Agenda and minutes

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Items
No. Item

69.

Apologies

70.

Declarations of Interest

    Members are required to declare any disclosable pecuniary, personal or personal and prejudicial interests they may have and the nature of those interests relating to items on this agenda and/or indicate if S106 of the Local Government Finance Act 1992 applies to them.   

    Minutes:

    There were no declarations of interests.

71.

Minutes pdf icon PDF 63 KB

    To consider the minutes of the meetings of the Shadow Integrated Commissioning Board held 9th and 16th January 2018

    Additional documents:

    Minutes:

    The Board considered the minutes of the meetings held 9th and 16th January 2018.

     

    The Board were advised that Dr Sanjay Kotegaonkar had resigned his membership and HMR CCG had been replaced him with Mr Paul Hinnigan.

     

    The Chair noted that the Board meetings had been inquorate recently in December 2017 and in January 2018 and he emphasised the importance of regular attendance by both parties and he welcomed the assurances that he received regarding attendance at future meetings.

     

    The Chair also advised that he was intending to hold ‘agenda’ meetings with key officers approximately two weeks prior to Board meetings, starting in April 2018, to ensure that agendas are in order and that the Board’s business is progressing in the way that it should.

     

    Decision:

    That the minutes of the meetings of the Shadow Integrated Commissioning Board held 9th and 16th January 2018 be approved as correct records.

72.

Commissioning Strategy pdf icon PDF 2 MB

    Joint Director of Commissioning/DASS to report

    Minutes:

    The Director of Commissioning gave a presentation that outlined the Authority’s Commissioning Strategy. The Strategy outlined three ‘pillars’ of transformation: Integrated Commissioning, Local Care Organisation and Transformation Delivery.  The Integrated Commissioning work streams and priorities provided an overview of priority themes including ambitions, vision and principles.

     

    In considering the presentation a Member sought clarification as to when the Integrated Commissioning Board would lose its shadow status, which was due to happen on 1st April 2018 and a report detailing the process for this was due to be considered at the Board’s next meeting.

     

    Decision:

    That the presentation be noted.

73.

Update on Transformation Fund pdf icon PDF 1 MB

    Programme Director to report

     

    Additional documents:

    Minutes:

    The Board considered a report of the Transformation Director that provided Members with an update on the following: (a) Finance – describing current status and the impact of any financial risks on the programme; (b) Programme Delivery – delivery continues but concern remains around the increase of deflection targets in the new financial year; the paper aimed to quantify this at high level and describes future steps to further develop understanding; (c) Local Care Organisation – the paper described the progression of activity towards the go live date; (d) Risk – the paper presented the new integrated risk management strategy, red risks with mitigating actions and references the quarterly ask from Greater Manchester Health and Social Care Partnership to update the programmes current high level and business as usual red risks.

     

    The overall rating of the programme for this period was Amber.

     

    Members of the Board referred to aspects of the report where there appeared to be some areas of concern and in this regard the Programme Director assured members that key individuals and organisations would be required to attend future meeting of the Integrated Commissioning Board to explain their actions and activities.

     

    Decision;

    That the report be noted

    That the Programme Director’s next report on this matter (to be submitted to the April 2018 meeting) to include details on areas of improvement plans in respect of areas where performance is not to the standards required.   

74.

Transformation Performance Report

    Programme Director to report

    Minutes:

    The Board considered a report of the Transformation Director that provided Members with an update on performance against two ‘deep dive’ areas; Accident and Emergency (A&E) and Emergency Admissions (NEL). The aim was to provide clarification on how the area is being monitored, local intelligence and data challenges and how the Locality Plan assists in deflecting activity. The second element of the report covered the second quarter (2017/18) national results from the Improvement and Access Framework (IAF)

     

    The A&E waiting times were often used as a barometer for overall performance of the NHS and social care system. This was because A&E waiting times could be affected by changing activity and pressures in other services such as the ambulance service, primary care, community-based care and social services. For example, patients cannot be admitted quickly from A&E to a hospital ward if hospitals are full due to delays in transferring patients to other NHS services or in arranging social care. Being treated quickly in A&E is clearly important for both the experience and clinical outcomes of patients.

     

    The Board was advised that the performance detailed at Appendix A of the report, examined the three national targets and what impact the Locality Plan work aimed to have on deflecting attendances, which should in turn reduce trolley waits and reduce attendances by specific cohorts of patients. Rochdale was mandated to achieve three national A&E targets as part of the NHS Constitution indicators as follows: 1. A&E-Percentage of patients who spent less than 4 hours in A&E from arrival to either transfer admission or discharge. 2. Trolley Waits-Total number of patients who have waited over 12 hours in A&E from the clinicians decision to admit the patient to their admission or transfer. 3. Total number of attendances at all A&E departments (excluding planned follow up attendances), including Urgent Care Centres such as Rochdale Infirmary.

     

    Decision

    1.    That the report be noted

    2.    That the next ‘deep dive’ report be around the subject of the Intermediate Tier Service.

75.

Exclusion of Press and Public

    To consider that the press and public be excluded from the remaining part of the meeting pursuant to Section 100(A)4 of the Local Government Act 1972 on the grounds that discussions may involve the likely disclosure of exempt information as defined in the provisions of Part 1 of Schedule 12A to the Local Government Act 1972 and public interest would not be served in publishing the information.

    Minutes:

    To consider that the press and public be excluded from the remaining part of the meeting pursuant to Section 100(A)4 of the Local Government Act 1972 on the grounds that discussions may involve the likely disclosure of exempt information as defined in the provisions of Part 1 of Schedule 12A to the Local Government Act 1972 and public interest would not be served in publishing the information.

76.

2018/19 Planning Guidance Update

Minutes:

The Board considered a report which advised that in February 2018, NHS England had released their guidance in relation to Financial Planning for 2018/19.  This has an impact nationally, at Greater Manchester and at a local level. The report proceeded to highlight the changes made for the 2018/19 planning guidance from previous years and especially the impact this will have for Heywood, Middleton and Rochdale.  The overview produced by Greater Manchester with the addition of the Heywood, Middleton and Rochdale impact was attached as an appendix to the report.

 

Nationally, there had been substantial increases in resources within the Health Sector over and above the budget previously identified.  These increases in national funding were allocated to Greater Manchester services, Provider Fund services, the new Commissioner Sustainability Fund, Specialised Commissioning, Other Direct Commissioning and NHS England Central Budgets.

 

HMR CCG was to see an overall increase of £12.5m to its £347.6m 2017/18 recurrent allocation, giving a £360.1m recurrent allocation in 2018/19.   This is made up of:

·                     £2.7m as part of the national £603m increase as mentioned above;

·                     £2.9m for HRG4 and IR rule changes which was given non recurrently in 2017/18;

·                     £6.9m as part of the original baseline allocations agreed in 2017/18 to cover growth and inflationary uplifts.

 

It was noted that the second and third values were already known about and have been included within previous budget assumptions used to calculate the financial gap.  It is only the £2.7m which was ‘new money’.

 

Decision:

It was agreed that the report be noted.

77.

QIPP Programme

    Chief Finance Officers to report.

    Minutes:

    The Integrated Commissioning Board considered a report of the Chief Finance Officer that update Board members on the latest projected position of the QIPP/Savings programme for the 2018/19 financial year, for the Pooled budget.

     

    The appendices to the report identified four areas that needed discussion and decision making for the decommissioning of services in 2018/19. The services described in the appendices were not currently captured in the financial values of the report but would be reflected once a decision had been made.

     

    The Clinical Commissioning Group (CCG) separately needed to make savings of £2m for services outside of the Pooled budget. To date the CCG had identified schemes to the value of £1.1m of which £0.258m still needs to be ratified and implemented. The CCG was therefore assessing all available options to ensure that it meets the NHS Business rules when it submitted its financial plans for 2018/19.

     

    The Board was asked to form a view on: IVF services, Digestive Disorders and Cataracts.

     

    Decision:

    1.    That in terms of IVF provision the Board approves one cycle of treatment, to be carried out at St. Mary’s Hospital, with an age limit of 35 years that can be varied in exceptional circumstances;

    2.    The Board agrees in principle the proposals for digestive disorders, detailed in the report, but request further information thereon at a future Board meeting;

    3.    That the Board rejects the options presented in the report regarding the provision of treatments for cataracts.    

78.

Integrated Commissioning Board - Development Session