July 2020

Request received

I am writing to you regarding the Cornwall (Kernow) trailblazer area expanding access to mental health care for children and young people.

We are trying to understand to what extent the programme is engaging with schools for excluded children.

1. Please could you provide a list of each educational setting the mental health support team is (or has been) active in since its inception. Please note the name and URN or UKPRN where applicable.
2. Please could you list which mental health support team members (role and NHS band) have been active in alternative provision settings and with what frequency. Where team members have visited multiple alternative provision settings, please list each one as a separate entry.
   • pupil referral units
   • alternative provision free schools
   • alternative provision academies
   • independent alternative provision
   • other alternative providers
3. Please indicate whether your trailblazer area has a specific strategy in place to work with pupils in schools for excluded children. If yes, please give details. Where this information is publicly available, please signpost.

Our response: 5 August 2020

NHS Kernow does not hold the information requested, for more information please contact Cornwall Partnership NHS Foundation Trust.

The strategy agreed as part of the local transformation plan for children and young people’s mental health, is that mental health support teams [MHST] have been recruited into localities, prioritised using the national guidance, based on a range of measures of deprivation and need. From wave 1, Kerrier and Restormel localities have received 1 team each and from wave 3, north Cornwall will receive 2 teams. At this time, the strategy is to target MHST at primary and junior age range children (reception to year 6) and their transition to secondary age range (Year 7). All children within localities with teams and with appropriate needs to the MHST skill set, are eligible to receive support from an MHST.

Request received

What specialist CAMHS services do you commission for children and young people and who provides these (e.g. eating disorder services, talking therapies, etc.)?

1. What other services do you commission to support the mental health of children and young people and who provides these?
2. Given the recent national decrease in referrals and the additional potential impact of Covid-19 on mental health, what plans are you developing to cope with increased or changing need for mental health support for children and young people in your area?
3. How many contacts did the CAMHS services you commission have with children and young people in the following months? March 2019, April 2019, May 2019, March 2020, April 2020, May 2020.
4. What proportion of these contacts were young people from the following ethnic backgrounds? Asian, black, mixed, white and other.

Our response: 5 August 2020

Unless annotated otherwise, CAMHS services are provided by Cornwall Partnership NHS Foundation Trust (CFT):

• child adolescent mental health service is commissioned as a single service based on pathways of care. Specific details on the diagnosable mental health conditions supported can be sourced from the provider
• children and young people crisis mental health response
• infant mental health (pilot)
• early intervention psychosis (from age 14+)
• community eating disorders is provided by a tri-partite set of providers; CFT, Royal Cornwall Hospitals NHS Trust and Kernow Health CIC with linked pathways to University Hospital Plymouth
• acute psychology service, provided by Royal Cornwall Hospitals NHS Trust

Other services commissioned:

• mental health support teams in schools (x2), provided by CFT
• children’s wellbeing practitioners, provided by Young People Cornwall
• creative arts and play therapy project, managed by Young People Cornwall, provided by independent psychotherapists
• mind and body, self-harm in schools, provided by We Are With You
• LGBTQ+ targeted support, jointly commissioned with Cornwall Council, provided by Intercom Trust
• domestic abuse and sexual violence, associate commissioner with Cornwall Council, provided by FirstLight and Barnardo’s
• general and suicide bereavement service, provided by Penhaligon’s Friends
• IAPT talking therapies (from age 16 years old), provided by Outlook South West (now part of CFT)

Adapted services commissioned to continue to support young people’s mental health:

• most complex crisis presentations remain face-to face unless suitable for intervention by virtual appointment
• non-crisis presentations moved to a majority non face-to-face operating model using Attend Anywhere
• 24/7 mental health helpline has dedicated option for children and young people services
• extension of web-chat and internet based activities later into the day (Young People Cornwall)
• creation of single resource page of mental health materials (Cornwall Council and NHS Kernow websites) including guides from local and national providers and across the age range and from parent and professional perspectives
• engagement process to seek the views of those accessing services during COVID-19 operations as to the benefits and dis-benefits of non-face-to-face delivery methods

Planned to commission additional services:

• children’s wellbeing practitioners [x2] from September 2020
• mental health support teams in schools [x2] from November 2020
• children crisis mental roles at implementation
• IAPT talking therapies

Modelled future demand on services 2 surge planning groups have been established:

1. 16+ surge planning group
2. children and young people surge planning group in conjunction with education and social care. A task and finish group from the children and young people transformation programme specifically looks at the age slice of 16 to 25 years old and the transition needs of this group across health, education and care

Developed a plan for your area

Children and young people plans in response to COVID-19 are drafted and are overseen by the CYPMH Partnership Group and then One Vision (STP level board for children, young people and families). The local transformation plan ‘Turning the Tide’ will be refreshed with the changes in September 2020

Partnered with other organisations such as charities and youth services

Children and young people’s mental health transformation has a long standing multi-partner partnership group including:

• care and education colleagues
• voluntary and community sector partners
• young people themselves
• specialist mental health clinicians and GPs
• parent carer representatives

Cornwall and Isles of Scilly is an i-Thrive community of practice site and partners lead on their areas of responsibility or expertise, rather than their commissioning responsibilities. For example, early help for schools and communities is facilitated by local authority colleagues; access to specialist support facilitated by NHS Kernow.

Other initiatives delivered to support young people’s mental health during this period

The COVID-19 response has been a system response involving commissioners and providers from across health, education and care. Details of the following can be sourced from Cornwall Council and separately the Council for the Isles of Scilly:

• early help for schools and communities
• return to school support and virtual binders
• BLOOM
• Together for Families (Cornwall Council)
• the work of the local authority psychology service

The following tabled statistics are extracted from the provider reports to the commissioner. They should be viewed with the following additional information:

• pre COVID-19 the transformation of children and young people mental health services included developments in the way activity is recorded and reported in conjunction with the needs of the mental health services data set
• infant mental health pilot activity is included within the core information line within the table below
• children crisis mental health response has been separated from being recorded in 2019 within the overall core activity to an activity line of its own. As such any requirement for this particular service line for 2019 would need to be sourced from CFT
• early intervention psychosis does not routinely report activity split by age. As such any requirement for this particular service line for 2019 would need to be sourced from CFT
• in March 2020, routine reporting was relaxed in line with the national pandemic response guidance
• acute psychology service information can be sourced from Royal Cornwall Hospitals NHS Trust

Core CAMHS:

Crisis response:

Primary mental health:

Community eating disorders:

The following tabled statistics are extracted from the provider reports to the commissioner. They should be viewed with the following additional information:

• the ethnicity measures used by the provider do not exactly match those requested in this FOI. Best endeavours have been made to collate the information into the FOI requested options. As such white has been interpreted as white British. If further analysis of the ethnicity analysis is required, a request should be made of CFT
• from 1 April 2020, the ethnicity data is not routinely reported to the commissioner as this data is available from NHS Digital and the mental health services data set

Core CAMHS:

Primary mental health:

Community eating disorders:

Marked * NHS Kernow holds the information. However where the numbers are less than 5, the information cannot be disclosed. It could potentially identify the individuals involved. Especially if combined with other data, this would constitute a breach of the Data Protection Act 2018. Therefore, this information is exempt from disclosure under section 40(2) of the Freedom of Information Act 2000 on the grounds that it is personal information.

Request received

1. Between March 2020 and July 2020, the number of childhood vaccinations administered under the NHS vaccination schedule for children aged 8 weeks, 12 weeks, 16 weeks and 1 year
2. Please provide same data for same period in the previous five years
3. Please provide data including total number of children up to 1 year old registered at GP practices in your CCG

Our response – 29 July 2020

NHS Kernow does not hold this information. For more information please contact NHS England.

Request received

1. How many packages of live-in care do you commission each year?
2. How many of these packages do you consider to be for standard care needs and how many are more complex?
3. How many providers do you currently purchase live-in care packages from?
4. What are the price points of your live-in care packages?
5. How do you procure these packages i.e. spot purchase, framework etc?
6. If via a framework or other formal contract arrangement, is this currently open for new providers to join?

Our response – 31 July 2020

NHS Kernow currently do not commission live in care.

Request received

1. What was the average time period in the CCG in days/hours from the point at which a Fast Track CHC application is made to the care package being provided for the financial year 2019 to 2020?
2. What was the average time period in days/hours from the point at which a Fast Track CHC application is approved to the care package being provided for the financial year 2019 to 2020?
3. During the financial year 2019 to 2020, how many applications for fast track CHC did the CCG receive?
4. During the financial year 2019 to 2020, how many applications for fast track CHC were funded?

Our response – 31 July 2020

1. NHS Kernow do not collect the data as requested.
2. NHS Kernow do not collect the data as requested.
3. 1,640.
4. 1,127.

Request received

1. Can you provide details of your current clinical benchmarking supplier: examples such as HED, Doctor Foster or CHKS?
2. Can you provide details of the current renewal/end date of this contract?
3. Who is the main point of contact for this contract and their title and contact details?
4. Which board member has responsibility for benchmarking?

Our response – 31 July 2020

1. HED and NHS benchmarking.
2. April 2021.
3. NHS Kernow does not release the names of employees below director level. The director with responsibility for procurement and contracting is Clare Bryan, chief finance officer.
4. Finance director.

Request received

1. The number of INR tests carried out in 2019 per month
2. The number of patients seen per month (would say for 2019)

Our response – 23 July 2020

Please see below for the number of INR tests carried out in the 2019 to 2020 financial year in NHS Kernow’s practices.

• April 2019: 6,451
• May 2019: 6,464
• June 2019: 6,577
• July 2019: 6,536
• August 2019: 6,233
• September 2019: 6,301
• October 2019: 6,387
• November 2019: 3,211
• December 2019: 6,091
• January 2020: 5,988
• February 2020: 5,628
• March 2020: 1,127

NHS Kernow has sought clarification from the requestor; we do not hold data for the number of appointments in general practice.

Request received

1. How many people are employed by your organisation, including full time and part time?
2. What is your current intranet solution (for example SharePoint, WordPress, Invotra)?
3. How long have you been using this intranet solution?
4. When is your intranet contract up for renewal?
5. What is your annual intranet budget?
6. Do you share an intranet/IT services with other organisations, if so who?
7. Which team and/or individual(s) are responsible for managing your intranet internally?
8. Are you using the Office 365 suite? If so, which applications from the suite are in use?
9. Which team and/or individual(s) are responsible for your intranet’s procurement within the organisation?
10. Is your Active Directory hosted on-premise, or in the cloud?
11. Could you provide us with a link to your Digital Workplace Strategy?

Our response – 17 July 2020

1. 309.
2. WordPress.
3. 2018.
4. N/A – no contract as managed in-house.
5. N/A – managed and built in-house.
6. IT services provided by Cornwall IT Services who are part of Royal Cornwall Hospitals NHS Trust.
7. Communications and engagement team.
8. Currently using Microsoft Teams.
9. Communications and engagement team.
10. On premise.
11. Not held.

Request received

Regarding patents since the year 2000, please provide me with:

1. Number of licensing or assignment agreements signed between your organisation and another entities, granting rights or transferring ownership
2. A list of all licensing agreements signed between your organisation and other parties on such patents, containing, for each agreement. Please provide the name of the party and year of signing.
3. The annual income from each of these licensing agreements by year.
4. A list of all patents that your organisation does own or has previously owned, as a sole owner or jointly with others.

Our response: 4 August 2020

NHS Kernow has not had any licensing or assignment agreements granting rights to patents or transferring ownership of patents since 2000.

Request received

1. What is your current telephony system?
2. How many users of the telephony system?
3. When is the contract up for renewal?
4. If it isn’t a VoIP system, will that be a consideration for the next contract cycle?
5. The email address of the primary contact for this contract?
6. Current annual spend?
7. Who is your current mobile phone provider?
8. How many mobile connections?
9. When is the contract up for renewal?
10. How long do you contract for (24 or 36 months)?
11. The email address of the primary contact for this contract?
12. Current annual spend?
13. Do you procure through the Networks Services 2 framework? (RM3808 previously RM1045)
14. Do you procure through the G-Cloud framework?

Our response – 31 July 2020

1. CISCO.
2. Approximately 210 extensions.
3. Part of ongoing SLA so not contracted individually.
4. N/A.
5. NHS Kernow does not release the names of employees below director level. Andrew Abbott, Director for Integrated Care (Primary Care) is responsibility for IT and telephony.
6. The annual support/maintenance costs are part of the block contract with Cornwall IT services.
7. Vodafone.
8. Total devices 249.
9. August 2022.
10. 36 months.
11. As answer 5.
12. £21,000.
13. Yes.
14. NHS Kernow does not currently use this system.

Request received

I would like to request the costs associated with the running of the warfarin INR monitoring service and a breakdown of these costs to the CCG. For example how much is the CCG paying out to the trust for the fulfilment of this service.

9 July 2020 – clarification requested

The team have asked for clarification of your FOI enquiry. We have a local enhanced service in place with our practices and can provide information on the cost of this last year but we are not sure if this is what you require.

9 July 2020 – clarification received

That is correct, I can confirm that is the information I require (financial breakdown of the LES).

Our response – 19 July 2020

• Anti-coag monitoring level 3: £60,000
• Anti-coag monitoring level 4: £741,000
• Total spend: £801,000

Request received

1. Please provide the information on agency (temporary) staff spending for the 2019 to 2020 financial year (April 2019 to March 2020), broken down by clinical and non-clinical staff
2. Based on the clinical agency spend provided above, please provide a further breakdown for nursing and other clinical staff
3. Please list the name of the top 5 agencies for spend on clinical agency staff in 2019 to 2020 and the spend associated to each agency if available.
4. Please provide information on bank staff spending for the 2019 to 2020, broken down by clinical and non-clinical staff
5. Does your CCG use or have access to a staff bank?
   • If yes, is this the CCGs own bank or a shared resource across other organisations? Please list all organisations involved across CCGs, NHS trusts and local authorities
   • Is your organisation planning to expand the bank and to which organisations?
   • If your organisation does not have a staff bank, are you considering implementing a staff bank and/or becoming part of a collaborative staff bank? Please name the organisations that would be included across CCGs, NHS trusts and local authorities.

Our response – 23 July 2020

1. Agency staff spend:
   • Total: £73,228
   • Non-clinical staff: £50,240
   • Clinical staff: £22,988
2. Agency staff spend:
   • Nursing staff: £22.988
   • Other clinical staff: £0
3. Name of agency: Computer Futures, SThree Partnership LLP. Total spend: £22,988
4. Bank staff spend: £0
5. No.

Request received

1. Could you please confirm whether your organisation has a sustainability or sustainable development strategy. If possible, please provide a copy.
2. If you answered yes to the first question can you confirm whether there is a strategy group or work/action plan in place to support this strategy? When the strategy was first developed within the organisation (year)
3. Is there an identified Executive Sponsor for sustainability within the organisation?
4. Are any members of staff dedicated to sustainability or sustainable development within the organisation? If so, how many hours per week are dedicated to this area of work, what is their job title and what Agenda for Change pay band are they?
5. Does your organisation have any environmental champions? If so, how many?
6. Do you offer any sustainability training for your staff? If so, what format is this delivered in (e.g. face to face, e-learning, etc)?
7. Is your organisation ‘paperless’? For NHS Trusts and CCGs providing clinical services (such as Continuing Health Care), if not, what year do you anticipate fulfilling the NHS target to fully digitise clinical records?
8. Have you engaged with the NHS Sustainable Development Unit over the past five years? If so, could you provide the names of the project titles that you worked with them on.
9. Does your organisation assess its impact on the environment when making decisions through use of a sustainability framework or another similar tool?

Our response: 29 July 2020

1. In March 2020, the NHS Kernow Governing Body approved the creation of one joint sustainability development management plan (SDMP) across NHS Kernow, Cornwall Partnership NHS Foundation Trust and Royal Cornwall Hospitals NHS Trust. This will ultimately be our strategy for managing our system actions on climate change. NHS Kernow is committed to the development of an action plan for the Cornwall and Isles of Scilly NHS organisations to meet the carbon emission target, aligned to Cornwall Council’s plan. The first action in the planning phase will be to work with Exeter University and Cornwall Council to gaining a baseline carbon calculation for each organisation and the system.
2. Yes, Natalie Jones, chief nursing officer.
3. No.
4. Dr Rob White is our Governing Body GP and acts as our environmental change champion.
5. Partners in the CIOS health and care system collectively declared a climate emergency on March 2020. As part of our joint work, wide engagement will be undertaken with staff to inform detailed action plans and identify carbon/green champions and identify training and learning needs.
6. No, and not determined as yet. This will form part of the climate change project plan.
7. For general practice the Royal College of GPs has developed the green impact for health scheme and some local practices have signed up to this.
8. Post COVID-19 response phase moving into recovery planned work with Exeter University and Cornwall Council to gaining a baseline carbon calculation for the CCG.

Request received

1. Staff headcount at your organisation?
2. Annual budget of your organisation for the financial year 2019-2020?
3. Who provides your organisations counter fraud provision? (In house – NHS consortium – Private provider)
4. How many days were recorded for proactive counter fraud work (Strategic governance, Inform and Involve and Prevent and Deter) carried out at your organisation during the financial year 2019-20?
5. How many days were recorded for carrying out reactive investigation work at your organisation during the financial year 2019-20 (hold to account)?
6. How many counter fraud referrals did your organisation receive during the financial year 2019-2020?
7. What was the recorded fraud loss identified by your organisation during the financial year 2019-2020?
8. What was the amount of fraud losses recovered by your organisation during the financial year 2019-2020?
9. How many criminal sanctions relating to fraud, bribery or corruption did your organisation apply during the financial year 2019-2020?
10. How many disciplinary sanctions relating to fraud, bribery or corruption did your organisation apply during the financial year 2019-2020?
11. What was the cost of counter fraud staffing to your organisation during 2019-2020 for – Strategic Governance, Inform and Involve and Prevent and Deter?
12. What was the costs of counter fraud staffing to your organisation during 2019-20 for – Hold to Account?

Our response – 23 July 2020

1. Staffing information is published in the annual report available on our website.
2. Level of funding for 2019 to 2020 is disclosed in the annual report and also in Governing Body papers.
3. Private provider.
4. 30 days per annum.
5. 15 days per annum.
6. 4.
7. No fraud loss identified.
8. N/A – see above.
9. None.
10. None.
11. Service is contracted out.
12. Service is contracted out.

Request received

We would like to make a few enquiries about how community equipment is commissioned in addition to technology enabled care (telehealth and telecare). This will help us to drive forward the TEC Industry and ensure service users receive the best possible service.

1. Does your organisation commission a community equipment service?
2. If yes, who is the lead (please provide contact details for the commissioner and contract manager.
3. Who do you commission the service from, who is the current contract holder? Please provide details.
4. When is the contract due to be re-tendered?
5. What geographic area does your commissioned community equipment service cover?
6. Do you specify any quality standards as part of the contract and procurement process?
7. Who is your Chief Information Officer and Clinical Chief Information Officer? Please provide contact details.

Our response – 14 August 2020

1. NHS Kernow does not commission a community equipment service, please contact Cornwall Council who commission the service for more information. NHS Kernow commissions a wheelchair supply and maintenance contract from Millbrook Healthcare Ltd, details of this contract are available on our website.
2. The director with responsibility for commissioning this service is John Groom, the director with responsibility for contracting is Clare Bryan.
3. See question 1.
4. See question 1.
5. This service covers Cornwall and the Isles of Scilly.
6. NHS Kernow uses the NHS standard contract, available the public online.
   Clare Bryan is our senior information risk owner, this is the closest role to the information you have requested. NHS Kernow does not have a chief information officer or clinical chief information officer.

The Telehealth service is commissioned and managed by Cornwall Partnership NHS Foundation Trust.

Technology enabled care is managed by Cornwall Council, please contact them for more information.

Request received

1. Has a shared care agreement/arrangement been established between the CCG, secondary care and local primary care services (e.g. general practitioners) for the treatment of Psoriasis and Psoriatic Arthritis? Psoriasis: Y/N Psoriatic Arthritis: Y/N
2. If you answered ‘Yes’ to Q1, what are the names and/or roles of the signatories of the shared care agreement?
3. If you answered ‘Yes’ to Q1, which of the following medicines can be prescribed within the shared care agreement?
   • Psoriasis: Apremilast, Methotrexate, Dimethyl Fumarate
   • Psoriatic Arthritis: Apremilast, Methotrexate, Tofacitinib
4. How many consultant-led community-based Dermatology or Rheumatology services has your CCG commissioned that treat Psoriasis or Psoriatic Arthritis?
5. Who and where are these services commissioned from?
6. Which of the following treatments can be prescribed by these services?
   • Methotrexate
   • Ciclosporin
   • PUVA
   • Apremilast (PDE4i)
   • Dimethyl Fumarate (Psoriasis)
   • Tofacitinib (Psoriatic Arthritis)
   • Biologics
7. How many general practitioners with extended roles (GPwERs) has your CCG commissioned for dermatology and rheumatology? Please provide the geographical locations of these commissioned services.
8. Are digital services commissioned by the CCG for the management of dermatology and rheumatology? If so, please specify the digital services provided? This may include tele-dermatology services (various levels) and/or virtual clinics.

Our response – 5 August 2020

1. NHS Kernow has a shared care agreement for the use of methotrexate for the treatment of psoriasis and psoriatic arthritis publicly available.
2. See Q1.
3. See Q1.
4. NHS Kernow does not commission any consultant led community based dermatology services. However, it does commission a community based dermatology service from Kernow Health Community Interest Company (Kernow Health CIC) which supports people in East Cornwall. Whilst the contract does not state it is consultant led, it is attended on a regular basis by local consultants. This service can see any non-two week wait dermatological problem, excluding vulval disorders.
5. NHS Kernow is the commissioner of both the community based dermatology and rheumatology services.
6. Details of which specific drugs can be prescribed are not explicit in our contract. We would advise that a decision to prescribe would be based on clinical judgement and in line with our prescribing formulary.
7. NHS Kernow has commissioned 4 GPwERs for dermatology; these services are delivered at various locations in East Cornwall under Kernow Health CIC. NHS Kernow does not currently commission any GPwERs for rheumatology.
8. Yes. The planned care strategy supports the use of digital technology in all specialties where this is clinically appropriate. This includes virtual/telephone consultations. We also use technology to improve the pathway. This includes using apps to take pictures in primary care to support tele-dermatology referrals and referral to our dermatology referral assessment services.

Request received

Information regarding the population of individuals with Smith-Magenis Syndrome, this is identified by a mutation or deletion of RAI1 gene on chromosome 17p11.2:

1. Total population covered by the CCG
2. The total number of people diagnosed with Smith-Magenis syndrome within this population
3. Year of birth
4. Male or female

Our response – 29 July 2020

1. This information is published in the annual report available on our website.
2. NHS Kernow does not hold this information.
3. NHS Kernow does not hold this information; however this information would be exempt from disclosure under section 40(2) of the Freedom of Information Act 2000 on the grounds that it is personal information.
4. As above.

Request received

Please provide a copy of, or link to, your clinical threshold policy for cataract surgery and state whether this has changed in the past 4 years. If it has changed, please provide a copy of, or link to, the former policy and date of change.

For each of the 4 financial years; 2016-17 b) 2017-18 c) 2018-19 d) 2019-20, please provide for each year:

1. The CCG registered population
2. The number of Individual Funding Requests (IFRs) and/or prior approval (PA) requests that the CCG received for cataract surgery
3. The number of Individual Funding Requests (IFRs) and/or prior approval (PA) requests that the CCG approved for cataract surgery
4. The CCG’s total activity for cataract surgery (i.e. the total number of procedures carried out)
5. The average waiting time in days for cataract surgery from first referral
6. The CCG’s total activity for cataract surgery (i.e. the total number of procedures carried out)
7. The average waiting time in calendar days for cataract surgery for the procedures completed in that month

Our response – 10 August 2020

NHS Kernow’s cataract commissioning policy is available on our website.

1. NHS Kernow’s registered population is available online in our annual report.
2. Cataract surgery is routinely commissioned by NHS Kernow and as such an IFR or PA is not required to access cataract surgery.
3. Cataract surgery is routinely commissioned by NHS Kernow and as such an IFR or PA is not required to access cataract surgery.
4. Please see table below.
5. NHS Kernow does not hold average waiting time data. Please contact the providers:
   • Royal Cornwall Hospitals Trust
   • University Hospitals Plymouth NHS Trust
   • Northern Devon Healthcare NHS Trust
   • Royal Devon and Exeter NHS Foundation Trust
   • Peninsula Treatment Centre
   • Probus Surgical Centre
6. Please see table below.
7. Please see question 5.

Request received

Please provide data for the last 5 financial years.

1. What was the annual budget for patients commissioned for care in ophthalmology and eye departments by the CCG?
2. How many patients commissioned for care by the CCG were treated by ophthalmology and eye departments outpatient clinics?
3. How many patients who were commissioned for care and treated ny ophthalmology and eye departments outpatient clinics were treated for complications arising from refractive surgery?
4. How many patients who commissioned for care by the CCG and treated by ophthalmology and eye departments outpatient clinics were treated for complications arising from contact lens wear?
5. Of all the patients who were commissioned for care by the CCG and treated by ophthalmology and eye departments outpatient clinics, what percentage were treated for complications arising from contact lens wear?
6. How many of the patients commissioned for care by the CCG had cataract surgery?
7. What were the average waiting times from point of referral to being listed for cataract surgery?
8. What were the average waiting times from point of referral to undergoing first eye cataract surgery?
9. How many patients are currently waiting to have cataract surgery?
10. What number and percentage of patients that have a cataract procedure on their first eye go on to have a cataract procedure on their second eye within 6 months of the first?
11. What number and percentage of patients that have a cataract procedure on their first eye go on to have a cataract procedure on their second eye within 12 months of the first?
12. What percentage of patients have a cataract procedure performed on each of their two eyes (bilateral procedure) on the same day?

Our response – 6 August 2020

1. Budgets are not available at this level, so total tariff payment national has been added to the results for Q2 to give an actual spend instead.
2. Please see below table for how patients were treated by ophthalmology services in each of the last 5 financial years with their spends.
3. NHS Kernow does not hold average waiting time data, please contact the providers: (Royal Cornwall Hospitals Trust), (University Hospitals Plymouth NHS Trust), Northern Devon Healthcare NHS Trust, (Royal Devon and Exeter NHS Foundation Trust), Peninsula Treatment Centre and (Probus Surgical Centre).
4. Please see Q3.
5. Please see Q3.
6. Please see Q12.
7. NHS Kernow does not hold average waiting time data, please contact the providers as per Q3.
8. NHS Kernow does not hold average waiting time data, please contact the providers as per Q3.
9. NHS Kernow does not hold average waiting time data, please contact the providers as per Q3.
10. Please see Q12.
11. Please see Q12.
12. Please see below table, noting that data for 2020 to 2021 only includes data for April and May.

Question 2 table:

Question 12 table:

Same day bilateral: as the number is less than 5, 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.

Request received

1. Name of NHS trust(s) in the CCG geographical boundary?
2. Does the CCG have or commission a referral management (assessment) centre that includes cataract surgery referrals?
3. If yes, please name the provider that manages it. If in-house, please state in-house?
4. For cataract surgery, which providers are commissioned to provide this surgery via NHS Standard Contract?
5. Is this as a block, AQP or NCA arrangement? Please state for each provider, including date (if applicable) the contract expires?
6. Is there an extension clause in the relevant contracts? If so please state length of extension and name of provider it relates to?
7. For Cataract Surgery – which providers have provided Cataract Surgery on a Non-Contract Activity Basis since 01/01/20?
8. Does the CCG operate a Prior Approval Policy for cataract surgery? If yes please attach the policy in your response?
9. What was the average waiting time and waiting numbers of patients, in June 2020 and June 2019 for patients waiting for non-complex cataract surgery at the local NHS Trust? If unable to provide at that level please state and provide information at Ophthalmology Specialty?

Our response – 29 July 2020

1. Royal Cornwall Hospitals NHS Trust (RCHT).
2. Yes.
3. NHS Kernow Clinical Commissioning Group has a Referral Management Service (RMS) which covers 50 GP practices. NHS Kernow also has a contract with Devon Referral Support Service (DRSS) which covers the remaining practices in the east locality.
4. Royal Cornwall Hospitals Trust (RCHT), Probus Surgical Centre (PSC), Peninsular Independent Treatment Centre (PITC), University Hospitals Plymouth Trust (UHPT), Royal Devon and Exeter, North Devon Hospitals Trust (RDE).
5. Block:
   • RCHT – block, expires 31 March 2021
   • PSC– block, expires 31 March 2021
   • PITC – PbR, expires 31 October 2020
   • UHPT – block, expires 31 March 2021
   • RDE – block, expires 31 March 2021
   • NDHT – block, expires 31 March 2021
6. PITC 4-week rolling.
7. Torbay and South Devon NHS Foundation Trust, Moorfields Eye Hospital NHS Foundation Trust, Queen Victoria hospital NHS Foundation Trust.
8. No.
9. NHS Kernow does not hold this information, please contact RCHT.

Request received

Please could you let me know who the clinical commissioning lead is for cardiovascular within the CCG? Also if you have a GP lead for CV or long term conditions lead within the CCG? If so, please could I have the names of those individuals.

Our response – 23 July 2020

NHS Kernow does not release the name of employees below director level. John Groom is the responsible director.

Request received

I am writing to make a request in relation to the matter detailed above. Please disclose all policies, guidance, and instructions, including terms, conditions, eligibility, and format/method of payment, held by NHS Kernow regarding:

1. Up-front funding for or reimbursement of travel available for patients and escorts of patients receiving Terminations of Pregnancy, both under nationally-directed schemes and any other provisions
2. Up-front funding for or reimbursement for overnight stays available of patients and escorts of patients receiving Terminations of Pregnancy
3. Where different to (1) above, up-front funding for or reimbursement of travel available for patients and escorts of patients receiving non-primary care, both under nationally-directed schemes and any other provisions
4. Where different to (2) above, up-front funding for or reimbursement of overnight stays available for patients and escorts of patients receiving non-primary care
5. The 2020-21 NHS Kernow budget for up-front funding for or reimbursement of travel and overnight stays for patients receiving terminations of pregnancy and non-primary care

Our response – 23 July 2020

All policies, guidance and instructions can be found on the NHS Kernow website.

Terminations of pregnancy are usually self-referrals. Self-referrals are a national exclusion criteria for both patient transport and the healthcare travel costs scheme; this includes funding for overnight stays. Therefore no budget is set for terminations of pregnancy, or any procedure or condition. Eligibility is based around an individual against the criteria set out in the NHS Kernow NHS funded patient transport policy available at the link above.

Due to COVID-19 our normal budgeting processes have been suspended, we therefore do not have budgetary information for the financial year 2020 to 2021 to provide in response to this question.