NHS Derby and Derbyshire Clinical Commissioning Group Constitution V3.8

Home , Bolsover, Borough of Chesterfield, Borough of Erewash, Brailsford, North East Derbyshire

NHS Derby and Derbyshire Clinical Commissioning Group

Constitution

NHS Derby and Derbyshire Clinical Commissioning Group Constitution v3.8

VERSION CONTROL

Version Effective Date Changes 1.0 August 2018 Standard model 2.0 15 October 2018 Draft NHS Derby and Derbyshire CCG Constitution 2.1 13 November 2018 Updated Draft NHS Derby and Derbyshire CCG Constitution with NHSE Feedback 2.2 28 November 2018 Updated Draft NHS Derby and Derbyshire CCG Constitution with NHSE Feedback 2.3 11 December 2018 Updated Draft NHS Derby and Derbyshire CCG Constitution with NHS Feedback, E Polgar NHS England , Derbyshire CCG’s Lay Members and Engagement with the Derbyshire CCGs membership 2.4 25 January 2019 Updated Draft NHS Derby and Derbyshire CCG Constitution following approval of the draft at the Derbyshire CCGs Governing Body Meetings in Common 24 January 2019 3.0 31 January 2019 Updated Draft NHS Derby and Derbyshire CCG Constitution following formal feedback from NHS England received 31.1.19 3.1 19 February 2019 Final Approved NHS Derby and Derbyshire CCG Constitution 3.2 13 February 2020 Updated Terms of Reference for Primary Care Commissioning Committee and Audit Committee. 3.3. 8 April 2020 Updated 1.1, 2.2, 2.3, 2.10 and 4.1of Annexure 1: Decisions, Authorities and Duties Delegated to Officers of the CCG Governing Body; for the duration of the COVID-19 emergency, as approved by the CCG Governing Body on 2 April 2020 3.4 16 April 2020 Updated Section 3.6 GB Quorum of Appendix 3: Standing Orders, for the duration of the COVID-19 emergency, as approved by the CCG Governing Body on 16 April 2020. Updated Audit Committee Terms of Reference, Section 4.2: Membership for the duration of the COVID-19 emergency, as approved by the CCG’s Governing Body on 16 April 2020. 3.5 21 May 2020 Updated Remuneration Committee Terms of Reference, following annual review and approval. 3.6 6 August 2020 Amendment to GB Composition Section 5.5.3(l) – Removal of the Turnaround Director voting GB member role. This was a fixed term post which expired 31st July 2020 and no longer part of the organisations permanent establishment.

Removal of COVID 19 emergency arrangements in section 3.6, 4.2 and Annexure 1, sections 1.1,2.2, 2.3, 2.10 and 4.1. 3.7 3 September 2020 Amendment to GB Composition Section 5.5.3(l) – inclusion of Executive Director of Commissioning as a voting GB Member; and Section 5.5.3(m) – Executive Director of Corporate Strategy and Delivery as a voting GB Member. NHS Derby and Derbyshire Clinical Commissioning Group Constitution v3.8

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Removal of 5.6.2 Additional Attendees at the Governing Body – 5.6.3(a) Executive Director of Commissioning; and 5.6.2 (b) Executive Director of Corporate Strategy and Delivery.

Amendment to revert to the original quoracy pre covid arrangement, Standing Orders section 3.6 Quorum 1 October 2020 Appendix 2 Committee Terms of References

Amendment to Audit Committee Terms of Reference

Amendment to Primary Care Commissioning Committee Terms of Reference November 2020 Review of Appendix 4: Standing Financial Instructions – Financial Limits for Delegated Authority 26 January 2021 Updated Appendix 4 to include interim arrangements for Primary Care, and Nursing & Quality directorate 3.8 May & June 2021 Updates made to Audit Committee, and Primary Care Commissioning Committee Terms of Reference in Appendix 2, following six-monthly review and approval by Committee and Governing Body.

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CONTENTS

1. Introduction ...... 6

1.1 Name ...... 6

1.2 Statutory Framework ...... 6

1.3 Status of this Constitution ...... 7

1.4 Amendment and Variation of this Constitution ...... 7

1.5 Related documents ...... 7

1.6 Accountability and transparency ...... 8

1.7 Liability and Indemnity ...... 11

2. Area Covered by the CCG ...... 12

3. Membership Matters ...... 19

3.1 Membership of the Clinical Commissioning Group ...... 19

3.2 Nature of Membership and Relationship with CCG ...... 24

3.3 Speaking, Writing or Acting in the Name of the CCG ...... 24

3.4 Members’ Rights ...... 25

3.5 Members’ Meetings ...... 25

3.6 Practice Representatives ...... 25

4. Arrangements for the Exercise of our Functions...... 26

4.1 Good Governance ...... 26

4.2 General ...... 26

4.3 Authority to Act: the CCG ...... 27

4.4 Authority to Act: the Governing Body ...... 27

5. Procedures for Making Decisions ...... 27

5.1 Scheme of Reservation and Delegation ...... 27

5.2 Standing Orders ...... 28

5.3 Standing Financial Instructions (SFIs) ...... 28

5.4 The Governing Body: Its Role and Functions ...... 28

5.5 Composition of the Governing Body ...... 30

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5.6 Additional Attendees at the Governing Body Meetings ...... 31

5.7 Appointments to the Governing Body...... 31

5.8 Committees and Sub-Committees ...... 31

5.9 Committees of the Governing Body ...... 32

5.10 Collaborative Commissioning Arrangements ...... 33

5.11 Joint Commissioning Arrangements with Local Authority Partners ...... 34

5.12 Joint Commissioning Arrangements – Other CCGs ...... 35

5.13 Joint Commissioning Arrangements with NHS England ...... 37

6. Provisions for Conflict of Interest Management and Standards of Business Conduct ...... 38

6.1 Conflicts of Interest ...... 38

6.2 Declaring and Registering Interests ...... 39

6.3 Training in Relation to Conflicts of Interest ...... 40

6.4 Standards of Business Conduct ...... 40

Appendix 1 – Definitions of Terms Used in this Constitution ...... 41

Appendix 2 – Committee Terms of Reference ...... 44

Appendix 3 – Standing Orders ...... 64

Appendix 4 – Standing Financial Instructions – Financial Limits for Delegated Authority ...... 79

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1. INTRODUCTION

1.1 Name

The name of this clinical commissioning group is NHS Derby and Derbyshire Clinical Commissioning Group (the “CCG”).

1.2 Statutory Framework

1.2.1 CCGs are established under the NHS Act 2006 (“the 2006 Act”), as amended by the Health and Social Care Act 2012. The CCG is a statutory body with the function of commissioning health services in England and is treated as an NHS body for the purposes of the 2006 Act. The powers and duties of the CCG to commission certain health services are set out in sections 3 and 3A of the 2006 Act. These provisions are supplemented by other statutory powers and duties that apply to CCGs, as well as by regulations and directions (including, but not limited to, those issued under the 2006 Act).

1.2.2 When exercising its commissioning role, the CCG must act in a way that is consistent with its statutory functions. Many of these statutory functions are set out in the 2006 Act but there are also other specific pieces of legislation that apply to CCGs, including the Equality Act 2010 and the Children Acts. Some of the statutory functions that apply to CCGs take the form of statutory duties, which the CCG must comply with when exercising its functions. These duties include things like:

(a) Acting in a way that promotes the NHS Constitution (section 14P of the 2006 Act);

(b) Exercising its functions effectively, efficiently and economically (section 14Q of the 2006 Act);

(d) Child safeguarding (under the Children Acts 2004,1989);

(e) Equality, including the public-sector equality duty (under the Equality Act 2010); and

(f) Information law, (for instance under data protection laws, such as the EU General Data Protection Regulation 2016/679, and the Freedom of Information Act 2000).

1.2.3 Our status as a CCG is determined by NHS England. All CCGs are required to have a constitution and to publish it.

1.2.4 The CCG is subject to an annual assessment of its performance by NHS England which has powers to provide support or to intervene where it is satisfied that a CCG is failing, or has failed, to discharge any of our functions or that there is a significant risk that it will fail to do so.

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1.2.5 CCGs are clinically-led membership organisations made up of general practices. The Members of the CCG are responsible for determining the governing arrangements for the CCG, including arrangements for clinical leadership, which are set out in this Constitution.

1.3 Status of this Constitution

1.3.1 This CCG was first authorised on 1st April 2019.

1.3.2 Changes to this constitution are effective from the date of approval by NHS England.

1.3.3 The constitution is published on the CCG website at:

https://www.derbyandderbyshireccg.nhs.uk/about-us/what-we-do/constitution- and-ccg-governance-handbook/

1.4 Amendment and Variation of this Constitution

1.4.1 This constitution can only be varied in two circumstances.

(a) where the CCG applies to NHS England and that application is granted; and

(b) where in the circumstances set out in legislation NHS England varies the constitution other than on application by the CCG.

1.4.2 The Accountable Officer may periodically propose amendments to the constitution which shall be considered and approved by the Governing Body unless:

(a) changes are thought to have a material impact;

(b) changes are proposed to the reserved powers of the members;

(c) at least half (50%) of all the Governing Body Members formally request that the amendments be put before the membership for approval.

1.5 Related documents

This Constitution is also informed by a number of documents which provide further details on how the CCG will operate. With the exception of the Standing Orders and the Standing Financial Instructions, these documents do not form part of the Constitution for the purposes of 1.4 above. They are the CCG’s:

1.5.1 Standing orders – which set out the arrangements for meetings and the selection and appointment processes for the CCG’s Committees, and the CCG Governing Body (including Committees).

1.5.2 Prime financial policies – which set out the arrangements for managing the CCG’s financial affairs. These are available in the Governance Handbook.

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1.5.3 The CCG Governance Handbook – which includes:

(a) Standards of Business Conduct Policy – which includes the arrangements the CCG has made for the management of conflicts of interest;

(b) The Scheme of Reservation and Delegation (SoRD);

(d) Prime Financial Policies

(e) Standing Financial Instructions

(f) Roles and Responsibilities

(g) Corporate Governance Framework

(h) General Duties

1.6 Accountability and transparency

1.6.1 The CCG will demonstrate its accountability to its members, local people, stakeholders and NHS England in a number of ways, including by being transparent. We will meet our statutory requirements to:

(a) publish our constitution and other key documents including CCG Governance Handbook;

(b) appoint independent lay members and non-GP clinicians to our Governing Body;

(c) manage actual or potential conflicts of interest in line with NHS England’s statutory guidance Managing Conflicts of Interest: Revised Statutory Guidance for CCGs 2017 and expected standards of good practice (see also part 6 of this constitution);

(d) hold Governing Body meetings in public (except where we believe that it would not be in the public interest);

(e) publish an annual commissioning strategy that takes account of priorities in the health and wellbeing strategy;

(f) procure services in a manner that is open, transparent, non-discriminatory and fair to all potential providers and publish a Procurement Strategy;

(g) involve the public, in accordance with its duties under section 14Z2 of the 2006 Act, and as set out in more detail in the CCG’s Clinical Commissioning Strategy and Engagement Strategy. Further information can be found on the following website www.derbyandderbyshireccg.nhs.uk;

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(h) when discharging its duties under section 14Z2, the CCG will ensure that it will make arrangements to secure public involvement in the planning, development and consideration of proposals for changes and decisions affecting the operation of commissioning arrangements by:

(i) delegating responsibility to its Governing Body and monitor its progress;

(ii) the Governing Body will delegate the responsibility for developing and delivering an Engagement Strategy which builds continuous and meaningful engagement with the public, patients and carers to influence the shaping of services and improve the health of people in Derbyshire including:

• working closely with seldom heard groups to ensure they have a voice;

• using patient experience data and information to inform our work;

• engaging all GP members, including practice managers, and CCG staff in the development and ongoing work of the CCG to ensure they are involved in the core business and related work streams;

• supporting the development of relationships with key stakeholders to ensure partnership working and involvement;

• developing core materials and mechanisms for ongoing two- way communications between the CCG and public to allow continual feedback in commissioning decisions

(i) comply with local authority health overview and scrutiny requirements;

(j) meet annually in public to present an annual report which is then published;

(k) produce annual accounts which are externally audited;

(l) publish a clear complaints process;

(m) comply with the Freedom of Information Act 2000 and with the Information Commissioner Office requirements regarding the publication of information relating to the CCG;

(n) provide information to NHS England as required; and

(o) be an active member of the local Health and Wellbeing Board(s).

1.6.2 In addition to these statutory requirements, the CCG will demonstrate its accountability by publishing useful documents and information on its website at www.derbyandderbyshireccg.nhs.uk:

(a) the CCG’s policies and procedures; NHS Derby and Derbyshire Clinical Commissioning Group Constitution v3.8

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(b) Annual reports and Governance Statements;

(d) relevant equality and diversity documents and information and comply with the Public Sector Equality Duty;

(e) relevant business resilience and emergency planning documents and information;

(f) patient information documents, including notices of any public engagement event;

(g) other communications issued by the CCG, including the clinical commissioning strategy, the financial plan and notices of procurement, public consultations, reports, Governing Body meetings dates, venues and papers;

(h) details of the CCG’s key strategic priorities and plans;

(i) expenditure over £25,000;

(j) Register of Interests;

(k) register of conflicts declared during meetings;

(l) Gifts and Hospitality Register;

(m) Register of Procurements Decisions.

1.6.3 The Governing Body of the CCG will throughout the year have an ongoing role in reviewing the CCG’s governance arrangements, to ensure that the CCG continues to reflect the principles of good governance.

1.6.4 The CCG may use other means of communication, including circulating information by post, electronic methods or making information available in venues or services accessible to the public.

1.6.5 The Statement of Principles of Derby and Derbyshire CCG in respect of public involvement is that we will:

(a) work in partnership and involve local people, partners and staff at all stages in planning, shaping, designing and delivering services, and in setting priorities for Derby and Derbyshire. We will make the involvement of people central to everything we do and we aim to make it as easy as we can for people to be involved and to actively include them in ways that are meaningful and give real opportunities to influence; and

(b) also tell people how their involvement has influenced decisions. Prioritising local health needs may mean that on occasions we are not able to do what people want, if that happens we will explain why and be held to account for our decisions;

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(c) aim to involve and engage local people through ongoing engagement and through project engagement, including through the following mechanisms:

(i) work in partnership with HealthWatch – the CCG will develop close working relationships with HealthWatch. A member of HealthWatch will also sit on the CCG Engagement Committee;

(ii) communications and engagement network – a map and contacts database for the CCG across Derby and Derbyshire that link to patients and the public to ensure a mechanism for two-way communication into and out from the CCG to existing groups;

(iii) there will be 2 Governing Body Leads for Involvement – These roles will provide strategic leadership across the CCG for engagement and involvement and will chair the CCG Engagement Committee;

(iv) Patient Participation Groups (PPGs) – set up for each practice drawing in patients from local practice population; and

(v) each of the 8 Places will look to develop lay participation in their local work.

1.7 Liability and Indemnity

1.7.1 The CCG is a body corporate established and existing under the 2006 Act. All financial or legal liability for decisions or actions of the CCG resides with the CCG as a public statutory body and not with its Member practices.

1.7.2 No Member or former Member, nor any person who is at any time a proprietor, officer or employee of any Member or former Member, shall be liable (whether as a Member or as an individual) for the debts, liabilities, acts or omissions, howsoever caused by the CCG in discharging its statutory functions.

1.7.3 No Member or former Member, nor any person who is at any time a proprietor, officer or employee of any Member of former Member, shall be liable on any winding-up or dissolution of the CCG to contribute to the assets of the CCG, whether for the payment of its debts and liabilities or the expenses of its winding- up or otherwise.

1.7.4 The CCG may indemnify any Member practice representative or other officer or individual exercising powers or duties on behalf of the CCG in respect of any civil liability incurred in the exercise of the CCGs’ business, provided that the person indemnified shall not have acted recklessly or with gross negligence.

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2. AREA COVERED BY THE CCG

2.1 The geographical area covered by NHS Derby and Derbyshire Clinical Commissioning Group is approximately 2495 km2 within Derbyshire and Derby City.

2.2 As NHS Derby and Derbyshire CCG is not fully coterminous with the areas covered by Local Authorities, the area covered by the CCG is defined by the Lower Layer Super Output Areas (LSOAs) as listed below. The CCG has circa 40,000 patients in the geographical area of the Derby and Derbyshire CCG who are registered with Tameside and Glossop CCG.

2.3 The following are the District and Borough Councils and the Upper Tier Local Authority which the CCG covers, the:

2.3.1 County Council of Derbyshire

2.3.2 City Council of Derby

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2.3.3 Borough of Chesterfield

2.3.4 Borough of High Peak

2.3.5 Borough of Amber Valley

2.3.6 Borough of Erewash

2.3.7 District of Bolsover

2.3.8 District of North East Derbyshire

2.3.9 District of Derbyshire Dales

2.4 In Derbyshire County Council Local Authority the CCG covers the following Lower Layer Super Output Areas (LSOAs):

LSOA Code LSOA Name LSOA Code LSOA Name Amber Valley E01019400 Amber Valley 001A E01019439 Amber Valley 013D E01019401 Amber Valley 001B E01019440 Amber Valley 013E E01019402 Amber Valley 001C E01019441 Amber Valley 017B E01019403 Amber Valley 003A E01019442 Amber Valley 005B E01019404 Amber Valley 001D E01019443 Amber Valley 004A E01019405 Amber Valley 007A E01019444 Amber Valley 003B E01019406 Amber Valley 002A E01019445 Amber Valley 005C E01019407 Amber Valley 010A E01019446 Amber Valley 015A E01019408 Amber Valley 009A E01019447 Amber Valley 011D E01019409 Amber Valley 009B E01019448 Amber Valley 015B E01019410 Amber Valley 011A E01019449 Amber Valley 011E E01019411 Amber Valley 011B E01019450 Amber Valley 015C E01019412 Amber Valley 009C E01019451 Amber Valley 012D E01019413 Amber Valley 009D E01019452 Amber Valley 017C E01019414 Amber Valley 007B E01019453 Amber Valley 017D E01019415 Amber Valley 010B E01019454 Amber Valley 006B E01019416 Amber Valley 009E E01019455 Amber Valley 005D E01019417 Amber Valley 010C E01019456 Amber Valley 005E E01019418 Amber Valley 011C E01019457 Amber Valley 005F E01019419 Amber Valley 010D E01019458 Amber Valley 008D E01019420 Amber Valley 005A E01019459 Amber Valley 008E E01019421 Amber Valley 008A E01019460 Amber Valley 006C E01019422 Amber Valley 008B E01019461 Amber Valley 006D E01019423 Amber Valley 002B E01019462 Amber Valley 006E E01019424 Amber Valley 002C E01019463 Amber Valley 008F E01019425 Amber Valley 016A E01019464 Amber Valley 012E E01019426 Amber Valley 016B E01019465 Amber Valley 015D E01019427 Amber Valley 016C E01019467 Amber Valley 015E E01019428 Amber Valley 007C E01019468 Amber Valley 003C E01019429 Amber Valley 006A E01019469 Amber Valley 003D E01019430 Amber Valley 007D E01019470 Amber Valley 004B E01019431 Amber Valley 012A E01019471 Amber Valley 003E E01019432 Amber Valley 008C E01019472 Amber Valley 016D E01019433 Amber Valley 012B E01019473 Amber Valley 004C NHS Derby and Derbyshire Clinical Commissioning Group Constitution v3.8

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LSOA Code LSOA Name LSOA Code LSOA Name E01019434 Amber Valley 013A E01019474 Amber Valley 004D E01019435 Amber Valley 013B E01019475 Amber Valley 004E E01019436 Amber Valley 013C E01019476 Amber Valley 004F E01019437 Amber Valley 017A E01019477 Amber Valley 002D E01019438 Amber Valley 012C E01032613 Amber Valley 017E Bolsover E01019478 Bolsover 001A E01019502 Bolsover 005E E01019479 Bolsover 001B E01019503 Bolsover 007A E01019480 Bolsover 008A E01019504 Bolsover 005F E01019481 Bolsover 009A E01019505 Bolsover 007B E01019482 Bolsover 008B E01019506 Bolsover 007C E01019483 Bolsover 004A E01019507 Bolsover 007D E01019484 Bolsover 004B E01019508 Bolsover 006A E01019485 Bolsover 004C E01019509 Bolsover 006B E01019486 Bolsover 005A E01019510 Bolsover 006C E01019487 Bolsover 005B E01019511 Bolsover 007E E01019488 Bolsover 004D E01019512 Bolsover 006D E01019489 Bolsover 005C E01019513 Bolsover 010D E01019490 Bolsover 005D E01019514 Bolsover 009B E01019491 Bolsover 001C E01019515 Bolsover 009C E01019492 Bolsover 002A E01019516 Bolsover 009D E01019493 Bolsover 001D E01019517 Bolsover 010E E01019494 Bolsover 001E E01019518 Bolsover 010F E01019495 Bolsover 002B E01019519 Bolsover 009E E01019496 Bolsover 003A E01019520 Bolsover 008C E01019497 Bolsover 003B E01019521 Bolsover 008D E01019498 Bolsover 003C E01019522 Bolsover 008E E01019499 Bolsover 010A E01019523 Bolsover 003D E01019500 Bolsover 010B E01019524 Bolsover 002C E01019501 Bolsover 010C E01019525 Bolsover 002D Chesterfield E01019526 Chesterfield 001A E01019561 Chesterfield 008E E01019527 Chesterfield 003A E01019562 Chesterfield 008F E01019528 Chesterfield 001B E01019563 Chesterfield 002A E01019529 Chesterfield 003B E01019564 Chesterfield 002B E01019530 Chesterfield 003C E01019565 Chesterfield 002C E01019531 Chesterfield 003D E01019566 Chesterfield 002D E01019532 Chesterfield 005A E01019567 Chesterfield 006E E01019533 Chesterfield 005B E01019568 Chesterfield 002E E01019534 Chesterfield 005C E01019569 Chesterfield 007B E01019535 Chesterfield 005D E01019570 Chesterfield 007C E01019536 Chesterfield 005E E01019571 Chesterfield 004E E01019537 Chesterfield 007A E01019572 Chesterfield 001C E01019538 Chesterfield 010A E01019573 Chesterfield 001D E01019539 Chesterfield 009A E01019574 Chesterfield 001E E01019540 Chesterfield 009B E01019575 Chesterfield 013A E01019541 Chesterfield 004A E01019576 Chesterfield 013B E01019542 Chesterfield 004B E01019577 Chesterfield 013C E01019543 Chesterfield 004C E01019578 Chesterfield 013D E01019544 Chesterfield 004D E01019579 Chesterfield 010D

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LSOA Code LSOA Name LSOA Code LSOA Name E01019545 Chesterfield 012A E01019580 Chesterfield 007D E01019546 Chesterfield 012B E01019581 Chesterfield 007E E01019547 Chesterfield 012C E01019582 Chesterfield 012E E01019548 Chesterfield 012D E01019583 Chesterfield 012F E01019549 Chesterfield 006A E01019585 Chesterfield 012G E01019550 Chesterfield 006B E01019586 Chesterfield 011A E01019551 Chesterfield 006C E01019587 Chesterfield 011B E01019552 Chesterfield 006D E01019588 Chesterfield 011C E01019553 Chesterfield 003E E01019589 Chesterfield 011D E01019554 Chesterfield 010B E01019590 Chesterfield 009D E01019555 Chesterfield 009C E01019591 Chesterfield 009E E01019556 Chesterfield 010C E01019592 Chesterfield 011E E01019557 Chesterfield 008A E01019593 Chesterfield 011F E01019558 Chesterfield 008B E01033387 Chesterfield 010F E01019559 Chesterfield 008C E01033388 Chesterfield 010G E01019560 Chesterfield 008D Derbyshire Dales E01019594 Derbyshire Dales 009A E01019616 Derbyshire Dales 008D E01019595 Derbyshire Dales 008A E01019617 Derbyshire Dales 003D E01019596 Derbyshire Dales 009B E01019618 Derbyshire Dales 002D E01019597 Derbyshire Dales 009C E01019619 Derbyshire Dales 006A E01019598 Derbyshire Dales 009D E01019620 Derbyshire Dales 006B E01019599 Derbyshire Dales 003A E01019621 Derbyshire Dales 005B E01019600 Derbyshire Dales 002A E01019622 Derbyshire Dales 005C E01019601 Derbyshire Dales 003B E01019623 Derbyshire Dales 006C E01019602 Derbyshire Dales 001A E01019624 Derbyshire Dales 005D E01019603 Derbyshire Dales 010A E01019625 Derbyshire Dales 006D E01019604 Derbyshire Dales 002B E01019626 Derbyshire Dales 006E E01019605 Derbyshire Dales 008B E01019627 Derbyshire Dales 005E E01019606 Derbyshire Dales 002C E01019628 Derbyshire Dales 005F E01019607 Derbyshire Dales 010B E01019629 Derbyshire Dales 010D E01019608 Derbyshire Dales 004A E01019630 Derbyshire Dales 004C E01019609 Derbyshire Dales 005A E01019631 Derbyshire Dales 001D E01019610 Derbyshire Dales 004B E01019632 Derbyshire Dales 006F E01019611 Derbyshire Dales 008C E01019633 Derbyshire Dales 007A E01019612 Derbyshire Dales 010C E01019634 Derbyshire Dales 007B E01019613 Derbyshire Dales 003C E01019635 Derbyshire Dales 007C E01019614 Derbyshire Dales 001B E01019636 Derbyshire Dales 007D E01019615 Derbyshire Dales 001C Erewash E01019638 Erewash 016A E01019675 Erewash 012B E01019639 Erewash 016B E01019676 Erewash 014A E01019640 Erewash 016C E01019677 Erewash 014B E01019641 Erewash 011A E01019678 Erewash 014C E01019642 Erewash 013A E01019679 Erewash 012C E01019643 Erewash 013B E01019680 Erewash 014D E01019644 Erewash 001A E01019681 Erewash 014E E01019645 Erewash 016D E01019682 Erewash 012D E01019646 Erewash 001B E01019683 Erewash 009A E01019647 Erewash 012A E01019684 Erewash 009B

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LSOA Code LSOA Name LSOA Code LSOA Name E01019648 Erewash 010A E01019685 Erewash 009C E01019649 Erewash 010B E01019686 Erewash 009D E01019650 Erewash 010C E01019687 Erewash 009E E01019651 Erewash 010D E01019688 Erewash 006D E01019652 Erewash 011B E01019689 Erewash 006E E01019653 Erewash 011C E01019690 Erewash 003F E01019654 Erewash 013C E01019691 Erewash 008B E01019655 Erewash 013D E01019692 Erewash 008C E01019656 Erewash 008A E01019693 Erewash 008D E01019657 Erewash 003A E01019694 Erewash 008E E01019658 Erewash 006A E01019695 Erewash 010E E01019659 Erewash 006B E01019696 Erewash 008F E01019660 Erewash 003B E01019697 Erewash 015A E01019661 Erewash 003C E01019698 Erewash 014F E01019662 Erewash 003D E01019699 Erewash 015B E01019663 Erewash 001C E01019700 Erewash 015C E01019664 Erewash 001D E01019701 Erewash 004C E01019665 Erewash 001E E01019702 Erewash 005B E01019666 Erewash 007A E01019703 Erewash 005C E01019667 Erewash 007B E01019704 Erewash 005D E01019668 Erewash 007C E01019705 Erewash 015D E01019669 Erewash 007D E01019706 Erewash 015E E01019670 Erewash 004A E01019707 Erewash 011D E01019671 Erewash 004B E01019708 Erewash 011E E01019672 Erewash 003E E01019709 Erewash 015F E01019673 Erewash 005A E01032614 Erewash 016E E01019674 Erewash 006C High Peak E01019710 High Peak 010A E01019736 High Peak 013B E01019711 High Peak 006A E01019737 High Peak 013C E01019712 High Peak 008A E01019741 High Peak 013I E01019713 High Peak 008B E01019742 High Peak 013D E01019714 High Peak 012A E01019743 High Peak 006C E01019715 High Peak 010B E01019744 High Peak 006D E01019716 High Peak 011A E01019745 High Peak 006E E01019717 High Peak 010C E01019746 High Peak 005A E01019718 High Peak 013E E01019747 High Peak 005B E01019719 High Peak 013F E01019748 High Peak 005C E01019720 High Peak 013G E01019755 High Peak 005D E01019721 High Peak 013H E01019759 High Peak 011C E01019722 High Peak 010D E01019760 High Peak 011D E01019723 High Peak 010E E01019761 High Peak 011E E01019724 High Peak 011B E01019762 High Peak 012D E01019725 High Peak 012B E01019764 High Peak 008C E01019726 High Peak 012C E01019765 High Peak 008D E01019734 High Peak 006B E01019766 High Peak 005E E01019735 High Peak 013A E01019767 High Peak 008E North East Derbyshire E01019769 North East Derbyshire 010A E01019802 North East Derbyshire 001B E01019770 North East Derbyshire 005A E01019803 North East Derbyshire 001C

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LSOA Code LSOA Name LSOA Code LSOA Name E01019771 North East Derbyshire 008A E01019804 North East Derbyshire 001D E01019772 North East Derbyshire 008B E01019805 North East Derbyshire 001E E01019773 North East Derbyshire 012A E01019806 North East Derbyshire 001F E01019774 North East Derbyshire 010B E01019807 North East Derbyshire 001G E01019775 North East Derbyshire 012B E01019808 North East Derbyshire 009E E01019776 North East Derbyshire 012C E01019809 North East Derbyshire 011A E01019777 North East Derbyshire 012D E01019810 North East Derbyshire 011B E01019778 North East Derbyshire 002A E01019811 North East Derbyshire 011C E01019779 North East Derbyshire 002B E01019812 North East Derbyshire 011D E01019780 North East Derbyshire 004A E01019813 North East Derbyshire 011E E01019781 North East Derbyshire 004B E01019814 North East Derbyshire 013A E01019782 North East Derbyshire 004C E01019815 North East Derbyshire 014C E01019783 North East Derbyshire 006A E01019816 North East Derbyshire 002D E01019784 North East Derbyshire 006B E01019817 North East Derbyshire 013B E01019785 North East Derbyshire 006C E01019818 North East Derbyshire 013C E01019786 North East Derbyshire 004D E01019819 North East Derbyshire 013D E01019787 North East Derbyshire 005B E01019820 North East Derbyshire 013E E01019788 North East Derbyshire 005C E01019821 North East Derbyshire 007B E01019790 North East Derbyshire 002C E01019822 North East Derbyshire 007C E01019791 North East Derbyshire 014A E01019823 North East Derbyshire 007D E01019792 North East Derbyshire 014B E01019824 North East Derbyshire 010C E01019793 North East Derbyshire 006D E01019825 North East Derbyshire 011F E01019794 North East Derbyshire 005D E01019826 North East Derbyshire 009F E01019795 North East Derbyshire 006E E01019827 North East Derbyshire 004E E01019796 North East Derbyshire 009A E01019828 North East Derbyshire 008C E01019797 North East Derbyshire 009B E01019829 North East Derbyshire 008D E01019798 North East Derbyshire 007A E01019830 North East Derbyshire 010D E01019799 North East Derbyshire 009C E01019831 North East Derbyshire 010E E01019800 North East Derbyshire 009D E01032586 North East Derbyshire 014D E01019801 North East Derbyshire 001A South Derbyshire E01019832 South Derbyshire 004A E01019863 South Derbyshire 008D E01019833 South Derbyshire 004B E01019864 South Derbyshire 008E E01019834 South Derbyshire 004C E01019865 South Derbyshire 008F E01019835 South Derbyshire 004D E01019866 South Derbyshire 001D E01019837 South Derbyshire 012A E01019867 South Derbyshire 005A E01019838 South Derbyshire 012B E01019868 South Derbyshire 005B E01019839 South Derbyshire 001A E01019869 South Derbyshire 005C E01019840 South Derbyshire 002A E01019870 South Derbyshire 011D E01019841 South Derbyshire 002B E01019871 South Derbyshire 011E E01019842 South Derbyshire 013A E01019872 South Derbyshire 011F E01019843 South Derbyshire 006A E01019873 South Derbyshire 003A E01019844 South Derbyshire 007A E01019874 South Derbyshire 003B E01019845 South Derbyshire 001B E01019875 South Derbyshire 003C E01019846 South Derbyshire 001C E01019876 South Derbyshire 009A E01019847 South Derbyshire 002C E01019877 South Derbyshire 009B E01019848 South Derbyshire 002D E01019878 South Derbyshire 009C E01019850 South Derbyshire 011A E01019879 South Derbyshire 009D E01019851 South Derbyshire 011B E01019880 South Derbyshire 005D E01019852 South Derbyshire 011C E01019881 South Derbyshire 003D

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LSOA Code LSOA Name LSOA Code LSOA Name E01019853 South Derbyshire 006B E01019882 South Derbyshire 003E E01019854 South Derbyshire 006C E01019883 South Derbyshire 013B E01019855 South Derbyshire 006D E01019885 South Derbyshire 013C E01019856 South Derbyshire 007B E01033531 South Derbyshire 012C E01019857 South Derbyshire 007C E01033532 South Derbyshire 002F E01019858 South Derbyshire 007D E01033533 South Derbyshire 002G E01019859 South Derbyshire 007E E01033534 South Derbyshire 002H E01019860 South Derbyshire 008A E01033535 South Derbyshire 013D E01019861 South Derbyshire 008B E01033536 South Derbyshire 012D E01019862 South Derbyshire 008C E01033537 South Derbyshire 012E Derby E01013453 Derby 013A E01013532 Derby 004C E01013454 Derby 013B E01013533 Derby 007A E01013455 Derby 017A E01013534 Derby 006D E01013456 Derby 013C E01013535 Derby 007B E01013457 Derby 013D E01013536 Derby 007C E01013458 Derby 017B E01013537 Derby 007D E01013459 Derby 020A E01013538 Derby 007E E01013460 Derby 013E E01013539 Derby 021A E01013461 Derby 001A E01013540 Derby 019A E01013462 Derby 001B E01013541 Derby 021B E01013463 Derby 001C E01013542 Derby 017C E01013464 Derby 001D E01013543 Derby 021C E01013465 Derby 002A E01013544 Derby 021D E01013466 Derby 002B E01013545 Derby 021E E01013467 Derby 002C E01013546 Derby 017D E01013468 Derby 002D E01013547 Derby 011A E01013469 Derby 002E E01013548 Derby 009A E01013470 Derby 024A E01013549 Derby 009B E01013471 Derby 025A E01013550 Derby 011B E01013472 Derby 026A E01013551 Derby 011C E01013473 Derby 025B E01013552 Derby 009C E01013474 Derby 024B E01013553 Derby 009D E01013475 Derby 025C E01013554 Derby 011D E01013476 Derby 024C E01013555 Derby 009E E01013477 Derby 025D E01013556 Derby 015A E01013479 Derby 013F E01013557 Derby 015B E01013480 Derby 016A E01013558 Derby 015C E01013481 Derby 018A E01013559 Derby 015D E01013483 Derby 016B E01013560 Derby 019B E01013484 Derby 018C E01013561 Derby 019C E01013485 Derby 016C E01013562 Derby 019D E01013486 Derby 018D E01013563 Derby 019E E01013487 Derby 018E E01013564 Derby 015E E01013488 Derby 022A E01013565 Derby 016D E01013489 Derby 022B E01013566 Derby 016E E01013490 Derby 022C E01013567 Derby 020B E01013491 Derby 022D E01013568 Derby 020C E01013492 Derby 027A E01013569 Derby 020D E01013493 Derby 027B E01013570 Derby 023A

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LSOA Code LSOA Name LSOA Code LSOA Name E01013494 Derby 027C E01013571 Derby 023B E01013495 Derby 027D E01013572 Derby 023C E01013496 Derby 028A E01013573 Derby 023D E01013497 Derby 026B E01013574 Derby 003A E01013498 Derby 028B E01013575 Derby 003B E01013499 Derby 028C E01013576 Derby 003C E01013500 Derby 028D E01013577 Derby 003D E01013501 Derby 028E E01013578 Derby 003E E01013502 Derby 025E E01013579 Derby 003F E01013503 Derby 025F E01013580 Derby 003G E01013504 Derby 026C E01013581 Derby 004D E01013505 Derby 006A E01013582 Derby 006E E01013506 Derby 006B E01013583 Derby 026D E01013507 Derby 012A E01013584 Derby 029A E01013508 Derby 012B E01013585 Derby 029B E01013509 Derby 012C E01013586 Derby 029C E01013510 Derby 012D E01013587 Derby 029D E01013511 Derby 012E E01013588 Derby 029E E01013512 Derby 012F E01013589 Derby 029F E01013513 Derby 006C E01013590 Derby 026E E01013514 Derby 031A E01013591 Derby 026F E01013515 Derby 031B E01013592 Derby 010A E01013517 Derby 030B E01013593 Derby 014A E01013518 Derby 030C E01013594 Derby 010B E01013519 Derby 031C E01013595 Derby 014B E01013520 Derby 031D E01013596 Derby 010C E01013521 Derby 030D E01013597 Derby 014C E01013522 Derby 008A E01013598 Derby 014D E01013523 Derby 008B E01013599 Derby 010D E01013524 Derby 008C E01033166 Derby 018F E01013525 Derby 008D E01033167 Derby 018G E01013526 Derby 005A E01033168 Derby 030E E01013527 Derby 005B E01033169 Derby 030F E01013528 Derby 005C E01033170 Derby 030G E01013529 Derby 005D E01033171 Derby 024E E01013530 Derby 004A E01033172 Derby 024F E01013531 Derby 004B

3. MEMBERSHIP MATTERS

3.1 Membership of the Clinical Commissioning Group

3.1.1 The CCG is a membership organisation.

3.1.2 All practices who provide primary medical services to a registered list of patients under a General Medical Services, Personal Medical Services or Alternative Provider Medical Services contract in our area are eligible for membership of this CCG.

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3.1.3 The practices which make up the membership of the CCG are listed below:

Practice Name Address Place Adam House Medical Centre 85-91 Derby Road, Sandiacre, Erewash Nottingham, NG10 5HZ The Aitune Medical Practice Midland Street, Long Eaton, Erewash Nottingham, NG10 1RY Alvaston Medical Centre 14 Boulton Lane, Alvaston, Derby City Derby, DE24 0GE Appletree Medical Practice 47A Town Street, Duffield, Amber Valley Derby, DE56 4GG Arden House Medical Sett Close, New Mills, SK22 High Peak Practice 4AQ Arthur Medical Centre Main Street, Horsley Amber Valley Woodhouse, Derby, DE7 6AX Ashbourne Medical Practice Clifton Road, Ashbourne, Derby, Derbyshire Dales DE6 1DR Ashbourne Surgery Clifton Road, Ashbourne, Derby, Derbyshire Dales DE6 1RR Ashover Medical Centre Milken Lane, Ashover, Derbyshire Dales Chesterfield, S45 0BA Bakewell Medical Centre Butts Quarry, Bakewell, De45 Derbyshire Dales 1ED Barlborough Medical Practice 7 Worksop Road, Barlborough, Bolsover and North Chesterfield, S43 4TY Eastern Derbyshire Baslow Health Centre Church Lane, Baslow, Bakewell, Derbyshire Dales DE45 1SP Blackwell Medical Centre 6 Gloves Lane, Blackwell, Bolsover and North Alfreton, DE55 5JJ Eastern Derbyshire Blue Dykes Surgery Eldon Street, Clay Cross, Bolsover and North Chesterfield, S45 9NR Eastern Derbyshire Brailsford Medical Centre The Green, Derby, DE6 3BX Derbyshire Dales Brimington Surgery Church Street, Brimington, Chesterfield Chesterfield, S41 1JG The Brook Medical Centre 183 Kedleston Road, Derby, Derby City DE22 1FT Brooklyn Medical Practice 65 Mansfield Road, Derby, Amber Valley DE75 7AL Buxton Medical Practice Temple Road, Buxton, SK17 High Peak 9BZ Calow & Brimington Practice Foljambe Road, Brimington, Chesterfield Chesterfield, S43 1DD Castle Street Medical Centre Castle Street, Bolsover, Bolsover and North Chesterfield, S44 6PP Eastern Derbyshire Chapel Street Medical 10 Chapel Street, Spondon, Derby City Centre Derby, DE21 7RJ Charnwood Surgery 5 Burton Road, Derby, DE1 1TH Derby City Chatsworth Road Medical Chatsworth Road, Brampton, Chesterfield Centre Chesterfield, S40 3PY Chellaston & Melbourne Rowallan Way, Chellaston, Derby City Medical Practice Derby, DE73 5GB

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Practice Name Address Place Chesterfield Medical Ashgate Manor, Ashgate Road, Chesterfield Partnership Chesterfield, S40 4AA Clay Cross Medical Centre Bridge Street, Clay Cross, Bolsover and North Chesterfield, S45 9NG Eastern Derbyshire College Street Medical 86 College Street, Long Eaton, Erewash Practice Nottingham, NG10 4NP Crags Health Care 174 Elmton Road, Creswell, Bolsover and North Worksop, S80 4DY Eastern Derbyshire Creswell & Langwith Welbeck Street, Creswell, Bolsover and North Surgeries Worksop, S80 4HA Eastern Derbyshire Crich Medical Practice Oakwell Drive, Crich, Derby, Amber Valley DE4 5PB Darley Dale Medical Centre Two Dales, Matlock, DE4 2SA Derbyshire Dales Derby Family Medical Centre 1 Hastings Street, DE23 6QQ Derby City Derwent Medical Centre 26 North Street, Derby, DE1 Derby City 3AZ Derwent Valley Medical 20 St Mark’s Road, DE61 6AT Derby City Practice Dronfield Medical Practice High Street, Dronfield, S18 1PY Bolsover and North Eastern Derbyshire Eden Surgery Cavendish Road, Ilkeston, Erewash Derbyshire, DE7 5AN Elmwood Medical Centre Burlington Road, Buxton, SK17 High Peak 9AY Emmett Carr Surgery Abbey Place, Renishaw, S21 Bolsover and North 3TY Eastern Derbyshire Evelyn Medical Centre Marsh Avenue, Hope, S33 6RJ Derbyshire Dales Eyam Surgery Church Street, Eyam, Hope Derbyshire Dales Valley, S32 5QH Family Friendly Surgery Welbeck Road, Bolsover, Bolsover and North Chesterfield, S44 6DE Eastern Derbyshire Friar Gate Surgery Agard Street, Derby, DE1 1DZ Derby City Gladstone House Surgery Gladstone Street West, Ilkeston, Erewash Derbyshire, DE7 5QS The Golden Brook Practice Midland Street, Long Eaton, Erewash Nottingham, NG10 1RY Goyt Valley Medical Practice Chapel Road, Whaley Bridge, High Peak SK23 7SR Gresleydale Healthcare Glamorgan Way, Church Derby City Centre Gresley, Swadlincote, DE11 9JT Hannage Brook Medical Hannage Way, Wirksworth, Derbyshire Dales Centre Derbyshire, DE4 4JG Hartington Surgery Dig Street, Hartington, SK17 High Peak 0AQ Haven Medical Centre 690 Osmaston Road, Derby, Derby City DE24 8GT Heartwood Medical Practice Civic Way, Swadlincote, Derby, Derby City DE11 0AE Hollybrook Medical Centre Hollybrook Way, Heatherton, Derby City Derby, DE23 3TX

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Practice Name Address Place Imperial Road Surgery 8 Imperial Road, Matlock, DE4 Derbyshire Dales 3NL Inspire Health 109 Saltergate, Chesterfield, Chesterfield S40 1LE Ivy Grove Surgery Steeple Drive, Ripley, Amber Valley Derbyshire, DE5 3TH Jessop Medical Practice Greenhill Lane, Riddings, Amber Valley Alfreton, DE55 1LU Kelvingrove Medical Centre 28 Hands Road, Heanor, Amber Valley Derbyshire, DE75 7HA Killamarsh Medical Practice 209 Sheffield Road, Killamarsh, Bolsover and North Sheffield, S21 1DX Eastern Derbyshire Lime Grove Medical Centre Lime Grove Walk, Matlock, DE4 Derbyshire Dales 3FD Limes Medical Centre Limes Ave, Alfreton, DE55 7DW Bolsover and North Eastern Derbyshire Lister House Chellaston Fellow Lands Way, Derby, DE73 Derby City Surgery 6SW Lister House Surgery 207 St Thomas Road, Derby, Derby City DE23 8RJ Littlewick Medical Centre 42 Nottingham Road, Ilkeston, Erewash Derbyshire, DE7 5PR Macklin Street Surgery 90 Macklin Street, Derby, DE1 Derby City 1JX Mickleover Medical Centre Vicarage Road, Mickleover, Derby City Derby, DE3 0HA Mickleover Surgery 10 Cavendish Way, Mickleover, Derby City Derby, DE3 9BJ The Moir Medical Centre Regent Street, Long Eaton, Erewash Nottingham, NG10 QQ Newbold Surgery 3 Windemere Road, Newbold, Chesterfield Chesterfield, S31 8DU Newhall Surgery 46-48 High Street, Swadlincote, Derby City Derby, DE11 0HU North Wingfield Medical Chesterfield Road, North Bolsover and North Centre Wingfield, S42 5ND Eastern Derbyshire Oakhill Medical Practice Oakhill Road, Dronfield, S18 Bolsover and North 2EJ Eastern Derbyshire Oakwood Surgery 380 Bishops Drive, Oakwood, Derby City Derby, DE21 2DF Old Station Surgery Heanor Road, Ilkeston, Erewash Derbyshire, DE7 8ES The Osmaston Surgery 212 Osmaston Road, Derby, Derby City DE23 8JX Overdale Medical Practice Breaston Surgery, 1 Bridgefield, Derby City Breaston, DE72 3DS Overseal Surgery 1 Hallcroft Avenue, Overseal, Derby City Derby, DE12 6JF Park Farm Medical Centre 3 Park Farm Centre, Allestree, Derby City Derby, DE22 2QN

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Practice Name Address Place Parkfields Surgery 1217 London Road, Alvaston, Derby City Derby, DE24 8QJ Park Lane Surgery 2 Park Lane, Allestree, Derby, Derby City DE22 2DS Park Medical Practice Maine Drive, Chaddesden, Derby City Derby, DE21 6LA Park Surgery 60 Ilkeston Road, Heanor, Amber Valley Ilkeston, DE75 7DX Parkside Surgery Alfreton Primary Care Centre, Amber Valley Church Street, Alfreton, DE55 7AH Park View Medical Centre Cranfleet Way, Long Eaton, Erewash Nottingham, NG10 3RJ Peartree Medical Centre 159 Peartree Road, Derby, Derby City DE23 8NQ Dr Purnell and Partners Ilkeston Health Centre, South Erewash Street, Ilkeston, DE7 5PZ Ripley Medical Centre Derby Road, Ripley, Derbyshire, Amber Valley DE5 3HR Riversdale 59 Bridge Street, Belper, Amber Valley Derbyshire, DE56 1AX Royal Primary Care Stubbing Road, Grangewood, Chesterfield Chesterfield, S40 2HP St Lawrence Road Surgery 17-19 St Lawrence Road, North Bolsover and North Wingfield, Chesterfield, S42 5LH Eastern Derbyshire St Thomas Road Surgery 207 St Thomas Road, Derby, Derby City DE23 8RJ Sett Valley Medical Centre Hyde Bank Road, New Mills, High Peak SK22 4BP Shires Healthcare 18 Main Street, Shirebrook, Bolsover and North Mansfield, NG20 8DG Eastern Derbyshire Somercotes Medical Centre 22 Nottingham Road, Amber Valley Somercotes, Derbyshire, DE55 4JJ The Springs Health Centre Recreation Close, Clowne, Bolsover and North Chesterfield, S43 3PL Eastern Derbyshire Staffa Health 3 Waverley Street, Tibshelf, Bolsover and North Alfreton, DE55 5PS Eastern Derbyshire Stewart Medical Centre Hartington Road, Buxton, SK17 High Peak 6JP Stubley Medical Centre 7 Stubley Drive, Dronfield Bolsover and North Woodhouse, Dronfield, S18 8QU Eastern Derbyshire The Surgery @ Wheatbridge 30 Wheatbridge Road, Chesterfield Chesterfield, S40 1AB Swadlincote Surgery Darklands Road, Swadlincote, Derby City Derbyshire, DE11 0PP Thornbrook Surgery Thornbrook Road, Chapel en Le High Peak Frith, SK23 0RH Tideswell Surgery Parke Road, Tideswell, Buxton, Derbyshire Dales SK17 8NS

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Practice Name Address Place The Valleys Medical Gosber Road, Eckington, S21 Bolsover and North Partnership 4BZ Eastern Derbyshire Vernon Street Medical 13 Vernon Street, Derby, DE1 Derby City Centre 1FW Village Surgery Village Community Medical Derby City Centre, Derby, DE23 8AL The Village Surgery The Hub, Shiners Way, South Bolsover and North Normanton, DE55 2AA Eastern Derbyshire Dr Webb & Partners Ilkeston Health Centre, South Erewash Street, Ilkeston, DE7 5PZ Welbeck Road Surgery 1b Welbeck Road, Bolsover, Bolsover and North Chesterfield, S44 6DF Eastern Derbyshire Wellbrook Medical Centre Welland Road, Derby, DE65 Derby City 5GZ Wellside Medical Centre 3 Burton Road, Derby, DE22 Derby City 4AU West Hallam Medical Centre The Village, West Hallam, Amber Valley Ilkeston, DE7 6GR Whitemoor Medical Centre Whitemoor Lane, Belper, Amber Valley Derbyshire, DE56 2JU Whittington Moor Surgery Scarsdale Road, Whittington Chesterfield Moor, Chesterfield, S41 8NA Willington Surgery Kingfisher Lane, Willington, Derby City Derbyshire, DE65 6YB Wilson Street Surgery 11 Wilson Street, Derby, DE1 Derby City 1PG Wingerworth Medical Centre 3 Allendale Road, Wingerworth, Bolsover and North Chesterfield, S42 6PX Eastern Derbyshire Woodville Surgery Burton Road, Woodville, Derby City Swadlincote, DE11 7JE

3.2 Nature of Membership and Relationship with CCG

The CCG’s Members are integral to the functioning of the CCG. Those exercising delegated functions on behalf of the Membership, including the Governing Body, remain accountable to the Membership.

3.3 Speaking, Writing or Acting in the Name of the CCG

3.3.1 Members are not restricted from giving personal views on any matter. However, Members should make it clear that personal views are not necessarily the view of the CCG.

3.3.2 Nothing in or referred to in this constitution (including in relation to the issue of any press release or other public statement or disclosure) will prevent or inhibit the making of any protected disclosure (as defined in the Employment Rights Act 1996, as amended by the Public Interest Disclosure Act 1998) by any member of the CCG, any member of its Governing Body, any member of any of its Committees or Sub-Committees or the Committees or Sub-Committees of its Governing Body, or any employee of the CCG or of any of its members, nor will it affect the rights of any worker (as defined in that Act) under that Act.

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3.4 Members’ Rights

3.4.1 A membership agreement shall describe the relationship between, and the respective responsibilities of Member practices, GPs and the CCG.

3.4.2 Member practices shall elect the GP Chair, who shall chair the Governing Body of, and take responsibility as the clinical leader of the CCG.

3.4.3 Member Practices shall elect six GPs to serve on the Governing Body, of the CCG.

3.4.4 Calling and attending a general meeting of the Members.

3.4.5 Submitting a proposal for amendment of the Constitution.

3.4.6 Putting themselves forward for the election to the Governing Body.

3.4.7 Removing the Chair (or other elected members) of the Governing Body.

3.4.8 Participating in the development of the CCG’s Corporate Governance documents, including the CCG Handbook.

3.5 Members’ Meetings

A Membership Forum, at which GPs and member practices will hold the Governing Body of the CCG to account at least three a year, shall be facilitated by the CCG; this Forum shall also meet on an ad hoc basis to consider matters of common interest and to procure dispute resolution.

3.6 Practice Representatives

3.6.1 Each Member practice has a nominated lead healthcare professional who represents the practice in the dealings with the CCG.

3.6.2 Practice representatives of the Membership Forum represent their practice’s views and act on behalf of them, in matters relating to the CCG. The role of each Representative is to:

(a) ensure the effective participation of each Member in the CCG, in order to develop and sustain high-quality commissioning arrangements and an understanding of local health needs;

(b) feed back the views of their practice to the CCG;

(d) feed back to the CCG the views of users, or potential users, of services in the area covered by the CCG, particularly in relation to any quality issues that might inform commissioning decisions;

(e) feed back to their practice any relevant information or guidance produced by the CCG, which may require changes in the way in which the practice functions, in respect of the provision of healthcare in the local area covered

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by the CCG, as well as facilitating the dissemination of newsletters or other updates to practice staff or attendees at their practices;

(f) establish effective working arrangements with the clinical leaders of the CCG’s main providers, to achieve improved local health outcomes;

(g) attend the regular Membership Forums and participate in an annual review of the CCG, the Governing Body and its Committees; and peer review as required; and

(h) ensure that key actions or information agreed by the CCG are noted and taken forward, as appropriate, by their own Member Practice.

4. ARRANGEMENTS FOR THE EXERCISE OF OUR FUNCTIONS.

4.1 Good Governance

The CCG will, at all times, observe generally accepted principles of good governance. These include but are not limited to:

4.1.1 use of the governance toolkit for CCGs www.ccggovernance.org;

4.1.2 undertaking regular governance reviews;

4.1.3 adoption of standards and procedures that facilitate speaking out and the raising of concerns including a freedom to speak up guardian if one is appointed;

4.1.4 adopting CCG values that include standards of propriety in relation to the stewardship of public funds, impartiality, integrity and objectivity;

4.1.5 the Good Governance Standard for Public Services;

4.1.6 the standards of behaviour published by the Committee on Standards in Public Life (1995) known as the ‘Nolan Principles’;

4.1.7 the seven key principles of the NHS Constitution;

4.1.8 relevant legislation including such as the Equality Act 2010; and

4.1.9 the standards set out in the Professional Standard Authority’s guidance ‘Standards for Members of NHS Boards and Clinical Commissioning Group Governing Bodies in England’.

The CCG Handbook includes the NHS Derby and Derbyshire CCG Corporate Governance Framework which supports the above.

4.2 General

4.2.1 The CCG will:

(a) comply with all relevant laws, including regulations;

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(b) comply with directions issued by the Secretary of State for Health or NHS England;

(d) take account, as appropriate, of other documents, advice and guidance.

4.2.2 The CCG will develop and implement the necessary systems and processes to comply with (a)-(d) above, documenting them as necessary in this constitution, its scheme of reservation and delegation and other relevant policies and procedures as appropriate.

4.3 Authority to Act: the CCG

The CCG is accountable for exercising its statutory functions. It may grant authority to act on its behalf to:

4.3.1 any of its members or employees;

4.3.2 its Governing Body;

4.3.3 a Committee or Sub-Committee of the CCG.

4.4 Authority to Act: the Governing Body

The Governing Body may grant authority to act on its behalf to:

4.4.1 any Member of the Governing Body;

4.4.2 a Committee or Sub-Committee of the Governing Body;

4.4.3 a Member of the CCG who is an individual (but not a Member of the Governing Body); and

4.4.4 any other individual who may be from outside the organisation and who can provide assistance to the CCG in delivering its functions.

5. PROCEDURES FOR MAKING DECISIONS

5.1 Scheme of Reservation and Delegation

5.1.1 The CCG has agreed a scheme of reservation and delegation (SoRD) which is published in full in the CCG handbook which is available on the CCG’s website via the following link:

https://www.derbyandderbyshireccg.nhs.uk/about-us/what-we-do/constitution- and-ccg-governance-handbook/

5.1.2 The CCG’s SoRD sets out:

(a) those decisions that are reserved for the membership as a whole;

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(b) those decisions that have been delegated by the CCG, the Governing Body or other individuals.

5.1.3 The CCG remains accountable for all of its functions, including those that it has delegated. All those with delegated authority, including the Governing Body, are accountable to the Members for the exercise of their delegated functions.

5.2 Standing Orders

5.2.1 The CCG has agreed a set of standing orders which describe the processes that are employed to undertake its business. They include procedures for:

(a) conducting the business of the CCG;

(b) the appointments to key roles including Governing Body members;

(d) the process to delegate powers.

5.2.2 A full copy of the standing orders is included in Appendix 3. The standing orders form part of this constitution.

5.3 Standing Financial Instructions (SFIs)

5.3.1 The CCG has agreed a set of SFIs which include the delegated limits of financial authority set out in the SoRD.

5.3.2 A copy if the SFIs are included at Appendix 4 and form part of this constitution.

5.4 The Governing Body: Its Role and Functions

5.4.1 The Governing Body has statutory responsibility for:

(a) ensuring that the CCG has appropriate arrangements in place to exercise its functions effectively, efficiently and economically and in accordance with the CCG’s principles of good governance (its main function); and for

(b) determining the remuneration, fees and other allowances payable to employees or other persons providing services to the CCG and the allowances payable under any pension scheme established.

5.4.2 The CCG has also delegated the following additional functions to the Governing Body which are also set out in the SoRD. Any delegated functions must be exercised within the procedural framework established by the CCG and primarily set out in the Standing Orders and SFIs:

(a) approving any functions of the CCG that are specified in regulations;

(b) ensuring delivery of the CCG’s statutory duties associated with its commissioning functions that have been delegated to the Governing Body as stated in section 5.9.6 below, including but not limited to:

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(ii) safeguarding, and ensuring patient safety;

(iii) promotion of a comprehensive health service and the mandate;

(iv) delivery of statutory financial duties;

(v) meeting the public sector equality duty;

(vi) working in partnership with the local authority(ies);

(vii) promoting and securing the involvement of patients, carers, local people, clinicians, partners and other stakeholders;

(viii) promoting awareness of the NHS Constitution;

(ix) acting effectively, efficiently and economically;

(x) securing continuous improvements in the quality of services, including primary medical services and specialised services, supporting the NHS Commissioning Board where required;

(xi) reducing health inequalities;

(xii) ensuring patient choice;

(xiii) obtaining appropriate advice;

(xiv) promoting innovation, research, education, training and integration;

(xv) working with local partners to ensure the effective Emergency Planning and Resilience (EPRR);

(c) approving all other matters delegated to it by the CCG, as detailed within the Scheme of Reservation and Delegation. The Governing Body will delegate decision making to other committees to act on its behalf;

(d) leading the development of vision and strategy of the CCG;

(e) overseeing and monitoring quality improvement;

(f) approving the CCG’s Commissioning Plans and its constitution arrangements;

(g) stimulating innovation and modernisation;

(h) overseeing and monitoring performance;

(i) overseeing risk assessment and securing assurance actions to mitigate identified strategic risks.

(j) promoting a culture of strong engagement with patients, their carers, Members, the public and other stakeholders about the activity and progress of the CCG;

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(k) ensuring good governance and leading a culture of good governance throughout the CCG.

The detailed procedures for the Governing Body, including voting arrangements, are set out in the standing orders.

5.5 Composition of the Governing Body

5.5.1 This part of the constitution describes the make-up of the Governing Body roles. Further information about the individuals who fulfil these roles can be found on our website in the CCG Handbook:

https://www.derbyandderbyshireccg.nhs.uk/about-us/what-we-do/constitution- and-ccg-governance-handbook/

5.5.2 The National Health Service (Clinical Commissioning Groups) Regulations 2012 set out a minimum membership requirement of the Governing Body of:

(a) the Clinical Chair;

(b) the Accountable Officer;

(d) a Secondary Care Specialist;

(e) a Registered Nurse (Chief Nurse Officer);

(f) two lay members:

(i) one who has qualifications expertise or experience to enable them to lead on finance and or audit matters; and another who

(ii) has knowledge about the CCG area enabling them to express an informed view about discharge of the CCG functions and who shall be the Vice Chair.

5.5.3 The CCG has agreed the following additional Members:

(a) a third lay member – one who shall be to be the Chair of the Primary Care Commissioning Committee;

(b) a fourth lay member who shall be a patient and public involvement lay member and Chair the Engagement Committee;

(d) a sixth lay member who shall lead on Governance,

(3 of the 6 Lay members will also represent the North, South and City areas);

(e) 1 GP who shall be also be the Place Board Chair;

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(f) 1 GP who shall be the General Practice lead and will also chair the Clinical and Lay Commissioning Committee;

(g) 1 GP who shall lead Quality and Performance who will also chair the Quality and Performance Committee;

(h) 1 GP who shall be the North lead and link with local Places and membership practices within that area;

(i) 1 GP who shall be the South lead and link with local Places and membership practices within that area;

(j) 1 GP who shall be the City lead and link with local Places and membership practices within that area;

(k) Medical Director;

(l) Executive Director of Commissioning; and

(m) Executive Director of Strategy and Delivery.

5.6 Additional Attendees at the Governing Body Meetings

5.6.1 The CCG Governing Body may invite other person(s) to attend all or any of its meetings, or part(s) of a meeting, in order to assist it in its decision-making and in its discharge of its functions as it sees fit. Any such person may be invited by the chair to speak and participate in debate, but may not vote.

5.6.2 The CCG Governing Body will regularly invite two Public Health Consultants; one Consultant from Derby City Council and one consultant from Derbyshire County Council to attend any or all of its meetings as attendees.

5.7 Appointments to the Governing Body

5.7.1 The process of appointing GPs to the Governing Body, the selection of the Chair, and the appointment procedures for other Governing Body Members are set out in the standing orders.

5.7.2 Also set out in standing orders are the details regarding the tenure of office for each role and the procedures for resignation and removal from office.

5.8 Committees and Sub-Committees

5.8.1 The CCG may establish Committees and Sub-Committees of the CCG.

5.8.2 The Governing Body may establish Committees and Sub-Committees.

5.8.3 Each Committee and Sub-Committee established by either the CCG or the Governing Body operates under terms of reference and membership agreed by the CCG or Governing Body as relevant. Appropriate reporting and assurance mechanisms must be developed as part of agreeing terms of reference for Committees and Sub-Committees.

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5.8.4 With the exception of the Remuneration Committee, any Committee or Sub- Committee established in accordance with clause 5.8 may consist of or include persons other than members or employees of the CCG.

5.8.5 All members of the Remuneration Committee will be members of the CCG Governing Body.

5.8.6 The Governing Body has also established a number of other committees to assist it with the discharge of its functions. The terms of references for these committees are published in the CCG handbook.

5.9 Committees of the Governing Body

5.9.1 The Governing Body will maintain the following statutory or mandated Committees:

(a) Audit Committee

(i) This Committee is accountable to the Governing Body and provides the Governing Body with an independent and objective view of the CCG’s compliance with its statutory responsibilities. The Committee is responsible for arranging appropriate internal and external audit and has the delegated authority for the approval of the Annual report and Accounts.

(ii) The Audit Committee will be chaired by a Lay Member who has qualifications, expertise or experience to enable them to lead on finance and audit matters and members of the Audit Committee may include people who are not Governing Body members.

(b) Remuneration Committee

(i) This Committee is accountable to the Governing Body and makes recommendations to the Governing Body about the remuneration, fees and other allowances (including pension schemes) for employees and other individuals who provide services to the CCG.

(ii) The Remuneration Committee will be chaired by a lay member other than the audit chair and only members of the Governing Body may be members of the Remuneration Committee.

This committee is required by the terms of the delegation from NHS England in relation to primary care commissioning functions. The Primary Care Commissioning Committee is accountable to the Governing Body and to NHS England. Membership of the Committee is determined in accordance with the requirements of Managing Conflicts of Interest: Revised statutory Guidance for CCGs 2017. This includes the requirement for a lay member Chair and a lay Vice Chair.

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5.9.2 None of the above Committees may operate on a joint committee basis with another CCG(s).

5.9.3 The terms of reference for each of the above committees are included in Appendix 2 to this constitution and form part of the constitution.

5.9.4 The Governing Body has also established a number of other Committees to assist it with the discharge of its functions. These Committees are set out in the SoRD and further information about these Committees, including terms of reference, are published in the CCG Handbook which is available on the website

https://www.derbyandderbyshireccg.nhs.uk/about-us/what-we-do/constitution- and-ccg-governance-handbook/.

5.10 Collaborative Commissioning Arrangements

5.10.1 The CCG wishes to work collaboratively with its partner organisations in order to assist it with meeting its statutory duties, particularly those relating to integration. The following provisions set out the framework that will apply to such arrangements.

5.10.2 In addition to the formal joint working mechanisms envisaged below, the Governing Body may enter into strategic or other transformation discussions with its partner organisations, on behalf of the CCG.

5.10.3 The Governing Body must ensure that appropriate reporting and assurance mechanisms are developed as part of any partnership or other collaborative arrangements. This will include:

(a) reporting arrangements to the Governing Body, at appropriate intervals;

(b) engagement events or other review sessions to consider the aims, objectives, strategy and progress of the arrangements; and

5.10.4 When delegated responsibilities are being discharged collaboratively, the collaborative arrangements, whether formal joint working or informal collaboration, must:

(a) identify the roles and responsibilities of those CCGs or other partner organisations that have agreed to work together and, if formal joint working is being used, the legal basis for such arrangements;

(b) specify how performance will be monitored and assurance provided to the Governing Body on the discharge of responsibilities, so as to enable the Governing Body to have appropriate oversight as to how system integration and strategic intentions are being implemented;

(c) set out any financial arrangements that have been agreed in relation to the collaborative arrangements, including identifying any pooled budgets and how these will be managed and reported in annual accounts;

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(d) specify under which of the CCG’s supporting policies the collaborative working arrangements will operate;

(e) specify how the risks associated with the collaborative working arrangement will be managed and apportioned between the respective parties;

(f) set out how contributions from the parties, including details around assets, employees and equipment to be used, will be agreed and managed;

(g) identify how disputes will be resolved and the steps required to safely terminate the working arrangements;

(h) specify how decisions are communicated to the collaborative partners.

5.11 Joint Commissioning Arrangements with Local Authority Partners

5.11.1 The CCG will work in partnership with its Local Authority partners to reduce health and social inequalities and to promote greater integration of health and social care.

5.11.2 Partnership working between the CCG and its Local Authority partners might include collaborative commissioning arrangements, including joint commissioning under section 75 of the 2006 Act, where permitted by law. In this instance, and to the extent permitted by law, the CCG delegates to the Governing Body the ability to enter into arrangements with one or more relevant Local Authority in respect of:

(a) delegating specified commissioning functions to the Local Authority;

(b) exercising specified commissioning functions jointly with the Local Authority;

5.11.3 For purposes of the arrangements described in 5.11.2, the Governing Body may:

(a) agree formal and legal arrangements to make payments to, or receive payments from, the Local Authority, or pool funds for the purpose of joint commissioning;

(b) make the services of its employees or any other resources available to the Local Authority; and

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(d) where the Governing Body makes an agreement with one or more Local Authority as described above, the agreement will set out the arrangements for joint working, including details of:

(i) how the parties will work together to carry out their commissioning functions;

(ii) the duties and responsibilities of the parties, and the legal basis for such arrangements;

(iii) how risk will be managed and apportioned between the parties;

(iv) financial arrangements, including payments towards a pooled fund and management of that fund;

(v) contributions from each party, including details of any assets, employees and equipment to be used under the joint working arrangements; and

(vi) the liability of the CCG to carry out its functions, notwithstanding any joint arrangements entered into.

5.11.4 The liability of the CCG to carry out its functions will not be affected where the CCG enters into arrangements pursuant to paragraph 5.11.2 above.

5.12 Joint Commissioning Arrangements – Other CCGs

5.12.1 The CCG may work together with other CCGs in the exercise of its Commissioning Functions.

5.12.2 The CCG delegates its powers and duties under 5.12 to the Governing Body and all references in this part to the CCG should be read as the Governing Body, except to the extent that they relate to the continuing liability of the CCG under any joint arrangements.

5.12.3 The CCG may make arrangements with one or more other CCGs in respect of:

(a) delegating any of the CCG’s commissioning functions to another CCG;

(b) exercising any of the Commissioning Functions of another CCG; or

5.12.4 For the purposes of the arrangements described at 5.12.3, the CCG may:

(a) make payments to another CCG;

(b) receive payments from another CCG; or

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(d) receive the services of the employees or the resources available to another CCG.

5.12.5 Where the CCG makes arrangements which involve all the CCGs exercising any of their commissioning functions jointly, a joint committee may be established to exercise those functions.

5.12.6 For the purposes of the arrangements described above, the CCG may establish and maintain a pooled fund made up of contributions by all of the CCGs working together jointly pursuant to paragraph 5.12.3 above. Any such pooled fund may be used to make payments towards expenditure incurred in the discharge of any of the commissioning functions in respect of which the arrangements are made.

5.12.7 Where the CCG makes arrangements with another CCG as described at paragraph 5.12.3 above, the CCG shall develop and agree with that CCG an agreement setting out the arrangements for joint working including details of:

(a) how the parties will work together to carry out their commissioning functions;

(b) the duties and responsibilities of the parties, and the legal basis for such arrangements;

(d) financial arrangements, including payments towards a pooled fund and management of that fund;

(e) contributions from the parties, including details around assets, employees and equipment to be used under the joint working arrangements.

5.12.8 The responsibility of the CCG to carry out its functions will not be affected where the CCG enters into arrangements pursuant to paragraph 5.12.1 above.

5.12.9 The liability of the CCG to carry out its functions will not be affected where the CCG enters into arrangements pursuant to paragraph 5.12.1 above.

5.12.10 Only arrangements that are safe and in the interests of patients registered with Member practices will be approved by the Governing Body.

5.12.11 The Governing Body shall require, in all joint commissioning arrangements, that the lead Governing Body Member for the joint arrangements:

(a) make a quarterly written report to the Governing Body;

(b) hold at least one annual engagement event to review the aims, objectives, strategy and progress of the joint commissioning arrangements; and

5.12.12 Should a joint commissioning arrangement prove to be unsatisfactory the Governing Body of the CCG can decide to withdraw from the arrangement, but has to give six months’ notice to partners to allow for credible alternative NHS Derby and Derbyshire Clinical Commissioning Group Constitution v3.8

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arrangements to be put in place, with new arrangements starting from the beginning of the next new financial year after the expiration of the six months’ notice period.

5.13 Joint Commissioning Arrangements with NHS England

5.13.1 The CCG may work together with NHS England. This can take the form of joint working in relation to the CCG’s functions or in relation to NHS England’s functions.

5.13.2 The CCG delegates its powers and duties under 5.13 to the Governing Body and all references in this part to the CCG should be read as the Governing Body, except to the extent that they relate to the continuing liability of the CCG under any joint arrangements.

5.13.3 In terms of either the CCG’s functions or NHS England’s functions, the CCG and NHS England may make arrangements to exercise any of their specified commissioning functions jointly.

5.13.4 The arrangements referred to in paragraph 5.13.3 above may include other CCGs, a combined authority or a local authority.

5.13.5 Where joint commissioning arrangements pursuant to 5.13.3 above are entered into, the parties may establish a Joint Committee to exercise the commissioning functions in question. For the avoidance of doubt, this provision does not apply to any functions fully delegated to the CCG by NHS England, including but not limited to those relating to primary care commissioning.

5.13.6 Arrangements made pursuant to 5.13.3 above may be on such terms and conditions (including terms as to payment) as may be agreed between NHS England and the CCG.

5.13.7 Where the CCG makes arrangements with NHS England (and another CCG if relevant) as described at paragraph 5.13.3 above, the CCG shall develop and agree with NHS England a framework setting out the arrangements for joint working, including details of:

(a) how the parties will work together to carry out their commissioning functions;

(b) the duties and responsibilities of the parties, and the legal basis for such arrangements;

(d) financial arrangements, including, if applicable, payments towards a pooled fund and management of that fund;

(e) contributions from the parties, including details around assets, employees and equipment to be used under the joint working arrangements.

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5.13.8 Where any joint arrangements entered into relate to the CCG’s functions, the liability of the CCG to carry out its functions will not be affected where the CCG enters into arrangements pursuant to paragraph 5.13.3 above. Similarly, where the arrangements relate to NHS England’s functions, the liability of NHS England to carry out its functions will not be affected where it and the CCG enter into joint arrangements pursuant to 5.13.

5.13.9 The CCG will act in accordance with any further guidance issued by NHS England on co-commissioning.

5.13.10 Only arrangements that are safe and in the interests of patients registered with member practices will be approved by the Governing Body.

5.13.11 The Governing Body of the CCG shall require, in all joint commissioning arrangements that the lead Governing Body Member for the joint arrangements make:

(a) a quarterly written report to the Governing Body;

(b) hold at least one annual engagement event to review the aims, objectives, strategy and progress of the joint commissioning arrangements; and

5.13.12 Should a joint commissioning arrangement prove to be unsatisfactory the Governing Body of the CCG can decide to withdraw from the arrangement but has to give six months’ notice to partners to allow for credible alternative arrangements to be put in place, with new arrangements starting from the beginning of the next new financial year after the expiration of the six months’ notice period.

6. PROVISIONS FOR CONFLICT OF INTEREST MANAGEMENT AND STANDARDS OF BUSINESS CONDUCT

6.1 Conflicts of Interest

6.1.1 As required by section 14O of the 2006 Act, the CCG has made arrangements to manage conflicts and potential conflicts of interest to ensure that decisions made by the CCG will be taken and seen to be taken without being unduly influenced by external or private interest.

6.1.2 The CCG has agreed policies and procedures for the identification and management of conflicts of interest.

6.1.3 Employees, Members, Committee and Sub-Committee members of the CCG and members of the Governing Body (and its Committees, Sub-Committees, Joint Committees) will comply with the CCG policy on conflicts of interest. Where an individual, including any individual directly involved with the business or decision- making of the CCG and not otherwise covered by one of the categories above, has an interest, or becomes aware of an interest which could lead to a conflict of interests in the event of the CCG considering an action or decision in relation to NHS Derby and Derbyshire Clinical Commissioning Group Constitution v3.8

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that interest, that must be considered as a potential conflict, and is subject to the provisions of this constitution and the Standards of Business Conduct Policy.

6.1.4 The CCG has appointed the Audit Chair to be the Conflicts of Interest Guardian. In collaboration with the CCG’s governance lead, their role is to:

(a) act as a conduit for GP practice staff, members of the public and healthcare professionals who have any concerns with regards to conflicts of interest;

(b) be a safe point of contact for employees or workers of the CCG to raise any concerns in relation to conflicts of interest;

(d) provide independent advice and judgment to staff and members where there is any doubt about how to apply conflicts of interest policies and principles in an individual situation;

(e) provide advice on minimising the risks of conflicts of interest.

6.2 Declaring and Registering Interests

6.2.1 The CCG will maintain registers of the interests of those individuals listed in the CCG’s policy.

6.2.2 The CCG will, as a minimum, publish the registers of conflicts of interest, gifts and hospitality of decision making staff and the procurement register of decisions and investments at least annually on the CCG website and make them available at our headquarters upon request.

6.2.3 All relevant persons for the purposes of NHS England’s statutory guidance Managing Conflicts of Interest: Revised Statutory Guidance for CCGs 2017 must declare any interests. Declarations should be made as soon as reasonably practicable and by law within 28 days after the interest arises. This could include interests an individual is pursuing. Interests will also be declared on appointment and during relevant discussion in meetings.

6.2.4 The CCG will ensure that, as a matter of course, declarations of interest are made and confirmed, or updated at least annually. All persons required to, must declare any interests as soon as reasonable practicable and by law within 28 days after the interest arises.

6.2.5 Interests (including gifts and hospitality) of decision making staff will remain on the public register for a minimum of six months. In addition, the CCG will retain a record of historic interests and offers/receipt of gifts and hospitality for a minimum of six years after the date on which it expired. The CCG’s published register of interests states that historic interests are retained by the CCG for the specified timeframe and details of whom to contact to submit a request for this information.

6.2.6 Activities funded in whole or in part by 3rd parties who may have an interest in CCG business such as sponsored events, posts and research will be managed in

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accordance with the CCG policy to ensure transparency and that any potential for conflicts of interest are well-managed.

6.3 Training in Relation to Conflicts of Interest

The CCG ensures that relevant staff and all Governing Body members receive training on the identification and management of conflicts of interest and that relevant staff undertake the NHS England Mandatory training.

6.4 Standards of Business Conduct

6.4.1 Employees, Members, Committee and Sub-Committee members of the CCG and members of the Governing Body (and its Committees, Sub-Committees, Joint Committees) will at all times comply with this Constitution and be aware of their responsibilities as outlined in it. They should:

(a) act in good faith and in the interests of the CCG;

(b) follow the Seven Principles of Public Life; set out by the Committee on Standards in Public Life (the Nolan Principles);

(c) comply with the standards set out in the Professional Standards Authority guidance – Standards for Members of NHS Boards and Clinical Commissioning Group Governing Bodies in England; and

(d) comply with the CCG’s Standards of Business Conduct and Managing Conflicts of Interest Policy, including the requirements set out in the policy for managing conflicts of interest which is available on the CCG’s website at https://www.derbyandderbyshireccg.nhs.uk/about-us/conflict-of-interest/ and will be made available on request.

6.4.2 Individuals contracted to work on behalf of the CCG or otherwise providing services or facilities to the CCG will be made aware of their obligation with regard to declaring conflicts or potential conflicts of interest. This requirement will be written into their contract for services and is also outlined in the CCG’s Standards of Business Conduct policy.

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Appendix 1 – Definitions of Terms Used in this Constitution

2006 Act National Health Service Act 2006 Accountable Officer An individual, as defined under paragraph 12 of Schedule 1A of (AO) the 2006 Act, appointed by NHS England, with responsibility for ensuring the CCG: • complies with its obligations under: o sections 14Q and 14R of the 2006 Act; o sections 223H to 223J of the 2006 Act; o paragraphs 17 to 19 of Schedule 1A of the NHS Act 2006; and o any other provision of the 2006 Act specified in a document published by the Board for that purpose; • exercises its functions in a way which provides good value for money. Area The geographical area that the CCG has responsibility for, as defined in part 2 of this constitution Chair of the CCG The individual appointed by the CCG to act as chair of the Governing Body Governing Body and who is usually either a GP member or a lay member of the Governing Body. Chief Finance Officer A qualified accountant employed by the CCG with responsibility for (CFO) financial strategy, financial management and financial governance and who is a member of the Governing Body. Clinical A body corporate established by NHS England in accordance with Commissioning Chapter A2 of Part 2 of the 2006 Act. Groups (CCG) Committee A Committee created and appointed by the membership of the CCG or the Governing Body. Governing Body The body appointed under section 14L of the NHS Act 2006, with the main function of ensuring that a Clinical Commissioning Group has made appropriate arrangements for ensuring that it complies with its obligations under section 14Q under the NHS Act 2006, and such generally accepted principles of good governance as are relevant to it. Governing Body Any individual appointed to the Governing Body of the CCG Member Healthcare A Member of a profession that is regulated by one of the following Professional bodies: • the General Medical Council (GMC); • the General Dental Council (GDC); • the General Optical Council; • the General Osteopathic Council; • the General Chiropractic Council; • the General Pharmaceutical Council; • the Pharmaceutical Society of Northern Ireland; NHS Derby and Derbyshire Clinical Commissioning Group Constitution v3.8

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• the Nursing and Midwifery Council; • the Health and Care Professions Council; and • any other regulatory body established by an Order in Council under Section 60 of the Health Act 1999. Joint Committee Committees from two or more organisations that work together with delegated authority from both organisations to enable joint decision-making. Lay Member A lay Member of the CCG Governing Body, appointed by the CCG. A lay Member is an individual who is not a Member of the CCG or a healthcare professional (as defined above) or as otherwise defined in law. Member practice Member practices appoint a healthcare professional to act as their representative practice representative in dealings between it and the CCG, under regulations made under section 89 or 94 of the 2006 Act or directions under section 98A of the 2006 Act. Member/ Member A provider of primary medical services to a registered patient list, Practice who is a Member of this CCG. NHS England The operational name for the National Health Service Commissioning Board.

Place An alliance of commissioners, community services providers local authority, (City, County, District & Boroughs), primary care, voluntary sector and other community stakeholders working together and utilising their collective resources most effectively to meet the needs of their local population. Primary Care A Committee required by the terms of the delegation from NHS Commissioning England in relation to primary care commissioning functions. The Committee Primary Care Commissioning Committee reports to NHS England and the Governing Body. Professional An independent body accountable to the UK Parliament which Standards Authority help Parliament monitor and improve the protection of the public. Published Standards for Members of NHS Boards and Clinical Commissioning Group Governing Bodies in England in 2013. Registers of interests Registers of the CCG is required to maintain and make publicly available under section 14O of the 2006 Act and the statutory guidance issues by NHS England, of the interests of: • the Members of the CCG; • the Members of its CCG Governing Body; • the Members of its Committees or Sub-Committees and Committees or Sub-Committees of its CCG Governing Body; and Its employees.

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STP Sustainability and Transformation Partnerships – the framework within which the NHS and local authorities have come together to plan to improve health and social care over the next few years. STP can also refer to the formal proposals agreed between the NHS and local councils – a “Sustainability and Transformation Plan”. Sub-Committee A Committee created by and reporting to a Committee.

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Appendix 2 – Committee Terms of Reference

Audit Committee Terms of Reference

1. PURPOSE

1.1 The Governing Body of Derby and Derbyshire CCG (the “CCG”) has established a committee of the Governing Body to be known as the Audit Committee (the “Committee”). The Committee has no executive powers, other than those specifically delegated in these terms of reference.

1.2 The Committee is established in accordance with the CCG’s constitution and Schedule 1A of the National Health Service Act 2006 (as amended) (the “NHS Act”). These terms of reference set out the membership, remit, responsibilities and reporting arrangements of the Committee and shall have effect as if incorporated into the constitution.

2. ROLES AND RESPONSIBILITIES

2.1 The Committee will incorporate the following duties:

2.1.1 Integrated governance, risk management and internal control

The Committee shall review the establishment and maintenance of an effective system of integrated governance, risk management and internal control, across the whole of the CCG’s activities that support the achievement of the CCG’s objectives. Its work will dovetail with that of the Quality and Performance Committee which the CCG has established to seek assurance that robust clinical quality is in place.

In particular, the Committee will review the adequacy and effectiveness of:

• all risk and control related disclosure statements (in particular the governance statement), together with any appropriate independent assurances, prior to endorsement by the CCG;

• the underlying assurance processes that indicate the degree of achievement of the CCG's objectives, the effectiveness of the management of principal risks and the appropriateness of the above disclosure statements;

• the policies for ensuring compliance with relevant regulatory, legal and code of conduct requirements and related reporting and self-certification; and

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• the policies and procedures for all work related to fraud and corruption as set out in Secretary of State Directions and as required by the NHS Counter Fraud and Security Management Service.

In carrying out this work the Committee will agree an annual audit plan and primarily utilise the work of Internal Audit, External Audit and other assurance functions, but will not be limited to these sources. It will also seek reports and assurances from directors and managers as appropriate, concentrating on the over-arching systems of integrated governance, risk management and internal control, together with indicators of their effectiveness. This will be evidenced through the Committee’s use of an effective assurance framework to guide its work and that of the audit and assurance functions that report to it.

2.1.2 Internal Audit

The Committee shall ensure that there is an effective internal audit function that meets mandatory Public Sector Internal Audit Standards and provides appropriate independent assurance to the Committee, Accountable Officer and CCG. This will be achieved by:

• consideration of the provision of the internal audit service, the cost of the audit and any questions of resignation and dismissal;

• review and approval of the internal audit strategy, operational plan and more detailed programme of work, ensuring that this is consistent with the audit needs of the organisation, as identified in the assurance framework;

• considering the major findings of internal audit work (and management’s response) and ensuring co-ordination between the Internal and External Auditors to optimise audit resources;

• ensuring that the internal audit function is adequately resourced and has appropriate standing within the CCG;

• an annual review of the effectiveness of internal audit.

2.1.3 External Audit

The Committee shall review the work and findings of the External Auditors and consider the implications and responses by officers of the CCG to their work. This will be achieved by:

• consideration of the performance of the External Auditors, as far as the rules governing the appointment permit;

• discussion and agreement with the External Auditors, before the audit commences, on the nature and scope of the audit as set out in the annual plan, and ensuring coordination, as appropriate, with other external auditors in the local health economy;

• discussion with the External Auditors of their local evaluation of audit risks and assessment of the CCG and associated impact on the audit fee;

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• review of all external audit reports, including the report to those charged with governance, agreement of the annual audit letter before submission to the CCG and any work undertaken outside the annual audit plan, together with the appropriateness of management responses.

2.1.4 Other assurance functions

The Committee shall review the findings of other significant assurance functions, both internal and external and consider the implications for the governance of the CCG. These will include, but will not be limited to any reviews by Department of Health arm’s length bodies or regulators/inspectors (for example, the Care Quality Commission and NHS Resolution) and professional bodies with responsibility for the performance of staff or functions (for example, Royal Colleges and accreditation bodies).

2.1.5 Counter fraud

The Committee shall satisfy itself that the CCG has adequate arrangements in place for countering fraud and shall review the outcomes of counter fraud work. It shall also approve the counter fraud work programme.

2.1.6 Management

The Committee shall request and review reports and positive assurances from directors and officers of the CCG on the overall arrangements for governance, risk management and internal control.

The Committee may also request specific reports from individual functions within the CCG as they may be appropriate to the overall arrangements.

2.1.7 Financial reporting

The Committee shall monitor the integrity of the financial statements of the CCG and any formal announcements relating to the CCG’s financial performance.

The Committee shall ensure that the systems for financial reporting to the CCG, including those of budgetary control, are subject to review as to completeness and accuracy of the information provided to the CCG.

The Committee shall review and approve the annual report and financial statements on behalf of the Governing Body and the CCG, focusing particularly on:

• the wording in the governance statement and other disclosures relevant to the terms of reference of the Committee;

• changes in, and compliance with, accounting policies, practices and estimation techniques;

• unadjusted mis-statements in the financial statements;

• significant judgements in preparing of the financial statements;

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• significant adjustments resulting from the audit;

• letter of representation; and

• qualitative aspects of financial reporting.

2.1.8 Whistleblowing

The Committee shall review the effectiveness of arrangements in place for allowing staff to raise concerns (in confidence) about possible improprieties in financial, clinical or safety matters and ensure that any such concerns are investigated proportionately and independently.

2.1.9 Conflicts of Interest

The Committee shall receive reports in respect of any Conflicts of Interest breaches. The Committee shall review the impact and actions taken.

3. CHAIR ARRANGEMENTS

The CCG Governing Body shall appoint the Chair of the Committee from its Lay or Independent members. The Chair shall have the lead independent role in overseeing audit in the CCG. In the event that the Chair is unavailable to attend, a Lay Member of the Committee will deputise and Chair the meeting.

4. MEMBERSHIP

4.1 Members of the Committee shall be appointed by the CCG Governing Body. Good practice recommends at least three Lay Members.

4.2 Membership will comprise:

• Governing Body Lay Member with responsibility for Audit;

• Governing Body Lay Member with responsibility for Finance;

• Governing Body Lay Member with responsibility for Governance;

• Secondary Care Doctor (‘by invitation’ in accordance with the Committee’s workplan or where clinical input is required).

The Chair of the Governing Body, the Accountable Officer and the Chief Finance Officer shall not be members of the Audit Committee and will be invited to attend.

5. DECLARATIONS OF INTEREST, CONFLICTS AND POTENTIAL CONFLICTS

5.1 The provisions of Managing Conflicts of Interest: Statutory Guidance for CCGs1 or any successor document will apply at all times.

1 https://www.england.nhs.uk/wp-content/uploads/2017/06/revised-ccg-coi-guidance-jul-17.pdf

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5.2 Where a member of the committee is aware of an interest, conflict or potential conflict of interest in relation to the scheduled or likely business of the meeting, they will bring this to the attention of the Chair of the meeting as soon as possible, and before the meeting where possible.

5.3 The Chair of the meeting will determine how this should be managed and inform the member of their decision. The Chair may require the individual to withdraw from the meeting or part of it. Where the Chair is aware that they themselves have such an interest, conflict or potential conflict of interests they will bring it to the attention of the Committee, and the Deputy Chair will act as Chair for the relevant part of the meeting.

5.4 Any declarations of interests, conflicts and potential conflicts, and arrangements to manage those agreed in any meeting of the Committee, will be recorded in the minutes.

5.5 Failure to disclose an interest, whether intentional or otherwise, will be treated in line with the Managing Conflicts of Interest: Revised Statutory Guidance and may result in suspension from the Committee.

5.6 All members of the Committee shall comply with, and are bound by, the requirements in the CCG’s Constitution, Standards of Business Conduct and Managing Conflicts of Interest Policy, the Standards of Business Conduct for NHS staff (where applicable) and NHS Code of Conduct.

6. QUORACY

The quorum necessary for the transaction of business shall be two Members.

7. DECISION MAKING AND VOTING

7.1 The Committee will use its best endeavours to make decisions by consensus. Exceptionally, where this is not possible the Chair (or Deputy) may call a vote.

7.2 Only members of the Committee set out in section 4 have voting rights. Each voting member is allowed one vote and a majority will be conclusive on any matter. Where there is a split vote, with no clear majority, the Chair of the Committee will hold the casting vote.

7.3 If a decision is needed which cannot wait for the next scheduled meeting or it is not considered necessary to call a full meeting, the Committee may choose to convene a telephone conference or conduct its business on a ‘virtual’ basis through the use of email communication. Minutes will be recorded for telephone conference and virtual meetings in accordance with relevant sections of the Derby and Derbyshire CCG Governance Handbook.

8. ACCOUNTABILITY

The Committee is authorised by the Governing Body to investigate any activity within its terms of reference. It is authorised to seek any information it requires from any

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employee and all employees are directed to cooperate with any request made by the Committee. The Committee is authorised by the Governing Body to obtain outside legal or other independent professional advice and secure the attendance of external personnel with relevant experience and expertise if it considers this necessary.

9. REPORTING ARRANGEMENTS

9.1 The Committee shall report to the Governing Body on how it discharges its responsibilities. The minutes of the Committee’s meetings shall be formally recorded by the secretary and submitted to the Governing Body. The Chair of the Committee shall draw to the attention of the Governing Body any issues that require disclosure to the full Governing Body, or that require executive action.

9.2 The Committee will report to the Governing Body at least annually on its work in support of the annual governance statement, specifically commenting on the:

• fitness for purpose of the assurance framework;

• completeness and ‘embeddedness’ of risk management in the organisation;

• integration of governance arrangements;

• appropriateness of the evidence that shows the organisation is fulfilling regulatory requirements relating to its existence as a functioning business;

• robustness of the processes behind the quality accounts.

9.3 The annual report should also describe how the Committee has fulfilled its terms of reference and give details of any significant issues that the Committee has considered in relation to the financial statements and how they were addressed.

10. ATTENDANCE AT MEETINGS

The Chief Finance Officer and appropriate Internal and External Audit representatives shall normally attend meetings but shall not have voting rights. In addition, the following good practice will be followed:

10.1.1 at least once a year the Audit Committee should meet privately with the External and Internal Auditors;

10.1.2 representatives from NHS Counter Fraud Authority may be invited to attend meetings and will normally attend at least one meeting each year;

10.1.3 regardless of attendance, external audit, internal audit, local counter fraud and security management (NHS Counter Fraud Authority) providers will have full and unrestricted rights of access to the Committee;

10.1.4 the Accountable Officer will be invited to attend and discuss, at least annually with the Audit Committee, the process for assurance that supports the annual governance statement. He or she would also normally attend when the Audit Committee considers the draft internal audit plan and the annual accounts;

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10.1.5 any other officers of the CCG who have responsibility for specific areas (or similar) may be invited to attend, particularly when the Committee is discussing areas of risk or operation that are the responsibility of that director; and

10.1.6 the chair of the Governing Body may also be invited to attend one meeting each year in order to form a view on, and understanding of, the Audit Committee’s operations.

11. FREQUENCY AND NOTICE OF MEETINGS

11.1 The Audit Committee must consider the frequency and timing of meetings needed to allow it to discharge all of its responsibilities. Meetings of the Committee shall be held at regular intervals, at such times and places that the CCG may determine, but not less than four times per year. The External Auditors or Head of Internal Audit may request a meeting if they consider that one is necessary. The Committee will agree an annual programme of meetings in advance to link with key business to be transacted. Papers will be issued at least five working days in advance of the meetings wherever possible.

11.2 The Chair of the Committee, Governing Body or Accountable Officer may call additional meetings as required, giving not less than 14 days’ notice.

12. SUB-COMMITTEES

12.1 Committee may delegate responsibility for specific aspects of its duties to sub-committees or working groups. The Terms of Reference of each such sub-committee or working group shall be approved by the Committee and shall set out specific details of the areas of responsibility and authority.

12.2 Any sub-committees or working groups will report via their respective Chair’s following each meeting or at an appropriate frequency as determined by the Committee.

13. ADMINISTRATIVE SUPPORT

The CCG’s governance lead shall be secretary to the Committee and shall attend to provide appropriate support to the Chair and Audit Committee members. The secretary will be responsible for supporting the Chair in the management of the Audit Committee’s business and for drawing the Audit Committee’s attention to best practice, national guidance and other relevant documents, as appropriate. The secretary will either take minutes or make arrangements for minutes to be taken.

14. REVIEW OF TERMS OF REFERENCE

These terms of reference and the effectiveness of the Committee will be reviewed at least annually or more frequently as required. The Committee will recommend any changes to the terms of reference to the Governing Body and will be approved by the Governing Body.

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Reviewed by Audit Committee: 18th March 2021

Approved by Governing Body: 6th May 2021

Review Date: September 2021

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Remuneration Committee

Terms of Reference

1. PURPOSE

1.1 The Remuneration Committee (the “Committee”) is established by NHS Derby and Derbyshire Clinical Commissioning Group (the “CCG”). In accordance with section 14M and 14L(3) of the NHS Act.

1.2 Subject to any restrictions set out in the relevant legislation, the Remuneration Committee has the function of making recommendations to the governing body about the exercise of its functions under section 14L(3)(a) and (b), i.e. its functions in relation to:

• determining the remuneration, fees and allowances payable to employees of the CCG and to other persons providing services to it; and

• determining allowances payable under pension schemes established by the CCG.

1.3 The purpose of the Committee is to make recommendations to Governing Body on the appropriate remuneration and terms of service for the Accountable Officer, Directors, other Very Senior Managers, Clinicians and Lay Members. The Committee will have delegated powers to act on behalf of the CCG within the approved Terms of Reference.

1.4 The Committee shall adhere to all relevant laws, regulations and policies in all respects including (but not limited to) determining levels of remuneration that are sufficient to attract, retain and motivate executive directors and senior staff whilst remaining cost effective.

2. ROLES AND RESPONSIBILITIES

The Committee will incorporate the following duties:

2.1 with regard to the Accountable Officer, Directors and other Very Senior Managers, make recommendations to Governing Body all aspects of salary (including any performance-related elements, bonuses);

2.2 make recommendations to Governing Body contractual arrangements for clinicians engaged to support the CCG Governing Body;

2.3 make recommendations on provisions for other benefits, including pensions and cars for all staff;

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2.4 make recommendations for arrangements for termination of employment and other contractual terms for all staff (decisions requiring dismissal shall be referred to the Governing Body);

2.5 ensure that officers are fairly rewarded for their individual contribution to the organisation – having proper regard to the organisation’s circumstances and performance and to the provisions of any national arrangements for such staff;

2.6 ensure proper calculation and scrutiny of termination payments taking account of such national guidance as is appropriate, advising on and overseeing appropriate contractual arrangements for such staff. This will apply to all CCG staff;

2.7 ensure proper calculation and scrutiny of any special payments.

3. CHAIR ARRANGEMENTS

The Committee will be chaired by a Lay Member other than the Audit Chair, and only Lay Members of the Governing Body shall be members of the Committee. It is recommended that the Committee shall be chaired by the Lay Member for Patient and Public Involvement and Lay Vice Chair of Governing Body.

4. MEMBERSHIP

4.1 Members of the Committee must be appointed from the CCG Governing Body.

4.2 To maintain the independence of members, the committee will comprise of four Lay members:

• Lay Member Patient and Public Involvement (Lay Vice Chair of GB and Chair of Remuneration Committee);

• Lay Member Audit;

• Lay Member Finance; and

• Lay Member Governance.

4.3 Only members of the Committee have the right to attend meetings, however, individuals such as the Accountable Officer, Chief Finance Officer, Clinical GB Chair, HR Advisor and external advisors may be invited to attend for all or part of a meeting as and when appropriate but shall not have voting rights. No member or attendee shall be party to discussions about their own remuneration or terms of service.

5. DECLARATIONS OF INTEREST, CONFLICTS AND POTENTIAL CONFLICTS

5.1 The provisions of Managing Conflicts of Interest: Statutory Guidance for CCGs2 or any successor document will apply at all times.

2 https://www.england.nhs.uk/wp-content/uploads/2017/06/revised-ccg-coi-guidance-jul-17.pdf

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5.4 Any declarations of interests, conflicts and potential conflicts, and arrangements to manage those agreed in any meeting of the Committee, will be recorded in the minutes.

5.6 All members of the Committee shall comply with, and are bound by, the requirements in the CCG’s Constitution, Standards of Business Conduct and Conflicts of Interest Policy, the Standards of Business Conduct for NHS staff (where applicable) and NHS Code of Conduct.

6. QUORACY

6.1 The quorum necessary for the transaction of business shall be two Lay Members.

6.2 A duly convened meeting of the Committee at which quorum is present at the meeting, are contactable by telephone conference call or by other virtual medium, is competent to exercise all or any of the authorities, powers and discretions vested in or exercisable by the Committee.

7. DECISION MAKING AND VOTING

7.1 The Committee will use its best endeavours to make decisions by consensus. Exceptionally, where this is not possible the Chair (or Deputy) may call a vote.

7.3 If a decision is needed which cannot wait for the next scheduled meeting or it is not considered necessary to call a full meeting, the Committee may choose to convene a telephone conference or conduct its business on a ‘virtual’ basis through the use of email communication or other virtual medium. Minutes will be recorded for telephone conference and virtual meetings in accordance with relevant sections of the Derby and Derbyshire CCG Governance Handbook.

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8. ACCOUNTABILITY

For the avoidance of doubt, in the event of any conflict the Standing Orders, the Standing Financial Instructions and the Scheme of Reservation and Delegation of the CCG will prevail over these Terms of Reference.

8.1 Review Role

8.1.1 The Committee may investigate, monitor and review activity within its terms of reference. It is authorised to seek any information it requires from any committee, group, clinician or employee (including interim and temporary members of staff), contractor, sub-contractor or agent, who are directed to co-operate with any request made by it.

8.1.2 The Committee will apply best practice in the decision making process. For example, when considering individual remuneration the Committee will:

• comply with current disclosure requirements for remuneration;

• on occasion, and where appropriate, seek independent advice about remuneration for individuals; and

• ensure that decisions are based on clear and transparent criteria and be able to withstand public scrutiny and audit.

8.1.3 The Committee will have authority to commission reports or surveys it deems necessary to help fulfil its obligations.

9. REPORTING ARRANGEMENTS

The Committee will provide an appropriate form of report of the meeting to the CCG Governing Body following each meeting, confirming all recommendations of decisions made.

10. FREQUENCY AND NOTICE OF MEETINGS

Meetings will be held at least four times a year and when required and may be called at any other such time as the Committee Chair may require.

11. ADMINISTRATIVE SUPPORT

The Governing Body Executive Assistant shall be secretary to the Committee and shall attend to provide appropriate support to the Chair and Remuneration Committee members. The secretary will be responsible for supporting the Chair in the management of the Committee’s business and for drawing the Remuneration Committee’s attention to best practice, national guidance and other relevant documents, as appropriate. The secretary will either take minutes or make arrangements for minutes to be taken.

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12. REVIEW OF TERMS OF REFERENCE

These terms of reference and the effectiveness of the Committee will be reviewed at least annually or sooner if required. The Committee will recommend any changes to the terms of reference to the Governing Body and will be approved by the Governing Body.

Reviewed by Remuneration Committee: December 2020

Approved by Governing Body: 14th January 2021

Review Date: July 2021

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Primary Care Commissioning Committee Terms of Reference

1. INTRODUCTION

1.1 In accordance with its statutory powers under section 13Z of the National Health Service Act 2006 (as amended); NHS England has delegated the exercise of the functions specified in Schedule 2 to these Terms of Reference to NHS Derby and Derbyshire CCG. Schedule 1 and 2 are specified in the NHS Derby and Derbyshire CCG Delegated Agreement.

1.2 The CCG has established the Primary Care Commissioning Committee (the “Committee”). The Committee will function as a corporate decision-making body for the management of the delegated functions and the exercise of the delegated powers.

1.3 It is a committee comprising representatives of the following organisations:

• NHS Derby and Derbyshire Clinical Commissioning Group (the “CCG”).

2. STATUTORY FRAMEWORK

2.1 NHS England has delegated to the CCG authority to exercise the primary care commissioning functions set out in Schedule 2 in accordance with section 13Z of the National Health Service Act 2006 (as amended).

2.2 Arrangements made under section 13Z may be on such terms and conditions (including terms as to payment) as may be agreed between NHS England and the CCG.

2.3 Arrangements made under section 13Z do not affect the liability of NHS England for the exercise of any of its functions. However, the CCG acknowledges that in exercising its functions (including those delegated to it), it must comply with the statutory duties set out in Chapter A2 of the NHS Act and including:

2.3.1 management of conflicts of interest (section 14O);

2.3.2 duty to promote the NHS Constitution (section 14P);

2.3.3 duty to exercise its functions effectively, efficiently and economically (section 14Q);

2.3.4 duty as to improvement in quality of services (section 14R);

2.3.5 duty in relation to quality of primary medical services (section 14S);

2.3.6 duties as to reducing inequalities (section 14T);

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2.3.7 duty to promote the involvement of each patient (section 14U);

2.3.8 duty as to patient choice (section 14V);

2.3.9 duty as to promoting integration (section 14Z1);

2.3.10 public involvement and consultation (section 14Z2).

2.4 The CCG will also need to specifically, in respect of the delegated functions from NHS England, exercise those set out below:

• duty to have regard to impact on services in certain areas (section 13O);

• duty as respects variation in provision of health services (section 13P).

2.5 The Committee is established as a committee of the Governing Body in accordance with Schedule 1A of the National Health Service Act 2006 (NHS Act).

2.6 The members acknowledge that the Committee is subject to any directions made by NHS England or by the Secretary of State.

3. ROLE OF THE COMMITTEE

3.1 The Committee has been established in accordance with the above statutory provisions to enable the members to make collective decisions on the review, planning and procurement of primary care services in the CCG, under delegated authority from NHS England.

3.2 In performing its role the Committee will exercise its management of the functions in accordance with the agreement entered into between NHS England and the CCG, which will sit alongside the delegation and terms of reference.

3.3 The functions of the Committee are undertaken in the context of a desire to promote increased co-commissioning to increase quality, efficiency, productivity and value for money and to remove administrative barriers.

3.4 The Committee have oversight of the CCG Recovery and Restoration work related to the Health and Care Pillar and will receive assurance regarding progress.

3.5 The role of the Committee shall be to carry out the functions relating to the commissioning of primary medical services under section 83 of the NHS Act. This includes the following decisions in relation to the commissioning, procurement and management of Primary Medical Services Contracts, including but not limited to the following activities:

3.5.1 decisions in relation to Enhanced Services;

3.5.2 decisions in relation to Local Incentive Schemes (including the design of such schemes);

3.5.3 decisions in relation to the establishment of new GP practices (including branch surgeries) and closure of GP practices;

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3.5.4 decisions about ‘discretionary’ payments;

3.5.5 decisions about commissioning urgent care (including home visits as required) for out of area registered patients;

3.5.6 the approval of practice mergers;

3.5.7 planning primary medical care services in the Area, including carrying out needs assessments;

3.5.8 undertaking reviews of primary medical care services in the Area;

3.5.9 decisions in relation to the management of poorly performing GP practices and including, without limitation, decisions and liaison with the CQC where the CQC has reported non-compliance with standards (but excluding any decisions in relation to the performers list);

3.5.10 management of the Delegated Funds in the Area;

3.5.11 Premises Costs Directions Functions;

3.5.12 co-ordinating a common approach to the commissioning of primary care services with other commissioners in the Area where appropriate; and

3.5.13 such other ancillary activities that are necessary in order to exercise the Delegated Functions.

3.6 The CCG will also carry out the following activities to:

3.6.1 plan, including needs assessment, primary medical care services in the CCG’s geographical area;

3.6.2 undertake reviews of primary medical care services in the CCG’s geographical area;

3.6.3 co-ordinate a common approach to the commissioning of primary care services generally;

3.6.4 manage the budget for commissioning of primary medical care services in the CCG’s geographical area.

4. GEOGRAPHICAL COVERAGE

The Committee will comprise NHS Derby and Derbyshire CCG’s geographical area.

5. MEMBERSHIP

5.1 The membership of the Committee is as follows:

• 3 x Governing Body Lay Members; • Chief Finance Officer or nominated Deputy; • Chief Nurse Officer or nominated Deputy;

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• Medical Director or nominated Deputy.

5.2 Representatives shall attend the Committee as regular attendees as follows:

• NHS England Primary Care Representative; • Local Medical Committee Representative; • Health and Wellbeing Board (County); • Health and Wellbeing Board (City); • Senior Healthwatch Representatives.

5.3 Officers of the CCG shall attend or nominate deputies appropriate to the items for discussion on the agenda. The Committee may also request attendance by appropriate individuals to present relevant reports and/ or advise the Committee.

5.4 The Chair of the Committee shall be the Governing Body Primary Care Commissioning Lay Member.

5.5 The Deputy Chair of the Committee shall be a Patient and Public Involvement Lay Member.

5.6 GP members of the Governing Body shall be invited to attend meetings to participate in strategic discussions on primary care issues, subject to adherence with the CCG’s conflicts of interest requirements and the appropriate management of conflicts of interest. They will be required, for example, to withdraw from the meeting during the deliberations leading up to decisions and from the decision where there is an actual or potential conflict of interest.

6. MEETINGS AND VOTING

6.1 The Committee will operate in accordance with the CCG’s Standing Orders. The Secretary to the Committee will be responsible for giving notice of the meetings. This will be accompanied by an agenda and supporting papers and sent to each member representative no later than five working days before the date of the meeting. When the Chair of the Committee deems it necessary in light of the urgent circumstances to call a meeting at short notice, the notice period shall be such as s/he shall specify.

6.2 Each member of the Committee shall have one vote. The Committee shall reach decisions by a simple majority of members present, but with the Chair having a second and deciding vote, if necessary. However, the aim of the Committee will be to achieve consensus decision-making wherever possible.

6.3 If a decision is needed which cannot wait for the next scheduled meeting or it is not considered necessary to call a full meeting, the Committee may choose to convene a telephone conference or conduct its business on a ‘virtual’ basis through the use of email/online communication platform. Minutes will be recorded for telephone conference and virtual meetings in accordance with the Derby and Derbyshire Corporate Governance Framework at Section 5.4.

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6.4 Members are required to declare any interest relating to any matter to be considered at each meeting, in accordance with the CCG’s constitution and the CCG Standards for Business Conduct and Managing Conflicts of Interest Policy. Members who have declared an interest will be required to leave the meeting at the point at which a decision on such matter is being made. At the discretion of the Chair, they may be allowed to participate in the preceding discussion.

7. QUORUM

7.1 A quorum shall be four voting members, at least two of whom shall be Lay Members, to include the Chair or Deputy Chair. Deputies are invited to attend in the place of the regular members as required.

7.2 A duly convened meeting of the Committee at which quorum is present at the meeting, or are contactable by telephone conference call, is competent to exercise all or any of the authorities, powers and discretions vested in or exercisable by the Committee.

7.3 If a decision is needed which cannot wait for the next scheduled meeting or it is not considered necessary to call a full meeting, the Committee may choose to convene a telephone conference or conduct its business on a ‘virtual’ basis through the use of email/online communication platform. Minutes will be recorded for telephone conference and virtual meetings in accordance with relevant sections of the Derby and Derbyshire CCG Governance Handbook.

8. FREQUENCY AND NOTICE OF MEETINGS

8.1 The meetings to discuss items of a confidential nature will be held monthly and cancelled if necessary.

8.2 The meetings held in public session will take place at least quarterly with the option to be held more frequently. On the dates of the meetings held in public session the meetings will be divided into two sections; Public and Confidential. The Public session will commence at the start of the meeting and shall be held in public.

8.3 The Committee may resolve to exclude the public from a meeting that is open to the public (whether during the whole or part of the proceedings) whenever publicity would be prejudicial to the public interest by reason of the confidential nature of the business to be transacted or for other special reasons stated in the resolution and arising from the nature of that business or of the proceedings or for any other reason permitted by the Public Bodies (Admission to Meetings) Act 1960 as amended or succeeded from time to time.

8.4 Members of the Committee have a collective responsibility for the operation of the Committee. They will participate in discussion, review evidence and provide objective expert input to the best of their knowledge and ability, and endeavour to reach a collective view.

8.5 The Committee may delegate tasks to such individuals, sub-committees or individual members as it shall see fit, provided that any such delegations are

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consistent with the parties’ relevant governance arrangements, are recorded in a scheme of delegation, are governed by terms of reference as appropriate and reflect appropriate arrangements for the management of conflicts of interest.

8.6 The Committee may call additional experts to attend meetings on an ad hoc basis to inform discussions.

8.7 Members of the Committee shall respect confidentiality requirements as set out in the CCG’s Standing Orders.

8.8 The Committee will present its public minutes to NHS England Midlands and the Governing Body of the CCG each quarter for information. Confidential minutes will be presented on a monthly basis.

8.9 The CCG will also comply with any reporting requirements set out in its constitution.

8.10 It is envisaged that these Terms of Reference will be reviewed from time to time, reflecting experience of the Committee in fulfilling its functions.

9. ACCOUNTABILITY OF COMMITTEE

The Committee will operate within the delegation detailed within the CCG Standing Orders, Schemes of Reservation and Delegation and Prime Financial Policies.

10. PROCUREMENT OF AGREED SERVICES

The detailed arrangements regarding procurement are set out in the delegation agreement3.

11. SUB-COMMITTEES

11.1 The Committee delegates responsibility for specific aspects of its duties to the following sub-committees:

• Primary Care Quality and Performance Review Sub Committee • Estates Steering Group Sub Committee • GP Digital Sub Committee • Primary Care Workforce Steering Group Sub Committee • Primary Care Leadership Sub Committee

11.2 Each sub-committee will be required to submit a summary of key actions and minutes from each meeting to the subsequent meeting of the Committee.

3 NHS England Next Steps in primary care co-commissioning guidance https://www.england.nhs.uk/commissioning/wp-content/uploads/sites/12/2014/11/nxt-steps-pc- cocomms.pdf

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11.3 Terms of Reference of the sub-committees will be reviewed annually by the Committee.

12. DECISIONS

12.1 Scheme of Delegation

12.1.1 The Committee will make decisions within the bounds of its remit.

12.1.2 The decisions of the Committee shall be binding on NHS England and the CCG.

12.1.3 The Committee will produce an executive summary report which will be presented to the Governing Body of the CCG each month for information.

12.2 CCG Allocations

12.2.1 The Committee shall make recommendations for CCG funding decisions to the Executive Team for additional and new allocations received in-year (please refer to section 2.10 within Annexure 1 of Appendix 4 – Standing Financial Instructions – Financial Limits for Delegated Authority).

12.2.2 The Committee are empowered to prioritise service investments and disinvestments within available resources. The Committee can review and recommend investment decisions based on which services should be commissioned or decommissioned, but cannot commit additional CCG financial resources, unless approved by the Executive Team.

12.2.3 Subject to 12.2.2, the Clinical and Lay Commissioning Committee shall make recommendations to the Primary Care Commissioning Committee on any changes in relation to the investment or disinvestment of Primary Care commissioned services.

13. REVIEW OF TERMS OF REFERENCE

Reviewed by Primary Care Commissioning Committee: 26th May 2021

Approved by Governing Body: 3rd June 2021

Review Date: November 2021

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Appendix 3 – Standing Orders

1. STATUTORY FRAMEWORK AND STATUS

1.1 Introduction

1.1.1 These standing orders have been drawn up to regulate the proceedings of the NHS Derby and Derbyshire Clinical Commissioning Group so that group can fulfil its obligations, as set out largely in the NHS Act 2006, as amended by the 2012 Act and related regulations. They are effective from the date the CCG is established.

1.1.2 The standing orders, together with the CCG’s scheme of reservation and delegation and the CCG’s standing financial instructions, provide a procedural framework within which the CCG discharges its business. They set out:

(a) the arrangements for conducting the business of the CCG;

(b) the appointment of member practice representatives;

(c) the procedure to be followed at meetings of the CCG, the Governing Body and any committees or sub-committees of the CCG or the Governing Body;

(d) the process to delegate powers;

(e) the declaration of interests and standards of conduct.

These arrangements must comply, and be consistent where applicable, with requirements set out in the NHS Act 2006 (as amended by the 2012 Act) and related regulations and take account as appropriate of any relevant guidance.

1.1.3 The standing orders, scheme of reservation and delegation and prime financial policies have effect as if incorporated into the CCG’s Constitution. Group members, employees, members of the Governing Body, members of the Governing Body’s committees and sub-committees, and persons working on behalf of the CCG should be aware of the existence of these documents and, where necessary, be familiar with their detailed provisions. Failure to comply with the standing orders, scheme of reservation and delegation and prime financial policies may be regarded as a disciplinary matter that could result in dismissal.

1.2 Schedule of matters reserved to the Clinical Commissioning Group and the scheme of reservation and delegation

The NHS Act 2006 (as amended by the 2012 Act) provides the CCG with powers to delegate the CCG’s functions and those of the Governing Body to certain bodies (such as committees) and certain persons. The CCG has decided that certain decisions may only be exercised by the CCG in formal session. These decisions and also those delegated are contained in the CCG’s scheme of reservation and delegation (please see CCG Governance Handbook).

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2. THE CLINICAL COMMISSIONING GROUP: COMPOSITION OF MEMBERSHIP, KEY ROLES AND APPOINTMENT PROCESS

2.1 Composition of Membership

2.1.1 Section 3 of the CCG’s Constitution provides details of the membership of the CCG.

2.1.2 Section 5 of the CCG’s Constitution provides details of the governing structure used in the CCG’s decision-making processes, whilst section 5.5 of the Constitution outlines certain key roles and responsibilities within the CCG and it’s Governing Body, including the role of practice representatives (section 3.6 of the Constitution).

2.2 Key Roles

2.2.1 Section 5.5 of the CCG’s Constitution sets out the composition of the CCG’s Governing Body whilst CCG Governance Handbook identifies certain key roles and responsibilities within the CCG and its Governing Body. These standing orders set out how the CCG appoints individuals to these key roles.

2.2.2 The Accountable Officer, is subject to the following appointment process:

(a) Nominations – n/a

(b) Eligibility – Appointment to be from individuals who meet the core competencies identified for the Accountable Officer role. Appointment to be proposed by the CCG and appointed to by NHS England

(d) Term of office – substantive appointment

(e) Eligibility for reappointment – n/a

(f) Grounds for removal from office – Gross misconduct – the process is to be overseen by NHSE and Lay Member for Audit

(g) Notice period – 6 months. Notice to be given in writing to the Chair of the CCG

2.2.3 The Clinical Chair/ Clinical Leader of the Governing Body, is subject to the following appointment process:

(a) Nominations – Membership of NHS Derby and Derbyshire CCG

(b) Eligibility – Must meet the core competencies identified for the role of Chair and subject to performance appraisal. Must be a GP within NHS Derby and Derbyshire CCG

(c) Appointment process – Election by Partner and salaried GP’s and long- term locums within NHS Derby and Derbyshire CCG. Expression of

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Interest/ application/ meeting a pre-determined criteria and interview process supported by the Local Medical Committee. The Governing Body will appoint the Clinical Chair

(d) Term of office – 3 years (annually reviewable). If the term of office is not to be continued at annual review, the Clinical Chair is able to serve 3 months’ notice

(e) Eligibility for reappointment – There is no limit to the number of terms served whether consecutively or not as long as the person wishes to continue and has the support of the local membership GPs

(f) Grounds for removal from office –

(i) You become bankrupt or make any composition with your creditors or you are convicted of an arrestable offence (other than a road traffic offence for which a non-custodial penalty is imposed)

(ii) You are unable to properly provide the Services by reason of ill- health, accident or any other reason for a period or periods of [60] working days or more (whether or not consecutive) in any 12 month period

(iii) You do not provide the Services efficiently and diligently or are guilty of any serious or (after warning) repeated breach of your obligations under this Agreement

(iv) You are guilty of serious misconduct or any other conduct (whether in the performance of the Services or otherwise) which adversely affects or is likely to adversely affect our interests

(v) You are guilty of gross misconduct

(vi) You cease to be a clinician in a member practice

(vii) You are deselected by the Membership through a vote as contained in the CCG Constitution

(viii) Your Practice ceases to be eligible for Membership

(ix) You become disqualified from being a member of the CCG in accordance with the CCG Regulations

(x) Your actions constitute a material breach

(g) Notice period – 6 months. Notice to be given in writing to the Accountable Officer of the CCG

2.2.4 The Chief Finance Officer is subject to the following appointment process:

(a) Nominations – n/a

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(b) Eligibility – Initial appointment from a pool of people that have passed National Assessment Centre to assess capability to meet the core competencies identified for the CFO role. Subsequent appointments to be via open advert

(d) Term of office – substantive appointment

(e) Eligibility for reappointment – n/a

(f) Grounds for removal from office –

(i) Removal of professional registration

(ii) Gross misconduct

Process overseen by Lay Member for Audit.

(g) Notice period – 6 months. Notice to be given in writing to the Accountable Officer

2.2.5 The Lay Member for Audit is subject to the following appointment process:

(a) Nominations – n/a

(b) Eligibility –Interview against person specification and job description for the role

(d) Term of office – 3 years (annually reviewable). If the term of office is not to be continued at annual review, the Accountable Officer is able to serve 3 months’ notice

(e) Eligibility for reappointment – Yes

(f) Grounds for removal from office – Gross misconduct including breach of Nolan principles

(g) Notice period – 3 months. Notice to be given in writing to the Accountable Officer

2.2.6 The 2 Public and Patient Engagement Lay Members are subject to the following appointment process:

(a) Nominations – n/a

(b) Eligibility –interview against person specification and job description for the role

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(d) Term of office – 3 years (annually reviewable). If the term of office is not to be continued at annual review, the Accountable Officer is able to serve 3 months’ notice

(e) Eligibility for reappointment – Yes

(f) Grounds for removal from office – Gross misconduct including breach of Nolan principles

(g) Notice period – 3 months. Notice to be given in writing to the Accountable Officer

2.2.7 The Governance Lay Member is subject to the following appointment process:

(a) Nominations – n/a

(b) Eligibility – interview against person specification and job description for the role

(d) Term of office – 3 years (annually reviewable). If the term of office is not to be continued at annual review, the Accountable Officer is able to serve 3 months’ notice

(e) Eligibility for reappointment – Yes

(f) Grounds for removal from office – Gross misconduct including breach of Nolan principles

(g) Notice period – 3 months. Notice to be given in writing to the Accountable Officer

2.2.8 The Finance Lay Member is subject to the following appointment process:

(a) Nominations – n/a

(b) Eligibility –interview against person specification and job description for the role

(d) Term of office – 3 years (annually reviewable). If the term of office is not to be continued at annual review, the Accountable Officer is able to serve 3 months’ notice

(e) Eligibility for reappointment – Yes

(f) Grounds for removal from office – Gross misconduct including breach of Nolan principles

(g) Notice period – 3 months. Notice to be given in writing to the Accountable Officer

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2.2.9 The Primary Care Commissioning Lay Member is subject to the following appointment process:

(a) Nominations – n/a

(b) Eligibility –interview against person specification and job description for the role

(d) Term of office – 3 years (annually reviewable). If the term of office is not to be continued at annual review, the Accountable Officer is able to serve 3 months’ notice

(e) Eligibility for reappointment – Yes

(f) Grounds for removal from office – Gross misconduct including breach of Nolan principles

(g) Notice period – 3 months. Notice to be given in writing to the Accountable Officer

2.2.10 The Chief Nurse Officer is subject to the following appointment process:

(a) Nominations – n/a

(b) Eligibility –Professional Registration. No conflicts of interest as defined by national guidance on NHS England website. Appraisal at interview against person specification and job description for the role

(d) Term of office – substantive post

(e) Eligibility for reappointment – n/a

(f) Grounds for removal from office –

• Removal of professional registration • Gross misconduct

Process overseen by Lay Member for audit.

(g) Notice period – 6 months. Notice to be given in writing to the Accountable Officer

2.2.11 The Secondary Care Doctor is subject to the following appointment process:

(a) Nominations – n/a

(b) Eligibility – Current registered doctor. Current or recent secondary care experience as defined by national guidance on NHCCB website. No conflicts of interest as defined by national guidance on NHSCB website

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(d) Term of office – 3 years (annually reviewable). If the term of office is not to be continued at annual review, the Accountable Officer is able to serve 3 months’ notice

(e) Eligibility for reappointment – yes

(f) Grounds for removal from office –

• Removal of professional registration • Can be deselected by the Membership through a vote or removed by the Clinical Chair • Gross misconduct including breach of Nolan principles

(g) Notice period – 3 months. Notice to be given in writing to the Accountable Officer

2.2.12 The GP Representatives are subject to the following appointment process:

(a) Expressions of Interest – Elected by the membership and appointed by the Governing Body

(b) Eligibility – GP member of NHS Derby and Derbyshire CCG

(d) Term of office – 3 years (annually reviewable). If the term of office is not to be continued at annual review, the Accountable Officer is able to serve 3 months’ notice

(e) Eligibility for reappointment – yes

(f) Grounds for removal from office –

• Removal of professional registration • Gross misconduct including breach of Nolan principles

(g) Notice period – 3 months. Notice to be given in writing to the Accountable Officer

2.2.13 The roles and responsibilities of each of these key roles are set out in the CCG Governance Handbook.

3. MEETINGS OF THE CLINICAL COMMISSIONING GROUP

3.1 Calling meetings

The Governing Body of the CCG will meet at least twelve times per year with at least half of these meetings held in public session. The agenda and supporting papers will be sent to all members five working days before the meeting either manually or electronically, whichever is appropriate at the time.

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3.2 Agenda, supporting papers and business to be transacted

3.2.1 Items of business to be transacted for inclusion on the agenda of a meeting need to be notified to the Chair of the meeting at least six working days (i.e. excluding weekends and bank holidays) before the meeting takes place. Supporting papers for such items need to be submitted at least six working days before the meeting takes place. The agenda and supporting papers will be circulated to all members of a meeting five working days before the date the meeting will take place.

3.2.2 Agendas and certain papers for the CCG’s Governing Body – including details about meeting dates, times and venues - will be published on the CCG’s website at https://www.derbyandderbyshireccg.nhs.uk/about-us/who-we-are/governing- body/ and will be made available for inspection at the CCG’s Headquarters.

3.2.3 The documents will be made available upon application either by:

(a) post – NHS Derby and Derbyshire CCG First Floor Cardinal Square, Nottingham Road Derby Derbyshire DE1 3QT

(b) email – via the website – [email protected]

3.3 Petitions

Where a petition has been received by the CCG, the Chair of the Governing Body shall receive the petition at the start of the meeting in public session.

3.4 Chair of a meeting

3.4.1 At any meeting of the CCG or its Governing Body or of a committee the Chair of the CCG, if any and if present, shall preside. If the Chair is absent from the meeting, the Deputy Chair, if any and if present, shall preside.

3.4.2 If the Chair is absent temporarily on the grounds of a declared conflict of interest the Deputy Chair, if present, shall preside. If both the Chair and Deputy Chair are absent, or are disqualified from participating, or there is neither a Chair or Deputy a member of the CCG, Governing Body, committee or sub-committee respectively shall be chosen by the members present, or by a majority of them, and shall preside.

3.5 Chair's ruling

The decision of the Chair of the Governing Body on questions of order, relevancy and regularity and their interpretation of the Constitution, standing orders, scheme of reservation and delegation and prime financial policies at the meeting, shall be final.

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3.6 Quorum

3.6.1 The quorum necessary for the transaction of Governing Body business must include:

• Clinical Chair or Vice Chair (PPI Lay Member) or Audit Chair; • At least 1 x CCG Officer or CCG Executive Director; • 2 x Lay Members; and • 3 x Voting Clinicians (to include GP Members Secondary Care Clinician, Clinical Chair, Medical Director and Chief Nurse Officer).

3.6.2 Voting Officers may nominate a deputy to attend on their behalf. The nomination must be approved by the Chair. Where a nominated deputy attends, the nominated individual will have delegated responsibility for representation at meetings including voting, actions as required and any decisions made.

3.6.3 For all other of the CCG’s committees and sub-committees, including the Governing Body’s committees, the details of the quorum for these meetings and status of representatives are set out in the appropriate terms of reference.

3.7 Decision making

3.7.1 Section 5 of the CCG’s Constitution, together with the scheme of reservation and delegation, sets out the governing structure for the exercise of the CCG’s statutory functions. Generally it is expected that at the CCG’s/Governing Body’s meetings decisions will be reached by consensus. Should this not be possible then a vote of members will be required, the process for which is set out below:

(a) Eligibility – Governing Body Members

(b) Majority necessary to confirm a decision – Majority

3.7.2 Should a vote be taken the outcome of the vote, and any dissenting views, must be recorded in the minutes of the meeting.

3.7.3 For all other of the CCG’s committees and sub-committees, including the Governing Body’s committees and sub-committee, the details of the process for holding a vote are set out in the appropriate terms of reference.

3.8 Emergency powers and urgent decisions

3.8.1 Emergency meetings of the Governing Body, Audit Committee, or Remuneration Committee and any other committees can be called at the request of the respective chair of the meetings, the Accountable Officer, the Chief Finance Officer or Lay Member with the responsibility for governance.

3.8.2 The need for an urgent decision exceeding individual’s delegated authority can be agreed by the Accountable Officer or Deputy (Chief Finance Officer or Assistant Chief Officer and Corporate Director) and the Chair. Such decisions

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must be reported to the next Governing Body Meeting. In such cases where the CCG is responding to an Emergency Planning Resilience and Response (EPRR) issue or when there is a need to implement the Business Continuity Plan then the Senior Officer with responsibility for decision making at the time will have the authority to make emergency decisions. Any decisions made must be reported upon as soon as possible following any incident to the Accountable Officer or Chief Finance Officer and Executive Director of Corporate Strategy and Delivery and the Chair and must be reported to the next Governing Body Meeting.

3.8.3 Where an urgent decision or approval needs to be made before the next scheduled meeting of the Governing Body a “virtual” decision can be made by contacting all voting members, usually by electronic means, including all the relevant information for them to make an informed decision. There must be a majority response to the proposals which must be quorate in line with the Terms of Reference. Any decision must be reported to the next meeting of the Governing Body.

3.9 Suspension of Standing Orders

3.9.1 Except where it would contravene any statutory provision or any direction made by the Secretary of State for Health or NHS England, any part of these standing orders may be suspended at any meeting, provided the majority of group members are in agreement.

3.9.2 A decision to suspend standing orders together with the reasons for doing so shall be recorded in the minutes of the meeting.

3.9.3 A separate record of matters discussed during the suspension shall be kept. These records shall be made available to the Governing Body’s Audit Committee for review of the reasonableness of the decision to suspend standing orders.

3.10 Record of Attendance

The names of all members of the meeting present at the meeting shall be recorded in the minutes of the CCG’s meetings. The names of all members of the Governing Body present shall be recorded in the minutes of the Governing Body meetings. The names of all members of the Governing Body’s committees present shall be recorded in the minutes of the respective Governing Body committee meetings.

3.11 Minutes

The names and designation of all members of the Governing Body, the Governing Body’s committees present shall be recorded in the minutes of the respective Governing Body, Governing Body’s committee meetings. The minutes of the Governing Body, Governing Body’s committee meetings will be formally signed off by the respective Governing Body, Governing Body’s committee at their next meeting and be made available on the CCG’s website. Minutes of a confidential nature will not be made available on the CCG’s website or by application to the CCG Headquarters. All meetings will ask for declarations of Conflicts of Interest at the commencement of the meeting and record any declared or which become apparent

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during the meeting in line with the CCG’s Conflicts of Interest policy which may be amended from time to time.

3.12 Admission of public and the press

3.12.1 Meetings of the Governing Body will be held in public, other than for business deemed to be confidential. Arrangements will accord with the Public Bodies (Admission to Meetings) Act 1960, the Freedom of Information Act 2000 and the General Data Protection Regulation (GDPR) 2018.

3.12.2 The public meetings of the Governing Body will be announced for the period ahead via the Clinical Commissioning Group’s website. The agenda papers of upcoming meetings and previous meetings (including minutes as approved) will be available on the Clinical Commissioning Group’s website.

3.12.3 Rooms used for Governing Body meetings will allow for the presence of as many members of the public as have attended previously. Those who attend have no right to speak other than by invitation from the Chair. Members of the Public are requested to submit any questions they wish to pose to the Clinical Commissioning Group’s Headquarters three working days in advance of the meeting.

3.12.4 The Governing Body must pass the following resolution to exclude the public on the grounds of confidentiality:

“That representatives of the press and other members of the public be excluded from the remainder of this meeting due to the confidential nature of the business to be transacted - publicity on which would be prejudicial to the public interest”

3.12.5 Where exclusion is anticipated, due to the nature of the business scheduled for a meeting, the public agenda will identify what the topic is for such an exclusion to be considered.

3.12.6 The meeting can consider an emergency resolution to exclude the public/press, or to adjourn to a private place, if any of those present are disrupting its business and will not leave on request.

3.12.7 When the public/press are excluded, group members, employees, and committee members will be required not to disclose the contents of papers or discussions without the express permission of the Clinical Commissioning Group’s Chair. The discussion can identify a future point at which the contents are no longer confidential and the minutes shall record this.

3.12.8 The Annual General Meeting of the CCG will be held in public for presentation of the Annual Report and Annual Accounts with members of the Governing Body present. A substantial proportion of this meeting time will be given over to hearing and responding to the views and questions of the public.

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3.13 Meetings of the members of the Clinical Commissioning Group

3.13.1 Calling meetings

The Membership of the CCG will meet as a Membership Forum, at which GPs and member practices will hold the Governing Body of the CCG to account at least three times a year. The Membership Forum shall be facilitated by the CCG. The Membership Forum shall also meet on an ad hoc basis to consider matters of common interest and to procure dispute resolution.

3.13.2 Agenda, supporting papers and business to be transacted

Items of business to be transacted for inclusion on the agenda of a meeting need to be notified to the Chair of the Membership Forum at least six working days (i.e. excluding weekends and bank holidays) before the meeting takes place. Supporting papers for such items need to be submitted at least six working days before the meeting takes place. The agenda and supporting papers will be circulated to all members of a meeting five working days before the date the meeting will take place.

3.13.3 Selection of the Chair

The selection of the Membership Forum Chair shall be by nomination and or expression of interest from the membership of NHS Derby and Derbyshire CCG. The Chair must be a GP. Engagement of the nominations and or expressions of interest will take place with the membership. The Chair will be elected by the membership of NHS Derby and Derbyshire CCG.

3.13.4 Chair's ruling

The decision of the Chair of the Membership Forum on questions of order, relevancy and regularity and their interpretation of the Constitution, standing orders, scheme of reservation and delegation and prime financial policies at the meeting, shall be final.

3.13.5 Quorum

(a) The quorum necessary for the transaction of the Membership Forum business shall be at least half or more of the GPs and member practices of NHS Derby and Derbyshire CCG.

(b) The members may nominate a deputy to attend on their behalf. The nomination must be approved by the Chair. Where a nominated deputy attends, the nominated individual will have delegated responsibility for representation at the Membership Forum including voting, actions as required and any decisions made.

3.13.6 Decision making

(a) Section 5 of the CCG’s Constitution, together with the scheme of reservation and delegation, sets out the governing structure for the exercise

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of the CCG’s statutory functions. Generally it is expected that at the Membership Forum meeting decisions will be reached by consensus.

(b) Should this not be possible then a vote of members will be required, the process for which is set out below:

(i) Eligibility – GPs and Member Practice Members

(ii) Majority necessary to confirm a decision – Majority

(iii) Casting vote – The Chair of the membership Forum

Should a vote be taken the outcome of the vote, and any dissenting views, must be recorded in the minutes of the meeting.

3.13.7 Emergency powers and urgent decisions

Where an urgent decision or approval needs to be made before the next scheduled meeting of the Membership Forum a “virtual” decision can be made by contacting all voting members, usually by electronic means, including all the relevant information for them to make an informed decision. There must be a majority response to the proposals which must be quorate in line with the Terms of Reference. Any decision must be reported to the next meeting of the CCG Governing Body.

3.13.8 Record of Attendance

The names of all members of the meeting present at the meeting shall be recorded in the minutes of the Membership Forum.

3.13.9 Minutes

The names and designation of all members of the Membership Forum present shall be recorded in the minutes of the respective Membership Forum meetings. All meetings will ask for declarations of Conflicts of Interest at the commencement of the meeting and record any declared or which become apparent during the meeting in line with the CCG’s Conflicts of Interest policy which may be amended from time to time.

3.13.10 Annual General Meeting

The Annual General Meeting of the CCG will be held in public for presentation of the Annual Report and Annual Accounts with members of the Governing Body present. A substantial proportion of this meeting time will be given over to hearing and responding to the views and questions of the public.

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4. APPOINTMENT OF COMMITTEES AND SUB-COMMITTEES

4.1 Appointment of committees and sub-committees

4.1.1 The CCG may appoint committees and sub-committees of the CCG, subject to any regulations made by the Secretary of State, and make provision for the appointment of committees and sub-committees of its Governing Body. Where such committees and sub-committees of the CCG, or committees and sub- committees of its Governing Body, are appointed they are included in section 5.8 of the CCG’s Constitution.

4.1.2 Other than where there are statutory requirements, such as in relation to the Governing Body’s Audit Committee, Remuneration Committee or Primary Care Commissioning Committee, the CCG shall determine the membership and terms of reference of committees and sub-committees and shall, if it requires, receive and consider reports of such committees at the next appropriate meeting of the CCG.

4.1.3 The provisions of these standing orders shall apply where relevant to the operation of the Governing Body, the Governing Body’s committees and sub- committee and all committees and sub-committees unless stated otherwise in the committee or sub-committee’s terms of reference.

4.2 Terms of Reference

Terms of reference shall have effect as if incorporated into the Constitution Appendices and in the CCG Governance Handbook. Terms of References are published on the CCG’s website at:

https://www.derbyandderbyshireccg.nhs.uk/about-us/what-we-do/constitution-and- ccg-governance-handbook/.

4.3 Delegation of Powers by Committees to Sub-committees

Where committees are authorised to establish sub-committees they may not delegate executive powers to the sub-committee unless expressly authorised by the CCG.

4.4 Approval of Appointments to Committees and Sub-Committees

The CCG shall approve the appointments to the Governing Body which it has formally constituted. The CCG shall agree such travelling or other allowances as it considers appropriate.

5. DUTY TO REPORT NON-COMPLIANCE WITH STANDING ORDERS AND PRIME FINANCIAL POLICIES

If for any reason these standing orders are not complied with, full details of the non- compliance and any justification for non-compliance and the circumstances around the non-compliance, shall be reported to the next formal meeting of the Governing Body for action or ratification. All members of the CCG and staff have a duty to disclose any

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non-compliance with these standing orders to the Accountable Officer as soon as possible.

6. USE OF SEAL AND AUTHORISATION OF DOCUMENTS

6.1 Clinical Commissioning Group’s seal

The CCG may have a seal for executing documents where necessary. The following individuals or officers are authorised to authenticate its use by their signature:

6.1.1 the Accountable Officer;

6.1.2 the Chief Finance Officer;

6.1.3 the Corporate Secretary.

6.2 Execution of a document by signature

The following individuals are authorised to execute a document on behalf of the CCG by their signature.

6.2.1 the Accountable Officer;

6.2.2 the Chief Finance Officer;

6.2.3 the Corporate Secretary.

7. OVERLAP WITH OTHER CLINICAL COMMISSIONING GROUP POLICY STATEMENTS / PROCEDURES AND REGULATIONS

7.1 Policy statements: general principles

The CCG will from time to time agree and approve policy statements / procedures which will apply to all or specific groups of staff employed by NHS Derby and Derbyshire Clinical Commissioning Group. The decisions to approve such policies and procedures will be recorded in an appropriate group minute and will be deemed where appropriate to be an integral part of the CCG’s standing orders.

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Appendix 4 – Standing Financial Instructions – Financial Limits for Delegated Authority

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Annexure 1 – Decisions, Authorities and Duties Delegated to Officers of the CCG Governing Body

1. The arrangements made by the CCG as set out in the Overarching Scheme of Reservation and Delegation of decisions shall have effect as if incorporated in the CCG’s Constitution.

2. The CCG remains accountable for all of its functions, including those that it has delegated.#

3. The Overarching Scheme of Reservation & Delegation (Schedule of Matters Reserved to the CCG and Scheme of Delegation) and details the arrangements made by the CCG for discharging its functions.

4. The Schedule below details the Operational Scheme of Delegation (and financial authority limits). These should be read in conjunction with the Prime Financial Policies (See CCG Governance Handbook).

5. This is prepared by the Accountable Officer and sets out those key operational decisions delegated to individual employees of the CCG.

6. The approval of the CCG’s Operational Scheme of Delegation that underpins the CCG’s “Overarching Scheme of Reservation and Delegation” is reserved to the Governing Body.

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1 Capital Projects and Assets

2 Budgetary Control

3 Approval of Revenue Business cases

4 Procurement

5 Commissioning Expenditure – Purchase of Healthcare

6 Non Healthcare Expenditure (Limits include VAT) Contracts

7 Payroll Expenditure

8 Income Generation and Research and Development

9 Income and debt write-off

10 Losses and Special Payments

11 Bank accounts and payment methods

12 Income from Fees and charges

13 Standards of business conduct

14 Insurance – clinical and non-clinical

15 Borrowing, lending and grants

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Responsibility Delegation Arrangements Further Information 1. Capital Projects and Assets This includes any expenditure that meets IFRS 16 – Leases criteria

1.1 Approval of capital business cases This includes cases any capital business cases that may including granting, terminating or receive external funding. These powers may not be extending leases: further delegated from the Governing Body. In the absence of the appropriate officer, authorisation must be (a) All PFI schemes and other (a) Governing Body obtained from the level above. schemes greater than £250,000 In urgent cases joint approval by the Accountable Officer and Chief Finance Officer is required (up to the approval (b) Up to £250,000 (b) Clinical and Lay Commissioning limits of approval of the Clinical and Lay Commissioning Committee, and Finance and Finance Committees). Committee

(c) Up to £10,000 (c) Director of GP Development The Director of GP Development and Assistant Director of GP Development can approve the funding of essential (d) Up to £5,000 (d) Assistant Director of GP capital works in primary care to address the COVID-19 Commissioning and crisis without the need for a capital business case. Development Approval required from NHSEI to confirm availability of capital funding before commencement of the works.

1.2 Capital expenditure variations over In urgent cases up to £100,000 joint approval by the the original business case figure Accountable Officer and Chief Finance Officer is required (up to approval limits of the Clinical and Lay Commissioning and Finance Committees) (a) Greater than £100,000 (a) Governing Body

(b) Greater than £25,000 and less (b) Clinical & Lay Commissioning than £100,000 or greater than Committee, and the Finance 5% of the original business Committee case whichever is the lower

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Responsibility Delegation Arrangements Further Information (c) Less than £25,000 or less than (c) Chief Finance Officer 5% of the original business case whichever is the lower

1.3 Maintenance of the capital asset Chief Finance Officer Operationally managed by Head of Finance – Financial register Control

1.4 Approval of asset disposals: Head of Finance – Financial Control must always be informed to enable the asset register to be updated. (a) Land and buildings (a) Governing Body Disposals include those items that are lost, obsolete, Other Assets, where asset has a redundant, and irreparable or cannot be repaired cost residual value: effectively.

(a) Greater than £100,000 (a) Governing Body

(b) £50,000 and up to £100,000 (b) Accountable Officer

(d) Less than £10,000 (d) Budget Holders i.e. Executive Directors

(e) Other – where the asset has no (e) Deputy Director of Finance residual value

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Responsibility Delegation Arrangements Further Information 2. Budgetary Control

2.1 Approval of budgets and their The approval of budgets and resources will usually take management place during the March Governing Body meeting when the Annual Plan is approved. (a) Approval of budgets and (a) Governing Body resources

(b) Delegation of Budgets (b) Accountable Officer and Chief Finance Officer

(c) Approval to spend (c) Budget Holder/Budget Manager is permitted to incur costs in accordance with their budgets & authorisation limits 2.2 Approval of budget virements Staff should refer to the CCG’s Financial Management Budget Book. If virement is the result of an authorised contract variation:

(a) Greater than £100,000 (a) Accountable office and either Chief Finance Officer or Functional Director

(b) Greater than £25,000 up to (b) Budget Holder and either Chief £100,000 Finance Officer or Functional Finance Director

(d) £500 and below (d) Budget Manager

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Responsibility Delegation Arrangements Further Information For other virements:

(a) Greater than £10,000 (a) Clinical and Lay Commissioning Committee

(b) Up to £10,000 (b) Budget Holder

3. Approval of Revenue Business Cases

3.1 Approval of Revenue Business For Capital see Section 1. Cases In urgent cases, joint approval by the Accountable Officer and Chief Finance Officer is required (up to limits (a) Greater than £500,000 (a) Finance Committee and of approval by the Finance Committee). Governing Body

(b) Up to £500,000 (b) Finance Committee

4. Procurement The detailed procedures supporting these delegations can be found in the CCG Procurement Policy 4.1 Financial appraisal of potential Chief Finance Officer As required dependant on goods and services being suppliers procured. Managed operationally by the Head of Finance – Financial Control

4.2 Authorisation of less than the The requisite number of tenders / quotes: requisite number of tenders/quotes: (a) Up to and including £20,000, at least 3 written (a) For all contracts of £250,000 (a) Accountable Officer competitive quotations for goods/services obtained. and above (b) Above £20,000 to £50,000, at least 5 written (b) For all contracts less than (b) Chief Finance Officer competitive quotations for goods / services £250,000 obtained. All procurement with a value exceeding £25,000 must be advertised on Contract Finder.

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Responsibility Delegation Arrangements Further Information (c) Above £50,000, a full tender is to be carried out.

Above the OJEU limit, an OJEU compliant tender is required.

Quotes/ tenders as per (a), (b) and (c) will not be required for the duration of the COVID-19 emergency for primary care expenditure. Robust evidence will be required (e.g. receipts, order confirmation/ invoices from suppliers) in order for primary care to receive reimbursement for expenditure however. 4.3 Single tender/ single quote: Where a single tender/single quote is received, the CCG shall as far as practical, determine that the price to be A single tender waiver form must be Chief Finance Officer paid is fair and reasonable and that details of the completed and approved. investigation carried out are recorded.

Single tender/single quote will be reported for information only, at the next Audit Committee.

Controls varied for primary care as set out in 1.1 for the duration of the COVID-19 emergency.

4.4 Single tender/single quote action for Chief Finance Officer Delegated to Head of Finance – Financial Control, who maintenance or other support will ensure such contracts are maintained on the contracts for existing goods or assets Register of Procurement Decisions. where the CCG is contractually tied to specific companies

4.5 Monitoring of the use of single Audit Committee on behalf of A single tender waiver must be completed and forwarded tender/single quote action. Governing Body to the Head of Finance – Financial Control.

Single Tender Actions must be maintained on the Register of Procurement Decisions. NHS Derby and Derbyshire Clinical Commissioning Group Constitution v3.8

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Responsibility Delegation Arrangements Further Information 4.6 Advertising of contracts/ publishing of Accountable Officer Managed by the CCG Procurement Lead. contract awards over £25,000 Such advertising and publishing must be made available on Contract Finder.

4.7 Opening of tenders In using the e-Tendering solution, the Procurement Lead will first open the tender before allocating to the correct (a) Where tender is below £25,000 (a) This will be automatic on subject matter expert as delegated across. Contracts Finder

(b) Where tender is above £25,000 (b) An Executive Director

4.8 Permission to consider late tenders Accountable Officer With advice from the CCG’s Procurement Lead

4.9 Tender ratification and award, including authorisation of any actions resulting from post tender negotiations:

All types of tenders (on the lifetime value of the contract):

(a) Up to £50,000 (a) Budget Holder i.e. Executive Director (b) Above £50,000 (b)

(i) Non-clinical spend (i) Accountable Officer

(ii) Clinical spend up to and (ii) Clinical and Lay including £1,500,000 Commissioning Committee

(c) Clinical spend above (c) Governing Body £1,500,000 NHS Derby and Derbyshire Clinical Commissioning Group Constitution v3.8

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Responsibility Delegation Arrangements Further Information 4.10 Sealing of documents As per the Standing Orders Section 6

5. Commissioning Expenditure – This includes NHS, independent care placements, private sector healthcare contracts. Purchase of Healthcare WHERE NO SIGNED CONTRACT OF THE BELOW DELEGATIONS EXISTS, EXPENDITURE MUST BE RAISED VIA A REQUISITION AND PURCHASE ORDER (unless there are exceptional circumstances)

5.1 Contract Signature: The delegations for contract signature apply even where the value is within budget. (a) All contracts over £10 million (a) Accountable Officer and Chief Finance Officer All contracts should be approved by Finance Committee (b) Greater than £1 million and up (b) Accountable Officer before signing by the delegated officers. to £10 million Signing of contracts including letters of intent. (c) Greater than £100,000 and up (c) Chief Finance Officer or to £1 million Executive Director of The amounts are the lifetime value of the contract. Commissioning Operations (d) Greater than £50,000 and up to (d) Budget Holders i.e. Exec Also applies to contract extensions and variations. £100,000 Directors Controls varied for primary care for the duration of the (e) Greater than £10,000 and up to (e) Director of GP Development COVID-19 emergency £50,000

(f) Up to £10,000 (f) Assistant Director of GP Commissioning and Development

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Responsibility Delegation Arrangements Further Information Requisitions: Where practical, requisitions should be raised following a contract being signed by both parties. (a) Greater than £50 million (a) Accountable Officer When requisitions are raised and approved, purchase (b) Greater than £1 million and up (b) Budget Holder i.e. Executive orders will be generated and sent directly to the provider to £50 million Director, or Accountable / supplier. Officer/Chief Finance Officer The provider must quote the purchase order number on (c) Greater than £50,000 and up to (c) Budget Manager i.e. Functional all invoices raised against that purchase order. £1 million Director

(d) Up to £50,000 (d) Senior Manager Band 8a or above

5.3 Invoice Payment

Where purchase orders have been Invoices for goods and services An invoice should only be receipted after it has been raised provided following a requisition and confirmed as correct. purchase order being raised are automatically approved when the COVID-19 temporary measure delivery/provision is receipted in All invoices / payment files that are the responsibility of Oracle, providing the invoice value either the Medical Director or Director of GP matches the purchase order and Development should be redirected to the Associate receipt Director of Finance. The Associate Director of Finance’s delegated limit is adjusted to match that of the Budget Holder.

All invoices/payment files that are the responsibility of the Nursing & Quality Directorate should be redirected to an Assistant Director of Finance (up to £1 million) and Associate Director of Finance (up to £50 million).

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Responsibility Delegation Arrangements Further Information Where purchase orders have NOT Where no signed contract exists, expenditure must be been raised raised via a requisition and purchase order (unless there are exceptional circumstances). (a) Greater than £50 million (a) Accountable Officer COVID-19 temporary measures (b) Greater than £ 1 million up to (b) Budget Holder i.e. Executive All invoices/payment files that are the responsibility of and including £50 million Director, or Accountable Officer either the Medical Director or Director of GP / Chief Finance Officer Development should be redirected to the Associate Director of Finance The Associate Director of Finance’s (c) Greater than £50,000 up to and (c) Budget Manager i.e. Functional delegated limit is adjusted to match that of the Budget including £1 million Director Holder.

(d) Up to and including £50,000 (d) Senior Manager – Band 8a or All invoices / payment files that are the responsibility of above) the Nursing & Quality Directorate should be redirected to an Assistant Director of Finance (up to £1million) and Associate Director of Finance (up to £50million).

5.4 Authorisation of monthly invoices in Either Accountable Officer, Executive excess of agreed contract value. Director of Commissioning Operations or Chief Financial Officer

5.5 Exceptional: Continuing Health Care Band 7 or above under £10,000

5.6 Exceptional: Non-Contracted Activity Band 7 or above under £1,000

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Responsibility Delegation Arrangements Further Information 6. Non-Healthcare Expenditure ALL EXPENDITURE MUST BE RAISED VIA A REQUISITION AND PURCHASE ORDER (Limits include VAT) (unless there are exceptional circumstances)

6.1 Contract Signature The delegations for contract signature apply even where the value is within budget. Signing of contracts including letters of intent. The amounts below are All contracts should be approved by Finance Committee based on the lifetime value of the before signing by the delegated officers. contract. Contracts should be sealed if it is in the interests of the (a) Greater than £500,000 (a) Accountable Officer and Chief CCG. Finance Officer Also applies to contract extensions and variations. (b) Greater than £50,000 and up to (b) Chief Finance Officer following £500,000 approval from the Finance In all contracts the CCG should endeavour to obtain best Committee value for money.

6.2 Authorisation of requisitions: Where practical, requisitions should be raised following a contract being signed by both parties. (a) £500,000 and above (a) Accountable Officer and Chief Financial Officer following When requisitions are raised and approved, purchase Finance Committee approval orders will be generated and sent directly to the supplier.

(b) Greater than £ 100,000 and up (b) Chief Financial Officer following The supplier must quote the purchase order number on to and including £500,000 approval from the Finance all invoices raised against that purchase order. Committee In line with budget management responsibilities (i.e. (c) Greater than £50,000 up to and (c) Budget Holder i.e. Executive delegated budgets) and subject to quoting & tendering including £100,000 Director as required (see Section 4 above)

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Responsibility Delegation Arrangements Further Information (d) Up to and including £50,000 (d) Budget Manager i.e. Functional These limits are the maximum limits for each delegated Directors group and at any time, as deemed necessary, the Chief Finance Officer can impose lower limits for each (e) Procurement of Professional (e) Accountable Officer, Deputy delegated group. Services - additional controls Accountable Officer or Chief are required due to the nature Finance Officer or Corporate of expenditure for: Secretary or nominated staff.

(i) Legal advice (ii) Specialist advice (iii) Specific projects

6.3 Invoice Payment

Where purchase orders have been Invoices for goods and services An invoice should only be receipted after it has been raised provided following a requisition and confirmed as correct. purchase order being raised are automatically approved when the All expenditure must be raised via a requisition and delivery/provision is receipted in purchase order (unless there are exceptional Oracle, providing the invoice value circumstances) matches the purchase order and receipt COVID-19 temporary measure All invoices / payment files that are the responsibility of Where purchase orders have NOT either the Medical Director or Director of GP been raised Development should be redirected to the Associate Director of Finance. The Associate Director of Finance’s (a) £500,000 and above (a) Accountable Officer and Chief delegated limit is adjusted to match that of the Budget Financial Officer following Holder. Finance Committee approval

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Responsibility Delegation Arrangements Further Information (b) Greater than £ 100,000 and up (b) Chief Financial Officer following to and including £500,000 approval from Finance Committee

(d) Up to and including £50,000 (d) Budget Holders i.e. Executive Directors

(e) Procurement of Professional (e) Accountable Officer, Deputy Services - additional controls Accountable Officer or Chief are required due to the nature Finance Officer or Corporate of expenditure for: Secretary or nominated staff

(i) Legal advice (ii) Specialist advice (iii) Specific projects

7. Payroll Expenditure Prior to incurring any pay expenditure including agency, interim and temporary workers, the CCG’s Establishment Vacancy Control Process must be followed.

7.1 Substantive and within budgeted All appointments must be passed All appointments require approval from finance to establishment through the Remuneration Committee confirm that budget is available.

(a) Appointment of substantive (a) Accountable Officer, Chief staff of VSM contracts Finance Officer and NHS England

(b) All other substantive (b) Budget Manager i.e. Functional appointments up to VSM Director or higher contracts

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Responsibility Delegation Arrangements Further Information 7.2 Not within budgeted establishment, including:

(a) Authority to appoint staff All members of the Exec team

(b) Authority to permanently To be signed off by both Accountable amend the formal Officer and Chief Finance Officer establishment

7.3 Off-payroll / Agency workers; For all agency, interim and other temporary workers the CCG’s “Temporary Agency Workers Procedure” (a) Daily rate less than £600 ex (a) Finance Committee incorporating escalation policies for rates outside either VAT, less than 6 months and framework or NHSE caps, must be followed. not categorised as a role of significant influence

(b) Daily rate more than £600 ex (b) Approval required from NHSE VAT or more than 6 months or categorised as a role of significant influence

7.4 Travel and Expenses Via submission on e-pay to the Any claims made by the Chair shall be authorised by the appropriate line manager within the Accountable Officer and any expenses claimed by the Authorisation of travel and expense allocated time period and Accountable Officer shall be authorised by the Chair of claims in line with the CCG’s Travel accompanied by scanned copies of Chief Finance Officer. and Expenses Policy receipts (except for mileage) Any claims that relate to expenses incurred over 90 days The maximum value of any single ago will be approved at the discretion of the monthly claim is restricted to £2,500. Departmental Managers/Heads of Department and could be rejected.

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Responsibility Delegation Arrangements Further Information 7.5 Authorisation of other travel and Any study leave and associated expenses should be expenses not covered by the CCG’s agreed by the Chief Finance Officer, Budget Manager Travel and Expenses Policy i.e. Functional Director and their Executive Director in advance.

(a) Over £300 (a) Accountable Officer or Chief Finance Officer

(b) Up to £300 (b) Budget Holder i.e. Executive Director

7.6 Overtime Overtime should be agreed in advance and will only be agreed in exceptional circumstances. (a) Approval to work overtime (a) Chief Finance Officer

(b) ESR authorisation of overtime (b) Line Manager following receipt of approval from Chief Finance Officer

8. Income Generation and Research and Development Contracts

8.1 Approval of income generation These powers may not be further delegated. In the contracts and variations or absence of the appropriate officer, authorisation must be extensions to income generation obtained from the level above. contracts:

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Responsibility Delegation Arrangements Further Information (a) Greater than £500,000 (a) Governing Body

(b) £250,000 and up to £500,000 (b) Accountable Officer

8.2 Approval of research and These powers may not be further delegated. In the development contracts (including absence of the appropriate officer authorisation must be variations or extensions) obtained from the level above

(a) Greater than £500,000 (a) Governing Body

(b) £250,000 and up to £500,000 (b) Accountable Officer

9. Income and debt write-off

9.1 Authorisation to refer debts to a debt Chief Finance Officer Operationally managed by the Head of Finance – collection agency Financial Control/Assistant Chief Finance Officer

9.2 Authorisation to write-off debt or Members of the Audit Committee This includes non-recovery of any payroll overpayments. income (total debt per debtor) following Chief Finance Officer recommendation Debit or credit notes are only to be raised after approval by the Members of the Audit Committee.

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Responsibility Delegation Arrangements Further Information 10. Losses and special payments All losses and special payments must be reported at every meeting to the Audit Committee

10.1 Authorisation of losses and special All to be ratified by Members of the All losses greater than £100,000 must be approved by payments, including ex-gratia Audit Committee before the below HM Treasury – see Losses Procedure contained in the payments: delegations are followed. General Financial Procedures, after advice taken by lawyers. (a) Greater than £50,000 (a) Governing Body The Chief Finance Officer will report any cases they (b) £10,000 and up to £50,000 (b) Accountable Officer consider to be “novel, contentious or repercussive” to the Chair of the Audit Committee as soon as they become (c) Up to £30,000 (staff (c) Executive Director of Corporate aware of the case. These should also be reported to compromise agreements only) Strategy and Development NHS England in line with current guidance.

(d) Up to £10,000 (d) Audit Committee or where urgent, Chief Finance Officer or Functional Finance Directors

10.2 Monitoring of losses and special Audit Committee Liaison with the CCG’s Local Counter Fraud Specialist & payments Police as required and in line with the CCG’s Fraud, Corruption and Bribery Policy.

10.3 Authorisation of early retirement, redundancy and other termination payments to staff:

(a) Greater than £100,000 (a) Governing Body

(b) £50,000 and up to £100,000 (b) Accountable Officer

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Responsibility Delegation Arrangements Further Information 11. Bank accounts and payment methods 11.1 Opening of bank accounts or Finance Committee The CCG will use Government Banking Services only. changes to banking arrangements

11.2 Signing of cheques for cash, signing See Bank Mandate Bank Mandate to be maintained by the Head of Finance of other cheques, and authorisation – Financial Control of electronic payments, cheque and BACs and CHAPs payment schedules

12. Income from fees and Charges

12.1 Approval of the amounts to be Chief Finance Officer Examples are course fees from running courses for non- charged for fees and charges CCG employees, use of equipment and facilities (such as photocopiers and rooms) 13. Standards of Business Conduct

13.1 Maintenance of the CCG Register of Executive Director of Corporate Maintained by Corporate Secretary Interests Strategy and Delivery

13.2 Maintenance of CCG Gifts and Executive Director of Corporate Maintained by Corporate Secretary Hospitality Register Strategy and Delivery

14. Insurance – Clinical and Non- Clinical

14.1 Decision on level of insurance Chief Finance Officer The risk should be managed by the Accountable Officer required, negotiated and agreement in conjunction with the CCG’s Executive Director of of premiums Corporate Strategy and Delivery.

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Responsibility Delegation Arrangements Further Information 15. Borrowing, Lending and Grants

15.1 Approval of all Loans and Grants Governing Body

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Annexure 2 – Conflicts of Interest Management

On 16 June 2017, NHS England published revised statutory guidance on managing conflicts of interest for CCGs. This replaces the 2016 version of the guidance.

The guidance has been updated to ensure it is fully aligned with the recently published cross system conflicts of interest guidance – Managing conflicts of interest in the NHS: Guidance for staff and organisations. A small number of changes have been made including:

• Registers of interest: We have updated the CCG guidance to require that CCGs have systems in place to satisfy themselves as a minimum on an annual basis that their registers of interest are accurate and up-to-date, and to require that only decision- making staff are included on the published register.

• Gifts from suppliers or contractors: In line with the NHS-wide guidance, gifts of low value (up to £6), such as promotional items, can now be accepted.

• Gifts from other sources: We have amended the thresholds so that gifts of under £50 (rather than £10) can be accepted from non-suppliers and non-contractors, and do not need to be declared. Gifts with a value of over £50 can now be accepted on behalf of an organisation, but not in a personal capacity.

• Hospitality – meals and refreshments: We have amended the thresholds so that hospitality under £25 does not need to be declared. Hospitality between £25 and £75 can be accepted, but must be declared, and hospitality over £75 should be refused unless senior approval is given.

• New care models: We have included a new annex to provide further advice on identifying, declaring and managing conflicts of interest in the commissioning of new care models: Annex K: Conflicts of interest and New Models of Care.

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