Official

Durham Dales, Easington and Clinical Commissioning Group North Durham Clinical Commissioning Group

NHS , EASINGTON AND SEDGEFIELD (DDES) CCG AND NORTH DURHAM CCG PRIMARY CARE COMMISSIONING COMMITTEES IN COMMON

Tuesday 21 January 2020 13:15 – 14:30 Lanchester Community Centre, Newbiggin Lane, Lanchester, Durham, DH7 0NT

CONFIRMED MINUTES

DDES CCG Primary Care Commissioning Committee Present: Andrew Atkin (AA) Lay Member Nicola Bailey (NB) Chief Officer Sarah Burns (SB) Director of Commissioning Strategy and Delivery Dr Stewart Findlay (SF) Chief Officer Gill Findley (GF) Director of Nursing and Quality Amanda Healy (AH) Director of Public Health, Feisal Jassat (FJ) Lay Member, Patient and Public Involvement (Chair) Mark Pickering (MPi) Chief Finance Officer Dr Jonathan Smith (JS) Clinical Chair

North Durham CCG Primary Care Commissioning Committee: Present: Andrew Atkin (AA) Lay Member Nicola Bailey (NB) Chief Officer Sarah Burns (SB) Director of Commissioning Strategy and Delivery Joseph Chandy (JC) Director of Commissioning Strategy and Delivery Dr Ian Davidson (ID) Medical Director Dr Stewart Findlay (SF) Chief Officer Gill Findley (GF) Director of Nursing and Quality Richard Henderson (RH) Chief Finance Officer Feisal Jassat (FJ) Lay Member, Patient and Public Involvement (Chair) Dr David Smart (DSm) Clinical Chair

In attendance: Denise Alexander (DA) Engagement and Signposting Lead,

1

Official

Healthwatch Joseph Chandy (JC) Director of Commissioning Strategy and Delivery (in attendance for DDES CCG) Dr Christine Hearmon (CH) Practice Partner, Skerne Medical Group (in attendance for Item PCCCiC/20/07) Helen Letts (HL) Finance Manager, Skerne Medical Group (in attendance for Item PCCCiC/20/07) David Logan (DL) Healthwatch County Durham representative Dr John Nicholls (JN) Primary Care Network Clinical Director (in attendance for Item PCCCiC/20/11) Dr Neil O’Brien (NO’B) Accountable Officer, DDES CCG and North Durham CCG Sue Parr (SP) Executive Assistant, North Durham CCG (minutes) David Steel (DSt) Primary Care Business Manager, NHS / NHS Improvement

DDES CCG Primary Care Commissioning Committee Apologies: Mike Brierley (MB) Director of Commissioning Strategy and Delivery Dr Rushi Mudalagiri (RM) GP Clinical Lead

North Durham CCG Primary Care Commissioning Committee: Apologies: Mike Brierley (MB) Director of Commissioning Strategy and Delivery Dr Pat Wright (PW) GP Clinical Lead Representative

Items Action

PCCCiC/20/01 Apologies for absence

Apologies were received as recorded above.

PCCCiC/20/02 Declarations of conflicts of interest

The Chair reminded members of the Committees of their obligation to declare any interest they might have on any issues arising at the meeting, which might conflict the business of Durham Dales, Easington and Sedgefield (DDES) CCG and / or North Durham CCG.

Declarations made by members of the Committees are listed in the CCGs’ Registers of Interests. The Registers are available either via the secretary to the Primary Care Commissioning Committees or the CCG websites at the following links:

https://www.durhamdaleseasingtonsedgefieldccg.nhs.uk/documents/dec larations-conflict-interest

2

Official http://www.northdurhamccg.nhs.uk/governancecommittees/declarations- of-conflict-of-interest/

The following interests were noted or declared with regard to the items on the agenda:

PCCCiC/20/07 Skerne Medical Group – Application to Close Surgery General practitioner members and providers of primary care services in Durham Dales, Easington and Sedgefield and North Durham had a non- financial professional interest in this item. The members were

- Joseph Chandy, Director of Commissioning Strategy and Delivery, DDES CCG and North Durham CCG - Dr Ian Davidson, Medical Director, North Durham CCG (not in attendance) - Rushi Mudalagiri, GP Clinical Lead – Easington (not in attendance) - Dr David Smart, Clinical Chair, North Durham CCG - Dr Jonathan Smith, Clinical Chair, DDES CCG - Dr Patrick Wright, (not in attendance)

It had been agreed prior to the meeting that the conflicted members could receive the report and could take part in the discussion but should not be involved with any decision making.

PCCCiC/20/08 Combined Primary Care Quality Report Any members as general practitioners and providers of primary care services in Durham Dales, Easington and Sedgefield and North Durham had a non-financial professional interest in this item. The members were: - Joseph Chandy, Director of Commissioning Strategy and Delivery, DDES CCG and North Durham CCG - Dr Ian Davidson, Medical Director, North Durham CCG (not in attendance) - Rushi Mudalagiri, GP Clinical Lead – Easington (not in attendance) - Dr David Smart, Clinical Chair, North Durham CCG - Dr Jonathan Smith, Clinical Chair, DDES CCG - Dr Patrick Wright, (not in attendance)

It had been agreed prior to the meeting that the conflicted members could receive the report and could attend the meeting because there was no financial information included in the paper that could influence or benefit any conflicted member.

PCCCiC/20/10 Primary Care and Primary Care Network Development Update The paper was for discussion only and no decisions were required.

3

Official

However, it was acknowledged that members of the Committees were partners of practices which were part of a Primary Care Network and therefore that must be documented and managed accordingly during the discussion. The members were:

- Ian Davidson, Medical Director, North Durham CCG (not in attendance) - Joseph Chandy, Director of Commissioning Strategy and Delivery, DDES CCG and North Durham CCG - Rushi Mudalagiri, GP Clinical Lead – Easington (not in attendance) - Jonathan Smith, Clinical Chair, DDES CCG

The following members also had personal conflict due to their previous roles in general practice. - David Smart, Clinical Chair, North Durham CCG - Patrick Wright, GP Clinical Lead, North Durham CCG (not in attendance)

It had been agreed prior to the meeting that the conflicted members could receive the report and could attend the meeting because there was no financial information included in the paper that could influence or benefit any conflicted members.

PCCCiC/20/11 Primary Care Network Update As an owner of a medical practice within the Derwentside area, Dr Ian Davidson declared a non-financial professional interest in this item. As this item was for information only it was agreed that he could remain in the meeting.

PCCCiC/20/03 Identification of any other business

One item of other business was identified:  Outcome of the discussion with regard to Application for merger of St Andrew’s Medical Practice and Oxford Road Medical Practice (FJ)

PCCCiC/20/04 Minutes from the Primary Care Commissioning Committees in Common held on 19 November 2019

The minutes were agreed as a correct record of the meeting.

PCCCiC/20/05 Matters arising from the Primary Care Commissioning Committees in Common held on 19 November 2019

There were no matters arising.

PCCCiC/20/06 Action Log

There were no outstanding actions.

4

Official

ITEMS FOR DECISION

PCCCiC/20/7 Skerne Medical Group – Application to Close Fishburn Surgery Director of Commissioning Strategy and Delivery, DDES CCG and North Durham CCG - Joseph Chandy In attendance to present the report Primary Care Assistant Contract Manager, NHS England and Improvement - Jennifer Long

General practitioner members and providers of primary care services in Durham Dales, Easington and Sedgefield and North Durham had a non- financial professional interest in this item. Those members present were

- Joseph Chandy, Director of Commissioning Strategy and Delivery, DDES CCG and North Durham CCG - Dr David Smart, Clinical Chair, North Durham CCG - Dr Jonathan Smith, Clinical Chair, DDES CCG

It was noted that the conflicted members had received the report and could take part in the discussion but should not be involved with any decision making.

The purpose of the report was to provide information to enable NHS Durham Dales, Easington and Sedgefield (DDES) Clinical Commissioning Group’s (CCG) Primary Care Commissioning Committee to consider an application from Skerne Medical Group to close their branch surgery located in Fishburn Village.

In the absence of Jennifer Long, JC advised that in December 2018 Skerne Medical Group submitted an application to permanently close two of their branch surgeries located in Village and Fishburn Village. The application had been considered by the DDES CCG Primary Care Commissioning Committee. The closure of the Trimdon Village surgery had been approved, however the proposal to close Fishburn surgery had been rejected on the basis that the letter sent to patients as part of the engagement process had not specified that the Fishburn Village surgery was being considered for closure. The Committee therefore requested that the practice undertake a review so that it would fully understand its long term future premises needs.

In October 2019 the practice submitted a further application to close its Fishburn Village surgery. The practice had stated the main reason for the application was due to GP recruitment and retention issues and to ensure the sustainability of the practice.

The practice had undertaken patient and stakeholder engagement which

5

Official had focused on five options with regard to their premises:

1. extend Harbinson House, Sedgefield and retain and extend Trimdon Colliery surgery, 2. extend Harbinson House, Sedgefield and build a larger new surgery in Trimdon Colliery to accommodate 7,000 patients and retain Trimdon Colliery until 2027, 3. build a new surgery in Trimdon Village for the entire practice plus retain Trimdon Colliery until 2027, 4. occupy a single site at Sedgefield Community Hospital plus retain the Trimdon Colliery premises until 2027, 5. extend Harbinson House, retain Trimdon Colliery branch surgery and Fishburn Village branch surgery.

It was noted that representatives from Skerne Medical Group had attended the Overview and Scrutiny (OSC) Committee meeting held on 3 October 2019. The OSC had considered both the robustness of the engagement process and the preferred option put forward by the practice. Their response to both of the considerations had been included as Appendix 22 - follow up letter from Overview and Scrutiny Committee. The OSC had requested that the letter be considered by the Primary Care Commissioning Committee when making their final decision.

JC advised that all permutations with regard to premises, staffing and service provision for patients had been considered in depth by Skerne Medical Group. A significant amount of effort had been put into the consultation and the evidence of this was appended to the report. The OSC had commended the practice on its comprehensive engagement with the public.

JC advised that, having taken into consideration all factors and patient feedback, the Practice was proposing to progress with Option 1: Approve the closure of Fishburn Village Surgery site. With this option the Fishburn Surgery would permanently close and the practice would retain and extend both Harbinson House, Sedgefield, and Trimdon Colliery Surgery. The date of the potential closure would need to be agreed, however the Fishburn Surgery would remain open until the extension work at Harbinson House and Trimdon Colliery had been completed.

DSt, the representative in attendance from NHS England and NHS Improvement, advised he had nothing to add to at this point.

The Chair introduced Dr Christine Hearmon (CH), a partner of Skerne Medical Group and Helen Letts (HL), the practice’s Finance Manager. CH said that it had been a long process but one that she hoped would come to a conclusion that would support the continuity of the practice. A number of issues remained that would need to be worked through, GP recruitment for example, but the practice was positive that GPs would be encouraged to stay with the practice. If the proposals were agreed she

6

Official felt that the practice could then better plan for the future continuity of services for its patients.

JC added that GP retention was an important issue and one that had put practices at risk. The publication of the NHS Long Term Plan was having an impact on GPs making a decision to remain with their practices. JC drew attention to pages 21 and 22 which provided detail of the two options available and their benefits and risks.

The Chair thanked NHS England for the comprehensive report that reflected the robustness of the consultation. The thoroughness of the report, which included information on such things as the cost implications for transport and bus routes etc., was welcomed.

JC then highlighted next steps. Should option 1 be approved, the date of the closure would need to be determined and would be subject to the following:

 Services would continue at Fishburn Surgery until the extension work was completed at Harbinson House and Trimdon Colliery surgeries.  Should Fishburn Surgery close patients would be given the choice to attend either Harbinson House or Station Colliery Surgery.  The practice would return a signed contract variation to vary the premises.  The practice would confirm that it had informed patients and stakeholders of the outcome and what the change meant to patients, including sharing frequently asked questions via the practice waiting area and website.  The practice would confirm that they had informed the OSC of the outcome prior to informing patients.  Patients would be advised of their options with regard to their right to exercise choice of GP practice.  The practice would inform the Care Quality Commission (CQC) of the change to premises sites.  The practice would be required to confirm that they had updated all websites, literature and practice leaflets.

Should Option 1 be approved then it was noted that the timescale for the completion of the building works at Harbinson House and Trimdon Colliery was between 18 months and 2 years and that services would continue at Fishburn Surgery until the work had been completed.

The DDES CCG Primary Care Commissioning Committee agreed to approve Option 1: the closure of Fishburn Branch Surgery.

The Chair thanked Dr Christine Hearmon and Helen Letts for attending the meeting. Dr Hearmon acknowledged that there was still a lot for the practice to do but felt that they would be in a better position going forward.

7

Official

ITEMS FOR DISCUSSION

PCCCiC/20/08 Combined Primary Care Quality Report Director of Nursing and Quality, DDES CCG and North Durham CCG – Gill Findley

General practice members and providers of primary care services in Durham Dales, Easington and Sedgefield and North Durham had a non- financial professional interest in this item. Those members present were

- Joseph Chandy, Director of Commissioning Strategy and Delivery, DDES CCG and North Durham CCG - Dr David Smart, Clinical Chair, North Durham CCG - Dr Jonathan Smith, Clinical Chair, DDES CCG

It was noted that the conflicted members had received the report and could take part in the discussion. No decision was required.

The purpose of the report was to provide a summary of the key points in relation to quality assurance in primary care across County Durham. GF advised that practices submitted their assurance data to NHS England via a web based tool. This calculated scores for each practice and flagged any outliers. In October 2019 NHS England identified one DDES CCG and two North Durham CCG practices as having five outlier markers on their assurance data. The practices had been asked to review the identified markers and to share any actions the practice had undertaken, or plans they would take, with regard to these indicators and to describe any mitigating factors and circumstances. Currently the CCGs were waiting for that information to be returned.

It had been confirmed that the Friends and Family Test (FFT) was a contractual requirement. Practices were required to undertake an FFT and to report the findings on their website. This was not being routinely done yet and practices had been reminded of the requirement via the CCGs’ newsletter.

On 1 November 2019 the North of England Commissioning Support (NECS) Clinical Quality Team had launched their process for the receipt and management of incidents from secondary care providers about issues they had identified in general practice. There had been some initial issues with the process that had needed to be resolved and the CCG had been keen not to overburden practices on minor incidences, however the CCGs now had a robust mechanism in place that provided oversight of incidences within primary care.

The Primary Care Commissioning Committees noted and discussed the content of the report.

PCCCiC/20/09 Primary Care Finance Report for the eight months ending 30 November 2019

8

Official

Chief Finance Officer, DDES CCG – Mark Pickering Chief Finance Officer, North Durham CCG – Richard Henderson

RH spoke to the report that presented a summary of the financial position on primary care budgets for the eight months ending 30 November 2019. This included those primary care budgets delegated from NHS England and also any other elements of primary care spend within the main commissioning budgets of the CCGs.

RH advised that there had been little change with regard to the budget positions since the previous report but this was to be expected given that the majority of the budget values and contracts were relatively fixed in nature.

As previously reported to the Committees, there was a recurring pressure on the delegated primary care budgets which was being managed on a non-recurring basis via the benefit of prior year slippage on the Quality Outcomes Framework (QOF) achievement and other non- recurring slippage on budgets, including enhanced services.

The CCGs were waiting on the publication of the NHS Operational Planning Guidance for 2020/21; once the budget allocation and its implications were understood, and what effect it would have on the delegated primary care budget for 2020/21, the CCGs would report back to the Committees. It was however expected there would remain a significant recurring financial pressures on the delegated primary care budget.

The Chair invited questions and comments from the table.

It was noted that the CCGs’ delegated primary care budgets were currently in a breakeven financial position as planned, which was positive.

SF pointed out that the growth in investment within primary care services had been above that allocated to acute services, however the CCGs did not know yet what the additional amount of funding would be and what other services it would need to fund. Nevertheless, the enhanced investment for primary care had been very welcome.

The Primary Care Commissioning Committees:  received the report,  noted the current and forecast financial position in respect of primary care budgets

PCCCiC/20/10 Primary Care and Primary Care Network Development Update Director of Commissioning Strategy and Delivery, DDES CCG and North Durham CCG - Joseph Chandy

9

Official

As this paper was for discussion only and no decisions were required there were no conflicts identified. However, it was acknowledged that some members of Primary Care Commissioning Committees were partners of practices which were part of a Primary Care Network and therefore this must be documented and managed accordingly during the discussion. Those members present were: - - Joseph Chandy, Director of Commissioning Strategy and Delivery, DDES CCG and North Durham CCG - Dr David Smart, Clinical Chair, North Durham CCG - Dr Jonathan Smith, Clinical Chair, DDES CCG

It was noted that the conflicted members had received the report and could take part in the discussion. No decision was required.

The purpose of the report was to provide an update to the Committees on the progress made by the CCGs on delivery against the General Practice Forward View and the ten high impact areas. The report highlighted key areas and included an update on the new GP Contract and the NHS Long Term Plan.

JC highlighted the following key areas:

NHS England had consulted General Practice on the new specifications as listed in the report. There was a lot of push back from General Practice and its representative professional bodies. NHS England was in the process of collating and considering the feedback.

Patient Participation Policy Template All practices had responded to the requirement for them to develop a patient participation policy. All had used the recommended template provided by the CCG and the policies were now being reviewed by the Patient Reference Groups.

Care Navigation Dentistry and Health Veterans pathways had now been shared with practices. Work was ongoing with County Durham and NHS Foundation Trust (CDDFT) to agree the musculo skeletal (MSK) pathway; it was expected to be rolled out in January 2020 for a three month trial to assess activity and demand on the physiotherapy service.

Primary Care Local Improvement Scheme (LIS 2020/21) Work was underway to develop a common Primary Care Local Improvement Scheme (LIS) for County Durham CCG. The Scheme included a number of new indicators, reflecting local and national priorities. The CCGs were working with Derwentside Federation to trial a new set of indicators / initiatives around prevention. This should support practices to prepare for the new population element of the Directed Enhanced Service (DES) that would be introduced in 2020/21. The funding associated with the scheme had been increased.

10

Official

During December 2019, initial engagement had been undertaken with some practices. Further engagement would take place with practices during January 2020 and any feedback would be considered prior to final sign off of the LIS at Executives in Common in February 2020.

Primary Care Strategy Refresh 2019-24 Work continued to align and update the outgoing primary care commissioning strategies across County Durham.

The CCGs had engaged with member practices and patient groups on what good primary care would look like in five years’ time and what the proposed priorities would be.

The engagement with practice representatives had been useful in drawing attention to workforce, IT and estate issues and giving practices an opportunity to say how they thought the CCGs could support them going forward. The Primary Care Strategy had been amended in light of the feedback received.

Further work was required to agree the shared vision for primary care and to ensure alignment with the County Durham placed based commissioning and delivery plan. It was anticipated that the final draft of the primary care strategy would be submitted to the CCG Governing Bodies for formal ratification in March 2020.

At this point AH raised a point of accuracy. AH advised that Public Health had been working in partnership with primary care and provided an example of Wellbeing for Life and the joint recruitment of the Social Prescribing Link Workers. AH felt that it would be nice to see that reflected in the paper.

The Primary Care Commissioning Committees noted and discussed the content of the report. Going forward the report would reflect the partnership working with Public Health.

PCCCiC/20/11 Derwentside Primary Care Network Update Director of Commissioning Strategy and Delivery, DDES CCG and North Durham CCG - Joseph Chandy In attendance to present the update Primary Care Network Clinical Director - John Nicholls

As an owner of a medical practice within the Derwentside area, Dr Ian Davidson declared a non-financial professional interest in this item. As this item was for information only it was agreed that he could remain in the meeting for the presentation and discussion.

JC introduced this item by advising that PCNs were fairly new across the

11

Official country but had been place for some time within County Durham.

Dr John Nicholls (JN) thanked the Chair for the invitation and introduced himself as a Practice Partner within Derwentside and the PCN Clinical Director for Derwentside East.

JN provided an overview of the role undertaken by Derwentside PCN within community services; this was summarised as follows:

 Derwentside PCN was a network of 13 GP practices, coordinating local services including community nurses, matrons, physiotherapy and occupational therapists and community mental health.  It covered approximately 93,870 patients, but usually worked in two neighbourhood groups - 'East' and 'West', broadly around Stanley and respectively.  New investment from NHS England would shortly provide funding for additional roles at this network level (pharmacists and social prescribing link workers initially), which was welcomed, but was also a challenge as practices would have to find the time to plan and work together to receive and manage this resource, and there were additional expectations.  The Extended Hours Access Scheme would be managed as part of a PCN.  Practices within the Derwentside PCN also provided healthcare as part of a GP Federation, and had already undertaken additional preventative work especially regarding cardiovascular disease.  The CCG was hoping to fund additional blood pressure and cholesterol preventative work at a network level from 2020/21. It would be short-sighted not to focus on prevention but the immediate pressures on services were often, understandably, the priority.  The role of the Clinical Director for Derwentside PCN was undertaken by four individuals as a job share arrangement. They aimed to balance appropriate clinical leadership of the network with their ‘coal- fac’ patient-facing time, and did not want them as clinicians to become managers.

JN added that Derwentside PCN would be happy to provide updates to the Committees at future meetings.

The Chair thanked JN for the first PCN update and invited questions and comments from the table.

FJ asked if PCNs would be obliged to undertake public and patient engagement as it was a statutory duty for CCGs to do this before any change to services. JN advised that the PCNs were not a legal identity and would not be required to do so however general practices had their own patient reference groups and he anticipated that the CCGs could provide support in developing patient engagement through this route.

SF said that PCNs would bring general practice back into partnership

12

Official

with Mental Health services, community services, social workers and the voluntary sector. Future partnership development would include optometrists, pharmacists and dentists. SF felt that as many community services as possible should be co-ordinated through PCNs and that it was an exciting way of working to bring general practice back to being a true partner in the health system for County Durham.

AH said that there had been a lot of work to date with PCNs to ensure joined up working with Public Health and the CCGs. This included determining what would be included in community services and the recruitment of staff, for example, Social Prescribing Link Workers. AH felt that the Patient Reference Groups had a real wealth of information with regard to their local communities and had been instrumental in shifting support to prevention instead of just at crisis point.

JS advised that not all PCNs were using Wellbeing For Life but used local expertise instead which also worked very well.

The Chair thanked JN for the update and said he looked forward to a further update in due course.

FOR INFORMATION

PCCCiC/20/12 Primary Care Navigation – HealthWatch County Durham Research into the experience of primary care staff and patients in County Durham, March 2019 Director of Commissioning Strategy and Delivery, DDES CCG and North Durham CCG - Joseph Chandy

In 2018 HealthWatch County Durham (HWCD) had been approached by the CCGs to independently evaluate the Care Navigation system. Care Navigation was the system where trained, non-clinical staff, talked to patients when they booked an appointment, providing information about the professionals or services that may be suitable for a patient’s needs. The CCGs wanted to understand the views and experiences of staff who were implementing the system and patients who were using it.

The report (Primary Care Navigation – research into the experience of primary care staff and patients in County Durham) had then been produced by HWCD; both CCGs acknowledged the content of the report and the main themes that had emerged from the evaluation. The CCGs had worked with HWCD to produce an action plan (see Appendix 1).

A significant number of people had completed the survey (350), which included 115 members of staff. Some of the surveys had been completed as a group which meant the final figure, had each individual been included, would have been higher.

13

Official

DL highlighted the following key points and observations from the survey:  ‘Navigators’ would like more training to develop their confidence and skills base. The number of ‘navigators’ not confident in navigating patients was higher than the CCGs would have liked.  ‘Navigators’ would like to understand how other practices delivered care navigation and to share best practice.  Implementing Care Navigation had identified gaps in linking to additional external services.  From a patient point of view, 69% said they were happy to explain to the receptionist the reason for their call / visit. This meant that 31% of patients were not happy and the main reasons given for this were lack of privacy and confidentiality as well as feeling embarrassed.

Attention was drawn to the staff and patient feedback and additional comments within the report. Referring to the action plan, JC advised that a number of the actions had now been completed including additional training and the development of further templates to signpost patients to additional external services.

JC said that, from a CCG perspective, the survey had been a really valuable exercise.

It was mentioned that HWCD could undertake a further evaluation in 2021 (June/July). It was agreed to discuss this out-with the meeting, noting that it would be subject to the approval of the HWCD Board.

Action: JC and DL to discuss further the proposal from HWCD to JC / undertake an evaluation of Care Navigation in June/July 2021. DL

Drawing discussion to a close, the Chair said that it was an invaluable report from both a CCG and HWCD perspective. The development of the action plan had resulted in some quick wins which would not have been made without the survey. He felt that it would be useful to see some of the hard data in the next report should a further evaluation go ahead in 2021.

The Primary Care Commissioning Committees:  noted that the CCGs were grateful to Healthwatch for this comprehensive report,  noted that the CCG had put in place an action plan to improve the approach to care navigation,  noted the CCGs would encourage an Improvement Grant to support improvement to premises that would assist confidentiality,  noted the CCGs would re-iterate with practices the opportunity to strengthen the phone message including support of the receptionist,  noted that practices had volunteered to supply their patient appointment data. The CCGs monitor this on a monthly basis. The

14

Official

data was showing that County Durham practices were offering an appropriate number of appointments for their population. The CCGs would continue to support practices in improving access.

PCCCiC/20/13 Questions from the Public

There had been no questions submitted prior to the meeting however the Chair invited questions from the members of the public in attendance.

There were no questions raised from those members of the public in attendance.

PCCCiC/20/14 Other Business

PCCCiC/20/14-1 Outcome of the discussion with regard to an application to merger from St Andrew’s Medical Practice and Oxford Road Medical Practice (C-PCCCiC/20/09)

FJ advised that a discussion had taken place during the confidential section of the Committee with regard to the merger of St Andrew’s Medical Practice and Oxford Road Medical Practice. He explained an administrative merger had previously been agreed by NHS England but the practices had now formally applied to fully merge which required the approval of the DDES CCG Primary Care Commissioning Committee.

FJ said the Committee had approved the merger and that it had been an easy decision to make given that the practices had been working so successfully together for some months now.

FJ added that any future applications for practice mergers would be discussed in the public part of the meeting.

PCCCiC/20/15 Standing item: Risk Round Up

There had been no new risks identified during discussion at the meeting.

PCCCiC/20/16 Date and time of next meeting The next meeting would be held on Tuesday 17 March 2020, 13:00 to 14:30. Fishburn Youth and Community Centre, Butterwick Road, Fishburn, Stockton-on-Tees, TS21 4ED

Post meeting note: it had subsequently been decided to replace this planned formal meeting with an informal development sessions that would be not be held in public.

15

Official

Contact for the meeting: Susan Parr, Executive Assistant, North Durham CCG Tel: 0191 389 8621 Email: [email protected]

Signed…………………..

Chair: Feisal Jassat

Date……………………...

16