NHS Kernow - Disclosure log Freedom of Information requests April 2017
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NHS Kernow - Disclosure log Freedom of Information requests April 2017
FOI disclosure log April 2017
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Contents Children’s health ........................................................................................................ 3
FOI59470 - Children’s dental services .................................................................... 3
Clinical management .................................................................................................. 4
FOI59540 - Delayed transfers ................................................................................ 4
FOI59690 - Diagnostics .......................................................................................... 4
Continuing healthcare ................................................................................................ 7
FOI59350 - Personal health budgets ...................................................................... 7
FOI59580 - Activity and spend ............................................................................... 9
Contracts .................................................................................................................. 11
FOI59460 - GP spend ........................................................................................... 11
FOI59570 - Community health services ................................................................ 11
FOI59750 - Patient transport ................................................................................ 13
Individual funding requests ....................................................................................... 14
FOI59400 - Hip and knee replacements ............................................................... 14
FOI59450 - Individual Funding Requests ............................................................. 15
Information Governance ........................................................................................... 16
FOI59820 - Enhanced data sharing ...................................................................... 16
Mental health & learning disabilities ......................................................................... 18
FOI59420 - CAMHS Tier 4 patients ...................................................................... 18
FOI59660 - Eating disorder services .................................................................... 19
FOI59740 - Mental health spend .......................................................................... 21
Organisation ............................................................................................................. 22
FOI59670 - Nursing shortages ............................................................................. 22
FOI59830 - Governing Body members ................................................................. 23
Prescribing & pharmacies ........................................................................................ 23
FOI59410 - Wound care products......................................................................... 23
FOI59510 - Homeopathy services ........................................................................ 27
Referral management ............................................................................................... 27
FOI59530 - Referrals for chiropractic / alternative medicines ............................... 27
Appendix: FOI59400 - Hip and knee replacements .................................................. 29
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.
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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.
Children’s health
FOI59470 - Children’s dental services Date received: 06/04/2017 1. As of March 31, 2017, can you tell me how many children were on the
waiting list to visit the CCG children's dental hospital? 2. If the CCG does not have a dedicated dental hospital, how long is the wait
as of March 31st, 2017, for children's dental services? 3. How long is the present waiting list, in terms of months/weeks to be seen? 4. How long is the wait for teeth extractions? 5. How many children are affected by the wait for teeth extractions? 6. Is there a wait for youngsters to be added to the waiting list? if, so how
many children are waiting to be placed on to the waiting list? 7. How many dental nurses does the CCG employ for children's dental
services? 8. How many vacancies does it have at present? 9. How many children were on the waiting list to visit the CCG's children's
dental hospital on: a) March 31st, 2016? b) March 31st 2015? c) March 31st 2014? d) March 31st 2013?
10. If the CCG does not have a dental hospital, how many children were on the waiting list to visit the CCG's children's dental services on: a) March 31st, 2016? b) March 31st 2015? c) March 31st 2014? d) March 31st 2013?
11. How many children received treatment at the children's dental services between January 1, 2016 and December 31, 2016?
A. NHS Kernow does not hold the information you have requested. Please redirect
your request to NHS England ([email protected]), who commissions dental services in Cornwall and the Isles of Scilly.
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Clinical management
FOI59540 - Delayed transfers Date received: 07/04/2017 1. What is the longest amount of time in days a patient had been kept in
hospital due to delayed transfer in the past 12 months? 2. Could you give me details for the three longest delayed transfer stays, the
name of the hospital concerned and if possible the age and sex of the patients concerned and the department they were in (ie elderly care/general surgery, paediatrics etc)?
3. Are you also able to give a brief reason for the delay in each instance (ie lack of beds in care facility/delay equipping home etc)?
A. NHS Kernow does not hold the information you have requested. Please redirect
your request to providers to request this information:
Cornwall Partnership NHS Foundation Trust: [email protected]
Plymouth Hospitals NHS Trust: [email protected]
Royal Cornwall Hospitals NHS Trust: [email protected]
FOI59690 - Diagnostics Date received: 11/04/2017 1. Please confirm how many of the following diagnostic tests have been
carried out in your area in each financial year since April 2013: 2. Please confirm what the average waiting time in your CGG was for the
following tests in each financial year since April 2013:
a) x-ray
A. NHS Kernow does not hold the information you have requested. Please redirect your request to providers to obtain this information:
Cornwall Partnership NHS Foundation Trust: [email protected]
Plymouth Hospitals NHS Trust: [email protected] We can however report that Royal Cornwall Hospitals NHS Trust has reported the following diagnostic test information. To obtain more detailed information, tests carried out in 2013/14 and information on waiting times, please contact Royal Cornwall Hospitals NHS Trust direct: [email protected]
2014/2015 2015/2016 01/04/16 to 31/12/16
Diagnostic test 60,064 60,797 47,010
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b) Ultrasound
2013/2014 2014/2015 2015/2016 2016/2017
Diagnostic test 30,636 25,427 23,067 30,584
Average waiting time 2 weeks 2 weeks 2 weeks 2 weeks
c) CT scan
2013/2014 2014/2015 2015/2016 2016/2017
Diagnostic test 14,685 16,345 14,950 19,101
Average waiting time 2 weeks 2 weeks 2 weeks 2 weeks
d) MRI scan
2013/2014 2014/2015 2015/2016 2016/2017
Diagnostic test 24,086 22,911 26,273 33,964
Average waiting time 2 weeks 2 weeks 2 weeks 2 weeks
e) Gastroscopy
2013/2014 2014/2015 2015/2016 2016/2017
Diagnostic test 2,969 3,125 4,000 3,779
Average waiting time 2 weeks 2 weeks 2 weeks 2 weeks
f) Colonoscopy
2013/2014 2014/2015 2015/2016 2016/2017
Diagnostic test 3,716 4,421 5,110 5,125
Average waiting time 2 weeks 2 weeks 2 weeks 2 weeks
g) flexible sigmoidoscopy
2013/2014 2014/2015 2015/2016 2016/2017
Diagnostic test 1,186 1,530 1,776 1,617
Average waiting time 2 weeks 2 weeks 2 weeks 2 weeks
h) histopathology
A. NHS Kernow does not hold the information you have requested. Histopathology
is covered within a block of pathology tests and this information is not reported to NHS Kernow. Please redirect your request to providers direct to request this information:
Cornwall Partnership Foundation Trust - [email protected]
Royal Hospitals NHS Trust - [email protected]
Plymouth Hospitals Trust - [email protected]
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Funding 3. Please confirm your CCG's budget allocation to fund imaging, pathology
and endoscopy activity in each financial year since April 2013, and what it
is forecast to be in 2017/18.
A. Budgets are allocated at contract level rather than diagnostic level, and therefore
we do not have specific diagnostic budgets. 4. Please confirm whether your CCG received additional funding from the
National Diagnostics Capacity Fund to increase capacity and productivity
of diagnostic services. If so, how much. A. NHS Kernow has not received additional funding from the National Diagnostics
Capacity Fund to increase capacity and productivity of diagnostic services. Plans to invest and monitoring 5. Please confirm how your CCG assesses anticipated changes in demand for
(a) x-ray; (b) ultrasound; (c) CT scan; (d) MRI scan; (e) gastroscopy; (f) colonoscopy; (g) flexible sigmoidoscopy; and (h) histopathology, and what
assessment it has made of projected changes in demand. A. NSH Kernow anticipates changes in demand by looking at demographic growth
both nationally and locally, ensuring that these are inclusive of local cancer pathway modeling data.
6. Please confirm whether your CCG has plans to improve and expand
diagnostic capacity in 2017/18 and, if so, what those plans are.
A. Diagnostic capacity is planned each year in line with demographic growth. 7. Please confirm how your CCG monitors capacity and performance for (a) x-
ray; (b) ultrasound; (c) CT scan; (d) MRI scan; (e) gastroscopy; (f) colonoscopy; (g) flexible sigmoidoscopy; and (h) histopathology.
A. NHS Kernow monitors diagnostic performance on a monthly basis through
contractual meetings. 8. If diagnostic capacity has not been subject to increased investment, which
of the 9 ‘must dos’ from the 2016/17 NHS England planning guidance have been prioritised?
A. As per our response to question six, diagnostic activity is planned each year in
line with demographic growth.
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Referral management centres 9. Please confirm whether your CCG operates or commissions a referral
management centre that assesses referrals by local GPs. A. NHS Kernow has a Referral Management Service (RMS), which manages
referrals from 58 GP practices, excluding those in East Cornwall. NHS Kernow commissions Devon Referral Support Services to manage referrals for the 11 practices in East Cornwall. More information on the referral management service is available on our website: https://www.kernowccg.nhs.uk/get-info/referral-management-service/
We therefore exempt the release of this information under section 21 of the Freedom of Information Act, information accessible by other means.
10. If yes to question nine, please confirm whether the list of specialities that
fall under the referral management centre’s remit include suspected cancer cases.
A. Devon Referral Support Services: Yes
Referral Management Service: No
Continuing healthcare
FOI59350 - Personal health budgets Date received: 03/04/2017 1. What is the Kernow CCG current local offer of Personal Health Budgets
beyond Continuing Health Care? A. NHS Kernow is currently in the process of evaluating the local offer of personal
health budgets beyond continuing healthcare and currently offers personal health budgets outside of continuing healthcare in small pilot NHS England evaluations areas.
NHS Kernow’s policy on personal health budgets is available to view on our website: https://www.kernowccg.nhs.uk/your-health/personal-health-budgets/ via this link: http://policies.kernowccg.nhs.uk/DocumentsLibrary/KernowCCG/OurOrganisation/Policies/PersonalHealthBudgetsPolicy.pdf
2. Where is this advertised?
NHS Kernow publishes information regarding personal health budgets on its website and information leaflets that are available via the link below: https://www.kernowccg.nhs.uk/your-health/personal-health-budgets/
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3. What is the current local offer for Personal Health Budgets for those with long term mental health conditions?
A. NHS Kernow offers consideration for personal health budgets to all continuing
healthcare eligible clients who have long term mental health conditions. Please refer to our response to question one for information regarding personal health budgets outside of continuing healthcare.
4. How do those with long term mental health conditions currently apply for a Personal Health Budget?
A. NHS Kernow is currently in the process of developing the local offer of personal
health budgets for those with long term mental health conditions outside of continuing healthcare.
5. What was the Kernow CCG local offer of Personal Health Budgets beyond
Continuing Health Care as advertised on the PHBs CCG webpage on 8/2/2017?
6. Can you provide me with an exact copy of the information that was advertised on the above webpage on 8/2/2017? (It has since been changed)
A. NHS Kernow’s personal health budgets page remains unchanged and has not
been edited since 6 December 2016. A local offer was not advertised on the website.
7. How many patients with long term mental health conditions were provided
with a Personal Health Budget between April 2015 - March 2016? A. None outside of continuing healthcare. 8. Of the above patients, how did they apply for such a budget? 9. Again, of the above, how were these patients identified as requiring need of
or benefit of a Personal Health Budget (i.e. If not advertised then his did these patients become chosen to apply for one?)
A. N/A. NHS Kernow offers consideration for personal health budgets to all
continuing healthcare eligible clients who have long term mental health conditions. Please refer to our response to question one for information regarding personal health budgets outside of continuing healthcare.
10. How many patients with long term mental health conditions were provided with a Personal Health Budget between April 2016 and March 2017?
A. None outside of continuing healthcare. 11. Of the above patients how did they apply for a Personal Health Budget? 12. Again, of the above patients, how did these patients become identified as
requiring need of or benefit from a PHB?
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A. N/A. NHS Kernow offers consideration for personal health budgets to all continuing healthcare eligible clients who have long term mental health conditions. Please refer to our response to question one for information regarding personal health budgets outside of continuing healthcare.
13. Between April 2016 and March 2017 was it at any time advertised on the
personal health budgets webpage on Kernow CCG website that patients with long term mental health conditions were able to apply for a PHB?
A. No.
FOI59580 - Activity and spend Date received: 11/04/2017 1. The number of (a) adults and (b) children receiving Continuing Healthcare
(CHC)/Continuing Care in your area. A. As of 1 May 2017:
Adults: 806 (CHC only – exclusive of FNC and joint funding
Children: Less than five 2. The number of those from 1(a) and 1(b) who receive a Personal Health
Budget (PHB)? A. As of 1 May 2017:
Adults: 37
Children: None. 3. The number of those from 1(a) and 1(b) who receive:
(a) care in their home A. As of 1 May 2017:
Adults: 342
Children: Less than five.
(b) care in a residential or nursing home. A. As of 1 May 2017:
Adults: 464
Children: None.
4. The number of those from 2(a) and 2(b) who receive: (a) care in their home
A. As of 1 May 2017:
Adults: 37
Children: None.
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(b) care in a residential or nursing home.
A. As of 1 May 2017:
Adults: None.
Children: None.
5. The smallest and largest weekly budgets in £’s for 1(a), 1(b), 2(a) and 2(b).
Reference Smallest weekly budget (£)
Large weekly budget (£)
1a £9.50 £6.5k
1b £388.80 £1,360.80
2a £10.17 £6.5k
2b - -
6. The indicative hourly rate paid for Personal Assistants/carers (PAs) under a
PHB for (a) standard care and (b) complex care. A. NHS Kernow does not hold the information you have requested. The budget
holder determines the individual hourly rate as part of their role in managing the finance within a care plan.
7. The indicative hourly rate paid for Personal Assistants/carers (PAs) under
CHC/CC for (a) standard care and (b) complex care. A. NHS Kernow does not hold the information you have requested. This information
is not routinely reported to NHS Kernow. 8. The maximum amount used under a PHB to fund social activities per
annum? 9. The maximum amount used under a PHB to fund respite per annum? A. NHS Kernow does not hold the information you have requested. There is no
maximum amount set. 10. The maximum amount used under a CHC/CC to fund respite per annum? A. NHS Kernow does not hold the information you have requested. There is no
maximum amount set. However, the current maximum is £46,800. 11. Whether you permit ‘close family members’ who do not live with the
‘service user’ to be employed under: (a) CHC
A. NHS Kernow does not permit close family members who do not live with service users to be employed for continuing healthcare.
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(b) PHB? A. Yes, under exceptional circumstances using national personal health budget
guidelines.
Contracts
FOI59460 - GP spend Date received: 05/04/2017 1. Total planned spending by the CCG on general practice services for
2017/18, and a breakdown of how this figure is made up.
Locally commissioned services (GPwSIs, physio, etc) - estimated - paid on activity £1,575,062
Out of hours - estimated (contract renewal mid year) £7,896,057
Local Enhanced Services - estimated - paid on activity £5,101,398
GP Forward View (GP Resilience etc.) - as per national allocations £92,000
GP Access Fund (to cover 110k population) £660,000
PMS Premium (year two of five year transfer of funds) £210,000
Transformation Fund ‘developing at scale primary care’ £825,000
Total £16,359,517
2. Total spending by the CCG on general practice services in 2016/17, and
a breakdown of how this figure is made up.
Locally commissioned services (GPwSIs, physio, etc) £1,575,062
Out of hours £7,896,057.05
Local Enhanced Services £5,101,398
GP Forward View (GP Resilience, etc.) - as per national allocations £184,000
GP Access Fund (to cover 110k population) - as per national allocation of £6 p/p £660,000
PMS Premium £105,000
Winter resilience £222,000
Total £15,743,517
FOI59570 - Community health services Date received: 10/04/2017 1. Please provide a list of all the organisations that have held contracts (or
other formal agreement) for the delivery of community health services since the creation of the CCG, together with the start and end dates of each contract. Please note that GMS and PMS GP contracts are excluded from this request (I believe the CCGs do not commission these in any case).
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A. Adult Community Services are currently provided by Cornwall Partnership NHS Foundation Trust. NHS Kernow routinely publishes information on contracts, including start and end dates for contracts / eye care services, on our website: https://www.kernowccg.nhs.uk/about-us/what-we-spend-and-how-we-spend-it/ via this link: http://policies.kernowccg.nhs.uk/DocumentsLibrary/KernowCCG/OurFinances/StrategicReportsAndPlans/ContractList.pdf
We therefore exempt the release of this information under section 21 of the Freedom of Information Act, information accessible by other means. These services were previously provided by Peninsula Community Health from 1 April 2013 to 31 March 2016.
2. Please state what services were covered by each contract: A. Adult community services:
Acute Care at Home Acute GP
Cardiac Rehabilitation Community Hospitals
Community Matrons Community Stroke Rehabilitation
Community Stroke Team Community Care at Home
Dermatology Clinic District Nursing Team
Domiciliary Care - CHC Diabetes Specialist Nursing
Elective Orthopaedics Expert Patient Programme
Falls Specialist Practitioners Health for Homeless
Intermediate Care Learning Disability Liaison
Macmillan Specialist Nursing MIU (Minor Injury Units)
MSK Interface Clinics MSK Physiotherapy
Neurocare Advisory Service Nurse Practitioner
Podiatry Records Management
Rehabilitation Specialist Nursing – Parkinsons
Specialist Respiratory Nursing Specialist Wheelchair Service
Speech and Language Therapy Service
Standard Wheelchairs
Stroke Rehabilitation Tuberculosis Service
Telehealth TIA
Tissue Viability Service Urodynamics and Continence
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FOI59750 - Patient transport Date received: 24/04/2017 1. Please provide details on the suppliers who applied for inclusion on each
framework/contract and were successful and not successful at the PQQ & ITT stages for non-emergency patient transport services in Cornwall and the Isles of Scilly?
A. The successful provider was NSL Care Services, the contract was subsequently
novated to E-Zec medical services in May 2016 when NSL exited the non-emergency patient transport services market and E-Zec took over their contracts.
NHS Kernow does not hold the information you have requested regarding providers involved at PQQ and ITT stage. The procurement was conducted by the former primary care trust. Please contact the Department of Health’s legacy team to request this information: reviews&[email protected].
2. The contract values of each framework/contract (and any sub lots), year to
date? A. The expected annual contract value for 2017/18 is £3,257,980. 3. The start date and duration of framework? A. The contract commenced on 1 October 2013 for a duration of five years. 4. Is there an extension clause in the framework(s)/contract(s) and, if so, the
duration of the extension? A. Yes, there are either 12 or 24 month extensions available. 5. Has a decision been made yet on whether the framework(s)/contract(s) are
being either extended or renewed? A. No. 6. If applicable, are the above services conducted in-house? A. N/A. 7. Who is the senior person in the Local Authority (outside of procurement)
responsible for the above services? A. The senior person responsible for non-emergency patient transport services is
Helen Childs, Chief Operating Officer.
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Individual funding requests
FOI59400 - Hip and knee replacements Date received: 03/04/2017 Questions 1-3 cover both full and partial replacements within each category. 1. The number of electives funded each year in 2013/14, 2014/15, 2015/16 and
2016/17 for: a) hip replacement b) knee replacement surgeries
Surgery type 2013/14 2014/15 2015/16 01/04/16 to 28/02/17
Hip replacement 1,435 1,380 1,329 1,219
Knee replacement 1,354 1,279 1,345 1,190
2. The number of successful Individual Funding Requests (or equivalent
procedure) made in 2013/14, 2014/15, 2015/16 and 2016/17 for: a) hip replacement b) knee replacement surgeries each year
A. None. 3. The number of unsuccessful Individual Funding Requests (or equivalent
procedure) made each year in 2013/14, 2014/15, 2015/16 and 2016/17 for: a) hip replacement b) knee replacement surgeries
A. None. 4. The number of people recorded as having malnutrition (i.e. under nutrition)
each year by GP practices in the area in 2013/14, 2014/15, 2015/16 and 2016/17 (if this is recorded by the CCG)
A. NHS Kernow does not hold the information you have requested. Please redirect
your request to NHS England ([email protected]), who commissions GP services, to request this information.
5. The number of people prescribed Oral Nutritional Supplements each year in
2013/14, 2014/15, 2015/16 and 2016/17, broken down by gender A. NHS Kernow does not hold the information you have requested. This information
may be held at GP practice or provider level. Please redirect your request to NHS England ([email protected]), who commissions GP services, for further assistance or local providers:
Cornwall Partnership NHS Foundation Trust ([email protected])
Northern Devon Healthcare NHS Trust ([email protected])
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Plymouth Hospitals NHS Trust ([email protected])
Royal Cornwall Hospital NHS Trust ([email protected]) 6. Please provide a list of all GP practices in the CCG area and a contact email
address for each. A. Please find attached a list of GP practices, including contact details, in the CCG
area. Please note that NHS England commissions GP services in Cornwall and the Isles of Scilly. If you require further information on these practices, please redirect your request to NHS England ([email protected]).
FOI59450 - Individual Funding Requests Date received: 05/04/2017 1. Please state the total number of Individual Funding Requests (IFRs)
received by the CCG in each of the following years: a) 2016-17 b) 2015-16 c) 2014-15 d) 2013-14
2. For each of the four years listed in Q1, please list the three most common treatment categories in which IFRs were submitted and how many requests were made in each category.
3. Please state the number of IFRs which were approved in each of the four years listed in Q1
Year Total requests
Three most common requests (number of each)
Total approved
2016-17 168 Removal of benign skin lesions (40)
Breast reduction (14)
Abdominoplasty (13)
23
2015-16 217 Removal of benign skin lesions (39)
Assisted conception (22)
Breast reduction (17)
30
2014-15 227 Removal of benign skin lesions (50)
Assisted conception (21)
Breast reduction (19)
34
2013-14 231 Removal of benign skin lesions (30)
Breast reduction (17)
Assisted conception (17)
37
4. Please state the number of appeals cases which were considered by the
IFR panel in each of four years listed in Q1
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A. 2016-17: None 2015-16: Less than five 2014-15: None 2013-14: Less than five
5. Please state the number of appeals cases which were upheld by the IFR
panel in each of the four years listed in Q1 A. None.
Information Governance
FOI59820 - Enhanced data sharing Date received: 27/04/2017 1. How many of the GP practices within your CCG have switched on
‘Enhanced Data Sharing’ from TPP? A. 10 practices have switched on Enhanced Data Sharing. 2. How is patient data being protected from being viewed by individuals who
are not involved with that patient’s care? A. NHS Kernow is not responsible for protecting patient data in eDSM, however, our
understanding is that in meeting the statement of compliance requirements, the system suppliers would have given assurances to NHS Digital with regard to the information governance security controls available within the system. Practices in our region have provided the following information:
Electronic access control is in place ensuring all internal patients identifiable data is secure. There are data sharing agreements that grant role based permissions support access all or part of a patient record and permission is only granted for the purposes of direct care or where a legal basis has been identified for its use and sharing. All access is role relevant based on clinical need.
Patients are able to opt-out of sharing their data and can completely opt-out of any override in any situation. Information on eDSM is available to all patients in leaflet form, posters and on GP practice websites.
Each organisation and all members of staff using eDSM must adhere to the Data Protection Act 1998, which is available to all staff. Each member of staff log into SystmOne with their own log-ins or smart cards, which allows for the audit of records access to.
Members of staff must adhere to Caldicott Principals around access and sharing of information. Annual information governance training is mandatory for all staff as part of the information governance toolkit requirements. This is underpinned by clauses in each contract of employment.
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3. How do patients with sensitive medical issues e.g. mental health, HIV
positive and early pregnancy prevent their data being shared? A. NHS Kernow is not responsible for appropriate sharing of patient data in eDSM,
however, practices in our region have provided the following information: Practices operate a default opt-out policy, with patients choosing to opt-in to sharing their data and can choose to opt-out at any time. This information is available to all patients in leaflet form, posters and on GP practice websites.
Within a SystmOne computer record, information can be marked as private. This must be an informed decision made by the patient in consultation with a healthcare professional.
Data added by the organisational unit is not visible to any other organisational unit, including emergency and out of hours services, unless record sharing is explicitly overridden. There is also the option on SystmOne to make some information not available in the online record.
In addition, records can be marked as sensitive or safeguarding relevant so that records can only be accessed by staff with the appropriate access right.
Patients are responsible for indicating their preferences at the point of contact to enable appropriate controls to be applied.
4. How is the CCG working to ensure data protection compliance and the
avoidance of misuse of the data? A. NHS Kernow is not responsible for ensuring data protection compliance or
misuse of data in eDSM, however, our understanding is that in meeting the statement of compliance requirements and information governance requirements the GP practices and system suppliers would have given assurances to NHS Digital.
NHS Kernow protects its own data by mandating annual information governance training for all staff and data protection compliance clauses are included within employment contracts. There is a data protection policy is in place, which is available to all staff and the organisation has an information governance lead responsible for all data protection matters, advice and guidance.
The use and transfer of identifiable data is mapped, monitored and secured throughout the organisation, with assurance obtained that there is a legal basis for the use of all identifiable data.
Staff are reminded on a regular basis of the essential data protection requirements with regard to data via staff communications and meetings.
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Staff in GP practices are supported by NHS Kernow’s Head of Information Governance on information governance advice and guidance. In addition to support provided by Data Quality Facilitators in each local area.
5. Does SystmOne have the capability to identify unauthorised access to a
patient record by a user not involved with the patient’s care? a) If so, how is this unauthorised access to patient data reported to the CCG? A. NHS Kernow is not responsible for securing data from unauthorised access or
misuse of data in SystmOne, however, our understanding is that in meeting the statement of compliance requirements and information governance requirements, GP practices and system suppliers would have given assurances to NHS Digital with regard to appropriate security controls.
Each GP practice has a nominated Privacy Officer. Access to records which are no longer active in the system are logged and alerted to the Privacy Officer. The Privacy Officer routinely reviews records for access, potential breaches or inappropriate access and incidents are escalated within the individual practices.
The Privacy Officer also checks if records are accessed outside of the practice and if access appears to have been inappropriate, this would be escalated within the practice and if required, reported to the Head of Information Governance and Information Governance Lead at NHS Kernow.
6. How is the CCG planning to report unauthorised access to the patient? A. NHS Kernow follows NHS guidance with regard to information incident reporting
and has internal processes for reported incidents. 7. What plans does the CCG have to handle data protection claims from
patients whose data has been illegally accessed? A. NHS Kernow is considering data protection insurance as part of its information
governance work plan.
Mental health & learning disabilities
FOI59420 - CAMHS Tier 4 patients Date received: 05/04/2017 1. Number of mental health beds for CAMHS Tier 4 inpatients every year from
2010-present. Please provide the information broken down per year where available.
2. Your procedure for dealing with CAMHS Tier 4 inpatients if no beds are available.
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3. If/when beds are unavailable how many times from 2010-present have CAMHS Tier 4 inpatients been admitted to: a) adult psychiatric wards b) prison cells
A. NHS Kernow was formed on 1 April 2013 and cannot provide information relating
to the former primary care trust (2010 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. Please redirect your request to the provider of these services, Cornwall Partnership NHS Foundation Trust ([email protected]), or NHS England ([email protected]), who commission Tier 4 beds to obtain this information.
FOI59660 - Eating disorder services Date received: 11/04/2017 1. All in-patient and out-patient eating disorder services currently provided for
CAMHS and adult services in your area A. NHS Kernow has signalled clearly to providers that it favours a single children
and young people eating disorder service that draws together into a single specification and contract the elements needed to meet the Access and Waiting Time Standards (2015) by 2020. At the time of this enquiry, pilot arrangements to bring together the three providers involved is underway and learning from the pilot will help to shape further how a single service operates. Although a single service, NHS Kernow will be looking at how elements such as physical monitoring and therapy can be provided at sites across Cornwall in response to the county’s rural nature and poor transport links. The providers of service involved in the pilot are Cornwall Partnership Foundation NHST, Royal Cornwall Hospital Trust and Kernow Health CiC and services are also provided by Plymouth Hospitals Trust. For more detailed information on in-patient and out-patient eating disorder services currently provided for CAMHS and adult services in Cornwall and the Isles of Scilly, please contact providers direct:
Cornwall Partnership Foundation Trust - [email protected]
Royal Hospitals NHS Trust - [email protected]
Plymouth Hospitals Trust - [email protected]
FOI disclosure log April 2017
20
The questions below relate to the financial years: 2014/15, 2015/16, 2016/17 and 2017/18.
2. The budget and monies promised to deliver the CAMHS access and waiting
time standards on Eating Disorders A. NHS Kernow has published details of the CAMHS transformation monies it has
been able to allocate to schemes in 2015/16 and 2016/17 and proposed schemes for 2017/18 in papers to the NHS Kernow Governing Body meetings of 6 December 2016 and 7 February 2017. These are available online at www.kernowccg.nhs.uk/get-info/governing-body-meetings
We therefore exempt this information under Section 21 of the Freedom of Information Act, information available by other accessible means.
3. The budget and monies received to deliver the CAMHS access and waiting
time standards on Eating Disorders A. NHS Kernow has received £302,000 from NHS England in the years 2015/16 and
2016/17 in support of CAMHS transformation work towards achieving the Access and Waiting Time Standards (July 2015).
4. Your total budget and expenditure for all CAMHS eating disorder services
(please include any additional monies received to deliver access and waiting time standards, as specified in Question 3.
A. Children and young people’s eating disorder services are contained within a
block contract with the following NHS providers and therefore, NHS Kernow does not hold the information you have requested. Please redirect your request to providers direct to request this information:
Cornwall Partnership Foundation Trust - [email protected]
Royal Hospitals NHS Trust - [email protected]
Plymouth Hospitals Trust - [email protected] 5. Your total budget and expenditure for all adult eating disorder services A. Adult eating disorder services are contained within a block contract with the
following NHS providers and therefore, NHS Kernow does not hold the information you have requested. Please redirect your request to providers direct to request this information:
Cornwall Partnership Foundation Trust - [email protected]
Royal Hospitals NHS Trust - [email protected]
Plymouth Hospitals Trust - [email protected] 6. Your average and range of waiting times for CAMHS eating disorder
services for both severe and non-severe cases
FOI disclosure log April 2017
21
A. Children and young people’s eating disorder services are contained within a block contract with the following NHS providers and therefore, NHS Kernow does not hold the information you have requested. Please redirect your request to providers direct to request this information:
Cornwall Partnership Foundation Trust - [email protected]
Royal Hospitals NHS Trust - [email protected]
Plymouth Hospitals Trust - [email protected] 7. Your average and range of waiting times for adult eating disorder services
for both severe and non-severe cases A. Adult eating disorder services are contained within a block contract with the
following NHS providers and therefore, NHS Kernow does not hold the information you have requested. Please redirect your request to providers direct to request this information:
Cornwall Partnership Foundation Trust - [email protected]
Royal Hospitals NHS Trust - [email protected]
Plymouth Hospitals Trust - [email protected]
FOI59740 - Mental health spend Date received: 20/04/2017 1. At the time of responding to this request, has the CCG’s financial plan for
2017/18 and 2018/19 been agreed by NHS England? A. No.
2. In the CCG’s financial plan for 2017/18, or latest draft of this plan if this has
not been finalised by NHS England at the time of responding to this request, has the Mental Health Investment Standard (formerly Parity of Esteem) been achieved?
A. No. 3. If the Mental Health Investment Standard (formerly Parity of Esteem) has
not been achieved for 2017/18, please indicate the reason using the codes below: 1) Commissioners in deficit, not achieving 1% plan metric or with very low
growth. 2) Mental Health Investment Standard (Parity of Esteem) achieved across
health economy. 3) Historically high investment in mental health. 4) Other.
A. 1 - Commissioners in deficit, not achieving 1% plan metric or with very low
growth.
FOI disclosure log April 2017
22
4. If answering ‘Other’, please provide further explanation as to why the
Mental Health Investment Standard (Parity of Esteem) has not been achieved for 2017/18.
A. N/A. 5. In the CCG’s financial plan for 2018/19, or latest draft of this plan if this has
not been finalised by NHS England at the time of responding to this request, has the Mental Health Investment Standard (formerly Parity of Esteem) been achieved?
A. Yes, however, as per our response to Q1, the financial plan has not yet been
approved.
6. If the Mental Health Investment Standard (formerly Parity of Esteem) has not been achieved for 2018/19, please indicate the reason using the codes below: 1) Commissioners in deficit, not achieving 1% plan metric or with very low
growth. 2) Mental Health Investment Standard (Parity of Esteem) achieved across
health economy. 3) Historically high investment in mental health. 4) Other.
7. If answering ‘Other’, please provide further explanation as to why the Mental Health Investment Standard (Parity of Esteem) has not been achieved for 2018/19.
A. N/A. 8. At the time of responding to this request, has the Chief Executive of your
main mental health provider signed a letter stating that the CCG’s mental health planned spend for 2017/18 and 2018/19 is an accurate reflection of health economy investment in mental health, as requested by NHS England?
A. No, not at this time.
Organisation
FOI59670 - Nursing shortages Date received: 18/04/2017 1. How many nurses are working for the NHS across Cornwall, without a
UK/British passport? 2. How many of these would be affected by the Freedom of Movement,
following Brexit? 3. The Department of Health says the NHS could be short of 40,000 nurses by
2026, how many of those are here in Cornwall?
FOI disclosure log April 2017
23
A. NHS Kernow does not hold the information you have requested. Please redirect
your request to providers direct to request this information:
Cornwall Partnership Foundation Trust - [email protected]
NHS England ([email protected])
Plymouth Hospitals Trust - [email protected]
Royal Hospitals NHS Trust - [email protected]
FOI59830 - Governing Body members Date received: 27/04/2017 1. Please supply me with a list of names and business email addresses of the
non-clinical members who sit on the Governing Body of the NHS Kernow CCG.
A. NHS Kernow publishes information on Governing Body members, including email
addresses, on our website: www.kernowccg.nhs.uk/about-us/who-we-are-and-what-we-do/
We therefore exempt the release of this information under section 21 of the Freedom of Information Act, information accessible by other means.
Prescribing & pharmacies
FOI59410 - Wound care products Date received: 04/04/2017 1. Who has operational responsibility for the formulary including the addition
or deletion of products? A. NHS Kernow’s Medicines Optimisation team have operational responsibility for
the formulary. 2. Please provide information on how compliance with your formulary is
enforced? A. NHS Kernow routinely reviews and audits the formulary. 3. Please provide information on how products are evaluated prior to being
accepted onto the formulary? If this is part of a clinical evaluation or clinical trial, please provide the results.
A. Products are evaluated based on clinical evidence, as well as being cost effective and safe evaluation.
FOI disclosure log April 2017
24
4. Please provide information on who is responsible for the cost of wound care in your setting – is it CCG or Acute?
A. NHS Kernow is responsible for the cost of wound care. 5. Please provide information if the wound care products are on prescription
FP10? 6. Please provide a list of the wound care products that you are planning to
keep on prescription FP10? A. Information on wound care products are available on the Cornwall Joint
Formulary: 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
7. Please provide information if you are planning to take wound care products
off prescription FP10? A. NHS Kernow undertook a contract tender for the direct supply of dressings and
awarded the contract to Convatec on 14 March 2017. The contract is currently in the mobilisation phase with the direct supply expected to commence on 1 June 2017.
8. Please provide a list of the wound care products that you are planning to
take off prescription FP10?
Actico
Acti-Fast blue- 7.5cm
Acti-Fast yellow 10.75cm
ActiFormCool
Activa brand
ActivHeal Hydrocolloid
ActivHeal Hydrocolloid Foam
ActivHeal Hydrogel
Activon Tulle Activon Tube Adaptic Touch Algivon Plus
Allevyn Life Anabact gel Aquacel Extra Cica-Care
Clinipod Clinisorb Comfeel Plus Comfeel Plus Transparent
Cosmopor easiGRIP (0.5m & 1m)
Flaminal Forte Flaminal Hydro
Hospicrepe 233
Hydrofilm Hydrofilm Plus
Intrasite Conformable
Iodoflex Irripod Juxta Wrap Kaltostat
K-Band
K-Soft
Medi Derma S Barrier cream 28g
Medi Derma S Barrier film applicators
Non-Sterile (100 pads per pkt)
Nurse it (Alvita)
PICO
Povitulle
Profore #1 Scanpor Sorbsan Flat Sorbsan Plus
Sorbsan Ribbon
Sterile (5 pads per pkt)
Steripaste
UCS cloth
FOI disclosure log April 2017
25
Urgotul absorb
UrgoTul Absorb Border
UrgoKTwo
Urgotul SSD
Vacutex
Vacuum Assisted Closure (VAC)
Zetuvit E Sterile
Zetuvit Plus
9. Do you hold information about your patient demographic? If so, please
provide information on what is your patient demographic and what are the most commonly treated wounds from your patient demographic
10. Please provide any information that you have relating to the average monthly usage of each product in the formulary?
A. NHS Kernow does not hold the information you have requested. Please redirect
your request to NHS Business Services Authority to request this information (http://www.nhsbsa.nhs.uk/FreedomOfInformation.aspx).
11. Please provide information on the number of wound care products used
that are not currently on the formulary? A. Information on wound care products are available on the Cornwall Joint
Formulary: https://www.eclipsesolutions.org/cornwall/. Therefore, products that are listed on the Drug Tariff but not on our formulary are the products not used.
12. Please provide any information on the monthly usage levels for non-formulary wound care products in the last twelve months?
A. NHS Kernow does not hold the information you have requested. Please redirect
your request to NHS Business Services Authority to request this information (http://www.nhsbsa.nhs.uk/FreedomOfInformation.aspx).
13. How often do you review your wound care formulary and when was this last
undertaken?
A. The wound care formulary is reviewed on an annual basis. The date of the last review was November 2016.
14. Please provide information about the procedure that you use of the
information you assess when reviewing your formulary? A. The review is undertaken based on NICE guidance and local trials alongside
specialist nurse input and advice.
15. Please provide a list of the suppliers that are currently on your formulary? 16. Please provide figures for your total spend on wound care products in 2015
and 2016? 17. Please provide figures for your total spend on Compression bandages in
2015 and 2016? 18. Please provide figures for your total spend on Foam dressings in 2015 and
2016?
FOI disclosure log April 2017
26
19. Please provide figures for your total spend on Anti-Microbial wound care products in 2015 and 2016?
20. Please provide figures for your total spend on Alginate (Silver) wound care products in 2015 and 2016?
21. Please provide figures for your total spend on Hydrocolloid wound care products in 2015 and 2016?
22. Please provide figures for your total spend on Wound contact products in 2015 and 2016?
23. Please provide figures for your total spend on Exudate Absorber (Super Absorber) Dressings products in 2015 and 2016?
24. Please provide figures for your total spend on Acute Wound Care products - Post Op Film Dressing Plus Pads, Steri-Strips, Stockinette and Semi Permeable Film Dressings in 2015 and 2016?
25. Please provide figures for your total spend on Skin Integrity wound products – Barrier Films and Barrier Creams in 2015 and 2016?
26. Please provide figures for your total spend on Vascular Access wound products – Semi Permeable Film Dressings and IV Dressings in 2015 and 2016?
27. Please provide figures for your total spend on hosiery products in 2015 and 2016?
A. This information is available from NHS Business Services Authority:
http://www.nhsbsa.nhs.uk/FreedomOfInformation.aspx. We therefore exempt the release of this information under section 21 of the Freedom of Information Act, information accessible by other means.
28. Are you planning on collaborating with another healthcare entity to provide
wound care services? A. Yes. 29. Please provide information on your current supply route – DHL, wholesaler
or vendor direct? A. N/A. Currently provided via FP10. 30. Do you currently have a contract in place for supply of wound care
products? If so when does it expire? A. No, not at this time.
31. Please provide information on how many delivery points do you have for
wound care deliveries? A. There are 152 delivery points for wound care deliveries. 32. Please provide information on how many community locations are holding
stock of wound care and prescribing to the community? A. N/A. Currently provided via FP10.
FOI disclosure log April 2017
27
33. Please provide information on what software platform do you use for
ordering wound care products? A. N/A. NHS Kernow does not use a software platform for the ordering of wound
care products. Products are ordered via the internet. 34. Do you have a wound care clinic in place for your local demographic and
where do your referrals come from? A. NHS Kernow does not hold the information you have requested. Please redirect
your request to Cornwall Partnership NHS Foundation Trust to request this information ([email protected]).
FOI59510 - Homeopathy services Date received: 06/04/2017 1. How much in total has your CCG spent on providing patients with
homeopathy services and medicine in (i) 2014/15 and (ii) 2015/16? 2. Please provide me with a list of the products/services that you sanctioned
in relation to Question 1. A. This request for information has previously been disclosed in an FOI request in
December 2016 (FOI 56840) and is available to view on our FOI Disclosure Log: www.kernowccg.nhs.uk/get-info/information-governance/freedom-of-information-(foi)-requests/foi-disclosure-log/
We therefore exempt the release of this information under section 21 of the Freedom of Information Act, information accessible by other means.
Referral management
FOI59530 - Referrals for chiropractic / alternative medicines Date received: 07/04/2017 1. Please give the number of referrals made by the CCG/health board for the
following treatments or services in each of the last three financial years (2014/15, 2015/16 and 2016/17): a) Chiropractic/Spinal Manipulation (low back and neck only)
A. 2014/15:995
2015/16: 992 2016/17: 1,110
b) Osteopathy (low back and neck only)
FOI disclosure log April 2017
28
A. 2014/15: 1,435 2015/16: 924 2016/17: 1,227
c) Cranial Osteopathy d) Craniosacral Therapy e) Iscador aka Mistletoe Therapy f) Herbal remedies g) Reflexology h) Traditional Chinese Medicine
A. NHS Kernow does not hold the information you have requested. NHS Kernow
does not routinely commission the treatments listed above. A list of these services are available on our website (https://www.kernowccg.nhs.uk/get-info/individual-funding-requests/treatment-policies/) via this link: http://policies.kernowccg.nhs.uk/DocumentsLibrary/KernowCCG/IndividualFundingRequests/Policies/CommissioningPolicies2016.pdf
FOI disclosure log April 2017
29
Appendix: FOI59400 - Hip and knee replacements
Pra
cti
ce
Co
de
Lo
cali
tyA
dd
res
s 1
Ad
dre
ss
2A
dd
res
s 3
Ad
dre
ss
4A
dd
res
s 5
Po
stc
od
eP
rac
tic
e M
an
ag
er
Pra
cti
ce M
an
ag
er
Em
ail
L82021
Alv
ert
on S
urg
ery
Alv
ert
on S
urg
ery
7 A
lve
rto
n T
err
ace
Pe
nza
nce
Co
rnw
all
TR
18 4
JH
Alis
on H
anle
yA
liso
n.H
anle
y@
nh
s.n
et
Y0
19
22
Ste
nn
ack S
urg
ery
The
Ste
nn
ack S
urg
ery
The
Old
Ste
nn
ack S
ch
oo
lS
t Iv
es
Co
rnw
all
TR
26 1
RU
Lyd
ia H
ale
lyd
ia.h
ale
@n
hs.n
et
L82038
Ca
pe
Co
rnw
all
Su
rge
ryC
ape
Co
rnw
all
Su
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ryS
t Ju
st
Pe
nza
nce
Co
rnw
all
TR
19 7
HX
Ian C
ary
Ian.C
ary
@nh
s.n
et
L82047
Ma
razio
n S
urg
ery
Ma
razio
n S
urg
ery
Gw
allo
n L
an
eM
ara
zio
nC
orn
wa
llT
R1
7 0
HW
Ja
ckie
Bro
wn
jackie
.bro
wn
23
@n
hs.n
et
Y0
10
50
Ro
sm
elly
n S
urg
ery
Ro
sm
elly
n S
urg
ery
Alv
ert
on T
err
ace
Pe
nza
nce
Co
rnw
all
TR
18 4
JH
Lorn
a N
ich
ola
slo
rna
.nic
hola
s@
nhs.n
et
Y0
10
51
Mo
rra
b S
urg
ery
Mo
rra
b S
urg
ery
2 M
orr
ab R
oad
Pe
nza
nce
Co
rnw
all
TR
18 4
EL
Jim
Pa
yn
ejim
.payn
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@n
hs.n
et
L82053
Pe
na
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Su
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ena
lve
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Su
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ena
lve
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Drive
Pe
nza
nce
Co
rnw
all
TR
18 2
RE
Lesle
y S
earle
lesle
y.s
earle
1@
nh
s.n
et
L82070
Su
nn
ysid
e S
urg
ery
Su
nn
ysid
e S
urg
ery
Ha
wkin
s R
oad
Pe
nza
nce
Co
rnw
all
TR
18 4
LT
Lin
da
Re
es
linda
.re
es@
nh
s.n
et
L82036
Bo
drig
gy H
ealth
Ce
ntr
eB
odrig
gy H
ealth
Ce
ntr
e6
0 Q
uee
nsw
ay
Bo
drig
gy
Ha
yle
Co
rnw
all
TR
27 4
PB
Ste
ph
an
ie J
one
sste
ph
an
ie.jo
ne
s19
@n
hs.n
et
L82017
The
He
alth
Ce
ntr
e,
St
Ma
ry's
The
He
alth
Ce
ntr
e,
St
Ma
ry's
Kin
g E
dw
ard
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t M
ary
sIs
les o
f S
cill
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orn
wa
llT
R2
1 0
HE
Alis
on J
enkin
sA
liso
n.J
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s9@
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et
L82057
St
Ke
vern
e H
ealth
Ce
ntr
eS
t K
evern
e H
ealth
Ce
ntr
eS
t K
evern
eC
orn
wa
llT
R1
2 6
PB
An
ita
Du
gm
ore
An
ita
.Du
gm
ore
@n
hs.n
et
L82056
Mu
llio
n &
Co
nsta
ntin
e G
roup
The
He
alth
Ce
ntr
eM
ulli
on
Co
rnw
all
TR
12 7
DQ
Ne
il S
teven
sN
eil.
ste
ven
s5@
nh
s.n
et
L82059
Me
ne
ag
e S
tre
et
Su
rge
ryM
ene
ag
e S
tre
et
Su
rge
ry1
00
Me
ne
ag
e S
tre
et
He
lsto
nC
orn
wa
llT
R1
3 8
RF
Lin
da
Gra
ng
er
l.g
ran
ger@
nh
s.n
et
L82018
He
lsto
n M
edic
al C
entr
e,
He
lsto
nH
els
ton M
edic
al C
entr
eT
rela
wn
ey R
oad
He
lsto
nC
orn
wa
llT
R1
3 8
AU
Alis
on B
utt
erill
A.B
utt
erill@
nh
s.n
et
L82617
Ph
oe
nix
Su
rge
ryP
hoe
nix
Su
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ryC
am
born
e H
ealth
Off
ice
Re
cto
ry R
oad
Ca
mb
orn
eC
orn
wa
llT
R1
4 7
DL
Ali
He
nle
ya
he
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y@
nh
s.n
et
L82068
Pra
ze
-an
-Be
eb
le S
urg
ery
Pra
ze
-an
-Be
eb
le S
urg
ery
Sch
oo
l R
oad
Pra
ze
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eeb
leC
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wa
llT
R1
4 0
LB
An
ne
Cra
iga
nn
e.c
raig
3@
nh
s.n
et
L82620
Ha
rris
Me
mo
rial S
urg
ery
Ha
rris
Me
mo
rial S
urg
ery
Ro
ba
rte
s T
err
ace
Illo
ga
nR
edru
thC
orn
wa
llT
R1
6 4
RX
Da
wn
Jo
na
than
d
aw
n.jo
na
than
@n
hs.n
et
L82041
Ca
rn t
o C
oast
Po
ol H
ealth
Ce
ntr
eS
tatio
n R
oad
Po
ol
Co
rnw
all
TR
15 3
DU
We
nd
y G
eorg
e/
Su
san
na
h G
reen
we
nd
y.g
eo
rge
3@
nhs.n
et/
su
san
na
hg
ree
n@
nhs.n
et
L82042
Ma
no
r S
urg
ery
, R
edru
thM
ano
r S
urg
ery
Ch
ap
el S
tre
et
Re
dru
thC
orn
wa
llT
R1
5 1
AU
Ju
lie C
am
pbe
llJu
lie.c
am
pbe
ll16@
nh
s.n
et
L82044
Ve
or
Su
rge
ryV
eor
Su
rge
ryS
outh
Terr
ace
Ca
mb
orn
eC
orn
wa
llT
R1
4 8
SN
Tere
sa K
em
pT
ere
sa.k
em
p1@
nh
s.n
et
L82014
Tre
vith
ick S
urg
ery
Tre
vith
ick S
urg
ery
Ba
sset
Ro
ad
Ca
mb
orn
eC
orn
wa
llT
R1
4 8
TT
Ste
ph
en
Ho
lby
ste
ph
en
.holb
y@
nh
s.n
et
L82024
Clin
ton R
oad
Clin
ton R
oad
19 C
linto
n R
oad
Re
dru
thC
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wa
llT
R1
5 2
LL
Ca
rolin
e P
ugh
ca
rolin
ep
ug
h@
nh
s.n
et
L82054
St
Ag
ne
s S
urg
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St
Ag
ne
s S
urg
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Pe
ng
art
h R
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St
Ag
ne
sC
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wa
llT
R5
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NL
iz T
hie
ren
sliz
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iere
ns@
nh
s.n
et
L82061
Ca
rno
n D
ow
ns S
urg
ery
Ca
rno
n D
ow
ns S
urg
ery
Bis
so
e R
oad
Ca
rno
n D
ow
ns
Tru
roC
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wa
llT
R3
6JD
Sa
lly R
icka
rdS
ally
.Ric
ka
rd4
@nh
s.n
et
L82015
Ch
ace
wa
ter
He
alth
Ce
ntr
eC
hace
wa
ter
He
alth
Ce
ntr
eC
hace
wa
ter
Co
rnw
all
TR
4 8
QS
Su
san
Gu
nn
Su
san
gu
nn
@n
hs.n
et
L82028
Thre
e S
pire
s M
edic
al P
ractice
Thre
e S
pire
s M
edic
al P
ractice
Tru
ro H
ealth
Pa
rkIn
firm
ary
Hill
Tru
roC
orn
wa
llT
R1
2JA
Ka
ty H
aw
ke
rK
.haw
ke
r@n
hs.n
et
L82001
Lan
de
r M
edic
al P
ractice
Lan
de
r M
edic
al P
ractice
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ro H
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all
TR
11 2
LH
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off
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nn
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race
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rnw
all
TR
11 2
UN
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nh
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25
17
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L82029
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all
PL
23
1D
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rnw
all
TR
2 5
EE
Nic
ola
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hs.n
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L82051
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che
Co
rnw
all
PL
26
8JF
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judith
.ku
rth
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hs.n
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L82011
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nn
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urg
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nn
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ph
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wa
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LL
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reva
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nh
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rth
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iel
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rnw
all
PL
22
0E
FR
ow
ena
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ge
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na
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nh
s.n
et
L82025
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vag
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vag
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urg
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vag
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wa
llP
L26
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hs.n
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L82026
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urg
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dle
wa
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urg
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wa
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laze
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ar
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rnw
all
PL
24
2JL
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trin
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Y0
49
57
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ste
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am
pson
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sa
mp
son
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hs.n
et
L82003
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rt I
sa
ac P
ractice
Po
rt I
sa
ac P
ractice
Hill
so
n C
lose
Po
rt I
sa
ac
Co
rnw
all
PL
29
3T
RP
at
Sh
utt
lew
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pat.
sh
utt
lew
ood
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hs.n
et
L82058
Bo
ttre
au
x S
urg
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ttre
au
x S
urg
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Bo
scastle
Co
rnw
all
PL
35
OB
GM
att
hew
Gib
bo
ns
ma
tth
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.gib
bo
ns4
@n
hs.n
et
L82008
Str
att
on M
edic
al C
entr
eS
tra
tto
n M
edic
al C
entr
eH
ospita
l R
oad
Str
att
on
Co
rnw
all
EX
23 9
BP
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thry
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elly
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ge
lly@
nh
s.n
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Y0
11
27
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ets
ide S
urg
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ets
ide S
urg
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thod
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urc
h H
all
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n R
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de
Co
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all
EX
23 8
LA
Me
lanie
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en
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eth
me
lanie
che
no
we
th@
nhs.n
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L82618
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me
lfo
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entr
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Dr
Ga
rro
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me
lfo
rd M
edic
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entr
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Dr
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rro
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urc
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ldC
am
elfo
rdC
orn
wa
llP
L32
9Y
TC
arm
el F
lyn
nca
rme
lfly
nn@
nh
s.n
et
L82009
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rne
wa
ter
Pra
ctice
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rne
wa
ter
Pra
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De
nn
iso
n R
oad
Bo
dm
inC
orn
wa
llP
L31
2LB
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lly P
oxo
nsa
lly.p
oxo
n@
nh
s.n
et
L82004
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de
brid
ge
& C
am
el E
stu
ary
Pra
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de
brid
ge
& C
am
el E
stu
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nW
ade
brid
ge
Co
rnw
all
PL
27
7B
SS
onia
Ge
ach
so
nia
.gea
ch@
nh
s.n
et
L82010
Stillm
oor
Ho
use
Me
dic
al P
ractice
Stillm
oor
Ho
use
Me
dic
al P
ractice
Be
ll L
an
eB
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orn
wa
llP
L31
2JJ
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helle
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tle
yp
ratle
y.m
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elle
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hs.n
et
L82007
Ca
me
lfo
rd M
edic
al C
entr
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Dr
Na
sh)
Ca
me
lfo
rd M
edic
al C
entr
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Na
sh)
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urc
hfie
ldC
am
elfo
rdC
orn
wa
llP
L32
9Y
TS
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abso
nsusa
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ab
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s.n
et
L82037
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ch
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oad
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nsilv
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iske
ard
Co
rnw
all
PL
14
5R
PC
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ca
therin
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hs.n
et
L82050
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ouse
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an
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ke
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rnw
all
PL
14
4A
QD
avid
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pa
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pa
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nhs.n
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L82016
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all
PL
14
3X
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iz D
elb
ridg
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pu
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09
69
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me
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up
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me
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up
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nn
torr
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alth
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vo
l R
oad
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oin
tC
orn
wa
llP
L11
2P
DC
laire
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ave
scla
ire
gre
ave
s@
nhs.n
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L82043
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ay L
an
e S
urg
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an
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urg
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ay L
an
eS
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erm
ans
Co
rnw
all
PL
12
5LH
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bb
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od
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eb
bie
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hs.n
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L82022
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rid
ge
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Co
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all
PL
13
1H
AM
ark
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nm
ark
alle
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hs.n
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L82012
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ar
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ar
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alth
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ntr
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aye
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ad
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orn
wa
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ldson
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ge
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linda
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ald
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nh
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et/
rosem
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ge
rs2
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hs.n
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L82046
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lta
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ntr
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alli
ngto
n R
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lta
sh
Co
rnw
all
PL
12
6D
LL
yn
n C
hen
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lyn
n.c
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s.n
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L82030
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nce
sto
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sto
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entr
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ad
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nce
sto
nC
orn
wa
llP
L15
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HP
ete
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arp
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L82066
Po
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lta
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alta
sh
Co
rnw
all
PL
12
4B
UT
ina S
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ho
use
tin
a.s
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ho
use
2@
nh
s.n
et
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