November 2020

Request received

1. A list of all the optional services and schemes commissioned by the CCG that your member GP practices could choose to participate in, in 2020 to 2021 such as local enhanced services, local improvement schemes (LISs) and prescribing incentive or improvement schemes.
2. The value of each, for example the total amount that can be earned for participation in the service/scheme per patient or per procedure.
3. The total budget for each for 2020/21.
4. The period in which this data for each scheme is valid, for example the start and end dates of its specification.
5. The specification for each of these services or schemes.
6. Additionally, have any of these schemes been paused, or are any subject to being paused as a result of either COVID-19 or the new COVID vaccine programme?

Our response – 17 December 2020

A list of optional services and schemes commissioned by NHS Kernow that our member GP practices could choose to participate in 2020/21:

• MRSA decontamination
• 24 hour ambulatory electrocardiogram (ECG) monitoring
• 24 hour ambulatory blood pressure monitoring (ABPM)
• minor injuries services
• pre- and post-operative procedures
• diabetes (insulin initiation in primary care)
• anti-coagulation monitoring
• near patient testing
• near patient testing (amiodarone and carbimazole only)

The value for each – the total amount that can be earned for participation in the service/scheme per patient per procedure is as below, please note we do not pay any additional payments for these services:

• MRSA pre-operatively – £20.00
• MRSA post contamination swabbing – £20.00
• MRSA prescription for decontamination – £20.00
• 24 hour ECG for patients registered at practice – £81.00
• 24 hour ECG for non-registered patients at practice – £91.00
• 24 hour blood pressure monitoring – £65.00
• Pre- and post-operative removal of sutures (ROS/ROC) – £15.25
• Pre- and post-operative wound dressings – £20.34
• Pre- and post-operative examination/tests – £15.25
• Pre- and post-operative GORH agonists – £15.25
• Pre- and post-operative one off injections £15.25
• Pre- and post-operative bloods – £10.17
• Pre- and post-operative urine tests – £10.17
• insulin starts – £183.71
• minor injuries advice and referral – £36.61
• minor injuries treatments – £54.91
• near patient testing NES (azathioprine, cyclosporine, gold auto-thiomalate, gold auranofin, hydroxychloroquine, penicillamine, sulfasalazine, tacrolimus, methotrexate, leflunomide) – £103.21
• near patient testing LES (amiodarone, carbimazole) – £49.55
• anti-coagulation level 3 – £119.55
• anti-coagulation level 4 – £129.54

In line with national guidance we are paying practices block amounts for this financial year so we don’t have budgets at individual service level. Instead we have one general budget to cover all of the GP LES schemes, the total budget is £6,135,000 for 2020 to 2021. The period for which this data is valid is from 1 April 2019 to 31 March 2021.

Services were paused from 1 April 2020 as per Simon Stevens’ letter dates 17 March 2020. A phased resumption of services began in July 2020 as a result of the letter from NHS England dated 9 July 2020.

Please email our FOI team for copies of the service specifications.

Request received

1. When was your current patient transport contract issued?
2. When does the current contract end?
3. Is there an extension clause?
4. What was your annual spend over the 2 previous years for patient transport?
5. Do you have any renal services?
6. Who is your current patient transport provider(s)?
7. Is secure transport included in these contracts? If not, what providers do you use for secure transport?
8. Name and contact details of the director of estates and facilities.
9. Name and contact details of the deputy director of estates and facilities.
10. Name and contact details of the head of procurement.
11. Name and contact details of the person directly responsible for patient transport service.
12. Is there a trust Facebook account?
13. Is there a trust Twitter account?
14. Is there a trust LinkedIn account?

Our response – 2 December 2020

NHS Kernow’s current non-emergency patient transport contract was issued in October 2016. This contract end on 31 March 2022.

This contract is currently in its extension period. This contract is block agreement worth £3,490,408.00 with year end reconciliation.

There is not a specific patient transport service for renal patients.

NHS Kernow’s current provider for non-emergency patient transport is E-Zec. Secure transport is not included in these contracts as NHS Kernow does not contract for secure transport.

NHS Kernow does not release the names of employees below director level. NHS Kernow’s director with responsibility for estates and facilities and procurement is Clare Bryan.

NHS Kernow has a Facebook, Twitter and LinkedIn account.

Request received

Please provide the number of GPs currently working in your area broken down into the following age categories:

• under 30
• 30 to 34
• 35 to 39
• 40 to 44
• 45 to 49
• 55 to 59
• 60 to 64
• 65+
• unknown

Please also provide the same data for 2015, 2016, 2017, 2018 and 2019. Any of the beginning of the calendar year, financial year or the point at which your CCG measured the information during that year are fine.

Our response – 9 November 2020

NHS Kernow does not hold the information requested, for more information please contact NHS England.

Request received

How much money was spent with private mental health care providers by your CCG for patients who were referred for inpatient or outpatient services in the last 4 years (2017, 2018,2019 and 2020 so far)? Please break this down by year of payment, private provider who received payment and state how much was given and if possible, service provided (ie inpatient treatment/ eating disorder care). However, if this bit goes over the cost threshold then please ignore it.

How many complaints has your trust received about the private providers you used in the last 4 years (2017, 2018, 2019 and 2020 so far)? Please break this down by private provider (if possible) and say whether any of the complaints led to financial compensation for the patient, and if so how much was received. If further action was taken, such as cancellation of further contacts, please state this.

What is the most amount of money given to a private mental health care provider for a single patient in the last 4 years? Please say who received the payment and what specific issue it was for (for example rehabilitation or eating disorder support).

Our response – 22 December 2020

Please see below NHS Kernow’s spend with private mental health care providers for patients who were referred for inpatient or outpatient services in the last for years. Please note that for 2017/18 there were changes in the way we monitored the information and the subsequent recording of data means that it is unreliable and therefore we have been unable to include this in our response.

Due to the way we record this information we are unable to break it down any further than how we have provided the information. This response includes all mental health lines excluding continuing healthcare but including children’s mental health packages.

* year to date to November 2020.

Complaints must be made to the providers of services; as such NHS Kernow does not hold information relating to provider complaints.

Request received – our response was sent on 30 November 2020

Please provide the name of the individual and their STP and ICS job title, associated to each of the below areas of responsibility. In cases where there are multiple leads, please include the names of all individuals.

System and STP lead: Vacant – out to advert. Currently covered through distributed leadership by collective of chief executives, system executive lead and CCG accountable officer.
Chair or independent chair: John Govett, independent chair.
Lead for workforce: Kerry Eldridge.
Workforce lead and LWAB chair: Phil Confue.
Lead for finance: Clare Bryan, NHS Kernow chief finance officer and STP finance lead.
Lead for continuing healthcare: John Groom, director for integrated care.
Chief operating officer: None – we do not have an STP chief operating officer role.
IT, technology and digital lead: Kelvyn Hipperson, chief information officer and system digital lead.
CIP, efficiency and savings lead: None, we do not have a separate lead person. Will be covered through distributed leadership by collective of chief finance officers and business strategy and planning leads across the system.
Procurement lead: None, we do not have a separate lead person. Addressed through collaborative leadership of directors of finance.
Transformation lead: Carolyn Andrews, system transformation director.

Request received

Please can you send me a list of the training hubs in your area, footprint and remit. I would also like the address and contact details of the training hubs together with the name and contact details of the workforce development leads or project managers.

Our response – 4 November 2020

Cornwall’s training hub is run by Kernow Health CIC, please contact them for more information.

Request received

I’d appreciate your assistance in obtaining some facts regarding the usage of NHS funded interim and intermediate care beds in private nursing and residential care homes.

In particular it would be helpful to have statistics on the number of patients whose step-down and acute hospital discharge was to NHS funded interim or intermediate care in a private nursing or residential home setting across Cornwall for each of the last 10 years for which records are available?

In asking this I assume this will apply across all Cornwall and Scilly resident patients who may be discharged not just from RCHT hospitals but also from Plymouth, Exeter and elsewhere.

It would help to go back to a period before the closure of Poltair and (temporary closure) Edward Hain, hence the 10-year reach.

If such statistics are available we’d also be interested to see the figures for step-up (NHS funded) interim and intermediate care in a private setting?

Our response – 9 December 2020

NHS Kernow does not record information in this way and is therefore unable to answer this request.

Please note NHS Kernow was formed on 1 April 2013 and cannot provide information relating to the former primary care trust (2010 to 2013). Please contact the Department of Health’s legacy team to request this information.

Request received

1. Please tell me what information you have regarding urinalysis dipstick prescriptions at primary care?
2. So what types are allowed?
3. What tests are allowed?
4. The manufacturers you allow?
5. What is the patient criteria?
6. Do you allow GPs at doctors offices to prescribe Microalbustix urine test strips by Siemens?
7. How many Microalbustix urine test strips prescription quantities and value have been issued in the previous 2 years

Our response – 26 November 2020

Under section 21 of the Freedom of Information Act, the urinalysis dipsticks that NHS Kernow supports the use of in primary care is available online via the Joint Cornwall Formulary. Information about urinalysis for glycosuria (glucose in the urine) is also available on the Joint Formulary.

Other types of urinalysis dipsticks which can be prescribed in primary care can be found on the NHS Business services authority website.

Request received

1. How many LGBTQ+ couple have sought IVF through the NHS in the last 10 years?
2. Please break this down by couples which are m/m, f/f/ trans and non-binary
3. How many LGBTQ+ couples have been through IVF in the last 10 years?
4. Please break this down by couples which are m/m, f/f/ trans and non-binary

Our response – 3 December 2020

NHS Kernow does not hold this information; please contact the providers of assisted conception services for more information:

• Royal Cornwall Hospitals NHS Trust
• University Hospitals Plymouth NHS Trust (until August 2020)
• Royal Devon and Exeter NHS Foundation Trust
• Centre for Reproduction and Gynaecology Wales and West (since August 2020)

Request received

In relation to treatment for fertility purposes, please can you confirm:

1. Whether your clinic or third-party provider has ever followed the guidance in Section 8 of the HFEA Code of Practice and conducted a welfare of the child assessment prior to providing treatment that is not regulated by the Human Fertilisation and Embryology Act 1990, but that falls within the definition of treatment services for the purpose of the Act?
2. If your centre or third-party provider has conducted welfare assessments in such cases in the past 5 years, please can you confirm:
   • How many assessments were carried out?
   • What treatment(s) the welfare assessment was conducted in respect of?
   • How did the clinic or third-party provider determine what particular treatment(s) the welfare assessment should apply to? Please outline any guiding principles/protocols considered.
   • Whether any, and if so, how many prospective patient(s) were refused treatment on welfare of the child grounds?
   • For what reason(s) (in general terms) were these individuals refused treatment on welfare of the child grounds?
3. In respect of treatment services regulated by the HFE Acts (treatments falling into including IVF/AI), in the past 5 years, please can you confirm how many individuals or couples have been refused treatment on the basis of a welfare assessment?
4. For what reason(s) (in general terms) were these individuals or couples refused treatment on welfare of the child grounds?
5. In the event that a welfare of the child assessment raises concerns and it is not immediately clear that the patient(s) should be refused treatment, what procedure does your centre follow to discuss more difficult cases? For example, is the involvement of an ethics committee sought to assist with decision-making?
6. Please confirm whether your centre or third-party provider considers the following factors to be relevant to the welfare of the child assessment (as opposed to, or in addition to, being medically relevant), and if so, please briefly explain how the centre/ and third-party provider considers this to be relevant:
   • stability or length of the relationship of the couple seeking treatment
   • living arrangements of the prospective patient(s)
   • financial interdependence of the couple seeking treatment
   • smoking status of the prospective patient(s)
   • prospective patient(s) consumption of alcohol (that is not alcohol abuse)
   • if funding is provided for single women, the single status of the woman seeking treatment
7. If you do not hold details in respect of all questions above on behalf of your third-party provider, please can you provide the name and contact email of the third-party provider so that they may be contacted in the alternative?

Our response – 19 November 2020

NHS Kernow does not hold this information; please contact the providers (listed below for more information). Our commissioning policy for assisted conception refers to HFEA welfare of the child assessments with respect to assisted conception treatments only.

• Royal Cornwall Hospitals NHS Trust
• University Hospitals Plymouth NHS Trust (until August 2020)
• Royal Devon and Exeter NHS Foundation Trust
• Centre for Reproduction and Gynaecology Wales and West (since August 2020)

Request received

1. Please provide dates in which your Clinical Commissioning Group will be contracting for NHS 111 services over the next 5 years?
2. Please provide when the existing contract ends with your current provider of NHS 111 services?
3. Is there an extension period on the existing contract for your NHS 111 services? If yes, what is it?
4. Please provide the annual and total contract value of your existing contract for NHS 111 services?
5. Please provide the name of the existing provider of your NHS 111 services?
6. Who is the main point of contact responsible for procurement of NHS 111 services? Please provide contact details.
7. Is there a mandate to use only pathways clinical content as part of your NHS 111 triage system?

Our response – 30 November 2020

1. NHS Kernow’s NHS 111 service is contracted from November 2017 to November 2022.
2. Our current contract ends in November 2022.
3. Not applicable.
4. The value of the contract is £48,409,755, divided over the contract term.
5. The current provider is Royal Cornwall NHS Hospitals Trust.
6. The director with responsibility for this contract is Andrew Abbott.
7. There is no mandate to only use pathways clinical content.

Request received

I would like you to provide me with the number of patients admitted to the trust’s accident and emergency department or hospital(s) who were classed as unidentified upon admission in the years 2014, 2015, 2016, 2017, 2018, 2019 and thus far in 2020.

In addition to this, I would like data on how many of these unidentified patients were not positively identified before either dying while in the trust’s care or being discharged from the trust’s care.

Our response – 11 November 2020

NHS Kernow is not able to provide this information as records are updated retrospectively and there is no way of telling if an unidentified record is where a person could not be identified, a withheld op out record or a sensitive record.

Request received

I am investigating requests for the inspection of a person’s hymen for the purpose of verifying whether they have had sexual intercourse.

1. How many people have received a hymen inspection for this purpose since 2015?
2. How many people have requested to have a hymen inspection for this purpose since 2015?

Our response – 11 November 2020

NHS Kernow does not hold this information.