Bulletin for proposed CCGs – Issue 22, 22 October 2012

Contents

• Welcome from Barbara Hakin
• CCG authorisation: Key dates agreed
• CCG authorisation: panel members agreed
• NHS Commissioning Assembly
• Service level agreements between CCGs and CSUs
• CCG configuration
• Update on arrangements for GP IT systems
• A new vision and strategy for nursing, midwifery and caregivers
• Clinical leaders webinar
• Learning disabilities guidance for CCGs
• Information governance
• Complaints handling resource pack
• NHS Property Services
• NHS Continuing Healthcare: Getting Ready for 2013
• National Learning Network for health and wellbeing boards

Welcome from Barbara Hakin

Welcome to this issue of the bulletin for emerging clinical commissioning groups – the regular opportunity for us to discuss the most up to date thinking and developments in the commissioning world.

I spoke to a number of you at my latest webinar last week. I hope it was useful for you to have an update about developments at the NHS Commissioning Board and the context in which we’re all working, along with the developments from our own team. Plus it’s always invaluable to hear which issues are most occupying your thoughts at any given time, so we’re able to respond accordingly. If you weren’t able to join the call, then you can listen to the conversation and see the slides on the CCG resources page.

One of the things I mentioned was the NHS CB’s approach to the operating model for primary care. The Operations Directorate are leading on this and will be gathering views from a wide range of stakeholders, including CCGs,  until the end of this month which will then be considered to determine the appropriate next steps. We will also be developing an overarching Strategy for Primary Care, which my directorate – Commissioning Development – will lead.

A number of you are also involved with the Commissioning Resources Steering Group which has recently had its first meeting (I always get a bit confused when I see the name ‘Resources’ as I think it’s about money – it isn’t, it’s about anything we publish or do which helps commissioning. So if anyone can think of a better collective noun than ‘Resources’ please let me know!). The group has been established to oversee the approach to, and prioritise the development of, an initial suite of NHS CB resources, tools and guidance. A small number of products have been proposed for publication before Christmas and we should have more news about this soon.

Meanwhile, as the preparation for CCG authorisation continues in earnest across the country, I’m pleased to be able to say that we have more information for you to make the process as clear as possible.

This month we have agreed and published the dates of all the key panel meetings and decision-making points for each application wave, plus the membership of those panels. We really do want the authorisation process to be as transparent as it can be, so we are keeping all CCGs up to date with their applications as they move from through evidence submission to the final outcomes. Final decision notification letters will be issued to CCGs shortly after each CCG Authorisation Sub-committee has reached its conclusions, and before being published online. I was at a panel meeting last week and found it really inspiring to hear about progress and feel the enthusiasm. Sir David said he felt the same when he attended.

The first moderation panel for wave 1 CCGs takes place tomorrow which really marks the start of the decision making process, but I think it’s important to remember that authorisation is not an end in itself. It is the start of an on-going developmental and assurance process to ensure that all CCGs are as good as they can be. Alongside the responsibility to provide support, the NHS CB also has a parallel duty to assure that CCGs are able to commission safely, use the their budgets responsibly, and exercise their functions to ensure high quality health services and better health outcomes for their populations.

The moderation panel will review all the evidence and recommend whether the CCG needs conditions and how many. Each application will proceed then to the conditions panel which will determine the nature of the conditions for any CCG not fully authorised. All this information will then go to the formal sub-committee of the NHS CB which will make the formal decisions.

Once the sub-committee has reported its decision, if CCGs have conditions, this should not be seen as a failure of the CCG, or of the process, but rather an indication of where we are at this point in time, and the comprehensive nature of authorisation. Each CCG has an opportunity to discharge its conditions prior to taking on its commissioning responsibilities in April 2013 and there will be a follow up review of conditions for all CCGs in March 2013 and quarterly thereafter.

Moving on, you’ll see in this issue that a number of the items in the bulletin aren’t just about the set up or authorisation of CCGs, but about the new roles and responsibilities that you as clinical commissioners will be taking on from next year. As we move closer to next April we are all becoming more occupied with ‘business as usual’ commissioning activities. I appreciate that many of you are currently continuing with your clinical work at the same time as taking on these new day to day responsibilities, as well as trying to establish CCGs which are the best they can be. I can’t overstate my appreciation for your continued hard work and commitment to make sure we deliver quality healthcare for our patients and populations, which is the most important thing.

I hope all clinical leaders will have received an invitation from Sir David Nicholson to attend the launch event of the new NHS Commissioning Assembly on 14 November. We’re working with a number of CCGs and managers from the NHS CB to make sure the day will be a really valuable opportunity to meet commissioning colleagues, discuss current issues and plan for the future . If you haven’t booked your place yet, please do so by 5 November, and I look forward to seeing you there.

Finally, I still get questions about pensions and tax where GPs are involved in CCG work. Could I remind you about the RSM Tenon document which is a comprehensive exposition of all the issues and with relevant advice. I will cover this ground in my next webinar so it would be great if you could let me know about any issues which still concern you. That way I can get the relevant advice before the webinar.

As always if you have any comments, questions or feedback about the commissioning development programme, please do get in touch via pathfinderlearningnetwork@nhs.net. And if you’re not on the mailing list to receive this bulletin, but would like to be, then just send an email to the same address.

Dame Barbara Hakin
National Director: Commissioning Development

CCG authorisation: Key dates agreed

Dates have been agreed for the key parts of the clinical commissioning group (CCG) authorisation process.

Meetings have now been set up for each wave of CCGs for:

• the moderation panel which reviews each waves’ results to ensure consistency and makes recommendations as to whether a CCG should be fully authorised or authorised with conditions;
• the conditions panel which considers what support is required where a CCG has not supplied sufficient evidence to meet a threshold for one or more authorisation criteria; and
• the CCG authorisation sub-committee which makes the authorisation decisions.

Meeting	Date
Wave 1
Wave 1 Moderation Panel	23/10/2012
Wave 1 Conditions Panel	02/11/2012
Wave 1 Sub-committee	05/12/2012
Wave 2
Wave 2 Moderation Panel 1	13/11/2012
Wave 2 Moderation Panel 2	26/11/2012
Wave 2 Conditions Panel 1.1	23/11/2012
Wave 2 Conditions Panel 1.2	03/12/2012
Wave 2 Conditions Panel 2.1	07/12/2012
Wave 2 Conditions Panel 2.2	10/12/2012
Wave 2 Sub-committee	18/01/2013
Wave 3
Wave 3 Moderation Panel 1	11/12/2012
Wave 3 Moderation Panel 2	07/01/2013
Wave 3 Conditions Panel 1.1	08/1/2013
Wave 3 Conditions Panel 1.2	11/01/2013
Wave 3 Conditions Panel 2.1	15/01/2013
Wave 3 Sub-committee	15/02/2013
Wave 4
Wave 4 Moderation Panel	28/01/2013
Wave 4 Conditions Panel 1	05/02/2013
Wave 4 Conditions Panel 2	08/02/2013
Wave 4 Sub-committee	06/03/2013

The full end-to-end process includes a flowchart identifying the points where CCGs will have the opportunity to submit any further evidence – where necessary – before their application is considered at the relevant NHS CB CCG authorisation sub-committee.

Although wave 1 CCGs will be able to identify all their individual dates and wave 4 CCGs will be able to see their moderation and sub-committee dates, this table does not show at which moderation and conditions panel individual CCGs in waves 2 and 3 will be considered, or at which conditions panel individual CCGs in wave 4 will be considered. The distribution of CCGs within these meetings is currently being agreed.

CCG authorisation: panel members agreed

The membership of the panels which make up the authorisation process (described above) have been agreed. They are:

Moderation panel

• Chair: Dame Barbara Hakin, National Director: Commissioning Development
• Ian Dalton, Chief Operating Officer (or a deputy)
• Paul Baumann, National Director: Finance
• John Bewick, Director, CCG Authorisation
• Sarah Pinto-Duschinsky, Head of Authorisation Process
• Louise Edwards, Head of Authorisation Content
• One clinical representative from the Clinical Commissioning Coalition

Conditions panel

• Chair: Ian Dalton, Chief Operating Officer
• Paul Baumann, National Director: Finance
• Richard Barker, Regional Director for the North
• Anne Rainsberry, Regional Director for London
• Paul Watson, Regional Director for Midlands and East
• Andrea Young, Regional Director for the South
• John Bewick, Director, CCG Authorisation
• Sarah Pinto-Duschinsky, Head of Authorisation Process

Authorisation sub-committee

• Chair: Lord Victor Adebowale, Non-Executive Director
• Naguib Kheraj, Non-Executive Director
• Ciaran Devane, Non-Executive Director
• Prof Bruce Keogh, National Medical Director or
• Jane Cummings, Chief Nursing Officer
• Ian Dalton, Chief Operating Officer
• Paul Baumann, Chief Finance Officer
• Dame Barbara Hakin, National Director: Commissioning Development

NHS Commissioning Assembly

All CCG clinical leads should have received their invitation to the NHS Commissioning Assembly launch event, to be held in Doncaster on 14 November.

The NHS Commissioning Assembly is a forum which brings together all the leaders with responsibility for NHS commissioning decisions in England from CCGs and the NHS CB. The launch event will provide a unique opportunity to meet others, get up to date with the latest developments across the country, and shape some of the important future areas in commissioning.

The deadline for booking is Monday 5 November, so please log on to the registration site shown in the email and book your place. You’ll also be able to choose your workshops and find out about local hotel accommodation.

If you haven’t received your invitation please email nhscb.communications@nhs.net. And if you’re on Twitter and would like to join the debate ahead of the event, please use #NHSAssembly.

Service level agreements between CCGs and CSUs

The NHS Commissioning Board (NHS CB) will provide CCGs with a template service level agreement (SLA) and guidance on how to complete SLAs for commissioning support services on its website this week.

In late September, the NHS CB asked CCGs and commissioning support units (CSUs) to ensure they are clear about what level of resource is available for commissioning support services, and finalise and agree the requirements, by the end of October 2012. This will involve CCGs specifying which CSUs they wish to use post-April 2013. The NHS CB has also asked CCGs and CSUs to agree and sign the SLAs by the end of November.

This will enable both CCGs and CSUs to finalise their staffing structures and recruit in line with the national HR transition process.

For an update on wider commissioning support developments, please take a look at the monthly commissioning support bulletin.

CCG configuration

Two proposed clinical commissioning groups (CCGs) in Birmingham (NHS Birmingham CrossCity and NHS NorthEast Birmingham) have made a pre-application change to their configuration to become NHS Birmingham CrossCity CCG.

The practices of NorthEast Birmingham CCG will become a locality of Birmingham CrossCity CCG and focus on supporting strategic delivery and local commissioning priorities. This move makes the combined CCG the fourth largest in the country in terms of population, with 117 GP practices looking after more than 730,000 people in the city.

As a result, the number of proposed CCGs in England has reduced from 212 to 211 and we will be updating the documents on the NHS Commissioning Board website shortly in line with this change.

Update on arrangements for GP IT systems

To date primary care trusts (PCTs) have led on the provision and support of GP IT systems. Therefore the safe transfer into the new commissioning system is highly important to ensure that GPs continue to have a choice of quality solutions which meet local needs.

The future operating arrangements for GP IT, to apply from 1 April 2013, are due to be published in the autumn.

GP IT services comprise of IT support services for GP practices as set out in GMS and   PMS contracts (and APMS contracts that specifically include these IT services) plus implementation and support for all appropriate nationally mandated systems.  They also include discretionary, locally determined IT support services. The NHS Commissioning Board (NHS CB) will be accountable for these services.

The NHS CB will continue to set overall direction, standards, strategy and budgets, such as the GP Systems of Choice (GPSoC) contract and maintaining national infrastructure. Clinical commissioning groups (CCGs) are best placed to plan the use of IT systems to support service delivery and service change to enable better patient care across local health communities. The NHS CB will therefore discharge its operational responsibilities for GP IT services by arranging for CCGs to provide these services locally on its behalf and by devolving associated funding to CCGs.

IT support for other primary care contractors will be incorporated into the NHS CB’s operating arrangements. The proposal is that the NHS CB, through its local area teams (LATs), will be the registration authority for all primary care contractors (administration of access to clinical and business systems) and will be responsible for clinical safety and assurance (adherence to dataset change notices).  We anticipate that LATs will arrange for commissioning support units or other IT providers to provide these services.

A new vision and strategy for nursing, midwifery and caregivers

Jane Cummings, the NHS CB’s Chief Nursing Officer is currently working with the nursing, care professions and stakeholders to develop a new vision and strategy.

Having completed some early work to create an outline framework for a strategy, she is now leading a national engagement process to build upon this and support the implementation phase.

A final document and work programme will be launched in December at the Chief Nursing Officer national conference, but before this Jane would like to receive feedback from as many relevant stakeholders as possible, including CCGs.

CCG Chairs are asked to work with their governing body nurse to ensure that engagement of relevant local professionals, stakeholders, patients and the public takes place across all social and health care settings.

We are particularly keen for feedback to include input from nursing homes and practice nurses.

The closing date for the vision and strategy feedback is Friday 16 November 2012. You can respond on the Nursing Vision page or by email to commissioningboard@nhs.net.

Meanwhile, CCG members are being invited to join a series of webinar sessions about developing a culture of compassionate care.

The NHS Commissioning Board is running the interactive, online webinars to discuss the new vision and strategy for nurses, midwives and caregivers, and its six key areas of focus.

The webinars are hosted by nursing leaders and involve debate and discussion around the vision and strategy. For more information about signing up visit the Nursing Vision webinars page.

Clinical leaders webinar

National Director: Commissioning Development Barbara Hakin has hosted the latest in her series of online webinars for clinical leaders.

The 45 minute session combined an overview of current progress within the commissioning development programme, how the work of her team sits within the wider context of the NHS Commissioning Board and an interactive question and answer session with participants. Questions were asked about the authorisation process, running costs allowances and agreements between CCGs and CSUs.

For those who weren’t able to attend, the slides and a recording of the audio from the session is now available on the CCG resources area.

Learning disabilities guidance for CCGs

Improving the Health and Wellbeing of People with Learning Disabilities: An Evidence-Based Guide for Clinical Commissioning Groups has been published on the Improving Health and Lives website:

The guide has been written to help CCGs:

• commission high quality, cost effective general and specialist health services for people with learning disabilities;
• jointly commission services for people who challenge services and those with complex needs; and
• work with health and wellbeing boards, local authorities and others to address the social factors which affect the health of people with learning disabilities.

For more information visit the CCG learning network.

Information governance

In the new commissioning system maintaining effective information governance (IG) will remain vital to safeguard the privacy and confidentiality of personal and confidential information. At the same time it is essential that information is shared appropriately when it is needed to provide care.

The Secretary of State for Health has asked Dame Fiona Caldicott to undertake a review of IG to consider the right balance between sharing and protecting patient and service user information. It is anticipated that the IG Review will report before the end of the current financial year.

Whilst the Review may recommend changes, until these are accepted and implemented, it is essential that all information processing is fully compliant with existing IG rules and legal obligations particularly in the context of Data Controllers and Data Processors.

All organisations, including CCGs, need to be aware of their obligations to ensure that information flows have a sound legal basis and ensure that they remain compliant with the law during transition.

If you require further information please contact:

Bill McAvoy, Interim Director of Intelligence, Patients and Information Directorate, NHS Commissioning Board billmcavoy@southcentral.nhs.uk; or

Carol Mitchell, Transition Head of Information Governance & Transparency, NHS Commissioning Board carol.mitchell5@nhs.net.

You can also refer to:

Frequently Asked Questions from the NIGB June 2012 Information Governance Workshops

Letter from DH / Information Commissioner’s Office

Complaints handling resource pack

The Parliamentary and Health Service Ombudsman is developing a resource pack for complaints handling which is designed to help CCGs and their member practices respond in the best possible way to complaints and ensure that the learning from complaints helps to improve quality.

The Ombudsman is asking for a few volunteer CCGs and practice managers to test the first draft and help them refine the resource pack.  If you would like to be involved please contact nicola.king@dh.gsi.gov.uk for more information.

NHS Property Services

NHS Property Services Ltd  – the new company set up by the Department of Health to develop and manage more than 3,500 NHS assets – is due to launch in April next year.

The new organisation is a private limited company wholly owned by the Secretary of State for Health. It will own the legal title to assets worth £5 billion (comprising estate, property and facilities) and will employ more than 3,000 staff across England.

Core functions will include strategic estates management, property management, operational estates management, facilities management and dedicated back office support.

As experts in healthcare infrastructure, NHS Property Services Ltd will support quality improvement, innovation, and efficiency, working closely with CCGs, the NHS Commissioning Board, the NHS Trust Development Authority and other partners.

NHS Property Services Ltd has now made key appointments and recently held its first Board meeting. For more information visit the Department of Health website.

NHS Continuing Healthcare: Getting Ready for 2013

NHS continuing healthcare (NHS CHC), NHS funded nursing care and personal health budgets is an area of £2bn spend and covers health and social care needs for very vulnerable people.

CCGs will be legally responsible from 1 April 2013 for undertaking this assessment process which is prescribed by the Department of Health, underpinned by legislation and must be consistently applied throughout England.

NHS North of England has prepared a set of slides as part of an overall briefing pack for CCGs.  The slides set out:

• An overview and why this is an issue for CCGs and CCG responsibilities
• An outline of the policy context
• An outline of what CCGs will inherit (individuals can ask for their cases to be looked at back to 2004)
• Whether there will be any policy changes after 2013
• Key performance issues (consistency in access is key to NHS CHC)
• What CCGs need to be able to deliver on NHS CHC from April2013
• Links to commissioning support, the NHS CB and local authorities

The work needed now to be legally compliant for April 2013

The pack also lists NHS CHC leads in each of the SHA areas.

National Learning Network for health and wellbeing boards, 8 November

CCG members are being invited to join the National Learning Network for health and wellbeing boards, Final Sharing Event in London on Thursday 8 November.

Online registration is now open via until 25 October.

The event is an opportunity to explore with other leaders, experts and colleagues how you can make a difference through your health and wellbeing board. Discussion and challenge sessions, facilitated by a range of experts, will develop your thinking and give you the opportunity to reflect on what you want to do differently with your board. The sessions will focus on the shared leadership action in three significant areas:

• achieving service integration
• improving health outcomes
• reducing health inequalities

As part of the day, there will be a session for CCGs to network, share and learn from colleagues. The session will be facilitated by Dr Jane Povey, Clinical Engagement Director, and Rachel Richards and will be open to all CCG members. There will also be an opportunity during the morning session to hear from Ivan Ellul, Director of Partnerships at the NHS Commissioning Board.

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