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July 2021

In July 2021 we received 22 FOI requests. On this page you can find a full list of the requests we received, along with our response.
Children’s health

FOI 88730 Services. Date requested 26 July 2021

Request received

To assess the current situation for children’s continence (bladder and bowel services) in the United Kingdom, please would you answer the following questions.

  1. Please state whether the following 5 paediatric continence (bladder and bowel) services are commissioned by your CCG (clinical commissioning group) or funded by your health board: bedwetting, daytime wetting, toilet training, constipation or soiling and product (nappy, pad or washable pants) supply for paediatric continence problems.
  2. If any of the above services are not commissioned or funded and delivered by your CCG or health board, does anyone else provide any of these services?
  3. If yes, please provide details of which partner organisation provides them, which service(s) they provide and the age ranges.
  4. Is there a single (integrated) service for all the above 5 problems? If the answer to 2 is yes, is this service led by a paediatric continence advisor? If the answer to 2 is no, please list the services that are commissioned or provided and the designation of each of the service leads.
  5. If the answer to 2 is yes, please could you tell us:
    • how many children and young people are on the waiting list for this service?
    • how long has the child currently at the top of the list had to wait?
  6. If you answered yes to any part of question 1, please tell us how many children and young people with continence problems are currently on the caseload of the service?
  7. Do you have any future plans to commission or provide new paediatric continence service or review the existing paediatric continence service? If so, please provide details.
  8. How many full time equivalent staff specialising in paediatric continence are currently employed by the services commissioned by your CCG or provided by your health board? Please specify whether they:
    • Are registered children’s nurse?
    • Have had specific training in paediatric continence management.
  9. Are you aware of the children’s continence commissioning guide? If yes, do the services commissioned in or provided by your CCG or health board use it?

Our response

  1. Cornwall and Isle of Scilly does not currently have structures for joint commissioning in children’s services under a health board. NHS Kernow commissions the services listed in an all-age service that covers children with complex disability. Other services listed are provided by public health commissioners in Cornwall Council. For more information please contact Cornwall Council.
  2. No. Bladder and bowel services for those with complex disability commissioned from Cornwall Partnership NHS Foundation Trust.
  3. Not applicable.
  4. Bladder and bowel service for those with complex disability.
  5. a) Not at this time and b) yes.
  6. NHS Kernow does not hold this information. This may be available from the provider of the service. Please contact Cornwall Partnership NHS Foundation Trust.
  7. Yes. It is used jointly with public health.
Clinical management

FOI 88760 Aural care service. Date requested 28 July 2021

Request received

Please clarify for me whether removal of epithelial debris is commissioned by you. I understand that earwax removal is no longer a service that you commission but have contradictory information regarding the removal of epithelial debris.

Our response

NHS Kernow does not have an enhanced service for removal of ear wax in primary care. There is a commissioned aural care service in secondary care but microsuction for epithelial debris is not routinely commissioned. The criteria for what is commissioned can be found in our commissioning policy available on our website.

FOI 88340 Pathway. Date requested 2 July 2021

Request received

  1. Is the NT-proBNP test commissioned for use for diagnosis of suspected heart failure in primary care in your clinical commissioning group (CCG)?
  2. If yes, are there any restrictions or limitations in place for a healthcare professional to request NT-proBNP?
  3. If yes, please detail for example we restrict NT-proBNP as a test to request on our GP system by cost or patient demographic.

Our response

  1. Yes.
  2. No.
  3. Not applicable.
Continuing healthcare

FOI 88380 Continuing healthcare systems. Date requested 7 July 2021

Request received

  1. Does the clinical commissioning group (CCG) fully outsource end to end continuing healthcare (CHC) delivery?
  2. Does the CCG use a third-party supplier or commissioning support unit (CSU) to deliver, support or outsource any of the below aspects of CHC? If yes, please provide information for each service area.
  3. Please provide the number of CHC and funded nursing care (FNC) staff and the number of vacancies in the current CHC team structure.
  4. Does the CCG use a resource allocation system (RAS) to calculate the provisional amount of funding available to meet a person’s care needs for personal health budgets? If yes, please state the name of the system and tool used.
  5. How many CHC assessments did the CCG have left to complete as of the end of March 2021?
  6. How many CHC assessments did the CCG have left to complete as of the end of June 2021?
  7. How many FNC reviews are in backlog (those that have not been reviewed in excess of a year) as of the end of March 2021?
  8. How many FNC reviews are in backlog (those that have not been reviewed in excess of a year) as of the end of June 2021?
  9. How many people at your CCG receive joint funded local authority and CHC packages of care as of the end of March 2021?
  10. What was the annual cost to the CCG for joint funded packages of care for the financial year 2020 to 2021 (April 2020 to March 2021)?
  11. How many people were covered by personal health budgets of care as of the end of June 2021?
  12. How many Deprivation of Liberty Safeguards (DoLS) assessments were carried out by the CCG in 2020 to 2021 (April 2020 to March 2021)?
  13. Does the CCG employ a specialist for DoLS? If yes, please state how many specialists are employed by the CCG?
  14. Does the CCG use a supplier for the legal process of DoLS (for example Bevan Brittan, Capsticks or Browne Jacobson)? If yes, please state the name of the supplier and the annual cost to the CCG for the financial year 2020 to 2021 (April 2020 to March 2021)?

Our response

To request a copy of the spreadsheet that was supplied for this response, please email our FOI team.

Please note that for answers relating to the numbers for CHC on the attachment do not just cover CHC but also other activity for personalisation and medicine prompts discharge to assess as it is not possible to split.

  1. No.
  2. Response provided as an attachment.
  3. Response provided as an attachment.
  4. NHS Kernow has an Excel sheet developed using the Oxford Budget tool to support equity when calculating direct payment personal health budgets.
  5. 86.
  6. 45.
  7. 391.
  8. 553.
  9. 128.
  10. £6,039,000.
  11. 105.
  12. Local authorities currently hold statutory responsibility for authorising a deprivation of liberty in care homes and hospitals and completing the assessments to do so. This includes people who are CHC funded. The Court of Protection currently authorises Deprivation of Liberty for people in settings other than hospitals or care homes. The CCG does not currently have a statutory responsibility currently for authorising in any of these settings. Therefore, the answer is none.
  13. Yes, 3.
  14. NHS Kernow have commissioned, via a crown commercial framework, Browne Jacobson to provide all their legal services. Browne Jacobson replaced Bevan Brittan in December 2017. The annual spend in relation to the mental health act, court of protections and deprivation of liberties is provided in the table below. Apart from the annual spend for 2 ongoing complex cases which have been retained by Bevan Brittan. This information cannot be disclosed as 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.
2018/19
£
2019/20
£
2020/21
£
Browne Jacobsen 172,055 183,715 183,429
Bevan Brittan Exempt Exempt

FOI 88640 personal health budget. Date requested 21 July 2021

Request received

In relation to last financial year (2020 to 2021) could you please provide me with information relating to the first 20 occasions in which you sanctioned the use of a patient’s personal health budget (PHB) to be spent on something that was not for the provision of care, medicine, or transport to a place where care or medicine was provided?

For each of these 20 occasions please state:

  • what the money was spent on
  • how much money was spent on it
  • the outcome the patient was working towards as a result of this spend

Note: What I am after is any capital expenditure which is not immediately apparent as of a medical purpose. So a specialist bed would be medical and I would not want to know about it, but a large screen television for a patient with vision problems would be something that I am interested in, as somebody not familiar with the case would not be able to tell that the set had been bought because of the patient’s vision problems. The request covers PHBs for both adults and children

Our response

NHS Kernow have not deployed capital expenditure which is not immediately apparent for anything other than a medical purpose within spend on personal health budgets for children.

For adults, NHS Kernow holds the information but as there have been less than 5 instances where capital expenditure has been used in this manner the information cannot be disclosed as 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.

FOI 88670 Atopic dermatitis. Date requested 22 July 2021

Request received

  1. Did NHS Kernow Clinical Commissioning Group (CCG) have a commissioning policy on adult atopic dermatitis between the dates 1 April 2017 and 21 June 2021?
  2. Does the CCG currently (as of July 2021) have a commissioning policy on adult atopic dermatitis?
  3. Once part of an integrated care system (ICS), is the CCG aware of plans for the ICS to have a commissioning policy on adult atopic dermatitis in place the next 2 years (from 21 June 2021 to 21 June 2023)?

Our response

  1. No.
  2. No. There are referral guidelines in place to support GPs on when to make a referral.
  3. NHS Kernow is currently not aware of plans for the ICS to have a commissioning policy for adult atopic dermatitis. However, we are aware that other CCG areas have commissioning policies (criteria based access) for this condition. As part of our assurance process on what we commission, NHS Kernow look to other CCGs commissioning policies as part of this process.
Finance and budgets

FOI 88350 Dermatology. Date requested 2 July 2021

Request received

  1. What is the annual spend on community dermatology services for the following years? If not available, please provide data for any available years ending:
    • 31 March 2019
    • 31 March 2020
    • Year ending 31 March 2021
  2. What is the annual spend on secondary care and acute dermatology services for the following years? If not available, please provide data for any available years ending:
    • 31 March 2019
    • 31 March 2020
    • Year ending 31 March 2021
  3. Which organisation(s) (for example third party providers) currently provide a community dermatology service to the CCG?
    • What is the total spend with these organisations (year ending 31 March 2021, or last available year)?
    • Do these organisations also provide services to the CCG outside of dermatology? If so, which areas?
  4. On what date does the contract for community dermatology services expire?
  5. Which organisation(s) (for example third party providers) currently provide secondary care and acute dermatology services to the CCG?
    • What is the total spend with these organisations (year ending 31 March 2021, or last available year)?
    • Do these organisations also provide services to the CCG outside of dermatology? If so, which areas?
  6. On what date does the contract for acute dermatology services expire?
  7. Are contracts for dermatology services in partnership with any other CCG(s)? If so, please provide a list of the CCGs that share this contract.
  8. Do you in-source any dermatology services? If so, which provider(s) do you use for in-sourcing dermatology services?

Our response

  1. Responses below:
    • £374,393.
    • £423,048.
    • £365,402.
  2. Responses below:
    • £5,701,413.
    • £7,346,190.
    • £5,643,893.
  3. The only community-based dermatology service is provided by Kernow Health community interest company (KHCIC).
    • As per 1c.
    • Yes, special allocation scheme.
  4. 31 March 2023.
  5. Royal Cornwall Hospitals NHS Trust, University Hospital Plymouth, Cornwall Partnership NHS Foundation Trust, Northern Devon Healthcare Trust and Royal Devon and Exeter Hospital
    • As per 2c.
    • These providers provide a host of services under their acute hospital contracts. It is not possible to list every service they are commissioned to deliver.
  6. There are currently no contracts between CCGs and NHS trusts due to COVID. NHS England agreements remain in place.
  7. Yes, for dermatology services that span the border of Devon and Cornwall there are contracts for which we are an associate commissioner with NHS Devon.
  8. No, as we are a CCG and do not deliver direct patient care.
Long term conditions

FOI 88360 Outcomes. Date requested 5 July 2021

Request received

I’d like to know how many people were living with, living beyond and dying of the following diseases in your area:

  • kidney cancer
  • testicular cancer
  • ulcerative colitis
  • thyroid disease
  • pregnancy induced hypertension (including pre-eclampsia)
  • hypercholesterolemia

Please include the number of people affected as a total number, but also as a rate (per 100,000 people) and as a proportion of the population covered by your clinical commissioning group for the years 2015, 2016, 2017, 2018, 2019 and 2020. Please also include the geographical extent of the area covered by your group.

Our response

NHS Kernow is the clinical commissioning group for Cornwall and the Isles of Scilly. We do not hold the information requested.

Kidney cancer and testicular cancer are rare cancers and are commissioned by NHS England specialist services, and may hold the information requested.

Royal Cornwall Hospitals NHS Trust may hold the information for hypercholesterolemia.

Mental health and learning disabilities

FOI 88430 Child and adolescent mental health services referrals. Date requested 9 July 2021

Request received

Please can you send me the most recent referral criteria the CCG has issued for child and adolescent mental health services (CAMHS) referrals. By referral criteria I mean any guidance that states what minimum threshold a child has to reach in their mental ill health in order for them to be referred to CAMHS.

Please can you also send me any other communications the CCG has issued about CAMHS referrals or CAMHS services in the past 2 years (1 July 2019 to present day).

Our response

NHS Kernow does not hold any of the information requested. The eligibility criteria for CAMHs is publicly available on the Cornwall Partnership NHS Foundation Trust website. For more information please contact Royal Cornwall Hospitals NHS Trust.

FOI 88540 inpatient services. Date requested 15 July 2021

Request received

Please provide average price per day for the financial year 2020 to 2021, 2019 to 2020, 2018 to 2019 for the following specialities for independent and NHS provision: 

  • psychiatric intensive care unit
  • general adult mental health
  • rehabilitation and recovery
  • neuropsychiatry
  • autism spectrum disorder (ASD) speciality units
  • general learning disability
  • complex learning disability (additional diagnosis such as autism)
  • neurorehabilitation (ABI Level 3)

Our response

NHS Kernow currently commission the following mental health inpatient services on a block contract basis and not on a tariff basis:

  • psychiatric intensive care unit
  • general adult mental health
  • rehabilitation and recovery
  • autism spectrum disorder (ASD) speciality units
  • complex learning disability (additional diagnosis such as autism)
  • neurorehabilitation (ABI Level 3)

Further information may be available from Cornwall Partnership NHS Foundation Trust.

NHS Kernow holds the information for neuropsychiatry but as cases are less than 5, the information cannot be disclosed as 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.

FOI 88620 Autism. Date requested 20 July 2021

Request received

  1. Do you have a locally commissioned NHS autism assessment service for adults? And if so:
    • What is the name and address of the service?
    • What are the current waiting times for new patients being referred to this service?
  2. Does your clinical coming group (CCG) have any other contracts, for example with other agencies, companies, or localities, to provide autism assessment services for adults? And if so:
    • Who are these contracts with? Please provide the provider name and address as a minimum.
    • What are the current waiting times for new patients being referred?
    • When are the current contracts due to end?
  3. Do you have a locally commissioned NHS autism assessment service for children (under 18)? And if so:
    • What is the name and address of the service?
    • What are the current waiting times for new patients being referred?
  4. Does your CCG have any other contracts, for example with other agencies, companies, or localities, to provide autism assessment services for children? And if so:
    • Who are these contracts with? Please provide the provider name and address as a minimum.
    • What are the current waiting times for new patients being referred?
    • When are the current contracts due to end?
  5. Has your CCG received any individual funding request (IFRs) for adult autism assessments in the last 12 months (or latest period for which you have this data, please specify the period)? And if so:
    • How many such requests did you receive?
    • How many such requests were refused?
  6. Has your CCG received any IFRs for child (under 18) autism assessments in the last 12 months (or latest period for which you have this data, please specify the period)? And If so:
    • How many such requests were received?
    • How many such requests were refused?
  7. Has your CCG received any patient choice referrals for adult autism assessments in the last 12 months (or latest period for which you have this data, please specify the period)? And if so:
    • How many such requests were received?
    • For how many such requests was funding approved?
    • For these requests how long did it take to approve funding? An ideal answer will include as many of the following as you can provide longest time, shortest time and average time to approve.
  8. Has your CCG received any Patient Choice referrals for child (under 18) autism assessments in the last 12 months (or latest period for which you have this data, please specify the period)? And if so:
    • How many such requests were received?
    • For how many such requests was funding approved?
    • For these requests how long did it take to approve funding? An ideal answer will include as many of the following as you can provide longest time, shortest time and average time to approve.

Our response

  1. Yes.
    • Outlook South West, 2 Low Meadow, Treleigh, Redruth, Cornwall TR16 4AR and Cornwall Partnership NHS Foundation Trust, Carew House, Beacon Technology Park, Dunmere Road, Bodmin PL31 2QN
    • 26 months from referral to full assessment (data from October 2020)
  2. No.
  3. Yes.
    • NHS Kernow has 4 commissioned pathways for autism spectrum disorder (ASD) assessments in under-18s:
      • autism spectrum diagnostic Assessment Team (ASDAT, age 5.5 to 18 years) provided by Cornwall Partnership NHS Foundation Trust, Carew House
      • former Outlook South West post-16 year high functioning ASD assessment team was integrated in April 2020 and now sits under Cornwall Partnership NHS Foundation Trust
      • under 5s ASD pathway sits with the community paediatricians at the Royal Cornwall Hospitals NHS Foundation Trust, Truro
      • CAMHS and complex neurodevelopmental assessments include autism as part of a co-morbid mental health assessment
    • It is not possible to give the current waiting times for starting assessment as COVID has disrupted face-to-face work and many case histories (first stage of assessment) have been taken but the ADOS (second stage of assessment) has not been undertaken while face-to-face clinic time is awaited. However, it is fair to say that children referred to the dedicated ASDAT team are experiencing waits of up to 2 years for completed assessments.
  4. No.
  5. Yes.
    • See note * below.
    • All were rejected.
  6. Yes.
    • See note * below.
    • All were rejected.
  7. Yes.
    • 5.
    • 5.
    • The approval times are not recorded.
  8. Yes.
    • 26.
    • 26.
    • The approval times are not recorded.

Please note for answers shown as *, NHS Kernow holds the information but where the numbers are less than 5, the information cannot be disclosed as 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.

FOI 88780 Inpatient services. Date requested 29 July 2021

Please provide average price per day for the financial year 2020 to 2021, 2019 to 2020, 2018 to 2019 for the following specialities for independent and NHS provision: 

  • psychiatric intensive care unit
  • general adult mental health
  • rehabilitation and recovery
  • neuropsychiatry
  • autism spectrum disorder (ASD) speciality units
  • general learning disability
  • complex learning disability (additional diagnosis such as autism)
  • neurorehabilitation (ABI Level 3)

Our response

NHS Kernow currently commission the following mental health inpatient services on a block contract basis and not on a tariff basis:

  • psychiatric intensive care unit
  • general adult mental health
  • rehabilitation and recovery
  • autism spectrum disorder (ASD) speciality units
  • complex learning disability (additional diagnosis such as autism)
  • neurorehabilitation (ABI Level 3)

Further information may be available from Cornwall Partnership NHS Foundation Trust.

NHS Kernow holds the information for neuropsychiatry but as cases are less than 5, the information cannot be disclosed as 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.

Miscellaneous

FOI 88610 IT systems. Date requested 20 July 2021

Request received

  1. How many instances of the Microsoft Windows 7 operating system are currently in operation across your entire network? How many devices such as kiosks, laptops are still running Windows 7?
  2. How many instances of the Microsoft Windows XP operating system are currently in operation across your entire network? How many devices such as kiosks, laptops are still running Windows XP?
  3. Who is the officer responsible for maintaining and delivering legacy applications to all your users?

Our response

None. NHS Kernow does not release the names of employees below director level. The responsible director is Andrew Abbott.

Primary care

FOI 88500 Primary care networks. Date requested 14 July 2021

Request received

  1. How many practices within your clinical commissioning group (CCG) have not signed up to primary care networks (PCNs)?
  2. How many practices within your CCG have not joined PCNs and not signed patient data-sharing agreements for full patient clinical records with the PCNs?
  3. If there are any such practices within your CCG who have not signed up to PCNs and/or data-sharing, then what is the CCG strategy for providing the PCN services to the patients of such practices? Does this include negotiating with these particular practices for them to provide such services?
  4. Presumably, if non-PCN practices have signed up to data-sharing with the PCNs, then relevant PCN services may then be provided on behalf of relevant patients directly. What is your approach should such data-sharing agreements for non-PCN practices have not, as yet, been signed? Does the PCN, for example, request practices to identify relevant patients to put forward together with their specific clinical records; or perhaps, rely on the summary care records on the NHS-spine or both?
  5. I would be grateful, please, for a listing of any relevant practices in these groups.

Our response

  1. There are 2 practices not signed up to a PCN.
  2. The 2 practices not in a PCN have signed data sharing agreements for a number of reasons, most recently for sharing data for the purposes of population health management. The 2 practices have not signed a specific DSA for sharing information with their neighbouring PCNs.
  3. We are working with the 2 practices who are not currently in a PCN to enable the provision of PCN services to their population under a local incentive scheme. This will ensure equity of service provision to the totality of the population of Cornwall and the Isles of Scilly.
  4. See responses to questions 2 and 3.
  5. The 2 practices not currently aligned with a PCN are Camelford Medical Centre and Camelford Churchfield Practice.

FOI 88570 GP practices. Date requested 18 July 2021

Request received

Could you kindly give me a list of GP practices that have merged within your clinical commissioning group (CCG)?

  1. GP mergers (list of merged practices) within your CCG covering the financial years 2013 to 2014 to 2017 to 2018.
  2. Funding of the merged GP practices covering the same financial period 2013 to 2014 to 2017 to 2018.
  3. I would like to know what the contract value was after the merger.

Our response

NHS Kernow does not hold this information as we only became delegated for GP practices from April 2020. For information prior to this date please contact NHS England who were responsible.

FOI 88700 GP federations. Date requested 26 July 2021

Request received

  1. Does your CCG have one or more GP federations? If so, can you please provide the name of each GP federation that is a part of your CCG.
  2. For each GP Federation that is part of your CCG, can you please provide the names of all the GP practices that form each GP Federation, along with the practice code for each GP practice?

Our response

The GP federation is Kernow Health Community Interest Company (Kernow Health CIC).

Practices are listed below:

  • L82038 Atlantic Medical Group
  • L82036 Bodriggy Health Centre
  • L82058 Bottreaux Surgery
  • L82011 Brannel Surgery
  • L82618 Camelford Medical Centre (Dr Garrod)
  • L82007 Camelford Medical Centre (Dr Nash)
  • L82041 Carn to Coast
  • L82009 Carnewater Practice
  • L82061 Carnon Downs Surgery
  • L82015 Chacewater Health Centre
  • L82049 Falmouth Health Centre
  • L82035 Fowey River Practice
  • L82620 Harris Memorial Surgery
  • L82018 Helston Medical Centre, Helston
  • L82001 Lander Medical Practice
  • L82030 Launceston Medical Centre
  • L82042 Leatside Health Centre (previously Manor and Clinton)
  • L82039 Lostwithiel Surgery
  • L82047 Marazion Surgery
  • L82059 Meneage Street Surgery
  • L82025 Mevagissey Surgery
  • L82026 Middleway Surgery
  • Y01051 Morrab Surgery
  • L82056 Mullion and Constantine Group
  • L82029 Narrowcliff Surgery
  • Y01127 Neetside Surgery
  • Y02517 Newquay Health Centre
  • L82016 Oak Tree Surgery
  • L82022 Old Bridge Surgery
  • L82006 Penryn Surgery
  • L82013 Perranporth Surgery
  • L82003 Port Isaac Practice
  • L82066 Port View Saltash
  • L82068 Praze-an-Beeble Surgery
  • L82045 Probus Surgery
  • L82043 Quay Lane Surgery
  • L82050 Rosedean House Surgery
  • Y01050 Rosmellyn Surgery
  • L82046 Saltash Health Centre
  • L82054 St Agnes Surgery
  • Y04957 St Austell Healthcare
  • L82057 St Keverne Health Centre
  • Y01922 Stennack Surgery
  • L82010 Stillmoor House Medical Practice
  • L82008 Stratton Medical Centre
  • L82070 Sunnyside Surgery
  • L82012 Tamar Valley Health
  • L82051 The Clays Practice
  • L82017 The Health Centre, St Mary’s
  • L82023 The Petroc Group
  • Y00969 The Rame Group Practice
  • L82048 The Roseland Surgeries
  • L82028 Three Spires Medical Practice
  • L82052 Trescobeas Surgery
  • L82044 Veor Surgery
  • L82004 Wadebridge and Camel Estuary Practice
  • L82622W estover Surgery

FOI 88790 Primary care networks. Date requested 28 July 2021

Request received

Thank you again for your informative and helpful response to FOI 88500. May I please clarify a couple of things. I gather that the 2 stated practices not in a primary care network (PCN) and who have not signed data-sharing agreements (DSA) with a PCN are, nevertheless, working with the clinical commissioning group (CCG) to provide services which would otherwise have been provided by the PCN umbrella; but are instead to be provided via a low income scheme (LIS). “The 2 practices not in a PCN have signed DSAs for a number of reasons, most recently for sharing data for the purposes of population health management”.

This situation is of particular interest in my survey as I am looking at such flexible, versatile and imaginative arrangements being developed and actioned to ensure proper patient and population access to appropriate services. Are you able to elucidate further as I am interested in the exact details here? Are you able to supply specimen DSA and LIS used here for this purpose please under FOI as this would be most useful?

I am looking to collect such examples of what are deemed good practice with a view to possibly sharing more widely, with the necessary permissions of course, should the data prove sufficiently interesting and useful.

Our response

NHS Kernow is unable to provide the information requested as the LIS is currently in draft form, though it is confirmed that there is no specific DSA assigned.

Organisation

FOI 88400 Staffing. Date requested 7 July 2021

Request received

  1. How many NHS staff are employed in Cornwall?
  2. Has their ethnic identity been requested and recorded?
  3. If ethnic identity has been established how many have declared themselves Cornish?

Our response

  1. NHS Kernow Clinical Commissioning Group has 288 employees.
  2. Yes, and recorded if they have chosen to give the information.
  3. 14.

NHS Kernow does not hold information on NHS staff employed by other organisations. The answers provided relate to NHS Kernow employees only. Please contact Royal Cornwall Hospitals NHS Trust, Cornwall Partnership NHS Foundation Trust and NHS England for information about their employees.

FOI 88750 Staffing. Date requested 27 July 2021

Request received

  1. Do you have a chief of staff? If so, what band are they please (you might have more than 1)?
  2. Do they have line management responsibilities (even just understanding if they manage a team or any individuals would be really helpful)?
  3. The final question is what team do they sit in, and job title might help with this, for example are they chief of staff in a particular office?

Our response

No.

Prescribing and pharmacies

FOI 88460 Rebates. Date requested 13 July 2021

Request received

  1. I would like to request the product names (brand and generic where applicable) with start and finish dates of all your rebates. Please distinguish which rebates are aligned to PrescQIPP and which are Independent.
  2. I would also like to request the process of how you review and evaluate the rebates presented to you.

Our response

  1. 1. This information is publicly available in our publication scheme.
  2. To request a copy of the policy, please email our FOI team.

FOI 88690 Rebates. Date requested 23 July 2021

Request received

  1. Details of any discount, rebate or reimbursement your organisation receives in respect of blood glucose testing strips.
  2. A copy of and or a link to your current blood glucose testing formulary and recommended blood glucose meters or strips
  3. The planned date to next review your blood glucose meters or strips formulary.
  4. The name, contact email address and telephone number of the person(s) in your organisation who are responsible for blood glucose meter, strip formulary and recommendations within your organisation.
  5. How will the formulary review be managed, what will be included in the process and anticipated timelines for completion?
  6. Are you working with any other CCG’s or PCO’s who will be part of this process, or who will adopt the same formulary? If so, please provide the names of these areas and the contact name, email address and telephone number for the person with responsibility for blood glucose meters

Our response

  1. None for blood glucose test strips. NHS Kernow publishes all rebate information on our website.
  2. This information is available on the Eclipse Formulary website.
  3. September 2024.
  4. NHS Kernow does not release the names of employees below director level. Andrew Abbott, director of integrated primary and community care. Call 01726 627800.
  5. Due to the transition from a CCG to an integrated care system, this information is not yet known.
  6. No.
Referral management

FOI 88490 Musculoskeletal disorders. Date requested 13 July 2021

Request received

I’m currently researching a paper exploring the cost and effectiveness of physiotherapy triage for musculoskeletal (MSK) disorders. I am in the process of trying to collate data from all UK clinical commissioning groups (CCGs) on the effectiveness of this set-up and would like to enquire whether you use such a triage system in your CCG? If this is the case, then I would be very grateful if you could let me know if you collect any data that you would be able to share? This could be in the form of:

  • cost of the triage service to the CCG
  • who runs the triage service, for example private firm or NHS group
  • number of patients referred for triage
  • average time taken from primary care referral to being triaged
  • percentage of these patients who eventually get referred to secondary care (and how long it took for this decision to be made)
  • number of X-rays and MRI scans done

Any information regarding the set-up of the triage service, for example are patients seen by a specialist MSK or sports doctor, or is it all specialist physio led?

Regarding the time scale, we are interested in data pre-COVID and post-COVID. Therefore, this would be 1 September 2018 to 1 September 2019 and 1 March 2020 to 1 March 2021.

Our response

NHS Kernow does not commission physiotherapy triage. A summary of MSK physiotherapy services that are commissioned is below.

  • NHS Kernow commissions MSK physiotherapy, but referrals into this service are not triaged.
  • NHS Kernow is also working with system partners in primary and community care to implement first contact practitioner (FCP) MSK physiotherapists. They are qualified autonomous clinical practitioners who are able to assess, diagnose, treat and discharge a person without a medical referral where appropriate. Results from across the UK where FCPs have been implemented are widely available publicly.
  • NHS Kernow also commissions a community MSK interface service. Entry criteria are patients with shoulder, hip, knee problems including sports medicine problems of these joints whereby conservative measures have failed including a course of tailored physiotherapy; diagnostic uncertainty (including if not sure whether surgery is indicated); patient is medically unfit or declining surgery.

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