NHS England Board meeting, 26 May 2016
Highlights by Anne Gray, Knowledge Officer, Arden & GEM CSU
Highlights by Anne Gray, Knowledge Officer, Arden & GEM CSU
Papers available here. Video available here. Minutes available here.
Agenda
Item 1: Board meeting agenda
Item 2: Minutes of meeting held on 31 March 2016
Item 3: Chief Executive’s Report
Item 4: Sustainability and Transformation Plans – progress report
Item 5: Strategic Framework
Item 6: NHS England Corporate and NHS Performance report
Item 7: NHS England Finance Report
Item 8: NHS England Governance Manual Approval
Item 9: NHS England Complaints Policy Update
Item 10:Conflicts of Interest summary report
Item 11: Update on NHS Diabetes Prevention programme
Item 12 Healthy Workforce
Item 13a Audit and Risk assurance Committee - verbal
Item 13b Commissioning Committee Update
Item 13c Specialised Services Commissioning Committee Update
Item 13d Investment Committee Update
Highlights :
Item 4: Sustainability and Transformation Plans – progress report
Agenda
Item 1: Board meeting agenda
Item 2: Minutes of meeting held on 31 March 2016
Item 3: Chief Executive’s Report
Item 4: Sustainability and Transformation Plans – progress report
Item 5: Strategic Framework
Item 6: NHS England Corporate and NHS Performance report
Item 7: NHS England Finance Report
Item 8: NHS England Governance Manual Approval
Item 9: NHS England Complaints Policy Update
Item 10:Conflicts of Interest summary report
Item 11: Update on NHS Diabetes Prevention programme
Item 12 Healthy Workforce
Item 13a Audit and Risk assurance Committee - verbal
Item 13b Commissioning Committee Update
Item 13c Specialised Services Commissioning Committee Update
Item 13d Investment Committee Update
Highlights :
Item 4: Sustainability and Transformation Plans – progress report
- Common themes emerged from the conversations between the STP footprints and NHS England include
- everyone welcomed the STP programme,
- everyone is at different starting points, and therefore a pipeline approach is being used to provide support across the work.
- Workforce was a key issue in almost every footprint
- Important to stress the ‘both/and’ message – that each footprint needs to identify tangible actions to improve 2016/17 as part of their flight path to 2020/21, making clear that any plans for 2020/21 have to reverse engineer back to today.
- There are a lot of good initiatives, but few yet at the degree of scale and pace required.
- The calibre and collaborative nature of partnerships with Local Authorities in many areas was impressive. It will be important for organisations to “pool sovereignty” to support the collaborative nature of the work.
- The next checkpoint is 30 June 2016. Guidance has been sent out (2 page letter available here.)
- Ongoing support will include
- Workshops
- Sharing of example plans from footprints
- Support by regional and central teams with specific requests
- System leadership support via the Leadership Board.
- Peer support from each other through virtual and face-to-face events
- The Kings Fund is evaluating the STP process through four footprints using an action learning approach.
- During questions it was emphasised that there will be no ongoing central team, and all activity will be devolved to the footprints with the centre using the pipeline approach to support local planning.
- STP plans will not be published until approved locally and nationally, so publication will be staggered across the country.
- NHS England will have to redevelop its funding model around commissioning. A working group with Arms Length Bodies is developing enables.
- New care organisations will emerge from the process.
- “Forward View for Specialised Services: Strategic Framework” sets out the vision and key elements of a new strategic framework for specialised services in 2020 and the next steps in achieving ambitions for specialised services, including expectations of STP submissions on Specialised Service planning, local collaboration and national level support.
- More detail on implementation and commissioning intentions will be published in the autumn.
- This vision and approach signal a fundamentally new direction for specialised services over the next five years on a number of elements in particular
- Recognition that different service models will be required to meet national standards:
- Moving away from a ‘binary choice’ of national or local commissioning:
- Moving towards a plurality of provider models:
- Using the leadership and expertise of clinical reference groups (CRGs) to transform future patient outcomes:
- Moving from ‘transactional’ use of information to rewarding high quality care
- Step change in the adoption of new treatments
- The outline of how the Strategic Framework for specialised services fits in with the Five year Forward View:
- Better health – focussing on personalisation and reducing harm
- Better care – Relinking fragmented pathways to improve the outcomes for both patients and clinicians
- Better value – Improving the grip on budget and refocus on resources
- Strategic services will link to place based commissioning and the STPs through collaborative commissioning and use of the new provider footprints. National support will be through reconfiguration of the Clinical Reference Groups and improved information gathering and research around new treatments.
- NHS England is engaging with CCGs through NHS Clinical Commissioners (NHS CC) to develop the new approach to collaborative commissioning.
- NHS England is working on a collaborative commissioning structure and the prioritisation process through its Commissioning Intentions.
- The RightCare programme will have a role in work in the specialised services going forward.
- The increasing budget was flagged up as a risk.
- Final NHS England accounts show an underspend for 2015/16.
- Issues going forward into 2016/17 include the requirement of a risk reserve of 1% held by all NHS bodies, which means that the efficiency savings by commissioners must increase to 3%.
- Appendix 1 contains the proposed contents of the NHS England Governance Manual.
- The NHS England complaints policy requires redrafting, to account for changes within the complaint sign off process, which will be reflected in the Scheme of Delegation.
- Statutory guidance on managing conflicts of interest for CCGs was published in December 2014. Following consultation some adjustments will be made to the guidance and a final version published in June 2016. The revised guidance will be accompanied by a series of case studies and short summary guides.
- The Diabetes Prevention Programme is novel and is based on a shared commissioning model, with the behavioural intervention courses themselves being commissioned centrally by NHS England and made available free of cost to CCGs and local authorities. CCG and local authority partners then work with NHS England to identify the framework provider which best meets their local needs and enter into a MOU in relation to the volume of referrals that they will make into the programme.
- The first 10 contracts have been awarded (Leeds, Cumbria , Lincolnshire, Birmingham, East Midlands, Herefordshire , Berkshire, South London, East London and Durham). South, Central and West CSU has been appointed to provide a contract management function on behalf of the Programme.
- Following a successful OJEU procurement process there is now a national provider framework in place with 4 providers. The current Framework Agreement is for 3 years.
- NHS England is considering a national digital offer to upscale the programme and an OJEU notice has been published indicating that we may wish to take forward procurement of a digital diabetes prevention service.
- Plans are in place with the leadership teams of 12 organisations (including NHS England) to fully deliver the offer in 2016.
- A new Commissioning for Quality and Innovation (CQUIN) payment provides a direct financial incentive for Trusts to invest in the health and wellbeing of their staff for the first time
- RAND Europe will to develop and deliver a bespoke survey for the 12 pilot organisations and NHS England will shortly select a contractor for a wider evaluation of the programme.
- Priorities for 2016/16 include support for the implementation of a strong offer for NHS England staff.
- Approach undertaken by the CSU Transition Team to ensure each CSU has developed a robust and realistic 2016/17 business plan.
- “It was noted that the CSU transition programme will deliver a break even position for 2015/16, and that all six CSUs will be operating in a highly competitive environment in 2016/17 when CCGs will be required to use the Lead Procurement Framework. The Committee supported the recommendations by the CSU Transition Team to support the submission of the CSU business plans for 2016/17.”
- CCG Improvement and Assessment Framework, which went live on 1 April 2016, replacing both the CCG assurance framework and CCG performance dashboard.
- Progress on the five frameworks for strengthening patient and public participation in NHS England commissioning. The first framework, for Primary Care, is complete, with Specialised Commissioning to be finalised in June, followed by Health and Justice, Armed Forces and Public Health frameworks in autumn
- The Collaborative Commissioning programme has been re-established with much stronger CCG ownership and a focus on patient pathways. Ten Collaborative Commissioning Hubs are now established across the country. The programme is also working much more closely with the devolution team to align overall approach.
