CWHHE CLINICAL COMMISSIONING GROUP COLLABORATIVE
Performance Committee
Thursday 18 June 2015, 10:30am-12.00pm
Room 5.4, 15 Marylebone Road
Members in attendance
Trevor Woolley (TW)
Lay member, Chair
Philip Young (PY)
Lay member, CWHHE CCGs
Nicola Burbidge (NB)
Chair, Hounslow CCG
Kathryn Magson (KM)
Deputy Chief Officer, CWHHE CCGs
David Tomlinson (DT)
Chief Financial Officer, CWHHE CCGs
Sue Jeffers (SJ)
Hammersmith & Fulham CCG, Managing Director
Louise Proctor (LP)
Deputy Managing Director, Hammersmith & Fulham CCG
Matthew Bazeley (MB)
Managing Director, Central London CCG
Janet Cree (JC)
Acting Managing Director, Hammersmith and Fulham CCG
James Eaton (JE)
Associate Director of Performance and Delivery, CWHHE CCGs
Elizabeth Ogunoye (EO)
Associate Director of Performance, NWL CCGs
John Riordan (JR)
Lay member, Ealing CCG
Ben Westmancott (BW)
Director of Compliance, CWHHE CCGs
Non-members in attendance
Riordan Hill (RH)
Governance Officer, CWHHE CCGs
Michael Roach (MR)
Clinical Improvement & Quality Assurance Manager, CWHHE
CCGs
Action
Business Items
1.
Welcome/apologies
1.1.
Apologies were received from Jonathan Webster, Ruth O’Hare and Alan
Hakim.
2.
Declaration of interests
2.1.
No interests were declared at the meeting beyond those identified
previously.
3.
Minutes from previous meetings
3.1
The minutes from 21 May were approved as an accurate record of the
previous meeting, subject to the following addition to [para no. etc]:
‘Providers will present back to the committee, updating on these actions on
a quarterly basis’.
CWHHE is a collaboration of Clinical Commissioning Groups: Central London, West London, Hammersmith & Fulham, Hounslow &
Ealing
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4.
Matters arising
4.1.
4.2 David Tomlinson to draft a letter to the DH to address the issues
pertaining to Property Services and report back to this committee.
David Tomlinson tabled a draft letter for the committee to review which
outlined the issues and how they needed to be resolved. As there were still
significant issues for all CCGs regarding the invoicing process, the
committee discussed the implications of withholding payment to Property
Services while the dispute was on-going. It was decided that, for the
moment, no such action would be taken until the issue had been raised
formally with NHSE. The letter would be sent once signed-off by Clare
Parker.
ACTION: David Tomlinson to quantify the extent of the unresolved
financial issues that pertain to Property Services and present
findings back to the committee, including a timeline for addressing
the issues.
(DT)
(DT)
ACTION: Place the Property Services issues on the assurance
agenda with NHSE.
4.2.
9.2 David Tomlinson to look at the process of escalating invoices
and consider any potential improvements that all 5 CCGs can
pursue.
Since this process had been brought in-house, the number of outstanding
invoices had reduced from 979 (£2.6m) in February to 127 (£0.35m) in
March.
Further work was being undertaken to improve the processes, including
the automatic approval of invoices under £50. Breac McLeod was leading
the process review.
Action closed.
5.
Performance report
5.1
Elizabeth Ogunoye introduced the item, highlighting the following
summaries:
- 18 Week Referral to Treatment (RTT) performance;
- A&E performance; and
- Cancer Performance.
Each is taken in turn below.
CWHHE is a collaboration of Clinical Commissioning Groups: Central London, West London, Hammersmith & Fulham, Hounslow &
Ealing
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5.2
18 weeks Referral to Treatment (RTT) performance:
a) the backlog at Imperial had reduced from 11,000 three months ago
to 4390 at the end of M1; however, this fell short of the 4,000
milestone and more work was required if the 2,500 target was to be
met. The trust had completed a plan to reduce the backlog and to
deliver RTT targets sustainably. A demand and capacity exercise
needed to be completed to inform that plan and work was
underway with the provider to ensure that this was done before the
assurance meeting with NHSE;
b) concerns were raised regarding London North West Healthcare’s
(LNWH) ability to deliver to target, with additional activity required
to meet all three standards. A trajectory had been put in place to
recover against the non-admitted target by end of Q1 and the
admitted target by Q2. Following the trajectory not being achieved
for Q1, work had been undertaken with the Trust to clarify what
could be delivered. It had been agreed across the patch to assess
what monitoring was in place and how this aligned to NHSE
requirements; and
c) West Middlesex University Hospital (WMUH) & Chelsea and
Westminster (CW) had met all three standards.
5.3
A&E performance;
a) A&E performance at Imperial had improved between M1 and M2. It
had been agreed that the Trust would achieve 95% by 16 June and
an action plan to take this forward had been put in place. The
Trust’s focus had moved to sustaining performance now its waiting
time targets were being met. Stress testing the system to ensure
that similar problems are not encountered later in the year were
being considered;
b) LNWH – Ealing Hospital had recovered its performance and was
meeting the 95% standard. Northwick Park had shown a slight
improvement but this was not sustained; action and resource
planning were required by the end of June;
c) WMUH had achieved the national standard for M2 with 95.0%; and
d) CW had achieved the national standard with 97.1%. The
committee discussed the A&E revamp, due to open in August. The
impact of this on the other sites needed to be monitored.
5.4
Cancer waits performance:
a) CW had achieved all the cancer waits standards;
b) LNWH had not achieved the 62 day standard, in alignment with
their trajectory.
c) ICHT had not achieved the screening standard. The Trust will
submit individual breach reports; and
d) WMUH had not achieve the screening and consultant upgrade
standards. The Trust will submit individual breach reports.
However, given the low volume, the Trust was expected to
recovery to achieve Q1 performance.
6.
IAFT deep dive Report
CWHHE is a collaboration of Clinical Commissioning Groups: Central London, West London, Hammersmith & Fulham, Hounslow &
Ealing
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6.1
Elizabeth Ogunoye introduced the item, highlighting:
a) IAPT access – target 3.75%;
b) IAPT recovery – target 50%;
c) 75% of patients had started treatment within 6 weeks of referral or
less; and
d) 95% waiting 18 weeks or less.
Each is taken in turn below.
6.2
IAPT Access;
a) CLCCG had achieved 0.78% against 1.25% monthly target; CNWL
Mental Health Trust’s under-performance in M1 was due to
referrals being brought forward to help achieve the Q4 target. A
joint action plan between CLCCG and the provider had been
implemented to increase referral rates. Matthew Bazeley advised
the committee that CLCCG had considered campaigns and was
speaking to GPs directly in a bid to increase referrals;
b) WLCCG had achieved 1.18% against the M1 target of 1.25%.
CNWL had sub-contracted the delivery of IAPT services to CLCH
and reported issues around staff turnover. CLCH had been asked
to see patients over M2 and M3 to recover the position;
c) ECCG had achieved 1.2% against M1 target of 1.25%. It was
reported that staff leave had resulted in a reduced capacity to triage
referrals;
d) HCCG had achieved 1.15% against the 1.25% monthly target; and.
under-performance had been attributed to a broken phone line at
Chiswick Health Centre resulting in some telephone assessments
being cancelled.
e) HFCCG had achieved 1.35% in M1.
6.3
ACTION: Elizabeth Ogunoye to investigate issue of a broken phone
line at Chiswick Health Centre and report back in July.
(EO)
CWHHE is a collaboration of Clinical Commissioning Groups: Central London, West London, Hammersmith & Fulham, Hounslow &
Ealing
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6.4
IAPT recovery (target: 50%):
a) CLCCG had achieved 41.1% at M12. At M1 15/16 CLCCG had
achieved 31.8%. The trust had reported complex caseloads and
transient populations as key contributors to under performance;
b) WLCCG had achieved 34.4% at M12. At M1 15/16, WLCCG had
achieved 34.4%. Staff capacity, complex caseloads and transient
populations had been identified at the key contributors to underperformance;
c) The WLMHT Ealing IAPT service had been the only team across
NWL to achieve the target at M12 - 50.6%. The target had been
consistently met between July 2014 and January 2015. However,
as the focus on IAPT access increased in Q4, there had been a
decline in performance in February and March. In M1 ECCG
achieved 47.2%;
d) Hounslow had achieved a year-to-date performance of 46.7%. The
trust had achieved 46.1% in M1. Root cause analysis of the
breaches will be undertaken and reported back to the committee;
and
e) HFCCG had met the IAPT recovery target since august 2014. For
M12 year-to-date the trust had achieved 49.5% and the trust
continued to perform well against the target, achieving 50% at M1.
6.5
Waiting times for IAPT had been met consistently across the patch apart
from the 6 week KPI in Hounslow which consistently fell beneath the 75%
target.
6.6
The committee discussed the nature of under-performance and the
following points were made:
a) the services are new and are still being established; and
b) Primary Care counsellors had previously not been able to report on
activity, and that had only been resolved in M1.
6.7
The committee discussed IAPT performance as a whole and its
disappointment that continued improvements had not been seen. The
committee questioned what action was needed to ensure all 5 CCGs meet
NHSE requirements.
6.8
ACTION: Elizabeth Ogunoye to compare the figures outlined in the
IAPT report with the latest London position and report back to
committee, with a view to discussing if inviting the Chief Executives
of each provider to present to the committee would be beneficial.
(EO)
ACTION: Kathryn Magson to raise the issue of how IAPT
underperformance can be escalated with the trusts with the SMT and
report back to this committee is July in an attempt to achieve
sustained performance.
(KM)
6.10
ACTION: Michael Roach to follow up about how each CCG was
learning lessons from H&F meeting both IAPT targets.
(MR)
6.11
ACTION: Michael Roach to report back to this committee about IAPT
related suicides.
(MR)
7.
Matters for escalation
7.1
No matters were escalated to the committee by CCG performance
committees.
6.9
CWHHE is a collaboration of Clinical Commissioning Groups: Central London, West London, Hammersmith & Fulham, Hounslow &
Ealing
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8.
Any other business
8.1
The terms of reference require us to self-assess the committee on an
annual basis. A questionnaire to be sent out to the committee to be
returned to the Secretary.
ACTION: Rory to provide anonymised report detailing the responses
to a self-assessment questionnaire to the committee in July.
(RH)
Dates of next meeting
Date and time of future meetings:
 Thursday 23 July 10:30 – 12:00
CWHHE is a collaboration of Clinical Commissioning Groups: Central London, West London, Hammersmith & Fulham, Hounslow &
Ealing
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