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Agenda Item: 16.19 Fr infrmatin Title f Reprt: Reprt Submitted by: Primary Care Cmmissining Reprt (September 2016/West Nrflk CCG) Andrea Patman Head f Cmmissining NHS England- Midlands and East -East Purpse: The reprt seeks t prvide the jint cmmittee with an verview f the key medical issues being managed by the NHS England Primary Care team fr the West Nrflk CCG area. Overview This is the secnd reprt submitted by the Primary Care Cmmissining team and utlines the key areas that the Primary Care Team are currently actively engaged in. The reprt als prvides details f General Practice Quality Issues t illustrate the nging wrk required by the primary care team in imprving quality

Part 1: Key Areas f Wrk General NHS England published its plans fr primary care GP Practice Frward View prviding investment in primary care fr infrastructure, wrkfrce and care redesign. The East team is reviewing the future cnfiguratin f the East Primary Care Team t deliver a mre efficient way f wrking and t deliver the required running cst efficiency targets thrugh nt replacing ne f the three Heads f Cmmissining rles fllwing the early retirement f the Head f Cmmissining fr the Central Lcality. A new structure is expected t be in place by end September 2016. Key areas f wrk in 2016/17 include: Prcurement f APMS cntracts where agreement is reached t re-prcure services fr time limited cntracts.(if applicable) The team supprt the evlving Jint Cmmissining arrangements in place with all CCGs acrss East. The team is develping an East wide and Lcality specific Wrk plan. Natinal Vulnerable practice pilt Prgramme Supprt t increase in Capacity fr the King s Lynn area East wide review f interpreting services fr primary care prviders East wide review f Alternative/Special allcatin services ( fr thse patients remved frm general practice due t vilent behaviur) Business as usual activity including QOF, Enhanced Services, relatinship management, merger requests, bundary change requests, issuing cntract variatin ntices, APMS cntract management and perfrmance. The NHSE Primary Care Team als cntinues t cntract manage Pharmacy, Dental and Optmetry cntracts and prcurement prjects within thse primary care specialties. Prpsed change t Terms f Reference There may be instances in the future when, due t the scheduling dates, that it s nt pssible t bring an applicatin fr say a list clsure r bundary change t the Jint Cmmissining meetings fr a decisin. There may be ther urgent items when a rapid decisin is required as well. Is the cmmittee happy fr a clause t be inserted int the Terms f Reference t allw virtual meetings t take place utside the nrmal schedule and the decisin reprted back at the next meeting? An exemplar clause frm anther JCC terms f reference is set ut belw but happy t adapt fr each CCG. Private meetings f the Cmmittee may be cnducted n a virtual basis thrugh the use f e-mail cmmunicatin if necessary. In such circumstances, minutes frm the virtual meeting will be presented t the next available meeting f the Cmmittee in public. Primary Care C-Cmmissining Jint Cmmittee Meeting in Public Sept 2016 Page 2 f 5

1.1 Medical Key Issues Mitigatins/Actins Details f GPFV Resilience Fund prgramme have been annunced recently, this replaces the Vulnerable Practices Fund. The details f this new scheme are at https://www.england.nhs.uk/urwrk/gpfv/resilience/ GP Frward View NHSE has als annunced a new GP indemnity supprt scheme designed t prvide a payment t practices t ffset the average indemnity inflatin. The scheme will initially run fr 2 years befre being reviewed. Full details can be fund at https://www.england.nhs.uk/urwrk/gpfv/gp-indemnity/ These payments are t cntractrs - practices - and it is fr practices t ensure these benefits are passed ne way r anther t all GPs wrking in the practice. Vulnerable Practices A letter has been sent t all NHS England lcal ffices setting ut the prpsal t identify and supprt vulnerable practices. There is an allcatin fr the East regin which will be utilised t supprt practices that meet a range f criteria. CQC Latest list fr CCG t be included here Great Massingham Surgery Gd A methdlgy which cnsiders safety, efficiency, wrkfrce, patient experience, rganisatinal issues and external influence is used t identify vulnerability. Funding is matched and practices will need t cntribute t match the NHS England cntributin either by funding r in kind ; if the latter this will be measured against criteria. NHS England has surced suppliers t undertake the diagnstics wrk, agree an actin plan and supprt needed with the practice. The Team cntinue t liaise with practices identified as requiring imprvement r in special measures t ensure that Actin Plans have been cmpleted and are being implemented effectively. AMS schemes & Patient allcatins The East wide Prgramme Management Bard is develping a wrk plan t ensure a cnsistent apprach is being taken t address cmmissining and mnitring f services such as these. A prject team has been set up t develp cmmissining plans acrss the system. A draft service specificatin was shared with prviders at a market event in mid August 2016. Primary Care C-Cmmissining Jint Cmmittee Meeting in Public Sept 2016 Page 3 f 5

Key Issues Mitigatins/Actins Practice specific issues Bughtn has been supprted t address issues highlighted by CQC Prcurements There are nne nging in West Nrflk currently Primary Care Services England (transfer frm Serc t Capita) Respnsibility fr primary care GP payments, supplies and deliveries, management f perfrmer list applicatins, recrds mvement and pharmacy applicatins transferred t Capita PCSE n 1 April 2016 under the natinal cntract framewrk. A number f ut f scpe services have transferred t NHS England, e.g. dental cntract payments and natinal system updates, GP rent reviews and phthalmic applicatins. NHS England (East) has met with representatives frm PCSE and NHS England Cntracts team t discuss the issues and cncerns raised by primary care prviders during transitin t PCSE. This cntinues t be mnitred clsely and nging cncerns escalated t the natinal team where apprpriate. Primary Care C-Cmmissining Jint Cmmittee Meeting in Public Sept 2016 Page 4 f 5

1.11 General Practice Quality Issues Medical Cntractual Issues N breach r remedial ntices have been issued t West Nrflk CCG Practices during this financial year. Mergers nne t reprt Cntractual Bundary changes nne t reprt 1.2 Pharmaceutical Services The Pharmaceutical Services Regulatins Cmmittee (PSRC) cntinues t meet mnthly t cnsider pharmacy applicatins and matters related t the NHS Pharmaceutical Regulatins. N Pharmacy breach ntices were issued t date. 1.3 Dental Services Primary Care C-Cmmissining Jint Cmmittee Meeting in Public Sept 2016 Page 5 f 5