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October 2020

In October 2020 we received 18 FOI requests. On this page you can find a full list of the requests we received, along with our response.
Continuing healthcare

FOI 82990 mental health services. Date requested 1 October 2020

Request received

  1. Name, job title, email address and telephone number of the commissioner with responsibility for commissioning complex care packages, for adults (aged 18 to 64) with complex physical or neurological disabilities.
  2. Total number of adults receiving continuing healthcare (CHC) funded packages of care; at year-end 2018 to 2019 and new placements during the year 2018/19
  3. Total number of adults with the following conditions receiving CHC funded packages of care in 2018 to 2019 at year-end and new placements during the year:
    • acquired brain injury
    • stroke
    • Huntington’s disease
    • multiple sclerosis
    • spinal injury
    • other neurological conditions, for example Pick’s disease, Korsakoff’s syndrome, muscular dystrophy, Parkinson’s disease, motor neurone disease
  4. How many of those adults (in question 3) are cared for in care home and hospital settings?
  5. Please provide the total expenditure on CHC funded packages of care for financial years 2016/17 and 2017/18. Also the CHC expenditure on care home and hospital placements over the same period. If expenditure for 2017 to 2018 is not yet available, please provide projected expenditure.
  6. Please provide the list of providers that received this funding.
  7. For a complex care (CHC funded) placement, what is the highest and lowest rate paid per week?
  8. For the above conditions, what is the highest and lowest rate paid per week for a complex care (CHC funded) placement?

Our response – 19 October 2020

NHS Kernow’s director with responsibility for continuing healthcare is John Groom.

At year end 2018 to 2019 there were 1,642 adults receiving continuing healthcare. There were 2,856 new placements in year.

At year end and new in 2018 to 2019 the following numbers of adults with the following conditions were receiving continuing healthcare:

Condition Number of adults: at year end Number of adults: new in year
Acquired brain injury 16 16
Stroke 134 187
Huntingdon’s disease 12 12
Multiple sclerosis 42 42
Spinal injury 16 Less than 5*
Other neurological conditions 86 114

Of the adults listed in question 3, the following are cared for in care home or hospital setting:

Condition Number of adults: at year end Number of adults: new in year
Acquired brain injury 10 10
Stroke 110 146
Huntingdon’s disease 9 * Less than 5
Multiple sclerosis 23 * Less than 5
Spinal injury * Less than 5 Less than 5
Other neurological conditions 65 77

See below NHS Kernow’s total expenditure on continuing healthcare for 2018/19. Please note continuing healthcare is provided in a person’s home or in a nursing home, not in a hospital setting.

  • Continuing healthcare: £40,818,000.00
  • Fast track: £4,399,000.00
  • Personal health budgets: £4,169,000.00

NHS Kernow does not separate spend on care homes in our ledger reporting so we are unable to provide this information.

The highest rate NHS Kernow pays per week for a complex care (CHC funded) placement is £13,623.00. The lowest rate NHS Kernow pays per week for a complex care (CHC) placement is £4.62.

The highest and lowest rate NHS Kernow pays for the care placements for the following:

Condition Highest rate paid Lowest rate paid
Acquired brain injury £6,140.61 £4.00
Stroke £4,174.11 £10.50
Huntingdon’s disease £6,489.01 £21.00
Multiple sclerosis £4,702.73 £21.00
Spinal injury £2,456.73 £21.00

*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.

Contracts

FOI 82990 mental health services. Date requested 28 October 2020

Request received

Do you use:

  • digital dictation?
  • speech recognition?
  • outsourced transcription?
  • telehealth?
  • health information systems?

Our response: 9 November 2020

NHS Kernow uses Dragon Naturally Speaking speech recognition software, licences have been purchased off the shelf when required, as such NHS Kernow does not have a contract for this.

We do not use:

  • digital dictation
  • outsources transcription
  • telehealth
  • health information systems

FOI 83480 Telephone and internet services. Date requested 15 October 2020

Request received

  1. What SEIM (security event and incident management) solution is used by your organisation?
  2. When does your SEIM platform licence subscription come up for renewal?
  3. If the SEIM solution was purchased via third party please disclose the contracting party’s details?
  4. Do you outsource your security management to a third party (managed security service provider)? If so can you disclose the name of the managed security service provider.
  5. When does the current service contract from the current managed security service provider end?
  6. Can you provide the email address of the individual that is responsible for your IT Security?
  7. How many cyber security breaches has your organisation had over the past 2 years?

Our response – 16 October 2020

NHS Kernow does not hold this information. NHS Kernow’s cyber security is managed centrally by Cornwall Information Technology Services, which is part of Royal Cornwall Hospitals NHS Trust; please contact them for more information.

FOI 83580 GP extended access. Date requested 20 October 2020

Request received

  1. Details of any general practice extended access contracts put out to tender by your CCG in the last 5 years, including the winner of those contracts
  2. Who are the current provider(s) of general practice extended access in your area?
  3. Name of the senior responsible officer at the provider(s) of general practice extended access in your area?
  4. Address of any site(s) where general practice extended access occurs in your area?
  5. Telephone number of the site(s)?
  6. Website URL for the provider(s)?

Our response: 10 November 2020

  1. Extended access is locally commissioned under the improving access to general practice (IAGP) scheme.
  2. NHS Kernow issued initial commissioning intentions on the 2 March 2018 to all potential providers of IAGP. Memorandum of understandings (MOU) were agreed between NHS Kernow and the providers who expressed an interest. This enables the parties to test and learn potential models as there was no developed national or local models for the parties to implement. The providers who expressed an interest and agreed an MOU with NHS Kernow were:
    • Kernow Health CIC
    • Lostwithiel, Fowey and Middleway Surgeries (Three Harbours)
    • St Austell Healthcare
    • The Alverton Practice, Rosmellyn Surgery, Sunnyside Surgery, Morrab Surgery, Cape Cornwall Surgery, Stennack Surgery, Marazion Surgery (Penwith)
    • North Kerrier Medical Ltd
    • Helston Medical Centre, Meneage Street Surgery, St Keverne Health Centre, Mullion and Constantine Group of Surgeries (South Kerrier)
    • Cornwall Partnership NHS Foundation Trust
  3. Cornwall current providers of IAGP are as follows:
    • Health and Wellbeing West Ltd
    • Helston Medical Centre, Meneage Street Surgery, St Keverne Health Centre, Mullion and Constantine Group of Surgeries
    • Clinton Road Surgery, Manor Surgery, Veor Surgery, Harris Memorial Surgery
    • Carn to Coast Health Centres, Praze Surgery
    • Lander Medical Practice, Three Spires Medical Practice
    • Falmouth Health centre, Penryn Surgery, Trescobeas Surgery, Westover Surgery
    • Watergate Primary Care Network Ltd
    • St Austell Healthcare
    • Lostwithiel Medical Practice, Fowey River Practice, Middleway Surgery
    • Carnewater Medical Practice, Stillmoor House Medical Practice
    • Kernow Health East Ltd
    • Cornwall Partnership Foundation Trust
    • North Cornwall Coast Ltd
    • Stratton Medical Centre, Neetside Surgery
  4. NHS Kernow is responsible to commission an extended hours service. There are no individuals within the providers who are specifically senior responsible officers for this service. There are however clinical directors for the primary care networks (PCNs). PCN clinical director information is publicly available under section 21 of the Freedom of Information Act. Under section 21 of the Freedom of Information Act, the addresses, telephone numbers and website URLs of NHS Kernow’s GP practices are publicly available on the nhs.uk website.
  5. See question 4.
  6. See question 4.

FOI 83500 Dermatology services. Date requested 15 October 2020

Request received

Could you please provide a list of the current GPs with extended roles for dermatology and also GPs with special interests in dermatology:

  • GP number
  • first name
  • last name
  • name of GP surgeries or clinics they are currently practicing at
  • GP surgery code
  • GP surgery postcode if NHS code is not available

Our response: 23 October 2020

NHS Kernow has accreditation for the following GPs with extended roles for dermatology and skin surgery:

  • Robert Allen, The Rame Group PL11 2TB. GMC number 6077801.
  • Lawrence Barnes, The Rame Group PL11 2TB. GMC number 4322236
  • Grant Stevens, Kernow Health CIC TR1 3LP. GMC number 4638489

FOI 83220 Wheelchair service. Date requested 7 October 2020

Request received

Does your local authority commission community equipment services and wheelchair services together as 1 service? If yes, are you able to provide contact details of the lead commissioner for the services. If no, have you ever considered combining these services? If this was not considered, what were the reason this was rejected?

Our response: 9 October 2020

NHS Kernow does not commission a community equipment services and wheelchair service as 1 service together. Cornwall Council are the lead commissioners for this service, please contact them for more information.

There has not been a consideration of combining these services.

FOI 83200 contract information. Date requested 5 October 2020

Request received

Please can you tell me if you have a contract in place with Silicon Practice Limited, or any working arrangement of any kind with this company.

If you do work with Silicon Practice Limited, please provide a copy of the contract. If there is no contract in place, please provide a detailed description of the work Silicon Practice Limited carries out for the CCG. Please also include any data processing agreement or privacy agreement the CCG has with Silicon Practice Limited.

Our response: 6 October 2020

NHS Kernow does not have a contract or any working arrangement in place with Silicon Practice Limited.

COVID-19

FOI 83980 Long COVID. Date requested 4 October 2020

Request received

Please can you confirm if you have an idea of patient numbers in your geographical response area who have long COVID.

Please can you tell me if you have any specific long COVID services for patients in your area. If such services do not exist for long COVID patients in your area, please can you tell me what plans there are to provide such continuity care.

Our response: 12 November 2020

NHS Kernow does not currently have an idea of long COVID-19 numbers or specific commissioned services but is taking the below measures.

Long COVID-19 demand modelling:

  • to understand the potential numbers of people in the Cornwall Health system with the condition and the likely symptoms they have
  • identification of existing services that can support post COVID patients
  • the potential patient numbers through existing services; for example numbers of COVID-19 patients with a lead symptom of fatigue who will be managed by the chronic fatigue service but supported as required by other service to manage other symptoms
  • review of the service capacity to deal with additional demand of long COVID-19 patients
  • identification of capacity issues
Finance and budgets

FOI 83530 Ophthalmology services. Date requested 16 October 2020

Please provide data for 1 April 2019 to 31 March 2020.

  1. Please provide the total amount spent by you for the following procedures (broken down by the applicable CCSD code) performed by independent providers:
    • cataract with implantation of a spherical (non-toric) intraocular lens
    • cataract with implantation of a toric intraocular lens
    • YAG capsulotomy
  2. Please provide the total amount paid to Optegra for the following procedures (broken down by the applicable CCSD code) performed:
    • cataract with implantation of a spherical (non-toric) intraocular lens
    • cataract with implantation of a toric intraocular lens
    • YAG capsulotomy
  3. Please provide a breakdown of the amount paid to Optegra for Cataract with implantation of a spherical (non-toric) intraocular lens treatment indicating amount paid in:
    • fees for the surgical procedures
    • pre and post-operative consultation fees (including stating the services provided)
  4. Please provide a breakdown of the amount paid to Optegra for Cataract with implantation of a toric intraocular lens treatment indicating amount paid in:
    • fees for the surgical procedures
    • pre and post-operative consultation fees (including stating the services provided)
  5. Please provide a breakdown of the amount paid to Optegra for YAG capsulotomy treatment between 1 April 2019 and 31 March 2020, indicating amount paid in:
    • fees for the surgical procedures
    • pre and post-operative consultation fees (including stating the services provided)
  6. When is your contract with Optegra for the provision of cataract procedures due for renewal?
  7. Please provide the total amount paid to SpaMedica for the following procedures (broken down by the applicable CCSD code) performed:
    • cataract with implantation of a spherical (non-toric) intraocular lens
    • cataract with implantation of a toric intraocular lens
    • YAG capsulotomy
  8. Please provide a breakdown of the amount paid to SpaMedica for cataract with implantation of a spherical (non-toric) intraocular lens treatments indicating amount paid in:
    • fees for the surgical procedures
    • pre and post-operative consultation fees (including stating the services provided)
  9. Please provide a breakdown of the amount paid to SpaMedica for cataract with implantation of a toric intraocular lens treatments indicating amount paid in:
    • fees for the surgical procedures
    • pre and post-operative consultation fees (including stating the services provided)
  10. Please provide a breakdown of the amount paid to SpaMedica for YAG capsulotomy treatments indicating amount paid in:
    • fees for the surgical procedures
    • pre and post-operative consultation fees (including stating the services provided)
  11. When is you contract with SpaMedica for the provision of cataract procedures due for renewal?
  12. Please provide the total amount paid to Newmedica for the following procedures (broken down by the applicable CCSD code):
    • cataract with implantation of a spherical (non-toric) intraocular lens
    • cataract with implantation of a toric intraocular lens
    • YAG capsulotomy
  13. Please provide a breakdown of the amount paid to Newmedica for Cataract with implantation of a spherical (non-toric) intraocular lens indicating amount paid in:
    • fees for the surgical procedures
    • pre and post-operative consultation fees (including stating the services provided)
  14. Please provide a breakdown of the amount paid to Newmedica for cataract with implantation of a toric intraocular lens treatments indicating amount paid in:
    • fees for the surgical procedures
    • pre and post-operative consultation fees (including stating the services provided)
  15. Please provide a breakdown of the amount paid to Newmedica for YAG capsulotomy treatments
    indicating amount paid in:

    • fees for the surgical procedures
    • pre and post-operative consultation fees (including stating the services provided)
  16. When is you contract with Newmedica for the provision of cataract procedures due for renewal?
  17. Please provide the total amount paid to Anglia Community Eye Service (ACES) for the following procedures (broken down by the applicable CCSD code):
    • cataract with implantation of a spherical (non-toric) intraocular lens
    • cataract with implantation of a toric intraocular lens
    • YAG capsulotomy
  18. Please provide a breakdown of the amount paid to ACES for cataract with implantation of a spherical (non-toric) intraocular lens treatments indicating amount paid in:
    • fees for the surgical procedures
    • pre and post-operative consultation fees (including stating the services provided)
  19. Please provide a breakdown of the amount paid to ACES for cataract with implantation of a toric intraocular lens treatments
    indicating amount paid in:

    • fees for the surgical procedures
    • pre and post-operative consultation fees (including stating the services provided)
  20. Please provide a breakdown of the amount paid to ACES for YAG capsulotomy treatments
    • fees for the surgical procedures
    • pre and post-operative consultation fees (including stating the services provided)
  21. When is your contract with ACES for the provision of cataract procedures due for renewal?
  22. Please provide the total amount paid to Optical Express for the following procedures (broken down by the applicable CCSD code):
    • cataract with implantation of a spherical (non-toric) intraocular lens
    • cataract with implantation of a toric intraocular lens
    • YAG capsulotomy
  23. Please provide a breakdown of the amount paid to Optical Express for cataract with implantation of a spherical (non-toric) intraocular lens treatments indicating amount paid in:
    • fees for the surgical procedures
    • pre and post-operative consultation fees (including stating the services provided)
  24. Please provide a breakdown of the amount paid to Optical Express for cataract with implantation of a toric intraocular lens treatments indicating amount paid in:
    • fees for the surgical procedures
    • pre and post-operative consultation fees (including stating the services provided)
  25. Please provide a breakdown of the amount paid to Optical Express for YAG capsulotomy treatments indicating amount paid in:
    • fees for the surgical procedures
    • pre and post-operative consultation fees (including stating the services provided)
  26. When is you contract with Optical Express for the provision of cataract procedures due for renewal?
  27. Please provide the names of any additional independent sector providers that have provided cataract and/or YAG capsulotomy procedures to the group.
  28. For each additional independent provider please provide the total amount paid for the following procedures (broken down by the applicable CCSD code)
    • cataract with implantation of a spherical (non-toric) intraocular lens
    • cataract with implantation of a toric intraocular lens
    • YAG capsulotomy
  29. For each additional independent provider please provide a breakdown of the amount paid for cataract with implantation of a spherical (non-toric) intraocular lens treatments indicating amount paid in:
    • fees for the surgical procedures
    • pre and post-operative consultation fees (including stating the services provided)
  30. For each additional independent provider please provide a breakdown of the amount paid for cataract with implantation of a toric intraocular lens treatments indicating amount paid in:
    • fees for the surgical procedures
    • pre and post-operative consultation fees (including stating the services provided)
  31. For each additional independent provider please provide a breakdown of the amount paid for YAG capsulotomy treatments indicating amount paid in:
    • fees for the surgical procedures
    • pre and post-operative consultation fees (including stating the services provided)
  32. For each additional independent provider please state when your contract for cataract procedures is due for renewal.

Our response: 6 October 2020

The information below relates to the financial year 1 April 2019 to 31 March 2020.

NHS Kernow spent the following amounts with independent providers:

  • Cataract with implantation of a spherical (non-toric) intraocular lens £1,603,778.00
  • Cataract with implantation of a toric intraocular lens none
  • YAG capsulotomy was none

NHS Kernow did not pay any money for any eye procedures or have a contract with:

  • Optegra
  • SpaMedica
  • Anglia Community Eye Service
  • Optical Express

NHS Kernow had contracts with Probus Surgical Centre and Peninsular Treatment Centre to provide cataract procedures.

For the period 1 April 2019 to 31 March 2020 NHS Kernow paid the following to independent providers for cataract with implantation of a spherical (non-toric) intraocular lens:

  • Probus Surgical Centre £1,156,901.00
  • Peninsula Treatment Centre £446,877.00

Cataract with implantation of a toric intraocular lens and YAG capsulotomy was none.

NHS Kernow paid the following to independent providers for pre- and post-operative consultation fees (including stating the services provided):

  • Probus Surgical Centre pre-operative £135,394.00, post-operative £49,300.00
  • Peninsula Treatment Centre pre-operative £52,402.00, post-operative £23,142.00

NHS Kernow’s contract with Probus Surgical Centre is due for renewal on 31 March 2021, and our contract with Peninsula Treatment Centre is due for renewal on 31 March 2021.

For questions 3, 4, 5, 8, 9, 10, 13, 14, 15, 18, 19, 20, 23, 24, 25, 30 and 31 the answer is not applicable.

FOI 83350 Ophthalmology services. Date requested 13 October 2020

Please provide data for 1 April 2019 to 31 March 2020.

Please break down the below by:

  • cataract with implantation of a spherical (non-toric) Intraocular Lens
  • cataract with implantation of a toric intraocular lens
  • YAG capsulotomy
  1. Names of all independent sector providers that have provided cataract and/or YAG capsulotomy procedures to you.
  2. Total number of procedures (per eye) completed by independent providers (broken down by the applicable CCSD code) for the surgical procedures.
  3. Number of procedures (per eye) (broken down by the applicable CCSD code) for the surgical procedures completed by:
    • Optegra
    • SpaMedica
    • Newmedica
    • Anglia Community Eye Service
    • Optical Express
    • any independent sector provider other than those listed above

Our response: 14 October 2020

The information below relates to the financial year 1 April 2019 to 31 March 2020.

  1. NHS Kernow contracted Probus Surgical Centre and Peninsula Treatment Centre to provide cataract procedures.
  2. Probus Surgical Centre and Peninsula Treatment Centre carried out 2,101 (both eyes) cataract with implantation of a spherical (non-toric) intraocular lens procedures. They did not carry out any cataract with implantation of a toric intraocular lens or YAG capsulotomy.
  3. The following did not carry out any eye procedures for NHS Kernow:
    • Optegra
    • SpaMedica
    • Newmedica
    • Anglia Community Eye Service
    • Optical Express

The following independent sector providers carried out cataract with implantation of a spherical (non-toric) intraocular lens procedures:

  • Peninsula Treatment Centre carried out 603 (both eyes)
  • Probus Surgical Centre carried out 1,498 (both eyes)

They did not carry out any cataract with implantation of a toric intraocular lens or YAG capsulotomy.

FOI 83150 Finances. Date requested 5 October 2020

Request received

Thank you for publishing your spend data. However, I notice that you haven’t published any spending data since January 2020. I’d like to make a request under the Freedom of Information Act 2000 for all transactions over £25,000 from February 2020 to at most a month in arrears from the date at which you publish in response to this request.

Our response: 14 October 2020

In line with section 21 of the Freedom of Information Act, NHS Kernow has now updated our website and our spending data is now available as far as September 2020.

Information governance

FOI 83100 Information governance. Date requested 1 October 2020

Request received

I am interested in the governance around Cornwall’s Guru shared record, and request 3 items of information. This is regarding the disclosure, and subsequent processing for purposes other than direct care, of personal confidential information from contributing data controllers (whether such processing is actually happening or being planned).

The latest:

  1. data protection impact assessment (DPIA) undertaken for direct care purposes (processing) of Guru
  2. DPIA undertaken for any secondary uses purposes (processing) of Guru (for example population health, commissioning, data analytics).
  3. data processor contract that GP surgeries contributing to Guru must be signatories and parties to

Please clarify who the data processor is and which provides the necessary instructions for direct care and any secondary care processing. If there is no data processor then please say.

Our response: 8 October 2020

NHS Kernow does not use the Guru shared record.

Organisation

FOI 83780 Executive members of staff. Date requested 30 October 2020

Request received

The name and email address of the person within the CCG that holds the following job title or equivalent:

  • chief executive office or chair
  • chief clinical information officer
  • chief information officer or director of IT
  • chief pharmacist
  • director of transformation or strategy

Our response: 10 November 2020

Please note NHS Kernow does not release the names of employees below director level.

  • NHS Kernow’s accountable officer is Helen Charlesworth-May. Our chair is Iain Chorlton.
  • Clinical information is the responsibility of Clare Bryan.
  • IT is the responsibility of Andrew Abbott.
  • Pharmacy is also the responsibility Andrew Abbott.
  • NHS Kernow hosts a director of transformation on behalf of the Cornwall and Isles of Scilly system.

FOI 83420 Executive members of staff. Date requested 15 October 2020

Request received

Could you please provide up to date names, job titles, telephone numbers and email addresses for the following:

  1. chief executive
  2. chief information officer
  3. chief digital officer
  4. senior information risk owner
  5. director of IT, ICT, IM&T, digital or information
  6. director or head of finance
  7. department directors and heads

In addition if you have an up to date 2020 senior staff organisation or structure chart could you please forward a copy to me in either Excel or PDF format.

Our response: 20 October 2020

Their emails addresses are as follows:

  1. Helen Charlesworth-May
  2. Tracey Lee
  3. Clare Bryan
  4. Natalie Jones
  5. Carolyn Andrews
  6. John Groom
  7. Andrew Abbott
  8. Jon Price

To see a copy of our most up to date senior staff structure chart please email our FOI team.

Prescribing and pharmacies

FOI 83230 Wound care products. Date requested 7 October 2020

Request received

Please state which supply route you currently use to procure wound care dressings:

  • FP10
  • online non-prescription ordering service (ONPOS)
  • NHS Supply Chain
  • Amcare Group
  • other (please specify).

Please state when your wound care formulary first adopted your current supply route.

Our response: 9 October 2020

Wound care dressings are procured through FP10, NHS supply chain and Amcare group, who have been in use since March 2017.

Referral management

FOI 83440 Weight management. Date requested 15 October 2020

Request received

  • What is the name of the tier 3 weight management service available to your patients?
  • Do you commission the tier 3 weight management service? If not, who does?
  • What number of patients have been referred to this service in the last 12 months of available data?

Our response: 9 November 2020

  • Service is known as the tier 3 weight management and bariatric service.
  • We commission the tier 3 weight management service as part of the bariatric service.
  • NHS Kernow does not hold the information requested. For more information please contact the provider Royal Cornwall Hospitals NHS Trust.
Urgent care

FOI 83630 Out of hours contract. Date requested 23 October 2020

Request received

Have any assessments of clinical risks been carried out or discussed by the CCG with regarding the pilots of 111 First? If so, please detail what clinical risks have been discussed prior to the launch of the 111 First pilots, and how these have been assessed.

Have any impact assessments been done by the CCG on 111 First? If so, please could you provide them.

Have any equalities impacts assessments been carried out by the CCG on 111 First? Again, if so please provide them. What equalities risks have been discussed by the CCG re: 111 First and how have they been assessed?

Our response: 2 November 2020

Clinical risks were assessed prior to going live through a programme of work which was supported by NHS England, designed to support the sites which were going first with Think 111 (nationally mandated programme). Nationally the guidance required:

Expanding the 111 First offer to provide low complexity urgent care without the need for an emergency department attendance, ensuring those who need care can receive it in the right setting more quickly. This includes increasing the range of dispositions from 111 to local services, such as direct referrals to same day emergency care and specialty hot clinics. As well as ensuring all type 3 services are designated as urgent treatment Centres. The Department for Health and Social Care will shortly be releasing agreed emergency department capital to help offset physical constraints associated with social distancing requirements in emergency departments.

The positive benefits to the system in terms of pre-alerting patients (heralding) so that the unit due to receive them are expecting them are clear and beneficial. This is in terms of meeting the stated objectives of reducing harm during the pandemic.

Reducing the number of people who walk in and thus support the objective of minimizing the spread of infection.

On arrival, the receiving clinical team already has information regarding the patient and the reason for their attendance, reducing the requirement to repeat information.

Patients who are pre-alerted have already been triaged as being appropriate for that service. This supports the right place, first time imperative by reducing duplication, maximizing clinical resources and improving patient experience.

Maximization of alternative settings of care. Reducing demand into the emergency department as the default option for attendance.

Clinical risks were also discussed and reviewed in regional forums as well as local clinical working groups and daily clinical huddles.

Local objectives agreed

  • COVID aim (protect people from COVID) to minimise harm and minimise death ensuring we have capacity to care for people in their local communities.
  • Influence public behaviour so that MORE people, who would otherwise have walked into urgent care settings, contact 111 first.
  • Create sufficient capacity in 111 and the local CAS. This ensures that people contacting get a timely and effective resolution to their presenting question or complaint. Ideally without the need for onward referral (increase of consult and complete model within the integrated urgent care service)
  • Maximise the number of alternative options to face-to-face urgent care and ensure they are all available on the directory of services.
  • Getting people to the right place first time – Increasing value, reducing duplication for patients and waste of clinical resource.
  • Ensure that receiving units are pre-alerted to expected patients, advice and care already provided and the reason for the onward referral, using the principals of trust of assessment.
  • Reduce face-to-face contact
  • Avoid overcrowding in all urgent care walk in settings to prevent spread of nosocomial infection (Royal College of Emergency Medicine paper May 2020).
  • Patients feel they get a timely and effective resolution to their presenting question or complaint.
  • Ensures there is no unintended impact on safety.
  • Ensure no unintended consequences for other parts of the system.

Comprehensive audits continue to be undertaken as part of the implementation, including patient level audits and monthly full end to end call reviews. These are at patient level and to release this information could risk identifying individuals involved, therefore NHS Kernow exempts the release of this information under section 40 of the Freedom of Information Act.

An equalities impact assessment is currently under development. This is currently being reviewed by system quality leads and vulnerable people leads. In terms of risk assessed, it is of course across all the protected characteristics. With a particular emphasis on the attention to detail around especially vulnerable groups in terms of:

  • deprivation
  • vulnerability
  • learning disability
  • mental health and access requirements

FOI 83490 out of hours contract. Date requested 15 October 2020

Request received

I am writing to request information relating to NHS 111 and the 111 First pilots used for triaging emergency department calls.

  1. Please could you provide (if this is not possible, please provide as many breakdowns of those calls as you can:
    • total number of NHS 111 calls received in the CCG region for each week from 1 August to 14 October.
    • weekly breakdown of the number of those calls in question 1) that were passed on by NHS 111 to:
      • in-hours primary care
      • out-of-hours primary care
      • emergency departments / urgent treatment centres
      • ambulance services
      • self-care
      • other
  2. Date that your region started piloting the 111 First scheme.
  3. National guidance you are using on how to run the 111 First pilots.
  4. Any local guidance you are using on how to run the 111 First pilots.

Our response: 5 November 2020

Please see below table detailing the numbers of NHS 111 calls received for NHS Kernow by directed to outcome.

This information is for data between 1 August 2020 and 14 October 2020.

Week ED Ambulance Clinical advisor Total
Week 1 257 411 1,157 5,436
Week 2 197 415 923 5,692
Week 3 210 412 1,089 5,744
Week 4 260 388 1,159 5,325
Week 5 210 415 1,115 6,033
Week 6 186 338 913 5,476
Week 7 205 395 1,101 6,296
Week 8 219 411 1,058 5,357
Week 9 172 381 1,031 4,435
Week 10 181 390 1,060 4,546
Week 11 138 298 739 3,222

The answer above is as far as NHS Kernow is able to breakdown the data.

NHS Kernow began piloting the 111 First scheme on 4 July 2020.

We are following the service specification addendum issued by NHS England and NHS Improvement. Any local guidance is in line with the national guidance and standard operating procedures issued.

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