CLINICAL COMMISSIONING GROUP PRIMARY CARE COMMISSIONING COMMITTEE

HELD IN PUBLIC SESSION ON FRIDAY 21 DECEMBER 2018 1:00pm – 3:00pm T051, 3RD FLOOR, HEALTH & SOCIAL CARE CENTRE, VENTURE WAY, BRIERLEY HILL, DY5 1RU QUORACY A meeting of the Committee will be quorate provided that at least 4 members are present of which:  one must be either the Chair or Vice-Chair of the Committee  one must be the Chief Finance Officer/Deputy Chief Finance Officer or Chief Nursing Officer/Head of Quality Assurance or nominated deputies PUBLIC AGENDA Time Item Attachment Presented by 1:00 pm 1 Apologies Mr S Wellings Declarations of Interest 2.1 To request members to disclose any interest they have, direct or indirect, in any items to be considered during the course of the meeting and to note that those members declaring an interest will not be allowed to take part in the consideration or discussion or vote on any questions relating to that item. 2 Mr S Wellings 2.2 This meeting is being held in public and is being recorded purely to assist in the accurate production of minutes, decisions and actions. Once the minutes have been approved the recording will be destroyed. 1:00 pm All care is taken to maintain your privacy; however, as a visitor in the public gallery, your presence may be recorded. Should you contribute to the meeting during questions from the public, you agree to being recorded. 1:00pm 3 Questions from the Public Mr S Wellings 1:10pm 4 Minutes of last meeting held on Friday 23 November 2018 Enclosed Mr S Wellings 1:20pm 5 Matters Arising/Action Log Enclosed Mr S Wellings 1:30pm 6 Report from the Primary Care Operational Group Enclosed Mrs J Robinson 1:45pm 7 Quality & Safety Report Enclosed Mr D King 2:15pm 8 Risk Register Enclosed Mr D King

2:30pm 9 Finance Report Enclosed Mr P Cowley 2:45pm 10 Practice Alternative Service Locations Enclosed Mr P Cowley 3:00pm 11 Glossary Enclosed For Information

Date and Time of Next Meeting 18th January 2019 1:00-3.00pm The Board Room Brierley Hill Health & Social Care Centre Venture Way, Brierley Hill, DY5 1RU

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Title First Name Surname Job Title Declarations of Interest

Mrs Caroline Brunt Chief Nurse None Senior Finance Manager – Mr Philip Cowley Partner works for Central Midlands CSU Primary Care Chief Officer of Dudley Mrs Andrea Crew None Healthwatch Senior Contract Manager - Mr Bal Dhami NHS (West None Midlands)

Chief Executive, Accord Group Visiting Professor at Birmingham City University

Board Member of: Lay Member for Quality & Dr Christopher Handy - Black Country LEP Board Safety - Matrix - Redditch Co-operative Homes - Black Country Consortium - Birmingham Chamber of Commerce - Walsall Housing Regeneration Agency - Direct Health

Director of Dudley Infracare Lift LTD

Director of Whitbrook Management Company Chief Operating & Finance Mr Matthew Hartland Member of Chartered Institute of Public Officer Finance and Accountancy Interim Strategic Chief Finance Officer, Walsall CCG Interim Strategic Chief Finance Officer, CCG

Clinical Executive for Primary Sessional GP - Netherton Health Centre. Dr Tim Horsburgh Care & LMC Representative Member of the Local Medical Committee Clinical Lead for SWITCH

Lay Member - Sandwell and West Lay Member – Patient & Mrs Julie Jasper Birmingham CCG Public Involvement Managing Director of Westland’s Associates Ltd Member of CIPFA

Mr Alan Johnson Secondary Care Clinician None Ms Sue Johnson Deputy Chief Finance officer None Head of Membership Mr Daniel King None Development & Primary Care

Interim Deputy Head of Commissioning (Primary Mrs Anna Nicholls Care) None NHS England (West Midlands)

Primary Care Commissioning Committee Member at Dudley CCG Public Health Representative Consultant in Public Health Medicine, Dr David Pitches - Primary Care Dudley MBC Commissioning Committee Wife is a Consultant Obstetrician at Heart of England Foundation Trust Occasional Church organist fees received for giving recitals or playing for services Primary Care Contracts Mrs Julie Robinson None Manager

Non-Executive Director _ Black Country Patient Opportunity Panel Mr David Stenson Partnership NHS Foundation Trust Representative Volunteer, Healthwatch Dudley Primary Care Commissioning Other: Daughter works at Moss Grove Mrs Joanne Taylor Manager Surgery Dudley Local Pharmaceutical Dudley LPC Member Mr Thomas Thomik Committee Representative Royal Pharmaceutical Society Member

Wife employed by Dudley MBC Housing Department Mr Steve Wellings Lay Member - Governance One Niece employed by DGFT as a nurse Member of CIPFA None Mr James Young Head of Quality Assurance

DUDLEY CLINICAL COMMISSIONING GROUP PRIMARY CARE COMMISSIONING COMMITTEE

MINUTES OF THE MEETING HELD IN PUBLIC ON FRIDAY 23 NOVEMBER 2018 THE BOARD ROOM, 3RD FLOOR, BRIERLEY HILL HEALTH AND SOCIAL CARE CENTRE, VENTURE WAY, BRIERLEY HILL, DY5 1RU

Quorum: A meeting of Committee will be quorate provided that at least four voting members are present of which one must be either the Chair or Vice Chair of Committee and one must be the Chief Finance Officer/Deputy Chief Finance or Chief Nursing Officer/ Head of Membership Development & Primary Care

ATTENDEES:

Voting Members

Mr S Wellings Non-Executive Director for Governance, Dudley CCG (Chair) Ms S Johnson Deputy Chief Finance Officer, Dudley CCG Dr D Pitches Consultant in Public Health, Dudley MBC Mr A Johnson Secondary Care Clinician, Dudley CCG Mrs C Brunt Chief Nurse, Dudley CCG Dr C Handy Non-Executive Director, Quality and Safety, Dudley CCG (Vice Chair) Mrs J Jasper Non-Executive Director for Patient and Public Involvement, Dudley CCG Mrs H Mosley Non-Executive Director for Patient and Public Involvement, Dudley CCG

Non-Voting Members

Mr T Thomik Dudley LPC Representative Mr D Stenson Patient Opportunity Panel Representative Mrs A Crew Chief Officer, Healthwatch Dudley

In Attendance Mr B Dhami Senior Contracts Manger (Primary Care), NHS England (West Midlands) Mr P Cowley Senior Finance Manager, Dudley CCG Joanne Taylor Primary Care Commissioning Manager, Dudley CCG Mr D King Head of Membership Development & Primary Care, Dudley CCG Mrs J Robinson Primary Care Contracts Manager, Dudley CCG

Minute Taker:

Miss T Fear PA to the Head of Membership Development & Primary Care, Dudley CCG

1.0 APOLOGIES FOR ABSENCE

Apologies were received from

Non-Voting Members Dr T Horsburgh Clinical Executive for Primary Care, Dudley CCG/LMC Representative

Mrs A Crew joined the meeting

2.0 DECLARATIONS OF INTEREST

To request members to disclose any interest they have, direct or indirect, in any items to be considered during 1 | P a g e

the course of the meeting and to note that those members declaring an interest would not be allowed to take part in the consideration or discussion or vote on any questions relating to that item.

No changes were made to those listed.

3.0 QUESTIONS FROM THE PUBLC

Mr Wellings noted that there were no questions submitted to committee prior to the meeting.

Resolved: 1) Committee noted that there were no questions submitted prior to the meeting. Mr D Stenson & Mr T Thomik joined the meeting

4.0 MINUTES OF THE LAST MEETING OF INTERST The notes of the last meeting held on 19 October 2018 were submitted to Committee and were agreed as an accurate record with the following amendments;  Mr D King to be included in the quoracy as a nominated deputy for the Chief Nurse  Incorrect spelling for the member of parliament on page three

Mr Wellings also suggested the following to replace paragraph two on page two

Each person formally attending the committee meeting was asked to identify themselves to the audience, explain their title and role, and to confirm whether or not they were a voting member of the committee. The Chairman explained that there were normally seven voting members, but that two had given their apologies for the meeting. The meeting was however still quorate and therefore should be able to make the decision today.

5.0 MATTERS ARISING/ACTION LOG

The action log was discussed and updated accordingly with the following points noted:

PCCC/AUG/2018/5.0 Moss Grove & Kinver There has been no further action with this however there are on-going discussions.

6.0 REPORT FROM THE PRIMARY CARE OPERATIONAL GROUP

Mrs Robinson spoke to this item to update Committee following the Primary Care Operational Group meeting held on 5 September 2018.

Committee were assured that there are no contractual breaches to be issued for any Dudley practice.

Primary Care Operational Group considered and made a recommendation for approval for a retrospective contractual variation for the inclusion of an additional partner at Moss Grove Surgery. Committee were advised that the CCG were made aware of this via NHS England, on further investigation it would appear that the Practice Manager was unaware of the process to notify the CCG of a contract variation. Committee were assured that although significant communication has been made regarding this process, a new guidance document was currently being drawn up. Dr C Handy left the meeting

The group then discussed a resignation of a GP within a sole GP partnership, this item was picked up as part of the risk register update. PCOG agreed to undertake an options appraisal in the event of termination of contract by contractors.

Assurances were given that all risks associated with the Crestfield Surgery closure had been successfully managed and that the project had been closed. However it is expected that NHS England will notify the CCG

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via the safeguarding team of the patients who have not re-registered with another GP practice, this will mirror the same process as previous closures. A further round of practice visits will be undertaken to those practices identified in the lower quartile of the PCAT tool. These visits will be conducted by the GP Engagement Lead & the Head of Membership Development & Primary Care.

Primary Care Operational Group discussed the Quality and Safety report and it was agreed that the quality and safety team will undertake an exercise to check that practices are ordering sufficient flu vaccine stock, and that there are systems in place between practices to share stock. Committee were assured that progress has been made on this, shortfalls and surpluses have been identified and the CCG have been liaising with the DPMA who have agreed for this to be raised at their regular meetings. Currently there have been 200 vaccines that have been shared between practices. Dr C Handy re-joined the meeting

A full report was received from Dr David Parry, GP Mentor on activities undertaken to date and has been identified as a useful resource however work could be done to ensure that it remains cost effective in relation to the IT support, this will be picked up via the IT Strategy group.

Finally the group discussed the GP survey results for 2018-19, the results and actions for which are presented in a separate report as part of this Committee meeting.

Resolved:

1) Committee noted the actions of the Primary Care Operational Group for assurance 2) Committee approved the contract variation to add a partner to Moss Grove Surgery

7.0 QUALITY AND SAFETY REPORT

Mrs Brunt spoke to this item to provide on-going assurance to the Primary Care Commissioning Committee regarding quality and safety in accordance with the CCG’s statutory duties.

Committee were advised that the Quality and Safety team have additional capacity who has expertise in Datix, it is expected that they will be involved with pushing the Primary Care element of Datix and to support practices with this. Mr P Cowley left the meeting

Special Allocation Scheme (SAS) was raised at a West Midlands Quality Surveillance group who advised there will be a Task & Finish group in relation to zero tolerance for aggression & violence against staff. The meeting highlighted that there was inconsistences across the Black Country and wider areas in relation to the thresholds for excluded patients however it was agreed that there would be discussions to try and obtain more consistency. It was then noted that Mrs Robinson was currently writing a SAS guidance including patient criteria for Dudley. Committee hoped that guidance document would feed into the discussions of the Task and Finish group. Mr P Cowley re-joined the meeting

Coseley Medical Centre have undergone a re-inspection from CQC and have remain overall “Good” rating however remains “requires improvement” for the responsive domain. The practice have made improvements in this domain since the inspection earlier in the year and are making positive steps for example implementing a new telephone system and increased their carers register however the GP patient survey still show patient dissatisfaction but it is expected it will take some time for the changes to be reflected in the surveys.

Resolved: 1. Committee noted the report for assurance

8.0 RISK REGISTER

Mr King spoke to this item to provide the Committee with an updated BAF & risk registers.

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Committee did not requested any changes at the last meeting however the risk register is regularly reviewed via the Primary Care Operational Group and it was identified that there is a risk of medical services being adversely effected due to insufficient workforce, therefore risk 136 has been reviewed and updated to reflect the position of one of the member practices.

Committee agreed an increase to the residual score for risk 136 from 9 to 12.

Committee were then advised that a partner within the practice has resigned and taken up a substantive position elsewhere however continues to maintain the contractual responsibility with their previous practice. The CCG were also informed that two salaried GP’s have also handed in their notice. The CCG has an obligation to ensure that the contract is being fulfilled and there is sufficient clinical capacity within the contract therefore the CCG are undertaking weekly monitoring with the practice and have oversight of how the clinical provisions are being provided to patients and assurances are being given through the Primary Care Operational Group.

The Primary Care team have worked with the practice to help facilitate meetings with the surrounding practices to discuss merger options.

Committee requested more information on this situation and it was agreed that further consideration should take place as an item for discussion during the private agenda.

Committee were assured that the CCG were doing everything to ensure that services are being provided, the practice has sufficient clinical capacity and remains safe.

Mrs. Robinson stated that the LMC have also offered their support to the practice.

It was proposed that the timescales for risks 135 & 139 should be amended to January 2019. Committee agreed the changes to the timescales. Action: Mr. King

Resolved: 1. Committee accepted the Risk Register 2. Committee agreed an increase to the residual score for risk 136 from 9 to 12. 3. Committee agreed that the timescales for risks 135 & 139 should be extended to January 2018

9.0 FINANCE REPORT

Mr Cowley spoke to this item to provide an overview of financial performance against budgets delegated to Committee for Month 5 2018/19.

There has been one change to the budget reported to Committee in August, with £331,000 received to fund the GP pay award.

As funding for the GP pay award had already been identified non-recurrently within existing budgets, this allocation is available for commitment against non-recurrent investments. This was considered as a separate agenda item.

On the basis that this identified funding will be committed in full, a break-even position is forecast to be achieved in respect of all budgets reported to Committee.

Resolved: 1) Committee noted the report for assurance.

9.1 USE OF UNALLOCATED RESERVES

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Mr Cowley spoke to this item to provide an overview of the resources available to Committee following national funding of the GP pay award, and provide recommendations as to their use. Following the announcement of the GP pay award, the CCG undertook a review to identify sources of funding for the GP pay award should national funding not be forthcoming.

On receipt of national funding these sources of funding have been added to the reserves, resulting in the full allocation balance of £331,000 being available for non-recurrent investment

Committee were provided with the following two options for the use of these resources:  Agree the additional discretionary pay award requested by the BMA; or  Fund a combination of additional winter access and the recommended range of targeted support for general practices.

It was agreed to discharge the first option relating to the additional discretionary pay award requested by the BMA as it was hoped that the discussions between the BMA and NHS England would progress sufficiently enough to allow the release of this money next year.

A menu of options for the use of the investment of the funds has been developed and submitted to Committee for consideration. These are as follows;

 Non-Medical Prescribing  Clinical Skills Training  Primary Care Networks (PCN) Workforce Planning  Early Career Path Network  NHSPS/CHP Lease Regularisation  Weekend Extended Access Extension

To further support the urgent care system over winter it is propose that the existing extended access scheme capacity is increased to provide an additional 15 hours per locality per weekend during the period December 2018. This would provide an additional 75 hours per weekend of primary care provision which equates to 300 appointments across Dudley.

It was noted that one locality model have expressed their concerns about fulfilling the additional 15 hours at weekends due to the way the locality organises itself for extended hours and enquired to the feasibility of distributing these hours across the week, after general discussions it was agreed that this should be resolved outside of the Committee meeting.

Committee were asked to note the reserves available for utilisation as a result of the allocation received for the GP pay award and approve Option 2 for the utilisation of the reserves to increase winter access and provide the menu of additional support to GP practices.

Resolved: 1) Committee agreed not to pay the GP pay award additional discretionary pay award. 2) Committee approved Option 2 for the utilisation of the reserves to increase winter access and provide the menu of additional support to GP practices.

10.0 PRIMARY MEDICAL SERVICES NEW CONTRACTUAL FRAMEWORK

Mrs Taylor spoke to this item to present to the Committee the review process of indicators, thresholds and associated finances for the ‘Dudley Quality Outcomes for Health’ (DQOFH) contract 2019/20 for ratification.

In line with previous years the CCG will undertake a review of the indicators, thresholds and subsequent finances for the contractual year 2019/20

An overview steering group has been set up to undertake this process which consists of representation from the CCG, GP Collaborative Steering Group and the wider GP Membership as well as IT, Public Health, Medicines Management and Finance. 5 | P a g e

The review process for indicators, thresholds and associated finances for the DQOFH framework contract 2019/20 were presented to Committee for ratification.

The DQOFH framework contract will be considered at a Senior Managers Meeting & brought to Committee for consideration in February 2019. It was noted that the document was subject to any national changes in the contract.

Committee was assured that sufficient actions have been taken to manage the conflicts of interest in relation to this issue.

The Committee was asked to approve the review process for indicators, thresholds and associated finances for the DQOFH framework contract for 2019/20.

Resolved: 1) Committee approved the DQOFH framework contract for 2019/20.

11.0 GP PATIENT SURVEY RESULTS COMPARISON REPORT

Mr King spoke to this item to update Committee on the GP Patient Survey 2018 results and agree the actions recommended by PCOG.

The CCC are communicating the survey results to all member practices and has a mechanism in place to ensure that they are aware of the reports, that they are taken seriously within their businesses, discussions are taking place within their Patient Participation Groups and are taking actions in relation to the feedback contained within the survey results.

The followings actions in relation to the GP survey were agree by the Primary Care Operational Group to ensure that there is a structure in place;  Share the results via members news  Discuss the results in each locality meeting, presented by the GP engagement lead  Invite practices to feedback to the Primary Care Team the actions being taken in respect of the GPPS results  Ask all practices to discuss the GP survey results with the Patient Participation Groups (PPG’s) and feedback with their locality meetings  GP engagement lead to present to present and discuss GPPS results with the Patient Opportunity Panel  Share and discuss the report with the Dudley Practice Management Alliance (DPMA)  Seek formal feedback from the Local Medical Committee (LMC)  Report back to the Primary Care Commissioning Committee on the outcome of practice discussions with their PPGs and locality groups

Mr King asked if Mr Stenson could encourage the Patient Participation Groups to place this item on the agendas for future PPG meetings.

Committee then discussed the key elements from the GP Patient Survey. Committee were advised that the practices who fall below the national average for telephone access that have been visited have either new telephone system already in place or will be implemented in the near future.

Committee enquired as to whether any audits have been carried out to assess accessibility, Committee were advised that this is not something that is carried out routinely.

Mr Stenson noted that a Health Care Forum meeting was due to take place shortly and asked the feasibility of the patient survey being made available for attendees. Committee felt that this was appropriate.

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Discussions also took place regarding a question within the survey relating to why patients choose to go to A&E, however it was felt that patients needed to better understand the difference between A&E and the Urgent Treatment Centre (UTC). Committee requested that the CGG liaise directly with the PPG in relation to the Patient Survey and asked Mr Stenson to draft appropriate communications. Action: Mr Stenson

Resolved: 1) Committee noted the report for assurance. 2) Committee agreed the actions recommended by the Primary Care Operational Committee with the inclusion of the survey being submitted to the Health Care Forum.

12.0 DATE AND TIME OF NEXT MEETING

Friday 21 December 2018 1pm - 3pm Brierley Hill and Social Care Centre, Venture Way Brierley Hill DY5 1RU T051, third floor

MINUTES ACCEPTED AS A TRUE AND CORRECT RECORD

Name Title Signed Date

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PRIMARY CARE COMMISSIONING COMMITTEE

OUTSTANDING ACTION LIST – 21 December 2018

MEETING REFERENCE ACTION LEAD STATUS DEADLINE DATE

Performance Report – Children’s Attendance PCCC/JAN/2017/1(c) Report to be presented to Committee regarding findings of Mrs Brunt In progress December 2018 children’s attendance at PAU.

Supporting Professional Decisions PCCC/APR/2017/13.0 The Committee requested further detail around the Dr Horsburgh In progress December 2018 membership of the panel and how that would work.

Chaperoning Policy PCCC/NOV/2017/8.0 Policy to be considered at LMC where GPs within the Dr Horsburgh In progress December 2018 group should discuss how to take this matter forward.

Moss Grove Kingswinford & Kinver PCCC/AUG/2018/5.0 Mrs Brunt On-going December 2018 A standing item on the action log for regular updates. GP Patient Survey

PCCC/NOV/2018/11.0 Communications to be sent to Patient Participation Groups Mr D Stenson In progress December 2018 encouraging them to discuss the survey with their practices

1 | P a g e DUDLEY CLINICAL COMMISSIONING GROUP PRIMARY CARE COMMISSIONING COMMITTEE

Date of Committee: 21 December 2018 Report: Update from the Primary Care Operational Group Agenda Item: 6.0

TITLE OF REPORT: Update from the Primary Care Operational Group

To update Committee following the Primary Care Operational Group PURPOSE OF REPORT: meeting held on 12 December 2018

AUTHOR OF REPORT: Mrs J Robinson, Primary Care Contracts Manager

MANAGEMENT LEAD: Mrs C Brunt, Chief Nurse

CLINICAL LEAD: Dr T Horsburgh, Clinical Executive for Primary Care The Primary Care Operational Group:

 Provides assurance that there are no contractual breaches to be issued for any Dudley practice.  Make a recommendation to Committee regarding applications to change branch surgery opening hours.  Noted the data quality exercise that will be carried out by Primary KEY POINTS: Care Support England on behalf of NHS England.  Agreed guidance to GP practices to help with the administration of clinical starters and leavers.  Received the quality and safety issues that are set out in the quality and safety report and agreed that learning from the report produced by NHE England, Medical Directorate, Professional & Practice Information Gathering Group (PPIGG) will be reviewed to identify any actions for Dudley. Committee is asked to:

 Note the actions of the Primary Care Operational Group for assurance RECOMMENDATION:  Approve the recommendation regarding applications to change branch surgery opening hours

FINANCIAL IMPLICATIONS: Not applicable

WHAT ENGAGEMENT HAS Not applicable TAKEN PLACE:

ANY CONFLICTS OF No conflicts of interest were declared in advance. INTEREST IDENTIFIED IN ADVANCE:  Decision ACTION REQUIRED: Assurance

1 | P a g e DUDLEY CLINICAL COMMISSIONING GROUP – PRIMARY CARE COMMISSIONING COMMITTEE UPDATE FROM THE PRIMARY CARE OPERATIONAL GROUP

1.0 INTRODUCTION

1.1 This report provides an update from the Primary Care Operational Group (PCOG) following its meeting held on 12 December 2018.

2.0 CONTRACTUAL

Changes to branch surgery opening hours

2.2 The group make a recommendation to Committee that any requests from practices wishing to change the opening hours of a branch surgery should only be approved provided that there is no overall reduction in appointments and that the capacity is taken up by either the main or another branch on the same day of the week.

Potential changes in clinical workforce and contractual arrangements

2.3 PCOG received further information with regards to the delivery of Primary Medical Services by a Dudley practice, where potential changes in clinical workforce could give rise to changes to the existing contractual arrangements. Detail will be presented in the private section of Committee.

3.0 NATIONAL DATA QUALITY EXERCISE

3.1 PCOG received information about a data quality exercise being carried out by Primary Care Support England (PCSE run by Capita) on behalf of NHS England.

3.2 PCSE will re-start the reconciliation/GP list cleansing process previously carried out by PCT’s to remove 'ghost patients'.

3.3 The exercise will see patient lists being reconciled with the National Health Application and Infrastructure Services (NHAIS) - generally known as the Exeter system that flows into the Personal Demographic System (Spine).

3.4 The list cleansing exercise will begin with PCSE contacting practices to verify the registration details of patients aged over 100 and will be followed by:

 patients aged under 16 recorded as living alone;  patients recorded as living in demolished properties;  patients recorded as being registered at student accommodation for over four years;  addresses with apparent multiple occupancy;  transient patients.

3.5 Practices may experience a reduction in global sum payments depending upon the outcome of the exercise.

4.0 PRIMARY CARE WORKFORCE – STARTERS AND LEAVERS

4.1 PCOG approved guidance for GP practices that clearly sets out the administrative process to be followed when there are changes in clinical workforce. 4.2 The guidance has been developed to help practices and covers resignations, new partners, 24 hour retirements, prescriber changes, actions to be taken regarding IT systems and notifications.

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5.0 PRIMARY CARE QUALITY & SAFETY

5.1 PCOG received the quality and safety issues that are set out in detail in the quality and safety report to Committee.

5.2 There are no issues in the quality and safety report that require contractual actions to be taken against any practice.

5.3 Included in the update was a report from the local office of NHSE England, Medical Directorate reporting on the Professional & Practice Information Gathering Group (PPIGG) incidents by type during April – September 2018. The themes included; clinical, contractual, complaints, regulatory bodies, performance concerns, safeguarding, dispensing errors, probity and prescribing.

5.4 PCOG agreed there was learning from the report that will be reviewed to identify any actions for Dudley.

5.5 PCOG noted the incidents, recommendations and next steps in the report that included:  Sharing the learning with NHS England, Quality Surveillance Group and via the GP Appraisal newsletter;  Production of quarterly themes/recommendations from PPIGG, Professional Advisory Group (PAG) and Performers List Decision Panel (PLDP); and  Splitting the themes across Arden Hereford & Worcester and Birmingham, Solihull and the Black Country.

5.6 The management of the national performers list, complaints management, revalidation and GP appraisal process remain functions reserved to NHS England.

6.0 RECOMMENDATION

Committee is asked to: o Note the actions of the Primary Care Operational Group for assurance. o Approve the recommendation that any requests from practices wishing to change the opening hours of a branch site should only be approved provided that there is no overall reduction in appointments and that the capacity is taken up at either the main or another branch on the same day of the week.

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DUDLEY CLINICAL COMMISSIONING GROUP PRIMARY CARE COMMISSIONING COMMITTEE

Date of Meeting: 21st December 2018 Report: Quality & Safety Report Agenda Item No: 7.0

TITLE OF REPORT: Quality and Safety Report

To provide on-going assurance to the Primary Care Commissioning PURPOSE OF REPORT: Committee (PCCC) regarding quality and safety in accordance with the CCG’s statutory duties

AUTHOR OF REPORT: Mr J Young, Head of Quality Assurance

MANAGEMENT LEAD: Mrs C Brunt, Chief Nurse

CLINICAL LEAD: Dr Ruth Edwards, Clinical Lead, Quality & Safety  There has been one CQC inspection carried out and one report published since the last meeting

KEY POINTS:  Guidance and support continues to be provided regarding flu vaccinations  Information has been sent out for practices to register for Datix access The Primary Care Commissioning Committee is asked to: RECOMMENDATION:  Note this report for assurance

FINANCIAL IMPLICATIONS: None to report

WHAT ENGAGEMENT HAS n/a TAKEN PLACE:

ANY CONFLICTS OF No conflicts of interest were declared in advance. INTEREST IDENTIFIED IN ADVANCE: ACTION REQUIRED:  Assurance

1 | P a g e Primary Care Analysis Report PCCC, 21/12/18

Produced : 13/12/18

Katie Hayes- Senior Insight Officer Jim Young – Head of Quality Assurance Primary Care Analysis Report – PCCC Summary

Care Quality Commission (CQC) Serious Incidents (SIs) • Stourside Medical Practice have been rated on re-inspection as good overall and for all • There are a total of two primary care SIs currently open; one of these is being domains following a previous overall RI rating managed by NHSE as it relates to a cold chain incident • The Waterfront Surgery have had a full re-inspection following a previous overall RI rating

Service Developments • Datix - seven practices are currently using Datix for incident reporting; a presentation & discussion at the GP Members event on 21/06/18 gained Infection Prevention & Control (IPC) agreement to provide Datix to all practices and arrange a training session via the DPMA. This was delivered at the October DPMA meeting. Details have now been sent out to all practices to enable them to register for access.

Immunisations Other • It continues to be a challenging season with some practices experiencing shortages of Special Allocation Scheme (Excluded patient scheme) aTIV, although NHSE remain confident that there is sufficient stock within Dudley as a • There are currently 24 patients on the EPS whole. Practices continue to discuss & action transfer of stocks where appropriate • The first review meeting to identify patients able to come off the scheme has been • Uptake levels remain lower than the same time last year, in part due to the delivery held; process & documentation is currently being defined schedule • CCG continues to engage with NHSE to help address any issues; work has already begun on better planning for next season, including early guidance on the recommended vaccines for various patient groups • Next imms group meeting scheduled for January 2019; to include reflections on this year to identify any potential improvements for next winter

Audits • Ten audits have now been completed since April

DUDLEY CLINICAL COMMISSIONING GROUP PRIMARY CARE COMMISSIONING COMMITTEE

Date of Meeting: 21 December 2018 Report: Board Assurance Framework & Risk Register Agenda item No: 8.0

Board Assurance Framework (BAF) & Risk Register (RR) for Primary TITLE OF REPORT: Care Commissioning Committee

PURPOSE OF REPORT: To provide the Committee with an updated BAF & RR

AUTHOR OF REPORT: Mr D King - Head of Membership Development & Primary Care

MANAGEMENT LEAD: Mrs C Brunt, Chief Nurse

CLINICAL LEAD: Dr T Horsburgh, Clinical Executive for Primary Care

KEY POINTS:  Enclosed is the BAF & RR as at 13 December 2018

RECOMMENDATION: Committee is asked to review the current status of risks

FINANCIAL IMPLICATIONS: Not applicable

WHAT ENGAGEMENT HAS Not applicable TAKEN PLACE:

ANY CONFLICTS OF No conflicts of interest were declared in advance. INTEREST IDENTIFIED IN ADVANCE:  Decision ACTION REQUIRED: Assurance

1 | P a g e Dudley CCG Combined Board Assurance Framework and Corporate Risk Register 2018/19 08-Nov-18 MASTER Document capturing changes to risks, agreed by Committee, for the month of December 2018

ID Original Date Last Review Last Update Risk Description Accountable Accountability Management Lead Initial Risk Key Controls Gaps in Control Internal Assurances External Assurances Gaps in Assurance Residual Risk Trend Actions Timescales COMMENTS (Committee (Risk Committee Sponsor & Owner Score (PxI) What controls/systems are in Where are we failing to put Board Reports, Minutes of Internal and External Audit Where are we failing to gain Risk Score To improve control, ensure delivery of Date action will be Date) Amended) Score place to assist in securing delivery controls/ systems in place / Where meetings Reports, CQC Reports evidence that our controls/ (PxI) principal objectives, gain assurance completed P I before any of our are we failing in making them systems, on which we place (R) P (R) I Score controls objective. Such as strategies, effective. For example lack of reliance, are effective. Such as no following LINK TO LINK are in policies and procedures training or no regular review of assurance a strategy or policy is controls put

KEY ABOVE) KEY CORPORATE performance effective OBJECTIVE (SEE (SEE OBJECTIVE place. in place

Work regular with CQC & NHS Committee agreed that this Risk England (Via PPIGG) to ensure that Receiving timely information from Report to PCCC regarding formal could be reduced (2x4 = 8) There is a risk that the provision of any concerns are addressed early. Gaps in reporting to Committee NHSE, There is no robust performance issues Appraisal process for individual GPs because the CCG had taken the Primary Care Medical Services are needs to be clarified as some of the 21/07/2017 28/09/2018 20/04/2018 4B PCC Steve Wellings Caroline Brunt 3 4 12 mechanism in place for the CCG to carried out by NHS England (Moved 2 4 8 Continue to review opportunity to contribute to the 135 adversely affected partially or fully Primary Care Team visits with soft intelligence is not suitable for a = Jan 2019 be informed of issues early on eg. Feedback from individual practices is from Key controls) PPIGG review and Complaints due to individual performer issues practice to obtain soft intelligence public meeting. Complaints, GMC investigations etc. reported through PCOG procedure so assured that gap was lessened

Annual Workforce Audit for clinical and non-clinical staff carried out

Recruitment Fayres/ Joint working and raising profiles in Primary Care

Training needs and skills set assessment

1) Develop and implement the new Primary Care Team visits with April 2019 model of care - Dudley Multispecialty practice to obtain soft intelligence Proposed to increase the residual Community Provider (MCP). As part of Report to PCCC regarding training Gaps in reporting to Committee risk score from 9 to 12 on the the new model, developing and investing Engagement with NHS England, needs and workforce analysis needs to be clarified as some of the basis that there is one practice in the clinical and non clinical workforce Health Education England and Local soft intelligence is not suitable for a who has failed to recruit a GP There is a risk that the provision of Workforce plan to be developed Workforce Advisory Board committed Feedback from individual practices is public meeting. partner. Primary Care Medical Services are 2) Develop a joint action plan with 21/07/2017 28/09/2018 28/09/2018 4B PCC Steve Wellings Caroline Brunt 4 4 16 to training and professional reported through PCOG 4 3 12 April 2019 136 adversely affected partially or fully No current model of care available to external partners (e.g.. HEE) to establish development. The contract is being delivered by due to insufficient workforce address the workforce gaps future workforce needs moving into an Report to PCC regarding EPIC CCG do not currently receive GP who retains partnership MCP provider. Joint working with local Community Programme progress notification from NHSE in respect of responsibility however, PCOG Provider Education Network (CPEN) outstanding appraisals had sufficient concerns about the 3) To confirm how the NHS England to maximise opportunities for Primary sustainability of this arrangement. intensive support programme will impact Care Workforce development Nov 2018 on the workforce risks

Productive General Practice Qucik Start programme

GPFV Workforce sub group established

CCG Estates Strategy in place There is no requirement upon Alternative suitable space is not Feedback on individual practice 1) Develop and implement the new practices to report issues with Rent Reviews in place/Review of readily available in the event of an issues is provided to PCOG. model of care - Dudley Multispecialty April 2019 premises to the CCG. There is a risk that the provision of Leases/Regular contact with unplanned loss, and the CCG has no Community Provider (MCP). As part of Work progressing with alternative Primary Care Medical Services are practices to highlight premises issues power to compel the relocation of Estates Issues are discussed at the the new model, developing infrastructure service locations, Primary Care Monthly performance monitoring GMS Contract responsibilities in 21/07/2017 28/09/2018 28/09/2018 4B adversely affected partially or fully PCC Steve Wellings Caroline Brunt 2 4 8 practices from unsuitable premises. monthly Estates Operational Group 2 3 6 and estate to deliver the model Finance Manager to discuss with 137 information published by NHS Digital respect of premises are not robust. = due to unplanned loss of Estates or CCG IT Strategy in Place IT Issues are discussed at the practices at locality meetings and IT infrastructure Regular Review meetings with EMIS operates under a national monthly IT Strategy Group 2) Develop and maintain a log of the then agree the proposals No assurance regarding Business TerraFirma (IT Provider) and EMIS contract with limited local scope for Senior level meetings in place alternative service locations included in Dec 2018 Continuity Plans include alternative EMIS is subject to national variation between CCG and EMIS Business Continuity Plans locations monitoring by NHS Digital

Primary Care Strategy Group

GPFV related increases in investment in Primary Care Develop and implement the new model There is a risk that the provision of Report To PCCC re investment in of care - Dudley Multispecialty Primary Care Medical Services are As independent businesses, the CCG 21/07/2017 28/09/2018 29/09/2017 4B PCC Steve Wellings Caroline Brunt 2 4 8 General Practice Resilience DQOFH GPFV Transformation Board 2 4 8 Community Provider (MCP). As part of Apr-19 138 adversely affected partially or fully have no oversight of financial issues = Programme the new model, developing and investing due to Financial issue in the back-office efficiency of practices Reinvestment of PMS Premium

PCCC will continue to monitor the Review capacity and inform PCCC and capacity of the PC team following agree a way forward. restructure due to MCP development. There is a risk that there is Establish a robust process for insufficient workforce and Work allocation, work plans and monitoring capacity issues on an on- appropriately skilled workforce within capacity is discussed at 1:1 and going basis the primary care team and wider primary care team meetings Not systematically recognising the CCG support teams to deliver the Monitoring has not been reported 21/07/2017 28/09/2018 28/09/2018 4B PCC Steve Wellings Caroline Brunt 5 3 15 skills and experience required to None None 3 3 9 The IT manager has had discussions 139 delegated Primary Care back to PCCC = maintain and develop Dudley QOFH internally with the team to mitigate the Jan 2019 Commissioning functions, projects Additional resources (through Arden risk. The requirements are being scoped such as the GP Forward View Plan &Gem CSU) have been identified to out with a recommendation to be made and Dudley Quality Outcomes for support the PC team on delivery of for recruitement, possibly an apprentice. Health the primary care at scale projects in In the meantime other CCG staff are GP Forward View being trained to run EMIS reports. Progress to be kept under review

DUDLEY CLINICAL COMMISSIONING GROUP BOARD

Date of Committee: 21 December 2018 Report: Finance Report Agenda item No: 9.0

TITLE OF REPORT: Primary Care Commissioning Finance Report

The report provides an overview of financial performance against budgets PURPOSE OF REPORT: delegated to Committee for Month 8 2018/19.

AUTHOR OF REPORT: Mr P Cowley, Senior Finance Manager

MANAGEMENT LEAD: Mr M Hartland, Chief Operating and Finance Officer

CLINICAL LEAD: Dr T Horsburgh, Clinical Executive for Primary Care

 There have been no changes to the budget reported to Committee in November.  A small overspend is forecast in respect of budgets reported to KEY POINTS: Committee, with an underspend against co-commissioned primary care services and break-even position being forecast in respect of Core commissioning budgets offset by a small overspend in respect of GP Forward View allocations.

Committee is requested to note the reported financial position for RECOMMENDATION: assurance.

FINANCIAL IMPLICATIONS: Budget reported to Committee: £45,540,000

WHAT ENGAGEMENT HAS Not applicable TAKEN PLACE:

ANY CONFLICTS OF No conflicts of interest were identified in advance. INTEREST IDENTIFIED IN ADVANCE: ACTION REQUIRED:  Assurance

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This report submitted to Dudley CCG Primary Care Commissioning Committee provides a breakdown of financial performance for Co- commissioned Primary Care for November 2018.

Contents

Financial Overview p2

Financial Detail p3 Financial Overview

Budget Allocations Budgets reported to the committee have an annual value at November 2018 of £45,540,000, including both the delegated co-commissioning allocation and core CCG budgets.

There have been no changes to the allocation reported to Committee in November.

Allocation Breakdown

GP Forward Primary Care Co- View Commissioning £2,565k £42,007k

CCG Core Commissioning £968k

2 Financial Detail Delegated Co-Commissioning

Expenditure against the delegated Co-Commissioning allocation is Annual Forecast forecast to achieve a small underspend against budget. Budget Budget Variance Area (WTE) (£'000) (£'000) As previously reported to Committee, the significant overspend GP Contract 28,232 (1) against Other GP services is due to an high level of Maternity locum QOF and Enhanced Services 6,806 (22) claims in this financial year above the budgeted level. These claims Premises Costs 4,739 16 are currently forecast at the maximum allowable claim under the Dispensing/Prescribing Drs 250 (4) SFEs, and it is possible that actual claim levels will be lower than Other GP Services 1,511 98 this. The forecast also includes a provision for additional claims to Contingency Reserve 470 (89) be received. Total - 42,007 (1)

Contingency reserves totalling £331,000 have been allocated to support the non-recurrent schemes approved by the previous Committee, with £89,000 of the reserves being held to cover the reported overspends in other areas. A balance of £50,000 is therefore available to support any increases in GP contract payments following the Q4 list size changes in January.

3 Financial Detail (continued)

Core Commissioning

A break even position is reported against both the GP with Special Annual Forecast Interest and the Primary Care Investments line. Budget Budget Variance Area (WTE) (£'000) (£'000) Primary Care Investments are made up of: GP with Special Interest 0.50 90 (0) • £474,000 for the Practice Engagement Scheme. Primary Care Investments 878 - • £278,000 recharge for the cost of the Enhanced Practice Based Total 0.50 968 (0) Pharmacy Scheme. • £126,000 contribution to the cost of the Prescribing Ordering Direct service.

GP Forward View

A small overspend is currently reported against the GP Forward View allocations, with a overspend of £1,000 reported against the Non- Annual Forecast Recurrent Transformational Support fund. Budget Budget Variance Area (WTE) (£'000) (£'000) Funding for GPFV Extended Access, and the Non-Recurrent Reception and Clerical Staff Training 56 - Transformation Support, have been committed in full from the start Online Consultation Software 110 - of the financial year, and programmes are in place to fully utilise the GPFV Extended Access 1,923 - allocations for Reception and Clerical Training and Online Non-Recurrent Transformation Support 476 1 Consultation Software by the end of the financial year. Total 2,565 1

4

DUDLEY CLINICAL COMMISSIONING GROUP PRIMARY CARE COMMISSIONING COMMITTEE

Date of Committee: 21 December 2018 Report: Practice Alternative Service Locations Agenda item No: 10

TITLE OF REPORT: Practice Alternative Service Locations

To present an update on the alternative service locations held within PURPOSE OF REPORT: practice Business Continuity Plans following the previous report to Committee.

AUTHOR OF REPORT: Mr P Cowley, Senior Finance Manager

MANAGEMENT LEAD: Mr M Hartland, Chief Operating and Finance Officer

CLINICAL LEAD: Dr T Horsburgh, Clinical Lead Primary Care Co Commissioning  A review of the alternative service locations included in practices’ Business Continuity Plans in spring 2018 found that most practices had plans in place, although these were of varying robustness and appropriateness.  Committee agreed that all practices should have at least one suitable alternative, defined as a clinical space a reasonable KEY POINTS: travelling distance for patients, within their plan  Following engagement with practices at the DPMA and locality meetings, 48 of the 49 sites have now met this standard.  The report details the arrangements made in respect of each site.  In the event of a loss of or serious disruption to a site, it is acknowledged that the CCG would need to provide significant additional assistance to affected practices. It is recommended that Committee:

 Note for assurance the current reported position in respect of the alternative service locations included in practice’s BCPs  Note for assurance the availability of space within Health RECOMMENDATION: Centres, and the ability of the CCG to make this space available at short notice if required.  Amend the Key Controls in respect of risk 137 to reflect: o practices having alternative locations in place; o the development of a register of available alternative space within CHP and NHSPS health centres As above. FINANCIAL IMPLICATIONS:

WHAT ENGAGEMENT HAS None TAKEN PLACE:

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ANY CONFLICTS OF INTEREST IDENTIFIED IN No conflicts of interest were identified in advance. ADVANCE: Decision √ ACTION REQUIRED: Approval Assurance √

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DUDLEY CLINCAL COMMISSIONING GROUP PRIMARY CARE COMMISSIONING COMMITTEE – 21 DECEMBER 2018 PRACTICE ALTERNATIVE SERVICE LOCATIONS ______

1. INTRODUCTION

1.1. In order to provide assurance that there are sufficient safeguards in place to mitigate against the risk that an unexpected lack of availability of premises would cause a loss of GP services, as outlined in the CCG risk register, a report was presented in June outlining the alternative locations within practices’ current Business Continuity Plans (BCPs). This report outlined that each practice should have plans in place including at least one suitable alternative location, defined as a clinical space a reasonable travelling distance for patients.

1.2. This report outlines the engagement undertaken with practices on the issue and presents the most up to date position in respect of each practice’s alternative locations.

2. PROCESS

2.1. In line with the process agreed with Committee the CCG undertook engagement with GP practices through the Dudley Practice Management Alliance, as part of a wider session on Business Continuity in September, and followed this up with a discussion at Locality meetings in October. During these sessions the importance of robust business continuity arrangements was emphasised and the standards that practices were advised to meet were outlined.

2.2. Practices agreed at these sessions that reciprocal arrangements between local practices were the most effective solution to business continuity and agreed to take forward arrangements as suggested by the CCG, with the aim of every practice achieving this standard.

3. UPDATED POSITION

3.1. As of 12th December, 48 of the 49 general practice sites have met the minimum recommended standard outlined above, having confirmed that they have an agreed reciprocal arrangement in place providing at least one suitable alternative location, with third of sites also having achieved the ‘gold standard’ of two alternative locations.

3.2. One practice has to date been unable to confirm that these arrangements are in place, due to the practice manager responsible being on leave. It is however hoped that this practice will be in a position to confirm those arrangements in time for a verbal update to be provided to Committee.

3.3. The position in respect of each practice is outlined in the table below, and following a review by the CCG the agreed arrangements of each practice are believed to be appropriate.

Practice Name Premises Locality Alternative 1 Alternative 2 Meadowbrook Meadowbrook Surgery Halesowen & Quarry Bank Alexandra MP Surgery Kingswinford, & Kingswinford Medical Moss Grove Surgery Moss Grove Surgery Moss Grove Surgery Brierley Hill Practice Kinver Stourbridge Health & Social Kingswinford, Amblecote & Lion Health Three Villages Care Centre Brierley Hill Medical Practice Kingswinford, Amblecote & Bridgnorth Road Surgery SHSCC Brierley Hill Eve Hill Medical Eve Hill Medical Practice Dudley & Netherton St James' Cross Street Practice The Ridgeway The Ridgeway Surgery , Gornal & Northway Surgery Kingswinford Medical Kingswinford, Amblecote & Wordsley Green Kingswinford Medical Practice Moss Grove Sugery Practice Brierley Hill Surgery

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Practice Name Premises Locality Alternative 1 Alternative 2 Kingswinford, Amblecote & Albion House Surgery Withymoor Surgery Brierley Hill AW Surgeries Kingswinford, Amblecote & Withymoor Surgery Albion House Surgery Brierley Hill Brierley Hill Health and Social Kingswinford, Amblecote & Waterfront Surgery Albion House Surgery Care Centre Brierley Hill Lion Health Lion Health Stourbridge, Wollescote & Lye 3 Vilages Medical Practice The Greens Health The Greens Sedgley, Gornal & Coseley Eve Hill MP Northway Centre Lapal Medical Clement Road Medical Lapal Medical Practice Halesowen & Quarry Bank Practice Practice Lower Gornal Lower Gornal Health Centre Sedgley, Gornal & Coseley Northway St James' Medical Practice Woodsetton Medical Woodsetton Medical Centre Sedgley, Gornal & Coseley The Northway The Greens Centre Stepping Stones Stepping Stones Medical Cross Street Health St James' Medical Dudley & Netherton Medical Practice Practice Centre Practice Kingswinford, Amblecote & Our Lady of Lourdes RC Summerhill Surgery Summerhill Surgery Brierley Hill Church The Limes Medical The Limes Medical Centre Stourbridge, Wollescote & Lye Pedmore Road Chapel St Centre Feldon Lane Halesowen & Quarry Bank Hawne Lane Feldon Practice Hawne Lane Halesowen & Quarry Bank Feldon Lane Coseley Medical Coseley Medical Centre Sedgley, Gornal & Coseley The Greens Centre Wordsley Green Kingswinford, Amblecote & Kingswinford Medical Stourbridge Health and Wordsley Green Health Centre Surgery Brierley Hill Practice Social Care Centre Cradley Road Medical Wychbury Medical Centre Stourbridge, Wollescote & Lye Chapel House Surgery Practice Wychbury Medical Cradley Road Medical Wychbury Medical Chapel House Surgery Stourbridge, Wollescote & Lye Group Practice Centre Wychbury Medical Cradley Road Medical Practice Stourbridge, Wollescote & Lye Chapel House Surgery Centre Cross Street Health Cross Street Dudley & Netherton Steppingstones Eve Hill Centre St James's Medical St James' Medical Practice Dudley & Netherton Eve Hill MP Practice 2 Quarry Bank Medical Quarry Bank Medical Centre Halesowen & Quarry Bank Thorns Road Surgery Centre Netherton Health Cross Street Health Netherton Health Centre Dudley & Netherton Central Clinic Centre Centre Pedmore Medical Pedmore Medical Practice Stourbridge, Wollescote & Lye The Limes Chapel St Practice Clement Road Feldon Lane Medical Clement Road Medical Centre Halesowen & Quarry Bank Medical Centre Practice Bean Road Medical Bean Road Medical Practice Dudley & Netherton Central Clinic Practice Northway Medical Northway Medical Centre Sedgley, Gornal & Coseley Ridgeway Surgery Bath St Surgery Centre Rangeways Road Kingswinford, Amblecote & Kingswinford Medical Rangeways Road Surgery Surgery Brierley Hill Practice Keelinge House Keelinge House Surgery Dudley & Netherton High Oak Surgery Halesowen Medical Halesowen Medical Practice Halesowen & Quarry Bank Stourside Medical Practice Practice Central Clinic Central Clinic Dudley & Netherton Bean Medical Practice St James's Medical St James' Medical Practice Dudley & Netherton Eve Hill MP Practice 1 Halesowen Road Netherton Dudley & Netherton Hazel Rd Links Medical Practice Hazel Rd, Dudley Dudley & Netherton Netherton Health Centre Kingswinford, Amblecote & Quincy Rise Surgery Quincy Rise Surgery Withymoor Surgery Brierley Hill

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Practice Name Premises Locality Alternative 1 Alternative 2 Castle Meadows St James' Medical Castle Meadows Surgery Sedgley, Gornal & Coseley Surgery Practice Bath Street Medical Bath Street Medical Centre Sedgley, Gornal & Coseley Northway Centre Alexandra Medical Alexandra Medical Centre Halesowen & Quarry Bank Meadowbrook Surgery Centre Chapel Street Chapel Street Surgery Stourbridge, Wollescote & Lye Pedmore Road The Limes Surgery Quarry Bank Medical Thorns Road Surgery Thorns Road Surgery Halesowen & Quarry Bank Centre Stourside Medical Halesowen Medical Halesowen Health Centre Halesowen & Quarry Bank Practice Practice Dudley Wood Dudley Wood Surgery Dudley & Netherton Netherton HC Surgery Kingswinford, Amblecote & High Oak Surgery High Oak Surgery Keelinge House Brierley Hill

4. CCG SUPPORT As previously outlined to Committee, while the proposed arrangements would meet practices’ initial requirements in the event of the short-term unavailability of their premises, they are unlikely to be suitable to meet longer term needs should premises be unavailable for a longer period, for example due to a fire or flood. Many premises already operate at or near capacity, and additional activity could only be accommodated by severely impacting upon services offered to patients of the of a host practice.

4.1. In the event of a longer term disruption to premises, the CCG therefore recognises that it may be necessary to make space available in one of the larger health centres that exist within the Dudley Health economy. Although these are few in number and spread widely throughout Dudley, each locality currently hosts at least one of these larger facilities, most of which contain unutilised space that could be made available.

4.2. The CCG is currently reviewing occupancy within health centres across Dudley and compiling a register of available space, which would enable it to quickly identify any space into which services could be relocated. Should no space be available, it would also allow the identification of the other services operating within each building and identify whether, in extremis, any of these services could be relocated to allow a practice to operate from the facility.

5. RECOMMENDATIONS It is recommended that Committee:

 Note for assurance the current reported position in respect of the alternative service locations included in practice’s BCPs  Note for assurance the availability of space within Health Centres, and the ability of the CCG to make this space available at short notice if required.  Amend the Key Controls in respect of risk 137 to reflect: o practices having alternative locations in place; o the development of a register of available alternative space within CHP and NHSPS health centres

Appendices N/A

Philip Cowley Senior Finance Manager – Primary Care December 2018

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Dudley Clinical Commisioning Group GLOSSARY - APRIL 2018

Abbreviation Meaning #NOF Fractured Neck of Femur £K £1,000 equivalent A&E Accident and Emergency ACO Accountable Care Organisation ACS Acute Coronary Syndrome ACS Ambulatory Care Sensitive Conditions ACSs Accountable Care Systems AD Assistant Director AfC Agenda for Change AGM Annual General Meeting AHSN Academic Health Science Networks ALE Auditors Local Evaluation ALOS Average Length of Stay (in hospital) AMI Acute Myocardial Infarction AMMC Area Medicines Management Committee AMR Antimicrobial resistance Anti-D An antibody occurring in pregnancy Anti-TNF Drugs used in the treatment of rheumatoid arthritis and Crohn’s disease AQP Any Qualified Provider ARIF Aggressive Research Intelligence Facility ASAP As soon as possible AVE Advertising Value equivalent BACs Bank Automated Credit BAF Board Assurance Framework BCC Black Country Cluster BCF Better Care Fund BCPFT Black Country Partnership NHS Foundation Trust BFT Behavioural Family Therapy BMA British Medical Association BME Black Minority Ethnic BMJ British Medical Journal BPAS British Pregnancy Advisory Board BSCCP British Society of Colposcopy and Cervical Pathology CAB Citizens Advise Bureau CAMHS Children and Adolescent Mental Health Service CAO Chief Accountable Officer CASH Contraception and Sexual Health CCBT (CBT) Computerised Cognitive Behavioural Therapy CCG Clinical Commissioning Group CCRN Comprehensive Clinical Research Networks CDC Commissioning Development Committee CDiff Clostridium difficile CEO Chief Executive Officer CETV Cash Equivalent Transfer Value CFO Chief Finance Officer CHADD The Churches Housing Association of Dudley & District Ltd CHC Continuing Healthcare CHD Coronary Heart Disease CIP Cost Improvement Plan CLT Collaborative Leadership Team CMO Chief Medical Officer CNST Clinical Negligence Scheme for Trusts CNT Community Nursing Team COPD Chronic Obstructive Pulmonary Disease COSHH Control of Substances Hazardous to Health Regulations 2002 CPA Care Programme Approach CPN Community Psychiatric Nurse CPR Cardiopulmonary Resuscitation CQC Care Quality Commission CQNO Chief Quality and Nursing Officer CQRM Clinical Quality Review Meeting CQUIN Commissioning for Quality and Innovation CRL Capital Resource Limit CRRT Community Rapid Response Team CSG Clinical Strategic Group CSU Commissioning Support Unit CT scan Computer Topography CVD Cardio Vascular Disease D&N Dudley and Netherton (Locality) DACHS Directorate of Adult Children and Housing Services DCS Dudley Community Services DCVS Dudley Community Voluntary Service DES Directed Enhanced Service DfES Department for Education and Skills DGFT Dudley Group Foundation Trust DHR Domestic Homicide Review DHSC Department of Health and Social Care DMO Designated Medical Officer DNA Did not attend DoH Department of Health DoLS Deprivation of Liberty Safeguards DoS Directory of Service DPMA Dudley Practice Managers Alliance DPO Data Protection Officer DQOFH Dudley Quality Outcomes for Health DSCB Dudley Safeguarding Children’s Board DTC Diagnostic and Treatment Centre DToC Delayed Transfer of Care DWMHPT Dudley and Walsall Mental Health Partnership Trust DXA Dual X-ray Absorptiometry (measures bone density) E&D Equality and Diversity EAU Emergency Assessment Unit ECA Extra Care Area ECM Every Child Matters ECT Electroconvulsive Therapy ED Emergency Department EI Early Implementer EI Early Intervention EIP Early intervention in Psychosis EMI Elderly Mentally Ill EMIS Education Management Information System EoL End of Life EPC Empowering People and Communities EPIC Enabling Practices to Improve and Change EPP Expert Patients Programme EPR Electronic Patient Record EPRR Emergency, Preparedness, Resilence, Response ERT Enzyme Replacement Therapy ESR Electronic Staff Record FCEs Finished Consultant Episodes FED Forum for Education and Development FFT Friends and Family Test FHS Family Health Services FMC Facility Management Centre FOI Freedom of Information FTE Full Time Equivalent FYE Full Year Effect FYFV Five Year Forward View GDPR General Data Protection Regulations GGI Good Governance Institute GMS General Medical Services GOWM Government Office for the West Midlands GP General Practitioner GPAQ General Practice Assessment of Quality GPFV GP Forward View GPwSI GP with Special Interest GU Genito-urinary GUM Genito-urinary Medicine H&QB Halesowen and Quarry Bank (Locality) HCAI Healthcare Associated Infections HCF Healthcare Forum HEE Health Education England HENIG Health Economy NICE Implementation Group HF Heart Failure HFMA Healthcare Financial Management Association HIAO Head of Interal Audit Opinion HIC Health Improvement Centre HIS Health Infrastructure Strategy HIV Human Immunodeficiency Virus HPA Health Protection Agency HPS/S Health Promoting Schools / Service HPU Health Protection Unit HR Human Resources HSC Health and Safety Commission HSCQC Health and Social Care Quality Centre HSE Health and Safety Executive HSMC Health Services Management Centre HT Home Treatment HV Health Visitor HWBB Health and Well-being Board IAF Improvement Assessment Framework IAPT Improved Access to Psychological Therapies IC Infection Control ICAS Independent Complaints Advocacy Service ICE Integrated Commissioning Executive ICNA Infection Control Nurses Association ICO Information Commissioner Office ICP Integrated Care Pathway IFR Individual Funding Request IG Information Governance IOSH Institute of Occupational Safety and Health ISAP Integrated Support Assurance Process IT Information Technology IUCD Intrauterine Contraceptive Device JCAB Joint Clinical Advisory Board JCC Joint Commissioning Committee JD Job Description JSNA Joint Strategic Needs Assessment KAB Kingswinford, Amblecote and Brierley Hill (Locality) KLOE Key Lines of Enquiry KPI Key Performance Indicators LAA Local Area Agreement LAC Looked After Children LACYP Looked After Children and Young People LAT Local Area Team LD Learning Disability LDP Local Delivery Plan LDR Local Digital Roadmap LEA Local Education Authority LeDeR Learning Disabilities Mortality Review LIFT Local Improvement Finance Trust LIG Local Implementation Group LIT Local Implementation Team LMC Local Medical Committee LNG Local Negotiating Committee LPS Local Pharmaceutical Scheme LRF Local Resilience Forum LSCB Local Safeguarding Children’s Board LTC Long Term Conditions LVD Left Ventricular Dysfunction LVSD Left Ventricular Systolic Dysfunction MAPA Management of Actual and Potential Aggression MASH Multi-Agency Safeguarding Hub MAU Medical Assessment Unit MBC Metropolitan Borough Council MCP Multi-speciality Community Provider MDT Multi Disciplinary Team MIAA Mersey Internal Audit Authority MIMT Major Incident Management Team MIRE Major Incident Response Executive MLSOs Medical Laboratory Scientific Officers MOU Memorandum of Understanding MRSA Methicillin Resistant Staphylococcus Aureus MSS Medium Secure Service NCA Non contract activity NCB National Commissioning Board NCM New Care Model NCRS National Care Record System NELHI National Electronic Library for Health Information NFI National Fraud Initiative NGMS New General MedicalServices NHS National Health Service NHSCPT NHS Community Practice Teacher NHSCSP NHS Cancer Screening Programme NHSE NHS England NHSI NHS Improvement NHSR NHS Resolution NHSP National Healthy Schools Programme NICE National Institute for Clinical Excellence NMC New Model of Care/Nursing and Midwifery Council NOF New Opportunities Fund NPfIT National Programme for IT NPSA National Patient Safety Agency NRF Neighbourhood Renewal Fund NRLS National Reporting and Learning System NSF National Service Framework OAT Out of Area Treatment OBD Occupied Bed Day OD Organisational Development ODM Oesophageal Doppler Monitoring OJEU Official Journal of the European Union OOH Out of Hours OPH Office of Public Health OSC Overview and Scrutiny Committee OT Occupational Therapist PACS Primary and Acute Care Systems PAF Positive Assurance Framework PALS Patient Advice and Liaison Service PAM Patient Activation Measures PAS Patient Administration System PAU Paediatric Assessment Unit PBP Practice Based Pharamcists PbR Payment by Results PC Personal Computer PCCC Primary Care Commissioning Committee PCDSG Primary Care Development Steering Group PCOG Primary Care Operational Group PDF Portable Document Format PDR Personal Development Review PDS Personal Dental Services PDSA Plan, Do, Study, Act PDU Professional Development Unit PE Pulmonary Embolism Database holding the main registered details of patients and associated referral, contact, PEAK caseload, outpatient, inpatient, MH Act and clinic information. PEAT Patient Environment Action Team PEPP Pooled Budget External Placement Panel PFI Private Finance Initiative PGD Patient Group Directives PHE Public Health England PHSO Parliamentary and Health Service Ombudsman PICU Psychiatric Intensive Care Unit PID Project Initiation Document PIN Prior Information Notice PMLD Profound and Multiple Learning Difficulties PMS Primary Medical Services PNA Pharmaceutical Needs Assessment POD Prescription Ordering Direct POPs Patient Opportunity Panels PPA Prescription Pricing Authority PPG Patient Participation Group PQQ Pre-Qualification Questions PSA Public Service Agreement PSHE Personal and Social Health Education PSIAMS Personal Social Impact Action Measurement System PTCA Percutaneous Transluminary Coronary Angioplasty Q&A Questions and Answers Q&S Quality & Safety QA Quality Assurance QIB Quality Improvement Board QIPP Quality, Innovation, Productivity and Prevention QMAS Quality Management and Analysis System QOF Quality and Outcome Framework QPDT Quality and Practice Development Teams RACPC Rapid Access Chest Pain Clinic RAG Red, Amber Green (rating) RAS Respiratory Assessment Service RCA Root Cause Analysis RCGP Royal College of General Practitioners RES Race Equality Scheme RHH Russells Hall Hospital RIDDOR Reporting of Injuries, Diseases and Dangerous Occurrences Regulations RMO Responsible Medical Officer RRL Revenue Resource Limit RTT Referral to Treatment SAP Single Assessment Process SAR Safeguarding Adult Reviews SAR Subject Access Request SCG Sedgley, Coseley and Gornal (Locality) SCIE Social Care Institute for Excellence SCR Serious Case Review SDU Sustainable Development Unit SDMP Sustainable Development Management Plan SEPIA Mental health computer system SFBH Standards for Better Health SFI Standing Financial Instructions SI Serious Incident SIC Statement of Internal Control SLA Service Level Agreement SPA Single Point of Access SQPR Service Quality Performance Review SQRM Safeguarding Quality Review Meeting SRE Sex and Relationship Education SRG System Resilience Group SSD Social Services Department SSDP Strategic Services Development Plan STI Sexually Transmitted Disease STP Sustainability and Transformation Plan STRW Support, Time & Recovery Worker SWL Stourbridge, Wollescote and Lye (Locality) SWOT Strength, Weakness, Opportunity and Threat TB Tuberculosis TCT Transforming Care Together TIA Transient Ischaemic Attack TP Teenage Pregnancy TPT Teenage Pregnancy Team TTO To Take Out UCC Urgent Care Centre UHBT University Hospital Birmingham Trust UCSCs Urgent Care Sensitive Conditions Vaccs & Imms Vaccinations and Immunisations VSM Very Senior Manager WAN Wide Area Network WCC World Class Commissioning WIC Walk in Centre WMAS West Midlands Ambulance Service WMCA West Midlands Combined Authority WMHTAC West Midlands Health Technology Advisory Committee WMSCG West Midlands Strategic Commissioning Group WMSSA West Midlands Specialised Services Agency WTE Whole Time Equivalent YHC Young Health Champion