Agenda and minutes

The Chair welcomed those present to the meeting and noted apologies.

The Chair advised that the quoracy had not been satisfied in line with the Terms of Reference for the SCB. From a CCG perspective, this would involve operating in good faith outside of the Standing Orders which would involve onward notification via appropriate governance channels. From a Council perspective, it was noted that the required quoracy in respect of elected members had been achieved. 

The Strategic Commissioning Board:

Noted the information.

The Chair reported that the CCG and Council both have statutory responsibilities in relation to the declarations of interest as part of their respective governance arrangements.

It was reported that the CCG had a statutory requirement to keep, maintain and make publicly available a register of declarations of interest under Section 14O of the National Health Service Act 2006 (as inserted by Section 25 of the Health and Social Care Act 2012). The Local Authority has statutory responsibilities detailed as part of Sections 29 to 31 of the Localism Act 2011 and the Relevant Authorities (Disclosable Pecuniary Interests) Regulations 2012.

The Chair reminded the CCG and Council members of their obligation to declare any interest they may have on any issues arising from agenda items which might conflict with the business of the Strategic Commissioning Board. 

Declarations made by members of the Strategic Commissioning Board are listed in the CCG’s Register of Interests which is presented under this agenda and is also available from the CCG’s Corporate Office or via the CCG website.

•      Declarations of interest from today’s meeting

There were no declarations of interest raised.

•      Declarations of Interest from the previous meeting

There were no declarations of interest from the previous meeting raised.

The Strategic Commissioning Board:

Noted the published register of interests.

•      Minutes

The minutes of the Strategic Commissioning Board meeting held on 1 November 2021 were agreed as an accurate record.

•      Action Log

There were no updates in relation to the Action Log.

The Strategic Commissioning Board:

Approved the minutes of the meeting held on the 1 November 2021.

There were no public questions raised.

The Strategic Commissioning Board:

Noted the information.

The Chief Executive, Bury Council / Accountable Officer, NHS Bury CCG provided an update on the latest CCG and Council developments. He advised that Covid rates were approx. 400 per 100,000 people which had been the case for a number of weeks. The prevalence in over-60s was much lower, a result of the successful rollout of booster jabs which exceeded GM indicators. The Omicron variant was being discussed at the Gold meeting later in the week with regards to how it might affect transmission rates and the degree of severity.

With regards to urgent care, he advised that the system continued to be challenged and was currently at OPEL Level 3. Command structures and partnerships were working well, and action plans were in place for patients. Significant pressures were being seen in primary care and it was noted that the Winter Access Fund would facilitate face to face appointments, the majority of which would be on the extended working hours service, and that national policy changes would allow for some cases to be deprioritised in recognition of the resources required to rollout all boosters by the end of January. Members also noted pressures in nursing home workforce, particularly with recruitment and retention.

Two inquests had been held in recent weeks, that of Matthew Young and Nicola Lomax who had died in the Bury Care System, and Members recorded their deepest sympathies for the families. Lessons had been learned and improvement plans were being developed for services relating to mental health and eating disorders. 

The Strategic Commissioning Board:

Noted the update.

The Commissioning Programme Manager, NHS Bury CCG introduced John Calleary, Consultant Urologist at Northern Care Alliance (NCA) and together they presented a report regarding the reconfiguration of Secondary Care Urology Services. This followed a previous report to the Board where Members requested further information on the ‘end to end’ clinical pathway and opportunities for delivery of care in primary care and community-based services. This paper provided an update on the collaborative work being undertaken by the CCG with NCA and offered assurance to the Board that the concerns raised at the previous meeting were being addressed.

Members discussed and commended the paper, welcoming the opportunity for GPs to engage with secondary care pathways and the inclusion of patient voice in codesign of services.

The Strategic Commissioning Board:

1.   Received the update on the work undertaken to date.

2.   Noted that a further update on the work of the Development Group and pathway review/redesign will be provided in April 2022.

3.   Endorsed the NCA pan-locality delivery model for the secondary care aspect of the Urology pathway, into which the pre-secondary care locality pathway will align.

The Director of Adult Social Care and Community Commissioning, Bury Council presented the report which sought permission to disseminate a combined total of £552,981 of Workforce Recruitment and Retention Fund monies from the Department of Health and Social Care. This grant would address workforce capacity pressures this winter through recruitment and retention activity.

In response to Members’ questions, it was noted that the level of workers available for recruitment was unknown, but that recruitment had been successful previously with a similar approach on a smaller scale. It was noted that a White Paper on Adult Social Care had been issued last week which addressed workforce and that a report on this would be brought to a future meeting of either the SCB or Locality Board.

The Strategic Commissioning Board:

1.   Approved the request to disseminate the grant monies in line with Department of Health and Social Care Grant requirements.

2.   Approved for the Executive Director of Strategic Commissioning to be delegated authority to agree the dissemination of any future Workforce Support Grants, in line with grant conditions, provided to support care providers during the remainder of the pandemic to ensure strict timescales are met.

3.   Noted that a report on the recently released White Paper on Adult Social Care would be brought to a future meeting of either the SCB or Locality Board.

The Clinical Director, NHS Bury CCG presented the report which provided an update in respect to the Terms of Reference and membership of the Individual funding Request (IFR) Panel. It was noted that the only change was removal of the requirement for the Chair to be a GP.

The Strategic Commissioning Board:

Approved the revised Terms of Reference for the Individual Funding Request (IFR) Panel.

The Executive Director of Finance, Bury Council & NHS Bury CCG presented the report which provided an update on the current Bury locality system financial position in 2021/22 now that NHS allocations had been finalised, including a forecasted overspend. It was noted that this report gave an overview across the wider footprint area, including an update on work that is going through the Northern Care Alliance (NCA) Chief Finance Officers Group in respect of 2022/23 and an update on Greater Manchester (GM) work with regard to pooling and S75 agreements in 2022/23.

The Strategic Commissioning Board:

1.   Noted system partners financial position in 2021/22 and the reliance upon non recurrent measures and savings to achieve break even.

2.   Noted the current £1.9m overspend on the Integrated Care Fund at month 7.

3.   Noted the current Bury Integrated Care Fund, in the context of the changing NHS architecture and the work to continue locality reporting from April 2022.

4.   Noted the work across both the NCA footprint and GM with regard to locality budgets, pooling and section 75 arrangements in 2022/23 and the latest outputs of this work.

The Joint Executive Director of Strategic Commissioning, Bury Council & NHS Bury CCG presented the report which provided an overview of performance in the key areas of urgent, elective, cancer and children’s and adults’ mental health care along with an overview of the impact of the COVID-19 response to these areas as the locality moves through the COVID recovery phases.

Members discussed the report, in particular the high number of patients waiting 52+ weeks for elective care, pressures in urgent care and flows through A&E, and the potential new-build Urgent Treatment Centre (UTC) which had been expanded with a robust waiting area and several clinic rooms.

The Strategic Commissioning Board:

Receives this performance update, noting the areas of challenge and action being taken.

The Joint Executive Director of Strategic Commissioning, Bury Council & NHS Bury CCG presented the report regarding the activity and performance plan formulated by the CCG and submitted to the Greater Manchester Health and Social Care Partnership (GMHSCP) which combines submissions from all GM commissioners and providers into a single GM system-wide plan. It was noted that, owing to tight timescales, this had already been submitted and had been accepted.

The Strategic Commissioning Board:

1.   Received the updates relating to 2021-22 planning contained within this report.

2.   Granted retrospective authority to the Executive Director of Strategic Commissioning to approve the H2 plan.

The Chair summarised the main discussion points from today’s meeting and thanked members for their contributions.

The Strategic Commissioning Board:

Noted the information.