Virtual Governing Body To be held on Thursday 6 August 2020 From 1pm until 3pm VIRTUAL GOVERNING BODY To be held on Thursday, 6 August 2020 at 1pm A G E N D A Ref Item Enclosure Led By Action Required 1. Apologies for Absence Verbal Dr Crichton For noting 2. Declarations of Interest Verbal All For noting 3. Minutes of the meeting held on 2 July Enc A Dr Crichton For approval 2020 4. Matters Arising not on the Agenda Verbal Dr Crichton For discussion 5. Notification of Any Other Business Verbal Dr Crichton For discussion 6. Questions from Members of the Public Verbal Dr Crichton For discussion (See our website for how to submit questions – required in advance) 7. Patient Story Verbal Dr Crichton For discussion Strategy 8. Healthwatch Annual Report Enc B A Goodall For noting Assurance 9. Quality & Performance Report Enc C A Fitzgerald & For noting A Russell • Spotlight Report on Living Well 10. Finance Report Enc D H Tingle For noting 11. Chair and Chief Officers Report Enc E Dr Crichton For noting Items to Note 12. Integrated Care System CEO Report Enc F Dr Crichton For noting Receipt of Minutes 13. Receipt of Minutes Enc G Dr Crichton For noting Page 1 of 2 Ref Item Enclosure Led By Action Required • Engagement & Experience Committee – Minutes of the meetings held on 4 June 2020. • Primary Care Commissioning Committee – Minutes of the meeting held on 11 June 2020. 14. Any Other Business Verbal Dr Crichton For discussion 15. Date and Time of Next Meeting For noting Thursday 3 September 2020 at 1pm Governing Body Quorum is 6 Members: Chair or Vice Chair, at least 3 Clinical Members and Chief Officer or Chief Finance Officer Page 2 of 2 Minutes of the Virtual Governing Body Thursday 2 July 2020 at 1pm Members Dr D Crichton NHS Doncaster Clinical Commissioning Present: Group (CCG) Chairman (Chair) J Pederson Chief Officer, CCG H Tingle Chief Finance Officer, CCG A Russell Chief Nurse Dr E Jones Secondary Care Doctor L Tully Lay Member P Wilkin Lay Member S Whittle Lay Member Dr M Khan Locality Lead, Central Locality Dr R Kolusu Locality Lead, East Locality Dr M Pieri Locality Lead, North Locality Dr M Pande Locality Lead, South Locality Formal Attendees A Fitzgerald Director of Strategy and Delivery, CCG Present: L Devanney Associate Director of HR and Corporate Services, CCG A Goodall Healthwatch Doncaster Representative In J Satterthwaite PA to Chair and Chief Officer (Minute attendance: Taker) P Hemingway Head of Communications A Harrington Interim Head of Strategic Commissioning and Transformation (Item 12 Quality and Performance Report G Wood Deputy Designated Nurse LAC and Safeguarding Children (Item 12 Quality and Performance report) Action 1. Apologies for Absence Apologies were noted from : • Dr R Suckling, Director of Public Health • P Holmes, Doncaster Council Representative 2. Declarations of Interest The Chair reminded Governing Body members of their obligation to declare any interest they may have on any issues arising at Governing Body meetings 1 which might conflict with the business of NHS Doncaster Clinical Commissioning Group (CCG). Declarations declared by members of the Governing Body are listed in the CCG’s Register of Interests. The Register is available either via the secretary to the Governing Body or the CCG website at the following link: www.doncasterccg.nhs.uk The meeting was noted as quorate. Declarations of interest from sub committees / working groups: None declared. Declarations of interest from today’s meeting: None declared. 3. Minutes From the Previous Meetings held on 4 June 2020 The minutes of the meetings held on 4 June 2020 were approved as a correct record. 4. Matters Arising not on the Agenda Primary Care Commissioning Committee Terms of Reference There were minor formatting changes to the Terms of Reference and it was deemed unnecessary for them to be presented to the Governing Body again. 5. Notification of Any other Business There was no notification of further business to discuss. 6. Questions from Members of the Public The following questions was received from a Member of the Public: There has been an increase in Paramedics in Primary Care due to their skills and training making them ideally suited providing recruitment and a fresh approach to care management and same day urgent care. Are there any plans to utilise / increase or increase the number of paramedics in primary care across the Doncaster CCG area? 1 NHS England, 2017. Next Steps on the Five-Year Forward View. 2 NHS England, 2016. General Practice Forward View. 3 NHS England, 2019. Investment and Evolution. A Fitzgerald gave the following response: 2 Thank you for your question relating to the number of paramedics based in primary care services in Doncaster. NHS Doncaster CCG commissions an Emergency Care Practitioner (ECP) service which uses very similar skill sets to those of paramedics. We recently reviewed our ECP service as part of our work to scope out and agree a new model of urgent and emergency care that will go live in October 2020. This model will maintain the number of ECPs that we have already. In addition, Primary Care Networks (PCNs) are currently developing their workforce plans to ensure that primary care services continue to develop in line with the NHS Long Term Plan, the General Practice Forward View and the wider NHS Investment and Evolution document, as identified in your question. Paramedics form one of a number of additional roles that PCNs can recruit to and receive funding for however the funding for these roles will not be released until 21/22. PCNs will want to ensure that any additional paramedics they recruit will not duplicate roles that already exist across Doncaster, but instead will work with our existing ECPs to provide services for patients in Doncaster. 7. Patient Story The Patient Story featured Sophie who became a first time Mum in October 2019. Sophie has pre-existing health conditions and is a shielded patient and she has a diagnosis of Attention Deficit Hyperactivity Disorder (ADHD). Sophie encountered the following difficulties: • Journey described as ‘chaotic and hectic’ • Repeated visits due to health problems and lost samples • Lack of consistency, communication and responsiveness to needs and wants (not knowing what is happening/birthing plan) • Delayed discharge from maternity ward’23.30pm discharge not ideal when it is cold and raining’ What worked well for Sophie: • Nurses at the induction visit ‘good experience’ • Support from nurses post-delivery at the hospital ‘brilliant night staff’ ‘lovely male midwife’ • Routine post-natal support in the community – Midwife What needs to change: • Consistency of staff • Communication • To be more informed Dr Crichton explained that there were elements of Sophie’s story which allowed her to undertake a more formal process which required further discussion and 3 action. The Head of Midwifery at Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust (DBTHFT) has reported that they are working with the Maternity Voices Partnerships of which Sophie is a member and environmental improvements have been made and staff training in new mothers implemented and an invitation has been extended to Sophie to re-visit the Maternity unit. G Wood, Deputy Designated Nurse Looked After Children and Safeguarding Children NHS Doncaster CCG advised that it was timely to re-visit improvements in Maternity Services. J Pederson queried where progress will be formally reported and was advised that the CCG has a Clinical Quality Review Group (CQRG) Sub-Group for Maternity, Neo-natal and Paediatric care and the Quality and Patient Safety Committee receives reports from the group as part of a check and challenge process. Dr Crichton informed the Governing Body that Healthwatch Doncaster has commenced a consultation with the public regarding their experiences accessing appointments via video or telephone which will run for a period of one month. 8. Primary Care Commissioning Committee Annual Report L Tully presented the Primary Care Commissioning Committee Annual Report to the Governing Body for endorsement prior to submission to NHS England. It provides assurance to NHS Doncaster CCG Governing Body and NHS England with regard to the delivery of the Primary Care Commissioning Committee work programme for the period 1 February 2019 to 31 January 2020. Dr Crichton observed inconsistency between the cover sheet and the report in that the Governing Body was asked to endorse the Report and not approve it. The Governing Body endorsed the Primary Care Commissioning Annual Report prior to submission to NHS England. 9. Policy for Commissioning Cryopreservation A Russell presented the Policy for Commissioning Cryopreservation to the Governing Body and explained that the policy and has previously been presented to the Clinical Reference Group for discussion. The proposed policy sets out the commissioning position on the provision of cryopreservation for a patient about to undergo a medically necessary procedure or intervention which may permanently impair their future fertility, for example chemotherapy, radiotherapy or gender dysphoria treatment. This policy follows the available national clinical guidelines including those published by NICE (CG156 Fertility problems: assessment and management). The revised policy outlines the commission criteria and specifies that the CCG will only fund storage of gametes and embryos for an initial 10 year period. If 4 storage is desired for longer than 10 years then a funding application should be made by the Individual Funding Request (IFR) panel. The policy also states that: • For females; the CCG will fund one cycle of egg retrieval, with or without fertilisation. If fewer than ten eggs are retrieved then one further cycle can be offered. • For Males; The CCG will commission a maximum of three semen samples. The changes to the proposed policy are not in relation to the commissioning criteria, but more to offer clarity around the scope, definitions, monitoring arrangements and policy review considerations.