Agenda item

(To receive a report from South Lincolnshire Clinical Commissioning Group which provides the Committee with an update in relation to the activities for South Lincolnshire Commissioning Group (SLCCG).  The report includes the commissioning activities of the CCG in addition to information on the wider developments which the CCG has had involvement in.  John Turner (Accountable Officer – South Lincolnshire CCG) and Caroline Hall (Chief Finance Officer – South Lincolnshire CCG) will be in attendance for this item)

A report by John Turner (Accountable Officer, South Lincolnshire CCG) was considered which provided an update in relation to the activities for South Lincolnshire Clinical Commissioning Group (CCG).  The Report included the commissioning activities of South Lincolnshire CCG in addition to information on the wider developments which the CCG were involved with.

John Turner (Accountable Officer, South Lincolnshire CCG) and Dr Kevin Hill (Chairman, South Lincolnshire CCG) were in attendance for this item of business.

The Committee was reminded that South Lincolnshire CCG served a registered population of approximately 162,000 and was made up of fifteen practices across to localities with distinct populations and needs. Seven practices were within the Welland locality which served a mainly affluent population with small pockets of deprivation in larger populated centres.  The locality of South Holland held eight practices and was more deprived with areas of rural poverty and a growing migrant population due to new arrivals from EU accession countries.  Services were commissioned for the populations of Stamford, Bourne, Market Deeping, Spalding, Long Sutton and surrounding areas.

The main hospitals to serve this population were Peterborough and Stamford Hospitals (P&SHFT), Johnson Community Hospital, Queen Elizabeth Hospital (Kings Lynn) and Pilgrim Hospital (Boston).

Performance Priority Areas included the following:-

·       Accident and Emergency Four Hour Standard;

·       Cancer Standards; and

·       East Midlands Ambulance Service (EMAS).

Full plans for the priority areas were included within the 2016/17 Strategic Operational Plan.

The CCG achieved the diagnosis rate during 2015/16 for Dementia and would continue to use the tools previously identified to sustain performance.  Recent procurement of the community services listed below provided patients and carers with the support raised as priority during public consultation. These include:-

·       Post Diagnostic Support;

·       Dementia Support Network;

·       Dementia Family Support Service;

·       Dementia Action Alliances; and

·       Integrated Personal Commissioning.

In April 2015, the CCG took on full responsibility under delegated commissioning for the commissioning of primary care services.  The CCG worked closely with GP practices and federated groups which had enabled a coherent and consistent approach to the development of systems, processes and the consideration of proposed developments. 

Partnership working with South West Lincolnshire CCG had resulted in the CCG becoming the first in the country to successfully access the new national Lead Provider Framework for commissioning support.  This framework gave CCGs a choice of accredited providers for 'back office' functions ranging from payroll to IT support.  Optum, a private company, had been selected as the new provider, following a rigorous selection process, and services had been transitioning from the previous provider since January 2016.

Members were given the opportunity to ask questions, during which the following points were noted:-

·       It had been acknowledged that people would continue to present to A&E Departments when their symptoms could be better addressed through primary care.  In order to manage these patients, GP services within A&E Departments were being considered with a trial underway at Peterborough City Hospital;

·       It was acknowledged that delayed transfers of care were a key issue and there was consideration of both admission and discharge arrangements.  An improvement to the Ambulatory Care Unit had been suggested and implemented which may improve the system;

·       The reported figures for delayed transfers of care were questioned and the difference between those presented by the CCG and those presented by United Lincolnshire Hospitals NHS Trust (ULHT).  It was explained that performance would always appear better at CCG level, compared to acute hospitals, as CCG figures also included Minor Injury Units (MIUs), which invariably met the four hour standard;

·       In relation to revalidation of GPs, it was explained that it was now more difficult to remain registered with the General Medical Council as the cost to do so was in the region of £10,000 per year.  This cost resulted in GPs actually retiring rather than continuing their registration by practising as a locum, as it would not usually be financially viable for them to do so.  This was further impacting on the decreasing levels of GPs available;

·       the service model provided by Optum was built on improving relationships with providers and an understanding of the service provided by South Lincolnshire CCG and NHS England.  The CCG had been impressed with the attitude of Optum and their ability to support the CCG which had resulted in a good start to the contract;

·       It was acknowledged that NHS funds tend to flow out-of-county, particularly in the South Lincolnshire area, and this impact on commissioning was a key issue faced by the NHS overall in Lincolnshire.  It was suggested that if care provision within Lincolnshire was improved sufficiently then more patients would choose to stay within the county. A cost and quality comparison had been undertaken through the selection process of a new provider;

·       It was stressed that patient choice was impacting on the use of Lincolnshire facilities but acknowledged that until service provision was improved, with the help of the CCGs, then patients would choose to utilise local facilities;

At 1.00pm, Councillors Mrs R Kaberry-Brown and Mrs P F Watson left and did not return.

·       The 'back office' functions provided by Optum were outlined and included business intelligence, human resources, communications, complaints, administration and information technology;

The Committee was advised that each CCG tended to report once per year to the Committee on its activities and developments.  It agreed that an update from South Lincolnshire CCG may be requested prior to the scheduled annual report.      

RESOLVED

1. That the report and comments be noted; and

2. That a further report be included in the Committee's work programme in the coming year on the activities of South Lincolnshire Clinical Commissioning Group.