DH 'impressed' with West Midlands clusters but 'worried' about QIPP

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PERFORMANCE: The Department of Health has been “impressed” with the PCT clusters in the West Midlands but has “worries” about QIPP plans and has recognised “issues” around coterminosity between GP commissioners and local authorities.

A note from Denise McLellan, chief executive of Birmingham and Solihull PCT cluster, contains the following key messages taken from an assurance process carried out by the DH.

Key points:

Impressed with the changes made over the last 15-16 months since the last assurance process. Recognised the issues raised then have been taken on board and that systems and processes are stronger than previous.
The early establishment of clusters has paid dividends in terms of relationships and agreement on boundaries.
They recognised that the bottom up approach to QIPP and the development of system plans may well be the right one - as opposed to the top down approach in some areas.
Great GPs - without exception - their contribution and level of involvement and engagement is as good as any.
West Mids does have one of the highest number of emerging GP commissioners per capita and there are issues around co-terminosity with local authorities.
Delivery on QIPP for 11/12 - some worries in some areas ( including Birmingham & Solihull) and will be closely monitoring.
FT pipeline is working well and impressed with the tripartite agreements. However some -non Birmingham and Solihull - providers have further to go.
Positive messages about working with local government and west mids is perceived to be improved and strong local govt relationships.
Strengthened systems and processes around governance and quality and perceived to be leading the pack on workforce planning.
Very convinced by the SHA performance management model and now looking at situations where Clusters should take over and the situations in which it will lie with the SHA- increasing shift to cluster.

Areas to address:

Emerging GPC boundaries - need to look at how this works and support effective relationships with the Local Authorities and the hospitals
FT trajectory for specific providers - ensuring we have strong risk management
Delivery of QIPP to focus more on future years, esp Birmingham
Not prepared to let 18 week and A&E targets slip. (issue for Heart of England Foundation Trust for Birmingham and Solihull)

The note adds: “On Birmingham and Solihull, the personal feedback is very positive and better than anticipated by the top team, particularly regarding provider relationships. There is a recognition that there is more to do on the longer term and ensuring we facilitate QIPP delivery this year and for future years.

“There was also a note made (this was more of a comment than an overall concern) re the children’s safeguarding and the issues in Birmingham.”