Minutes of the Quality & Risk Committee

GB 13/075 MINUTES OF THE QUALITY & RISK COMMITTEE (On behalf of the NNE, NW and Rushcliffe CCGs)Thursday 18 April 2013 1:30 – 4:30pmWollaton Meeting room Easthorpe House 165 Loughborough Road Ruddington NG11 6LQMembership: ‘A’ denotes absenceMike Wilkins (Chair) (MW) Lay Member, NNE CCG and Non Executive, PCT Cluster Dr Cheryl Crocker (CC) Director of Quality and Patient Safety, NNE, NW and Rushcliffe CCGs Helen Cawthorne (HC) Head of Quality and Patient Safety, NW CCG A Marie Bonser Estates, Legal and Compliance Manager, NHS Nottinghamshire County Max Booth (MB) Patient Representative, Rushcliffe CCG Shirley Inskip (SI) Patient Representative, NW CCG Rachael Rees (RR) Head of Primary Care Operations, NNE CCG Lynne Sharp (LS) Head of Governance and Integration, Rushcliffe CCG John Tomlinson (JT) Deputy Director of Public Health, NHS Nottinghamshire County A Hazel Buchanan Head of Assurance and Performance, NNE CCG (left at 12.30) Sheila Hyde (SH) Lay Member, Rushcliffe CCG Val Blackmore (VB) Assistant Director of Quality and Patient Safety, NNE, NW and Rushcliffe CCGs A Amanda Jones Safeguarding Lead – Adults, NNE, NW and Rushcliffe CCGs Dr Mohammed Al-Uzri (MAU) Consultant Psychiatrist, Leicestershire Partnership NHS Trust/ NNE CCG Clinical representative (arrived at 10.45am) Dr Ian McCulloch (IM) GP Representative – Rushcliffe CCG A Dr Ram Patel (RP) GP Representative – Rushcliffe CCGIn Attendance: Elizabeth Owen (minutes) (EO) Quality & Patient Safety Team Secretary, NNE, NW and Rushcliffe CCGsItem number Agenda Item - Key Points of Discussion ACTIONQRC/13/027 Welcome and Introductions MW welcomed all to the meeting and new members were introduced. QRC/13/028 Apologies for Absence Apologies were received from: Amanda Jones and Hazel Buchanan.QRC/13/029 Declarations of interest SI noted that her role as Director of Notts Healthwatch had previously been declared.Quality and Risk Committee 2013 Page 1 of 13 Item number Agenda Item - Key Points of Discussion ACTIONQRC/13/030 Draft minutes of the previous meeting of 21 February 2013 MB informed the group that his query of hospital food been given the green light although there was anecdotal evidence that there may be problems in some areas had not been recorded within these minutes.ACTION: Send wording to EO via email for inclusion in these MB minutes.Once this amendment has been made the group agreed the minutes could then be ratified.QRC/13/031 Action log/Matters arising QRC/13/005 – QRC/12/146 North CCG QRC – A summary of key risks had been requested by the North CCGs from the South CCGs, this action was complete.QRC/12/146 - Air Liquide – Clarify whether a patient had been admitted due to late delivery of a product. This had not been substantiated and therefore the action was to be closed.QRC/12/145 - Vacc and Imms updates – It was noted that although Iolanda Shaker was still the contact for Vacc and Imms, Iolanda was currently seconded to the Local Area Team (LAT). The question arose of whether or not Vacc and Imms updates were still required at this Committee as the CCGs were not responsible for Vacc and Imms. It was noted that the Primary Care Quality (PCQ) sub group Reviewed Vacc and Imms and any recommendations or risks could be escalated from that meeting group to this Committee. Members agreed to remove this as a standing item from the agenda for this forum. It was confirmed that responsibility now lies with the LAT but that there was a need for CCGs to review in terms of quality. It was noted that Iolanda did not need to be a member of this Committee.ACTION: Remove Vacc and Imms update item from the agenda for this Committee. EOQRC forward planner was on the agenda therefore this action was to be closed.QRC/12/157 - EMAS QAG minutes of 23.10.2012 – would there be a degree of retrospection. It was confirmed that there was now retrospective data available back to April 2012, if was felt that if data prior to this was required it would have to be made clear the reasons behind the request.MW confirmed he had received the invitation to the NW GB; this action was to be closed.QRC/12/161 - Health and Safety – this was on the agenda.The action regarding NUH was actioned.HP action regarding Q2 complaints report; HP had implemented customer care training as mandatory and there was to be a review of Quality and Risk Committee 2013 Page 2 of 13 Item number Agenda Item - Key Points of Discussion ACTION their appointment systems. There was a CQUIN for this year regarding patient experience. HP were also seeking to improve on the number of surveys sent out as currently only 0.4% of patients on their caseload receive a patient experience survey form, CQUIN target is to improve on this percentage. Monitored through Quality Scrutiny Group (QSG) therefore information is brought to this Committee via the meeting minutes, it was suggested that there is not the level of assurance required then this should be highlighted and brought back to this forum as an agenda item. F&FT CC asked members not to solely concentrate on the number that the family and Friends test was a composite indicator. The value was in unpicking the data to see the variance between wards and to share learning for improvement. The F&F test methodology has changed for this year and will no longer use face to face surveys as this is thought to add potential bias. Therefore comparisons between hospitals prior to this is not always helpful.ACTION: Assurance required from SFHT regarding patient experience surveys. VBNEMS action – Nottingham City were to lead on the procurement process. MB stated the response and findings were potentially flawed as he thought patients that found it difficult to access the services would not have filled in this survey. Assurance given that these points were being addressed therefore no further action on this was required, action was to be closed.QRC/13/007.1 – NUH Serious Incidents - This was on the agenda. e-Healthscope Janet Baker, Project Manager, NNE CCG was currently reviewing how practices were using e-Healthscope, it was felt that the system would standardise reporting. There was clarification that e-Healthscope would be for reporting general issues and concerns and that all SIs must be recorded on STEIS. This did raise concern that practices may report SIs on the incorrect system. These may then not be picked up appropriately. There was a comment that the Complaints policy has an escalation system and that this may require something similar. There was to be a meeting regarding e-Healthscope once it had been reviewed and it was suggested that this include a member of the Quality Team to ensure that all aspects were covered.A risk regarding e-Healthscope was highlighted in that it was currently being managed by one person and if it were to be promoted it would need to be a robust system and not reliant upon one person. It was felt there would need to be acceptance from all practices across the three South CCGs to use e-Healthscope and that resource to manage the system would need to be reviewed. GPs would need the confidence that the information was being reviewed and appropriate action was taking place. The group discussed the best way to take this forward. It was decided that this would be reviewed by Quality and Risk Committee 2013 Page 3 of 13 Item number Agenda Item - Key Points of Discussion ACTION the PCQ sub group.ACTION: PCQ to review the risk regarding e-Healthscope and lack of resource to manage and report back to the QRC. HCGPs SI reporting – Ensure robust reporting for Primary Care. There was not a recognised process for GPs reporting SIs however this would now fall to the LAT to resolve. Suggested that this discussion takes place at focussed group. SIs was to be discussed at PCQ Sub Group and low level issues to be discussed at the Task and Finish Group for Francis.ACTION: Discussion to take place at PCQ sub group meeting re GP reporting for SIs. HC ACTION: Discussion to take place at the Task and Finish Group – Francis regarding reporting of low level issues and concerns in GP practices. CCIt was felt that all issues needed to be clarified and mapped out in relation to Primary Care and Secondary Care, hard and soft information and responsibilities clarified.ACTION: Sub groups to report back to the QRC in 6 months’ time. HC/CC CQUIN progress – dementia screening. It was noted that the National target had been 90% in 3 consecutive months within the year. NUH had chosen to run an electronic system which proved to take longer than expected to set up and therefore they had missed the target, as had many Trusts in the Country. The CQUIN had been rolled over to this year.QRC/13/009 – Primary care quality update was on the agenda.QRC/13/010.2 Care home update appeared incomplete.ACTION: Check with Amanda Jones whether this was only a 2 page document. VB QRC/13/010.3 this had been actioned.QRC/13/012 – Health and Safety update was on the agenda.QRC/13/017 – Non-medical prescribing lead role, this was ongoing.QRC/13/018 – Policies and procedures/ToR action regarding and easy read guide for complaints and concerns was to be sent to patient groups for consideration. This action was to be closed as this was now with the LAT.QRC/13/019 – Risk Registers were to be discussed at the South Quality meeting.The group agreed that the action log be sent out prior to the meeting for updates to be added to ensure that last time was spent on these during the meetings.Quality and Risk Committee 2013 Page 4 of 13 Item number Agenda Item - Key Points of Discussion ACTIONACTION: Update action log and circulate to Committee members for updates prior to the forthcoming meeting. EOPerformance monitoring 1 – Quality and scrutiny of providersQRC/13/032 Quality – 30 minute Presentation Deferred.ACTION: Ensure; Quality – 30 minute presentation item is included EO on the 18 July 2013 meeting agenda.QRC/13/033 Francis 1. Update from extraordinary meeting It was agreed that a Task and Finish group be set up. This group was to formerly meet on Monday 29 April 2013. The work plan would be brought to this Committee once devised by the group. Commissioners and Providers had met to agree the way forward. Three separate groups had been agreed and there was a LAT forum set up which would enable information sharing across the wider Community. Post meeting note City CCG have agreed to join the South task and finish group. The question of resource consequences for the Quality Team arose and it was mentioned that Capita had been commissioned to undertake a review of the Quality Team, the first meeting was to take place on Tuesday 30 April 2013. QRC/13/034 Director of Quality update (Summary of Provider minutes) of: 1. NUH QSG –Unratified 15/3/2013 There had been concern around potential unsafe discharges in the Community where District Nurses (DNs) and GPs had received none or poor information regarding patient discharges. There had also been concern for Infection Control Matrons in that MRSA positive patients had been discharged with no decontamination medication and/or no note of MRSA positive in letter. There had also been concerns for Social Care. It had been agreed that information on all these incidents was to be co-ordinated and sent to CC for monitoring.Assurance had been received regarding falls prevention and there had been a decrease in harm and repeat fallers. It was noted that NUH had set themselves high targets on fall prevention. NUH were to submit an annual report. There was not a CQUIN for falls. NUH liaise with other Trusts of a similar scale to them in order to bench mark themselves. NUH had recently had one never event downgraded to an SI as it did not meet the criteria of a never event of which they had 5 in 12/13.2. CHP QSG – 25/2/2013 There had a been a report carried out by RCN regarding safe staffing for older people wards, the ratio of staff to patients was Quality and Risk Committee 2013 Page 5 of 13 Item number Agenda Item - Key Points of Discussion ACTION being reviewed by HP and followed up through QSG. £500 fine for avoidable PUs was now in place and work continued to prevent PUs. Improvements had been made.3. SFHFT QSG - 13/2/2013 (Meeting was cancelled)4. Nottingham Treatment Centre Patient Safety Group - 05/02/13 and 02/04/13 CQUIN NET promoter family and friends score used. 5. Quality Contract Review meeting with NHCT – 29/1/2013, 26/02/13 and 26/03/13 (26/03/13 meeting was cancelled) There were no questions raised by the group regarding the minutes.6. EMAS Quality Assurance Group – 26/3/2013 It was noted that SIs were on the agenda. Awaiting CQC visit update. There were issues of staff sickness and vacancies within the complaints and PALS team at EMAS. These issues are being taken up by the Coordinating commissioner Erewash and the North lead on behalf of Nottinghamshire.ACTION: Once members had reviewed the minutes appropriately, any concerns/queries were to be sent to CC. All 7. North CCGs' Quality and Risk Committee – 4.2.2013 and 09/04/13 There were no questions raised by the group regarding the minutes.QRC/13/035 Serious Incidents 1. Serious Incidents – month end report The month end report was reviewed and explained for the benefit of new members. SIs should be reported on STEIS within 2 working days of the incident occurring. RCAs should be carried out and submitted within 45 working days for grade 1 and 60 working days for grade 2. No more than 20 days extension can be requested from CC. RCAs are reviewed to ensure the route cause has been identified and sufficient work has been undertaken. The group reviewed the NUH/CHP/Whatton Prison graph of SIs, this showed that the largest amount of SIs was of PUs. Other SIs were noted to be MRSA and C Diff as well as slips, trips and falls. The SFHT and NHCT graph was then reviewed, again PUs were the highest number of SIs and then suicide and unexpected related deaths. A conversation followed with regards to unexpected deaths, it was noted that within Mental Health there was a tendency for younger age deaths due to the mental illness experienced. The discussion went on to the review/scrutiny of unexpected and suicide deaths, the SHA had previously looked at trends and it was felt this would now fall to the LAT. It was mentioned that an internal review does take place following these types of death.Quality and Risk Committee 2013 Page 6 of 13 Item number Agenda Item - Key Points of Discussion ACTIONThe EMAS graph showed that there had been 62 SIs of which the highest figure was for care management for which there had been 21, followed by 13 delayed responses and 11 incorrect codes. It was now a National requirement to report delayed response figures. EMAS had also classed 3 incidents as Local Never Events.2. Serious Incidents - level of assurance of risks and SIs coming to commissioners attention and information on aftercare The group agreed that this item had not been intended for this Committee.QRC/13/036 NUH 1. CQUIN progress NUH were likely to succeed in all CQUINs apart from Dementia. 10 CQUINs had been set for this year some were carried over from this year.2. NUH A&E Survey 2012 - action plan The action plan was monitored through the QSG. Included in the quality report which was submitted to the Governing Body and therefore in the public domain.QRC/13/037 CHP 1. Discharge communication process for DNs/CMs This was regarding the concerns that DNs/CMs were not being informed of their patients discharge from hospital. Noted that all NNE and NW GP practices were now signed up for E-discharge. Not all Rushcliffe practices were signed up in all areas; it was felt there needed to be clarity on what was fully meant by ‘signed up’. There was not a formal process documented and further discussions were to take place. There was concern that practices may have the facility set up but this did not guarantee usage of the system. IM stated that at their practice they had not received assurance of the E-Discharge system. There was an issue of the system not being timely enough. Clarity was required on how the system worked for each Provider; discharge letters were required to be received by GPs/CMs within 24 hours.ACTION: PCQ sub group to co-ordinate regarding E-Discharge. HCACTION: Source meeting date and either VB, HC or LS to attend if VB possible.LS stated that she would be happy to attend the meeting regarding the E- Discharge system.2. Slips, trips and falls report Q1-Q3 2012/13 Assurance had been received from Lings Bar that processes were in place to prevent falls. Visit taken place and information received.Quality and Risk Committee 2013 Page 7 of 13 Item number Agenda Item - Key Points of Discussion ACTION3. CQUIN progress There were 12 CQUINs set for this year which were briefly explained to the group.QRC/13/038 Primary Care Quality subgroup (PCQS) 1. PCQS minutes of 08/04/2013 There was a discussion around quality accreditation tools for GP practices, it was noted that there were several available and that currently the three South CCGs were all looking at different tools, Rushcliffe were using the IQ CQC tool, NNE were about to review different tools but there had been consideration of using the RCGP toolkit and NW currently were not recommended further use of accreditation tools but had used ADVANCE previous years. Members present from Rushcliffe CCG stated that they had already undertaken a review of several toolkits and had decided on promoting the IQ CQC as it supported CQC compliance which gave greater benefit to practices. There was agreement that it was not a case of ensuring that all CCGs used the same toolkit but that CCGs reviewed the toolkits and made recommendations to their practices on which, if any, to use, There was a need to promote quality processes/culture in general practice, it was suggested that in the long term there was the issue of engagement with practices and the need for all to view as a franchise. It was felt that the GB should focus on the strategic direction of the NHS and there was a suggestion that this Committee might ask CCGs for a report on options of how they might move strategically in the future and how this would be implemented in to GP practices within the next 2-3 years.2. Primary Care Quality Subgroup ToR update It was highlighted that until the LAT clarified roles and responsibilities it would be unrealistic to confirm the ToR, therefore the group agreed that the ToR would be clarified on receipt of relevant information from the LAT.QRC/13/039 Care Homes update 1. Care Home Subgroup minutes of 15/03/2013 Joint draft policies were discussed at the meeting, there were being led by Nottinghamshire County Council (NCC) who were looking to finalise the documents soon once done so the policies would be brought to this Committee. The group were seeking to establish quality monitoring co- ordination between all the organisations and a task and finish group had been set up to review audit tools and ensure work was not being duplicated. It was noted that this sub group had been established to provide assurance though monitoring of action plans of homes of concern, and information sharing and there was concern that the minutes did not reflect the ToR. CQC reports were available from their website to the public and it was possible to sign up for alerts from CQC to receive information on homes of concern. In the future CCG reports were to be submitted to the GB and therefore would be available in the public domain.Quality and Risk Committee 2013 Page 8 of 13 Item number Agenda Item - Key Points of Discussion ACTIONAssurance was required that homes of concern were being addressed and reviewed with a focus on the outcome.ACTION: Care Homes subgroup action plan regarding homes of VB concern to be brought to this Committee forum.There followed a conversation around GP awareness of homes of concern in their area, it was felt that GPs were probably not aware of this but if this sort of information was to be given to GP practices then the same would need to be carried out across the system, There was concern raised that there needed to be consistency and ownership of judgement, it would need to be made clear where these concerns had arisen from; methods would need to be assimilated, reviewed and acted upon. The group were reminded that the CCGs do have a responsibility to monitor and report care homes whereas they do not have a responsibility to monitor and report GP practices as this was the role of the AT. The group agreed that GPs should be encouraged to report issues they have with care homes they go in to. 2. Care Home update This paper provided an update on the actions taken regarding Winterbourne. It had been noted that the CCGs did not currently have enough capacity within the team to fully address the safeguarding adult’s agenda and a review of the team was to be completed. It was noted that the health care professionals feedback form was a very useful document though it had been mentioned by some practices that it was too long. The group agreed that it should be clarified that not all sections require completion and GPs should be informed of any homes of concern in their area.ACTION: Amanda Jones to amend the feedback form by seeking Amanda views of clinicians JonesPerformance monitoring: 2 – Area Team/CCGQRC/13/040 Vaccination and Immunisation - Summary of risks from PCQSG This item had been removed from the agenda.QRC/13/041 Health and Safety update – Arrangements The Executive Director Lead for Health and Safety was stated to be CC and a lead in each CCG had been identified, this was LS for Rushcliffe, HC for NW and Bridget Meats, Assurance Officer for NNE. The RIDDOR lead had been identified as Liz Gundel, Quality Support Officer, NNE, NW and Rushcliffe CCGs. There had been no handover or Legacy from the PCT. A work plan was to be drawn up. This will be monitored through the Health and Safety sub group which is to be set up. ToR to come to this meeting.Quality and Risk Committee 2013 Page 9 of 13 Item number Agenda Item - Key Points of Discussion ACTIONACTION: Submit ToR for the Health and Safety Subgroup to this LS Committee once drawn up.QRC/13/042 South CCG Equality and Diversity Forum minutes of 13.3.2013 – (The meeting had been deferred until 10 April 2013) As the meeting had not long taken place the minutes were not yet available. The group were informed that the meetings had previously been quarterly but were to change to monthly in light of the equality delivery system. Consultation was to be completed by the end of 2013. Training had been undertaken by certain staff members across the 3 CCGs which enabled them to deliver the training necessary to other staff members. There was currently a review underway to ascertain which staff members had not completed the E&D training. There was a view to rolling out the training to practices and PPGs. Work had been done with Disabled Go contract, this was with regards to access and facilities, there was a website that gave information on disabled access at health venues.There was to be an E&D accreditation module run 21 May 2013 which would be free and open to patient groups and local voluntary groups supported by North Nottinghamshire College.ACTION: Summary/key points of E&D forum and minutes when RR available to be brought to this Committee.QRC/13/043 Shared Learning Review Group – unratified minutes of 4/2/2013 It was felt that patient stories had been a useful tool for extracting learning and more focus should be placed on these at the meetings of this sub group. Concern was raised that the meetings still appeared to be more performance monitoring rather than sharing the learning and a steer to learning was required.ACTION: CC to attend the next two SLR subgroup meetings. CCACTION: promote the use of proformas at the meeting as a way of VB capturing learningQRC/13/044 Training and Development post April 2013 The question was asked of how often the Committee would like to receive T&D reviews. The group agreed that an annual report would be sufficient.ACTION: Provide an annual Training and Development report to the QRC. CCApproval/ratificationQRC/13/045 Policies and procedures 1. Training and development updated policy This was approved by the group.2. Health and Safety policy This was a new policy and it was suggested that member of the Committee have time to review the policy and relay any commentsQuality and Risk Committee 2013 Page 10 of 13 Item number Agenda Item - Key Points of Discussion ACTION to CC. There was a request that a section on reporting incidents be included in the policy.ACTION: Any comments on the Health and Safety Policy to be sent All via email to CC within two weeks of this meeting (by Thursday 2 May 2013).ACTION: Include incident reporting process in the policy. CC3. Integrated EIA/QIA policy for QIPP This was to be reviewed for all services. There was a request that a contents page be added. Members to send comments to CC by 2nd May CC ACTION: Include a contents page into the policy.It was agreed that pending the amendment the policy would be approved.4. South Care Homes sub group ToR There were two amendments agreed; under the section of ‘Quorum’ the wording ‘each locality’ was to be removed and under the section ‘Duties – Advisory/Performance Monitoring’ for the first bullet point the wording ‘for monitoring quality’ was to be included. The group agreed that amendments as per the discussion were sufficient for approval and the ToR would not be required to be brought back at the next meeting.ACTION: Amendments to be made as discussed. EO The 4th policy for approval Provider Quality Impact Assessments for Cost Improvement ProgrammesProcess for Review and sign off by Clinical Commissioning Groups was approved.Decision makingQRC/13/046 ‘Clinical’ Risk Registers – south CCGs 1. Rushcliffe This document had not been updated since the last QRC meeting. It was commented upon that some of the risks stated that they were closed, these were to be moved to the end of the report. Co-ordination was required between the three CCGs on the process of updating the risk registers.2. NNE It was requested that this be brought to the meetings on A3 so that it would be consistent with the other two risk registers and easier to read. Request that the risk regarding Air Liquide be closed; this was agreed. Noted how long this had been a risk for a new provider, it Quality and Risk Committee 2013 Page 11 of 13 Item number Agenda Item - Key Points of Discussion ACTION was felt that lessons should be learned from this.ACTION: Air Liquide risk to be closed. CCRR16 regarding misdirected letters was considered as to whether the score of 9 was appropriate, the group agreed that it was.3. NW This also had not been amended since the last QRC meeting and there was a need to bring it into line with the other two CCGs.Quality reps for the three CCGs were to meet and update the risk registers so there was consistency across the three and agree a process for continuation of this.CC reported she had updated the clinical risks and asked for this to be circulated to all CCGs but this had not happened.Action: Quality leads to review processACTION: Risk registers to be updated for the next QRC meeting. CC/LS/HCQRC/13/047 Lay member representation at QSGs Lay members had been receptive to this idea and this was to be trialled by MB attending the NUH QSG in July 2013. Quality Visits It was noted that there was a need to clarify the role, capacity and ensure such as CRB checks are completed if required. There were six volunteers to attend quality visits from the PRG at NW, before they would be able to attend a visit though there would need to have been the appropriate checks and information given as with the QSG.ACTION: At the July 2013 meeting this Committee is to agree the All terms for attending quality visits and QSG meetings for patient representatives.For information/escalation/discussionQRC/13/048 QRC Forward planner 2013/14 The group reviewed the document, it was commented that it was too small for some to read. It was noted that items in red where ad-hoc items for that meeting only.QRC/13/049 Identification of risks resulting from agenda item discussions Risk of lack of resource in managing eHealthscope, it was felt this was a positive system but did not have the infrastructure required to promote more widely.ACTION: Liaise with Andy Hall, Director of Outcomes and Information, Rushcliffe CCG for Andy to communicate with Mike LS O’Neil regarding this risk.QRC/13/050 Feedback on Internal Audit Reports 1. EMIAS Final Internal Audit Report: Quality Monitoring in Quality and Risk Committee 2013 Page 12 of 13 Item number Agenda Item - Key Points of Discussion ACTIONSecondary Care. 2. The report gave significant assurance. An action plan will be developed in relation to the amber areas and presented to the Audit committee. Members asked how providers data was quality assured:ACTION: Request report from Andy Hall on assurance that CC provider’s data capture system is robust and reliable. LS ACTION: Follow up with EMIAS regarding internal audit report, work on provider’s data system.QRC/13/051 Update on South Quality Team structure In light of Francis recommendations Capita had been commissioned to review the quality team. It had been confirmed that GP and dental complaints would sit with the LAT. The CCGs had decided to keep their Patient Experience Teams and the work carried out by these members of staff was to be reviewed. The Patient Experience Team for the three South CCGs was currently the former Complaints Manager and the PALS Officer. There was to be recruitment to the Quality and Patient Safety Team of a Quality Monitoring Officer.QRC/13/052 Issues to be raised for commissioners None.QRC/13/053 Items for escalation to the Governing Bodies None.QRC/13/054 Any other business None.QRC/13/055 Date and Time of Next Meeting Thursday 18th July 2013 1.30 – 4.30pm Reception room Gedling Civic Centre Arnot Hill Park Arnold, Nottingham NG5 6LUAll attendees should be aware that NNE CCG is legally required to comply with the Freedom of Information Act 2000 The minutes and papers from this meeting could be released as part of a request for information Quality and Risk Committee 2013 Page 13 of 13

Minutes of the Quality & Risk Committee

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