Deepdive presentation to the NHS Eastern Cheshire CCG on identified risk around Primary Care delegated commissioning responsibilities

1. Deep Dive GBAF 20 Risk:
Delegated Commissioning of Primary Care
(General Medical)
Neil Evans
Turnaround Director/Commissioning Director
26 October 2016

2. The handover of commissioning responsibility from
NHS England to NHS Eastern Cheshire CCG
• CCG commenced as a delegated commissioner of Primary Care in April 2016
(having joint commissioned in 2015-16)
• CCG has recruited to two additional posts to the Core Team:
• Primary Care Commissioning Manager
• Primary Care Support Manager (Part Time)
• Additional Finance Post (Part Time)
• In addition to:
• Contract Manager (Part Time), Finance Team Support, Business Analysts,
Transformation and Clinical
• A transition plan was developed jointly with NHS England with a gradual
handover of activities:
• Contract Management (GMS, Enhanced Services and Caring Together)
• The majority of payments are under the direct governance of the CCG
(within budget year to date)
• Both parties share information on any issues with EC CCG making all
commissioning decisions

3. Governance
• Primary Care Committee established and Terms of Reference Approved by
the CCG Governing Body:
• Primary Care Operational Group (PCOG) established with
representation from the CCG and NHS England. Terms of Reference
are in place outlining the scope and delegated decision making for
management of operational matters
• Where decisions need to be made between Primary Care Committee
meetings that fall outside of the delegated authority of PCOG virtual
meetings are held by email e.g. Practice list closure requests
• The Clinical Quality and Performance Meeting now has a standing item to
monitor Primary Care (General Medical) quality
• GBAF 6 is in place to monitor the CCG effectiveness in managing conflicts
of interest and effective governance processes are in place
• Performance and Quality Monitoring in place:
• All Practices monitored by CQC as Good or Outstanding

4. • Delivering GP Five Year Forward View plans
• Complete implementation of “commissioning handover”:
• Contract Management (GMS, Enhanced Services and Caring Together)
• Payment/administrative processes and link with Primary Care Services
(Capita)
• Benefits realisation of investment in Primary Care
• Monitoring variation in Primary Care (performance and quality)
• Learning Disability DES (separate risk to be developed)
• Estates:
• Estates and Technology Transformation Funding (ETTF) bids
• Working with Cheshire East Council in relation to
• Development of the Primary Care workforce (recruitment and development)
• Achievement of Quality Premium priorities:
• Work with and support Primary Care to increase the number of e-Referrals
• Work with Primary Care to support patients to use the e-Referral system
(eRs) and make informed choices
Current Priorities

5. Main Areas of Risk
• Issues with Primary Care Services (Capita) in relation to medical
records, performers list and payment processes
• CCG capability to support development and implementation of our
estates strategy, in relation to Primary Care, and completion of
business cases for ETTF schemes
• Endorse: Maintaining risk at 3x3 = 9