Meeting of Wigan Borough Clinical Commissioning Group Board
Meeting of Wigan Borough Clinical Commissioning Group Board
Held on Tuesday 22nd May 2012 at 1.30pm in Meeting room 17, Wigan Life Centre
Present:
Dr Tim Dalton, Interim Chairman of WBCCG (TD)
Dr Ashok Atrey, Clinical Lead, TABA (AA)
Dr Tony Ellis, Clinical Lead, WCC (TE)
Dr. Mohan Kumar, Clinical Lead ALPF [MK]
Dr Pete Marwick, Clinical Lead, North Wigan (PM)
Dr Deepak Trivedi, Clinical Lead, ALPF (DT)
Trish Anderson, Deputy Managing Director for NHSALW/Interim Accountable Officer for WBCCG (TA)
Mike Tate, Director of Finance (MT)
Frank Costello, Lay Member (FC)
In Attendance:
Julie Southworth, NHS ALW Chief Operating Officer and advising on Governance (JS)
Viv Smith, PA, Minutes (VS)
1. / Chairman’s WelcomeThe Chairman opened the meeting at 1.30pm formally welcoming all attendees to the May Wigan Borough Clinical Commissioning Board. The Chairman extended the welcome to the members of the public in attendance and also to Dr Sanjay Wahie, who is a member of the group of practices applying to join Wigan Borough CCG.
The Chairman formally welcomed Michael Greenwood from NHS GM, in attendance to mentor the Chairman.
2. / Apologies for Absence
Canon Maurice Smith
Alan Stephenson
3. / Declarations of Interest
Other than the recorded declarations of interest there were no additional declarations of interest for any items on this agenda.
4. / Minutes from the Previous Meeting
The minutes were accepted as a true and accurate record of the meeting.
5. / Actions/Decisions Log from Previous CCG Board Meetings
· Due to the Diabetes Redesign meeting being cancelled Dr Marwick was unable to provide Board members with an update of the diabetes redesign. Dr Marwick advised that work on the restructure is ongoing and that a written report will be shared with Board members when progress has been made.
· Julie Southworth asked for the two actions relating to Governance to be deferred to June Board as new guidance is expected. The Chairman agreed to the deferral.
All remaining actions from previous Board were reported as complete
6. / Questions From Members Of The Public
None
7. / Locality Updates
7.1 / Patient Focus
Report circulated. Report received. MK informed the Board that Patient Focus discussed locality member practices and have produced a simple format for patients and public on the principles of the CCG. TA asked that the completed leaflet be shared with Paul Wilson of Communications for wider use.
Action: MK to share the electronic version of the leaflet with Board members / MK
7.2 / Atherleigh
Report circulated with agenda. Report received. One outcome from the meeting details that the Localities are prepared to be the driving force for QiPP savings
7.2 / TABA
Report circulated with agenda. Report received. Ashok Atrey informed the Board that Trish Anderson attended the May meeting to speak about the authorisation process which was followed by an energetic Q&A session.
7.3 / WCC
Report circulated with agenda. Report received. There was no Locality Board meeting in May. Locality members attended a patient engagement event at Wigan Investment Centre focusing on the roles of patients in the CCG
7.4 / Wigan North
Pete Marwick gave apologies for not submitting a report to Board. Wigan North Locality met w/c 14.05.12 discussing the standing items of Finance, QiPP, and dermatology referrals. PM gave assurance that a Locality report would be presented to the June Board.
Items 10.1 and 11.2 were taken out of sequence on the agenda to enable the authors of the papers be in attendance to present to Board
Item for Information - Healthcare Associated Infections Report
Chris Sweeney [Public Health] joined the meeting to present the item. The paper describes the zero tolerance approach towards avoidable infections which continues to be highlighted as a quality requirement in the NHS Outcome Framework 2012/13. Reducing health care associated infections including Clostridium difficile and MRSA are a key part of this.
For the year 2011/12 there were 9 cases of MRSA bacteraemia (2 over trajectory) and 123 cases of Clostridium difficile (12 over trajectory).
Training of home care and care home staff continues. Work continues to improve antibiotic prescribing in primary care.
Public Health are currently undertaking a root cause analysis with patients and will share the findings with the Board
Action: Chris Sweeney to share the root cause analysis findings from the patient feedback with Board members
Board members were asked to receive this report and to support the following recommendations:
· Urgent implementation – To put alerts on the GP electronic patient records to flag high risk patients.
· Further work needs to be done with regards to patients receiving treatment out of area to ensure that the health protection team receives timely information on which to act.
· The health protection team to provide high level infection control support for GPs on a case-by-case basis recognising that many GPs rarely see C. diff cases.
· That C. diff/MRSA bacteraemia be a regular item on the GP locality meeting agendas with the health protection team presenting case studies and lessons learned.
· Continue to work with GP’s regarding antibiotic prescribing.
· That the board receives monthly updates on HCAI performance.
Action: CS to implement the above and report back at the next Board.
Action: Clinical Governance Committee to monitor the detail of this area
The Chairman welcomed the recommendations in the paper adding that WB CCG Board members are committed to achieving excellent results and will welcome a monthly report. The Board is encouraged by work already underway with the Acute Trust, Bridgewater CH, with Care Homes and with patients.
Decision: Approved
Chris Sweeney left the meeting. / CS
CS
Item For information - Staff Health Safety And Wellbeing Report
Tracie Smith [Health, Safety and Facilities Manager] joined the meeting to present the report and to give a presentation intended to inform the Board members of the current Health, Safety and Wellbeing activities and the proposed plans for 2012-13.
Following the presentation the Board were asked for approval to continue working towards the second stage ‘Achievement Level’ of accreditation of the Good Work, Good Health Workplace Wellbeing Charter which aims to create a safe and healthy working environment for all staff employed by the WBCCG. The work will not incur any additional financial implications as it will be managed within the current allocated budget. The Health, Safety and Wellbeing Group intend to investigate how this good practice can be shared with the CCG Localities and Practices in the future.
The Chairman thanked Tracie Smith for the presentation and welcomed the report with a view of broadening the scope to include staff of all CCG Localities and Practices.
Decision: Approved –
Action: JS to provide details of how inclusion of staff within Localities will be implemented
Tracie Smith left the meeting / JS
8. / Committee Updates
8.1 / Chairperson’s Report from the WBCCG Corporate Governance Committee meeting held on 17th April 2012.
Report on agenda. Report received. The Corporate Governance Committee is now developing and understanding its role however it still seeks reassurance that all aspects are being appropriately covered. A check and review will be undertaken to identify any gaps and to confirm that all topics are being covered appropriately.
9. / Strategic Items
9.1 / Feedback from NHS GM
The Chairman asked Mike Greenwood to give feedback to the NHS GM Board members that CCG Board members do not automatically receive any communication or feedback from NHS GM Board meetings.
Trish Anderson gave feedback from NHS GM Weekly Ops meeting. The format of the meetings has been changed. Weekly Ops will be held bi-weekly with a Transition Project meeting to be held on the alternate weeks.
9.2 / Feedback from Clinical Strategy Board
The Chairman advised that papers for the next Clinical Strategy Board meeting have not yet been circulated. It was agreed that the new Governance Arrangements for Pan Greater Manchester working are acceptable for the next 10 months but Board members need to be aware that nothing is in place for post April 2013.
9.3 / Finance Budget Book
Mike Tate presented this paper which was approved by the WBCCG Finance and Performance Committee on 21.05.12. The Budget Book represents the Financial Plan in greater detail and establishes the baseline for the coming year. The planned resource for 2012/13 is £590.5m which will ensure that the planned surplus of £2.8m will be delivered.
It has been agreed that the Finance and Performance Committee will continue with monthly meetings to demonstrate effective stewardship of the budget and to ensure that effective Performance Management is in place.
Board members were asked
· to approve the 2012/13 Budget Book
· to note that further work is being undertaken to break down CCG budgets to locality and practice level
· to note that the Budget Book 2012/13 is based on the 2012/13 Financial Plan which was approved at the WB CCG March Board
The Chairman thanked the Finance team for the Budget Book. The Board welcomes the vigilance of holding monthly F&P meetings. The Chairman asked that the local Health & Wellbeing economy feeds in to NHS GM and that any feedback is reported to this Board.
Decision: Noted and approved
9.4 / 2011/12 Performance Month 12
Mike Tate presented the report which focuses on the Integrated Performance Measures [IPMs] included in the 2011/12 NHS Operating Framework, released in December 2010. The four main areas of concern are:
· Clostridium Difficile
· MRSA
· Waiting Patients/RTT
· Non-elective admissions
Board members were asked to note the content of the report.
Following detailed discussion and debate the Chairman welcomed and accepted the report noting the four areas of concern. The Chairman also noted that the trends are improving on three out of four of the areas of concern.
Decision: Noted
9.5 / NHS ALW Legacy Document
Julie Southworth presented the Document for information and assurance with regard to the CCG authorisation process. The document sets out the organisations position as at August 2011.
CCG Authorisation requires that the CCG demonstrate understanding of the inheritance from the PCT. This will allow the CCG to declare that it has quantified, identified and understood its likely inheritance from the PCT and has taken all steps to ensure robust transition arrangements are in place.
The paper is in 2 parts: Part 1 provides a position statement as at April 2012. Part 2 provides the original document from August 2011.
JS recommended to the Board that another statement be done in August 2012 as this is an evolving document.
The Chairman welcomed and accepted the document and asked that JS maps the changes that have already been made.
Action: JS to map the changes from the original document / JS
9.6 / NHS Constitution Review
Julie Southworth presented the paper for information and assurance with regard to the CCG authorisation process. CCG Authorisation requires that the CCG demonstrate commitment to, have regard to and promote the NHS Constitution.
The document sets out the constitution having regard to the rights to which patients, public and staff are entitled, and pledges which the NHS is committed to achieve, together with responsibilities which the public, patients and staff owe to one another to ensure that the NHS operates fairly and effectively.
The paper is in 2 parts, Part 1 provides an overview of the constitution.
Part 2 provides a review of the current evidence supporting the NHS Constitution and where there is none how this will be evidenced in the future.
TA recommended that the review be fed through the Localities enabling any perceived gaps to be identified and captured.
MT recommended using a benchmarking exercise to check that the self-assessment is robust.
The Chairman welcomed the report and also welcomed the input from a critical observer such as MIAA
Decision: Noted
9.7 / Wrightington Wigan and Leigh Foundation Trust Performance Report for March 2012
Julie Southworth presented the paper for information and discussion regarding any observations made by the Board for future improvement. The report is a public document available on WWL FT website. Board members are asked to review it and to make comments.
Board members were asked to pay particular attention to CQUIN.
MT informed the Board that there is a Performance Framework built into the contract and that all contract meetings with WWL are now divided into Quality/Performance/Finance with sub committees for each section. Any performance issues will be highlighted.
The Chairman welcomed the report and asked all Board members to review and provide comments
Decision: Report noted,
Action: Board members to review and provide comments / ALL
9.8 / Commissioning Board Report
Trish Anderson presented the report to provide an update to the Board of local and national developments within commissioning and to provide an update on the progress of key projects.
The report is in a short format designed to give a general oversight of the whole programme including a summary plus the names of the leads of each work stream.
FC commented that the report does not mention the priority areas of obesity and alcohol which currently sit within Public Health.
The Chairman welcomed this report as an excellent starting point adding that the Localities may wish to feed into their report with their specialties.
Decision/Action: The Commissioning Board report to come to Board on a quarterly basis
10. / Items for Information
10.1 / Safeguarding Inspection and Chairman’s Report
TA presented the report on behalf of David Valentine, the former PCT Board lead for Safeguarding. TA now holds the role of for WB CCG Board Lead for Safeguarding Children. The report highlights issues around the flagging system and issues around the training system.
TA informed the Board that the Safeguarding Inspection commenced on 21.05.12. Inspectors will be on site for two weeks, the report will be published in three months.
TA asked Board members to receive the information, to be aware of what WB CCG responsibilities are regarding Safeguarding, and to note that the Inspection is taking place.
The Chairman welcomed the reports and the information. Safeguarding is an important issue to WBCCG
10.2 / Communications Update
Trish Anderson presented the paper for information. There are initially three upcoming PPG Engagement sessions as the CCG is doing further listening and discussing to take more into account the wants and needs of patients and public. It is presumed more will follow subject to preferences to the contrary.
TA attended the LINK AGM and was asked to talk about the CCG views on development and priorities. The talk was followed by a healthy Q&A session.
The Chairman welcomed the report.
Decision : Noted
11. / Any Other Business
None
Part 1 of the meeting closed at 3.30pm
The Chairman thanked the members of the public for attending.
Date and Time of Next Meeting
25th June 2012 – 1.30pm
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