Agenda item

On 19 October 2018, the Clinical Commissioning Group (CCG) membership had voted on and agreed amendments to the CCG constitution to establish a joint committee of NW London CCGs, permit electronic voting and reduce the quorum for meetings.  It was anticipated that these changes would be ratified by NHS England on 13 December 2018 in time for the December 2018 meeting of the Joint Committee where it would be able to move from shadow form to decision-making form. 

Hillingdon CCG continued to experience financial challenges with significant adverse variances within acute and continuing care.  Processes had been put in place to try to control these variances.  It was also noted that Hillingdon CCG was £1,139k behind its QIPP target for month 6 of 2018/2019.

Winter funding had been allocated to support Discharge to Assess to streamline the discharge process for those patients that required additional support to leave hospital.  To support this work, Hillingdon CCG had been working with partners to implement a range of measures with care home providers, for example, training around pressure ulcers and falls.  In addition, the GP care home service pilot had been extended from the end of October 2018 to April 2019.  This pilot had provided an urgent visiting service for identified care homes as well as care planning onto the ‘Coordinate My Care’ care planning tool. 

The care homes that had been included in the pilot had been those that had had the highest proportion of emergency admissions.  The success of the pilot could be gauged through the subsequent reductions in the number of emergency admissions from these homes.  It was noted that information on the progress of the pilot would be fed back to the Primary Care Board in January 2019. 

With regard to end of life care, it was anticipated that the single point of access work would provide a positive message.  The Council’s External Services Select Committee had looked at the closure of Michael Sobell Hospice inpatient unit at its meeting on 30 October 2018 and would be looking at what action would now be taken at a further meeting on 11 December 2018.  Although information had been provided to the Committee at its first meeting, it felt as though there was more information that had not been shared.  To move forwards, estate would be needed to put beds in.  In the meantime, Hillingdon CCG had a spot purchasing arrangement in place for beds at the Peace Hospice (this had been the same arrangement that had been in place with Michael Sobell Hospice). 

The focus needed to be on having an appropriate clinical model in place to care for people at the end of their lives.  As a long term solution, it was not satisfactory for patients at end of life to be cared for on hospital wards and further work needed to be undertaken to determine how palliative care should be delivered in future.  Clarity would need to be sought from East and North Hertfordshire NHS Trust as to the organisation’s intention regarding the building as this lack of clarity was preventing Hillingdon CCG from putting short term plans in place. 

RESOLVED:  That the Health and Wellbeing Board noted the update.