Agenda item

Clinical Commissioning Group Update

The Select Committee will receive an update from the Clinical Commissioning Group (CCG) on current issues.

Minutes:

Tracey Cox, Chief Officer, CCG addressed the Select Committee. A copy of the update can be found on their Minute Book and as an online appendix to these minutes, a summary of the update is set out below.

 

A&E performance

 

In October 89.9 per cent of patients were seen in A&E within four hours against a national target of 95 per cent.  We continue to work closely with the Royal United Hospital to help coordinate a whole-system response to manage pressure on services and drive up four hour waiting time performance. The CCG is making sure that primary care and community services are operating as effectively as they can, so that patients can be cared for out of hospital wherever possible. 

 

A number of initiatives are being introduced to help reduce the pressure on hospitals. Home First enables patients who no longer need hospital care, but might need a bit of extra support, to go home as soon as possible. Once at home, the patient is met by a therapist and reablement workers who immediately provide a detailed assessment and organise support for up to six weeks to help the patient regain the skills and confidence to live at home independently – rather than stay in hospital. 

 

Home First is being extended so it accepts referrals at weekends, in addition to Monday to Friday. We are also funding additional appointments at GP practices from January to March 2018 to help divert patients away from A&E and expanding our Early Home Visiting Service across all our practices. 

 

She added that the NHS was due to be given £350m from the Autumn Budget as additional winter funding.

 

Integration of health and social care services

 

Plans to improve existing joint working arrangements between the CCG and Council have been approved at the Council’s Cabinet (8 November) and CCG Board (9 November). 

 

The focus on further integration is also in response to the changing needs of the local population, challenging budgets and to ensure services are sustainable in the longer term. By joining up the delivery of services, more of the local health and care budgets can be pooled and commissioners will be able to plan and deliver services for local people more effectively.

 

Plans to restrict access to three non-urgent services

 

We have begun engaging with the public on proposals to restrict access to fertility treatment, vasectomies and female sterilisations. In June we announced publicly that, like many NHS organisations across the UK, BaNES CCG is facing unprecedented financial pressures. We also signalled that we would need to make difficult decisions about the best way to fairly distribute NHS resources in B&NES.

We are proposing to remove NHS funding for vasectomies and female sterilisations in all but exceptional circumstances.

We are also proposing to continue providing one cycle of IVF for individuals who qualify for NHS-funded fertility treatment, but that to qualify, women need to be aged under 35 years, men under 55 years and couples need to have been trying for a baby for at least two years.

As with vasectomies and sterilisations, the CCG will still consider funding IVF treatment for people who do not meet these criteria but for whom there are exceptional circumstances.

The consultation is open until 27 December to allow as many people as possible to give their views on the proposals. The CCG is particularly interested in hearing from anyone who would be affected directly by the proposals, including health professionals, any suggestions people have about additional and/or alternative proposals to consider.

Tamsin May, Head of Communications, CCG added that street surveys were also planned to take place in Keynsham on Tuesday 5th December and in Bath on Thursday 7th December.

 

Councillor Eleanor Jackson commented that she would be happy to deliver copies of the survey to members of the public in Radstock / Midsomer Norton via her weekly local surgery.

 

She added that the Labour Group would also be writing a considered response to the proposals to restrict access to the three non-urgent services mentioned. She asked if there was a definition of exceptional circumstances and if social pressure would also be taken into account.

 

Tracey Cox replied that current figures show a decline in the number of vasectomies and the figures for female sterilisation are already low. She said that any requests for these procedures would be judged by a Clinical Panel.

 

Councillor Eleanor Jackson said that she was concerned at the time it takes on occasion to carry out care assessments prior to patients being discharged from hospital.

 

Tracey Cox replied that there has been a huge focus this year on delayed transfers of care which has included the formation of an Action Plan. She added that the CCG have also commissioned a number of discharge to assess beds in the new care home situated in the Chocolate Quarter, Keynsham.

 

Councillor Lin Patterson asked if they were aware of the possible legal action against the Secretary of State for Health regarding the moving of Health & Social Care to a USA model.

 

Tracey Cox replied that she was aware of a challenge to the Accountable Care System being non-compliant with the Health & Social Care Act. She added that as far as she was aware there was no assumption that patients will have to pay for care.

 

Councillor Tim Ball said that he felt that the consultation survey relating to the three non-urgent services was misleading and proposed that it be amended. He stated that potential patients on benefits would not be able to afford these procedures.

 

Tracey Cox thanked him for his feedback and assured him that a comprehensive consultation process will be carried out and that an Impact Assessment will be completed prior to a decision being made.

 

Tamsin May added that the consultation had been tested through patient user groups and that other mechanisms, such as the street surveys will be carried out. She added that a colleague was meeting a community group in Foxhill this morning to discuss the proposals.

 

Councillor Tim Ball commented with regard to patients being fit for surgery. He suggested that patients returning in short succession for similar operations and having already been through the six-week programme of physiotherapy and physical exercise and maintained it, might not need to be asked to go through it again. He said this could therefore save time and money.

 

The Chair thanked Tracey Cox and Tamsin May for the update on behalf of the Select Committee.