December 2020

Request received

1. Where is the new care home in Penzance situated? Please give the post code.
2. What form did the confirmation that a purpose built new care home is to be open in Penzance take? Who sent it, and to whom? Please provide a copy.
3. Who is or will be the owner of the building that is to house the new care home and who is or will be the owner of the land on which it is situated?
4. Has planning permission been granted for building the new care home and/or for any conversion works that are anticipated? If not, when is it expected to be granted?
5. Does a signed contract exist between NHS Kernow, Cornwall Council and the owner of the building? If so, please provide a copy of that document.
6. What communications have there been between NHS Kernow and Cornwall Council officers and members (Governing Body members and Cornwall councillors) concerning the new care home and the role that it will play? Please provide copies of those communications.
7. What decisions have been taken, and by whom, and where are they recorded, about who will manage the building that is to house the new care home? Please provide those records.
8. What decisions have been taken, and by whom, and where are they recorded, about the numbers or proportions of nurses, physiotherapists, occupational therapists and members of other professions who will work in the new care home, and who their employer(s) will be? Please provide those records.
9. What decisions have been taken about how the new building will be equipped, and who will pay for the equipment and its installation? Please provide the records of those decisions.
10. What steps has NHS Kernow taken to ensure that its officers are familiar with the NICE guideline: Intermediate care including reablement?
11. Has NHS Kernow decided that the new care home should accommodate long-term residents? If so, please provide documents that demonstrate that thought has been given to how to accommodate short-term and long-term residents in the same establishment.
12. Please also provide documents that demonstrate that thought has been given to how to accommodate people who are being assessed for continuing healthcare (discharge to assess) alongside people who are taking part in a reablement programme.
13. Is NHS Kernow recording – and planning to record in the future – the numbers of Penwith residents (aged both under and over 65) who on discharge from Treliske find themselves in a community hospital in St Austell, Newquay, Bodmin or Liskeard? Please supply those numbers for the individual months since 5 April 2020?

Our response

The new care home is the responsibility of Cornwall Council; please contact them for more information. The care homes purpose will be determined by its owners.

Governing Body members were informed about the new care home in the public session of the Governing Body meeting on 1 December, the minutes are published on our website.

As the numbers of Penwith residents (aged both under and over 65) who have been discharged from Royal Cornwall Hospital to community hospitals in St Austell, Newquay, Bodmin or Liskeard, broken down by hospital, age and month since April 2020 are less than five, NHS Kernow is unable to provide this information in this way due to section 40 of the Freedom of Information Act 2000, as it could identify individuals involved.

Please see below summary by month and by hospital:

• April 2020 – 7
• May 2020 – 5
• June 2020 – less than five
• July 2020 – 5
• August 2020 – 8
• September 2020 – less than five
• October 2020 – less than five

Please see below summary by hospital:

• St Austell Community hospital – 12
• Bodmin Hospital – less than five
• Liskeard Community Hospital – less than five
• Newquay Hospital – 13

In total there have been 32 Penwith residents discharged from Royal Cornwall Hospital to the above community hospitals April to October 2020.

Request received

Under the FOI Act could you please provide me with the following information for financial year 2020 to 2021:

• your budget for continuing healthcare (adults and children combined).
• how much you spent on promoting continuing healthcare as outlined in the National Framework for NHS Continuing Healthcare and NHS Funded Nursing Care (2018), paragraph 21(b) on page 10.

Our response

Under 21 of the Freedom of Information Act NHS Kernow publishes budgets on a monthly basis as part of our Governing Body papers.

NHS Kernow has not spent any money on promoting NHS continuing healthcare and NHS funded nursing care.

Request received

1. What platform are you currently using for video consultations?
2. When was the platform in (1) procured?
3. Under what framework was the platform in (1) procured?
4. What is the contract length for the platform in (1), including any extensions?
5. Was the platform in (1) procured centrally (for example by NHSD) or locally (for example by your organisation)?
6. What was the pricing methodology of the platform in (1) – per patient, per appointment, per seat, other? If other, please specify.
7. How many organisations within the CCG (practices, primary care networks, any others) are currently using the platform?
8. Prior to COVID-19, what platform was being used by the organisation for video consultations?
9. Once the central contract for AccuRx ends, does your organisation plan to go out to the market via a framework? If yes, which framework will be used? If no, will AccuRx’s contract be extended?

Our response

NHS Kernow is a clinical commissioning group and not a clinical provider.

59 GP practices are registered with AccuRx.

NHS Kernow has not received any specific funding for video consultations; the decision will be down to primary care networks.

Request received

I understand that currently consideration is being given to deliver upwards of 1,000 vaccinations a day from the village of Pensilva.

Please could I ask for a copy of the selection criteria and copies of any locally developed discussion documents. I also would like to know whether the police have been consulted regarding traffic management.

What criteria were applied regarding accessibility by public transport, availability of volunteer drivers?

How were the needs of a rural car poor community considered?

Our response

This is because deliveries of the Pfizer vaccine are in batches of around 1,000 and need to be used within a few days.

The vaccine roll out is run by NHS England, all selection criteria documentation is publicly available. We therefore apply section 21 of the freedom of information act: Information reasonably accessible to the applicant by other means.

NHS Kernow does not hold any locally developed discussion documentation; if it exists it will be held by the local GP network.

The police are notified of all primary care vaccination sites and provide advice on traffic management and security.

Each group of practices can determine their own criteria based around the national restrictions of the Pfizer vaccine. The CCG does not hold any of this information.

Request received

Do you fund your hospital trusts on block funding or national tariff?

Our response

NHS Kernow funds hospital trusts on both block funding and national tariff.

Request received

Do you incentivise your GP practices on any aspects of delivery of the national diabetes eight key care metrics?

Our response

In addition to the national quality outcomes framework incentives for the eight key care metrics, NHS Kernow also incentivise for targeted projects. This includes improvement of the three treatment targets (Hba1C, blood pressure, cholesterol), and a person centred approach to annual reviews.

Request received

Who is responsible for the delivery of the personal health budgets for:

• mental health and what are their contact details (name, email and phone number)?
• children, young people and families and what are their contact details (name, email and phone number)?
• end of life care and what are their contact details (name, email and phone number)?
• people with a learning disability or autism or both and what are their contact details (name, email and phone number)?

Could also tell me who is responsible for the delivery of personal wheelchair budgets and maternity care budgets what are their contact details (name, email and phone number)?

Our response

The director with responsibility for personal health budgets is John Groom.

Request received

Since December 2019, anyone who is eligible for an NHS wheelchair is entitled to a personal wheelchair budget. Clinical commissioning groups must publicise and promote the availability of personal wheelchair budgets, and provide information, advice and support to those eligible, their representatives, families and carers, to help them decide if a budget is right for them. This information should be readily available (guidance on the legal rights to have personal health budgets and personal wheelchair budgets, version 1, December 2019).

Please provide a copy of the information you provide to those entitled to a personal wheelchair budget, and confirm the number of families, of primary school aged children, that have elected to use their personal wheelchair budget outside of NHS commissioned services, with a third party provider since December 2019.

Our response

Personal wheelchair budgets are still currently being implemented in Cornwall and the Isles of Scilly. Until this implementation is completed a voucher scheme is in operation. For further information on the voucher scheme, information provided to those entitled and a breakdown of those families with primary school aged children that have elected to use the voucher scheme with a third party provider since December 2019, please contact the Cornwall wheelchair service who will hold this information.

Request received

For questions 2 to 6, please supply this information as a snapshot at the end of the year for the financial years 2019 to 2020 and the most up to date snapshot available for 2020/21.

1. Please could you supply the name, email address and telephone number of the commissioner with responsibility for learning disabilities placements?
2. Please provide the total number of adults with learning disabilities funded by the CCG in residential care.
3. Of the total number of adults with learning disabilities funded by the CCG in residential care (Q2) please provide the number that are in area placements and the number that are in out of area placements.
4. Please provide the total number of adults with learning disabilities funded by the CCG in supported living.
5. Please provide the number of adults with learning disabilities who transitioned from children’s learning disabilities services into adult’s services – in total, into adult residential care services only, and into adult supported living services only.
6. Please provide the number of adults with learning disabilities who stepped down from specialist inpatient hospital placements into adult residential care and supported living services.
7. Please provide the CCG’s total expenditure on residential care and supported living for adults with learning disabilities for the financial year 2019 to 2020, and budgeted expenditure for 2020/21.
8. Please provide the highest, lowest, and average weekly rate paid by the CCG for residential care placements for adults with a learning disability for each of the financial years 2019 to 2020 and 2020 to 2021. If the CCG has weekly rate bands, please also provide these.
9. Please provide the highest, lowest, and average hourly rate paid by the CCG for supported living placements for adults with a learning disability for each of the financial years 2019 to 2020 and 2020 to 2021. If the CCG has hourly rate bands, please also provide these.

Our response

The director with responsibility for learning disabilities is John Groom or call 07917 643646.

The total number of adults with learning disabilities funded by NHS Kernow are below.

• in residential care: 2019/20 – 43, 2020/21 – 41
• in area residential care: 2019/20 – 30, 2020/21 – 29
• out of area residential care: 2019/20 – 13, 2020/21 – 12
• in supported living: 2019/20 – 19, 2020/21 – 17

As the number of adults with learning disabilities who stepped down from specialist inpatient hospital placements into adult residential care and supported living services is less than five, NHS Kernow exempts the release of this information under section 40 of the Freedom of Information Act 2000 – Personal Information, as it could identify individuals involved.

NHS Kernow’s total expenditure on residential care and supported living for adults with learning disabilities for the 2019 to 2021 was £7,594,512.00 and spend to date for 2020 to 2021 is £7,898,456.00.

The highest, lowest and average weekly rates paid by NHS Kernow for residential care placements for adults with a learning disabilities are below.

2019 to 2020:

• highest – £4,281.00
• lowest – £44.42
• average – £1,673.00

2020 to 2021:

• highest – £6,221.00
• lowest – £52.86
• average – £2,115.00

The hourly ceiling rates for domiciliary care funded by NHS Kernow are below.

2019 to 2020:

• Home care (day rate) – £19.94
• Home care (waking night role) – £15.90
• Supported lifestyles (core) – £15.90
• Supported lifestyles (1:1) – £17.49
• Supported lifestyles/home care (night rate-sleep in) – £11.75
• Supported lifestyles (waking night) – £15.90

2020 to 2021:

• Home care (day rate) – £20.54
• Home care (waking night role) – £16.38
• Supported lifestyles (core) – £16.38
• Supported lifestyles (1:1) – £18.01
• Supported lifestyles/home care (night rate-sleep in) – £12.10
• Supported lifestyles (waking night) – £16.38

Request received

1. Have you heard of the service Shout? If yes, was this an advertisement on the tv, word of mouth or through marketing communications?
2. Since the beginning of the 2018 to 2019 financial year, have you commissioned or used (if free) any external provision to support individuals who may be anxious, stressed, depressed, suicidal or overwhelmed and who need immediate support? This can include provision delivered directly to targeted populations or universal services marketed and offered in your locality? If yes, please can you provide the name of the provision, name of the provider, what the focus and main issues addressed by the provision are? For example relationships, online safety; bullying; domestic abuse or healthy relationships; self-esteem or resilience; mental health; anxiety and depression).
3. Who is the provision aimed at? For example children and young people, adults, new parents, the locality population.
4. How is the provision delivered? For example group work, one to one work, marketing of support services, helpline.
5. Are there any target groups your current provision is unable to reach? For example new parents, children in care, secondary school, unemployed.
6. What is the annual cost of the provision?
7. If you have an ongoing contract or licence for the provision, when does this end?
8. Do you have an annual budget for externally commissioned mental health provision? If yes, how much is the budget and how is it split? For example cost of service delivery, marketing budget for new service.
9. Since the beginning of the 2018 to 2019 financial year, have you commissioned or used (if free) any external provision to train and support staff working with individuals who may be anxious, stressed, depressed, suicidal or overwhelmed and who need immediate support? This can include training for targeted populations or universal training within your locality? If yes, who is the provider, what is the focus or the main issues addressed by the training, who is the provision aimed at, how is the provision delivered and what is the cost of the training?
10. If you have an ongoing contract/licence for the training, when does this end?
11. Did your organisation tender for any mental health support service provisions during the 2019 to 2020 or 2020 to 2021? If yes, please can you provide the name of the service tendered for, the name of the successful bidder, the value of the tender per annum and the start and end date of the new service.
12. Who is the lead contract in your organisation for commissioning Mental Health support Services

Our response

NHS Kernow has not heard of Shout services for adults.

In 2018 to 2019 NHS Kernow has commissioned external provision from NHS providers to support individuals who may be anxious, stressed, depressed suicidal or overwhelmed and who need immediate support as below.

Name of provision: Vocational workers, community development workers and community enablement:
Provider: Pentreath Ltd
Main focus: Employment and mental health
Aimed at: 18+
How provision is delivered: A range of face to face, group work, online, digital
Annual cost or provision: £45,000.00
Contract end date: 31 March 2023

Name of provision: Mobile crisis pop-up café
Provider: Valued Lives
Main focus: Crisis support
Aimed at: 14+
How provision is delivered: A range of face to face, group work, online, digital
Annual cost or provision: £180,000.00
Contract end date: Part of block contract with CFT

Name of provision: Safe and supported return home scheme
Provider: Valued Lives
Main focus: Crisis support
Aimed at: 14+
How provision is delivered: A range of face to face, group work, online, digital
Annual cost or provision: As part of the £180,000.00 above
Contract end date: Part of block contract with CFT

Name of provision: Hear our Voice
Provider: Young People Cornwall
Main focus: Anxiety and depression
Aimed at: 8 to 18 year olds
How provision is delivered: Virtual, individual and group provision
Annual cost or provision: Incremental increases year on year to 2023 to 2024 – £223,000
Contract end date: 31 March 2024

Name of provision: Interpersonal psychotherapy for adolescent
Provider: Xenzone
Main focus: Anxiety and depression
Aimed at: Young people
How provision is delivered: Individual provision
Annual cost or provision: £53,000 for one year in 2019 to 2020

NHS Kernow does not set budgets that specifically cover mental services that exclude those commissioned and provided by NHS mental health providers as some budgets will include both NHS and private provider spend. However, we can confirm that in 2019 to 2020, spend against private providers for mental health services excluding continuing healthcare was £16.077m. Please note that this includes mental health packages of care.

NHS Kernow did not tender for any adult mental health support service provisions during the 2019 to 2020 or 2020 to 2021.

NHS Kernow submitted on behalf of the Cornwall and Isles of Scilly system, successful expressions of interest in waves 1 and 3 of the national mental health support teams in schools (MHST) programme. The delivery of MHST forms part of the overall children and young people’s mental health contract with Cornwall Partnership NHS Foundation Trust (CFT). CFT will receive the national transformation funding profile for the years set out in the NHS mental health implementation plan 2019 to 2020 and 2023 to 2024.

NHS Kernow is not planning any tenders for the provision of adult or children’s mental health support during 2020 to 2021.

The director with responsibility for mental health is John Groom director for planned care and integrated care. You can contact John on 01726 627800.

Request received

Please can you tell me how many GP practices in your CCG area have sent letters out to patients requesting they complete do not attempt resuscitation (DNAR) forms between 1 March 2020 and the present date (8 December 2020).

Please can you include the name of the practice, how many DNAR forms were sent, how many DNARs have been issued and the age of the person who is the subject of the DNAR.

If possible, please also include the basis on which the DNAR was issued.

Please can you also tell me how many complaints you are aware of related to a DNAR being issued at any point between 1 March 2020 to 8 December 2020 in your area and please provide as much detail as possible about the nature of the complaint.

Our response

NHS Kernow does not hold this information on behalf of GP practices, for more information please contact them directly.

Request received

Please provide the following information in electronic format regarding formularies and rebate schemes for blood glucose test strips

1. Does the health board have a formulary for blood glucose test strips? If so please can you provide the formulary or link to the formulary.
2. If you cannot provide a link, can you advise which products are included under what guidance?
3. Please advise who the responsible medicines optimisation contact for the above formulary and their contact details.
4. Please advise the dates when the above formulary was last reviewed and when it is due for next review?
5. Please provide a list of all blood glucose test strip rebate schemes that are currently in place
6. For each of the blood glucose test strip rebate schemes currently in place please provide the following information where possible
7. The name of the blood glucose test strip included in the rebate scheme.
8. The start and, if applicable, end date of the rebate scheme.
9. Is the rebate scheme based on an agreed volume?
10. Is the rebate scheme based on a percentage of blood glucose test strips prescribed?
11. Is there any other condition to the rebate scheme?
12. What is the value of the discount applied to the NHS drug tariff price of the blood glucose test strip?

Our response

NHS Kernow’s blood glucose formulary is available online on the Cornwall Joint Formulary. This formulary was last reviewed in November 2018, it is due for review in November 2021.

The director with responsibility for medicines optimisation is Andrew Abbott.

NHS Kernow does not have any rebate schemes for blood glucose test strips.

Request received

I am contacting yourselves to request the following information regarding details of blood glucose monitors within the CCG:

1. A weblink to your current blood glucose testing formulary.
2. The name(s), direct contact email address(es) and direct telephone numbers of the person(s) in your medicines management team who is responsible for the blood glucose meters formulary within the CCG
3. The date of the next review of your formulary in respect of blood glucose meters.
4. How do you intend to review your formulary (detail to include process, time lines)?
5. Is your CCG part of a local partnership arrangement for formulary review?
6. If so, please provide the names of other CCG’s included in the arrangement and the contact name, email address and telephone number for the person with responsibility for blood glucose meters.

Our response

NHS Kernow’s blood glucose formulary is available online on the Cornwall Joint Formulary.

The medicines management team may be contacted via email, please note they do not have a direct dial phone number. The director with responsibility for this service is Andrew Abbott.

The blood glucose formulary will be reviewed in November 2021.

Meters will be assessed against a number of criteria, including but not limited to meter specification, accessibility, user acceptability and cost effectiveness.

NHS Kernow is not part of a local partnership arrangement for formulary review.

Request received

I am writing to you to request for information under the Freedom of Information Act 2000 regarding the following:

• accessing newly approved migraine treatment – Fremanezumab
• the number of headache specialists/clinics in your commissioning area

I would be grateful if you would let me know:

1. Whether you have signed the relevant documentation to make Fremanezumab available for patients who are eligible?
2. Has it been signed off and implemented?
3. Was access to Fremanezumab signed within the 90 days of NICE approval?
4. How many patients have blue tech approval in your clinical commissioning area?
5. How many specialists are there in your area or do you have a headache specialist clinic?
6. Do you know the waiting time to access a specialist who prescribes Fremanezumab?
7. Whether the administration of the treatments is monitored by a headache specialist?
8. Has there been applications to access the drug made by patients?

Our response

NHS Kernow approved the use of the migraine treatment Fremanezumab at the Cornwall Area Prescribing Committee on 16 September 2020. This has been implemented.

Royal Cornwall Hospitals NHS Trust (RCHT) have two full time consultant neurologists, a part time consultant neurologist and a GP who does regular hours for the service.

NHS Kernow does not hold the information on waiting times and administration, please contact the providers Royal Cornwall Hospitals NHS Trust and University Hospitals Plymouth NHS Trust.

Request received

1. How do persons seeking advice on a sexual health matter engage with your services?
2. Do you provide online self-service sexual health services (such as STI or HIV testing or contraception queries)? If yes – please provide a link. If no, see next question.
3. Which organisations provide sexual health specific services within your CCG? Please provide website or contact information.
4. Who is responsible for health care digital transformation (please provide contact information) within region? If this is a specific team, then again, please provide contact details.
5. What is the appropriate channel to arrange a conversation or meeting with the digital transformation lead?
6. What is the annual cost of the provision of sexual health services within your CCG region?

Our response

Sexual health services are commissioned by Cornwall Council’s public health team. Please contact them for more information.

Request received

Could you please provide me with the following information related to Cornwall’s Integrated Urgent Care service:

• Provider name
• Partner provider name (if applicable)
• Service(s) provided (for example 111 or GP out of hours)
• Contract start date
• Contract end date
• Optional contract extension in years (if applicable)
• Contract value in Great British Pounds
• Commissioning intentions at the end of the current contract

Our response

Cornwall’s integrated urgent care service contract is with Royal Cornwall Hospitals NHS Trust. The partner providers are Kernow Health CIC and Vocare. They provide 111 and GP out of hours services.

This contract started on 30 November 2017 and the end date is 30 November 2022.

The value of the contract is £48,409,755.00.

The commissioning intentions for the end of the contract are under review.