Southwark Integrated Governance & Performance Committee

Transcription

1 Southwark Integrated Governance & Performance Committee Minutes of the meeting held on 26 March 2015 Room 132, Tooley Street. MINUTES Present: Robert Park (RP) Dr Richard Gibbs (RG) Andrew Bland (AB) Malcolm Hines (MH) Rob McCarthy (RMc) Dr Nancy Küchemann (NK) Catherine Worsfold (CW) Dr Noel Baxter (NB) Dr Jonty Heaversedge (JH) Aarti Gandesha (AG) Paul Jenkins (PJ) Kieran Swann (KS) Jacquie Foster (JF) Dr Alison Furey (AF) Jean Young (JY) Rebecca Scott (RS) Carol-Ann Murray (CM) Apologies: Diane French (DF) Dr Omar Al-Ramadhani (OA) Dr Adam Bradford (ABr) Harriet Agyepong (HA) Gwen Kennedy (GK) Lay Member, SCCG Committee Chair Lay Member, SCCG Chief Officer, SCCG Chief Financial Officer, SCCG AD Acute Contracting Team, SECSU Clinical Lead, SCCG Corporate Governance Manager, SCCG Clinical Lead, SCCG Chair, SCCG Healthwatch Southwark Manager Director of Integrated Commissioning, SCCG Head of CCG Planning and Assurance, SCCG Head of Quality and Organisational Development, SCCG Consultant, Lambeth & Southwark Public Health Head of Primary Care and Community Commissioning, SCCG Programme Director, Dulwich. SCCG. Senior Mental Health Commissioner, SCCG. Lay Member, SCCG Planning & Assurance Manager, SCCG Clinical Lead, SCCG Head of Acute Performance Management, SECSU Director of Quality and Safety, SCCG 1. Introduction and Apologies The Chair welcomed members and attendees to the meeting. Apologies were noted. 1

2 Declaration of Interest 2. All members were asked to declare any conflicts of interests specific to the business on the agenda. No changes were declared. Minutes of the Previous Meeting The minutes were noted to be an accurate record. Subject to the following amendments: 3. NK suggested to change the page 3 paragraph, which refers to the impact on hospital care in relation that received by patients in A&E so that it makes clear the request was for hospital care should be as high as A&E given the focus their. Actions one and two were agreed as closed and action three was agreed as in progress with further oversight to be picked up with the Integrate Programme Board. Progress made against actions has been recorded in the appended action log. CCG Risk Report & Year End BAF CW highlighted the report and flagged the excellent Internal Audit Report on Risk for the CCG. She highlighted the red risks relating to A&E; RTT and London Ambulance Service performance. RP asked about the inclusion of an issue about King s financial position becoming a risk to the delivery of quality and safety of care and suggested this be added to the new BAF risk. This was agreed to be included on the new BAF Action CW. 4. RP led a short discussion on the coming year and the impact of overall system pressures (including any post-election situations) on the NHS as a whole and the possible impact on the CCG. Members talked about the potential implications of NHS organisations being increasingly asked to support others, in the way GSTT is supporting Medway recently. The committee agreed that this be considered in the BAF and risk management approach for 2015/16. CW has now closed IC-19 risk and agreed add new risk to BAF on implementation of HWBS Action CW. NK asked whether we should include a further risk associated with public health reductions and another risk associated with the shift of referral routes to Choose and Book. CW agreed to review these risks with directors and play back in the new year s BAF Action CW. The committee noted the Risk Report & BAF and recommended it to the Governing Body for their approval. 2

3 CCG Performance Highlight Report (M10) The Committee went through the updated performance pack and supported the addition of a summary of the acute contract report. AB updated on King s A&E performance, which he noted was similar in February and March. He noted that the trust has been required to development recovery trajectories to be signed-off with Q1 2015/16 for emergency departments at both sites. He also noted the review work commissioned at PRUH to further understand emergency department performance. AB reported a local position where A&E activity was only annual up by a 0.3% increase, reduced non-elective admissions were evident and a low rate of delayed transfers of care. He noted he had explained this to the Southwark OSC in the last month. 5. AB explained the failure of outsourced providers to meet the agreed targets for elective catch up has impacted King s RTT targets. He noted the CCG having made investment to support weekend working for diagnostics and that cancer standards are not improving rapidly enough and consequently there are reviews commissioned by NHSE to improve this. AB flagged the good positions on dementia and IAPT performance. PJ also highlighted the significant performance issues at the London Ambulance Service and described some of the action plans in place at the provider to support an improvement. He noted a business case to be put forward across London to support a performance trajectory. Action for OR to update and include Keogh indicators in the Performance Highlight Report Action OR. The committee noted the report. CCG Finance Report (M11) 6. MH assured the committee that the CCG is on track to meet targets for 2014/15 and he highlighted that the predicted surplus at year end as being delivered. He highlighted the year-end agreements in place with all providers and the full delivery of QIPP having been achieved in 2015/16. MH outlined the timetable for the completion of annual year end accounts. He also explained the position for the new year where local acute contracts are likely to be signed with providers before the end of the month. MH flagged the financial risk associated with the LAS business plan to improve performance in 2015/16. The committee noted the content of the report. 3

4 Report from the Quality and Safety Programme Board 7. NB presented the report and outlined that the report incorporates feedback from Clinical Quality Review Group meetings with the CCG s main providers. The Committee received assurances on the SLaM CQRG meeting being positive with attendance from senior trust clinicians. NB reported that the CCG had a conversation with the CQC ahead of their inspection of King s College Hospital. The committee noted the content of the report. Draft CCG Corporate Objectives 2015/16 8. KS presented the draft Corporate Objectives and explained that these form the basis of the CCG s Business Plan, which would be presented to the CCG Governing Body at its next meeting in May The plan sets out the key tasks and programmes of work the CCG should complete in the year and stated that it is to be used as the basis for the CCG s risk assessment as described as the BAF. The committee approved the corporate objectives. CCG Approach to Delivering New Mental Health Targets CM explained the new NHS Constitution standards associated with access to mental health targets for IAPT and psychosis care. She outlined the CCG s plan to commission additional service capacity at SLaM; increase out-of-hours sessions; increasing practicebased counselling hours in 2015/16; promote self-referral to services and commission online access to IAPT services. 9. CM explained that current access under waiting time targets were close to regularly being met so the additional commissioned access should support sustainable delivery in 2015/16. AG asked about whether patient choice had impacted access and wanted to know the reason for this. CM suggested that access in the evening was cited as important by patients and would be addressed in the way the CCG commissioned additional capacity for IAPT services. CM sated that baselining work on psychosis access was being completed by SLaM. The committee agreed that appropriate capacity planning had been completed but wanted this target to be included on the new BAF action CW. The Committee agreed the actions in place to manage the implementation of the new standards. 4

5 10. Board Effectiveness Survey JF summarised the outcome of the survey. The group discussed the results and noted areas of progress and development required. Risk Management Framework 11. CW advised the group that the policy has been refreshed. She highlighted the developments that the CCG had implemented in year to improve the CCG s approach to risk. RP extended his thanks and reflected that the positive audit report on risk was a good example of that these improvements have made a positive impact. The committee endorsed the refreshed Risk Management Framework 2015/16. CCG Annual Report and Annual Governance Statement MH described the process for the development and agreement of the Annual Report and Annual Governance Statement. He asked for comments and suggestions ahead of signoff process via the CCG s Audit Committee. 12. RP asked about whether we will produce a public version of the Annual Report, which MH agreed will be produced. RP suggested this would be good as the CCG has completed a number of positive developments and these should be incorporated in the summary version. NK asked whether the Annual Report could include an index to help readers look at what we have done in specific areas e.g. on obesity. MH suggested that this can be incorporated. JH cited the mention of Integrated Care and suggested a review to ensure that all contents are written in the past tense. RP also asked whether on page 9 the pie chart included more segments than were included in the key. Action MH to oversee the edit. The Committee agreed to both documents subject to the above comments being incorporated and a further review being completed by the CCG Audit Committee. CCG Conflict of Interest Policy 2015/16 update 13. MH explained the engagement previously completed on the policy, which has been refreshed to incorporate the CCG s new co-commissioning responsibilities. RG endorsed the revision. The Committee agreed to approve the revised policy. 5

6 Information Governance Toolkit submission 14. MH explained that the CCG has an IG group to oversee work related to this area on behalf of the Committee. He explained that the national IG Toolkit supports organisations to develop and maintain good information governance. The toolkit is also acts as an assurance review, which MH confirmed this year has been scored at 88% in 2014/15, which was an improvement on the previous year. The Committee approved the submission. Pandemic Flu Plan 15. JY reminded the Committee that they had previously approved a draft of this plan, which has subsequently been reviewed by the CCG SMT and Borough Resilience Forum. RP asked whether we have been involved in emergency planning exercises. MH said that we participate in these exercises on a pan-london basis, approximately twice a year. The plan was approved by the Committee. SELDOC Out of Hours 16 PJ explained that the south east London procurement timetable for NHS 111 would now mean it begins in March The proposal was that in the meantime the CCG continues it s commissioning of SELDOC out-of-hours for practice that have opted-out of out of hours provision in the borough. The Committee agreed to look at scheduling a deep-dive to look at out-of-hours pathways and NHS 111. KS to feedback request to SMT to agree an appropriate place for this to happen Action KS. The Committee agreed to support the proposal and extend this contract for one year. 6

7 Dulwich Hospital Business Case Affordability RS started by noting that the Department of Health have recently confirmed that the future Dulwich Health Centre will be developed by the LSL LIFT Co under a Land Retained Agreement (LRA). This follows some detailed modelling work that has demonstrated that an LRA represents slightly better value for money than a capital funded development. With an LRA the land remains in the ownership of the NHS and the building reverts to NHS ownership at the end of the lease period. RS explained that as CCGs cannot own land or hold head leases Community Health Partnerships (CHP) will be the organisation who will procure the building on our behalf, and who will hold the head lease. LIFTCo is the organisation who will develop a proposal and subject to the approvals process will build it. In order to progress this CHP require a number of assurances from the CCG. The first three are all in place: the CCG has an approved PID, an approved site options appraisal and signed off participants requirements. They also require assurances that there is commitment in principle to commissioning services to be provided from the health centre for the duration of the lease. 17 RS explained that the CCG would need to confirm that they would underwrite the transaction costs borne by CHP. These include technical, legal, and financial advice and would be needed to allow the development to proceed. She explained that this was within an agreed cost envelope for the project and would be market tested to ensure value for money. MH confirmed that resources had been set aside in the corporate budget to cover these. She also explained that once the project reached a certain stage the CCG would become liable for development costs should they abandon the project. This liability only held if the proposal being worked up was both demonstrably value for money and was also within the affordability envelope. CHP are asking that we confirm our acceptance of this liability. Finally RS asked the committee to set the affordability cap at 1.5m per annum. RS explained how this figure had been reached, and MH confirmed that that these costs had been accounted for and included in the 5 year strategic plan. MH also noted that there was scope to reduce the on-going revenue impact of the project by paying some of the development costs up front rather than having them rolled into the lease for the building. The Committee agreed to approve the commitments outlined in the proposal. CCG Constitution 2015/16 Primary Care Co-Commissioning MH outlined the proposed changes, which are included in the paper and noted that the CCG Council of Members will sign-off. 18 AB noted that he had been through the proposed changes with the LMC and they have agreed with the proposed changes. AB also noted that these changes have been through both national and regional panels and have been endorsed by both. The Committee supported the proposed changes and agreed they should be sent through to the Council of Members for agreement. 7

8 19 Any Other Business JF noted that Governing Body elections will shortly be launched. MH noted that the adverts for two new director posts have now been issued. 8