Minutes of the Trafford Sub-committee held on Wednesday 13 th Nov at Sam Platts, Old Trafford PRESENT:

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. Salford and Trafford Local Medical Committee 2 nd Floor, Oakland House, Talbot Road, Old Trafford, M16 0PQ E-mail: vsimenoff@nhs.net or LMC.office@trafford.nhs.uk PRESENT: Minutes of the Trafford Sub-committee held on Wednesday 13 th Nov at Sam Platts, Old Trafford EXECUTIVE MEMBERS Dr C Kelman (CK) Dr I Maclean (IM) MEMBERS Dr C Westwood (CW) Dr A Freeman (AF) Dr J Chandy (JC) CO-OPTED MEMBERS & OBSERVERS Mr C Booth (CB) Rep PM s Trafford South Mrs D Darlington (DD) Rep PM s Trafford North Ms G Lawrence (GL) CCG Mr R Bellingham (RB) NHS England Ms K Thornton (KT) Trafford Council Mr C Marton (Gtr Mcr CSU) Ms S Ball (Gtr Mcr CSU) IN ATTENDANCE Mrs V Simenoff Mrs K Rowlands APOLOGIES Dr N Guest Ms A Ferguson Ms M Buck Trafford Subcommittee FINAL Nov Minutes part A 1

Declaration of interest None declared Special business Dr Imran Najmi attended the meeting to introduce elocum24 which is a free online Locum database. His presentation included key features and benefits as well as a brief description of how the system works. More detail can be found in the presentation slides to be sent out with these minutes. AGENDA - PART A 1. Review of Actions from the last meeting No Subject Closed/ carried forward Update Who 1 Lack of understanding of the process for claiming/re-imbursement of invoices in relation to LES s 2 (VS) Had commented on work being done to review the ELIGIBILITY criteria for patient s access to services. She said it would be useful if someone could attend from council to update members on the process for Trafford residents. 3 The CCG had recruited 10/12 GP s to work with them and a list of who they were would be distributed Carried Forward from the last meeting Carried forward from the last meeting Carried forward from the last meeting (KT) agreed to send an email to the LMC outlining the process for the LMC to forward to all practices. Update: email recv d from Stewart Reynolds. Update in the meeting: The LMC requested that the proposed cut off date for submission of claims was moved from the 5 th of the month to the 10 th (KT) felt this was acceptable and agreed to discuss with Debbie Blackburn from Salford also Action (KT) (KT) agreed to invite Linda to attend the next sub committee meeting Update in the meeting: (KT) said that she was a little unclear of what was being asked. (GL) said that the criteria in Trafford had already been reviewed two years ago and therefore this piece of work had already been completed. Action closed. GL to forward the list to the LMC Action carried forward to next month (KT) (KT) (GL) 2. Enhanced services post payment verification process The document sent out with the agenda was noted and comments invited. Kylie Thornton (KT) informed members that following feedback from the meeting held with the LMC and Salford, some changes to the PPV process relating to viewing fitness to practice documentation as part of the process had been already been made. Practices would now be required to provide a declaration that their practice requirements were up to date. Trafford Subcommittee FINAL Nov Minutes part A 2

Members commented on how onerous the visits were and asked for the requests for information built into the contract were removed.. (KT) noted the requests and agreed to put the proposals forward. Action (KT) There was a lengthy discussion about the work involved to check CRB checks are in place for practitioners. It was assumed that if a GP was on a performers list they were CRB checked. Gina Lawrence (GL) confirmed that was the case however care should be taken as the CRB could have expired. It was agreed that further guidance was needed and that this could be sought from GPC on the frequency of updates if needed. 3. CSU process claims for LES s Discussed as part of review of actions 1 noted again here for reference. The LMC requested that the proposed cut off date for submission of claims was moved from the 5 th of the month to the 10 th (KT) felt that this was acceptable and agreed to discuss with Debbie Blackburn Action (KT) 4. Area Team update Rob Bellingham attended the meeting and provided the following update: Changes to Primary Care Services Consultation began on Mon 11 th Nov 2013, on the proposal to make 40% efficiency savings in the support currently being provided to primary care across England. (RB) added that the proposal included the reduction of the 17 service delivery points in the North of England to 7. In Gtr Mcr it is proposed that future support will be delivered from a single service hub located in Preston. The following offices will be affected: Oakland House, Trafford; Millennium house in Denton; Stockport Norbury court in Manchester National Call to action (RB) said that the deadline for responses closed on Sunday 10 th November and that he had read the LMC s response with interest and would comment again further into the agenda (See item 7) Primary Care Strategy of Healthier Together This is on plan to be signed off before Xmas Trafford Subcommittee FINAL Nov Minutes part A 3

Operating issues A meeting had been held with the CCG to look at where processes were falling down, in particular issues with finance and receipt of payments. He added that work was being done to understand exactly where the service failure points were. He was asked if he would respond to emails from practices that were unable to resolve finance issues, or felt they were getting the run around. (RB) said that he would. His email address is robbellingham@nhs.net. Discussion ensued regarding issues surrounding premises and the investment needed. (GL) asked if this could be added to next months agenda as a discussion between the CCG and Area team was planned for the future. As the next meeting is the LMC s AGM Dec 9 th it was agreed to add this to January s agenda Action LMC Deborah Darlington (DD) asked (RB) if the area team were able to provide contact numbers in case of a disaster. (RB) informed members that Laura Browse was working on a manageable system and he would feedback once this was agreed Action (RB) 5. Council update No further update was given. 6. Trafford Commissioning consortium update (GL) provided the following update: Risk profiling and care management scheme DES This DES was introduced in April 2013 by NHS England with the aim of rewarding GP practices for the identification and case management of patients classified as seriously ill or at risk of emergency hospital admission. She referred to the email that had recently been sent out and later retracted due to an error in the figures. A copy of which was handed out in the meeting for reference. (GL) went on to say that a delay in developing the risk profiling tool had caused the CCG to repeatedly postpone implementation. However a local solution had been developed (detailed in the information handed out) and she asked for any comments to be emailed to her by next week. She added that although practices would still need to review the same number of patients (approx 40) in a shorter period of time, due to the late start, the CCG would be flexible if practices were struggling. (VS) Asked if Trafford Subcommittee FINAL Nov Minutes part A 4

a statement that reflected that could be added to the supplementary information. This was agreed. Action (GL) Trafford General changes from A&E to urgent care A leaflet had gone out to all Trafford residents to inform them of the changes. In order to ensure a smooth transition and provide capacity to manage the change over the winter months, 18 additional beds had been introduced in Trafford and 10 in Salford. In addition it was proposed that Trafford should adopt the same model as Salford for those patients that turn up at A&E and are referred back to their GP. The CCG are suggesting that each practice keeps 2/3 slot available dependant on their list size. Members felt that this could be manageable. (GL) added that a draft paper would b coming out shortly and sought comment from the LMC she said that she would welcome LMC support for this proposal. NHS 111 North West Ambulance service is the stability partner and are in place until the re-tendering process is completed. Walk in centre (GL) said that an update on this will be provided in the January meeting. Action (GL) 7. Healthier Together/Improving general practice- a call to action (RB) reminded that this was a National call to action and that responses would be fed into the national process. However he said that he had already asked the LMC what they wanted to happen as a result of their response highlighting GP concerns to him. It had been agreed that a response from the area team would be welcomed. 8. Statement of intent Due to the lateness of the hour this item was not discussed in detail and it was agreed to carry this forward to the next meeting. AOB None raised. Meeting closed at 2.45pm DATE OF NEXT MEETING Monday December 9 TH 2013 evening Sam Platts LMC AGM - JOINT FOR ALL MEMBERS OF BOTH SALFORD AND TRAFFORD COMMITTEES Trafford Subcommittee FINAL Nov Minutes part A 5

2014 Meeting dates 1-2.30pm, preceded by lunch from 12.30pm. Held at Sam Platts, Trafford Wharf Road, Old Trafford M17 1EX Weds Jan 15th Weds Feb 12th Weds March 12th Weds April 16th Weds May 21st Weds June 11th Weds July 16th No meetings Weds Sept 10th Weds Oct 15th Weds Nov 12th Monday December 8 TH evening JOINT FOR ALL MEMBERS OF BOTH SALFORD AND TRAFFORD COMMITTEES Trafford Subcommittee FINAL Nov Minutes part A 6