nhs kernow - disclosure log freedom of information...
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NHS Kernow FOI Disclosure Log - October 2016
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Contents Care homes ................................................................................................................ 3
FOI55620 - Morleigh Group .................................................................................... 3
Children’s health ........................................................................................................ 4
FOI55560 - Self-harm ............................................................................................. 4
Continuing healthcare ................................................................................................ 5
FOI55960 - Packages of care ................................................................................. 5
FOI56010 - Policies ................................................................................................ 7
Contracts .................................................................................................................... 7
FOI55540 - Patient transport .................................................................................. 7
FOI55740 - AQP ..................................................................................................... 8
FOI55870 - IT services ........................................................................................... 8
FOI56030 - Services ............................................................................................... 9
Individual funding requests ......................................................................................... 9
FOI55860 - Homeopathic treatment ....................................................................... 9
Long term conditions ................................................................................................ 10
FOI55430 - HIV support ........................................................................................ 10
FOI55820 – Bariatric surgery policies ................................................................... 10
FOI56020 - Type 1 diabetes ................................................................................. 11
Mental health & learning disabilities ......................................................................... 12
FOI55950 - Mental health funding ........................................................................ 12
FOI55970 - Rehabilitation ..................................................................................... 13
Organisation ............................................................................................................. 15
FOI55490 - STP supporting documents ............................................................... 15
FOI55770 - IT training ........................................................................................... 15
Prescribing & pharmacies ........................................................................................ 16
FOI55510 - Sip feeds / nutrition ............................................................................ 16
FOI55550 - Smoking medications ........................................................................ 16
FOI55750 - NICE recommendations ..................................................................... 17
Urgent care .............................................................................................................. 17
FOI55500 - NHS 111 and OOH ............................................................................ 17
FOI55630 - GP referrals ....................................................................................... 18
FOI55670 - Services ............................................................................................. 20
Appendix .................................................................................................................. 25
FOI55960 - Packages of care ............................................................................... 26
NHS Kernow FOI Disclosure Log - October 2016
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The information supplied to you continues to be protected by the Copyright, Designs and Patents Act 1988. You are free to use it for your own purposes, including any non-commercial research you are doing and for the purposes of news reporting. Any other re-use, for example commercial publication, would require the permission of the copyright holder. Most documents supplied by NHS Kernow Clinical Commissioning Group will have been produced by local officials and will be our copyright. Information you receive which is not subject to our copyright continues to be protected by the copyright of the person, or organisation, from which the information originated. You must ensure that you gain their permission before reproducing any third party information.
Disclosure log for October 2016
Care homes
FOI55620 - Morleigh Group Date received: 10/10/2016 1. Please provide me with the following information in relation to the Morleigh
Group of homes. If possible, please provide each response with a breakdown by residence.
a) Please disclose (i) the amount of money paid by the CCG to the Morleigh Group of care homes in the last 12 months to the date of answering this request. If the data is not available for this period, please disclose data for the most recent 12 months that you have available.
A. £1.2 million (for the period up to 17 October 2016). b) Please disclose (i) the total number of residents funded wholly in or in part
by the CCG and resident at any of the Morleigh Group of care/nursing homes at any stage in the last 12 months to the date of answering this request. If the data is not available for this period, please disclose data for the most recent 12 months that you have available.
A. 116 (for the period up to 17 October 2016). 2. Please provide me with the following information in relation to the Morleigh
Group of homes for the period between January 2015 and the date of this request. Please provide each response to a question with a breakdown by residence. a) Please provide the following information in relation to deaths of
residents at Morleigh Group homes in the last 12 months. If the data is not available for this period, please disclose data for the most recent 12 months that you have available.
Expected deaths;
Unexpected deaths.
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A. NHS Kernow does not hold the information you have requested. Please redirect your request to Cornwall Council ([email protected]) to obtain this information.
3. Please disclose the number of Serious Incidents (or equivalent) at the
Morleigh Group of care homes in the last 12 months to the date of answering this request. If the data is not available for this period, please disclose data for the most recent 12 months that you have available.
A. Less than five. 4. I understand that the Morleigh Group of Care Homes were suspended from
receiving new NHS placements in 2015. Please provide an overview of the reasons for that suspension and
5. I also understand that the suspension was later lifted. Please provide (i) the date on which the suspension was lifted (ii) an overview of the reasons for the suspension being lifted.
6. I also request the rationale that was used to decide that the homes were unsuitable for new admissions but still considered safe and appropriate for the residents already living there?
A. Morleigh Group of Care Homes was suspended on approximately 15 January
2015 and Collamere, St Theresas and Tregurtha suspension was lifted on 27 February 2016. Once the homes were suspended, a full serious incident led investigation was implemented by NHS Kernow to look at quality of care in all the homes with CHC funded residents. The investigations produced individual reports and all actions were addressed.
7. Please disclose all internal emails, correspondence and documents relating
to that suspension. A. NHS Kernow has estimated that it will cost more than the appropriate limit to
provide this information. The appropriate limit, specified in regulations, is set at £450. We therefore exempt the release of this information under Section 12 of the Freedom of Information Act.
Children’s health
FOI55560 - Self-harm Date received: 10/10/2016 Please could you provide the following information to cover the Cornwall Partnership Trust:
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1. Details of how many individual admissions there have been for 12-18 year olds who have self- harmed in each of the last 5 financial years - i.e. 2011/12, 2012/13, 2013/14, 2014/15 and 2015/16.
2. Details of how many inpatient days stay have there been for 12-18 year olds who have self- harmed in in the same 5 financial years.
A. NHS Kernow does not hold the information you have requested. Child and
adolescent mental health services (CAMHS) are contained within the block contract with Cornwall Partnership NHS Foundation Trust and therefore the information you have requested on individual admissions cannot be identified. Please redirect your request to Cornwall Partnership Foundation Trust ([email protected]) to obtain this information.
Continuing healthcare
FOI55960 - Packages of care Date received: 27/10/2016 1. Please supply the name, job title, email address and telephone number of
the Commissioner with responsibility for commissioning Complex Care packages, for adults (aged 18-64) with complex physical or neurological disabilities.
A. Kathryn Hudson – Director of Integrated Commissioning
Telephone: 01726 627800 | Email: [email protected] 2. Please provide the total number of adults receiving Continuing Healthcare
(CHC) funded packages of care; a) At year-end 2014/15 and 2015/16
A. 2014/15: 1,954. 2015/16: 2,059
b) New placements during the year 2014/15 and 2015/16
A. 2014/15: 3,336. 2015/16: 3,240
3. Please provide the total number of adults with the following conditions
receiving CHC funded packages of care in 2015/16 – at year-end and new placements during the year. If data not available for 2015/16, please provide 2014/15 data;
A. The information below relates to diagnosis groups for patients with packages open any time between 01/04/2015 and 31/03/2016:
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Condition Active in year Of which new in year
ABI 13 8
Stroke 253 200
Huntington’s disease 14 9
Multiple sclerosis 66 50
Spinal injury 18 11
a) Other neurological conditions e.g. Pick’s disease, Korsakoff’s
syndrome, muscular dystrophy, Parkinson’s disease, motor neurone disease (MND) – please state which conditions are included in your response
A. The information below relates to diagnosis groups for patients with packages
open any time between 01/04/2015 and 31/03/2016. A list of conditions, which are included in this figure, is attached.
Active in year Of which new in year
1,311 978
4. How many of those adults (in question 3) are cared for in Care Home and
Hospital settings? a) Acquired brain injury (ABI) b) Stroke c) Huntington’s Disease d) Multiple sclerosis e) Spinal injury f) Other neurological conditions e.g. Pick’s disease, Korsakoff’s
syndrome, muscular dystrophy, Parkinson’s disease, motor neurone disease (MND) – please state which conditions are included in your response
A. Care homes: All of the above were cared for in a care home setting.
Hospital settings: None. 5. Please provide the total expenditure on CHC funded packages of care for
financial years 2014/15 and 2015/16, and the CHC expenditure on Care Home and Hospital placements over the same period. If expenditure for 2015/16 is not yet available, please provide projected expenditure.
A. 2014/15: £51m
2015/16: £58m 6. Please provide the list of providers that received this funding. A. A list of providers is attached. 7. What is the highest rate paid per week for a Complex Care (CHC funded)
placement?
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A. £7k. 8. What is the lowest rate paid per week for a Complex Care (CHC funded)
placement? A. £12.
FOI56010 - Policies Date received: 28/10/2016 1. Please could you send us a copy of your "Continuing Healthcare Choice &
Equity Policy", or any similar policy which sets out how decisions for Continuing Healthcare are made.
A. NHS Kernow’s continuing healthcare choice and equity policy is currently under review and will be published on our website once it has been ratified. We therefore exempt this information under section 22 of the Freedom of Information Act, information intended for future publication.
Our website provides information on our CHC process, such as the ‘Explaining the Continuing Healthcare process’ leaflet and the National Framework for CHC and FNC which we adhere to: https://www.kernowccg.nhs.uk/get-info/continuing-healthcare/who-is-eligible-for-continuing-healthcare/
Contracts
FOI55540 - Patient transport Date received: 04/10/2016 1. With regards to your patient transport service, please confirm if E-Zec are
meeting their KPIs since they took over the contract? Please provide a breakdown by month.
A. NHS Kernow is unable to provide the information you have requested at this time.
The information you have requested is currently being validated and a report on E-Zec’s KPI compliance will be published on our website in December 2016.
We therefore exempt the release of this information under Section 22 of the Freedom of Information Act, information intended for future publication.
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FOI55740 - AQP Date received: 12/10/2016 1. be grateful if you could kindly let me know the numbers of patients treated
in Cornwall under the AQP contract for back and neck pain, broken down by provider? Please could you supply this information for the year 2015/16 and the current year to date position.
A. The below table is based on the number of first appointments for AQP MSK
physiotherapy for 2015-2016 and 2016-2017 year to date (end September 2016). For 2015/16 RCHT, this is the number of first attendances, and for all other providers/years this is the total number of initial assessments only plus the number of full packages from which patients have been discharged during these timeframes.
Provider Count of first appointments
2015/16 2016/17 YTD
RCHT 866 342
PCH / CPFT 6,684 2,475
Judith Handley 85 38
Three Spires 519 131
Cathedral Chiropractic 669 362
Corbett Chiropractic 316 141
Falmouth Osteopaths 366 196
Lander 402 153
North Cornwall Physio 285 138
Plymouth Chiropractic 78 33
Sandy Hill 1,853 717
South Devon Osteopaths 759 442
TICCs 932 427
Walsingham Clinic 14 59
FOI55870 - IT services Date received: 25/10/2016 1. Which Web Filtering Solution do you currently have implemented at the
CCG? 2. Who was this purchased through? 3. How many users does your web filter support and which other institutions
do you support? 4. How much is the current contract value and how many years does this
cover? 5. When is the Web Filtering contract due to expire? 6. Which individual is currently in charge of evaluating and renewing web
filtering solutions?
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A. NHS Kernow does not hold the information you have requested. NHS Kernow utilises Cornwall IT Services, which is hosted by Royal Cornwall Hospital Trust. Please redirect your request to Royal Cornwall Hospital: [email protected] to request this information.
FOI56030 - Services Date received: 31/10/2016 1. Has your CCG introduced or planned limits to access or eligibility for
services during 2016/17 for financial, efficiency or value reasons? 2. If yes, please could you provide details about which services/treatments
will be affected where possible. A. NHS Kernow is responsible for securing value for money in all of its
commissioning decisions and has a range of mechanisms in place for doing so through re-procurement, policy change and referral criteria.
NHS Kernow publishes a list of treatments routinely and not routinely funded on our website: https://www.kernowccg.nhs.uk/get-info/individual-funding-requests/treatment-policies/
NHS Kernow also has a duty to consult on significant changes to services, which sometimes include access or eligibility. All such consultations are routinely published on our website: https://www.kernowccg.nhs.uk/get-involved/consultation/
In addition, any decisions to dis-invest or decommission services following review are published on our website, along with a copy of the criteria and process followed in reaching those decisions: https://www.kernowccg.nhs.uk/about-us/what-we-spend-and-how-we-spend-it/services-review-update/
We therefore exempt the release of this information under Section 21 of the Freedom of Information Act, information accessible by other means.
Individual funding requests
FOI55860 - Homeopathic treatment Date received: 25/10/2016 1. Does your clinical commissioning group fund homeopathic treatment? If
so, what kind of treatment(s) were offered? A. No, NHS Kernow does not fund homeopathy treatments. NHS Kernow’s policy on
homeopathy is available on our website: https://www.kernowccg.nhs.uk/get-info/individual-funding-requests/treatment-policies/
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We therefore exempt the release of this information under Section 21 of the Freedom of Information Act, information accessible by other means.
2. How much have you spent on those treatments in each of the last four
financial years? A. NHS Kernow was formed on 1 April 2013 and cannot provide information relating
to the former primary care trust (2012 to 2013). Please contact the Department of Health’s legacy team to request this information: reviews&[email protected].
NHS Kernow has not funded any homeopathy treatments between 1 April 2013 and 31 March 2016.
Long term conditions
FOI55430 - HIV support Date received: 03/10/2016 This request relates to CCG spending on support for people living with HIV in 2015/16 and plans for 2016/17: 1. Did you provide any funding through contracts or grants for services
specifically supporting people living with HIV? A. NHS Kernow does not fund, through contracts or grants, services specifically
supporting people living with HIV. 2. Is support for people living with HIV explicitly mentioned within the
contractual documentation for any generic services you funded? A. No, people living with HIV are not explicitly mentioned within contractual
documentation for generic services that are funded.
FOI55820 – Bariatric surgery policies Date received: 21/10/2016 1. I would like to request a copy of your clinical commissioning group’s policy
on the commissioning of Tier 3 weight management clinics and Tier 4 Bariatric Surgery.
A. NHS Kernow does not have a policy at this time on the commissioning of Tier 3
weight management clinics and Tier 4 bariatric surgery.
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FOI56020 - Type 1 diabetes Date received: 28/10/2016 1. The total direct spend by the CCG on treating Type 1 Diabetes in each of
the last five years. A. NHS Kernow was formed on 1 April 2013 and cannot provide information relating
to the former primary care trust (2011 to 2013). Please contact the Department of Health’s legacy team to request this information: reviews&[email protected].
For information relating to 1 April 2013 to date, NHS Kernow does not hold the information you have requested. We are unable to provide the total spend on diabetes or by type of diabetes. Diabetes care is provided across all areas of the health community eg primary care, acute hospitals and community services to over 28,000 people all of whom have different needs and use different services at different points in their lives. Therefore we are unable to extract specific costs for diabetic care.
2. The number of Continuous Glucose Monitors funded by the CCG for i)
adults, and ii) children with Type 1 Diabetes in each of the last five years, A. NHS Kernow was formed on 1 April 2013 and cannot provide information relating
to the former primary care trust (2011 to 2013). Please contact the Department of Health’s legacy team to request this information: reviews&[email protected].
2013/14 2014/15 2015/16
Adults None None None
Children None None Less than five.
3. The number of Flash Glucose Meters funded by the CCG for i) adults, and
ii) children with Type 1 Diabetes in each of the last five years. A. NHS Kernow was formed on 1 April 2013 and cannot provide information relating
to the former primary care trust (2011 to 2013). Please contact the Department of Health’s legacy team to request this information: reviews&[email protected].
NHS Kernow has not funded any flash glucose meters for adults or children with Type 1 Diabetes in 2013/14, 2014/15 or 2015/16.
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Mental health & learning disabilities
FOI55950 - Mental health funding Date received: 26/10/2016 1. I would like to know how much of the CCG’s budget has been allocated to
the main provider of adult mental health services in the CCG area (probably a mental health trust), and how much has been allocated to the main provider of child and adolescent mental health services (CAMHS) in the CCG area, over the last five years.
Please give the break down per financial year; 2011/12, 2012/13, 2013/14, 2014/15, 2015/16. would like a figure, and the figure as a percentage of the CCG’s overall budget, for each year.
A. NHS Kernow was formed on 1 April 2013 and cannot provide information relating
to the former primary care trust (2011 to 2013). Please contact the Department of Health’s legacy team to request this information: reviews&[email protected].
Adult and child mental health services are provided by Cornwall Partnership NHS Foundation Trust as part of a block contract. Please redirect your request to Cornwall Partnership NHS Foundation Trust ([email protected]) to obtain information for the period prior to the CCG inception.
Information on NHS Kernow’s total spend is routinely published on our website, including how much we commission CPFT to provide adult community services and mental health services: https://www.kernowccg.nhs.uk/about-us/what-we-spend-and-how-we-spend-it/ https://www.kernowccg.nhs.uk/about-us/annual-report/
We therefore exempt the release of this information under Section 21 of the Freedom of Information Act, information accessible by other means. Please be aware that NHS Kernow also commissions other providers to support people with mental health needs (requirements) such as IAPT, funding for CHC and joint funded placements with social care, which is not included in this figure. We have estimated that it will cost more than the appropriate limit to breakdown this information. The appropriate limit, specified in regulations, is set at £450. We therefore exempt the release of this information under Section 12 of the Freedom of Information Act. Tier four CAMHS are commissioned by NHS England. Please contact NHS England’s FOI team at [email protected] to obtain this information.
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FOI55970 - Rehabilitation Date received: 27/10/2016 1. purchase mental health rehabilitation services on a block contract or as a
spot purchase? A. NHS Kernow purchases mental health rehabilitation services on a block contract
and as a spot purchase.
2. If services are bought on a block contract, please provide the number of bed days commissioned and £ spent on mental health rehabilitation services for 2012/13, 2013/14. 2014/15. 2015/16 financial years (FY), defined as April- March.
A. NHS Kernow was formed on 1 April 2013 and cannot provide information relating
to the former primary care trust (2012 to 2013). Please contact the Department of Health’s legacy team to request this information: reviews&[email protected]. For information relating to 2013/14, 2014/15 and 2015/16 a total of 18 beds were commissioned to an NHS provider with 5,584 bed days at 85 per cent occupancy and 6,570 maximum occupancy allowing for flexibility.
3. If services are spot purchased on a sport contract, please provide the day
rates, in £, of the latest 20 service users you have placed in a mental health rehabilitation service; further please state if the provider in which the service was place an independent (private or charity) or NHS provider.
Service users
Year of placement
Day rate (£)
Type of provider (independent or NHS)
1 2015 365 Independent
2 2015 421 Independent
3 2015 243 Independent
4 2015 375 Independent
5 2015 399 Independent
6 2015 432 Independent
7 2015 432 Independent
8 2015 365.24 Independent
9 2015 448.43 Independent
10 2016 446.95 Independent
11 2016 582 Independent
12 2016 582 Independent
13 2016 369.96 Independent
14 2016 432 Independent
15 2016 489 Independent
16 2016 368 Independent
17 2016 432 Independent
18 2016 350 Independent
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Service users
Year of placement
Day rate (£)
Type of provider (independent or NHS)
19 2016 489 Independent
20 2016 445 Independent
a) If any of the service users above have received any further payments (in the
forms of top-ups/ additional observations/ specialising) please indicate the latest available weekly cost; please use the service user number above as a reference/index. Indicate if when a service user did not get further payments with “N/A”
A. Less than five of the above service users received further payments in the form of
top-ups / additional / observations / specialising. We exempt the release of this information under section 40 (2) of the Freedom of Information Act, personal information, as disclosing this information may lead to identification of the individuals concerned.
4. Do you purchase Learning Disability rehabilitation services on a block
contract or as a spot purchase? A. NHS Kernow does not commission specific learning disability rehabilitation
services. People with a learning disability would be supported to access mainstream services dependent upon their health need at the time.
5. If services are bought on a block contract, please provide the number of
bed days commissioned and £ spent on Learning Disability rehabilitation services for 2012/13, 2013/14. 2014/15. 2015/16 financial years (FY), defined as April- March.
A. NHS Kernow was formed on 1 April 2013 and cannot provide information relating
to the former primary care trust (2012 to 2013). Please contact the Department of Health’s legacy team to request this information: reviews&[email protected]. For information relating to 2013/14, 2014/15 and 2015/16, NHS Kernow does not commission learning disability rehabilitation services as part of a block contract.
6. If services are spot purchased on a spot contract, please provide the day
rates, in £, of the latest 20 service users you have placed in a Learning Disability rehabilitation service; further please state if the provider in which the service was place an independent (private or charity) or NHS provider.
a) If any of the service users above have received any further payments (in the forms of top-ups/ additional observations/ specialising) please indicate the latest available weekly cost; please use the service user number above as a reference/index. Indicate if when a service user did not get further payments with “N/A”.
A. N/A. NHS Kernow has not spot purchased learning disability rehabilitation
services.
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Organisation
FOI55490 - STP supporting documents Date received: 04/10/2016 1. Your organisations, as leads in the STP process, were required to submit
full “Finance & Efficiency template” returns to NHS England/the national Five Year Forward View office by 5pm on 16 September. Please provide: The full template return as submitted.
A. Under section 1(1) of the Freedom of Information Act 2000, we confirm that we
do hold the above template however, we exempt the release of this information under Section 36 of the Freedom of Information Act, prejudice to the effective conduct of public affairs and Section 43 (2) of the Freedom of Information Act, commercial interests.
In reaching this conclusion we have carried out a public interest test and, whilst recognising the need for being open and transparent, we believe this is outweighed by concerns that these details are commercially sensitive and the CCG needs to be able to negotiate contractual arrangements to secure appropriate services for the best value for money.
We advise that NHS Kernow will be involved in an engagement programme overseen by the Transformation Board during November, December and January to gain the views of patients, the public, staff, providers and wider stakeholders about the STP. Whilst we recognise that this will not present all the data captured by the template that we have exempted, it might assist you to learn of the proposals covered by the STP. Details of the events will be published on our website once confirmed.
FOI55770 - IT training Date received: 17/10/2016 1. Have you purchased any IT / ICT technical training courses or any other
training Since April 2016 from QA training or QA Limited or any other of QA's offices?
A. No, NHS Kernow has not purchased any IT / ICT technical training courses or
any other training from QA Training, QA Limited or any other of QA’s offices.
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Prescribing & pharmacies
FOI55510 - Sip feeds / nutrition Date received: 06/10/2016 1. Does the CCG reference or work to any guidelines in relation to sip feeds
for adults and children? If so, please provide a copy or website link. 2. If yes, when is/are the document(s) expected to be reviewed? A. Yes. The guidelines for sip feeds for adults and children is available on our
Cornwall Joint Formulary website: https://www.eclipsesolutions.org/Cornwall/
We therefore exempt the release of this information under Section 21 of the Freedom of Information Act, information accessible by other means.
3. What is the current referral time for patients to see a dietician? A. 10-12 weeks. 4. Is nutrition included in any incentive scheme or other programmes that are
being implemented? If so, what are they? A. Yes, we have an ONS audit/protocol, which has been included in our 2015/16 Q3
incentive scheme.
5. Does the CCG routinely ‘MUST’ screen / nutritionally screen patients? A. Yes, NHS Kernow will be running an audit in 2017 to confirm the number of
patients screened.
6. Please can you confirm whether we are permitted to reuse any information provided under the Open Government Licence?
A. NHS Kernow permits the reuse of this information.
FOI55550 - Smoking medications Date received: 07/10/2016 1. I am writing to request copies of the following for the period since 1st
January 2016: a) Any governing body minutes and papers concerning prescription of,
and funding for, any stop smoking medications including any minutes and papers distinguishing between practices for different products and different groups of smokers.
b) Any CCG communications with GP practices in the CCG area concerning decisions on the funding prescription of, and funding for any stop smoking medications.
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A. NHS Kernow does not hold the information you have requested. There have been no decisions concerning prescriptions or funding of stop smoking medications since 1 January 2016.
FOI55750 - NICE recommendations Date received: 13/10/2016 1. Does the CCG have a budget to fund new treatments/drugs approved by the
National Institute for Health and Care Excellence (NICE) each year? If so, please state what this budget was for the past three financial years (2013/14 – 2015/16). Please breakdown by year
A. NHS Kernow does not have a specific budget for each new treatment / drug
approved by NICE. The funding for these treatments / drugs is part of an uplift of the budget for prescribing, which is 5% for 2016/17.
2. Please list the NICE approved treatments/drugs which the CCG does not allow clinicians to prescribe
A. NHS Kernow does not disallow clinicians to prescribe NICE approved treatments
/ drugs. 3. To illustrate any trend, please provide this list for the past three financial
years (2013/14 – 2015/16). Please breakdown by year 4. Please give a brief and general explanation why the CCG does not allow
clinicians to prescribe these treatments/drugs A. N/A.
Urgent care
FOI55500 - NHS 111 and OOH Date received: 05/10/2016 1. For the financial year ending April 2016 can you please tell me what per
cent of cases the OOH provider achieved a face to face contact within two or six hours (Dx05, 85, 97 and Dx06, 80 are I understand the main dispositions from NHS Pathways respectively) and what percent of 'speak to' dispositions are contacted by the service within one or two hours (Dx11, 117 and Dx12).
A. During the time period you have requested, NHS Kernow had two providers for
out of hours services. The model commissioned from Serco was different to the model commissioned from Cornwall Health, with slightly different reporting arrangements and therefore we have provided the information separately for each provider.
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The ‘speak to’ dispositions are not reported within one or two hours within the out of hours service. For Serco, it was within one hour and Cornwall Health calls are prioritised as urgent within 20 minutes and routine within 60 minutes. Details are included in the table below.
Serco April 2015 - May 2015
Start definitive clinical assessment for urgent calls within 20 minutes Not reported against
Start definitive clinical assessment for all calls within 60 minutes 95.76%
Face to Face within two hours 93.94%
Face to Face within six hours 97.62%
Cornwall Health June 2015 - March 2016
Start definitive clinical assessment for urgent calls within 20 minutes 78.53%
Start definitive clinical assessment for all other calls within 60 minutes 83.77%
Face to Face within two hours 86.26%
Face to Face within six hours 94.26%
Please note that out of hours performance is now published on our website via the monthly Governing Body meeting papers (Appendix one - Quality and Performance report): https://www.kernowccg.nhs.uk/get-info/governing-body-meetings/
FOI55630 - GP referrals Date received: 11/10/2016 1. Non-urgent/unnecessary GP referrals for hospital treatment a) Does the CCG currently have any procedures in place to reduce non-
urgent/unnecessary GP referrals for hospital treatment? A. Yes.
b) If yes, please provide details: please state which areas/specialities the
policy covers, how long it has been in place and how long it will apply.
A. NHS Kernow’s referral guidelines can be found on our RMS website: http://rms.kernowccg.nhs.uk/primary_care_clinical_referral_criteria
NHS Kernow’s limited clinical priority policy is also available on our website: https://www.kernowccg.nhs.uk/get-info/individual-funding-requests/treatment-policies/
We therefore exempt the release of this information under Section 21 of the Freedom of Information Act, information accessible by other means.
c) If there is no current policy, are there any plans to implement one within the next three months? If so, please give details as in 1a.
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A. N/A. 2. Inappropriate GP referrals for diagnostic tests a) Does the CCG currently have any polices in place to reduce inappropriate
GP referrals for diagnostic tests? A. Yes.
b) If so, please give details stating which tests are included, how long this policy has been in place and how long it will apply.
A. NHS Kernow’s referral guidelines can be found on our RMS website:
http://rms.kernowccg.nhs.uk/primary_care_clinical_referral_criteria
We therefore exempt the release of this information under Section 21 of the Freedom of Information Act, information accessible by other means.
c) If there is no current policy, are there any plans to implement one within the
next three months? If so, please give details as in 2a. A. N/A. 3. Inappropriate A&E attendances a) Does the CCG have any policies to reduce inappropriate A&E attendances?
If so, please specify. b) Does the CCG have any policies to redirect patients who have arrived at
A&E inappropriately – eg to primary care/pharmacy. If so, please provide details.
A. No, NHS Kernow does not have a policy on reducing inappropriate A&E
attendances however, we have developed a demand management work stream and the key priorities for this year include:
Project Description
MIDOS roll out Roll out access to MIDOS across the healthcare system and to the general public.
MIU resilience Deliver sustainable MIU services that are adequately resourced and operational.
Minor ailments and emergency supply services
Increase uptake of the minor ailments and emergency supply services.
111/OOH pathway redesign Identify and implement high impact opportunities to redesign 111 and out of hours operational pathways.
Reducing 999 conveyances Increase the use of Hear and Treat and See and Treat patient pathways where clinically appropriate.
NHS Kernow FOI Disclosure Log - October 2016
20
FOI55670 - Services Date received: 11/10/2016 1. Does the CCG operate or commission, a referral management centre that
assesses referrals by local GPs? If yes, when was this introduced? A. Yes, the referral management centres were was transferred from Cornwall and
the Isles of Scilly Primary Care Trust to NHS Kernow on 1 April 2013. 2. Which organisation(s) operates the referral management centre for the
CCG?
A. NHS Kernow has a RMS, which manages referrals from 53 GP practices, excluding those in East Cornwall. NHS Kernow commissions Devon Referral Support Services (DRSS) to manage referrals for the 11 practices in East Cornwall.
3. Please list the relevant branches of medicine that fall under the referral management centre’s remit e.g. cardiology, gastroenterology, palliative care etc.
A. Referral Management Service:
Allergy Cardiology Children’s and adolescent services
Dermatology Diabetic medicine Diagnostic endoscopy
Diagnostic imaging Diagnostic Physiological Measurement
Dietetics
Ear, nose & throat Endocrinology and metabolic medicine
Genetics
Geriatric medicine GI & liver (medicine and surgery)
Gynaecology
Haematology Immunology Nephrology
Neurology Neurosurgery Ophthalmology
Oral and maxillofacial surgery
Orthopaedics Pain management
Podiatry Rehabilitation Respiratory medicine
Rheumatology Sleep Medicine Surgery – Breast
Surgery – Not otherwise specified
Surgery – Plastic Surgery – Vascular
Urology
Devon Referral Support Services:
Audiology Breast CAMHS
Cardiology Dermatology Diagnostics
NHS Kernow FOI Disclosure Log - October 2016
21
ENT Gastroenterology General medicine
Geriatric medicine Maxillo-facial Medicine
Neurology Neurophysiology Neurosurgery
Ophthalmology Orthopaedic Paediatric
Plastic surgery Respiratory Rheumatology 4. How much did the CCG spend on referral management centres for GP
referrals in the past three financial years (2013-14, 2014-15, 2015-16)? Please break down by month
A. NHS Kernow does not hold the information in the format you have requested. We
can however provide a breakdown by year and provide the details below: Referral Management Service:
2013-14: £811k
2014-15: £920k
2015-16: £960k
DRSS has had an annual contract in place from 2013/14 with NHS Kernow for £273k.
5. Does the CCG track or estimate savings made from using a referral
management scheme? If yes, please give actual (or estimated) savings for past three financial years (2013-14, 2014-15, 2015-16)
A. NHS Kernow does not hold the information you have requested for 2013/14. Information on the savings made for 2014/15 and 2015/16 are below: Referral Management Service:
2014-2015: £2.9 million
2015-2016: £2.9 million
These savings are calculated using the cost of appointment/treatment for referrals which were returned to the GP due to:
Incomplete workup
Duplicate referral
Procedure of limited clinical benefit
DRSS:
2014-2015 = £856k
2015-2016 = £1.3 million 6. How many GP referrals did the CCG process over the past three financial
years (2013-14, 2014-15, 2015-16)? Please break down by month
A. Referral Management Service:
2013-2014 2014-2015 2015-2016
April 7,841 9,325 9,891
NHS Kernow FOI Disclosure Log - October 2016
22
May 8,192 9,733 9,524
June 7,432 9,773 10,051
July 8,728 9,778 10,646
August 7,410 6,954 9,012
September 8,073 8,125 10,361
October 8,843 8,645 10,789
November 9,292 7,439 10,310
December 8,091 7,117 9,306
January 9,729 8,869 9,918
February 8,999 9,377 10,470
March 9,686 10,791 10,593
DRSS: NHS Kernow does not hold the information you have requested for 2013/14
2014-2015 2015-2016
April 2,387 2,629
May 2,488 2,416
June 2,586 2,439
July 2,822 2,914
August 2,330 2,299
September 2,602 2,724
October 2,851 2,842
November 2,315 2,528
December 2,476 2,507
January 2,333 2,426
February 2,399 2,598
March 2,893 2,801
7. Over the past three financial years (2013-14, 2014-15, 2015-16) how many
referrals from GPs were rejected? (approx. if necessary) Please break down by month
A. Referral Management Service:
2013-2014 2014-2015 2015-2016
April 440 591 748
May 581 726 695
June 555 719 724
July 648 667 752
August 563 470 627
September 681 515 790
October 760 605 697
November 752 565 687
December 560 502 643
January 706 543 713
February 603 610 716
March 654 748 805
NHS Kernow FOI Disclosure Log - October 2016
23
DRSS: NHS Kernow does not hold the information you have requested for 2013/14
2014-2015 2015-2016
April 87 131
May 86 116
June 76 146
July 91 164
August 63 104
September 97 133
October 90 155
November 72 149
December 80 167
January 77 139
February 26 160
March 141 149
8. For this time period, please state how many referrals were returned for the
following reasons: a) Information missing in the referral b) Not meeting criteria for commissioning policies and clinical referral
guidelines c) A specialist has reviewed the referral and advised the GP on how to
treat the patient or has requested other investigations should be carried out ahead of a referral
d) Any other reason e) Please state any other reasons for rejecting a referral and say how many
rejections there were of each type A. Referral Management Service:
2013-2014 2014-2015 2015-2016
Not appropriate – Further Tests Required 414 70 0
Not appropriate – Incomplete Workup 0 2360 3333
Not appropriate – Insufficient Information 2588 202 0
Not appropriate – Missing Attachments 0 1797 2172
Not appropriate – No BMI/BP 952 794 1086
Not appropriate – Returned with Advice 1141 81 0
Rejected – Duplicate Referral 241 321 376
Rejected – Further Treatment in Primary Care 429 54 0
Rejected – Not Ready, Willing and Able 218 45 11
Rejected – Patient to be admitted 30 38 41
Rejected – Private Referral 10 20 33
Rejected – Procedure of Limited Clinical Benefit 750 827 798
Rejected – Request to Expedite 7 18 16
NHS Kernow FOI Disclosure Log - October 2016
24
2013-2014 2014-2015 2015-2016
Rejected – Upgraded to 2WW 723 634 683
DRSS: NHS Kernow does not hold the information you have requested for 2013/14
2014-2015 2015-2016
Returned with clinical advice 257 632
Returned as covered by clinical referral guidelines\commissioning policy
162 303
Returned as information incomplete 567 778
9. For the past three financial years (2013-14, 2014-15, 2015-16) how many
complaints has the CCG received about its referral process? A. NHS Kernow has received the following number of complaints regarding its
referral process:
2013/14: Less than five.
2014/15: Less than five.
2015/16: Less than five.
NHS Kernow FOI 55960
f) For other neurological conditions, please state which conditions are
included in your response.
HIV and AIDS Dementia - Picks Disease
Infectious Diseases – Other Dementia - Vascular
Cancer, Head and Neck Depression
Cancer, Upper GI Dermotomyositis
Cancer, Lower GI Diabetes
Cancer, Lung Diabetes - Type I
Cancer, Skin Diabetes - Type II
Cancer, Breast Displacement Of Hip Replacement
Cancer, Gynaecological Down's Syndrome
Cancer, Urological Dysphagia
Cancer, Haematological Dysphasia
Cancers and Tumours – Other Ehles-Danlos Syndrome
Disorders of Blood Emphysema
Diabetes Encephalitis
Endocrine Epilepsy
Endocrine, Nutritional and Metabolic problems – Other
Ewings Sarcoma
Substance Misuse Extra Skeletal Calcification
Dementia Falls
Vascular Dementia Familiar Spastic Peraparesis
Alzheimer’s Dementia Fracture - C2
Korsakoff’s Fracture - Femur
Psychotic Disorders Fracture - Humerus
Child and Adolescent Mental Health Disorders
Fracture - NoF
Mental Health Disorders – Other Fracture - pubic rami
Problems of Learning Disability Fracture - Rib(s)
Chronic Pain Fracture - Tibia
Parkinson’s Fracture - Tibia & Fibula
Multiple Sclerosis (MS) Frailty
Motor Neurone Disease (MND) Friedreichs Ataxia
Progressive Supranuclear Palsy (PSP) Frontal Lobe Dysfunction
Multiple System Atrophy (MSA) Gangrene
Acquired Brain Injury (ABI) Gangrene - Rt Foot
Encephalitis Genetic Disorder
Huntington’s Disease (HD) Glaucoma
Meningitis Gout
Subarachnoid Haemorrhage (SAH) Guillan Barre Syndrome
Guillain-Barré Syndrome (GBS) Haematemesis
Cerebral Palsy Haemorrhagic Gastritis
Epilepsy Hearing Loss
Other Neurological Conditions Hearing Loss - Profound
Problems of Vision Hemiparesis – Lt
Problems of Hearing Hemiparesis – Rt
NHS Kernow FOI 55960
Coronary Heart Disease Hiatus Hernia
Cerebrovascular disease Huntingtons
Problems of Rhythm Hydrocephalus
Problems of circulation – Other Hypertension
Obstructive Airways Disease Hypotension
Asthma Hypothyroidism
Problems of the respiratory system – Other
Ileostomy
Dental problems Immobility
Upper GI Incontinence
Lower GI Incontinence - Double
Hepatobiliary Incontinence - Faecal
Problems of the gastro intestinal system – Other
Incontinence - Urinary
Burns Intracerebral Haemorrhage
Problems of the Skin – Other Intraventricular Haemorrhage
Problems of the Musculo-skeletal system Ischaemic Bowel
Problems due to Trauma and Injuries Ischaemic Leg(s)
Genital tract problems Kidney Disease
Renal problems Korsakov's Psychosis
STD Learning Disability
Problems of Genito-urinary system – Other
Leg Ulcers
Maternity and Reproductive Health Leukaemia
Conditions of neonates Leukaemia - Acute Myeloid
Unintended consequences of treatment Leukaemia - Chronic Lymphocytic
Poisoning Linderbaun Syndrome
Violence Liver Cirrhosis
Poisoning and adverse effects – Other Liver Disease
NSF Prevention programme Liver Failure
NSF Mental health prevention Liver Sclerosis
Healthy Individuals – Other Lymphoedema - Legs
Social Care Needs Lymphoma
Other Macular Degeneration
Other - Multiple Conditions ME/Chronic Fatigue Sundrome
Alcohol Related Cognitive Impairment MELAS
Alcohol Related Disease - Other Memory Loss
Amnesia Memory Loss - Long Term
Amputee Bilateral Memory Loss - Short Term
Amputee Bilateral - Above Knee Menieres Disease
Amputee Bilateral - Below Knee Mesothelioma
Amputee Bilateral - Hind Quarter Motor Neurone Disease
Amputee Lt Leg Mrsa
Amputee Lt Leg - Above Knee Multi Organ Failure
Amputee Lt Leg - Below Knee Multi System Atrophy
Amputee Lt Leg - Hind Quarter Multipathology
Amputee Rt Leg Multiple Sclerosis
Amputee Rt Leg - Above Knee Multiple Sclerosis - Cerebral
NHS Kernow FOI 55960
Amputee Rt Leg - Below Knee Multiple Sclerosis - End Stage
Amputee Rt Leg - Hind Quarter Multiple System Atrophy
Anaemia Munchausens Disease
Anaemia - Pernicious Muscle Wasting Disease - Unknown Origin
Aneurysm Muscular Dystrophy
Angina Mute
Anorexia Myelodysplasia
Anxiety Myoedema
Aortic Aneurysm Nephrectomy - Left
Arachnoiditis Nephrectomy - Right
Arthritis Neurocardiogenic Syncope
Arthritis - Osteo Neurofibromatosis
Arthritis - Rheumatoid Non Hodgkins Lymphoma
Arthroplasty - Left Hip Obesity
Asthma Obsessive Compulsive Disorder
Astrocytoma Obstruction
Astrocytoma - Benign Oedema
Autism Oedema Legs
Bi Polar Disorder Oesophageal Pouch
Bilat Foot Drop Oesophageal Stricture
Blind Ogilvies
Brain Aneurysm Open Hip Wound - Non Healing
Brain Injury Osteoporosis
Brain Tumour Benign Pagets Disease
Bronchiectasis Pain - Acute Back
CA Abdomen Pain - Chronic Back
CA Adenocarcinoma Pain - Knee
CA Advanced Disseminated Malignancy Pancreatitis
CA Basal Cell Paranoia
CA Bladder Paraphrenia
CA Bone Paraplegia
CA Bowel Parkinsons Disease
CA Brain Tumour Parkinsons Disease - End Stage
CA Breast Pelvic Mass
CA Bronchus pemphagoid
CA CAchexia Perforated Colon
CA Cervix Peripheral Neuropathy
CA Colon Peripheral Vascular Disease
CA Face Peronis Disease
CA Gall Bladder Personality Disorder
CA Glioma Personality Disorder - Eccentric
CA Glioma - Right Occipital - Removed Pfeiffer Syndrome
CA Groin Plasmacytoma
CA Head Pleural Effusion
CA Kidney Polymyalgia
CA Larynx Polymyalgia Rheumatica
CA Liver Polyneuropathy
NHS Kernow FOI 55960
CA Lung Postural Osthostatic Tachycardia Syndrome
CA Lymph Gland Pressure Ulcer(s)
CA Mandible Prolapse Of Rectum
CA Melanoma Prostate Hypertrophy - Benign
CA Melanoma Vagina Pseudo Obstruction
CA Metastases Psoriasis
CA Metastases Adrenal Psychosis
CA Metastases Bone Pulba Palsy
CA Metastases Bowel Pulmonary Embolism
CA Metastases Cerebral Pulmonary Fibrosis
CA Metastases Liver Quadraplegia
CA Metastases Lung Rectal Bleeding
CA Metastases Spine Renal Failure
CA Metastatic Adenocarcinoma Renal Failure - End Stage
CA Mouth Respiratory - Copd
CA Myleoma Respiratory - Copd - End Stage
CA Neck Respiratory - Dyspnoea ?Cause
CA Non Hodgkins Lymphoma Respiratory - Infection
CA Oesophagus Respiratory - Lung Fibrosis
CA Ovary Respiratory - Pneumonia
CA Pancreas Rio Cerebral Meningioma
CA Pituitary Scheuermann'S Disease
CA Prostate Schizo Affective Disorder
CA Rectum Schizophrenia
CA Renal Scoliosis
CA Site Unknown Seminoma
CA Skin Septicaemia
CA Spine Sigmoid Volvulus - Recurrent
CA Stomach Soft Tissue Injury
CA Testicle(s) Spastic Paraplegia
CA Throat Spastic Quadraparesis
CA Thyroid Spina Bifida
CA Tonsil Spinal Cord Decompression
CA Trachea Spinal Injury
CA Uterus Spondylosis
Cardiac - Angina Spondylosis - Cervical
Cardiac - Atrial Fibrilation Spondylosis -Thoracic
Cardiac - CHD Stroke
Cardiac - Coronary Artery Bypass Stroke - Brain Stem
Cardiac - Myocardial Infarction Stroke - Left Sided Hemiplegia
Cardiac - Subacute Endocarditis Stroke - Right Sided Hemiplegia
Cardiac Failure Subarachnoid Haemorrhage
Cardiac Failure - CCF Subdural Haematoma
Cardiac Failure - End Stage Supranuclear Palsy
Cardiac Failure - LVF Tau Syndrome
Cellulitis TB Meningitis
Cerebral Atrophy Tetraplegia
NHS Kernow FOI 55960
Cerebral Palsy Thoracic Vertebral Collapse
Cerebral Palsy - Progressive Thromocytopenia
Cerebrotendinous Xanthomatosis Thyroid Disease
Cervical Myelopathy TIA(s)
Cervical Scoliosis Tracheotomy
Cervical Spondylitis Ulcerative Colitis
Cervical Spondylosis Upper Gastrointestinal Haemorrhage
Challenging Behaviour Urinary Tract Infection(s)
Challenging Behaviour - Sexual Vertebral Collapse
Charles Bonnet Syndrome Vertebral Collapse - Thoracic
Cholitis Visual Impairment
Chronic Lymphoid Leukemia Weight Loss
Chronic Pain - Back Wilson's Disease
Coeliac Disease Ischaemic heart disease
Cognitive Decline chronic kidney injury
Cognitive Impairment Metastatic ca
Cognitive Impairment - Severe Pelvic osteosarcoma with rt hind quarter amputation
Congenital Dislocation Of Both Hips Short term memory
Craniotomy paranoid, inappropriate behaviour (sexual)
Crest Syndrome Spinal Muscular Atro[hy
Creutzfeldt-Jakob disease (CJD) Confusion
Crohns Disease Brain Tumour
Debility Fractured left hip
Degenerative Neuropathy Heart failure
Delusional Lumbar spondylosis
Dementia behaviors which challenge
Dementia - Advanced Lewy Body Dementia
Dementia - Alzheimers UTI Confusion
Dementia - Binswanger Pneumonia
Dementia - Early Onset Postural Hypotension
Dementia - End Stage Dychenne Muscular Dsytrophy
Dementia - Lewy Body
6. Please provide the list of providers that received this funding. A. Supplier list:
16 Pendean Court Manor House Residential Home
A & D Community Care Marie Curie Cancer Care
A Caring Touch Meadbank Care Home
A2B Taxis (Truro) Ltd Meadowside & St Francis Care Centre
Able Care Agency Memory Matters Southwest CIC
Accora Mencap Support Service
Acorn Court Care Home Menwinnion Country House
Acorn Park Lodge Merafield View Nursing Home
Active Assistance (Suffolk) Merlin Ms Centre
NHS Kernow FOI 55960
Active Assistance Brain Injury Service Mid Cornwall Lifestyles
Adlington Manor Care Home Mihomecare
Advantage Healthcare Group Ltd Millaton Court Care Centre
Age Concern (Boscawen House) Millpond View Care Home
Age UK Falmouth Day Centre Mind Full Mark James
Age UK Newquay Day Centre Modus Care Limited
Albert House Nursing Home Moorecare Home Care Services
Alexander Chapel Healthcare Ltd Moorgate Residential Home
Alexandra House Nursing Home Moorvue Rural Centre
Alexandra's Community Care Morovahview Residential Home
Allied Healthcare Group Morwenna Nursing Home
Allington Court Morwenner Care Agency
Alveston Leys Nursing Home Motor Neurone Disease Association
Amberley House - Plymouth Mount Edgcumbe Hospice
Amberley House Care Home Mount Pleasant House (Camborne)
Amberwood Nursing Home Mount Pleasant Residential Home (St Agnes)
Amcare Mountford House
Angela Court Nursing Home Mrs Susan Coram (Private Carer)
Anley Hall Nursing Home Mss Care
Annette's Care Murdoch And Trevithick Centre
Ansom Home Care Ltd My Choice
Antron Manor Care Home Nazareth House Nursing Home
Appleby Lodge Network Healthcare Professionals Limited
Appledown Care Home Limited Neurological Physiotherapy Practice
Ar-Lyn Newcross Healthcare Solutions Ltd Domiciliary Care Agency
Asheborough House Care Centre Newquay Nursing & Residential Home
Athelstan Domiciliary Care Norma Elston
Athelstan Home North Hill Home Care
Atlantis Care Home North Hill House Nursing Home
Atlantis Domiciliary Care Nurse Plus And Carer Plus (Uk) Limited
Averlea Domiciliary Care Agency Nursefinders
Averlea Residential Home Oak Lodge Nursing Home
Backdated Payment - North Oakwood (Cheshire) Home
Backdated Payment - West Oasis Community Care Ltd
Beaconville Nursing Home Ocean Hill Lodge
Beaumont Court Old Roselyon Manor (Domiciliary Care)
Beech Lawn Nursing & Residential Home Old Roselyon Manor Nursing Home
Beechwood College Old Vicarage Care Home
Belmont House Origin
Benoni Nursing Home Paladin Life
Bickleigh Down Care Home Park House
Black Cab Company / Crownhill Taxi Services
Park House Healthcare
Blackdown Nursing Home Park House Nursing Care Centre
Blackwood House Parker Meadows
NHS Kernow FOI 55960
Blantyre Day Centre Parkwood Nursing Home
Bluebird Care (Bath) Parnells Taxis
Bluebird Care (Cornwall North) Pathfinders-Care (Ollerton) Limited
Bluebird Care (Mid Cornwall) - Starboard Tack Llp
Payroll Direct
Bna PCT - Anita Cornelius, Modern Matron, Bodmin Hospital
Bodmeyrick Residential Home Penberthy Residential Home
Boisdale House Penbownder House
Bonaer Nursing Home Pendarves Residential Care Home
Bornel Care Ltd Pendeen Community Care Ltd
Bourne Bridge House Pendine Park Nursing Home
Bowden Derra Park Pendrea Homecare
Brace Orthopaedic Pendruccombe Dom Care
Brandon Trust Pendruccombe House Nursing Home
Breage House Pengarth Day Centre
Bristol County Council Pengover House Residential Home
Broadgate House Nursing Home Penhellis Community Care Ltd
Brocastle Manor Care Home Penhellis Nursing Home
Brook House Care Centre Peninsula Care
Burdon Grange Peninsula Community Health
Burford House Nursing Home Penlee Residential Care Home
Calton House Ltd Penmeneth House
Calvert Trust (Exmoor) Penmount Grange Residential Care Home
Camille's Nest Nursing Home Penrice House Residential Home
Cann House Care Home Pentowan Home Care
Caprera Pentreath Ltd
Carers Break Penwith Care
Carers Break Service (Bodmin) Penwith Respite Care Ltd
Carers Break Service (Camborne) Perran Bay Home For The Elderly
Carewatch (Tamar) Philiphaugh Residential Home
Caritate Nursing Home Phoenix Care Cornwall Ltd
Carol Spinks Homecare Phoenix Health Care Services Ltd
Carrick Lodge Pine Trees Residential Care Home
Castle Hill House Domiciliary Care Ltd Plymouth Taxis Ltd
Castle Hill House Nursing Home Pol Community Care
Castle View Nursing Home & Residential Home
Poldhu Care Home
Cathedral View Nursing Home Polventon House
Cathedral View Residential Home Ponsandane Care Home
Caton House Nursing Home Porte Rouge Residential Home
Cedar Grange Porthgwara Nursing Home
Celtic Care Premier Care
Chelfam Senior School Premier Healthcare Solutions
Cherry Trees Nursing Home Pressure Care Management
Choice Prestige Nursing Ltd
Choice Care Services Prism Medical UK
NHS Kernow FOI 55960
Chollacott House Nursing Home Proper Care (Cornwall) Ltd
Chy Byghan Prospects
Chy Keres Pulse
Chy Koes Respite Unit Purple Balm
Chypons Queens Court Nursing Home
Chyvarhas Qumran Care Home
Clann House Red Gables
Clevedon Court Nursing Home Redannick House
Clinton House Reflections
Clovelly House Regal Care
Coastline Care Ltd Restgarth & Network Health & Social Care
Collamere Care Home Restgarth Domiciliary Care Ltd
Comfort Care Restgarth Residential Home
Compass Disability Services Retirement Villages Care Ltd
Complete Cleaning Services Right At Home Guildford & Farnham
Consultus Care & Nursing Agency Limited
Right Nurse Care Services
Cookham Riverside Nursing Home Riverview Care Home
Coombe House Riviera Ambulance Service
Copper Beeches Lodge Roborough House
Coppice Lea (Caring Homes Group) Roscarrack House
Cornwall Care Ltd Rosedale Nursing Home
Cornwall Care Respite Services Bungalow
Rosehill House Residential Home Ltd
Cornwall Council (Adult Social Care) Roseland Nursing Home
Cornwall Mobility Centre Rosewarne
Cornwall Partnership Foundation Trust Roslyn House
Cornwallis Nursing Home Rowan House Domiciliary Care Agency
Courtlands Residential Home Rowan House Residential Home
Cowbridge Nursing Home Rowans Domiciliary Care Agency
Crantock Lodge Rowans Lodge
Creative Workshop Royal National College For The Blind
Crick Care Home Scope Inc Domiciliary Care Agency
Crossroads House Care Home Scott Tomkinson
Dame Hannah Rogers School Seating Matters Ltd
Darren Williams Share Lives South West
Deer Park Nursing Home Sheldon House Nursing Home
Derriford Hospital Sidmouth Nursing Home
Derwen Residential College Somerleigh Court Nursing Home
Direct Payment - PHB South Western Homecare
Disability Cornwall Spectrum
Douglas House Springfield House Residential Home
Drym Valley Centre St Anthony's Care Home
Duchy Care Domiciliary Care Agency St Breock Residential Home
Dwaine Lattibeaudiere St Clair House Care Home
E2l Ltd St Erme House
Echo Day Centre St Hilary
NHS Kernow FOI 55960
Eirenikon Domiciliary Care St Johns Nursing Home
Eirenikon Residential Home St Margaret's Community Care Ltd
Eldon House Residential Home St Margaret's Nursing Home
Elmsleigh Care Home St Martin's House
Embrace (Formerly European Lifestyles) St Mary's Haven Respite Unit
Embrace Cornwall & Devon St Petrocs Care Home
Enham St Teresa's Cheshire Home
Enviva Care Limited St Theresa's Care Centre
Eshcol House Nursing Home Stayathome Ltd
Eventide (Bude) Stephen Richard Martin
Eventide (Liskeard) Steps Ahead Care & Support Limited
Fairfield Country Rest Home Sunningdale House
Fairholme Nursing Home Sunshine Care Ltd
Falcare Surecare Services (Wessex)
Fernleigh House Domiciliary Care Surrey County Council
Fernleigh House Residential Home Sutton Valance Nursing Home
First City Nursing Sutton Veny House Nursing Home
Fore Dore Nursing Home Swallowcourt Ltd
Forget Me Not Homecare Services Symmetrikit
Four Seasons Community Care Tamar Care Services
Four Seasons Nursing Home Tamar House Nursing Home
Foxleigh Grove Nursing Home Tamara Residential Home
Freshfields Tamarisk Care Agency
Furzehatt Court Nursing Home Tarrant House
Garsewednack Rh Ceased 20/4/2016 Tavy Care Services
Garsewednack Rh Trading WEF 21/4/2016
Taylors Of Grampound Ltd
Gifford House Care Home Telmenow.Com
Gladys Holman House Tender Loving Care
Glencoe Nursing Home The Beeches
Glenside Manor Healthcare Services Limited
The Brake Manor
Godolphin House The Complete Group
Gorfenna Day Centre The DOVE. Project
Grafton Manor The Donnington Residential And Nursing Home
Green Light PBS Ltd The Downes
Greenslades Nursing Home The Elms Care Centre
Guinness Care & Support The Green
Halwill Manor The Grove Residential Home
Harbour The Hollies
Harbour Home Care (T/A Anson Care Services)
The John Daniel Centre
Harbour House The Lawns Nursing Home
Harriet Nanscawen Nursing Home The Manse
Hartcare Nursing Home The Mellowes Nursing Home
Hartley Home Care The Merlin Centre
Hartley Park Nursing Home The Old Manor House
NHS Kernow FOI 55960
Hatchmoor Nursing Home The Old Rectory
Havencare (South West) Limited Supported Living
The Old Vicarage Care Home
Headlands The Pine Trees Nursing Home
Heart Of The South Care Agency The Regard Partnership
Help At Home Care Service The Reigate Beaumont
Helping Hands (Midshires Care Ltd) The Rowans
Herons Park Nursing Home The White House (Bodmin)
Highermead Care Home The White House (Falmouth)
Highpoint Lodge The Wingfield Care Home
Highwell House Nursing Home Thornbury Nursing Services
Hillcrest Care Ltd Thyme Care Limited
Hillcrest House Nursing Home Tolverth House
Hillsborough Domiciliary Care Torcare Ltd Domiciliary Care Agency
Hillsborough Residential Home Torpoint Nursing Centre
Hinwick Hall College Torr Home
Holifield Farm Project Total Community Care Ltd
Hollybush Travel 4000
Holywell Bay Nursing Home Trecarrel Residential Home
Home Farm Trust Trefula House Nursing Home
Home Instead Tregenna House Nursing Home
Hooklands Nursing Home Tregertha Court Residential Home
In Caring Hands Tregolls Manor
Independence House Tre-Heights
Independent Living Fund Trelana Nursing Home
Interserve Healthcare Trelawney Domiciliary Care Ltd
Ismeer Tremanse Nursing Home
Ivydeane Nursing Home Tremethick House
J & P Supplies Tremorvah Industries
Jacob Centre - Ramsay Neurological Services
Trengrouse House
Jobline Staffing Treseder House
Karrek Community CIC Tresillian
K-Care Nursing Agency Trevarna
Kehelland Trust Trevaylor Manor Care Home
Keith's Taxi Trevern
Kenwyn Trewartha House Nursing Home
Kernou Residential Home Trewcare Domiciliary Care Ltd
Kernow Home Care Ltd Trewiston Lodge Domiciliary Care
Kernow House Trewiston Lodge Nursing Home
Kerrier Homecare Truro And Penwith College
Kilmar House Ty Mair Care Home
Kimberley Court United Care Concepts Ltd
King Charles Court Nursing Home United Response
Kingston House Upminster Nursing Home
Kingswood Court Care Home Victoria Domiciliary Care Agency
Langholme Volunteer Cornwall
Lanhydrock Care Waters Park House
NHS Kernow FOI 55960
Larne Care Centre Wellcross Grange Care Home
Lavender Lodge Care Home Wentworth Residential Home
Lifestar Medical Ltd West Cornwall Care Ltd
Lifestyles Choices Care Westcountry Case Management Limited
Liskeard Care Limited Westcountry Home Care Ltd
Little Lotus Westlake Care
Little Trefewha White River Homecare
Live Life Care Ltd Windmill Court
Ll Pearce Wood View Short Breaks
Llanyravon Court Care Home Woodland House
Loan Store Woodmill Nursing Home
Longview Care Home Woodside Farmhouse
Lowena Wray Common Nursing & Residential Home
Lowenva Care Home Young Epilepsy
Lufton College Of Further Education Young Foundations Ltd (Mental Health Care Group (UK) Ltd)
Magdalen House Nursing Home Zion House
Malvern House Nursing Home Manor House Residential Home