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MINUTES OF THE FINANCE & PERFORMANCE MEETING
HELD ON WEDNESDAY 20th APRIL 2016 AT 10.00 AM
AT MEETING ROOM, KING’S COURT, CHAPEL STREET, KING’S LYNN
Present: Chair Rob Bennett (RB) Lay Member (Finance) (Chair)
Dr Sue Crossman (SC) Chief Officer
Dr Ian Mack (IM) WNCCG Chair
Melvin Peveritt (MP) Vida Healthcare
Chris Humphries (CH) Director of Operations
Chris Randall (CR) Chief Financial Officer
Rev Hilary De Lyon (HDL) Lay member Audit & Deputy Chair (By Telephone)
Attendees Philip Riedlinger (PR) Interim Project Support Officer (For Item 7)
Cathy Hudson (CaH) Admin Support (Minutes)
ACTION1 / APOLOGIES
Apologies were received from Emma Kriehn-Morris (EKM)
2 / NEW DECLARATIONS OF INTEREST
No new declarations were declared.
3 / CONFIRMATION OF ANY PART OF THE AGENDA THAT IS EXEMPT UNDER THE FREEDOM OF INFORMATION ACT
Item 11 Feedback from Contracting Executive Meeting and Item 13 Clinical Academic Reserve update will be exempt under the Freedom of Information Act.
4 / MINUTES OF THE PREVIOUS MEETING HELD ON 16th MARCH 2016
The following amendments will be made to the minutes of the meeting on March 16th;
· Pg 2, Item 5, Para 1 – Remove sentence ‘SC said there is an issue with terminology and individuals recognising the projects that they are doing may be QIPP and may not be QIPP.
· Pg 2, Item 5, Para 2 – Change to ‘QIPP training feedback overview to come from Phillip Riedlinger’
· Pg 2, Item 5, Para 3 – Change ‘detox’ to ‘DTOC’.
· Pg 2, Item 6.1 Para 1 – Change ‘underspend’ to ‘surplus’
· Pg 3, Item 6.1 Para 1 – Add action to action log.
· Pg 3, Item 6.1 Para 7 – Change ‘Clarified’ to ‘Asked for clarification of’.
· Pg 5, Item 6.3 Para 1 – include ‘achieving their key performance targets’.
· Pg 5, Item 6.3 Para 1 – Remove ‘CC suggested that a mitigation that could be tried would be to put to QEH to remove?? which would affect their flow’
· Pg 6, Item 7.1 Para 3 – change ‘clarified’ to ‘ asked for clarification’
· Pg 6, Item 7.2 Para 2 – change to ‘HDL pointed out that some CCGs do not contribute to this’ wording amended to minutes.
· Pg 7, Item 7.4 Para 1 – Amendments made to wording.
· Pg 8, Item 10 Para 1 – Change to ‘HDL stated that Great Yarmouth and Waveney do not use CSUs for some areas of work’
5 / ACTION LOG/MATTERS ARISING
· 5/15 – This has been discussed at Audit Committee. Chris Humphris and Chris Randall are now in post. There will be changes to the staffing structure and a
ACTION
draft proposal is being prepared. This should be ready next week and formal consultation will be conducted with staff if appropriate. This can now be turned closed.
· 04/16 – The training feedback is on the agenda for today’s meeting. SC has asked HR for QIPP to be part of staff key work objectives. This can now be closed.
· 07/16 – This can be discussed with the internal audit team. This can now be closed.
· 08/16 – On agenda for today’s meeting. This can now be closed.
· 09/16 – RB has developed a programme of suggested topics for 2016 and this will be discussed at today’s meeting.
· 10/16 – Terms of Reference will be reviewed. On agenda for today’s meeting.
6 / KEY FINANCIAL ISSUES
6.1 / Month 12 Report and QIPP Report: The overall position as at month 12, end of year, is a surplus of £1.32m, which is £1m short of the original planned 1% surplus of £2.32m. This includes the £500k payment to the Clinical Academic Reserve (CAR). This is a very good result from the position WNCCG were in six months ago. NHS England have been updated of the current position.
The QIPP delivery as at month 12 is as expected. Lessons learnt over the last 12 month will be applied to the schemes for the coming QIPP year.
The Finance and Performance Committee thanked all of the team for their hard work over the last financial year which enabled WNCCG to end the year with a £1.32m surplus. A message will be prepared to practices to inform them of the current position and the challenges ahead for 2016/17. IM will speak to Emily Arbon to plan a form of words. / IM
RB asked CR if the year end position with providers reflect the liabilities we have with various providers. CR responded to say, with the QEH, there is a small gap but he is confident that with the month end claims process this will go some way to bridge the gap.
6.2 / 2016/17 Budget: The 2016/17 budget paper has been to the Governing Body meeting in March. This has now been submitted to NHS England. Next year the process will alter to ensure the Committee has had chance to scrutinise the budget in full before submission.
7 / PERFORMANCE MATTERS BY EXCEPTION
The A&E four hour target performance is our biggest concern. For the whole year, the A&E performance was 89.8%. The QEH have not hit the 95% for a year since 2011/12. This result has continued to decline steadily. A joint plan is being worked on. There has been changes nationally to the way the target is reached and this has affected how CCGs can deal with hospitals not meeting targets within their contracts.
Performance issues with the ambulance trust and turnaround times are a consequence of the A&E performance.
The System Resilience Group meetings have been refreshed to a monthly meeting with senior management oversight on a number of work streams to address some underlying issues. This aligns with the ongoing work to reform urgent and emergency care.
The NCH&C contract for 2015/16 has been concluded. The 2016/17 contracts are now being discussed.
8 / 2016/17 QIPP
8.1 / 2016/17 QIPP Plan: CH presented a paper giving an update on the QIPP schemes.
· Within unplanned care there are currently three schemes aimed at supporting patients at home and admission avoidance.
ACTION
· Planned care includes schemes on Prior Approval and Acute Productivity Metrics. Schemes on referral management in primary care will involve working with primary care to encourage appropriate and effective referrals.
· Contractual challenges have three schemes including data challenge for QE and NNUH.
· Schemes on prescribing include the prescribing Quality Scheme which happens every year.
· Continuing Health Care schemes are CHC & non-CHC IPP and CHC Optimisation
· Other schemes are BCF Renegotiations 16/17, Review LD in patient services, ICES efficiency scheme and QEH psychology provision.
This report will now come to each meeting to show the progress of each scheme. Meetings will happen regularly with scheme owners to keep up to date. Work is ongoing to develop new schemes.
IM asked if the funding for the Care Home Matrons is not found what would be the risks and how much funding is being sought. CH responded to say that some of the investment will come from the funding previously given to PMS practices from NHS England which will now come to utilising a greater proportion of the money set aside for investing in the support of unplanned care from resilience funds, or do less. We are looking for in excess of £1m to invest in the QIPP schemes.
The committee felt the report in its current form was very informative and will be updated regularly for meetings.
8.2 / QIPP Training Feedback: PR has been conducting a series of project training sessions. Another series of sessions have been arranged for staff to book in to. The training is aimed at all staff including management and clinicians. The benefits of the training to clinicians were discussed. PR offered to conduct further training to clinicians and this could take place off site if required. RB has attended one of these sessions and said that it is very informative and worthwhile staff attending.
9 / QUALITY PREMIUM AWARD
There is no information yet on the outcome of the 2015/2016 Quality Premium Award. This is due around September. CH reminded the committee that Quality Premium is a combination of national and local. The WNCCG financial position may reduce the amount received for 2016/17. Three local indicators have been chosen for the Quality Premium for this year. Two of these are around respiratory and one covering injuries sustained through falls.
CH will prepare an update for the next meeting. / CH
10 / PRIOR APPROVAL PROCESS AND APPLICATION
Prior approvals are included within QIPP. Changes have been made to allow the cross checking of procedures completed against the requests made. Support will be given to general practice to ensure GPs are using the correct criteria and referring appropriately. MP told the meeting that keeping the system streamlined and easy to use would be best for GPs.
11 / FEEDBACK FROM CONTRACTING EXECUTIVE MARCH 16
CH attended the Contracting Executive meeting from April. The contract negotiations for 2016/17 are still ongoing. The contracts database was discussed at the meeting. A list of all of the contracts is held which shows which contracts we are the lead for along with contracts we are an associate. Work has begun on the list to ensure a contract is held and if not, then negotiations begin for 2016/17. Not having an agreed contract in place does put us at risk. The data challenge will be ongoing through next year. CH and CR will be meeting with Helen Hughes to discuss the staffing structure.
ACTION
The NCH&C contract has now been signed. It is expected that the NSFT contract will be signed by Monday April 25. The finances for the QEH contract have been agreed. The contract documentation is being prepared for signing.
12 / CSU PERFORMANCE MONITORING
A performance report will be prepared for future meetings.
CH reminded the committee that although there areas of concern within the CSU there are also areas of good performance.
13 / CLINICAL ACADEMIC RESERVE (CAR) UPDATE
****FOI EXEMPT ITEM ****
14 / DRAFT ANNUAL PROGRAMME FOR FINANCE AND PERFORMANCE COMMITTEE
RB had prepared a draft programme of topics for the future Finance and Performance Committee meetings for 2016/17.
An addition will be made to include the quality premium awards. RB asked that any comments or additions can be sent through to him. The timings of the meeting will be looked at to ensure all items are covered and given enough time to discuss in detail. / CH/CR
15 / TERMS OF REFERENCE REVIEW AND REPORT TO GOVERNING BODY
CR will prepare a report to the Governing Body to show how the Finance and Performance Committee have met their Terms of Reference over 2015/16. / CR
An amended version of the terms of reference has been circulated to the committee.
3. The Accountable Officer and Chief Financial Officer will be moved from 3.2 Other Attendees list to the 3.1 Core Membership list.
6. Frequency 6.1 will be changed to The committee will meet monthly but the frequency of meetings will be kept under review.
11. Remove except in exceptional circumstances at the Chairs discretion from 11.2.
Subject to these changes, the committee approved the Terms of Reference.
16 / Date of Next Meeting:
There being no further business the meeting closed at 12.30pm.
The next meeting of the Finance and Performance Committee will take place on Wednesday May 18th 2016 at 10am.
Finance and Performance Committee Meeting – 20.04.16