Link Engagement and Partnership Committee
Minutes of the meeting held at 10.30am on Tuesday the 14th July 2015
at Central 40, Lime Tree Way, Chineham Park, Basingstoke, RG24 8GU.
Attendees
June Balcombe (JB) Community Development Team Leader Bas & Deane BC
Jo Dixon (JD) Community Action Hampshire (Deputy for Christine Pattison)
Colin Godfrey (CG) Patient Representative on the Governing Body NH CCG
Peter Kelly (PK) (Chair) Interim NH CCG Lay Member (Chair)
Sian Martyn (SM) Healthwatch Hampshire (Deputy for Libby Thomas)
Jenny Murray (JM) Business Development Administrator (Minute Taker)
Cllr Cathy Osselton (CO) Councillor Basingstoke and Deane BC
Anne Phillips (AP) NHCCG Head of Stakeholder Communications and Engagement
Alan Turvey (AT) Interim Chair Basingstoke Voluntary Services
Paul Woodgate (PW) Vice Chair NH CCG PPG; A member of the Quality Team from the NHCCG
Apologies
Simon Bryant (SBR) Public Health, Hampshire County Council
Dr Anne Crampton (AC) Councillor Hart District Council
Mark Fletcher (MF) Chair of NH CCG PPG
Alison Hewlett (AH) Hampshire County Council
Claire Hughes (CH) East Hampshire DC
Dr. Matthew Nisbet (MN) Chair of the NH CCG Membership Senate
Christine Pattison (CP) Action Hampshire
Andrew Smythe (AS) Practice Manager Representative
Libby Thomas (LT) Healthwatch Hampshire
Graham Wallis (GW) Chief Officer (Interim) NHCCG
Carl Westby (CW) Head of Leisure and Environment Promotion Hart DC
Action1. / Declarations of Interest
There were no declarations of interest
2. / Minutes of the previous meeting and matters arising
2.1. The minutes of the meeting were agreed, with a job title amendment for June Balcombe.
2.2. AP to add one item of the Equality delivery system to the July LEAP meeting agenda. This was delayed until next meeting due to staffing issues. / AP
3. / Update from the CCG
AP reported
3.1 Co-commissioning - NHS England has approved shadow joint commissioning between the Wessex Area Team and North Hampshire CCG, with effect from 01 July 2015
3.2 Procedures of Limited Clinical Value (PLCV). There is an agreed Procedures of Limited Clinical Value (PLCV) policy covering Southampton, Hampshire, the Isle of Wight and Portsmouth. Prior approval is required for a range of procedures before being carried out on the NHS. The patient’s GP, consultant orNHSclinician completes a proforma via email detailing how the patient meets the agreed clinical criteria. In 2014/15, 47% of PLCV did not have prior approval, an increase from 33% in 2013/14. The CCG is working on reducing the number of PLCV procedures that do not have prior approval. Members from the CCG patient group met on the 20th May to discuss PLCV and how this important subject should and could be communicated to local people. A communications and engagement plan has been drafted taking into account the views of the PPG. This plan was approved by clinical cabinet on the 2nd July.
3.3 Finance and Performance Update
a) The year to date budget as at 31 May 2015 is £37.51m with expenditure of £38.80m giving an over spend of £1.28m. The year-end forecast is £5.5m in excess of the revenue allocation, but in line with the agreed plan for the year.
b) Hampshire Hospitals Foundation Trust (HHFT) – This is the largest provider contract held by the CCG making up 46% of the total programme budget. The contract has not yet been signed however there is an agreed finance and activity plan of £106.8m. The CCG is finalising the detail including clauses to encourage joint responsibility for QIPP delivery and performance against NHS Constitutional obligations.
c) Analysis of the HHFT position at a headline level is as follows:-
Elective Care Activity is 5.1% over plan but is of low complexity.
Non Elective 5.0% under plan but the number of excess beds days is extremely high reflective of the level of delayed discharges.
First Outpatients above plan by 3%.
Follow up outpatients above plan by 5%
d) The QIPP plan for 2015/16 is £8.672m, with a further £2.2m of schemes or mitigating action required for the CCG to deliver a financial deficit plan of £5.5m. Limited activity and performance information is available at this stage in the year to make a robust assessment of delivery to date. However, the year to date QIPP plan is £1.812m and £0.706m has been delivered to date, resulting in a £1.106m under achievement. The CCG remains committed to deliver the £8.672m QIPP in 2015/16.
e) The North and Mid Hampshire system still continued to be stretched during June with high numbers of attendances at ED and flow in the hospital is still impacting on 4 hr waits for admissions. HHFT did not achieve Q4 4hr target reporting 88.82% of patients seen within 4hr. Latest position for Q1 15/16 is 91.67% (based on w/e 21/06/15).
f) There has been a slight improvement in the numbers of Delayed Transfers with a clear improvement plan in place. Hampshire County Council are rolling out Phase 2 of their recruitment campaign in July for care staff.
3.4 The North Hampshire CCG website. The website build phase has been completed. Although there are a range of issues with compatibility with Internet Explorer 8 which are still being overcome. CCG staff are finishing adding content and the site is expected to be launched in August after testing has taken place. The CCG patient participation groups will be asked to test the site from a user perspective.
3.5 The North Hampshire CCG annual report for 2014-15 has been completed and is available on the CCG website printed copies will be available for the CCG AGM in September and copies will be circulated to GP practices, libraries and other information points.
3.6 Commissioning of Acute Services Engagement continues on the draft North and West Hampshire CCG acute commissioning strategy. Following the stakeholder event held on the 13th May the CCGs are developing a survey that will further test the principles of the strategy. The CCGs are especially keen to get the views from more hard to reach groups.
3.7 Basingstoke and Deane Health and Wellbeing Partnership conference. This conference is being held on the 22nd October. A wide range of stakeholders will be setting the priorities for the Health and Wellbeing Partnership for the next 3 years.
3.8 Department of Work and Pensions - working in partnership. The CCG is exploring ways of working with the DWP team in Hampshire to support people back to work, moving away from receiving long term sickness benefits. Success for the health system would be seen in a reduction in the number of GP appointments taken up by ‘sick note’ visits, a reduction in prescribing and a whole raft of benefits for the patient.
3.9 South Ham and Buckskin Neighbourhood Partnership. At its most recent meeting the Partnership agreed a set of priorities for the future. One of these is a reduction in the health inequalities of South Ham and Buckskin compared to other wards in the Borough. A working group (comprising representatives from the CCG, Basingstoke and Deane Community development team and community centre managers from South Ham and Buckskin) has been set up to identify health issues from the neighbourhood plans and public health profiles. Action plans will then be developed to resolve problems identified by neighbourhood plans and reverse poor health trends identified in the public health profiles.
3.10 North Hampshire CCG Patient Group. The meeting of the PPG on the 10th June heard Dr Nicola Decker (GP lead for Dementia) update the group on her work with Dementia care and in particular the development of Dementia friendly surgeries: How Overton and Oakley surgeries have become Dementia friendly and how this work is being extended to other CCG practices. PPG members were keen to support their own surgeries to become Dementia friendly. / Action
4. / Sharing Information – Reports from the group on work being done relating to Health
4.1. BDBC (CO)
· The draft council plan incorporates many elements relating to health:
o Supporting wellbeing initiatives
o Supporting the homeless
o Maintaining the green environment
· CO voiced her concern at the lack of homes for late stage dementia patients.
· CO commented on The New Care Act and to ensure to read the small print relating to Care Homes and the payments that families would need to be aware of once a loved one had passed on.
4.2. BDBC (JB)
· An Older Peoples Partnership workshop session had been held which was looking at updating the older peoples plan by the end of the year. This plan in turn feeds into the Hampshire Older Persons strategy.
· JB was supporting the Basingstoke Dementia Action Group who were delivering training on Dementia Awareness.
· The Viables memory club was working well with about 15 people attending the club. The club was naturally splitting into two separate age groups. The attendees themselves wanted to make this differentiation regarding age.
4.3 North Hampshire CCG PPG (PW)
The Tadley surgeries PPG had been active and focus was on:-
· A reduction in repeat dispensing
· Local Youth PPG Forum (15-16 age group) ascertaining ways to engage them. The Hurst School had offered support
· Promoting increased uptake of the flu vaccination
· Antibiotic use reduction
AP said that she would be interested in the feedback of these issues, so that they may be able to replicate successes to other PPGs.
4.4 HealthWatch Hampshire (SM)
· Research had begun into residential and nursing homes, both HCC and private homes. This would be carried out by surveys and focus groups. The target audience were care home staff; care home residents and resident’s families. Looking at improvements and training. Announced visits to be carried out and also the possibility of unannounced visits. AP suggested that SM be introduced to Chris Gunner, Quality at NHCGG. LT to feedback report findings at the next meeting.
· The Community Cash Fund Awards were now agreed – yet to be announced. Awards for access to services up to £2500.
· HealthWatch had won highly commended award for their work
· Research into Hospital Pharmacy Dispensing - finishing their report–
CO mentioned that Battle Hospital in Reading had introduced a return prescription to the ward system that was proving effective. HHFT were also working towards improvements to their system. PW advised that the Local Pharmacy Committee (LPC) were discussing hospital and community pharmacists communication issues.
4.5 Community Action Hampshire (CAH) (JD)
· CAH hosted and facilitated a stakeholder event on the 13th May for North and West Hampshire CCGs looking at the principles of commissioning acute services. A report on the event had been circulated. Main feedback had been the around the time of day of the event and venue. A change to both would encourage attendance of a different age profile.
· CAH are encouraging village hall committees to make their buildings more dementia friendly.
· Public Health had invited CAH to carry out a Rapid Participatory Appraisal on the health and wellbeing priorities for a ward in Portsmouth. Community activists and leaders would be interviewed. An evaluation report would be available on completion.
4.6 Patient Representative on Governing Body NHCCG (CG)
· CG fed back about a Community Cash Fund awarded previously to Hampshire Wellbeing Services The project covered cultural sensitivities relating to access to the health service, 124 minority communities gave feedback. The report is now available – experiences around communication being the main outcome. Available on the Healthwatch website. JD to ask LT if it would be appropriate to let AP send to GP practices. / (PW)
(AP)
(LT)
(JD)
5. / Standing Agenda Item – Compliments and concerns about services commissioned by the North Hampshire CCG
5.1. AT said he had heard many good comments about South Central Ambulance Service.
5.2 Discussions about A&E increase in numbers of walk Ins. Should the 111 service issue a reference number to patients who have telephoned them first and are being directed to A&E? Maybe current government suggestions around 7 day GP appointments would help.
5.3. JB spoke about an experience where a GP stopped a patient’s repeat prescription, and advised patient should make appointment to see them. The patient was confused as the prescription had originally been prescribed by a consultant specialist, advising 6 month appointment follow up. When the patient went to GP it was a waste of time as the prescribed drugs were specialist and the GP could not advise further. Patient felt a waste of GP resource and money. AP mentioned that there should be “Shared Care Agreements” but the GP is usually the responsible person in the community. AP to feedback this information to the medicines management team at the CCG / (AP)
6. / Any other business (Chair)
6.1.AP will ask CW for the alcohol report (increased risk drinking) for onward circulation to LEAP members.
6.2. PK advised that the NHCCG had been established for 2 years and with all the financial and interim measures, all the committees across the NHCCG were now being reviewed for their validation and effectiveness. Link, Engagement and Partnership (LEAP) aims were to ensure two-way flows of communication and information were shared in and out of the CCG to a wide range of audiences through trusted routes, groups and contacts and to build external relationships with external local agencies. PK asked for the views of the group
· AT stated it was a committee with no teeth – PK reiterated that although the Minutes were distributed to the Governing Body there were no delegated powers.
· AP said if LEAP was not in existence then any problems arising would be dealt with via NHCCG Quality Team, who fed into the Integrated Care Committee.
· All agreed that good relationships with external agencies had been established and NHCCG representatives now attend some of the agencies meetings.
· JB suggested that instead of bi-monthly meetings, it might be of greater relevance to hold quarterly and then more agencies might be available to attend. AP commented on the representation of deputies had aided today’s meeting. It was also stated by JB and agreed by others that is was a useful communication forum, where information was picked up from agencies that they may not have otherwise dealt with.
· JD and LT had a discussion prior to the meeting about the LEAP relevance and were questioning the Engagement element of the meeting. It was agreed that it acted as a useful work stream – sparking thoughts for other agencies to share.
PK concluded that he would take the feedback of the LEAP review discussions onto the Governing Body. If it was still appropriate to continue the LEAP Committee then the next meeting would be held as stated below. / (AP)
7. / Date of next meeting
Tuesday the 8th September 2015. 10.30 to 12.30 at the North Hampshire CCG Offices.
There being no further business the meeting closed at 12.10
Future meeting dates to be advised
Page 6 of 7