FOI 1749 – Headache Services

Response

Date: 14 February 2023

FREEDOM OF INFORMATION – DECISION NOTICE

Dear Sir / Madam,

FOI Reference Number: 1749

1. Does your ICB have an inter-organisational group with a responsibility for neurology? (e.g. clinical prioritisation group, clinical reference group) If no, what governance process is in place for decisions relating to neurology pathways?

There is not currently a specific neurology system group or expert advisory forum (EAF). Any decisions relating to the services are held through Providers and system governance. The Primary Care Delivery Board (PCDB) oversees all elective care.

Home oxygen is prescribed by acute Trusts and primary care for cluster headaches through the NHS England nationally procured contract that Arden & GEM manage for us.

2. Is there a person with responsibility for migraine and headache services? If yes, what is their name and role?

No individual is specifically identified as system lead for this pathway.

3. What is the name and job title of the individual responsible for leading the group?

Not applicable.

a) ICB lead

This would be the chair of the relevant EAF, or the Chair of Clinical and Professional Leadership Group (CPLG). Currently the Chair of the CPLG is Dr Avi Bhatia.

b) Primary care lead

No Primary Care lead is assigned to this pathway but PCDB has GP representation through Hazel McMurray.

c) Secondary care lead

This information is held by University Hospitals Derby and Burton NHS Foundation Trust.

4. What is the name and job title of the individual responsible for overseeing the set of inter-organisational groups across your ICB (e.g. Clinical Prioritisation Group, Clinical Reference Group)?

This depends on which groups or system. Across the ICB / ICS in general it would be Dr Chris Clayton, Chief Executive Officer, but for example in the case of the Clinical Reference Group it would be Dr Chris Weiner, Chief Medical Officer.

5. If an inter-organisational group with a responsibility for neurology exists, which organisations are members of this group?
a) Acute providers
b) Community providers
c) Voluntary and Charity
d) Primary care
e) Other

Not applicable.

6. Does your ICB have a budget specifically allocated to neurology?

No.

If yes, what is the value of this budget?

Not applicable.

7. a) What is the name of the ICB’s Chief Pharmacist?

Steve Hulme, Director of Medicines Management & Clinical Policies NHS Derby and Derbyshire Integrated Care Board

b) What is the name of the medicines management / high-cost drugs Lead?

Slakahan Dhadli, Assistant Director of Medicines Management and Clinical Policies.

8. How does your ICB make decisions around ICS budgets to determine how to invest and who is responsible for this?

We have a planning process involving providers that takes a triangulated view of activity, workforce and finance. Also the impact of performance, quality and patient experience. Proposals are discussed at relevant programme boards and depending on the impact of the decision is escalated through additional groups to reach a conclusion including through consideration of quality, finance, patient experience, and clinical issues.

What is the name of the person responsible for service transformation and contracting primary care providers?

Zara Jones, Executive Director of Strategy and Planning.

9. What forums do you have for primary and secondary care to collaborate and design services around population needs?

We work with system partners through all forums; population health needs are a priority for the ICB and are embedded in all programmes with oversight at Population Health and Strategic Commissioning Committee (PHSCC) and ICB Executive Board.

10. What, if any, specific priorities do the ICB have around neurology, and migraine in particular?

None.

11. Are there any examples of any Integrated Care Partnerships, Primary Care Networks or Provider Collaborations in your ICB who have focused on reviewing pathways relating to migraine and headache?

The CPLG offers a system-wide clinical and care professional view on pathway proposals. Sukhi Mahil is the Management Lead for CPLG, and Dr Avi Bhatia the CPLG Chair.

To assist you further, I can advise that a headache pathway proposal was made to CPLG in February 2022 and was seeking support to publish the pathway through JUCD. CPLG were unable to support the pathway in its current state; further development was required including engagement with primary care and Chesterfield Royal Hospital NHS Foundation Trust before full support could be given.

12. What governance process does the ICB have in place for reviewing clinical pathways?

The CPLG provides a multi-disciplinary review of proposed pathway work. This group will work to ensure that appropriate consultation has been undertaken with the various other supporting structures within the ICS, e.g. The GP Provider Board, the Urgent and Emergency Care Board and the Integrated Care provider structures. The PHSCC will review service proposals that require a ‘board’ considered review of the commissioning arrangements. Minor changes to pathways that can be accommodated with current commissioning arrangements may proceed without formally being presented to PHSCC.

13. What is the name and job title of the individual(s) accountable for the effectiveness of clinical pathways?

Chris Weiner, Chief Medical Officer.

14. What is the name and job title of the individual(s) accountable for the redesign of pathways?

We do not have anyone directly and specifically responsible for the redesign of pathways; it would depend on which specific pathway.

I hope that this answers your queries with the information we currently hold, but if I can be of any further assistance please do not hesitate to contact me.

If you are dissatisfied with the handling of your request, you have the right to ask for an internal review. Internal review requests should be submitted within two months of the date of receipt of the response to your original letter and should be addressed to:

NHS Derby and Derbyshire ICB
FOI Team
Scarsdale
Nightingale Close
Newbold
Chesterfield
S41 7PF

Or:

ddicb.foi@nhs.net

If you are not content with the outcome of our review, you may apply directly to the Information Commissioner for a decision. Generally, the ICO cannot make a decision unless you have exhausted the complaints procedure provided by the Derby and Derbyshire Integrated Care Board (ICB).

The Information Commissioner can be contacted at: Information Commissioners Office, Wycliffe House, Water Lane, Wilmslow, Cheshire SK9 5AF, telephone 0303 123 1113, email casework@ico.org.uk.

Yours faithfully,

Kathryn Jacklin
FOI Officer
Derby and Derbyshire ICB

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