Chorley and South Ribble CCG
Greater Preston CCG
Delegated Commissioning Committee
Date of meeting
5th April 2017
Title of paper
Process for informing the Delegated Commissioning Committee of
GP Practice Contractual breaches
Presented by
Donna Roberts
Author
Brenda Vernon
Clinical lead
Dr Richard Kelsall
Confidential
No
Purpose of the paper
The purpose of this report is to seek approval from the Delegated Commissioning
Committee for the proposed process for action to be taken for enforcing contractual breach
notices following CQC visits and informing this committee.
Executive summary
At the previous Committee held on 8th February it was agreed that responsibility for future
breach notices should be delegated to officers to enact breaches to avoid time delay and
actions reported to DCC.
Recommendations
The Delegated Commissioning Committee is asked to approve the attached process for
all future required breaches notices.
Links to CCG Strategic Objectives
SO1 Improve Quality through more efficient, safer services which deliver a better
patient experience
SO2 Commission care so that it is integrated and ensures an appropriate balance
between in-hospital and out of hospital provision
SO3 Be an integral part of a financially sustainable health economy
SO4 Ensure patients are at the centre of the planning and management of their
own care and their voices are heard
☒
☐
☐
☒
GP contractual breach notices
Delegated commissioning committee
5 April 2017
Chorley and South Ribble CCG
Greater Preston CCG
Page 1 of 4
Chorley and South Ribble CCG
Greater Preston CCG
SO5
☒
Be seen as a well-run clinical commissioning group and the system leader
Governance and reporting
(list committees, groups or other bodies that have discussed this paper)
Meeting
Date
Outcome
Were any conflicts of interest identified at previous meetings
(mark X in the correct box below)
Yes
No
If conflicts of interest were identified what were these:
Implications
Quality/patient experience
implications?
(Potential) conflicts of interest?
Equality Impact Assessment?
Privacy Impact Assessment?
Are there any associated risks?
Are the risks on the CCG’s risk
register?
If yes, please include risk description
and reference number
Yes ☐
Yes
Yes
Yes
Yes
☐
☐
☐
☐
Yes ☐
No ☐
No
No
No
No
☐
☐
☐
☐
No ☐
N/A ☒
N/A
N/A
N/A
N/A
☒
☒
☒
☒
N/A ☒
Assurance
As part of the proposed process the CCG will work with NHS England and agree where a
contractual breach has taken place. This may be the result of a CQC inspection or an EDeclaration has been made.
Both the Quality & Performance Committee and the Delegated Commissioning Committee
will be informed of any breach notices issues to general practice.
GP contractual breach notices
Delegated commissioning committee
5 April 2017
Chorley and South Ribble CCG
Greater Preston CCG
Page 2 of 4
Chorley and South Ribble CCG
Greater Preston CCG
1.0
Background
1.1
A previous paper was presented on 8th February informing the Committee of
two individual practices who had been placed in special measures following
CQC inspection and consideration was sought on whether contractual breach
notices should be issued.
1.2
Further discussion took place and it was agreed that a process should be
developed and presented to the committee in relation to responsibility being
delegated to officers to enact breaches in order to avoid any time delay.
2.0
Current Position
2.1
CQC inspections across all practices other than new registrations had to have
taken place prior to the end of January 2017.
2.2
During 2016/17 24 inspections have taken place in Greater Preston with the
following ratings:
20 have been rated as Good overall
3 Inadequate (Special Measures)
2 Requires Improvement
Of the 20 overall good - 2 received a rating of outstanding in 1 domain and
2 received a rating of requires improvement in 1 domain.
2.3
5 further inspections will take place during 2017/18 for those practices with
new registrations.
2.4
During 2016/17 27 inspections took place in Chorley South Ribble with the
following ratings:
24 have been rated as Good overall
1 Inadequate (Special Measures)
2 Requires Improvement
Of the 24 overall Good – 2 received a rating of outstanding in 1 domain and 5
received a rating of requires improvement in 1 domain.
2.5
Both CCG’s and NHS England have been developing a process for quality
assuring all practices following CQC inspections. This will be expanded as
part of our ongoing responsibility for improving quality in primary care to
ensure identification of practices requiring support is ongoing and proactive to
enable earlier intervention as required.
2.6
Further to the previous recommendation the CCG have requested that the
breach notices presented to this committee on 8th February are issued.
3
Chorley and South Ribble CCG
Greater Preston CCG
Furthermore it is requested that NHS England review the summary of rating
outcomes from all other inspections and determine whether any contractual
breaches have taken place where CQC have highlighted that a Regulation
has not been met.
3.0
Future process
3.1
In order that any further contractual breach notices are not delayed, officers
will take responsibility for seeking advice on Regulation breaches from NHS
England and requesting immediate issue of contractual breaches where
identified.
3.2
Where a Regulation has not been met and it is confirmed that this constitutes
a Contractual breach, NHS England will issue a breach notice.
3.3
Both the Quality & Performance Committee and the Delegated
Commissioning Committee will be informed of any Contractual breach notices
that have been issued.
Brenda Vernon
Locality Development Manager
4