To receive a presentation on the work of the National Commissioning Board, Arden, Herefordshire and Worcestershire.

The Committee received a presentation from Lesley Murphy, Area Director, Arden Herefordshire and Worcestershire, National Commissioning Board.  During her presentation, Ms Murphy highlighted the following areas:

•        That the Board’s role was to ensure that the NHS delivered better outcomes for patients within its available resources.  Sir David Nicholson had been appointed as Chief Executive, and would manage five regional teams which would, in turn, oversee twenty seven local teams across the country. The West Mercia PCT would cease to exist on the 31 March.

•        The Arden, Hereford & Worcester Area Team Structure.

•        The Staffordshire Commissioning Support Service.  The Service would provide support functions to the HCCG, with costs to be covered within the £25 per head running cost requirement.  The details of the agreement were currently included in a series of service specifications within a Memorandum of Understanding.  Contracts would be in place before the 1 April 2013.

•        That there were other NHS bodies that were being created.  These included the NHS Trust Development Authority (NHS TDA) which would, from 1 April 2013 provide governance and accountability for NHS Trusts in England, and would ensure the delivery of Foundation status for those Trusts. Health Education England would be the new national leadership organisation responsible for ensuring that education, training and workforce development supported public health and patient outcomes.

In the ensuing discussion, the following points were raised:

In reply to a Member, the Chief Officer of the Herefordshire Clinical Commissioning Group (HCCG) said that GPs who were involved in the governance of the HCCG had all negotiated cover in their practices, and patients would not be unattended.  As Chairman, Dr Watts spent two days with the HCCG and the rest of the week as working GP. Other GPs leading specific pieces of work for the HCCG had their time backfilled whilst they were involved with the Group.

In reply to a further question, the Area Director went on to say that, in change of this nature, there was always an on-going bedding down process.  Pressure was being kept on the system to ensure quality and performance.  There was a Quality Systems Group that included the Care Quality Commission and patients, and their work would be incorporated into the new structure to help ensure that there was on going confidence that lessons would continue to be learnt.  Concerns regarding incidents could be picked up from local staff and driven through the system, which had been set up to be more appropriate to local patients.

That there were mechanisms in place to help ensure the wellbeing of staff, and that all staff should be aware of where they would be placed by the end of December 2012.  Whilst some staff were being moved to different parts of the organisation, every member of staff who was without a post was receiving support.  This was a dwindling pool of individuals, as more staff found jobs.

In reply to a further question, the Area Director said that joining a number of PCTs up, each with different IT systems, was a challenge which was being addressed.  Chief Officer (HCCG), said that a decision had been made that all practices would have the same IT systems. District nurses and the Wye Valley NHS Trust had been consulted on the matter. Consideration was also being given as to how the Sentinel system, currently being used by Worcestershire, could be brought to Herefordshire.  It was likely that the Sentinel system would be in place by the summer.

In reply to a question regarding how the National Commissioning Board would work with the Council to deliver public health, the Area Director said that two senior staff had been appointed to lead on public health commissioning.  There would be clarity as to how this would dovetail with the Council and the Health and Wellbeing Board within a month or so.

A Member asked what the risks where concerning the HCCG authorisation process.  The Area Director replied that the Area Team would work with the HCCG in order to ensure that there was a system in place for both financial and leadership processes. There could also be financial support available to facilitate changes in the financial and quality arenas.