGs, and then updated for actions to mitigate existing risks and the addition of new emerging risks.

Next Steps Work is underway to streamline risk reporting across North Central London, with registers across the Sustainability and Transformation Plan, CCGs, the NCL Joint Commissioning Committee and NCL Primary Care Committee-in-Common.

Appendices

Appendices are: 1. The Committee Risk Tracker; 2. The Committee Risk Heat Map. 3. Risk scoring key

Page 78 of 83

Risk ID Risk Title Risk Owner Strategic Update AUG OCT DEC FEB

PCCC12

Managing variation in primary care quality and performance across NCL (Threat)

Paul Sinden, Director of Performance, Planning and Primary Care

Following sign-off of the NCL Strategy for General Practice CCG action plans to deliver the strategy arebeing developed and will include a focus on primary care at scale and the use of Quality ImprovementSupport Teams (QISTs) to help reduce unwarranted variation. The direction of the strategy is confirmedby the NHS Long Term Plan published in January 2019. The introduction of the new GP contract fromApril 2019 includes practice alignment to primary care networks supported by the introduction of a DirectEnhanced Service to help practices sign-up to joining the networks.

This work is supported by securing funds from NHS England (for integrated care) to support thedevelopment of primary care networks, and support for the development of GP Federations by each CCG.

The new GP contract also introduces a greater quality improvement focus in the Quality OutcomesFramework.

12 12 12 12 6

PCCC13

Developing primary care workforce to support delivery of local strategies (Threat)


Development of primary care workforce is included within the approved strategy for general practice. TheCommittee will focus on workforce in August 2019. The local response to the NHS Long Term Plan,scheduled for autumn 2019, will include workforce plans that are aligned to finance and activity plans.

The NCL Strategy for General Practice, approved in November 2018, focuses on workforce developmentthrough primary care networks (with pharmacists, physicians and social prescribers supporting practicestaff) and the benefits of working at scale. The new GP contract allows core funding to be used to extendskill-mix in practices in this way.

12 12 12 12 6

PCCC14

Ensuring service continuity of Alternative Primary Medical Service (Special Allocation Service) (Threat)


In February 2019 the Committee approved the service specification and business case for the re-procurement of the service across North Central London (NCL). The procurement will be carried outthrough Tranche 7 of the London-wide Alternative Personal Medical Services (APMS) procurement.

The new NCL-wide service is scheduled to start in November 2019, with a paper to the Committee inApril 2019 asking that existing services are extended to run until October 2019 (with an option to run untilMarch 2020 if the procurement is delayed).

12 12 12 12 4

PCCC18

Primary Care Support England – capita contract delivery (Threat)


Capita have recommenced the patient list cleansing process in agreement with NHS England. Theprocess will begin with checks on people aged over 100 on practice lists, with the second phase focusingon patients from overseas and homes with high multiple occupancy which will consider higher volumes ofpatients. The London process will start in North Central London.

NHS England are using active contract management particularly in the areas of concern raised by theNational Audit Office - pensions, optometry payments and performer’s list management. This includesfining with service credits as appropriate and utilising external expertise to strengthen contractmanagement.

16 16 16 16 6

PCCC Risks- Highlight Report2018/19

Movement From Last Report

Target Risk ScoreCurrent Risk Score

Page 79 of 83

PCCC22

Ensuring early warning system in place to support practices prior to regulatory actions (Threat)


This risk has been added to the risk register as regulatory action has been taken with a series of practicesrecently following “inadequate” or “requires improvement” ratings following Care Quality Commission(CQC) inspections. Action in some cases has included having to put in place caretaking arrangements atpractices at very short notice.

The aim of the risk is to promote earlier recognition of struggling practices, and ensure that support isprovided before regulatory action is required. This risk continues the work to address the now closed riskPCCC9 relating to “Loss of service provider at short notice due to regulatory intervention”.

A meeting has been set up for CCG primary care teams to consider the development of an early warningsystem to identify struggling practices and enhance current levels of support before regulatory action isrequired.

The existing quality report provides an overview of performance and variation across a range of indicatorsalongside local intelligence. The meeting will identify other sources of information to help NCL CCGsdevelop an early warning system to identify struggling practices and enhance current levels of supportbefore regulatory action is required.

16 16 6

Risk Key

Risk Improving ê

Risk Worsening é

Risk neither improving nor worsening but working towards target è

This risk focuses on the need to ensure on-going capacity is in place to deliver the delegated responsibilities (from April 2017) for Primary Care Medical Services. This risk continues the work to address the now closed risk PCCC2 relating to “Delegation risks (resources, finances, practice member relationships)” established to monitor the initial delegation from NHS England in April 2017.

This risk will cover any changes to the existing Standard Operating Procedure for delegated duties between NHS England and CCGs and any new requirement for the commissioning of Primary Medical Services such as work on half-day closures with relevant practices.

A Standing Operating Procedure (SOP) is in place between NHS England and NCL CCGs to support the delegated function, with any changes to the balance of responsibilities set out in the Standard Operating Procedure subject to Committee approval.

Delivery of the Standard Operating Procedure will be further supported by the transfer of the Primary CareCommissioning Team into NCL CCG structures from NHS England on 1 April 2019. The team has transferred into NCL structures with current funding plus an additional £50k support for non-pay costs. The team will retain current support from functions retained by NHS England including the Medical Directorate and Legal.


Ensuring capacity and resources in place to delivering the Standard Operating Procedure for Primary Medical Services (Threat)

PCCC23 12 12 6

Page 80 of 83

BAF Risk Heat Map

2 3 4 5

3

4

5

Consequence

Likelihood

2

1

1

Current Risk Score: Target Risk Score:x x

PCCC

12

PCCC

13

PCCC

23

PCCC

12

PCCC

14

PCCC

14

PCCC

22

PCCC

13

PCCC

18

PCCC

18

PCCC

22

PCCC

23

Page 81 of 83

NCL PRIMARY CARE COMMISSIONING COMMITTEE

FORWARD PLANNER 2019 / 20

Area

Feb 2019

April 2019

May 2019

(seminar)

June 2019

Aug 2019

Oct 2019

Dec 2019

Governance

Review of Risk Register X X X X X X

Review of Terms of Reference (TOR)

X

Review of Committee Effectiveness X

Contracting

Decisions relating to GMS, PMS and APMS contracts eg: practice mergers

X X X X X X X

Local Commissioned Services

Alternative Patient Allocation Service

X

Quality & Performance

Quality and Performance Report X X X X X X

Finance Report

Finance Report - to include the run rate and adjustments on future finance reports.

X X X X X X

Page 82 of 83

Strategy

NHS Long Term Plan X X X

Other papers

Proposal on the CCG role for responding to Sis in General practices.

X

Developing Primary Care workforce X

GP Patient Survey learning X

ETTF Business Cases - Primary Care Estates leads

Management of practices who close half a day

X X

New GP Contract X X X

Page 83 of 83

Documents

North Central London Primary Care Committee in Common ... · Ian Bretman Lay Member (Patient and Public Involvement) Citizens Advice Bureau,Barnet No No Yes Indirect Chair 1.4.2017