gp healthcare mk

GP Healthcare MK Minutes of the Board Meeting held on Thursday 5th May 2011 at 2.00pm

at Parkside Medical Centre

Present: Board Members: In attendance: Dr Nicola Smith ‐ Chairman NS Rod Marshall RM Dr Probir Sen PS Sue Lacey‐Bryant SL‐B Dr Mulukutla Prasad MP Dr Ganeschandra Haldar GH Dr Jawad Ahmad JA Dr Mohammed Jahngir MJ Dr Suvarna Bharamgoudar SB Dr Mohammed Ahad MA

Other Attendees: Angie Croxton AC Minute Secretary, NHS MK

ACTION 1. Apologies Naomi Eisenstadt

2. Minutes of Previous Meeting Agreed

3. Matters arising a) Item 4: Andy Peedle and Heather Wicks to be invited to the next Steering

Group ‐ done b) Item 7: family planning ‐ MP to contacted VM re practice collaboration c) Item 9: Website development: Chris Knibb has been on leave, meeting to be arranged next week for Jahngir and Chris. Nicola and/or Sue to attend if possible d) Item 10: Board member Job Descriptions – see item 6 e) Item 10: Governance documents – Signed governance documents are to be

brought to the next Steering Group meeting; also an opportunity to discuss any queries. Board members agreed to contact individual practices to remind colleagues re outstanding documents

e) Item 10: Practice visits – in progress f) Item 10: Invite to Jeannie Ablett to attend meetings as and when required ‐

done

AC MP PN ALL PN

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4. Conflict of Interest None reported

5. Lead Commissioning: Unplanned Care Programme Update a) NS Updated the group. Heather Wicks and Andy Peedle will be attending the

next Steering Group to discuss further. PS felt they should highlight the benefits of why patients shouldn’t be sent to A&E.

ACTION: NS to discuss with AP and HW b) MJ currently looking at referrals data; Board endorsed his plan to look at the

3 practices from which there was the highest rate of over‐attenders, and liaise with practices with a view to ensuring a management plan is in place for the top 10 frequent attenders. Update to be presented at June Steering Group.

ACTION: MJ to present findings to June Steering Group ACTION: to circulate Unplanned Care newsletter to board members

NS MJ NS

6. Focus ‐ staff assignment ‐ Board roles and job descriptions

a) SL‐B introduced a paper produced from discussions at the last meeting on 28th April, which the board felt was a good reflection of their requirements. It was felt that consortia should not rush into any decisions as to what roles and staff they required however, due to the imminent re‐assignment of current PCT staff into either clusters or commissioning hubs and , coupled with Premier MK’s own staffing requirements, there was concern that this could limit staffing choices for GP Healthcare. The board also felt guidance was needed on which staff should be interviewed for each role. SL‐B stated that PCT staff will remain in the employ of the PCT until 2013. At present the Consortium is not in a position to directly employ staff. Consortia that are either a Social Enterprise or a Community Interest Company can employ staff directly. NS said a meeting with MK and Northampton Consortia leads had been called that evening and hoped it would provide some clarity on current thinking.

ACTION: Work in progress, for further consideration at future board meetings b) NS tabled a job description for the Consortia Lead for discussion. It was

agreed that although the Consortia Lead had overall responsibility for each element the responsibilities should be split between the other board members. This was seen as a good basis for each board member to produce their job descriptions, ensuring they encompass all roles and responsibilities

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GP Healthcare MK Board Meeting Notes 5 May 11 V1.0 Nicola Smith 19/05/11 NHS Classified

of the programme boards. ACTION: Draft job descriptions to be emailed to NS or to SL‐B within the next 2 weeks for further discussion at 16th June board meeting

ALL

7. Key Points from Programme Boards a) Low priority treatments – there are currently 50 patients waiting for

operations that have not been approved by the priorities panel. These patients will be removed from the waiting lists and referred back to their GPs so they can be referred through the correct process. Board requested the PCT explain the process and how the criteria was set for each treatment

ACTION: SL‐B to invite PCT representative b) Physiotherapy – JA reported that the tender process has been suspended as

it was felt that the goals were unrealistic and unfair to small providers. British Red Cross will continue with their current service until September. It is likely that practices will have their own budget in the future.

c) Delivering Capability – RM reported that not many practices have signed up

to the summary care record project. An update on the current estates situation was provided. MP requested a meeting with the relevant PCT lead to discuss charges for the PCT owned health centres.

ACTION: SL‐B to put relevant Estates lead in touch with MP

SL‐B; IH SL‐B

8. Clinical Quality and Practice – referrals data form March 2011 a) Referral data report was discussed and it was agreed that the lead of the

performance /quality workstream will report to the first board meeting of each month.

ACTION: report to first board meeting of the month in future (allowing for inclusion of previous month’s data).

JA

9. Practice Managers’ Update a) Next Practice Manager’s meeting is in the next couple of weeks.

ACTION: RM to provide update at next meeting.

RM

10. Areas of Concern a) None reported.

11. AOB a) Newsletter: Agreed the newsletter to be distributed once a month from now

on.

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ACTION: Items for inclusion to be emailed to Chris Knibb, copied to NS b) Expenses policy: The board were unsure as to what functions they will be

reimbursed for. ACTION: SL‐B to draft proposal for expenses claims for discussion at the next

board meeting. c) Annual report: NS summarised the draft report on the consortium’s activity

over the past year (distributed with the papers). ACTION: Comments on the activity report to NS d) Pathfinder status: NS referred to a recent email sent to the board from NHS

Northants regarding application for Pathfinder status and that if in agreement, SL‐B had offered to draft the application. The board agreed to move forward.

ACTION: SL‐B to progress application e) PS queried representation on Maternity and Child Health programme Board;

agreed f) Practice visits: the Board to review ACTION: SL‐B to check back who had agreed to visit which practice.

All SL‐B ALL SL‐B SL‐B

Date of Next Meeting 19th May 2011 at 2.00 pm, Sherwood Drive board room 2

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GP Healthcare MK Minutes of the Board Meeting held on Thursday 19th May 2011 at 2.00pm Sherwood Drive, Board Room 2

Present: Board Members: In attendance: Dr Nicola Smith ‐ Chairman NS Rod Marshall RM Dr Probir Sen PS Sue Lacey‐Bryant SL‐B Dr Ganeschandra Haldar GH Dr Mohammed Jahngir MJ Dr Suvarna Bharamgoudar SB Other Attendees: Angie Croxton AC Minute Secretary, NHS MK The meeting was Quorate ACTION 1. Apologies Naomi Eisenstadt, Dr Jawad Ahmad, Dr Mulukutla Prasad

2. Minutes of Previous Meeting – 5th May 2011 a) Rod Marshall was in attendance, minutes were otherwise agreed

ACTION: Add Rod Marshall and re‐issue Minutes

AC

3. Matters arising a) Family planning ‐ MP to contact VM re practice collaboration. The current

PCT Family Planning tender was discussed. ACTION: It was agreed that Lucy Hubber be invited to present and discuss with the Board. b) Governance documents – all but Neath Hill and Stantonbury has been

signed and received. ACTION: A letter to be sent from the Board stating that the signed papers are needed urgently, inviting discussion of any queries/concerns, and that failing that if the papers are not received by an agreed date, the Board will assume non participation. c) Practice visits – ongoing. Not all practices have received the pack sent out

by NS (e.g. Wolverton and Bedford Street).

SB NS

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ACTION: PN to send pack out in advance as soon as each visit is arranged.

d) Item 6 Board members Job descriptions still outstanding. Members

welcome to mail these into SL‐B. ACTION: Board Members to provide Job Descriptions to Chair e) Item 7 Beryl Anderson, Estates lead has been asked to contact MP. f) Item 11 – Expenses claims proposal ACTION: SL‐B to bring to next meeting.

PN ALL SL‐B

4. Conflict of Interest a) PS noted that he is also a member of MKDoC out‐of‐hours Board.

5. Lead Commissioning: Unplanned Care Programme Update a) SL‐B tabled a progress report from Heather Wicks, SRO for Unplanned Care

programme board. The Board noted the contents of the Report

b) The board discussed the Contract for MKHFT and requested a copy of the

contract and a presentation and discussion from the relevant lead, to include the variation and block contract options, and COBIC (Capitation Outcomes Based Incentivised Contracts)

ACTION: SLB to invite Claire Weston

c) There was discussion on whether GPs should sign off and agree the

Unplanned Care COBIC PID as well as the relevant leads at the PCT. It was agreed that as a member of the Unplanned Care Programme Board, NS

could sign it on behalf of GPHCMK Board. Any actions taken on the Consortium’s behalf will be communicated to all practices via board

minutes and newsletter.

SL‐B ALL

6. Steering Group a) There was discussion on whether the Steering Group meetings should be

held at each practice in rotation. As all premises did not have suitable facilities, it was decided that this was impractical but agreed that it is desirable to hold steering group meetings at different venues across the consortium where

practices can accommodate a meeting of this size. It was agreed that each Board member will rotate as Chair of the Steering group and GH agreed to chair the next meeting.

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ACTION: GS to chair the next Steering Group meeting on 9th June 2011

GS

7. Focus a) John Parkes message on Assignment of staff was noted. NS updated the

Board on early discussions on hub configuration. ACTION: Agreed to take a further update to the next Steering Group meeting. b) There was discussion on whether Board members should be selected or

elected. PS agreed to investigate how this is done elsewhere, with support from SB, and report back to the Board for further discussion and agreement.

ACTION: PS and SB to investigate

NS PS/SB

7. Clinical Quality and Practice – referrals data form March 2011 a) The Chair thanked Thao Nguyen and Nazia Mohammed for their work on

the Milton Keynes wide referrals project and that this project had now concluded as an aspect of the Planned care programme.

ACTION: Noted that a consortium‐wide approach to be developed headed up by JA.

JA/MJ

8. Practice Managers’ Update a) RM updated the Board on discussions from the last Practice Managers

meeting.

The Board recognised that Practice Managers’ have many skills that can be utilised and that they could and want to take a more active role in the

work of the Consortia.

9. Areas of Concern a) None reported.

11. AOB a) SL‐B offered to support Board members informally as they assume their new

responsibilities for example by sitting in on meetings with them, as and when required.

The board thought this could be helpful; individuals to contact Sue direct, and

schedule in such meetings and time to talk. E‐mail sue.lacey‐[email protected]

b) There was discussion as to whether the Board should formally invite the LMC

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mailto:[email protected]


to the Steering group.

The Board noted that there are LMC members on the Steering group in any case. To be considered.

c) There was discussion on whether extended hours arrangements for practices

within the consortium should be agreed by individual practices or at consortium level?

The Board agreed to wait until the new LES and DES were finalised before

further discussion.

ALL ALL

Date of Next Meeting 2nd June 2011 at 2.00 pm, Sherwood Drive board room 2

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GP Healthcare MK Minutes of the Board Meeting held on Thursday 2nd June 2011 at 2.00pm Sherwood Drive, Board Room 1

Present: Board Members: In attendance: Dr Mohammed Jahngir (Chair) MJ Rod Marshall RM Dr Probir Sen PS Sue Lacey‐Bryant SL‐B Dr Ganes Haldar GH Naomi Eisenstadt NE Dr Jawad Ahmad JA Dr Mulukutla Prasad MP Other Attendees: Angie Croxton AC Minute Secretary, NHS MK The meeting was Quorate ACTION

1. Apologies

Dr Nicola Smith, Dr Mohammed Ahad, Dr Suvarna Bharamgoudar, Dr M Mahendran

2. Minutes of Previous Meeting – 19th May 2011

a) Agreed

3. Matters arising

a) Invite to Lucy Hubber to future board to discuss Family Planning tender b) Governance documents – Neath Hill was received at meeting. Stantonbury

is still outstanding. c) Practice visits – ongoing, email visit pack to board members d) GH requested finance forms from Edna Muraya. AC to organise e) Job Descriptions – still outstanding. SLB agreed to look at JD’s already

produced by other Consortia as a reference. To compile a list of current responsibilities of each board member, by the end of the meeting; to be shared.

f) Claire Weston to be invited to a future board to discuss the Acute contract

SB MJ AC AC SL‐B ALL SL‐B

4. Conflict of Interest

a) None

5. Clinical Quality and Practice Performance Group

a) Received an outline proposal of the vision and remit of the group. There was discussion on nominations and appointment to the roles of Chair and Vice

GP Healthcare MK Board Meeting Notes 2nd June 11 V1.0 Nicola Smith 160611 NHS Classified

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Chair. This group is being formed as a sub‐committee, building on the work of the former MK‐wide referrals group. This was recognised as an important and key requirement of the Consortia. MP agreed to liaise with Dr Mahendran regarding his involvement. The Board identified other potential candidates. Agreed to mail a request for applications around all practices

b) GH agreed to be temporary vice chair. c) Agreed to invite Janet Corbett, Chief Pharmacist to join this group, and look

to the Pharmacy team for assistance. in working with practices on referrals as well as medicines management.

ACTION: Email all GPs and discussed at next Steering Group ACTION: MP to discuss with previous chair and other potential candidates

The Board agreed the proposal subject to securing a Chair and Vice Chair

MJ SL‐B/MP

6. Commissioning: Unplanned Care Programme Update

a) Andy Peedle gave a presentation,

The overall status of the programme is Amber with 70% of actions on action plan complete.

Hospital contract not yet signed, but block contract in place to generate savings of £2.7m for this financial year.

COBI contract ‐ full market testing is a legal requirement and has been approved. Agreement reached with CES for demand and capacity planning exercise, project resource approved but yet to be recruited.

GP triage ‐ South Central Ambulance Service informed of participating practices, telephone directory complete, SCAS to provide monthly reports.

Case management ‐ CES paper produced detailing ‘Guided Care’ (number of patients, potential savings, staffing levels, high level process). Project not yet started although will be included in the system specification project, Need to identify clinical and project leads

Case management of out of area patients – project agreed and started. Project initiation document to Methodology to identify OOA patients to be established and agreed identify appropriate services available in Milton Keynes to repatriate patients into and methodology to repatriate patients back to Milton Keynes to be established.

A&E Attendances ‐ routine reports are generated monthly, average attendances per month for the Consortia and practices exceeding monthly average target has been identified. Need to agree with GP Healthcare MK on how to improve the position and generate savings and Generate ideas and suggestions for reducing the number of people using the A&E department.

ACTION: Board to contribute to discussions on how to reduce A&E attendance

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The Board noted the above

7. Key Points from programme Boards

a) Planned Care – Physio tender has been reinstated and it was agreed that the Steering

Group should receive an update from John Parnell, NHSMK project lead. – MCAT

o Premier MK is leading on this work; o 8 high referring practices identified as being the pilot practices to

receive support and development and initiate the CASSO triage model.

o Triage Referral system for new outpatient referrals being set up through C&B; launch date tbc

o Low priorities policies incorporation ACTION: Invite John Parnell to the next Steering Group

JA/AC

8. Practice Managers update

a) Managers have raised queries regarding CQC registration. It was agreed to approach Alison Jamson to see if she could assist with this. The next meeting is on 23rd June.

ACTION: Suggest Practice managers group discuss CQC process with Alison

Jamson

RM

7. Governance of Delegation of Health Budgets to Consortia

a) Received update paper prepared for Audit Committee

8. Update from MK/NHSN GPCC Meeting

a) We understand that the NHS N/MK cluster is aiming to form a single Commissioning Hub to be managed by a joint consortia Board. Nene is moving into NHS N HQ building on 1st July

b) GP Healthcare MK has expressed a wish to be a client of the hub (commissioning support service) rather than to manage it.

c) A proposal for joint funding for consultancy around governance and organisational development, prepared by Nene was received very late the previous evening. To be emailed to Board. The timelines are very tight.

d) Noted the Board has previously received a paper by NS suggesting that the consortium part fund some short‐term work to look at how consortia can best contract healthcare in future.

ACTION: SL‐B to email to MJ for dissemination to the Board

SL‐B/MJ

9. Focus: Low priority treatments

a) Ivo Haest gave a presentation to the Board and tabled copies. There have


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been no MK Hospital or GP reps on the panel since the resignation of Dr Eric Webb.

b) New electronic referral forms will soon be available; if criteria are met then referrals will not need to go to the panel. Those referrals that do not meet the criteria will need to go to the panel. MK Hospital will return referrals that do not meet the criteria and have not had authority for the panel.

11. AOB

a) SL‐B drafting up expenses policy, looking at samples from elsewhere, and will bring these and sample role descriptions to the next Board meeting.

Date of Next Meeting

16th June 2011 at 2.00 pm, Sherwood Drive board room 2

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