"Letter Pf Reference Corporate Finance"
Paper I Professional Executive Committee Tuesday 10th July 2007 1pm – 3pm Board room, Thornbury Health Centre MINUTES Present Dr Nicola Burbidge - Chair NB Sue Jeffers SJ Luke O’Byrne L’OB Hardevinder Gorae HG Matt Greenwood MG Dr Talac Mahmud TM Helen Smith HS John James JM Dugald Miller DM Sharon Daye SD Pauline Fahy PF In Attendances Alison Baker AB Sharon Sue Evans SE Neetu Kaushal (minutes) NK Farid Fouladinejad FF Apologies Nikki Hill 1. Apologies As above 2. Minutes from Previous meeting For accuracy – Page 7 under the Re-configuration of Paper I PEC it should say : There would be no representation from organisations and professions on the re-configuration of PEC. 2.1 Matter Arising IVF Tracey Warrener has spoken to Hammersmith Hospital and they have agreed to support the PCT. Diabetes SJ updated the committee that Dr G Williams will be meeting Raj Kaushal to discuss diabetes. SPMS Procurement Update SJ informed PEC that the papers are with lawyers and it is hoped that Greenbrook will be signing the contract on 1st August 2007, with an intended start date of 1st September 2007. Unscheduled Care L’OB updated the committee on unscheduled care, and questioned the Out of Hours plan. SJ informed the committee that the A&E utilisation review is due to report shortly and that the current diversion scheme is likely to be changed a ‘See and Sort’ 24/7. The Chair noted that the PCT needs to clarify their position with regards to payments for patient care when diverted from A&E. If there is a change GPs would need due notice as it would affect the practices’ business plans. PF suggested to PEC that re-routing patients from A&E after surgery has finished to Harmoni out of hours for 3 months until the A&E utilisation plan comes into place. PEC recommended a letter to be sent out to all GPs to inform them of this and they should also be informed that an A&E Utilisation review is taking place. SJ is to take PEC’s recommendations to the Project Paper I Management Office (PMO) Action: SJ Smart Card update SJ updated the committee that Adam Wickings has met with Ealing PCT and they have agreed to issue smart cards on behalf of the Hounslow PCT. This will start from July until early November. Ealing PCT will clear the backlog by visiting each practice. PEC requested for this item to come back to PEC in October, to check on progress. Clinical Priority Setting Panel SJ updated the committee and informed the committee that the Clinical Priority Setting Panel is now called the Exceptional Circumstances Panel. This group has met to discuss policies and they are currently working on an overall framework and cosmetic surgery policy. These policies would need to come to October PEC and then go to the Board. It was also suggested that these policies should go to the Clinical Reference group. SLA Update The Chair of the committee updated the committee and told them that Hounslow PCT has met WMUH and issues have been discussed regarding the SLA. The Chief Executive has sent a letter out to WMUH regarding further discussion. PF thought it would be helpful for the committee to know about the overspend. The committee carried out further discussion regarding Rehabilitation beds. The committee was informed that the PCT have commissioned 16 Paper I rehabilitation beds; however WMUH have been using 22 beds. SD queried if there is a Clinical protocol in place for patients being moved from A&E to MAU. SJ informed the committee that David Quigley will be responding to this. 3. Commissioning, Corporate, Finance and Performance matters 3.1 Finance Report The Chair of the committee informed the committee that the PCT is already £900k overspent by the end of month 2. SJ informed the committee that £800k of this overspend is at WMUH, all other budget lines are in balance. 3.2 Commissioning Strategic Plan The Chair welcomed Farid Fouladinejad to the committee. FF went through the Commissioning Strategic plan and told the committee that the SHA is doing a review of all PCTs, and has asked all PCTs to submit a 5 year Commissioning Strategic Plan. This would address gaps and hopefully provide an equitable provision of healthcare. The initiatives for Hounslow’s plan are: • Unscheduled care – A&E • Planned care – reducing the number of outpatients, providing the service closer to home • Maternity services • Sustaining financial balance • Long term conditions The next steps are: FF explained that between now and October the PCT will be going through all the feedback, to achieve this Paper I FF will be running workshops/stakeholders event. FF is also looking at running a workshop for patients. TM suggested that the Commissioning Strategic plan should be passed on to the PBC consortium. SJ suggested inviting members of the PBC Consortium to the stakeholders’ event on 18th July 2007. FF informed committee that a survey is being carried out and it will be sent to patients. He also informed the committee that he is engaging with local press. 4 Items for Discussion 4.1 PEC Restructure NB went through the draft terms of reference of the PEC and the job descriptions of PEC chair and clinician line by line. The re-typed paper will be submitted to the August Board. Human Resources will prepare a separate paper for remuneration of PEC clinicians. 4.2 Provider Services L’OB introduced his paper, and PEC noted. 4.3 Physio Practitioner A&E Sue Evans, Head of Physiotherapy introduced this paper to PEC. The bid for this paper is to employ an additional whole time Physio to provide a 52 week service. The service that is currently being provided is a 42 week service, and there are still a number of patients who are not being seen. Initial savings are still to be made. Majority of the patients that are being seen are not coming through A&E. There was an issue concerning Extended Scope Physiotherapist not having direct access to x-rays as yet. This needs to be negotiated with WMUH. PEC endorsed the clinical pathway proposed. It Paper I appeared to be a cost effective and they endorsed the Chief Executive’s approach of taking it to the Project Management Office for assessment. 5. Standing Items Practice Based Commissioning Update Hounslow/Heston/Feltham Consortium: TM told the committee that a ballot is being held currently to decide whether members of the consortium wish to be in a PBC Consortium. The result of this ballot would be available on Monday 16th July. TM also informed the committee that he is working on Anti-Coagulant care pathway. BCI Consortium: They met on Friday 13th July to discuss whether or not to take their budget. They have care pathway plans in gestation for dermatology, ophthalmology and diabetes. The musculoskeletal pathway started on 1st July. There is a prescription incentive scheme for approval by panel. 18 Week Target The next clinician to clinician forum will be focusing on the 18 week target, on Wednesday 22nd August 2007. It transpired that this overlapped with work Action: being done by DQ and TM. The PEC Chair advised TM/DQ/ NB collaborative working. PALS Report PF introduced this paper on behalf of Julie Fuller. The paper review and reconfigures the PALS team. PF would like PEC to endorse the paper. PEC endorsed the paper on direction of travel. 6 Minutes from other committees The Clinical Reference Group PEC noted. 7. A.O.B Paper I None 8. Date and time of next meeting Tuesday 14th August 2007 1.00pm – 3.00pm Board room, Thornbury Health centre