Agenda item
Future Commissioning intentions of Brent Clinical Commissioning Group
This report sets out the commissioning intentions of Brent Clinical Commissioning Group with regard to local primary care and acute service for the coming period.
Members of the Scrutiny Committee are invited to comment on the CCG’s commissioning intentions for 2015/16.
Minutes:
Sarah Mansuralli (Chief Operating Officer, Brent Clinical Commissioning Group) introduced the report on the commissioning intentions of the Brent Clinical Commissioning Group for 2015/16, which would contribute to achieving improved patient care and patient experience of care across community, secondary and acute health care services. The committee was informed that the commissioning intentions, set out in detail in the report, encompassed four key categories; working with acute providers to ensure that national performance standards were met; investing in out-of-hospital services with a focus on integration with other services and social care; working with partners and providers to reduce hospital admissions; and, proactive work to improve mental health provision for children and adults. It was explained that the intentions had been informed by significant engagement via the health partners forum, and community and voluntary groups. The commissioning intentions had also been discussed at the Brent Health and Wellbeing Board. It was emphasised that there had been no significant change between the commissioning intentions for 2014/15 and 2015/16.
Members’ attention was drawn to section three of the report which set out the evidence base underpinning the commissioning intentions. This drew specifically on the Joint Strategic Needs Assessment and the Brent Better Care Fund Plan. Highlighting key challenges that had been identified, Sarah Mansuralli noted that whilst Brent had a relatively young population, it was expected that the population of those aged 65 and above would grow more rapidly than the rest of the population generally. In addition, the Brent CCG medium term financial modelling indicated that the Brent CCG’s allocation would not keep pace with the predicted higher demand for services and population growth. The commissioning intentions and their successful delivery was therefore instrumental in ensuring that these challenges were met.
The committee raised several queries in the subsequent discussion. Members questioned the quality of engagement with community groups, emphasised the failure to meet national performance standards in the previous year, questioned what was being done differently to address these issues and sought specific timescales for achieving improvements. It was queried what action was being taken to raise awareness of dementia amongst different communities, including the provision of materials in a variety of languages. A member sought clarity regarding Brent CCG spending for 2014/15, noting that having accounted for commissioning for acute and community care there remained approximately a further £80m unaccounted for. A further query was raised regarding the 2014/15 spending on enhanced GP services and the work undertaken to evaluate their success.
Sarah Mansuralli advised that Brent CVS had been instrumental in supporting the CCG’s engagement with different communities and had helped community groups to organise workshops around the proposals. Addressing concerns around national performance standards, Rob Larkman (Accountable Officer) explained that significant investment had been made to support the North West London Hospitals Trust in achieving these standards and there was an agreement between commissioner and provider for those standards to be delivered in the current financial year. Sarah Mansuralli clarified that though the strategic focus of the commissioning intentions had not significantly changed from 2014/15, the detail of the proposals had been amended to reflect lessons learnt, including closer working with providers and earlier intervention to agree remedial action if required. With regard to the operational standard for Referral to Treatment (RTT), it was expected that the 18 week target would be met in the current year, following additional investment in the previous and current years. Trajectory for this target was being monitored, the results of which were awaited. In response to a query regarding access to GP appointments, Rob Larkman explained that though the CCG did not commission GP services, Brent CCG had been working with NHSE and had invested outside of the GP contract to create GP Hubs throughout the borough. Work was currently underway to achieve a co-commissioning arrangement with NHSE which would enable Brent CCG to have a greater input regarding GP services in the borough. It was clarified that the funds spent on enhanced GP services accounted for out of hours access to primary care and the provision of enhanced services within GP practices to ensure that patients did not have to be referred elsewhere. Addressing concerns regarding CCG spending for 2014/15, Sarah Mansuralli advised there were many areas outside of acute and community care for which the CCG provided funding including services for people with learning disabilities, continuing healthcare and carer support. The committee was subsequently referred to the report available on the Brent CCG website detailing the full approved budget for 2015/16. Turning to the question on dementia services, Sarah Mansuralli acknowledged that work regarding dementia had focussed on enabling earlier diagnosis which could improve quality of life for those affected and ensure the right care plans were put in place but it was agreed that a specific community focus could be beneficial.
Councillor Daly expressed the view that the committee had been given insufficient time to scrutinise the issue. The Chair advised that a task group report on health would be available in June 2015.
RESOLVED:
That an update be provided to a future meeting of the committee.
Supporting documents: