Agenda Item: 3.6 REPORT TO: GOVERNING BODY MEETING

Agenda Item: 3.6
REPORT TO:
MEETING DATE:
REPORT TITLE:
SUMMARY OF REPORT:
GOVERNING BODY
23 March 2015
Sub Committee Summary
This report summarises each Sub-Committee meeting of
the Governing Body. Full copies of all minutes are available
from the Board Secretary on request.
The report identifies:
 Items requiring approval from the Governing Body
 Advises on delegated decisions taken
 Reports on key decisions
 Highlights items of particular interest or potential risk.
REPORT RECOMMENDATIONS:
FINANCIAL IMPLICATIONS:
REPORT CATEGORY:
AUTHOR:
PRESENTED BY:
OTHER COMMITTEES/
GROUPS CONSULTED:
EQUALITY ANALYSIS (EA)
RISKS:
CONFLICT OF INTEREST:
PATIENT ENGAGEMENT:
PRIVACY STATUS OF THE
REPORT:
a.
Ratify and endorse the delegated decisions taken by
the Sub Committees;
b. Receive the monitoring information on key decisions;
c. Be advised of the items of particular interest or risk;
d. Receive the Stakeholder Committee minutes for
information.
None
Tick
Formally Receipt
√
Action the recommendations outlined in the report.
Debate the content of the report
Receive the report for information
Anne MacLeod
Board Administration Manager
Report supported & approved by your Senior
Y
Lead
Angela Brown
Director of Corporate Business
Content discussed at Local Delivery Group and Quality &
Safety Committee.
N
Has an EA been completed in respect of this report?
N
Have any risks been identified / assessed?
N
Is there a conflict of interest associated with this
report?
Y
Has there been any patient engagement associated
with this report?
Y
Can the document be shared?
Which Strategic Objective does the report relate to
1
2
3
4
Commission the right services for patients to be seen at the right time, in the right place,
by the right professional.
Optimise appropriate use of resources and remove inefficiencies.
Improve access, quality and choice of service provision within Primary Care
Work with colleagues from Secondary Care and Local Authorities to develop seamless
care pathways
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Tick
Agenda Item: 3.6
NHS EL CCG Governing Body
23 March 2015
SUB COMMITTEE SUMMARY OF BUSINESS
1.
INTRODUCTION
1.1
This report summarises each sub-committee of the Governing Body and identifies:
 Items requiring approval from the Governing Body
 Advises on delegated decisions taken
 Reports on key decisions
 Highlights items of particular interest or potential risk.
Full copies of the minutes are available from the Board Secretary on request.
2.
SUB COMMITTEES
2.1
Audit Committee:
The minutes of the 9 February 2015 are attached in full at Appendix A.
2.2
Local Delivery Group: 19 January & 16 February 2015
Chair : Dr Mike Ions
The Group discussed issues relating to the following areas:
a. Items requiring approval from the Governing Body
b. Delegated decisions taken, requiring ratification by the Governing Body
c. Reporting on key decisions

Transforming Care – Winterbourne Concordat
The Transforming Care Programme had been revised following a DoH review
undertaken by Stephen Bubb and the report summarised the actions required
by CCGs and Local Authorities to address the recommendations in the Bubb
report. A significant amount of work was required to ensure the
recommendations are monitored and managed and additional capacity would
be provided to manage this workstream for the organisation.

Pennine Lancashire Cases for Change Programme Update
The performance tracker for each workstream was presented and members
discussed possible changes to the domains to provide assurance and
likelihood of success of the project.

Finance & Planning Update
Members received an update on the financial position for the nine month
period to 31 December 2014 which confirmed that all statutory targets would
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be achieved in the financial year. Key financial issues were considered in
terms of planning for 2015/16, noting that the final Planning return was due for
submission by 27 February.
The Month 10 financial report was presented to the February meeting which
outlined significant overtrade with ELHT, the prescribing forecast was in line
with previous assumptions and Individual Patient Activity reports suggested
significant over-performance.

QIPP Delivery
The status report identified that all schemes have achieved planned savings to
date, bringing the level of target savings achieved to 83% in Month 10.

Navigation Hub
The Navigation Hub is a scheme to support system resilience and the
implementation of the Better Care Fund Plan objectives with partners across
the health & social care system, providing a key interface with current services
in three specific areas:
 Integrated Discharge & Discharge to Assess
 Intensive Home Support
 Clinical Navigation Hub including a Director of Services
Phase 2 of the service looks to further develop the Directory of Services to
ensure it is robust and resilient and develop marketing material to promote the
service.
Further information was presented to the February meeting to enable a
decision on the commissioning of the phased incremental increases to the
service including elements of finance, key performance indicators and the
evaluation process to understand the impact of the pilot. Members agreed to
support the Directory of Services and Phase 1 to March 2016, using the
service as a single point of access referral parallel to ICAT and to see how
BwD proceed with Phase 2.

EMIS Web for Hospices
Members were asked to consider a funding request to update Hospice clinical
systems to EMIS web in respect of the East Lancashire, Pendleside and
Rossendale Hospices. Members agreed to support Option 2, providing 5 year
funding of EMIS web using non recurrent funding.

GP in Urgent Care Evaluation
Members received an evaluation of the GP in Urgent Care Service. It was
recognised that the flow and number of patients has increased more quickly at
the GP in UCC than the reduction seen within A&E. Following the success of
the Challenge Fund Bids submitted by both CCGs, commissioners would
continue with the Pilot for a further 12months whilst procurement processes
were put in place for the Primary Care Front End model bid. It was agreed that
a number of changes were required to the pilot going forward in relation to the
triage model, IT, shared processes between provider and the deflection target.

Hospital Alcohol Liaison Service
Members received an evaluation of the enhanced Hospital Alcohol Liaison
Service (HALS) pilot, which commenced in July 2013 and was due to expire on
31 March 2015. A recommendation was made for continuation of the pilot in
its current form until March 2016 and reissue commissioning intentions in
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September 2015 moving towards the redesign of a single PL Integrated
Specification, linking HALS, mental health and Police Liaison.
Members agreed to extend the pilot for 12 months, with a request to check the
hours of the service to ensure the service is available when needed.

NHS 111
NW CCGs supported the proposal for a single procurement process for the
NHS 111 service in June 2014 and the Invitation to Tender (ITT) was issued to
the market place in October 2014. The final stages of the evaluation period
have now been reached and the NHS 111 Programme Board were in a
position to request final sign off of the recommendations.
Members supported the recommendations which would be ratified by the
Governing Body at the February meeting.

Re-Commissioning of Locally Commissioned Medical Services
The report outlined the review of Locally Commissioned Medical Services
undertaken by EL CCG with a proposal for the re-commissioning of these
services during 2015/16 and beyond. Members accepted the
recommendations which would be presented to the Remuneration Committee
for approval.

Dermatology Procurement Options
The CCG had embarked upon a programme of service re-design for
Dermatology Services with ELHT as the existing main provider.
Simultaneously the existing community Dermatology service contract with
About Health ended on 31 December 2014 and an interim extension was in
place to ensure continuity of service. It was recognised that re-design work is
not progressing in line with anticipated timescales and a number of options
were being re-visited.

NHS England Consultation – Prioritising Specialised Services
Following NHS E Consultation on prioritizing specialised services, it was
anticipated that elements of specialised services coming back to the CCG
would be Wheelchairs and Neurology Outpatients.

Re-Design of Diabetes Services in East Lancashire
Members received proposals for a redesigned primary care model for Diabetes
Services across EL. The model is designed to improve outcomes and quality
of life for patients with diabetes by providing a high quality service to patients
closer to home. The model is aimed at building a robust infrastructure to
ensure a sustainable and resilient service, while at the same time allowing
secondary care to concentrate on more complex patients. The proposed
model was well received and would be presented to the Remuneration
Committee for approval, prior to submission of the final report to the Governing
Body following the General Election.

Prime Ministers Challenge Fund Sustainability
Members received a copy of the bid submitted to the Challenge Fund by the
EL Federation regarding additional GP access at ELHT. The Area Team were
considering the bids and it was emphasised that the CCG were considering
the totality of primary care in terms of the re-design.
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
Public Health Budgets – Policy & Practice Guidance
Members endorsed the revised policy and practice guidance developed to
ensure the consistent and transparent delivery of Personal Health Budgets for
eligible persons and made recommendation to the Governing Body for
ratification.
d. Items of particular interest or risk : NONE
2.3
Quality & Safety Committee: 14 January & 18 February 2015
Chair – Michelle Pilling
The Group discussed issues relating to the following areas:
a. Items requiring approval from the Governing Body : NONE
b. Delegated decisions requiring ratification by the Governing Body : NONE
c. Reporting on Key Decisions

Calderstones Partnership Foundation Trust
A Quality Summit was held in December 2014 following the publication of the
CQC report. The report identified areas of good practice and highlighted areas
where improvement was required. Calderstones had responded with a
detailed action plan and it was agreed to establish a Quality Improvement
Board to support the organisation to move forward, chaired by the Chief Nurse
of NHS E Lancashire & Greater Manchester, with senior representation from
all stakeholders. A Quality Improvement Plan was also being developed,
using the same methodology as used for ELHT post Keogh. The Chair
congratulated the teams on the work and support provided to Calderstones
and was encouraged that a system wide mechanism was in place to offer
support to patients.

Integrated Business Report
Members received a comprehensive report and attention was drawn to key
areas in respect of contracting and performance, particularly relating to 36
week waiting times, A&E performance, Ambulance handover and Stroke
admissions and the work ongoing to address these areas.

Serious Incident Review Group
The Group had received and scrutinised a number of reports from Provider
organisations and recommendations outlined in the report were approved.

HCAI Update
The report provided an update on the current position in terms of MRSA, CDiff,
MSSA and EColi infections allocated to ELCCG. Public Health England were
working to support social care providers on how to manage outbreaks of
presumed Norovirus. ELHT had their own policy in place regarding MRSA
screening and a thematic review was ongoing, working towards involvement
with primary care.

Reconciliation of CQUIN – Q2 Update
Members received an updated report providing a summary of requirements,
evidence submitted and recommendations for both ELHT and Calderstones.
Members supported the recommendations outlined in the report.
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
Safeguarding Update
The Safeguarding Dashboard outlined current activity together with information
regarding the Channel Programme. Details of the Prevent agenda and
counter terrorism strategy were also provided, noting that a Bill was
progressing through Government to strengthen the partnership arrangements.
Responsibility would fall to the CCG going forward and it was agreed that
primary care needs to be involved in this work.

Safeguarding Annual Report
The revised Annual Report was presented for formal receipt following
discussion at the November meeting when a number of amendments were
suggested. A user friendly version would also be developed and included on
the CCG website.

Policy for Approval
The Claims Management Policy had been updated to ensure the CCG has a
robust system for the management of claims and that clearer procedures are
in place for staff.
The policy was approved, subject to clarification on the
appropriateness of including Duty of Candour in the policy. This was
subsequently included.

CQC Intelligence Monitoring Data on GP Practices
The report provided a summary of the CQC intelligence monitoring data and
bandings in relation to GP Practices in EL, which had been published on the
CQC website. The report was well received and emphasised the need to
ensure Practices categorised as Band 1 are supported when under review.

Fundamental Standards
Following the publication of the Francis Report, further legislation had been
published introducing fundamental standards for all current health and social
care providers from October 2014 and for all providers registered with the
CQC from April 2015. These are intended to help improve the quality of care
and transparency of providers, ensuring that those responsible for poor care
can be held to account.

Calderstones – Friends & Family Test
The Friends & Family Test requires monthly reporting on numbers of
responses from both staff and patients. Due to the static nature of the clients
based within Calderstones and their different levels of understanding, it was
agreed to change the frequency of reporting to quarterly.
18 February 2015 : This was a Virtual Meeting approach due to a clash with
other meetings and Members were asked to consider key documents and
support the recommendations:

Serious Incident Review Group Recommendations
The Group had received and scrutinised a number of reports from Provider
organisations and recommendations outlined in the report were approved.

2014/15 CQUIN Reconciliation Q3 for EL CCG Hosted Contracts
The report set out the EL CCG hosted provider performance against each
indicator of their 2014/15 CQUIN schemes for Quarter 3. Recommendations
in relation to the release of payment against each indicator were considered
and approved.
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
2015/16 CQUIN Development Position
The report set out the current position in relation to the development of local
CQUIN indicators and quality requirements for EL CCG hosted provider
contracts. ELHT, Calderstones and BMI Hospitals were at different stages of
discussion and agreement, details of which were outlined in the report.

Safeguarding Update
The report summarised the outcome of a meeting with ELHT to review their
safeguarding arrangements, in line with the Safeguarding Standards. Areas
for development were outlined together with progress made. There are plans
in place for improvement and the CCG will continue to monitor progress.

Duty of Candour – Improving Patient Safety & Openness
The DoH issued a consultation on how NHS organisations can be incentivised
to implement the Duty of Candour and how the NHS Litigation Authority might
be given a role in its enforcement. Members provided feedback to enable a
CCG response to the consultation to be submitted.

Integrated Business Report
The comprehensive report provided key messages in terms of contracts,
performance and quality.

Risk Management Report
The report outlined the work ongoing across the organisation in relation to risk
management. Each risk is owned by a senior manager and members were
assured that all risks are being actioned and mitigated.
d. Items of Particular Interest of Risk : NONE
2.4
Locality Steering Group Summaries : Chair – GP Clinical Leads
Locality summaries are attached at Appendix B.
3.
STAKEHOLDER COMMITTEES
The following Stakeholder Committee minutes are attached at Appendix C for information.
 Pennine Lancashire Clinical Transformation Board : 7 January & 4 February 2015
 East Lancashire Health & Wellbeing Partnership : 4 February 2015
 CCG Network : 18 December 2014 & 29 January 2015
4.
RECOMMENDATIONS
Members are asked to:
a. Ratify and endorse the delegated decisions taken by the Sub Committees;
b. Receive the monitoring information on key decisions;
c. Be advised of the items of particular interest or risk;
d. Receive the Stakeholder Committee minutes for information.
ANGELA BROWN
Director of Corporate Business
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