Agenda item

To receive a report from Leicester City CCG on their submission of a formal expression of interest to NHS England to undertake co-commissioning of primary care services.

Leicester City CCG submitted a report on their submission of a formal expression of interest to NHS England to undertake co-commissioning of primary care services.  Sue Lock, Chief Operating Officer, Leicester City Clinical Commissioning Group, attended the meeting to present the report.

It was noted that:-

·         The CCG had submitted an expression of interest following an announcement that CCGs would be allowed to request the ability to co-commission primary care services with NHS England to provide greater leverage over local health systems and act as an enabler for delivering integrated care outside of hospitals.

·         The CCG had received initial feedback that that their expression of interest was acceptable.  Since submitting the expression of interest, a further announcement was made indicating that the NHS Area Teams were being re-structured, and whilst it was not clear how this would impact upon co-commissioning, it was possible that all CCGs could now be given co-commissioning responsibilities by April 2015.  It was expected that NHS England would issue Guidance in the near future.

Following comments and questions from Members, the Chief Operating Officer stated:-

·         There were benefits to patients in the arrangements for co-commissioning as:-

o   The CCG worked closely with GP practices on a geographical basis and understood the local pressures and issues facing both patients and GPs, and it would be possible to build up specific local plans to improve services.

o   There was an opportunity for the CCG to influence Key Performance Indicators for GPs performance in delivering services and to add elements of local sensitivity to the contracts.  For example, GP practices in the west of the City could have an emphasis on smoking cessation whilst practices in the east of the City could have more focus on dementia screening to reflect the different needs on pressures in the two areas.  This could have benefits in reducing health inequalities across the City through local decision making and improving health outcomes for patients.

·         There was unlikely to be any additional resources either in workforce or finance and, whilst the CCG already carried out regular visits to GP practices, the skills required for contract negotiation were different to the existing skills used to support and influence GPs.  Although some staff had contract skills, this would nevertheless present a challenge to implement successfully.

·         The staffing levels in the three CCGs for Leicester, Leicestershire and Rutland were less than those previously employed in the previous primary care trusts, so capacity could also be an issue that needed to be managed.

·         The CCG used the Director of Public Health’s Annual Report to identify areas of health pressures and local health needs.  The protective characteristics were also taken into account and embedded into service delivery as everyone needed access to services irrespective of personal circumstances.

·         The CCG worked closely with the Director of Public Health and public health staff in relation to a number of health issues and data collection.   Having co-commissioning at the local level rather than at the higher NHS England Area Team level should result in more responsive services to local needs.

The Chair commented upon his and the Vice-Chair’s recent meeting with the Leicester City CCG Board which had been beneficial in establishing the relationship between the Council’s scrutiny function and the CCG and defining definite pathways for the future on governance.

RESOLVED:-

That the update report be received and that a further report be submitted to the Commission’s meeting in December outlining the details for the implementation co-commissioning.