PCCC Papers - 21...Dr Sanjay Gadhia GP Governing Body Member, NHS Corby CCG Bie Grobet Assistant Director of Commissioning Development Andrew Hammond Lay Member, NHS Corby CCG Dr Sebastian

Primary Care Commissioning

Committee

Tuesday 21 November 2017

15:00 – 17:00

Meeting Room 1,

Corby Enterprise Centre, London Road, Corby NN17 5EU

A G E N D A

Primary Care Commissioning Committee

Tuesday 21 November 2017 15:00 – 17:00

Meeting Room 1, Corby Enterprise Centre, London Road, Corby NN17 5EU

Time Agenda Item Action Presented by Enclosure

INTRODUCTORY ITEMS 15:00 1. Introductions and Apologies:

C Dehghani, S Wright

Note Tansi Harper Verbal

2. Declarations of Interest Note Tansi Harper Verbal

3. Minutes of meeting held on 19 September 2017

Approve Tansi Harper PC-17-52

4. Matters Arising and Action Log Note Tansi Harper PC-17-53

GOVERNANCE AND ASSURANCE 15:10 5. 360° Survey Results Summary Note Tansi Harper PC-17-54

15:15 6. Locally Commissioned Services near

Patient Testing (NPT) Review Approve Julie Lemmy PC-17-55

15:25 7. PMS Premium Reinvestment Year 3 Draft Proposal

Approve Julie Lemmy PC-17-56

STANDING ITEMS 15:35 8. Risk Register Note Caron Williams PC-17-57

15:40 9. Finance Update Note Mike Alexander PC-17-58

16:00 10. Delegated Commissioning: • Work Programme Update

Note Julie Lemmy PC-17-59

16:10 11. NHS England Update Note Keiren Leigh PC-17-60

SUB-GROUP MEETING UPDATES 16:20 12. Primary Care Operational Group -

Minutes of meeting 26 September and Draft Minutes of meeting 24 October 2017

Note Julie Lemmy PC-17-61 PC-17-62

16:30 13. Workforce Group

Note Dr Sanjay Gadhia Verbal

16:40 14. PMS Group Note

Julie Lemmy Verbal

FOR INFORMATION 16:50 15. Register of Interests

Note Tansi Harper PC-17-63

DATE OF NEXT MEETING The next meeting will be held at 15:00 on Tuesday 16 January 2018 in Meeting Room 1, Corby Enterprise Centre.

This paper is being submitted to the Primary Care Commissioning Committee for amendment and/or approval as appropriate. It should not be regarded, or published, as CCG policy until formally agreed at the

Primary Care Commissioning Committee meeting.

NHS Corby Clinical Commissioning Group Primary Care Commissioning Committee

21 November 2017 Title: Minutes of previous meeting Number: PC-17-52

Author: Primary Care Commissioning Committee Contact No:

01536 560420

Executive Sponsor:

Caron Williams, Director of Commissioning and Strategy

Presented by: Tansi Harper, Lay Member for Patient and Public Engagement

Which Strategic Objectives does this paper address?

☐ 1. Prevention ☐ 5. Quality

☐ 2. Early Diagnosis ☐ 6. Engagement

☐ 3. Better Care ☐ 7. Sustainable

☐ 4. Commission 8. Accountable

Executive Summary

Minutes of the meeting held on 19 September 2017 for approval.

Recommendations

The Committee is asked to: • Approve the minutes of the meeting held on 19 September 2017

Committee Action Required

Approval/Decision ☐ For Review

☐ For Assurance ☐ For Update/Information

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Minutes of the Primary Care Commissioning Committee Meeting

Tuesday 19 September 2017 at 15:00

Meeting Room 1, Corby Enterprise Centre, London Road, Priors Hall Corby NN17 5EU

Present Tansi Harper Lay Member NHS Corby CCG (Chair) Mike Alexander Chief Finance Officer, NHS Corby CCG Carole Dehghani Chief Executive, NHS Corby CCG Helen Storer Independent Lay Member, NHS Corby CCG In Attendance Dr Sanjay Gadhia GP Governing Body Member, NHS Corby CCG Bie Grobet Assistant Director of Commissioning Development Andrew Hammond Lay Member, NHS Corby CCG Dr Sebastian Hendricks Secondary Care Consultant Dr Jonathan Ireland Chair, Local Medical Council Salim Issak Assistant Contract Manager, NHS England Central Midlands Julie Lemmy Head of Primary Care, NHS Corby and NHS Nene CCGs Sara Nye Executive Assistant, NHS Corby CCG Dr Miten Ruparelia Clinical Vice Leader, NHS Corby CCG Dr Nathan Spencer GP Governing Body Member, NHS Corby CCG Dr Joanne Watt Clinical Chair, NHS Corby CCG Sharon Wright Interim Quality Improvement manager, NHS Corby and NHS Nene CCGs Apologies Jay Dobson Interim Corporate Services & Governance Manager Jane Kettlewell Interim Deputy Chief Finance Officer Keiren Leigh Contract Manager, NHS England Central Midlands Caron Williams Director of Commissioning & Strategy, NHS Corby CCG

Minute No. Agenda Item PCCC17/18 034 Welcome and Introductions Mrs Harper welcomed members to the meeting. PCCC17/18 035 Apologies for Absence Apologies were recorded as above.

PCCC17/18 036 Declarations of Interest Dr Ruparelia and Dr Spencer both expressed Declarations of Interest in Item 13 and 14.

PCCC17/18 037 Previous Minutes Following a minor amendment the minutes of the previous meeting held on 18 July 2017

were APPROVED as an accurate record of the meeting.

PCCC17/18 038 Action Log The matters arising and action log from meeting 18 July 2017 were considered by the

Committee. Further actions were noted and would be added to the log and circulated.

Action: Mrs Nye The Committee NOTED the Matters Arising and Action Log.

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PCCC17/18 039 Risk Register / BAF Update Mrs Harper advised that Mr Dobson and Mr Hammond had recently met. Mr Hammond

added that responsibilities would be taken back to the relevant Committees for them to review. Mrs Harper stated it was her intention to work with Mr Dobson. The Committee NOTED the update on the Risk Register.

PCCC17/18 040 Finance Update In the absence of Ms Kettlewell, Mr Alexander presented the Finance Update to the

Committee. Appendix 1 showed the forecast outturn for delegated funds which was currently showing a balanced position. Key points noted were: clinical peer review budget agreed at the last meeting was now included; sickness and maternity/paternity leave were forecasting overspends; other central budgets are invoiced by NHSE so were currently forecast to budget; rates under budget following rates reviews and the required set aside of 1% was still available for non-recurrent spend.

It was requested there be more of a financial narrative between meetings.

Discussion took place around budgeting. Mr Issak advised that GMS Core Contract and QOF were set nationally. Mrs Storer queried what would be core and what would be Primary Care Commissioning. Mrs Harper felt the committee needed to further understand the budget going forward.

The committee NOTED the update.

PCCC17/18 041 Quality Report Mrs Wright gave an overview of the key matters of quality and safeguarding in primary care

within Corby CCG. It was noted that a new CQC inspection was to commence in October 2017. Innovative ways to capture Friend and Family Test data had been discussed with practices. NHSE contract teams have made contact with practices not submitting their data. Issues with national CQRS submission tool had been resolved. Mrs Storer said that no serious untoward incidents were reported and asked how we encouraged people to do so. Discussion took place around online services. Mrs Harper thanked Mrs Wright for her report. The Committee NOTED the Quality Update.

PCCC17/18 042 Commissioning Intention Process Mrs Williams presented the NHS Corby CCG and NHS Nene CCG Commissioning Intentions.

The presentation provided an updated position on the preparation of both CCGs Commissioning Intentions for 2018/19. The process had taken a different approach than in previous years. It was noted that the commissioning intentions had been used to shape the contractual conversations on coding and counting issues and this year’s QIPP plans for both CCGs. The financial position of both CCGs was now significantly challenged. The Committee NOTED the Commissioning Intention Process.

PCCC17/18 043 Delegated Commissioning- Work Programme Update Ms Lemmy gave an update on the Primary Care Operations Group work plan for 2017/18.

It was noted the Primary Care ops group meeting had been cancelled in August, the plan would be reviewed in September and an update provided for the next committee meeting.

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Mr Hammond felt there was no sense of scale, priorities and blockers and felt this work was drifting. Discussion took place. Mrs Harper asked Ms Lemmy to take on board the comments going forward. Mrs Harper thanked everyone for the helpful discussion. The Committee NOTED the update on Delegated Commissioning Work Programme.

PCCC17/18 044 NHS England Update Mr Issak presented the NHS England Update.

The update was based on International Recruitment applications, expressions of interest were encouraged from practices to apply. It was noted the lack of GPs coming through the system in England and that a meeting would be taking place at the end of the month. Northamptonshire’s needs must be recognised by NHS England. Ms Lemmy added that a joint bid was being put together for clinical pharmacist. The Committee NOTED the NHS England update.

PCCC17/18 045 Sub-group Update: Operational Group

The Committee noted the Primary Care Operational Group meeting draft minutes of 25 July 2017. Workforce Group – Dr Gadhia advised that bids to Health Education England for GP and nursing staff to assist in rolling out the new swipe tool. Funding was being sought as the issue would be time for practices to do this work. PMS Group were due to meet soon and an update would be provided at the next meeting. It was noted the Workforce group was being reconvened and the PMS workgroup was going to be re-established early in September 2017. The Committee NOTED the Sub-group updates.

PCCC17/18 046 Register of Interests Mrs Harper presented the Register of Interests.

The Committee NOTED the Register of Interests.

PCCC16/17 047 Date and Time of the next meeting The next meeting would be held at 15:00 on Tuesday 21 November 2017 in Meeting Room

1 at Corby Enterprise Centre. Mrs Harper brought the meeting to a close at 16.30 p.m.




21 November 2017 Title: Action Log Number: PC-17-53

Author: Primary Care Commissioning Committee Contact No:

01536 560420

Executive Sponsor:








Executive Summary

Action Log from the meeting held on 19 September 2017.

Recommendations

The Committee is asked to: • To note the Action Log from the meeting of the 19 September 2017


☐ Approval/Decision ☐ For Review

For Assurance ☐ For Update/Information

Completed On Track Overdue No further action

Action Log Primary Care Commissioning Committee (PCCC) Updated 26 September 2017

Action Number

Subject Action Lead Status Timescale RAG

18 July 2017 PC-31 Payment for GP Child

Protection Reports Piece of work to be undertaken to identify which organisation is responsible for the payment of GP safeguarding reports.

Tina Swain 19.9.2017 – updated awaited from Tina Swain

21 November




21 November 2017 Title: 360° Survey Results 2016/17 Number: PC-17-54

Author: Jay Dobson - Associate Director to the Chief Executive and Chief Finance Officer

Contact No:

01536 560420

Executive Sponsor:

Mike Alexander, Chief Finance Officer




☐ 2. Early Diagnosis 6. Engagement



Executive Summary

The attached report includes a brief summary of the 360° survey that NHS England commissioned Ipsos Mori to undertake across all CCGs in the country in 2017. Field work for this survey was undertaken from 16th January to 28th February 2017. The survey was previously carried out in 2012 prior to authourisation and then again in 2014, 2015 and 2016. The survey was split into five components of assurance: • Component 1 – Well-Led • Component 2 – Performance • Component 3 – Finance • Component 4 – Planning • Component 5 – Delegated Functions The areas for improvement have been identified from the survey and planned next steps are included within the report.

Recommendations

The Committee is asked to: • Note the results of the survey and planned next steps.



☐ For Assurance For Update/Information

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Analysis of NHS Corby CCG 360 Survey Results 2016/17 1. Introduction NHS England commissioned Ipsos Mori to undertake a 360° survey of all CCGs in the country in 2017. Previous surveys were undertaken in 2012 before authorisation, 2013/14, 2014/15 and 2015/16. The field work for this survey was undertaken from 16th January to 28th February 2017. The CCG 360o stakeholder survey is a key part of ensuring these strong relationships are in place. The survey allows stakeholders to provide feedback on working relationships with CCGs. The results from the survey will serve two purposes:

1. To provide a wealth of data for CCGs to help with their ongoing organisational development, enabling them to continue to build strong and productive relationships with stakeholders. The findings can provide a valuable tool for all CCGs to be able to evaluate their progress and inform their organisational decisions.

2. To provide a wealth of data for CCGs to help with their ongoing organisational development, enabling them to continue to build strong and productive relationships with stakeholders. The findings can provide a valuable tool for all CCGs to be able to evaluate their progress and inform their organisational decisions.

The CCG was required to provide a list of core stakeholders plus any additional stakeholders as part of the fieldwork process. The overall response rate for the survey for 2016/17 was 58% (compared to 2015/16 at 59% and 2014/15 at 79%) with 21 stakeholders completing the survey (up from 17 in 2016). The survey was split into five components of assurance:

• Component 1 – Well-Led • Component 2 – Performance • Component 3 – Finance • Component 4 – Planning • Component 5 – Delegated Functions

The 2016/17 survey results cannot be directly compared with those of 2014/15 due to the change in the format of the survey, including the alignment of five components of assurance in 2015/2016 compared to the six domains used in 2014/15. Ipsos Mori strongly recommend for questions with fewer than 30 stakeholders answering, that one should examine the number of stakeholders giving each response rather than the percentage, as the percentage can be misleading when based on so few stakeholders. You will also see that not all stakeholders have responded to each question.

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2. Component 1 – Well-led Component 1 of the survey focused on the overall engagement undertaken by the CCG. This section of the survey had several sections, with certain questions aimed at different stakeholder groups.

• Engagement over past 12 months Overall stakeholders felt that they had been engaged over the past 12 months (57% great deal/fair amount), with 62% feeling very/fairly satisfied with the way in which the CCG has engaged with them over the past 12 months.

• Working Relationship The majority of stakeholders (67%) felt that their working relationship with the CCG was very good or fairly good, with a further 19% of all stakeholders stating that the relationship had stayed about the same.

• Commissioning Decisions This section focussed on involvement and engagement of stakeholders in the commissioning decisions taken by the CCG, and the confidence stakeholders have in those decisions. 62% (up from 53% in 2015/16) of all stakeholders felt that the CCG involved and engaged with the right individuals and organisations when making commissioning decision, and 62% (up from 59% in 2015/16) of all stakeholders had confidence in the CCG to commission high quality services for the local population. Overall stakeholders understood the reasons for the decisions that the CCG makes when commissioning services (at 67% up 8% on 2015/16) and 48% agree that the CCG’s plans will deliver continuous improvement in quality within available resources.

• Leadership and Clinical Leadership Stakeholders indicated that there is clear and visible CCG leadership up by 14%, over the year to 67% and a slight increase to 67% for clinical leadership specifically. Our stakeholders also showed an increase in confidence of our CCG to deliver its plans and priorities, showing an increase of 16% over the year to 57%. Stakeholders indicated that they did feel that the CCG had the necessary blend of skills and experience at 57% (an increase of 22%). Overall stakeholders felt that the CCG is delivering continuous quality improvements and indicated that they have continued confidence in the leadership of the CCG to deliver improved outcomes for patients.

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• Quality This section focussed on the quality of services the CCG commissions. Stakeholders indicated that if they had concerns about the quality of local services they would be able to raise their concerns with the CCG, and that they would have confidence in the CCG to act on the feedback provided. Last year (2015/16) stakeholders stated that they did not have confidence in the CCG effectively monitoring the quality of services it commissions; this year confidence has doubled from a previous 35% in 2015/16 to this year being 71%.

• CCG role in the wider health economy Stakeholders agreed that the CCG worked effectively as a ‘local system leader’, working proactively and constructively with other partners in its local economy around, for example, sustainability and transformation plans and seeking the best health and wellbeing outcomes for the local population. A majority (57%) of all stakeholders indicated that they felt the CCG is a very/fairly effective local system leader; this is, however, down from 76% in 2015/16. In wider discussions with local groups such as Quality Surveillance group, Urgent care working Group, Council of Voluntary services, Strategic Clinical Networks etc., a majority of stakeholders felt the CCG contributed to wider health economy discussions.

• Patient and Public Engagement The CCG had a better response to this question this year, so there is no year on year comparison, 48% of respondents were satisfied with the steps taken to engage with the local population. Similarly 48% of stakeholders felt that the CCG acted upon the views of patients and public when making decisions, with 38% of our stakeholders believing that the CCG effectively communicate this back to them.

• Health Watch and Patient Groups

A majority of Stakeholders (67%) felt the CCG has engaged with seldom-heard groups.

• Provider Organisations This section of the survey was aimed at NHS Provider organisations. All organisations indicated that they felt that clinicians from the CCG are involved in discussions about quality and all indicated clinician involvement in discussions regarding service redesign. However, one of the organisations indicated that they felt that the CCG does not understand the challenges facing the provider organisations particularly well.

• Member Practice Engagement The questions in this section were asked of our member practices only. A response was received from only two member practices (out of a possible five) for each question.

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50% indicated that there were fairly effective arrangements are in place for member participation in decision-making in the CCG; the other practice did not know.

50% of practices also felt very confident in CCG systems to sustain two-way accountability between the CCG and its member practices. 100% of member practices felt able to (a fair amount/just a little) influence the CCG decision-making process.

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3. Component 2 – Performance The second component related to performance by the CCG. Overall a large majority (81%) of stakeholders feel that improving patient outcomes is a core focus of the CCG; this applied across all stakeholders surveyed. The majority of questions in this section were aimed at the NHS Providers who took part in the survey, with a focus on contract monitoring and responses to issues on quality of services.

• Amount of monitoring the CCG carries out on the quality of your services is too much, too little or about right – 50% too much and 50% don’t know.

• Response by CCG to issue with the quality of services is proportionate and fair – 50% tend to agree and 50% don’t know.

4. Component 3 – Finance Component 3 focused on finance, with two questions asked of member practices only. Only two of the five member practices responded to these questions. Overall 50% tend to agree that they are regularly involved in discussions regarding the management of the CCG’s finances, 50% of practices felt that they are fairly familiar with the financial position of the CCG. Financial information is regularly shared with our member practices at the monthly Council of Members (COM) meeting, and forms part of the standing agenda items. A representative from each practice attends COM.

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5. Component 4 – Planning This component focussed on planning and how much our stakeholders are aware of the plans developed by the CCG, and the extent to which they have influenced these plans. The majority of stakeholders (76%) felt that they know about the CCG’s plans and priorities although a slightly smaller majority (65% down to 57%) feel they have been given an opportunity to influence them. However, only 43% (59% in 2015/16) feel these are right ones. There has been a similar decrease in the view that comments have been taken on board by the CCG down 10% to 43% and that the CCG has effectively communicated with stakeholders, this is down from 71% in 2015/16 to 57% this year.

Our local authority gave the CCG 100% for our working together on delivering shared plans for integrated commissioning, being part of Local Safeguarding Children Board and Safeguarding Adults Board. A number of questions were for member practices only, with only two of the five member practices responding to each question, the responses are difficult to draw conclusions from:

• 50% tended to agree and 50% didn’t know to the following questions o Value for money is a key factor in decision making when formulating the

CCG’s plans and priorities. o The CCG’s plans to improve the health of the local population. o The CCG’s plans to tackle health inequalities. o The referral and activity implications for the CCG’s plans. o The implications of the CCG’s plans for service improvement. o The financial implications of the CCG plans.

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• 50% tended to strongly agree and 50% Didn’t Know to the following questions: o I have confidence in the clinical leadership of my CCG to deliver its plans and

priorities. There was also a specific question to NHS Providers in this section relating to how well they believe the CCG works with the NHS Provider organisations to develop long-term strategies and plans. Only two responses were received, and these indicated that one believed this was done fairly well, while the other believed this to be not very well. The majority of 57% all stakeholders indicated that the CCG had effectively communicated its plans and priorities, and 43% said that these are the right ones for the CCG. Both these are below that of 2015/16; therefore it is apparent that further work is required to ensure all of our stakeholders, especially our member practices, understand the implications of the plans across a number of areas. 6. Component 5 – Delegated Functions Component 5 related to delegated functions with only one questions asked of member practices. Only 2 out of our five practices responded to these questions. 50% of the member practices felt very involved whilst 50% felt not very involved, in discussions about the CCG’s plans for primary care co-commissioning.

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7. Areas for Improvement

• To continue to improve visibility of leadership and clinical leadership, building confidence of stakeholders in the leadership of the CCG.

• Improve patient and public engagement across a wider number of groups. • Improved engagement with Health and Wellbeing Board members. • Ensure that member practices are involved and informed in the development of CCG

plans, including improving understanding of the implications of these plans. • Ensure clarity on stakeholder groups and how the CCG engages with key groups and

individuals in the development of future plans and the implementation of these. 8. Next Steps The CCG has already begun working on actions to address the areas for improvement identified in the report, including:

• Continuing to hold regular Council of Members meetings. • Opening dialogues with Member Practices to ensure greater engagement in the

survey for 2017/18, and continuing the dialogue around understanding of the implications of CCG plans going forward.

• Continuing the integrated communication and engagement strategy for CCG key commissioning plans for the next 18 months.

• Developing an engagement calendar for the next 12 months for key stakeholders and groups.




21 November 2017 Title: Locally Commissioned Services Near Patient Testing

(NPT) Review Number: PC-17-55

Author: Amanda Swingler, Primary Care Development Manager and Julie Lemmy, Deputy Director of Primary Care

Contact No:

01604 651717 01604 651334

Executive Sponsor:


Presented by: Julie Lemmy, Deputy Director of Primary Care





☒ 4. Commission ☐ 8. Accountable

Executive Summary

This paper is in response to an action raised at Nene CCG’s Primary Care Co-Commissioning Joint Committee (PCCJC) meeting which took place in January 2017. The committee requested that a task a finish group, led by Medicine Management and attended by members of the LMC and Clinical Colleagues at both Nene and Corby CCGs be setup to review the existing list of Amber 1 drugs which have an associated Near Patient Testing (NPT) Fee. This paper outlines the list of drugs where agreement was made for them to be removed from the list, and provides recommendations to the committee as to how this can be commissioned going forward.

Recommendations

The committee is asked to ratify the decision made by the Task and Finish group to remove 16 Amber 1 drugs which have an associated NPT fee as they either require no monitoring within primary care, are now classed as Red drugs or have been discontinued. Additionally, to agree that a further development of this scheme is to be conducted in 2018/19 to exam the true impact of the removal of these drugs and considers whether it may be more feasible to unbundle the current payment mechanism to allow a cost per drug as oppose to cost per patient.


☒ Approval/Decision ☒ For Review


Background: In January 2017, Nene CCG’s Primary Care Co-Commissioning Joint Committee (PCCJC) (with the exception of GPs and LMC) approved a paper which recommended that the Near Patient Testing (NPT) tariff be reverted back to six units of care at £126 per patient from 5 at £105 per patient, with effect from 1st April 2017. In addition, the paper recommended that a Task and Finish Group led by the Medicine Management Team, and which included members of the Primary Care Team, LMC and clinical colleagues from both CCGs, be established to carry out a review of current and future Amber 1 drugs which have an associated NPT fee. This will then continue to form a part of a rolling programme of reviews conducted year on year, and recommendations would then be fed back to both Nene and Corby Committees for ratification. Review: A meeting took place on the 29th August 2017 (Appendix One) with the aim of going through the list of Amber 1 drugs currently being monitored under Near Patient Testing and to seek agreement as a group as to whether they should still remain on the list. It was agreed that the classification of Amber 1 drugs should be dependent on additional monitoring being required due to the drug itself, rather than the patient’s condition. The review concluded that 16 drugs be removed from the current Amber 1 list as they:

• do not require additional monitoring in primary care and so should be classified as Amber 2 or • They should only be prescribed in secondary care and so should be classified as Red.

This applies to:

1. Cabergoline 2. Chlorambucil 3. Cyproterone 4. Daclizimab 5. Dalteparin 6. Dapsone 7. Desferrioxamine 8. Dornase Alfa 9. Enoxaparin 10. Fluorouracil 11. Flutamide 12. Galantamine 13. Gold (aural) 14. Gold (injection) 15. Hydroxychloroquine 16. Mesna

It is also important to note that further discussions need to be had with Secondary Care colleagues regarding a number of drugs relating to treatment of prostate cancer and renal patients. Consultants in Secondary Care have indicated that monitoring in Primary Care is variable for prostate cancer drugs, and quite often secondary care do the monitoring of PSA and U&E levels. It was discussed whether it was more beneficial to commission Secondary Care to provide the monitoring service instead. Patient choice would still need to be considered but the principal of Secondary Care conducting the monitoring of these drugs should be explored. During the meeting the LMC suggested that the group should also explore the different option for funding the service by looking at payment per patient vs payment per drug being monitored. The complication with this is the current payment mechanism is per patient and not per drug so practices are not required to list all drugs a patient is being monitored on in order for a payment to be triggered. Therefore in its current format, commissioners are unable to assess accurately the impact of the removal of the 16 Amber 1 drugs identified during the clinical review, or conduct a true assessment on cost per patient vs cost per drug being monitored. From April 2018 practices will be asked to list all drugs a patient is being monitored against so that commissioners can accurately explore the different funding options for the service.

Appendix 1

NPT Clinical Review Meeting

29 August 2017 In Attendance: Giles Owen Beth George Julie Lemmy Amanda Swingler Naomi Caldwell Matthew Davies Sanjay Gadhia

Peter Medcalf

Sharon Firmin Notes: The purpose of this meeting is follow up on the action from the PCCJC in January. Action stated that a task and finish group led by meds management would be setup to review the Amber 1 drugs which have an associated NPT fee. Findings would then be taken back to both Corby and Nene CCGs’ Boards. The aim of today is to go through the list of Amber 1 drugs and see if the group agree if they should still be classed as Amber 1. It was discussed that the classification of Amber 1 drugs should be dependent on the drug itself rather than the condition. LMC suggested that in this case, payment should be made per drug, rather than per patient. Bicalutamide – consultants in secondary care have indicated that monitoring in primary care is variable for prostate cancer drugs, so often secondary care do the monitoring (e.g. PSA and U&E levels). Secondary Care have suggested that it may be better to commission them to provide the monitoring service instead. Patient choice will also need to be considered but the principal of secondary care doing the monitoring for these drugs should be explored. It was agreed that payment will remain in Primary Care until the review has concluded.

Cabergoline – requires no monitoring according to BNF. To be removed.

Chlorambucil - should be red. Practices are not prescribing it, shouldn’t be on this list. Cinacalcet – discrepancies between shared care protocols for whether phosphate binders require monitoring or not. Some further clarification is required from secondary care colleagues as to what the monitoring requirements are. Cyclophosphamide – this should be red. Cyproterone – should be monitored within secondary care. Daclizimab – should be red, not currently being prescribed.

Dalteparin – doesn’t need additional

monitoring within primary care, therefore Amber2 drug.

Dapsone – no monitoring in primary care, should come off.

Darbepoetin Alfa – monitoring is already being done in secondary care. GO to have a discussion with Renal Team about the best way forward. This potentially brings up a wider issue of repatriation of renal prescribing. Degarelix – advised that this should sit within secondary care. It’s a relatively new drug to treat prostate cancer. Desferrioxamine – should be red, especially in peads. Dornase Alfa – should be red (very specialist), and should not be done in primary care.

Enoxaparin – no monitoring required which makes it an Amber 2.

Fluorouracil - should be red. There is a topical version but neither should be monitored within primary care. Flutamide – should be red, as monitoring in primary care is merely a follow up Galantamine – now amber 2. Gold (aural) – Should come out. This has been discontinued. Gold (injection) – should be red. We had 22 items. But agreement that we need to investigate what they are. Hydroxycarbamide – red. Question was raised as to whether there are any primary care patients out there having it? Further investigation required. Hydroxychloroquine – common in ophthalmology. Agreement that it should be amber 2.

Leuprorelin – prostate cancer drug, needs further reviewing as previously discussed.

Mepacrine – potentially used for rheumatology, so therefore requires further clarity.

Mesna – NPAG have now classified it asred.

Mycophenolate – can be used in rheumatology and transplant patients. Used for renal transplant patients who are currently being repatriated to secondary care. It is recommended that these drugs continue to be listed on GP clinical systems, but need to ensure that this doesn’t then flag as a claim. It would be helpful if standard searches for each clinical system could be produced for practices to assist in claiming NPT fees. Palivizumab – is red.

Riluzole – amber 2.

Sevelamer (Renagel) – phosphate binder, need consistency in phosphate binder Shared Cared Protocols. Sevelamer Carbonate (Renvela) - phosphate binder, need consistency in phosphate binder shared card protocols. Sirolimus – needs further clarity. DiethylStilboestrol – prostate cancer drug, therefore requires further investigation.

Triptorelin – prostate cancer drug, again requires further investigation.

Next steps… It was agreed that notes from today’s meeting will be shared, but ask that the information is kept within the group as no decision has been made. Once we have concluded the clinical review, the finding must be presented back to committees for advice on next steps. The group acknowledge and thanked GO for the preliminary research conducted on the current list of Amber 1 drugs. MD noted that this will be a change to drug monitoring, and that we all need to agree a way forward as there will be financial implications involved in this. SF suggested that the group explore the different financial models, looking at payment per patient vs payment per drug monitored. It was agreed that overall, the general principal is that there should be no NPT payment made if no monitoring is required. Further clarification is needed around drugs used for renal patients. SW asked if it was possible for monitoring of prostate cancer drugs could be done in primary care, if additional training was provided.




21 November 2017 Title: PMS Premium Reinvestment Year 3 Draft Proposal Number: PC-17-56

Author: Amanda Swingler, Primary Care Development Manager and Julie Lemmy, Deputy Director of Primary Care

Contact No:

01604 651717 01604 651334

Executive Sponsor:


Presented by: Julie Lemmy, Deputy Director of Primary Care





☒ 4. Commission ☐ 8. Accountable

Executive Summary

This paper provides the Primary Care Commissioning Committee (PCCC) with a proposal for the reinvestment of the PMS reinvestment premium funding for year 3. The proposed service will provide a mechanism to allow Corby practices to be paid £0.50p per patient per year for the provision of Ear Irrigation. This services currently fall outside of the core General Medical Services (GMS) and Personal Medical Services (PMS) contracts.

Recommendations

The committee is asked to agree in principle the Year 3 PMS Reinvestment funding proposal as detailed above pending further development of service specifications for the recommended provision. In line with previous years, copies of the service specification will come to the committee at the January 2018 meeting for approval.


☒ Approval/Decision ☒ For Review


Overview NHS England (NHSE), Nene CCG and Corby CCG Task and Finish Group (TAFG) has now concluded its review of available options for the reinvestment of PMS premium funding for Year 3 (2018/2019) as detailed below. The TAFG consisted of members of the LMC, Practice Managers from Northampton and Corby Practices, and Clinical Colleagues and Commissioners at both Nene and Corby CCGs. Of the 38 PMS practices in the county, 37 (3 Corby CCG, 34 Nene CCG) elected to move to a GMS contract with transitional support, with effect from 1st April 2016. The Maple Access Partnership practice within Nene CCG elected to remain within their PMS contract and negotiate the premium element which has already been supported at the TAFG. As outlined previously, PMS premium funding will be removed and reinvested in equal amounts over 5 years which commenced in April 2016. This in financial terms equates to circa £0.50 per patient per year for Corby CCG over the 5 practices, and circa £1.29 per patient per year for the 66 practices under Nene CCG. Reinvestment of PMS premium funding in Year 1 (2016/17) was approved for Choose and Book and 24 Hour Ambulatory Monitoring, and for Year 2 (2017/18) Spirometry and Leg Ulcer Management. Practices will continue to be funded for these services.

Corby CCG Proposal The TAFG has now concluded the review and is recommending the following services be commissioned from general practice with effect from 1st April 2018:

• £0.50p – Ear Irrigation

Nene CCG Proposal The TAFG has now concluded the year 3 review and is recommending the following services be commissioned from general practice with effect from 1st April 2018

• £0.50p - Ear Irrigation • £0.50p - Leg Ulcer Clinic Enhancement to fund use of Dopplers (this will be on top of last year’s

allocation of £0.79p) • £0.20p - Fitting of Ring Pessaries • £0.09p - Young People with Type 2 Diabetes Audit and Referrals to NDPP

Rationale Ear Irrigation The assessment and on-going care for Ear Irrigation is widely considered over and above core GMS/PMS work. Nene CCG and Corby CCGs are aware that many practices are considering whether they are able to continue providing this service, some have already stopped. A number of practices have already ceased delivery this service and are referring patients to one of the number of practices who have an Aural Toilet Locally Commissioned Services (LCS) contract. Leg Ulcer Clinic Enhancement to fund use of Dopplers It was recognised by the Task and Finish Group that the funding received in the previous year for Leg Ulcer Management was insufficient to provide an effective service. Therefore, it was agreed that an enhancement in funding would be beneficial to support the use of Dopplers when treating leg ulcers.

Ring Pessaries As with the services listed above, the assessment and on-going care for Ring Pessaries is widely considered over and above core GMS/PMS work. Activity data shows a variance in the level of Ring Pessaries being fitted in general practice. Some practices will refer all patients directly to secondary care whereas others will manage in house, and therefore, the service is not consistent across the county. Young People with Diabetes Audit and Referrals to NDPP It was agreed that it would be more cost effective to incorporate the objectives set by NHS England in regard to the Young People with Type 2 Diabetes audit and referrals in the National Diabetes Prevention Programme (NDPP) into the PMS reinvestment monies. This would then allow the transformation money to be focused into supporting insulins starts.




21 November 2017 Title: Primary Care Commissioning Risk Register Number: PC-17-57

Author: Jay Dobson, Interim Corporate Services & Governance Manager

Contact No:

01536 560420

Executive Sponsor:

Caron Williams, Director of Commissioning & Strategy

Presented by: Caron Williams, Director of Commissioning & Strategy


☐ 1. Prevention 5. Quality


☐ 3. Better Care 7. Sustainable

4. Commission 8. Accountable

Executive Summary

The risk register details the risks identified for Primary Care Commissioning. Each risk has been reviewed and updated to reflect any changes and progress on actions.

Recommendations

The Committee is asked to: • Review and note the changes to the updated risk register being presented to the Committee



For Assurance ☐ For Update/Information

NHS Corby CCG Corporate Risk Register - Index

PCCC Ref RR Ref Risk Description Inherent Risk Score Nov-17

Last Month Trend

PC3 CRR10 Same Day Access (SDA) access options 4 x 3 = 12 4 x 3 = 12 12

PC4 CRR11 Federation developments including Lakeside and 3 Sixty 4 x 3 = 12 4 x 3 = 12 12

PC5 CRR12

Risk of lack of a robust and effective plan to recruit and retain GPs

• Retirement of existing GPs from member practices • Inability to recruit new GPs to the area.• Lack of University teaching school in the County• People do not want to live in the CountyEffect:• Insufficent GP provision to meet patient need• Increased pressure on A&E and other services• Poor Patient Experience

4 x 3 = 12 4 x 3 = 12 12

PC7 CRR14

QOF

Risk relating to the lack of access to the national CQRS reporting system in relation to QOF. 4 x 3 = 12 4 x 3 = 12 12

PC10 CRR16

Premises

Risk of financial impact of lack of completed 3 yearly rent reviews for member practices. The CCG are aware that NHSE are behind on rent reviews, those practices who have not had their rent reviewed have been identified 4 x 1 = 4 3 x 1 = 3 3

PC11

Resilience Fund

Risk of their being no new schemes for 2017/18 due to the 2016/17 schemes being carried over to the current year. There has been a 50% cut and NHSE were proposing a contingency pot of money for any urgent schemes 3 x 4 = 12 3 x 4 = 12 12

PC12

AQP & LCS

Risk of challenge to the CCGs as legacy contracts have not been retendered and possible distabilsation of existing providers. Conflict of interest of GPs working in the CCGs which could lead to a challenge from the external market. 3 x 4 = 12 3 x 4 = 12 12

Ref Monitoring Committee

Risk definition Executive Lead

Operational Lead

Cause and Effect

Inherent risk score

L x IExisting mitigation/Controls

Assurance / Evidence

Who / Where can we gain evidence that these controls

are working effectively?

Assurance Level (see key)

Residual Risk ScoreL x I

Last MonthL x I

Trend Delivery

DateUpdated Planned Actions

Progress on Action

PC3 PCCC Same Day Access (SDA) access options

Increased use of urgent care facilities for same day access primary care needs


Bie Grobet, Assistant Director of Commissioning

4 x 3 = 12 Identify any unspent money for SDA investments as part of the gateway process. SDA Specification written and overall funding envelopes agreed as part of the Federation /Super Practice gateway process, SDA model discussed at CoM meeting and with Federation ansd Super Practice

Option appraisal per SDA delivery written in specification.

4 x 3 = 12 12 Nov-17 Bie to update Oct 17

PC4 PCCC Federation developments including Lakeside and 3 Sixty

Complex new model of care - rapidly emerging Policies - lots of stakeholders, diversity and views on delivery.



4 x 3 = 12 Development of new models of care with Federations and super practice. Both organisations attending CCG Governing Body Meeting in August 2016.

Control: Gateway Assurance process agreed and in place for Federations. Gateway 1 completed, Gateway 2 completed Jan 2017. Draft Specifications comments received and reviewed. Clinical reference group developed across Corby and Nene.

Action: Operational Group to be established to take the actions further. CW and BG engaged in the gateway process.

• Dedicated lead appointed (Dr Sanjay Gadhia)• Primary Care Workforce Sub Group established as a sub-group of the LWAB• Workforce update added as standing agenda item of the Primary Care Commissioning Committee

4 x 3 = 12 12 Mar-18 Nov-17 Actions: International Recruitement Bid to be submitted on 1 November 2017Workforce Strategy being developed - draft to be submitted to NHSE by 30 November 2017Workforce Group meets monthly

PC5

PCCC Risk of lack of a robust and effective plan to recruit and retain GPs




4 x 3 = 12 Controls:• Dedicated lead appointed (Dr Sanjay Gadhia)• LETC Primary Care Workforce Sub Group established as a sub-group of the Primary Care Commissioning Committee• Workforce update added as standing agenda item of the Primary Care Commissioning Committee

Actions: • Develop Primary Care at Scale under the five year forward view by 2018 as part of the Federations/ Super Practice gateway process, Primary Care Operational group looking at submitting a resilience fund bid across all 5 practices, SDA model will start to address the shortfall of GP appointments through the development of MCP offers in the Federation and Super Practice

4 x 3 = 12 12

Mar-18

Nov-17 Action: to escalate lack of process to NHSE, as this was previously undertaken nationally on behalf of the CCG. NHSE have confirmed the current process as detailed in the policy booklet NHSE. We have also obtained the Capita National SLA which appears to cover list size reviews. KL to check the detail with Capita. Feedback at next PCCC in April 17 to get the matter resolved.

PC7

PCCC

QOF

Risk relating to the lack of access to the national CQRS reporting system in relation to QOF.


Julie Lemmy, Head of Primary Care 4 x 3 = 12

Control: National training being undertaken by the Primary Care Team. National reporting still being provided by NHSE due to lack of access for the CCG due to system set up.

Action: the CCG will work with NHSE CQRS Lead to obtain the data and then develop local policy to undertake QOF validation reviews. However in the mean time the CCG must await further guidance on the national outcomes on this.December 2016 - early indications suggest that CCGs will not have access to the system to September 2017 . 4 x 3 = 12 12 Apr-17

Nov-17 No change

PC10 PC Ops

Premises

Risk of financial impact of lack of completed 3 yearly rent reviews for member practices. The CCG are aware that NHSE are behind on rent reviews, those practices who have not had their rent reviewed have been identified


Julie Lemmy, Head of Primary Care 4 x 1 = 4

Control: CCG working with NHSE area team and the LMC to monitor practices

Action: Practice visits, quality monitoring via Risk Sharing & Ops group.

3 x 1 = 3 3 May-17

Nov-17 October 2017 - NHSE resilience funding available for emergency support and the OPS group will continue to monitor practices.

PC11

PCCC Resilience Fund

Risk of their being no new schemes for 2017/18 due to the 2016/17 schemes being carried over to the current year. There has been a 50% cut and NHSE were proposing a contingency pot of money for any urgent schemes


Julie Lemmy, Deputy Director of Primary Care 3 x 4 = 12

Control: Application of the conflict of interest policy to manage potential challenges.Action: Full review of all services to be undertaken jointly with Nene CCG by 1 April 2018.Finance Committee and Operational Group to manage the associated risks of any challenges.

3 x 4 = 12 12 Apr-18

Nov-17

October 2017 - Paper sent to Finance Committee and final paper with options going in December 2017

PC12

PCCC

AQP & LCS

Risk of challenge to the CCGs as legacy contracts have not been retendered and possible distabilsation of existing providers. Conflict of interest of GPs working in the CCGs which could lead to a challenge from the external market.


Daljit Sandhu Project Manager/Julie Lemmy, Deputy Director of Primary Care 3 x 4 = 12

Control:

Action: 3 x 4 = 12 12 Apr-18

Nov-17

No Controls or Actions Given

PRIMARY CARE COMMISSIONING COMMITTEE RISK REGISTER

Catastrophic 5 5 10 15 20 25

Serious 4 4 8 12 16 20

Moderate 3 3 6 9 12 15

Minor 2 2 4 6 8 10

Insignificant 1 1 2 3 4 5

Rare Unlikely Possible Likely Almost certain1 2 3 4 5

Low Risk Moderate Risk High Risk Extreme risk

(1-3) (4-6) (8-12) (15 – 25)

Level Descriptor Financial Service Delivery

Health &Safety Reputational

1 Insignificant Less than £100kA slightadjustment to service

First aidtreatment.

No Effects onreputation

2 Minor £100k - £250kService quality impaired

Medical treatment required.

Slight reputation damage arising

3 Moderate £250k - £500kSignificant reduction expected.

Serious injuries

Uncomfortable for Organisation

4 Serious £500k - £1m

Service quality cannot bemaintained

Excessive injuries.

Reputation damage KeyStakeholders

5 Catastrophic Above £1mPotential closure ofthe CCG

DeathReputation damage is irrecoverable

Level Descriptor Description

1 Rare

The event mayoccur only inexceptional circumstances –within 1 – 3 years

2 UnlikelyThe event couldoccur at some time– within 12 months

3 PossibleThe event shouldoccur at some time– within 6 months

4 Likely

The event willprobably occur inmost circumstances –within a month

5 Almost Certain

The event isexpected to occur– within a week

Likelihood Chart

LIKELIHOOD

KEY:

Impact Chart

RISK RATING MATRIX

IMPACT




21 November 2017 Title: Finance Update – Month 7 Number: PC-17-58

Author: Jane Kettlewell, Interim Deputy Chief Finance Officer

Contact No:

01536 560425

Executive Sponsor:

Mike Alexander, Chief Finance Officer

Presented by: Mike Alexander, Chief Finance Officer




☐ 3. Better Care 7. Sustainable


Executive Summary

Appendix 1 shows the forecast outturn for delegated funds. As reported in month 5, the forecast remains to plan. Some of the central charges are yet to be received from NHS England.

Recommendations

The Committee is asked to: • Note the update




Appendix 1

CORBY CCG Delegated Budgets 2017/18 Budget 2017/18 Fcast Outturn £'000 £'000 Allocation 9,898,000 9,898,000 1% Set aside -98,980 -98,980 Dispensing Drs 45,000 45,000 Add back set aside 98,980 98,980

9,943,000 9,943,000

GMS Contract 6,660,028 6,660,028 Global Sum 6,424,214 6,424,214 MPIG 8,030 8,030 PMS Transition Payments 148,313 148,313 Use of GMS/PMS 79,471 79,471

Premises 907,792 789,058 Actual rent 165,000 165,000 Notional rent 514,956 514,956 Rates 211,065 92,331 trade ref 10,849 10,849 Water Rates 5,922 5,922

Enhanced Services 298,021 298,021 Learning Dis 23,011 23,011 DSQS 5,107 5,107 Minor Surg 130,628 130,628 Extended Hrs 139,275 139,275 Unplanned Admissions 0 0

QOF 993,825 993,825 Aspiration 695,678 695,678 Achievement 298,147 298,147

PCO 97,259 97,259 Drs Retainer Scheme 5,125 5,125 Seniority 92,134 92,134

Dispensing Fees 317,968 317,968 Prof fees -Disp 297,172 297,172 Prof fees - Presc 22,805 22,805 Presc/Disp charges collected -2,009 -2,009

Central Contracts 569,127 687,861 Clin Waste 25,910 25,910 Mat Leave 28,339 30,566 Occy Health 2,267 2,267 Sickness 2,185 60,918 Sterile Equip 8,251 7,794 Susp Drs 5,825 6,640 Translation 20,506 19,148 Leg Ulcer Clinic 65,000 65,000 Clinical Peer Review 76,785 76,785 Other 334,059 392,833

Sub Total 98,980 98,980 Set aside 1% 98,980 98,980

Total 9,943,000 9,943,000




21 November 2017 Title: Delegated Commissioning Plan - Primary Care

Operations Group Work Plan Number: PC-17-59

Author: Julie Lemmy, Deputy Director of Primary Care & Bie Grobet, Assistant Director of Commissioning Development

Contact No:

01604 651334

Executive Sponsor:


Presented by: Julie Lemmy, Deputy Director of Primary Care & Bie Grobet, Assistant Director of Commissioning Development





☐ 4. Commission

8. Accountable

Executive Summary

To note the primary care operations group work plan for 2017/18 - the committee is asked to note the project status reports attached. The Primary Care Ops group continues to meet and the minutes of the meetings from September and October (draft) 2017 are being tabled at the meeting,

Recommendations

The Committee is asked to: Note the project status reports and primary care operations group actions notes from the meetings held in September and October (draft) 2017.



For Assurance

For Update/Information

1 2 3 4 5 6 7 8 9 10 11 14 15

Ref Risk Title Risk definitionInherent risk score

L x I

Current L x I

Last MonthL x I

Trend Executive Lead Operational Lead Update date Current Mitigation/ ActionsDelivery

Date

Target scoreL x S

PC3 Same Day Access (SDA) access options

Increased use of urgent care facilities for same day access primary care needs

4 x 3 = 12 4 x 3 = 12 12 Caron Williams, Director of Commissioning and Strategy


Mar-17 PINs have been issued for Exstended Primary Care 2 year pilots. Service specifications and contract are being finalised with NHSE and GPFV representatives. Intended start date of 2 years pilots Mid January 2018.

Option appraisal per SDA delivery written in specification.

Nov-17 3 x 3 = 9

PC4 Federation developments including Lakeside and 3 Sixty

Complex new model of care - rapidly emerging Policies - lots of stakeholders, diversity and views on delivery.



Oct-17

Development of new models of care with Federations and super practice. Both organisations attending CCG Governing Body Meeting in August 2016.

Control: Gateway Assurance process agreed and in place for Federations. Gateway 1 completed, Gateway 2 completed Jan 2017. Draft Specifications comments received and reviewed. Clinical reference group developed across Corby and Nene i.e. New Models of Care Group established and meets monthly.

Action: Operational Group meets monthly.

Mar-18 3 x 3 = 9

PC5

Risk of lack of a robust and effective plan to recruit and retain GPs




Oct-17Controls:• Dedicated lead appointed (Dr Sanjay Gadhia)• Primary Care Workforce Sub Group established as a sub-group of the LWAB• Workforce update added as standing agenda item of the Primary Care Commissioning Committee

Actions: International Recruitement Bid to be submitted on 1 November 2017Workforce Strategy being developed - draft to be submitted to NHSE by 30 November 2017Workforce Group meets monthly Mar-18 3 x 3 = 9

PC6

Delegated functions - Practice list size reviews

Risk of inaccurate list sizes causing financial impact for the CCG and member practices. Quarterly reviews should be undertaken for the list sizes, however there is currently a lack of process around this. This is a business as usual function and needs to be removed from the risk register as its managed by Capita on behalf of the CCGRecommend risk is removed from the register from October 2017 as this is a business as ususal and managed by the CCG. 4 x 1 = 4 3 x 1 = 3 3 New risk


Keiren Leigh, Contracts Manager, NHSE Oct-17

Action: to escalate lack of process to NHSE, as this was previously undertaken nationally on behalf of the CCG. NHSE have confirmed the current process as detailed in the policy booklet NHSE. We have also obtained the Capita National SLA which appears to cover list size reviews. KL to check the detail with Capita. Feedback at next PCCC in April 17 to get the matter resolved.

Dec-16 3 x 1 = 3 To be removed

PRIMARY CARE COMMISSIONING COMMITTEE RISK REGISTER

PC7

QOF

Risk relating to the lack of access to the national CQRS reporting system in relation to QOF. 4 x 3 = 12 4 x 3 = 12 12


Julie Lemmy, Deputy Director of Primary Care Oct-17

Control: National training being undertaken by the Primary Care Team. National reporting still being provided by NHSE due to lack of access for the CCG due to system set up. Action: the CCG will work with NHSE CQRS Lead to obtain the data and then develop local policy to undertake QOF validation reviews. However in the mean time the CCG must await further guidance on the national outcomes on this.December 2016 - early indications suggest that CCGs will not have access to the system to September 2017 .October 2017 - No change to the system and is still being managed by NHSE on behalf of the CCG

Apr-17 3 x 3 =9

PC8National Service provision

Risk of national services potentially due to cease in March 2017 for:- contracts for clinical waste- interpreter and translation services- SBS services via Capita for finance This is a business as usual function and needs to be removed from the risk register as its managed by Capita on behalf of the CCGRecommend risk is removed from the register from October 2017 as this is a business as ususal and managed by the CCG. 4 x 1 = 4 4 x 1 = 4 4


Julie Lemmy, Deputy Director of Primary Care

Oct-17

Control: Current provision in place however lack of clarity around when this service will ceaseAction: CCG must escalate to NHSE as these contracts are nationally agreed and to understand the impact on the CCGs for this. There may be a cost pressure for the CCG in relation to these services post March 2017 and also lack of service provider post March 2017. Data and national allocations required for the CCG from NHSE. Nov 2016 - awaiting NHSE update on procurement/access to services post March 2017.December 2016 - NHSE have confirmed that the services will continue to be provided post March 2017 as they are still waiting for confirmation nationally from the NHSE. Pearl Translation provider has gone into liquidation from 1 March 2017, alternative provider list has bee circulated to practices by the Head of Primary Care. NHSE have agreed a Memorandum of Understanding in place with Language Line to provide an interim sevice in the medium term. Corby CCG to seek assurance that NHSE will pick up the invoices for interim service providers.October 2017These services are now managed by the CCG and there has been no change to the providers and NHSE are still responsible for procuring no further update available. Jul-17 4 x 1 = 4

PC9 Financial Risk - Late Claims

Risk of financial impact on the CCG for any late claims or anything linked to SFE (linked to core contract) by Practices. 4 x 1 = 4 4 x 1 = 4 4


Jane Kettlewell, Deputy Chief Finance Officer Oct-17

Control: NHSE have provided assurance that they will honour late claims, however lack of end date for this.

Action: Confirm with all practices that all claims have been submittedOctober 2017 - no claims have been received to date so recommend that this risk is removed. Dec-16 4 x 1 = 4 To be removed

PC10 Premises

Risk of financial impact of lack of completed 3 yearly rent reviews for member practices. The CCG are aware that NHSE are behind on rent reviews, those practices who have not had their rent reviewed have been identified

4 x 1 = 4 3 x 1 = 3 3



Control: CCG working with NHSE to resolve, however resource issue at NHSE to complete this.

Action: 1. District Valuer (DV) to carry out district rent review asap2. Back dated cost pressure and current cost pressure expected however amount unknown currently3. November 2016 - meeting scheduled with NHSE Lead in December 2016 to discuss estates issues, update to be provided in January 2017. 4. December 2016 - no rent reviews have been completed, regular updates will be provided by NHSE estate team. 5. Resource has now been identified from NHSE6. One rent review is outstanding for NHS Corby7. Rent review has been scheduled for April 178. NHSE now has a dedicated Premises resource and rent reviews will be completed by April 2018.

Apr-18 3 x 1 = 3

PC11 Resilience Fund

Risk of their being no new schemes for 2017/18 due to the 2016/17 schemes being carried over to the current year. There has been a 50% cut and NHSE were proposing a contingency pot of money for any urgent schemes 3 x 4 = 12 3 x 4 = 12 12



Control: CCG working with NHSE area team and the LMC to monitor practices

Action: Practice visits, quality monitoring via Risk Sharing & Ops group.October 2017 - NHSE resilience funding available for emergency support and the OPS group will continue to monitor practices. Apr-18 3 x 3 = 9

PC12 AQP & LCS

Risk of challenge to the CCGs as legacy contracts have not been retendered and possible distabilsation of existing providers. Conflict of interest of GPs working in the CCGs which could lead to a challenge from the external market. 3 x 4 = 12 3 x 4 = 12 12


Daljit Sandhu Project Manager/Julie Lemmy, Deputy Director of Primary Care Oct-17

Control: Application of the conflict of interest policy to manage potential challenges.Action: Full review of all services to be undertaken jointly with Nene CCG by 1 April 2018.Finance Committee and Operational Group to manage the associated risks of any challenges.October 2017 - Paper sent to Finance Committee and final paper with options going in December 2017 Apr-18 3 x 3 = 9

PC13

Control:

Action:

PC14

Control:

Action:

PC15

Control:

Action:

PC16

Control:

Action:

Catastrophic 5 5 10 15 20 25

Serious 4 4 8 12 16 20

Moderate 3 3 6 9 12 15

Minor 2 2 4 6 8 10

Insignificant 1 1 2 3 4 5

Rare Unlikely Possible Likely Almost certain1 2 3 4 5

Low Risk Moderate Risk High Risk Extreme risk

(1-3) (4-6) (8-12) (15 – 25)

Level Descriptor Financial Service Delivery

Health &Safety Reputational

1 Insignificant Less than£100k

A slightadjustment to service

First aidtreatment.

No Effects onreputation

2 Minor £100k -£250k

Service quality impaired

Medical treatment required.

Slight reputation damage arising

3 Moderate £250k -£500k

Significant reduction expected.

Serious injuries

Uncomfortable for Organisation

4 Serious £500k - £1m

Service quality cannot bemaintained

Excessive injuries.

Reputation damage KeyStakeholders

5 Catastrophic Above £1mPotential closure ofthe CCG

DeathReputation damage is irrecoverable

Level Descriptor Description

1 Rare

The eventmay occuronly inexceptional circumstances – within 1 –3 years

2 Unlikely

The eventcould occurat some time– within 12months

3 Possible

The eventshould occurat some time– within 6months

4 Likely

The eventwill probablyoccur inmost circumstances – within amonth

5 Almost Certain

The event isexpected tooccur –within aweek

Likelihood Chart

LIKELIHOOD

KEY:

Impact Chart

RISK RATING MATRIX

IMPACT

Project Status report Oct-17

2 LCS (list based services)

2.1 ECG

All practices in Corby are signed up to this service. Any changes would need to be agreed via the LMC/Nene as these are delivered in most practices in the county.List based service - previous review deemed list based service. The OPS group along with cliniciancs from both CCGs need to review and agree do we continue to commission at practice level. Review to be completed by June 2017.Contracted via NHS Std Contract 2017/19 - services commissioned for 12 months with a 3 months notice period.

See separate project status report 01/04/2017 30/03/2018Primary Care Ops

group

2.2 Near Patient Testing

All practices in Corby are signed up to this service. Any changes would need to be agreed via the LMC/Nene as these are delivered in most practices in the county.Contracted via NHS Std Contract 2017/19 - services commissioned for 12 months with a 3 months notice period.

Paper to Primary Care Committee following the review completed in October 2017See separate project status report

01/04/2017 30/03/2018Primary Care Ops

group

2.3 Neo-Natal

All practices in Corby are signed up to this service. Any changes would need to be agreed via the LMC/Nene as these are delivered in most practices in the county.Contracted via NHS Std Contract 2017/19 - services commissioned for 12 months with a 3 months notice period.

See separate project status report 01/04/2017 30/03/2018Primary Care Ops

group

2.4 LUTS

This is a Corby only service commissioned back in 2012/13. A review needs to take place as this was linked to the wider work in Urology, the planned care leads need take this forward and complete the review. The service is open to patients in Corby, Kettering and Wellingborough and activity for Nene is cross charged to the the CCG.

The contract is considerably under-utilised but there is a lack of data to understand why. It was recommended that this is not considered for inclusion within the new Community Surgery contract at this stage, but that a review of the service is undertaken by the Quality Team. See AQP project status report

01/04/2017 31/03/2018 Quality Team

2.5 Warfarin

All practices in Corby are signed up to this service. Any changes would need to be agreed via the LMC/Nene as these are delivered in most practices in the county.List based service - previous review deemed list based service. The OPS group along with cliniciancs from both CCGs need to review and agree do we continue to commission at practice level. Review to be completed by June 2017.Contracted via NHS Std Contract 2017/19 - services commissioned for 12 months with a 3 months notice period.

All practices provide this service (provided by practices in both CCGS) financial value is high. List based service, inlcuded in the portfolio for 17/18 need to revew as part of commissioning intentions in September 2017.Joint working required between the CCGs/LMC to agree review of this service. Discussions to take place during May 2017.The Ops group meeting was cancelled in June and will now meet in July - an update will be provided at the next meeting.The Ops group meeting was cancelled in August and will now meet in September - an update will be provided at the next meeting.See Countywide LCS project status report

01/04/2017 30/03/2018Primary Care Ops

group

2.6 Pro-active Care

This was a countywide service but Nene have decommissoned this at practice level and incorportated into the CCT scheme. The service was included in the LCS portfolio for 2017/18 whilst a decision by the CCG is made to continue to commission at practice level/Fed level etc.Contracted via NHS Std Contract 2017/19 - services commissioned for 12 months with a 3 months notice period.

4 practices signed up to this service financial value is high (Studfall not signed up). List based service, inlcuded in the portfolio for 17/18 need to revew as part of commissioning intentions in September 2017.Bie to produce a briefing paper on proposed changes for the Ops group to review ahead of the next meeting in May 2017 .The Ops group meeting was cancelled in June and will now meet in July - an update will be provided at the next meeting.See Countywide LCS project status report

01/04/2017 30/03/2018Primary Care Ops

group

2.7 DVTTo reduce the number of low risk DVT based on national evidence. This is a Corby only service commissioned back in 2012/13.

4 practices provide this service (Studfall Partnership not signed up). Review activity and outcomes and included in the commissioning intentions review in September 2017.Dave Cole to review activity/evidence assumptions for this service and make recommendation to the Primary Care Ops Group by June 2017.The Ops group meeting was cancelled in June and will now meet in July - an update will be provided at the next meeting.The Ops group meeting was cancelled in August and will now meet in September - an update will be provided at the next meeting.See Countywide LCS project status report

01/04/2017 30/03/2018Primary Care Ops

group

3 Delegated PMS to GMS transition

3.4 Year 3 PMS Premium investment for 2018/19 The PMS task and finsish group and met in October 2017.A paper is being tabled at the PCCC November 2017 meeting to sign off the Year 3 Funding release.

01/07/2017 31/03/2018PMS Task and Finish Group

4.1 Primary Care Commissioning CommitteeThe minutes from the Primary Care Ops group and updated plan to be submitted to the committee for information.

Admin Team to include approved minutes to the committee agenda and cirulate with other papers.

01/04/2017 31/03/2018Chile/Sara Admin

teamn/a

5 Engagement

5.1 Council of MembersBie/Sanjay to ensure the engagement of member practices via COMs on any decisions on the above services.

All services changes to be agreed by Corby Council Of Members. 01/04/2017 31/03/2017 Bie Grobet/Julie Lemmy/Sanjay

n/a

5.2

6 Procurement Process

6.1NEL CSU support to be obtained as and when services are ready to be commissioned and procured.

n/aProcuremnt team to produce timeline and provide advice and guidance where applicable on the above services.See individual project services update reports

01/04/2017 31/03/2018 Ros Clarke n/a

7 Reprovision

7.1 Hypertension, Peer Review, Leg Ulcer & Long term Conditions See Corby Only LCS project status report. See separate project status report 01/10/2017 31/10/2017 Primary Care Ops

Management Lead Corby Bie Grobert/Daljit Sandhu

Status

Nene/Corby CCG Clinical Lead: RED: CONCERN/INABILITY TO COMPLETE ACTIONAz Ali/Sanjay Gadhia AMBER: IN PROGRESSNene CCGManagement LeadJulie Lemmy/Amanda Swingler

GREEN: ACTION COMPLETE

Procurement LeadRos ClarkeFinanceJane KetterwellNHSE Keiren Leigh/Lamont MontezuQualitySharon WrightPractice Manager LeadKay Taylor Great Oakley Surgery

Overall RAG

Milestone 1:

Milestone 2:

Miesltone 3

BLUEGREEN

AMBER

RED

Programme Leader Daljit Sandhu/Lisa Riddaway

Project Status ReportProgramme Name AQP ServicesProgramme Sponsor Caron Williams

Next Steps:• Commission and undertake a review of the current service – October – November 2017• Hold a further bidder event to agree pathways with the market place• Develop key areas with interested providers & as part of ‘consult’ period - October-December• Confirm scope - October • Develop a specification - October-December • Financial input - October-December• Contracting input - October-December• Link with HEE re training needs analysis/possible support - October-March • Give notice to providers –December onwards • PIN out – 2nd January 2018 • LUTS Service - an audit by the quality team to be undertaken to inform the next steps for this service.

Summary

Reporting DateOct-17

Milestone RAG AMBER / GREEN

AMBER/GREEN

Status Event to be held between October & December 2017 and see next steps.

Sign off and procurement of the new service model

Project Name Countywide AQPsClinical Lead Sanjay Gadhia/Az AliBrief Description of Scheme:The following existing contracts could be considered for inclusion within the new Community Surgery contract:• Carpal Tunnel AQP• Vasectomy AQP• Basal Cell Carcinoma AQP• Minor Surgery AQP • LUTS LCS

Progress and Key Updates This Period:1. A review of these contracts has been undertaken by the Planned Care Team which concludes that these services are appropriately undertaken in the community. 2. A PIN notice was issued in May 2017, asking for Expressions of Interest in the new service, to which twelve responses were received.

Successful delivery appears feasible but significant issues already exist requiring management attention. These appear resolvable at this

AMBER / REDSuccessful delivery is in doubt with major risks or issues apparent in a number of key areas. Urgent action is needed to ensure these are addressed, and to determine whether resolution is feasible.Successful delivery appears to be unachievable. There are major issues on project definition, with project delivery and its associated

Status Work underway by the Sustainable Elective Care Group - updates to be provided in throughout November 2017 to March 2018.Development of the New Community Services Contract from April 2018

Risks, Issues and Mitigations:LUTS - the contract is considerably under-utilised but there is a lack of data to understand why. It was recommended that this is not considered for inclusion within the new Community Surgery contract at this stage, but that a review of the service is undertaken by the Quality Team.

Support Required:Procurement advice will be needed from NEL CSU and will be sought once the service specification is developed fully.Quality team to carry out a review during November/December 2017 on outcomes metrics.

CompleteSuccessful delivery of the project is on track and seems highly likely to remain so, and there are no major outstanding issues that appear to

ID No 1.1, 1.2, 1.3, 1.4 & 1.6

AMBER / GREENSuccessful delivery appears probable however constant attention will be needed to ensure risks do not materialize into issues threatening delivery.

Progress against milestones: Where are there significant variances from plan milestones and/or savings

Review of the existing portfolioStatus The planned care completed the initial review further work is required and a paper detailing the options was taken to the Finance

Committee in October and a further update will be taken in December 2017.

Scoping work reivew of existing services & Hold Bidder event with the market entrants.

Overall RAG

Milestone 1:

Milestone 2:

Miesltone 3

BLUEGREEN

AMBER

RED

Project Status Report Summary ID No 1.5Programme Name AQP Services - Opthalmology

Reporting DateOct-17Programme Sponsor Caron Williams

Programme Leader Daljit Sandhu/Lisa RiddawayMilestone RAG AMBER / GREEN

Project Name Countywide AQPsClinical Lead Sanjay Gadhia/Az Ali AMBER/GREENBrief Description of Scheme:A countywide GPwSI Opthalmology - only 1 provider for the county.


Review by Sustainable Elective Care GroupStatus Contract for 2018/19 to be included in the commissioning intentions.

Completed October 2017Progress and Key Updates This Period:There is currently only one contract in place with a GPSI. Due to significant pressures within the acute sector to deliver timely Ophthalmology care – in particular, at KGH where patients have waits of over 52-weeks - work is underway to vary this contract, in order that the GPSI can work more locally one day a week, to review referrals and triage patients. This is being progressed through the Sustainable Elective Care Group. The longer-term plan is to use Optometrists, and to therefore have more contracts in place.October 2017 - The recommendation is to continue this contract as is, until the above plans are put in place.

Contract for 2018/19 Status Awaiting the outcome of commissioning intentions document to be signed

off by CCGsOctober 2017 - CCGs Cis were approved and have been issued to all providers.Completed October 2017

Approval to commission and contractual paperwork to be completed in readiness for 2018/19

Status October - await sign off by Finance in November/December 2017

Next Steps:Agreement of next steps by the Sustainable Elective Care GroupContract for 2018/19 inlcuded in commissioning intentions - options paper to Finance Committee in November/December from . which requires CCGs sign off expected in the next month.

Risks, Issues and Mitigations:Only one provider in the county for 2017/18.

Support Required:

CompleteSuccessful delivery of the project is on track and seems highly likely to

Successful delivery appears to be unachievable. There are major issues on

AMBER / GREENSuccessful delivery appears probable however constant attention will be needed to ensure risks do not materialize into issues threatening delivery.Successful delivery appears feasible but significant issues already exist

AMBER / REDSuccessful delivery is in doubt with major risks or issues apparent in a number of key areas. Urgent action is needed to ensure these are addressed,

Overall RAG

Milestone 1:

Milestone 2:

Miesltone 3

BLUEGREEN

AMBER

RED

Project Status Report Summary ID No 2.1 to 2.7Programme Name Locally commissioned services (Nene/Corby) Reporting Date

Oct-17Programme Sponsor Charlotte Fry/Caron WilliamsProgramme Leader Julie Lemmy/Bie Grobert Milestone RAG AMBER / GREENProject Name Countywide LCSClinical Lead Naomi Caldwell/Sanjay Gadhia AMBER / GREENBrief Description of Scheme:All locally commissioned services to be reviewed and outcome to be included in the commissioning intentions for 2018/19 if applicable.Remaining LCS (list based) to be reviewed by Primary Care Ops Group and produce recommendations for PCCC.ECG, Near Patient Testing, Neo-natal, Warfarin,DVT,Primary Care Development Scheme.


Commissioning Intentions to be ratified by CCGsStatus Awaiting the sign off of the commissioning intentions for 2018/19.

CCGs approved Cis and letters issued to providers on 24/10/2017Completed October 2017

Progress and Key Updates This Period:Commissioning intentions have been now been approved by the CCGs and sent to all practices.Clinicians and Management Leads met to discuss the remaining services - update and recommendations to be taken to PCCC November 2017.

Contractual arrangementfor 2018/19Status Awaiting the sign off of the commissioning intentions for 2018/19 - now

approved.October 2017 - Recommendations from the Primary Care Ops group on the remaining contract, paper to PCCC in November for discussion and agreement.Nene CCG to agree to the review of the countywide LCS - discussions to take place in November 2017.

Commissioning of LCS for 2018/19Status Not started.

Next Steps:PCCC to agree recommendations of the Project Group recommendations for the reamining LCS contracts.Nene CCGs to review the recommendation from the Primary Care Ops group on the remaining LCS for 2018/19.Advice from Procurement on the outcome of the review carried out by the Primary Care OPS group to be obtained once agreement to the recommednations by PCCC.

Risks, Issues and Mitigations:Whilst most services are list based, there is always a potential challenge from other providers in the market. EQIA have been completed by Primary Care Ops group in October 2017.Procurement advice to be sought on the outcome of the clinical review of services carried out by the Primary Care Ops gorup.

Support Required:Procurement & Quality input required from CCG/NEL.





Overall RAG

Milestone 1:

Milestone 2:

Miesltone 3

BLUEGREEN

AMBER

RED

Project Status Report Summary ID No 3.1Programme Name PMS Year 3 Funding Reporting Date

Oct-17Programme Sponsor Charlotte Fry/Caron WilliamsProgramme Leader Julie Lemmy Milestone RAG AMBER / GREENProject Name PMS Year 3 FundingClinical Lead Naomi Caldwell/Sanjay Gadhia AMBER / GREENBrief Description of Scheme:PMS funding reinvestment Scheme 2018/19


Task and Finish group to review options for Year 3 funding optionsStatus The task and finish group met and agreed recommendations for PCCC to

review and agree for 2018/19 reinvestment option for the CCG.Completed October 2017

Progress and Key Updates This Period:The PMS Task and finish group met in October 2017 and the recommendation paper is going to PCCC in November which outlines the options for the reinvestment of released funding for 2018/19.

Contractual arrangementfor 2018/19Status Awaiting the sign off of recommendation paper being presented to PCCC in

November 2017.

Commissioning of PMS contract for 2018/19Status Not started.

Next Steps:PCCC to agree recommendations of the Project Group recommendations for the released PMS premium funding options for 2018/19The Primary Care Team to produce the service spec and contract and issue to providers by 1 April 2018.

Risks, Issues and Mitigations:None

Support Required:Not required as funding can only be reinvested into General Practice as this is core funding linked to core contracts.





3.2 Spirometry

Release of PMS Premium (this funding is ringfenced) and was used for year 1 funding by both CCGs. Corby CCG £0.50pcontracted via standalong NHS Standard Contract - all practices signed up for 17/18

Review 2020/21 Year 3 investment to be agreed Summer 2017.The reinvestment options for year 3 will need to be considered by the group in early summer to influence the year 3 premium release funding for Corby.

01/04/2016 31/03/2017PMS Task and Finish

Group

3.324 Hour Ambulatory Blood Pressure Monitoring (24ABPM)

Nene CCG used its PMS premium in Year 1 to fund this service and Corby included in the Practice Delivery Scheme to align and ensure consistency of access for patients.

Review 2020/21 Year 3 investment to be agreed Summer 2017The reinvestment options for year 3 will need to be considered by the group in early summer to influence the year 3 premium release funding for Corby.

01/04/2016 31/03/2017PMS Task and Finish

Group

1.2 Vasectomy AQPCountywide service - we have 4 providers in the county delivering this service. Review complete- next review due 2019 n/a n/a

Tim O'Donova

n

3.5 Leg Ulcer ClinicService being Procured for Corby only patients. Procurement commenced April 2017.

Bie to provide the ops group details as when available.Yearly review - review in September in line with commissioning intentions.Contracting vehicle TBA - as the OPS meeting was cancelled in August this is to be discussed and agreed at the September meeting.

01/04/2017 30/09/2017

Bie Grobet/Sa

njay Gadhia

2.8Primary Care Development Scheme

The scheme orginates from the old access funding given to PCTs and this was developed to create a baseline of number of contacts within General Practice. Capitation payment.Contracted via NHS Std Contract 2017/19 - services commissioned for 12 months with a 3 months notice period.

Review activity and outcomes and included in the commissioning intentions review in September 2017.Bie to produce a briefing paper on proposed changes for the Ops group to review ahead of the next meeting in May 2017 The Ops group meeting was cancelled in June and will now meet in July - an update will be provided at the next meeting.The Ops group meeting was cancelled in August and will now meet in September - an update will be provided at the next meeting.

01/04/2017 30/09/2017

Bie Grobert/S

anjay Gadhia

7.1Hypertension, Peer Review, Leg Ulcer & Long term Conditions

See Corby Only LCS project status report. See separate project status report Completed October 2017 01/10/2017 31/10/2017Primary

Care Ops

1 AQP Services (Countywide) Back ground on service

1.1 Aural Toilet AQPCountywide service - we have 5 providers in the county delivering this service.

Proposal to include as part of the new community surgery serviceSee separate project status report

01/04/2017 31/03/2018

Sustainable Elective Program

me

1.3 Basal Cell Carcinoma (BCC) AQP

Countywide service - we have 3 providers in the county delivering this service.Contracted via NHS Std Contract 2017/19 - services commissioned for 12 months with a 3 months notice period.


01/04/2017 31/03/2018


me

1.4 Minor Surgery AQP

Countywide service - we have 3 providers in the county delivering this service.Contracted via NHS Std Contract 2017/19 - services commissioned for 12 months with a 3 months notice period.


01/04/2017 31/03/2018


me

1.5 Opthalmology AQP

Countywide service - we have 1 provider. in the county delivering this service.Contracted via NHS Std Contract 2017/19 - services commissioned for 12 months with a 3 months notice period.

Proposal to include as part of the new community surgery service. See separate project status report

01/04/2017 31/03/2018


me

1.6 Carpel Tunnel AQP

Countywide service - we have 1 provider. in the county delivering this service.Contracted via NHS Std Contract 2017/19 - services commissioned for 12 months with a 3 months notice period.


01/04/2017 31/03/2018


me

AQP Services

ID Task Name StartReview task

Responsible

StatusRED:

Responsible

StatusRED:

Finish

ID Task Name Review task Start Finish

Overall RAG

Milestone 1:

Milestone 2:

Miesltone 3

BLUEGREEN

AMBER

RED

Project Status Report Summary ID No 7.1Programme Name Corby LCS only

Reporting DateOct-17Programme Sponsor Caron Williams

Programme Leader Daljit SandhuMilestone RAG BLUE

Project Name Countywide AQPsClinical Lead Sanjay Gadhia BLUEBrief Description of Scheme:(Corby CCG only) Hypertension LCS Long Term Conditions LCSPeer Review LCSLeg Ulcer


Locally commissioned services to be contracted with member practices.Status Approval sought and given by Finance Committee

Completed October 2017

Progress and Key Updates This Period:Approval obtained from CFO and AO - completed October 2017Contracts and service specs issued to all providers

Contractual paperwork to be completedStatus The Primary care team issued contract and specs to all practices in October

2017.Completed October 2017

Status

Next Steps:Await return of contract variations from member practicesThe primary care team to chase member practices.

Risks, Issues and Mitigations:All identified in the finance paper in October 2017.

Support Required:








21 November 2017 Title: NHS England Update Number: PC-17-60

Author: Keiren Leigh, NHS England Midlands and East (Central Midlands)

Contact No:

0113 824 8919

Executive Sponsor:


Presented by: Keiren Leigh, NHS England Midlands and East (Central Midlands)


☐ 1. Prevention 5. Quality

☐ 2. Early Diagnosis 6. Engagement

3. Better Care 7. Sustainable

4. Commission ☐ 8. Accountable

Executive Summary

PCCC is asked to note the update provided by NHS England.

Recommendations

The Committee is asked to: • Note the update




NHS England Update 21 November 2017

General Updates : Pharmacy Pharmacy Integration Fund In October 2016, NHS England announced a £42m Pharmacy Integration Fund (PhIF) to support pharmacy to transform how it operates across the NHS for the benefit of patients over the next two years. The Pharmacy Integration Fund will support community pharmacy as it develops new clinical pharmacy services, working practices and digital platforms to meet the public’s expectations for a modern NHS community pharmacy service. It follows the announcement of the Department of Health’s new Community Pharmacy Contractual Framework and associated funding, and comprises a package of proposals for 2016- 2018.The aim of the PhIF is to support the development of clinical pharmacy practice in a wider range of primary care settings, resulting in more integrated and effective NHS primary care for patients. In particular, the fund will drive the greater use of community pharmacists and pharmacy technicians in new, integrated local care models. This will improve access for patients, relieve the pressure on GPs and accident and emergency departments, ensure best use of medicines, drive better value and improve patient outcomes. One area of early implementation will be the deployment of prescribing pharmacists in the Integrated Urgent Care Clinical Assessment Service contact centres and in NHS 111 services to help reduce the pressures on urgent and emergency care and general practice. Locally, NHS England will be working with the commissioners of NHS 111 in how pharmacists can be integrated in the contact centres. General Practice General Practice Forward View Clinical Pharmacist in General Practice NHS England has supported three successful applications in wave 1 and wave 2 pilots as part of the clinical pharmacists in general practice programme for the Northampton and Corby area. WAVE 1 WAVE 2 3Sixty Care Partnership General Practice Alliance and Principal Medical/DocMed The deadline for the third wave of applications closed on 29th September 2017 and a further application has been received for the Corby area. NHS England will be making a decision on all Wave 3 applications by the end of November 2017.

Improving Access Further to the Improving Access to General Practice next steps webinars that NHS England have been hosting, below are the core slides that have been used. The aim of the slide pack is to support the rollout of improved access to general practice, as detailed in the NHS Operational Planning and Contracting Guidance 2017-19. This slide pack is aimed at general practice staff and commissioners and provides a breakdown of the national core requirements, answers to a number of frequently asked questions and an update on the range of resources that have been made available nationally to support rollout. These slides have now been through the NHS England gateway process and will be published on the NHS England website. The aim is to promote these slides through the various NHS England bulletins, and will be distributed to practices for their information. https://www.england.nhs.uk/publication/improving-access-to-general-practice-national-slidepack/ Other Updates linked to Primary Care Winter Along with Public Health England, the Department of Health and NHS Improvement, NHS England unveiled measures to boost the uptake of flu vaccinations along with a package of new contingency actions to respond to pressures on frontline services this winter. The measures include: •Providing free flu vaccines to care home staff. •Increasing the number of jabs for young children in schools and vulnerable people. •Directing NHS trusts to ensure they make vaccines readily available to their staff and record why those who choose to opt out of the programme do so. •Reminding doctors, nurses and other healthcare workers of their professional duty to protect patients by being vaccinated. •Setting up a new National Emergency Pressure Panel to provide independent clinical advice on system risk and an appropriate regional and national response. The panel will be senior managers at NHS England, NHS Improvement and Public Health England and will determine system risk levels across the country and whether these should be escalated or de-escalated. Their judgement will inform the national and regional actions that will be taken if the NHS faces significant pressures. •The expansion in training for A&E consultants with more doctors over the next four years and other healthcare staff. NHS England together with NHS Improvement, Health Education England and the Royal College of Emergency Medicine has published plans to increase the number of people starting Emergency Medicine training next year (2018) and for three years thereafter. More out-of-hours GP services to be made available

https://www.england.nhs.uk/publication/improving-access-to-general-practice-national-slidepack/

https://www.england.nhs.uk/publication/improving-access-to-general-practice-national-slidepack/

NHS England has announced plans to help strengthen out-of-hours (OOH) GP services by making an extra £10 million available to GPs. The money will be provided to help GPs afford indemnity costs, which cover them against any clinical negligence accusations, previously raised as a barrier to delivering OOH care. NHS England ran a similar indemnity scheme last year and an extra 80,000 GP out-of-hours (OOH) sessions took place. With an increased budget this year, it is anticipated even more sessions will be provided. The scheme will run from 1 October 2017 until after the Easter weekend, 2 April 2018, and means doctors can commit to more OOH sessions without the need for them to negotiate additional changes to their level of indemnity cover.

1

Minutes of the Primary Care Operation Group meeting

Tuesday 26 September 2017 at 14:00 in Meeting Room 2, Corby Enterprise Centre, London Road, Priors Hall Corby NN17 5EU

Present Julie Lemmy Deputy Director of Primary Care (Chair) Bie Grobet Assistant Director of Commissioning Development Lamont Montezu Support Contracts Manager, NHS England Sharon Sanderson Interim Support Officer Dr Nathan Spencer GP Governing Body Member Amanda Swingler Primary Care Development Manager NHS England Kay Taylor Practice Manager, Great Oakley Sharon Wright Quality Improvement Manager Apologies Dr Sanjay Gadhia GP Governing Body Member Dr Miten Ruparelia Clinical Vice Chair

Minute No: Item 14 Welcome and Introductions Ms Lemmy welcomed members to the Primary Care Operational Group.

15 Apologies for absence Apologies were received from Dr Sanjay Gadhia and Dr Miten Ruparelia.

16 Declaration of Interests There were no new Declarations of Interests declared.

17 Minutes of the meeting held on 25 July 2017

The minutes of the Primary Care Operational Group meeting held on the 25 July 2017 were

APPROVED as a true and accurate recording of proceedings.

18 Delegated Responsibilities Ms Lemmy gave an update on;

Contractual Changes- An application to close list was discussed at the Primary Care Commissioning Committee and the outcome will be discussed with the practice on 27.9.2017. Feedback on the decision and discussion will be shared at the next Operational meeting. Premises/ETTF- Ms Lemmy said that there was no further update since the last meeting and that discussions were ongoing. PMS Task and Finish Group- Dr Gadhia informed the group that he was representing Corby CCG and was putting together options and gathering evidence to take to the Committee. It was agreed that Anna Lewis would be invited to the next meeting.

19 Countywide Community AQP Contracts and Locally Commissioned Services Portfolio Ms Grobet agreed that a meeting would be arranged with herself, Helen Storer and Tansi

Harper to discuss Countywide Community AQP Contracts and Locally Commissioned Services Portfolio and this would be shared at the next meeting.

Action: Mrs Sanderson

20 International Recruitment

2

Ms Lemmy gave an update on International Recruitment and informed the group that NHS England were currently working to recruit two thousand additional GPs. Several CCGs are working together to put into place the best practice for recruiting GPs. NHS England will fund applicant’s Visas and were looking at recruiting as far afield as South Africa and Australia. Dr Spencer asked if the successful applicants would be able to chose which Practice they work at and asked if they would be able to leave within the first two years to go elsewhere. Ms Lemmy said that applicants would have to stay at their Practice for a minimum of two years. Ms Lemmy also informed the group that there will be specialist recruitment agencies that will be responsible to find applicants to match the practice requirements and then get them ready to go through the International process. Ms Lemmy also said that language skills would be tailored and local Universities/HEE/RCGP would be responsible for the recruits education programme.

21 NHS England and GP Resilience Update Mr Montezu gave a short update and said that the Clinical Pharmacists in General Practice

would be sending communications to federations with the final version of the Enhanced Service Specification (the ES). Mr Montezu went on to say that a template agreement, commissioned by and produced on behalf of the BMA, which practices could adopt for use as the agreement between the relevant parties in their application site was also being sent to practices.The template was developed to enable adaptation to suit the needs of the collaborative arrangement. Practices and providers were advised to must take their own independent legal advice before it is signed by the relevant parties. The agreement will also be available on the BMA website in the near future, and we will share the link when it is available.

22 Quality Dashboard and Practice Visits: Mrs Wright informed the group that Practice visits will be booked between January and April

2018.

23 Finance Update There was no update on Finance as Mrs Kettlewell was unable to attend.

24 Risk Register Update Ms Lemmy said that the Risk register needs to be updated for the next meeting. A meeting will

be arranged between Ms Gobet, Ms Lemmy and Mrs Sandhu to action this. Action: Mrs Sanderson

25 Date of Next Meeting The next Primary Care Operational Group meeting would be held at 14:00 on 24 October 2017

in Meeting Room 2, Corby Enterprise Centre London Road, Priors Hall Corby NN17 5EU. Ms Lemmy brought the meeting to a close at 15:10

1

Minutes of the Primary Care Operation Group meeting

Tuesday 24 October 2017 at 14:00 in Meeting Room 2, Corby Enterprise Centre, London Road, Priors Hall Corby NN17 5EU

Present Julie Lemmy Deputy Director of Primary Care (Chair) Dr Sanjay Gadhia GP Governing Body Member Janita Mackin Practice Manager, Lakeside Bie Grobet Assistant Director of Commissioning Development Salim Issak Assistant Contract Manager, NHS England Jane Kettlewell Deputy Chief Finance Officer Dr Miten Ruparelia Clinical Vice Chair Sharon Sanderson Interim Support Officer Amanda Swingler Primary Care Development Manager NHS England Sharon Wright Quality Improvement Manager Apologies Lamont Montezu Support Contracts Manager, NHS England

Minute No: Item 26 Welcome and Introductions Ms Lemmy welcomed members to the Primary Care Operational Group.

27 Apologies for absence Apologies were received from Lamont Montezu.

28 Declaration of Interests There were no new Declarations of Interests declared.

29 Minutes of the meeting held on 26 September 2017 The minutes of the Primary Care Operational Group meeting held on the 26 September 2017

were APPROVED as a true and accurate recording of proceedings.

30 Delegated Responsibilities Ms Lemmy gave an update on:

Contractual Changes- An application to close a list had been presented by the Studfall Partnership which went to the Primary Care Commissioning Committee for their decision. The application was rejected and the practice had been briefed on this decision. Premises/ETTF- Ms Lemmy informed the group that a further meeting would be arranged with the Studfall practice to work on resilience support under ETTF and to find ways of utilising the practice premises in a better way and that NHS England and the CCG would arrange a formal review of the premises at a joint meeting yet to be set up. Action: Sharon Wright/Julie Lemmy Mr Issak gave an update on rents for practices and said that there would be potential rent increases. Mr Issak advised the group that there was a 3 year cycle for rent charges and that landlords should initiate rent reviews. Mrs Mackin commented that her practice had two overdue rent reviews and was advised that Nina Mills would look into this. PMS Task and Finish Group- Dr Gadhia informed the group that a 3 year funding for ear wax removal had been agreed and would be going to the relevant PCCC committee for ratification.

2

There was a discussion around funding for leg ulcer treatment and that Nene CCG had been receiving 50 pence more that Corby CCG. Dr Gadhia also said that doppler assessments were not currently covered by the funding for leg ulcer and that an extra 50 pence would be needed for this treatment. Ms Kettlewell said that a full business case analysis would need to be carried out. Mrs Kettlewell also said that the CCG had been investing more into PMS practices than the amount it had taken back, and that investment had a 5/6 year projection period. Ms Lemmy suggested taking the finance paper to the PCCC committee for discussion and action to look at options and forecasts going forward.

31 Countywide Community AQP Contracts and Locally Commissioned Services Portfolio

Ms Lemmy updated the group on AQP contracts and said that project status reports had been completed for each service line, and that these would be finished before going to the Primary Care Co-Committee (PCCC). Ms Lemmy said that decisions were needed around items on the report including LCS, ECG, Near patient testing and Neo-natal services. This would be mapped back to the Commissioning Intentions and taken to PCCC for a decision on 2018-19 services.Ms Lemmy suggested that a small group of people including clinicians and management leads would be set up to provide rationale replicate across Nene CCG. Dr Ruparelia commented that Commissioning Intentions did articulate some of these services and asked which services we do keep regarding Primary Care and Intermediate care. Mrs Wright said that a LUTs review needs to be carried out and would be presented back to the Sustainable Elective Programme Group which would be included in the paper being presented to the Finance Committee in November/December 2017.

32 International Recruitment Ms Lemmy gave an update on International Recruitment and confirmed that the deadline for

applicants had been extended to 30 November 2017 and we the CCGs were aware of 27 vacancies being advertised on the LMC website within the County. All practices should have received an email last Friday (20 October) regarding the deadline but Mrs Mackin informed the group that her practice had only received the email regarding this today. Ms Lemmy said that practices were being encouraged to send submissions and advised that there were currently 2 project managers involved in the recruitment process. Dr Ruparelia asked if Brexit would be an issue in the recruitment process and was told by Ms Lemmy that all visa issues would be handled by the national recruitment office before the person leaves their Country of origin.

33 NHS England and GP Resilience Update Mr Issak told the group that there had been one application form the Corby area. Feedback

would be given to the applicant once the National Team had made a decision. Mr Issak also said that the International GP recruitment team were closely looking at what was wanted for this particular area. Mr Issak then updated the group on flu jabs and said that the flu jab scheme had been extended to include care home staff. Dr Ruparelia asked Mr Issak if it was for any kind of home ie Residential or Nursing. Mr Issak said that he would get this clarified. Dr Gadhia brought up the subject of claim indemnity cover and that he found it hard to forecast for winter sessions as specific figures had to be provided in advance. Mr Issak said he would look into this subject and feedback to the group. Action:Mr Issak

34 Quality Dashboard and Practice Visits: Mrs Wright informed the group that a Corby only practice visit would take place on 13

November. Mrs Wright said that the dashboard would not be updated until all results were in. Ms Grobet told the group that there would be a Rightcare visit in the next few months. Mrs Wright advised the group that there was an aspiration to reduce e.coli and blood stream infections and that the CCG in London had been looking at ways of reducing urinary tract infections (UTI). Mrs Wright also mentioned that a large number of patients with UTIs had

3

catheters insitu. Mrs Wright informed the group that she would give feedback as soon as a proposal was in place. Mrs Kettlewell left the meeting at 15:00

35 Finance Update Mrs Wright said she had spoken to Mike Alexander regarding the financial recovery and that

reviews were needed in order to improve on performance management and to determine if services should be stopped after 3 months if not needed. Ms Lemmy told the group that programmes should be developed on ways to work smarter, that consisitency was needed to work and engage better with practices and that information from the Commissioning Intentions should be used going forward. Ms Lemmy updated the group on CCG underspend and said that any underspend discrepancies were under review. Dr Ruparelia told the group that 2017/18 spend would be put to the PCCC to articulate what has happened and said that some really good recommendations had not materialized and not been put into primary care. Dr Ruparelia proposed that discussions should take place at PCCC around funding. Ms Lemmy agreed that she would speak to Ms Kettlewell and Mr Alexander regarding this. Action: Ms Lemmy It was also agreed that Ms Kettlewell and Mr Alexander would provide a finance paper around primary care at the next Finance Committee. Action: Ms Kettlewell/Mr Alexander

36 Risk Register Update Ms Lemmy told the group that the risk register had been updated as per the last meetings

action and would be taken to PCCC for approval. Mr Issak was asked to look at PC7 on the risk register-lack of access to QOF by Mrs Wright but was informed by Mrs Wright that most practices had been achieving training levels. The group were told that a new QOF would be out next year and Ms Grobet said that was why the CCG had made no further movement on this subject. It was also noted there was a risk relating to the lack of access to the national CQRS reporting system in relation to QOF.

37 Date of Next Meeting The next Primary Care Operational Group meeting would be held at 14:00 on 30 November

2017 in Meeting Room 2, Corby Enterprise Centre London Road, Priors Hall Corby NN17 5EU. Ms Lemmy brought the meeting to a close at 15:20




21 November 2017 Title: Register of Interests Number: PC-17-63

Author: Sarah McKenzie, Executive Assistant Contact No:

01536 560420

Executive Sponsor:


Presented by: Tansi Harper, Lay Member Patient and Public Engagement






Executive Summary

Register of Interests for NHS Corby CCG Primary Care Commissioning Committee.

Recommendations

The Committee is asked to: • Note the updated register of interests




1

NHS Corby Clinical Commissioning Group Register of Interests

Updated 10 November 2017

Name Current position(s) held

in the CCG i.e. Governing Body member; Committee member; Member practice, CCG employee; other

Declared Interest (Name of organisation and nature of business)

Nature of Interest Nature of Interest

Date of Interest Action taken to mitigate risk

Fina

ncia

l In

tere

st

Non

-fina

ncia

l in

tere

st

Non

-fina

ncia

l pe

rson

al

inte

rest

Direct or Indirect?

From To

GOVERNING BODY MEMBERS Carole Dehghani

Chief Executive None to declare N/A N/A N/A N/A

Mike Alexander

Chief Finance Officer None to declare N/A N/A N/A N/A

Caron Williams Director Commissioning & Strategy

None to declare N/A N/A N/A N/A

Dr Miten Ruparelia

Clinical Vice Chair Partner at Woodsend Medical Centre, including Wollaston and Bozeat Surgeries. Work across both Practices

Direct

Current

Will declare the interest and manage in line with appropriate policy

2

Name Current position(s) held in the CCG i.e. Governing Body member; Committee member; Member practice, CCG employee; other




Fina

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Direct or Indirect?

From To

Practice is a Member of 3Sixty Care Ltd Federation Former Shareholder Lakeside + Ltd Honorary contract holder at Kettering General Hospital Working with ECIP one day per week The Practice holds an enhanced contract with a provider from whom the CCG commissions services

Direct

Direct

Direct

Direct

Current

Current

Current

Current

Will declare the interest and manage in line with appropriate policy Will declare the interest and manage in line with appropriate policy Will declare the interest and manage in line with appropriate policy Will declare the interest and manage in line with appropriate policy

3





Fina

ncia

l In

tere

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Non

-fina

ncia

l in

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st

Non

-fina

ncia

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rson

al

inte

rest

Direct or Indirect?

From To

Dr Joanne Watt Clinical Chair Partner at Great Oakley Medical Centre Independent contractor to the Department of Sexual Health at NHFT Husband is a Consultant at KGH Practice is a Member of 3Sixty Care Ltd Federation

Direct

Direct

Direct

Direct

Current

Current

Current

Current


Dr Nathan Spencer

GP Governing Body Member

Partner at Great Oakley Medical Centre Practice is a Member of 3Sixty Care Ltd Federation

Direct

Direct

Current

Current

Will declare the interest and manage in line with appropriate policy Will declare the interest and manage in line with appropriate policy

4





Fina

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Non

-fina

ncia

l in

tere

st

Non

-fina

ncia

l pe

rson

al

inte

rest

Direct or Indirect?

From To

Dr Sanjay Gadhia

GP Governing Body Member

Partner at Lakeside Surgery Director of Gadhia Healthcare Ltd Shareholder Lakeside + Ltd Honorary contract holder at Kettering General Hospital Occasional presenting at education meetings/session by Pharmaceutical Companies

Direct

Direct

Direct

Direct

Direct

Current

Current

Current

Current

Current

Will declare the interest and manage in line with appropriate policy Will declare the interest and manage in line with appropriate policy Will declare the interest and manage in line with appropriate policy Will declare the interest and manage in line with appropriate policy Will declare the interest and manage in line with appropriate policy

5





Fina

ncia

l In

tere

st

Non

-fina

ncia

l in

tere

st

Non

-fina

ncia

l pe

rson

al

inte

rest

Direct or Indirect?

From To

Locum shift at Urgent Care Centre Wife employed as physiotherapist at Nuffield Hospital

Direct

Indirect

Current

Current


Dr Sebastian Hendricks

Secondary Care Consultant

Owner and Director at FixEar Ltd, wife is also a Director Consultant at Royal Free London NHS FT and University College London Hospitals NHS FT Thomson Screening Children’s Hearing Screening Service

Direct

Direct

Direct

Current

Current

Current

Will declare the interest and manage in line with appropriate policy Will declare the interest and manage in line with appropriate policy Will declare the interest and manage in line with appropriate policy

6





Fina

ncia

l In

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st

Non

-fina

ncia

l in

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Non

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rson

al

inte

rest

Direct or Indirect?

From To

Fellow of the Royal College of Physicians (London) Fellow of the Royal College of Paediatric & Child Health Member for the British Association of Audiovestibular Physicians Member of the British Society of Audiology Member of the International Association of Physicians in Audiology

Direct

Direct

Direct

Direct

Direct

Current

Current

Current

Current

Current


7





Fina

ncia

l In

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Non

-fina

ncia

l in

tere

st

Non

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ncia

l pe

rson

al

inte

rest

Direct or Indirect?

From To

Member of Doctors for the NHS Member of the British Medical Association

Direct

Direct

Current

Current


Andrew Hammond

Lay Member for Governance (Audit Chair)

Director of Instructus Director of CQM Training and Consulting, Director Springboard Consultancy – provide some training to the NHS Wife registered podiatrist undertaking work privately in Northampton

Direct

Direct

Current

Current


8





Fina

ncia

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Non

-fina

ncia

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Non

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rson

al

inte

rest

Direct or Indirect?

From To

Tansi Harper Lay Member for Patient Participation Engagement

Non-Executive Director Richmond Fellowship Board STP Board Chair

Direct

Direct

Current

Current


Helen Storer Independent Lay Member

Employed as Integrated Health & Social Care Manager, Nottingham City Care Partnership Registered Dietitian, Member of the British Dietetic Association

Direct

Direct

Current

Current


9





Fina

ncia

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Non

-fina

ncia

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tere

st

Non

-fina

ncia

l pe

rson

al

inte

rest

Direct or Indirect?

From To

Practice Delivery Leads (PDLs) Dr Satish Kumar Practice Delivery Lead Partner in Studfall

Partnership LMC Member Practice holds shares in 3sixty Care Ltd Holds shares in private limited company – No business with the CCG. No conflict identified with CCG activities Ongoing research projects done by the practice. None likely to conflict with CCG activities. LMC member GP appraiser

Direct

Direct

Direct

Direct

Current

Current

Current

Current


10





Fina

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Non

-fina

ncia

l in

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Non

-fina

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l pe

rson

al

inte

rest

Direct or Indirect?

From To

Spouse is partner at the Studfall Partnership. Spouse is director of private limited company. No business with the CCG. No conflict identified with CCG activities. Spouse is partner at practice holding shares in 3 Sixty Care Limited. Spouse can be associated with ongoing research projects done by the practice. None likely to conflict with CCG activities.

Direct

Direct

Direct

Direct

Current

Current

Current

Current


11





Fina

ncia

l In

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Non

-fina

ncia

l in

tere

st

Non

-fina

ncia

l pe

rson

al

inte

rest

Direct or Indirect?

From To

Dr Lipi Pradhan Practice Delivery Lead Partner at Great Oakley Medical Centre Practice is a member of GP Federation 3sixty Care Ltd

Direct

Direct

Current

Current


Dr Roman Sumira

Practice Delivery Lead Practice is a member of GP Federation 3sixty Care Ltd Shareholder with GSK and Astra Zeneca Shareholder with BT

Direct

Direct

Direct

Current

Current

Current


12





Fina

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Non

-fina

ncia

l in

tere

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Non

-fina

ncia

l pe

rson

al

inte

rest

Direct or Indirect?

From To

Dr Emily Winters

Practice Delivery Lead GP at Woodsend Medical Centre

Direct Current Will declare the interest and manage in line with appropriate policy

Dr Tony Penney Practice Delivery Lead GP Partner and Chief Operations Officer, Lakeside Healthcare

Shareholder Lakeside+ (not more than 5%)

Chief Clinical Information Officer, NEL CSU

Direct

Direct

Direct

Current

Current

Current


Vanessa Hurling Deputy Practice Delivery Lead

None to declare N/A N/A N/A N/A N/A N/A

13





Fina

ncia

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st

Non

-fina

ncia

l in

tere

st

Non

-fina

ncia

l pe

rson

al

inte

rest

Direct or Indirect?

From To

Nicki Adams Deputy Practice Delivery Lead

Managing Partner, Woodsend Medical Centre

Director of 3Sixty

√ √

N/A N/A Direct

Direct

Current

Current


Dr Shalini Singh Deputy Practice Delivery Lead

Partner Lakeside Surgery

Non-Executive within Lakeside Healthcare

√

√

Direct

Direct

Current

Current


Kay Taylor Deputy Practice Delivery Lead

Practice Manager Great Oakley

N/A N/A N/A N/A N/A N/A

14





Fina

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-fina

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l in

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Non

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rson

al

inte

rest

Direct or Indirect?

From To

Anna Lewis Deputy Practice Delivery Lead

Practice Manager Studfall Medical Centre

N/A N/A N/A N/A N/A N/A

Other including staff, Governing Body member attendees and Committee attendees Jane Kettlewell Interim Deputy Chief

Finance Officer Employed by ArdenGEM Commissioning Support Unit


Bie Grobet Assistant Director of Commissioning Development

Reviewer for West Midlands Quality Review Service


David Cole Head of Programme Management Office


Emma Follis Corporate Services & Governance Manager


Lucy Douglas-Green

Director of Public Health & Well-Being, NCC

Husband is a Director at University Hospitals of Leicester

Indirect Current Will declare the interest and manage in line with appropriate policy

Sarah Newall Independent Contractor - Communications Lead, Arch Communications


15





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-fina

ncia

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Non

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rson

al

inte

rest

Direct or Indirect?

From To

Ric Barnard Member of PPEA Committee

Board Member of Healthwatch Northamptonshire Chair of Lakeside Practice Patient Participation Group Chair of Corby Practice Patient Participation Group

Direct

Direct

Direct

Current

Current

Current


Julie Ashby-Ellis Designated Nurse for Safeguarding children and looked after children, Nene and Corby CCGs


Darren McGregor

Deputy Head of Urgent Care, NHS 111 Clinical Lead, Nene and Corby CCGs


Richard Jarvis Urgent Care Planning and EPRR Manager, Nene and Corby CCGs

Director of Raypat Property Limited

Direct Current

16





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Non

-fina

ncia

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st

Non

-fina

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l pe

rson

al

inte

rest

Direct or Indirect?

From To

Kristian Nicol Quality Improvement Manager, Nene and Corby CCGs

Spouse of Advance Nurse Practitioner Intermediate Care Team NHFT


Anne Holland Business Analyst, Nene and Corby CCGs


Cath Ratcliffe Quality Improvement Manager, Nene and Corby CCGs


Julie Lemmy Deputy Director Primary Care, Nene and Corby CCGs

Brigstock Parish Councillor

N/A N/A N/A

Georgette Fitzgerald

Designated Nurse Adult Safeguarding , Nene and Corby CCGs


Arti Chauhan Medicines Optimisation Pharmacist, Nene and Corby CCGs


17





Fina

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Non

-fina

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l in

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st

Non

-fina

ncia

l pe

rson

al

inte

rest

Direct or Indirect?

From To

Chris Murphy Senior Acute Contracts Manager, Nene and Corby CCGs


Helen Seddon Prescribing Advisor to Corby CCG

Medicines Management Consultant at Weavers Medical Centre and Huntingdon CCG


Matthew Spilsbury

Head of Performance, Nene and Corby CCGs


Helen Adams Children and Maternity Commissioning Manager, Nene and Corby CCGs


David Knight Senior Quality Improvement Manager, Nene and Corby CCGs


Lisa Riddaway Commissioning Manager, Integrated Commissioning Team, Nene and Corby CCGs


18





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Non

-fina

ncia

l in

tere

st

Non

-fina

ncia

l pe

rson

al

inte

rest

Direct or Indirect?

From To

Sarah Salter Head of Non Acute Contracts, Nene and Corby CCGs


Emma Clarke Senior Quality Improvement Manager, Nene and Corby CCGs


Catherine O’Rourke

Head of Integrated Commissioning, Nene and Corby CCGs


Sian Heale Children and Young People’s Commissioning Manager, Nene and Corby CCGs


Sharon Wright Interim Quality Improvement Manager, Nene and Corby CCGs


19





Fina

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Non

-fina

ncia

l in

tere

st

Non

-fina

ncia

l pe

rson

al

inte

rest

Direct or Indirect?

From To

Richard Bailey Head of System Transformation, Nene and Corby CCGs


Sue Freeman Commissioning Manager Learning Disabilities, Nene and Corby CCGs


Andrea Contini Resilience Officer, Nene and Corby CCGs


Neil Boughton Head of Non-Clinical Contracting and Procurement , Nene and Corby CCGs


Marianne Price Care Home Pharmacist, Nene and Corby CCGs


Linda Dunkley Commissioning Lead, Planned Care, Nene and Corby CCGs


20





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Non

-fina

ncia

l in

tere

st

Non

-fina

ncia

l pe

rson

al

inte

rest

Direct or Indirect?

From To

Denise Rickaby Senior Contracts Manager, Nene and Corby CCGs


Arshad Nana Head of Business Intelligence, Nene and Corby CCGs


Mark Darlow Deputy Director of Contracting and Procurement, Nene and Corby CCGs


Anne Maher Specialist Interface Pharmacist, Nene and Corby CCGs


Giles Owen Deputy Director of Prescribing and Medicines Management, Nene and Corby CCGs


21





Fina

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Non

-fina

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l in

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Non

-fina

ncia

l pe

rson

al

inte

rest

Direct or Indirect?

From To

Kate Longthorne

Patient Safety Lead, Nene and Corby CCGs


Dr James Findlay

Clinical Pathway Lead, Nene and Corby CCGs

25% ownership of Rushden Medical Centre building Clinical Pathways Advisor for DXS International PLC Council member of the National Association of Primary Care

Direct

Direct

Direct

Current

Current

Current


Alison Jamson Deputy Director of Quality, Corby and Nene CCGs


Gabriella O’Keeffe

Senior Quality Improvement Manager Corby and Nene CCGs


22





Fina

ncia

l In

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st

Non

-fina

ncia

l in

tere

st

Non

-fina

ncia

l pe

rson

al

inte

rest

Direct or Indirect?

From To

Jay Dobson Associate Director to the CEO and CFO Corby CCG


Tina Swain Head of Nursing and Safeguarding, Corby and Nene CCGs


Matt Youdale Independent Contractor Director and 90% owner ARCH Communications who provide communications and engagement services to the CCG Wife is Director and 10% owner ARCH Communications who provide communications and engagement services to the CCG

Direct

Direct

Current

Current



23





Fina

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Non

-fina

ncia

l in

tere

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Non

-fina

ncia

l pe

rson

al

inte

rest

Direct or Indirect?

From To

Robert Ward Senior Management Accountant, Hays Recruitment Agency

Wife is Finance Business Partner supporting Adult Social Care Services for NCC


Neil Horner Senior Management Accountant, Hays Recruitment Agency

Sister in law works as a Maxiofacial surgeon at Coventry and Warwick Hospital


Gwyn Roberts PPEA Committee member

Deputy CEO Northamptonshire Carers


Teresa Dobson

Chair of Healthwatch Northamptonshire

Director Process Chain Ltd – may provide occasional spot purchased independent advocacy services

Direct

Current


24





Fina

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Non

-fina

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l in

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Non

-fina

ncia

l pe

rson

al

inte

rest

Direct or Indirect?

From To

Caroline Richardson

Communications Consultant, ARCH Communications

Husband is Director of Process Chain Ltd Sessional worker at Northamptonshire Carers on their support line ½ day a week Lives near Kettering – occasional user of KGH and UCC. As is husband Husband is public governing for Kettering and Corby at Northamptonshire Healthcare Foundation Trust. None to declare

N/A

N/A

N/A

Indirect

Direct

Direct

Indirect

N/A

Current

Current

Current

Current

N/A

Will declare the interest and manage in line with appropriate policy Will declare the interest and manage in line with appropriate policy Will declare the interest and manage in line with appropriate policy Will declare the interest and manage in line with appropriate policy N/A

25





Fina

ncia

l In

tere

st

Non

-fina

ncia

l in

tere

st

Non

-fina

ncia

l pe

rson

al

inte

rest

Direct or Indirect?

From To

Kate (Cathryn) Holt

CEO Healthwatch Northamptonshire

CEO Connected Together CIC CEO/contract Manager Healthwatch Northamptonshire Trustee Autism Concern Represent public views and views of the Healthwatch Northamptonshire Board and Volunteers

Direct

Direct

Direct

Direct

Current

Current

Current

Current


Documents

PCCC Papers - 21...Dr Sanjay Gadhia GP Governing Body Member, NHS Corby CCG Bie Grobet Assistant Director of Commissioning Development Andrew Hammond Lay Member, NHS Corby CCG Dr Sebastian