Information Management Specialist Clinical Commissioning ... of Informatio… · community. The...

Information Management Specialist

Clinical Commissioning Group CCG HQ, Building A

The APEX St. Cross Business Park

Newport Isle of Wight

PO30 5XW

Tel: 01983 822099 Ex 4862 Ref FOI16083 Date 02 June 2016 Dear Sir/Madam Request for information under the Freedom of Information Act 2000 Please find attached /see the below response to your request: The number of GPs on the Isle of Wight (Beacon Centre and surgeries) who fall into the below age brackets: Under 25 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+ RESPONSE: The CCG is unable to provide this information as a Freedom of Information request as a comprehensive Date of Birth database is not held by the Isle of Wight CCG. This letter also confirms the completion of this request. A log of this request will be held on a database by the CCG. All hard copy correspondence relating to this request will be held for one year from the date of this letter, before being confidentially destroyed. If you are unhappy about the response you have received your first line of action should be to write and request the CCG to undertake an internal review of your application. A senior member of staff, who was not involved with your initial application, will undertake this review. If after this process you are still not satisfied with the response you receive from the CCG you can complain to the Information Commissioner at the following address: Information Commissioner Wycliffe House Water Lane Wilmslow Cheshire SK9 5AF Please do not hesitate to contact this office if you have any further questions. Yours faithfully Freedom of Information Team





PO30 5XW

Tel: 01983 822099 Ex 4862 Ref FOI16084 Date 19 May 2016 Dear Sir/Madam Request for information under the Freedom of Information Act 2000 Please find attached /see the below response to your request:

1) Do you currently commission either intermediate or community dermatology services for your population?

2) If so, please provide a copy of the service specification for this service;

3) Please advise the name of the organisation that has been commissioned to provide this service;

4) Please advise the date on which the contract is due to end.

Response:

1) The Isle of Wight CCG commissions an integrated intermediate and specialist dermatology service to be provided in a community setting.

2) Please see the service specification below.

3) The Isle of Wight NHS Trust has been commissioned to provide this service. It is currently delivering

the service as part of a joint venture with Lighthouse Medical.

4) The contract is due to end on 31st December 2017.

5)

Service Specification No. DERM1

Service Integrated Intermediate and Specialist Dermatology Services

Commissioner Lead Ann Ticehurst, Commissioning Manager, Acute, IOW CCG

Provider Lead Mark Denman-Johnson, Operational Medical Director, Beacon Healthcare

Period 1 January 2013 – 31 December 2015

Date of Review

1. Population Needs

1.1 National/local context and evidence base The Government’s White Paper Our Health, our care, our say: a new direction for community services (published 2006) proposed a planned shift of care closer to the patient and their community. The National Dermatology Workforce Group (sub group of the Long Term Conditions Care Group Workforce Team) was commissioned by the Workforce Review Board to assess current service models for dermatology and suggest future models. A report was published in January 2007.

In summary, the report found that the present balance of service provision may be skewed with too many patients attending hospital based services for the provision of care that could be managed in a community setting.

Services should be delivered in line with the following guidance:

Our Health, Our Care, Our Say; A new direction for community services (DH January 2006) Commissioning Framework for Health and Well being (DH 2007) Commissioning safe and sustainable specialised paediatric services (DH 2008) Shifting care closer to home dermatology report (DH 2006) Implementing care closer to home, Parts 1 – 3 (DH 2007) Revised guidance and competences for the provision of services using GPwSI (DH 2011) Commissioning Guidance – BAD (British Association of Dermatologists 2008) Improving Outcomes for People with Skin Tumours including Melanoma ( NICE 2006) Model of Integrated Service Delivery in dermatology Improving Outcomes Guidance for Skin Tumours including Melanoma (NICE updated May

2010) Skin cancer Peer Review Measures (NCAT 2008 and update 2011) Referral guidance for skin cancer (NICE 2005) Quality Standards for Dermatology (BAD 2011) Other NICE TAGS

Please note: these guidance documents are not an exhaustive list and the provider will be expected to work to new and emerging policy guidance which relates to and links the delivery of dermatology community services and the well being of local populations. Skin disease is a common and distressing problem. It is estimated that of the nearly 13 million people presenting to general practitioners with a skin problem each year in England and Wales, around 6.1% (0.8 million) are referred for specialist advice. Most (92%) are referred to NHS specialists rather than private dermatologists.1

1 Skin Conditions in the UK: A Health Care Needs Assessment: Schofield, Grindlay, Williams 2009

Whilst there are some 3000 dermatological diseases, 10 of them (eczema, psoriasis, acne, urticaria, rosacea, infections/infestations, leg ulcers and gravitational disorders, lichen planus and drug rashes) account for 80% of consultations for skin disease in General Practice. Although it is the case that the commonest disorders are not life threatening, if not treated appropriately patients can suffer harm and longer term health problems. Many of the rare and some of the severe common skin conditions have an associated morbidity and mortality thus early and accurate diagnosis is critical to appropriate management. For those disorders that are not life threatening, the psychological impact on everyday life, work, social interaction and healthy living are substantial.

2. Scope

The Provider will comply with and carry out its proposals in relation to the provision of the services as set out in the ITT/Bid documents (as referred to in Section C4) save insofar as they are inconsistent with any other provisions in the Agreement. 2.1 Aims and objectives of service • To provide an integrated intermediate and specialist dermatology service, delivered in the local

community on the Isle of Wight; The Service will deliver Level 3 care ( see 2British Association of Dermatologists (BADS) Quality Standards for Dermatology 2011) provided by a full range of professional staff. Patients should only have to travel off the Isle of Wight for Tertiary (Level 4 - supra specialist) treatment.

• To provide an integrated model of care comprising of local dermatology services that includes

Consultant Dermatologists, GPs with Special Interest (GPwSI) and their teams working in local settings. These services must interface seamlessly with referring GPs to ensure direct and unencumbered patient pathways in the event that the patient is referred onwards to tertiary care or an alternative specialism.

• To develop a system where follow up appointments are not routinely offered and the

patient/carer is confident to self manage their condition, supported by access to an increased range of patient education and/or the Expert Patient Programme (EPP).

It is anticipated that a minimum of 70% of new patients (by activity) will be seen by the Intermediate level of the service at commencement of the contract. We would look to the provider to provide a trajectory showing further improvement in the relative use of the intermediate level over the period of the contract. The objectives of this service are:

Enhancement of the current dermatology pathway to integrate Level 3 intermediate and specialist care under a single provider in a predominantly community setting.

To improve access, maintain a high quality service and effectively manage all patients in a community setting, where appropriate, with the exception of those requiring a tertiary service (Level 4).

To give patients the choice to attend a local service with equitable access across their local area.

To provide a service which demonstrates cost effectiveness and clinically based

2 http://www.bad.org.uk/Portals/_Bad/Quality%20Standards/Dermatology%20Standards%20FINAL%20-%20July%202011.pdf

http://www.bad.org.uk/Portals/_Bad/Quality%20Standards/Dermatology%20Standards%20FINAL%20-%20July%202011.pdf

http://www.bad.org.uk/Portals/_Bad/Quality%20Standards/Dermatology%20Standards%20FINAL%20-%20July%202011.pdf

interventions. To provide a patient centred service with a strong emphasis on patient education, self

management and prevention. To support primary care management of conditions and the implementation of local

guidance on Procedures of Limited Clinical Value (PLCV) or exclusion criteria for low priority procedures.

2.2 Service description/care pathway The service is expected to:

Provide a service for all patients in need of dermatological treatment. Provide comprehensive new patient assessments with rapid and effective triage of all

dermatology referrals using referral guidelines and compliance with the latest NICE Guidance (including IOG Skin Cancer) and other relevant (BADS) guidelines as a framework to direct the patient to the right person and right place. Liaising with other specialties where necessary to facilitate appropriate care

Triage referrals- triage should be carried out by experienced clinicians; this should occur at all stages of the patient pathway and in all directions within the service and to other specialisms, if necessary.

Refer to the appropriate level of service. It is anticipated that patients with skin conditions designated suitable for diagnosis, management and treatment in the community will have their needs met via access to level 3 intermediate and specialist care with only the more severe and complex clinical care requiring level 4 intervention (tertiary care).

Treat the majority of needs (at least 70%) in the intermediate service, with the residue being treated in the specialist element of the service by a Consultant grade or appropriate clinician. It is anticipated that the percentage of care offered by the intermediate service will improve following the first year of the contract.

Direct patients along integrated, evidence based pathways. Decrease waiting times for appointments, both first and follow up, within the time-span of

the contract. Provide patient access to telephone follow up, where appropriate. Undertake a full range of Level 3 (Intermediate and Specialist) surgical interventions, where

clinically appropriate. Provide timely access to advice and guidance, assessment, diagnostics and treatments in

local settings. Fully inform patients of the treatment options and the treatment proposed and ensure

written consent for procedures is obtained. Refer onwards to alternative secondary care specialisms only where clinically indicated. Refer to the appropriate tertiary centre (Level 4) for the investigation and treatment of rare

diseases and the management of severe diseases, not suitable or not responding to conventional treatment available from a local service.

Make strong links and develop appropriate communications with a Pathology department to provide access for associated pathology investigations

Provide an Out-patient service to HMP Isle of Wight patients referred by the telemedicine service. N.B. Commissioning Board will be responsible for Community and Secondary Care for Prisoners and other detainees from 1 April 2013. 3

Provide discharge information within 2 working days to the originating referrer. Provide rapid access slots for Cancer two-week-waits

3 The National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) Regulations 2012. (2012) SI 2012/2996. London HMSO. Retrieved December 13, 2012 from http://www.legislation.gov.uk/uksi/2012/2996/contents/made

http://www.legislation.gov.uk/uksi/2012/2996/contents/made

Ensure that any GPwSI working as part of their services has local arrangements in place with the dermatology consultant (member of the local MDT) for their ongoing accreditation and revalidation.

Ensure that nursing staff employed by the service have considerable dermatology expertise and experience, and are able to manage their own caseload of patients normally in eczema and psoriasis clinics if they are trained in this area.

It is expected that referral and clinical pathways should be reviewed regularly to incorporate best clinical practice. The service is responsible for ensuring that it is applying the most up-to-date agreed referral and clinical criteria and management regimes. The key elements of the service should be as follows: – a) The assessment and management of Patients with skin diseases (including skin cancers) shall be

performed by a multidisciplinary team, including dermatology specialist clinicians. b) The Provider will operate a clinical triaging team to ensure that referrals are easily received and

processed and managed by the appropriate team member. c) Assessment, investigation and treatment, (including prescribing, surgery and PUVA treatment),

of patients suffering with skin disease, will include full diagnostic service including phlebotomy, histology, microbiology, biopsy and swab taking and reporting of results. The service will develop close working relationships with pathology and microbiology services. Service to provide investigations in tariff.

d) Advice and education for referring GP’s, patients and primary care staff. e) Patients can be expected to be prescribed up to 4 weeks of new medications from a list of

prescribing choices agreed with the PCT (or their successor organisation). The patient’s GP will be expected to manage all repeat prescriptions.

f) Management and follow up when indicated (service is aimed at one stop so follow-up should be minimised)- See Section B, Part 4.5

g) Ensure that referring GP’s are given prompt and full information about their patient’s diagnosis or treatment (with Management Plan) in line with national standards. Discharge summary for patients should be sent to the GP within 2 working days with a copy sent to patient.

h) Maintain a full clinical register and record of all patients treated, collect data for agreed KPIs and conduct and report on local and network wide audits.

i) The service will treat adults and children. Those patients with severe skin conditions or requiring specialised surgical procedures must be referred to the appropriate supra specialist care or appropriate alternative specialisms via contracted pathways already in place.

j) Paediatrics – referral for children aged 0-12 years who require a dermatology service should be referred to the service by a Paediatrician. Children aged 12-18 can be referred directly to the service and triaged appropriately according to need.

k) The Service will be managed and delivered in accordance with the rights, principles and values set out in the NHS Constitution and will comply with current referral to treatment times standards and cancer 2 week wait requirements.

It is expected that the following services/treatments could be undertaken by the Level 3 Intermediate service:

Management of mild to moderate forms of common rashes in adults such as eczema, psoriasis, lichen planus, urticaria, fungal infections – refer to dermatology referral guidelines (see 3.2 Care Pathways).

Premalignant skin lesions such as solar keratoses or Bowen’s disease. Low risk BCCs on trunks and limbs in line with NICE skin cancer guidance 2010. Mild to moderate acne not requiring oral isotretinoin. Non scarring acne unresponsive to

routine treatment in primary care. Diagnosis, investigation or management of other chronic rashes in adult unless diagnostic

doubt. Diagnosis, investigation or management of mild/moderate/non-worrying dermatoses and

skin lesion in patients over 12 unless diagnostic doubt. Conditions of hair scalp and nails. Medication review. Management and advice including follow up of skin cancer conditions treated in specialist

care by agreement. It is expected that the following services/treatments could be undertaken by the Level 3 Specialist Care element of the service:

Skin Cancer Clinics (including high risk BCCs, SCCs and suspected melanoma) Severe inflammatory skin disease requiring non-conventional therapy Facilities for dermatological surgery, cancer multi-disciplinary teams (MDTs) and data

collection compliant with NICE guidance Medical dermatology for complex problems, often in MDT clinics with other specialities such

as Rheumatology. Specialised skin surgery Laser treatment Photo-investigation and specialised photo-dermatology, iontophoresis, wound care and

other day treatments Day case units for infusion of disease-modifying drugs Genital dermatology Non-malignant lymphoedema Specialised dermapathology Medical mycology Occupational dermatoses and contact dermatoses Genetic dermatology Cellulitis day-case services Hair and Nail disease Teaching, training and assessment of GPs, GPwSIs, and other health professionals in

appropriate setting e.g. Community Collection and analysis of clinical data, clinical audit and compliance with clinical governance

requirements Management of skin problems in hospital patients with other illnesses Referral arrangements with tertiary services for conditions outside the remit of the service.

These lists are indicative and not prescriptive. The service will provide a consultant led triage service to assess and appoint all referrals to the appropriate area of the service within two working days of receipt of referral.

Patients should be offered a choice of appointment times and locations, preferably through an electronic system, across the area subject to available sites. Appointments should be within National Referral to Treatment Time Standards.

Providers should ensure that services are accessible in terms of geographical location and should take into account equality and diversity as well as the most appropriate clinical setting.

Locations of sites should be accessible to public and private transportation and parking facilities. Sites should also be accessible by patient transportation service vehicles for those patients with identified clinical need for transportation.

Providers should make reasonable adjustments in order that services are accessible e.g. appointments times, length of appointments, information and signage to demonstrate compliance with their Disability & Equality Duty. They should ensure that they make

reasonable adjustments for people with learning disabilities. All premises are required to be DDA (Disabilities Discrimination Act) compliant and Department of Health ‘You’re Welcome’ Quality Standards for young people.

The service will receive suspected skin cancer referrals from GPs via the 2ww cancer referral service. GPs will use the 2 week referral form which contains detailed information on the patient and their medical history – all cancer 2 week wait referrals must be seen within 14 days of receipt of the referral.

Table 1 Level of Skin Diseases Quality Standards for Dermatology Services (BAD 2011)

Level of Care Setting Level 1 – Self-care People with skin conditions, their family and

friends, books, magazines, television, the internet, local community pharmacists, expert patient programme

Level 2 – Generalist Care Usually GP Level 3 – Intermediate and specialist care

Integrated intermediate and specialist dermatology service

Level 4 – Supra-specialist care

Tertiary Care

Supra-specialist care (tertiary) – Level 4

Intermediate and specialist care – Level 3

Level 2 – GP care

Triage of all referrals at this point

Level 1 (Self managed care)

Table 2 Care Pathway

Table 3 Cancer Skin Cancer Pathway To be included by Service Variation following agreement by Cancer Network 2.3 Population covered The services will be available to all patients registered with the Isle of Wight PCT’s local GP services or be normally resident at an Isle of Wight address. This will include patient’s resident with HMP Isle of Wight until 1 April 2013 (see 2.2 Footnote 3). In exceptional circumstances the service may see patients who are resident elsewhere. Referral route GPs All GP referrals will be accepted by referral to the dermatology consultant led triage service. GPs will indicate on referral forms whether the referral is routine or urgent to aid triage and prioritisation of treatment. Suspected skin cancers must be referred on an urgent cancer referral form (2 week wait). The Provider may develop revised referral forms in liaison with GP representatives.

Level 2 - Routine patient referral to Consultant led Dermatology Triage Service

2-week cancer referrals

Triage service, checks information and assesses most appropriate clinic within two working days of receiving referral and forwards referral to the clinic (electronically)

Intermediate Care -Nurse Specialist & PUVA clinic

Intermediate Care - GPwSI

Specialist Care -Consultant

Patient either treated & discharged or followed up; referred to another part of the service or SSMDT (tertiary). Long term chronic disease management if clinically appropriate

Self- Care Level 1 and Self Help Groups

Day Case Surgery Out patient procedure

Consultant to Consultant Referrals from Secondary Care Clinicians must meet the Isle of Wight Consultant to Consultant Referral Policy. The Service will accept referrals from Paediatric Consultants for patients under 12 year of age. Exceptional Circumstances Referrals may need to be seen from other routes e.g. A &E, Specialist/District Nurses and from Ward staff re. in-patients. Triage and Appointment The Provider is responsible for contacting the patient and booking an appointment slot, in accordance with patient choice, to suitable clinics as indicated by the triage service. The service provider will need to provide appointment slots on a suitable electronic system to enable a seamless booking system from GP referral through triage into the correct element of the service. The service provider shall refer on to the following services in line with the onward referral protocol, if appropriate:

Back to GP with a treatment plan or discharge. Acute Specialist Care clinicians outside the remit of this specification. Level 4 Supra Specialist Dermatology

Patients referred onwards from the Level 3 Dermatology Service to Primary Care or other Specialist Care shall have a full treatment plan and/or reasons for referral to the referring clinician, and include:

The results of all tests and preoperative health assessment including scans, films and reports.

Reason for referral. Recommended treatment or procedure(s) where relevant.

Response time & detail and prioritisation a) Referrals should be dealt with on a first come, first served basis irrespective of the location of

the practice to which the patient belongs. Prioritisation will be made purely on clinical grounds. b) Referrals to the service will be triaged as soon as possible by the clinical triage team, with all

new appointments following a GP referral appointed no more than 4 to 6 weeks from the date the referral was received by the Clinical triaging team unless the patient chooses to attend at a later date (after being offered at least two different appointment dates and two different appointments times within 4 -6 weeks from referral)

c) Patients who do not attend (DNA) will be returned to the GP. The Provider will not be paid for DNAs.

d) The provider will work to ensure that the waiting times are kept as short as possible and will ensure they comply with the 18 week referral to treatment waiting time standard.

e) Follow-up appointments should be appropriate to the patient’s condition. f) The provider will ensure that systems are in place for the transportation, analysis & reporting of

diagnostic tests. g) The provider will ensure that any biopsy results are received and acted upon within 3 working

days of receipt of result for the appropriate intervention or arrangements for follow-up or procedure. The provider will report results back to the referring GP for their records only.

2.4 Any acceptance and exclusion criteria Exclusion criteria

Leg ulcers – please refer to community leg ulcer or vascular surgeon HIV and infectious disease of the skin Leprosy Severe paediatric skin disease Life threatening skin disease Specialised skin cancer Cosmetic procedures

The Provider is not expected to undertake procedures excluded by the PCT/ SHAs Individual Funding Request Policy or specialist services already provided by existing acute tertiary care providers. 2.5 Interdependencies with other services

Access to diagnostics, e.g. (laboratory services, pathology, radiology etc) Regular attendance and membership of Local and Regional Acute MDTs in line with

required NICE protocols

2.6 Relevant networks and screening programmes Local Cancer Network Cancer LMDT meetings Association where relevant with the SMDT

3. Applicable Service Standards

3.1 Applicable national standards eg NICE, Royal College

a) The Service Provider is to deliver services which are evidence based i.e. NICE Guidance and British Association of Dermatologists (BAD) guidelines, and meet best practice including Improving Outcomes Guidance.

b) Providers are expected to offer a comprehensive range of patient information and shall

direct Patients to other resources such as support groups in order to educate, support and empower them to live with their skin problems. Information leaflets should be made available in different languages and formats as required.

c) The Service Provider should aim to be the focal point for patient management and provide

advice and guidance to the referring GP for the on-going maintenance of the condition.

d) The Service should be available for paediatrics (see point 2.1j) and adults who are registered with the local PCT’s GP practices. In addition, the provider should adhere to the local Safeguarding children and Safeguarding adults policies of both the NHS and Local Authority.

e) The provider clinician(s) must be a member(s) of the skin cancer multidisciplinary team (LSMDT). This is to ensure best clinical practice compliance with NICE and NCAT/Cancer Network requirements. Skin cancers should be excised by the appropriately qualified member of the team and comply with guidance issued by NICE and National Cancer Peer Reviews, and inform LSMDT/SSMDT.

f) The planned treatment of Basal Cell Carcinomas shall be restricted to approved doctors who

have specialist training in skin cancer work, and are a member of the LSMDT.

g) All letters to Patients and GPs shall be clearly legible, shall be posted within 2 working days

of the appointment and shall contain as a minimum: Named clinician in charge Primary and where appropriate, secondary diagnosis and/ or procedure Full management plan and follow up arrangements and suggestions for further

treatments, which could if necessary be added by the GP in case the Patient fails to respond to initial therapy

A medication update for the Patient stating dose, frequency and duration of course of newly prescribed drugs and notification if any medications are stopped

Skin specialist contact number for ease of communication and query Where possible copies of clinical protocols/guidelines

3.2 Applicable local standards Facilities and Equipment

Premises must be fully approved for infection control and be stocked with the required equipment which meets Health and Safety standards.

Processes to monitor stock control and regular reviews to ensure standards are complied with are to be in place.

The consultation room should have good lighting and adequate facilities for diagnosis and treatment procedures, and operative equipment that meets the requirements necessary to undertake skin surgery.

Where skin surgery sessions are performed, there should be appropriate documentation of lesions, including photographic records and established links to the local dermatology and histopathology departments.

Suitably equipped and compliant operating theatres should be available as required by the specialist element of the service.

There should be adequate space to provide a ‘waiting’ area and have disabled access to the premises.

Diagnostic testing should be provided by a pathology department attached to an LSMDT to ensure continuity and quality of both the requesting and reporting of diagnostic tests, and to inform treatment decisions made at LSMDT/SSMDT.

Staff should be trained to the appropriate standard to manage an electronic booking and appointment system.

Staffing The service provider shall ensure that all practitioners who provide the service are competent and should be able to provide demonstrable evidence of competence, in line with Appendix D of Quality Standards for Dermatology (2011). Staff underperforming should be subject to robust performance management, should it be necessary. Evidence should include:

The service provider will be responsible for ensuring that all clinical staff hold current professional registration, are current members of their respective professional bodies and have current CRB clearance. The PCT will require evidence that all GPwSIs, clinicians working within independent contractor status and independent or third sector providers are appropriately indemnified.

Certificate of any external postgraduate courses or accreditation. Certificate or a sign off letter from the mentoring Consultant(s) for any clinician working

within an extended scope of practice, e.g. Nurse Specialist or GPwSI. Evidence of ongoing and continued competence.

Evidence of completion of statutory and mandatory training. Clear management and administrative structures and procedures. All staff (clinical and non-clinical) should have an annual appraisal and an agreed personal

development plan. Appropriate supervision arrangements for all levels of staff will be in place, including

induction and clinical supervision. Competent practitioners will assess referrals and patients in accordance with protocols

(agreed with commissioners) and pathways which are based on national clinical guidelines and evidenced good practice.

A clinical lead for the service will be required with responsibility for overseeing the clinical governance framework and processes, including Medicines Management and Prescribing.

Staff working with young people and vulnerable adults shall have the necessary safeguarding training

The service provider will be responsible for ensuring that it maintains a staffing complement which allows it to meet the objectives set out in this specification at all times. In particular, all staff will be required to work flexibly to ensure continuity of care and equity of access across all sites and treatment pathways. Medicine Management The Service Provider shall have a named clinical governance lead that shall ensure that all prescribing is within national and locally agreed guidelines and treatment pathways. All prescribers must adhere to both legal and good practice guidance on prescribing and medicines management in line with the Medicines Act 1968, associated legislation and regulations. The service provider shall comply with all statutory regulatory requirements and have robust, auditable systems in place to cover responsibility, reconciliation, record keeping and disposal requirements for the movement of drugs for which they are responsible. The service provider shall work with local clinicians to develop and continue shared care initiatives. The service provider shall record and report significant events and trends on near misses to the commissioner regarding prescribing or medicines management. Prescribing

a) The Provider shall ensure that prescribing is safe, clinically effective and cost efficient.

b) Prescribing shall be in accordance with national and local guidelines and in line with local preferred prescribing list.

c) Prescribing decisions and recommendations shall only be made by suitably qualified medical

or non-medical independent prescribers. All independent prescribers shall adhere to local, DH and professional body Medicines Management standards.

Patients should be prescribed 4 weeks (or full treatment course if intended duration less than 4 weeks) of new medications from a list of prescribing choices agreed with the PCT. The referring GPs will be expected to provide all subsequent repeat prescriptions (Excluding Roaccutane (exPBR); which is prescription only by, or under supervision of, physician with expertise in the use of systemic retinoids enrolled in infoRM (information on Roaccutane Management).

Governance

The service provider will have an established clinical governance programme which will be led by a named senior clinician or other senior member of staff and a deputy with clear responsibility for ensuring clinical governance arrangements are in place and for monitoring the effectiveness of the clinical governance systems which as a minimum considers the following:

Patient, public and carer involvement. Fit for purpose patient booking and administration systems. Risk management, including incidents and complaints reporting and investigation processes. Serious untoward incident reporting processes. Staff management and performance, including recruiting workforce planning and appraisals. Education, training and continuous professional development. Clinical effectiveness and audit programme. Information governance policies and procedures (e.g. Caldicott). Communication with both internal and external organisations. Leadership at all levels of the organisation. Infection control arrangements.

Location(s) of Service Delivery The service will ensure equitable access to local residents by providing clinics in accessible areas with suitable public transport links and parking. The service provider will be responsible for providing appropriate equipment at each of the designated locations and ensure that those are adequately maintained. The tariff is inclusive of premises costs. Days/Hours of operation The service opening hours will be by agreement with the provider; however the service will be required to offer appointments between the core clinical hours of 9am and 5pm on the days on which the service operates (as a minimum). Evening and weekend working is encouraged to meet the needs of patients and provide a range of appointment options. The service will be available throughout the year at a frequency that ensures that sufficient capacity exists to meet demand and that waiting time standards are achieved. The service provider must ensure flexible capacity to cope with seasonal and unexpected changes in demand. Information

The Service will offer a comprehensive range of patient information including advice on self-management and will direct patients to other resources as appropriate.

The Service should give relevant information to patients as to what services to access should a treatment complication arise outside normal working hours.

The Service will make available to patients the agreed procedure for booking appointments and the policy on DNAs and cancellations.

Patient Information will be formatted according to agreed guidelines and should be made available in different languages as required.

Treatment and care, and the information patients are given about it, should be culturally appropriate. It should also be accessible to patients with additional needs such as physical, sensory or learning disabilities, and to patients who do not speak or read English.

If patients do not have the capacity to make decisions, healthcare professionals should follow the Department of Health’s advice on consent and the code of practice that accompanies the Mental Capacity Act

Patient & Public Involvement

Section 242 of the NHS Act 2006 places a duty on Primary Care Trusts to make arrangements to involve and consult with service users and the public in the planning and organisation of services. The service provider will therefore be expected to consult with patients by equality characteristic as required by the above Act and to facilitate the Primary Care Trust in meeting all statutory responsibilities in this area. The service provider will also ensure that the views of people who use services are taken into account when making decisions about how services are delivered and improved. The Service should have a patient panel which is involved in service development and governance. Patient Experience The service provider will be asked to provide evidence of methods they use to capture patient experience in order to improve their service. The Service provider will also be required to provide evidence on how they ensure any issues or areas of concern are identified and addressed and ideas taken forward. They should ensure that views on patient satisfaction and changes made as a result of the information collected are communicated to patients and other stakeholders. Communications The provider is responsible for communications and marketing of the services specified. All such activity must conform to the NHS Identity Guidelines, the NHS Promotions Code and communications guidelines produced by NHS Isle of Wight. The provider's communications plan should be proportionate to the scale of service being provided and should be agreed with the PCT's communications department prior to implementation. The provider must alert the PCT’s communications department to any enquiries from public stakeholders (e.g. politicians, key professional groups) relevant to the services commissioned by the PCT and should agree a response. The provider should also alert the PCT to potential adverse media coverage and statements/media releases regarding the service commissioned by the PCT should be agreed with the PCT's communications department before release. All promotional or marketing literature relating to the service commissioned by the PCT should take account of health literacy issues and should also be submitted to the PCT’s communications department for approval before committing to production. Registration & Assurance The provider must be able to demonstrate current registration with the Care Quality Commission (CQC) for the service to be delivered where this is applicable to the service or provider. The provider must notify the commissioner of registration renewal dates and of any amendments, variations or applications. The provider must also notify the commissioner of any penalties imposed for non registration (services can no longer provide a service if not registered as this is a legal requirement), CQC inspections (planned or unannounced) and enforcements for delivery of poor quality. The provider should make available all inspection reports, CQC periodic and special reviews, national audit reports, and national patient and staff surveys as applicable. The service must be able to demonstrate compliance with all generic and service specific Registration Requirements and Regulations of the Care Quality Commission. This applies even in cases where CQC registration is not required of the provider. These regulations and outcomes ensure that the care people receive meets essential standards of quality and safety. The regulations and outcomes cover;

Involvement & information – The provider will ensure that patients and carers are involved

in making decisions about their care, treatment & support. They will also ensure that the views of people who use services are taken into account when making decisions about how services are delivered and improved. Providers shall make information available so that people can make informed choices about their care, treatment & support.

Personalised care, treatment & support – The provider will ensure that people who use services receive effective, safe & appropriate care, treatment and support that meets their individual needs. Providers will assess health needs, develop care plans, take account of published research and best practice, co-operate with other agencies involved in the care, treatment and support of a person and share information in a confidential manner with all relevant services, teams or agencies.

Safeguarding & safety – The provider will ensure that people who use the service, workers and others who visit are as safe as they can be and that risks are managed. They will also ensure that the human rights and dignity of people who use services are respected and identify and respond when people are in vulnerable situations. Providers will ensure that the premises and equipment they use to provide care, treatment & support are safe and suitable. Providers will comply with guidance for safeguarding people who use services from abuse, cleanliness and infection control, management of medicines, safety & suitability of premises and safety and suitability of equipment.

Suitability of staffing – The provider will ensure that they have the right staff with the right skills, qualifications, experience and knowledge to support people. Providers will comply with guidance relating to staffing and supporting workers.

Quality and management – The provider will manage risk in order to ensure that essential standards of quality and safety are maintained and have systems in place to assess and monitor the quality of service provision. Providers will also take account of comments and complaints, investigations into poor practice and advice from and reports by the Care Quality Commission. The provider will improve the service by learning from adverse events, incidents, errors and near misses, the outcome from comments and complaints and the advice from expert bodies. The provider will also notify the Care Quality Commission about incidents that affect the health, safety and welfare of people who use services including injuries to people, making an application to deprive someone of their liberty, allegations of abuse and police investigations.

3.3 Service Specific Quality Standards The following are assumed to form part of this service specification:

- Commissioning for Quality and Innovation (CQUIN schemes) - Clinical effectiveness guidance (NICE, NSFs etc) - National audits

NICE outcome measures - quality outcomes that reflect clinical care are included in those clinical areas that relate to NICE guidance and must be measured. For example:

NICE skin cancer guidance (for example discussion of cases at MDT, information provision for patients)

NICE guidance requirements for the prescribing of biological agents for psoriasis

The provider must be aware of, and comply with, all relevant NICE guidance both new and revised. Specific quality of life (QoL) measures are available for a range of inflammatory skin conditions and should be used to measure outcome of care in the common skin diseases as follows:

Atopic eczema Psoriasis Acne Other types of eczema

The QoL tools can be used in generalist and specialist settings.

4. Key Service Outcomes

• Equitable access and treatment of dermatology patients within different levels of deprivation. • Achievement of a reduction in follow-up ratios to no greater than the national average or better. • Increasing overall patient satisfaction with dermatology services. • Services delivered closer to patients’ homes. • Enhanced communication between provider intermediate and specialist clinicians and GP’s. • Improved quality of care within Intermediate and Specialist settings. • Improved access to advice and information and increased knowledge and awareness of the

management of dermatology in Levels 1 & 2. • Reduced waiting time for patient access to specialist care. • Reduction in incidence of skin disease and deaths from skin cancer.

5. Location of Provider Premises

The Provider’s Premises are located at: Beacon Health Centre, St Marys Hospital, Newport PO30 5TG East Cowes Medical Centre, Church Path, East Cowes PO32 6RP Sandown Health Centre, Broadway, Sandown PO36 9GA Tower House Surgery, Rink Road, Ryde PO33 1LP Brookside Health Centre, Queens Road, Freshwater PO40 9DT

This letter also confirms the completion of this request. A log of this request will be held on a database by the CCG. All hard copy correspondence relating to this request will be held for one year from the date of this letter, before being confidentially destroyed. If you are unhappy about the response you have received your first line of action should be to write and request the CCG to undertake an internal review of your application. A senior member of staff, who was not involved with your initial application, will undertake this review. If after this process you are still not satisfied with the response you receive from the CCG you can complain to the Information Commissioner at the following address: Information Commissioner Wycliffe House Water Lane Wilmslow Cheshire SK9 5AF Please do not hesitate to contact this office if you have any further questions. Yours faithfully Freedom of Information Team





PO30 5XW

Tel: 01983 822099 Ex 4862 Ref FOI16085 Date 19 May 2016 Dear Sir/Madam Request for information under the Freedom of Information Act 2000 Please find attached /see the below response to your request: Response: The Isle of Wight CCG does not have the information to answer this request. Please redirect your request to the Isle of Wight NHS Trust via their Freedom of Information Team [email protected]

• How many car parks out of the total number designated for hospital patients/visitors offer free parking, as of your most up-to-date statistics? (please state how many and out of the total).

• If you charge fees for hospital patients/visitor designated parking, do you have the same pricing structure at all your parking sites? (Yes/No).

• What is your most commonly charged minimum rate for patient/visitor parking (excluding any free parking), and for how long does this allow somebody to park?

• What is your most commonly charged maximum rate for patient/visitor parking (excluding any free parking), and for how long does this allow somebody to park?


mailto:[email protected]





PO30 5XW

Tel: 01983 822099 Ex 4862 Ref FOI16086 Date 09 June 2016 Dear Sir/Madam Request for information under the Freedom of Information Act 2000 Please find attached /see the below response to your request: RESPONSE: The My Life a Full Life programme is a partnership of key organisations across the Island including Isle of Wight NHS Trust, Isle of Wight Clinical Commissioning Group, Isle of Wight Council, Community Action IW, One Wight Health (a collaborative of GPs), the voluntary, independent and private sector. The programme is seeking to engage all Islanders and particularly the users of health and care services, to help address the challenges faced by health and care services through a redesign of the Island’s health and care system. In total 73,400 copies of ‘Caring for our Island – Time to Act’ were printed and distributed across the Island. The total print and delivery cost was £15,505. Of this £4,153 was the cost of distributing copies via Royal Mail to 53,400 households. An ‘easy read’ leaflet was also printed and distributed to selected locations across the Island at a total cost of £3,452. In addition to this £2,765 was spent on advertising in the County Press to directly support the initiative and associated engagement events. The Island has received national funding as part of NHS England’s ‘New Care Models’ programme to enable this to be undertaken without taking resources from front line services. The results of the exercise are being collated and will help inform a formal consultation which we anticipate will commence later in 2016. I would like to know how much has been spent on producing and distributing the My Life A Full Life leaflets sent to 69,000 households during May. I would also like to know the cost of any extra leaflets produced for any information points or centres for people to pick them up. This letter also confirms the completion of this request. A log of this request will be held on a database by the CCG. All hard copy correspondence relating to this request will be held for one year from the date of this letter, before being confidentially destroyed. If you are unhappy about the response you have received your first line of action should be to write and request the CCG to undertake an internal review of your application. A senior member of staff, who was not involved with your initial application, will undertake this review. If after this process you are still not satisfied with the response you receive from the CCG you can complain to the Information Commissioner at the following address: Information Commissioner Wycliffe House Water Lane Wilmslow Cheshire SK9 5AF Please do not hesitate to contact this office if you have any further questions.

Yours faithfully Freedom of Information Team





PO30 5XW

Tel: 01983 822099 Ex 4862 Ref FOI16087 Date 19 May 2016 Dear Sir/Madam Request for information under the Freedom of Information Act 2000 Please find attached /see the below response to your request: How much of your baseline funding for 2016-17 has been identified by NHS England as additional funding for (a) children and young people’s mental health services and (b) eating disorder services?

a) £191,000 b) £76,000

How much of this additional funding do you plan to spend on (a) children and young people’s mental health services and (b) eating disorder services in 2016-17?

a) £191,000 b) £76,000

How much of this additional funding for (a) children and young people’s mental health services and (b) eating disorder services has been released to mental health providers since the start of the financial year 2016-17?

a) £0 b) £0






PO30 5XW

Tel: 01983 822099 Ex 4862 Ref FOI16088 Date 19 May 2016 Dear Sir/Madam Request for information under the Freedom of Information Act 2000 Please find attached /see the below response to your request: 1. Does the CCG or any constituent practices currently utilise any of the following prescribing support

software? Please indicate which: 1. Eclipse Live 2. Scriptswitch 3. FDB Optimise RX 4. DXS 5. Other RESPONSE: The Isle of Wight CCG utilises Eclipse Live, Scriptswitch and DXS. 2. Does the CCG utilise any of the following as processes or policy to support adherence to the local

formulary or specific medicines usage? Please indicate which: 1. GP quality management contract or payment (or similar) 2. Enhanced service payment (or similar) 3. Prescribing incentive scheme (or similar) RESPONSE: The CCG utilises all of the above. 3. What is the current year 16/17 CCG QIPP/efficiency savings plan target? RESPONSE: This information is not yet available, but will be published on the Isle of Wight CCG Website in due course. 4. What is the value of the prescribing element for the current year 16/17 CCG QIPP/efficiency savings

plan target? RESPONSE: The above information has not yet been finalised. This letter also confirms the completion of this request. A log of this request will be held on a database by the CCG. All hard copy correspondence relating to this request will be held for one year from the date of this letter, before being confidentially destroyed. If you are unhappy about the response you have received your first line of action should be to write and request the CCG to undertake an internal review of your application. A senior member of staff, who was not involved with your initial application, will undertake this review. If after this process you are still not satisfied with the response you receive from the CCG you can complain to the Information Commissioner at the following address:

Information Commissioner Wycliffe House Water Lane Wilmslow Cheshire SK9 5AF Please do not hesitate to contact this office if you have any further questions. Yours faithfully Freedom of Information Team





PO30 5XW

Tel: 01983 822099 Ex 4862 Ref FOI16089 Date 19 May 2016 Dear Sir/Madam Request for information under the Freedom of Information Act 2000 Please find attached /see the below response to your request: 1. We understand that the CCG refers patients with suspected prostate cancer to the following NHS trusts. Please confirm: Frimley Health NHS Foundation Trust Isle of Wight NHS Trust Confirm* Portsmouth Hospitals NHS Trust Royal Surrey County Hospital NHS Foundation Trust Taunton and Somerset NHS Foundation Trust The Royal Marsden NHS Foundation Trust University College London Hospitals NHS Foundation Trust

*Please note that the above is the normal pathway, but patient choice allows referrals to any Provider. 2. Please advise whether the CCG refers patients with suspected prostate cancer to any other NHS trusts? The normal pathway is for an Isle of Wight GP to refer to the Isle of Wight local Urology MDT which links with the Portsmouth Hospital Trust (PHT) Urology MDT for specialist discussion and referral for early or organ confined prostate cancer where radical treatments are an option. Patients requiring radical Prostatectomy will be discussed and referred to the Specialist MDT to perform the surgery. 3. We understand that the CCG does not reference any Referral Pathways / Care Pathways in relation to the treatment of Prostate Cancer? Please can you confirm. The Isle of Wight CCG considers referral and care pathways as standard operating practice, but does not publish referral pathways in the public domain. 4. If the CCG does reference any Referral Pathways / Care Pathways in relation to the treatment of Prostate Cancer, please provide a copy or website link. Please see response to question 3 5. If yes, when is/are the document(s) expected to be reviewed? Currently under review, working in conjunction with Wessex Cancer Strategic Clinical Network and providers.

6. Please can you confirm whether we are permitted to reuse the above information under the Open Government Licence? Yes you are permitted to reuse the above information under the Open Government Licence. We (IMS Health) request permission to re-use as a part of an independent analysis into the treatment of patients with Prostate Cancer, which has been commissioned by one of our clients. The contents of the report will not be made available publically, but may be used by other IMS Health Group entities and service suppliers. The information in the report will be presented in a factual manner with all publication details staying true to the publisher. We acknowledge that information provided may be protected by copyright and will include a copyright statement to this effect at the end of any information we publish if requested by you. This letter also confirms the completion of this request. A log of this request will be held on a database by the CCG. All hard copy correspondence relating to this request will be held for one year from the date of this letter, before being confidentially destroyed. If you are unhappy about the response you have received your first line of action should be to write and request the CCG to undertake an internal review of your application. A senior member of staff, who was not involved with your initial application, will undertake this review. If after this process you are still not satisfied with the response you receive from the CCG you can complain to the Information Commissioner at the following address: Information Commissioner Wycliffe House Water Lane Wilmslow Cheshire SK9 5AF Please do not hesitate to contact this office if you have any further questions. Yours faithfully Freedom of Information Team





PO30 5XW

Tel: 01983 822099 Ex 4862 Ref FOI16090 Date 19 May 2016 Dear Sir/Madam Request for information under the Freedom of Information Act 2000 Please find attached /see the below response to your request: Response: The Isle of Wight CCG does not have the information to answer this request. Please redirect your request to the Isle of Wight NHS Trust via their Freedom of Information Team [email protected] I’m looking to get a better understanding of the performance of mental health services across the UK. I appreciate there is already some data and information published, such as through the health and social care information centre (http://www.hscic.gov.uk/catalogue/PUB20275). However, I’d like to look at the current waiting times for the various therapies which may be on offer in your area. I appreciate there may be no ‘average’ waiting time or data that already collates an overall picture of how long people are waiting for treatment. However, there will be a referral system in place to facilitate the treatment of people via a GP or other referral mechanism in order for appointments to be made. It is this referral or ‘booking’ system I would like you to interrogate, in order to give me the current waiting time (as of a specific date) for various therapies. I’d also like you to provide the current shortest and longest waits on that referral system.

1. What is the current waiting time for treatment for talking therapies in your area in primary healthcare? Please break down the wait for each type (or ‘choice of modality’) which is available in your area.

2. What is the current longest wait for talking therapies in your area in primary healthcare? That is, what length of time has the person who’s been waiting the longest been waiting? Please give the wait for each type of therapy (or ‘choice of modality’) which is available in your area.

3. What is the current waiting time for treatment for talking therapies, appointments with psychologists or psychiatrists in your area in secondary healthcare? (Please break down the wait for each type (or ‘choice of modality’) which is available in your area.

4. What is the current longest wait for talking therapies, appointments with psychologists or psychiatrists in your area in secondary healthcare? That is, what length of time has the person who’s been waiting the longest been waiting? Please give the wait for each type of therapy (or ‘choice of modality’) which is available in your area.


For the above questions please provide the figure for referral to first treatment waiting time, not referral to 'assessment' or 'intervention' time.

5. How many referrals have there been into adult mental health services in your area at a) primary care level and b) secondary care level in the calendar years 2013, 2014, 2015 and 2016 to date.

6. What is the maximum number of talking therapy sessions an adult, eligible for therapy, can receive in your area at primary and secondary care level.






PO30 5XW

Tel: 01983 822099 Ex 4862 Ref FOI16091 Date 19 May 2016 Dear Sir/Madam Request for information under the Freedom of Information Act 2000 Please find attached /see the below response to your request: Response: The Isle of Wight CCG does not have the information to answer this request. Please redirect your request to the Isle of Wight NHS Trust via their Freedom of Information Team [email protected]

1. In Child and Adolescent Mental Health Services (CAMHS), what is the current waiting time for a young person to receive talking therapies. Please give the wait for each type of therapy (or ‘choice of modality’) which is available in your area.

2. In CAMHS, what is the current longest wait to receive talking therapies? Please give the wait for each type of therapy (or ‘choice of modality’) which is available in your area.

3. What is the maximum number of talking therapy sessions a young person, eligible for therapy, can receive in your area at primary and secondary care level.

4. How many referrals have there been into child and adolescent mental health services in your area at a) primary care level and b) secondary care level in the calendar years 2013, 2014, 2015 and 2016 to date.

I hope the above is clear, but to avoid any misunderstanding I have included an example of the kind of response I hope to receive for each request (one for adult and one for CAMHS). Please supply your answers in an editable word document or in the plain text body on an email for easy transcription. Please do not send a PDF document. I request this format in line with the ICO guidance on FOIs – in that they should be provided in the format requested (see here: https://ico.org.uk/for-organisations/guide-to-freedom-of-information/receiving-a-request) Therapy Type Current Wait Longest wait Maximum sessions CBT 8 weeks 18 weeks 4 Group Therapy 2 weeks 6 weeks 6 Counselling 4 weeks 8 weeks 4 Family therapy 10 weeks 12 weeks 6 Please note the table above is not an exhaustive list or therapies and is only being used for illustrative purposes.






PO30 5XW

Tel: 01983 822099 Ex 4862 Ref FOI16092 Date 10 June 2016 Dear Sir/Madam Request for information under the Freedom of Information Act 2000 Please find attached /see the below response to your request: I am writing under the Freedom of Information Act 2000 to request details of breaches of the Data Protection Act within in your organisation; specifically I am asking for: 1a. Approximately how many members of staff do you have? RESPONSE: 78.79 full time equivalent 1b. Approximately how many contractors have routine access to your information? RESPONSE: 2 (see www.suresite.net/foi.php for clarification of contractors if needed) 2a. Do you have an information security incident/event reporting policy/guidance/management

document(s) that includes categorisation/classification of such incidents? RESPONSE: Yes 2b. Can you provide me with the information or document(s) referred to in 2a? (This can be an email

attachment of the document(s), a link to the document(s) on your publicly facing web site or a 'cut and paste' of the relevant section of these document(s)) RESPONSE: http://www.isleofwightccg.nhs.uk/about-us/good-governance-and-transparency/policy-suite/policy-suite.htm

3a. Do you know how many data protection incidents your organisation has had since April 2011? (Incidents reported to the Information Commissioners Office (ICO) as a Data Protection Act (DPA) breach)

RESPONSE: Only since (date): 2013/14 3b. How many breaches occurred for each Financial Year the figures are available for? RESPONSE: FY11-12: Not Available FY12-13: Not Available FY13-14: 0 FY14-15: 0 4a. Do you know how many other information security incidents your organisation has had since April

2011? (A breach resulting in the loss of organisational information other than an incident reported to the ICO, eg compromise of sensitive contracts or encryption by malware. )

RESPONSE: Only since (date): 2013/14 4b. How many incidents occurred for each Financial Year the figures are available for? RESPONSE: FY11-12: Not Available FY12-13: Not Available FY13-14: 0 FY14-15: 7 5a. Do you know how many information security events/anomaly your organisation has had since April

2011? (Events where information loss did not occur but resources were assigned to investigate or recover, eg nuisance malware or locating misfiled documents.)

RESPONSE: Only since (date): 2013/14 5b. How many events occurred for each Financial Year the figures are available for? RESPONSE: 13/14 None, 14/15 None

http://www.isleofwightccg.nhs.uk/about-us/good-governance-and-transparency/policy-suite/policy-suite.htm

http://www.isleofwightccg.nhs.uk/about-us/good-governance-and-transparency/policy-suite/policy-suite.htm

6a. Do you know how many information security near misses your organisation has had since April 2011? (Problems reported to the information security teams that indicate a possible technical, administrative or procedural issue.)

RESPONSE: Only since (date): 2013/14 6b. How many near-misses occurred for each Financial Year the figures are available for? RESPONSE: FY11-12: Not Available FY12-13: Not Available FY13-14: 1 FY14-15: 0 If the specific answers to 4, 5 and 6 are not readily available, I am content for these questions to be modified/replaced with similar questions that are derived from your organisations categorisation/classification system within the documents requested in question 2. I would need to first make an FoI request for question 2 in order to frame suitable questions 4, 5 and 6, then make a second request. If you are considering a manual review of all incidents to satisfy 4, 5 and 6, please re-read this section and interpret it as latitude to reuse information that you are currently recording (manual review may be the best for some organisations). Similarly calendar year can replace financial year. Please state in the reply if this option has been implemented. Question 6a is typically IG SIRI level 2 or higher incident, Question 7a is typically IG SIRI level 1 incidents and Question 8a is typically IG SIRI level 0 incidents. If your information is managed by a parent organisation or the information I seek is consolidated for several organisations, I am content to accept a consolidated return from the lead organisation identifying who the return covers. My preferred format to receive this information is electronically, but if that is not possible I will be willing to accept hard copy. I would be grateful if you could include my reference - Ref: 405820 This letter also confirms the completion of this request. A log of this request will be held on a database by the CCG. All hard copy correspondence relating to this request will be held for one year from the date of this letter, before being confidentially destroyed. If you are unhappy about the response you have received your first line of action should be to write and request the CCG to undertake an internal review of your application. A senior member of staff, who was not involved with your initial application, will undertake this review. If after this process you are still not satisfied with the response you receive from the CCG you can complain to the Information Commissioner at the following address: Information Commissioner Wycliffe House Water Lane Wilmslow Cheshire SK9 5AF Please do not hesitate to contact this office if you have any further questions. Yours faithfully Freedom of Information Team





PO30 5XW

Tel: 01983 822099 Ex 4862 Ref FOI16093 Date 02 June 2016 Dear Sir/Madam Request for information under the Freedom of Information Act 2000 Please find attached /see the below response to your request: This request relates to our work around improving NHS continuing healthcare. Many thanks in advance for your assistance. I have included tables which you can enter your responses into. The figures all exclude Closing the Gap 1. For each of the years

a. April 2013 to March 2014 273

b. April 2014 to March 2015 376

c. April 2015 to March 2016 386

Please supply the total number of applications made to your Clinical Commissioning Group (CCG) for NHS continuing healthcare funding that proceeded past the initial checklist stage to a full assessment of needs.

2. For each of the years

a. April 2013 to March 2014 72

b. April 2014 to March 2015 89

c. April 2015 to March 2016 124

Please tell us the total number of applications for NHS continuing healthcare your CCG refused following a full assessment of needs.

3. For each of the years

a. April 2013 to March 2014

b. April 2014 to March 2015

c. April 2015 to March 2016

Please tell us:

April 2013 to March 2014



The number of requests made for a local review following a decision by your CCG of ineligibility for NHS continuing healthcare funding.

12 19 20

The number of decisions your CCG made resulting in ineligibility for NHS continuing healthcare that were overturned at the local review

0 4 2

The number of decisions your CCG made of ineligibility for NHS continuing healthcare that were upheld at the local review

12 15 18

The number of requests made to your CCG for an independent review panel following a local review upholding a decision of ineligibility for NHS continuing healthcare.

0 4 1

The number of decisions of ineligibility for NHS continuing healthcare made by your CCG that were overturned at the independent review panel.

0 2 Pending decision

The number of decisions of ineligibility for NHS continuing healthcare made by your CCG that were upheld at the independent review panel.

0 2 Pending decision

The number of decisions of ineligibility for NHS continuing healthcare made by your CCG referred to the Parliamentary and Health Services Ombudsman.

0 0 0

The number of decisions of ineligibility made by your CCG that were overturned by the Ombudsman, with NHS continuing healthcare funding then being awarded.

0 0 0

The number of decisions of ineligibility for NHS continuing healthcare made by your CCG that were upheld by the Ombudsman.

0

4. For each of the years April 2013 to March 2014, April 2014 to March 2015 and April 2015 to March 2016, please tell us:

RESPONSE: Section 12 of the Act makes provision for public authorities to refuse requests for information where the cost of dealing with them would exceed the appropriate limit, which for central government is set at £600. This represents the estimated cost of one person spending 3.5 working days in determining whether the department holds the information, locating, retrieving and extracting the information.

April 2013 to

March 2014



What is the median time taken by your CCG to conduct NHS continuing healthcare assessments, from receiving the initial checklist to notifying the applicant of the eligibility result?

Please refer to Section 12 of the

Freedom of Information

Guidance



Guidance



Guidance 5. Does your CCG always involve experts in the assessment of the specific medical condition that the

person being assessed for NHS continuing healthcare presents with? For example a Parkinson’s nurse, an MS specialist nurse, a neurologist etc.

Yes, where possible. 6. We know that people with long term, progressive conditions who are found eligible for NHS continuing

healthcare are often reassessed after a set period. For each of the years April 2013 to March 2014, April 2014 to March 2015 and April 2015 to March 2016, please supply:

RESPONSE: Section 12 of the Act makes provision for public authorities to refuse requests for information where the cost of dealing with them would exceed the appropriate limit, which for central government is set at £600. This represents the estimated cost of one person spending 3.5 working days in determining whether the department holds the information, locating, retrieving and extracting the information.




The total number of NHS continuing healthcare reviews conducted by your CCG, on people who have existing eligibility. Please include all reviews including 3 month and annual.



Guidance



Guidance



Guidance The total number of cases in your CCG where NHS continuing healthcare eligibility was withdrawn following the review of a person previously found eligible for NHS continuing healthcare.



Guidance



Guidance



Guidance

7. For each of the years April 2013 to March 2014, April 2014 to March 2015 and April 2015 to March 2016

please give us the numbers relating to how many people receive NHS continuing healthcare in each of the locations listed below, across the area your CCG covers.

These figures do not include Fast Tracks

Location Number of people receiving NHS continuing healthcare between April 2013 and March 2014

Number of people receiving NHS continuing healthcare between April 2014 and March 2015

Number of people receiving NHS continuing healthcare between April 2015 and March 2016

In their own home 14 19 11

In a residential care home 12 7 13 In a hospice 0 1 0

In a nursing home 58 69 68

Other, please specify N/A N/A 1 8. Does your CCG have a policy that would, in all but exceptional circumstances, cap the cost of a care at

home package against the equivalent cost of a residential care package?

a. Yes/No - 10% above the contracted rate.

b. If so, please tell us the cap amount for

i. April 2013 to March 2014 £699.23 plus 10%

ii. April 2014 to March 2015 £720.23 plus 10%

iii. April 2015 to March 2016 £741.93 plus 10%






PO30 5XW

Tel: 01983 822099 Ex 4862 Ref FOI16094 Date 19 May 2016 Dear Sir/Madam Request for information under the Freedom of Information Act 2000 Please find attached /see the below response to your request: Response: The Isle of Wight CCG does not have the information to answer this request. Please redirect your request to the Isle of Wight NHS Trust via their Freedom of Information Team [email protected] I wish to make a Freedom of Information request regarding the prescription of diamorphine to patients addicted to heroin. Please tell me: 1. How many people were prescribed with diamorphine in the following years: 2011/12, 2012/13, 2013/14, 2014/15, 2015/16 2. Please tell me, if known, how many of those people prescribed diamorphine subsequently overcame their heroin addiction. 3. If known, tell me how long each diamorphine prescription lasted for. This letter also confirms the completion of this request. A log of this request will be held on a database by the CCG. All hard copy correspondence relating to this request will be held for one year from the date of this letter, before being confidentially destroyed. If you are unhappy about the response you have received your first line of action should be to write and request the CCG to undertake an internal review of your application. A senior member of staff, who was not involved with your initial application, will undertake this review. If after this process you are still not satisfied with the response you receive from the CCG you can complain to the Information Commissioner at the following address: Information Commissioner Wycliffe House Water Lane Wilmslow Cheshire SK9 5AF Please do not hesitate to contact this office if you have any further questions. Yours faithfully Freedom of Information Team






PO30 5XW

Tel: 01983 822099 Ex 4862 Ref FOI16095 Date 02 June 2016 Dear Sir/Madam Request for information under the Freedom of Information Act 2000 Please find attached /see the below response to your request: RESPONSE: Please be advised that both documents you are requesting can be accessed through the Isle of Wight CCG Website via the following links:

1) http://www.isleofwightccg.nhs.uk/Downloads/Annual%20Report/CCG%20Annual%20Report%20and%20Accounts%202015-16%20FINAL.pdf

2) http://www.isleofwightccg.nhs.uk/Downloads/IOW%20Operational%20Plan%202016-17%20Final%20Submission%20to%20NHS%20England%2018.04.16%20for%20circulation.pdf

Please provide the following information: • 1. Most current Annual Report • 2. Most current Organisation Business Plan This letter also confirms the completion of this request. A log of this request will be held on a database by the CCG. All hard copy correspondence relating to this request will be held for one year from the date of this letter, before being confidentially destroyed. If you are unhappy about the response you have received your first line of action should be to write and request the CCG to undertake an internal review of your application. A senior member of staff, who was not involved with your initial application, will undertake this review. If after this process you are still not satisfied with the response you receive from the CCG you can complain to the Information Commissioner at the following address: Information Commissioner Wycliffe House Water Lane Wilmslow Cheshire SK9 5AF Please do not hesitate to contact this office if you have any further questions. Yours faithfully Freedom of Information Team

http://www.isleofwightccg.nhs.uk/Downloads/Annual%20Report/CCG%20Annual%20Report%20and%20Accounts%202015-16%20FINAL.pdf

http://www.isleofwightccg.nhs.uk/Downloads/Annual%20Report/CCG%20Annual%20Report%20and%20Accounts%202015-16%20FINAL.pdf

http://www.isleofwightccg.nhs.uk/Downloads/IOW%20Operational%20Plan%202016-17%20Final%20Submission%20to%20NHS%20England%2018.04.16%20for%20circulation.pdf

http://www.isleofwightccg.nhs.uk/Downloads/IOW%20Operational%20Plan%202016-17%20Final%20Submission%20to%20NHS%20England%2018.04.16%20for%20circulation.pdf

Information Management Specialist Clinical Commissioning Group

CCG HQ, Building A The APEX

St. Cross Business Park Newport

Isle of Wight PO30 5XW

Tel: 01983 822099 Ex 4862

Ref FOI16096 Date 13 June 2016 Dear Sir/Madam Request for information under the Freedom of Information Act 2000 Please find attached /see the below response to your request: Under the Freedom of Information Act, please can you supply me with the following information:

1. The contact details of the Procurement Officer or Medicines Management Pharmacist responsible for the evaluation of blood glucose testing strips. RESPONSE: N/A - we work closely with Diabetes Centre. Diabetes Centre St Marys Hospital Newport IW

2. The contact details of the GP Diabetic Lead for the evaluation of blood glucose testing strips. RESPONSE: Currently Vacant

3. The contact details of the Lead Diabetic Nurse for the evaluation of blood glucose testing. RESPONSE: Diabetes Centre St Marys Hospital Newport IW

4. Please confirm if the CCG follows any guidance for the standardisation and guidance for Blood glucose strips from an independent body e.g. LPP, GMMMG. RESPONSE: All guidance taken into account as appropriate

5. Please confirm which strips are currently recommended on the CCG formulary. RESPONSE: Use e – formulary on St Marys Website. Diabetes Centre St Marys Hospital Newport IW

6. Please provide the current standardisation guidelines for blood glucose meters and testing strips. RESPONSE: Diabetes Centre St Marys Hospital Newport IW

7. Please can you confirm or deny whether the CCG currently has rebates for ANY blood glucose strips and if so, which ones are these? RESPONSE: None

This letter also confirms the completion of this request. A log of this request will be held on a database by the CCG. All hard copy correspondence relating to this request will be held for one year from the date of this letter, before being confidentially destroyed. If you are unhappy about the response you have received your first line of action should be to write and request the CCG to undertake an internal review of your application. A senior member of staff, who was not involved with your initial application, will undertake this review. If after this process you are still not satisfied with the response you receive from the CCG you can complain to the Information Commissioner at the following address:

Information Commissioner Wycliffe House Water Lane Wilmslow Cheshire SK9 5AF Please do not hesitate to contact this office if you have any further questions. Yours faithfully Freedom of Information Team





PO30 5XW

Tel: 01983 822099 Ex 4862 Ref FOI16097 Date 14 June 2016 Dear Sir/Madam Request for information under the Freedom of Information Act 2000 Please find attached /see the below response to your request: I am writing to make an open government request for all the information to which I am entitled under the Freedom of Information Act 2000. Please provide the following information:

1. Annual IT Budget RESPONSE: The CCG Annual IT Budget is as follows:

• CCG IT - c£81k (revenue only); c£65k of this is outsourced to NHS South, West and Central CSU • GMS (GP) IT - £364k (revenue) the GMS (GP) IT capital budget is held by NHS England

Please provide split between: • Capital Expenditure • Revenue Expenditure

2. How much of your capital expenditure is spent on outsourced IT services? RESPONSE: The CCG does not have any IT capital expenditure.

Provide split between: • Capital Expenditure • Revenue Expenditure

3. What is your anticipated capital refresh budget for data centre investment? RESPONSE: The CCG does not have a data centre. Its IT services are outsourced to NHS South, West and Central CSU

This letter also confirms the completion of this request. A log of this request will be held on a database by the CCG. All hard copy correspondence relating to this request will be held for one year from the date of this letter, before being confidentially destroyed. If you are unhappy about the response you have received your first line of action should be to write and request the CCG to undertake an internal review of your application. A senior member of staff, who was not involved with your initial application, will undertake this review. If after this process you are still not satisfied with the response you receive from the CCG you can complain to the Information Commissioner at the following address: Information Commissioner Wycliffe House Water Lane Wilmslow Cheshire SK9 5AF Please do not hesitate to contact this office if you have any further questions.

Yours faithfully Freedom of Information Team





PO30 5XW

Tel: 01983 822099 Ex 4862 Ref FOI16098 Date 02 June 2016 Dear Sir/Madam Request for information under the Freedom of Information Act 2000 Please find attached /see the below response to your request: I am writing to request data (under the UK Freedom of Information Act) on Ophthalmology procedures performed at hospitals that are commissioned by the aforementioned CCG. I have tried to find this data through HSCIC published data but it is unavailable. Therefore, I would like to request the following: • Catchment population of CCG by age • Volumes of cataract surgery performed for each financial year between 2006 and 2016 by name and type of provider (e.g. NHS Hospital, vs. Independent Provider of NHS services) o Prior to CCGs, please provide data from the PCTs • Source of referrals (GP, optician, hospital, other) for cataract surgery for each financial year between 2006 and 2016 o Has e-Referrals (i.e. choose and book) been implemented? YES o What is the nature of your referral management system (if any)? N/A o How many referrals by GPs, Opticians, Hospital Doctors or Others are received by the referral management system for cataract surgery, and how many of these are declined? N/A • Mean and median waiting times from referral to cataract surgery for each financial year between 2006 and 2016 • Total volume of injections for macular degeneration performed per financial year - between 2006 and 2016 o If recorded, please also provide number of unique patients receiving injections per financial year I have attached an excel document to aid in data collection should you require it. My hope is that this data is readily available as I believe most of it is sent to HSCIC by all CCG/Trusts on a yearly basis. If this request is too wide or unclear, I would be grateful if you could contact me as I understand that under the Act, you are required to advise and assist requesters. If any of this information is already in the public domain, please can you direct me to it, with page references and URLs if necessary.

Response: Thank you for your enquiry. Please find attached a completed spreadsheet as per your request. This letter also confirms the completion of this request. A log of this request will be held on a database by the CCG. All hard copy correspondence relating to this request will be held for one year from the date of this letter, before being confidentially destroyed. If you are unhappy about the response you have received your first line of action should be to write and request the CCG to undertake an internal review of your application. A senior member of staff, who was not involved with your initial application, will undertake this review. If after this process you are still not satisfied with the response you receive from the CCG you can complain to the Information Commissioner at the following address: Information Commissioner Wycliffe House Water Lane Wilmslow Cheshire SK9 5AF Please do not hesitate to contact this office if you have any further questions. Yours faithfully Freedom of Information Team

Isle of Wight

AGE OF CATCHMENT POPULATIONData available fromhttp://www.hscic.gov.uk/article/2021/Website-Search?q=Numbers+of+Patients+Registered+at+a+GP+Practice&go=Go&area=both

NUMBER OF CATARACT SURGERIESOrganisation Type Provider Name 2008/09 2009/10 2010/11 2011/12 2012/13 2013/14 2014/15 2015/16

Local NHS Provider FRIMLEY HEALTH NHS FOUNDATION TRUST

4 or less (suppressed due to low number)

Hampshire PCT


ISLE OF WIGHT NHS TRUST 966 1209 1088 1324Isle of Wight NHS PCT 892 831 959 890

PORTSMOUTH HOSPITALS NHS TRUST





4 or less (suppressed due to low number) 5 9 8

ROYAL SURREY COUNTY HOSPITAL NHS FOUNDATION TRUST


SOUTHERN HEALTH NHS FOUNDATION TRUST


UNIVERSITY HOSPITAL SOUTHAMPTON NHS FOUNDATION TRUST 20 10 5 9 9 9 9 12

WESTERN SUSSEX HOSPITALS NHS FOUNDATION TRUST


Local Private Provider BMI - THE HAMPSHIRE CLINIC



CARE UK HEAD OFFICE 14

SOUTHAMPTON NHS TREATMENT CENTRE 8 17 5

4 or less (suppressed due to low number) 11 10

SPIRE SOUTHAMPTON HOSPITAL


ST MARY'S NHS TREATMENT CENTRE 10 8 8 6 12 13St Mary's NHS Treatment Centre 31

Other NHS Provider 7 7 8

4 or less (suppressed due to low number) 6

4 or less (suppressed due to low number) 9 5

Other Private Provider


SOURCE OF REFERRALS FOR CATARACT SURGERYReferral Source 2008/09 2009/10 2010/11 2011/12 2012/13 2013/14 2014/15 2015/16

CCG Code



General Practitioner Practice Code not known 6 10 20GP Practice 1222 1102 1339NHS Provider 5 10 9

Referring Organisation Code not applicable



Referring Organisation Code not known 13 4

Unknown 955 865 992 929 998 6



MEAN AND MEDIAN WAITING TIMES FOR CATARACT SURGERYMEAN

(AVERAGE)MEDIAN (in

weeks)2006/072007/082008/092009/102010/112011/12 15.20

2012/13 15.682013/14 14.552014/15 20.032015/16 19.00

TOTAL NUMBER OF INJECTIONS DONE FOR MACULAR DEGENERATION (AMD)

Total Number Performed

Total Number of Unique Patients

2006/072007/082008/09 666 2092009/10 672 2282010/11 592 2242011/12 841 2912012/13 998 3172013/14 1250 3822014/15 1511 4802015/16 1560 504

REFERRAL MANAGEMENT NO REFERRAL MANAGEMENT RUN BY CCGTotal Number of R Total Number of Referrals Declined by Referral Mangement Centre

2006/072007/082008/092009/102010/112011/122012/132013/142014/152015/16





PO30 5XW

Tel: 01983 822099 Ex 4862 Ref FOI16099 Date 08 June 2016 Dear Sir/Madam Request for information under the Freedom of Information Act 2000 Please find attached /see the below response to your request: I am making this freedom of information request in order to obtain information on the volume and costs of continuing healthcare funded by the NHS Isle of Wight CCG, and provided by non-NHS providers. Please find below a breakdown of the information we would like to obtain. Please provide the following information (or estimates if appropriate) on the volume and costs of continuing healthcare funded by the CCG and provided by non-NHS providers If you are unable to provide disaggregated information for each setting / age group, please complete the TOTAL All Ages row only. NAME OF CCG: Isle of Wight Clinical Commissioning Group PERIOD OF April 2015 To March 2016 MONTHS ENDING 31/03/2016 Settings

Age group

Number of Continuing

Healthcare patients at the specified period end date

Gross annual fees for Continuing Healthcare

paid to providers for the period ending at the

specified date Non-NHS Nursing homes (independent sector and local authority, if any)

<65 4 £463,545 65+ 113 £4,628,359 All Ages

Non-NHS Residential homes (independent sector and local authority, if any)

<65 2 £1,249,392 65+ 18 £655,499 All Ages

Non-NHS non-residential settings

<65 65+ All Ages 95 £2,312,629

TOTAL

<65 6 £1,712,936 65+ 131 £5,294,858 All Ages 95 £2,312,629

Notes: please use this space to provide any explanatory notes you think may be helpful in interpreting the data This letter also confirms the completion of this request. A log of this request will be held on a database by the CCG. All hard copy correspondence relating to this request will be held for one year from the date of this letter, before being confidentially destroyed. If you are unhappy about the response you have received your first line of action should be to write and request the CCG to undertake an internal review of your application. A senior member of staff, who was not involved with your initial application, will undertake this review. If after this process you are still not satisfied with the response you receive from the CCG you can complain to the Information Commissioner at the following address: Information Commissioner Wycliffe House Water Lane Wilmslow Cheshire SK9 5AF Please do not hesitate to contact this office if you have any further questions. Yours faithfully Freedom of Information Team





PO30 5XW

Tel: 01983 822099 Ex 4862 Ref FOI16100 Date 02 June 2016 Dear Sir/Madam Request for information under the Freedom of Information Act 2000 Please find attached /see the below response to your request: Please can you advise me in regards to the last 5 years?

1) How many compromise agreements has the trust entered into with staff or former staff? RESPONSE: Zero

2) How many of these compromise agreements require staff members not to discuss the existence of the compromise agreement itself? RESPONSE: Zero

3) How many of these compromise agreements contain non-disparagement clauses that require staff members not to criticise the employees of the trust? RESPONSE: Zero






PO30 5XW

Tel: 01983 822099 Ex 4862 Ref FOI16101 Date 20 June 2016 Dear Sir/Madam Request for information under the Freedom of Information Act 2000 Please find attached /see the below response to your request: I am conducting contract research on behalf of the Vocare Group, a national provider of OOH and front of house services for accident and emergency. I have collated information available from the Contracts Finder government service, however due to the transition between the archived site and the current site, there is some information which should be in the public domain which has proven difficult to locate. As such, I am requesting information regarding urgent and unscheduled care contracts within the NHS Isle of Wight CCG. I am requesting the following: Please provide details of current commissioned Urgent or Unscheduled Care Services, including GP Out of Hours services, NHS 111, Minor Injuries Units, Urgent Care Services and any other service (but excluding A&E and Ambulance services). It is important to know specific details, please provide the value, population supported by the contract(s). Please also provide the start and completion dates for these contracts and if/when they may be due for re-tendering. Please can you also provide a hard copy or a link to an overview of these contracts either as a tender specification or award. This letter also confirms the completion of this request. A log of this request will be held on a database by the CCG. All hard copy correspondence relating to this request will be held for one year from the date of this letter, before being confidentially destroyed. If you are unhappy about the response you have received your first line of action should be to write and request the CCG to undertake an internal review of your application. A senior member of staff, who was not involved with your initial application, will undertake this review. If after this process you are still not satisfied with the response you receive from the CCG you can complain to the Information Commissioner at the following address: Information Commissioner Wycliffe House Water Lane Wilmslow Cheshire SK9 5AF

Please do not hesitate to contact this office if you have any further questions. Yours faithfully Freedom of Information Team

Freedom of Information Request FOI16101a) Please provide details of current commissioned Urgent or Unscheduled Care Services, including GP Out of Hours services, NHS 111, Minor Injuries Units, Urgent Care Services and any other service (but excluding A&E and Ambulance services).

It is important to know specific details, please provide the value, population supported by the contract(s).

b) Please also provide the start and completion dates for these contracts and if/when they may be due for re-tendering.

c) Please can you also provide a hard copy or a link to an overview of these contracts either as a tender specification or award.

Provider Service Value (including pass-through costs) Population served Start date End date Retendering date

Isle of Wight NHS Trust Beacon Health Centre - GP led walk in centre and GP Out of Hours services (combined contract)

£12,312,967 population of the Isle of Wight including visitors 13 March 2009 30 September 2016

Isle of Wight NHS Trust NHS 111 £3,234,347 population of the Isle of Wight including visitors 01 April 2014 31 March 2017

Service DocumentationBeacon Health Centre Documentation does not exist in

format requested

NHS 111 Documentation does not exist in format requested

(C )

The relevant services are currently being reviewed as part of a Whole Integrated System Re-design (WISR) which is yet to be completed. This review is part of the 'Vanguard Programme' currently in place on the Isle of Wight. A number of contractual decisions are based on the outcome of the re-design work.

The Beacon contract includes GP Out of Hours / Urgent care Services and Minor Injuries Unit

Additional comments

3 year rolling contract for all services within the IW NHS Trust. (although principle agreement is in place to pause re-tendering to support the development of the Vanguard programme and the Whole Systems Review/Redesign including review of all urgent care pathways)

(A) / (B)

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