Author / Lisa Featherstone
Version / 0.1
Target Audience / Wider CCG and General Public
Date Created / 22 March 2017
Date of Issue
To be Agreed / May 2017 – Governing Body
Document Status (Draft/Final) / Draft
Description / Minutes of the Governing Body 22/03/17 – Meeting in Public
Document History:
Date / Version / Author / Notes
22/03/17 / 0.1 / L Featherstone / Initial Draft reviewed by CCG Chair
Approved:
Signature: /
Dr Kiran Patel, Chair
Governing Body
Meeting in Public
MINUTES OF MEETING22 March 2017
Chair – Dr Kiran Patel
ATTENDANCE
Governing Body MembersDr Kiran Patel (Chair)
Mrs Fiona Boyd, Clinical Member of the Governing Body – Registered Nurse
Mr Peter Bury, Lay Member for Quality and Performance
Dr Wissam El-Jouzi, North Sector Lead
Dr Cathy Fines, Clinical Director
Mr Howard Hughes, Clinical Director
Mrs Catherine Jackson, Executive Nurse
Dr Ajay Kotegaonkar, West Sector Lead
Mr Stuart North, Chief Officer
Ms Margaret O’Dwyer, Director of Commissioning and Business Delivery
Dr Jeff Schryer, Clinical Director
Mr Chris Wild, Lay Member for Finance and Audit
Ms Rachel Coaker, Deputy Chief Finance Officer ( for item 9 only)
Others in attendance
Mr Paul Horrocks, Communications Advisor to the Governing Body
Mrs Lisa Featherstone, Deputy Director of Business Delivery, Bury CCG
Dr Henry Ticehurst, Medical Director, PCFT (for item 1 and 7 only)
Mrs Zoe Molyneux, Associate Director of Quality Governance, PCFT(for item 1 and 7 only)
Members of the Public
Mrs B Barlow, Chair of Healthwatch Bury and Bury resident
Mr D Parker, Bury resident
Mr D Buckley, Bury resident
Mr D Taylor, reporter, Bury Times
MEETING NARRATIVE & OUTCOMES
1 / WELCOME, APOLOGIES AND QUORACY1.1
1.2
1.3
1.4
1.5 / Dr Patel welcomed those present to the meeting and introduced Dr Ticehurst, Medical Director, Pennine Care Foundation Trust (PCFT) and Mrs Molyneux, Associate Director of Quality Governance, PCFT who are attending to provide an update on the progress being made following the CQC visit of PCFT which was undertaken in November 2016.
Apologies were noted from:
· Dr Fazel Butt, Sector Chair;
· Mr Chandock, Secondary Care Consultant;
· Mrs Lesley Jones, Director of Public Health;
· Mr David McCann, Lay Member for Patient and Public Involvement; and
· Mr Mike Woodhead, Acting Chief Finance Officer.
It was noted that Ms Coaker would attend on behalf of Mr Woodhead for agenda item 9, with full delegated authority to act on his behalf.
The meeting was confirmed to be quorate.
The sequence of agenda items was re-arranged, with item 7 discussed immediately following the introductions and in advance of agenda item 2. Item 9 was also discussed after Item 10 and Item 8 was deferred to the end of the meeting.
2 / DECLARATIONS OF INTEREST
2.1
2.2
2.3
2.4 / Dr Patel reminded Governing Body members of their obligation to declare any interest they may have on any issues arising from agenda items which might conflict with the business of NHS Bury Clinical Commissioning Group.
Declarations made by members of the Governing Body are listed in the CCG’s Register of Interests which is presented under this agenda, available from the CCG’s Corporate Office or via the CCG website here.
Declarations of interest from today’s meeting
There were no further declarations made from those already recorded in the register in relation to the agenda items for discussion and decision.
Dr Fines advised that an entry on the register was incorrect and required amending.
ID / Type / The Governing Body: / Owner
DC/17/03/22/1 / Decision / Noted the published register of interests
AC/17/03/22/1 / Action / Requested the register of Interest to be updated to reflect accurate interests for Dr Fines / Governance Manager
3 / MINUTES OF THE LAST MEETING AND ACTION LOG
3.1 / The Governing Body considered the minutes of the meetings held on 18 January 2017 and 25 January 201.
Subject to an amendment at paragraph 7.1 of the minutes from 25 January 2017, both sets were accepted as a true and correct record.
The two actions were considered and the following was agreed:
· Gluten Free Prescribing – closed from Governing Body and referred to Quality and Performance Committee
· Single Outcomes Framework – closed as progressed outside the meeting
ID / Type / The Governing Body: / Owner
DC/17/03/22/2 / Decision / Approved the minutes of the meetings held on 18 January 2017 as a true and correct record.
Decision / Approved the minutes of the meetings held on 25 January 2017 as a true and correct record subject to the amendment at 7.1
DC/17/03/22/3 / Decision / Closed both open actions on the action log
4 / CHAIR’S UPDATE
4.1 / No update was provided from Dr Patel.
5 / CHIEF OFFICER’S UPDATE
5.1
5.2
5.3
5.4
5.5
5.6
5.7
5.8
5.9
5.10
5.11 / Mr North advised the Governing Body that the consultation on Bury’s proposed future model for urgent care has been paused to allow NHS Bury Clinical Commissioning Group (CCG) a chance to consider a new directive aimed at improving urgent and emergency care nationally.
Advising that following the Chancellor’s Budget statement earlier this month, NHS England and NHS Improvement have jointly signaled urgent action is now needed to turnaround urgent care performance during 2017and that the new requirements highlight the need for ‘concrete changes’ to secure a more robust urgent care system throughout the country to overcome the difficulties experienced in previous winters.
Reflecting that it is clear that many elements of the new directive are in line with Bury’s future proposed model; including better use of telephone triage, investment in evening and weekend GP appointments and GPs and nurses assessing and treating patients who do not need to be at A&E; Mr North confirmed that more detailed guidance on the requirements are awaited in the NHS Delivery Plan, which will be published in the coming weeks.
In this context Mr North advised that it is appropriate for the CCG to review these new requirements to ensure that they align fully with our proposed future model for urgent care in Bury and it is on this basis, from 14th March 2017, that the consultation has been paused. This includes collection of feedback via the online survey and the two planned public meetings.
The position will be reviewed once the additional guidance is received.
Mr North updated the Governing Body that at the end of February the Greater Manchester Health and Social Care Strategic Partnership Board approved a proposition that Greater Manchester directly commissions the Ambulance 111 Services for its population with effect from the 1st of April 2017 and advised that It has been agreed that Bury CCG will operate as the lead commissioner for Greater Manchester for these services.
Explaining that the contract for the next 2 years has already been agreed, the focus of work as commissioner will be on improving performance understanding the required transformation.
Dr Fines queried the workforce capacity that NHS Bury CCG will receive to support this lead commissioner role and how it will integrate with existing commissioning resource. Mr North advised this is still under discussion and once agreed consideration will be given to whether this is sufficient.
Mr North announced that Wi-Fi has become operational in all GP Practices in Bury and that Digital Champions have been identified in at least ¾ of our practices, who will be responsible for showing patients how to use technology to support their care and access health services in a more convenient manner.
Dr Schryer reflected this is a really positive step and enhances the CCG’s approach to social prescribing.
As a final point to note, Mr North advised that the CCG had undergone its annual assurance assessment, which was positive and there is no reason to assume that the good rating awarded last year would not remain in place. Formal confirmation of the outcome will be shared with the CCG once all visits have been undertaken and validation has been completed.
ID / Type / The Governing Body: / Owner
DC/17/03/22/4 / Decision / Received the update from the Chief Officer.
6 / PUBLIC QUESTIONS
6.1
6.2 / Dr Patel advised that no questions had been received in advance of the meeting in accordance with the CCG’s Constitution, however invited the members of the public in attendance to raise any questions relating to the items on the agenda.
No questions were raised.
7 / Pennine Care Foundation Trust Care Quality Commission Action Plan
7.1
7.2
7.3
7.4
7.5
7.6
7.7
7.8
7.9
7.10
7.11
7.12 / Dr Ticehurst addressed the Governing Body and advised the presentation was delivered to the CQC Summit meeting in January 2017 and is supported by a comprehensive and approved action plan which is monitored through the Quality Improvement Board.
Advising that the presentation and supporting action plan has been themed to ensure an appropriate focus of resources, overall what is demonstrated through the CQC review is that the current system is heating up and without appropriate support and intervention is not sustainable. Acknowledging the responsibility of PCFT in addressing this, the requirement for partners and stakeholders to also step up was expressed in order that the services delivered meet the population needs.
Mrs Molyneux delivered a detailed presentation, advising that the inspection which had been carried out over a 5 week period had returned an overall rating of ‘requires improvement’, although it is important to acknowledge that across the 16 service areas inspected there was a range of individual ratings which also included a number of ‘outstanding’ ratings.
Advising that the action plan contains over 70 actions which have been grouped into key improvement themes to enable delivery of sustainable improvement, Mrs Molyneux assured the Governing Body that a number of the issues raised through the inspection were addressed immediately and those yet to be completed are discussed on a monthly basis through the CQC meeting.
Mr North thanked colleagues from PCFT for their presentation and the open approach being taken. Reflecting that whilst Bury as a locality was noticeably absent from the areas requiring improvement, it is essential that there is a standardised quality of service offered across all areas and sites within PCFT and asked what the question is that needs to be answered to enable this to happen.
Dr Ticehurst advised that there is a need to drive economies of scale, and although the current PCFT footprint offers this, with some good estate, particularly in Bury, and plans are to remedy the findings, this is only a short term fix and wouldn’t be sufficient to bring radical change.
In response to Ms O’Dwyer’s query regarding oversight at a local level of the short, medium and long-term actions, Dr Ticehurst agreed to share the action plan and confirmed that scrutiny is undertaken through the Quality Improvement Board, chaired by NHS Heywood, Middleton and Rochdale CCG’s Chief Officer.
Reflecting on Dr Ticehurst’s point regarding the system overheating, Dr Schryer shared that we need to stop people from going into hospital in the first place and the importance of ensuring that addressing one aspect does not detract from the other. This was supported by Dr Ticehurst who agreed that need to focus on how we keep people safe within their homes and communities before consideration is given to the base bed numbers needed in hospital settings.
Mrs Jackson sought clarity on the challenges associated with recruitment and retention of the workforce and whether there is an understanding of the baseline investment required to ensure this is in place. Dr Ticehurst responded that key to this will be getting the model right so the offer is attractive and that work is underway with Manchester Metropolitan university to further develop the thinking on this.
Mr North referred back to the presentation where CAMHS inpatient services had been assessed as outstanding and asked what learning could be taken from these areas and integrated across other sites. A discussion around commissioning and contracting arrangements followed which provided some response to this point.
As a final point, Dr Patel asked for clarity on the support PCFT need from NHS Bury CCG to help support continued improvement and offered through Executive discussion to make this available.
It was agreed that a further update would be provided to the Governing Body in 6 months.
(Dr Ticehurst and Mrs Molyneux left the meeting)
ID / Type / The Governing Body: / Owner
DC/17/03/22/5 / Decision / Noted the presentation.
DC/17/03/22/6 / Decision / Requested a further update in 6 months
AC/17/03/22/2 / Action / PCFT CQC Update to be added to GB forward plan / Governance Manager
8 / LOCALITY PLAN AND TRANSFORMATION FUNDING UPDATE
8.1 / Dr Patel noted that the presentation and supporting brief had been circulated to Governing Body members and made available on the CCG’s Website, however the presentation was deferred with an agreement to re-arrange for a future date.
ID / Type / The Governing Body: / Owner
DC/17/03/22/7 / Decision / Noted receipt of the presentation in paper form.
DC/17/03/22/8 / Decision / Agreed for the presentation to be delivered at a future meeting
AC/17/03/22/3 / Action / Locality Plan update to be re-scheduled / Governance Manager