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Agenda Item 20 Enclosure CKWCB/11/31

Calderdale, Kirklees and Wakefield District Cluster Board Report To:

Cluster Board meeting on 1st November 2011

Title:

Commissioning Development

FOI Exemption Category

Open

Lead Director and contact details:

Ann Ballarini, Director of Commissioning and Service Development ann.ballarini@wdpct.nhs.uk Ann Ballarini, Director of Commissioning and Service Development ann.ballarini@wdpct.nhs.uk

Author Name and contact details:

Danny Alba, Commissioning Programmes Manager Danny.alba@wdpct.nhs.uk Louise Auger, Head of Performance Improvement louise.auger@wdpct.nhs.uk

Key Points to Note:

Recommendation:

Key Points: 1. Good progress is being made against the transition milestones at Q2; 2. Cluster responsibilities and milestones achieved for Offender Health & Military Health: prison health needs assessments completed; a regional Military Health Network established; 3. Project established to deliver Commissioning Support Offer and a full time project manager appointed; recommendation to produce one prospectus across West Yorkshire footprint; 4. Development of the authorisation process for Clinical Commissioning Groups (CCGs) to be enhanced through board-to-board confirmation-and-challenge meetings against a checklist of requirements. 1. Note the report and progress being made against the key transition areas the Cluster Partnership is responsible for; and 2. Approve recommendation for a single Commissioning Support Prospectus to be developed across West Yorkshire.

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Cluster Board Commissioning Development Report November 2011

1 Purpose This paper has four purposes: Firstly, to provide a full quarter 2 (Q2) report against the Commissioning Development Assurance Framework 2011/12, including any exceptions, risks, issues and mitigations for the 40 areas of commissioning transition in our Cluster Partnership Responsibilities and Accountability Framework; Secondly, to provide a fuller update on Offender Health & Military Health; Thirdly, to provide an update of progress on Commissioning Support; and, Finally, to provide an overview of the authorisation process for local Clinical Commissioning Groups (CCGs) and the CKW Cluster approach to supporting them to achieve authorisation. 2 Commissioning Development: update, including any exceptions, risks, issues and mitigation A full update, including exceptions, risks, issues and mitigations against each of the 6 key transition areas outlined in the Cluster Operating Model Framework is provided at appendix 1. The full update report for Q2 is structured against the 6 key headings: 1. 2. 3. 4. 5. 6.

Integrated Finance, Operations and Delivery; Commissioning Development; Ensuring Quality (Effectiveness, Experience and Safety); Emergency Planning and Resilience The Commissioning Elements of Provider Development Communication and Engagement

All areas are green, with the exception of 12 areas which are rated as amber. These areas are described below with mitigating actions to achieve green or where we are awaiting a national template or clarification. Integrated Finance, Operations and Delivery Amber Rating - Management and implementation of Medium-term QIPP Plans: Mitigation collaborative working across the Cluster between QIPP leads to share learning opportunities and agree impact. Clinical leads established for each scheme and included in objectives for scheme of delegation for Clinical Commissioning Executives (CCEs). Commissioning Development; Amber Rating - Primary Care Commissioning: Existing primary care contracts have been catalogued; now awaiting national template for completion. Amber Rating - Specialised Commissioning: 3


Discussions with CCGs are planned in November to determine how these services will be commissioned in the future. Amber Rating - Above consortia level commissioning: Meetings to be set up with CCGs to discuss future commissioning arrangements. Amber Rating - Existing Prison Health and Military Health contracts categorised as NHSCB or CCG: Mitigation awaiting national template to categorise these; all Clusters in same position; SHA aware Amber Rating – Prison Health - Identification of contract weaknesses in Direct Commissioning areas to be fixed in the 12/13 contracting round: Mitigation contract reviews underway to address contract weaknesses to be completed by end of November Amber Rating - Military Health: Mitigation Cluster lead working with other Cluster leads and SHA to determine most effective approach to identify secondary care usage for this patient group. Amber Rating – Convergence plans for Direct Commissioning functions agreed by SHAs with Clusters and shadow NHSCB: Mitigation Work underway Amber Rating – Police Custody: Preparing for the likely future transfer of custody health care commissioning from the police to the NHS. Amber Rating – Enabling development of GP Commissioning Consortia and wider reform: Mitigation Cluster lead is developing an authorisation process checklist for board-to-board challenge and confirm meetings that are planned and scheduled – (see section 5 of this report). Amber Rating - Supporting development of commissioning support for consortia: Mitigation Cluster lead, project manager, now appointed. Developing a prospectus comprising service specifications and agreed to do this at West Yorkshire level. The Commissioning Elements of Provider Development Amber Rating - Increasing the Range of Providers in the Local Market: Working through the AQP workstream to determine a shortlist of services for choice through AQP by deadlines – (see section of provider development report)

3 Offender Health & Military Health Introduction With the abolition of Primary Care Trusts (PCTs) in 2013 the responsibility for the commissioning of prison health and military health services will transfer to the new NHS Commissioning Board (NHSCB). Nationally the Department of Health (DH) has set out the expectations for Strategic Health Authorities (SHA’s) and PCTs to achieving this transition. These include milestones by which a set of actions are to be achieved during 2011/12.

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Offender Health Responsibility for commissioning prisoner health services transferred from the Home Office (now the Ministry of Justice) to the Department of Health in 2005 and then to Wakefield District PCT for prison healthcare. Within Calderdale, Kirklees and Wakefield District Cluster there are two prisons, both in Wakefield District – HMP Wakefield: a high security prison for men located nearby Wakefield city centre, and HMP & YOI New Hall: a medium security prison and young offenders institution for girls and women located near Flockton. Prison Health Commissioning is typified by its complexity, risk, high cost (around £6million), with interdependencies between health and criminal justice systems and the need for transformational change. The prisoner population is over 1,000 prisoners at any one time with a throughput of around 3,000 prisoners per annum, with high levels of health inequalities, prevalence of long term conditions, mental disorder and substance misuse. The programme’s aim is to reduce health inequalities by improving access to health care for prisoners as could be expected in the wider community. It does this by overseeing the implementation of a number of projects and contracts which cover all aspects of health care for prisoners, e.g. primary care, mental health, substance misuse, dental, optical, urgent and nonurgent care, secondary care etc, and also hospital escort and bedwatch management. The key strategic priorities for 11/12 are to fully engage with stakeholders, secure needs assessments, and enable effective contract management in terms of service delivery improvement, relationship management and contract administration. Key challenges include delivering contracts within budget, improving service delivery, a focus on QIPP to improve quality and performance, integrated drug treatment system, new mental health and primary care service provision, and coordinating death in custody investigations. Going forward the NHSCB will be responsible for commissioning Primary Care provision with CCGs responsible for commissioning Secondary Care provision. Military Health Primary Care for Armed Forces personnel is generally the responsibility of the ‘single service primary healthcare organisations’ (Army, Royal Navy, and RAF). This includes both in-house provision and some outsourcing to independent healthcare providers or NHS trusts. Responsibility for secondary care for Armed Forces personnel rests with the NHS for normal elective care, but for specialist secondary care the Defence Medical Service (DMS) has an arrangement with the NHS to pay for this specialist treatment (through direct contracting with the NHS). A key requirement is to ensure that military veterans receive priority access to NHS secondary care for any conditions which are likely to be related to their service, subject to the clinical needs of all patients generally. This means that GPs’ referrals and treatment by secondary care clinicians should prioritise this group of patients where the disorder is related to their service. To enable this, it includes the use of Choose & Book and an ongoing programme for the direct transfer of medical records to GPs when individuals leave the Armed Forces. The basic principle for Armed Forces’ dependents and veterans is that generally they are the responsibility of the NHS in the same way as normal residents. Where a member of the Armed Forces is referred for NHS secondary care via a standard NHS pathway, including non-elective care, the PCT where the MoD medical centre of the resident Armed Forces population is located then that PCT should fund this care. The MoD is required to fund secondary care services where the requirement varies from the standard NHS pathways, i.e. either the 5


treatment requested or for specific management requirements, e.g. fast-track care or nonstandard treatment. Commissioning responsibility for Military Health is destined for the NHS Commissioning Board (NHSCB). Statutory duties for this are subject to passage of the Health & Social Care Bill through Parliament and will mean that current PCT responsibilities in relation to healthcare for HM Forces and their families (who are registered to MoD medical centres) will be transferred to the NHSCB who may in turn delegate some of these to Clinical Commissioning Groups (CCGs). The NHSCB will receive the secondary and community allocation for resident Armed Forces and the full allocation for families registered at military medical practices. This allocation will be managed collaboratively between the NHSCB and the MoD (Joint Medical Command). To manage this change programme all regions are required to establish an Armed Forces Network (AFN) with representation from the SHA, the Armed Forces’ Defence Medical Service and NHS PCT Clusters. The AFN for Yorkshire & Humber region is chaired by Chris Long, Chief Executive of the Humber Cluster, and with representation from each PCT Cluster in the region. The AFN and its work programme are still at an early stage of development so the workstreams are somewhat unclear, although the milestones set out in the Shared Operating Model for PCT Clusters are a helpful start for PCT Cluster leads. These milestones have been mapped against the Calderdale, Kirklees & Wakefield District Cluster Partnership Responsibilities and Programme Framework to enable progress. The priority for Clusters is that they will need to take account of the current responsibilities particularly during 2012/13 and the requirement to ensure that the responsibilities of Priority Treatment are delivered.

4 Commissioning Support Offer The development of our NHS Calderdale Kirklees and Wakefield District commissioning support offer is progressing within the given timescales. Draft service specifications are being written collaboratively across the Cluster by service leads and these will form part of the draft commissioning support offer and will be collated by the end of the month. In turn, these will inform our draft Prospectus describing to CCGs the range of services we will potentially deliver to them should they choose to purchase them from us. The timescale for the development of the draft Prospectus is driven by the SHA and a first draft copy is also needed by the end of October 2011. As part of staff engagement, a survey of their views on commissioning support has been completed and a total of 80 responses were received. These responses are being used to help inform the development of the Prospectus. On 3rd October 2011 there was a Cluster strategy event with staff, during which part of the day was used to update managers on the latest commissioning support guidance and thinking and to start some development work on the completion of service specifications. Monthly staff briefings are also being used in each part of the Cluster to regularly provide an opportunity for questions and answers on this important piece of work. In addition to this, a regular update is provided in the three Cluster newsletters and a dedicated CSO page is going to be provided on the intranet by the end of this month so staff can easily access the latest documents and news as it develops. Draft service specifications are being written collaboratively across the Cluster by service leads and these will form part of the draft commissioning support offer and will be collated buy the end of the month. In turn these will inform our draft prospectus describing to CCGs the range of services we will potentially deliver to them should they choose to purchase them from us. 6


The timescale of development of the draft prospectus is driven by the SHA and a first draft copy is also needed by the end of October 2011. The draft model suggests that many Commissioning Support Services should be delivered at scale, i.e. across West Yorkshire. Discussions with the Bradford, Airedale & Leeds Cluster have reached the agreement to produce one Prospectus for a West Yorkshire Commissioning Support Offer. External support has been offered by the SHA through Cameron Ward, who is advising the development of Commissioning Support in the North East Cluster and the first meeting of a small project group was held on 17th October to take this work forward. A consultation document on ‘Developing Commissioning Support’ has been issued and is subject to change following feedback from the NHS. Some of the highlights include: The proposal to extend the period of NHS development and this may be achieved by the NHS Commissioning Board (NHSCB) ‘hosting’ some commissioning support from 2013 until no later than 2016; During the hosting period, it is proposed that commissioning support would operate at arm’s length from the NHSCB; and When CCGs are ready to go to the market, they will do so through formal procurement. Until then they will use NHSCB hosted commissioning support. Finally, in recognition of the size and importance of developing the Commissioning Support Offer (CSO), a full time Project Manager, Rachel Spilsbury, has been seconded internally to lead this piece of work for the CKW Cluster and to ensure all the transition milestones are delivered. The key milestones are outlined below.

Key proposed milestones going forward By December 2011

Checkpoint 1 (environmental)

All prospectuses tested through 360 review

By March 2012 Outline Business Plans reviewed

Checkpoint 2 (commercial)

By September 2012 Full Business Plans assessed

Checkpoint 3 (commercial)

From April 2013 Operational (and hosted). Commercialisation plans implemented 9

5 Developing Clinical Commissioning Groups – towards authorisation update report The ambition is to create an NHS rooted in the three principles of giving patients more power, focusing on healthcare outcomes and quality standards, and giving frontline professionals much greater freedom and a strong leadership role. CCGs are at the heart of these proposals. 7


Developing Clinical Commissioning Groups – towards authorisation (published by DH, September 2011) sets out a process by which CCGs will be assessed as ready to take on responsibility for health care budgets for their local communities. Principles for authorisation The DH has developed a set of principles to guide the development and implementation of the authorisation process to ensure it is consistent, sufficiently robust, adds value and sets the tone for a positive relationship between CCGs and the NHSCB. Once the NHSCB is formally established it will consider applications for the establishment and authorisation of CCGs. The authorisation process is a stage of continuous improvement which includes the following steps: Initial development phase; Application; Authorisation process; and, Annual assessment. The focus of authorisation The authorisation process should support and reinforce the work needed to create excellent CCGs so the content of the authorisation process is built around 6 domains. These are: 1. A strong clinical and multi-professional focus which brings real added value; 2. Meaningful engagement with patients, carers and their communities; 3. Clear and credible plans which continue to deliver the QIPP challenge within financial resources in line with national requirements and local joint health and wellbeing strategies; 4. Proper constitutional and governance arrangements, with the capacity and capability to deliver all their duties and responsibilities including financial control, as well as effectively commission all the services for which they are responsible; 5. Collaborative arrangements for commissioning for commissioning with other CCGs, local authorities and the NHSCB as well as the appropriate Commissioning Support; 6. Great leaders who individually and collectively can make a real difference. Commissioning Support Key to the authorisation of CCGs are the Cluster’s plans for a commissioning support offer and what commissioning support the CCGs want to share or buy in for the non-clinical aspects of commissioning. Commissioning Support is likely to be the single biggest issue for CCGs and the Cluster in terms of the development of the new system (see full update report at section 4 above). The steps to authorisation Road map to authorisation is based on a phased approach with the first phase being a risk assessment of the proposed configuration of the CCG. The second would be the development path which is the period the emerging CCG can gain experience and build up a track record. The final stage is the full authorisation process where CCGs will need to apply to the NHSCB to be established and authorised. 8


Evidence for authorisation The formal application to grant establishment of a CCG will have three aspects: first, will be their submission of evidence to demonstrate capability across each of the domains; second, where the NHSCB satisfies itself about the validity of the evidence submitted; and third, where the Board draws together all its background knowledge and information for discussion with the prospective CCG and any local stakeholders the Board believes should be involved in further assessment. Outcomes to authorisation The Bill refers to the establishment of CCGs and provides that a CCG can be established with or without conditions depending on the extent to which the requirements for establishment have been met. There are three outcomes to authorisation: 1. Shadow CCGs established but not authorised to undertake commissioning; 2. Authorised with conditions; and, 3. Fully authorised. Roles in the authorisation process The Cluster will prepare and support emerging CCGs across the patch through to authorisation. The Cluster will not be involved in decisions about authorisation of local CCGs though. The SHA Cluster will oversee and manage the flow of applications for authorisation ahead of the establishment of the NHSCB. Establishment and authorisation can only be undertaken by the NHSCB itself. There will be a role for shadow Health and Wellbeing Boards in the authorisation process Timeline toward authorisation October – December 2011

Invitation to participate in risk assessment of the proposed configuration Undertaken by SHA Cluster working with emerging CCGs Will focus on sign-up from member practices, geography and impact of proposed size

October onwards

Preparation for authorisation Build track record (increased delegation, leading 2012/13 planning) Build partnerships, engagement and collaborative arrangements Design proposed organisational form, decision making, governance

Summer 2012

Application to the NHSCB for establishment and authorisation Submit application

October 2012

Formal authorisation process Demonstrate capability across the 6 domains 9


360 degree assessment to ensure views of partners are captured April 2013

All of England covered by established CCGs (vast majority should be fully authorised)

CKW Cluster support for CCG development toward authorisation Locally, CCGs are being supported by the Cluster to develop organisation development (OD) plans utilising where appropriate the national tools: National Pathfinder Learning Network; Self-assessment diagnostic tool; and, National Leadership Development Framework. A scheme of delegation is under development to give CCG’s responsibility and accountability for commissioning decisions and use of resources to enable them to build a track record of delivery. Also in development is an ‘authorisation checklist’ which will be used to support CCGs to make progress towards authorisation. A schedule of board-to-board ‘confirm-andchallenge’ meetings between individual CCG Boards and the Cluster Board is being organised as part of this work.

6 Recommendations Members are asked to: 1. Note the report and progress being made against the key transition areas the Cluster Partnership is responsible for; and 2. Approve recommendation for a single Commissioning Support Prospectus to be developed across West Yorkshire. Ann Ballarini Executive Director of Commissioning & Service Development Danny Alba Commissioning Programmes Manager Louise Auger Head of Performance Improvement

November 2011

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Appendix 1 – Update against the 6 Key Areas, including any exceptions, risks, issues and mitigations 1. Integrated Finance, Operations and Delivery Capital Estates Maintain Relations with Local Government and Partners Local Authority and Public Health Transition Employment Responsibilities

Governance

No specific risks identified, other than there are potentially risks but possibly opportunities from the changes in Property Management arrangements set out in the recent White Paper. No specific risks identified. Shadow HWBBs in place across the Cluster footprint. CCGs are actively involved with the HWBBs.

No specific risks identified; as above.

No specific risks identified. Progress is being made with the collapse of the three PCT boards with the establishment of one Cluster Board and successful delivery against the milestones to date. Risks/issues are: lack of clarity on which specific statutory functions will transfer where. Mitigation NHSCB to be established by end October 2011 and clarification of statutory functions. Risks/issues are: potential loss of key governance resources up to 31 March 2013 to oversee closedown; Mitigation business critical roles identified and collaborative working across the Cluster to support resilience uncertainty about management cost envelope for clinical commissioning groups (CCGs); Mitigation financial model being done on £20. Clarification of cost envelope in Operating Plan November 2011

Oversight of Closedown of PCTs

loss of organisational memory; Mitigation legacy documents for three PCTs ongoing differing understanding of closedown requirements by three PCTs and inconsistent approach; Mitigation formation of single Cluster Board, governance and operating model lack of clarity within new commissioning system – no final confirmation nationally yet on which functions will transfer to (CCGs) and which to NHS Commissioning Board; 11


Mitigation establishment of NHSCB end October 2011 with clarification of functions. Maintain Talent and Support People Through Change

No specific risks identified. Risks/issues are: delivering sustained and robust programme and project management in a time of organisational transition; securing and maintaining the involvement of clinical commissioners; clear understanding local economy impact of planned QIPP;

Management and implementation of Medium-term QIPP Plans

Mitigation collaborative working across the Cluster between QIPP leads to share learning opportunities and agree impact. Clinical leads established for each scheme and included in objectives for scheme of delegation for CCEs complexity of planning implementing and measuring programmes of transformational QIPP – that which involves service and pathway redesign across organisations and sectors, and particularly delivering secondary care efficiencies in partnership with provider organisations; ensuring alignment between QIPP and CIP within the acute sector – without which it is difficult to get real costs out of the system; Mitigation identified as one of the programmes under the HEFT Board

Performance Management of Key Performance Measures Informatics, Contracts and Intelligence for Commissioning

No specific risks identified.

No specific risks identified.

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2. Commissioning Development Primary Care Existing primary care contracts have been catalogued; now awaiting Commissioning national template for completion. The Cluster is working through the Y&H Specialised Commissioning Group and has identified all staff currently involved in directly commissioning specialised services (specialised commissioning team). A programme of support is in place to assist these staff through the transition to National Commissioning Board. During August the PCT finance/contracting teams are working with SCG to separate specialised and non specialised elements of activity in every Specialised acute /mental health contract according to planned activity for 2011/12. Commissioning Clusters are currently working with SCT to identify all services that are not within the specialised services definition but that have been commissioned on a collaborative basis through SCG. This work will be completed by end of September and migrate to Cluster/CCG responsibility. Discussions with CCGs are planned in November to determine how these services will be commissioned in the future. No specific risks identified. When work with SCG completed on non-specialised services that have Above consortia been collaboratively regionally commissioned by end September level meetings will be set up with CCGs to discuss future commissioning commissioning arrangements. No specific risks identified. Direct Milestone not due; no specific risks identified. Commissioning Cancer Drug No specific risks identified. Fund Existing Prison Partly achieved, but awaiting national template: Health and NHSCB: Primary Care and Mental Health identified; Military Health Some secondary care delivered in the prisons; contracts CCG: Secondary Care, includes Planned and Unplanned Care categorised as identified. NHSCB or CCG Mitigation awaiting national template to categorise these; all Clusters in same position; SHA aware Identification of Key contract weaknesses to be addressed in the 2012/13 round are: contract 1. Hospital Escorts & Bedwatches Contract with HMP Wakefield (SLA) weaknesses in significantly overspending; Direct 2. In Patients Service Contract (NHS Standard Community Contract) Commissioning with HMP Wakefield – notice likely to be served, or notice for a areas to be significant contract variation, as service is not fit-for-purpose; fixed in the 3. Close Supervision Centre Contract with Humber NHS Foundation 12/13 Trust (SLA) – notice served. contracting round Mitigation contract reviews underway to address contract weaknesses Convergence Mitigation Work underway plans for Direct Commissioning functions agreed by SHAs with Clusters and shadow NHSCB

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Clusters to have identified staff currently involved in directly commissioning prison health and military services Clusters to have ensured current Prison Health Needs Assessments remain fit for purpose, and to have revised [them] accordingly for use in the 12/13 commissioning round.

Clusters should have identified secondary care activity usage by prison and custodial services from new data flows and use it to inform commissioning plans Clusters to have separately identified prison health secondary contract activity by services, speciality/HRG value in order to allow 12/13 contracts to separately identify shadow NHSCB and CCG responsibilities

Posts: Commissioning Programmes Manager 1 x 8b wte Commissioning Support Managers 2 x 5 wte

Confirmed that prison health needs assessments for both HMP Wakefield and HMP & YOI New Hall have recently been completed and are assessed as being fit for purpose for use in 2012/13 commissioning round. Key thematic areas from the new HNAs are: HMP Wakefield: covers the areas of general health and in addition focuses on three areas identified by the Offender Health Strategic Partnership Board: BME (black and ethnic minority) groups Learning Disability Older prisoners HMP & YOI New Hall: also covers the areas of general health and in addition focuses on four areas identified by the Offender Health Strategic Partnership Board: Learning Disability Learning Difficulty and low educational attainment Sexual Health Maternity Services Offender Health: flows of secondary care activity usage have been identified and there are a number of key issues arising for the commissioning round. The most significant issue, and identified as the funding and activity for prisoner hospital escorts and bedwatches. This has been a high risk from the outset when responsibility for funding these was transferred to PCTs. For example, the outturn for 10/11 was £318k, which was £120k overspent compared to a £334k overspend in 09/10. For 11/12 the forecast overspend for escorts & bedwatches is £150k. Mitigation SHA is aware of policy problems re: prisoner hospital escorts and bedwatches Both have been identified but identification of secondary care contract activity linked to prison health is well advanced and that linked to Military Health is still in its infancy. Prison Health secondary care contract activity: 1. Hospital escorts and bedwatches contract with HMP Wakefield for all secondary care planned and unplanned care; 2. Telemedicine healthcare interventions contract with Airedale NHS Trust; 3. Dental services, Podiatry, Physiotherapy, Respiratory contracts with Mid Yorkshire Hospitals NHS Trust. Mitigation awaiting national templates for NHSCB and CCG contract forms

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Clusters to have identified secondary care activity usage by armed forces from new data flows and use it to inform commissioning plans Clusters to have separately identified military health secondary contract activity by services, speciality/HRG value in order to allow 12/13 contracts to separately identify shadow NHSCB and CCG responsibilities Negotiations start for separate shadow NHSCB and CCG contracts Clusters to have completed cataloguing existing contracts for prison and custodial health and offender health according to a national template setting out the broad contents of the contracts and their state of readiness for handover to the NHSCB.

Military Health: to date it has not been possible to identify flows of secondary care activity usage, although there has been progress to identify and map numbers of veterans across the patch. Work is in development to investigate flows of secondary care activity usage. Mitigation awaiting national templates for NHSCB and CCG contract forms

Work is underway – but no military health secondary contract activity identified across this Cluster to date; SHA is expecting a nil return from Clusters. Mitigation Cluster lead working with other Cluster leads and SHA to determine most effective approach to identify secondary care usage for this patient group

Activity modelling for CCG contracts due to commence; templates completed and submitted for DH Offender Health / SHA OH leads, i.e. CD39 submitted. Mitigation Cluster lead working with other Cluster leads and SHA to separate shadow NHSCB and CCG contracts We are still awaiting national templates so Amber. Key contract weaknesses to be addressed in the 2012/13 round are: 1. Hospital Escorts & Bedwatches Contract with HMP Wakefield (SLA) significantly overspending; 2. In Patients Service Contract (NHS Standard Community Contract) with HMP Wakefield – notice likely to be served, or notice for a significant contract variation, as service is not fit-forpurpose; 3. Close Supervision Centre Contract with Humber NHS Foundation Trust (SLA) – notice to be served as service is not fit-for-purpose (in confidence as not yet given). Mitigation awaiting national templates to set out the broad contents of the contracts and their state of readiness for handover to the NHSCB

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Police Custody

As a result of the success of the Integrated Offender Management schemes in the region and the effectiveness of Police/health partnerships West Yorkshire Police have been awarded early adopter status, by the Department of Health, to scope out how custody healthcare can best be provided. This is in preparation for the likely future transfer of custody health care commissioning from the police to the NHS. Resource intensive; looking to appoint a dedicated project manager for this workstream. No specific risks identified.

Development and Delivery of No specific risks identified. Integrated Plans Currently all CCGs are undertaking the self-assessment process but it is Enabling unlikely 100% of CCGs will complete all self assessment by end development of October. GP Commissioning Mitigation Cluster lead is developing an authorisation process checklist Consortia and for board-to-board challenge and confirm meetings that are planned and wider reform scheduled – (see update report) Commissioning National NHS Continuing Healthcare Process

Supporting development of commissioning support for consortia

NHS Outcomes Framework for Maternity and Children Children and Young People – Mental Health Strategy Healthy Ambitions LTC Programme for Children Provider Children and Maternity Networks Continuing Care for Children

No specific risks identified.

No specific risks identified. Resource intensive; appointed a dedicated project manager for this workstream. No specific risks identified in terms of delivery against first milestone but due to the significant change management required for this it is rated as Amber – (see update report). Mitigation Cluster lead, project manager, now appointed. Developing a prospectus comprising service specifications and agreed to do this at West Yorkshire level

No specific risks identified.

No specific risks identified.

No specific risks identified.

No specific risks identified.

No specific risks identified. 16


Patient Safety No specific risks identified. Statutory Safeguarding No specific risks identified. Children Duties Safeguarding No specific risks identified. 3. Ensuring Quality (Effectiveness, Experience and Safety) Statutory Duty to Safeguard and Promote the Welfare of No specific risks identified. Children & Responsibility to Safeguard Adults Quality Accounts No specific risks identified. Quality Legacy No specific risks identified. Document 4. Emergency Planning and Resilience Emergency No specific risks identified. Preparedness 5. The Commissioning Elements of Provider Development Social No specific risks identified. NHS Kirklees Community Services Enterprise successfully transferred to Locala Community Partnerships CIC on 30 Development September 2011. Increasing the No specific risks identified. Working through the AQP workstream to Range of determine a shortlist of services for choice through AQP by deadlines – Providers in the (see update report) Local Market 6. Communication and Engagement No specific risks identified. Inclusion

Stakeholder Media and Reputation Management

Risks/issues are: potential loss of capacity in the team due to staff changes; an engagement/consultation programme is due to start about a national communications service, which it is anticipated will come into effect from April 2012; until we see more detail it is not possible to fully assess the impact of this change, but it could be that we need to start making changes in advance of next April.

Mitigation collaborative working across the Cluster to support resilience Support National Public Health No specific risks identified. Campaigns PPI Freedom of Information (FOI) Requests

No specific risks identified. No specific risks identified

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