Agenda item

Purpose: To receive an update in respect of the changes to the Primary Health Care in West Berkshire and examine the Clinical Commissioning Groups management of its quality responsibilities following handover from the PCT in April 2013.

(Councillor Tony Vickers declared a personal interest in Agenda item 10 by virtue of the fact that his wife was a member of Health Watch. As his interest was personal and not prejudicial he determined to take part in the debate).

Doctor Abid Irfan, Clinical lead for the Newbury and District Clinical Commissioning Group (CCG), presented the Commission with a verbal update in respect of agenda item 10.

The Newbury and District Clinical Commissioning Group (CCG) was made up of 11 local GP practices and served a total registered population of approximately 113,000 people, which was relatively small in comparison to other CCG’s. The CCG had established a Governing Body which included membership from GPs, a nurse director, a chief finance officer, a chief officer and lay members. The CCG is a membership organisation and was supported by the Council of Member Practices. A GP lead from each practice made up the GP Council. The CCG worked in a federation very closely with the other 3 CCGs in Reading and Wokingham to bring economies of scale, financial stability and significant negotiating influence when commissioning services.

The CCG aimed at working with local GP’s to develop review and design patient journeys and address required changes. 

Dr Irfan advised the Commission that this year amongst other things the CCGs focused on 3 local priorities:

·              The increased identification of local carers who contribute significantly to our health economy. This would enable them to be invited for healthchecks, flu injections and be listed for priority appointments

·              The identification of people at high risk of developing diabetes to deliver proactive, preventative measures.

·              Increasing the number of people receiving NHS Healthchecks

The Commission heard that on 14^th November 2013, the CCG would be holding an evening event inviting the public to provide their views on local priorities identified by the CCG, along with how to maintain a sustainable health system and discuss the “Call to Action” issued by NHS England

Dr Irfan stated that the CCG had a limited budget to establish the sustainable and effective care required in an area with an ageing demographic and people with complex needs.

The CCG used the Berkshire West Quality Committee to track inherited areas of high risk via the review of a monthly scorecard. The scorecard used performance levels from 2012 to offer a comparator and was available for the public to view via the CCG website.

Due to the fact that the CCG was small (compared to the previous PCT population of approximately 500,000), even very small numbers recorded in the scorecard negatively would have an adverse affect on overall ratings. Dr Irfan used the example of cancer waiting times and explained that for some cases where people had reportedly been on the waiting list for a long time, it was found that there were valid reasons for the delay which related to the requirement of complex diagnostics and testing pathways. However, it was noted that at our local trust level (The Royal Berkshire Hospital) they were performing to the all the cancer standards. Dr Irfan explained that after further investigation the statistics were fully understood.

It was agreed that scorecard would be circulated to the Members of the Commission.

Dr Irfan advised the Commission that the Royal Berkshire Hospital had been placed in special measures by The Clinical Quality Commission (CQC). The CCG had invested funds into Accident and Emergency provision to adequately assess the delivery of service. The Trust was under significant pressure to see that the issues were appropriately addressed. The CCG would review reports to ensure that the statistics were a true reflection of the Trust’s performance and conduct quality assurance checks.

Councillor Quentin Webb asked whether Health Watch had been tasked with reviewing the CCG’s performance, as requested by the Health Scrutiny Panel in March 2013. Dr Irfan advised that Health Watch was a member of the West Berkshire Public Health and Wellbeing Board and were aware of the CCG’s activity.

Councillor Tony Vickers suggested that the delivery of care could be assisted with agencies sharing patient information. Dr Irfan was asked to what extent GP’s could share patient information. In response Dr Irfan informed the Commission that the CCG hoped to address the issue of sharing information to avoid duplication, but acknowledged that the issue was complex and required sophisticated systems to ensure that personal data was not compromised.

In response to questions asked by Members, Dr Irfan confirmed the following points:

·              All CCG’s submitted monthly performance scorecards to the Federation Quality Committee for scrutiny and review

·              Measures to assist patients with diabetes focused on adults only. The Health and Wellbeing Board hoped to deliver a scheme to local schools in response to the agreement that early preventative measures would deliver significant long term benefits.

The Commission thanked Dr Irfan for a comprehensive update.

Resolution:

(1)   The report was noted

(2)   That the Scorecard be provided