NHS NORTH DERBYSHIRE CCG PRIMARY CARE CO-COMMISSIONING COMMITTEE PUBLIC SESSION
Date & Time: Thursday 22 February 2018, 10.30am
Venue: Robert Robinson Room, Scarsdale
Date and time of next meeting: Thursday 29 March 2018, 10.30am, at Scarsdale
Item Subject Paper Presenter
Time
PCCCC/1718/01
Welcome & Apologies Apologies received from Mr Gary Apsley, Dr Ben Milton, and Dr Carolin Shearer
Verbal IS 10.30
PCCCC/1718/02
Declarations of Interest • Primary Care Co-Commissioning
Committee Register of Interests • Summary Register for Recording
Any Interests During Meetings
Enclosed (Paper A)
ALL 10.35
PERFORMANCE PCCCC/1718/03
Primary Care Co-Commissioning Quality And Performance Assurance Report
Enclosed (Paper B)
JD 10.40
FOR INFORMATION PCCCC/1718/04
The Grange Family Health Centre/Royal Primary Care Update
Verbal HB 10.50
MINUTES AND MATTERS ARISING PCCCC/1718/05
Minutes of the meeting held on Thursday 25 January
Enclosed (Paper C)
IS 11.00
PCCCC/1718/06
Matters arising from the minutes not elsewhere on agenda
Enclosed (Paper D)
IS 11.05
PCCCC/1718/07
AOB
Verbal ALL 11.10
PRIMARY CARE CO-COMMISSIONING COMMITTEE
22 February 2018
PAPER NO. A
PRIMARY CARE CO-COMMISSIONING COMMITTEE – 22 February 2018
TITLE Declaration of Interest Register
PRESENTER Isabella Stone, Vice-Chair
AUTHOR Suzanne Pickering, Head of Governance
SPONSOR Louise Bainbridge, Chief Finance Officer
IS THIS PAPER FOR: Decision Assurance X Discussion
RECOMMENDATIONS The Committee is asked to: To review the Declaration of Interest for the Finance and Performance Committee to ensure that it is correct and consistent REPORT SUMMARY A Declaration of Interest Register is required under the Code of Accountability and the interests declared will be reported to the North Derbyshire CCG Finance and Performance Committee and will be available for public inspection. Key matters for consideration To provide a Declarations of Interest Register for North Derbyshire Clinical Commissioning Group (NDCCG). IS THERE A FINANCIAL IMPACT?
None
HAVE ANY QUALITY & COMPLIANCE ISSUES BEEN IDENTIFIED/ACTIONS TAKEN?
None
HAVE ANY CONFLICTS OF INTEREST BEEN IDENTIFIED/ACTIONS TAKEN?
Conflicts of interest will be declared as appropriate in relation to the agenda.
LINK TO BOARD ASSURANCE FRAMEWORK/ RISK REGISTER
1
Reference Number: BAF/ RR N/A Current Risk Score N/A
How does this paper provide assurance to the Committee that the risk is being managed? Requirement to embed into the CCG to ensure sound corporate governance structures and transparent decision-making processes within NDCCG.
CCG IMPROVEMENT & ASSESSMENT FRAMEWORK Please describe how this report and/or the services described within it supports CCG performance in the following domains: Better health outcomes for all N/A Improved patient access and experience N/A Empowered, engaged and well-supported staff N/A Inclusive leadership at all levels N/A
CLINICAL PRIORITY AREAS (please tick) Mental Health Dementia Learning Disabilities Cancer Diabetes Maternity
EQUALITY AND DIVERSITY IMPACT
Due Regard to the proactive duties of the Equality Act 2010 has been taken in development of this paper and:
It is judged that it is not proportionate on the basis that the register of interest is not a decision making tool, this completes the due regard required.
NOTE: Policies/decisions may need to be adjusted in line with any equality analysis or due regard that is brought back at a future date. Any decision that is finalised without being influenced by appropriate due regard could be deemed unlawful.
2
NHS NORTH DERBYSHIRE CCG REGISTER OF INTEREST
FEBRUARY 2018
Fin
an
cia
l In
tere
st
No
n F
inan
cia
l
Pro
fessio
nal
Inte
rest
No
n-F
inan
cia
l
Pers
on
al
Inte
rest
From To
Alla, Praveen
Governing Body GP Member,
Finance & Performance Committee Member
GP Partner at Welbeck Road Health Centre P Direct On going On going
Withdraw from all discussion and
voting if organisation Is potential
provider unless otherwise agreed by
the meeting chair
Welbeck Road Health Centre is a member of the North
Derbyshire GP Federation P Direct On going On going No action required
Apsley, Gary
Lay Member Patient and Public Involvement Governing
Body Member, Chair Primary Care Co Commissioning
Committee, Audit Committee Member
No relevant interests Apr-13 On going
Finance and Performance Committee Member No spouse with relevant interests
Austin, Debbie Deputy Clinical Chair, Governing Body GP
School Governor Taxal and Fernilee Primary School, Whaley
Bridge
P Indirect On going On going No action required
Primary Care Co Commissioning Committee Member,
Clinical Commissioning Committee Member
Spouse is Employee of DCHS, Associate Director of
Transformation
P Indirect On going On going No action required
Locum GP P Direct On going On goingWithdraw from all discussion and
voting if organisation Is potential
Belcher, Hannah Head of Primary Care No relevant Interests
No spouse with relevant interests
Bainbridge, Louise
Chief Finance Officer, Governing Body Member, Finance
and Performance Committee Member, Audit Committee
Member, Primary Care Co Commissioning Committee
Member,
Clinical Commissioning Committee Member
No relevant interests Nov-17 On going
Bhatia, Upendra Clinical Commissioning Committee Member GP Partner at Newbold Surgery, Chesterfield
P
Direct 2009 On going
Withdraw from all discussion and
voting if organisation Is potential
provider unless otherwise agreed by
the meeting chair
Action taken to mitigate risk
Type of Interest Date of Interest
Name
Current Position(s) held in CCG i.e. Governing Body
member, Committee member, Member Practice, CCG
Employee or other
Declared Interest (Including direct/ indirect Interest)
Direct or
Indirect
Interest
GP Practice part of Chesterfield Health Provider Company P Direct 2009 On going On going
Director Veincare Ltd P Indirect Apr-13 On going No action required
Consultant Surgeon NUH P Indirect 2000 On going No action required
No spouse with relevant interests
Braithwaite, Bruce Specilaist Secondary Care Dierctor of Clinical Services, Alliance Surgical PLC P Indirect 2007 On going No action required
Governing Body Member, Clinical Commissioning Director BD Braithwate
Committee Member Director Veincare Ltd P Indirect 2003 On going No action required
Consultant Surgeon Nottingham University Hospitals P Indirect Apr-13 On going No action required
No spouse with relevant interests P Indirect 2000 On going No action required
Butler, Richard Clinical Commissioning Committee Member GP Partner at The Valleys Medical Partnership
P Direct On going On going
Withdraw from all discussion and
voting if organisation Is potential
provider unless otherwise agreed by
the meeting chair
Clayton, Chris
Derbyshire CCG Chief Executive Officer
Governing Body Member, Audit Committee Member,
Primary Care Co Commissioning Committee MemberSpouse is a Director at PWC.
Finance and Performance Committee Member, Clinical
Commissioning Committee Member
Clarey, Richard Member of Prescribing Sub Committee No relevant interests
Dentith, Jill Non-voting Lay Member for Audit & Governance
Lay member for Audit & Governance (Voting) & Vice Chair of
NHS Hardwick CCGP
Direct 2012 31/03/2018
To be mindful of the conflict of
interestMember of Governing Body, Audit Committee,
Remuneration Committee, Chair of Finance & Performance
Committee
Self-employed through own Management Consultancy
business trading as Jill Dentith Consultancy
P
Direct 2012 On going
To be mindful of the conflict of
interest
Emslie, Carolyn Dr Member of Prescribing Sub Committee Practice member of NDCCG
Partner at Springs Health Centre, Clowne
Springs Health Centre is part of North Derbyshire GP
Federation
P
P
Direct
Direct
On going
On going
On going
On going
Withdraw from all discussion and
voting if organisation Is potential
provider unless otherwise agreed by
the meeting chair
Ennis, Adrian Turnaround Director No relevant interests
Fitzsimons, Diane Dr Member of Prescribing Sub Committee Director of Darley Private Healthcare
Partner at Darley Dale Medical Centre
Darley Dale Medical Practice is a member of North
Derbyshire GP Federation
P
P
Direct
Direct
On going
On going
On going
On going
Withdraw from all discussion and
voting if organisation Is potential
provider unless otherwise agreed by
the meeting chair
Fleming, Isobel Service Director – Countywide Commissioning Director of Child Outcomes Research Consortium (CORC).
CORC is a not for profit organisation. The Director position is
not paid.
Member of National Group. NHS England – Measuring
Children and Young People’s Mental Health Outcomes
Group.
P
P
Direct
Direct
Current
Current
On going
On going
Should CORC tender for contracts any
interests to be clearly declared and
may result in Isobel Fleming
withdrawing from involvement in the
process.
Should CORC tender for contracts any
interests to be clearly declared and
may result in Isobel Fleming
withdrawing from involvement in the
process.Gibbard, Ian Audit Committee Chair No relevant interests Apr-13 On going
Finance and Performance Committee Member No spouse with relevant interests
Gillott, Aaron Assistant Chief Finance Officer, Member of Senior
Leadership Team NDCCG
No relevant interest
no spouse with relevant interest On going On going
Indirect 2001 On going As per conflicts of interest policy.
Green, Darran Assistant Chief Finance Officer, Primary Care Co
Commissioning Member No relevant interestsApr-13 On going
Gregory, Helen Medicines Management Technician No relevant interests On going On going
No spouse with relevant interests
Harvey, Chris Member of the Clinical Commissioning Committee Locality Lead for High Peak
GP Partner Stewart Medical Centre, Buxton Derbyshire Aug-09 On going
OOH Sessional GP 2012 On going
GP Appraiser Dec-15 On going
Jordon, Louise Clinical Commissioning Committee Member GP Partner at Baslow Health Centre
P Direct On going On going
Withdraw from all discussion and
voting if organisation Is potential
provider unless otherwise agreed by
the meeting chair
Chair of the Dales Community Meeting Chair of the Board of Trustees for Helen's TrustP
Indirect 2001 On going
To be mindful of the conflict of
interestThe Valleys Medical Partnership is a member of the North
Derbyshire GP Federation P
Direct On going on going No action required
Knight, David Primary Care Manager NHS England No relevant Interests
No spouse with relevant interests
Linfoot, Amanda Clinical Commissioning Committee Member Member of ND CCG Lay Reference Group P Direct May-16 On going No action required
Lunn, Joe Primary Care Co Commissioning Member Head of Primary Care, NHSE North Midlands
Markus, Kath Primary Care Co Commissioning Member Chief Executive, DERBY and Derbyshire LMCP Indirect On going No action required
GP Partner at Calow and Brimington Practice P Direct On going On going
Withdraw from all discussion and
voting if organisation Is potential
provider unless otherwise agreed by
the meeting chair
Merriman, Louise Clinical Commissioning Committee Member GP P Direct On going On going
Withdraw from all discussion and
voting if organisation Is potential
provider unless otherwise agreed by
the meeting chair
Lead GP for Cancer On going On going
Member of Pathology liaison group On going On going
G2 locality lead GP On going On going
Miller, Roger Local Authority Representative, Governing Body Assistant Director Derbyshire Adult Care Mar-16 On going
No spouse with relevant interests
Milton, Ben Clinical Chair Sessional (locum) GP in North Derbyshire CCG Practices P Direct Oct-16 On going
Withdraw from all discussion and
voting if organisation Is potential
provider unless otherwise agreed by
the meeting chair
Governing Body Member, Primary Care Co Commissioning
Committee Former Partner at Darley Dale Medical CentreP Direct Oct-03 Sep-16 As above
Finance and Performance Committee Member, Clinical
Commissioning Committee Member
Darley Dale Surgery is a member of the Primary Care
Research Network and is funded to carry out research
projects accordingly
P Indirect Apr-13 On going As above
Unpaid support to the Medical & Health Coaching Academy
Member of the Advisory Board Medical Health Coaching
Academy
P Indirect Apr-13 On going As above
Monck, Kelly Member of Prescribing Sub Committee No relevant interests On going On going
Moore, Laura Assistant Chief Nurse and Quality Officer
No relevant interest
No spouse with relevant interest On going On going
Needham, Kate
Assistant Chief Quality Officer Medicines Management,
Member of Senior Leadership Team NDCCG. Member of
Prescribing Sub Committee
Director/ Secretary (10% Shareholder) of Hollowmoor
Consultancy Ltd
P Indirect On going On going No action required
North, Maxine
Lead Medicines Management Pharmacist
Member of Prescribing Sub Group No relevant interests
Parkin, Tim Dr Member of Prescribing Sub Committee Owner/Partner Blackwell Pharmacy, Gloves Lane, Blackwell
Derbyshire.
Partner Limes Medical Centre, Blackwell.Blackwell Medical
Centre, Village Surgery (Pinxton & South Normanton)
Member of Hardwick CCG, Prescribing Lead, Learning
Disabilities Lead and Research Lead.
P
P
Direct
Direct
On going
On going
On going
On going
Withdraw from all discussion and
voting if organisation Is potential
provider unless otherwise agreed by
the meeting chair
Pickering, Suzanne Head of Governance
No relevant interest
No spouse with relevant interest
Phillip, Tracey Primary Care Support Officer NHS England No relevant Interests
No spouse with relevant interests
Riches, Elizabeth Dr Member of Prescribing Sub Committee
Partner of GP Practice at Chatsworth Road Medical Centre
GP Partner NDCCG
Chatsworth Road Medical Centre is a member of North
Derbyshire GP Federation
P
P
Direct
Direct
On going
On going
On going
On going
Withdraw from all discussion and
voting if organisation Is potential
provider unless otherwise agreed by
the meeting chair
Richards, Jean
Hardwick CCG employee, member of Prescribing Sub
Group No relevant interestsOn going On going
Rutter, Eleanor
Public Health Specialist Local Authority, Governing Body
Member, Clinical Commissioning Committee Member Consultant in Public Health Derbyshire County Council
P Indirect Jan-17 On going No action required
Scouse, Marie Assistant Chief Nurse Officer Primary Care No relevant interests
Shearer, Carolin Primary Care Co Commissioning Member Board member of Healthwatch Derbyshire P Direct On going On going
Withdraw from all discussion and
voting if organisation Is potential
provider unless otherwise agreed by
the meeting chair
Shepherd, Martin Member of Prescribing Sub Committee No relevant interests
Spooner, Anne-Marie Governing Body GP Member GP Partner at Hasland Medical Centre P Direct On going On going
Withdraw from all discussion and
voting if organisation Is potential
provider unless otherwise agreed by
the meeting chair
Clinical Commissioning Committee member
Hasland Medical Centre is a member of the North Derbyshire
GP Federation.P Direct On going On going No action required
Hasland Medical Centre is a member of the Chesterfield GP
Federation.P Direct On going On going No action required
No spouse with relevant interests
Shaw, Denise Medicines Management Technician No relevant interests On going On going
Stone, Isabella
Lay Member Patient and Public Involvement Governing
Body Member, Deputy Chair Primary Care Co
Commissioning Committee, Audit Committee Member,
Finance and Performance Committee Member
No relevant interests On going On going
No spouse with relevant interests
Street, Jocelyn Clinical Commissioning Committee Member
Member of NDCCG Lay Reference Group
ND CCG Clinical Commissioning Committee
Member of DCHS Lessons Learned Committee Tideswell
Surgery PRG Dales PLACE Group
Cross Reference Group
ND CCG Equalities Committee
Chapel-en-le-Frith Parish Councillor P
On going
On going
On going
On going
Stringfellow, Jayne
Chief Nurse Officer
Governing Body Member, Primary Care Co Commissioning
Member
Partner Governor Chesterfield Royal Hospital Foundation
TrustP Direct Apr-13 On going No action required
Finance and Performance Committee Member, Clinical
Commissioning Committee Member
Interim Chief Nurse and Director of Quality for Southern
Derbyshire CCG from 1 January 2017P Direct Jan-17 On going No action required
Interim Chief Nurse and Director of Quality for Erewash CCG
from 3 July 2017P Direct Jul-17 On going No action required
Spouse is an employee of Mansfield and Ashfield CCG P Indirect Jun-17 On going No action required
Spouse is Trustee of Carers Trust East Midlands P Indirect Apr-12 On going No action required
Interim Chief Nurse and Director of Quality for Hardwick CCG
from 1 September 2017P Direct Sep-17 On going No action required
Soultana, Lisa Primary Care Co Commissioning Member Alexin Healthcare Ltd –Non-Executive Director P Direct On going On going No action required
Sutherst, Adam
Head of Planning and Performance, Member of Senior
Leadership Team NDCCG
No relevant interest
No spouse with relevant interest On going On going
Taylor, Vikki Locality Director NHS England No relevant interest
No Spouse with relevant interests
Twibey, Carl Head of Financial Management
Partner is employed by Derbyshire Community Health Care
Services NHS TrustP Indirect On going On going No action required
Whitworth, MichaelInterim Director for Contracting and Performance
Development
Owner and Director of Michael Whitworth Consultancy
LimitedP Jul-16 On going
Woods, Kerrie Primary Care Co Commissioning Member No relevant Interests
No spouse with relevant interests
Wooster, Lorraine Dr Member of Prescribing Sub Committee Partner to be at Stubley Medical Centre
Stubley Medical Centre is s member of North Derbyshire GP
Federation
P
P
Direct
Direct
On going
On going
On going
On going
Withdraw from all discussion and
voting if organisation Is potential
provider unless otherwise agreed by
the meeting chair
Wright, Angela Interim Deputy Director (Place) Derbyshire CCGs on
secondment from ECCG to NDCCG
Trustee and Board member of Ashgate Hospicecare a
provider that has a contract with NDCCG
P
Direct Jan-13 on going
No involvement in direct contracting
arrangements. Interest to be declared
at formal meetings where the
provider is discussed. No involvement
in the decision making process or
presence in the discussion regarding
the contract or investment
PRIMARY CARE CO-COMMISSIONING COMMITTEE
22 February 2018
PAPER NO. B
PRIMARY CARE CO-COMMISSIONING COMMITTEE– 22.02.18
TITLE Primary Care Co Commissioning Committee Quality and Performance Assurance report.
PRESENTER Judy Derricott Head of Primary Care Quality
AUTHOR Judy Derricott Head of Primary Care Quality
SPONSOR Marie Scouse Assistant Chief Nurse Primary care
IS THIS PAPER FOR: Decision Assurance Discussion
RECOMMENDATIONS The PRIMARY CARE CO-COMMISSIONIGN COMMITTEE is asked to: The Primary Care Co Commissioning Committee is asked to accept and note the contents of the attached paper REPORT SUMMARY In April 2016 NHS NDCCG became responsible for Co-Commissioning of Primary Medical Services. As part of this delegated responsibility NDCCG is required to provide assurance as to the Quality and Performance of membership practices to Primary Care Co Commissioning Committee and NHS England. The attached Primary Care Quality and Performance Assurance report is submitted to provide assurance to the Committee that North Derbyshire Clinical Commissioning Group is fulfilling its responsibility under delegated authority to monitor and support primary care quality and performance. Key matters for consideration are highlighted below with additional information contained within the attached full report. NDCCG is working closely with the newly commissioned North of England Commissioning Support Unit (NECCSU) to develop the Primary Care Quality and Performance Quality Matrix to support the triangulation of information at the monthly Primary Care Quality and Performance Review Committee (PCQ&PRC) meetings. The matrix will be Derbyshire wide and will provide a consistent approach to the triangulation of information pertinent to primary care. A small working group was established to review the content of the matrix and further develop
this into the Derbyshire Wide Approach. We now have all CCG agreement as to the content of the matrix and are awaiting a timeline detailing availability of information with agreement for completion February 2018 Key matters for consideration are highlighted below with additional information contained within the attached full report. Monthly meetings with Royal Primary Care (RPC) continue to be held providing the opportunity to review the CQC action plan, gain assurance as to progress towards achievement of action plan and other areas identified at the meeting. Care Quality Commission Actions – All identified actions completed December 2017. These have been reviewed monthly with RPC. The Care Quality Commission carried out an announced comprehensive inspection at Darley Dale Medical Centre on 1 November 2017. Overall inspection rating GOOD The ratings in response to CQC inspections for the reporting period up to 31st December 2017 for all practices are detailed below: Outstanding 9 practices Good 25 practices Inadequate 1 practice Practices in NDCCG continue to perform well against the NHS England antibiotic quality premium. CCG figures for the 12 month period to November 2017. Friends and Family Test (FFT) In January 2017 37% North Derbyshire Practices submitted Friends and Family data, after a targeted piece of work with practice’s, by December 2017 83% of practices submitted data. IS THERE A FINANCIAL IMPACT?
There is no direct financial impact on the CCG with regards this report.
HAVE ANY QUALITY & COMPLIANCE ISSUES BEEN IDENTIFIED/ACTIONS TAKEN? The Clinical Commissioning Group has a statutory obligation to support the quality of services delivered through Primary Care. To meet this requirement the availability and triangulation of available information and local intelligence is integral to good decision making. The development of the Primary Care Quality and Performance Review Committee supports this, the committee meets monthly and information to support the meeting and is updated monthly or when available. HAVE ANY CONFLICTS OF INTEREST BEEN IDENTIFIED/ACTIONS TAKEN?
No
LINK TO BOARD ASSURANCE FRAMEWORK/RISK REGISTER Reference Number: BAF/ RR
* Current Risk Score
How does this paper provide assurance to the PRIMARY CARE CO-COMMISSIONING COMMITTEE that the risk is being managed?
CCG IMPROVEMENT & ASSESSMENT FRAMEWORK
Please describe how this report and/or the services described within it supports CCG performance in the following domains:
Better health outcomes for all This report provides the Primary Care Co Commissioning Committee with an overview of the Clinical Commissioning Group’s Quality and performance position across Primary Care.
Improved patient access and experience Empowered, engaged and well-supported staff Inclusive leadership at all levels
CLINICAL PRIORITY AREAS (please tick)
Mental Health Dementia Learning
Disabilities Cancer Diabetes Maternity
PRIVACY IMPACT ASSESSMENT NOT APPLICABLE
QUALITY IMPACT ASSESSMENT NOT APPLICABLE
PATIENT, PUBLIC AND STAKEHOLDER INVOLVEMENT NOT APPLICABLE
EQUALITY AND DIVERSITY IMPACT
Due Regard to the proactive duties of the Equality Act 2010 has been taken in development of this paper and:
1. It’s influence on the decision is evidenced in: The Clinical Commissioning Group has a statutory obligation to support the quality of services delivered through Primary Care.
OR 2. It is judged that it is not
proportionate on the basis that………………………….
This completes the due regard required.
OR 3. Further equality analysis is
required and it is recommended that the Governing Body receives this by…………………(date)
NOTE: Policies/decisions may need to be adjusted in line with any equality analysis or due regard that is brought back at a future date. Any decision that is finalised without being influenced by appropriate due regard could be deemed unlawful.
*Delete as appropriate
Primary Care Co-Commissioning Committee
PUBLIC SESSION
Primary Care Quality and Performance Review Committee Assurance Report. This report covers the time period 1st October to the 31st December 2017 and is intended to provide the Primary Care Co Commissioning Committee with assurance that North Derbyshire Clinical Commissioning Group (NDCCG) is fulfilling its responsibility under delegated authority to monitor and support primary care quality and performance. Primary Care Quality and Performance Review Committee To comply with the delegated authority powers the Clinical Commissioning Group has established a Primary Care Quality and Performance Review Committee to provide assurance to the Primary Care Co Commissioning Committee (PCCCC) as to the performance of the Clinical Commissioning Group’s membership practices. The group has been established to review available quality and performance intelligence to identify those practices where additional support from the CCG may be required. The key responsibilities of the Primary Care Quality and Performance Review Committee are to:
• Review practice level data and dashboard matrix • Identify and review practices that are highlighted as outliers within the dashboard matrix • Identify practices that require support as per recovery model process • Identify practices that have performance or contractual concerns • Identify and triangulate practice level information from NHS England, Primary Care Contracting,
Primary Care Quality, Patient Experience, Finance, Workforce • Monthly review all individual agreed action plans • Produce exception report to Primary Care Co Commissioning Committee (PCCCC) quarterly • Produce report to PCCCC monthly for practices requiring intense support
NDCCG is working closely with the newly commissioned North of England Commissioning Support Unit (NECCSU) to develop the Primary Care Quality and Performance Quality Matrix to support the triangulation of information at the monthly Primary Care Quality and Performance Review Committee (PCQ&PRC) meetings. The matrix will be Derbyshire wide and will provide a consistent approach to the triangulation of information pertinent to primary care.
A small working group was established to review the content of the matrix and further develop this into a Derbyshire Wide Approach. We now have all CCG agreement to the content of the matrix; the CCG was assured that the matrix would be completed by January 2018; this has now been further extended until February 2018. In addition to the Matrix information additional reports will be reviewed to support the Primary Care Quality and Performance Review Committee meetings
PCQ&PRC PUBLIC Assurance Report FEBUARY 2018
Practice Summary
The following five areas have been chosen to be included into the Practice summary. Inclusion of this information is liable to change as new information becomes available which may be felt to reflect a quality summary of primary care more appropriately.
• Procedure of Limited Clinical Value (PLCV) • GP Experience (Patient Survey) • Care Quality Commission (CQC) rating • Antibiotic Prescribing • Quality Outcomes Framework (QOF)
Data has been rated according to the CCG median and used Inter Quartile Range (IQR) (The difference between upper (3) and Lower (1) quartiles for outliers) unless otherwise stated.
High Outliers are worked out by Quartile 3 + (1.5 X IQR) and Low Outliers Quartile 1 – (1.5 X IQR). The workings can be found on the PLCV tab within the spread sheet.
• Green = less than median • Amber = Between Quartile 3 + (1.5 X IQR) and Median • Red = Greater than Quartile 3 + (1.5 X IQR) NDCCG average has been used as the baseline
PCQ&PRC PUBLIC Assurance Report FEBUARY 2018
1. Procedures of Limited Clinical Value -Referrals –referrals per 1000 weighted population:
Data Indicator: Inter Quartile Range
This data highlights the number of referrals per 1000 weighted population by practice for conditions which are included within the Clinical Commissioning Referral Policy formerly known as PLCV. This data shows overall referrals for conditions covered within the policy and does not differentiate between appropriate and inappropriate referrals.
2. GP Patient Experience Survey:
Data Indicator: Inter Quartile Range
Comparative Analysis of National GP Patient Survey by NHS North Derbyshire CCG GP Practice On behalf of the CCG Arden Gem Commissioning Support Unit ( now NEC CSU) updated the comparative analysis on key questions resulting from the July 2016 GP Survey alongside that of the July 2017 GP Patient Surveys at GP practice level. The data is derived from the GP Patient Survey of July 2016 and July 2017. The data is weighted and aggregated from a survey collected during July-September 2015 & January-March 2016 [July16 update] and January-March 2017. The July 2017 update generated 4,190 responses to the survey. This equated to a response rate of 51%. Nationally, England had a response rate of just over 37%. The July 2016 update had 4,233 responses at a response rate of 51%. Improvement to the response to; Overall Experience of Making a GP Appointment contributes to the CCG Quality Premium for 2017/2018, a 3% increase (baseline 76%) on previous year or 85% of responders reporting that they had a good experience of making an appointment. Makes up 17% of overall Quality Premium with a financial value set against achievement of £244,800 and will be based upon the annual publication of the GP Patient Survey. The Quality Premium (QP) scheme is about rewarding Clinical Commissioning Groups for improvements in the quality of the services they commission. The scheme also incentivises CCGs to improve patient health outcomes and reduce inequalities in health outcomes and improve access to services. Access is discussed at all Support for Quality Improvement Visits and the latest report has been shared with all practices.
3. Care Quality Inspection Outcome:
The Care Quality Commission overall outcome has been included and rated as below:
Data Indicators: National
• Green - Outstanding • Light Green - Good • Requires Improvement – Amber
4. Antibiotic Prescribing:
Antimicrobial resistance (AMR) is an ever-increasing problem and it is estimated that by 2050 worldwide deaths directly attributable to AMR will outnumber any other single cause. Any use of antimicrobials, however PCQ&PRC PUBLIC Assurance Report FEBUARY 2018
appropriate and conservative, contributes to the development of resistance, but unnecessary and excessive use exacerbates the issue.
Practices in NDCCG continue to perform well against the NHS England antibiotic quality premium. CCG figures for the 12 month period to November 2017.
NHSE Quality Premium indicator NDCCG NHSE QP target
Total antibacterial prescribing (items per antibacterial STAR PU)
1.136 1.161
Broad Spectrum % age 7.7% 10% Number of trimethoprim items for patients over 70 years
5,197 7,525
Trimethoprim items : nitrofurantoin items ratio 0.523 1.137
Practice level prescribing figures are shared regularly, and practices who are high in any area are offered audits, guideline updates and patient information resources to try and reduce prescribing levels.
European antibiotic awareness week ran from 13th to 19th November and European (and World) antibiotic awareness day was on the 18th November. To coincide with this Public Health England (PHE) have recently launched a national ‘Keep Antibiotics Working’ campaign including television and radio adverts as well as media resources. All practices have received posters to support the campaign and are being encouraged to add campaign materials to their surgery screens.
Campaign materials and other antibiotic messages have also been shared with North of England Commissioning Support Unit communications to use throughout the winter months.
The figures have been shared down to practice level at prescribing leads’ meetings and, although overall results are below the CCG target, the medicines management team are continuing to work with the higher prescribing practices
Data indicators: Local CCG average
• Green – prescribing is below NDCCG average • Amber – prescribing is above CCG average but below National average • Red – prescribing is above National average
5. Quality Outcomes Framework
This reflects practice achievement against available Quality Outcomes Framework (QOF). The Primary Care Quality and Performance Review Group have worked with Arden Gem CSU (now North of England Commissioning Support Unit) to identify a measure to include overall practice exception rates within the information. There have been no changes to the QOF 15/16 16/17, exception reporting has been added to the public summary to provide context. This is reviewed with all practices as part of Support for Quality Improvement Visits.
Data Indicator: Inter Quartile Range - Where exception rates are identified as red/amber this demonstrates a higher exception rate than the CCG average.
PCQ&PRC PUBLIC Assurance Report FEBUARY 2018
Care Quality Commission Update and Inspection Update 1st October to 31st December 2017
Royal Primary Care Update
The Care Quality Commission (CQC) carried out an announced comprehensive inspection at The Grange Family Health Centre on 24 May 2017. This was the first inspection of Royal Primary Care at this location as the new provider of this service. The Care Quality Commission Quality Report was published on the 10th of August Overall Rating for the service – Inadequate Domain Rating Are services safe? Inadequate Are services effective? Inadequate Are services caring? Requires Improvement Are services responsive to people’s needs?
Inadequate
Are services well-led? Requires Improvement On the basis of the ratings highlighted above the practice has been placed into special measures. This will be for a period of six months. CQC will inspect the practice again in six months (follow up visit planned for January 2018) to consider whether sufficient improvements have been made. The CCG have continued to meet monthly with Royal Primary Care (RPC) providing the opportunity to review the CQC action plan, to gain assurance as to progress towards achievement of action plan. Care Quality Commission Actions – All identified actions completed December 2017. Darley Dale Medical Centre The Care Quality Commission carried out an announced comprehensive inspection at Darley Dale Medical Centre on 1 November 2017. A previous inspection was undertaken October 2014
Domain Rating 2014 Rating linked to inspection 2017
Are services safe? Good Good Are services effective? Good Good Are services caring? Good Good Are services responsive to people’s needs?
Outstanding Good
Are services well-led? Good Good
Summary of findings from published CQC report:
Overall inspection rating GOOD
The partners invested high levels of funding in their practice team to provide sufficient capacity, and ensure there was adequate and trained administrative support to relieve pressures on clinical time. There was strong clinical leadership and CQC saw how this impacted positively upon the quality of the service. For example, the GP prescribing lead had overseen cost effective prescribing, and lower rates of PCQ&PRC PUBLIC Assurance Report FEBUARY 2018
antimicrobial prescribing. The practice had a live strategy which focussed on the new challenges faced by general practice. This was supported by the appointment of a strategic business manager, and a new premises development to provide an environment to respond to local patients’ needs. CQC spoke with community based health, social and care home staff who overwhelmingly provided us with positive feedback about their interactions with the practice team, In particular, CQC observed that the relationship with social care was driving responsive and compassionate care for patients, including keeping those at risk from harm safe. The practice had received the Derbyshire Dignity Award in 2013 and continued to aspire to maintain this achievement. At the time of inspection, the practice had submitted an application to the county council as part of the biennial renewal which focused on their work with local care homes. Results from the latest national GP patient survey showed that the practice had performed above local and national averages in the majority of the questions about patient experience. This was particularly evident in relation to GP access and comments regarding being cared for in a dignified and respectful manner. Patients who responded that they were satisfied with the practice’s opening hours was marginally below the local and national averages. The practice was proactively looking to address this via a collaborative approach with other practices to implement an 8am-8pm hub service locally. The practice encouraged and supported staff to report incidents and near misses. When incidents did happen, the practice learned from them and improved their processes. Positive events were also recorded in recognition that sharing best practice was an equally valid means of learning, and a way to celebrate success. The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines. Care planning was embedded within the practice to reflect individual’s patients’ needs and their own wishes. We saw that 8% of patients had at least one care plan in place at the time of our inspection. There was a strong focus on continuous learning and improvement at all levels of the organisation. Staff training records were up to date, and regular appraisals encouraged development at all levels. The practice had an established quality improvement programme. This included involvement in research.
The ratings in response to CQC inspections for the reporting period up to 31st December 2017 for all practices are detailed below:
Outstanding 9 practices Good 25 practices Inadequate 1 practice CQC next steps
Quarterly meetings arranged between the Clinical Commissioning Group and Care Quality Committee to review practices visited.
• Every practice has been visited and all new inspections will be in the new format. • The new way of inspecting commenced on Nov 1st 2017 – Darley Dale have been the first in
Derbyshire to be inspected this way. • The regulation by CQC will stay the same. • More emphasis on well-led in future inspections as this filters into all areas.
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Future Visiting Regime
• For practices that have a good or outstanding report, a fully focused visit will take place up to every five years.
• Practices who are rated Requires improvement will now have a return visit within 12 months, with the 6 month time frame being abolished.
• Inadequate practices will still have a revisit within 6 months Support for Quality Improvement Visits Support for Quality Improvement Visits. Support for Quality Improvement Visits (SQI) were introduced by North Derbyshire Clinical Commissioning Group in 2014 to support membership practices to review current health care information in relation to individual practice quality and performance, share good practice, learn from visiting peer GPs, understand the information available and make change where needed to improve the quality of care for their registered population. SQI supports the Clinical Commissioning Groups commitment to continuously improving the quality of healthcare for its population with a focus on the needs of the registered population of our membership practices. Aims:
• To hold up the mirror of data and get the practice to reflect on its performance Re. resource utilization; sharing best practice, learning from others and seeking to understand the information more completely in order to change where necessary.
Outcomes:
• Reduce Clinical Variation • Continue to be a mechanism for encouraging practice development and sharing good practice.
Peer to Peer Review:
Peer Review is integral to Support for Quality Improvement Visits, all practices reflect on available information about practice performance, one of these areas are referrals and practices will often conduct a retrospective review where data is not consistent or felt to be reflective of activity. We will add the following to future agendas: Does the practice have a system of Peer to Peer review – formal or informal? How does the practice share any learning/ learning needs identified as part of this? Can the practice share any identified learning with the CCG. The Primary Care Team will also: Work with North of England Commissioning Support Unit (NECCSU) to develop Peer to Peer Supporting analysis to be shared with practices. PCQ&PRC PUBLIC Assurance Report FEBUARY 2018
Support the development of a HOT TOPICs approach to sharing educational material on a monthly basis. Key themes from this quarters visit are:
• Care of Respiratory patients and referral to Support networks. • Patient Survey results • Increasing demand on GP practices • Peer to Peer review. • Available support offered to General Practice by the Cancer Research Network.
NHS England Complaints NHSE Patient Complaints re; Primary Care are received monthly; any themes highlighted within the report are raised with the practice and discussed at Support for Quality Improvement visits if appropriate. Serious Incident When serious incidents occur, the National Health Service (NHS) has a responsibility to ensure that there are systematic measures in place for safeguarding people, property, NHS resources and reputation. This includes responsibility to learn from these incidents to minimise the risk of them happening again. All providers of NHS funded care services, for which the NDCCG is lead commissioner are required to report Serious Incidents (SIs) as per NDCCG Serious Incident Policy.
NDCCG via the Primary Care Clinical Quality Team offers guidance and support to all member practices, to report, investigate and to complete the required documentation for SIs. All Primary Care SIs are reported via the Strategic Executive Information System (STEIS) data base to NHS England by NDCCG
For events categorised as Patient Safety Incidents, the practice will be asked to conduct an internal Audit and report learning from the audit to the CCG.
For events categorised as Serious Incidents, the CCG will work alongside the practice to support the completion of a Route Cause Analysis. The CCG will report findings to NHS England via STEIS. Further detail is outlined in the report below.
Learning from Serious Incidents
Learning from Serious Incidents is a standard agenda item within Clinical Governance Leads meetings offering the opportunity for discussion/ reflection and shared learning identified as part of the Serious Incident process. Incidents shared are not only from NDCCG but from Derbyshire and wider if there is identified learning.
Access Friends and Family Test (FFT)
Submission of Friends and Family Test data to NHSE is a contractual requirement and a 0 submission is accepted as completion.
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Enhanced Services Participation
Extended Hours: 32/35 practices providing – no additions or withdrawals in the first quarter, new conditions will be introduced from 1 October 2017 - regularly close for a half day (weekly) will not ordinarily qualify (Stubley MC, Killamarsh MP and Arden House MP do not offer extended hours)
Learning Disabilities: 35/35 practices providing – no additions or withdrawals in this quarter.
Author: Judy Derricott Head of Primary Care Quality Sponsor: Marie Scouse Assistant Chief Nurse Primary care Date: 14.02.18
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NHS North Derbyshire CCG Primary Care Co-Commissioning Committee 22 February 2018
Paper B
NORTH DERBYSHIRE CCG PRIMARY CARE CO-COMMISSIONING COMMITTEE Robert Robinson Room, Scarsdale
Thursday 25 January 2017
MINUTES
Present Gary Apsley (Chair) Lay Member (Patient and Public Engagement) Isabella Stone Lay Member (Patient and Public Engagement) Ian Gibbard Lay Member (Audit) Ben Milton CCG Chair and Clinical Lead, GP Debbie Austin GP (High Peak and Dales Locality) Louise Bainbridge Chief Finance Officer Jayne Stringfellow Chief Nurse & Quality Officer Marie Scouse Assistant Chief Nurse Hannah Belcher Head of Primary Care Commissioning Carolin Shearer HealthWatch Representative David Knight GP Contract Manager, NHS England Apologies Minute-Taker
Rosalind Combes PA to Chief Nurse & Quality Officer
Opening of Business
PCC001.18 The Chair welcomed Primary Care Co-Commissioning Committee Members; introductions were not required, and no members of the public attended.
PCC002.18 Apologies for Absence No apologies for absence had been received.
PCC003.18 Declaration of Interests The Register of Interests was noted. It was noted for complete transparency that Dr Austin was working at Thornbrook Surgery under winter pressures funding. It was reported for the avoidance of doubt Dr Austin had been approached by the practice to undertake locum work. Dr Austin
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NHS North Derbyshire CCG Primary Care Co-Commissioning Committee 22 February 2018
Paper B agreed to withdraw from discussions should it be deemed appropriate by the Chair, but no such need was foreseen as there was no conflict of interests against any item on the agenda. No further declarations were made.
PCC004.18 Minutes of the Primary Care Co-Commissioning Committee meeting of 21 December 2017 The minutes were agreed as an accurate record of the meeting, and were signed by the Chair.
PCC005.18 Matters Arising from the Primary Care Co-Commissioning Committee Meeting of 21 December 2017/Action Log PCC0086.17 – SBS Report re Missing Patient Information The item was CLOSED and could be removed from the active action log. PCC0096.17.1 The Grange Family Health Centre/Royal Primary Care Update The matter appeared on the main agenda; the action log item could therefore be CLOSED. PCC0097.17 Avenue House & Hasland Partnership Contractual Merger with Hasland Medical Centre No update was due until October 2018; item to be RETAINED. PCC0098.17.1 NHS Annual Complaints Report The matter was deferred owing to issues of capacity in the Primary Care Team and would be presented instead in February; the action log entry was to be RETAINED. PCC0098.17.2 NHS Annual Complaints Report Mrs Scouse had contacted NHS England as requested; the action could be CLOSED. A number of typographical errors including incorrect dates were noted in the Action Log. The Decision Log was NOTED.
PCC006.18 The Grange Family Health Centre/Royal Primary Care Update Miss Belcher presented the paper and summarised key points. It was noted that the CQC follow-up inspection had taken place on Tuesday 23 January; an update would be provided at the February Committee meeting. The matter was also to be discussed during confidential session. The Committee NOTED the report.
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NHS North Derbyshire CCG Primary Care Co-Commissioning Committee 22 February 2018
Paper B PCC007.18 Finance Update Report
Ms Bainbridge presented the report, highlighting Year To Date and forecast overspend on QOF and outlining reasons for this overspend. NHS England support in ensuring an appropriate budget for 2018/19 had been requested. Section 4 of the paper (Analysis of Risk) was considered. Ms Bainbridge confirmed that the CCG was close to the limit of its budget and advised that concerns had been raised with NHS England accordingly. A response from NHS England was awaited. The Committee recognised that NHS England’s guidance on contingencies, usually issued before Christmas, had not yet been received. Discussion took place around the effect of good performance in Primary Care, and Dr Shearer suggested that it appeared from a lay perspective that the CCG was being penalised for general practice overperformance. Dr Milton noted that CCGs which performed well on QOF were generally at a disadvantage. The Committee NOTED the report.
PCC008.18 Any Other Business Apologies Mr Apsley and Dr Milton gave advance apologies for the meeting on 22 February; it was noted that Ms Stone would chair the meeting in Mr Apsley’s absence and that Dr Austin would be present. No further business was transacted.
Date and time of next meeting: Thursday 22 February 2018 in the Robert Robinson Room, Scarsdale, Chesterfield, Derbyshire at 10.30am.
Signed by: …………………………………………………. Dated: ………………… (Chairman)
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MATTERS ARISING MATRIX
NHS NORTH DERBYSHIRE CCG PRIMARY CARE CO-COMMISSIONING COMMITTEE – 22 February 2018: Matters Arising Action Matrix Meeting Date
Item number Item Title and Issue Owner Actions Status Forecast Closed Date
21.12.17 PCCC/1718/01 Formerly PCC0097.17
Avenue House & Hasland Partnership Contractual Merger with Hasland Medical Centre
DK The outcome of the stakeholder and patient engagement following the merger will be presented to the October 2018 meeting
Open 21.10.18
21.12.17 PCCC/1718/02 Formerly PCC0098.17.1
NHS Annual Complaints Report MS A separate annual report to be provided for the January 2018 Committee from the information on the dashboard.
Open 22.02.18
Items that have been actioned and closed since the previous Primary Care Co-Commissioning Committee remain on the list (highlighted in grey) for completeness for one month only and are then removed.