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Formal Governing Body Meeting

January 2014

This briefing is to update you on the key messages that were presented at

our Governing Body meeting on Thursday 16th January 2014.

We hope you find it useful. However you may want to raise a concern, ask

questions or feed back your comments about individual items contained in

the briefing. Please contact the named person at the end of the agenda item

or feed back your comments to our patient and public engagement team.

Huw Charles-Jones Alison Lee Chair Chief Officer Page Contents West Cheshire Clinical Commissioning Group Governing Body Governing Body Agenda – Thursday 16th January 2014 You can access the full agenda and papers by clicking here Chair’s Opening Remarks Priorities: Developing Primary Care Priorities: Starting Well Programme Update Planning: NHS West Cheshire Clinical Commissioning Group’s Commissioning Plan 2014-16 (Presentation) Quality Improvement Report Finance Update Performance and Delivery Report Chief Officer’s Business Report Clinical Commissioning Group Polices and Governance Documents

a) Information Governance Policy

b) Information Governance Strategy

c) Freedom of Information Act Policy

d) Subject Access Request Policy

e) Confidentiality and Data Protection Policy

f) Corporate Records and Retention Policy

g) Anti Fraud, Bribery and Corruption Policy

h) Harassment and Bullying Policy

i) Retirement Policy

j) Secondment Policy

k) Travel and Expenses Policy Feedback 9


AGENDA Formal Governing Body Meeting to be held in Public on Thursday 16th January 2014, at

9.00am in The Manning Suite, The Groves, Chester Road, Whitby, Ellesmere Port CH66 2NZ Item Agenda Item Presenter Welcome and Open Forum Dr Huw Charles-Jones GP Chair Chairs Opening Remarks Dr Huw Charles-Jones GP Chair A Apologies for absence Dr Huw Charles-Jones GP Chair B Declarations of interests in Dr Huw Charles-Jones GP Chair agenda items C Minutes of last meeting held on Dr Huw Charles-Jones 21st November 2013 GP Chair D Matter

–  –  –

Chair’s Opening Remarks We had a Checkpoint Meeting with NHS England before Christmas which was generally very positive Winter pressures and A&E has clearly been of high national priority and public and political interest lately. Locally the urgent care system has generally coped well during the previous few months with the health economy working pulling together to meet the challenges.

Making sure you get the healthcare you need 4 The Countess of Chester has been successful in its application to the Safer Hospitals, Safer Wards Technology Fund. Local organisations have agreed to match this funding and the money will be used to work on an integrated local health record. This will underpin some of the workstreams mentioned in papers presented today.

Alison will mention in her report the Planning Guidance which has recently been published and Laura will talk about how we are already responding to this in her presentation on the commissioning plan for 2014-16

Developing Primary Care Programme

A blue print for general practice was published in November 2013 and the majority of practices have expressed an interest in becoming a ‘Pioneer Practice’.

Significant non-recurrent funding has been approved to support the primary care development programme.

All member practices have completed their listening visit and the programme of quality visits to member practices has begun.

The productive general practice programme has commenced.

All member practices have committed to deliver the general practice commissioning for quality and innovation scheme.

A draft primary care information communication and technology strategy has been developed and an operational group has been established to oversee the implementation.

A new governance structure is being developed to ensure appropriate reporting lines for the Programme for 2014-16.

In order to underpin the transformation of primary care, a programme of education and training for clinicians/practice staff will be developed and the role of ‘patient leadership’ to work alongside clinical leads is being explored.

The Governing Body noted the progress to date of the Developing Primary Care Programme For further information, please email: sarah.murray2@nhs.net Starting Well Programme Update The Starting Well Programme focuses on supporting children, young people and their families to reduce reliance on care in hospitals. Based on our biggest health challenges, this will focuses on long term conditions and also on children and young people with multiple needs.

The Integrated Early Support Service was formally launched on 11 th October 2013.

Children’s Hospital @ Home introduced a triage service for children who self-present at Accident and Emergency in October 2013.

–  –  –

The draft Special Educational Needs Code of Practice was published in October 2013 and the Clinical Commissioning Group must secure the health elements of the new Education Health Care Plans and identify a Designated Health Officer to ensure it meets its statutory responsibilities in this area from September 2014.

Within the maternity redesign programme; funding to develop a two-bedded midwife-led unit has been secured and an Options clinic has been successfully established to support increasing rates of vaginal birth after caesarean section.

The Governing Body noted the Starting Well Programme progress report and approved the proposal of the appointment of the Designated Health Officer for special educational needs For further information, please email: fay.quinlan@nhs.net Quality Improvement Report The Countess of Chester Hospital NHS Foundation Trust is within expected performance levels against all national mortality measures.

An increasing number of pressure ulcers are being reported across the health economy as a result of a focussed effort by providers of health care to identify and report pressure ulcers more robustly. For every pressure ulcer reported there is a review of the care provided by a senior clinician and plan to improve practice is developed and implemented.

In the 12 month period to October 2013 there were 732 incidents reported on the local incident reporting system. The majority of the incidents did not cause actual harm but highlighted a need for improved practice by a range of NHS providers. Analysis of the

incidents identified that over 75% of them identified a need to :

o Improve Communication o Redesign tasks/processes o Improve skills through Education and Training The Clinical Commissioning Group has analysed all the patient experience information we have access to over the previous 12 months so we can identify what is important to our local population. This report will be available on our website and is being used to inform how we commission services in 2014-2015.

The Governing Body:

Reviewed the information on serious incidents Noted the assurance and concerns provided about the providers of NHS care Reviewed the thematic analysis of incidents reported on the local incident reporting system and the planned response to identified themes Noted the update from the Designated Nurse Safeguarding Children Noted the update provided about Nursing Homes Making sure you get the healthcare you need 6 Noted the planned response to the publication of How to ensure the right people, with the right skills, are in the right place at the right time – A guide to establishing nursing, midwifery and care staffing capacity and capability Reviewed the patient experience intelligence report

For further information, please email: paula.wedd@nhs.net

Finance Update At the end of November 2013 the clinical commissioning group is underspent by £3.083 million and on course to deliver its financial duties.

2 year clinical commissioning group allocations have been announced.

West Cheshire Clinical Commissioning Group is very close to its target allocation.

A draft 2 year financial plan has been developed and work is continuing to develop a shared local health economy long term financial strategy.

The Government has announced the creation of a Better Care Fund whereby £3.8 billion is to be spent on health and care to drive closer integration, expansion of care in community settings and improve outcomes for patients and carers. For West Cheshire, the Better Care Fund will total a minimum of £15.8 million.

The Governing Body noted:

Financial performance to the end of November 2013.

The 2 year financial allocations including growth in allocations.

The draft financial plan for financial years 2014/15 and 2015/16 along with the underpinning planning assumptions.

The level of non-recurrent resource available during 2014/15.

The work being undertaken to agreed a shared local health economy long term financial strategy.

The update on the Better Care Fund and agreed the actions outlined in paragraph 28.

For further information, please e-mail: garethjames@nhs.net Performance and Delivery Report Update The report highlights areas of concern in terms of measures that have not been achieved against the required level of performance for the period under review and the actions that are being taken to improve performance.

The majority of the projects within the Delivery Plan continue to progress against designated milestones. An improved framework for tracking savings at programme level has been developed.

Improving access – referral to treatment times – targets achieved Making sure you get the healthcare you need 7 Excess waiting times – specific patient numbers are being identified with actions being taken Diagnostic – performance is above the 99% standard by achieving 99.5% Cancer – Performance is above target for 2-week waits. The 62-day waits was not achieved with performance of 80.9% against the 85% target Stroke –The contract standard of 80% of stroke patients spending 90% of their stay on a Stroke Unit has not been achieved this month. Performance currently stands at 67.9% against the 80% target.

Transient ischaemic attack (TIA) – Performance against the standard of 60% was 73.3% for the month Reducing health care acquired infections – Methicillin-resistant Staphylococcus aureus (MRSA) has seen no further breaches this month. The Clostridium difficile target for October breached the standard with 8 cases against a plan of 6 Accident and emergency targets - the Accident & Emergency 4 hour waiting time has not been met this month with 94.8% of patients being seen against the 95% standard Emergency ambulance performance – Emergency arrival times within 8 minutes (Category A referred to as life threatening calls) has not been achieved and is performing at 62.5% against the 75% target.

Delivering Same Sex Accommodation – no breaches have taken place in October Electronic Discharge information – Performance in this area continues to improve and exceed target with the Countess of Chester Hospital NHS Foundation Trust achieving 92% against the 90% target The Governing Body noted the financial performance at the end of October 2013 and the progress against the delivery plan.

For further information, please e-mail: rob.nolan@nhs.net or laura.marsh2@nhs.net Chief Officer’s Business Report

Provided in this report is:

An overview of the recently published NHS England Planning Guidance;

An update on the NHS Assurance Framework Guidance;

A summary of the Assurance Framework Checkpoint 2 meeting with NHS England Area Team;

The implications for West Cheshire of the Cheshire, Warrington and Wirral Breast Screening review;

High level meetings and events attended by the Chief Officer and Chief Finance Officer.

For further information, please e-mail: alisonlee2@nhs.net

–  –  –

This report provides 11 policies/ governance documents for Governing Body approval/ratification. Five are new/ finalised policies and six policies/ governance documents have been reviewed since April 2013 and are re-presented for ratification.

The Governing Body approved/ ratified the policies/governance documents provided.

FEEDBACK We hope the information contained in this briefing has been of interest to you.

However you may want to raise a concern, ask questions or feed back your comments about individual items contained in the Briefing. You can also contact our patient and public

engagement team:

Sally Pritchard and Debbie Smith 01244 650438 / 650317 sallypritchard@nhs.net or debbie.smith24@nhs.net

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