Putting Barnsley People First on Thursday 9 June 2016, 9.30 am at the Grimethorpe ......

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Putting Barnsley People First

A meeting of the NHS Barnsley Clinical Commissioning Group Governing Body will be held on Thursday 9 June 2016, 9.30 am at the Grimethorpe Pentecostal Church, Brierley Road, Grimethorpe, Barnsley S72 7EH

AGENDA (Public)

Item Session GB Requested

to

Enclosure Lead

Time

1. Apologies

09.30 am

2. Quoracy

3. Patient Story

09.30 am 10 mins

4. Declarations of Interest Relevant to the Agenda

GB/Pu/16/06/04 Nick Balac

09.40 am 5mins

5. Questions from the Public on Barnsley Clinical Commissioning Group Business

Nick Balac 09.45 am 10 mins

6. Minutes of the Meeting held on 12 May 2016 Approve GB/Pu/16/06/06 Nick Balac

09.55 am 5 mins

7. Minutes of the Extraordinary Meeting held on 26 May 2016.

Approve GB/Pu/16/06/07Nick Balac

10.00 am 5 mins

8. Matters Arising Report

Note GB/Pu/16/06/08 Nick Balac

10.05 am 5 mins

Strategy

9. Report of the Chief Officer

Information GB/Pu/16/06/09 Lesley Smith

10.10 am 10 mins

Quality Governance

10. Special Education Needs Update

Information

GB/Pu/16/06/10 Brigid Reid

10.20 am 10 mins

11. Quality Highlights Report

Assurance GB/Pu/16/06/11Brigid Reid

10.30 am 10 mins

12. Social Prescribing Information GB/Pu/16/06/12 Lesley Jane

Smith

10.40 am 10 mins

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Signed

Dr Nick Balac – Chairman Exclusion of the Public: The CCG Governing Body should consider the following resolution: “That representatives of the press and other members of the public be excluded from the remainder of this meeting due to the confidential nature of the business to be transacted - publicity on which would be prejudicial to the public interest” Section 1 (2) Public Bodies (Admission to meetings) Act 1960

13. CCG Committees Terms of Reference Approve GB/Pu/16/06/13 Vicky Peverelle

10.50 am 10 mins

14. Risk and Governance Exception Report Assurance & Approval

GB/Pu/16/06/14Vicky Peverelle

11.00 am 10 mins

Finance and Performance

15. Integrated Performance Report

Assurance GB/Pu/16/06/15 Heather Wells Vicky Peverelle

11.10 am 15 mins

16. Budgets 2016/17 Approve GB/Pu/16/06/16 Heather Wells

11.25 am 10 mins

Committee Reports and Minutes

17. Minutes of the Audit Committee held on 23 May 2016

Assurance GB/Pu/16/06/17 Chris Millington

11.35 am 5 mins

18. Minutes of the Finance and Performance Committee held on 5 May 2016

Assurance GB/Pu/16/06/18 Nick Balac

11.40 am 5 mins

19. Minutes of the Quality and Patient Safety Committee held on 31 March 2016

Assurance GB/Pu/16/06/19 Mehrban Ghani

11.45 am 5 mins

20. Minutes of the Equality Steering Group held on 18 February 2016

Assurance GB/Pu/16/06/20Brigid Reid

11.50 pm 5 mins

21. Primary Care Co-Commissioning Committee Assurance Report

Assurance GB/Pu/16/06/21Chris Millington

11.55 pm 5 mins

22. Date and Time of the Next Meeting: 14 July 2016 at 09.30 am at the Rockingham Centre, Sheffield Road, Hoyland, Barnsley S74 OPY.

12.00 pm Close

GB/Pu/16/06/04

1


GOVERNING BODY

9 June 2016

Declarations of Interests Report

1. PURPOSE OF THE REPORT

To provide the Governing Body with all Governing Body members declarations of interest.

2. EXECUTIVE SUMMARY

This report details all Governing Body members declared interests for members to update and to enable the Chair and members to foresee any potential conflicts of interests.

3. THE GOVERNING BODY IS ASKED TO:

Review that their individual declared interests are up to date

Receive and note the Governing Body members declarations of interest

Agenda time allocation for report:

5 minutes

Report of: Vicky Peverelle

Designation: Chief of Corporate Affairs

Report Prepared by:

Lynne Richards

Designation: Governance, Assurance and Engagement Facilitator.

GB/Pu/16/06/04

2

1. SUPPORTING INFORMATION

1.1 Links to the Assurance Framework

The report is especially relevant to the following risks on the Governing Body Assurance Framework: 2.1 and 5.2.

1.2 Links to Objectives

To have the highest quality of governance and processes to support its business

To commission high quality health care that meets the needs of individuals and groups

Wherever it makes safe clinical sense to bring care closer to home

To support a safe and sustainable local hospital, supporting them to transform the way they provide services so that they are as efficient and effective as possible for the people of Barnsley

To develop services through real partnerships with mutual accountability and strong governance that improve health and health care and effectively use the Barnsley £.

1.3 Governance Arrangements Checklist

Financial Implications

Not relevant

Contracting Implications

Not relevant

Quality

Not relevant

Consultation / Engagement

Not relevant

Equality and Diversity

Not relevant

Information Governance

Not relevant

Environmental Sustainability

Not relevant

Human Resources

Not relevant

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REGISTER OF INTERESTS

NHS Barnsley Clinical Commissioning Group

This register of interests includes all interests declared by members and employees of Barnsley Clinical Commissioning Group. In accordance

with the Clinical Commissioning Groups constitution and the Clinical Commissioning Groups Accountable Officer will be informed of any conflict

of interest that needs to be included in the register within not more than 28 days of any relevant event (e.g. appointment, change of

circumstances) and the register will be updated regularly (at no more than 3-monthly intervals)

Register: Governing Body

GOVERNING BODY

Name Position Details of interest

Nick Balac Chair of Barnsley Clinical Commissioning Group

Partner at St Georges Medical Practice (PMS)

Practice holds Barnsley Clinical Commissioning Group Vasectomy contract

Member Royal College General Practitioners

Member of the British Medical Association

Member Medical Protection Society

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GOVERNING BODY


The practice is a member of Barnsley Healthcare Federation which may provide services for Barnsley CCG

Mehrban Ghani Medical Director for Barnsley Clinical Commissioning Group

GP Partner at White Rose Medical Practice, Cudworth, Barnsley

Directorship at SAAG Ltd, 15 Newham Road, Rotherham


Madhavi Guntamukkala

GP Member Barnsley Clinical Commissioning Group

GP partner at The Grove Medical Practice

Member of British Medical Association and member of Royal College of General Practitioners


John Harban GP Member Barnsley Clinical Commissioning Group

GP Partner at Lundwood Medical Centre and The Kakoty Practice, Barnsley

AQP contracts with the Barnsley Clinical Commissioning Group to supply Vasectomy, Carpal Tunnels and Nerve Conduction Studies services

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GOVERNING BODY


Owner/Director Lundwood Surgical Services

Wife is Owner/Director of Lundwood Surgical Services

Member of the Royal College of General Practitioners

Member of the faculty of sports and exercise medicine (Edinburgh)


Anne Marie Hoyle

Practice Manager Member Barnsley Clinical Commissioning Group

Business Manager at The Kakoty Practice, Barnsley

Cllr Alice Cave, BMBC Elected Councillor is related

Member of Yorkshire NAPC Steering Group

Director Barnsley Enterprise for Living Well (CIC)

Member of the Institute of Healthcare Management


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GOVERNING BODY


Nick Luscombe GP Member Barnsley Clinical Commissioning Group

GP partner at Huddersfield Road Partnership

Practice lead for a small dispensing branch surgery

A fierce advocate of the adoption of first world standards of medical practice into Barnsley health care

Member of the British Medical Association but not actively

Medical student and F2 tutor for University of Sheffield

Lawrence King


Salaried GP at Kingswell Surgery

Local Medical Committee Member

Sudhagar Krishnasamy


GP Partner at Royston Group Practice, Barnsley

Member of the Royal College of General Practitioners

GP Appraiser for NHS England

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GOVERNING BODY


Executive member of Barnsley Local Medical Committee

Member of the Medical Defence Union

Director of SKSJ Medicals Ltd


Chris Millington

Lay Member, Barnsley Clinical Commissioning Group

Partner Governor Barnsley Hospital NHS Foundation Trust

Vicky Peverelle Chief of Corporate Affairs, Barnsley Clinical Commissioning Group

No interests to declare

Brigid Reid Chief Nurse, Barnsley Clinical Commissioning Group

Volunteer registered Nurse, St Gemma’s Hospice, 329 Harrogate Road, Moortown, Leeds LS17 6QD

Partner works at Leeds Teaching Hospital NHS Trust which provides services to Barnsley patients via Specialised Commissioning and could tender to supply

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GOVERNING BODY


others.

Mark Smith


Senior Partner at Victoria Medical Centre also undertaking training and minor surgery roles.

Lesley Smith Chief Officer, Barnsley Clinical Commissioning Group

Husband is Director of Ben Johnson Ltd a York based business offering office interiors solutions, furniture, equipment and supplies for private and public sector clients.

Board Member (Trustee), St Anne’s Community Services, Leeds

Member of the Regional Leadership Council (RLC), Yorkshire and Humber Leadership Academy, Health Education England

Chair, South Yorkshire Cancer Strategy Group

Chief Officer lead, Working Together o Living With and Beyond Cancer Programme (in conjunction with

McMillan Cancer Support) o CVD Stroke

Chair, Working Together, Programme Executive Group

Mike Simms Secondary Care Clinician, Barnsley Clinical Commissioning Group

No interests to declare

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GOVERNING BODY


Heather Wells Chief Finance Officer, Barnsley Clinical Commissioning Group

Partner holds a Senior Management position with BUPA –potential supplier of services to the NHS.

GB/Pu/16/06/06

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Minutes of the Meeting of the BARNSLEY CLINICAL COMMISSIONING GROUP GOVERNING BODY (PUBLIC SESSION) held on Thursday 12 May 2016 at 09.30 am in the Boardroom, Hillder House, 49/51 Gawber Road, Barnsley S75 2PY MEMBERS PRESENT: Dr Nick Balac (in the chair) Chair Dr Mehrban Ghani Medical Director Dr Madhavi Guntamukkala Member Dr John Harban Member Ms Marie Hoyle Member Dr Lawrence King Member Dr Sudhagar Krishnasamy Member Dr Nick Luscombe Member Mr Chris Millington Lay Member Ms Heather Wells Chief Finance Officer Mrs Lesley Smith Chief Officer Ms Brigid Reid Chief Nurse Mr Mike Simms Secondary Care Clinician IN ATTENDANCE: Mr Khawer Ashfaq Medicines Management Pharmacist (for minute

reference GB 16/107 only) Mrs Chris Lawson Head of Medicines Optimisation (for minute reference

GB 16/108 only) Mrs Susan Metcalf PTS Review Programme Lead (for minute reference GB

16/106 only) Ms Kay Morgan Governing Body Secretary Ms Hilary Mosley Health Improvement Nurse Principle (for minute

reference GB 16/109 only) Mrs Vicky Peverelle Chief of Corporate Affairs Ms Kirsty Waknell Communications Manager APOLOGIES: Dr Mark Smith Member MEMBERS OF THE PUBLIC: Miss Alison Edwards CCG Quality Co-ordinator (observing member of CCG

staff) Ms Nora Everitt Member of the Public Mrs Margaret Sheard Member of the Public

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The Chairman welcomed members of the public to the Governing Body meeting.

Agenda Item

Action

Deadline

GB 16/99 QUORACY

The Chairman declared that the meeting was quorate.

GB 16/100 PATIENT STORY

The Governing Body received a Patient Story which reflected a positive experience about the support that a patient and his family had received from Dementia services, in particular the Memory Team. The Chairman invited the views of the Governing Body in relation to the Patient Story. It was recognised that dementia patients were not necessarily aware of the impact of their illness on family members and interest from families was not always evident in every dementia case. The Story had provided a good example of service integration to provide holistic care and best outcomes for the patients and their families. It was important to maintain the level and flexibility of Dementia services in Barnsley to prevent hospital and care home admissions. An evaluation of the Memory Team will come to the Governing Body in June 2016. The Chief Nurse informed the meeting that 12 May 2016 was International Nurses Day. It was noted that a group of nurses from Primary Care were currently meeting to undertake work on infection control. The Chair commended the key contribution nurses were making to healthcare.

The Governing Body noted the Patient Story.

GB 16/101 DECLARATIONS OF INTEREST, SPONSORSHIP, HOSPITALITY AND GIFTS RELEVANT TO THE AGENDA

The Governing Body considered the Declarations of Interest Report. Dr N Luscombe commented that all GP elected members would have an interest in agenda item 11 Clinical Pharmacists. The Chairman indicated that the use of clinical

GB/Pu/16/06/06

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Agenda Item

Action

Deadline

pharmacists in Primary Care was a national initiative. The CCG was investing in clinical pharmacists to improve outcomes for the people of Barnsley and address sustainability in Primary care in addition there would be no financial gain to Practices. Agreed Action: Dr J Harban’s declaration would to be updated to read: ‘AQP contracts with the Barnsley Clinical Commissioning Group to supply Vasectomy, Carpal Tunnels and Nerve Conduction Studies services’.

VP

09.06.16

GB 16/102 QUESTIONS FROM THE PUBLIC ON BARNSLEY CLINCIAL COMMISSIONING GROUP BUSINESS

The Chairman invited questions from the public. Availability of Care Home Placements for People with Dementia A member of the public referred to the Patient Story and her own personal experience of finding a care home placement for a relative with dementia. In response, the Chairman commented that there had been an increase in availability of dementia places within care homes. However, for more advanced cases of dementia placements were required in specialised care home secure units. There were however lesser numbers of these types of placements. The numbers of very severe dementia cases may decline due to support provided from the Memory Team and a focus on providing cognitive skill sets for people with dementia. It was noted that there was also a wealth of support within the local community for people with dementia, their families and carers. The Chief Nurses commented that she had requested Healthwatch and the Barnlsey Metropolitan Borough Council to assist with guidance to relatives choosing a care home. Public Involvement and Engagement A member of the public extended an invitation to Governing Body members to attend a Barnsley Save our

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Agenda Item

Action

Deadline

NHS Campaign Group public meeting on Saturday 14 May 2016. The member of the Public referred to the NHS England publication NHS Citizen and public and patient involvement tool and queried the involvement of the public and patients in the Sustainability Transformation Plan (STP) and vanguards. A meeting had been held on 25 April 2016 but wider promotion and engagement was required. The Chief Officer advised that there was a Communication and Engagement Strategy for the STP and if there were deficiencies with Public engagement then this would need to be addressed. The Chief Officer and the member of the public agreed to further discuss this issue outside of the meeting.

LS

12.05.16

GB 16/103 MINUTES OF THE PREVIOUS MEETING HELD ON 14 APRIL 2016

The Minutes of the meeting held on 14 April 2016 were verified as a correct record of the proceedings.

GB 16/104 MATTERS ARISING REPORT

The Governing Body considered the Matters Arising Report and the following main points were noted: Minute reference GB 15/96 - Patient X-rays It was reported that seven Practices could now access and view patient X-rays at Practice level. It was noted that GP NHS.net email addresses were required to access the system. The Chair of the Practice Managers Group was working to move this project at pace. Minute reference GB 15/185, 14/347 & 15/210 - Hospital Discharge Notifications (D1 letters) From a patient safety perspective it was agreed that a letter be sent to GPs, practice nurses, advanced nurse practitioners and Practice Managers as a matter of urgency to advise of the current difficulties with D1’s.

MG

31.05.16

The Governing Body noted the Matters Arising Report.

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Agenda Item

Action

Deadline

STRATEGY

GB 16/105 REPORT OF THE CHIEF OFFICER

The Chief Officer updated the Governing Body on key issues and developments relevant to the strategic direction of the CCG. The following key points were noted: Yorkshire Ambulance Service The Chief Officer referred members to the proposed changes to the way in which 999 and NHS 111 services will be commissioned and managed. From 1 April 2016 NHS Wakefield CCG will act as lead commissioner and contractor for 999 and the Greater Huddersfield CCG for NHS 111. Discussion took place. In response questions raised it was noted that:

Performance of the contract will be monitored and managed by the relevant lead commissioner and contractor. A contract performance floor level would be determined for all CCGs, with reference to quality and safety measures.

A hub and spoke type model of emergency services, linked to the Urgent and Emergency Care Network Strategy would be introduced.

The proposed changes formalised responsibilities in relation to the commissioning, contracting and performance management of 999 and NHS 111 Service.

The CCG had previously diverted management time to address poor performance. In future this would be handled by the lead commissioner and the new arrangements would bring economies of scale.

An explanation was provided regarding the terminologies of ‘hear and treat’ and ‘see and treat’. The role and use of Rightcare Barnsley by the ambulance and NHS 111

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Agenda Item

Action

Deadline

service in the provision of care for Barnsley people was highlighted. The Chairman concluded discussion indicating that the new arrangements demonstrated excellent principles of collaboration and would lead to a reduction in health inequalities. South Yorkshire and Bassetlaw Sustainability Transformation Plan (STP) The Chief Officer provided feedback from a meeting to discuss the STP held on 11 May 2016. It had been recognised that South Yorkshire and Bassetlaw had a long history of working successfully together and had established itself in terms of a collaborative. However the ability of the collaborative to deliver at scale and pace was questioned. The Chief Officer advised that an STP event will be held on 10 June 2016. She would raise comments received about the involvement of the public in the STP at the event. Barnsley Accountable Care Partnership Board It was noted that the Barnsley Hospital NHS Foundation Trust had confirmed their intention to become a partner of the Barnsley Accountable Care Partnership Board. The Barnsley Hospice will also be invited to attend the Board in a non-voting capacity.

The Governing Body approved the proposed changes to the way ambulance services are commissioned going forward including: i) The Strategic Approach to Commissioning

Ambulance 999 & NHS 111 Services in Yorkshire and the Humber 2015-2019

ii) The Memorandum of Understanding for the collaborative commissioning of 999 ambulance services between Clinical Commissioning Groups across Yorkshire and the Humber.

iii) The Memorandum of Understanding for the collaborative commissioning of NHS 111

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Agenda Item

Action

Deadline

services between Clinical Commissioning Groups across Yorkshire and the Humber.

And noted the report for Governing Bodies which sets out the proposal for the collaborative commissioning of 999 & NHS 111 services by Yorkshire and Humber CCGs, with a lead commissioner/contractor. Agreed actions: To query public engagement and involvement in development of the STP at an STP event on 10 June 2016 The Governing Body noted the contents of the Chief Officer Report.

LS

09.06.16

QUALITY AND GOVERNANCE

GB 16/106 PTS REVIEW PAPER

The PTS Review Programme Lead provided the Governing Body with the final report of the four South Yorkshire CCGs on the outcome of the South Yorkshire-wide Patient Transport Services. Members noted the project risks and the roles and responsibilities for the PTS Procurement Team. It was highlighted that there was a role for a clinical lead on the Procurement Team.

The Chairman highlighted that engagement in the review had predominantly been from the Sheffield area. In response the PTS Review Programme Lead clarified that wider representation would be acquired from all CCGs within the review.

It was noted that the review provided a real opportunity to commission a quality service for patients who regularly use and depend on the patient Transport service.

The Governing Body approved the following recommendations:

That patient transport services should be procured on a South Yorkshire CCG-wide basis (Sheffield, Rotherham, Doncaster and Barnsley

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Agenda Item

Action

Deadline

CCGs)

The procurement route should be the Competitive Dialogue procedure carried out in accordance with The Public Contracts Regulations 2015

That lot 2 for core PTS services should be procured on the basis of a Lead Provider Model

The length of contract should be 5 years plus an option to extend for a year and then a further year (5+1+1). This will enable providers to invest in the service, finance fleet, implement new technology and continually improve services.

There should be a separate Any Qualified Provider (AQP) procurement for a ‘Take, Go and Collect’ service for repatriations and transport to care homes out of area from hospital to put in place a framework of qualified providers who can undertake these journeys.

Agreed Actions The Practice Manager Member and Lay Member to be involved in development of services and public engagement approach. To request expressions of interest for the clinical lead role on the PTS Procurement Team and advise the PTS Review Programme Lead accordingly.

MH/CM/SM KM

09.06.16

09.06.16

GB 16/107 REVIEW OF THE “AUTOMATED DISPENSING – IN PATIENT AUTOMATION PROJECT” BUSINESS CASE

The Lead Medicines Management Pharmacist provided the Governing Body with an update on the “Automated Dispensing- inpatient automation program” at the Barnsley Hospital NHS Foundation Trust (BHNFT).

With regard to Patient Hospital Discharge Letters (D1’s) the Medical Director explained that inaccuracies in prescribing occurred before submission to the pharmacy. It was noted that ward based pharmacists and electronic prescribing could reduce medication errors. Cultural issues would also need to be addressed to improve the quality and timeliness of D1’s.

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Agenda Item

Action

Deadline

The original business case for the pharmacy automation project had indicated that there would be a release of manpower in pharmacy and a redeployment of pharmacists to work at ward level. The meeting was advised that a skill reassessment of pharmacists had been undertaken and there was an increased presence of pharmacists in ward areas.

The Chairman indicated that the CCG would not be complacent with regard to the return on investment.

The Governing Body noted the report. Agreed Actions To develop an action plan to acquire additional value for the CCGs investment in the Pharmacy automation scheme.

MG/KA

09.06.16

GB 16/108 CLINCIAL PHARMACISTS

The Head of Medicines Optimisation presented the Governing Body with an overview about the introduction of Clinical Pharmacists into Primary Care Settings across Barnsley. It was noted that the business case for the programme had been approved by the Governing Body and Membership Council.

The Head of Medicines Optimisation reported that the interviews for the clinical pharmacist posts would be on 18 and 19 May 2016 with pharmacists commencing in post from June to September 2016. The pharmacists would be inducted and supported by the Medicines Optimisation Team. It was noted that the Scheme would be monitored to quantify return of investment.

It was highlighted that the clinical pharmacist service would increase capacity in Primary Care and assist with the shortage of GPs. The service would be promoted to Practices and patients. The Chief Nurse commented that the ‘First Port of Call' Training would incorporate the clinical pharmacist and social prescribing schemes.

The Governing Body noted the report and that Clinical pharmacist into Primary Care was an invest to save scheme, would increase capacity in primary

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Agenda Item

Action

Deadline

Care.

GB 16/109 COMMUNITY SHOP

The Health Improvement Nurse Principle provided the Governing Body with an update on how the previous CCG grant to the Community Shop was facilitating and enhancing the health offer that they provide. The Chairman commented that the CCG’s investment had enabled empowerment of people to help themselves and others. It was noted that an additional Community Shop would be opened in Athersley by the Autumn 2016

As a social presence, it was recognised that the Community Shop and other similar organisations, in partnership with the CCG and local area council networks could help deliver the strategic local agenda for the people of Barnsley.

The Governing Body noted the Community Shop Update. Agreed Actions: The Health Improvement Nurse Principle and Mrs Margaret Sheard to further discuss partnership working between the company shop and area council networks,

HM

09.06.16

GB 16/110 RISK AND GOVERNANCE EXCEPTION REPORT

The Chief of Corporate Affair’s provided the Governing Body with the Risk and Governance Exception Report, including the full Register of Interests and an update on the process for appointing the CCG’s External Auditors from 2017/18.

Risk Register The Chairman commented that the score for risk reference CCG 14/10, ‘Capacity of Primary Care’, would decrease with the introduction of Clinical Pharmacists.

The Governing Body:

Agreed:

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Agenda Item

Action

Deadline

That the red (extreme) risks on the GBAF were appropriately scored and there is sufficient assurance that they are being effectively managed as at 12 May 2016

Reviewed and Noted

The risks rated as extreme on the Risk Register

The risks escalated from the Risk Register as gaps in control against risks on the Assurance Framework

The Registers of Interests, Sponsorship, Gifts and Hospitality

The update regarding the procurement of the External Audit service from 2017/18.

The Governing Body did not Identify any positive assurances relevant to the risks on the GBAF

FINANCE AND PERFORMANCE

GB 16/111 INTEGRATED PERFORMANCE REPORT

The Chief Finance Officer and Chief of Corporate Affairs introduced the Integrated Performance Report to the Governing Body. Finance The Chief Finance Officer informed the meeting that subject to audit , the CCG was reporting the achievement of all financial targets and duties , including a surplus £8,280,000 in line with NHS England expectations. No significant issues had been identified by the external auditors at this point. However, further work around third party assurances was required to complete the audit. The Audit Committee would consider the CCG’s Annual Report and Accounts, together with documentation from internal and external auditors on 23 May 2016, prior to making recommendations to the extraordinary meeting of the Governing Body on 26 May 2016.

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Agenda Item

Action

Deadline

Performance The Chief of Corporate Affairs presented the CCGs key performance indicators and exception report. It was noted that year to date performance against the A&E 4 hour indicator was at 93% for April 2016. This improved performance needed to be sustained and this was being monitored via the Systems Resilience Group. In response to questions raised about diagnostic tests the Chief of Corporate Affairs clarified that the dip in performance was linked to the industrial action by junior doctors and the impact of Easter bank holidays in March 2016. It was further confirmed that diagnostic tests were being undertaken at weekends.

The Governing Body noted the contents of the report including:

2015/16 performance to date

year end financial outturn

the delivery of all financial duties, subject to the findings and opinion of external audit.

COMMITTEE REPORTS AND MINUTES

GB 16/112 MINUTES OF THE MEMBERSHIP COUNCIL HELD ON 15 MARCH 2016

The Governing Body noted the minutes of the Membership Council held on 15 March 2016.

GB 16/113 MINUTES OF THE AUDIT COMMITTEE HELD ON 28 APRIL 2016

The Governing Body received the minutes of the Audit Committee held on 28 April 2016. It was noted that the Audit Committee had considered the NHS Barnsley CCG 2015/16 Annual Report and Accounts in detail and had proposed some amendments. The Committee had been assured on the quality, accuracy and robustness of the Annual Report and Accounts. Agreed Action

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Agenda Item

Action

Deadline

The Governing Body agreed to convey their appreciation to Ms Anne Arnold for her support to and chairing of the Audit Committee and to the Finance and Corporate Affairs Team for their work on the CCG’s Annual Report, Annual Governance Statement and Annual Accounts.

LS 09.06.16

GB 16/114 MINUTES OF THE FINANCE AND PERFORMANCE COMMITTEE HELD ON 7 APRIL 2016

The Governing Body received the minutes of the Finance and Performance Committee held on 7 April 2016. A typographical error was noted on page 4, first bullet point to read: ‘The majority of activity and finance proposals have been agreed’.

GB 16/115 MINUTES OF THE PATIENT AND PUBLIC ENGAGEMENT COMMITTEE HELD ON 24 MARCH 2016

The Committed considered the minutes of the Patient and Public Engagement Committee held on 24 March 2016. It was noted that:

All CCG commissioning managers were utilising the Engagement Toolkit and checklist.

The Patient Council were to review the CCG Engagement Strategy.

GB 16/116 PRIMARY CARE COMMISSIONING COMMITTEE ASSURANCE REPORT

Mr C Millington highlighted that the Primary Care Commissioning Committee had reviewed the prioritisation of the Primary Care Transformation Fund Bids and noted the year-end financial position in respect of the Primary Care Commissioning delegated budget. The Chairman commented that the CCG had made significant investment in Primary Care.

The Chief of Corporate Affairs advised that the Primary Care Transformation Fund was primarily to resource estates and technology proposals. It was noted that the portal for submission of proposals was between the 2 and 30 June 2016.

The Governing Body noted the Primary Care

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Agenda Item

Action

Deadline

Commissioning Committee Assurance Report. Agreed Action: To inform Practices regarding the outcome of the prioritisation of the Primary Care Transformation Fund Bids. To distribute the final guidance and template for Primary Care Transformations bids to practices when received by the CCG.

VP

VP

20.05.16

09.06.16

GB 16/117 CLINICAL TRANSFORMATION ASSURANCE REPORT

The Governing Body noted the Commissioning Assurance Transformation Board Clinical Transformation Assurance Report.

GB 16/118 MINUTES OF THE HEALTH AND WELLBEING BOARD HELD ON 5 APRIL 2016

The Governing Body noted the minutes of the Health and Wellbeing Board held on 5 April 2016.

GB 16/119 MINUTES OF THE COMMISSIONERS WORKING TOGETHER BOARD HELD ON 2 FEBRUARY 2016

The Governing Body noted the minutes of the Commissioners Working Together Board held on 2 February 2016.

GENERAL

GB 16/120 GOVERNING BODY ASSURANCE WORK PLAN AGENDA AND TIMETABLE

Members received the Governing Body Work Plan / Agenda Timetable 2016/17. The Chief Nurse indicated that she had submitted comments for updating of the work plan to the Governing Body Secretary.

GB 16/121

QUESTIONS FROM THE PUBLIC

The Chairman invited questions from the public.

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Agenda Item

Action

Deadline

Hospital Discharge Summary Letters (D1’s) A member of the public referred to problems previously discussed about D1’s and asked if the Governing Body intended to take action to resolve issues? In response it was advised that the quality and timeliness of D1’s had been a long standing concern of the CCG and Primary Care. The Chairman said that the public could be assured that the CCG had taken all necessary action and were supporting the Barnsley Hospital NHS Foundation Trust (BHNFT) to bring about the required improvement in D1’s. The CCG has received assurance from the BHNFT that action was being taken to improve D1’s. Patient Transport In response to a questions raised it was clarified that the safeguarding of patients would be a key quality element Patient Transport Service Specification. The Chief Nurse clarified that within the last three years there had been no Serious Incidents relating to Patient Transport Services. Community Pharmacists A member of the public highlighted that the public would not necessarily be aware about the differences between Community Pharmacists and Clinical Pharmacists and advised of intended budget cuts for Community Pharmacies. The Chairman indicated that unfortunately it was not with in the CCG’s power to influence nationally imposed budget reductions for Community Pharmacists. The CCG would however continue to provide support for Community Pharmacists. Agreed Action Mr C Millington and Ms Kirsty Waknell with the member of the public raising the question to consider the Comms messages to the public in respect of the Primary Care Clinical pharmacists Scheme.

/KW/NE

09.06.16

GB 16/122 DATE AND TIME OF THE NEXT MEETING

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Agenda Item

Action

Deadline

The next meeting of the Governing Body will be held on:

Thursday 9 June 2016 at 9.30 am, Grimethorpe Pentecostal Church, Brierley Road, Grimethorpe, Barnsley S72 7EH

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Minutes of the Meeting of an Extraordinary Meeting of the BARNSLEY CLINICAL COMMISSIONING GROUP GOVERNING BODY held on Thursday 26 May 2016 at 09.30 am in the Boardroom, Hillder House, 49/51 Gawber Road, Barnsley S75 2PY MEMBERS PRESENT: Dr Nick Balac (in the chair) Chair Dr Mehrban Ghani Medical Director Dr Madhavi Guntamukkala Member Dr John Harban Member (from minute reference GBEO 16/03 03.1) Ms Marie Hoyle Member Dr Sudhagar Krishnasamy Member Dr Nick Luscombe Member Mr Chris Millington Lay Member (from minute reference GBEO 16/03 03.1) Dr Mark Smith Member Ms Heather Wells Chief Finance Officer Ms Brigid Reid Chief Nurse Mr Mike Simms Secondary Care Clinician IN ATTENDANCE: Ms Anne Arnold Interim Chair Audit Committee Ms Kay Morgan Governing Body Secretary Mr Richard Walker Head of Assurance Ms Linda Wild KPMG Audit Manager APOLOGIES: Dr Lawrence King Member Mrs Vicky Peverelle Chief of Corporate Affairs Mrs Lesley Smith Chief Officer

Agenda Item

Action

Deadline

GBEO 16/01

QUORACY

The Chairman declared that the meeting was quorate.

GBEO 16/02

DECLARATIONS OF INTEREST, SPONSORSHIP, HOSPITALITY AND GIFTS RELEVANT TO THE AGENDA

No declarations of interest, sponsorship, hospitality and gifts relevant to the agenda were received.

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Agenda Item

Action

Deadline

GBEO 16/03

NHS BARNSLEY CCG ANNUAL REPORT AND ACCOUNTS 2015/16

The Governing Body were presented with the CCG’s Annual Report, Governance Statement and Accounts and advised that the Audit Committee had reviewed the documents in detail. The Audit Committee recommended that Governing Body:

Approve and adopt the Annual Report and Accounts 2015/16

Authorise the Accountable Officer to sign and date the Performance Report, Accountability Report, the Governance Statement, the Statement of Accountable Officers Responsibilities and the Statement of Financial Position on the CCG’s behalf

Authorise the Chair and Accountable officer to sign and provide to KPMG the Management Representation Letter 2015/16.

The interim Chair of the Audit Committee commented that the production of the Annual Report and Accounts was a significant exercise undertaken each year to defined timescales. The Audit Committee had recognised that despite losing two key members of staff there had been a strong team effort in producing the year end accounts. The Audit Committee had undertaken scrutiny including a ‘page turner’ review of the draft Annual Report, Governance Statement and Accounts on 28 April 2016 and reviewed these documents again on 23 May 2016. All amendments proposed by the Audit Committee had been incorporated into the final documents presented before the Governing Body.

The Chief Finance Officer advised the Governing Body that subsequent to the Audit Committee meeting on 23 May 2016:

Two outstanding Service Auditors Reports had been received from NHS Business Services Authority regarding Prescription Services, and HSCIC regarding GP Payments Services. These had been reflected in the CCG’s Governance Statement.

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Agenda Item

Action

Deadline

At 4.00 pm on 25 May 2016 the External Auditors had advised the CCG of a mapping error in NHSE’s Accounts template. This has affected all CCGs with level 3 co-commissioning status but was a purely presentational error with no impact on the CCGs financial targets.

03.1 Annual Report & Governance Statement

The Head of Assurance presented the Annual Report to the Governing Body. It was noted that the draft Annual Report had been received by the Governing Body in April 2016. The Head of Assurance drew members attention to:

The Statement as to Disclosure from each individual member of the Governing Body. It was clarified that this confirmation would also be sought from Governing Body members who were absent from the meeting.

The proposed amendments to section 4.9.3, ‘Third Party Assurances’ in respect of a Service Auditor Report from PwC for HSCIC’s GP Payments Services. The CCG had determined that the issues identified in the HSCIC letter did not represent a significant risk to the CCG in terms of materiality and in the light of other compensating controls operated by the CCG.

The Governing Body noted and approved the revised text for section 4.9.3.

In response to a questions raised, it was clarified sections 5.2.1 (Salaries and Allowances) and 5.2.2 (Pension Benefits) were subject to Audit review and this was reflected in the KPMG Opinion. The figures recorded in these sections were also confirmed to be correct.

The Governing Body approved the Chief Officer as Accountable Officer to sign off the relevant sections of the Performance Report and Accountability Report.

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Agenda Item

Action

Deadline

03.2 Annual Accounts

The Chief Finance Officer presented the Governing Body with the CCG’s Annual Accounts 2015/16. It was noted that the CCG had met all its required financial targets.

The Governing Body considered the Annual Accounts and approved the Chief Officer as Accountable Officer to sign off the financial statements.

03.3 KMPG ISA 260 Summary of Audit Findings 2015/16

The KPMG Manager presented the Governing Body with the ISA 260 Summary of Audit Findings. The KPMG Manager reported that KPMG intended to issue an unqualified audit opinion on the accounts and an unqualified value for money conclusion, following the Governing Body adoption of them on 26 May 2016 and receipt of the signed accounts and Management Representation Letter. There were no recommendations in respect of the CCGs control environment. The KPMG Audit Manager reported that there had been a slight delay in preparation for the audit, unfortunately, the hard copy working papers provided for the audit were not cross referenced or provided en-bloc electronically as requested. It was recognised that despite losing two key members of staff from the Finance Team, there had been a strong team effort in producing the year end accounts. Looking ahead the learning from this year’s audit process would be incorporated into a revised year end timetable to ensure all required information was available at the specified time for year-end audits in future years. The KPMG Audit Manager drew members’ attention to the proposed fee for the audit £57,050 plus VAT. It was noted that the fee was £800

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Agenda Item

Action

Deadline

above that highlighted within the audit plan and this was due to additional audit resource required as a result of the working papers provided for the audit not being in line with agreed expectations. In addition as a result of carrying out additional audit procedures via NHSE to gain assurance on Co-commissioning expenditure extra fees will be charged. Approval would be sought from the Chief Finance Officer and Public Sector Audit Appointments Limited for the increase in audit fee.

03.4 Head of Internal Audit Opinion & Annual Report 2015/16

The Governing Body received and noted the Head of Internal Audit Opinion & Annual Report 2015/16.

03.5 Annual Report of the Local Counter Fraud Specialist 2015/16

The Governing Body received and noted the Annual Report of the Local Counter Fraud Specialist 2015/16

03.6 Management Representation Letter

The Governing Body received the Management Representation Letter and approved the letter for sign off by the Chairman and Chief Officer as Accountable Officer. The letter reflected the national template and no additional disclosures specific to Barnsley CCG were proposed or required.

03.7 Statement as to Disclosure to Auditors

It was noted that this item had been previously discussed under minute reference GB EO 16/03 3.1.

03.8 Approval and Adopt the Annual report and Accounts and approve the letter of Representation

The Governing Body:

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Agenda Item

Action

Deadline

Confirmed that the Statement as to Disclosure to Auditors is accurate

Approved and adopted the Annual Report and Accounts 2015/16

Authorised the Accountable Officer to sign and date the Performance Report, the Governance Statement, the Statement of Accountable Officer’s Responsibilities, the Accountability Report, and the Statement of Financial Position on the CCG’s behalf.

GBEO 16/04

DATE AND TIME OF THE NEXT MEETING

The next meeting of the Governing Body will be held on:

Thursday 9 June 2016 at 9.30 am, Grimethorpe Pentecostal Church, Brierley Road, Grimethorpe, Barnsley S72 7EH

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GOVERNING BODY

9 June 2016

MATTERS ARISING REPORT

The table below provides an update on actions arising from the previous meeting of the Governing Body (public session) held on 12 May 2016.

Table 1

Minute ref Issue Action Outcome/Action

GB 16/101 Declarations of Interest, Sponsorship, Hospitality and Gifts Relevant to the Agenda To amend Dr J Harban’s declaration and update Register to read: AQP contracts with the Barnsley Clinical Commissioning Group to supply Vasectomy, Carpal Tunnels and Nerve Conduction Studies services.

VP

COMPLETE

GB 16/102 Questions from the Public – Public Involvement & Engagement STP The Chief Officer and the member of the public to further discuss Public Involvement & Engagement in the South Yorkshire and Bassetlaw Sustainability Transformation Plan outside of the meeting.

LS

COMPLETE

GB 16/105 Report of the Chief Officer – South Yorkshire and Bassetlaw Sustainability Transformation Plan To query public engagement and involvement in development of the STP at an STP event on 10 June 2016

LS

COMPLETE

of 5


GB 16/106 PTS Review Paper The Practice Manager Member and Lay Member to be involved in development of services and public engagement approach. To request expressions of interest for the clinical lead role on the PTS Procurement Team and advise the PTS Review Programme Lead accordingly.

MH CM SM KM

COMPLETE COMPLETE

GB 16/107 Review of the “Automated Dispensing – In Patient Automation Project” Business Case To develop an action plan to acquire additional value for the CCGs investment in the Pharmacy automation scheme.

MG KA

GB 16/109 Community Shop The Health Improvement Nurse Principle and Mrs Margaret Sheard to further discuss partnership working between the company shop and area council networks.

HM

GB 16/113 Minutes of The Audit Committee held on 28 April 2016 To convey their appreciation to Ms Anne Arnold for her support to and chairing of the Audit Committee and to the Finance and Corporate Affairs Team for their work on the CCG’s Annual Report, Annual Governance Statement and Annual Accounts.

LS

COMPLETE

of 5


GB 16/116 Primary Care Commissioning Committee Assurance Report To inform Practices regarding the outcome of the prioritisation of the Primary Care Transformation Fund Bids. To distribute the final guidance and template for Primary Care Transformations bids to practices when received by the CCG.

VP VP

COMPLETE COMPLETE

GB 16/121 Questions from the Public – Community Pharmacists Mr C Millington and Ms Kirsty Waknell with the member of the public who raised the original question to consider the Comms messages to the public in respect of the Primary Care Clinical pharmacists Scheme

CM KW NE

COMPLETE

1. ITEMS FROM PREVIOUS MEETINGS CARRIED FORWARD TO FUTURE MEETINGS

Table 2 provides an update/status indicator on actions arising from earlier Board meetings held in public.

Table 2

Minute Ref

Issue Action Outcome/Actions

GB 15/42 Terms of Reference Clinical Senate

The Chairman to ascertain interest in the membership of the Clinical Senate from GPs.

NB

Pending – Dr M Guntamukkula to attend Clinical Senate

GB 15/96 Summary of Lorenzo demonstration Pharmacy Robot Patient X-rays to be made available to respective GPs

VP

In Progress. Seven Practices can access & view Patient X-rays at Practice level. GP NHS.net email address required to access the system. The Chair of the Practice Managers Group

of 5

Minute Ref


is working at pace to move this project forward.

GB 15/155 Report of the Chief Officer – Establishment of Urgent and Emergency Care Networks To raise transfer of work from the District Nursing Service to Primary Care at the South West Yorkshire NHS Partnership Trust through Contracting arrangements.

HW/VP

To build into contract discussions after evidence provided through membership. No evidence provided as yet.

GB 15/185 14/347 & 15/210

Hospital Discharge Notifications To write to GPs, Practice Nurses, Advanced Nurse Practitioners and practice Managers advising of the current difficulties with D1’s and that information provided in D1’s should be where appropriate checked for accuracy.

MG

GB 15/193 Minutes of the Patient and Public Engagement Committee (16 July 2015) To provide updates on the Patient Partner Telephone System to the Governing Body

CM

Schedule completed detailing all participating Practices: RAG rated for clarity All work in line with action plans is ongoing to resolve issues around the Patient Partner Telephone System Patient Partner System to be promoted to Practices. Progress reported requested from Mike Austin

GB 15/182 Minutes of the Clinical Transformation Board 1 October 2015 To consider and proposed options for a consistent approach to the provision of minutes to the Governing Body on 10 December 2015.

NB/VP

Corporate processes being renewed 09.05.2016.

of 5

Minute Ref


GB 15/307 Integrated Performance Report To determine the commencement date for provision of primary care triage by i-Heart Barnsley in the A&E Department at BHNFT

VP

Bid included for Primary Care Transformation Fund

GB 16/67 The Chief Officer agreed to communicate to both providers the CCG’s frustration that the A & E Department were not diverting patients to the I HEART service and how these two providers could work together to benefit each other.

LS

COMPLETE

GB 16/76 QUARTERLY UPDATE ON CHILDRENS SERVICES The Chief Nurse to submit a report about Education, Health and Care Plans and the role of the Designated Clinical Officer to the next meeting of the Governing Body on 12 May 2016.

BR

COMPLETE - Scheduled for Governing Body Agenda 9 June 2016

GB 16/77 UPDATE ON CHILD SEXUAL EXPLOITATION The Chief Nurse agreed to acquire the detail of CSE training and report back to the next meeting of the Governing Body on 12 May 2016.

BR

327 Licensed drivers have received safeguarding training focussed on drivers coming into contact with vulnerable children and adults. All remaining 367 drivers will complete training by no later than end of July.

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1


GOVERNING BODY

9 June 2016

REPORT OF THE CHIEF OFFICER

1. PURPOSE OF THE REPORT

To update the Governing Body on key issues and developments relevant to the strategic direction of the CCG.

2. EXECUTIVE SUMMARY

This report provides an update on the following issues:

Stronger Communities Partnership

Medical Interoperability Gateway (MIG) Project Update

Year End Assurance Letter

Pre-consultation for children’s surgery and anaesthesia and hyper acute stroke services – to note the report

Communications and engagement strategy and the future plans for public consultation comments.

3. THE GOVERNING BODY IS ASKED TO:

Note the report and provide comment on the communications and engagement strategy and the future plans for public consultation for children’s surgery and anaesthesia and hyper acute stroke services.

Agenda Item – Allocation of Time

10 Minutes

Report Of

Lesley Smith

Designation Chief Officer

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2

1. DISCUSSION / ISSUES

1.1 STRONGER COMMUNITIES PARTNERSHIP

The Stronger Communities Partnership Group met on the 24 May 2016. The key elements of the meeting were as follows: 1) The terms of reference were agreed which included the vision:

'Through collaborative working we aim to ensure a coordinated approach to prevention and early intervention, ensuring that individuals and families have easy access to all forms of early help, making best use of their own skills and resources and preventing needs escalating. Wherever possible we will work in a co-productive manner focusing on ‘what works’. We recognise that achievement of our vision will require a longer-term shift to focusing on the causes rather than symptoms of need but with the benefit of better outcomes and reduced demand on more costly, specialist services.'

2) There was a discussion regarding the development of the 4 delivery groups

for; early help (all ages), early help (children), resilient and healthy communities and anti-poverty and the progress these groups are making. Early Help (Children). Children's centres converted into family centres successfully. Early help for children booklet available. Explains offer to children. Early help (adults) - delivered 2 workshops - social prescribing and falls. It is also overseeing the universal information and advice work which is nearing completion. Anti-poverty. Teams have been brought together and co located at civic centre to assist with coordination of information and advice. Further efforts to review ways of working and self-serve methods.

3) Development of an All Age Early Help Plan for the Borough. The SCP have agreed the development of this which will be borough wide. Fundamental to this is an agreed set of definitions, principles and outcome measures which will be shared at a later date.

4) Housing and Health update. Berneslai Homes are the managing agent on behalf of BMBC responsible for the management and maintenance of 18,800 council houses. They deliver a range of core and added value services detailed below:

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3

1.2 MEDICAL INTEROPERABILITY GATEWAY (MIG) PROJECT UPDATE

Of the 36 practices in Barnsley, 30 practices have switched on the MIG to date. A further 2 practices are expecting to switch the MIG on. The remaining 4 practices will be contacted individually to try and work through any outstanding issues. Work has commenced to rollout access to the MIG with the Barnsley Hospice, BHNFT and SWYPFT in the next phase.

1.3 YEAR END ASSURANCE LETTER

The CCG had its Annual Review Meeting for 2015/16 on 19 April 2016. A copy of the informal feedback letter is attached at Appendix A. NHS England’s assessment of the CCG against the five assurance components has been reported as GOOD, subject to regional and national moderation.

1.4 COMMISSIONERS WORKING TOGETHER PROGRAMME CHILDREN’S SURGERY AND ANAESTHESIA AND HYPER ACUTE STROKE SERVICES

Pre-consultation for children’s surgery and anaesthesia and hyper acute stroke services Between January and April 2016, the CWT Programme held an open pre-consultation for the review of children’s surgery and anaesthesia services and also hyper acute critical care services across the region. The purpose of the pre-consultation communications and engagement work was to gather views to inform plans and the development of the options for future service configuration. These options will inform the consultation that will be opening to the public in September 2016.

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4

Complementing the overarching communications and engagement activity and support from the core team, local CCG based activity was also carried out. Each CCG followed similar methods and approaches for engaging with their respective stakeholders and local populations. A copy of the report is attached at Appendix B; page 4 of the report explains the methods and approaches for engaging with stakeholders and the local population in Barnsley. Communications and engagement strategy and the future plans for public consultation During the pre-consultation phase views were gathered from key stakeholders to inform plans for future service configuration and consultation. Preparations are now underway to enter a 12 week or 16 week public consultation (depending on guidance from the OSC) on the options for reconfiguring children’s surgery and anaesthesia and hyper acute stroke services across our commissioning and provider partners in the region. The draft Strategy is attached at Appendix C, and Governing Body is asked for comment.

Dr Nick Balac, Chair Lesley Smith, Accountable Officer Barnsley CCG

Dear Nick and Lesley RE: CCG 2015/16 ANNUAL REVIEW Thank you for meeting with us on 19 April for your Annual Review Meeting. The purpose of this letter is to provide informal feedback on the key issues we discussed, and to confirm next steps for the publication of the 2015/16 CCG Headline Assurance Assessment. We discussed the good work in 2015/16 on Rightcare Barnsley in establishing a single point of access, and on the development of primary care. The CCG has maintained a focus on health inequalities, through the HIT scheme, and implemented some innovative work in general practice workforce which we would like to share across Y&H. We also acknowledged the improved relationships between the CCG and the hospital Trust which has resulted in an agreed contract for 2016/17 within the nationally-required timescales. I congratulated the CCG on ensuring continued improvement through your commissioning for the people of Barnsley. The sustainability of local acute services remains an issue. You described the work in progress to develop a strategic solution to this, through the development of an Accountable Care Organisation (ACO) and the wider Sustainability and Transformation plan (STP) work on acute services. The CCG has started to consider what the STP and ACO will mean for the overall governance structure of the CCG. We acknowledged the work that is underway to develop the STP for South Yorkshire & Bassetlaw. I thanked Lesley for her significant contribution to date in drawing the STP together. Your continued leadership and clinical engagement from the wider CCG membership will be essential to the successful delivery of the plan. As part of the STP, we expect to see the successful completion of the work on hyper acute stroke and children’s services within 2016/17. As we discussed there is excellent work being undertaken collaboratively, but it is essential for the sustainability of services that the implementation of these plans moves at pace.

Direct 0113 82 47511 Date:26/05/16

NHS England – North (Yorkshire & the Humber)

3 Leeds City Office Park Meadow Lane

Leeds LS11 5BD

We discussed the achievement of NHS Constitution standards, and agreed that the necessary improvement in A&E performance in 2016/17 will require a step change in the service model, which is being led through the STP. It will be important for you to ensure that the STP addresses this within 2016/17 in order to secure improved emergency access for your population. Whilst there is still work to do, in order to finalise the Better Care Fund plan, we discussed the strength of the 2016/17 Operating Plan and the work the CCG has done to firmly embed the Right Care approach in their QIPP planning. We discussed the annual assurance assessment of the CCG, in the context of the 2015/16 CCG Assurance Framework. Our assessment of your CCG, against the five assurance components, is as follows:

Well Led Organisation

Delegated Functions

Financial Management

Performance Planning

Good Good Good Good Good It is important to note that this assessment is provisional, and subject to regional and national moderation. As you will be aware, NHS England is required in the 2016/16 Mandate for the NHS, to publish a Headline Assessment of the CCG by the end of June. The Headline Assessment will be determined by the lowest of the assessments across the five components. It is clear from our discussions that the CCG is continuing to improve and delivering well through your leadership and the hard work of the organisation. Thank you. I will write to you again at the end of June, with your finalised Headline Assurance Assessment. In the meantime, please do not hesitate to contact Alison Knowles or Mark Janvier should you require any further information. Yours sincerely

Moira Dumma Director of Commissioning Operations

Communications and engagement report: pre-

consultation for children’s surgery and anaesthesia and

hyper acute stroke services

April 2016

1. Introduction

As Commissioners Working Together (CWT), we are a collaborative of eight clinical

commissioning groups (CCGs) across South and Mid Yorkshire, Bassetlaw and North

Derbyshire and NHS England.

Some people have better experiences, better outcomes and better access to services than

others – and to ensure that everyone experiences the highest quality and safest service

possible, we are working with all local hospitals and care providers, staff and patient groups

to understand how best to do this for the benefit of everyone in the region.

Over the last year, we have focused on four key areas – reviewing both hyper acute stroke

and children’s surgery and anaesthesia services, urgent and emergency care and have also

developed a partnership with Macmillan for people living with and beyond cancer.

Between January and April 2016, we held an open pre-consultation for the review of

children’s surgery and anaesthesia services and also hyper acute critical care services

across the region.

The purpose of the pre-consultation communications and engagement work was to gather

views and input to inform plans and the development of the options for future service

configuration. These options will inform our consultation that will be opening to the public in

September 2016.

2. Methods and approach

During pre-consultation, we focused our efforts on three key groups:

Patients, carers, families and the wider public

Clinicians and staff working in the services

Place-based stakeholders such as Overview and Scrutiny Committees (OSCs),

Health and Wellbeing Boards, MPs and other interested groups.

A comprehensive stakeholder map – developed with input from all CCGs – helped to shape

and inform the approach and develop appropriate methods and ways of connecting with our

identified audiences.

We followed the NHS England Planning, Assuring and Delivering Service Change for

Patients Guidance (November 2015) and had conversations with and learned from

colleagues in parts of the country where successful, large-scale engagement has already

taken place (eg Manchester and Wakefield).

Our approach was inclusive and included:

Overarching strategic communications and engagement from the Commissioners

Working Together team

CCG-led local conversations and awareness raising based on comprehensive, place-

based communications and engagement plans

Regionally-led clinical and managerial engagement

Clinically informed materials

Clinically led communications materials

Patient and public involvement in development of materials

Our methods have included:

Digital communications and engagement through our website, with background about

why changes are being considered and materials. This was the central point for

signposting and survey responses

An online survey, asking the questions:

What matters to you when accessing children’s surgery and anaesthesia services?

What matters to you when accessing critical care for people who have had a stroke?

Social media – Twitter and Facebook led

Events, supported by the same toolkit (presentation, topline messages and Q&A)

Broadcast and print media releases and conversations

One to one briefings and updates with place-based stakeholders, via regular chief

officer briefings

Briefings with Healthwatch

Setting up a Joint Health Overview and Scrutiny Committee

A working group with all communications and engagement leads from our eight CCG’s,

along with communications leads from the region’s acute provider organisations and NHS

England has been meeting regularly since June 2015. As well as helping to shape the

communications and engagement approach, the group has met to discuss what materials

were needed to support local conversations (which were subsequently developed by the

core team) and update on engagement progress.

As well as promoting the pre-consultation, each CCG has been leading on local

conversations with local groups and communities – ranging from established patient and

public participation groups to health ambassadors (representing community and interest

groups such as the homeless, asylum seekers and the deaf community), parent and carer

groups (including a group for parents with children who have autism), stroke groups,

disability networks and local employers. These have been complemented by regional events

with clinicians, staff involved in the services and patient and public representatives.

3. Overview of communications and engagement activity

The pre-consultation period started in January 2016 and since early February, the website

has seen a significant increase in traffic, with 6,756 page views between 1 February and 15

April. The top three page destinations throughout pre-consultation were:

/what-we-do/childrens-surgery/share-your-thoughts

/what-we-do/critical-care-stroke-patients

/what-we-do/children’s-surgery

Interest in the Commissioners Working Together Twitter and Facebook presence has also

grown – with Twitter followers increasing at a rate of around 50 a month and tweet

impressions averaging around 15,000. Profile visits reached almost 1,300 in February and

over 1,100 in March. Facebook has also helped raise awareness of the pre-consultations,

with videos of the clinical leads and patients reaching more than 700 users. A blog from the

clinical lead for children’s surgery services was read by 140 individual users with Twitter

being the main source of traffic.

For further awareness raising, contact was made with the region’s key media with briefings

given and a press release issued. This also resulted in an article in the Health Service

Journal (HSJ) – a national trade publication.

Collectively, as a core team and as individual CCG’s we have held, attended and shared

information at 22 events. This includes patient and public participation groups, parent and

carer forums and stroke support groups. Attendance at the events has varied from

audiences of 15 to over 200.

We have also been gathering views on a one-to-one basis in outpatient clinics, local

authority settings, sixth form colleges, stroke groups and parent and carer forums.

By the end of the pre-consultation phase, we received 247 online responses as well as

written feedback from each of the events. We estimate that more than 500 face to face

conversations have taken place; though the awareness of the need to look at changing the

two service areas has reached many thousands.

3.1 Overview of clinical engagement

In establishing the workstreams and subsequent pre-consultations, clinical spokespeople

were identified and have been involved in helping shape the messaging for our various

communications and engagement methods and materials.

At least five clinical workshops were held centrally throughout the pre-consultation phase

and Commissioners Working Together workstream leads continue to work with clinical

representatives from each commissioning and provider organisation in South and Mid

Yorkshire, Bassetlaw and North Derbyshire to ensure all plans and developments are

clinically-sound and sustainable.

We have also actively engaged with and worked alongside a number regional clinical

experts from the Yorkshire and Humber Strategic Clinical Network throughout this process,

where they have attended events, acted as spokespeople and been kept informed through

regular e-bulletins and face to face meetings.

3.2 Overview of MP engagement

Building on existing relationships, each individual clinical commissioning group held the

responsibility for communicating and engaging with their local MPs through regular briefings

with the respective Chief Officers.

4. Overview of communications and engagement activity by area

Complementing the overarching communications and engagement activity and support from

the core team, local CCG based activity was also carried out. Each CCG followed similar

methods and approaches for engaging with their respective stakeholders and local

populations.

4.1 NHS Barnsley Clinical Commissioning Group

NHS Barnsley Clinical Commissioning Group (Barnsley CCG) carried out various

communications and engagement activity for the two workstreams, alongside promoting the

pre-consultations, and how to get involved, via their website which was supported by social

media signposting from their Facebook and Twitter accounts (over 9,700 followers).

Quantitative communications included the promotion of the pre-consultations via e-bulletins

to various partner organisations and patient and public groups from across Barnsley. This

included information being distributed to their patient council, OPEN (a public engagement

network of around 200 members), GP patient reference groups (PRG’s) and to local partners

from across health and social care, as well as their local authority and voluntary sector

organisations.

Patient and public communications and engagement

Qualitative engagement in Barnsley with patients and the public included the pre-

consultations being discussed at the Barnsley Patient Council meeting on 24 February 2016.

The meeting was attended by members of local GP patient reference groups from across

Barnsley with a presentation given by a member of the CWT core team alongside open,

participatory discussion on the pre-consultations. Feedback from this meeting has been

incorporated into the overall themes.

Further qualitative engagement for the pre-consultation into hyper acute stroke services

included attendance at an Afternoon Tea Party and Dance held by the Rotary Clubs of

Barnsley, which provided an afternoon of company, discussions and entertainment for

lonely, elderly and socially isolated people from across the borough. Over 200 people were

in attendance and took part in a number of informal, face to face discussions. Again, the

feedback was then incorporated centrally.

Staff and partner communications and engagement

Qualitative engagement with partner organisations, which did also include some patient

groups and representatives, was the presentation of and discussions on the work of

Commissioners Working Together and the pre-consultations at Barnsley CCG’s

Commissioning Plans Event on 12 February 2016. As well as having a stand with

information to take away, round table discussions on the workstreams were had with the 50+

people in attendance.

Barnsley CCG built on their strong relationships with their partner and provider organisations

for further quantitative communications and engagement activity. Promotion of the pre-

consultations and the opportunities to get involved was included in:

Voluntary Action Barnsley’s weekly e-bulletin as well as through social and digital

media (their own website and Facebook and Twitter accounts)

South West Yorkshire Partnership NHS Foundation Trust circulated the information

to all practice governance coaches in Barnsley, including physical and community

services as well as mental health. Information was also sent widely to staff within

physical and community services, including district nurses.

Barnsley Hospital NHS Foundation Trust promoted the pre-consultations via their

own existing networks, including Barnsley Parents and Carers Forum.

Via their volunteering and engagement team, Barnsley Metropolitan Council

promoted the pre-consultations to their staff, area teams and through their Service

User and Carer Groups database (of which there are over 200 members).

Communications and engagement with seldom heard groups and those in protected

characteristics

As well as qualitative engagement at the Rotary Club event for elderly and socially isolated

people, Barnsley CCG targeted the following groups for promotion of and involvement in the

pre-consultations:

Barnsley BME Women and Children Forum

Healthwatch Children and Young People

Barnsley Maternity Service User Group

4.2 NHS Bassetlaw Clinical Commissioning Group

NHS Bassetlaw Clinical Commissioning Group (Bassetlaw CCG) posted information on the

pre-consultations and the links to the central online surveys on their own website and

supported the awareness raising via their social media accounts (over 2,900 followers on

Twitter and 50 on Facebook).


Qualitative engagement by Bassetlaw CCG throughout the pre-consultation phase included

attendance at their Patient Experience Steering Group. The group, consisting of patient

representatives from across Bassetlaw, received a presentation on the two pre-consultations

with the opportunity for follow up, participatory discussion.

Quantitative communications and engagement included the dissemination of pre-

consultation information through various community and voluntary sector organisations in

the area. These included:

Bassetlaw Action Centre

Advice Bureau, and;

Bassetlaw Community Voluntary Services.


Further awareness raising included the dissemination of information through Bassetlaw

CCG’s Working Voices project. This is an ongoing partnership project between the CCG and

the workforce of five local employers – Eatons Electrical, Ryton Park Primary School, BPL,

North Nottinghamshire College and Bassetlaw CAB.

Regular updates on the work of Commissioners Working Together and the pre-consultations

were also given at Bassetlaw CCG’s Governing Body meetings throughout the phase.

4.3 NHS Doncaster Clinical Commissioning Group

NHS Doncaster Clinical Commissioning Group (Doncaster CCG) actively promoted the pre-

consultations, engaging with a wide range of local communities for involvement in the two

pre-consultations. This was complemented by hosting locally tailored online surveys on their

website which was signposted to from their own Twitter account of over 9,500 followers

The former chair of Doncaster CCG also promoted the pre-consultations through his regular

comment piece in the Doncaster Star.


Qualitative engagement for the pre-consultation into children’s surgery and anaesthesia

services included attendance at seven participatory events with various patient and public

groups including; two local colleges, Doncaster Parent’s Voice, Doncaster’s patient and

participation group network and Happy Hands, Doncaster’s Deaf Parent Group.

Similarly, qualitative engagement for the hyper acute stroke services pre-consultation

included attendance at three participatory events with a local stroke group, Doncaster

Speakability and the Doncaster Stroke Support Group.

Vox pop sessions were also carried out at the Civic Building in Doncaster, engaging

members of the public in 1:1 conversations about the two pre-consultations and feeding their

views into the overall feedback.

Quantitative engagement on the two workstreams included the distribution of information,

including how to get involved to targeted patient and public groups across Doncaster,

including children’s centres, parent partnerships, carers’ services and charities.


Quantitative communications and engagement activity was carried out with Doncaster

CCG’s partner organisations through the distribution of information and survey questions for

all internal and external publications of the following:

Doncaster Metropolitan Borough Council

Public Health

Doncaster and Bassetlaw Hospitals NHS Foundation Trust

Rotherham, Doncaster and South Humber NHS Foundation Trust

The Doncaster Chamber of Commerce

St Leger Homes (who provide housing services for the 21,000 council-owned homes

in Doncaster)

The online survey was also distributed to a number of BME community groups and to the

CCG’s Health Ambassadors who represent a range of seldom heard community groups

such as the homeless and asylum seekers.


characteristics

Through their various communications and engagement activity, Doncaster CCG also

targeted the below groups with information and opportunities to get involved:

Doncaster Men’s Group

Doncaster Age UK

Doncaster Mencap

Doncaster Mind

Doncaster Autistic Society

Doncaster Deaf Parent and Toddler Group

The LADDER group (supporting young people across Doncaster with a range of

disabilities)

4.4 NHS Hardwick and NHS North Derbyshire Clinical Commissioning Groups

NHS Hardwick and NHS North Derbyshire Clinical Commissioning Groups (CCGs)

submitted joint communications and engagement activity plans and reports and worked

jointly to target their respective populations and audiences.

Information on the pre-consultations was posted on their individual websites and supported

by social media signposting through their respective Twitter accounts (over 3,700 combined

followers).


Qualitative engagement covering the two CCGs included attendance at two participatory

events and meetings where information was shared and discussions had on the two pre-

consultations. This included a focus group at the Derbyshire Stroke Centre on Thursday 17

March 2016. Feedback from this group has been incorporated into the central themes.

Quantitative communications and engagement by the two CCGs included the contacting of

and dissemination of information to at least ten specific patient and public groups relevant to

each service. The opportunity to have a face to face discussion with a member of either

Hardwick or North Derbyshire CCG was also offered to these groups, which included, the

North Derbyshire Stroke Club, Dales and High Peak Council for Voluntary Service, the

Derbyshire Parent forum and Cypress Parent Support Group.


Quantitative communications and engagement across the two areas included the mass

communication of pre-consultation information through each CCG’s internal and external

publications, chief officer blogs, GP newsletters and information shared with the provider

organisations in the region, Chesterfield Royal Hospitals NHS Foundation Trust and

Derbyshire Community Health Services.

Due to the engagement with and by building on their relationships with partners, information

was then cascaded independently via the local Healthwatch and NVDA (a registered charity

supporting health related voluntary organisations across Derbyshire) to their own

stakeholders and audiences.

The executive teams of each CCG provided regular updates to the region’s Health and

Wellbeing Board and information was also shared amongst all Patient Participation Groups

(PPGs) and practice managers in the region.

4.5 NHS Rotherham Clinical Commissioning Group

Overarching communications and engagement methods carried out by NHS Rotherham

Clinical Commissioning Group (Rotherham CCG) included the publishing of the pre-

consultations on their website with links to the central feedback surveys on the

Commissioners Working Together site. This was supported by further digital and social

media engagement with signposting from the CCG’s Twitter account (to over 7000

followers).

Quantitative communications also included the inclusion of the pre-consultations in emails

out to all 31 Rotherham GP practices as part of their regular GP e-bulletin, alongside articles

printed in internal and external partner publications and newsletters, for example, those of

The Rotherham NHS Foundation Trust and Rotherham Metropolitan Borough Council.


Rotherham CCG had a strong focus on qualitative engagement with various face to face

conversations having taken place throughout the pre-consultation phase. These

conversations included targeted engagement with local groups for stroke survivors and

those having suffered from other neurological conditions. Presentations on the two

workstreams were given to these individual groups in February and March 2016 with

discussions then feeding into the overall pre-consultation feedback.

For the children’s surgery and anaesthesia workstream, qualitative engagement was carried

out with the Rotherham Parent’s Forum. The forum is an active group of parents and carers

who work with health and care organisations who provide services for disabled children and

their families in Rotherham.

Further qualitative engagement with patients and the public included presentations to and

discussions with the Rotherham PPG network, made up of patient and public

representatives from across all GP practices in the area. Workstream leads from the central

Commissioners Working Together team also attended this participatory event and were able

to discuss the pre-consultations and also answer any questions the audience had.


Information on the work of Commissioners Working Together and how to get involved with

the two pre-consultations was also shared via qualitative engagement with a number of

Rotherham CCG’s partner organisations. For example, the CCG had regular catch ups with

Healthwatch Rotherham throughout the pre-consultation period as well as chief officer and

chair conversations with the local health overview and scrutiny committee.


characteristics

Communications and engagement targeted to groups as identified in the protected

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Putting Barnsley People First on Thursday 9 June 2016, 9.30 am at the Grimethorpe ......

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