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NHS Kernow’s website closed on 30 June 2022. Visit the NHS Cornwall and Isles of Scilly Integrated Care Board website for information about our health and care services.

May 2022

In May 2022 we received 9 FOI requests. On this page you can find a full list of the requests we received, along with our response.
Clinical management

FOI 90840. Virtual wards. Date requested 16 May 2022

Request received

  1. Has your ICS published its plans for the rollout of tech-enabled virtual wards? Does this include plans for frailty?
  2. Has your ICS identified a tech provider or supplier for the delivery of a frailty virtual ward? If so, who?
  3. Do you have phased targets between now (May 2022) and December 2023 to ensure you reach the national ambition of 40 to 50 per 100,000? If so, what are they?
  4. What is your ICS’s current average length of time between being deemed medically fit for discharge and discharge occurring for patients aged 65 and over?
  5. What assessment, if any, have you made of the cost savings of utilising tech-enabled virtual wards for frailty?
  6. Who is the clinical lead for your frailty virtual ward?
  7. Does your CCG expect to recruit additional roles to support the delivery of tech-enabled virtual wards within the next 12 months? If so, what are they?
  8. How do you plan to integrate with social care and local authorities for the delivery of frailty virtual wards?

Our response

  1. No. The Cornwall system plan has been shared with NHS England and NHS Improvement but not published in public as yet. The plan does include a workstream for frailty.
  2. The service will be provided by Royal Cornwall Hospitals NHS Trust (RCHT) and Cornwall Partnership Foundation Trust (CFT) using their current provider, Tunstall.
  3. Yes.
  4. It is intended to have 50 people at any one time on any virtual ward by December 2022.
  5. RCHT and CFT’s current average length of the between being deemed medically fit for discharge and discharge occurring for patients aged 65 and over is 4.4 days.
  6. Not yet commenced.
  7. Not yet known.
  8. Not yet known.
  9. Social care are part of our locality multiple disciplinary teams and will be part of the multiple disciplinary teams for virtual wards in the future.
Continuing healthcare

FOI 90860. Care for individuals aged 18 or older. Date requested 23 May 2022

Request received

  1. How is domiciliary care services (visiting) and live in care service currently commissioned?
  2. If support is commissioned via a framework, DPS or block contract when does this contract re-open and what is the name of the contract?
  3. How can new providers support the local CCG with visiting care and live in care on a spot agreement?
  4. What is the current average hourly rate for visiting care?
  5. What is the current average weekly fee for live in care?
  6. How many hours of visiting care are current commissioned each week by the CCG?
  7. How many live in packages are current commissioned by the CCG?
  8. What are the current contact details for the brokerage team/placement team?
  9. What are the current contact details for the commissioning team?
  10. What is the current market capacity and need for complex care?
  11. What are the major challenges currently facing the CCG regarding clinical groups of support?

Our response

  1. Via our buyer care service.
  2. Commissioned via a DPS contract (variable NHS short form contract) joint with Cornwall Council or non DPS contract direct with NHS (short form contract).
  3. Providers are encouraged to apply to become an approved DPS provider for home care and supported lifestyles via Supplying in the South West. Alternatively, they can apply to be on the NHS Kernow non-DPS or escalation list. The registration form is attached and when completed the form is sent to our contracts team. If the provider decides to go down this route, we can add them to our database of providers within about 48-hours of the full application being sent. This will then allow for the provider to take packages of care and also give them more time to apply to become a DPS approved provider (which takes considerably longer).
  4. £23.41.
  5. NHS Kernow does not hold this information as the database does not record this separately.
  6. 17,022.
  7. NHS Kernow does not hold this information as the database does not record this separately.
  8. Email our buyer care team.
  9. NHS Kernow does not release the names of employees below director level. Dylan Champion, system director adults and community.
  10. This varies as unable to predict when this provision is required. We do have a large number of complex care providers and always looking to engage with new complex care providers for choice and capacity purposes.
  11. Lack of provider capacity as demand still outstrips supply. Lack of specialist complex care providers. Recruitment delays to packages being ready to deliver.
Contracts

FOI 90890. ECG monitoring. Date requested 26 May 2022

Request received

  1. Who is the person responsible for the ECG and GP budget?

Our response

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

The directors responsible for the ECG and GP budget are John Groom director of planned care and Andrew Abbott director of primary care.

Miscellaneous

FOI 90790. Primary care networks. Date requested 4 May 2022

Request received

  1. Please supply copies of any LIS documents for the non-PCN practices for such primary care network (PCN) proposed services that have been agreed so far; and/or as soon as agreed.
  2. Please supply the minutes of the July 2021 primary care commissioning committee (PCCC) meeting as seen in the minutes of 10 June, 2021 where the progress of the LIS was going to be discussed.
  3. Please supply minutes of any other meeting where PCN-proposed services to the patients of non-PCN practices were discussed.
  4. We would be interested in any information collected and available from elsewhere in England as to how non-PCN practices were managed in these regards.
  5. Any policies or minutes that the CCG has adopted or discussed in the eventuality that non-PCN Practices were not able or willing to provide PCN-proposed services to the patients of these practices.

Our response

The local incentive scheme (LIS) document is still only in draft form and not yet agreed. Unfortunately we did not manage to agree the LIS with the 2 Camelford practices last year and the national changes to the PCN DES meant changing the content of the LIS. We are hopeful that we will be able to secure PCN services for the population shortly.

As the LIS was not agreed as hoped last year there was no update to the PCCC during the months following the discussion in June 2021. All PCCC papers can be found on our website. The delivery of PCN services to non-PCN practices were not discussed in any other committee meetings. The solution of a LIS was suggested in a verbal conversation with a NHS England colleague and as both practices are willing to provide the services under the LIS this seemed like the best solution. Therefore it was not deemed necessary to conduct any research into alternate solutions. As the solution of the LIS is still favoured by NHS Kernow and the practices and we are reaching an agreed document it has not been necessary to consider other options up to this point.

The current solution of a LIS does not require any data sharing agreements (DSAs) to be signed as practices will only be accessing their own information and there are no third party providers involved therefore your questions about DSAs are not relevant to these particular circumstances.

Organisation

FOI 90830. Integrated care system. Date requested 16 May 2022

Request received

Has your integrated care system (ICS) has established any data platform or collaboration platform to integrate the data?

Our response

Information can be found on the Cornwall and the Isles of Scilly Health and Care Partnership website.

As part of NHS England’s ICS business intelligence function strategies are being formulated on a single cloud based data warehouse for the system with organisational and controlled access roles.

FOI 90870. Hospitality, gifts and declarations of interest register. Date requested 24 May 2022

Request received

Please provide a copy of the register for your organisation – which would include potential conflicts of interest and financial gifts. If there is not a complete register held, we request the information on this topic that the organisation does hold; and information on why the organisation does not hold a complete register.

Please can you tell us whether this register is available online, and if so, the URL, or whether it is only available on request.

Our response

NHS Kernow publishes the declaration of interests (DOI) for decision makers and the gifts and hospitality registers on our document library:

In line with NHS England guidance, NHS Kernow does not routinely publish the DOI entries for employees who are not deemed to be decision makers. Please see attached copies of the DOI registers for years to 31 March 2021 and 2022. Names and job roles have been redacted as NHS Kernow does not release the names of employees below director level. Any information which may identify another individual (non-employee) has also been redacted in line with section 40(2) of the Freedom of Information Act 2000 on the grounds that it is personal information.

Please email our FOI team if you require a copy of the documents.

FOI 90880. Transforming care partnerships plans. Date requested 25 May 2022

Request received

  1. Are your plans regarding transforming care up to date and reviewed regularly? Could you please define the frequency. If you do not, do you plan to start and when?
  2. Please share significant learning points you have identified from review of your plans in the last 12 months.
  3. How do you monitor patient safety across this patient group, and what are the main challenges for you at the moment?
  4. How are you monitoring reduction in restraint across this patient group?
  5. How frequently is mechanical or chemical restraint being used?
  6. Do you actively involve the patient in the development of your plans?
  7. Do you actively involve families and extended networks in the development of your plans?
  8. What are your current adult target rates, and what are your reduction targets year on year?
  9. Can published versions of your findings be accessed online?
  10. I also request a digital PDF version of your latest transforming care partnerships plan, although we acknowledge it me be under another name.

Our response

  1. The transforming care partnership was in place from 2016 to 2019, with the work continuing under the NHS long term plan for learning disability and autism (LDA). We also have the local 3 year plan for LDA that describes our trajectory for inpatient care, including out of area placements. The measures against this plan, including inpatient admission, care education and treatment reviews (CETR) and blue light processes are reviewed at the learning disability programme board.
  2. We have held the safe and wellbeing reviews in the last 6 months and have immerging themes to action. These include:
    • improving assurance of the independence and efficacy of advocates for individuals in out of area hospitals
    • improving timely family contact for inpatients, including facilitation of visiting and, where consented, information sharing
    • ensuring good physical health care for individuals in inpatient units, including access to primary care services, dentistry and opticians
    • developing robust care pathways between secure inpatient unit teams and their corresponding teams in the community to facilitate discharge
    • developing, along with Cornwall Council, a clear housing and accommodation strategy to prevent delayed discharges for inpatients who are awaiting housing solutions
    • to ensure a robust governance and monitoring mechanism for the monitoring of quality and clinical effectiveness of out of area placements for vulnerable people
    • ensuring that commissioners are informed of all admissions of individuals with learning disabilities or autistic people by increasing awareness of the transforming care partnership programme in mainstream mental health settings
    • Cornwall uses more local inpatient facilities than out of area placements, as this is seen as the least harmful approach for vulnerable individuals who are experiencing distress as a result of mental illness; further augmentation of mainstream services is required to ensure that people with learning disability or autistic people receive equitable mental health treatment
  3. Inpatients with either learning disabilities or autism have an 8 weekly check by one of the NHS Kernow clinical reviewers, a care and treatment review (CETR) every 6 months and a one off piece of work with the Safe and Wellbeing reviews that took place following the Cawston Park inquiry. We also have a peer advocacy group who undertake regular contact with our out of county individuals via zoom meetings and face to face meetings.
  4. This recorded monthly on our assuring transformation database and restrictive practices are monitored both by NHS Kernow clinical reviewers and the local care coordinators.
  5. NHS Kernow does not recognise the term mechanical or chemical restraint and is therefore unable to answer this question. However, all individuals who are using antipsychotic medication who also have learning disabilities are monitored under the STOMP programme within Cornwall Partnership NHS Foundation Trust.
  6. A number of people with a lived experience meet on a monthly basis and are involved in influencing commissioning intentions and further planning to implement the NHS long term plan objectives for people with learning disabilities and autistic people. The people in the group focus particularly on individuals who have experienced a crisis and inpatient admission. The group is represented on the learning disability programme board.
  7. We are re-establishing our family carers group which is being facilitated by Cornwall Partners in Policymaking. This group was very active pre-COVID and developed the Cornwall and Isles of Scilly family charter. The group has influenced commissioning intentions, particularly with regards to ensuring the voice of the family is heard at all levels of NHS organisations.
  8. The target is to reduce the number people with learning disabilities or autism in inpatient settings to 6 during 2023 to 2024.
  9. The majority of the answers in this request are sourced from internal NHS Kernow information sources which is not available online. Cornwall Council and NHS Kernow are both developing post transforming care plan strategies for people with learning disabilities and autistic people. Following consultation and finalisation, these will be published online, however the timeframe is not yet known.
  10. This plan is available on the NHS Kernow website, although it is currently being updated to a mental health strategy that delivers the NHS long term plan objectives.
Women’s health

FOI 90810. Menopause. Date requested 13 May 2022

Request received

Current local CCG primary care guidelines associated with management of menopause and perimenopause. Typically, these might be in the form of a PDF document or a webpage on a guidelines website and I am crucially looking for your guidelines regarding first line hormone replacement therapy (HRT) options that are recommended (for example oral or transdermal preparations).

Our response

NHS Kernow does not have any local primary care guidance for the management of menopause or perimenopause. In the event of a query from a practice, we would direct them towards national guidance such as NICE guidance NG23 menopause: diagnosis and management.

A list of our first line HRT options, including transdermal, oral and topical preparations, is shown on our joint formulary website.

FOI 90820. IVF. Date requested 16 May 2022

Request received

  1. In the financial years (1 April to 31 March) each, 2017 to 2018, 2018 to 2019 and 2019 to 2020, the number of rounds of IVF (including ICSI) you CCG funded?
  2. In the financial years (1 April to 31 March) each, 2017 to 2018, 2018 to 2019 and 2019 to 2020, the number of patients which your CCG funded IVF (including ICSI)?

Our response

  • 2017 to 2018: 70
  • 2018 to 2019: 78
  • 2019 to 2020: 91

For question 2, NHS Kernow does not hold this information. Please contact the providers for this information:

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