Minutes of Executive Health and Care Commissioning Committee
held in the Boardroom, Building 4, Spencer Close,
St Margaret’s Hospital, Epping
on Thursday 5th February 2015
Present:
Dr Rob Gerlis
Clare Morris
Chris Martin
Toni Coles
Dr Christine Moss
Peter Wightman
Dr Miranda Roberts
Dr Susan Humphrey
Dr David Tideswell
Dr Naveed Akhtar
Dr Amik Aneja
CCG Chair (Chair)
Chief Officer
Integrated Commissioning Director
(West)
Director of Transformation
Clinical Director
Director of Primary Care and Localities
GP Clinical Lead
GP Clinical Lead
GP Clinical Lead
GP Clinical Lead
GP Clinical Lead
In attendance:
Howard Martin
Kerry Franklin
Kirsty O’Callaghan
Frances Barnes
Mark Balaam
Jacquie Matthews
Deputy Director of Finance, Contracting
and Performance (item.51/15)
Associate Director of Governance and
Corporate Services
Head of Transformation Vulnerable
People (item.44/15)
Head of Programme Management (item
47/15)
Assistant Director of Contracts and
Performance (item.53/15)
Minute taker
Apologies:
Maggie Pacini
Dr Sanjeev Rana
Dr Kamal Bishai
Dean Westcott
Jane Kinniburgh
Consultant in Public Health
GP Clinical Lead
CCG Vice Chair
Director of Finance, Contracting and
Performance
Director of Nursing and Quality
39/15 Declarations of Interest
None advised.
40/15 Register of interests
It was reported that the CCG’s constitution (8.3) sets out the need to maintain a register of
interests for members of the Board and committees. The register of interest of the Executive
Health and Care Commissioning Committee will be publically available and placed on the
CCG’s website. Each committee will receive a register of interest relevant to the committee
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membership for advising of any changes to those interests declared. Members who had not
completed the declaration of interests for the register were asked to complete and return to
Danielle Owens.
The Executive Health and Care Commissioning Committee noted the above and those
present confirmed the accuracy of the information recorded.
41/15 Minutes of the meeting of the West Essex Executive Health and Care
Commissioning Committee on 15th January 2015
The minutes were agreed as a true and accurate record and signed by the Chair subject to:
31/15 should read ‘Adults with Learning Disabilities’
42/15 Action Log and matters arising from the minutes of the last meeting (not
covered by the agenda)
19/15 Procurement Training – KF reported that this would be provided at the Executive
Health and Care Commissioning Committee on the 5th March 2015.
29/15 Hospice at Home Night Care Business Case –This would be presented at the
Executive Health and Care Commissioning Committee in March 2015.
34/15 Prevention Strategy – The members were asked to read the strategy and respond with
any comments to Maggie Pacini.
Action: All
30/15 Reorganisation of Hyper Acute Stroke Services at PAH – CM reported that two Stroke
Consultants at PAH were stepping aside so these posts would be included in the
reorganisation of HASU services at PAH.
37/15 Challenge Fund Bid – It was noted that this has been submitted by Stellar on behalf of
the CCG.
43/15 Chairman’s action
None reported.
44/15 Essex Carers Strategy
Helen Gilbert from ECC reported on the Integrated Carers Strategy developed in partnership
with ECC and Carers in West Essex. It was noted that the CCG is a member of the Carers
Partnership Group and outcomes and principles have been agreed. The members were
asked to comment on the strategy and Helen Gilbert will feed the comments back as part of
the consultation. Comments were as followed:
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The respite element is not to be lost from the strategy.
Personal health budgets should be recognised.
The action plan should be strengthened.
Action: Kirsty O’Callaghan/Helen Gilbert
Local needs should be included.
Carers confidentiality issues should be resolved.
Once the carers have finished their role they should have support and be reintegrated.
An equality impact assessment was required to inform the strategy.
The final strategy will go to the Board for noting and then be signed off by the Health and
Wellbeing Board at the end of March 2015.
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The Executive Health and Care Commissioning Committee approved the strategy with the
changes that were raised
45/15 Essex Acute Service Review update
Clare Morris reported that the Essex Acute Service review outlines the revised approach to
securing sustainability in acute services and associated governance following feedback from
CCG and Trust Boards on the original Acute Services Review proposal. It was highlighted
that the acute services review has a revised scope and will be focusing on clinical pathways.
It was noted that Christine Moss asked if we should join the cancer parts of the Service
Review or remain focusing our Service Review on London Cancer or do both. It was agreed
that this would be discussed further.
Action: Clare Morris/ Christine Moss
The Executive Health and Care Commissioning Committee noted the above
46/15 Operational Plan 2015/16
Kerry Franklin reported on the development of the Operational Plan. The time line for the
submission of the first draft of the Operational Plan has been brought forward to the 13th
February by the East Anglia Area Team who have built in a review time and feedback prior to
the final submission of the first draft on the 27th February. It was agreed that the
Transformational Programmes within the plan would be circulated to members of the
committee. This will enable clinical leads to have an oversight and would enable input to the
plan.
Action: Fran Barnes
The Executive Health and Care Commissioning Committee noted the above
47/15 Transformation and Productivity and efficiency plans
Toni Coles reported on the Transformation and Productivity and Efficiency plans and sought
input on the clinical areas from the members of the Executive Health and Care
Commissioning committee. The two transformation plans discussed were Mental Health and
Frailty. All members were asked to review each Transformation programme and all
comments/feedback to be sent to Toni Coles early next week. A copy of all the
Transformational Plans were provided to the members.
Action: All
48/15 Integrated Care Organisation
Clare Morris reported that Boston Consulting Group were working on three key pieces of
work – a business case to support the ICO concept, a first cut of financial modelling data to
provide analysis for the business case and population health modelling. A Programme
Executive Working Group has been set up and is meeting weekly, this is to drive the process
and shape the outcomes. A Professional Leaders Group, with clinicians in attendance will
lead the clinical and professional engagement and develop recommendations for pathway
changes. All providers are attending with more meetings planned in the next couple of
weeks.
As part of the national planning guidance, there has been a call for systems to be put forward
as ‘vanguard’ systems in implementation of the 5 year forward plan models of care. A bid is
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being submitted Monday 9th February 2015 and this is on behalf of all the partner
organisations involved in the integrated care programme in west Essex. Communications
and stakeholder support is being provided by Wendy Smith. A briefing paper is being
developed and this will be circulated to all stakeholders and will be communicated at the next
GP shutdown.
Co-creating new models of care was discussed and multispecialty community providers
(MCPs) and integrated primary and acute care systems (PACS) were explained in more
detail. National guidance will be circulated.
Action: Clare Morris
49/15 Transformation programme evaluation process
Frances Barnes reported on the time line for evaluations of transformational projects. It was
noted that the new evaluation process is being communicated to staff in a lite-bite session to
be held on the 11th February 2015. This will be facilitated by Maggie Pacini. A time table of all
current and developing schemes has been consolidated to provide the Executive with a time
line of when evaluations will be brought for sign off. The time scale for evaluation of each
scheme may be different, depending on the size, significance, availability of data to evaluate.
This may also vary as it currently reflects expected start dates which may move as
development of schemes progresses.
The Executive Health and Care Commissioning Committee noted the above
50/15 Paediatric Business case
Chris Martin reported on the update of the paediatric business case. Following the 14/15 high
impact pathways project recommendation from two local audits and in preparation for 16/17
the business case has made a recommendation to recruit two additional paediatric clinical
posts, one advanced nurse practitioner to work on the front door of PAH to mirror the winter
14/15 emergency department model as per the System Resilience Group sign off. The
second post to compliment the first is an additional specialist children’s community nurse.
The additional resource in the community will mean that activity can be moved from PAH into
the community. Discharge management will also be improved by the additional capacity,
allowing the community children’s nurses to have more of a presence on the ward and
making decisions for when children are ready to be discharged. An additional 10k for the
recruitment of two community children’s nurses was outlined in the full business case.
The Executive Health and Care Commissioning Committee approved the above.
51/15 Financial Recovery Plan & Performance Recovery Plan
Howard Martin reported on the following:
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The CCG’s “control total” is to deliver a surplus of £3.299m.
The CCG has notified NHSE that it is unlikely to achieve the control total surplus in
2014/15, and that a £1.89m surplus is more likely.
Achievement of a £1.89m surplus assumes 100% delivery of £4.81m of additional
measures detailed in the Financial Recovery Plan (FRP).
The CCG has been notified of a return of £0.7m for slippage on a nationally held
contingency for CHC redress. This increases the likely target to a £2.6m surplus.
The CCG will still be aiming to achieving its control total surplus in line with NHSE
expectations.
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Key risks:
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Prescribing forecast moved adversely in the month 10 reports by £500k
Barts Health 2013/14 - still in dispute. Letter was received from Barts proposing
that the Trust and CCG submit their respective cases for the 2013/14 position to an
independent consultant to provide a binding mediation. MB will seek legal advice
and feedback before FRB follow up meeting on Monday 9th February 2015.
PAH 2014/15 –mediation paper has been sent. CCG will withhold RTT funding until
evidence is received that the backlog is cleared.
Property Co – Large proportion of the overcharge appears to be related to underbilling of estates cost to SEPT – CCG formally disputed this charge. CCG not liable
for the new VAT charge of £0.334m.
The Executive Health and Care Commissioning Committee noted the above.
52/15 Performance Recovery Plan update
Martin Howard reported on the following:
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Referral to Treatment (RTT) – PAH not reporting
Cancer – still 2nd best in Essex with 62 day standard – 8.3% and 62 day Screening
standard – 84.2%
Dementia – inaccurate data through acute coding.
The Executive Health and Care Commissioning Committee noted the above.
53/15 Contracting 15/16 update
Mark Balaam reported on the progress of the 2015/16 contract negotiations.
Key Issues:
 Urgent Care block agreement to mitigate system risk in 2015/16 – need early
decision from PAH and SEPT on principle of the block arrangement so detailed
negotiations can begin.
 SEPT: MSK Physiotherapy service is not meeting the 2014./15 contract waiting time
target and SEPT maintain additional funding is required to allow the target to be met.
 NEPT: Agreeing funding level will be the biggest challenge with the mental health
contract.
 East of England Ambulance Service: EEAST are requesting a 3 year contract.
 Addenbrookes: Implementation of new EPR is the biggest risk within this contract.
 Barts: The Trust maintains we should have an NCA relationship in 2015/16.
2015/16 contract documentation has not yet been published which significantly reduces the
time available to compile the finished contracts.
The Executive Health and Care Commissioning Committee noted the above.
54/15 Procurement update
Mark Balaam reported on the procurement update. It was noted that the PCPT and NonUrgent PTS tender evaluations was presented to the CCG Board on the 29th January 2015
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and these were approved so the successful bidders will be informed. It was noted that there
is a 10 day standstill which is due to end on the 9th February 2015.
The Executive Health and Care Commissioning Committee noted the above.
55/15 Items for Practice Membership meeting
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PCPT update
Integrated Business Case
56/15 Programme Board Minutes
The Executive Health and Care Committee noted the minutes below:
a.
b.
c.
d.
e.
Cancer Board
Working Age Adults
MSK
Urgent Care
Children, Young People and Maternity
Any other business
57/15 Anglia Ruskin University visit
Rob Gerlis reported on the recent meeting with Prof. Patrick Geoghegan at the Anglia Ruskin
University. The University is involved in research and would like to get more involved with
Primary Care. It was noted that similar organisations had contacted the CCG and it was
agreed that more information would be gathered. It was suggested that further discussion
could take place on this at the 11th March Board Development Day – KF agreed to explore
with CM.
Action:Kerry Franklin
Date & time of next meeting
As there were a number of apologies for the 19th February it was agreed not to proceed with
this meeting and TC and KF would review the agenda for any decision making requirements.
Action Toni Coles and Kerry Franklin
The next meeting will be held on Thursday 5th March 2015 at 2pm in the Boardroom,
Spencer Close, St Margaret’s Hospital, Epping
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