15 minutes to be allocated for questions from members of the public based on agenda items. Time Agenda item Action Presenter

Transcription

1 NHS WEST LANCASHIRE CLINICAL COMMISSIONING GROUP GOVERNING BODY MEETING 23 JULY 2013, 9:30-11:30 Tanhouse Community Centre, Ennerdale, Skelmersdale, WN8 6AN 15 minutes to be allocated for questions from members of the public based on agenda items. Item WLCCGB Time Agenda item Action Presenter 7/13/01 09:30 Welcome Dr Caine 7/13/ Declaration of Interests All 7/13/ Minutes of previous meeting held on 28 May 2013 DR Dr Caine 7/13/ Matters arising - Action sheet DR Dr Caine Communication 7/13/ Chair s update I Dr Caine 7/13/ Chief Officer s Update I Mike Maguire Governance 7/13/ Register of interest I Paul Kingan 7/13/ Medicine Optimisation Committee - draft terms of DR Nicola Baxter reference Operational Management Section 7/13/ Integrated business report D Paul Kingan 7/13/ Funding allocation risk D Paul Kingan 7/13/ Dementia appraisal D Jo Worswick Consent items 7/13/ Minutes of sub-committees: - Quality Improvement Committee 25 June Executive Committee 18 June 2013 Other minutes: - Lancashire CCG network 25 April Lancashire CCG network 30 May 2013 Other Business 7/13/ Any other business Dr Caine I Information D Discussion DR Decision Required I Dr Caine Date and Time of Next Meeting 24 September 2013, 9:30 am Boardroom, Hilldale, Ormskirk Members of the governing body will be available after the close of the meeting for informal discussion, time permitting

2 Minutes D R A F T Meeting Title: NHS West Lancashire Clinical Commissioning Group Governing Body Meeting Time: am Present: Dr John Caine, Chair Dr Anand Bisarya, Clinical Lead Dr Bapi Biswas, Clinical Lead Dr John (Jack) Kinsey, Clinical Lead Douglas Soper, Lay Member Dr Adam Robinson, Secondary Care Doctor Mike Maguire, Chief Officer Paul Kingan, Chief Financial Officer Helen Clarke, Chief Nurse Date: 28 May 2013 Venue: Boardroom, NHS West Lancashire, Ormskirk Apologies: Jo Worswick, Deputy Chief Officer Lucinda Cawley, Senior Operating Officer Planning and Service Redesign Dr Simon Frampton, Clinical Lead Greg Mitten, Lay Member In attendance Katie Wightman, Head of Corporate Affairs Karen Thompson, Public Health Specialist Dr Rosalind Bonsor, GP Cathy Ashcroft, Executive Assistant Agenda Summary of Discussion Item WLCCGB/ 5/13/01 Welcome and apologies for absence John Caine opened the meeting of the West Lancashire Clinical Commissioning Governing Body meeting. Introductions were made by the governing body and members of the public. No questions had been received from the public in respect of the agenda. Action Three member of the public were in attendance for the meeting. Apologies for absence were received from the above noted. 5/13/02 Declarations of interests There were no declarations of interests pertinent to agenda items. 5/13/03 Minutes of previous meeting held on 23 April 2013 The minutes of the meeting held on 23 April 2013 were agreed as an accurate record. The governing body: - approved the previous minutes 5/13/04 Matters arising The action sheet was updated. West Lancashire Clinical Commissioning Group Governing Body meeting 28 May 2013 Page 1 of 7

3 COMMUNICATION 5/13/05 Chair s update The report provided members with an update on both strategic and operational issues since the last meeting. John Caine highlighted key areas of interest: NHS England updates: Putting Patients First business plan to , based on the Everyone Counts document. The document sets out how NHS England will support commissioners to use their valuable public resources to improve quality and secure the best possible outcome for people. Assurance Framework to give assurances that CCGs are delivering quality outcomes for patients. There are a number of check points to allow progress to be shared. A&E standards NHS England has written to all CCGs to address the current pressures on urgent and emergency care systems being experienced on a national level. An improvement plan for each A&E will be submitted by 31 May, by each CCG. This is being compiled across the health community by Jo Worswick, Malcolm Cunningham and Billie Dodd, as lead commissioners, plus Southport and Ormskirk Hospital NHS Trust. The draft plan will be sent to Local Area Teams (LAT) and their feedback will be presented at the CCG executive committee, following by the governing body meeting. Quality premium the paper outlines the quality premiums, which reward CCGs for improvements in the quality of services they commission. Indicators listed are reducing potential years of lives lost through amenable mortality; reducing avoidable emergency admissions; ensuring roll-out of the Friends and Family Test and improving patient experience of hospital services; and preventing healthcare associated infections. The governing body: - noted the content of the report 5/13/06 Chief Officer s update The report provided members with an update on both strategic and operational issues since the last meeting. Mike Maguire highlighted key areas of interest: Community events following six open public community events held in April, a survey to continue collecting the pubic s perception of the NHS will be available via the website, practices and other channels. The Lancashire Commissioning Support Unit (CSU) will then report back on the findings and use this as a benchmark in the future. Practice manager engagement Mike Maguire and Meg Pugh attended a practice manager meeting in April to ascertain the practical issues they are facing with new system working. It was agreed that the CCG and NHS England will attend regular meetings to help boost collaboration and understanding. Patients insight report Lancashire CSU have been requested to produce a more in-depth patient insight report to be received by the CCG on a monthly basis. Meg Pugh, head of locality communication and engagement, is involved in this to identify the trends and themes from patients. West Lancashire Clinical Commissioning Group Governing Body meeting 28 May 2013 Page 2 of 7

4 Quality improvement event (Care Closer to Home) the event scheduled for 6 June will address active case management workstream of the care closer to home programme. The event, which will address patient pathways and how to improve quality, is expected to receive 60 attendees including patients, public and clinical professionals. Mike Maguire requested the clinical leads to encourage their GP colleagues to attend. In addition to the written report Mike Maguire reported on the current position with the move of the CCG to its new building, Hilldale. The move has been delayed due to the contractor going into liquidation. As the building owners, NHS Property Services are instructing the architects to evaluate the remaining work. Regular meetings with NHS Property Services will continue to monitor progress. There are no financial implications for the CCG at this stage. NHS England had written to the CCG raising concerns that clauses in the national template for CCG s constitution may be perceived to gag staff and members from whistleblowing. As a result NHS England have asked CCGs to insert a paragraph in the constitution making it clear that as defined in the Employment Rights Act 1996, (as amended by the Public Interest Disclosure Act 1998) nothing contained in the constitution will prevent or inhibit the making of any protected disclosure. CCGs will have the opportunity to submit revised constitutions to NHS England by the end of June It was agreed to amend the constitution and seek Membership Council approval. Katie Wightman GOVERNANCE The governing body: - noted the content of the report 5/13/07 Register of Interests As part of governance the CCG informs the governing body of any alterations to the register of interests. The report recorded two additional declarations of interest which had been added to the comprehensive list of declarations of interest for all West Lancashire CCG governing body members. The governing body: - noted the updated declared interests of its members 5/13/08 Board Assurance Framework (BAF) and Risk Register The BAF and risk register have been in place since September 2012, but have been recently been refocused to concentrate on the key risk areas for the CCG. The progress on the following key areas was highlighted: Engagement risk rating is moderate Delivery risk rating is moderate Contracts risk rating is moderate Operational systems risk rating is moderate Authorisation removed from the BAF and risk register West Lancashire Clinical Commissioning Group Governing Body meeting 28 May 2013 Page 3 of 7

5 The risk register is a live document and risks which reach an overall score of 15 or above will be reported to the governing body. At this stage no risks are scored at 15. However, the financial risk in terms of the national specialist commissioning allocations is being monitored closely, as this impacts on the contract sign-off, which subsequently has an overall score of 12. A risk share process for Lancashire is being discussed to mitigate the allocation risk and this is being reviewed weekly. The national single finance ledger is currently being implemented and this is being monitored closely, alongside the processes supplied by Lancashire CSU. Doug Soper praised the new BAF and thanked Paul Kingan and Katie Wightman for producing this. Contracts have been agreed with sign off expected by the end of June, aligned to the allocations risk share above. The issue around the allocations is being managed through the LATs and their relationships with the regions. Doug Soper raised the local issue of the budget split from the primary care trust between the three CCGs which include budgets for the respective hospitals. Paul Kingan is working with Ian Crossley at Greater Preston and Chorley & South Ribble CCG to address this and it is expected to be resolved within the same timeframe, although some issues will continue to be worked through in future months. There is a risk that the CCG will not receive the correct budget to fully match our commitments at this stage. Helen Clarke commented that it is known that overall nationally there is enough money in the system, but it has been left to the CCGs and LATs to find a local solution to this via the risk share. Fair share budgets for 2014/15 are still being debated and no figures are available yet. If agreed, they may be implemented through a pace of change arrangement. It is not clear whether the allocation formula will be biased towards age or deprivation weighting. Paul Kingan will keep the governing body informed accordingly. The risk register will be presented to the clinical executive committee for appropriate action and to the audit committee for monitoring of this action. OPERATIONAL MANAGEMENT SECTION 5/13/09 Integrated Business Report The report provided summary information on the financial position and activity performance of the CCG for March It also included quality and performance analysis for community based targets for Southport and Ormskirk Hospital NHS Trust. Paul Kingan highlighted key information from the report: - At month 12 the CCG had successfully delivered its financial plan for the year - The CCG had an end of year underspend of 966k, including 626k surplus relating to the CCG s share of the PCT s surplus of 3.762m. - The auditors had practically completed the end of year accounts audit, with no issues for West Lancashire CCG to date. - Main issues to have impacted on the financial position for the year included planned care and outpatient follow-ups, unplanned care, prescribing underspend contributing to the surplus, an underspend in West Lancashire Clinical Commissioning Group Governing Body meeting 28 May 2013 Page 4 of 7

6 issues with complex cases off set with an overspend in mental health. Overall balanced financial position but some key underlying issues to address. - The CCG will carry forward its QIPP programme to 2013/14 to continue to perform better and deliver better quality in the future. The 1m pressure on non-electives needs to be addressed through the care closer to home programme. Key performance indicators (KPIs) are being developed to support the delivery of the 2.9m QIPP target - The reported reduction of 7% in GP referrals to all providers over the last year is being investigated and may reflect some data anomalies in March for outpatient follow-ups. - Non-recurrent issues include ophthalmology and musculoskeletal clinics. Mike Maguire reported on quality and performance and highlighted the key information from the report, which was produced by mainly February data. The 2 key risk areas are : 18 weeks waiting from referral to treatment targets shortage of theatre staffing is impacting on the trust achieving this target. The CCG provided additional funding in this area and although this has helped, the trust missed the year to date target. This will be monitored very carefully. A&E performance there is a higher level of demand from Sefton patients than in west Lancashire. Work is being undertaken to address the performance issue, with Jo Worswick s input to the A&E improvement plan. An external emergency care intensive support team are being invited to investigate the situation further, drawing upon the outcomes from their previous investigation as a benchmark. This action has been agreed with Fiona Clark and Sheilah Finnegan. The support team, which should commence in the next few weeks, will capture more data on re-admissions. Staff sickness in A&E is high compared to the hospital internal targets, therefore Jo Worswick is gathering information from other hospitals to establish a common benchmark. Difficulty in filling a vacant consultant post is a contributory factor. Mike Maguire will ask if advanced nurse practitioners are used in the A&E department as an alternative for junior doctors. Bapi Biswas commented that the CCG should be mindful that the outcomes of the investigation may require funding eg the possibility of seven day working for consultants. Mike Maguire The governing body: - noted the performance to date and the actions in place to improve performance. 5/13/10 Communication and Engagement Strategy Paul Kingan presented the strategy, which was prepared by Meg Pugh from Staffordshire and Lancashire CSU. The strategy provides a foundation for the CCG s communication and engagement activity and details its statutory requirements to engage. Section 7 eludes to an action plan which is key for the CCG to be aware of in our communication and engagement with partners and patients. West Lancashire CCG has invested more than other CCGs in communication support from the CSU, but this is beneficial to the organisation and invaluable in meeting our objectives. One minor change is required to section 14 to the stakeholders diagram. West Lancashire Clinical Commissioning Group Governing Body meeting 28 May 2013 Page 5 of 7

7 CONSENT ITEMS The governing body: - approved the Communication and Engagement Strategy, following the stated alteration. 5/13/11 Minutes of sub-committees: Quality Improvement Committee The draft minutes of the Quality Improvement Committee (QIC) meeting held on 23 April 2013 were noted. Jack Kinsey briefly provided feedback on the matters discussed and action completed. Responses had not been received from Southport & Ormskirk Hospital NHS Trust to the quality enquiries from the committee. Greg Mitten, Chair of the committee, has been attending the provider quality meetings, but the benefit of this attendance will be reviewed. The QIC is working well, being proactive and challenging, but relationships need to develop further with the provider. Helen Clarke suggested that to avoid duplicating visits to the provider with those of the Southport and Formby CCG, it would be more efficient for the CCGs to lead on specific areas. CCG Review of Southport & Ormskirk Hospitals NHS Trust Quality Account Jackie Moran had reviewed the Southport & Ormskirk Hospital NHS Trust quality account and focussed her report on the areas delivering excellent results and those that need attention. The trust is not performing well in: responsiveness to the personal needs of patients; readmissions; summary hospital level mortality indicator. The Care Quality Committee has reviewed outcomes and service provision. The governing body: - noted the report and were satisfied that this matter is being addressed. Executive Committee The minutes of the Executive Committee meetings held on 16 and 30 April 2013 were noted. Other minutes: Lancashire CCG network The minutes of the Lancashire Clinical Commissioning Network meeting held on 28 March 2013 were noted. Bapi Biswas requested further information regarding the item on domestic violence. Lucinda Cawley will be requested to provide this information at a future Executive Committee meeting. Lucinda Cawley Other business 4/13/09 Any other business John Caine provided feedback on the NHS 111 progress. Commissioners have met to look at current contracts of the NHS 111 provider in the north west and any changes to the contract would have an impact on the provider s ability to provide other contracts. The full 111 service is currently only provided to approximately one third of the population in the north west region. The 111 service are handling the 0845 service only to the rest of the region. This is a political issue and the CCG will have to be aware of the Department of Health review of the 111 launch. West Lancashire Clinical Commissioning Group Governing Body meeting 28 May 2013 Page 6 of 7

8 Meeting closed at am Date and time to next meeting: Tuesday 23 July 2013, 9:30 am Boardroom, Ormskirk West Lancashire Clinical Commissioning Group Governing Body meeting 28 May 2013 Page 7 of 7

9 Agenda item no: WLCCGB West Lancashire CCG Governing Body meeting 28 May Action Lead Date required by Action completed 5/13/06 Chief Officer s update Whistleblowing it was agreed to amend the constitution and seek Membership Council approval. 5/13/09 Integrated Business Report enquire if advanced nurse practitioners are used in the A&E department as an alternative for junior doctors. 5/13/11 Minutes Lancashire CCG Network Further information regarding domestic violence will be provided at the Executive Committee. Katie Wightman 19 June 2013 Mike Maguire 23 July 2013 Lucinda Cawley June April Action Lead Date required by Action completed 4/13/07 Integrated business report Complaints reporting A record of GP s concerns is fedback to the GP Operational Forum, which report to the Strategic Partnership Group. Jo Worswick will look to see what benchmarking information is available and include in future reports. Jo Worswick June 2013 Page 1 of 2

10 26 March 2013 Action Lead Date required by Action completed 3/13/14 Frances report - A formal letter to the provider was sent on 5 March suggesting collaborative work take place, as yet no reply had been received and it was recommended that this was escalated to the chair or chief officer to follow-up. A follow up letter was sent, with some of the outstanding information received. The quality issues will be raised at the executive committee and return to the next governing body meeting. Dr John Caine and Mike Maguire 23 July 22 January 2013 Action Lead Date required by Action completed 1/13/09 Integrated business report - It was agreed that a report should be produced by Southport and Ormskirk NHS Hospital Trust to detail the reason for the winter pressures breach. Helen Clarke will share similar work produced by Bolton. Helen Clarke 28 May COMPLETE Page 2 of 2

11 WEST LANCASHIRE CLINICAL COMMISSIONING GROUP GOVERNING BODY REPORT DATE OF BOARD MEETING: DRAFT 23 July 2013 Agenda item no: WLCCGB 7/13/05 TITLE OF REPORT: Chair s Update BRIEFING POINTS: Does this report / its recommendations have implications and impact with regard to the following: A. Commissioning Board s Aims and Objectives 1. Quality (including patient safety, clinical effectiveness and patient experience) please outline impact No 2. Commissioning of hospital and community services please outline impact No Outlines plans for implementing a virtual ward model 3. Commissioning and performance management of GP Prescribing please outline impact No 4. Delivering Financial Balance please outline impact No 5. Development of the commissioning group as a commissioning organisation please outline impact No B. Governance Yes 1. Does this report: provide the Commissioning Board with assurance against any of the risks identified in the assurance framework (identify risk number) have any legal implications promote effective governance practice 2. Additional resource implications (either financial or staffing resources) No 3. Health Inequalities No 4. Human Rights, Equality and Diversity Requirements No 5. Clinical Engagement No 6. Patient and Public Engagement No REPORT PREPARED BY: REPORT PRESENTED BY: Katie Wightman, Head of Corporate Affairs John Caine, CCG Chair Chair s Update West Lancashire Clinical Commissioning Group Governing Body Meeting 23 July

12 WEST LANCASHIRE CLINICAL COMMISSIONING GOVERNING BODY CHAIR S UPDATE PURPOSE 1. This report provides an update on both strategic and operational issues of interest to Governing Body members in the months since the last meeting. Quality Premium Update 2. The aim of the quality premium is rewarding CCGs for improvements in quality of services that they commission and for associated improvements in health outcomes and reducing inequalities. CCGs also have to deliver the patient rights and pledges on waiting times with the NHS Constitution to receive the quality premium. 3. The CCG has had confirmation from NHS England that the local measures the CCG suggested for making improvements in health outcomes against have been accepted. 4. Assessments will be made during the end of 12 months to see if the CCG has satisfied the requirements of the local measures and delivered the NHS Constitution rights. Urgent and Emergency Care Review 5. NHS England is seeking views on a review of urgent and emergency care which is being led by Professor Sir Bruce Keogh, NHS England s Medical Director. The aim of the review is to develop a national framework to help commissioners ensure high quality, consistent standards of care across the country. 6. Four emerging principles have been drafted that outline the case for change, for a system that: Provides consistently high quality and safe care, across all seven days of the week; Is simple and guides good choices by patients and clinicians; Provides the right care in the right place, by those with the right skills, the first time; Is efficient in the delivery of care and services. 7. These are not agreed solutions at this stage, but have been presented to stimulate debate and help explain what a future system might look like. 8. Sir Bruce Keogh is seeking comments to ensure that the evidence base and principles are scrutinised and clinically sound. 9. Comments received will be used to develop a national framework for commissioning of urgent and emergency care. Clinical commissioning groups will then be able to use this framework to commission local urgent and emergency care services. 10. Comments can be submitted via an online questionnaire at The engagement period for comments closes on 11 August. Update on I attended a meeting on 20 June which was to discuss the way forward for the 111 service. The meeting was attended by other north west CCGs. The proposed model for 111 was discussed for Chair s Update West Lancashire Clinical Commissioning Group Governing Body Meeting 23 July

13 operation both in hours and out of hours. Further information is likely to be issued by NHS England in the summer. Commissioning Conference 13. I attended the Commissioning Show in London on 12 June. The event was free to qualified health care professionals. It followed the normal format of speakers but also encouraged delegates to join facilitated workshops where people could work with colleagues and other groups on real life scenarios. It was useful day hearing the challenges, solutions and innovations in other health economies. Governing Body Development Day 14. A governing body development day was held on 9 July. The CCG was 101 days old on the 9 July and seem an opportune time to reflect on our performance to date. CCG staff also attended the day and the results were very positive. Everyone felt that CCG had achieved a lot in a short time but there was also recognition that there was a lot more to do. An action plan is now being produced from the day. Recommendation 11. Members are asked to note the content of the report. John Caine Chair July 2013 Chair s Update West Lancashire Clinical Commissioning Group Governing Body Meeting 23 July

14 Agenda item no: WLCCGB 7/13/06 WEST LANCASHIRE CLINICAL COMMISSIONING GROUP GOVERNING BODY REPORT DATE OF MEETING: DRAFT 23 July 2013 TITLE OF REPORT: Chief Officer s Update BRIEFING POINTS: Does this report / its recommendations have implications and impact with regard to the following: A. Commissioning Board s Aims and Objectives 1. Quality (including patient safety, clinical effectiveness and patient experience) please outline impact No 2. Commissioning of hospital and community services please outline impact Yes Contracting process and care closer to home 3. Commissioning and performance management of GP Prescribing please outline impact No 4. Delivering financial balance please outline impact No 5. Development of the commissioning group as a commissioning organisation please outline impact Yes Contracting process and care closer to home B. Governance information governance No 1. Does this report: provide the Commissioning Board with assurance against any of the risks identified in the assurance framework (identify risk number) have any legal implications promote effective governance practice 2. Additional resource implications (either financial or staffing resources) No 3. Health Inequalities No 4. Human Rights, Equality and Diversity Requirements No 5. Clinical Engagement 111 assurance Yes 6. Patient and Public Engagement No REPORT PREPARED BY: REPORT PRESENTED BY: Katie Wightman, Head of Corporate Affairs Mike Maguire, Chief Officer Chief Officer s Update West Lancashire Clinical Commissioning Group Governing Body Meeting 23 July

15 WEST LANCASHIRE CLINICAL COMMISSIONING GOVERNING BODY CHIEF OFFICER S UPDATE Purpose 1. This report provides an update on both strategic and operational issues of interest to Governing Body members in the months since the last meeting. Quality improvement event (Care Closer to Home) 2. As mentioned in my last report we arranged a stock take event for Care Closer to Home programme for 6 June. This event has now been held. The event was a valuable opportunity for all parties to work collaboratively with the aim of further progressing the work in respect of the Care Closer to Home programme. 3. I am pleased to report that the evaluation and feedback has generally been very positive and we are currently in the process of assessing all the outputs and actions from the day to determine the most appropriate way to take them forward. West Lancashire CCG and West Lancashire Community Safety Partnership 4. On 1 April 2013, clinical commissioning groups (CCGs) became responsible authorities on community safety partnerships (CSPs). The Health and Social Care Act 1 outlines how this duty, previously held by Primary Care Trusts, was to transfer to CCGs. 5. This means that CCGs now have a statutory responsibility to work in partnership with other responsible authorities to tackle crime and disorder. Specifically, the Act places a duty on CCGs to; Participate in a strategic assessment (usually annual) of crime and disorder, anti social behaviour, and drug and alcohol misuse for the CSP area or areas in which they fall. In our CCG area the CSP covers the district of West Lancashire. Contribute to the development of local strategies that effectively deal with the issues where are identified. 6. Through the annual strategic assessment, CSPs have the opportunity to focus on work addressing a range of national and local priorities for reducing crime and disorder and through these duties, CCGs are afforded influence in shaping local action. This includes areas that overlap with health and wellbeing priorities including health inequalities, improving the quality of life and independence of vulnerable people and improving the life changes of children. There is evidence of the association between improving health and wellbeing and reducing offending behaviour. 7. Whilst the extent of CCG involvement is not specified, locally examples of areas relevant to the CCG s priorities include the harm associated with drug and alcohol misuse; domestic and sexual abuse; and child sexual exploitation (safeguarding). More information, including good practice examples can be found at /journal_content/56/10171/ /publication-template 1 Schedule 5, paragraph 84. Chief Officer s Update West Lancashire Clinical Commissioning Group Governing Body Meeting 23 July

16 8. Two CSP meetings have been held since April and the CCG has participated in both. The CCG has facilitated contact to services for their engagement in CSP related activities including the forthcoming Digmoor Community action Day and Freshers week. The CCG will be working with the Constabulary to review local use and recording of the Trauma and Injury Intelligence Group (TIIG) dataset and has offered support to drug and alcohol services for facilitating contact with practices for recovery focussed peer support. CCG Constitution 9. Following the agreement at the last governing body meeting to approve NHS England s request to insert an additional paragraph relating whistleblowing I can confirm that the amendment, along with some other minor amendments, were approved by the membership council on 19 June. 10. The amended constitution has now been submitted to NHS England who is responsible for approving all amendments to CCG constitutions. Feedback from NHS England will be reported to both the governing body and membership council once it has been received. Primary Care Trust and Strategic Health Authority Transfer Schemes 11. The Staff and Transfer Schemes are a legal instrument made by the Secretary of State. The Transfer Schemes were formally received by the CCG on 6 June The Staff Transfer Schemes were made by the Secretary of State in exercise of the powers conferred by sections 300(1) and (3) and 301(1), (3), (5) and (6) of, and Schedule 23 to, the Health and Social Care Act The schemes transferred the rights and liabilities of PCTs and SHAs under or in connection with contracts of employment to transferees as permitted by section 300(3) of, and Schedule 23 to, the Health and Social Care Act The Property Transfer Schemes were made by the Secretary of State in exercise of the powers conferred by section 300(1) and (2) to (3), (4) and (6) of, and Schedule 22 to, the Health and Social Care Act The schemes transferred the property, rights and liabilities of PCTs and SHAs (other than rights or liabilities under or in connection with contracts of employment) to transferees as permitted by section 300(2) of, and Schedule 22 to, the Health and Social Care Act Each Transfer Scheme was signed by a member of the Senior Civil Service by authority of the Secretary of State for Health and came into effect on 1 April The CCG has asked a member of the Internal Audit team to work with the Head of Corporate Affairs to ensure that all property transfers are appropriate. Recommendation 16. Members are asked to note the content of the report. Mike Maguire Chief Officer July 2013 Chief Officer s Update West Lancashire Clinical Commissioning Group Governing Body Meeting 23 July

17 Agenda item no: WLCCGB 7/13/07 WEST LANCASHIRE CLINICAL COMMISSIONING GROUP GOVERNING BODY REPORT DATE OF BOARD MEETING: 23 July 2013 TITLE OF REPORT: Declaration of Members Interests - Update BRIEFING POINTS: To record the declared interests of the members of West Lancashire Clinical Commissioning Governing Body Does this report / its recommendations have implications and impact with regard to the following: A. Commissioning Board s Aims and Objectives 1. Quality (including patient safety, clinical effectiveness and patient No experience) please outline impact 2. Commissioning of hospital and community services please outline impact 3. Commissioning and performance management of GP Prescribing please outline impact No No 4. Delivering Financial Balance please outline impact No 5. Development of the commissioning group as a commissioning organisation please outline impact Will provide the commissioning board and commissioning group with practical experience of implementing good governance practices Yes B. Governance please outline impact Yes 1. Does this report: provide the Commissioning Board with assurance against any of the risks identified in the assurance framework (identify risk number) have any legal implications promote effective governance practice The report promotes good governance practices. It provides a summary of the declared interests of members. Since the register was first presented to the governing body additional posts have been recruited to. 2. Additional resource implications (either financial or staffing resources) No 3. Health Inequalities No 4. Human Rights, Equality and Diversity Requirements No 5. Clinical Engagement No 6. Patient and Public Engagement No REPORT PREPARED BY: Katie Wightman, Head of Corporate Affairs Register of Interest West Lancashire Clinical Commissioning Group Governing Body meeting 23 July 2013

18 WEST LANCASHIRE CLINICAL COMMISSIONING GROUP GOVERNING BODY DECLARATION OF MEMBERS INTERESTS - UPDATE BACKGROUND 1. The purpose of this report is to record the declared interests of the members of West Lancashire CCG Governing Body. 2. Since the register was presented at the previous Governing Body meeting, one declaration of interest has been received and one has been removed. 3. The additional and the removed declarations of interest have been included in the register and is detailed below. ACTIONS 4. The Governing Body is asked to: a. note the declared interest of its member Register of Interest West Lancashire Clinical Commissioning Group Governing Body meeting 23 July 2013

19 REGISTER OF INTERESTS JULY 2013 West Lancashire Clinical Commissioning Group Michael Maguire, Chief officer Dr R Bonsor Interim Governing Body GP Nil GP partner at Beacon Primary Care, 11 Railway Road, Ormskirk, L39 2DN Minority shareholding director of Aspire Pharmacy, 9 Railway Road, Ormskirk, L39 2DN Married to Dr David Roe, Consultant in Emergency Medicine, Whiston Hospital Chair of Ormskirk 30 th Lathom Park Scout Group (Ormskirk District Scouts are currently being supported by Aspire Pharmacy with provision of free discounted first aid kits) Fundraiser / supporter for West Lancashire Defibrillator Campaign Register of Interest West Lancashire Clinical Commissioning Group Governing Body meeting 23 July 2013

20 WLCCGB 7/13/08 WEST LANCASHIRE CLINICAL COMMISSIONING GROUP GOVERNING BODY REPORT DATE OF BOARD MEETING: 23 July 2013 TITLE OF REPORT: Terms of Reference Medicines Optimisation Committee BRIEFING POINTS: Does this report / its recommendations have implications and impact with regard to the following: A. Commissioning Board s Aims and Objectives 1. Quality (including patient safety, clinical effectiveness and patient experience) please outline impact 2. Commissioning of hospital and community services please outline impact 3. Commissioning and performance management of GP Prescribing please outline impact 4. Delivering Financial Balance please outline impact 5. Development of the commissioning group as a commissioning organisation please outline impact B. Governance please outline impact 1. Does this report: provide the Commissioning Board with assurance against any of the risks identified in the assurance framework (identify risk number) have any legal implications promote effective governance practice. 2. Additional resource implications (either financial or staffing resources) 3. Health Inequalities 4. Human Rights, Equality and Diversity Requirements 5. Clinical Engagement 6. Patient and Public Engagement REPORT PREPARED BY: Nicola Baxter Head of Medicines Optimisation

21 Review of Medicines Management Committee functions, CCG competencies and future arrangements Introduction This paper reviews the responsibilities of the CCG Medicines Management Committee (MMC) in the light of nationally defined organisational competencies for medicines management. It considers these competencies and suggests actions which CCGs should consider in order to ensure that they are fully able to take early responsibility for medicines management functions. Background The National Prescribing Centre published a document entitled An organisational competency framework to ensure the effective delivery of medicines management functions and responsibilities: A guide for Commissioning Consortia Boards in June The document identified 48 key competencies, which CCGs will need to demonstrate in order to successfully discharge their functions in relation to commissioning for medicines. The table identifies the roles of CCG MMC based on the NPC competencies. The resulting draft terms of reference for the CCG MMC are in Appendix 1 It is important that CCGs give early consideration to their future responsibilities in relation to medicines management and put in place appropriate arrangements to enable these responsibilities to be discharged. Therefore it was agreed at the membership council on 18 April that a CCG MMC should be set up as a way forward. The membership was agreed at the clinical executive committee on the 14 May Recommendations CCGs should consider setting time aside to work through the NPC competency selfassessment process in order to identify gaps and ways to address them. This may involve adapting the current PCT MMC functions, or replacing them with new structures. The CCG Governing Body are asked to consider and approve the following: Draft terms of reference Appendix 1 MMC is a subcommittee to the clinical executive MMC will make recommendations to the clinical executive and is not authorised to approve expenditure. Nicola Baxter Head of Medicines Optimisation West Lancashire CCG 1July

22 Table: NHS West Lancashire CCG Medicines Management Committee functions and related NPC competencies NPC competency MMC activity Future responsibility 1. HAS A STRATEGIC OVERVIEW, activities 5, 7,8,9 To develop strategies and operational plans to improve the management of medicines within West Lancashire CCG, and across the interface with hospitals and social services. for activity CCG NCB 1. HAS A STRATEGIC OVERVIEW, activity 11 1.HAS A STRATEGIC OVERVIEW, activity 4, 2. ESTABLISHES EFFECTIVE PARTNERSHIPS activities 12, 15, 16, 4. PROVIDES MEDICINES OVERSIGHT activity 27, HAS MEDICINES EXPERTISE activity 36, 4. PROVIDES MEDICINES OVERSIGHT activity 27, 1.HAS A STRATEGIC OVERVIEW, activities 7, 4. PROVIDES MEDICINES OVERSIGHT activity COMMISSIONS SERVICES THAT OPTIMISE THE USE OF MEDICINES activities 21, 24, To forecast and monitor developments in local, regional and national NHS policy that affect prescribing and use of medicines (including NICE guidance and NSFs) and provide appropriate advice to the CCG on the local implications of these changes, and their management. To act as a focus for developing and agreeing local professional opinion on drugs, therapeutics and associated medicines and pharmaceutical issues, and to convey such opinion to all relevant organisations and bodies, including those not directly represented on the committee. To advise on the allocation of resources for medicines use within the CCG and at individual practice level. To manage the financial risk associated with prescribing, and deploy resources effectively and efficiently to meet the needs of patients in West Lancashire, in line with best evidence, national guidance and local priorities. To advise CCG on the development of prescribing incentive schemes in accordance with CCG priorities, to encourage evidence-based and costeffective prescribing. To ensure that medicines use issues are given due weight in wider healthcare planning and service delivery agreements locally.

23 4. PROVIDES MEDICINES OVERSIGHT activity ESTABLISHES EFFECTIVE PARTNERSHIPS activities 14, PROVIDES MEDICINES OVERSIGHT 32 3.COMMISSIONS SERVICES THAT OPTIMISE THE USE OF MEDICINES activities 22, 26 To ensure policies and procedures promote the safe and secure handling of medicines in line with the updated Duthie Report 2, NHS Healthcare Commission Standards and legal and ethical requirements. To foster links between the Medicines Management Team and all disciplines of current and emerging prescribers, in order to enable the Team to give appropriate support to all relevant clinicians on the safe, effective and evidence based use of medicines. To develop measures/ indicators for monitoring the management of medicines and reporting to the CEC and Board. These will cover: safe, evidence-based and cost-effective prescribing clinical and financial risk management (e.g. budgets, adverse incidents, audit, education and training) 2. ESTABLISHES EFFECTIVE PARTNERSHIPS activity 18 To advise on the development of pharmaceutical services to meet the increasing need for information and advice to patients, prescribers and managers, reflecting national policy (e.g. Pharmacy in the Future Implementing the white paper Pharmacy in England; building on strengths, delivering the future, Clinical Governance in Community Pharmacies, Older Peoples NSF). 1. HAS A STRATEGIC OVERVIEW, activities 5, 9 4. PROVIDES MEDICINES OVERSIGHT activity HAS MEDICINES EXPERTISE activity 35 To develop coherent policies and procedures for the introduction of new medicines through contractual frameworks relating to primary, community, secondary and tertiary care provider Trusts, making recommendations to the CEC and Board. To oversee the development of Patient Group Directions (PGDs) for use across the PCT area, and ratify them. 2 RPSGB. The safe and secure handling of medicines: A team approach March 2005 DH

24 Appendix 1 1. Membership DRAFT TERMS OF REFERENCE WEST LANCASHIRE CCG MEDICINES MANAGEMENT COMMITTEE CCG GP Prescribing Lead Chair Head of Medicines Optimisation West Lancashire Medicines Optimisation Pharmacist Stakeholder GP representation (2) Practice Nurse Representative Lay Member Finance Representative Provider members: Interface Pharmacist, Southport and Ormskirk Hospitals Trust (or Deputy) The chair of the committee will be a Clinical Executive Committee GP and will be agreed by the Clinical Executive Committee. The vice chair will be agreed by the committee. 2. Accountability The committee is accountable to the Clinical Executive Committee and any changes to these terms of reference must be approved by the Clinical Executive Committee body. 3. Purpose Medicines management encompasses all systems, policies and procedures designed to ensure the safe, secure and cost-effective use of medicines. This includes: Evidence-based and cost-effective prescribing practice at an individual and population level safe and secure supply, storage and administration of medicines efficient purchase and distribution systems for medicines development of pharmaceutical and other services to improve the clinical use of medicines development of and compliance with contractual requirements relating to medicines management The Medicines Management Committee will direct this activity, and will do so using the principles of world class commissioning to ensure the effectiveness of its work.

25 4. In attendance The committee may also extend invitations to other personnel with relevant skills, experience or expertise as necessary to enable it to deal with matters before the committee. 5. Quorum The meeting will be quorate if a minimum of seven members are present and must include two GPs, one medicines management team pharmacist and two other members. 6. Frequency of Meeting The committee will meet monthly, except in August each year. Dates will be set in advance for each year. Provider Members will attend the meetings in the months of: 7. Authority The committee is authorised to: To develop and oversee the implementation of a strategy, approved by the CCG Governing Body, which positively influences the quality and costeffectiveness of medicines use across the local health system. To work in partnership with organisations providing primary, community, secondary and tertiary care services to patients in the CCG, to ensure coherent approaches to the management of medicines across the health economy, through developing and monitoring performance against contractual obligations and ensuring value for money in respect of medicines management. This committee is to advise the Clinical Executive Committee over medicines expenditure. The committee is not authorized to approve expenditure. 8. Objectives To develop strategies and operational plans to improve the management of medicines within the health economies, and across the interface with hospitals and social services. To forecast and monitor developments in local, regional and national NHS policy that affect prescribing and use of medicines (including NICE guidance and NSFs) and provide appropriate advice to the CCG on the local implications of these changes, and their management. To act as a focus for developing and agreeing local professional opinion on drugs, therapeutics and associated medicines and pharmaceutical issues and to convey such opinion to all relevant organisations and bodies, including the Lancashire Medicines Management Group, Pan Mersey APC, the Trust Drugs

26 and Therapeutics Committee and those not directly represented on the committee. To manage the financial risk associated with prescribing, and deploy resources effectively and efficiently to meet the needs of patients in the CCG, in line with best evidence, national guidance and local priorities. To act as a forum for discussing and agreeing actions relating to issues affecting prescribing across care settings. To advise the CCG on the development of prescribing incentive schemes in accordance with CCG priorities, to encourage evidence-based and costeffective prescribing. To ensure that medicines use issues are given due weight in wider healthcare planning and service delivery agreements locally. To foster links between the Medicines Optimisation Team and all disciplines of current and emerging prescribers, in order to enable the Team to give appropriate support to all relevant clinicians on the safe, effective and evidence based use of medicines. To develop measures/ indicators for monitoring the management of medicines and reporting to the CCG Clinical Executive Committee. These will cover: safe, evidence-based and cost-effective prescribing clinical and financial risk management (e.g. budgets, adverse incidents, audit, education and training) To identify medicines optimisation issues which are best addressed through the development of pharmaceutical services. To highlight these issues to the Local Professional Network (LPN) and to work with the LPN to develop and implement appropriate corresponding services. To work seamlessly with the Lancashire Medicines Management Group and Pan Mersey APC to ensure the development of coherent policies and procedures for the introduction of new medicines through contractual frameworks relating to primary, community, secondary and tertiary care provider Trusts, making recommendations to the CCG Board. To review, amend, ratify and organisationally sign off draft Patient Group Directions (PGDs) developed by the Commissioning Support Unit for use within the CCG. 9. Reporting a) The committee has the following reporting responsibilities: i) to ensure that the minutes of its meetings are formally recorded and submitted to the Clinical Executive Committee;

27 ii) to ensure that conflicts of interest are managed in accordance with the CCG s policies and procedures; iii) to bring to the attention of the Clinical Executive Committee any items of specific concern; b) to provide exception reports to the Clinical Executive Committee, highlighting any key developments /achievements or potential risks/ issues. 10. Responsibility Of Committee Members And Attendees Members of the committee have a responsibility to: attend meetings, having read all papers beforehand; agree an annual work programme for the committee; act as champions, disseminating information and good practice as appropriate; identify agenda items and submit papers to the secretary ten working days before the meeting; 11. Administrative Arrangements The responsible manager will ensure: correct minutes are taken, and once agreed by the chair distributing minutes to the members; conflicts of interest are recorded along with the arrangements for managing those conflicts; a record of matters arising is produced with issues to be carried forward; an action list is produced following each meeting and ensuring any outstanding action is carried forward on the action list until complete; the agenda is agreed with the chair prior to sending papers to members no later than five working days before the meeting; the minutes of the meeting are distributed within 7 working days of the meeting taking place; the papers of the committee are filed in accordance with the group s policies and procedures. Standard Agenda Item will include prescribing financial report 12. Links with other Groups CCG Quality Improvement Committee Southport and Ormskirk Hospitals Trust D&T Committee Lancashire Care Trust D&T Committee Integrated care pathway group CCG Peer Groups LPC liaison Committee