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Agenda and Papers PCCC 5Th November 2020

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Agenda and Papers PCCC 5Th November 2020 Agenda NHS Cheshire CCG Primary Care Commissioning Committee Date / Time 5th November 2020 / GoTo Webinar 2.00pm - 5.30pm Chair: Pam Smith QUORUM A quorum necessary for the Committee to undertake its business shall be at least four voting members of the Committee, comprising: • Chair (or Vice Chair) • One other Independent Governing Body Member • Two Directors from the CCG’s Executive Team Item Format & Page No. Timing Item Speaker No Action 1 MEETING MANAGEMENT 1.1 Welcome and Chair’s Comments Chair Verbal - 1.2 Apologies for absence Chair Verbal - 1.3 Declarations of interests Chair Verbal - 15 mins (2.15) Minutes of NHS Cheshire CCG Primary 1.4 Care Commissioning Committee held Chair Page 4 th 1.4 PCCC Minutes on 27 August 2020 27.08.20 Part A.pdf Paper Chair To follow 1.5 Matters arising / action log 2 Committee Business Single Agenda Item Consideration of the application from Danebridge Medical Practice close their 5 branch surgery mins 2.1 (2.20) Introduction to format of today’s meeting Chair and papers available Reminder to Committee Members of Papers (for papers decision) 1 Item Format & Page No. Timing Item Speaker No Action - Covering Paper Page 14 2.1 Covering Paper.pdf - Appendix A – Practice Application Page 34 Appendix A Danebridge - applicat - Appendix B - Outcomes of the Page 41 Patient Consultation Process/FOI Requests Appendix B.pdf - Appendix C - Other relevant Page 124 information as submitted by Appendix C.pdf Danebridge Medical Practice / FOI requests Page 150 - Appendix D – Equality and Quality Appendix D - EQIA (2).pdf Impact Assessment Page 193 - Appendix E - Feedback from Appendix E 12 October Letter re San Cheshire West and Chester Overview and Scrutiny Committee Appendix E Closure of Sandiwy surgery re - Appendix F – Feedback from Local Medical Committee and Appendix F Page 202 surrounding Practices Feedback and Respon - Appendix G Additional information from Danebridge Medical Practices Appendix G - Further Page 203 information from Dane following the meeting of the Cheshire West and Cheshire Overview and Scrutiny Committee Appendix H Report for the PCC Part 1_SO Page 209 - Appendix H –Papers from SOS (Save Our Surgery) Appendix H Report for the PCC Part 2_SO Appendix H Retention case SOS.p 269 - Appendix I – Extract from NHS Appendix I Branch Surgeries_extract_po Policy Book 2 Item Format & Page No. Timing Item Speaker No Action 10 CCG Officer overview Verbal (referring mins • Contractual process CL to relevant (2.30) MC • Consultation and Engagement papers above) Mandy Skelding- Jones 10 Verbal (referring (Practice Statement to relevant - mins Danebridge Medical Practice Manager) papers above) (2.40) Dr Mike Mullen (Partner) Public Feedback - SOS (Save Our Surgery) John Kerrigan 10 Statement mins - Questions/Points raised in advance Chair Verbal (2.50) by public (read by Chair) 10 Committee Attendee Feedback Representati mins - LMC (Local Medical Committee) ve Verbal - Healthwatch LB (3.00) 5 Feedback from Cheshire West and mins Chester Overview and Scrutiny MC Verbal Committee (3.05) 30 mins Committee Question and Answer Chair/All Verbal Session (3.35) 10 mins Comfort Break (3.45) 60 mins Committee DeIiberation and Decision Chair/All (4.45) 15 mins Summary of decision and next steps Chair/All (5.00) 3 ANY OTHER BUSINESS DATE AND TIME OF NEXT MEETING: 4 TBA 3 Minutes Meeting Name: NHS Cheshire CCG Primary Care Commissioning Committee – Part A th Date/Time: Wednesday 27 August 2020 Venue/Format: GoTo Webinar 9.00am – 11.15am Chair: Pam Smith Voting Members in Attendance Name Role Attending Pam Smith (Chair) Lay Member, Chair, Daniel Howcroft Secondary Care Doctor Governing Body Wendy Williams Lay Member Suzanne Horrill Lay Member apologies Lynda Risk Executive Director of Finance, Cheshire CCG Executive Director of Quality & Patient Experience, Paula Wedd Cheshire CCG Neil Evans Executive Director of Planning & Delivery, Cheshire CCG Others in Attendance Name Role Attending Lesley Appleton Governing Body GP ` Dr Michael Clark Governing Body GP Dr Fiona McGreggor-Smith Governing Body GP apologies Dr Gwydion Rhys Governing Body GP William Greenwood LMC Representative Dr Simon Powell LMC Representative Louise Barry Chief Executive, Healthwatch James Burchell Head of Estates, Cheshire CCG Louise Gittins Cheshire West and Chester Council Ian Ashworth Cheshire West and Chester Council Laura Jeuda Cheshire East Council Matt Tyrer Cheshire East Council Christopher Leese Associate Director of Primary Care, Cheshire CCG Andrew Whittingham Associate Director of Finance, Cheshire CCG Jim Britt Head of Urgent Care, Cheshire CCG Dean Grice Head of Primary Care, Cheshire CCG apologies Kevin Highfield IT Lead, Cheshire CCG Katie Mills Clinical Quality Manager, Cheshire CCG Carla Sutton Senior Contract Manager, NHS England Lorraine Weekes-Bailey Senior Primary Care Accountant, Cheshire CCG Tanya Jefcoate-Malam Deputy Head of Primary Care, Cheshire CCG Christine France Note taker 4 Ref. Discussion and Action Points Action 1.1 Welcome and introductions 1.1.1 The Chair welcomed attendees to the Committee meeting and advised that the meeting was being held in public but was not a public meeting. The chair confirmed that she received no questions from the public in advance of the meeting. 1.2 Apologies 1.2.1 Apologies were received from Fiona McGregor-Smith, Suzanne Horrill and Dean Grice. 1.3 Declarations of Interest 1.3.1 All GPs on the committee were conflicted by agenda item 2.1, Enhanced Care in Care Homes. 1.4 Minutes of Previous Meetings The Minutes of the Primary Care Commissioning Committee meeting held on 24th June 2020 were agreed as an accurate record with the deletion of the repeated word “however” on page 7. 1.5 Matters Arising & Action Log A2 – Finance report Due to the current financial framework and arrangements this action is no longer a current request so would need to be considered once the Clinical Commissioning Group knows how much funding it will receive at the end of September. This action can now be closed. A5 – Finance Report This action has been completed. The outcome of the review of last year’s QOF was communicated to practices. Following this an appeal was received which is being heard this afternoon with some additional evidence sent by the practice being reviewed. A6 Estates This action is on the agenda of the Part B meeting today. A7 Future Planning Project This conversation is now not as urgent as previously but will still need to take place in readiness for 2021. A8 GP Representation This issue was discussed at the membership meetings held in July and Andrew Wilson has communicated to practices this week asking if they wish to use their Governing Body representation or an alternative GP. A9 Future Meeting Dates All future meetings of the committee will be held on Thursdays, dates beyond November have not been issued as a review is taking place of where all the CCG’s committee meetings sit in the calendar month. 5 Ref. Discussion and Action Points Action 2.1 Enhanced Care in Care Homes It was agreed that the GPs on the committee were conflicted with this item and the chair decided that they could be permitted to listen into the discussion but not contribute to the discussion at this time. Tanya Jefcoate-Malam presented the options provided following the extensive review undertaken at the request of the Committee at its June meeting. The first option is to do nothing meaning delivery of the direct enhanced service would come into effect from 1st October and the five contracts currently running across Cheshire would continue. This would mean that locally the requirements of the national direct enhanced service would be duplicated and so would payment. This option would also not assist with the move to a new consistent contracting framework across Cheshire, ensuring outcomes are delivered consistently and funding is clarified. The second option would be to commission the direct enhanced service as required nationally and whilst commissioning this, decommission the various local enhanced services in place. The advantage of this would be to enable the pot of funding to be utilised in Primary Care differently, however this would not reduce the CCGs overspend, could lead to disengagement from Practices and a reduction in outcomes for care home residents. The third option would be to continue commissioning a local contract over and above the direct enhanced service but to do so in a way that is consistent across Cheshire, ending the five different contracts that are in place and giving equity to the funding model and services received by our residents. The outcomes currently being seen in nursing homes could be spread to residential homes and learning disability homes. The different funding models agreed would depend on whether the Clinical Commissioning Group is able to sign-off additional investment in Primary Care at this time and in turn how likely it is that patient outcomes will be achieved in homes not previously covered by the scheme, i.e. mainly residential and LD homes. The first option available to the committee is to commission the local enhanced service at a cost neutral tariff, meaning, that the national budget which has been made available via the direct enhanced service would be pooled with the current CCG budget for all Care Homes Local Enhanced Services and then split between either all beds (as per the DES) or occupied beds only. If this funding was split between all beds as per the direct enhanced service statutory requirements this would result in a tariff of c.£303 per bed payable in Cheshire or if based on the local enhanced service for beds that are occupied it will be c.£329 per bed. This option would mean that the vast majority of the Primary Care Networks would see an increase in the funding that is available to them other than in three Primary Care Networks where they have previously covered all beds within nursing and residential homes and occupancy has been high.
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