GOVERNING BODY MEETING TUESDAY 24 MAY 2016 MINUTES TO BE RECEIVED GROUP NETWORK 25/02/2016. RATIFIED Dr Tony Naughton Mr Peter Tinson

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1 GOVERNING BODY MEETING TUESDAY 24 MAY 2016 MINUTES TO BE RECEIVED Agenda item no. 30 Title of Meeting Date of Meeting Status (ratified/draft) CCG Representatives LANCASHIRE CLINICAL COMMISSIONING GROUP NETWORK 25/02/2016 RATIFIED Dr Tony Naughton Mr Peter Tinson Summary of key issues discussed: Dr Robin Jackson TD, Chairman of the NHS Armed Forces Network Northwest, presented a briefing on the work of the Armed Forces Network (AFN). It was agreed that veteran health would be included within the Sustainability and Transformation Plan. A presentation was delivered on the Research and Innovation Strategy across Lancashire. A discussion took place on the format of future Network meetings. Network members were joined by members of the Lay Chairs/Vice Chairs group for a discussion on the Healthier Lancashire programme governance arrangements. Matters requiring action by Governing Body Details: By whom: Timescale: No actions required. Recommendation The Governing Body is asked to review and note the contents of the minutes. Dr T Naughton Clinical Chief Officer

2 Lancashire CCGs Network Minutes Thursday, 25 February 2016, Boardroom 1, Chorley House, Lancashire Business Park, Leyland PR26 6TT at 9.00 am Present In Attendance Mr Andrew Bennett, Lancashire North CCG Dr Chris Clayton, Blackburn with Darwen CCG (Chair) Dr Alex Gaw, Lancashire North CCG Mrs Jan Ledward, Chorley and South Ribble CCG and Greater Preston CCG Dr Tony Naughton, Fylde & Wyre CCG Dr Dinesh Patel, Greater Preston CCG Mr Peter Tinson, Fylde and Wyre CCG (Vice Chair) Mr David Bonson, Blackpool CCG Mr Carl Ashworth, Strategic Locality Lead, Fylde and Wyre CCG, Senior Executive - Transformation Ms Kirsty Hollis, Acting Chief Finance Officer, East Lancashire CCG Mr Gary Raphael, Chief Finance Officer, Blackpool CCG Mrs Linda Riley, MLCSU Ms Sam Nicol, Healthier Lancashire Mrs Jill Truby, Lancashire CCGs Network Dr Robin Jackson TD (item 4) Dr Umesh Chauhan (item 5) Mr Roy Fisher, Blackpool CCG (item 7) Mr Anthony Gick, Chorley & South RIbble CCG (item 7) Mrs Michelle Pilling, East Lancashire CCG (item 7) 1 Welcome, apologies and declarations of interest Dr Clayton opened the meeting and welcomed everyone. Apologies for absence were received from Dr Bangi, Dr Doyle, Dr Ions, Dr Cane, Mr Maguire, Mrs Nixon, Mr Parr, Mr Youlton, Mr Crossley, Mr Kingan and Mr Harrison. There were no declarations of interests. It was noted that the meeting was not quorate. 2 Minutes of previous meeting held 28 January 2016 The minutes of the meeting held on 28 January 2016 were recommended as an accurate record. 3 Matters arising and action sheet Dr Clayton sought and obtained confirmation that the actions from the previous meeting were either complete or in hand. 4 Work of the Armed Forces Network (AFN) Dr Robin Jackson TD, Chairman of the NHS Armed Forces Network Northwest, presented a briefing to Lancashire CCGs. Highlights of the presentation: Responsibilities:

3 Serving personnel mobilised reservists NHS England Families with a DMS practice NHS England Families with an NHS practice CCGs Reservists not mobilised CCGs Veterans CCGs The Armed Forces Clinical Reference Group (CRG) provides clinical advice to NHS England in support of its commissioning decisions regarding serving Armed Forces personnel, their families, mobilised Reservists and Veterans. In particular, this CRG will review and support the integration of care pathways between Ministry of Defence and NHS medical services, ensuring that patients experience a seamless transition between services. Armed Forces Covenant Fair treatment Removing disadvantage: same access to services as the civilian community Sets out relationship between the nation, the government and the Armed Forces Recognises more obligation to members of the Armed Forces and their families Establishes how they should be expect to be treated The Covenant s principles are: The Armed Forces community should not face disadvantage compared to other citizens in the provision of public and commercial services in the area where they live Special consideration is appropriate in some cases, especially for those who have given most such as the injured and the bereaved Nine regional Networks, closely aligned to the military regional structures, meet regularly to ensure close collaborative work between local and regional people. CCG preparedness operating framework Identify veterans Referring for priority treatment Support staff who volunteer for Reserve duties Supporting reservists having time off for training/deployment Implementing Murrison Report Prosthetic needs Maintaining and developing AFN Communication One message: Tell them you ve served Will encourage veterans and personnel newly out of Service to present in primary, secondary or mental health providers to state their veteran status. This will allow greater awareness and identification of veterans, which in turn will allow more specific access to mental health and health support, signposting to wider support services and allow those delivering care to be aware of the context of their Service in a considerate manner. Health Education England should ensure that training is available so that there can be a specialised GP in every CCG trained in the physical and mental health needs of Armed Forces veterans by summer HEE will design a training programme/e-learning module for Veterans Health

4 Champions, aimed at training health professionals to recognise, and raise awareness of, veterans health needs across primary, secondary and community care settings. HEE, through the LETBs, will work with employers and other partners to ensure this training is available for the whole health workforce before spring New for New read codes Publicity for veterans to declare themselves to Primary and Secondary care Imperative for H&WBBS to use this data for JSNAs Handbook for Secondary Care and CCGs New e-learning package for Health professionals Dr Jackson summed up by stating that CCGs have a financial, clinical and moral responsibility to commission services in accordance with the Armed Forces Covenant for the Armed Forces Community. Many veterans and/or their families will have complex needs and require specialised help. The Armed Forces Network NW can provide advice and guidance. The CCGs were asked to identify a specialist GP as a contact for Dr Jackson s group. It was suggested that Fylde & Wyre CCG and Greater Preston CCG would be better placed to identify a collective person due to the number of army barracks within their areas. Members reported that records were not always readily available to GP practices. Dr Jackson stated that this was an issue currently being addressed. He confirmed that all veterans received a discharge letter and consent to their records being released. Ms Nicol was asked to include veteran health within the STP. ACTION: Fylde & Wyre/Greater Preston CCGs to identify specialised GP Veteran health to be included within the STP Sam Nicol 5 Lancashire plan around R&D Dr Umesh Chauhan spoke to the Research & Innovation Strategy. The purpose of the strategy is to set out how the NHS East Lancashire CCG will promote research activity and the utilisation of research methodologies to contribute to the achievement of improved health care for the patients in East Lancashire area based on sound clinical evidence and in line with NHS England duty to promote research. The strategy sets out the action plan for Research and Development within the CCG, reflecting the changes and opportunities for R&D in Commissioning. The strategy sets out how these targets will be achieved and affirms the CCG s commitment to promotion of research, service evaluation and innovation. The Chief Officer is ultimately accountable for ensuring a clear duty to demonstrate a commitment to promote research. This duty is delegated to the Director of Quality/Chief Nurse who is responsible for ensuring that research and evidence based practice takes place locally in line with national policy. The CCG aims to positively engage with the research agenda and be evidence-driven organisation utilising research methodologies. Currently the NWC CRN provides support to the CCG around Research Management and Governance for Commissioning and Provider based studies. Health Research Authority approval will host the approval process that will be required for research to commence in the NHS in England. It is a new process that comprises a review by a

5 Research Ethics Committee as well as an assessment of regulatory compliance and related matters undertaken by dedicated HRS staff. Staff have access to NHS Library Services to enable access to online evidence. It was considered that this was a challenge even though there was agreement to move forward on a Lancashire level. It was suggested that an infrastructure be produced. It was proposed that this work was linked to Healthier Lancashire and the Health Economy Plan. Mr Raphael was asked to work with Dr Chauhan via the Healthier Lancashire agenda. Mrs Ledward also agreed to link in the work that was being undertaken by Chorley and South Ribble CCG and Greater Preston CCG in respect of the workforce project Any other business Fylde & Wyre CCG tabled a Memorandum of Understanding for the Mobilisation of NHS Resources received from Public Health England. Mr Tinson enquired as to whether all other CCGs had received this document and whether there was a consistent approach in relation to signing up to this. Some members had not had sight of the document. Dr Clayton suggested that the document was discussed at the next meeting of the EPRR leads on 7 March. A lengthy discussion took place on the format of future Network meetings and it was proposed that the agenda be split into three as follows: Open forum sharing current hot issues Shared Learning platform Jill to create a regular rota for this Future View using the network to tackle important issues that are coming through such as Hyper-acute stroke, linked to Healthier Lancashire, Amanda / Sam to take the responsibility to map this out. 7 Healthier Lancashire discussion with Lay Chairs / Vice Chairs Network members were joined by members of the Lay Chairs / Vice Chairs group. Ms Nicol presented background information relating to the Healthier Lancashire programme and where it was up to in terms of governance. A short briefing paper will be presented to all CCG governing bodies for discussion initially in part II which will include the proposed terms of reference of the joint committee of the CCGs which will be formed in collaboration with local authorities and NHS England. The joint committee will be delegated to take decisions. The programme board will include all providers. These terms of reference will eventually become a memorandum of understanding which will be presented to all governing bodies. Ms Nicol confirmed that the MOU will then become a public document and should be available by April. The lay members considered it was important to have lay membership involvement. Mrs Pilling reported that she had attended East Lancashire s Health and Wellbeing Board partnership meeting where concerns had been expressed from the Local Authority of lack of engagement. She was reassured that there had been representatives from all authorities involved in the process. Mr Gick, speaking from experience, stated that legalities were of the utmost importance as some decisions will be difficult to make, with some losers and some winners around the table. He considered that it was extremely important to ensure that the right person was appointed as the Chair and that there should be clarity on where the decision making lies.

6 Mr Tinson confirmed that all CCGs had seen sight of the draft document but not all the comments made, and said that he would find this useful from a you said, we did perspective. One of the first decisions to be made will be the signing off of the STP. CCGs confirmed that their memberships were being kept informed of progress. 8 Date, time and venue of next meeting Thursday, 31 March 2016, 9:00 am, Boardroom 1, Chorley House, Lancashire Business Park, Leyland, PR26 6TT