LUTON CLINICAL COMMISSIONING GROUP BOARD MEETING Part 1 - HELD IN PUBLIC ON TUESDAY 21st January 2020, 13:00-15:30 Youthscape, Bute Mills, 74 Bute Street, Luton, LU1 2EY A G E N D A Standing Items Lead Suggested Timing Time 1. Welcome, Apologies and Chair’s introduction Dr Nina Pearson 3 mins 2. Declarations of Interests in relation to Agenda Items * Dr Nina Pearson 2 mins 3. Declarations of Hospitality relating to Agenda Items ** Dr Nina Pearson 2 mins 13:00-13:15 4. Minutes of the Meeting held in Public on 19th November 2019 Dr Nina Pearson 3 mins 5. Matters Arising from the Meeting held in Public on 19th November 2019 Dr Nina Pearson 5 mins 6. Patient Story Dr Safiya Virji 20 mins 13:15-13:35 7. Chairs’ Report – to follow Dr Nina Pearson 5 mins 13:35-13:40 8. BLMK Accountable Officer’s Report Patricia Davies 10 mins 13:40-13:50 *Board Members are reminded that it is their responsibility to update their declarations of interests, notifying any change in circumstances on a new form to LCCG within a maximum of 28 days. New declarations will be requested from all Board members at least annually. ** All Declarations of Hospitality should be confirmed by email. Strategic Development 9. One Team Programme Geraint Davies 25 mins 13:50-14:15 10. Long Term Plan Update & 2020/21 Commissioning Delivery Planning Geraint Davies 25 mins 14:15-14:40 Break Performance Items 11. Integrated Quality and Performance Report Nicky Poulain 10 mins 14:55-15:05 12. Month 08 Finance Report Liz Cox/Chris Ford 10 mins 15:05-15:15 Items for Assurance 13. Board Assurance Framework Michael Wuestefeld-Gray 10 mins 15:15-15:25 Items for Information 14. Minutes of Committee Meetings: a) Clinical Commissioning Committee – 31st October 2019 b) Finance and Performance Committee – 1st November 2019 Dr Nina Pearson 5 mins 15:25-15:20 c) Patient Safety and Quality Committee – 31st October 2019 d) Primary Care Commissioning Committee – 24th September 2019 e) Transformation Board – 18th September 2019 15. Any Other Business Dr Nina Pearson 5 mins 15:25-15:30 Next Meetings Date Time Location Meeting Type Open to the Public? 18th February 2020 13:00-16:30 Conference Room, Arndale House Development No 17th March 2020 13:00-16:30 TBC Public Board Yes Draft Minutes Meeting: Luton CCG Board Meeting held in Public Date: Tuesday 19th November 2019 Time: 14:15 – 16:30 Location: Art Studio, Youthscape, Bute Mills, 74 Bute Street, Luton, LU1 2EY Present: Mahmood Aziz (MA) Lay Member, Finance & Procurement Geraint Davies (GD) Director of System Commissioning, Executive Team Patricia Davies (PD) Accountable Officer, Executive Team Chris Ford (CF) Chief Finance Officer, Executive Team Kathy French (KF) Independent Nurse Member David Kempson (DK) Lay Member, Audit & Governance, Deputy Lay Chair Jane Meggitt (JM) Director of Partnerships, Engagement and Communication, Executive Team Anne Murray (AM) Chief Nurse, Executive Team Dr Nina Pearson (NP) Chair Nicky Poulain (NPo) Chief Operating Officer Dr Uzma Sarwar (US) Clinical Director Dr Kirti Singh (KS) Clinical Director Gerry Taylor (GT) Corporate Director Public Health and Wellbeing, Luton Borough Council Dr Helen Turner (HT) Secondary Care Member Dr Safiya Virji (SV) Clinical Director Apologies: Dr Chirag Bakhai (CB) Clinical Director, Deputy Clinical Chair Rev. Lloyd Denny (LD) Lay Member, Patient & Public Involvement Angela Duce (ADu) Associate Director Strategy and Governance Dr Hetal Talati (HTa) Clinical Director Dr Sarah Whiteman (SW) Medical Director, Executive Team In Attendance: Chloe Allen (CA) Graduate Management Trainee Elaine Baugh (EB) Governance & Risk Support Officer (minutes) Amanda Murrell (AMu) Communications and Engagement Manager, Bedfordshire CCG Michael Wuestefeld-Gray (MW-G) Interim Assistant Director of Governance Risk and Corporate Affairs Actions 76/19 1. Welcome, Apologies and Chair’s Introduction The meeting commenced at 14:35. The Chair apologised for the late start of the meeting. The Chair welcomed all to the meeting and introductions were made. Apologies received as noted above. The Chair reminded the meeting that as a General Election as been called for the 12th December 2019 the meeting is subject to Purdah conditions. The Communications and Engagement Team were in attendance posting live ‘Tweets’ during the meeting. 77/19 2. Declarations of Interest in relation to Agenda Items There were no declarations of interest in relation to agenda items. 78/19 3. Declaration of Hospitality relating to Agenda Items There were no declarations of hospitality relating to agenda items. 79/19 4. Minutes of the Meeting held in Public on 17th September 2019 The minutes of the meeting held on the 17th September 2019 were reviewed with the following amendments noted: 69/19, page 6 – To be re-worded ‘…who they would not usually engage with’. 70/19, page 7 – Typographical and grammatical errors noted. 71/19, page 8 - Typographical and grammatical errors noted. The Board approved the minutes of the meeting held on the 17th September 2019 subject to the amendments noted above. 80/19 5. Matters arising from the Meeting held in Public on 17th September 2019 The Board reviewed the Action Log with the following updates noted: 30/19a – Luton and Dunstable Hospital (L&D) and Bedford Hospital Trust (BHT) are proposing to merger with effect from April 2020 with a shadow Board in place from January 2020. Luton CCG and Bedfordshire CCG are endeavouring to hold a Board to Board meeting with the Shadow Board in the New Year. There is also a proposed Board to Board meeting with East London Foundation Trust (ELFT). 51/19a – A risk has been drafted, ongoing work still required. 51/19b – Work is ongoing, there is national support with clearing the backlog. As a system we are the best achieving on improvement for LeDeR in the country. 70/19 – The dates of the Parent and Carers Forum have been circulated. This is an ongoing programme of work. 73/19c – Agenda item 14. NHS Luton CCG Constitution The updated draft Constitution will be presented at the Members Forum on Thursday 21st November 2019 for approval. The draft is using the NHS England best practice model. The Member Practices listed under section 3 has been updated. MW-G advised that typographical errors and amendments identified by DK have been corrected. NP advised that specific areas will be brought to the attention of Member Practices at the Members Forum, which differ from the previous version on the constitution, including to quoracy detailed on page 62, which is less that the current position. 81/19 6. Patient Story NP presented a verbal Patient Story. NP explained the process for the huddles. The Patient Story focused on a couple, where the husband has had ten admissions this year 2 | P a g e and was discussed at a huddle. The husband is in his 80s, multiple conditions i.e. diabetes, ischemic heart disease, COPD, dementia, severely frail. His admissions were usually related to his diabetes or as a result of a fall. His wife also has multiple conditions i.e. Parkinson’s, ischemic heart disease, osteoporosis and severely frail. NP conducted a joint home visit and identified the following: A supportive family network. Both were receiving carers visiting 3-4 times per day. The husband was in a single hospital bed in a single room at the front of the house. He was in gradual decline, feeling nauseous, spending most of his time in bed, sleeping, not eating or drinking, low mood and deaf. The wife was in a single hospital bed in the lounge, with a recliner chair. She shared her anxieties and worries about her husband. NP conducted an examination, resulting is some medication changes, others were de- prescribed and a referral made for a hearing-aid. For the wife, NP queried if she would like to go out more i.e. a Day Centre or the Hospice, she expressed an interest in going to the Hospice, which NP made the referral. At the next Multi-disciplinary Team (MDT) meeting it was agreed to do some end of life planning and see if changes could be made with the arrangements at home. The husband was started on a mild antidepressant; however the couple did not what to make changes to the arrangements at home. The District Nurses continue to look after the husband and the wife was not eligible for Hospice Care. Since the first contact with the family approx. 10 weeks ago the husband has had only one contact with the Out of Hours service, no admissions or Ambulance calls. NP felt that having a conversation with the wife about her concerns for her husband was good to have, although the interventions made have been very modest. NP suggests that it is better to see couples together in order to unlock unidentified issues. Comments from the Board: The Board felt this demonstrated the value of personalisation. This was an example of changing people’s perceptions that there are non- medical approaches to feeling better. The Board queried whether there was a model in place to develop this type of interaction with patients to identify issues which could be impacting on their health and wellbeing. The credence give from a visit from a GP or a senior nurse gives confidence to a situation, however this cannot be measured. Follow ups are conducted by a Care Co-ordinator. The Board queried whether a system could be established where following a number of admissions the patient is flagged. This is the role of the huddle to review these patients; more complex cases are discussed at the weekly MDT meeting. A second pair of eyes can see things from a different angle.