Agenda item

This report sets out the draft H&F CCG Commissioning Intentions for 2014/15.

Dr Tim Spicer tabled a summary of the key areas of intent from the H&F CCG Commissioning Intentions for 2014/2015. There would be further changes to the document during the following week, but substantial alterations to the majority of intentions were not anticipated.

Dr Spicer referred to the graphic representation of the process, which indicated that the CCG was currently refining/developing commissioning intentions, which were summarised by joint CCG and local authority (LA) and CCG specific intentions, subsequently split to indicate health only intentions.

In respect of Children’s services, it was agreed that the work with LA social care and education partners to develop robust plans for delivering the new Children and Families Legislation (statute September 2014),  which was included in the detail of the report should also be brought forward as a headline.

Keith Mallinson referred to community dressing services and the high number of patients presenting to Urgent Care Centres (UCC). Dr Spicer responded that there were different models of tissue viability services across the country. H&F CCG was currently redrafting the details of the provider statement. Whilst there would always be a requirement for some home visits, patient experience and outcomes seemed to be better by centralising services, maybe at a local hospital.

Liz Bruce referred to anxieties around joint commissioning and specifically the Tri-Borough Community Intelligence Service specification and learning disabilities essential activity. There were cross cutting issues in respect of for example transition from children’s to adult services, including specialised educational needs.  Dr Spicer responded that transition this was clearly a risk area from a clinical aspect.

Councillor Georgie Cooney queried the continued use of the hydro-therapy pool. Dr Spicer responded that  this would be dependent on  which therapies the providers considered to be best. 

Eva Hrobonova queried whether the commissioning intentions could alter spending patterns in terms of care and age groups. Dr Spicer responded that whilst the commissioning process made it difficult to give a definite answer,  it was intended to shift resources away from unplanned to planned care.

Andrew Christie commented that the forward plan for the Local Safeguarding Children’s Board might overlap with that of the HWB, and there were a number of serious case reviews where issues might be relevant to the HWB, such as the CCG and LA working together, particularly in respect of information sharing. A report could be brought to a future meeting as the basis for a discussion on how the two boards could ensure that vulnerable people were being supported. Ms Bruce stated that these issues linked with the HWB’s responsibility for the implementation of the learning from the Winterbourne View Inquiry.

Mr Mallinson commented that education should also be included. There were specific issues in respect of children in bed and breakfast accommodation and encouraging parents to avail themselves  of services.

Action:

A report/discussion on support to vulnerable children and adults to be added to the work programme.

Action: Sue Perrin

Dr Spicer responded to a comment in respect of looked after children remaining with one GP that her was personally supportive,  but ensuring consistency across the borough was outside his remit.

In response to a query from Councillor Helen Binmore, Dr Spicer agreed to provide a written response in respect of the definitions of  Targeted CAMHS and CAMHS on call’.

Action: Tim Spicer/Philipa Jones

Dr Spicer confirmed that the work in respect of GP access included teenage pregnancy.

Members considered the move from a process based approach to an outcomes based approach and the greater involvement of Public Health. Dr Spicer noted  a number of services were provided for individuals with chronic illnesses, who would never return to a healthy and independent state. The outcome would be in respect of improved health and able to manage for themselves in their own home.

Philippa Jones clarified that the document set out the starting point for Consultant delivered care seven days a week, with the aim of achieving 24/7 delivered care by 2017/18.

Mr Mallinson referred to the sustainability of services and queried the safeguards to ensure that quality was maintained. Dr Spicer responded that he did not believe that this had been fully achieved, and that there had been compromises between integration, competition and quality.  

Ms Jones stated that the CCG was keen to improve the process for 2015/2016. Councillor Ginn noted the Council’s responsibility to share appropriate documents, including the Business Plan with the CCG.

RESOLVED THAT:

(i)                  The HWB endorsed the H&F CCG Commissioning Intentions for 2014/2015.

(ii)                The HWB noted the CCG’s efforts to engage with a wide group of stakeholders and the HWB.

(iii)               The HWB, at its March meeting, would agree the process for developing Commissioning Intentions for 2015/2016.