Primary Care Co-Commissioning Committee Agenda Part I · Somen Banerjee Director of Public Health...

Primary Care Co-Commissioning Committee Agenda Part I

Tuesday, 27 September 2016, 3.30pm-5.30pm

The Quayside Room, Museum of London Docklands, No.1 Warehouse, West India Dock Road, London E14 4AL

1. General Business Action required Presenter Enc. Time Page

1.1 Welcome, introductions and apologies

- Julia Slay

10 minutes

1.2 Declarations of interest -

1.3 Minutes of Part I of the meeting 26 July 2016 To approve Julia Slay A

2. Finance

2.1 Finance Report

To note Andrea Antione B 10 minutes

3. Commissioning and Contracting

3.1 Updated Terms of Reference For information Chima Olugh C 15 minutes

3.2 Commissioning Intentions For discussion Jenny Cooke Verbal 30 minutes

4. Quality and Performance

4.1 CQC update (report already completed)

For information

Pacifique Kimonyo D 15 minutes

5. Governance

5.1 BAF For information Chima Olugh E 20 minutes

5.2 Forward planner

For discussion Chima Olugh F 10 minutes

5.3 AOB

All 10 minutes

Primary Care Co-Commissioning Committee Minutes Part I

Tuesday, 26 July 2016, 3.30-5.30pm

Room 7, Burdett House, Mile End Hospital, Bancroft Road, London E1 4DG

1 General Business

1.1 Welcome, introductions and apologies

1.1.1 Voting Members

Name Role Organisation Mariette Davis Lay Member (Governance) NHS TH CCG Dr Tan Vandal Secondary Care Specialist Doctor NHS TH CCG Julia Slay Governing Body Member – Lead for Patient and Public

Involvement NHS TH CCG

Martin Marshall Independent Clinical Advisor UCL

1.1.2 Non-voting Members

Name Role Organisation Virginia Patania Urgent Care Representative NHS TH CCG Karen Bollan Healthwatch Representative Healthwatch

1.1.3 In attendance

Name Role Organisation Chima Olugh Primary Care Commissioning Manager TH CCG Jenny Cooke Deputy Director of Primary Care TH CCG Jo-Ann Sheldon Primary Care Commissioning Manager TH CCG Lynne Smith PA and Administrator (Minute Taker) TH CCG Simon Hall Director of Commissioning TH CCG Pacifique Kimonyo Quality and Performance Manager TH CCG Andy Nuckcheddee Governance Manager TH CCG

1.1.4 Apologies

Name Role Organisation Somen Banerjee Director of Public Health LBTH Luke Addams Director of Adult Services LBTH Jane Milligan Chief Executive Officer TH CCG Denise Radley Director of Adult Services LBTH Jackie Applebee LMC Representative LMC Maggie Buckell Registered Nurse Member – Primary Care GB Board

Lead NHS TH CCG

Henry Black Chief Finance Officer/Deputy Chief Officer NHS THCCG Nicola Hagdrup GP Representative NHS THCCG

Enclosure A

1.0 General Business

1.2 Welcome, Introductions and Apologies

The Chair welcomed everyone to the committee meeting.

Apologies noted at 1.1.4.

1.3 Declarations of Interest

Karen Bollan explained that she has a possible declaration for item 4.1 which she will explain during the agenda item.

The complete register of interests is published on the NHS Tower Hamlets Clinical Commissioning Group’s (CCG) website: http://www.towerhamletsccg.nhs.uk/about/conflict-of-interest-register.htm

1.3 Minutes of the last meeting

The minutes were agreed as accurate apart from the attendance list which needs to be checked against the terms of reference to make sure attendees are noted in the correct areas.

Action log:-

The Tower of London Practice and QIPP will be discussed on the agenda.

2.0 Finance

At month three the CCG is reporting 557k overspent against the budget. The reason for this is that the allocation we have noted doesn’t cover what we expect to spend. In terms of QIPP, 217K is not showing as this has not come through to the year to date figures. Queries were raised regarding the Direct Enhanced Service figure which was confirmed reflects what we spent last year, along with the GMS underspend which is based on information from NHS England and due to list cleansing. It was confirmed that for future reports the key risk of taking on co-commissioning will be removed.

3.0 Commissioning and Contracting

3.1 Tower of London Practice

Jo-Ann Sheldon reminded the Committee about the paper written by NHS England that she spoke about at last month’s meeting regarding 60 or so patients at the Tower of London Practice who have in the past had a ‘special arrangement’ with City and Hackney that the Wapping Practice have now volunteered to take on instead. Henry Black requested information regarding the costs involved which he will now need to assess. There could be a delay with IT which we must be aware of and be prepared to chase up. Karen Bollan asked how patients will be informed, and Alison Goodlad confirmed that this will be the responsibility of NHS England. Martin Marshall raised the issue again regarding the clinical competency of the GP at the Tower of London Practice and Alison Goodlad confirmed she will flag this with the Medical Director at NHS England.

http://www.towerhamletsccg.nhs.uk/about/conflict-of-interest-register.htm

http://www.towerhamletsccg.nhs.uk/about/conflict-of-interest-register.htm

Action 1: Alison Goodlad to raise competency issues of GP at Tower of London Practice to Medical Director at NHS England.

3.2 Primary Care Strategy

The reference group has now finished along with four locality workshops which has now given us an overview of the work done over the last six months. A slide presentation was handed round which sets out the next steps and to get feedback from the committee. An overview of this is set out below.

We accept that Primary Care is struggling and now have an outline from our workshops that our vision is a commitment to care which will be equitable. The idea of a health and wellbeing club for our patients will mean that they shouldn’t have to re-register if they move in the borough and in this respect we need to think about how we organise the borough to see more alignment of back office functions, build on hubs and work much closer with pharmacies as integrated providers. In this respect more clarification is needed about what sits at borough level, locality level and network level etc. Our main aim is to work towards a population based capitated budget. When these ideas were presented to the GP Care Group the response was very positive. The changes should be in place next year.

Martin Marshall commented that he liked the balance between incremental and ‘the club’. However, there is no social solidarity included in this model as there is no patient involvement. The other problem is the idea of a single point of access, as Martin feels that access is best kept personal, most patients wish to see their own GP. Virginia Patania explained that there is going to be a trial taking place for single point of access. The aim of this is that the single point of access via a telephony system will direct the activity urgently to one place which would be GP lead. Karen Bollan commented that the presentation is good however there is no patient voice included. We need to make the patient voice more explicit so that the public recognise themselves. Martin Marshall commented that although most GPs recognise that the world needs changing they may have questions around resourcing and the GP forward view. Virginia Patania has concerns regarding how we clearly articulate quality and improvement which Simon Hall thinks should be lead through the GP Care Group. An action was made to make the strategy plan more visible.

Virginia Patania explained that the Workstream one initial pilot will take place in the next four weeks. Funding is still a problem and Virginia will try to establish how the various methods of funding we are looking into might ‘trickle down’. We are also looking at funding to create an ‘academy’.

Action 2: Primary Care Strategy Plan to be made more visible

4.0 Quality

4.1 CQC – SOP

This Standard Operating Procedure (SOP) is going to be presented at all the Primary Care Committee’s across London and is to provide assistance with the governance process around CQC visits and where improvement may be needed or to issue breach notices. Jenny Cooke commented that with regard to Tower Hamlets we would probably only use breach notices in the case of non-engagement for improvement. It was agreed by the Committee that we would adopt this SOP. Karen Bollan explained that she may have a conflict of interest here as she is a member of the Royal College of Practitioners who often attend practices experiencing difficulties emerging from CQC visits.

5.0 Governance

5.1 Risks

The Primary Care team risk register was presented at the meeting and it was explained that we have gone through the wording so these are risks rather than statements and also reassessed the risk rating. It was agreed that the risk relating to the APMS contract should be escalated to the BAF risk register and that we also need to look at the grading however, we will look into this first before escalating. There were no further comments made however, it was noted that the BAF risks should be monitored at this Committee on a regular basis.

Action 3: Risk relating to the APMS Contract to be assessed for possible escalation to the BAF

5.2 Governance Review

It was agreed that as there has been an overall governance review in the CCG, we should also look at governance for the Primary Care Committee and focus on items such as who should attend part II of the meeting and the Terms of Reference. Looking at the Terms of Reference is was noted that the role of Committee hasn’t changed however some changed items were noted as follows:-

The Primary Care Programme Board now needs to be changed in alignment with the new structure to Primary Care Planning and Delivery Meeting. The wording needs to be changed with regard to how the Committee is reporting to the finance and audit Committees. There is now a new chair of the committee, Julia Slay and as Mariette Davis is no longer able to be the vice chair due to conflicts of interest, we will require a vice chair which is likely to be Maggie Buckell. Virginia Patania commented that her role in the Committee is incorrect and it was decided that it will now be changed to Urgent Care Representative as a non-voting member. Cate Boyle and Dianne Barham now need to be removed as they are no longer members along with WEL Advisory Board. It is not clear in the Terms of Reference what should be part I, II or III, so it was decided that part I will be public, part II will be sensitive and part III for the conflicted members to leave. It was noted however that we will consider agenda items on an individual basis. With regard to gap analysis we will be working on this process in the Audit Committee which Andy Nuckcheddee will either work on a forward planner or will send us a template for use.

AOB

None Noted.

Next meeting 27th September 2016, 3.30-5.30pm, The Quayside Room, Museum of London Docklands, No.1 Warehouse, West India Dock Road, London E14 4AL

Actions

Key

Action required Action near completion Action completed Item formally approved/agreed

Action reference Action Lead Due Date Update

#July 1 Alison Goodlad to raise competency issues of GP at Tower of London Practice to Medical Director at NHS England.

AG

Sep 2016

#July 2

Primary Care Strategy Plan to be made more visible.

JC

Sep 2016

#July 3 Risk relating to the APMS Contract to be assessed for possible escalation to the BAF.

CO

Sep 2016

Primary Care Committee Enclosure

Date of meeting 27rd September 2016 B

Agenda item

Title of report: M5 Primary Care Finance report

Author(s): Andrea Antoine – Deputy Chief Finance Officer –TH CCG

Olya Klufas – PC Liaison Officer –TH CCG

Presented by: Sponsor (if different): For further information

Andrea Antoine – Deputy Chief Finance Officer –TH CCG

Executive summary

The month 5 report provides the Primary Care Committee with the financial position for Primary Care Co-commissioning as at 31st August 2016 and consists of the following:

• Executive Summary

• Key Risks and issues

• QIPP

• Revenue Financial Position

• Commentary on the reported position

Recommendation

Information Approval To note X Decision

To note the contents of the report, and discuss any actions required

Conflicts of Interest There are no identified conflicts of interest.

Key issues • Meeting the QIPP savings should this not be met by NHS Englands co-ordinated national business rates appeal process.

• Level of funding Tower Hamlets CCG may have to mobilise to meet the difference between the Primary Care allocation and proposed spend for financial year 2016/17.

Report history Finance report is reviewed by Deputy Chief Finance Officer to ensure that it is line with the monthly finance report that is sent to the Governing Body.

Patient and Public N/A

involvement

Link to the Board Assurance Framework

Ensuring that the Primary Care committee is sighted on key finance and performance targets:

BAF Risk 3.4: Failure to understand Primary Care cost pressures and effectively plan the allocation could have a negative impact on the CCG’s running costs.

Impact on Equality and Diversity

N/A

Resource requirements None.

Next steps Continue to monitor.

Month 5 Finance Report – 2016/17

Executive Summary

This report provides an update on the Primary Care co-commissioning financial position for the CCG at Month 5 (August 2016) and a forecast for the year. At Month 5 the CCG is reporting a year to date (YTD) over spend of £290k and full year forecast of £476k overspend.

The report notes the mitigating actions being undertaken by the CCG, in consultation with NHS England, to ensure that the final position is closer to balance.

Key Risks and Issues

In financial year 2015/16 Tower Hamlets CCG Tower Hamlets CCG was granted delegated authority for Primary Care Co-commissioning. This meant that NHS England took the lead for budgeting and authorisation of payments, but any shortfall in expenditure was the responsibility of the CCG.

Since April 2016 the CCG has full delegation for Primary Care Co-commissioning. This means that we are responsible for the budgeting and authorisation of primary care payments and meeting any shortfalls in expenditure. The CCG continues to work cooperatively with NHS England, which remains the contract holder for all GP contracts.

1. Insufficient Allocation for financial year 2016/17 The Primary Care allocation for financial year 2016/17 is £42.59m and the proposed budget set by NHS England is £43.148m. This is a shortfall of £558k. The CCG will be responsible for meeting this shortfall from its internal reserves, if it cannot be meet by other means. The CCG is in discussion with NHS England in order to mitigate this shortfall through the potential use of prior year accruals, or other flexibilities.

Enclosure B

2. Authorisation of payments

On behalf of NHS England, Capita is the third party supplier tasked with making GP payments. Capita coordinates the payment process, collating the data streams relating to payments from the different sources (GP practices, NHS England, the “Exeter” system etc.), seeking authorisation to make the payments from the CCG and actually paying the GP practices, using funds from the CCG bank account. The risk is that the CCG is approving payments, but is not actively involved in their administration. The CCG does has the facility to retrospectively claw back any payments that it feels, with hindsight, should not have been made.

3. QIPP NHS England applied a QIPP saving of £216,828 for financial year 2016/17. There were no detailed plans agreed by NHS England relating to how this QIPP saving was to be achieved At present, how the full QIPP will be delivered is yet to be finalised. NHS England has pointed to the national business rates review, which they estimate will result in savings for Tower Hamlets. We will ensure that we continue to keep this Committee appraised on how this develops.

4. 1% Headroom funding The current year allocation of £42.59m includes £425.9k headroom funding. NHS 16/17 business rules require all CCGs to hold the 1% separately, and for it to remain unallocated.

Proposed Primary

Care budget

2016/17

Actual Primary

Care Allocation 2016/17

Variance % Variance

£000's £000's £000's

Primary Care Co-commissioning 43,148 42,590 (558) -1.3%

Revenue Financial Position The CCG’s summary revenue financial position is summarised below.

Primary Care co-commissioning - 2016/17 Financial Position at Month 5

Annual budget

YTD budget

YTD actual

YTD (Under)/

Over spend

Full Year Forecast

actual

Full Year (Under)/

Over spend

£000's £000's £000's £000's £000's £000's

General Practice - APMS 10,298 4,306 4,409 103 10,579 280

General Practice - GMS 14,729 6,137 6,122 (15) 14,693 (35) General Practice - PMS 5,554 2,314 2,355 41 5,651 97

QOF 2,487 1,036 1,046 10 2,512 25

Premises Cost Reimbursement 7,349 3,062 3,126 64 7,503 154 Other Premises costs 81 34 34 0 81 0

Direct Enhanced Services 1,495 622 622 0 1,495 0

Dispensing/Prescribing Drs 143 60 60 0 143 0

Other GP Services 454 174 261 87 626 172

QIPP 0 0 0 0 (217) (217)

Grand Total 42,590 17,745 18,035 290 43,066 476

Tower Hamlets Exeter list size comparison

Date Period RAW list size

Inc. in RAW

% Inc. in RAW

WEIGHTED list size

Inc /Dec in WEIGHTED

% Inc. in WEIGHTED

01/01/16 Q4 15/16

295,924

291,228.81

01/04/16 Q1 16/17

298,529 2,605 0.88%

293,596.62 2,367.81 0.81%

01/07/16 Q2 16/17

301,806 3,277 1.10%

291,041.17 (2,555.45) -0.87%

APMS Contract payments The APMS contract position is showing a £280k cost pressure on the full year outturn. The budget was already under pressure, due to a £166k shortfall in the allocation. The additional pressure of £114k is due to the continued growth in the raw practice list size (see table above). The APMS contract value is primarily calculated using the raw practice list size. Changes in the “funding redistribution formula” for financial year 2016/17 approved by NHS England added a further £3.65 to the cost of each patient registered with an APMS practice.

PMS Contract payments The PMS contract position is showing a £97k cost pressure on the full year outturn. The budget was already under pressure, due to a £92k shortfall in the allocation. The additional pressure of £5k is due to the continued growth in the raw practice list size (see table above). The PMS contract value is primarily calculated using the raw practice list size. Changes in the “funding redistribution formula” for financial year 2016/17 approved by NHS England added a further £3.95 to the cost of each patient registered with a PMS practice. GMS Contract payments The GMS contract position is showing a £35k underspend on the full year outturn. Although the Global Sum payment per weighted patient is £80.59 for financial year 2016/17 (last year the average payment per weighted patient was £76.14) this increase has not caused a cost pressure because the Quarter 2 weighted practice list size has fallen (see table above). The GMS contract value is primarily calculated using the weighted practice list size and the reduction in list size resulted in a reduction in the payments made to practices. Quality Outcome Framework (QOF) The QOF position is showing a £25k cost pressure on the full year outturn. The budget was already under pressure, due to a £25k shortfall in the allocation. To date there is no indication of any additional activity which would contribute to additional pressure on funding. Premises Costs Reimbursement The Premises position is showing a £154k cost pressure on the full year outturn. The budget was already under pressure, due to a £208k shortfall in the allocation. Other GP Services The GP Services position is showing a £172k cost pressure on the full year outturn. The budget was already under pressure, due to a £164k shortfall in the allocation. The additional pressure of £8k is due to several GP practices applying for, and being awarded financial support to help with their locum costs, resulting from illness and maternity cover of GPs in the practice.

Summary and Recommendations Although this report shows a projected deficit financial position for the primary care co-commissioning budget at this time, there are a series of mitigations outlined that, at present, we are confident will go some way to meeting this gap. We are in active discussions with NHS England with respect to this, and will update this Committee on progress at its next meeting. The Primary Care Committee are, therefore, asked to note the report, and to comment on the mitigations being pursued, at present, by the CCG.


Date of meeting 27th September 2016 C

Agenda item Updated Terms of Reference

Title of report: Primary Care Committee Terms of Reference

Author(s): Chima Olugh, Primary Care Commissioning Manager

Presented by: Sponsor (if different):

Chima Olugh, Primary Care Commissioning Manager

Executive summary

In light of discussions at the July 2016 Primary Care Committee it was agreed that the Terms of Reference be updated to reflect changes to the membership.

The Primary Care Committee is asked to approve the updated Terms of Reference.

Recommendation

Information Approval × To note Decision

Conflicts of Interest There are no conflicts of interests in this instance.

Key issues N/A

Report history N/A

Patient and Public involvement

N/A


N/A


N/A

Resource requirements

Primary Care Team

Next steps The updated Terms of Reference to be approved.

1

Tower Hamlets CCG Primary Care Commissioning Committee

Terms of Reference

Introduction

1. Simon Stevens, the Chief Executive of NHS England, announced on 1 May 2014 that NHS England was inviting CCGs to expand their role in primary care commissioning and to submit expressions of interest setting out the CCG’s preference for how it would like to exercise expanded primary medical care commissioning functions. One option available was that NHS England would delegate the exercise of certain specified primary care commissioning functions to a CCG.

2. In accordance with its statutory powers under section 13Z of the National Health Service Act 2006

(as amended), NHS England has delegated the exercise of the functions specified in Schedule 2 to these Terms of Reference to Tower Hamlets CCG. The delegation is set out in Schedule 1.

3. The CCG has established the CCG Primary Care Commissioning Committee (“Committee”) set out

in Schedule 3. The Committee will function as a corporate decision-making body for the management of the delegated functions (Schedule 2) and the exercise of the delegated powers.

4. The ongoing relationship the Primary Care Committee will have with NHS England will be revised

on an ongoing basis, though is currently outlined as in Schedule 4, giving details of the Memorandum of Understanding between the CCG and NHS England.

5. It is a committee comprising representatives of the following organisations:

• Tower Hamlets CCG • NHS England • Tower Hamlets Local Authority • LMC • Healthwatch • Tower Hamlets General Practice

Statutory Framework 6. NHS England has delegated to the CCG authority to exercise the primary care commissioning

functions set out in Schedule 2 in accordance with section 13Z of the NHS Act.

7. Arrangements made under section 13Z may be on such terms and conditions (including terms as to payment) as may be agreed between NHS England and the CCG.

Enclosure C

2

8. Arrangements made under section 13Z do not affect the liability of NHS England for the exercise of any of its functions. However, the CCG acknowledges that in exercising its functions (including those delegated to it), it must comply with the statutory duties set out in Chapter A2 of the NHS Act and including:

a) Management of conflicts of interest (section 14O);

b) Duty to promote the NHS Constitution (section 14P);

c) Duty to exercise its functions effectively, efficiently and economically (section 14Q);

d) Duty as to improvement in quality of services (section 14R);

e) Duty in relation to quality of primary medical services (section 14S);

f) Duties as to reducing inequalities (section 14T);

g) Duty to promote the involvement of each patient (section 14U);

h) Duty as to patient choice (section 14V);

i) Duty as to promoting integration (section 14Z1);

j) Public involvement and consultation (section 14Z2).

9. The CCG will also need to specifically, in respect of the delegated functions from NHS England, exercise those set out below: - Duty to have regard to impact on services in certain areas (section 13O); - Duty as respects variation in provision of health services (section 13P).

10. The Committee is established as a Committee of the Tower Hamlets CCG Governing Body in

accordance with Schedule 1A of the “NHS Act”. 11. The Primary Care Committee, as an established committee of the Governing Body, is formally

accountable for keeping the Finance, Performance & Quality Committee, and the Audit Committee abreast of decisions and updates so as to assure the CCG Governing Body that Primary Care Co-Commissioning is being effectively governed and managed.

12. The members acknowledge that the Committee is subject to any directions made by NHS England

or by the Secretary of State.

3

Role of the Committee 13. The Committee has been established in accordance with the above statutory provisions to enable

the members to make collective decisions on the review, planning and procurement of primary care services in Tower Hamlets under delegated authority from NHS England.

14. The overall scope of the Primary Care Committee draws together three core functions as follows:

a) The primary care co-commissioning functions formally delegated by NHS England to the CCG as a new CCG function from 1st April 2015

b) The duty to improve quality in primary care - already an existing CCG function since April 2013

c) Oversight and assurance of the development of the CCG's overarching Primary Care Strategy - a new function.

15. In performing its role the Committee will exercise its management of the functions in accordance

with the agreement entered into between NHS England and Tower Hamlets CCG, which will sit alongside the delegation and terms of reference.

16. The functions of the Committee are undertaken in the context of a desire to promote increased co-

commissioning to increase quality, efficiency, productivity and value for money and to remove administrative barriers.

17. The role of the Committee shall be to carry out the functions relating to the commissioning of

primary medical services under section 83 of the NHS Act.

18. This includes the following:

• GMS, PMS and APMS contracts (including the design of PMS and APMS contracts, monitoring of contracts, taking contractual action such as issuing breach/remedial notices, and removing a contract);

• Newly designed enhanced services (“Local Enhanced Services” and “Directed Enhanced

Services”);

• Design of local incentive schemes as an alternative to the Quality Outcomes Framework (QOF);

• Decision making on whether to establish new GP practices in an area;

• Approving practice mergers; and

• Making decisions on ‘discretionary’ payment (e.g., returner/retainer schemes).

4

19. The Committee is accountable for exercising the agreed delegated functions from NHS England; these functions operate at practice level and not at individual Primary Care Contractor level.

Geographical Coverage 20. The Committee will comprise of decisions relating to primary care in Tower Hamlets

Membership The members below, and listed in Appendix A.

21. The Committee shall consist of:

Voting members: Lay chair (Julia Slay), Lay vice chair (Maggie Buckell), Board Secondary Care Consultant (Tan Vandal), CCG Chief Finance Officer (Henry Black), Independent Clinical Adviser (Martin Marshall), CCG Accountable Officer (Jane Milligan). Non-voting members: HWBB rep (vacant), LBTH Public Health representative (Somen Banerjee), Healthwatch Representative (Karen Bollan), LMC (Jackie Applebee), 1 CCG GP Representative (Nicola Hadgrup), Urgent Care Representative (Virginia Patania), NHS England Representative (Alison Goodlad).

22. The Chair of the Committee shall be a CCG Lay Member (Julia Slay). 23. The Vice Chair of the Committee shall be a CCG Lay Member (Maggie Buckell).

24. Non-voting members will be Healthwatch representative (Karen Bollan), LMC representative

(Jackie Applebee), Public Health representative (Somen Banerjee), HWBB representative (vacant), NHS England representative (Alison Goodlad), a CCG General Practice representative (Nicola Hadgrup), and an Urgent Care representative (Virginia Patania).

25. The committee may appoint ad-hoc members to advise it on specific matters within its terms of

reference from time to time as appropriate. 26. There will be an annual review of the committees’ membership to support its efficient functioning.

Conflicts of Interest 27. Conflicts of Interests will be managed in accordance with the CCG Constitution that outlines the

current policy; ‘Standards of Business Conduct and Managing Conflicts of Interest Policy’. 28. In practice attendees with non-conflicting roles are considered to be voting members. Non-voting

members are those who are potentially conflicted, though they can contribute to the debate. 29. Any conflicted individual member will leave the meeting for the relevant discussion.

5

30. All non-voting members will leave the meeting at the point that a vote is being taken to conclude a decision.

Meetings and Voting 31. The Committee will operate in accordance with the CCG’s Standing Orders. The Secretary to the

Committee will be responsible for giving notice of meetings. This will be accompanied by an agenda and supporting papers and sent to each member representative no later than 7 days before the date of the meeting. When the Chair of the Committee deems it necessary in light of the urgent circumstances to call a meeting at short notice, the notice period shall be such as s/he shall specify.

32. Each member of the Committee shall have one vote. The Committee shall reach decisions by a

simple majority of members present, but with the Chair having a second and deciding vote, if necessary. However, the aim of the Committee will be to achieve consensus decision-making wherever possible.

Quorum

The Committee will be Quorate with three of the seven voting members in attendance, with at least one Lay member present. Where the GP or other non-voting members have a conflict of interest they will be excluded from the agenda item discussion and decision.

Confidentiality

33. Non-voting members will be in attendance for the confidential Part II of the meeting and will be bound by the committee’s decisions on how, whether and when information is shared more widely.

Frequency of meetings

34. The committee shall meet monthly though the format of these meetings will alternate

between a formal meeting in public and a seminar in private for developmental purposes. At least six meetings will be held in public over the financial year as highlighted in Schedule 6.

The Primary Care Commissioning Committee has a statutory duty to make a range of decisions relating to the commissioning of primary medical services. In the vast majority of cases these decisions can be made by the committee as part of business as usual. However, there will be occasions when an urgent situation arises that require a decision or actions to be agreed either immediately or before the next Primary Care Commissioning Committee takes place. Urgent Decision Making (UDM) meetings can be called by the chair (or vice chair in their absence) and by the chief officer (or deputy chief officer in their absence) and the chief finance officer. This is outlined in Schedule 5.

6

A minimum of two of the above CCG members should be on the teleconference for it to be quorate. A meeting will be convened with the chair (or vice chair in their absence), the chief officer

(or deputy chief officer in their absence) and the chief finance officer (or deputy chief finance officer in their absence. Consultation will be made with the vice chair and all other available Governing Body unless in exceptional circumstances where a time delay cannot be permitted. If other Governing Body members are not consulted they will be informed at the earliest possible time.

All decisions will be reported at the next available CCG Governing Body.

37. Meetings of the Committee shall: a) be held in public, subject to the application of 23(b);

b) the Committee may resolve to exclude the public from a meeting that is open to the public

(whether during the whole or part of the proceedings) whenever publicity would be prejudicial to the public interest by reason of the confidential nature of the business to be transacted or for other special reasons stated in the resolution and arising from the nature of that business or of the proceedings or for any other reason permitted by the Public Bodies (Admission to Meetings) Act 1960 as amended or succeeded from time to time.

38. Members of the Committee have a collective responsibility for the operation of the Committee. They

will participate in discussion, review evidence and provide objective expert input to the best of their knowledge and ability, and endeavour to reach a collective view.

39. The Committee may delegate tasks to such individuals, sub-committees or individual members as it

shall see fit, provided that any such delegations are consistent with the parties’ relevant governance arrangements, are recorded in a scheme of delegation, are governed by terms of reference as appropriate and reflect appropriate arrangements for the management of conflicts of interest..

40. The Committee may call additional experts to attend meetings on an ad hoc basis to inform

discussions. 41. Members of the Committee shall respect confidentiality requirements as set out in the CCG. See Appendix B for criteria of the different Committee meeting formats.

7

Constitution or Standing Orders. 42. The Committee will present its minutes to the London Area Team of NHS England and the

governing body of Tower Hamlets CCG each month for information, including the minutes of any sub-committees to which responsibilities are delegated under paragraph 27 above.

43. The CCG will also comply with any reporting requirements set out in its constitution. 44. It is envisaged that these Terms of Reference will be reviewed annually, reflecting the

experience of the Committee in fulfilling its functions. NHS England may also issue revised model terms of reference from time to time.

Decisions 45. The Committee will make decisions within the bounds of its remit.

46. The decisions of the Committee shall be binding on NHS England and Tower Hamlets, CCG. 47. The Committee will produce an executive summary report which will be presented to NHS England

and the governing body of Tower Hamlets CCG each month for information, together with the minutes as set out in 42. above

8

Appendix A. Primary Care Committee Membership Position Name Voting Members Lay Chair Julia Slay Lay Vice Chair Maggie Buckell CCG Accountable Officer Jane Milligan CCG Chief Finance Officer Henry Black Independent Clinical Advisor Martin Marshall Board Secondary Care Consultant Tan Vandal Non-voting Members HWBB representative Vacant Urgent Care representative Virginia Patania Healthwatch representative Karen Bollan Local Medical Council representative Jackie Applebee CCG GP representative Nicola Hadgrup LBTH Public Health representative Somen Banerjee NHS England representative Alison Goodlad

9

Appendix B Criteria of the different Committee meeting format, for the purpose of these Terms of Reference.

• A Part I Committee meeting implies the meeting is open to all members of the Committee (and the public in the case of a public meeting) to attend.

• A Part II Committee meeting implies there is sensitive information to discuss in the

meeting, and therefore not open to some members of the Committee (and the public in the case of a public meeting).

• A Part III Committee meeting would take place when a member(s) of the Committee is

conflicted on a particular issue, and would have to leave the meeting. This will be considered on an individual case by case basis.


Date of meeting 27th September 2016 D

Agenda item CQC update

Title of report: CQC Inspection Report

Author(s): Pacifique Kimonyo - Performance and Quality Manager, THCCG

Presented by: For further information

Pacifique Kimonyo - Performance and Quality Manager, THCCG [email protected] Tel:(02038163838)

Executive Summary

In October 2014, the CQC introduced a new style of inspection framework. Under the new framework, inspectors now consider 5 key questions:

• Is the service safe? • Is it effective? • Is it caring? • Is it responsive? • Is it well-led?

A 4-point rating scale, is then used used to describe a service’s performance against each of these questions. The ratings are:

• Outstanding • Good • Requires improvement • Inadequate

To date, 18 of the 36 GP surgeries in Tower Hamlets have been inspected by the CQC using the new inspection model. A review of the reports produced by the CQC reveals that the majority of the practices in Tower Hamlets have been rated overall as providing a ‘Good’ service, with St Paul’s Way Medical Centre being the only practice to date rated as outstanding.

Of concern is the service provided by the Harford Health and East One Health Centres. The CQC has rated these practices as requiring improvement. The Performance and Quality Manager is working with the Primary Care Team to support these practices in making the required improvements.

Recommendation

Information Approval To note Decision

The Committee is asked to note the contents of the report, particularly in relation to the Board Assurance Framework.

Key issues Key Findings The table below analysis overall CCG performance of the 18 GP practices inspected under each CQC domain:

CQC Domain

Rating of Practices Under Each CQC Domain

Outstanding Good Requires Improvement

Inadequate

Safe 0 14 4 0 Effective 1 17 0 0 Caring 0 18 0 0 Responsive 1 16 1 0 Well Led 1 16 1 0

• 14/18 practices inspected to date have been rated as ‘good’ under the

safe domain. • 4/18 practices have been rated as ‘requiring improvement’ under the

safe domain. As a CCG, future quality improvement plans need to focus on this domain.

• All 18 of the practices inspected to date have been rated as good with regards to providing a caring service.

• St Paul’s Way practice has been rated as outstanding under the ‘Effective’, ‘Responsive’ and ‘Well-Led’ domains.

Common areas for improvement identified across different practices: Develop an ongoing programme of clinical audit and re-audit to ensure outcomes for patients are maintained and improved. Formulate a written strategy to deliver the practice’s vision. Review how carers are identified and recorded on the clinical system to ensure information, advice and support is made available to them. Carry out Disclosure and Barring service (DBS) checks on all staff Review the Business Continuity Plan Review and update practice policies and procedures Review and update health and safety risk assessments (fire risk assessments, legionella risk assessments etc).

Conflicts of Interest

There are no identified conflicts of interest.

Report history This report has not been presented at any other internal or external committees or meetings.


The Friends and Family Test (FFT) provides patient feedback to improve service provision as well as NHS Choices providing patient comments on services.


Objective 1: To commission high quality health and social care services that are accessible, provide good treatment and achieve good patient outcomes. Risk 1.3: Primary Care Commissioning


Monitoring and actively improving the performance and quality of service provision will have a benifical impact for all patients in Tower Hamlets.


N/A

Next steps Performance and Quality Manager will work with the Primary Care Team to support practices in making the required improvements.

CQC Inspection Log*

* Log last updated on 02/09/2016

Safe Effective Caring Responsive

Well led

Overall Rating

1 Pollard Row Practice

1 04/02/2016 23/05/2016 Good Good Good Good Good Good

2 Mission Medical Practice


3 The Globe Town Surgery


4 The Blithehale Medical Centre


5 The Spitalfields Practice


6 City Wellbeing Practice

3 10/11/2015 31/03/2015 Requires Improvement

Good Good Good Good Good


Well led

Overall Rating

Actions from CQC Report Actions Completed?

Actions Completed?

• Review the cleaning arrangements for the practice and infection control audit to ensure all standards have been assessed accurately.• Ensure there is an effective system for recording to whom prescription pads are issued.

•Ensure that staff receive training in the safeguarding of vulnerable adults and implement a procedure for safeguarding vulnerable adults. Review the system for reviewing vulnerable children on the practice database. •Formalise the system for ensuring all staff are aware and taking any necessary action on medical updates and safety alerts• Implement a procedure for the security of blank prescription forms in accordance with national guidance• Introduce a system for carrying out full-cycle clinical audits• Review and update the health and safety riskassessment• Carry out a Legionella risk assessment• Ensure staff undergo fire safety training and carry out regular fire safety drills• place information on opening and appointment times in the reception/waiting area

Actions from CQC Report

Network Date Inspected

Date Report Published

Practice

CQC Rating Practice Network Date Inspected


CQC Rating

•Develop an ongoing programme of clinical audit and re-audit to ensure outcomes for patients are maintained and improved.• Formulate a written strategy to deliver the practice’s vision.• Review how carers are identified and recorded onthe clinical system to ensure information, advice and support is made available to them.

• Ensure all staff are trained on the use of the recently acquired automated external defibrillator (AED) and ensure the device is included in a schedule for electrical and medical equipment checks in line with guidance.• Record and implement actions identified from the infection control audit.• Ensure there is an effective system to track blank prescriptions through the practice in line with national guidance.

• Ensure all staff complete infection control training.• Develop the patient participation group to become more representative of the patient population

• Put arrangements in place to audit the practice’s infection prevention and control systems and processes on an annual basis.• Put systems in place to make available all information required in respect of each person employed by the service.

Enclosure D

7 Harford Health Centre


Good Good Requires Improvement

Good Requires Improvement

8 East One Health


Good Good Good Requires Improvement

Requires Improvement

9 The Wapping Group Practice


10 St Katherines Dock Practice


11 Harley Grove Medical Centre


12 St Stephens


13 Ruston Street



Well led

Overall Rating

14 St Paul’s Way Practice

6

26/11/2014 31/03/2015

Good Outstanding

Good Outstanding

Outstanding

Outstanding

• Put in place a written policy and procedure to ensure notifiable safety incidents are always handled in accordance with the duty of candour.

• Carry out a fire risk assessment to ensure patients and staff are protected from the risks associated with fire in the premises.

•Ensure there is an effective system for recording to whom prescription pads are issued to.• Review the arrangements in place for hard of hearing patients.• Ensure the practice actively identifies and supports patients who are also carers.

• Review the infection control audit and cleaning arrangements for the practice.

•Ensure recruitment arrangements include all necessary employment checks for all staff. •Ensure there is an effective system for recording to whom prescription pads are issued.• Develop a system to ensure mandatory training is up-to-date.• Review the Business Continuity Plan.• Develop an ongoing quality improvement programme including clinical audit and re-audit to ensure outcomes for patients are maintained and improved.• Carry out staff appraisals annually and provide structured opportunities for staff to review their performance with their manager.• Develop a carers' register to ensure information, advice and support is made available to them.• Improve the availability of non-urgent appointments and review the telephone system to ensure patients can access the surgery in a timely manner.• Review and update practice policies and procedures.

•Review the practice’s safeguarding children and adult policy.• Ensure there is an effective system to track blank prescriptions through the practice in line with national guidance.• Ensure all risk assessments and actions identified have been carried out in line with regulation.• Review the business continuity plan.• Consider improving communication with patients who have a hearing impairment.• Ensure written complaint responses include all patient information in line with national guidance.• Advertise translation services in the patient waiting areas.• Formulate a written strategy to deliver the practice’svision.

• The provider should keep clinical waste secure in an enclosed place away from public access.• The provider should take action to improve uptake of child immunisations.• The practice should ensure agreements are in place with neighbouring practices to take care of homeless patients.• The practice should do more to clarify access to female GPs at neighbouring practice and ensure all patients are made aware of the availability of chaperoning and translating services.

• Implement and record actions identified from the infection control audits and review the cleaning arrangements for the practice• Put a system in place to ensure mandatory training, in particular safeguarding, chaperoning and infection control, is up-to-date.• Ensure recruitment checks are carried out for locum staff •Develop an ongoing programme of clinical audit and re-audit to ensure outcomes for patients are maintained and improved.• Formulate a written strategy to deliver the practice’s vision.• Review the system for disseminating and acting upon national patient safety alerts to ensure staff are aware of the process.• Ensure all policies and procedures to govern activity are reviewed and relevant to the service.• Install emergency pull cords in the accessible toilet facilities.

Practice Network Date Inspected


CQC Rating Actions from CQC Report Actions Completed?

15 Stroudley Walk


16 Limehouse 7 17/03/2016 05/07/2016 Good Good Good Good Good Good

17 Docklands Medical Centre


18 Island Health


Good Good Good Good Good

19 Strouts Place

1

20 Bethnal Green

1

21 XX Place 222 Health E1 223 Albion

Health 2

24Whitechapel Health Centre

3

25 Brayford 326 Jubilee

Street 4

27 The Grove Road Surgery

5

28 Tredegar 529 Bromley by

Bow 6

30 St Andrews 6

31 Gough Walk

7

32 Chrisp Street

7

33 All Saints 734 Aberfeldy 735 Barkantine

Practice8

36 Island Medical Centre

8 No Inspection Report Available

No Inspection Report Available


No Inspection Report AvailableNo Inspection Report Available


No Inspection Report AvailableNo Inspection Report AvailableNo Inspection Report Available







• Ensure all medicines are accounted for and are stored securely at all times.• Ensure systems are in place to assess the different responsibilities and activities of staff to determine if they are eligible for a Disclosure and Barring Service (DBS) check and to what level.• Ensure systems are embedded so that all information required in respect of each person employed by the service is available and that adequate medical indemnity insurance arrangements are in place. •Staff were working through a suite of e-learning modules that enabled them to complete training courses at their own pace. A system was not in place however so that the provider could readily track the progress staff weremaking towards completing all the required training in a timely way.

• Carry out Disclosure and Barring service (DBS) checks on all staff who undertake chaperone duties at the practice. • Include complaints procedure information on its website and translate existing complaints posters in reception into local community languages.• Ensure all staff who undertook chaperone activities are suitably trained.


Ensure a legionella risk assessment is completed to reduce the risk of infection to staff and patients and ensure records are in place to demonstrate the effective implementation of a cleaning schedule for the building.• Ensure portable electrical equipment is routinely tested.• To ensure all staff confirm they have read and understood governance policies.• Define a unified vision for the practice to follow.• Implement and record actions identified from the infection control audits and review the cleaning arrangements for the practice.• Develop a system to monitor role specific training to ensure the timeframes for updates does not lapse.


Date of meeting: 27th September 2016 E

Agenda item: Business Assurance Framework (BAF)

Title of report: Risk Management - Business Assurance Framework (BAF)


Presented by: Chima Olugh, Primary Care Commissioning Manager

Executive summary

The CCG corporate objectives are used to develop the organisations approach to risk management, inform programme priorities and provide a framework for performance management. Risks that are assessed as being significant are escalated to the BAF.

The BAF has been updated for the period up to September.

This paper highlights the risks in the BAF that pertain to Primary Care Commissioning.

Recommendation

Information Approval To note X Decision

To note


Key issues A failure to keep effective oversight of our key risks could lead to a failure to fully achieve our corporate objectives.

Report history N/A


N/A


Yes


N/A


Primary Care Team

Next steps N/A

1 | P a g e

Revised Governing Body Assurance Framework (BAF) September 2016

Document information

Version Version 7 Months covered July, August and September 2016 Next review October – December 2016 Author(s) Andy Nuckcheddee- Interim Governance Lead

Enclosure E

2 | P a g e

1.0 Corporate Objectives (CO) 2016 - 2019

Our corporate objectives relate to the CCG in its entirety, providing the organisation with a clear direction for commissioning intentions and supporting the development of more detailed programme, team and personal objectives. The corporate objectives reflect our direction of travel as well as our obligation to fulfil our statutory duties. The objectives will be used to develop our approach to risk management, inform programme priorities and provide a framework for performance management.

CO (1) - To work in partnership to commission high quality hospital services that are accessible, provide the appropriate treatment in the right place, and achieve good patient outcomes for people of all ages living in the borough CO (2) - To commission person-centred, integrated health and care service that are sustainable and that equally meet the mental and physical needs of our residents CO (3) - To contribute towards a financially sustainable and responsive health and care economy which delivers value for money and innovation and supports the appropriate use of services CO (4) - To support local people and stakeholders to have a greater influence on services we commission CO (5) - To promote equality both as an employer and a commissioner of health care services CO (6) - To create a high performing and sustainable workforce that continuously learns and is engaged in delivering our ambitions.

3 | P a g e

Risk to the Corporate Objectives.

Risk 1.3: Primary Care Commissioning

Comment: Tower Hamlets CCG were awarded delegated co–commissioning for primary medical services from 1st April 2015. This provides us with the greater opportunity to shape the way in which primary care develops to ensure it meets the needs of our local population and is aligned closely with our wider strategies. Delegated commissioning offers an opportunity for CCGs to assume full responsibility for commissioning general practice services. Our intention is to act collaboratively across Waltham Forest, Tower Hamlets and Newham (WEL) and work towards the aims set out in the Strategic Commissioning Framework for Primary Care Transformation in London. Lead Committee Comment: BAF risked reviewed at the January 2016 meeting of the Primary Care Committee

Risk 1.3 Risk Description Controls

Assurances

GAPS in Controls and Assurances

Risk Ratings

Likelihood x Severity

Inadequate staff resources from NHS England to cover the requirements supporting delegated authority could impact on the ability to deliver the Primary Care strategy and appropriately manage the delegated responsibilities given to the CCG from NHSE.

1- NHSE Core contracting remains at London-wide team. Core NHS E are undertaking a review of this function, stage one is complete and stage two is underway. The review is to ensure sufficient resource released to CCGs / SPGs. NEL STP are working with NHSE to agree a timeframe to transition this function to the STP. 2 - Tower Hamlets Primary Care Team in place to manage additional work from co-commissioning. 3 - WEL Co-Commissioning Group

1 – Primary Care organogram 2- Memorandum of Understanding 3 – THCCG has set up its own team that oversees primary care co-commissioning. The team works closely with NHSE to ensure they undertake their support role. In some instances the team takes on additional tasks as NHSE lacks the capacity to do them.

TST Primary Care Work Plan

Mar 2016

3 x 4

Date added

April 2016

3 x 4 Q1 2016/17– risk

continued from BAF 15/16 Governing Body Lead

Simon Hall

June 2016

3 x 4

Management Lead

July 2016 3 x 2

Jenny Cooke Lead Committee Primary Care Committee Finance, Performance &

http://cms.pulsetoday.co.uk/Uploads/2014/11/26/f/z/s/Strategic-Commissioning-Framework---Engagement-Draft-261114.pdf

4 | P a g e

Quality Committee

4 - Local Primary Care Strategy

Risk Appetite

<9

Actions HIGH priority (30 days) MEDIUM priority (30 – 90 days) LOW priority (90 days plus)

- Mobilisation of Co-commissioning work plan including contract reviews

- Co-creation and mobilisation of Primary Care Strategy

- Development and mobilisation of Co-Commissioning work plan and Primary Care Strategy Implementation in year 2.

Risk 3.5: Financial challenges of Primary Care Co-commissioning Comment: The CCG has agreed on full delegation of Primary Care Services from NHSE which is to be funded by allocation cost. Several concerns have been identified:

- Financial reports from NHS England are high level with insufficient detail - Adjustments to allocations; not sure what they are and uncertain if allocations factored in growth

The CCG has formulated its own QIPP plans; where there was a gap the CCG has tried to quantify savings within primary care. The 16/17 Primary Care allocation is deemed to be insufficient to meet the existing gap in funding of £ 0.5m and in addition, a gap in funding ‘Save our Surgeries’ has also been identified. Lead Committee Comment: FPQ agreed to take assurance from current risk management approach – 30 March 2016

5 | P a g e


Assurances GAPS in

Controls and Assurances

Risk Ratings


Insufficient information from NHSE which makes it difficult for the CCG to comprehensively understand primary care cost pressures. This reduces the CCG’s ability to put in place a robust financial strategy.

1- Monthly monitoring at Primary Care Committee

2- Monthly monitoring at FPQ 3 – Local financial reporting and forecasting based on NHS England information 4 - Pan London technical group established to support primary care finance planning, including QIPP

5 – The Primary Care Team have modelled before and after delegation scenarios of full delegation but await NHSE guidance regarding process

1- Primary Care Committee minutes and reports 2- FPQ minutes and reports. 3 – Primary Care Programme Board review and minutes.

This will be monitored and developed as appropriate as the new structures and resources are put in to place. Transfer on 1/4/16 of payment functions to CCG still unclear. Lack of control over coding of activity data which is still controlled by NHSE this financial year.

Mar 2016

3 x 4 Date added

April 2016

3 x 4

Q1 2016/17– continued from 2015/16 Governing Body Lead

June 2016 4 x 4

Henry Black

Management Lead

Andrea Antoine Lead Committee Finance, Performance and Quality Primary Care Commissioning Committee

Risk Appetite

<16


- Review of allocation to date to check if on target with NHSE assumption

- Review of allocation

6 | P a g e

Risk 3.6: Outsourcing of services to NHS SBS and other service organisations for Primary Care Commissioning

Comment: In their external audit findings report 2015/16, KMPG has advised the CCG to ensure that it has robust understanding of the processes and controls in managing Primary Care Commissioning. Balances relating to primary care commissioning are inherently complex. It is, therefore, advised that the CCG should seek the correct level of assurances over these processes and controls in relation to complexes balances in its accounts and seek the right level of assurances from external outsourcing organisations. Lead Committee Comment: FPQ and Primary Commissioning Committee to seek the correct level assurances- June 2016


Assurances

GAPS in Controls and Assurances

Risk Ratings


Failure to ensure that there are robust processes and controls in place to manage Primary Care Co-Commissioning.

1. Outsourcing of services to

NHS SBS and other service organisations to manage flow of invoices.

2. Monthly monitoring at the Primary Care Commissioning Committee.

3. Monthly reporting at the FPQC.

1. A full time dedicated Primary Care Liaison Officer in post. 2. CCG & NHSE have joint constructed a process detailing all the payments flows and which organisation has primary responsibility for each process. 3. There is a vetting process in place between the CCG and Capita in relation to all payments. 4. Capita has been commissioned by NHS England to ensure payments are promptly with the appropriate level.

Any change in personnel within any of the organisations could lead to weakness in the controls that are currently in place.

June 2016

3 x 3 Date added

Q1 2015/16– New risk

Governing Body Lead

Henry Black Management Lead

Andrea Antoine Lead Committee Finance, Performance and Quality Primary Care Commissioning Committee

Risk Appetite

<8



Date of meeting: 27th September 2016 F

Agenda item: Primary care Forward Planner 16/17

Title of report: Primary care Forward Planner 16/17


Presented by: Jenny Cooke, Deputy Director of Primary Care

Executive summary

This forward planner sets out a systematic methodology for primary care commissioning. It lists the areas of work that are pertinent to primary care and will ensure that resources are focussed on appropriate areas.

The Forward Planner also has a direct correlation to the role of the Primary Care Committee.

Recommendation

Information Approval To note Decision

For discussion


Key issues N/A

Report history N/A


N/A


N/A


N/A


Primary Care Team

Next steps Update

Areas

Stakeholder engagement

Demand Planning

Service Review

Commissioning Intentions 16 17

Primary Care StrategyPrimary Care DevelopmentQuality ImprovementImproving AccessNetwork Improvement ServicesDirect Enhanced ServicesQoF

Primary Care Risk Register

Exploring Alternative ModelsResilience and Assurance

Reports to governing body

ProcurementContracts , Management & Review

Communications & Engagement StrategyProvider Development

Commissioning & Contracting

Primary Care Business Cycle Planner 2016/17

Assessing Needs

Describing Services

Priorities

Governance & Risk Management

Enclosure F

Clinical engagement and decision makingStakeholder engagementDemand ManagementInnovationTransformationWorkforce and Recruitment

Primary Care Quality Dashboard

Finance ReportQuarterly NHSE Assurance UpdatePrimary Care Commissioning Activity Report

CQC reports and updates

Declaration of interestsMinutes of the previous meeting and Action TrackerQuestions from the public Register of Interests & Conflicts of Interest Report

Performance & Quality Management

General Business

Summary Lead 27-Sep 25-Oct 22-Nov 27-Dec

Ensure collaborative working with allstakeholders to inform and developcommissioning priorities.

Assess the levels of demand forservices models, this will inform contract negotiations.

Set out a prioritisation outline forclinically led service reviews to informfuture service provision.

Outline the Commissioning Intentions for 16/17.

Overview and update

Overview of primary care risks that relate to the BAF.

Assurance that the primary care system is resilient and continues to provide a high quality service for patients.

Updates to ensure providers are delivering a planned, proactive, outcomebased service.

Discuss as part of the strategy.Discuss as part of the strategy.

This will provide oversight on a range of GP practice quality and and performance indicators.

The key areas of interest for the 2016/17 reporting round include:a) Management of contractual underperformanceb) Management of contract disputesc) Financial assistance to providersd) Procurement and expiry of contractse) Availability of services, including closed lists.

Review and update

Review and updateReview and actionReview and updateReview and update

31-Jan 28-Feb 28-Mar

Primary Care Co-Commissioning Committee Agenda Part I · Somen Banerjee Director of Public Health...

Documents

Transcript of Primary Care Co-Commissioning Committee Agenda Part I · Somen Banerjee Director of Public Health...