Cannock Chase Clinical Commissioning Group South East Staffordshire and Seisdon Peninsula Clinical Commissioning Group Stafford and Surrounds Clinical Commissioning Group
Primary Care Commissioning Committees Meeting in Common
to be held on 30 May 2018 at 2.00 pm am in the Rudyard Suite, Staffordshire Place 2, Stafford ST16 2LP
AGENDA
A=Approval R=Ratification S=Assurance I=Information D=Discussion Enc Lead A/R/S/I Timing 1. Welcome by the Chair Verbal AHe - 2.00 2. Apologies Verbal AHe - 3. Quoracy Verbal AHe - Declarations of Interests and actions taken to 4. Enc. 01 AHe I manage conflict 5. Minutes of the Meeting held on 26 April 2018 Enc. 02 AHe A 6. Actions Sheet Enc. 03 AHe A 2.10
Assurance 7. Risk Register Enc. 04 SJ S 2.15
Strategic and Planning
8. Extended Access Specification Enc. 05 LM/VO I 2.25
9. Patient Participation Groups Enc. 06 SH S 2.35
Items for Information
10. 3600 Stakeholder Survey Enc. 07 LM I 2.50
11. Head of Primary Care National Update Enc.08 RB I 3.00
Any Other Business 12. Questions from Members of the Public - All D 3.15
Glossary of terms 13. Enc. 09 All I - Glossary of Terms
Date, Time and venue of next meeting 28 June 2018 at 2.00 pm in the Aquarius 14. - All A 3.30 Ballroom, Cannock TO BE RESCHEDULED
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Cannock Chase Clinical Commissioning Group South East Staffordshire and Seisdon Peninsula Clinical Commissioning Group Stafford and Surrounds Clinical Commissioning Group
CANNOCK CHASE CLINICAL COMMISSIONING GROUP, SOUTH EAST STAFFORDSHIRE & SEISDON PENINSULA CLINICAL COMMISSIONING GROUP AND STAFFORD & SURROUNDS CLINICAL COMMISSIONING GROUP CONFLICTS OF INTEREST REGISTER 2017/18 PRIMARY CARE COMMITTEE AS OF 22 MAY 2018
Employin Forename Surname Role in the CCG Directorships held in Ownership of private Shareholdings in health Positions of authority in Connection with Research Any other role or relationship g private companies, PLCs companies, and social care field of health & social care voluntary,other organisation funding/grants CCG businesses, consultancies
Members CC CCG Neil Chambers Lay Member - Governance, Old Hall Partnership None None None Voluntarily run a debt and None Chair of Audit Committee Cannock Chase CCG and Stafford Darlaston Town (1874) benefits advice surgery for a and Surrounds CCG Football charity of which I am a Chair of Club Trustees SAS CCG Sue Harper Lay Member - Patient and Public None None None None None None Justice of the Peace, South Staffordshire Bench Interest/Vice Chair of Governing Body for Stafford and Surrounds CCG
SES CCG Anne Heckels Lay Member - Patient and Public None None None None None None Member of Patient Participation Group at Spires Interest (PPI) / Finance and Practice Performance/Vice Chair of Member of South Staffordshire and Shropshire Governing Body for South East Healthcare NHS Foundation Trust (SSSFT) Staffordshire and Seisdon Family Member is an employee shareholder - Peninsula CCG NORR Consulting, providing architectural services to public service
SES CCG Lynne Smith Lay Member, Governance, South None None None None None None Lay Member for Quality at East Staffordshire CCG East Staffordshire & Sesidon since June 2013 Peninsula CCG
CC CCG Janet Toplis Lay Member, Cannock Chase None None None Vice Chair of Adoption and None None Chair of a Staffordshire Primary School CCG Permanence Panel for Walsall Member of High Street Practice, Cheslyn Hay Borough Council Vice Chair of PPG the Fostering Panel for Walsall Council
In Attendance CC CCG Tracey Cox* Senior Primary Care None None None None None None Adhoc consultancy work outside core Development Manager working hours for Long Term Conditions Network, West Midlands Academic Health Science Network (October 2016 - ongoing)
SES CCG Andy Hadley* Senior Primary Care None None None None None None Chair of Intelligent Customer Forum for Development Manager Staffordshire and Shropshire Health Informatics Service (HIS)
SAS CCG Paddy Hannigan Chair of Governing Body, Stafford None Partner at Holmcroft Practice is a member and None None None Spouse is a Consultant Neonatologist at and Surrounds CCG Surgery shareholder in GP First University Ltd. (GP Federation) Hospital North Midlands (UHNM)
CC CCG Mo Huda Chair of Governing Body, None Partner at Aelfgar Practice is a member None None None AQP Provider uses practice for Ultrasound Cannock Chase CCG Surgery and shareholder in GP scans and Hearing Aid First Ltd. (GP Chair Educational meetings for various Federation) PHARMA companies.
NHS Darrell Jackson* Primary Care Lead None None None None None None Registered with GP practice in Stafford England - North Midlands Employin Forename Surname Role in the CCG Directorships held in Ownership of private Shareholdings in health Positions of authority in Connection with Research Any other role or relationship g private companies, PLCs companies, and social care field of health & social care voluntary,other organisation funding/grants CCG businesses, consultancies
CC CCG Sarah Jeffery* Senior Primary Care None None None None None None None Development Manager
SES CCG Gulshan Kaul General Practitioner Cloisters Practice Lichfield and Burntwood None None None None
SAS CCG Lynn Millar* Director of Primary Care None None None None None None None
SES CCG Ehtesham Noor Chair of Govenring Body, None Partner at Darwin Darwin Medical None Currently Clinical Co-Chair None Darwin Medical Practice is a member and SES&SP CCG Medical Practice Practice is a member at the SE Alliance Board - I shareholder in Alexin Locality Director - Lichfield and and shareholder in represent the CCG on this Membership of South East Staffordshire Burntwood Alexin board Alliance Board
SAS CCG Anne Perry* Finance Manager None None None None None None None
SAS CCG Vanessa Ridout* Executive Assistant None None None None None None None
SAS CCG Lynn Tolley* Head of Quality and Safety None None None None None None Family member works at NHS England West Midlands
SAS CCG Sarah Turner Primary Care Development None None None None None Non None Manager
SES CCG Eleanor Wood* Primary Care Development None None None None None None None Manager
NHS Rebecca Woods Head of Primary Care None None None None None No Friend with Dr J Ward of Darwin Practice and a England member of the Primary Care Committee - North Midlands
SAS CCG Sally Young* Director of Corporate Services, None None None None None None None Governance and Communication
*All staff work across Cannock Chase CCG, South East Staffordshire & Seisdon Peninsual CCG, Stafford & Surrounds CCG.
Cannock Chase Clinical Commissioning Group South East Staffordshire and Seisdon Peninsula Clinical Commissioning Group Stafford and Surrounds Clinical Commissioning Group
The healthiest place to live and work, by 2025
Primary Care Commissioning Committees Meeting in Common
Thursday 26 April 2018, 10am Pieces Room, Aquarius Ballroom, Hednesford, Cannock WS12 1BT
8
Members: May July June /04/201 March August October January 6 Quoracy February September December November 2
Neil Chambers (NC), Lay Member
Cannock Chase (CC) CCG Sue Harper (SH), Lay Member S&S CCG Anne Heckles (Chair) (AHe), Lay Member South East Staffordshire & Seisdon Peninsular (SES&SP) CCG Jan Toplis (JT), Lay Member CC CCGs Lynne Smith (LS), Lay Members SES & SP CCG Diane Smith (DS) Lay Member S&S CCG In attendance:
Tracey Cox (TC), Primary Care Development Manager, S&S CCG Andy Hadley (AHa), Senior Primary Care Development Manager SES&SP Dr Paddy Hannigan (PH), GP Chair S&S CCG Dr Mo Huda (MH), GP Chair CC CCG Darrell Jackson (DJ), Primary Care Lead NHS England (NHSE) – North Midlands Sarah Jeffrey (SJ), Head of Primary Care Development, CC, SES&SP and S&S CCGs Gulshan Kaul (GK), Secretary South Staffordshire Local Medical Council Lynn Millar (LM), Executive Director of Primary Care, CC, SES&SP and S&S CCGs Anne Perry (AP), Finance Manager – Primary Care, CC, SES&SP and S&S CCGs Mark Rayne (MR), Interim Deputy Director of Primary Care, CC, SES&SP and S&S CCGs Vanessa Ridout (VR), Executive Assistant – Minute Taker, S&S CCG Sarah Turner (ST), PC Development Manager CC, SES&SP and S&S CCGs Eleanor Wood (EW), Senior Primary Care Development Manager (Lichfield Locality) SES&SP CCG Rebecca Wood, Head of Commissioning Primary Care, NHSE
Page 1 of 7
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8
Members: May July June /04/201 March August October January 6 Quoracy February September December November 2 Sally Young (SY), Assistant to the Chief Executive, CC, SES&SP and S&S CCGs Thomas O’Hann, PWC Ian Saberton, Primary Care Development Manager, CC, SES&SP and S&S CCGs Matt Gollins, Administrator (minutes)
Action
1. Welcome by the Chair AH opened the meeting and welcomed members.
2. Apologies Apologies were received from Lynne Smith
3. Quoracy The Committee was not quorate; therefore reports which required approval would be issued to those members not present to seek their virtual approval.
AHe stated that the Committee will review the Terms of Reference following current CCG organisational changes.
4. Declarations of Interests and actions taken to manage conflict No further conflicts of interest were declared.
5. Minutes of the Meeting held 29 March 2018 It was noted that only Stafford and Surrounds CCG was quorate at the previous meeting.
The minutes of the meeting held on 31 January were agreed as an accurate record of proceedings. As mentioned above, minutes to be shared with those not present to seek virtual approval.
6. Actions Sheet The risk register was updated as follows:
Ref 85 It was agreed that the action be moved to the confidential action log.
Ref 84 TC to identify attendee(s) for the next Primary Care Committee meeting.
Ref 83 Closed
Ref 82 Closed
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Action
Ref 81 Included within the Risk register. Close Action.
Ref 80 LM reported that this work is within the confidential section of this meeting.
Ref 75 Close action.
7. Risk Register TC stated that there were no new risks and no changes to the current risk scoring since the last meeting.
Risk 290 It has been requested that this risk is to be closed at the next Risk Group meeting on 30 April 2018. Members agreed that this risk can be closed.
JT queried text from the Pattingham report: it read that concerns raised by patients were dealt with. PT sought clarification.
IS stated that CCG and NHSE had responded jointly to patient concerns. IS added that the CCG continue to work with PPGs, working on mechanisms to flag any concerns. IS highlighted that a large proportion of the concerns were around the site moving, rather than patient specific concerns.
AH added that there was comprehensive discussion at SES District Patient Group, where it was perceived that patients had reached an understanding of Pattingham surgery (as opposed to ‘concerns being dealt with’, as iterated within the report). Assurance was given that the practice would increase the numbers of home visits to alleviate accessibility concerns.
LM suggested that the situation is reviewed in coming months, to monitor and managed any developing concerns or issues. Risk 271 TC informed the group there had been a request to close this risk. This will be determined at the next Risk Group meeting on 30th April.
Risk 255 This had been reviewed at the January 2018 Risk Group meeting. It was agreed that this remain open for the following months for the monitoring of the financial implications of delegated commissioning.
Members RECEIVED the report.
8. GP Forward View Highlight Report
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Action
The report was provided for assurance and for information.
Extended access Procurement LM stated that confirmation had been received from all CCG Governing Bodies to restrict procurement lists. CCG are currently working with federations and practices, and will be sharing the specifications.
Funding Formula LM summarised the report regarding the lack of clarity on the weighting formula from NHS England on allocation of funds. LM reported issues with the size of allocations using ONS data. LM confirmed that allocations will be in place for the next three years.
JT queried values included within the report. LM responded, stating that CCG have had assurance that it will be received, but it is unclear at what level. LM will update the Committee once this is known.
GPFV AHe asked GP members if practices had felt an impact following changes to work streams from GPFV.
MH stated that, from a practice point of view, signposting and other staff related work streams have gone down quite well. MH highlighted that there are a number of practices across Staffordshire that are not engaging in these models, creating patches across the county.
PH stated that programmes, such as the Brighton and Hove model (workflow), have widely been taken on. PH expressed concerns however that the programmes are coming into place equally as fast as workforce issues are escalating. PH added that there are increasing challenges in securing partners within general practice.
LM stated that the CCG have a broad idea on individual practice stability, and where appropriate, support and resilience funding is provided.
DJ added that, overall, risks are known, and work is in progress to mitigate this.
LM informed the group of planned work from a CCG perspective: that work is being undertaken to promote benefits of collaborative working between health organisations, to improve the overall systems. LM is developing a strategy, which will include specific details. Furthermore, around £70k BMJ fund has been allocated to run a yearlong advertisement programme to attract more GPs to Staffordshire and Stoke on Trent.
The committee agreed that these pieces of work will support the Primary Care system and begin to address and alleviate pressures.
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Action
Estates LM summarised from the report. With regards to Estates, capital is limited therefore CCG are adopting a priority approach. Priority areas have been mapped out for estates and transformation funds.
LM highlighted that there are ETTF sites in Burntwood (Greenwood House), Outwoods in Burton, and Chadsmoor. The Memorandum of Understanding (MoU) has been signed to commence work at the Chadsmoor site. This will potentially accomodate up to four practices.
STP LM agreed to provide a report to the next Primary Care Committee meeting, relating to the 23 STP localities within Staffordshire, which will map out Alliance footprints, care hubs, main sites, and community hospital sites.
Members RECEIVED the report.
9. GMS Contract TC summarised from the report. The report included for assurance and information regarding the recent outcome of GMS contract negotiations.
E-referrals Target is to achieve 100% by October 2018. If a practice is unable to achieve, then mitigating action plans will be developed to avoid practices being penalised for something outside of their control whilst balancing that practices are actually utilising e-referrals where they can.
Electronic Prescribing It was reported that there were issues with three practices not undertaking electronic prescribing, due to dispensing procedures.
GP Online Services Practices undertaking less than 10% will be in receipt of support to improve uptake numbers.
PH stated that these systems and processes take time to introduce and embed – although these will support practice workload capacity, it takes a lot of time and energy to implement. There has been particular interest in uptake regarding Patient Access, such as records and lab results. PH suggested that some of the implementation procedures may require review, as it may not be feasible in some situations across different practices.
Members RECEIVED the report.
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Action
10. PC Quality Report
Dr. Murugan Practice TC gave a summary of the report. The practice was previously inspected by CQC, with an outcome of Special Measures. A more recent CQC inspection saw improvement, rated as Requires Improvement overall and across all domains.
Dr. Murugan has recruited a new GP to the practice. A CQC inspection followed six weeks later, and the positive impact of the recruitment was noticed. The GP has now become a partner within the practice. An action plan is being drawn up for the practice to continue to improve toward a CQC rating of Good. An inspection will be due in approximately twelve months.
Friends and Family tests (FFT) AH reported that Patient Groups had expressed frustrations at the requirements of FFTs following every appointment. FFTs are often not completed as a result, which has an impact on response rate figures.
TC stated that this has been raised nationally, as not fit for purpose within general practice; however NHSE have advised that this is a mandatory requirement.
Members RECEIVED the report.
11. Head of Primary Care Updates – March 2018
GDPR The report summarised the requirements and implications of GDPR legislation.
PH stated that an external speaker following a GDPR event will provide support and guidance on what GDPR means at practice level.
Commissioning Activity Report LM summarised that this activity was related to a national system being introduced to capture general practice activity levels.
ST added that new functionality within EMIS is being refined. It is unclear at this stage if the activity reported will accurately portray true activity. TC gave examples where certain aspect of software was used incorrectly, such as an appointments system where the appointment book is being used more like a calendar. As such, activity is potentially being misreported, therefore skewing any reports.
PH added that it would be beneficial to understand activity at practitioner level. Reporting from this would then inform productivity levels, in turn aiding strategic planning.
Members RECEIVED the report.
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Action
12. Questions from Members of the Public There were no members of the public in attendance.
13. Glossary of terms The Glossary of Terms was noted for information.
14. Date, Time and venue of next meeting 30 May 2018 at 2.00 pm in the Rudyard Suite, Staffordshire Place 1, Stafford
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Enclosure 02
PRIMARY CARE COMMISSIONING COMMITTEE MEETING IN COMMON ACTION LIST
MEETING Responsible Outcome/update Ref: REFERENCE AGENDA ITEM ACTION (Completed Actions remain on the Action List for the following PCC and are DATE Officer then removed to the 'Completed' Worksheet) 16.4.18 - representative being sought from GP practice to present at a future meeting 84 31/01/2018 9 GP Forward View Highlight Report TC to seek representatives from practices to attend a future PCC TC Update: 26/04/2018 Pauline Scott from the Horsefair Practice to attend the June meeting. Update: 26.04.2018 LM reported that this work is pending. Action 80 31/01/2018 7 Risk Register A report on rent reviews to be submitted to the March PCC EW/DJ ongoing.
X:\CCG\Cannock Staffs and Surrounds\Corporate\Governance\Mtgs - Leg Require\12 Primary Care Committee\2018 ~19\30 05 18\Public\Papers\Enc 03 Action Sheet 1 of 1 Item: 07 Enc: 04
Cannock Chase Clinical Commissioning Group South East Staffordshire and Seisdon Peninsula Clinical Commissioning Group Stafford and Surrounds Clinical Commissioning Group
The healthiest place to live and work, by 2025
REPORT TO: Public Primary Care Commissioning Committee Meeting in Common
TO BE HELD ON: 30 May 2018
Subject: Primary Care Committee Risk Register Board Lead: Lynn Miller, Executive Director of Primary Care Officer Lead: Sarah Jeffery, Head of Primary Care Development Approval/ Recommendation: Assurance Discussion Information Ratification
PURPOSE OF THE REPORT:
This report provides the Primary Care Committee with information about the primary care related risks currently facing Cannock Chase CCG, South East Staffordshire & Seisdon Peninsula CCG and Stafford & Surrounds CCG.
KEY POINTS: The risk register includes risks related to Cannock Chase CCG, South East Staffordshire & Seisdon Peninsula CCG and Stafford & Surrounds CCG, associated to Primary Care.
There are currently nine risks on the Primary Care Committee register:
1 16 High 3 9 High 3 6 Moderate 1 4 Moderate 1 0 Low
New Risks: There have not been any proposed new risks for the Primary Care Risk Register.
Risk Changes: Risk 271 has been downgraded to a risk score of 0 and a proposal to close the risk. This will be discussed at the Risk Group on 12 June 2018.
Risk Closures: The Risk Group received a request to close risk 290 relating to the closure of the Pattingham branch of Claverley and Pattingham surgery. The group agreed the closure and the risk was closed down.
We are honest, accessible Quality is our day job We innovate and deliver Care and respect for all and we listen Page | 1 Item: 07 Enc: 04
Risk 271 is reported on the register as no further updates required, a further request to close this risk will be discussed at the Risk Group on 12 June.
CCG GOALS: Change the culture: The risk register will inform the CCGs of any issues • Hospital to home arising in supporting the change in culture. • Professional to patient The risk register provides assurance that risks are More focus on prevention being monitored and will highlight any issues around prevention. Involving everyone for improved Assurance that risks are being monitored will enable a health and care more focused approach to improving health and care. Patients will have more confidence to monitor their own Empower and support patients to take health needs knowing risks are being monitored and control of their own health mitigated. Risk monitoring gives the CCGs assurance that the Services supporting people to make services they are promoting are safe for patients to informed decisions make decisions.
IMPLICATIONS: YES: unmitigated clinical risk could have NHSLA repercussions. Any real Legal and/or Risk legal implication will be described in the appropriate risk. YES: any involvement by the CQC with any practices and its potential CQC impact will be described within the risk. YES: unmitigated Clinical Risk could have repercussions to safe Patient Safety services. Any patient safety implications will be described in the appropriate risk. Patient Engagement No: if patient engagement is required this will be described within the risk YES: unmitigated clinical risk could have financial repercussions. Any Financial financial implications will be described in the appropriate risk Sustainability None Workforce/Training None
RECOMMENDATIONS/ACTION REQUIRED: The Primary Care Commissioning Committee is asked to:
• Review the Risk Register report to confirm that assurance has been provided regarding the management of clinical risks across the three CCGs. • To reflect on any other risks that the Committee considers should be on the risk register.
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Not KEY REQUIREMENTS Yes No Applicable Has a quality impact assessment been undertaken? Has an equality impact assessment been undertaken? Has a privacy impact assessment been completed? Has a communications & engagement impact assessment been completed? Have partners/public been involved in design? Are partners/public involved in implementation? Are partners/public involved in evaluation?
We are honest, accessible Quality is our day job We innovate and deliver Care and respect for all and we listen Page | 3 Item: 07 Enc: 04
CCG VALUES We are honest, accessible and listen
Care and respect for all
Quality is our day job
We innovate and deliver
We are honest, accessible Quality is our day job We innovate and deliver Care and respect for all and we listen Page | 4 Cannock Chase CCG, South East Staffordshire and Seisdon Peninsula CCG and Stafford and Surrounds CCG Primary Care Commissioning Committee - Risk Register
Risk ID Objective Description Of Risk Associated BAF Risks Mitigating Action (Internal) Future Actions (Internal) Assurance (Internal)
CCG
Initial
Review
Current Current
Created
mitigations RiskOwner
ClinicalRisk
Date of Next of Date Next
Consequence Consequence
ExecRisk Lead
of controls and
InitialRisk Score
InitialLikelihood
LastReview Date
Current risk score risk Current
pre consideration consideration pre
Current Risk Score Current Current Likelihood Current 273 The CCGs have a statutory duty to remain within The new service specification for wound care has Failure to support and develop sustainable Yes 1 5 5 11/05/2018 - The new arrangements will start from April across Cannock Chase and South East 11/05/2018 - The new arrangements will start from April across Cannock Chase and South 11/05/2018 - The new arrangements will start from April across Cannock Chase and South 16 4 4 16 the Revenue Resource Limit in 2017/2018 and identified a service gap within the community. This Primary Care and General Practice .;#103 Staffs practices. A conversation at Primary Care Committee around the wound care risk on the East Staffs practices. A conversation at Primary Care Committee around the wound care East Staffs practices. A conversation at Primary Care Committee around the wound care must ensure that they remain within an agreed could lead to general practices not delivering this risk register was undertaken. it was agreed that although this has been agreed to be included risk on the risk register was undertaken . It was agreed that although this has been agreed risk on the risk register was undertaken. It was agreed that although this has been agreed control total set by NHS England.;#The CCGs have service due to no payment available for the service. through the PMS re-investment for both Cannock and SES that we should keep this on the risk to be included through the PMS re-investment for both Cannock and SES that we should to be included through the PMS re-investment for both Cannock and SES that we should a duty to support and develop safe and This may result in patients not receiving treatment they register for the next month or so to ensure that everything moves over smoothly. 11/04/2018 - keep this on the risk register for the next month or so to ensure that everything moves keep this on the risk register for the next month or so to ensure that everything moves
31/05/2017 08:20 31/05/2017 sustainable primary care that meets the Five Year require and an added financial cost to the CCG where The new arrangements will start from April across Cannock Chase and South East Staffs over smoothly. 11/04/2018 - The new arrangements will start from April across Cannock over smoothly. 11/04/2018 - The new arrangements will start from April across Cannock Cannock Chase CCG Chase Cannock Forward View.;#The CCGs have a statutory duty additional payment may be required for the GPs or an practices. A conversation at Primary Care Committee around the wound care risk on the risk Chase and South East Staffs practices. A conversation at Primary Care Committee around Chase and South East Staffs practices. A conversation at Primary Care Committee around to improve the quality of services, to promote alternative provider deliver this service. register was undertaken . It was agreed that although this has been agreed to be included the wound care risk on the risk register was undertaken . It was agreed that although this the wound care risk on the risk register was undertaken . It was agreed that although this
continuous improvement and ensure the safety through the PMS re-investment for both Cannock and SES that we should keep this on the risk has been agreed to be included through the PMS re-investment for both Cannock and SES has been agreed to be included through the PMS re-investment for both Cannock and SES Mahon Melanie (CCG) CCCCG (CCG) Melanie Mahon and effectiveness of services. register for the next month or so to ensure that everything moves over smoothly. 12/03/2018 - that we should keep this on the risk register for the next month or so to ensure that that we should keep this on the risk register for the next month or so to ensure that
Primary care service specification agreed by Cannock Chase Membership board together with everything moves over smoothly. 12/03/2018 - Service level agreement (SLA) to be everything moves over smoothly. 12/03/2018 - Practices have agreed to deliver wound Care Primary of Director Executive usage of PMS reinvestment monies to fund wound care arrangements. Meeting undertaken agreed and signed on 14th march. data quality facilitators to finalise activity recording and care against the agreed specification and to receive PMS reinvestment funds as with SSOTP to discuss interrelationships and interdependencies and agree transition referral form and roll out to all practices following piloting period. 20/02/2018 - Work remuneration. 20/02/2018 - PMS funding and specification discussed at 14th February arrangements. Data Quality Facilitators (DQFs) have developed an activity recording template underway with data quality facilitators to develop reporting template to understand Cannock Chase membership Board. Dr Choudhury will formally write to practices to
and onward referral form, which has been piloted at Rugeley Practices and to be rolled out by activity and transitions. Draft specification to complete. Awaiting formal agreement by confirm. 08/06/2018 DQFs to all practices. Service level agreement (SLA) drafted to be discussed on 14th march at practices to undertake wound care in response to Dr Choudhurys notification of PMS Older updates have been archived and are available if required. 11/05/2018 Cannock Chase Membership Board. 20/02/2018 - PMS reinvestment monies to be used to funding. fund wound care for Cannock Chase practices was agreed by PCCC at 31st January meeting. Older updates have been archived and are available if required. This was shared with Cannock Chase Membership Board at their meeting on 14th February together with the draft wound care specification. Dr Choudhury will write to practices formally to share this information. meeting undertaken with SSOTP regards primary care wound care specification element, interrelationships and interdependencies in respect of clarity of pathway and transitions. Older updates have been archived and are available if required.
281 Sustainable Primary Care Service A private company are offering to take over GP practice Failure to support and develop sustainable No 3 3 9 10/04/2018 - Previous actions continue. 13/03/2018 - No further update. 19/02/2018 - 10/04/2018 - Previous actions continue. 13/03/2018 - Previous actions will continue. 10/04/2018 - Commissioners have to agree the terms of lease prior to a sale and therefore 9 3 3 9 lease's. This poses a risk to the CCG around being tied in Primary Care and General Practice .;#103 Commissioners have to agree the terms of lease prior to a sale and therefore there is no risk of 19/02/2018 - Commissioners will continue to agree the terms of lease prior to a sale. This there is no risk of unexpected rent increases. 13/03/2018 - Commissioners have to agree to long and expensive leases. unexpected rent increases. 24/01/2018 - Work is continuing. Commissioners have to agree the reduces the risk of unexpected rent increases. The risk is being continually monitored in the terms of lease prior to a sale and therefore there is no risk of unexpected rent terms of lease prior to a sale and therefore there is no risk of unexpected rent increases. order to ensure that the risk to the CCG is managed. 24/01/2018 - The risk is being increases 19/02/2018 - Commissioners have to agree the terms of lease prior to a sale and
09/11/2017 - Work is continuing. Commissioners have to agree the terms of lease prior to a continually monitored in order to ensure that the risk to the CCG is managed. 09/11/2017 - therefore there is no risk of unexpected rent increases. 24/01/2018 - Commissioners have PeninsulaCCG
14/09/2017 15:33 14/09/2017 sale and therefore there is no risk of unexpected rent increases. Continuing work with Local Estates Forum and LMC. to agree the terms of lease prior to a sale and therefore there is no risk of unexpected rent
Older updates have been archived, but are available if required. Older updates have been archived, but are available if required. increases 09/11/2017 - Work is continuing with the Local Estates Forum and the LMC. 08/05/2018
Commissioners have to agree the terms of lease prior to a sale and therefore there is no 10/04/2018 Staffordshire and Seisdon Seisdon and Staffordshire
risk of unexpected rent increases. East CCG;#South Surrounds Wood Eleanor (SES & SP CCG) SP & WoodEleanor (SES
Older updates have been archived, but are available if required. & CCG;#Stafford Chase Cannock Executive Director of Primary Care Primary of Director Executive 21 The CCGs have a statutory duty to promote The risk is the failure to maintain clinical engagement of Failure to support and develop sustainable No 4 3 12 10/04/2018 - Actions continue. 13/03/2018 - Actions continue. 19/02/2018 - Actions 10/04/2018 - continuation of previous actions. 13/03/2018 - Continuation of previous 10/04/2018 - 360 survey now completed. Results will be reviewed once released and 9 3 3 9 engagement including arrangments for Membership. Primary Care and General Practice .;#103 continue. 24/01/2018 - The 360 survey is being promoted during practice quality visits and actions. 19/02/2018 - Continue with previously identified actions. 24/01/2018 -To necessary actions taken. 13/03/2018 - 360 survey now completed. Results will be consultation in changes to services inline with feedback is also being encouraged at those meetings. 07/12/2017 - A representative of Care continue to monitor engagement through changes to the CCG management team and to reviewed once released and necessary actions taken. 19/02/2018 - Feedback through the national guidance.;#The CCGs have a duty to Team is to attend Communication and Engagement Committee. The 360 degree feedback take note of feedback provided at quality visits and the 360 survey that is currently 360 degree survey continues to be promoted through Locality/Membership Boards and support and develop safe and sustainable from GPs on the CCG engagement is expected during January 2018. underway. 07/12/2017 - Awareness at Membership/Locality meetings during December through Quality Visits. 24/01/2018 - Awareness at Membership/Locality meetings during
01/10/2014 12:11 01/10/2014 primary care that meets the Five Year Forward Older updates have been archived and are available if required. and January is being made to prompt for completion of the 360 degree survey. December and January is being made to prompt for completion of the 360 degree survey.
View. Older updates have been archived and are available if required. 07/12/2017 - Awareness at Membership/Locality meetings during December and January Seisdon PeninsulaCCG Seisdon is being made to prompt for completion of the 360 degree survey.
Older updates have been archived and are available if required. CCCCG (CCG) Sarah Jeffery
Executive Director of Primary Care Primary of Director Executive
10/04/2018 05/06/2018 Cannock Chase CCG;#Stafford & Surrounds CCG;#South East Staffordshire and and East Staffordshire CCG;#South Surrounds & CCG;#Stafford Chase Cannock
20 The CCGs have a duty to support and develop There is known variation across practices within the Failure to identify quality/safety risks Yes 3 4 12 10/04/2018 - Actions will remain the same and quality visits continue. A summary of the visits 10/04/2018 - Actions will remain the same . A summary of the visits will be pulled together 10/04/2018 - Quality visits are continuing with practices within each CCG where variation is 9 3 3 9 safe and sustainable primary care that meets the CCGs which is leading to potentially higher than impacting patient outcomes/patient will be pulled together once all visits have been completed. 13/03/2018 - Actions will remain once all visits have been completed. 13/03/2018 - Quality visits continue to take place, discussed. The CCG is also supporting practices to undertake greater analysis where Five Year Forward View.;#The CCGs have a expected outpatient referrals, admissions and A&E experience.;#105 the same and quality visits continue. 19/02/2018 - Actions remain the same. 24/01/2018 - peer review is in place and consultant connect is available to all practices. A further review required. A further review will take place once all quality visits have taken place. statutory duty to ensure a safe and effective activity. There is potential inequitable service provision. Mitigating actions remain the same as the quality visits are in the process of taking place. The will take place once all quality visits have taken place. 19/02/2018 - Continuation of visits. 13/03/2018 - Quality visits are continuing with practices within each CCG where variation is
urgent care system which meets the visits will continue over the next few months and are due to be completed by end of March 24/01/2018 - To continue with quality visits highlighting variation and having discussions discussed. The CCG is also supporting practices to undertake greater analysis where PeninsulaCCG
01/10/2014 12:11 01/10/2014 constitutional targets.;#The CCGs have a 2018. with practices as necessary. required. A further review will take place once all quality visits have taken place. statutory duty to improve the quality of services, Older updates have been archived and are available if required. Older updates have been archived and are available if required. 19/02/2018 - Quality visits are continuing with practices within each CCG where variation is to promote continuous improvement and ensure discussed. The CCG is also supporting practices to undertake greater analysis where
the safety and effectiveness of services.;#The required. 24/01/2018 - Quality visits are continuing with practices within each CCG where CCCCG (CCG) Sarah Jeffery
13/03/2018 08/05/2018 CCGs have an increasing number of National variation is discussed. The CCG is also supporting practices to undertake greater analysis
priorities they must deliver in line with the where required. Care Primary of Director Executive
Operational Plan. Older updates have been archived and are available if required.
Cannock Chase CCG;#Stafford & Surrounds Surrounds & CCG;#Stafford Chase Cannock Seisdon and East Staffordshire CCG;#South
276 The CCGs have a duty to support and develop A Cannock Chase GP practice currently provides the Failure to support and develop sustainable Yes 3 3 9 10/04/2018 - Actions continue as previously recorded. 14/03/2018 - A service specification is 10/04/2018 - Actions continue. 14/03/2018 - Service Specification to be finalized. 10/04/2018 - The practice continues to provide the service whilst the specification is being 6 3 2 6 safe and sustainable primary care that meets the violent patient scheme on behalf of the 3 CCGs. The Primary Care and General Practice .;#103 in development. There has been a slight delay in this due to the Practice Manager being on sick 19/02/2018 - Service specification to be confirmed. 24/01/2018 - The practice is happy to developed. The risk is therefore minimized. 14/03/2018 - The practice continues to CCG Five Year Forward View. practice have raised issues regarding undertaking home leave. This has not increased the risk as the practice has confirmed that they will continue the continue offering the service. The service specification is being reviewed. The practice has provide the service whilst the specification is being developed. The risk is therefore visits for patients out of the Cannock Chase area, this service whilst the specification is being developed. 19/02/2018 -The practice is happy to been asked for the cost of providing out of area home visits in the interim whilst a further minimized. 19/02/2018 - The practice are happy to continue providing the service and currently affects three patients as such, the Practice is continue to offer the service whilst the service specification is being developed. 24/01/2018 - solution is being worked up with AVS. therefore the risk is being minimized. 24/01/2018 - The practice are happy to continue
28/07/2017 12:47 28/07/2017 considering pulling the service as they do not feel this is The practice is happy to continue offering the service. The service specification is being Older updates have been archived and are available if required providing the service and therefore the risk is being minimized.
a sustainable option in the future. The risk is that if the reviewed. The practice has been asked for the cost of providing out of area home visits in the Older updates have been archived and are available if required 08/05/2018
practice no longer wishes to continue providing this, all interim whilst a further solution is being worked up with AVS. 10/04/2018 Jeffery Sarah (CCG) CCCCG (CCG) Sarah Jeffery patients currently under this scheme will not be Older updates have been archived and are available if required East CCG;#South Surrounds
registered with a GP resulting in these cohort of & CCG;#Stafford Chase Cannock
patients possibly utilizing other services such as A&E, Care Primary of Director Executive Staffordshire and Seisdon Peninsula Seisdon and Staffordshire 227 The CCGs have a duty to support and develop DISCHARGEMIU etc. LETTERS VIA PROCESS HUB Failure to identify quality/safety risks Yes 4 3 12 11/04/2018 - All sites now working on Docman 10 and connections to HEFT completed. HEFT 11/04/2018 - All sites now working on Docman 10 and connections to HEFT completed. 11/04/2018 - All sites now working on Docman 10 and connections to HEFT completed. 6 3 2 6 safe and sustainable primary care that meets the Discharge letters from Heart of England NHS Foundation impacting patient outcomes/patient continue to send a reduced amount of discharges electronically due to some problems with HEFT continue to send a reduced amount of discharges electronically due to some HEFT continue to send a reduced amount of discharges electronically due to some Five Year Forward View.;#The CCGs have a Trust (HEFT) are now being sent electronically via the experience.;#105 sending/content. Project team staying engaged with HEFT to ensure this progresses and problems with sending/content. Project team staying engaged with HEFT to ensure this problems with sending/content. Project team staying engaged with HEFT to ensure this statutory duty to improve the quality of services, Central Hub which diverts letters automatically to the electronic comms can be started en masse. progresses and electronic comms can be started en masse. The CCG continues to progresses and electronic comms can be started en masse. The CCG continues to progress to promote continuous improvement and ensure patients General Practitioners (GP). This means GP's The CCG continues to progress a strategic resolution for all electronic discharges for progress a strategic resolution for all electronic discharges for Staffordshire providers a strategic resolution for all electronic discharges for Staffordshire providers (whilst also
16/08/2016 11:56 16/08/2016 the safety and effectiveness of services. within the CCG border are not receiving discharge Staffordshire providers (whilst also connecting with Birmingham/Black Country footprint). (whilst also connecting with Birmingham/Black Country footprint). Engagement with connecting with Birmingham/Black Country footprint). Engagement with providers and letters because there is no access to the system and Engagement with providers and formation of a detailed business case continues. Meeting providers and formation of a detailed business case continues. Meeting scheduled with formation of a detailed business case continues. Meeting scheduled with UHNM 11 April, letters are no longer being posted. scheduled with UHNM 11 April, engaging with BHFT to ensure all providers covered in UHNM 11 April, engaging with BHFT to ensure all providers covered in Staffordshire. engaging with BHFT to ensure all providers covered in Staffordshire. 19/03/2018 - All sites Staffordshire. 19/03/2018 - All sites now working on Docman 10 and connections to HEFT 19/03/2018 - All sites now working on Docman 10 and connections to HEFT completed. now working on Docman 10 and connections to HEFT completed. Project team have SESCCG (CCG) Andy Hadley There is also concern reported about the poor quality completed. Project team have advised that HEFT have reduced the amount of traffic being sent Project team have advised that HEFT have reduced the amount of traffic being sent advised that HEFT have reduced the amount of traffic being sent electronically due to some
of the discharge letters, this being addressed at UHB electronically due to some problems with sending/content. Project team staying engaged with electronically due to some problems with sending/content. Project team staying engaged problems with sending/content. Project team staying engaged with HEFT to ensure this Care Primary of Director Executive CRB (Quality and Perfomance). HEFT to ensure this progresses and electronic comms can be started en masse. The CCG with HEFT to ensure this progresses and electronic comms can be started en masse. progresses and electronic comms can be started en masse. The CCG continues to progress continues to progress a strategic resolution for all electronic discharges for Staffordshire The CCG continues to progress a strategic resolution for all electronic discharges for a strategic resolution for all electronic discharges for Staffordshire providers (whilst also providers (whilst also connecting with Birmingham/Black Country footprint). Engagement with Staffordshire providers (whilst also connecting with Birmingham/Black Country footprint). connecting with Birmingham/Black Country footprint). Engagement with providers and
providers and formation of a detailed business case continues. Meeting scheduled with UHNM Engagement with providers and formation of a detailed business case continues. Meeting formation of a detailed business case continues. Meeting scheduled with UHNM 11 April,
19/03/2018 20/04/2018
11 April, engaging with BHFT to ensure all providers covered in Staffordshire. 20/02/2018 - All scheduled with UHNM 11 April, engaging with BHFT to ensure all providers covered in engaging with BHFT to ensure all providers covered in Staffordshire. 20/02/2018 - All sites PeninsulaCCG Seisdon and East Staffordshire South sites now working on Docman 10 and connections to Birmingham being completed. The CCG Staffordshire. 20/02/2018 - All sites now working on Docman 10 and connections to now working on Docman 10 and connections to Birmingham being completed. The CCG continues to progress a strategic resolution for all electronic discharges for Staffordshire Birmingham being completed. continues to progress a strategic resolution for all electronic discharges for Staffordshire providers (whilst also connecting with Birmingham/Black Country footprint). Engagement with The CCG continues to progress a strategic resolution for all electronic discharges for providers (whilst also connecting with Birmingham/Black Country footprint). Engagement providers and formation of a detailed business case continues. Little progress to date due to Staffordshire providers (whilst also connecting with Birmingham/Black Country footprint). with providers and formation of a detailed business case continues. Little progress to date priority of ensuring current systems active. With all practices now being setup for electronic Engagement with providers and formation of a detailed business case continues. Little due to priority of ensuring current systems active. With all practices now being setup for discharge, next months action will be to get confirmation they are all receiving discharges and progress to date due to priority of ensuring current systems active. With all practices now electronic discharge, next months action will be to get confirmation they are all receiving then practices are happy with output from live departments. being setup for electronic discharge, next months action will be to get confirmation they discharges and then practices are happy with output from live departments. Older updates have been archived and are available if required. are all receiving discharges and then practices are happy with output from live Older updates have been archived and are available if required. departments. Older updates have been archived and are available if required. Cannock Chase CCG, South East Staffordshire and Seisdon Peninsula CCG and Stafford and Surrounds CCG Primary Care Commissioning Committee - Risk Register
Risk ID Objective Description Of Risk Associated BAF Risks Mitigating Action (Internal) Future Actions (Internal) Assurance (Internal)
CCG
Initial
Review
Current Current
Created
mitigations RiskOwner
ClinicalRisk
Date of Next of Date Next
Consequence Consequence
ExecRisk Lead
of controls and
InitialRisk Score
InitialLikelihood
LastReview Date
Current risk score risk Current
pre consideration consideration pre
Current Risk Score Current Current Likelihood Current 205 The CCGs have a statutory duty to remain within The CCG is responsible for the reinvestment decision Failure to deliver the control total;#99 No 4 4 16 10/04/2018 - An updated re-investment proposal has been approved by PCC. This will be put in 10/04/2018 - An updated re-investment proposal has been approved by PCC. This will be 10/04/2018 - An updated re-investment proposal has been approved by PCC. This will be 6 3 2 6 the Revenue Resource Limit in 2017/2018 and regarding the reinvestment of the PMS premium. The place for 2018/19. A further review will take place in early 2019. 14/03/2018 - A proposal has put in place for 2018/19. A further review will take place in early 2019. 14/03/2018 - A put in place for 2018/19. A further review will take place in early 2019. 14/03/2018 - Plans must ensure that they remain within an agreed financial consequences of the PMS contract changes been presented to each of the Locality/Membership Boards. The feedback from these boards report is due to be presented to Primary Care Committee in March. 19/02/2018 - An continue to be monitored in order to ensure funds are being appropriately spent and control total set by NHS England.;#The CCGs have may exceed the premium and cause a financial pressure will be fed in to a report to the Primary Care Committee in March for final agreement. updated proposal has been developed and will be presented to the 1st March Primary distributed. Discussions continue with the membership. 19/02/2018 - Plans continue to be a duty to support and develop safe and for the CCG. In addition, there may be an issue around 19/02/2018 - A proposal has been updated and will be presented to the 1st March Primary Care Committee. It will then be presented to the Membership/Locality Boards for monitored in order to ensure funds are being appropriately spent and distributed.
31/01/2016 17:35 31/01/2016 sustainable primary care that meets the Five Year service continuity if practices choose to cease services Care Committee and to the March Membership/ Locality Boards. 24/01/2018 - A meeting discussion. 24/01/2018 - A paper to be developed describing the proposals for 2018/19 24/01/2018 - The PMS premium will continue to be monitored and the plan for the future
Forward View. as a result of the review. with CCG Clinical Chairs was held on 23rd January to discuss the investment for 2018/19 and and years 4 and 5 of the re-investment. This will be presented to Membership Boards and investment will be presented to Membership Boards and the Primary Care Committee. Seisdon PeninsulaCCG Seisdon the proposal for years 4 and 5. A paper will be developed and presented to the relevant Boards the Primary Care Committee. Older updates have been archived and are available if required.
and to the February Primary Care Committee. 07/12/2017 - A Task Group including an Older updates have been archived and are available if required.
10/04/2018 04/12/2018 Wood Eleanor (SES & SP CCG) SP & WoodEleanor (SES Executive Director and Clinicians is to be established to develop PMS reinvestment Seisdon and EastStaffordshire
opportunities for 2018/19. A paper will be brought to Primary Care Committee in January Care Primary of Director Executive 2018.
Older updates have been archived and are available if required. and East Staffordshire Peninsula;#South Cannock Chase;#Stafford & Surrounds;#South Surrounds;#South & Chase;#Stafford Cannock 255 The CCGs have a duty to support and develop There is a risk of the CCGs not having the resource / Challenge in delivery of constitutional targets No 4 3 12 10/04/2018 - The risk will continue to be monitored. 13/03/2018 - The risk will continue to be 10/04/2018 - The risk will continue to be monitored. 13/03/2018 - The risk will continue 10/04/2018 - The risk will continue to be monitored. 13/03/2018 - The risk will be 4 2 2 4 safe and sustainable primary care that meets the capacity and expertise to assume delegated may impact patient care & monitored. 19/02/2018 - The risk will continue to be monitored. 24/01/2018 - The risk will to be monitored. 19/02/2018 - The risk will continue to be monitored. 24/01/2018 - The monitored through the Primary Care Committee. 19/02/2018 - The risk will be monitored CCG Five Year Forward View. commissioning responsibility of general practice. performance.;#104;#Failure to support and continue to be monitored. 23/01/2018 - Risk Group met on 16 January 2018 and the request risk will continue to be monitored. 23/01/2018 - Risk Group met on 16 January 2018 and through the Primary Care Committee. 24/01/2018 - The risk will be monitored through the develop sustainable Primary Care and General to close the risk was rejected on the basis the group were not assured the risk has been the request to close the risk was rejected on the basis the group were not assured the risk Primary Care Committee. 23/01/2018 - Risk Group met on 16 January 2018 and the Practice .;#103 mitigated. 07/12/2017 - Proposed closure. The CCG has assumed responsibility for delegated has been mitigated. 07/12/2017 - Proposed closure. The CCG has assumed responsibility request to close the risk was rejected on the basis the group were not assured the risk has
23/11/2016 15:39 23/11/2016 commissioning since April 2017. Expertise in the CCG and NHS England continue to offer for delegated commissioning since April 2017. Expertise in the CCG and NHS England been mitigated. 07/12/2017 - Proposed closure. The CCG has assumed responsibility for
support and advise. continue to offer support and advise. delegated commissioning since April 2017. Expertise in the CCG and NHS England continue 05/06/2018 Older updates have been archived and are available if required. Older updates have been archived and are available if required. to offer support and advise. 10/04/2018
Older updates have been archived and are available if required. East CCG;#South Surrounds
Wood Eleanor (SES & SP CCG) SP & WoodEleanor (SES
Cannock Chase CCG;#Stafford & & CCG;#Stafford Chase Cannock
Executive Director of Primary Care Primary of Director Executive Staffordshire and Seisdon Peninsula Seisdon and Staffordshire
271 The CCGs have a statutory duty to remain within Medicine Optimisation Team Recruitment/Vacancy Risk: Failure to support and develop sustainable Yes 3 3 9 16/05/2018 - all new pharmacists have now started with the CCGs and are being training up to 16/05/2018 - No future actions as the risk is now deemed to be fully addressed. 19/03/2018 - There is assurance through the QiPP monitoring and review process that the 9 0 0 0 the Revenue Resource Limit in 2017/2018 and Vacancies within the Medicines Optimisation team Primary Care and General Practice deliver clinical pharmacy support to practices. The pre-MOC medicines optimisation team 19/02/2018 - To ensure all staff are in post and providing support to practices as soon as prescribing QiPP is on track to achieve FYE savings for 2017/18. All other essential must ensure that they remain within an agreed following staff departures and MoC restructure. The .;#103;#Failure to deliver the control structure is therefore fully appointed to and therefore no longer remains a risk. 12/04/2018 - possible. 15/11/2017 - The roles have been advertised and interviews are to be held 22nd requirements of the MO team are being provided by other team members. control total set by NHS England.;#The CCGs have structure of Band 8a (and below) positions to be agreed total;#99;#Failure to identify quality/safety As of the 12/4/18 we have 2 new pharmacists in place with a further 3 starting in April and 1 in and 23rd November. Older updates have been archived and are available if required.
a statutory duty to improve the quality of across the 3 CCG’s. Vacancies within team are risk for risks impacting patient outcomes/patient early May 2018. 19/03/2018 - We now have one of the new pharmacists in post with the Older updates have been archived and are available if required. PeninsulaCCG
13/04/2017 10:17 13/04/2017 services, to promote continuous improvement QiPP delivery and governance of medicines within the experience.;#105 remainder to be in place over the next few weeks. No further update required. 19/02/2018 - and ensure the safety and effectiveness of CCG. We now have start dates for the majority of the practice pharmacist roles starting from 26th services. February to early May 2018 so a full complement of staff will be in place from the 8th May
2018. 16/01/2018 - Pre-employment checks are continuing (led by recruitment) and still 16/06/2018 awaiting confirmed starting dates but expected from March 2018. Practice support is being 16/05/2018
provided by existing MO team in interim. Care Primary of Director Executive
Older updates have been archived and are available if required. SASCCG (CCG) Samantha Buckingham
Cannock Chase CCG;#Stafford & Surrounds Surrounds & CCG;#Stafford Chase Cannock Seisdon and East Staffordshire CCG;#South Item 8 Enc: 05
Cannock Chase Clinical Commissioning Group South East Staffordshire and Seisdon Peninsula Clinical Commissioning Group Stafford and Surrounds Clinical Commissioning Group
The healthiest place to live and work, by 2025
REPORT TO: Primary Care Commissioning Committees Meeting in Common
TO BE HELD ON: 30 May 2018
Subject: Extended Access Final Service Specification & Update Board Lead: Lynn Millar Officer Lead: Mel Mahon / Vicky Oxford Approval/ Recommendation: Assurance Discussion Information Ratification
PURPOSE OF THE REPORT:
To share a copy of the final service specification for the extended access and brief update on the progress since the last meeting.
KEY POINTS: Service Specification
• The service specification that was agreed at the previous Primary Care Commissioning Committee, was shared with all clinical membership/locality boards for information in May 18 and shared with the legal team who have been supporting this process. • Following these meetings, feedback and clarification questions were raised that needed to be reflected within the specification. It was agreed these comments would be reviewed before the specification was shared as part of the formal engagement to ensure clarify around what we were commissioning. • These comments and clarifications have been reflected in the attached specification. The main points are: o Providing additional clarification on what is meant by ‘additionality’ and ensuring the rationale behind the direct award is clear from the requirements within the specification. Section 3 (previously section 4) has been expanded to outline the requirements of the provider to deliver the transformation of primary care at scale. o The outcomes in section 2 have been expanded to provide examples of how those can be delivered, and they also include 2 additional outcomes linked to transforming primary care and transforming the primary care workforce. o It has been made explicit that this is in addition to the Direct Enhanced Service (sec 1.2.8) o Finances in section 7 have remained however a sentence has gone in to explain these We are honest, accessible Quality is our day job We innovate and deliver Care and respect for all and we listen Page | 1 Item 8 Enc: 05
may be refreshed once we have confirmed funding from NHSE. o It was agreed at the steering group that the £0.34 for Oct – March 18 would be held back as part of the shared infrastructure costs to cover IM&T and any impact on prescribing budgets. This would be for 1819 only. • These have been reviewed and agreed at the Extended Access Steering Group, which is chaired by Lynn Millar and has senior clinical representation on, and one of our Lay Members, who has now agreed to take over as Chair of the group. • Due to the timescales being worked to, it was felt that although the specification has been amended, it now provides additional clarity rather than changes the requirements and therefore this paper is for information to inform the group of these changes.
Progress Update (as of writing this paper – 22nd May 2018)
• NHS England have changed the requirement and confirmed that ALL CCGs in the country need to be rated as green by the 1st September 2018 – not October. This is 100% coverage. • The formal engagement process has started and all documents were shared on a primary care web portal on Friday 18th May. The documents went to all practices and federation leads across Staffordshire to ensure consistency in approach across General Practice. • The following has been made available via this web portal: o Specification o Proforma for proposals to be submitted on as part of the assurance process. o IM&T requirements o FAQ’s paper o Public Health Profiles o Patient Survey results • Proposals will be submitted to the CCG by Friday 22nd June. The Primary Care team will be supporting the localities/federations to complete these. • A non-conflicted panel will meet by Friday 29th to assure the proposals meet the requirements. The panel will consist of primary care colleagues, finance, quality, IM&T, non-conflicted GP from Wolverhampton, lay member and a patient representative. • A paper will be taken then to Governing Bodies in July to approve the contracts • The legal team are working on producing the contract which will be an APMS contract • We are also working and liaising with NHSE to assure them of the rationale behind the direct award. They are nervous about this; however this is an assurance process not an approval process and we have been advised we can still proceed the way we have to ensure delivery by the 1st September.
CCG GOALS: Change the culture: • Hospital to home • Professional to patient More focus on prevention Involving everyone for improved health and
care
We are honest, accessible Quality is our day job We innovate and deliver Care and respect for all and we listen Page | 2 Item 8 Enc: 05
Empower and support patients to take control
of their own health Services supporting people to make informed
decisions
IMPLICATIONS: Legal and/or Risk CQC Patient Safety Patient Engagement Financial Sustainability Workforce/Training
RECOMMENDATIONS/ACTION REQUIRED: The Primary Care Commissioning Committees Meeting in Common is asked to:
Receive the report
Not KEY REQUIREMENTS Yes No Applicable Has a quality impact assessment been undertaken? Has an equality impact assessment been undertaken? Has a privacy impact assessment been completed? Has a communications & engagement impact assessment been completed? Have partners/public been involved in design? Are partners/public involved in implementation? Are partners/public involved in evaluation?
CCG VALUES We are honest, accessible and listen
Care and respect for all
Quality is our day job
We innovate and deliver
We are honest, accessible Quality is our day job We innovate and deliver Care and respect for all and we listen Page | 3
Service Specification No. FINAL Version 5 160518
Service Extended Primary Care Access Service Specification
Commissioner Lead
Provider Lead
Period 1st September 2018 – 31st August 2021
Date of Review 1st January 2019
1. Population Needs
1.1 National context and evidence base
1.1.1 The General Practice Forward View (GPFV) published in April 2016 committed £500 million by 2020/21 to enable clinical commissioning groups (CCGs) to commission and fund additional capacity across England to ensure that, by 2020 everyone has access to GP services, including sufficient routine appointments at evenings and weekends to meet locally determined demand, alongside effective access to out of hours and urgent care services.1
1.1.2 The NHS operational Planning and contracting guidance (2017-19) published by NHS England and NHS Improvement explains how the guidance supports and reaffirms the national priorities and sets out the financial and business rules for 2017/18 and 2018/19. Primary Care is one of the Nine National ‘must do’ priorities which clearly set out the importance of sustaining General Practice through the implementation of the GP Forward View.
1.1.3 The planning guidance clearly states the requirements of commissioners to extend and improve access in line with national funding. These core requirements are the minimum, subject to further national guidance, and can be added to by CCGs.
1.1.4 The National seven core requirements for extended access are : 1. Timing of appointments 2. Capacity 3. Measurement 4. Advertising and ease of access 5. Digital 6. Inequalities 7. Effective access to wider whole systems services
1.2 Local context and evidence base
Transformation of Primary Care ‘ambition’
1.2.1 There is an expectation that adopting a local approach to providing extended access across Staffordshire will allow for a level of ‘additionality’. The 7 core requirements
1 https://www.england.nhs.uk/gp/gpfv/redesign/improving-access/ 1 | P a g e
are a minimum standard and therefore this specification is enhanced to enable the transformation of General Practice services and patient workflows e.g. how practices provide same day urgent access, longer appointments for frail older people and people with Long term conditions etc.
1.2.2 By transforming the way General Practice delivers care, this specification shall enable the introduction of new workforce models and new ways of working that will also maximise value for money and provide a case for future investment into General Practice.
1.2.3 The GPFV states that CCGs should invest in general practice to “truly transform” and that “in delivering improved access we will want to secure transformation in general practice”. The proposed service model for Staffordshire is built along the premise that by providing access collaboratively, this will free capacity in practices to deliver care in different ways to reflect the needs of their patients across core and extended hours.
1.2.4 By delivering a shared surgery for urgent and same day bookable patients, the two local Prime Ministers Challenge Fund pilot sites have been able to manage their resources in a more effective way. This has resulted in additional capacity and more time in their own surgeries to provide longer appointment for the patients with more complex needs, such as the frail and elderly. This has only been achieved through a network of local GPs delivering the service due the collective approach to managing their own workforce differently that is mutually beneficial to the practice and the practices within the Network.
1.2.5 The model is unique to General Practice as the services required by this specification will lead to the transformation of General Practice workflows, as well as delivering the minimum criteria set nationally as the 7 core requirements. For these reasons, the service specification will include a requirement to deliver in hours and extended access which is a core requirement of the GMS contract and, as such cannot be delivered by any other provider. This approach is supported by the GPFV that states some capacity can be inside core hours.
1.2.6 Evidence from pilots show that there are fewer handoffs when local GPs provide primary care services compared to other providers. This is due to the relationships that have developed as a result of locality working which requires a high level of trust between individual doctors and practices.
1.2.7 On this basis, there is a view that, based on our experience to date from the PMCF pilots, to ensure the effective delivery of services and to minimise the burden on core general practices, extended access should be commissioned from local practices working at scale as an extension of their core services and day to day management of service provision. Two examples of where this is particularly important are referral management and diagnostics which the CCG would like to work with practices to deliver consistent process to reduce the burden on individual practices and ensure a safe and streamlined pathway for patients.
1.2.8 For the avoidance of doubt, the provision of this service will be in addition to the Direct
2 | P a g e
Enhanced Service (DES) arrangements some practices in Staffordshire are still signed up to with NHS England.
2. Outcomes
2.1 NHS Outcomes Framework Domains & Indicators
Domain 1 Preventing people from dying prematurely Enhancing quality of life for people with long-term Domain 2 conditions Helping people to recover from episodes of ill-health Domain 3 X or following injury Domain 4 Ensuring people have a positive experience of care X Treating and caring for people in safe environment and Domain 5 X protecting them from avoidable harm
2.2 Local defined outcomes
2.2.1 The service shall deliver the following outcomes…. 1) Timing of appointments: provide weekday provision of access to pre-bookable and same day appointments to general practice services in evenings (after 6:30pm) – to provide an additional 1.5 hours a day; alongside weekend provision of access to pre-bookable and same day appointments at weekends to meet local population needs. 2) Capacity: a minimum additional 30 minutes consultation capacity per 1000 population. The provider will be required to increase this to 45 minutes per 1000 population if and when patient demand requires. 3) Measurement: ensure usage of a nationally commissioned new tool to automatically measure appointment activity by all participating practices, both in- hours and in extended hours. A key requirement of the new service is that the provider must standardise activity coding and monitoring activity and demand. This will only be achieved with the cooperation and involvement of practices 4) Advertising and ease of access: ensure services are advertised to patients, including notification on practice websites, notices in local urgent care services and publicity that into the community, so that it is clear to patients how they can access these appointments and associated service; ensure ease of access for patients including: o all practice receptionists able to direct patients to the service and offer appointments to extended hours service on the same basis as appointments to non-extended hours services o Patients should be offered a choice of evening or weekend appointments on an equal footing to core hour’s appointments. 5) Digital: use of digital approaches to support new models of care in general practice. The use of digital technology to integrate booking facilities, enable onward referrals, accessing diagnostics etc... will ensure IM&T solutions will be used to integrate core and extended hours or working. 6) Inequalities: improve issues of inequalities in patients’ experience of accessing general practice and Improve accessibility and flexibility for patients, ensuring care is built around the patients.
3 | P a g e
7) Effective access to wider whole system services: Effective connection to other system services enabling patients to receive the right care from the right professional, including access from and to other primary care and general practice services such as urgent care services. Learning from local pilots within Staffordshire has informed the STP New Models of Care Programme which has prioritised a programme of work to enhance primary and community care. This will require practices to be part of the development of integrated care teams. These will provide the opportunity for teams to work together to help deliver additional capacity within primary care, for example integrated community nursing teams which could provide clinics during extended hours. 8) Strategic Transformation of Primary Care: In addition to the 7 core requirements this service shall act as an enabler to transform the way patient’s access primary care. The provider is required to deliver a service which creates additional capacity available within core hours so more time can be spent in practices to provide longer appointment for the patients with more complex needs, such as the frail and elderly and provide continuity of care for the patient by being able to see their own GP. 9) Transform Primary Care Workforce. The Provider shall develop the current workforce model so that patient’s first point of contact is not always a GP. This will help to release capacity by working together and sustain the current GP workforce.
Outcomes 1 to 7 above are the 7 core requirements.
2.2.2 The service shall contribute to the following overarching outcomes: Ensure patients have a positive experience of care and report satisfaction with accessing primary care services A reduction in numbers of people accessing other parts of the care system as an alternative to primary care appointments, such as A&E, Minor Injury Units and Walk In Centres.
3. Local Delivery Model and ‘Additionality’
3.1.1 In order to meet the requirements of this specification, the Provider shall be a federated group of practices working at scale (minimum population of 30,000-50,000). The Provider shall be expected to work in partnership with neighbouring locality groups to ensure resilience and flexibility. There is recognition that each Alliance footprint and locality may require a different service model to meet the needs of the local population.
3.1.2 The Alliance footprints cover the following areas:
Northern Staffordshire (North Staffordshire and Stoke on Trent) South West Staffordshire (Stafford and Surrounds, Cannock Chase and Seisdon Peninsula) South East Staffordshire (East Staffordshire, Tamworth and Lichfield)
3.1.3 The Service shall be a GP-Led service and include a hub and spoke delivery model to provide extended and same day access at a number of designated locations, rather than extended access being provided at all practices. There may be local variation in the detail of the model, however the common requirements are:
• Patients from all member practices be able to access extended and same day
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appointments and wider services from the hub • GPs providing the service need to have read and write access to patient records • Integrated telephony, so that the hub can divert to practice systems and vice versa as necessary • Hubs at an appropriate location and with sufficient capacity, based on robust modelling and planning • Access to and from the wider health system, including urgent care walk in centres, A&E departments, OOH and 111.
3.1.4 The overarching aim is to offer improved and extended access to routine bookable and on the day appointments for General Medical Services during the week, as a minimum from 6.30pm up to 8pm in the evening and during weekends (hours to be locally determined and informed by feedback from local patient survey results).
3.1.5 The service will support additional capacity for local General Practice where appointments cannot be offered to patients within their own practice.
3.1.6 Between September 2018 and March 2019 the Provider shall work with commissioners to embed the initial 7 core requirements across primary care.
3.1.7 In order to truly transform primary care across Staffordshire the Provider shall work with commissioners between January 19 and March 19 to develop and agree a Service Development Improvement Plan which will outline the key development areas identified by each locality/federation and shall be implemented as part of the services pursuant to this specification from 1 April 2019 with clear milestones for delivery.
3.1.8 The minimum requirements for these Service Development and Improvement plans are: To develop and deliver a new workforce model within the practices / localities within core and extended hours. This may include for example the introduction of physiotherapists, mental health practitioners, elderly care facilitators as first point of contacts for registered patients. To introduce a new workflow system that changes the way patients access primary care, for example extended clinic appointments and continuity of care for patient with complex needs or Long Term Conditions. This will also include looking at how practices can share back office functions to deliver further efficiencies. Opportunities to extend and deliver immunisations and screening programmes to registered patients within the practices/hubs, for example influenza clinics delivered under a single locality approach.
3.1.9 The IM&T solution used to enable the integration of practices for extended access, will be seen as shared infrastructure, and must be available for future primary care services.
4. Scope
4.1 Service description/care pathway
GP/ ANP / Nurse /wider Primary Care Team Appointments
4.1.1 Patients will be booked via their GP Practice or 111 into an appropriate GP / ANP/
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practice nurse or other primary care appointment. (the ratio of this is pending national guidance)
4.1.2 The service will provide timely access to appropriate clinical expertise so the right response is provided to each patient’s need, the first time round.
4.1.3 The service is expected to be able to assess, diagnose and treat acute illness and, if required, refer a patient on for further diagnostic or intensive/ specialised care.
Direct Booking from General Practice and NHS 111
4.1.4 The service shall accept referrals/ direct bookings from NHS 111 and General Practices within the geographical area covered by this service specification. (the ratio of this is pending national guidance)
Days/ Hours of Operation
4.1.5 The service shall be delivered, as a minimum:
1. Weekdays (Monday to Friday) from 6.30pm-8pm
2. Saturday and Sunday (locally determined to meet patient needs)
3. Bank holidays (locally determined to meet patient needs)
4.1.6 In hours operation and appointments will be locally determined to meet patient needs and reflected in the provider’s proposal.
Accessibility and acceptability
4.1.7 The provider must supply to all non-English speaking patients a professional translation and interpretation service during all consultations and must also provide translation materials describing clinical diagnosis, treatment and procedures as required. This service is currently provided by NHS England. The provider must also adhere to accessibility standards.
4.2 Location (s) of Service Delivery
4.2.1 The service will be provided from locations across the CCG geographical area that fully meets the needs of patients. The locations will be agreed with the CCG in order to ensure alignment with the planned integrated care hubs and community hospitals configuration and reflected in the provider’s proposal.
4.3 Workforce
4.3.1 Acknowledging national and local workforce challenges, the service shall be staffed by appropriately qualified health care professionals in sufficient numbers so as to meet the flexible demands of the population across the geographical location of the CCG, ensuring that there is a GP available at all times.
4.3.2 The Provider shall be responsible for ensuring that (where relevant) their clinical and / or non-clinical staff: Have relevant professional registration and enhanced Criminal Record and Barring checks undertaken prior to seeing patients alone; Have maintained relevant professional registration whilst delivering services on
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behalf of the Provider. The Provider is required to conduct frequent registration audits to ensure compliance; Have the appropriate Medical Indemnity Insurance and that their conduct is in line with the relevant terms and conditions set out in insurance as to not render that insurance invalid; Are on the NHS Performers list within England (GPs only); Have access to, and build, child protection training and development in line with their professional bodies’ recommendations and the local Safeguarding Children’s Board recommendations. The Provider shall ensure that at least one Level 3 child protection trained GP is present whilst the organisation is open and providing care. All clinical staff are required to be at least level 2 child protection trained; Are up to date with all statutory mandatory training as set out by the Provider; Undertake annual audit to ensure compliance with the above and forward this to the CCGs;
4.4 Medicines Optimisation
4.4.1 The Provider shall ensure that all clinicians and health care staff involved in enabling access to medicines are aware of the requirements of this section of the specification and abide by its terms.
4.4.2 The Provider shall develop and maintain organisational policies and procedures that reflect the standards of care and patient safety that might reasonably be expected from such a provider and ensure that policies and procedures are effectively communicated throughout the organisation. All policies and procedures must comply with the relevant regulations with regards to medicines including the Medicines Act 1968, Human Medicines Regulation 2012, the Misuse of Drugs Act 1971 (as amended), the Misuse of Drugs Regulations 2001 (as amended), the Misuse of Drugs (Safe Custody) Regulations (as amended), the Health Act 2006 and the Mental Health Act 2007.
4.4.3 The Provider shall ensure that all prescribing personnel have access to and adhere to the relevant Staffordshire CCG’s Joint Formulary and the local Antimicrobial Prescribing Guidelines in General Practice.
4.4.5 The service shall ensure that prescription forms (whether single sheets or pads) are stored securely and that robust and auditable systems are in place for use of prescription forms ensuring that each form can be accounted for.
4.4.6 The Provider shall have appropriate written procedures in place for dealing with patient safety incidents and near misses involving medicines. Reporting of these incidents shall comply with both local and national systems. The Provider shall undertake audits of reported incidents at intervals specified by the Commissioner with audit reports submitted to the Commissioner
4.4.7 All staff involved in supply or prescribing of medicines must have the relevant qualification to perform that role.
4.4.8 The CCG(s) will monitor antimicrobial prescribing. In order to establish a baseline in year one and to inform KPI target from year two, the Provider shall report all prescriptions for co-amoxiclav, cephalosporins and quinolones as a percentage of total prescriptions for all antibiotics. Note that good practice dictates that prescribing of co- amoxiclav, cephalosporins and quinolones should be minimised.
4.4.9 The Provider shall carry out risk assessments and audits of medicines management
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arrangements at intervals stipulated by the commissioner.
4.4.10 The Provider must have a process in place with the CCG Medicines Management team to ensure all prescribing undertaken by the service is recorded and measured.
4.5 IM&T Interoperability
4.5.1 At initiation of service in September 2018, the provider will be expected to:
• The service shall be able to communicate with and access records on the GP system providing bi-directional, real time recording and sharing information. • The service shall have read only access to GP patient records, encompassing all GP practices and be able to deliver Post Event Messaging to the appropriate GP practice. • Where technically possible, the service shall utilise Docman Share to access patient’s clinical documents during their extended access appointment only. • IT systems and processes must be interoperable with other GP systems, NHS 111 and the NHS Spine as appropriate. • The Provider shall collaborate with NHS 111 including the configuration to ensure IT and data systems support booking into the service by NHS 111. • eReferrals will be used as the default referral route for all referrals into secondary care consultant led services. eReferrals is the preferred route for all referrals, however, the commissioner appreciates not all services utilise this tool currently and other referral routes may be required i.e. NHS.net email. • Wi-Fi available for patients and staff.
IM&T Interoperability Future Transformation.
4.5.2 Following September 2018 implementation, future transformation will be required in the following areas:
• The provider will be required to work collaboratively with commissioners and suppliers to ensure robust clinically appropriate systems are in place to manage diagnostics and referrals. • The provider will actively implement Electronic Prescription Service (EPS) as and when this functionality becomes available. • The service will support provision of online consultations (triage via online forms) when functionality is available to extended access service providers. • The provider will review the GP systems used across the locality to explore how a single system in general practice could further support interoperability, clinician access and functionality. • Docman should be used by all practices where technically possible to ensure secure efficient sharing of clinical documentation. Practices with a GP system incompatible with Docman will work with commissioners and suppliers to implement a suitable solution for sharing documents to support care delivery. • The provider will review how digital tools can support evaluation of services such as text messaging providers i.e. MJog, iPlato and Clinical System built in tools where available.
4.6 Interdependence with other services/providers
4.6.1 The Provider shall ensure there are effective connections to other system services enabling patients to receive the right care from the right professional, including access
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from and to other primary care and general practice services such as urgent care services.
4.6.2 The provider shall have processes in place to ensure that onward referrals are made for the patient including the the 2 week wait (2WW) protocols. Referrals will need to be made electronically unless specified by the selected provider.
4.6.3 The service will be required to provide post event messaging as required to the patients registered GP. These must be provided electronically.
4.6.1 The provider shall take into consideration the wider service providers within the local health economy that may have an interdependency with the service: • Local Secondary Care providers, • NHS 111, • Out of Hours Provider, • SSoTP NHS Trust (Community Nursing and MIU), / Virgin Care Limited • Neighbouring Federations • SSSFT (mental health), Combined Health Care (mental health) • Local authorities (Health & Wellbeing Boards), • WM Ambulance Services Trust, • Local Care Homes including nursing homes, ?Residential • Local Pharmacies, • Local University Nursing and Medical Schools and West Midlands Deanery.
5. Applicable Service Standards 5.1 National Requirements
Applicable national standards (e.g. NICE)
Alternative Provider Medical Services (APMS) Directions 2013 Department of Health (2009) Guidance and competencies for the provision of services using practitioners with special interests (PwSIs) – Urgent and Emergency Care Care Quality Commission Essential Standards of Quality & Patient Safety, March 2010; What providers should do to comply with the section 20 regulations of the Health & Social Care Act 2008. NPSA, Safe Handover: Safe Patients, BMA (2004) NHSE, 2015. Commissioning Standards Integrated Urgent Care. London. Gateway ref 04020 Department of Health, 2006. National Quality Requirements in the Delivery of Out of Hours. Services. London. Gateway ref 6893 NHSE, 2015 Improving outcomes for patients with sepsis
5.2 Applicable local standards
Patients from all member practices need to be able to access extended and same day appointments and wider services from the hub GPs providing the service need to have read and write access to patient records
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Hubs at an appropriate location and with sufficient capacity, based on robust modelling and planning The service will be expected to respond to periods of surge, rather than a model that provides flat capacity Localise CCG Joint Formulary and the local Antimicrobial prescribing Guidelines in General practice
6. Applicable quality requirements and CQUIN goals Individual
6.1 Applicable quality requirements (Please refer to Appendix 1)
7. Activity
7.1 Indicative Activity Plan
7.1.1 The core requirement advises that the CCG must commission at least 30 minutes of consultation time for every 1,000 head of population. (Raw practice population as per NHS England Guidance)
CCG Raw practice Hours Per week Population @ 01/01/2018* Stafford and Surrounds 148,814 74.5 Cannock Chase 132,879 66.4 South East Staffordshire and Seisdon Peninsula 217,624 108.8
North Staffordshire 218,229 109.1 Stoke on Trent 290,775 145.4 East Staffordshire 141,546 70.7 *NHSE is due to confirm if weighted list sizes as of 1st October 17 should be used here. This table will be updated or confirmed by 26th May 18.
There will be phased implementation appropriate in order to achieve 100% of the population covered by the service from 1st September 2018.
7.2 Indicative Budget
The NHS England total financial allocation for 2018/19 is £4,189,468 The NHS England total financial allocation for 2019/20 is £6,698,178
7.2.1 The NHS England Financial allocation is calculated using ONS weighting formulae. The allocations for each CCG are highlighted in the table below. This allocation is expected to increase and we are awaiting NHS England confirmation.
Shared infrastructure costs:
7.2.2 In order to support the strategic direction to transform primary care, £0.34 per head of population will be held by the CCG to invest and support the shared infrastructure
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costs. These include costs to cover the IM&T requirements and the estimated increase in prescribing. This will be reinvested back to the Provider before April 2019 if the funding is unallocated at this time.
7.2.3 The Provider is expected to work with the CCG Digital Lead to ensure a consistent IM&T solution is sought across Staffordshire. There is an expectation that the investment in IM&T infrastructure will enable and support the true transformation of primary care over the duration of the service.
2018/19 pilot sites at £6 2019/20 all £6 per per head and others at ONS weighted head of ONS CCG 3.34 per head against populations weighted ONS weighted population populations SAS 136,250 790,344 817,500 SES/SP 205,189 685,332 1,231,134 CC 127,729 552,159 766,374 North 209,580 699,998 1,257,480 Staffs Stoke on 302,292 1,009,655 1,813,752 Trent
East staffs 135,323 451,980 811,938
TOTAL 1,116,363 4,189,468 6,698,178
8. Performance Management
8.1 Reporting
8.1.1 The current reporting schedule is based on current pilot sites, which may be amended and modified following release of any further National requirements
8.1.2 The provider will be required to submit monthly data on:
Accessibility Number of patient appointments available per day Staffing model used (clinicians providing the appointments) number of patients seen through the service and whether these were GP or Nurse appointments Number of DNAs (NHS 111 booked appointments) Number of unused appointments (NHS 111 ring fenced appointments) Number of patients referred elsewhere by day
Activity The provider will be required to submit monthly data on: Ensure timely reporting back to the patient’s registered practice (through clinical system) within 24 working hours of the patient attending the service Number of patients seen through the service by practice Number of patients seen on a Saturday, Sunday and at a Bank holiday
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Outcome of the patients visits – proposed breakdown: o Number of patients referred to A&E by date o Number of patients referred to emergency portals by date, i.e. AMU o Number of patients referred to diagnostics by date o Number of patients referred using a two week referral pathway by date o Number of patients referred back to own GP by date o Number of patients referred to a pharmacy by date o Number of patients recommended to self-care by date o Number of patients referred elsewhere by date
The provider will be required to submit monthly data on the wait profile by day to include: 1) Shortest wait 2) Longest wait 3) Average wait
Patient Satisfaction 8.1.3 The Provider will undertake patient feedback of the service on a monthly basis as part of the evaluation of the pilot with the outcomes of this feedback being shared with Commissioners on a quarterly basis. The patient feedback will be via patient surveys and case studies. Satisfaction with access arrangements; and Satisfaction with modes of contact available.
8.1.4 The Provider will undertake a monthly privacy audit for Information Governance purposes relating to appropriate access by the Primary Care Access Centre to patient records.
Governance
8.1.5 The Provider must demonstrate high standards of both corporate and clinical governance and shall deliver healthcare to consistent quality and safety standards as defined in CQC essential standards of quality and safety.
8.1.6 The Provider must demonstrate the appropriate registration with CQC at the commencement of the contract. The Provider will be required to produce an annual statement of compliance against the CQC, to publish this information so that it is accessible to the public and to provide it formally to the Commissioner.
8.1.7 The Provider must comply with all relevant legislation and guidance issued by the relevant Staffordshire CCG, NHS England or the Secretary of State.
8.1.8 Regular quality review meetings will be held with the Commissioner in addition to a programme of unannounced visits.
8.1.9 Feedback from services and other stakeholders in the health community is also expected and should be used to evidence and support that the Provider is achieving quality standards.
8.1.10 Clinical governance arrangements must be in place to ensure the clinical safety of the patient, providing assurance to commissioners that appropriate internal escalation processes are in place, adhered to and reported on.
8.1.11 Strong relationships and partnership working should be established between all providers involved in the pathway so that issues can be identified and service
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improvements made.
8.1.12 Clinical governance arrangements should include: Clarity about lines of accountability, from the Senior Responsible Officer through to individual members of staff within the service and any partner provider organisations, and the manner in which the clinical governance of the service engages with and supports the governance arrangements in other provider organisations; A robust policy detailing the way in which adverse and serious incidents will be identified and managed, ensuring that the clinical leadership of the service plays an appropriate role in understanding, managing and learning from these events; Clear and well-publicised routes for both service users and health professionals to feedback their experience of the service, ensuring prompt and appropriate response to that feedback with shared learning between organisations, including feedback to the individual who was the source of the comment in the first place; Regular surveys of patient and staff experience (using both qualitative and quantitative methods) to provide additional insight into the quality of the service; Regular staff training, and refreshing where required on updated policies and procedures, to ensure quality of service is maintained, and; Provision of accurate, appropriate, clinically relevant and timely data about the service to ensure that it is meeting the quality standards set out in this specification. The Provider will ensure that an infection prevention control audit is undertaken by an external provider
Key Performance Indicators
8.1.13 The Provider will be expected to work with the commissioners to develop a dashboard that will report compliance with the 7 core requirements on a monthly basis, plus the additional transformation programmes, referenced in section 5.
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Item: 9 Enc: 06
Cannock Chase Clinical Commissioning Group South East Staffordshire and Seisdon Peninsula Clinical Commissioning Group Stafford and Surrounds Clinical Commissioning Group
The healthiest place to live and work, by 2025
REPORT TO: Primary Care Commissioning Committees Meeting in Common
TO BE HELD ON: 30 May 2018
Subject: Patient Participation Groups Board Lead: Sue Harper, Chair of Communications and Engagement Committee Officer Lead: Adele Edmondson, Senior Communications and Engagement Manager Approval/ Recommendation: X Assurance Discussion Information Ratification
PURPOSE OF THE REPORT:
To update the committee on the Patient Participation Group (PPG) workshop held with patients and practice managers on 28th March 2018. To seek agreement of the Primary Care Commissioning Committee to support the development of PPGs across all practices.
KEY POINTS:
• Practice-based patient participation groups provide a forum to represent the patient voice in an ongoing dialogue with GP practices. • It is a contractual requirement for GP practices to have a PPG but not all practices have an effective one or indeed have one at all. • Although independently managed, PPGs are also the foundation of the CCGs’ face to face engagement model – providing geographical coverage across the three CCG areas • To support PPGs, the Communications and Engagement Team is proposing to develop a password-protected area of the CCGs’ websites, including resources and a single point of access and support with the introduction of Facebook. • At a recent workshop The CCG was asked to encourage the introduction and/or development of PPGs.
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CCG GOALS: Change the culture: • Hospital to home • Professional to patient The development of patient participation More focus on prevention groups supports the CCGs wider face to face Involving everyone for improved health and engagement model and will provide a care mechanism to communicate and engage with Empower and support patients to take control patients around all five of the CCG goals. of their own health Services supporting people to make informed decisions
MPLICATIONS: PPGs can support the CCG in its statutory duty to engage with patients Legal and/or Risk and the public CQC PPGs can support practices through CQC inspections PPGs can support communication/engagement with patients around Patient Safety matters relating to patient safety PPGs provide a forum to represent the patient voice in an ongoing Patient Engagement dialogue with GP practices and the CCGs through the wider face to face engagement model PPGs can support communication/engagement with patients around the Financial financial position of both practices and the CCGs PPGs can support communication/engagement with patients around Sustainability actions being taken to support sustainability of primary care PPGs can support communication/engagement with patients around Workforce/Training matters relating to workforce in primary care
RECOMMENDATIONS/ACTION REQUIRED: The Primary Care Commissioning Committees Meeting in Common is asked to:
1) Support the development of PPGs across South Staffordshire via Locality and Membership Boards 2) Clarify the position in regard to support on offer via the Primary Care Team in relation to the development of Facebook within practices and PPGs 3) Note the progress being provided to PPGs from the Communications and Engagement Team namely: a. Development of the website to include access to resources and an interactive facility for PPGs b. Introduction of a single point of contact for patients to receive information and technical support for the setting up of or development of a face to face or virtual PPG c. Encourage the development of a mentor scheme
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Not KEY REQUIREMENTS Yes No Applicable Has a quality impact assessment been undertaken? x Has an equality impact assessment been undertaken? x Has a privacy impact assessment been completed? x Has a communications & engagement impact assessment been x completed? Have partners/public been involved in design? x Are partners/public involved in implementation? x Are partners/public involved in evaluation? x
CCG VALUES We are honest, accessible and listen
Care and respect for all
Quality is our day job
We innovate and deliver
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Patient Participation Groups
Background
The CCG’s have a statutory duty to consult with their public and patients on the delivery of NHS services. To comply with this duty we have developed a face to face model of engagement. The model is reliant on each practice having a Patient Participation Group (PPG). Each practice is required to have a PPG as part of its GP contract. In reality the picture across South Staffordshire is patchy with some holding regular face to face meetings, virtual groups or in some cases no engagement with a PPG at all.
PPG Workshop
In March 2018 a workshop was held to work with patients and practice managers to encourage the introduction and/or development of practice-based PPGs, both face to face and virtual. The aims identified at the start of the workshop were to: • Provide a reminder of the contractual requirement for a patient PPG, the purpose and value of its role. • To explain the PPGs in the context of the CCGs’ face to face engagement model and the resource available to support them. • To share details of the proposed new PPG area on the CCGs’ websites, the revised PPG Handbook, CCG Information (including links to useful videos) and seek suggestions as to content. • Share good practice between existing PPGs and identify potential gaps or areas for development. • Consider the use of buddying/mentors. The event was well received and a number of those present highlighted the importance of GP Partners and/or Practice Managers being involved in PPG meetings to hear the patient voice but to also provide information about the practice and local commissioning decisions.
Participants also asked that practices encourage involvement of PPGs as a way of making a difference and to add greater visibility of the Practice Improvement Plans.
A number of actions were agreed at the end of the workshop, which have been summarised below: • CCGs to establish the PPG area on the website and update resources following feedback received – including provision of a 'single point of access' email for PPGs to ask for practical and technical support • The CCGs to support all practices to get a standardised Facebook page through the Membership Agreement, which will link with the PPG as a two- way communication platform • A paper to be taken to the Primary Care Commissioning Committee to highlight the importance and benefits of having a PPG and to garner wider support • A paper to be taken to the locality Membership Boards to communicate and promote the value of PPGs to member practices
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Recommendation
The PCCC is asked to:
1) Support the development of PPGs across South Staffordshire via Locality and Membership Boards
2) Clarify the position in regard to the support on offer via the Primary Care Team in relation to the development of Facebook within practices and PPGs
3) Note the progress being provided to PPGs from the Communications and Engagement Team namely:
a. Development of the website to include access to resources and an interactive facility for PPGs b. Introduction of a single point of contact for patients to receive information and technical support for the setting up of or development of a face to face or virtual PPG c. Encourage the development of a mentor scheme
Sue Harper Lay Member for PPI Stafford and Surrounds Chair of the Joint Communications and Engagement Committee
21.5.18
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Item: 10 Enc: 07
Cannock Chase Clinical Commissioning Group South East Staffordshire and Seisdon Peninsula Clinical Commissioning Group Stafford and Surrounds Clinical Commissioning Group
The healthiest place to live and work, by 2025
REPORT TO: Primary Care Commissioning Committees Meeting in Common
TO BE HELD ON: 30 May 2018
Subject: 3600 Stakeholder Survey Board Lead: Lynn Millar, Director of Primary Care and Medicines Optimisation Officer Lead: Anna Collins, Head of Communications and Engagement Approval/ Recommendation: Assurance Discussion Information Ratification
PURPOSE OF THE REPORT: To provide members with the results of the CCG 3600 Stakeholder Survey.
The CCG 360o Stakeholder Survey enables stakeholders to provide feedback about their CCGs. The results of the survey serve two purposes: 1. To provide data for CCGs to help with their ongoing organisational development, supporting them to build strong and productive relationships with stakeholders. The findings can provide a tool for all CCGs to evaluate their progress, and inform the way that they work and make decisions. 2. To help NHS England to assess CCGs’ stakeholder relationships and leadership within their local health and care systems, and how effectively they commission services to improve service quality and health outcomes.
KEY POINTS: • It was the responsibility of each CCG to provide the list of stakeholders to invite to take part in the CCG 360° stakeholder survey. • CCGs were provided with a specification of core stakeholder organisations to be included in their stakeholder list. Beyond this, CCGs had the flexibility to determine which individual within each organisation was the most appropriate to nominate. • CCGs were also given the opportunity to add up to ten additional stakeholders they wanted to include locally. These could include: Commissioning Support Units, Health Education England, lower tier local authorities, MPs, private providers, Public Health England, local care homes, GP out-of-hours providers and others. • Stakeholders were sent an email inviting them to complete the survey online. Stakeholders who did not respond to the email invitation, and stakeholders for whom an email address was not provided, were telephoned by an Ipsos MORI interviewer who encouraged
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response and offered the opportunity to complete the survey by telephone. There were also follow up calls to some stakeholders by CCG/CSU staff, to request that they complete the survey and reminders in GP newsletters. • Within the survey, stakeholders were asked a series of questions about their working relationship with the CCG. In addition, to reflect each core stakeholder group’s different area of expertise and knowledge, they were presented with a short section of questions specific to the stakeholder group they represented. • Fieldwork was conducted between 15th January and 28th February 2018.
CCG GOALS: Change the culture: • Hospital to home n/a • Professional to patient More focus on prevention n/a Involving everyone for improved health and n/a care Empower and support patients to take control n/a of their own health Services supporting people to make informed n/a decisions
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IMPLICATIONS: Legal and/or Risk n/a CQC n/a Patient Safety n/a Patient Engagement n/a Financial n/a Sustainability n/a Workforce/Training n/a
RECOMMENDATIONS/ACTION REQUIRED: The Primary Care Commissioning Committees Meeting in Common is asked to:
Receive the report.
Not KEY REQUIREMENTS Yes No Applicable Has a quality impact assessment been undertaken? Has an equality impact assessment been undertaken? Has a privacy impact assessment been completed? Has a communications & engagement impact assessment been completed? Have partners/public been involved in design? Are partners/public involved in implementation? Are partners/public involved in evaluation?
CCG VALUES We are honest, accessible and listen
Care and respect for all
Quality is our day job
We innovate and deliver
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Summary Report covering Staffordshire and Stoke-on-Trent CCGs April 2018
Cannock Chase Clinical Commissioning Group North Staffordshire Clinical Commissioning Group Stafford and Surrounds Clinical Commissioning Group East Staffordshire Clinical Commissioning Group South East Staffordshire and Seisdon Peninsula Clinical Commissioning Group Stoke-on-Trent Clinical Commissioning Group 23/05/2018 1 Contents
Slide Numbers Background and Objectives of the Survey 3
Methodology 4
Response Rates 5 - 11
Combined Stakeholders’ Responses 12 - 18
GP Member Practices Responses 19 - 23
Last Year’s Action Plans 24 - 27
Appendix 1: Overall Summary Slides by CCG 28 - 40
Cannock Chase Clinical Commissioning Group North Staffordshire Clinical Commissioning Group Stafford and Surrounds Clinical Commissioning Group East Staffordshire Clinical Commissioning Group South East Staffordshire and Seisdon Peninsula Clinical Commissioning Group Stoke-on-Trent Clinical Commissioning Group 2 Background and Objectives of the Survey
Clinical Commissioning Groups (CCGs) need to have strong relationships with a range of stakeholders in order to be successful commissioners within their local health and care systems. These relationships provide CCGs with valuable intelligence to help them make the effective commissioning decisions for their local populations.
The CCG 360o Stakeholder Survey enables stakeholders to provide feedback about their CCGs. The results of the survey serve two purposes:
1. To provide data for CCGs to help with their ongoing organisational development, supporting them to build strong and productive relationships with stakeholders. The findings can provide a tool for all CCGs to evaluate their progress, and inform the way that they work and make decisions.
2. To help NHS England to assess CCGs’ stakeholder relationships and leadership within their local health and care systems, and how effectively they commission services to improve service quality and health outcomes.
Cannock Chase Clinical Commissioning Group North Staffordshire Clinical Commissioning Group Stafford and Surrounds Clinical Commissioning Group East Staffordshire Clinical Commissioning Group South East Staffordshire and Seisdon Peninsula Clinical Commissioning Group Stoke-on-Trent Clinical Commissioning Group 3 Methodology
• It was the responsibility of each CCG to provide the list of stakeholders to invite to take part in the CCG 360° stakeholder survey. • CCGs were provided with a specification of core stakeholder organisations to be included in their stakeholder list. Beyond this, CCGs had the flexibility to determine which individual within each organisation was the most appropriate to nominate. • CCGs were also given the opportunity to add up to ten additional stakeholders they wanted to include locally. These could include: Commissioning Support Units, Health Education England, lower tier local authorities, MPs, private providers, Public Health England, local care homes, GP out-of-hours providers and others. • Stakeholders were sent an email inviting them to complete the survey online. Stakeholders who did not respond to the email invitation, and stakeholders for whom an email address was not provided, were telephoned by an Ipsos MORI interviewer who encouraged response and offered the opportunity to complete the survey by telephone. There were also follow up calls to some stakeholders by CCG/CSU staff, to request that they complete the survey and reminders in GP newsletters. • Within the survey, stakeholders were asked a series of questions about their working relationship with the CCG. In addition, to reflect each core stakeholder group’s different area of expertise and knowledge, they were presented with a short section of questions specific to the stakeholder group they represented. • Fieldwork was conducted between 15th January and 28th February 2018.
Cannock Chase Clinical Commissioning Group North Staffordshire Clinical Commissioning Group Stafford and Surrounds Clinical Commissioning Group East Staffordshire Clinical Commissioning Group South East Staffordshire and Seisdon Peninsula Clinical Commissioning Group Stoke-on-Trent Clinical Commissioning Group 4 Response Rates
• The response rates for each CCG across all stakeholders are shown on the following six slides
Cannock Chase Clinical Commissioning Group North Staffordshire Clinical Commissioning Group Stafford and Surrounds Clinical Commissioning Group East Staffordshire Clinical Commissioning Group South East Staffordshire and Seisdon Peninsula Clinical Commissioning Group Stoke-on-Trent Clinical Commissioning Group 5 Response Rates – North Staffordshire
29 of the CCG’s stakeholders completed the survey. The overall response rate was 49%.
Cannock Chase Clinical Commissioning Group North Staffordshire Clinical Commissioning Group Stafford and Surrounds Clinical Commissioning Group East Staffordshire Clinical Commissioning Group South East Staffordshire and Seisdon Peninsula Clinical Commissioning Group Stoke-on-Trent Clinical Commissioning Group 6 Response Rates – Stoke-on-Trent
39 of the CCG’s stakeholders completed the survey. The overall response rate was 57%.
Cannock Chase Clinical Commissioning Group North Staffordshire Clinical Commissioning Group Stafford and Surrounds Clinical Commissioning Group East Staffordshire Clinical Commissioning Group South East Staffordshire and Seisdon Peninsula Clinical Commissioning Group Stoke-on-Trent Clinical Commissioning Group 7 Response Rates – Cannock Chase
29 of the CCG’s stakeholders completed the survey. The overall response rate was 43%.
Cannock Chase Clinical Commissioning Group North Staffordshire Clinical Commissioning Group Stafford and Surrounds Clinical Commissioning Group East Staffordshire Clinical Commissioning Group South East Staffordshire and Seisdon Peninsula Clinical Commissioning Group Stoke-on-Trent Clinical Commissioning Group 8 Response Rates – Stafford & Surrounds
32 of the CCG’s stakeholders completed the survey. The overall response rate was 56%.
Cannock Chase Clinical Commissioning Group North Staffordshire Clinical Commissioning Group Stafford and Surrounds Clinical Commissioning Group East Staffordshire Clinical Commissioning Group South East Staffordshire and Seisdon Peninsula Clinical Commissioning Group Stoke-on-Trent Clinical Commissioning Group 9 Response Rates – South East Staffs & Seisdon Peninsula
34 of the CCG’s stakeholders completed the survey. The overall response rate was 47%.
Cannock Chase Clinical Commissioning Group North Staffordshire Clinical Commissioning Group Stafford and Surrounds Clinical Commissioning Group East Staffordshire Clinical Commissioning Group South East Staffordshire and Seisdon Peninsula Clinical Commissioning Group Stoke-on-Trent Clinical Commissioning Group 10 Response Rates – East Staffordshire
22 of the CCG’s stakeholders completed the survey. The overall response rate was 55%.
Cannock Chase Clinical Commissioning Group North Staffordshire Clinical Commissioning Group Stafford and Surrounds Clinical Commissioning Group East Staffordshire Clinical Commissioning Group South East Staffordshire and Seisdon Peninsula Clinical Commissioning Group Stoke-on-Trent Clinical Commissioning Group 11 Combined Stakeholders’ Responses
• There were 22 questions which were common to all stakeholders
• The responses to the first of those questions around the views on the effectiveness of the working relationship with each CCG are shown on the following six slides
• The summary findings for each of the CCGs for the questions asked of all stakeholders can be found at Appendix 1 of this report
Cannock Chase Clinical Commissioning Group North Staffordshire Clinical Commissioning Group Stafford and Surrounds Clinical Commissioning Group East Staffordshire Clinical Commissioning Group South East Staffordshire and Seisdon Peninsula Clinical Commissioning Group Stoke-on-Trent Clinical Commissioning Group 12 North Staffordshire
Cannock Chase Clinical Commissioning Group North Staffordshire Clinical Commissioning Group Stafford and Surrounds Clinical Commissioning Group East Staffordshire Clinical Commissioning Group South East Staffordshire and Seisdon Peninsula Clinical Commissioning Group Stoke-on-Trent Clinical Commissioning Group 13 Stoke-on-Trent
Cannock Chase Clinical Commissioning Group North Staffordshire Clinical Commissioning Group Stafford and Surrounds Clinical Commissioning Group East Staffordshire Clinical Commissioning Group South East Staffordshire and Seisdon Peninsula Clinical Commissioning Group Stoke-on-Trent Clinical Commissioning Group 14 Cannock Chase
Cannock Chase Clinical Commissioning Group North Staffordshire Clinical Commissioning Group Stafford and Surrounds Clinical Commissioning Group East Staffordshire Clinical Commissioning Group South East Staffordshire and Seisdon Peninsula Clinical Commissioning Group Stoke-on-Trent Clinical Commissioning Group 15 Stafford & Surrounds
Cannock Chase Clinical Commissioning Group North Staffordshire Clinical Commissioning Group Stafford and Surrounds Clinical Commissioning Group East Staffordshire Clinical Commissioning Group South East Staffordshire and Seisdon Peninsula Clinical Commissioning Group Stoke-on-Trent Clinical Commissioning Group 16 South East Staffs & Seisdon Peninsula
Cannock Chase Clinical Commissioning Group North Staffordshire Clinical Commissioning Group Stafford and Surrounds Clinical Commissioning Group East Staffordshire Clinical Commissioning Group South East Staffordshire and Seisdon Peninsula Clinical Commissioning Group Stoke-on-Trent Clinical Commissioning Group 17 East Staffordshire
Cannock Chase Clinical Commissioning Group North Staffordshire Clinical Commissioning Group Stafford and Surrounds Clinical Commissioning Group East Staffordshire Clinical Commissioning Group South East Staffordshire and Seisdon Peninsula Clinical Commissioning Group Stoke-on-Trent Clinical Commissioning Group 18 GP Member Practices Responses
• The table on the following slide sets out the responses to the 11 questions asked of GP member practices • Where the same question was asked in 2017, that score is also shown
Cannock Chase Clinical Commissioning Group North Staffordshire Clinical Commissioning Group Stafford and Surrounds Clinical Commissioning Group East Staffordshire Clinical Commissioning Group South East Staffordshire and Seisdon Peninsula Clinical Commissioning Group Stoke-on-Trent Clinical Commissioning Group 19 Responses from GP Member Practices
North Staffs % Stoke-on-Trent Cannock SAS SESP East Question Posed Positive Indication % % % % % 2018 2017 2018 2017 2018 2017 2018 2017 2018 2017 2018 2017 To what extent, if at all, do you feel able to A great deal / Fair amount influence the CCG’s decision-making process? 12 6 33 34 21 62 38 31 29 26 43 77 Red = Scores of less
I have confidence in the clinical leadership of the Strongly / Tend to agree than 60% and any CCG 47 50 63 66 64 69 77 62 47 52 79 85 There is clear and visible clinical leadership of Strongly / Tend to agree scores that are lower the CCG 53 67 71 92 53 79 than the score for the The clinical leadership of my CCG has effective Strongly / Tend to agree influence within local partnerships 41 50 57 54 41 71 same question last (STPs/ACSs/other)
Understanding of the financial implications of the Very / Fairly well year CCG’s plans 47 61 54 62 43 69 85 54 59 52 71 69 Understanding of the implications of the CCG’s Very / Fairly well plans for service improvement 35 50 50 52 43 77 77 38 65 39 71 85 Amber = Scores of Understanding of the referral and activity Very / Fairly well implications of the CCG’s plans 41 50 46 69 57 92 85 62 65 48 71 85 more than 60% but The CCG’s plans to improve the health of the lower than for the local population and reduce health inequalities Very / Fairly well 41 58 57 54 71 71 same question in 2017 To what extent do you agree or disagree that value for money is a key factor in decision making when formulating my CCG’s plans and Strongly / Tend to agree 65 72 79 83 79 92 100 77 76 61 79 92 priorities? Green = Scores of How familiar are you, if at all, with the financial Very / Fairly familiar 60% or above, except position of your CCG? 71 67 88 69 36 85 100 100 82 74 71 69 To what extent do you agree or disagree that Strongly / Tend to agree for those worse than representatives from member practices are able to take a leadership role within the CCG if they 71 56 58 72 86 69 85 77 71 74 86 85 last year’s score want to?
Cannock Chase Clinical Commissioning Group North Staffordshire Clinical Commissioning Group Stafford and Surrounds Clinical Commissioning Group East Staffordshire Clinical Commissioning Group South East Staffordshire and Seisdon Peninsula Clinical Commissioning Group Stoke-on-Trent Clinical Commissioning Group 20 Areas of weakness
Areas of weakness identified in the responses given by GP Member Practices suggest that improved communication and engagement is required in the following areas:
• Feeling unable to influence the CCG’s decision-making process • Lack of confidence that the clinical leadership of their CCG has effective influence within local partnerships (STPs/ACSs/other) • Lack of confidence in the CCG’s plans to improve the health of the local population and reduce health inequalities • Poor understanding of the financial implications of the CCG’s plans • Poor understanding of the implications of the CCG’s plans for service improvement • Poor understanding of the referral and activity implications of the CCG’s plans
Cannock Chase Clinical Commissioning Group North Staffordshire Clinical Commissioning Group Stafford and Surrounds Clinical Commissioning Group East Staffordshire Clinical Commissioning Group South East Staffordshire and Seisdon Peninsula Clinical Commissioning Group Stoke-on-Trent Clinical Commissioning Group 21 Comments re CCG Governance / Hearing Voice of Member Practices / Leadership Role
Member practices were asked to provide suggestions for how the CCG could strengthen its governance systems and ability to hear the voice of the member practices, including opportunities for representatives from practices to take more of a leadership role in the CCG.
The main themes of responses to that question were as follows:
• Amount of time needed for a GP to take up leadership roles in the CCG / some concerns that those GPs in leadership roles are not always having an impact
• CCG listens when the views expressed back up what it wants to do, but GPs can’t influence strategic direction
• GPs aren’t involved earlier enough in decision making process
• Lack of openness on the part of the CCG
• CCG should hold more practice meetings
Cannock Chase Clinical Commissioning Group North Staffordshire Clinical Commissioning Group Stafford and Surrounds Clinical Commissioning Group East Staffordshire Clinical Commissioning Group South East Staffordshire and Seisdon Peninsula Clinical Commissioning Group Stoke-on-Trent Clinical Commissioning Group 22 Themes from GP Member Practice Comments
The major themes coming from other verbatim comments which appear to be attributable to GPs are similar:
• Grassroots GPs are not being involved in potential changes and their views are not taken into account (from all 6 CCGs)
• GPs not being involved at an early enough stage (from all CCGs except for Stafford and East)
• The CCGs don’t seem to appreciate the pressures on GPs and General Practice or take it into account when making decisions (All CCGs except Cannock and North Staffs)
• Lack of openness on the part of the CCGs (Cannock and North Staffs)
Cannock Chase Clinical Commissioning Group North Staffordshire Clinical Commissioning Group Stafford and Surrounds Clinical Commissioning Group East Staffordshire Clinical Commissioning Group South East Staffordshire and Seisdon Peninsula Clinical Commissioning Group Stoke-on-Trent Clinical Commissioning Group 23 Action Plans from 2017
In response to last year’s survey, the following action was taken:
• North – it was decided to focus on the GP Membership and the action plan to address this is shown on slide 24 • South – the Primary Care Team produced a summary report on the survey findings, which contained actions which are shown on slides 25-26 • East – no plan was created last year as ESCCG’s scores for all of the questions posed in the national survey were better than those achieved for the national average, CCG cluster and their DCO, instead there was a drive to improve the response rates by focusing on the initial recruitment/selection of stakeholders and the following up during the fieldwork window with targeted communications
Cannock Chase Clinical Commissioning Group North Staffordshire Clinical Commissioning Group Stafford and Surrounds Clinical Commissioning Group East Staffordshire Clinical Commissioning Group South East Staffordshire and Seisdon Peninsula Clinical Commissioning Group Stoke-on-Trent Clinical Commissioning Group 24 North’s Action Plan for 2017
Communications Media Relations Generate pro-active press releases to Comms & Engagement celebrate and share best practice Social Media Generate content to share with Practice Comms & Engagement Facebook accounts and websites
Newsletter Review readership, reach, relevance and Comms & Engagement frequency Intranet Review GPP intranet to meet their needs Comms & Engagement / Primary Care
Committee Highlight Reports, agendas, Send summary from Primary Care Delivery Primary Care / Admin minutes and actions Group, Primary Care Commissioning Committee and Joint Planning Committee to locality leads
Engagement Practice Manager Groups Provide briefings and updates and listen Primary Care and act upon their concerns Members Events To be held bi-annually – agenda shaped Comms & Engagement / Primary Care / based on key messages Execs Localities Meetings Provide briefings and updates and listen Execs Wednesday lunchtimes to be kept free to and act upon their concerns enable this to happen Bi-Annual Visit to each practice To discuss commissioning, finance, plans Meds OP conduct annual visits and to listen Primary Care Quality Visits GP Forward View Comms Plan being developed with NHS E Comms & Engagement Delivery Plans, 10 high impact actions to roll out across system. Comms NHS E National PMO & Comms teams and the difference they will make. guide/toolkit in development. Workshops, theme per month videos etc being prepared.
STP Clinical engagement Dr John James is interim lead. New substantive Primary Care lead to be appointed. Clinical Leaders group to disseminate info and engage with Primary Care
Cannock Chase Clinical Commissioning Group North Staffordshire Clinical Commissioning Group Stafford and Surrounds Clinical Commissioning Group East Staffordshire Clinical Commissioning Group South East Staffordshire and Seisdon Peninsula Clinical Commissioning Group Stoke-on-Trent Clinical Commissioning Group 25 South CCGs 2017 Actions (1)
The following actions were contained within the South’s Primary Care Team’s summary report of the 2017 survey:
• Work will continue in prior to the 2018 survey to continue and improve the uptake for the 2018 survey. This will be through a reminder at practice quality visits, which was felt to be a successful mechanism at SaS CCG for the 2017 survey and the result support this, and engagement with practices prior to the survey deadlines. • Most member practices felt engaged by the CCG in the 12 month period from January 2016 to January 2017. The results for Stafford and Surrounds CCG showed a higher level of engagement than that of Cannock and SESSP. A lower percentage of practices however felt satisfied with the way in which the CCG engages and this needs to be an area of focus in the coming twelve months. • In terms of quality practices feel able to raise quality concerns with the CCG. Further work needs to be undertaken in order to address the confidence they have in the CCG acting on feedback and there may be an opportunity to learn from processes in Cannock where practices felt that their concerns were acted upon. The quality team are already working on a soft intelligence report to be presented to Locality and Membership Boards so that practices are aware of what actions are being taken as a result of their information. Cont’d….
Cannock Chase Clinical Commissioning Group North Staffordshire Clinical Commissioning Group Stafford and Surrounds Clinical Commissioning Group East Staffordshire Clinical Commissioning Group South East Staffordshire and Seisdon Peninsula Clinical Commissioning Group Stoke-on-Trent Clinical Commissioning Group 26 South CCGs 2017 Actions (2)
…Cont’d • Practices in both Cannock and Stafford felt they knew the CCGs plans and priorities. A slightly less positive result can be found for SES&SP CCG. There is opportunity for member practices to influence and comment on the CCGs plans and priorities in this financial year. The CCG also needs to focus on ensuring that practices in SES&SP feel that plans and priorities have been effectively communicated to them. This could be through practice visits, necessary officers communicating plans at Locality Boards and also through direct communication to practices.
• There are varying results by CCG with a focus needing to be taken around how we feed back to practices about how the CCG acted upon information provided by patients and the public. The results in SES&SP CCG are significantly lower than Cannock and Stafford and this needs to be understood further. Ensuring that information on engagement is shared with the membership may help to increase the percentages.
• In Cannock practices understand the CCGs plans to improve the health of the local population however further work needs to be undertaken in both SES&SP and Stafford around this agenda.
• It is really positive that practices feel that they are able to take a leadership role within the CCG and the CCG is keen to develop this further to ensure further clinical engagement with the organisation.
Cannock Chase Clinical Commissioning Group North Staffordshire Clinical Commissioning Group Stafford and Surrounds Clinical Commissioning Group East Staffordshire Clinical Commissioning Group South East Staffordshire and Seisdon Peninsula Clinical Commissioning Group Stoke-on-Trent Clinical Commissioning Group 27
Appendix 1 - Overall Summary Slides
• On the following pages are the overall summary slides for each of the CCGs • These show the results at CCG level for the questions asked of all stakeholders - including the direction of travel comparisons where available
Cannock Chase Clinical Commissioning Group North Staffordshire Clinical Commissioning Group Stafford and Surrounds Clinical Commissioning Group East Staffordshire Clinical Commissioning Group South East Staffordshire and Seisdon Peninsula Clinical Commissioning Group Stoke-on-Trent Clinical Commissioning Group 28 Summary This report presents the results from North Staffordshire CCG’s 360° Stakeholder Survey 2017-18. The annual CCG 360° Stakeholder Survey, which North has been conducted online and by telephone since 2014, allows a range of key stakeholders to provide feedback on working relationships with Staffs (1) their CCG. The results are used to support CCGs’ ongoing development and feed into improvement and assessment conversations with NHS England.
The following chart presents the summary findings across the CCG for the questions asked of all stakeholders. This provides the percentage of stakeholders responding positively to the key questions, including year-on-year comparisons where the question was also asked in 2017 and 2016.
Base = all stakeholders except CQC (2018; 29, 2017; 30, 2016; 47) unless otherwise stated Overall Engagement 2018 2017 2016
Overall, how would you rate the effectiveness of your working relationship with the CCG? 69% 50% 70%
% very/fairly good How satisfied or dissatisfied are you with how the CCG involves patients and the public?* 45% - -
% very/fairly satisfied
Commissioning services 2018 2017 2016
The CCG involves the right individuals and organisations when commissioning/decommissioning 45% 50% 55% services % strongly/tend to agree
The CCG provides adequate information to explain the reasons for the decisions it makes when 48% - - commissioning/decommissioning services % strongly/tend to agree
I have confidence the CCG’s plans will deliver high quality services that demonstrate value for money 52% - - % strongly/tend to agree
I have confidence in the CCG to commission/decommission services appropriately 45% - -
% strongly/tend to agree
The CCG demonstrates it has considered the views of patients and the public when making commissioning decisions* 48% - - % strongly/tend to agree
North Staffordshire CCG *Base = all stakeholders (2018; 29, 2017; 30, 2016; 47)
CCG 360 Stakeholder Survey 2018 - Report | April 2018 | Public Fieldwork: 15th January - 28th February 29 Summary cont. Leadership of the CCG 2018 2017 2016
How effective, if at all, do you feel your CCG is as a local system leader? 62% 70% 53% North % very/fairly effective Staffs (2) The leadership of the CCG has the necessary blend of skills and experience* 34% 60% 62% % strongly/tend to agree There is clear and visible leadership of the CCG* 48% 63% 64% % strongly/tend to agree I have confidence in the leadership of the CCG to deliver its plans and priorities* 45% 50% 57% % strongly/tend to agree
The leadership of CCG is delivering high quality services within the available resources* 45% - - % strongly/tend to agree I have confidence in the leadership of the CCG to deliver improved outcomes for patients* 45% 47% 49% % strongly/tend to agree The leadership of the CCG is contributing effectively to local partnership arrangements (including Sustainability Transformation Partnerships (STPs), Accountable Care Systems (ACSs) where 55% - - applicable and/or other local partnership arrangements)* % strongly/tend to agree Monitoring and reviewing services 2018 2017 2016
I have confidence that the CCG monitors the quality of the services it commissions in an 52% 77% 64% effective manner % strongly/tend to agree If I had concerns about the quality of local services I would feel able to raise my concerns within 76% 73% 83% the CCG % strongly/tend to agree I have confidence in the CCG to act on feedback it receives about the quality of services 59% 50% 66% % strongly/tend to agree Plans and priorities 2018 2017 2016
69% 70% 62% How much would you say you know about the CCG’s plans and priorities? % a great deal/fair amount
I have been given the opportunity to influence the CCG’s plans and priorities 34% 33% 49% % strongly/tend to agree
When I have commented on the CCG’s plans and priorities I feel that my comments have been 38% 43% 43% considered (even if the CCG has not been able to act on them) % strongly/tend to agree
The CCG has effectively communicated its plans and priorities to me 45% 53% 53% % strongly/tend to agree
North Staffordshire CCG Base = all stakeholders except CQC (2018; 29, 2017; 30, 2016; 47) unless otherwise stated
CCG 360 Stakeholder Survey 2018 - Report | April 2018 | Public Fieldwork: 15th January - 28th February 30 Summary
This report presents the results from Stoke on Trent CCG’s 360° Stakeholder Survey 2017-18. The annual CCG 360° Stakeholder Survey, which has Stoke- been conducted online and by telephone since 2014, allows a range of key stakeholders to provide feedback on working relationships with their on-Trent CCG. The results are used to support CCGs’ ongoing development and feed into improvement and assessment conversations with NHS England.
(1) The following chart presents the summary findings across the CCG for the questions asked of all stakeholders. This provides the percentage of stakeholders responding positively to the key questions, including year-on-year comparisons where the question was also asked in 2017 and 2016.
Base = all stakeholders except CQC (2018; 39, 2017; 42, 2016; 35) unless otherwise stated Overall Engagement 2018 2017 2016
Overall, how would you rate the effectiveness of your working relationship with the CCG? 67% 71% 80%
% very/fairly good How satisfied or dissatisfied are you with how the CCG involves patients and the public?* 56% - -
% very/fairly satisfied
Commissioning services 2018 2017 2016
The CCG involves the right individuals and organisations when commissioning/decommissioning 31% 64% 46% services % strongly/tend to agree
The CCG provides adequate information to explain the reasons for the decisions it makes when 41% - - commissioning/decommissioning services % strongly/tend to agree
I have confidence the CCG’s plans will deliver high quality services that demonstrate value for money 49% - - % strongly/tend to agree
I have confidence in the CCG to commission/decommission services appropriately 44% - -
% strongly/tend to agree
The CCG demonstrates it has considered the views of patients and the public when making commissioning decisions* 38% - - % strongly/tend to agree
Stoke on Trent CCG *Base = all stakeholders (2018; 39, 2017; 42, 2016; 35)
CCG 360 Stakeholder Survey 2018 - Report | April 2018 | Public Fieldwork: 15th January - 28th February 31 Summary cont. Leadership of the CCG 2018 2017 2016
How effective, if at all, do you feel your CCG is as a local system leader? 62% 69% 74% % very/fairly effective The leadership of the CCG has the necessary blend of skills and experience* 46% 64% 60% Stoke- % strongly/tend to agree on-Trent There is clear and visible leadership of the CCG* 51% 62% 66% % strongly/tend to agree (2) I have confidence in the leadership of the CCG to deliver its plans and priorities* 46% 57% 60% % strongly/tend to agree
The leadership of CCG is delivering high quality services within the available resources* 51% - - % strongly/tend to agree I have confidence in the leadership of the CCG to deliver improved outcomes for patients* 46% 50% 54% % strongly/tend to agree The leadership of the CCG is contributing effectively to local partnership arrangements (including Sustainability Transformation Partnerships (STPs), Accountable Care Systems (ACSs) where 44% - - applicable and/or other local partnership arrangements)* % strongly/tend to agree Monitoring and reviewing services 2018 2017 2016
I have confidence that the CCG monitors the quality of the services it commissions in an 49% 62% 57% effective manner % strongly/tend to agree If I had concerns about the quality of local services I would feel able to raise my concerns within 72% 74% 83% the CCG % strongly/tend to agree I have confidence in the CCG to act on feedback it receives about the quality of services 38% 64% 63% % strongly/tend to agree Plans and priorities 2018 2017 2016
74% 67% 77% How much would you say you know about the CCG’s plans and priorities? % a great deal/fair amount
I have been given the opportunity to influence the CCG’s plans and priorities 51% 52% 49% % strongly/tend to agree
When I have commented on the CCG’s plans and priorities I feel that my comments have been 41% 43% 51% considered (even if the CCG has not been able to act on them) % strongly/tend to agree
The CCG has effectively communicated its plans and priorities to me 51% 57% 51% % strongly/tend to agree
Stoke on Trent CCG Base = all stakeholders except CQC (2018; 39, 2017; 42, 2016; 35) unless otherwise stated
CCG 360 Stakeholder Survey 2018 - Report | April 2018 | Public Fieldwork: 15th January - 28th February 32 Summary
This report presents the results from Cannock Chase CCG’s 360° Stakeholder Survey 2017-18. The annual CCG 360° Stakeholder Survey, which has been conducted online and by telephone since 2014, allows a range of key stakeholders to provide feedback on working relationships with their CCG. The results are used to support CCGs’ ongoing development and feed into improvement and assessment conversations with NHS England.
Cannock The following chart presents the summary findings across the CCG for the questions asked of all stakeholders. This provides the percentage of Chase (1) stakeholders responding positively to the key questions, including year-on-year comparisons where the question was also asked in 2017 and 2016.
Base = all stakeholders except CQC (2018; 29, 2017; 31, 2016; 35) unless otherwise stated Overall Engagement 2018 2017 2016
Overall, how would you rate the effectiveness of your working relationship with the CCG? 72% 74% 80%
% very/fairly good How satisfied or dissatisfied are you with how the CCG involves patients and the public?* 55% - -
% very/fairly satisfied
Commissioning services 2018 2017 2016
The CCG involves the right individuals and organisations when commissioning/decommissioning 41% 45% 60% services % strongly/tend to agree
The CCG provides adequate information to explain the reasons for the decisions it makes when 52% - - commissioning/decommissioning services % strongly/tend to agree
I have confidence the CCG’s plans will deliver high quality services that demonstrate value for money 48% - - % strongly/tend to agree
I have confidence in the CCG to commission/decommission services appropriately 48% - -
% strongly/tend to agree
The CCG demonstrates it has considered the views of patients and the public when making commissioning decisions* 52% - - % strongly/tend to agree
Cannock Chase CCG *Base = all stakeholders (2018; 29, 2017; 31, 2016; 35)
CCG 360 Stakeholder Survey 2018 - Report | April 2018 | Public Fieldwork: 15th January - 28th February 33 Summary cont. Leadership of the CCG 2018 2017 2016
How effective, if at all, do you feel your CCG is as a local system leader? 69% 74% 74% % very/fairly effective The leadership of the CCG has the necessary blend of skills and experience* 55% 68% 69% Cannock % strongly/tend to agree There is clear and visible leadership of the CCG* 52% 74% 71% Chase (2) % strongly/tend to agree I have confidence in the leadership of the CCG to deliver its plans and priorities* 48% 58% 66% % strongly/tend to agree
The leadership of CCG is delivering high quality services within the available resources* 52% - - % strongly/tend to agree I have confidence in the leadership of the CCG to deliver improved outcomes for patients* 59% 58% 54% % strongly/tend to agree The leadership of the CCG is contributing effectively to local partnership arrangements (including Sustainability Transformation Partnerships (STPs), Accountable Care Systems (ACSs) where 59% - - applicable and/or other local partnership arrangements)* % strongly/tend to agree Monitoring and reviewing services 2018 2017 2016
I have confidence that the CCG monitors the quality of the services it commissions in an 52% 65% 63% effective manner % strongly/tend to agree If I had concerns about the quality of local services I would feel able to raise my concerns within 83% 81% 74% the CCG % strongly/tend to agree I have confidence in the CCG to act on feedback it receives about the quality of services 59% 68% 66% % strongly/tend to agree Plans and priorities 2018 2017 2016
48% 65% 60% How much would you say you know about the CCG’s plans and priorities? % a great deal/fair amount
I have been given the opportunity to influence the CCG’s plans and priorities 34% 48% 51% % strongly/tend to agree
When I have commented on the CCG’s plans and priorities I feel that my comments have been 41% 58% 57% considered (even if the CCG has not been able to act on them) % strongly/tend to agree
The CCG has effectively communicated its plans and priorities to me 41% 61% 49% % strongly/tend to agree
Cannock Chase CCG Base = all stakeholders except CQC (2018; 29, 2017; 31, 2016; 35) unless otherwise stated
CCG 360 Stakeholder Survey 2018 - Report | April 2018 | Public Fieldwork: 15th January - 28th February 34 Summary This report presents the results from Stafford and Surrounds CCG’s 360° Stakeholder Survey 2017-18. The annual CCG 360° Stakeholder Survey, which has been conducted online and by telephone since 2014, allows a range of key stakeholders to provide feedback on working relationships with their CCG. The results are used to support CCGs’ ongoing development and feed into improvement and assessment conversations with NHS Stafford & England. Surrounds The following chart presents the summary findings across the CCG for the questions asked of all stakeholders. This provides the percentage of (1) stakeholders responding positively to the key questions, including year-on-year comparisons where the question was also asked in 2017 and 2016.
Base = all stakeholders except CQC (2018; 32, 2017; 31, 2016; 27) unless otherwise stated Overall Engagement 2018 2017 2016
Overall, how would you rate the effectiveness of your working relationship with the CCG? 81% 71% 67%
% very/fairly good How satisfied or dissatisfied are you with how the CCG involves patients and the public?* 66% - -
% very/fairly satisfied
Commissioning services 2018 2017 2016
The CCG involves the right individuals and organisations when commissioning/decommissioning 63% 55% 44% services % strongly/tend to agree
The CCG provides adequate information to explain the reasons for the decisions it makes when 63% - - commissioning/decommissioning services % strongly/tend to agree
I have confidence the CCG’s plans will deliver high quality services that demonstrate value for money 59% - - % strongly/tend to agree
I have confidence in the CCG to commission/decommission services appropriately 63% - -
% strongly/tend to agree
The CCG demonstrates it has considered the views of patients and the public when making commissioning decisions* 44% - - % strongly/tend to agree
Stafford and Surrounds CCG *Base = all stakeholders (2018; 32, 2017; 31, 2016; 27)
CCG 360 Stakeholder Survey 2018 - Report | April 2018 | Public Fieldwork: 15th January - 28th February 35 Summary cont. Leadership of the CCG 2018 2017 2016
How effective, if at all, do you feel your CCG is as a local system leader? 81% 74% 63% % very/fairly effective The leadership of the CCG has the necessary blend of skills and experience* 69% 74% 78% Stafford & % strongly/tend to agree Surrounds There is clear and visible leadership of the CCG* 72% 84% 85% (2) % strongly/tend to agree I have confidence in the leadership of the CCG to deliver its plans and priorities* 56% 61% 67% % strongly/tend to agree
The leadership of CCG is delivering high quality services within the available resources* 66% - - % strongly/tend to agree I have confidence in the leadership of the CCG to deliver improved outcomes for patients* 59% 48% 44% % strongly/tend to agree The leadership of the CCG is contributing effectively to local partnership arrangements (including Sustainability Transformation Partnerships (STPs), Accountable Care Systems (ACSs) where 66% - - applicable and/or other local partnership arrangements)* % strongly/tend to agree Monitoring and reviewing services 2018 2017 2016
I have confidence that the CCG monitors the quality of the services it commissions in an 66% 58% 48% effective manner % strongly/tend to agree If I had concerns about the quality of local services I would feel able to raise my concerns within 91% 87% 78% the CCG % strongly/tend to agree I have confidence in the CCG to act on feedback it receives about the quality of services 59% 61% 59% % strongly/tend to agree Plans and priorities 2018 2017 2016
78% 74% 63% How much would you say you know about the CCG’s plans and priorities? % a great deal/fair amount
I have been given the opportunity to influence the CCG’s plans and priorities 47% 45% 37% % strongly/tend to agree
When I have commented on the CCG’s plans and priorities I feel that my comments have been 66% 48% 41% considered (even if the CCG has not been able to act on them) % strongly/tend to agree
The CCG has effectively communicated its plans and priorities to me 66% 65% 41% % strongly/tend to agree
Stafford and Surrounds CCG Base = all stakeholders except CQC (2018; 32, 2017; 31, 2016; 27) unless otherwise stated
CCG 360 Stakeholder Survey 2018 - Report | April 2018 | Public Fieldwork: 15th January - 28th February 36 Summary This report presents the results from South East Staffordshire and Seisdon Peninsula CCG’s 360° Stakeholder Survey 2017-18. The annual CCG 360° Stakeholder Survey, which has been conducted online and by telephone since 2014, allows a range of key stakeholders to provide feedback on working relationships with their CCG. The results are used to support CCGs’ ongoing development and feed into improvement and assessment South conversations with NHS England. East The following chart presents the summary findings across the CCG for the questions asked of all stakeholders. This provides the percentage of Staffs stakeholders responding positively to the key questions, including year-on-year comparisons where the question was also asked in 2017 and 2016. (1) Base = all stakeholders except CQC (2018; 34, 2017; 35, 2016; 34) unless otherwise stated Overall Engagement 2018 2017 2016
Overall, how would you rate the effectiveness of your working relationship with the CCG? 85% 77% 76%
% very/fairly good How satisfied or dissatisfied are you with how the CCG involves patients and the public?* 68% - -
% very/fairly satisfied
Commissioning services 2018 2017 2016
The CCG involves the right individuals and organisations when commissioning/decommissioning 50% 54% 56% services % strongly/tend to agree
The CCG provides adequate information to explain the reasons for the decisions it makes when 41% - - commissioning/decommissioning services % strongly/tend to agree
I have confidence the CCG’s plans will deliver high quality services that demonstrate value for money 56% - - % strongly/tend to agree
I have confidence in the CCG to commission/decommission services appropriately 59% - -
% strongly/tend to agree
The CCG demonstrates it has considered the views of patients and the public when making commissioning decisions* 50% - - % strongly/tend to agree
South East Staffordshire and Seisdon Peninsula CCG *Base = all stakeholders (2018; 34, 2017; 35, 2016; 34)
CCG 360 Stakeholder Survey 2018 - Report | April 2018 | Public Fieldwork: 15th January - 28th February 37 Summary cont. Leadership of the CCG 2018 2017 2016
How effective, if at all, do you feel your CCG is as a local system leader? 62% 66% 65% % very/fairly effective South East The leadership of the CCG has the necessary blend of skills and experience* 47% 63% 68% % strongly/tend to agree Staffs (2) There is clear and visible leadership of the CCG* 53% 57% 74% % strongly/tend to agree I have confidence in the leadership of the CCG to deliver its plans and priorities* 59% 63% 68% % strongly/tend to agree
The leadership of CCG is delivering high quality services within the available resources* 50% - - % strongly/tend to agree I have confidence in the leadership of the CCG to deliver improved outcomes for patients* 50% 54% 68% % strongly/tend to agree The leadership of the CCG is contributing effectively to local partnership arrangements (including Sustainability Transformation Partnerships (STPs), Accountable Care Systems (ACSs) where 47% - - applicable and/or other local partnership arrangements)* % strongly/tend to agree Monitoring and reviewing services 2018 2017 2016
I have confidence that the CCG monitors the quality of the services it commissions in an 71% 60% 68% effective manner % strongly/tend to agree If I had concerns about the quality of local services I would feel able to raise my concerns within 91% 89% 88% the CCG % strongly/tend to agree I have confidence in the CCG to act on feedback it receives about the quality of services 71% 69% 76% % strongly/tend to agree Plans and priorities 2018 2017 2016
65% 66% 79% How much would you say you know about the CCG’s plans and priorities? % a great deal/fair amount
I have been given the opportunity to influence the CCG’s plans and priorities 44% 51% 68% % strongly/tend to agree
When I have commented on the CCG’s plans and priorities I feel that my comments have been 56% 49% 65% considered (even if the CCG has not been able to act on them) % strongly/tend to agree
The CCG has effectively communicated its plans and priorities to me 44% 51% 56% % strongly/tend to agree
South East Staffordshire and Seisdon Peninsula CCG Base = all stakeholders except CQC (2018; 34, 2017; 35, 2016; 34) unless otherwise stated
CCG 360 Stakeholder Survey 2018 - Report | April 2018 | Public Fieldwork: 15th January - 28th February 38 Summary This report presents the results from East Staffordshire CCG’s 360° Stakeholder Survey 2017-18. The annual CCG 360° Stakeholder Survey, which has been conducted online and by telephone since 2014, allows a range of key stakeholders to provide feedback on working relationships with East their CCG. The results are used to support CCGs’ ongoing development and feed into improvement and assessment conversations with NHS Staffs (1) England.
The following chart presents the summary findings across the CCG for the questions asked of all stakeholders. This provides the percentage of stakeholders responding positively to the key questions, including year-on-year comparisons where the question was also asked in 2017 and 2016.
Base = all stakeholders except CQC (2018; 22, 2017; 20, 2016; 33) unless otherwise stated Overall Engagement 2018 2017 2016
Overall, how would you rate the effectiveness of your working relationship with the CCG? 64% 85% 82%
% very/fairly good How satisfied or dissatisfied are you with how the CCG involves patients and the public?* 73% - -
% very/fairly satisfied
Commissioning services 2018 2017 2016
The CCG involves the right individuals and organisations when commissioning/decommissioning 68% 80% 61% services % strongly/tend to agree
The CCG provides adequate information to explain the reasons for the decisions it makes when 68% - - commissioning/decommissioning services % strongly/tend to agree
I have confidence the CCG’s plans will deliver high quality services that demonstrate value for money 68% - - % strongly/tend to agree
I have confidence in the CCG to commission/decommission services appropriately 68% - -
% strongly/tend to agree
The CCG demonstrates it has considered the views of patients and the public when making commissioning decisions* 68% - - % strongly/tend to agree
East Staffordshire CCG *Base = all stakeholders (2018; 22, 2017; 20, 2016; 33)
CCG 360 Stakeholder Survey 2018 - Report | April 2018 | Public Fieldwork: 15th January - 28th February 39 Summary cont. Leadership of the CCG 2018 2017 2016
How effective, if at all, do you feel your CCG is as a local system leader? 73% 85% 76% % very/fairly effective The leadership of the CCG has the necessary blend of skills and experience* 64% 85% 73% East Staffs % strongly/tend to agree There is clear and visible leadership of the CCG* 68% 80% 85% (2) % strongly/tend to agree I have confidence in the leadership of the CCG to deliver its plans and priorities* 68% 75% 76% % strongly/tend to agree
The leadership of CCG is delivering high quality services within the available resources* 68% - - % strongly/tend to agree I have confidence in the leadership of the CCG to deliver improved outcomes for patients* 68% 75% 70% % strongly/tend to agree The leadership of the CCG is contributing effectively to local partnership arrangements (including Sustainability Transformation Partnerships (STPs), Accountable Care Systems (ACSs) where 73% - - applicable and/or other local partnership arrangements)* % strongly/tend to agree Monitoring and reviewing services 2018 2017 2016
I have confidence that the CCG monitors the quality of the services it commissions in an 82% 85% 64% effective manner % strongly/tend to agree If I had concerns about the quality of local services I would feel able to raise my concerns within 86% 100% 85% the CCG % strongly/tend to agree I have confidence in the CCG to act on feedback it receives about the quality of services 73% 90% 73% % strongly/tend to agree Plans and priorities 2018 2017 2016
64% 85% 82% How much would you say you know about the CCG’s plans and priorities? % a great deal/fair amount
I have been given the opportunity to influence the CCG’s plans and priorities 41% 80% 61% % strongly/tend to agree
When I have commented on the CCG’s plans and priorities I feel that my comments have been 64% 70% 61% considered (even if the CCG has not been able to act on them) % strongly/tend to agree
The CCG has effectively communicated its plans and priorities to me 55% 75% 76% % strongly/tend to agree
East Staffordshire CCG Base = all stakeholders except CQC (2018; 22, 2017; 20, 2016; 33) unless otherwise stated
CCG 360 Stakeholder Survey 2018 - Report | April 2018 | Public Fieldwork: 15th January - 28th February 40
Item: 11 Enc: 08 Leads of Primary Care- National Update May 2018
MEDICAL
1 Sensitive Patient Registrations – Adoptions:
PCSE has highlighted a concern that a number of GP practices are not following the correct procedure to deduct and register patients when an adoption occurs. This poses a significant clinical and safeguarding risk to the patient. In an attempt to assist GP’s, PCSE has updated its website FAQs https://pcse.england.nhs.uk/services/registrations/ and guidance https://pcse.england.nhs.uk/media/1247/adoption-medical-records-practice- guide.pdf with the process for adoptions and highlighted this guidance in the March PCSE GP bulletin.
March PCSE GP bulletin:
Process for adopted patients: It is important that GP practices are aware of the steps that need to be taken when a patient is adopted. Following the process will ensure continued patient care and ensure there isn’t an impact on your practice payments.
When a patient is adopted, they are given a new NHS number and must be registered as a new patient at your practice. All previous medical information relating to the patient needs to be transferred into a newly created medical record. Details on the process to follow can be found on the PCSE website.
Practices should complete new registrations for the adopted patient within five working days to ensure no interruption to patient care.
Due to concerns regarding patient safe-guarding and clinical risk, an appropriate channel of escalation is required through CCGs, who will be required to provide assistance in resolving both the cases in progress, and ensuring GPs are compliant with the required procedure.
Actions:
NHS England Regional Local Teams (RLT) to engage with CCGs as necessary.
RLTs to collect and collate a list of appropriate contacts within delegated CCG and NHSE RLTs for escalation, to be returned to [email protected] no later than Friday 25 May 2018.
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2 General Practice Resilience Programme:
Data summary for 17/18:
Total unique practices Total unique Total Hubs receiving Region selected to receive practices receiving support resilience support support
North 1307 1289 102
Mids & East 691 683 76
South 399 367 15
London 606 588 92
Total 3003 2927 285
• 3,678 ‘packages’ of support: this is the total number of ‘projects’ funded through GPRP (i.e. some practices may have received more than one intervention). • Difference between practices selected and receiving is down to practices withdrawing or the offer of support being withdrawn. • Increase in use of Hubs this year – possibly because funding in 17-18 was half that of 16-17? • NHSE allocations ‘topped up’ by 10% locally. • Gathered qualitative data in 17-18 (case study pilot (asked for 40, got over 60). • Reduced central admin transaction costs by 75% by streamlining reporting process. • Scope for reviewing the impact of the Programme has started. We’ll keep you updated on progress and will ask for your input in due course. • Work is ongoing to look at the total number of individual practices receiving support across the two years of the programme.
GPFV workshop 1/5/18
We got useful feedback from Resilience Leads at this event and we’ll use this to make iterative improvements to the process.
3 Asylum Seekers:
Immigration Assessment Centres
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Sarah Stephenson has secured additional funding for the next 2 years (£3.7m (an increase of £2.7m on the existing budget)). This is on the basis that further work will be done to review the service specification and improve data quality.
The original IA Centres in London, Wakefield, Birmingham and Liverpool will receive an uplift to their funding and will be funded at 17-18 levels (i.e. what NHSE gave them last year and what they funded locally). Funding for the new centre (Derby) and the proposed centre (Widnes) needs further work as the costings are unusually high (Derby) or currently unknown (Widnes). All commissioners are aware of the current situation (a conversation is expected with Derby shortly as they are meeting the service provider to discuss the future of the service and its staff mix).
All commissioners have agreed to work with NHSE to standardise the service specification and data collection. Sarah has secured support from PHE for the data collection but there is no plan at present for a national data collection via PHE.
Asylum seekers on Resettlement Schemes:
Home Office has reported problems with pathways in to secondary care for people arriving on Resettlement Schemes. Sarah Stephenson will work with them to understand the scale of the issue. The complexity of healthcare needs for asylum seekers is increasing and Sarah is looking in to whether this will cause pressure for certain specialisms in particular geographic areas.
4 Translation and Interpreting:
The guidance document is still awaiting sign off and Sarah Stephenson is working with the Commercial Team to update statements of requirement as new services are procured.
5 Accessible Information Standard:
We have been made aware that the AIS isn’t being implemented consistently across the country (not a surprise to us as we’ve had some individual complaints). Sarah Stephenson is working with the relevant team to consider how to improve this, being mindful that this needs to complement the translation and interpreting guidance (awaiting sign off) and be pragmatic given that interpreting services are being recommissioned at different rates and that there is no funding available to implement the AIS. The issue is hottest in dental and optom.as these are services that haven’t historically had CCG-commissioned interpreting services and the responsibility for funding these services sits with the providers.
6 Deadline for Submitting Payment Claims:
GPC has raised concern about a GP practice whose vaccination payment claim was
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refused as it was time barred when it was submitted (days/week late rather than months/years). This is despite a case being made by the practice for extenuating circumstances. GPC has asked if NHS England could look at this within the context of general practice under pressure (while recognising clear SFE messaging on V&I claims – 6 months max).
Do Heads of Primary Care/GP contracting teams:
a) recognise extenuating circumstances around such claims / deadlines – e.g. staff sickness / vacancies specially in admin / management that could account for a loss of management control
b) If so, what leniency is shown – do you operate set days, case by case? Principles how do we apply consistency over this across local offices (or CCGs)
For discussion/feedback at Heads of Primary Care (or email a response to [email protected]).
7 System Supplier Risk for Monthly GPES Extracts: Update on the TPP/Vision Extractions:
TPP Month 1:
Two of the remaining three extracts (Men ACWY and Men B) have now been certified. This will allow the extracts to take place in a mop up scheduled on Monday 14th May meaning only a short delay in payments to practices.
Pneumococcal still has remaining issues but these are expected to be resolved and another mop up scheduled as soon as possible, hopefully next week.
The above certifications have only been certified for the first month extractions as required intensive support/fixes so the focus will now be moving to enduring strategic solution for these issues as quickly as possible. Failure to do so would mean being in a similar position next month, relying on temporary solution.
Embedded below is a draft of the communication NHS Digital is sending to local commissioners.
TPPcomms2 NH review.docx
Vision:
We have also been informed that the software release for Vision practices is now being rolled out to practices. We may therefore be able to include a number of Vision practices in the automated GPES extracts for month 2, with the aim of being able to include them all for month 3.
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8 Seasonal Flu Reconciliation:
Primary care leads have previously been alerted to an issue with the TPP flu data extract.
The error was across the entire TPP estate and required a new collection for all of the practices and then reconciliation between the two figures. The attached spreadsheet details the reconciliation.
Unapproved figures will be overwritten with new data and can then be processed via CQRS for payment. For those with approved figures it will require an off system reconciliation by local teams.
Total number of TPP Practices with a change to data: 1594 (detail in the spreadsheet).
Flu Type Counts x £9.80
Mop Up value greater than value declared (monies owed) 2939 £28,802.20
Mop Up value less than declared value (monies to be clawed back) 372 £3,645.60
Action: GP contracts teams to reconcile payments for flu using the data embedded below:
CQRS TPP Seasonal flu Analysis 2.0.xlsx
DENTAL
9 Interim Policy for End of Year reconciliation 2017 – 2018:
As you will be aware contractors have and in some instances continue to encounter problems associated with new performer list application in respect to dentistry. Whilst we know the landscape has changed and improved it has not improved to the extent we anticipated and delays continue to affect a number of new performer applications.
Last year we issued guidance on the end of year procedure for contracts that could demonstrate an impact of Performer List delays on their ability to deliver within contractual tolerance. As a result of this, some contractors were allowed to carry forward additional
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UDA’s over and above normal tolerance. It has become apparent that many contracts have been unable to fulfil the delivery of such. It is important we adopt a consistent approach to managing contracts that have under delivered in 17/18. We have sought information from local teams regarding the management of contracts that carried forward activity from 16/17 and from this information four local teams report that they have remained in regular contact with contract holders and reviewed extra activity on a monthly basis, two offices report no contracts carrying forward extra activity; five teams have made no contact during the year to check delivery and the remainder of offices have not responded.
It is in this context that we are writing to advise you of how we wish to reflect the performer list issues in our handling of the 17/18 contract management process.
Contracts carrying forward extra activity from contract year 16/17:
If the underperformance occurs despite meaningful engagement and dialogue with a contractor (which can be evidenced), we would have expected the year end procedure will be as per NHS England policy book. This is inclusive of breech issue and relevant claw back.
If however, there is no evidence that meaningful engagement and dialogue between contractor and commissioner has occurred throughout the contract year, then we have thin grounds to issue a breach notice, and we would advise no breach is issued in respect to under delivery. Over payment should however be clawed back as per NHS England policy book requirements.
Contracts that continue and or who have experienced delays in performer list applications:
In order to mitigate the impact of performer list delays on dental practices that have been unable to fulfil their contracted units of dental activity, we are recommending a change to usual tolerances of contract under delivery. Contractors that can evidence being affected by significant delays in performer’s list processes, (significant in this context means > 16 weeks delay from application to PL registration.) will benefit from a greater tolerance of under delivery which can be carried forward to 18/19.
To apply for consideration of carry forward, contractors must, via a template supplied to them provide: • Date of performer application commenced • The date of performer number issued, if applicable. • Estimated number of UDAs lost as a result of delays greater than 16 weeks (lost activity 1 – 16 weeks not applicable) • Contractors to have the option of claw back, carry forward tolerance or a combination of both • Carry forward to equate to not greater than 7000 UDAs per FTE • Assurance to be provided via an action plan.
As this will be deemed to be carry forward activity contractors must provide assurance that they have an action plan, detailing how additional activity will be performed without any detrimental effect to normal contractual activity.
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NHS England commissioners will communicate with all contract holders no later than 30 June 2018 providing a template and detail of the above. Contractors are required to return all fully completed templates to local offices by 31 July 2018.
This change is for 17/18 year only and only relates to contract under delivery. There will be no increase for over delivery tolerance, this will remain at 102%.
If your contractors feel they are unable to carry forward all underperformance or a percentage of such claw back will be applicable but we again recommend no breach for under delivery to be issued.
ASSURANCE
10 Assurance of Delegated CCGs – Internal Audit Framework:
The draft framework introducing internal audit requirements for delegated CCGs primary medical care commissioning was presented and discussed at the Audit Chairs network last month (April).
In addition to clear feedback that not everyone had received the letter from Dominic Hardy (dated 27th February 2018) giving notice to introduce the audit requirement in 2018-19, other key points of discussion included:
• Timing – too late for the 18/19 internal audit programme? • Proportionality – primary care < 10% CCG spend. • As sovereign boards CCGs should have control over their own internal audit programmes. • Some already have substantial assurance from past internal audits • Should be a risk-based approach • Assurance levels would be low • Need to decide and communicate on this quickly
The draft framework has been revised, building on this and other stakeholders feedback and is currently being tested back with a working group of audit chairs – essentially this seeks to give delegated CCGs an additional year to complete the scope of the audit programme detailed. The latest version is embedded below (any HoPC comments by w/e 18 May please).
NHS England CCG PMC internal audit fra
Following the next round of comments we will be meeting with Joanne Shaw at the end of May (Non-Executive Director, who chairs the Audit and Risk Assurance Committee and the Audit Chairs Network) to update on the suggested approach and agree a way forward (publication of the framework in June or take back to ARAC).
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Please send any comments or questions to [email protected]
11 Delegated Primary Care Commissioning – 13Q compliance:
NHS England has a legal duty (section 13Q of the NHS Act 2006 (as amended)) to involve the public in commissioning. Where responsibility for commissioning primary care has been delegated to CCGs, NHS England remains accountable (and liable) for this ‘13Q duty’. To strengthen assurance in this regard, at its March meeting PCOG agreed a proposal to rollout a version of the ‘public involvement assessment form’ (currently used by NHS England staff to assess whether the 13Q duty applies, and plan accordingly) to CCGs with delegated responsibility for commissioning primary care. A copy of the PCOG paper is embedded below along with a Word document version of the form itself (which is hosted on Sharepoint) – for discussion.
Word version of PCOG paper 13Q Q3 Sharepoint 13q form. 17-18 Final.docx
National Team Update
12 The following staffing changes have been made to the national primary care commissio team:
• Sameena Akhtar has joined the team to provide maternity cover for Mel Lucas, leading on business support for the assurance and the wider team.
• Gary Williams has been appointed to the team permanently as Senior Policy Lead (Primary Medical Services).
• Mark Smith was successful in his application to succeed Helen Parkin as Head of Primary Care Commissioning (Primary Medical Services) when she retires at the end of June (we are working to retain Helen in a reduced capacity under the retirement and return scheme).
• Sherry King returns from maternity leave at the end of May to pick up the reigns again on Primary Care Assurance from Mark.
• We have some good quality candidates to provide maternity cover for Keira Moulds – we are interviewing this week and next.
• Matthew Boycott has been appointed to Senior Programme Manager for the next two years, recognising additional responsibilities to help deliver our performers list responsibilities.
• Celia Hutton is with us for another year, appointed as National Performers List
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Assurance and Support Manager and will work to ensure the internal audit actions delivered are embedded.
• Emma Wallis has been appointed to Senior Programme Manager (Programme Lead for Dental Contracting, Contract Reform, and Orthodontics), recognising additional responsibilities around planning next steps for dental contract reform.
• Deema Marzouq (Dental Commissioning Manager) is on 6-month stretch assignment to Alex Morton’s Public Health team.
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Item 12 Enc 09 Acronyms
1. A&E Accident & Emergency 2. AHP Allied Health Professional 3. ANNP Advanced Neonatal Nurse Practitioner 4. AO Accountable Officer 5. APMS Alternative Provider Medical Services 6. AQP Any Qualified Provider 7. ASD Autism Spectrum Disorder 8. AVS Acute Visiting Service 9. BADGER Birmingham and District General Emergency Rooms 10. BAF Board Assurance Framework 11. BCF Better Care Fund 12. BCHFT Birmingham Children’s Hospital NHS Foundation Trust 13. BEN Birmingham East and North PCT 14. BHFT Burton Hospital NHS Foundation Trust 15. BOTOX Botulinum Toxin Type A 16. BPAS British Pregnancy Advisory Service 17. C&E Communications & Engagement 18. CAG Commissioning Advisory Group 19. CAMHS Children and Adolescent Mental Health Service 20. CAS Clinical Assessment Service 21. CC Cannock Chase 22. CCG Clinical Commissioning Group 23. Cdiff Clostridium Difficile Infection 24. CEO Chief Executive Officer 25. CEPN Community Education Provider Network 26. CHC Continuing Health Care 27. CMT Contract Management Team 28. COPD Chronic Obstructive Pulmonary Disease 29. CPAG Clinical Policies Advisory Group 30. CPN Community Psychiatrist Nurse 31. CQC Care Quality Commission 32. CQRM Clinical Quality Review Meetings 33. CQUIN Commissioning for Quality and Innovation 34. CRT Crisis Response Team 35. CSU Commissioning Support Unit 36. CSW Clinical Support Worker 37. CWG Clinical Working Group 38. DES Direct Enhanced Service 39. DN District Nurse 40. DoH Department of Health 41. DPA Data Protection Act 42. DQF Data Quality Facilitator 43. ED Emergency Department 44. EDS Equality Delivery System 45. EL Elective 46. EMT Executive Management Team 47. ENT Ear Nose Throat 48. EOL End of Life 49. EPR Electronic Patient Record 50. ESR Electronic Staff Record 51. ETTF Estates and Technology Transformation Fund 52. EWISS Emotional Well Being in Stafford & Surrounds 53. EWTD European Working Time Directive 54. F&P Finance and Performance 55. FE Frail Elderly 56. FET Funding Exceptional Treatment 57. FFT Friends and Family Test 58. FNOF Fractured Neck of Femur 59. FOI Freedom of Information 60. FPC Finance Performance & Contract Committee 61. FRP Financial Recovery Plan 62. GB Governing Body 63. GDRP General Data Protection Regulations 64. GMS General Medical Services (Practice) 65. GP General Practitioner 66. GPWSI GP with special interest 67. GSF Gold Standard Framework 68. HCAI Healthcare Associated Infections 69. HEFCE Higher Education Funding Council for England 70. HEFT Heart of England Foundation NHS Trust 71. HIS Health Informatics Service 72. HPS Health promoting Schools 73. HPSS Health promoting Schools Scheme 74. HR Human Resources 75. HROD Human Resources Organisational Development 76. HSJ Health Service Journal 77. IAF Improvement and Assessment Framework 78. IAPT Improving Access to Psychological Therapies 79. ICG Infection Control Group 80. IFR Independent Funding Request 81. IG Information Governance 82. IM&T Information Management and Technology 83. IP Inpatients 84. IPC Infection Prevention & Control 85. IPR Individual Performance Review 86. IQT Improving Quality Team 87. ISA Intermediate Support Assistant 88. ITT Invite to Tender 89. JSNA Joint Strategic Needs Assessment 90. KPI(s) Key Performance Indicator(s) 91. KPMG Global Network of Profession Firms providing audit, tax and advisory services 92. LAA Local Area Agreement 93. LDD Learning Disability and/or Difficulty 94. LDP Local Delivery Plan 95. LDR Local Digital Roadmap 96. LES Local Enhanced Service 97. LHE Local Health Economy 98. LMC Local Medical Council 99. LMS Local Medical Services 100. LSP Local Strategic Partnership 101. LTC Long Term Conditions 102. M&L CSU Midlands & Lancashire Commissioning Support Unit 103. MAT Maternity 104. MAU Medical Assessment Unit 105. MB Membership Board 106. MCA Mental Capacity Act 107. MDT Multidisciplinary Team 108. MHRA Medicines & Healthcare products Regulatory Agency 109. MICATS Musculoskeletal Integrated Clinical Assessment & Treatment Service 110. MICOT Minor Injuries Community Outreach Team 111. MIU Minor Injuries Unit 112. MLU Midwife-led Unit 113. MOI Memorandum of Information 114. MORI (Market & Opinion Research International) 115. MOU Memorandum of Understanding 116. MPIG Medical Practice Income Guarantee 117. MRSA Meticillin-Resistant Staphylococcus Aureusis Infection 118. MSFT Mid Staffordshire NHS Foundation Trust (now part of UHNM as County Hospital) 119. MSK Musculoskeletal 120. NEL Non-Elective 121. NES National Enhanced Service 122. NHQAC Nursing Home Quality Assurance Group 123. NHS National Health Service 124. NHSE NHS England 125. NICE National Institute for Clinical Excellence 126. 127. NMC Nursing and Midwifery Council 128. NSL Non Urgent Patient Transport Provider 129. OD Organisational Development 130. OOH Out of Hours, also Out of Hospital 131. OP (D) Outpatients (Department) 132. OT Occupational Therapist 133. PAED Paediatrics 134. PALS Patient Advice and Liaison Service 135. PASS Professional Advice and Support Service 136. PAU Paediatric Assessment Unit 137. PBR Payment By Results 138. PCT Primary Care Trust 139. PEC Professional Executive Committee 140. PID Project Initiation Document 141. PIS Prescribing Incentive Scheme 142. PLCV Procedures of Limited Clinical Value 143. PLT Protected Learning Time 144. PM Practice Manager 145. PMO Programme Management Office 146. PMS Personal Medical Services 147. PPG Patient Participation Group 148. PPI Patient and Public Involvement 149. PPI (prescribing) Proton Pump Inhibitors 150. PPV Post Payment Verification 151. PQQ Pre Qualifying Questionnaire 152. PRF Patient Report Form 153. PRISM Personnel Resource Information System for Management 154. PROMs Patient Related Outcome Measures 155. PT Physical Therapist 156. PU Pressure Ulcer 157. PWSI Pharmacist with Special Interest 158. QIA Quality Impact Assessment 159. QIF Quality Improvement Framework 160. QIL Quality Improvement Lead 161. QIP Quality Improvement Programme 162. QIPP Quality, innovation, productivity and prevention. 163. QOF Quality and Outcomes Framework 164. RAG Red Amber Green 165. RAP Remedial Action Plan 166. RCA Root Cause Analysis 167. RIA Risk Impact Assessment 168. RIO Electronic Care System 169. RRL Revenue Resource Limit 170. RSUH Royal Stoke University Hospital 171. RTT Referral to Treatment 172. RWT Royal Wolverhampton Hospital Trust 173. SALT Speech & Language Therapist 174. SARC Sexual Assaults Referrals Centre 175. SAS Stafford and Surrounds 176. SCC Staffordshire County Council 177. SCR Strategic Change Reserve 178. SI Serious Incident 179. SIRO Senior Information Risk Officer 180. SLAM Service Level Agreement Model 181. SSOTP Staffordshire & Stoke on Trent Partnership Trust 182. SSPAU Short Stay Paediatric Assessment Unit 183. SSSFT South Staffordshire & Shropshire Foundation Trust 184. SSSHFT South Staffs & Shropshire Healthcare Foundation Trust 185. STP Sustainability and Transformation Plan 186. SUI Serious Untoward Incident(now known as SI’s) 187. SUS Secondary User Services 188. TDA Trust Development Authority 189. TOR Terms of Reference 190. TSA Trust Special Administrator 191. TV Team Tissue Viability Team 192. UCC Urgent Care Centre 193. UHB University Hospital Birmingham 194. UHNM University Hospitals of North Midlands NHS Trust 195. UHNS University Hospital North Staffordshire 196. VAT Value Added Tax 197. VFM Value for Money 198. WCC World Class Commissioning 199. WHT Walsall Hospitals Trust 200. WIC Walk in Centre 201. WMAS West Midlands Ambulance Service 202. WMQRS West Midlands Quality Review Service 203. WRES Workforce Race Equality Standard 204. WTE Whole Time Equivalent 205. WUCTAS Wolverhampton Urgent Care Triage Access Service 206. YTD Year to Date
http://www.nhsemployers.org/your-workforce/primary-care-contacts/general-medical- services/gms-acronyms