Agenda and minutes

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Items
No. Item

28.

Apologies

29.

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.

30.

Urgent Items of Business

    To determine whether there are any additional items of business which, by reason of special circumstances, the Chair decides should be considered at the meeting as a matter of urgency.

    Minutes:

    There were no urgent items of business for this meeting of the Integrated Commissioning Board to consider.

31.

Minutes pdf icon PDF 75 KB

    To consider the Minutes of the meeting of the Integrated Commissioning Board held 26th June 2018 (3.30pm – 3.40pm)   

    Additional documents:

    Minutes:

    The Integrated Commissioning Board considered the minutes of its previous meeting held on 26th June 2018.

     

    Further to minute 19, a Member asked for an update on ‘Over the Counter Prescribing Medicines’ insofar it had been anticipated that a meeting of the CCG’s Prescribing Medicines Sub-Group had been expected to meet, prior to this meeting of the Integrated Commissioning Board. 

     

    The Chair referred to recent training/development sessions that had been recently provided for the Board’s members and key supporting officers on 30th May 2018 and 18th July 2018 respectively. In terms of possible outcomes from these development sessions one particular issue surrounded the format of future meetings and the opportunity to, perhaps, have fewer formal Board meetings and to hold more development type sessions which would enable, for example, the Board’s membership to focus on a specific issue or an area that may be giving cause for concern. A few possible topics in this regard could include: financial procedures, the development of the Board’s legal framework, the relationship with the North West (Northern Care Alliance) Consortium and ‘Best Practice’.

     

    Decision:

    1.    The minutes of the meeting of the Integrated Commissioning Board, held 26th June 2018, be approved as a correct record.

    2.    A meeting of the CCG’s Prescribing Medicines Sub-Group be convened at the earliest opportunity to consider the issue of over the counter prescribing medicines (further to minute 19 of the Board’s meeting held 26th June 2018) and the Integrated Commissioning Board be presented with an update on this at its next scheduled meeting on 25th September 2018.

    3.    The Director of Commissioning/DASS be requested to present a report to the next meeting of the Integrated Commissioning Board, on 25th September 2018 outlining options for the future format and content of Integrated Commissioning Board meetings.

32.

Local Care Organisation - Quarterly Update

    Presentation/update report by the LCO Chief Executive and Chair (3.40pm – 4.10pm)

    Minutes:

    The Board received a presentation from the Chief Officer Northern Care Alliance (NCA) Bury and Rochdale and Chief Officer of the Local Care Organisation (LCO) which provided an update on the activities of the Local Care Organisation in the first quarter period of 2018/19.

     

    The NCA was an NHS Group formed by bringing together two NHS Trusts, Salford Royal NHS Foundation Trust and The Pennine Acute Hospitals NHS Trust. The NCA Group provided a range of healthcare services including five hospitals and associated community services - Salford Royal, The Royal Oldham Hospital, Fairfield General Hospital in Bury, Rochdale Infirmary and North Manchester General Hospital.

     

    The NCA was being developed to fully align and to be consistent with the priorities of the strategic themes of the Greater Manchester Health and Social Care Partnership. One of its key aims was to develop new ways of working that will ensure patients receive consistently high standards of care. Another key function of the Group is to support its Care Organisations in the following areas: Developing Service Strategy; Agreeing new/replacement building and equipment; Agreeing annual operational delivery plans; Developing a standardised operating model which determines best care on the basis of evidence of best practice; and organising standardised care to be delivered effectively across multiple sites and locations.

     

    A key are of development for the LCO had been the promulgation of mental health services and in this regard a Mental Health Steering group had been established to monitor progress.

     

    Decision:

    That the presentation be noted.

33.

Intermediate Tier Service Deep Dive Report pdf icon PDF 192 KB

    Director of Joint Commissioning/DASS to report

    Minutes:

    The Board considered a report that was presented by the Director of Commissioning, which provided members with detailed information on the Intermediate Tier Service, with particular reference to evidence of the service impact on Non-Elective Admissions for over 65’s.

     

    Following the submission of a performance report to the Board’s meeting on 28th February 2018, which had  highlighted the increase in Non-Elective admissions in over 65’s, a request was made to provide further evidence of the impact of the Intermediate Tier Service in the Rochdale locality, and its work in reducing emergency admissions to hospital for this cohort of patients. The submitted report thus provided further details around the performance of this service.

     

    The Intermediate Tier Service was provided by Pennine Acute NHS Hospitals Trust commissioned by Rochdale Borough Council and Heywood Middleton and Rochdale CCG. The service has been in operation since 1st September 2015, with performance and outcomes being monitored through a monthly contract board. The service was available for any patients who reside within the Heywood, Middleton and Rochdale CCG area, or who were registered with a local GP based in that area.

     

    The objectives of the Intermediate Tier Service were to fulfil the need for a reduction of non-elective admissions for the over 65s and support patients aged 18 and over; to reduce the lengths of a patient’s stay in hospital  and to deliver a more flexible service which will have the capacity to expand, in a cost effective way, to fill the increased demand from the increasing number of citizens aged over 65 years, and especially those aged over 85 years who presented with frailty and multi-morbidity.  

     

    The Board were advised that the statistical information contained in this report would be incorporated into future ‘performance’ reports that are presented by the Transformation Programme Director.

     

    Decision:

    That the report be noted.

34.

ICB Constitution Performance Report pdf icon PDF 150 KB

    Strategic Commissioning Programme Director to report (4.10pm – 4.20pm)

    Additional documents:

    Minutes:

    The Board considered a report of the Transformation Programme Director that reported upon NHS Constitution indicators which included granular detail facts which described the affects that these indicators were going to have on the Borough of Rochdale’s residents, using 2017/18 data as a 12 month summary. It was reported that in future these would likely evolve to reflect current performance with a proposed summary of quarter one activity (2018/19) to be reported to the Board’s next meeting.

     

    The report covered the following areas:  Accident and Emergency; Referral to Treatment; Early Intervention Psychosis; waiting times for Cancer treatment; and improving Access to Psychological Therapies.

     

    The Transformation Programme Director reported that illustrated in Appendix A of the report was a proposed new methodology of reporting NHS constitution and Adult Social Care indicators to the Integrated Commissioning Board. This proposal was intended to evolve each month to report current areas of concern and to share good news.

     

    Decision:

    1.    The report be noted

    2.    The Board approves the revised style of report template, as presented.

35.

Transformation Highlights report pdf icon PDF 145 KB

36.

Greater Manchester funded Transformation Fund Programme pdf icon PDF 187 KB

    Chief Finance Officer to report (4.30pm – 4.40pm)  .

    Minutes:

    The Integrated Commissioning Board considered a report of the Chief Finance Officer that updated on expenditure that had been incurred through to June 2018 on the Greater Manchester funded Transformation Fund.

     

    The Board were informed that Heywood, Middleton and Rochdale CCG and the Council had jointly applied for Transformation Funding from the Greater Manchester Health and Social Care Partnership in 2017/18. This bid was successful and £25,170,000 of funding was received, of which £4,640,000 was utilised in 2017/18. The submitted report updated the Board on current plans for the Transformation Fund Programme.

     

    Alternatives considered:

    The Transformation Fund funding from the Greater Manchester Health and Social Care Partnership gave the Rochdale locality ‘up front pump priming funding’ that was required to fund the transformational activity, which was a requirement in order to help to move activity from the acute to the community sector.

     

    Decision:

    That the report be noted.

37.

Health and Social Care Better Care Fund - Budget Monitoring Report pdf icon PDF 228 KB

    Chief Finance Officer to report (4.40pm – 4.50pm)

    Minutes:

    The Integrated Commissioning Board considered a report of the Chief Finance Officer that updated Members with the Quarter 1 (period ending 30th June) budget monitoring for the Better Care Fund for the financial year 2018/19.

     

    The Integrated Commissioning Board was requested to approve a capital budget realignment of £35,000 between the Discharge to Assess scheme and the Springhill scheme and £40,000 to the Mental Health Safe Haven transformation project and to agree that any unspent capital budget funds at the end of 2018/19 are carried over into 2019/20 against existing, or any new, schemes that are identified.

     

    Alternatives considered:

    It is a requirement of the NHS England guidance to produce a budget for 2018/19 and this was approved by the Integrated Commissioning Board at its meeting on 29th May 2018. The submitted report updated the monitoring against the 2018/19 budget which is a requirement of the ‘Section 75 agreement’. Therefore there were no alternatives to consider.

     

    In considering this matter a Member sought clarification as to the ‘capital DFG budget’ that was referred to in paragraph 5.2 of the submitted report.

     

    Decision:

    1.    The Integrated Commissioning Board notes the monitoring information at Quarter 1 (period ending 30th June) 2018/19.

    2.    The Integrated Commissioning Board notes that there are contingencies being held for the revenue and capital budgets that were not yet allocated in 2018/19 - the revenue budget now takes account of an additional £125,000 protection of Adult Care Services, to reduce the reported ‘pooled gap’ in 2018/19 and that the revenue position currently shows a forecasted underspend of £88,900.

    3.    The capital DFG allocation for 2018/19 be confirmed and it is noted that the figures in the submitted report are based on information received from NHS England therefore the Integrated Commissioning Board approves a budget realignment from the Discharge to Assess scheme to the Springhill scheme of £35,000 and £40,000 to the Mental Health Safe Haven transformation project and approves the carry forward of any unspent capital budget at the end of 2018/19 into 2019/20, noting further that this will be arranged in the Local Authority accounts to be used against existing and any new schemes in 2019/20.

38.

Pooled Budget Savings Programme 2018/19 July Update pdf icon PDF 159 KB

    Chief Finance Officer to report (4.50pm – 5.00pm)

    Minutes:

    The Integrated Commissioning Board considered a report of the Chief Finance Officer that updated members on the savings requirement 2018/19 report that was presented to the Board’s meeting on 29th May 2018 which highlighted a pooled fund deficit of -£5,100,000. The updates in the report were based on the month 3 (June 2018) financial position for the CCG and the Council. The Pooled Fund deficit as at the end of month 3 (June 2018) was -£3.1m which represented an improvement of £2,000,000.

     

    The submitted report highlighted actions that had been identified and implemented during months 2 and 3 (May and June) of 2018/19.

     

    The report also stated the need to identify on-going savings schemes due to the remaining financial gap within the pooled budget and gave examples of possible mitigations that were available to close the current financial gap of £3,100,000 within the pooled budget.

     

    In considering the report the Board’s members were informed that the total savings required for a balanced pooled budget was £16,654,000 and reports on this would be submitted to a meeting of the Integrated Commissioning Board in due course.

     

    Alternatives considered:

    None reported.

     

    Decision:

    1.    The report be noted.

    2.    The Board notes that the Chief Finance Officer will present a report/presentation to a future meeting, in due course, regarding the total saving required for a balanced pooled budget.

     

    Reasons for the decision:

    The report confirmed the status of the savings proposals for the pooled fund and was presented for information purposes at this report.

39.

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:

    Decision:

    The Press and Public be excluded from the meeting during consideration of the following item of business, in accordance with the provisions of Section 100A (4) of the Local Government Act 1972, as amended.

     

    Reason for Decision:

    Should the press and public remain during debate on this item there may be the disclosure of information that is deemed to be exempt under Part 1 of Schedule 12A of the Local Government Act 1972.

40.

LCO - Gateway 3 Update

    Assistant Director (Legal, Governance and Human Resources) to report (5.00pm – 5.30pm)

    Minutes:

    The Director of Resources reported that following completion of Gateway 2, a review of the project to date had taken place before moving on to Gateway 3. Some challenges and options had emerged from that review, which the submitted, confidential, report explored and which set out options for the Board to consider and discuss.

     

    Alternatives considered:

    A range of alternative options were detailed in the confidential report that was considered by the Board.

     

    Decision:

    1.    Consideration of Gateway 3 be deferred until the Board’s next scheduled meeting on 25th September 2018 at which it is requested the Director of Resources submit a report detailing a preferred option.

    2.    If necessary an informal meeting of the Integrated Commissioning Board’s membership and appropriate officers be convened to discuss the options available, with a view to informing recommendations for the Board to formally consider.

     

    Reasons for the decision:

    To allow the members of the Board more time to explore available options and risks with officers and key stakeholders.