Minutes
North Hampshire Clinical Commissioning Group – Governing Body (CGB)
Minutes of the meeting of the North Hampshire CCG Governing Body held on Tuesday 25th June 2013 at 13:00 hrs at Central 40, Lime Tree Way, Chineham Business Park, Basingstoke, Hants, RG24 8GU
Present:Dr Hugh Freeman (HF)Chair
Dr Sam Hullah (SHu)Chief Clinical Officer
Pam Hobbs (PH)Chief Finance Officer
Jan Baptiste-Grant (JG)Chief Nurse
Dr Nick Sorby (NS)Secondary Care Consultant
David Rice (DR)Lay Member – Audit and Remuneration
Derek Tree (DT)Lay Member – Integrated Governance and
Patient and Public Engagement
Sue Pidduck (SP)Area Director - Older People and Physical Disability Services, North and North East Adult Services, Hampshire County Council
Dr Sallie Bacon (SB)Public Health Consultant
Dr Angus Carnegy (AG)GP Elected Member
Dr Andrew Cameron (AC)GP Elected Member
In attendance:Nikki Kenny (NK)Business Services Manager
Presenter:Samantha Hudson (SH)Head of Health Partnerships
Apologies:
Dr Amanda Britton (AB)Vice Chair of the Clinical Cabinet
Lisa Briggs (LB)Chief Operating Officer
Colin Godfrey (CG)Patient Representative
Anne Phillips (AP)Head of Communications and Stakeholder Engagement
1 / Chairman’s Introduction1.1 / Dr Hugh Freeman welcomed everyone present to the meeting of the North Hampshire Clinical Commissioning Group Governing Body (CGB).
2. / Declarations of Interest (Paper CGB13/077)
2.1 / No amendments to the Declarations of Interest were made.
3. / Minutes of the previous meeting held Tuesday 21st May 2013(CGB13/078)
3.1 / Dr Hugh Freeman requested that members review the minutes for accuracy.
PH asked that an amendment be made to item 13.1.
3.2 / OUTSTANDING ACTIONS:
Local Authority Report (CGB13/006) from 21st May 2013 meeting. Lisa Briggs asked David Rice that the following guidance issued from Sir David Nicholson, Chief Executive of NHS – England, entitled “Update and advice for CCGs on the process for approval of severance payments and wording in constitutions on whistleblowing” be considered by the next Remuneration Committee and then be brought back to the Governing Body for further discussion.
All other actions had been completed. / LB
and
DR
3.3 / AGREED.
The NHGB approved the minutes of the meeting held on 21st May 2013 as being a correct record and commended them for signature by the Chair.
4. / Matters Arising
4.1 / There were no matters arising.
5. / Report from Chief Operating Officer (CGB13/079)
5.1 / The report was noted.
SHu presented the report in LB’s absence. SHu wanted to highlight, for the Governing Body, 4 items from the report:
5.2 / Authorisation: The Wessex Area Team cannot discharge the remaining two conditions as the contract has yet to be agreed and signed with HHFT and there are still a number of outstanding risks around the CCG financial position. NS enquired whether other CCGs had these kinds of conditions over them. HF replied that there were approximately half a dozen other CCGs that have conditions around their budget deficit. SHu reiterated to the Governing Body that it didn’t stop NHCCG doing anything, it just ‘sits over us’.
ACTION: HF to talk to LB regarding outstanding conditions. / HF
5.3 / New Staff: SHu reported that two new members of staff had been appointed within the last month and extended a welcome to them.
5.4 / Office Accommodation: SHu reported that the office move had gone extremely well and that staff were very happy with their new accommodation at Central 40. Thanks were extended to Dr Weaver and partners at Old Basing Health Centre and to all those involved in the commissioning process. Special thanks were extended to Nikki Kenny for managing the move so well.
5.5 / Raising the profile of the NH CCG: SHu reported that the North Hampshire CCG had appeared in the Basingstoke Gazette newspaper and the Health Service Journal publication during the last month. The Basingstoke Gazette is also involved with the NH CCG regarding a campaign entitled ‘Help us to Help You’. The campaign will start with an article regarding DNA figures. The emphasis of the article will reflect the impact on other patients who tried to get appointments and failed, due to the high number of ‘no shows’. However, the tone of the article is ‘let’s work together’ and the message is that the NHS belongs to us all and better use of resources must be made. Week 2 of this campaign will be medicines waste and week 3 will look at inappropriate use of GP time/A&E attendance. SB enquired whether social media and Twitter were to be used. SHu said it was and that it could also go onto television screens in the waiting rooms of GP surgeries.
5.6 / AGREED.
The NHGB agreed to accept the Report from the Chief Operating Officer.
6. / Hampshire Joint Health and Wellbeing Strategy (CGB13/080)
6.1 / Samantha Hudson (SH), Head of Health Partnerships, presented and spoke in depth regarding the previously distributed Hampshire Joint Health and Wellbeing Strategy to the Governing Body. There were four key themes: Starting Well; Living Well; Ageing Well and Healthier Communities and three key focuses: Fewer people dying, a reduction in health inequalities and an improvement in community based services. After the presentation, JG queried how 16 different targets were to be achieved in year one. SH explained that the 16 different targets were to be achieved over a five year period. SHu asked why focus on children with disabilities rather than dysfunctional families? SH replied that there was a strategy in place already for dysfunctional families and the idea was to add value rather than duplicate. SP informed the Board that the Health and Wellbeing Governing Body was the overarching architecture that the CCG engage with. SH asked that the North Hampshire Clinical Commissioning Group adopt this Strategy.
6.2 / AGREED.
The NHGB agreed to accept and adopt the strategy of the Health and Wellbeing Board.
7. / Headway (CGB13/081)
7.1 / This item was moved to Part Two Business.
8. / Clinical Cabinet Meeting Minutes(6th June 2013) (CGB13/082)
8.1 / The report was noted.
SHu reported that the last Clinical Cabinet meeting was held on 6th June 2013. SHu wished to highlight, for the Governing Body, 4 items from the report:
Item 6.1: Media Campaign. The NH CCG are mounting a ‘Help Us to Help You’ Campaign related to primary care, starting with DNAs. Members of the Clinical Cabinet had been asked to forward ideas to Anne Phillips. SHu was hopeful that this campaign would be successful.
Item 6.2: Maria Miller MP. SHu reported that he has sent Maria Miller a letter inviting her to look around the new NH CCG offices. No response has been received as yet.
Item 9.1: Medicines Management.SHu reported that there was a 5% underspend on allocated funds from Medicines Management Team. The Governing Body acknowledged the hard work of Alma Kilgarriff and Pam Hobbs.
Item 11.1: Hip and Knee Surgery.SHu outlined a very difficult and controversial area where differing CCGs used different criteria for their decision-making. SB was in favour of adopting a shared decision-making model along the lines of the one currently used by MSK. NS felt that there were issues with liaison services generally and contributing problems regarding the psychiatric liaison services. PH stated that monies had been set aside to commission this service. NS will contact Dr Rob Green (Clinical Lead for Mental Health) outside of this meeting.
Item 3.2.5. Public Health MOU. SHu clarified this item for SB. / NS
8.2 / AGREED.
The NHGB agreed to accept the Clinical Cabinet Meeting Minutes of 6th June 2013.
9. / Audit Committee Meeting (11th June 2013) (CGB13/083)
9.1 / The report was noted.
DR reported that the minutes were self-explanatory. The Governing Body had no questions.
9.2 / AGREED:
The NHGB agreed to accept the Audit Committee Meeting Minutes of 11th June 2013.
10. / Quality Report (CGB13/084)
10.1 / The Quality Report was noted.
JG presented the June 2013 Quality Highlight Report which dealt with the following:
The Hampshire Clinic:
- Monitoring of Commissioned Services
- Quality of Commissioned Services
- Monthly CQRM meetings scheduled throughout year
- Quarterly safety walk rounds
- Infection Prevention and Control (IPC)
- Vista Healthcare
- Quality Surveillance Group
- Quality and Technology
10.2 / JG informed the Governing Body that the designated Safeguarding Children’s Nurse (a statutory position) has temporarily become vacant. West Hants CCG has taken over responsibility from NE Hants CCG for this post. HF felt that this needed to be kept high on the Governing Body’s agenda. JG to produce a paper for the July Board meeting. HF asked that this go onto the NH CCG Risk Register. JG to speak to Richard Clarke. / JG
10.3 / JG reported to the meeting that she had received an email from the Chief Nurses Office, NHS England asking whether she would present to 400 decision makers at the Telehealth Annual Conference in October 2013. JG has agreed to do this.
10.4 / AGREED
The NHGB agreed to accept the Quality Report.
11. / Finance and Performance (CGB13/085)
11.1 / The Finance and Performance report was noted.
Revenue Resource Available - Position to end of May 2013 (Month 2)
•Revenue Allocation comprise of Patient Care (programme) and Running Costs
•Changes to allocations since budget setting relate to the estimated impact of Specialised Maximum Take
Expenditure Position
•Year to date spend of £34.144m against a budget of £34.176m, with an underspend against plan of £0.032m. Year end forecast position being £211.796m which is line with planned deficit of £2m.
•QIPP required savings for the year are £9.1m, delivery year to date £1.512m
Points to note
•The CCG is working with providers to ensure that data submissions reflect revised commissioning responsibilities.
•Summary financial position utilises 1 month of data. With just 1 month data and a number of data issues, detailed analysis is limited
•Contractual agreements provide some reduction in the level of financial risk in year for the CCG, but it remains essential that QIPP savings are delivered according to planned levels to enable the financial plan to be achieved.
•The CCG is required to recover the £2m deficit in 2014/15 therefore QIPP planning and 2013/14 delivery should reflect this requirement.
11.2 / JG asked PH if a comprehensive paper purely on Performance and Capacity could be produced for the July Governing Body meeting. SB asked that this report tie up with the quality report. JG and PH agreed to discuss how best to approach this. / PH
JG
11.3 / AGREED:
The NHGB agreed to accept the Finance and Performance Report.
12. / Integrated Governance Committee Minutes (13th June 2013) (CGB13/086)
12.1 / The report was noted.
DT informed the Governing Body that PH was to present an update of the work of the Performance and Assurance Working Group at the next meeting of the Integrated Governance Committee.
12.2 / SB is to update the IGC on monies held by Public Health England for immunisation programmes. The IGC wants to know what is happening with money that has moved from the health budget, formerly controlled by the PCT, to the Local Authority. SB reported that the money for immunisation from the PCT has gone to NHS England. The Area Team is responsible for commissioning, so for an update the Area Team will need to be contacted. The National Immunisation Programme will be delivered.
12.3 / DT reported that Alma Kilgarriff (AK), Lead Pharmacist for the NH CCG, had asked for clarification regarding PGDs as she felt that this was a ‘grey area’. Clarification sought from the Hampshire 5 or Ship 8 on PGDs.HF agreed to speak to AK regarding PGDs. / HF
12.4 / DT reported that he had attended the ‘15 steps Challenge’ training in Portsmouth, which included a walk-about. It is a simple but effective way of assessing quality in the hospital environment. This will not replace unannounced visits, some of which will be at night.
12.5 / DT also informed the meeting that he had attended some Corporate Risk Register training in Bristol. KPMG presented BAF models that were designed to focus a Trust or Governing Body on only 5 or 6 risks, in addition to retaining the full set of risk registers. DT reported that Datix will be available for NH CCG from September. SHu felt that performance and quality markers were a very important area and that the Governing Body should concentrate on 4,5, or 6 risks that are selected by the Board.
12.6 / AGREED:
The NHGB agreed to accept the Integrated Governance Meeting Minutes of 13th June 2013.
13. / Collaborative Commissioning Agreements(CGB13/087)
– SCAS (approval)
– Vulnerable Adults
– Maternity and Children’s Services
13.1 / PH reported that National Guidance from NHS England recognised that CCGs were different to PCTs and there was a need to work together.
PB reported that the above three collaborative Commissioning Agreements had been before the Hampshire 5. PH asked the Governing Body to agree them in principle, as further drafts were still to be brought back to the Governing Body.
13.2 / AGREED:
The NHGB agreed to accept the Collaborative Commissioning Agreements – SCAS, Vulnerable Adults and Maternity and Children’s Services in principle.
14. / Hampshire County Council Update Report (CGB13/088)
14.1 / The verbal update was noted.
SP gave the Governing Body an update on the Pioneer Bid. Karen Ashton’s team is co-ordinating the 21 person input. No money comes with it, but there will be bespoke learning support. Will hear in September whether successful or not.
14.2 / AGREED:
The NHGB agreed to accept the Local Authority Report.
15. / Public Health Report (CGB13/089)
15.1 / The report was noted.
SB reported that the 2013/14 work plan to deliver the Memorandum of Understanding between the public health team and the CCG is being finalised. A summary annual report is to be presented to the July Governing Body and an update on delivery of the 2013/14 MOU is to be presented to the September Governing Body meeting.
15.2 / SB reported that the 2013 Hampshire JSNA will be presented at the first meeting of the Hampshire Health and Wellbeing Board in July 2013. This will provide an overview of the health needs of the CCG. SHu asked whether the JSNA would be available for the August Clinical Cabinet. SB confirmed that this would be possible.
15.3 / SB asked the Governing Body to continue supporting the development of the Familial Hypercholesterolaemia testing service. SHu asked SB whether she or anyone in the public health team were in touch with Dr Jess Pizzotti? SB will ask Robert Pears to contact Dr Pizzotti. / SB
15.4 / AGREED:
The NHGB agreed to accept the Public Health Report.
16. / Patient Representative Report (CGB13/090)
16.1 / There was no report at this meeting.
17. / Shadow Hampshire Health and Wellbeing Board (Undated Minutes) (CGB13/091)
17.1 / HF reported to the meeting that currently they are operating in statutory form as a sub-committee of Hampshire County Council and Councillor Manns is chair. Five CCGs have proposed HF as vice chair which was accepted. This now goes before the full Council meeting for ratification in July.
17.2 / The first full meeting of the Health and Wellbeing Board is to be held in August 2013.
17.3 / AGREED:
The NHGB agreed to accept the Shadow Hampshire Health and Wellbeing Board (undated minutes)
18. / Any Other Business
18.1 / There was no other business.
19. / Date of Next Meeting
19.1 / The next meeting of the North Hampshire Clinical Commissioning Group Governing Body will be held on Tuesday16th July at 13:00 hours at Alton Maltings Centre, Maltings Close, Alton, Hants, GU34 1DT. This meeting will be open to the public.
20. / Dates of Future Meetings
16th July 2013 at 13:00 hrs at Alton Maltings Centre, Maltings Close, Alton, Hants, GU34 1DT (OPEN TO THE PUBLIC)
27th August 2013 at 13:00 hrs Central 40, Lime Tree Way, Chineham Business Park, Basingstoke, RG24 8GU.(CLOSED MEETING)
24th September 2013 at 13:00 hrs at Central 40, Lime Tree Way, Chineham Business Park, Basingstoke, RG24 8GU.(OPEN TO THE PUBLIC)
Meeting closed at 15:30 hours
Signed as a true record
Name: Dr Hugh FreemanTitle: Chair
Signature:Date: 25th June 2013