February 2021

Request received

1. Do you have a children’s palliative care service specification? If so, please attach a copy to your response to this request.
2. Do you have a children’s palliative care service specification which states that infants, children and young people with a life-limiting condition and their parents or carers should have opportunities to be involved in developing an advance care plan?
3. Do you have a children’s palliative care service specification which states that infants, children and young people with a life-limiting condition should have a named medical specialist who leads and coordinates their care?
4. Do you have a children’s palliative care service specification which states that infants, children and young people with a life-limiting condition and their parents or carers should be given information about emotional and psychological support, including how to access it?
5. Do you have a children’s palliative care service specification which states that infants, children and young people with a life-limiting condition should be cared for by a multidisciplinary team that includes members of the specialist paediatric palliative care team?
6. Do you have a children’s palliative care service specification which states that parents or carers of infants, children and young people approaching the end of life should be offered support for grief and loss when their child is nearing the end of their life and after their death?
7. Do you have a children’s palliative care service specification which states that infants, children and young people approaching the end of life and being cared for at home should have 24-hour access to both children’s nursing care and advice from a consultant in paediatric palliative care?
8. Do you have a children’s palliative care service specification which states that infants, children and young people with a life-limiting condition and their families should have access regular short breaks for respite?

Our response

1. Yes.
2. Yes.
3. Yes.
4. Yes.
5. Yes.
6. Yes.
7. No, this is available on an individual basis commissioned through continuing care.
8. Yes, health funded residential short breaks, family breaks through the hospice and at home through continuing care.

Request received

1. The number of pulmonary rehabilitation requests for NHS Kernow?
2. Does the CCG refer to an external provider under a separate contract? If so, who is the provider, and when is the contract due to end?
3. What are the costs per patient for a pulmonary rehabilitation programme?

Our response

1. Circa 800 to 1,000 per annum.
2. Yes. Cornwall Partnership NHS Foundation Trust, they are the community service provider.
3. The service that is commissioned is an integrated community respiratory service includes:
   • outpatient
   • home visits
   • staff education and training delivered by specialist respiratory physiotherapists
   • dietetics
   • occupational therapists
   • speech and language therapist
   • offer of pulmonary rehabilitation

   We therefore cannot provide an accurate cost per patient for pulmonary rehabilitation. In addition due to COVID-19 restrictions pulmonary rehabilitation has changed significantly with virtual and face to face models further skewing the staffing and associated costs.

Request received

1. Please state the number of patients whose care is funded by your CCG who are suffering from a prolonged disorder of consciousness, or otherwise in a minimally conscious state.
2. Please state the number of these patients for whom the condition was the result of an assault, stabbing, or other violent attack. This should be identifiable from records you hold, and given the number of patients is likely small, would be unlikely to breach the cost limit to check.
3. In addition to this, please also state the number of these patients for whom the condition was the result of an assault by a sharp object. However, if looking into this exceeds the cost limit, feel free to limit your response to questions 1 and 2 only.
4. Please provide a breakdown of the cost of caring for these patients, and the length of time they have spent in your care.

Our response

NHS Kernow confirms that we do fund care for people with a prolonged disorder of consciousness. However we are unable to provide the information requested as this is not captured as a disorder of consciousness.

Request received

1. How many packages of live-in care did you commission for the financial year 2019 to 2020?
2. How many providers do you currently purchase live-in care packages from?
3. What is the weekly average price for live in care?
4. How many packages of 24-hour care did you commission for the financial year 2019 to 2020?

Our response

NHS Kernow currently do not commission live in care and are unable to provide the information requested.

Request received

Could you please confirm the following:

1. Total contract value.
2. Start date.
3. End date (if there’s potential for extensions, please confirm this).
4. Procurement route (for example open, direct award).
5. Relevant contact or department managing the contract.
6. Weblink to award notice if possible (Contracts Finder, TED or FTS preferred).

Our response

1. Variable contract, with an indicative value of £146,732.00.
2. April 2018.
3. March 2021 plus 1-year extension to March 2022.
4. G-Cloud framework.
5. Primary care digital team.
6. Details not held.

Request received

1. Which primary care network (PCN), company or other service operates the COVID vaccination clinic(s) (CVC) in your CCG?
2. What date did they start vaccinating patients?
3. Do they have to submit CVC policies and procedures to the CCG for approval?
4. What is the CCG policy on CVCs giving second doses of the vaccines?
5. What procedures do the CVC follow if the vaccine vials have more than the stated doses in, for example if a 10 dose vial has 13 doses; can these doses be used?
6. In CVCs in your CCG, who can administer any extra vaccine doses? Is a PSD needed, and who completes this?
7. In the CVCs in your CCG, what is the procedure at the end of each shift or day for vials with unused doses?
8. Has the CCG had any involvement in this decision?

Our response

1. Each PCN has at least 1 designated site from which clinics are run. They also deliver vaccinations via roving teams visiting care homes and people who are housebound.
2. The first PCN sites (Bodmin, St Austell and Truro) started on 15 December.
3. All sites are required to adhere to nationally defined Standard Operating Protocols. An example of which is the vaccination services deployment in community settings.
4. We are following national guidance that second doses are given 11 weeks after the first vaccination.
5. Yes. PCN sites will hold reserve lists to ensure vaccine is not wasted.
6. PCNs administer all vaccinations in line with national guidance and protocols including national protocols, patient group directives and patient specific directives as required.
7. PCN sites hold reserve lists to ensure vaccine is not wasted.
8. NHS Kernow supports minimising vaccine wastage and ensuring it is used to vaccinate people in line with the Joint Committee on Vaccine and Immunisation prioritisation framework.

Request received

1. Please tell me what correspondence exists between Cornwall Council and NHS Kernow in relation to a section 75 (NHS Act 2006) financial dispute between the 2 organisations. Please list any reports compiled by either organisation within the past 3 months.
2. Please also tell me what aspect of health or social care the dispute relates to, and which organisation had sought to commission the service.
3. How much money is disputed?
4. What are the formal dispute resolution procedures which may have to be invoked?
5. How did this dispute come about within the context of a brand new integrated care system?

Our response

1. NHS Kernow can confirm that there is correspondence between NHS Kernow and Cornwall Council regarding a section 75 financial dispute. Legal advice is being obtained which will inform any action taken by NHS Kernow on this issue. The communications between the 2 parties form part of this request for advice and are therefore subject to legal professional privilege and exempt from disclosure under section 42(1) of the Freedom of Information Act 2000. NHS Kernow considers the public interest in maintaining communication between client and legal advisor overrides the public interest in disclosing the advice in this case. Any reports will also form part of this legal case.
2. The supported living service (SLS) which forms part of the Better Care Fund section 75 agreement.
3. £1.8m.
4. The Better Care Fund section 75 agreement contains a dispute resolution procedure. However, as noted at the Governing Body meeting on Tuesday 2 February 2021, a conflict of interest (COI) has arisen for Helen Charlesworth-May in her joint chief officer role with Cornwall Council and NHS Kernow. We have therefore invoked the bespoke COI protocol that was developed by the 2 organisations should such instances arise.
5. The matter is a legacy issue which pre-dates the integrated care system.

Request received

Regarding the £150m COVID-19 capacity expansion fund (outlined in the NHS England letter of 9 November 2020):

1. How much funding in total was allocated to each of your CCGs from this £150m fund?
2. How much of this funding has been spent by each CCG to date (please indicate the date)?
3. How much of the funding has been committed to be spent by each CCG to date (please indicate the date)?
4. How much of the funding is currently still available to practices at each CCG (please indicate the date)?

Our response

1. £1.531m.
2. As at end of February, £1.371m.
3. £1.531m by 31 March.
4. There is £160k still to be deployed at the end of February.

Request received

1. Please could you confirm the name, title and email address of the individual responsible for commissioning IAPT services?
2. Please could you confirm the name, title and email address of the individual responsible for managing the IAPT service on behalf of the Cornwall Partnership NHS Foundation Trust?
3. If different from the above, please could you confirm the name title and email address of the individual responsible for managing and improving waiting times for the IAPT service on behalf of the Cornwall Partnership NHS Foundation Trust?
4. Please could you confirm the current total cost of the IAPT service and duration of the contract?
5. Please could you confirm when the IAPT service will next be re-tendered?
6. For the years 2018, 2019 and 2020, please confirm:
   • total number of referrals to the IAPT service
   • total number of patients treated by the IAPT service
   • average time to first appointment
   • average number of appointments per patient referred prior to discharge
   • average time from assessment to next session
   • DNA rate of IAPT services
   • number of patients referred back to their GP following initial assessment
   • total number of patients who had:
     • call with assessment team
     • group or course
     • SilverCloud online package
     • appointment with professional (following initial assessment) or step 2 CBT only
     • step 2 and step 3 CBT
     • counselling
7. Please confirm the total number of individuals who have currently been waiting more than 6 months for counselling services?
8. Please share any satisfaction or complaint data you have with regard to your IAPT service.

Our response

1. NHS Kernow does not release the names of employees below director level. John Groom is director for integrated care.
2. Please contact Cornwall Partnership NHS Foundation Trust for this information.
3. As above.
4. 5 years at £4.3m per annum.
5. Procurement timeframes are not yet agreed.
6. Information below for each year:
   • number of referrals – 2018: 9,705; 2019: 13,922; 2020: 10,382
   • data counts distinct patients each year, so will count the same patients’ multiple times in different years if they occur – 2018: 6,996; 2019: 8,300; 2002: 4,847
   • this is based on the year of referral received date in days – 2018: 39.75; 2019: 19.34; 2020: 18.42
   • only counting patients who have been discharged having completed treatment, based on year of discharge date – 2018: 5.28; 2019: 5.12; 2020: 5.77
   • initial assessment to first treatment date in days – 2018: 21.68; 2019: 15.84; 2020: 15.69
   • DNA rate of IAPT services – 2018: 14.85%; 2019: 13.65%; 2020: 11.20%
   • information not held
   • NHS Kernow does not hold this information; this may be available from CFT
7. NHS Kernow does not hold any of this data; this may be available from CFT.
8. NHS Kernow have not received any formal complaints regarding the IAPT service. Please refer to CFT for information regarding satisfaction or complaint.

Request received

1. A copy of the register for your organisation, which would include potential conflicts of interest and financial gifts. If there is not a complete register held we request the information on this topic that the organisation does hold; and information on why the organisation does not hold a complete register. If you are able to send this as a CSV file that would be appreciated.
2. Please can you tell us whether this register is available online, and if so, the URL, or whether it is only available on request.

Our response

NHS Kernow publishes the declaration of interests and gifts and hospitality registers on our website. View the latest declaration of interests and gifts and hospitality register.

Request received

1. The number of NHS GP surgeries or primary care centres currently within NHS Kernow (most recent data available). If possible, can you also provide the names and addresses of these properties.
2. The number of NHS GP surgeries or primary care centres within NHS Kernow currently (most recent data available) located in previously residential class properties. For clarity, I mean how many properties currently in the use class D1 (under 1987 UCO), now E(e) (under 2020 UCO), have been previously classed as C3 (dwelling houses). If possible, can you also provide the names and addresses for any such properties.
3. If held, could you provide equivalent data for the years 2000 and 2010.

Our response

1. Information about Cornwall and Isles of Scilly primary care networks (PCNs) in Cornwall is available on NHS Kernow’s website primary care networks webpage.
2. There are 59 PCN’s and 110 GP branches. NHS Kernow exempts the release of the information requested under section 21 of the act: information is reasonably accessible to the applicant by other means. Names and addresses of GP properties can be obtained through the website link included above. Each GP practice includes branch details.
3. NHS Kernow does not hold this information.

Request received

1. Any application you made in 2019 or 2020 to be a Stonewall Diversity Champion or to be included on Stonewall’s Workplace Equality Index. Please include any attachments or appendices to those applications. Please redact personal details if necessary.
2. Any feedback you received in 2019 or 2020 from Stonewall in relation to either application or programme.
3. Any other communication you have received from Stonewall in 2019 or 2020 unless privileged or otherwise exempt from disclosure. If you claim privilege or exemption in relation to any material, please say in broad terms what the material is and the basis on which you claim to be entitled to withhold it.
4. Full details of any equality impact assessment you carried out connected with any of these applications. Please include any equality impact assessment carried out prior to an earlier application of the same kind, if no further assessment was done.
5. Details of the total amount of money you paid to Stonewall in 2019 and 2020 for payment for goods or services.
6. Whether you intend to continue your membership of any Stonewall scheme in the future, and if so which.

Our response

1. 2019 application available.
2. Feedback received.
3. Emails received.
4. Not completed.
5. 2019: £9,966. 2020: £0.
6. Awaiting funding for 2021/22 to be approved.

For answers 1 to 3, please email our FOI team for a copy of the response.

Request received

The name and email address of your:

1. Performance director, or the person within the CCG that has responsibility.
2. Transformation director, or the person within the CCG that has responsibility.
3. Chief information officer, or the person within the CCG that has responsibility.
4. IT manager, or the person within the CCG that has responsibility.
5. Telecoms manager or director, or the person within the CCG that has responsibility.
6. Head of primary care, or the person within the CCG that has responsibility.
7. Medical director or chief medical officer, or the person within the CCG that has responsibility.

Our response

1. Clare Bryan.
2. Carolyn Andrews.
3. As number 1.
4. Andrew Abbott.
5. As number 4.
6. As number 4.
7. Natalie Jones.

Request received

1. Is your CCG a member of any integrated care partnerships (ICPs)?
2. Please provide the name(s) of all the ICP(s) that you participate in.
3. Who within your CCG or GP practices sits on the ICP board?
4. For each ICP, please provide the name and ODS code for each participating GP practice.

Our response

1. Yes.
2. Cornwall and the Isles of Scilly Health and Care Partnership.
3. Information relating to Isle of Scilly Health and Care Partnership was previously released in September 2020. The response was published on our website September 2020 disclosure log. More information is available on the Cornwall and the Isle of Scilly Health and Care Partnership website.
4. Information about Cornwall and Isles of Scilly primary care networks is available on our website.

Request received

1. Which department or departments are responsible for overseeing legal affairs when your CCG is a party to a legal hearing, for example legal services or HR? Legal hearings such as those brought against or for the CCG (high court, coroners court, criminal proceedings), or more internal matters, for example employment tribunals.
2. Please can you provide the name and contact details of the people overseeing this department(s)?
3. Within this department(s), please, can you provide the details of staff who are responsible for day-to-day managing of the following legal areas:
   • commercial litigation
   • crime
   • crime-fraud
   • employment
   • intellectual property
   • litigation general
4. Which department or departments are responsible for managing or supporting staff who are giving evidence at a legal hearing. For example providing time off to attend court or providing support with training. Please can you provide the name and contact details of the people overseeing this department(s)?

Our response

1. There is not one team who holds this responsibility for NHS Kernow. Our corporate governance team take the lead for the overseeing of legal affairs relating to clinical negligence and employer liability claims when the CCG is party to hearing. They do this in liaison with NHS Resolution, who provide legal expertise. In the event of an employment tribunal the legal aspect would be led by human resources. Our nursing and quality team will support issues relating to the coroners court and the court of protection. Our contracting team is the first point of contact with NHS Kernow’s solicitors.
2. Due to the different teams involved, the first point of contact is typically the deputy director of corporate governance via the (corporate governance email address). They would then ensure correspondence is forwarded to the appropriate individual. Please note as a CCG we do not provide the names and contact details of members of staff below director level as part of FOI requests.
3. The information requested is not held by NHS Kernow as we do not have team members with specific responsibilities relating to specific legal areas. NHS Kernow has access to specific legal expertise through NHS Resolution. It also has a counter fraud service provided by TIAA.
4. Our HR team are responsible for providing access to training and manage our leave policy. The director with responsibility for this is Paul Hulme, interim director of people and corporate services.

Request received

1. Between 29 October 2019 and 28 October 2020 (inclusive), how many:
   • patient safety incidents did community pharmacies report to your CCG, relating to the CPCS?
   • near misses did community pharmacies report to your CCG, relating to the CPCS?
   • incidents relating to the CPCS referral process did community pharmacies report to your CCG?
   • operational issues relating to the CPCS did community pharmacies report to your CCG?
2. Since 29 October 2020 (inclusive), how many:
   • patient safety incidents have community pharmacies reported to your CCG that relate to the CPCS?
   • near misses have community pharmacies reported to your CCG that relate to the CPCS
   • incidents relating to the CPCS referral process have community pharmacies reported to your CCG
   • operational issues relating to the CPCS have community pharmacies reported to your CCG
3. For each incident recorded in response to questions 1 and 2, please provide a copy of the incident reporting form submitted to the CCG, with patient identifying data redacted.

Our response

NHS Kernow does not hold the information requested, for more information please contact NHS England who commission community pharmacies services.

Request received

1. Do you have any guidelines or formularies in place which govern the use of patient blood glucose monitoring meters at the point of care? If yes please provide the details of these guidelines.
2. Do you have any guidelines or formularies in place which govern the use of patient blood ketone monitoring meters at the point of care? If yes please provide the details of these guidelines.
3. From the options below, please indicate the closest proportion of consolidated blood glucose and ketone meters in use at your site as compared to separate meters:
   • 10% consolidated meters versus 90% separate meters
   • 25% consolidated meters versus 75% separate meters
   • 50% consolidated meters versus 50% separate meters
   • 75% consolidated meters versus 25% separate meters
   • 90% consolidated meters versus 10% separate meters

Our response

1. Yes. This information is available on NHS Kernow formulary website under glucose meters.
2. Yes. See above.
3. Available in the manufacturer’s guidance included in the formulary website, which can be accessed through link provided in answer 1.