Governing Body - Thursday 28 March 2019
Q. I am writing to request that an explanation of the future withdrawal of Minor Injuries facilities in Catterick Garrison is given to the public attending this meeting. I would like a definitive response as to where they should go, the impact of resultant delay, and, the likelihood of it being reinstated/incorporated into the new MOD/NHS facility.
Further I would like an explanation and reassurance regarding the removal of A&E facilities at The Friarage Hospital. Catterick Garrison has a very different demographic to other areas within the District and County - that uniqueness needs to be taken into account.
A.The CCG are experiencing significant financial challenges.As part of our planning for 19/20, we have reviewed all of the contracts to see where savings can be made that would least impact the majority of the population, in view that the availability of an urgent treatment centre (Whitby)or minor injuries unit, (FHN) services the majority of the population within reasonable travelling distance and the comparatively low level of activity and verygood 4 hour response targets and Whitby and the Friarage Hospital.The difficult decision was made to decommission this service having previously discussed this with the Local Medical Committee. We have carefully considered concerns raised particularly in consideration to rurality and accessand where the distance to travel to a minor injuries unit, A&E or urgent care centre is in excess of 25 miles. We are in discussion with practices to continue providing a minor injuries service in Reeth Surgery and Central Dales Practice.We acknowledge that our decision will cause inconvenience to some patients, but are assured that the alternative services are available and we will be providing information to practices to provide to patients, signposting to the alternative services available to them.The CCG continues to be investing in primary care and providing care closer to home as demonstrated by the investment in the support for the frail, elderly and practice based clinical community pharmacists for the next 3 years.We have designed posters covering all of the local areas to show where the services are provided, these have been shared with the practices.The likelihood of this service being reinstated and incorporated into the new MOD facility? A minor injuries unit is still included in our plans for the centre and we would be looking to incorporate that both for the military and civilian population.There is a poster being distributed to letterboxes about the urgent treatment centre and the what it can treat, this is being distributed by South Tees Hospitals.The Catterick Integrated Care Campus will be designed around the needs of the demographic of the area it will serve.
Governing Body - Thursday 24 January 2019
Q. Is the new Chief Officer, Amanda Bloor, aware of how poor the current Wheelchair Service is for service users? I have personal experience of poor service in the last 6 months, as have 2 people for whom I act as their advocate. In both cases the original decision by Blatchford's was overturned by my involvement. Another contact of mine who is the mother of an adult son with complex needs ( AS from Ingleby Greenhow), is funded by HRW CCG to go back to Rosscare in Leeds, who were the previous contracted provider in this area. In her case NRS Healthcare could not meet her son’s needs. Sadly I believe that these 4 examples that I know of, are the tip of a far larger iceberg.
What positive action will the HRW CCG take now to improve this second rate and underfunded service?
A. The Wheelchair Service is provided by NRS across all of North Yorkshire and Amanda Bloor our new AO is very aware of the current issues, as she is also AO at Harrogate and Rural District CCG. HRW CCG are working with the other North Yorkshire commissioners, via the partnership board to improve this service. We are currently undertaking an audit of all complaints and concerns and will meet with NRS to discuss how the emerging themes will be addressed and an action plan produced. We have also encouraged VoY CCG as lead commissioner to re-instate the service user group to ensure they have the opportunity to discuss concerns with the commissioners.
Governing Body - Thursday 22 November 2018
Q. Is the Governing Body aware of the concerns that I have, as a wheelchair user, about the quality of the current privatised wheelchair assessment service provided by Blatchfords? An FOI request made by me established that spend on the new wheelchair service contract is 32% down when compared with the old contract. Inevitably, fewer wheelchairs and powerchairs are being prescribed. In addition, despite assurances to the contrary, made prior to the award of the new contract, the wheelchair services Scarborough office at Spring Hill no longer does assessments, requiring newly disabled people to travel to Northallerton or York. Finally, the wheelchairs services forum, previously facilitated by Vale of York, on behalf of the 4 CCGs involved, has ceased. What was identified in 2014/15 by NHS Improving Quality as an under-performing service, has just got worse. I would like the Governing Body to consider an audit of the service as the KPIs do not tell the whole story.
A. Charles advised that the CCG were aware of the above concerns and Gill Collinson, Chief Nurse and her team were currently working with Vale of York on a new more robust Governance Structure for management of this service.
Governing Body - Thursday 27 September 2018
No questions submitted.
Governing Body - Thursday 26 July 2018
No questions submitted.
Governing Body - Thursday 24 May 2018
No questions submitted.
Extraordinary Governing Body - Thursday 22 March 2018
Q. Could the CCG please tell me what the implications of the £6.7m deficit will have on existing or future services for Whitby and also the impact on the proposals for Whitby Hospital?
A. Bernard advised the CCG were still progressing with the development of the full business case for Whitby Hospital and the deficit should not impact on this process.
Governing Body - Thursday 22 March 2018
Q. On 28 February the Guardian paper reported that GPs are to be paid, by the CCG, for not referring patients to hospital. I know, it sounds preposterous but I would be grateful if you would clarify this in writing so that I can stop the worry.
A. Charles noted he strongly refuted any rumours that the CCG paid GPs not to refer patients for hospital opinions or investigations. This does not help the CCG with the issue that more patients are referred for further care than the CCG is funded for by the NHS. The CCG has worked with local residents through multiple public meetings and one to one conversations held across the patch including Patient Congress meetings, market day stands, local shows or organisations such as the WI. This has led to multiple strands of work that come under our banner of “Fit for the Future”. The focus for this work provides care as close to home as possible, that is as cost effective as possible. Examples of where GPs provide an alternative cost
effective service to hospital based services include deep vein thrombosis management, treatment of acute retention of urine, provision of 24-hour ECGs, the nursing workforce projects and the frailty service. The CCG is proud of this work so far and will continue to work with residents and GPs to continue to develop local services that support the development and resilience of general practices, whilst providing these services in the communities where people live. The CCG is looking at alternative ways of making referring more cost effective.
Q. Against the background of recent revelations about the actions of Facebook in relation to the release of data about US users of their software, via another party, to Cambridge Analytica, which, it is presumed, would be in clear breach of current legislation concerning the use of data were it to have occurred for UK citizens under current legislation notwithstanding the enhanced legislation which is being adopted in the UK in May 2018 under the General Data Protection Regulation (GDPR), I wonder if the CCG has any concerns about Facebook being a fit and proper organisation and whether or not it has already, or will be reviewing its' use of the Facebook software in the very near future? Further, has the CCG approached NHS Digital, or
has NHS Digital approached the CCG about the use of Facebook and has any advice from NHS Digital been provided? If so what is that advice?
A. Bernard Chalk advised that as yet no advice had been published by NHS Digital re the use of Facebook
however, it should be noted that the information was reported to have been gathered via the use of a personal quiz app. It has therefore been recommended that the CCG continues to be cautious in respect of how it uses Facebook and does not use Facebook as a way to collect service user or others information.”
Q. Why does Catterick Garrison not have hospital facilities when it is the largest Army base in Europe? In the past there has been a hospital since the First World War, which not only treated Forces personnel but civilians as well. Many people living in and around Catterick, especially the Lower Dales area, have to travel many miles to the nearest hospital, which is unacceptable, especially for A&E services. It seems to me that anything North of the Watford Gap means we are disregarded and not only in the lack of hospitals.
A. Janet Probert noted that the CCG understood the challenge that travel and transport posed to the rural population and were working hard to deliver our vision of care as close to home as is possible to mitigate this challenge. We also know that the population of Catterick is significantly different to the majority of the Hambleton, Richmondshire and Whitby area with considerably greater numbers of younger people and children. This population is expanding and will grow even further during the next decade due to the Army 2020 rebasing exercise.
CCGs commission outcomes and services from health care providers and would not therefore commission ‘hospital facilities’. However, in response to the issues that we know are facing the Catterick and surrounding health economy, we are working with our Ministry of Defence partners to establish a ‘Catterick Integrated Care Campus’. The vision for the ‘Catterick Integrated Care Campus’ would see a fully integrated health and care site that would be inclusive of diagnostic facilities and minor injury and ailment alongside primary health and care facilities and would provide a major new health and care facility for the population of Richmondshire. We are already developing these plans and are working to a current site opening date of December 2021.
Governing Body - Thursday 25 January 2018
Q. Could the CCG please provide an answer to B Forbes’s letter printed in the Darlington and Stockton Times on 12 January 2018?
A. Gill Collinson noted that the CCG had been actively involved in the public engagement led by South Tees Hospitals NHS FT. Earlier this year the Trust advised the CCG of significant workforce issues which have led to challenges in service provision – particularly involving anaesthetics and other interdependent services. The challenges have also been presented to the North Yorkshire Scrutiny of Health Committee and other local committees including district councils. Where there is a need for significant service change, a public consultation will need to take place. It is not yet clear whether this will be required. The CCG is not accountable to the Scrutiny of Health Committee as suggested in Mr Forbes’s letter, however we are statutorily required to present any proposed service change to the Committee in order for them to scrutinise the process.
Q. What happened to the STP Review which I believe was held in November 2017, but I have not seen anything published.
A. There has been a lot of information by the public and clinicians regarding the approach to the Better Health Programme and a good analysis of the way forward. We hope further information will be available in the next month or 2 and an update will be brought to a future Governing Body meeting.
Q. We are assured that the CCG are still committed to the Whitby Hospital redevelopment and that the Chief Executive has written to ask for the funding to be made available. Our first question therefore is still ‘what can we do to help’?
A. George Campbell advised that just before Christmas the CCG were informed that there would be a delay in the release of the capital for the project. George also noted there are always hiccups/delays with large projects. It was noted that the public would be notified only if there was to be a significant delay. All local GP practices, North Yorkshire County Council and the local MP were informed before Christmas. George advised that any member of the public can communicate with their local MP.
Q. Will you send us copies of the minutes of your meetings? This will help communication and allay conspiracy theories.
A. George Campbell noted that all Governing Body minutes were available on the CCG website. Due to a decrease in admin support the CCG is unable to send minutes out to individual groups.
Q. It was suggested recently that one of the criteria by which CCG’s will be judged in the future will be their success or otherwise in communicating with stakeholders and the public. Is this true and if so, how will this be assessed?
A. George Campbell advised that an assessment is being undertaken this year, but the findings will not be published. This is to ensure that the methodology is correct. Gill Collinson noted that the preliminary report was mostly taken from the CCG website and she has had conversations with NHS England about the process.