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Paper 2a Yorkshire & Humber PCT Collaborative West Yorkshire Sub regional commissioning forum (WYCOM) Part 2: Notes of the Commissioners only meeting 2 March 2011 (12:00 – 14:30) Present; Alan Wittrick (Chair) Ann Ballarini Matt Neligan Mike Potts Carol McKenna Kevin Howells Lisa Marriott Sean Duffy Colin Mcilwain Alison Bagnall

NHS Wakefield District NHS Wakefield District NHS Bradford & Airedale NHS Kirklees NHS Kirklees NHS Leeds Y&H SCG YCN Y&H SHA WY Cardiovascular Network Manager

In attendance Amanda Britton Greg Fell Martin Pursey

NHS Wakefield District PH Lead NHS Bradford + Airedale NHS Calderdale

1. Apologies for Absence Rob Webster John Lawlor Simon Morritt Ailsa Claire

NHS Calderdale NHS Leeds NHS Bradford & Airedale Y&H SHA

2. Minutes from the meeting held 2 February 2011 Notes of the last meeting were agreed as a true and accurate record. 3. Matters Arising 3.1 Hyper Acute Stroke Services in West Yorkshire (Pump-priming through the best practice tariff) A consistent approach is required for the use of the best practice tariff. Action: PCTs to feedback to Matt Neligan on their approach to the use of the best practice tariff in relation to hyper acute stroke services in West Yorkshire 3.2 Familial Hypercholesterolaemia (FH) – (Implementing NICE guideline CG71) Action: To be discussed under matters arising at the April WYCOM meeting. Programme Office NHS Wakefield District Version 1.0 FINAL 1

4. Commissioning Development (Colin Mcilwain) The 3rd cohort of pathfinders is in progress – there are 17 across the Y&H region, with 74% of the population covered to-date. Information is due to be published soon on the clusters. The regional health transition leadership group is meeting this month. The Single Integrated Plans are due at the end of March. It is expected that the SHA will undergo further convergence over the next year: with a transition phase to the Commissioning Board formation. There will be a standard approach to PMS. GP engagement: PCTs need to assure the DH that they will deal with current performance/service delivery issues rather than hand these over to the newly formed clusters. Assurance: A paper detailing key questions relating to assurance will be published following the commissioning ‘stock-take’. Consortia self-assessment and diagnostic tool: Work is ongoing. Business capability review: Progress to be confirmed. DH transition assurance visit: this takes place on 13 May 2011 to review single integrated plans and QIPP plans. Think Tank event: Notes from this event have been circulated; guidance on Commissioning Support Units will be published. The structure of the Commissioning Board (CB) is to be confirmed; clusters could form the footprint for the CB. Social enterprises: no advice/guidance is currently available.

5. West Yorkshire resilience planning: WYCOM tracker (Matt Neligan) A summary of progress was given including outstanding amendments. An update will be provided to the group at each WYCOM meeting. Action: RAG ratings are to be reviewed at the April WYCOM meeting to ensure they reflect a true picture of each PCTs progress and action plans. Programme Office NHS Wakefield District Version 1.0 FINAL 2

6. WY Urgent Care: Re-procurement and ‘111’ service (Martin Pursey) The urgent care contract expires next year however it has been extended until March 2013. A timeline is to be developed for the re-procurement process and its links with the ‘111’ pilot service. A meeting with GP consortia is planned for 5th April 2011 to discuss issues. Action: Martin Pursey to update the group in April on the outcomes of the GP meeting. 7. SCG: Vascular review (Lisa Marriott) Details of the vascular services review: post consultation recommendations and implementation plan were given in paper 7; feedback was received from the national groups and also the overall feedback from the public was positive in relation to the centralisation of services. The recommendations have been supported by SCG. The proposal is to be taken further with local delivery being built into the plans. Action: Ann Ballarini to provide a progress report to WYCOM in April. 8. Atrial fibrillation and stroke prevention: Use of Dabigatran (Greg Fell) The West Yorkshire Cardiovascular Network commenced work regarding economic modelling for Dabigatran, the new anti-coagulant expected to be licensed in April/May 2011 for use in patients with Atrial Fibrillation. The prescribing cost (approx £900 per year per patient) of this drug is significantly more than current costs for prescribing and monitoring Warfarin and therefore the Network agreed to facilitate the modelling, clinical opinion and local discussion as to whether the introduction of this drug pre-NICE was viable. NICE guidance on the use of Dabigatran is not due to be published until the end of the year. The use of this drug will be for those patients currently on Warfarin but who are poorly controlled. Guidelines will also be given to GPs to ensure consistency in prescribing and prevent over use as Dabigatran is not an alternative treatment to Warfarin. The recommendations are supported subject to discussions with Primary Care leads.

9. AOB Mass casualty plans: (Action) Ben Fryer to provide an update at the April WYCOM meeting. Overall costs are to be addressed as YAS have already submitted at business case detailing costs in relation to transport requirements. Programme Office NHS Wakefield District Version 1.0 FINAL 3

Urgent care contract: The group agreed to fund the upgrade of the IT hardware (laptops) for the urgent care crews as previously discussed at WYCOM.

Please forward agenda items as soon as possible to: Deadline for receipt of papers: 29 March 2011 Next meeting: 6 April 2011 (12:00 – 14:30) Sandal Rugby Club, Wakefield

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