Herts Valleys CCG Decision Register Quarter 1 2020-21

Name and Date of MeetingMinute

ReferenceTitle of Agenda Item Decision Made Associated Costs

Conflicts of Interest Reported

byHow the Conflict was Managed Date Reported to Audit Committee

Board meeting in private

23 April 2020 BC/165.3/20 Board Assurance Framework

The board approved the BAF with the requirement

to reassess the current risks and develop further. n/a n/a n/a 16/07/2020

Board meeting private

23 April 2020 BC/166.3/20

Covid 19 Response:

CCG Covid 19 Governance

The board approved the CCG governance

arrangements. n/a n/a n/a 16/07/2020

Board meeting private

23 April 2020 BC/167.3/20

CCG Covid 19 Financial

Governance Arrangements

and Expenditure Report

The board approved the CCG Covid 19 Financial

Governance Arrangements and Expenditure Report. n/a RE / NS / RP

S Bloom chaired the meeting for

the decision around finances 16/07/2020


23 April 2020BC/168.3/20

CCG Covid 19 Local

Response The board approved CCG Covid 19 Local Response. n/a n/a n/a 16/07/2020


23 April 2020BC/169.4/20

Funding for Primary Care

virtual desktop

The board approved the cost of £144,000 for the

year with a view that a revised paper will be

presented to board once details have been finalised.

£144,000 RE, TF, AF, NS, RP, DCC, CC, KP

Stuart Bloom chaired the meeting

for this agenda item.

Herts Valleys GP’s are conflicted

therefore they will be included

within the discussions only and

not in the decision making.

Elizabeth Eyitayo will have an

input as an Independent GP.

16/07/2020


23 April 2020BC/170.3/20

Respiratory Hub clinical

model

The board ratified the west Hertfordshire COVID-19

primary care clinical pathways and standard

operating procedure which have been developed in

detail since board agreement on 26th March 2020.

Resources approved by the CCG board in principle were

a. ££1,277,796 for 4 locality Hot Hubs

b. £487,699 for the HUC Domiciliary Car

The revised costings of the for the Board to note are:

a. £1,277,796 for 4 locality Hot Hubs including the

workforce for the domiciliary care

b. £78,232 for the costs of the Car from HUC

TF, AF, RP, DCC, CC, KP

Stuart Bloom will chair the

meeting for this agenda item.

Herts Valleys GP’s are conflicted

therefore they will be included

within the discussions only and

not in the decision making.

Elizabeth Eyitayo will have an

input as an Independent GP.

16/07/2020

Audit Committee

24 April 2020AC/53.2/20 Provision for doubtful debt Approved £5,239.35 n/a n/a 16/07/2020

Exec Committee

27th April 20204 Tabelau Training

Exec approved two separate sets of training to get

all BI team members to intermediate level skill £9,000 plus VAT n/a n/a 16/07/2020

Exex Committee

4th May 202013 Webex Training

Execs approved that the CCG expand its WebEx

licence facilities to include a licence for training,

which will enable the ODL team to deliver more

agile training across the three CCGs, using WebEx.

The cost will be covered by the HR and ODL budget.

£320.00 n/a n/a 16/07/2020

Executive Committee

8th June 202013 Authority to Engage Additional and enhanced pay for the CHC team £20,041 n/a n/a 16/07/2020

Executive Committee

8th June 202013 Authority to Engage Additional and enhanced pay for CHIT nurses £2,300 n/a n/a 16/07/2020

Commissioning Executive

11 June 2020CE/52.1/20

Evaluation of Primary Care

hot hubs and future clincial

options

The Committee approved Option 3 to be developed

as set out in the paper to include Clinical Pathwaysn/a All HVCCG GPs conflicted

Clinical decision only. Financial

decision to be taken by the board

with support from an

independent GP

16/07/2020

Herts Valleys CCG Decision Register Quarter 1 2020-21


11 June 2020CE/53.1/20

Clinical Model for an

Integrated Respiratory

Virtual Hospital

The committee approved the proposal for the

Integrated COVID Virtual Hospital Service, including:

• noting the future Integrated Respiratory

Transformation programme working in collaboration

with WHHT and CLCH.

• the combined costs of CLCH and WHHT for the 6

weeks of £105,110. This will enable the providers to

work through the backlog of patients within 6

weeks' timeframe. The £105,110 will be recoverable

through the NHSE central COVID costs and no

transactions will take place between providers.

£105,110

but this will be recoverable through NHSE central covid

costs.

n/a n/a 16/07/2020


11 June 2020CE/55/20

Extension of Community

Gynaecology contract

The committee approved the proposal to extend the

Enhance Community Gynaecology Service for 2

years to 31st March 2023 in line with the contract,

with the provider asked to complete the finance

template for the cost of the service for the 2 year

extension.

No new funding requested as block values were set out at

the time of commissioning.n/a n/a 16/07/2020

Audit Committee

16 June 2020AC/63.3/20

Approval of Annual

Accounts

The committee approved the draft annual accounts

subject to final auditor work and delegated

authority to the Audit Chair, Joint CEO and CFO to

agree the final submission with auditors.

n/a n/a n/a 16/07/2020

Audit Committee

16 June 2020AC/64.3/20 Approval of Annual Report

The committee approved the final draft annual

report subject to nothing further being identified by

the auditors and delegated authority to the Audit

Chair, Joint CEO and CFO to agree the final

submission with auditors.

n/a n/a n/a 16/07/2020

Audit Committee

16 June 2020AC/65.3/20

Proposal to extend the

contracts for internal and

external audit for another

year (ET)

The committee approved direct placement of

contracts for a further year for internal and

external services, with the incumbent providers.

n/a n/a n/a 16/07/2020

Joint Accountable Officer, Audit Chair

and Chief Finance Officer

25 June 2020

Email

correspondence

and signatures

Approval of Annual Report

and Accounts

The Joint Accountable Officer, Audit Chair and Chief

Finance Officer approved the final ARA for

submission

n/a n/a n/a 16/07/2020

Audit Committee

Virtual decision 30 June 2020

By email and

reported to

AC on 16 July

2020

Approval of updates to

Detailed Financial Policies

authorisation schedule.

The committee approved the amendments listed

below.

The schedule has been amended to:

- add the Joint Accountable Officer with existing CEO

authorisation limits;

- amend the job title of former Interim CEO to

Managing Director;

- clarify arrangements for acting roles;

- clarify arrangements and weekly limits for high

cost care packages.

n/a n/a n/a 16/07/2020


ReferenceTitle of Agenda Item Decision Made Associated Costs



Executive Committee

6th July 202013 Homeworking policy

Cost of £150 towards purchase of equipment to

allow staff to buy a monitor, keyboard, headset and

mouse.

£150 n/a n/a 16/07/2020

Commissioning Executive Committee

9th July 2020CE/67.1/20

Continued commissioning of

Faecal immunological

testing

Funding approved for FIT following 12 month pilot

The new funds required will be for the value of £352,293

out of which £165,060 will be for primary care, £113,233

for *CLCH and £74,000 will be for I.T. infrastructure (1

iPAD per care home

*In line with COVID finance route CLCH to charge to their

own COVID budget

n/a n/a


9th July 2020CE/68/1/20

Proposal for Primary Care

Covid Hot Hubs

Approved in principal hubs decommission 2 of the

current hubs

Reimburseable expenditure under covid emergency

guidance. The CCG Board approved expindure for 4 hot

hubs on the 26 March 20

National COVID Funding through NHSE ceases on the 31st

July 2020, therefore the CCG will have to pick up the costs

for the two hubs for 1st August 2020 – 31st January 2020.

The costs for the Hot Hubs will be presented at the CCG’s

July Board for approval.

GP's conflictedClinical input required - final

decision Board


9th July 2020CE/69/1/20

Cessation of the Community

Dermatology Service

The committee approved report whilst noting

continued assurance on progress required

Discussions are ongoing between the CCG and WHHT

with regards to funding arrangements in the current

climate. Ending the community service will significantly

reduce spend on the HealthHarmonie service which cost

c£500k per annum.

n/a n/a


9th July 2020CE/70.1/20

Extension of the Integrated

Musculoskeletal (iMSK)

Contract.

The committee approved the paper with specific

requirements noted to be taken forward with

Connect as part of the service

delivery/transformation plan with tight turnaround

The Governing Body agreed a new finance model at the

finance and performance committee in June 2019 and

approved additional funding of £1.4m per annum

(£2.878M over 2019/20 and 2020/21) for the iMSK

service. The additional renegotiated contract value

enabled the provider to recruit the resources required to

deliver the 40% increase in referrals which in turn

improved performance and outcomes for patients. This

was monitored via an agreed PIP process.

Daniel Carlton-Conway –

hosted first contact physio

practitioner.

Post meeting note added 21/9/20

Daniel Carlton-Conway declared

interest as surgery hosted first

physio practioner - although no

lonver involved therefore

committeee agreed no longer

conflicted


9th July 2020CE/71.1//20

Update on Mental Health

Investment Standard The committee agreed funding areas in paper

Meeting the Mental Health Investment Standard

requires additional CCG investment in mental health services

each year. Prior to Covid the total budget available for

investment to meet MHIS in 20/21 was calculated at £5.467m.

Although there is some uncertainty on the CCG allocations from

month 5 (July) onwards, NHSE have confirmed that there is the

expectation that MHIS will be met for 2020/21. Clarification of

specific requirements and further guidance on the finance

regime is expected from NHS England by the middle of July.

n/a n/a


9th July 2020CE/72.1/20

Review of the autism

assessment pathway and

post-diagnostic support for

adults in Hertfordshire

The committee approved the paper and

agreed the next steps to

review approve the recommendation to agree to

the development of a new autism assessment

pathway and post diagnostic support model which

can then return to Commissioning Executive for

approval

None at this point. Potential investment in the diagnosis

pathway and post diagnostic support

will be considered alongside other priorities as part of the

Mental Health Investment Standard discussions.

n/a n/a


9th July 2020CE/74.1/20

Evaluation of mindfulness

sessions for

keyworkers in Hertfordshire

The committee approved the paperThe cost to extend the service to March 2021 is £8,840.

To be funded from existing MH budget.n/a n/a


Executive Committee

20th July 20209

NEPTs out of hours

authorisation

Exec agreed to the recommendation of a £500

threshold for out of hours non-emergency patient

transport requests, whereby no authorisation is

required from HVCCG on call managers subject to

challenges and reviews being incorporated into the

process.

£500 n/a

Executive Committee

20th July 202012

Provision of Secondary Care

(SUS) data on a weekly basis

Exec approved the expenditure of £12,000 for the

period from August 2020 until March 2021 (£1,500

per month x 8 months), for the provision of a weekly

SUS data feed.

£12,000 n/a n/a 17.09.20

Board meeting held in Public

23 July 2020 B/179.2/20 Items approved virtually

The board noted the virtual approval of the Risk and

Strategy Management Procedure.

The board noted the virtual approval of the

Standards of Business Conduct Policy.

n/a n/a n/a 17.09.20


23 July 2020 B/181.3/20 Board Assurance Framework

The board approved the BAF 2020/21, Q1 position

as proposed by the Executive team.

The board noted the BAF assurance summary as

presented in Appendix 1.

n/a n/a n/a 17.09.20


23 July 2020 B/182.3/20 Values behaviours refreshed

The board approved the Values behaviours

refreshed with the amendments as requested by the

board.

n/a n/a n/a 17.09.20


23 July 2020 B/184.3/20

Restarting referrals for

specialist fertility

treatments

The board approved the recommendation to restart

referrals for specialist fertility treatments. n/a n/a n/a 17.09.20

Board meeting held in Private

23 July 2020

(mins not yet approved)

BC/207.3/20

Update on future financial

arrangements under Covid-

19

The board noted the changes to the financial regime

and revised timescales for implementation.

The board approved the continued expenditure on

the current Covid schemes.

n/a n/a n/a 17.09.20

Board meeting held in Private

23 July 2020


BC/208.3/20Non-Emergency patient

transport service

The board approved to continue providing

additional non-emergency patient transport

resources to support the government Covid 19

Hospital Discharge Service Requirements (HDSR) of

2 hours until end of March 2021, at a cost of £318k.

The board approved the expenditure incurred to

end of July 2020 of £252.7k.

£252.7k until the end of July 2020

£318k until end of March 2021n/a n/a 17.09.20

Board meeting in Private

23 July 2020


BC/209.3/20

Respiratory Hot Hubs

(Proposal for Primary Care

COVID Hot Hubs in two

localities)

The board approved the business case for two hubs

across the four localities with two HUC cars from 01

August 2020 – 31 January 2021 at a maximum value

of £982,514.

£982,514k from 01 Aug - 31 Jan 2021 All GPs declared a conflict

S Bloom chaired the meeting.

GPs were involved in the

discussion and not the decision

making.

The paper was shared with

Independent GP Dr Andrew for

approval.

17.09.20

ICP Partnerhip Board ICP/23.2/20 Winter plans 2020/21 Board endorsed the Winter plans 2020/21 paper n/a n/a n/a

Executive Committee

17th August 2020IG Policies

Exec approved the following policies:

• Information Governance Framework

• Data Protection and Confidentiality Policy

• Information Governance Policy

• Information Governance Strategy

Amendment has been made to each policy to reflect

Managing Director and Joint CEO positions/Jane

Kinniburgh is now the Caldicott Guardian for each of

the CCGs.

n/a n/a n/a 17.09.20

Executive Committee

17th August 2020Item 13 CSA Transformation Bid

Exec agreed to support the bid to facilitate improved

services for children/families who experience child

sexual abuse (CSA). The Designated Team will

continue to work in collaboration with our partners

to support this model pending outcome of bid

application.

n/a n/a n/a 17.09.20

Primary Care Commissioning

Committee Part 1 in private

20 August 2020

Item C7 Highfield business case

The committee did not support the application for

the following reasons:

• The premises are not constrained and are suitably

reimbursed under the Premises Costs Directions, as

agreed when the business case was approved post

2013;

• The practice is suitably reimbursed under their

GMS Contract, accounting for the factors used to

determine the Global Sum i.e deprivation, patient

complexities, list turnover/increases.

No expenditure agreed

Trevor Fernandes was

conflicted as a member of the

same PCN

TF withdrew from the decision 17.09.20


Committee Part 1 in private

20 August 2020

Minutes not yet approved

Item C10Transformation plan for 'flu

and immunisationThe committee agreed the plan

The committee approved the recommendation to re-

purpose the previously approved non-recurring funding of

£1,174,376 to support the delivery of the 2020/21 flu and

immunisation programme at PCN level. However this is

above the committee's financial approval limit and will

therefore require a board decision.

Alan Pond: Potential indirect

interest. His partner (Dr

Corina Ciobanu) is a GP

Partner in Herts Valleys CCG

(at Haverfield Surgery, Kings

Langley) and is Chair of the

Dacorum Locality - she could

benefit under the agenda

items.

Daniel Carlton Conway: Direct

financial interest. His

practice/PCN will benefit from

this funding.

Trevor Fernandes: Direct

financial interest. GP in

practice.

None necessary as the committee

was only being asked to approve

the plan in principle and

recommend it to the board: the

board will be asked to make this

decision.

17.09.20


Committee

Part 2 in public

20 August 2020


Item 10 PMOT summary report

The Committee ratified the recommendations

reached by MOCL.

The Committee ratified the recommendations

reached by HMMC on treatments that are not

subject to NICE TAs; note the NICE TAs published

and likely impact of these on

the commissioner’s budget; note national

directives/initiatives that will impact

on medicines optimisation.

NICE technical appraisals (TAs) are national guidance

and Herts Valleys CCG is

legally obliged to fund and resource medicines and

treatments recommended by

these TAs. They are presented to the Primary Care

Commissioning Committee for

information and to note the likely impact on the

commissioner’s budget.

Total resource implication for this paper: £295.4k

Medicines Optimisation Clinical Leads Meeting (MOCL)

- Resource implications identified for implementation of

the majority of MOCL decisions are none.

- Stoma papers presented which support our QIPP savings

plan for stoma, no new savings identified

Herts Medicines Management Committee (HMMC)


recommendations reached by HMMC on treatments that

are not subject to NICE TAs - no new spend identified


the following NICE TAs

-NICE TA631 Fremanezumab for preventing migraine

impact for HVCCG is £56k in year 1 increasing to £179k in

year 5

-NICE TA633 Ustekinumab in ulcerative colitis impact max

£58.2k pa

- NICE TA626 Avatrombopag for thrombocytopenia in

chronic liver disease in people needing a planned invasive

procedure impact max £58.2k pa

Trevor Fernandes GP

prescriber.

No action necessary.

Recommendations reached by

HMMC and MOCL are negotiated

with a committee of clinicians,

with particular focus on evidence

base, cost and patient safety.

HMMC and MOCL

recommendations are presented

to the Primary Care

Commissioning committee for

ratification, although decisions

with no negative financial

impacts made at MOCL may be

implemented prior to PCCC

approval.

17.09.20


Committee

Part 2 in public

20 August 2020

Item 11PMOT LIS achievement

payments

The Committee approved the data to allow prompt

payments of the 2019/20 Local Incentive Scheme.

The budget has been approved by PCCC previously to be a

maximum of 70p/weighted head, max £448K.

Alan Pond: Indirect potential

interest. Partner (Dr Corina

Ciobanu) is a GP Partner in

Herts Valleys CCG (at

Haverfield Surgery, Kings

Langley) and is Chair of the

Dacorum Locality and she

could benefit under the

agenda item.

Daniel Carlton-Conway: Direct

financial interest. My practice

may benefit from this

decision.

Trevor Fernandes: Direct

financial interest. Practice

gets paid.

Conflicted parties recused

themselves from the decision.17.09.20

Executive Committee

1st September 2020Item 8 Office re-opening

Re-opening of the office on 21st September 2020,

Mon-Wed, 8am-6pm, with staggered start and finish

times.

n/a n/a n/a 17.09.20

Executive Committee

14th September 2020Item 10 Health & Safety policy Exec agreed for the policy to go to Board n/a n/a n/a

Executive Committee

14th September 2020Item 11 Incident management policy

Exec agreed for the policy to go to Board

Development in Octobern/a n/a n/a

Executive Committee

14th September 2020Item 12 Office re-opening

Re-opening of the office on 21st September, Tues &

Wed, 8am - 6pmn/a n/a n/a


24 September 2020 B/197/20

Flu Programme, Extended

Flu and Immunisations

proposals and supporting

Practices Winter Plan

The board noted the virtual approval of the Flu

Programme, Extended Flu and Immunisations

proposals and supporting Practices Winter Plan.

The board approved the non-recurring funding of


immunisation programme at PCN level.

The paper was presented at

PCCC and was approved in

principle. The board approved

with a reduced quorum as all

GPs are conflicted. However

HVCCG’s Constitution allows

for this.


24 September 2020 B/198/20CCG Constitutional

amendment

The board approved the amendments to the HVCCG

constitution to reflect the earlier decisions to have a

Joint Executive team including a locally based

Managing Director.

The board noted the amendments to financial limits

for delated authority related to the Joint Executive

Team appointments.

n/a n/a n/a


24 September 2020 B/200/20

CCG Strategic Objectives

2020-2022 & Board

Assurance Framework (BAF)

The board approved the HVCCG’s strategic

objectives 2020-2022.

The board noted the updates to the existing Board

Assurance Framework at the end of Q2, 2020/21.

n/a n/a n/a


24 September 2020 B/210/20Terms of reference

amendments

The board approved the amendments made to

committees’ terms of reference in relation to:

- The new Joint Executive posts, authority to

deputise; and

- Joint operation of the Quality and Performance

committees.

n/a n/a n/a

Executive Committee

29th September 2020Item 10 Staff flu vaccinations

Flu vaccines will be made available from community

pharmacies in Hertfordshire with reimbursement by

the CCG through LPC so that staff members do not

have to pay direct. In addition to this, those staff

members further afield are able to get their

vaccines carried out privately from their local

pharmacies and claim back the cost via the expense

system.

£13 and £20 per vaccination n/a n/a



Reference

Title of Agenda ItemDecision Made Associated Costs



Column1 Column2 Column3 Column4 Column5 Column6 Column7 Column8

Executive Committee

1st September 2020Item 8 Office re-opening

Re-opening of the office on 21st

September 2020,

Mon-Wed, 8am-6pm, with staggered start and finish

times.

n/a n/a n/a 17.09.20

Executive Committee

14th September 2020Item 10 Health & Safety policy Exec agreed for the policy to go to Board n/a n/a n/a

21.01.21

In the assurance pack circulated for

assurance.

Executive Committee

14th September 2020Item 11 Incident management policy

Exec agreed for the policy to go to Board

Development in Octobern/a n/a n/a

21.01.21


assurance.

Executive Committee

14th September 2020Item 12 Office re-opening

Re-opening of the office on 21st September, Tues &

Wed, 8am - 6pmn/a n/a n/a

21.01.21


assurance.


24 September 2020 B/197/20

Flu Programme, Extended

Flu and Immunisations

proposals and supporting

Practices Winter Plan

The board noted the virtual approval of the Flu

Programme, Extended Flu and Immunisations

proposals and supporting Practices Winter Plan.

The board approved the non-recurring funding of


immunisation programme at PCN level.

All HVCCG GPs were

conflicted

The paper was presented at PCCC

and was approved in principle.

The board approved with a

reduced quorum as all GPs are

conflicted. However HVCCG’s

Constitution allows for this.

21.01.21


assurance.


24 September 2020 B/198/20CCG Constitutional

amendment

The board approved the amendments to the HVCCG

constitution to reflect the earlier decisions to have a

Joint Executive team including a locally based

Managing Director.

The board noted the amendments to financial limits

for delated authority related to the Joint Executive

Team appointments.

n/a n/a n/a

21.01.21


assurance.


24 September 2020 B/200/20

CCG Strategic Objectives

2020-2022 & Board


The board approved the HVCCG’s strategic

objectives 2020-2022.

The board noted the updates to the existing Board

Assurance Framework at the end of Q2, 2020/21.

n/a n/a n/a

21.01.21


assurance.


24 September 2020 B/210/20Terms of reference

amendments

The board approved the amendments made to

committees’ terms of reference in relation to:

- The new Joint Executive posts, authority to

deputise; and

- Joint operation of the Quality and Performance

committees.

n/a n/a n/a

21.01.21


assurance.

Executive Committee









system.


21.01.21


assurance.

Executive Committee









system.


21.01.21


assurance.


Committee in private

14 October 2020


Approved

virtually and

noted at PCCC

Pt1/78.1/20 in

November

Ctte

West Herts Winter

Commissioning Plan

2020/21: Enhanced

commissioning for care

homes

The committee approved the recommendation that

the CCG support the implementation of the

Enhanced Health in Care Homes by Primary Care

Networks (PCNs) included in the Network Contract

Directed Enhanced Service (DES) for 2020/21 by

agreeing with option 3 to be implemented with

effect from 1st November 2020.

As option3 left a funding shortfall of £117k, the

committee agreed that this could be met from the final

year PMS Transition funding which was currently

unallocated. The total available PMS Transition funding

for 20/21 is £142k, leaving £25k unallocated.

It is noted that all HVCCG GPs

have a direct financial conflict

in relation to this decision

HVCCG GPs did not participate in

the decision. However, they were

invited to enter into the online

discussion and request

clarification as necessary.

21.01.21


assurance.


Committee in private

20 October 2020


Approved

virtually and

noted at PCCC

Pt1/78.1/20 in

November

Ctte

Egton Contract Renewal

The committee approved the recommendation to

renew the current contract for a further 12 months

and, during this time, work with ENHCCG on

progressing a procurement in April 2021 to have in

place a new contract for September 2021.

None n/a n/a

21.01.21


assurance.


12th November 2020CE/138/1/20

Adult Weight Management

HertfordshireAgreed extension of service until May 2021

HVCCG to contribute £57,276 in 2021/22 and £99,942 in

22/23 to Tier 2 community weight management services,

in order to extend the WW contract to 6th May 2023.

None reported n/a

21.01.21


assurance.


Committee Pt 1 in private

19 November 2020


PC/85.3/20 SAS Contract Extension

The committee approved extension of the current

provider’s contract for a further 12 months, giving

time to review and assess the framework against the

needs of the Hertfordshire region and noted that an

updated position will be provided in March 2021.

None n/a n/a

21.01.21


assurance.



19 November 2020


PC/87.3/20

Community Transformation

Adult and Older Adults

Mental Health including

Primary Care Mental Health

2020

The committee approved the proposal to adopt

Option 2 in principle, for the Primary Care Mental

Health pilots to continue for a further three months

to allow for the integration of these pilots with the

transformation of community mental health and

ARRS roles, with the condition that actions need to

be in place for implementation from January 2021

with a changed model that clearly defines how it is

complementary to the ARR scheme.

The contract totals for Primary Care Mental Health are

currently £853,926.87 non recurrent funding

The contract for a further six month extension was quoted

in the pack as £426,963.43

Direct financial :

Asif Faizy

Daniel Carlton-Conway

Trevor Fernandes

Indirect potential:

Alan Pond

Participate in the discussion and

recuse themselves from the

decision.

21.01.21


assurance.



19 November 2020


PC/88.3/20

GP prescribing budget

distribution methodology to

GP surgeries

The committee approved the method for budget

allocation.

This paper does not affect resources made available for

primary care prescribing, but is about how the available

budget is planned to be distributed in a fair and balanced

way.

All HVCCG GPs had a direct

financial conflict.

Alan Pond had an indirect

conflict.

Conflicted committee members

did not participate in any

discussion or the decision

21.01.21


assurance.


Committee Pt 2 in public

19 November 2020


PC/101/20PCN Development Funding

Proposal 2020/21

The committee approved the proposal for the

devolution of the funding down to PCN on a

weighted capitation basis and agreed the

governance process by which to provide assurance

on the utilisation of this funding at PCN level.

The national allocation for Herts Valleys CCG is £452,157 n/a n/a

21.01.21


assurance.


Committee Pt 2 in public

19 November 2020


PC/104.2/20HMMC and MOCL

recommendations

The committee ratified the recommendations from

HMMC and MOCL

Total resource implication for this paper 20/21 : £-4K

Total resource implication for this paper per annum:

+£56.2K

One off saving of (-£93K)

Medicines Optimisation Clinical Leads Meeting (MOCL)


the majority of MOCL decisions are none.

- NB ScriptSwitch savings are already accounted for in

QIPP targets 20/21 (-£4k) increasing to (-£61k) pa

Herts Medicines Management Committee (HMMC)

Subcutaneous vedolizumab Cost to CCG-£93K (one off

saving)

Sequential use tekinumab and vedolizumab Cost to CCG

£13K pa

Naldemedine Cost to CCG Max £58.2K pa

NICE hypertension guidance Co st to CCG £9K pa rising to

£46k pa in year 5

n/a n/a

21.01.21


assurance.

Executive Committee

24th November 202013

Herts Sexual Assault

Referral Centre policyExec approved the policy No associated costs n/a n/a

21.01.21


assurance.

Executive Committee

24th November 2020

Neglect Strategy Exec endorsed and supported the approach and

proposed campaign that the Hertfordshire

Safeguarding Children Partnership (HSCP) are taking

to tackle childhood neglect in Hertfordshire

No associated costs n/a n/a21.01.21


assurance.

Board meeting held in public

26 November 2020

mins yet to be approved

B/223.3/20 CCG Strategic Objectives

2020-2022 & Board


The board approved the proposed amendment to

HVCCG’s strategic objectives 2020-2022.

N/A N/A N/A21.01.21


assurance.


26 November 2020


B/223.4/20 CCG Strategic Objectives

2020-2022 & Board


The board approved the updates to HVCCG’s Board

Assurance Framework, mid-Q3, 2020/21 and noted

the narrative updates to reflect the additional

mitigations being prioritised in order to achieve the

objectives and respond to the challenging

environment.

N/A N/A N/A

21.01.21


assurance.


26 November 2020


B/229.2/20 Financial Plan: M7-12

financial plan and budgets

The board approved the financial plan and budgets

for Months 07 – 12.

N/A N/A N/A 21.01.21


assurance.

Executive Committee

virtual approval

14th December 2020

n/a Business continuity plan Approved No associated costs n/a n/a 21.01.21


assurance.

Executive Committee

virtual approval

15th December 2020

n/a Incident plan Approved No associated costs n/a n/a 21.01.21


assurance


Committee

by virtual approval

23 December 2020

Will be

reported to

the PCCC on

21.01.21 as

paper

approved

virtually since

the last

meeting.

GPECF restart

The committee approved the proposed changes for

the GPECF Restart from 1 December 2020 – 31

March 2021.

No additional resources were required for this proposal

All HVCCG had a direct

financial conflict


conflict

Committee members who were

conflicted participated in the

virtual discussion but were not

involved in taking the decision.

21.01.21


assurance.

Name and Date of Meeting Minute Reference Title of Agenda Item Decision Made Associated CostsConflicts of Interest

Reported byHow the Conflict was Managed Date Reported to Audit Committee

Executive Committee

11th January 2021Item 9

Domestic Abuse Policy for CCG

StaffApproved n/a n/a n/a 22-Apr-21

Executive Committee

12th January 2021n/a

HVCCG Privacy Impact

Assessment Virtual approval n/a n/a n/a 22-Apr-21

Executive Committee

12th January 2021n/a HVCCG Information Risk Policy Virtual approval n/a n/a n/a 22-Apr-21

Commissioning Executive Committee 14

January 2021 CE/05.2/21

Integrated MSK, Rheumatology,

Pain and Postural Stability

Service – Update on Service

Transformation

Approved n/a None n/a 22-Apr-21


January 2021CE/05.3/21

Integrated MSK, Rheumatology,

Pain and Postural Stability

Service – Update on Service

Transformation

Approved £374,000 over 2 years None n/a 22-Apr-21


January 2021 CE/06.1/21

Herts Valleys CCG Vague/Non-

Specific Symptoms Pathway

including GP Direct Access to

Urgent CT

Chest/Abdomen/Pelvis

Approved

A sum of £46,456 has been agreed

from the Herts and West Essex Rapid

Diagnostics Centre (RDC) Cancer

Transformation Funds 2020/2021. Any

funds not allocated by end of March

2021 may be withdrawn and

repurposed

None n/a 22-Apr-21

Primary Care Commissioning Committee

21 January 2021

PCCC/C04/21

Virtual approval

noted

GPECF restartApprove the proposed changes for the GPECF

Restart from 1 December 2020 – 31 March 2021.No additional resource required

All HVCCG GPs were

conflicted


conflict as his partner is a

HVCCG GP

All those conflicted were excluded from the

virtual decision22-Apr-21


21 January 2021PCCC/07.3/21 Schopwick OBC

The committee approved the proposal in principle,

subject to the practice meeting a number of

conditions which will be itemised in a letter to the

practice.

The final decision was delegated by the committee

to AP, DE and AS.

If the OBC is approved and based on

the opinion of the District Valuer

which the practice and Haven agree

with, the additional annual rent will be

£236,250 PA.

Plus, if deemed eligible and approved,

£67k as one off payments for Stamp

Duty Land Tax (SDLT) and reasonable

legal fees.

None n/a 22-Apr-21


21 January 2021PCCC/08.3/21

HMMC and MOCL

recommendations

The committee approved the recommendations

made by the committees at their December

meetings

Total resource implication for this

paper per annum: £56k

Medicines Optimisation Clinical Leads

Meeting (MOCL)

- Resource implications identified for

implementation of the majority of

MOCL decisions are none

- Despite removal of one rebate, other

rebates coming on stream mean that

the QIPP target for 20/21 will be met

Herts Medicines Management

Committee (HMMC)

- Lenzetto transdermal spray for

hormone replacement therapy- cost

pressure £5k per annum

- 5th line sequential therapy in the

treatment pathway for moderately to

severely active ulcerative colitis – cost

pressure £36k per annum

- Subcutaneous (SC) infliximab

(Remsima®) for licensed indications –

cost pressure if temporary agreement

is continued –£15k per annum

All HVCCG GPs declared

that they are prescribers

The independent GP on the committee was

able to satisfy the quorum for this decision.22-Apr-21

Boards in Common with ENH & WE CCGs in

Private

28 January 2021BiC/2.3/21 Increments

The Herts Valleys, East & North Herts and West

Essex CCG Boards approved recommendation 3 in

the paper

n/aAll VSM board members

were conflicted

No VSM board member was present at the

meeting. Quorocy was met with deputy

DoN in attendance

22-Apr-21


Private

28 January 2021 BiC/9.2/21

East of England Home Oxygen

Service (HoS) re-procurement

for West Essex, Herts Valleys

and East and North Herts CCGs


Essex CCG Boards approved:

- the proposed contract duration;

- the proposed total contractual value of the new

service;

- the West Essex, Herts Valleys and East & North

Herts proportion of cost;

- proposed approach to the procurement process;

- and management of the new contract by WECCG

subject to the EIA.

N/A N/A 22-Apr-21


Private

28 January 2021BiC/10.2/21

Awards of the contracts for the

provision of specialist fertility

services


Essex CCG Boards gave approval for a contract to

be awarded to the preferred bidders: Bourn Hall

Clinic, Cambridge University Hospital NHS

Foundation Trust, Care Fertility, Create Health Ltd

and IVF Hammersmith, for a contract period of 5

years initial term with an extension period of up to

2 years (as required).

N/A N/A 22-Apr-21

Boards in Common with ENH CCG in Private

28 January 2021 BiC/15.3/21

Joint Clinical Commissioning

Group End of EU Transition

Assurance Paper

Herts Valleys CCG board approved the contents of

the paper and the proposal to maintain a watching

brief through the relevant Local Resilience Forum

and Health Economy meeting groups.

N/A N/A 22-Apr-21


11 February 2021 CE/15.2/21

Enhanced Community ENT

Service contract extension

The committee approved the extension subject to

any ongoing changes required in pathways

This will continue at the same contract

value of £2,031,123 per annum.

National net inflationary uplift will

apply to contract year on year

N/A N/A 22-Apr-21


11 February 2021CE/16.1/21 Nutrition & Dietetics Options

The committee approved 2 year extensions (Nov

21-Oct 23) subject to flexibility in contract to

reflect any pathways/integration issues, also

subject to any technicalities to be refined

£1.13m a year with an extension value

of £2.26m. National net inflationary

uplift will apply to contract year on

year

N/A N/A 22-Apr-21


11 February 2021 CE/17.1/21

Termination of Pregnancy and

Contraception Service contract

extension

The committee approved extension of contracts

together with aligning currencies and prices as

detailed in paper

The cost impact for Herts Valleys CCG

only is £66k for 2021/22 and £84k for

2022/23 (total of £150k).

N/A N/A 22-Apr-21


11 February 2021CE/18.1/21

Level 2 Competency Training

Provision in west Hertfordshire

(Melanie Powell)

The committee approved paper whilst requesting

close monitoring of the contract

TOTAL COSTS

Yr 1 £132,373

Yr 2 £90,939

Note in Year 1 it is assumed that it will

take 6 months to appoint and

therefore the first 6 months is agency

cost at a higher cost. The non-pay and

overhead costs are updated to reflect

this as well.

N/A N/A 22-Apr-21

Executive Committee

3rd March 2021n/a Information Shaing Policy Virtual approval n/a n/a n/a 22-Apr-21

Executive Committee

9th March 202110 IPC Service Business Case

Exec agreed Option 2:

The IPC service to be led by an Assistant Director

for IPC at 8C, with a Developmental IPC Nurse to

be equally divided between the 3 CCGs. 1 interim

RN IPC Project Lead post to be made substantive.

£521,986 n/a n/a 22-Apr-21

Audit Committee

18 March 2021

(Minutes not yet approved)

AC/37.3/21 Write off The committee approved the write off £5,060 n/a n/a 22-Apr-21

Primary Care Commissioning Committee held

in Public

18 March 2021

(minutes not yet approved)

PC/05.3/21Management of Controlled

Drugs

The committee noted and approved the work

done by the Pharmacy & Medicines Optimisation

Team and the memorandum of understanding

(MoU) which moves some work from NHSE to the

CCG PMOT.

n/a n/a n/a 22-Apr-21

Primary Care Commissioning Committee held

in Private

18 March 2021


PC/20.3/21

GP extended access contract

extension for Watford

Extended Access

The committee approved the extension of the

APMS contract for the Watford & Three Rivers

Extended Access contract by 9 months from 1 July

2021 to 31 March 2022 to align

with the other three Extended Access contracts in

St Albans & Harpenden, Dacorum

and Hertsmere until the implementation of the

PCN DES Extended Hours & Extended Access

service in April 2022.

The funding for Extended Access is

part of a national allocation of GPFV

monies. This is funded at £6 per head

per weighted patient population. This

is recalculated at 1 April every

financial year. Based on 1 January

2021 list sizes the resource implication

for Watford contract is as below:

1 Jan 2021 weighted list size Funding

(1 July 2021 - 31 March 2022)

203,448.33 £915.517.49

Watford and Three Rivers

GPs were conflicted but

Asif Faizy Locality Chair and

PCCC member was not able

to attend this meeting.

Not necessary. 22-Apr-21


Public

25 March 2021


tbc CCG Annual Workforce Equality

Data Report 2019-2020

The Boards agreed to the publication of the 2020

workforce equality data and report to meet the

publication requirements of the Equality Act 2010.



Public

25 March 2021


tbcCCG Gender Pay Gap Report

2020

The Boards noted the findings of the Gender Pay

Gap analysis, produced as required by the Equality

Act 2010 (Specific Duties and Public Authorities)

Regulations 2017 and approved the publication

for the CCGs wheres this is required by the 2017



Public

25 March 2021


tbcAutism Spectrum Disorder

(ASD) Backlog Business Case

The Boards approved the non-recurrent funding

for clinical ASD backlog work, and the additional

programme/project management funding to

support backlog clearance.

£2,561,730 n/a n/a 22-Apr-21


Public

25 March 2021


tbc

S256 agreement for the

provision of health and social

care support to community

services within Hertfordshire

HVCCG and ENHCCG Boards approved:

the CCG’s contribution of £6m (HVCCG) and £4m

(ENHCCG) to the S256 agreement for the provision

of health and social care support to community

services within Hertfordshire

£6m n/a n/a 22-Apr-21


Public

25 March 2021


tbc

A framework for harnessing the

power of the Voluntary

Community Faith and Social

Enterprise (VCFSE) sector for

‘health creation

The Boards approved the framework and direction

of travel and the setting up a Joint Strategic

Commissioning Board (VCFSE and Health Creation)



25 March 2021


tbc

West Hertfordshire Hospitals

NHS Trust Electronic Patient

Record System

The Board approved the CCG’s support of £3.8m to

manage the short term cost pressure of the

accelerated timeline of implementation.

£3.8m n/a n/a 22-Apr-21


25 March 2021


tbcBoard tenure decisions for

ratification

The Board ratified the decisions made through

HVCCG designated processes:

1) To extend those GP board member tenures that

would otherwise expire on March 31 2021, until

March 31 2022.

2) To extend those Lay member tenures that would

otherwise expire on March 31 2021, until March

31 2022.

n/aGP board members and Lay

Members

GP board members and lay members were

not included in the decision making

process. A separate appointments

committee which included an independent

lay member was present to approve the

decision.

22-Apr-21

Documents

Herts Valleys CCG Decision Register Quarter 1 2020-21