Agenda and minutes
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Contact: Andrew Spragg
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APOLOGIES FOR ABSENCE AND SUBSTITUTIONS
Minutes: Apologies were received from Rachael I. Lake. Carol Coleman substituted for Rachael I. Lake. |
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MINUTES OF THE PREVIOUS MEETING: 14 SEPTEMBER 2016
To agree the minutes as a true record of the meeting. Minutes: The minutes of the previous meeting were agreed as a true and accurate record. |
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DECLARATIONS OF INTEREST
All Members present are required to declare, at this point in the meeting or as soon as possible thereafter (i) Any disclosable pecuniary interests and / or (ii) Other interests arising under the Code of Conduct in respect of any item(s) of business being considered at this meeting NOTES:
Minutes: Dr Darryl Ratiram declared a prejudicial interest in Item 7, as he was currently employed as a consultant at Frimley Park Hospital.
Helena Windsor declared a prejudicial interest in Item 7, as she was currently a Shadow Governor at Surrey and Sussex Healthcare. |
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QUESTIONS AND PETITIONS
To receive any questions or petitions.
Notes: 1. The deadline for Member’s questions is 12.00pm four working days before the meeting (Friday 4 November 2016). 2. The deadline for public questions is seven days before the meeting (Thursday 3 November 2016). 3. The deadline for petitions was 14 days before the meeting, and no petitions have been received. Minutes: There were no questions or petitions received. |
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CHAIRMAN'S ORAL REPORT
The Chairman will provide the Board with an update on recent meetings he has attended and other matters affecting the Board. Minutes: The Chairman provided an update to the Board regarding business undertaken since the previous meeting. A copy is attached as an annex to these minutes. The Board noted and accepted the Chairman’s report. |
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RECOMMENDATIONS TRACKER AND FORWARD WORK PROGRAMME
Purpose of the report: Scrutiny of Services and Budgets/ Policy Development and Review.
The Board will review its Recommendation Tracker and draft Work Programme. Additional documents: Minutes: The Board noted and agreed with the recommendations tracker and forward work programme.
The Chairman drew attention to recommendation SC085, SECAmb update, for which an update was due in November. He went on to explain the proposed joint scrutiny approach for SECAmb, and the proposed Terms of Reference which were due to be agreed at the South East Regional HOSC meeting on 18 November 2016.
It was suggested that the Epsom & St Helier Estate Strategy should be added on to the forward work programme.
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NHS SUSTAINABILITY AND TRANSFORMATION PLAN UPDATES
To provide the Surrey Wellbeing and Health Scrutiny Board with an update on progress towards NHS Sustainability and Transformation Plans (STPs). Additional documents: Minutes: Witnesses:
Julia Ross, Chief Officer, NHS North West Surrey CCG & Surrey Heartlands STP lead Giselle Rothwell, Head of Communications and Engagement, NHS North West Surrey CCG Tina White, Frimley Health STP Programme Director Amanda Fadero, Sussex and East Surrey STP Programme Executive Board Member Cliff Bush, Chair, Surrey Coalition of Disabled People Matthew Parris, Evidence and Insight Manager, Healthwatch Surrey
Graham Ellwood, Tim Hall and Ben Carasco were absent from the room for a brief time during this discussion.
Key Points raised during the discussion:
Surrey Heartlands STP 1. The Chief Officer reported that at a recent Committees in Common on 20 October 2016, the Sustainability and Transformation Plan (STP) received good feedback overall, and that the focus now was very much on work-stream mobilisation and robust engagement activity to enable implementation to begin in 2017/2018.
2. The Chief Officer explained that following the Committees in Common meeting on 20 October 2016, the plan had been amended, to take on board comments raised at the meeting. These changes included clarification of governance arrangements of shared resources and the role of carers. The plan would be published when the STP had received the latest feedback from NHS England. The next stages of the plan were dependent on the widespread public, staff and patient engagement that was being undertaken.
3. Members were informed that engagement thus far had identified that quality and speed of care was of greater importance to the public than location. The next stage of engagement would entail a quantitative survey with 1500 randomly selected people from the community being invited to take part.
4. It was acknowledged that the biggest challenge was primary care. The Board noted that within 10 years, the population of over 85s would have increased by 36%, placing additional pressures on the health system with no additional resource. Having not received investment for a long time, the workforce needed to evolve and the delivery model would need to change with it. This was exemplified in the Epsom Health and Care model, where acute services were now working in partnership with community health and social services to meet demand in a different way. Witnesses highlighted that this had led to a decrease of acute bed days by 25%.
5. Members enquired whether there were plans to de-layer the governance structure within the STP. The Chief Officer explained that this would be a challenge due to there being 11 organisations involved in the STP including three Clinical Commissioning Groups (CCGs). The Board was informed that the CCGs deliver primary care at community level, therefore their contribution was vital.
6. The Board noted that the STP sought to balance individual requirements by consulting with a representative sample of the community. It was highlighted that, traditionally, working-age adults had been the hardest group to engage with. A number of engagement approaches would been undertaken to ensure this group was involved and that all care needs were identified.
7. The Board noted that the Council had an ... view the full minutes text for item 58/16 |
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HIV CLINICAL SERVICES IN SURREY
To provide the Board with an update on HIV Clinical Service provision in Surrey. Minutes: Witnesses:
Fiona Mackison, Service Specialist, Specialised Commissioning, NHS England South Lisa Andrews, Senior Public Health Lead
Key points raised during the discussion:
1. The Service Specialist began by explaining that NHS England had worked in collaboration with the Local Authority to procure a provider of HIV clinical services for Surrey. She clarified that HIV preventative services were the responsibility of the Local Authority; whilst HIV care from diagnosis fell under the remit of NHS England.
2. The Board was informed that HIV drug provision continued to be funded by NHS England. This followed recent news that NHS England had lost its High Court appeal to overturn the ruling that it had the power to commission pre-exposure prophylaxis (PrEP) treatment.
3. The Board noted that the commissioners were working collaboratively to ensure that the provider was performance managed; ensuring seamless provision of the care pathway to service users.
4. Members questioned the cost per patient for HIV treatment. It was explained that patients are categorised into one of three groups; new, stable and complex patients. New patients would require more support with diagnosis and prescription management. Complex patients would usually have other health conditions and therefore would be seen in an acute hospital in order to manage their care before being supported within the community upon their discharge. Stable patients would generally only require an annual check up. It was therefore extremely difficult to specify a cost per patient. However, the provider was aware of the financial envelope available to them.
5. Members enquired whether awareness of the availability of PrEP treatment had led to an increase of cases due to lack of precaution. The Senior Public Health Lead explained that this was not the case, however it was still extremely important that the Local Authority fulfilled its responsibility to encourage good sexual health practice and precaution in order to minimise potential increased demand in the future.
6. Members were assured that whilst Royal Surrey County Hospital (RSCH) was appointed as a specialised treatment hub, the treatment provided there was completely paid for by NHS England and not impacting on RSCH’s difficult financial situation.
7. Members noted that service users crossed border into London or Essex from time to time, to fit with their lifestyles. The service specifications were part of a national framework ensuring consistent standard of provision irrespective of location.
Recommendations:
None |
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CHILDREN COMMUNITY HEALTH SERVICES PROCUREMENT UPDATE
NHS Guildford and Waverley Clinical Commissioning Group (GWCCG) has led the procurement process for Children Community Health Services on behalf of the Surrey CCG Collaborative, Surrey County Council and NHS England. A preferred bidder has been identified; public announcement will be made in due course. This report details the procurement process to date and the next steps with regards to mobilisation Minutes: Witnesses:
Sarah Parker, Director of Children’s Commissioning (Surreywide), NHS Guildford and Waverley CCG. Karina Ajayi, Head of Children’s Commissioning (Surreywide), NHS Guildford and Waverley CCG Harriet Derrett-Smith, Commissioning and Performance Principal, Public Health Matthew Parris, Evidence and Insight Manager, Healthwatch Surrey
Tim Hall left the meeting at 1:20pm
Key points raised during the discussion:
1. The Director of Children’s Commissioning began by explaining that the procurement process had been undertaken by NHS Guildford and Waverley CCG on behalf of the six Surrey CCGs, Surrey County Council and NHS England. The Board were told that a preferred bidder had been identified, however Commissioners were not currently in a position to announce who this would be.
2. The Director of Children’s Commissioning explained that where Adult and Children community health services had previously been procured together under one contract, the delivery of children health services had sometimes been overshadowed against adult health service delivery. The Board was informed that the procurement of children community health services as a separate entity contract would enable better scrutiny, transparency and visibility of performance data.
3. The Board was advised the new procurement would deliver a single countywide community health service for children and young people under one contract rather than the three community health providers at present. This would allow for streamlined service delivery, with a view of making access equitable irrespective of location within the county.
4. The Director of Children’s Commissioning explained that the suite of services being provided encompassed 19 different children’s health services. Some of these services were jointly commissioned by the CCGs and Surrey County Council. For some of these services, there were performance data benchmarks available. For services where no benchmark was available, Commissioners would work with Public Health to establish what level of performance was required as a minimum standard.
5. Members were informed that extensive stakeholder engagement had been undertaken in order to establish what was important to the service users and their families, what was working well and to identify areas in need of development. The majority of the 612 stakeholders engaged with were aged between 12-18. The key findings were that information being shared with their GP, care close to home, equitable care and the need to only tell their story once were of the highest importance to the service users and their families. The Board was informed that Family Voice Surrey were also involved in the engagement process and the development of service specifications.
6. The Board were informed that Commissioners, alongside Family Voice Surrey, had specified a set of principles which were to be embedded across all services by the new provider, as well as a list of outcomes with measures to which the provider can be held to account.
7. The Director for Children’s Commissioning explained that whilst there were many benefits to the new contract, it was important to look ahead and start planning for three years time. The visibility of performance data and service ... view the full minutes text for item 60/16 |
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DATE OF NEXT MEETING
The next meeting of the Board will be held at 10.30am on Monday 23 January 2017. Minutes: The next public meeting of the Board will be held on Monday 23 January 2017 at 10:30am. |