Thurrock Managed Care Clinical Commissioning Group

Board Meeting – 16th May 2012

At Culver Centre, Daiglen Drive, South Ockendon RM15 5RR

Present:Mel Porter (MP)(Chair) Mr R Vine (RV Hassengate Medical Centre

Mr S Khan (SK)East Tilbury Medical Centre

Dr L Grewal (LG)Chafford Hundred MC Dr Nimal Raj (NR) Accountable Officer

Dr R Arhin (RA)Aveley Medical Centre

Dr K Cheung (KC)Ash Tree Surgery

Dr V Devaraja (VD)Sorrells Surgery

Dr N Tresidder (NT)Hassengate Medical Centre

Dr A Kalill (AK)Dr Colburn Practice

Dr P Mallik (PM)Thurrock Health Centre

Julie Leatherbarrow (JL)Thurrock Health Centre

Dr R MohileChadwell Medical Centre

Mandy Ansell (MA)COO Thurrock

Len Green (LJG)Lay Member (PPI Lead) Ade Olarinde (AO) Finance Lead, NHS SWE

Roger Harris(RH)Thurrock Council

In attendanceSteve Stavrinou (SS)

Rahul Chaudhari (RC)

Jane Foster-Taylor (JF-T)

Kim James (KJ)

Yvonne Anarfi

:Christine Celentano (CC)

Pat Cook (PC), Minutes

Actions
1. / Welcome & Apologies
MP welcomed everyone to the meeting. R H & RM advised they would have to leave at 10.30am.
MP advised RH’s item will be taken first and that Item 6 Constitution will now be taken under Part 2 of the meeting.
2. / Minutes of last meeting and matters arising
The Minutes of the last meeting were agreed as a true record and all matters arising are covered on the agenda for this meeting.
3. / Local Authority Update
RH gave updates on meetings that had taken place.
  • MP, NT and MA had attended the Health and Wellbeing Board meeting last week.
  • Rapid Response Assessment Service is working well and a pilot has been set up to extend the hours from 09.00-22.00 on weekdays
  • and 09.00-17.00 on weekends. It was noted that this service is the back-bone of the CCG Unplanned Care QIPP Plan. LG requested the SPA telephone number be sent to all GP practices together with the pathway to ensure the service is used correctly.
  • Public Health team will be moving across to the Civic Offices in July this year.
  • Andrea Atherton has been appointed to the joint Director of Public Health Post which has been agreed with Southend.
  • It is hoped to make space available in the Civic Offices for the CCG Office team later this year.
  • The Health & Wellbeing Board has expressed concern at the low number of health checks carried out for LD patients, although it was noted that numbers have improved to over 50% of patients. It was agreed this would be taken to the CEG for further discussion and will report back to the Board on how this is being taken forward.
  • A dialogue exercise is underway to establish a clear strategic direction and to design a model of service to deliver positive mental health outcomes. RM advised that Mental Health is the topic for the June Time to Learn Session. It was agreed that RH/RM meet outside this meeting to discuss how the Council can link into this session. RM will provide a report to the Board following the Time to Learn session.
  • Discussions will take place with the Council re Sections 75 and 256 agreements.
  • A GP representative is required to attend the JNSA meetings in addition to MA/NR.
/ Action
Action
Action
Action
4. / CEG update
LG gave an update on the last CEG meeting:
  • Constitution – this is on the Agenda for this meeting.
  • Practices were asked to analyse their referral data and bring minutes from their internal practice meetings in order that a peer review can be undertaken at the next meeting. The QP indicators have been circulated to all practices.
  • A presentation had been given regarding the pilot GP at A&E.
  • Irene Lewsey had given a presentation on the Dementia Intensive Support Team.
  • RC and his team will be visiting all practices to ensure they are aware of their individual QIPP targets. The Medicines Management Team are also taking the prescribing targets to practices.
  • Glenn Gooch to be invited to the July meeting to give an overview of the procurement process.
It was suggested that each practice should nominate a lead for QOF sign off and a list should be held centrally.
Safeguarding
Yvonne Anarfi, Designated Nurse for Safeguarding Children, introduced herself and gave an outline of her role. She suggested that Safeguarding should be a standard agenda item for future meetings. It was agreed that this would be responsibility of the Quality and Governance Committee and JF-T and RV will bring reports back to the Board via the CEG. It was noted that the Board will require formal training on safeguarding. It was also noted that Safeguarding will be part of the authorisation process for CCGs. / Action
Action
5. / Finance
  • AO reported on the Month 11 Finance report together with the Month 12 draft Finance Summary. It was noted that the overall position on the 2011/12 Commissioning Budget is a deficit of £3.5m on a £88.7m budget, representing a 4% variance. Within this £3m is attributable to the acute contracts (BTUH £2m and Mid Essex £800K). The balance is due to prescribing costs.
  • It was noted that delivery of all QIPP plans is crucial to the CCG achieving financial balance for 2012/13.
  • It was noted that AO and SK will now attend PCT Finance Committee meetings at which the CCG reports will be studied in detail. There will be periodic in depth scrutiny of individual CCG finances at the Finance Committee and Thurrock’s review will take place on the 29th August.
  • Minutes of the CCG Finance & Technical Committee meetings will routinely be taken to the PCT Finance Committee.
  • It was reported that with effect from 1st June, Thurrock CCG will receive practice allocation for the whole population of Thurrock, i.e. 166,000.
  • The PCT is encouraging CCGs to consider and agree portfolios that can be risk-shared in order to manage financial risks. The Board needs to consider its preferred position in advance of the next meeting of the replacement body for the Cluster CEC scheduled for 30/05/12.
  • Payment for attendance at meetings - SK requested Board Members to submit claims for 2011/12 by the end of this month to ensure payment is made. Any claims received after this date may not be paid.
  • From April 2012 claims must be received by SK by the end of each month in order that they can be approved for payment by the Finance &Technical Committee at its meeting during the first week of each month.
  • It was agreed that an Attendance sheet will be completed for all formal meetings but that claims for ad hoc informal meetings must be made to SK.
  • It was agreed that responsibility for the Risk Register will lie with the Finance & Technical Committee.
/ Action
6. / QIPP Update
  • RA advised that the overall QIPP target has been increased slightly due to the final BTUH Contract value.
  • He advised the QIPP Group are producing a gant chart to show progress on all QIPP Schemes, which will be presented to the Board each month.
  • It was noted that Drs Sidana, Bellworthy & Davies will be the clinical representatives for the BTUH Contract Review meetings with Drs Nimal Raj and Dr Mallik will be the representatives for the NELFT Contract Review Meetings.
  • The Medicines Management Team is visiting practices and will be sharing their prescribing targets for 2012/13. The Commissioning Team, together with a QIPP lead clinician, is also visiting practices with their QIPP targets for this year.
  • MA advised a QIPP system meeting is being held on 17th May at 17.00 with the Chief Executive and PMO. She and NR will be attending for the CCG but any other board members are welcome to attend.
  • NR reported the Medical Director for NELFT had been appointed.
  • PM reported there had been a delay in the starting of the Dermatology Outreach Clinic at Thurrock Health Centre which was due to an IT problem. It is expected to be resolved this week. It was noted that this service is being provided by BTUH at 90% of the current tariff. Discussion took place around whether it would be possible to find an alternative provider, possibly a GPwSI and it was noted that whilst this was possible, 6 months’ notice would need to be given to BTUH before a new service could be implemented.
    Discussion also took place around whether the Tele-dermatology service which is used by Thurrock Health Centre could be rolled out for the whole of Thurrock. It was agreed that a report be brought back to the next Board meeting for decision on whether to adopt either of the two options.
  • It was noted that the membership on the Terms of Reference for the QIPP Committee were incorrect and it was agreed that these be ratified following amendment. To amend membership of QIPP Committee on TOR.
/ Action PM
Action MP
7. / PPI Update
  • LJG advised that patient involvement is crucial for future commissioning plans. He reported he had attended several Patient Group meetings and now had 20 individuals who wished to sit on the Clinical Reference Group. It was noted that to date 5 practices have still not responded with details of their patient representative, despite several reminders.
  • LJG reported that the first meeting of the Clinical Reference Group is due to take place at the end of June/beginning of July.
  • “Patient Revolution – what is it”? KJ explained this is a pilot programme managed by Patient opinion where patients can feed back on their experiences via the website, by text, or telephone. The reports will be sent to LINk/Healthwatch and will be filtered through stakeholder groups before being circulated. JF-T stated the need for this information to be triangulated with the Quality and PALS teams and LG advised that this will be undertaken by the Clinical Reference Group.
    It was agreed that JF-T/RV will link in with LJG through the Quality & Governance Committee.

8. / Any other business
MP reminded members that, in future, AOB items should be raised one week in advance of the meeting.
  • SK requested details of who would represent the CCG at the meetings with Sheila Bremner on 25th May and 16th June re CSS and the PCT meeting on 29th May. It was agreed that Board representatives would be nominated by the Chair/Accountable Officer – SK/MA/NR/RV will attend the CSS meetings. It was agreed that AO would attend any meetings which will be attended by Finance Officer colleagues.
  • Discussion took place around the name of the CCG Clinical Group and it was agreed that it will revert to “Clinical Engagement Group” to avoid any confusion with the PCT CEC or its successor.

9. / Date of next meeting
The next meeting will take place on Wednesday, 20th June 2012 at 08.30 at the Culver Centre, Daiglen Drive, South Ockendon, RM15 5RR

1