meeting of the primary care commissioning …...wendy kerr informed that she will be unable to sign...

Meeting of the Primary Care Commissioning Committee

Wednesday 6th September 2017 – 2:50pm to 4:00pm

The Robert Peel Suite, Holiday Inn Express,

Second Avenue, Burton on Trent, DE14 2WF

AGENDA

No. Item Decision/ Discussion/ Information

Enc. Lead Time

1. Welcome, Introductions and Apologies Verbal Chair 2:50

2.

Quoracy and Declarations of Interest: If any member has any interest in any contract, proposed contract or other matter under consideration at this meeting, he/she shall disclose the fact to the Chair and shall not take part in the consideration or discussion of the matter or vote on any question with respect to it.

Verbal Chair 2:55

3. Minutes of the Meeting held on 14th June 2017

Approval Enc. 1 Chair 2:55

4. Actions from the meeting held on 14th June 2017

Assurance Enc. 2 Chair 3:05

Strategic Planning

5. Business Cycle Assurance Enc. 3 Kirsten Owen 3:15

Performance

6. Quality report Assurance Enc. 4 Sarah Shingler 3.20

7. Finance report Assurance Enc. 5 Wendy Kerr 3:35

8. Directed Enhanced Service Assurance Enc. 6 Kirsten Owen 3:50

Governance

9. Memorandum of Understanding Assurance Enc. 7 Kirsten Owen 3.55

10. Any items for Escalation Discussion Verbal Chair 3:55

11. Date and time of next meeting: Wednesday, 1st November 2017 from 2:30pm - 4:00pm in the Robert Peel Suite, Holiday Inn Express, Second Avenue, Burton on Trent.

Verbal Chair 4:00

Dates of Future Meetings East Staffordshire Clinical Commissioning Group

Primary Care Commissioning Committee Meetings 2017/18

Wednesday 14th June 2017 4:00pm – 5:30pm Robert Peel Suite,

Holiday Inn

Wednesday 6th September 2017 2:30pm – 4:00pm Robert Peel Suite, Holiday Inn

Wednesday 1st November 2017 2:30pm – 4:00pm Robert Peel Suite, Holiday Inn

Wednesday 3rd January 2018 2:30pm – 4:00pm Robert Peel Suite, Holiday Inn

Wednesday 7th March 2018 2:30pm – 4:00pm Robert Peel Suite, Holiday Inn

EAST STAFFORDSHIRE CLINICAL COMMISSIONING GROUP

Minutes of the Primary Care Commissioning Committee Held on Wednesday 14 June 2017 at 4:30pm to 5:30pm

The Robert Peel Suite, Holiday Inn Express, Second Avenue, Burton upon Trent, DE14 2WF

Present Voting Lynne Smith David Harding Tony Bruce Wendy Kerr Nicola Harkness Sarah Shingler

Lay Member for Quality, ESCCG (Chair) Lay Member for Governance, ESCCG Accountable Officer, ESCCG Chief Finance Officer, ESCCG Chief Operating Officer, ESCCG Chief Nurse and Director of Quality, ESCCG

Non-Voting Kirsten Owen Julie Hughes Rebecca Woods

Programme Manager for Primary Care, ESCCG Primary Care Manager, ESCCG Head of Primary Care Commissioning, NHS England (supporting ESCCG in discharging its duties)

In Attendance

Angie Gough

Secretary, ESCCG (Minutes)

MINUTES OF THE MEETING OF THE PRIMARY CARE COMMISSIONING COMMITTEE

ACTION

PCCC(06)01 WELCOME AND INTRODUCTION Lynne Smith welcomed all present to the meeting of the East Staffordshire Primary Care Commissioning Committee (PCCC).

APOLOGIES Apologies were received from Cllr Alan White (Health and Wellbeing Board Representative), Gulshan Kaul (South Staffordshire LMC), Keith Mann and Julie Whittingham (NHS England – supporting ESCCG in discharging its duties).

PCCC(06)02 QUORACY AND DECLARATIONS OF INTEREST It was agreed that the meeting was quorate.

Declarations of interest for Committee members are publicly available and can be accessed via the ESCCG website.

There were no further declarations of interest.

PCCC(06)03 MINUTES OF THE MEETING HELD ON 4TH MAY 2017 The minutes were accepted as a true and accurate record.

PCCC(05)04 ACTION LOG All actions are updated in the action log.

PCCC(05)05 BUSINESS CYCLE

The updated Business Cycle paper was presented to the Committee and it was accepted as read: The Committee asked that only Committee business should be shown on

the Business Cycle, which will inform the Committee agenda and that managerial activity on the months where there are no Committee meeting should be removed from the Business Cycle.

Enc. 1

2

Wendy Kerr informed that she will be unable to sign off the Business Cycle as it currently stands, as she requires the Annual GP Practice Budget Plans to be signed off by March, or April at the latest.

Wendy Kerr will raise the issue with Michael Sargent and Sarah Gober at NHSE.

ACTION: Wendy Kerr to raise concerns over the timing of the Annual GP Practice Budget Plans with Michael Sargent and Sarah Gober at NHSE.

The Committee queried the lack of a quality report on the September agenda and requested that a quality report should be a standing agenda item for every meeting. Tony Bruce enquired about the Business Cycles of other Primary Care Commissioning Committees. Kirsten Owen advised that she had given consideration to Business Cycles for other areas when preparing the Committees Business Cycle and also ensured that the Committee Business Cycle remained relevant to the Delegation Agreement.

Wendy Kerr informed the meeting that external audit might be undertaking work in April and May which would come to the June Committee but internal audit may wish to do some work in either November, January or March, so she suggested that internal audit should go on the Business Cycle in January and external audit in June. The Committee agreed that the internal and external audits will be presented to Audit Committee and then brought to PCCC for information.

The Committee asked for clarity about the E-dec. Rebecca Woods advised the Committee that this is practice Electronic Declaration mechanism used by practices to submit data within certain timescales to provide assurance over various items in relation to primary care. NHSE will provide ESCCG with a list of all items covered under the E-dec submission.

ACTION: Rebecca Wood to provide ESCCG with a list of items covered under the E-dec submission.

Kirsten Owen provided clarification regarding the Contracts Audits, as an internal piece of work that ESCCG and NHSE would undertake each year. It is considered good practice, as occasionally practices do not submit the correct data onto Edec. The audits could be used to identify actions and re-emphasise the importance of submitting the data.

Wendy Kerr asked for clarification about the sign off process for the Quality Outcomes Framework payment. Rebecca Woods confirmed that ESCCG will not be expected to sign off the QOF as it is undertaken by NHSE on behalf of the CCG and this is largely automatic

ACTION: Kirsten Owen will make the changes to the Business Cycle and bring it back to the next PCCC for approval.

Wendy Kerr

Rebecca Woods

Kirsten Owen

PCCC(06)06 FINANCE

The Delegated Commissioning Finance Budget paper was presented to the Committee and it was accepted as read: Wendy Kerr provided a verbal update: this is the Month 2 report shared

from the leger so it is very high level. The Finance Team will undertake Deep Dives into future reports to provide further information and address queries. Monthly review meetings have been set up with the Finance Team for that purpose.

At present there is nothing of concern within the report but a lot of items

will become apparent later on in the year, such as undertaking rent reviews and paying Directed Enhanced Services (DES’s). However, it is

3

too early to say in Month 2, as the claims will not have been received. There are currently no reliable trends other than last year’s and there is a lot of work to be undertaken to check assumptions on rent reviews and property reviews, as there is a backlog.

From the information provided, Wendy Kerr is comfortable that the

position in the report reflects the current position and at the moment she cannot see anything that gives her cause for concern for the future.

David Harding asked about the underspend against the Directed

Enhanced Services. Kirsten Owen confirmed that the budget had been set with the assumption that all practices would take up the DES, although as it stands, a number of practices have declined to take up the DES for access for 2017/18.

Clarification was given to the Committee that all rent reviews and any rent

review disputes prior to delegated commissioning have been underwritten by NHSE. Wendy Kerr advised the Committee that there is a key piece of work to do with NHSE to close down the disputes and finalise the last few rent reviews.

The committee was informed that there are some practices due for rent

reviews this year. The impact will need to be assessed and there is a small reserve within the budget. Appendices will be added to the report to ensure that, if there is a rent reserve, that it is shown.

ACTION: Wendy Kerr to ensure that future Finance Reports contains appendices showing if there is a rent reserve. The Committee had a discussion regarding the NHSE winter funding for

2017/18 and the need to develop a business case to be considered by NHSE in order to release the funding. Wendy Kerr highlighted to the Committee that this funding was outside of the delegated budget and that the governance arrangements for this funding would be provided via QIPP, Finance and Performance Committee.

Concerns were raised regarding the cyber-attack with the report seeming

to imply that ESCCG had been tipped off about issues with the server prior to the attack but nothing was done. Clarification was given that prior to the attack ESCCG had received conflicting assurance and following the cyber-attack doubts were raised that the server may not be supported in the event of another cyber-attack. The upgrade has been brought forward. Assurance was given that ESCCG have proactively followed technical advice, have the COIN in place and will be triangulating risk registers during the IT sub-group.

The Committee were assured by the Finance Report.

Wendy Kerr

PCCC(06)07 TERMS OF REFERENCE

The Terms of Reference (TOR) paper was presented to the Committee and it was accepted as read: The Committee accepted the TOR in principal with the following amendments: Clause 18 - The words ‘by the Governing Body’ to be removed as the

Committee will elect its own Chair. Clause 19 - Previously there was a debate about David Harding as Vice

Chair as the guidance says the Governance lay member shouldn’t be Chair, but it was suggested that he could be Vice Chair in exceptional circumstances. It is suggested that the sentence should be changed to

4

read ‘but will exclude the Lay Member for Governance (as Audit Committee Chair) except in exceptional circumstances’.

Appendices Schedule 2 - Chris Ragg and Sarah Shingler should be added to the List of Members.

Clause 41 - To be amended with everything deleted apart from the final sentence which will be amended to state ‘The Committee will be obligated to advise the Governing Body of decisions and recommendations taken in terms of the remit where appropriate in forming the Governing Body’s commissioning decisions’. This is to reflect the fact that whilst NHSE have delegated to the PCCC, at times there may be interdependencies and also to allow the Governing Body to have full visibility of the PCCC decisions which may influence the Governing Body’s decision making in accordance with its statutory duties.

Clause 47 to be amended to say ‘once a quarter’ rather than ‘every month’. Public minutes of the PCCC can be shared with Governing Body which is standard practice with other sub-committees but the confidential ones might not be shared. NHSE would be happy to receive the minutes of the meetings but in addition require a quarterly assurance report on a standard template which will form part of Quarterly Assurance Meetings with NHSE and will be a regular agenda item for those meetings, which will be chaired by Trisha Thompson of NHSE. As Rebecca Woods team provide support, it would not be appropriate for them to ask for assurance from ESCCG.

The Committee approved the Terms of Reference subject to the changes being made and a copy of the document is to be circulated by email for agreement and sign off by Lynne Smith. ACTION: Kirsten Owen to make the required amendments to the TOR and circulate by email for agreement with Lynne Smith being the final sign-off. People to respond within 7 days of the email or Lynne Smith will assume the document is agreed and will sign it off.

Kirsten Owen

PCCC(06)08 MINUTES OF THE LAST JCC

The Confidential Joint Commissioning Meeting Minutes were presented to the Committee and were accepted as read. The Committee were assured they were an accurate record of the meeting and that all of the actions have taken place.

PCCC(06)09 ESCALATION

No items to escalate and nothing for the risk register.

PCCC(06)10 DATE AND TIME OF NEXT MEETING

The date of the next meeting is Wednesday 6 September 2017, 2:30pm to 4:00pm at The Robert Peel Suite, Holiday Inn Express, Burton upon Trent, Staffordshire, DE14 2WF.

1

ACTION LIST PRIMARY CARE COMMISSIONING COMMITTEE – 14 JUNE 2017 Meeting

Date

Agenda Item

Subject and Action

Date

Required

14/06/17

PCCC(06)05 Business Cycle: Wendy Kerr to raise concerns over the timing of the Annual GP Practice Budget Plans with Michael Sargent and Sarah Gober at NHSE. Completed: this has now being resolved and the refreshed times are included on the revised business cycle

Wendy Kerr

Completed

14/06/17

PCCC(06)05 Business Cycle: Rebecca Wood to provide ESCCG with a list of items covered under the E-dec submission.

Rebecca Woods

06/09/17

14/06/17

PCCC(06)05 Business Cycle: Kirsten Owen will make the changes to the Business Cycle and bring it back to the next PCCC for approval.

Kirsten Owen

Completed

14/06/17

PCCC(06)06 Finance: Wendy Kerr to ensure that future Finance Reports contains appendices showing if there is a rent reserve.

Wendy Kerr

06/09/17

14/06/17

PCCC(06)07 Terms of Reference: Kirsten Owen to make the required amendments to the TOR and circulate by email for agreement with Lynne Smith being the final sign-off. People to respond within 7 days of the email or Lynne Smith will assume the document is agreed and will sign it off. Completed: the changes were made to the TOR circulated to the committee members for comment and signed off by Lynn Smith as agreed during the June Committee meeting.

Kirsten Owen

Completed

Meeting

Date

Agenda Item

Subject and Action

Status

05/05/17

PCCC(05)05 Memorandum of Understanding (MOU) with NHS England: Kirsten Owen will continue to update the MOU in line with the comments from the Committee and further work on the Quality Schedule and bring this back to the September meeting for final approval. Update: 14/06/17 – It was noted that the MOU would be brought back to the PCCC in September for approval. Wendy Kerr asked if the current MOU could be formally signed by the parties and the Quality Schedule could be appended after this time. Kirsten Owen to facilitate the signing of the MOU.

Kirsten Owen

06/09/17

Enc. 2

2

CLOSED ACTIONS Meeting

Date

Agenda Item

Subject and Action

Status

1

Author: Kirsten Owen Date: June 2017 East Staffs CCG

Title Business Cycle

Reporting to Primary Care Commissioning Committee

Date of Meeting 6th September 2017

Commissioning Lead(s) Author(s)

Nicola Harkness Kirsten Owen

Purpose of the Report (Please select)

Approval Assurance Discussion

Key Points/Executive Summary

The attached business cycle has previously been shared with the Primary Care Commissioning Committee (PCCC) at the May and June 2017 meetings. The work programme allows the CCG to forward plan the committee’s business and ensure that the full duties of the committee are contain within the annual programme. Discussions are taking place to understand the Audit timeline with NHS England and this will be updated in due course. The updated annualised business cycle, which now includes finance, has been presented to the committee and will be used to develop the agenda of future committee meetings.

Recommendations (what is expected from the Committee) The Primary Care commissioning Committee is as to:

Approve the updated business cycle

Management of the conflicts of interest

None

Enclosures

Annualised CCG cycle of business

X

Enc. 3

2

Author: Kirsten Owen Date: June 2017 East Staffs CCG

PCCC Business April May June July Aug Sept Oct Nov Dec Jan Feb March

Governance Conflicts of interest u u u u u

Minutes u u u u u

Action tracker u u u u u

Minutes from MB actions for the board u u u u u

Risk Manangement u u u u u

Primary Care Quality Quality assurance framework u

Quality report u u u u u

Performance Quality Outcomes Framework achievement u

ContractingDES u u

Edec u

Contract changes (as they occur) u u u u u

Contracts internal validation u

Primary Care Financial Monthly Financial Reporting u u u u u

Annual GP Practice Budget Plans u u

GMS contract negotiations u u

Internal Audit (to be agreed)External Audit (to be agreed

Primary Care PlanningPrimary Care Planning u

Premises u u u u

Committee EffectivenessAnnual Cycle of business u

Committee Effectiveness u

Terms of reference u

1

Author: Kirsten Owen Date: September 2017 East Staffs CCG

Title Primary Care Quality Report




Sarah Shingler Wendy Henson Kirsten Owen

Sarah Shingler




This report is intended to provide the Primary Care Commissioning Committee with assurance in respect of the on-going monitoring of quality and safety in General Practice. This assurance is obtained as a result of the quality and safety monitoring and regular interactions with General Practice via NHS England from any contract discussions and queries and the CCG for more general discussions.

The Primary Care Commissioning Committee will note that there are three areas that this report is providing assurance to the committee on CQC ratings, Friends and Family Test and the recent GP Patient Survery Results

Recommendations (what is expected from the Committee)

The primary care commissioning committee is as to:

Be assured that the CQC inspections have taken place with regards to the 18 East Staffordshire Practices

Be assured that three of the four practices with a rating of requires improvement in one of the inspection domains has been re-inspected and are now rated as being good

Be assured that the single practice outstanding their re-inspection has been inspected and we are just awaiting the publication of the report.

Be assured that those practices who have not submitted the friends and family test data have been formally written to and the escalation process has commenced.

Be assured that any trends from the nationally published GP Patient Survey Data are used as part of the Primary Care Quality dashboard reviews.

X

Enc. 4

2


Management of the conflicts of interest

There are no GP representatives present during the discussion of the Primary Care Quality Dashboard and emerging actions

Enclosures

Primary Care Quality report

3


Introduction This report is intended to provide the Primary Care Commissioning Committee with assurance in respect of the on-going monitoring of quality and safety in General Practice. This assurance is obtained as a result of the quality and safety monitoring and regular interactions with General Practice via NHS England from any contract discussions and queries and the CCG for more general discussions. Key quality information is collected in a single primary care dashboard and collates all of the national and local quality information, for this to be considered in its totality. This dashboard is reviewed by NHS quality, contracting and CCG representatives in order to provide a detailed report highlighting any areas for further discussion and if needed recommendation for action by the Primary Care Commissioning Committee. The Primary Care commissioning committee are advised of the following specific actions being taken within each area: CQC ratings Summary of the CQC ratings - all 18 practices have now been inspected by the CQC, one practice has had its full comprehensive review in June 2017 and has been rated as GOOD. A further three practices have been re-inspected following a rating of “requires improvement” in at least one CQC inspection domain. These practices have all shown improvement following the most recent CQC visit and have now been rated as “good”. There is still one further report outstanding for a practice who was rated as required improvement in the two inspection domains of Safe and Well Led, which resulted in the practice receiving an overall rating of requires improvement. When a practice receives a “requires improvement” rating in an inspection domain, CQC requires the practice to develop an action plan for recovery; this plan is agreed by CQC and monitored by NHS E and CQC. We understand that a focused re-inspection is due by the end of August 2017 and the report will be published accordingly. The next series of inspections will take place during October2017 and March 2018, the CCG and NHS England are able to direct the inspections if there are particular practices where there are emerging concerns. Friends and Family Test It is a contractual requirement that practices must give all patients who use the practice an opportunity to provide feedback about the services provided through the friends and family test (FFT). The contract stipulates that the results of completed FFT must be published and submitted to the Board of NHSE. A total of five practices are noted as having no data listed in the latest FFT data publication for June 2017 reporting period. This is an increase of three compared to the May 2017 reporting period. Two of the five practices are noted as having had no data published for three or more months. This number has reduced from ten to two since the last PCCC report. Two practices have been issued an escalation letter from NHS England advising them of the contractual requirement to submit FFT data and display the results in addition with the offer of support relating to achievement of FFT.

4


The CCG will pick up with those practices who have not reported any Friends and Family test data during the CCG practice visit schedule. Patient Access Survey The GP Patient Survey (GPPS) is an England-wide survey, providing practice-level data about patients’ experiences of their GP practices. The most recent publication of this data was in July 2017, there has been a change in terms of data collection from previous years, the data is now only collected in a single wave of fieldwork (undertaken between January to March 2017) however, the sample size has remained the same. In NHS East Staffordshire CCG, 4,569 questionnaires were sent out, and 2,036 were returned completed. This represents a response rate of 45%. The data and trends from this report is used as part of the suite of data sources which form part of the overarching primary care quality dashboard review. If there are particular concerns from trends in the survery data these will be picked up in a separate discussion with the practice. The information from the patient access survey does form part of the Practice Visit Data Pack and can be a focus of discussion with a practice during the CCG practice visits. Recommendations The primary care commissioning committee is as to:

Be assured that the CQC inspections have taken place with regards to the 18 East Staffordshire Practices

Be assured that three of the four practices with a rating of requires improvement in one of the inspection domains has been re-inspected and are now rated as being good

Be assured that the single practice outstanding their re-inspection has been inspected and we are just awaiting the publication of the report.

Be assured that those practices who have not submitted the friends and family test data have been formally written to and the escalation process has commenced.

Be assured that any trends from the nationally published GP Patient Survey Data are used as part of the Primary Care Quality dashboard reviews.

Title Primary Care Delegated Finance Report Month 4 2017/18


Date of Meeting Wednesday 6th September 2017


M Afzal/ W Kerr




This report provides a summary of the delegated Primary Care Delegated Co-commissioning budget as at Month 4, along with a forecast outturn position for 2017/18. Information provided within this report will also be incorporated within the CCG’s overall finance report provided to the Governing Body, since it is an element of the CCG’s overall allocation.

This report is produced in conjunction with NHS England Primary Care support team who

undertake the day to day operational management of undertaking payments to general practices. CCG supporting and reviewing to obtain and provide the committee with overall assurance as to the budget management of primary care delegated funds.

The financial position at month 4 is showing an under spend of £110, table one below

summarises expenditure by category.

Table One – Primary Care Summary

Enhanced services are underspending due to not all 18 practices signing up to the DES. Premises Costs reimbursements is showing an overspend due to a number or rent reviews

having taken place, QIPP reduction on rates currently not being delivered. A number of rent reviews relating to prior to April 2017 have still to be finalised. This issue is

being treated as a priority by the CCG and discussions have commenced with NHS England to resolve as soon as possible, to ensure appropriate prior year budget adjustments are undertaken but also provide resolution for practices.

All outstanding prior year rent reviews that require increased funding will be funded by NHSE if relate to prior to April 2017/18 on a recurrent basis. Any new rent reviews that are post April 2017 will be the responsibility of the CCG to fund within the delegated funding allocated.

Enc. 5

List sizes have increase practices payment levels by £31k, although this has been covered from the £171k demographic growth reserve which sits under the General Practice Category.

The CCG continues to work with NHSE in validating the budgets and aligning the reporting

requirements to the CCG’s required standard. Appendix one below provides further detailed analysis of the individual expenditure categories

shown above.

Recommendations (what is expected from the Board)

1. Understand this is the first year of the CCG taking on the Primary Care Delegated Co-

commissioning budgets and as such adjustments will continue to be made to accommodate improvements in reporting standard. Whilst also ensuring all funding issues that are identified as relating to prior to April 2017/18 are correctly addressed as additional recurrent allocations

2. Be Assured that there are no major risks currently being identified and that the CCG is forecasting to remain within the allocation provided.

3. Recognise that the allocation will change as there is to be a clean-up exercise carried out regarding the budgets and spend across all categories. Expenditure correctly being aligned to budget spends lines, to ensure any anomalies relating to prior year are identified and addressed.

Enclosures

Appendix One – Additional Analysis Tables

Appendix One – Primary Care Co-commissioning Additional tables.

1 Author: Date: East Staffs CCG

Title Directed Enhanced Services 2017/18 Reporting to Primary Care Commissioning Committee Date of Meeting 6th September 2017

Commissioning Lead(s) Author(s) Nicola Harkness Kirsten Owen

Purpose of the Report (Please select) Approval Assurance Discussion

Key Points/Executive Summary This paper provides an update and assurance on the 2017/18 Directed Enhanced Services to the Primary Care Commissioning Committee and the extent to which the population of East Staffordshire is covered by these services. Recommendations (what is expected from the Committee) The committee is asked to:

• To note the update to the DES’s for 2017/18

• To note the population covered by the national Directed Enhanced Services

• Be assured that all practices have been given the opportunity to sign up to the 2017/18 Directed Enhanced Services.

Management of the conflicts of interest The Directed Enhanced Services are nationally negotiated and nationally mandated. All practices have an opportunity to sign up to the DES and this is managed by NHS England, following the national policy and procedures.

Enclosures Directed Enhanced Services Report

X

Enc. 6


Introduction This paper provides an update and assurance on the 2017/18 Directed Enhanced Services to the Primary Care Commissioning Committee and the extent to which the population of East Staffordshire is covered by these services. Background Directed Enhanced Services (DES) are nationally prescribed services which are primary care services that are different to the essential services all practices have to deliver. The DES that the Practice agrees to deliver is against the nationally agreed contract and service specification, all DES’s are voluntary. These services are part of the annual national negotiations that take place between NHS Employers, on behalf of NHS England and the General Practitioners Committees (GPC) of the British Medical Association. Information Directed Enhanced Services 2017/18

• Extended Hours: This DES has been designed by NHS England to support extended opening times for patients. Practices that sign up to this service must provide extended clinical appointments outside of core hours either before 08:00 or after 18:30. Practices must offer at least 30 mins per 1,000 registered population per week. Update for 2017/18: From October 2017 practices are only able to participate in the DES if they are open Mon-Fri 08:00- 18:30, if the practice is closed for half a day during the week, they are not able to sign up to the DES.

• Learning Disabilities Health Check: This DES is designed to encourage practices to identify all patients aged 14 and over with learning disabilities, to maintain a learning disabilities 'health check' register and offer them an annual health check, which will include producing a health action plan. Update for 2017/18 The payment for the Learning Disabilities Health Check Scheme will increase from £116 to £140 per health check. A new health check template has been developed by NHS England for practice use if they so choose.

• Minor Surgery: This DES sets out a model for an enhanced service for minor surgery. Minor surgical procedures carried out by general practitioners in general practice premises have high levels of patient satisfaction and are highly cost-effective. Since 1 April 1990, general practitioners on Health Authority minor surgery lists (and their equivalents) have been able to receive payment for undertaking a range of minor surgery procedures on their patients. This service seeks to ensure that there is the opportunity to provide a wider range of minor surgery in the primary care sector.

• Out of Area registration: This DES has been designed by NHS England to support the new out of area patient registration arrangements being introduced 5 January 2015 to extend choice of GP practice. It seeks to secure access to local GP practices for patients living in the practice area but who are registered with a practice away from home without access to home visits.


• Violent patient scheme: This DES is to cover support services to staff and the public in respect of the care and treatment of patients who are violent. The participation of the provider in a directed enhanced service must at all times be voluntary. This DES allows for the enhancement of resources for the provider of the service and the provision of services to a specified standard

Population Coverage: Within East Staffordshire all practices are written to by NHS England regional office, once the national contract negotiations have concluded and asked if they wish to sign up to the current year DES’s. Extended Hours: 14 out of the 18 practices have signed up for the extended hours DES, which provides an additional 3225 minutes per week and covers a population of 106,867 (76%). All practices that operate extended hours open Mon-Fri between 8:00 and 18:30. Learning Disabilities Health Check: 18 of our practices have signed up for Learning Disabilities Health Check, which covers 100% of our population Minor Surgery: 17 out of 18 practices have signed up to the Minor Surgery DES, which covers 95% of our population Out of Area registration: 6 out of the 18 practices have signed up to the Out of Area registration DES, the areas covered by this DES is Tutbury, Barton, Burton, and Rocester. Violent patient scheme: 2 practices out of 18 practices have signed up for the violent patient scheme. Recommendation: The committee is asked to: To note the update to the DES’s for 2017/18 To note the population covered by the national Directed Enhanced Services Be assured that all practices have been given the opportunity to sign up to the 2017/18 Directed Enhanced Services.

1

Author: Date: East Staffs CCG

Title Memorandum of Understanding - UPDATE




Nicola Harkness Kirsten Owen




The memorandum of understanding (MOU) was presented and approved in principle at the May 2017 Committee meeting.

The MOU sets out the agreed working arrangements between Staffordshire, Shropshire County and Telford and Wrekin CCGs and NHS England Primary Care team including contracting, finance and quality functions.

It details the responsibilities for the delivery of primary care general practice under delegated commissioning arrangements from April 2017 until March 2018.

The purpose of the MOU is to set out the principles, objectives and detailed working arrangements between NHS England and the CCGs; this is further strengthened by the formally signed Delegation Agreement.

At the May meeting it was reported that the work with regards to the Quality Schedule and this was to be concluded by the end of July 2017.

The Quality schedule has been finalised with all relevant CCGs and NHS England, from East Staffordshire CCG the Chief Nurse / Director of Quality has agreed and signed off this quality schedule.

We are still in the process of getting the MOU formally signed off by all the partners included in the MOU, it is expected that this will be finalised by the end of September 2017.

Recommendations (what is expected from the Board)

The committee is asked to 1. To be assured that there are the appropriate arrangements in place in order to

support the PCCC and the CCG in discharging its duties as delegated commissioners of General Medical Services,

2. Note that the Memorandum of Understanding has been updated with the inclusion of a quality schedule.

Conflicts of interest

None

Enclosures

None

X

Enc. 7

meeting of the primary care commissioning …...wendy kerr informed that she will be unable to sign...

Documents