Nhs East Lancashire Clinical Commissioning Group Constitution

NHS EAST LANCASHIRE CLINICAL COMMISSIONING GROUP CONSTITUTION

Version 9

Working with People and Communities to live happier and healthier lives

Version 9_approved by NHS England 2nd October 2020

TABLE OF CONTENTS 1. INTRODUCTION AND COMMENCEMENT ...... 4 1.1 Name ...... 4 1.2 Statutory Framework ...... 4 1.3 Status of this Constitution ...... 4 1.4 Amendment and Variation of this Constitution ...... 5 2. AREA COVERED ...... 5 3. MEMBERSHIP ...... 6 3.1 Membership of the Clinical Commissioning Group ...... 6 3.2 Eligibility ...... 6 4. MISSION, VALUES AND AIMS ...... 7 4.1 Mission, Values and Aims ...... 7 4.2 Principles of Good Governance ...... 7 4.3 Accountability ...... 7 4.4 Protected Disclosure ...... 8 5. FUNCTIONS AND GENERAL DUTIES ...... 9 5.1 Functions ...... 9 5.2 General Duties - The Group will: ...... 9 5.3 Public Involvement ...... 10 5.4 General Financial Duties – The Group will ...... 10 5.5 Arrangements by the Group to comply with its functions – The Group shall exercise the functions set out in Part 5 of this Constitution by: ...... 11 5.6 Other Relevant Regulations, Directions and Documents ...... 11 6. DECISION MAKING: THE GOVERNING STRUCTURE ...... 12 6.1 Authority to act ...... 12 6.2 Scheme of Reservation and Delegation ...... 12 6.3 General ...... 12 6.4 The Council of Members ...... 13 6.5 Joint Arrangements ...... 14 6.6 Joint Commissioning Arrangements ...... 14 6.6.1 Joint commissioning arrangements with other Clinical Commissioning Groups ...... 14 6.6.2 Joint commissioning arrangements with NHS England for the exercise of CCG functions 15 6.6.3 Joint commissioning arrangements with NHS England for the exercise of NHS England’s functions ...... 16 6.7 The Governing Body and Sub Committees ...... 17 6.7.1 Functions ...... 17 6.7.2 Composition of the Governing Body ...... 18 6.7.3 Committees of the Governing Body ...... 18 (A) Audit Committee ...... 18 (B) Remuneration Committee ...... 19 (C) Pennine Lancashire Quality Committee ...... 19 (D) Primary Care Committee ...... 19 (E) Patient Partners Board ...... 19 (F) Sustainability Committee ...... 20 7. ROLES AND RESPONSIBILITIES ...... 21 7.1 Member Representatives ...... 21 7.2 Other GP and Primary Care Health Professionals ...... 21 7.3 All Members of the Group’s Governing Body ...... 21 7.4 The Chair of the Governing Body ...... 22 7.5 The Deputy Chair of the Governing Body ...... 22 7.6 Lay Member with a Lead role in Overseeing Key elements of Governance ...... 22 7.7 Lay Member with a Lead in Championing Patient and Public Involvement ...... 23 7.8 Lay Member with a Lead in Championing Equality & Inclusion (non-voting) ...... 23 7.9 GP Locality Clinical Lead (5 posts – one for each locality) ...... 24

7.10 Role of the Accountable Officer ...... 24 7.11 Role of the Chief Finance Officer ...... 25 7.12 Role of Director of Quality and Chief Nurse ...... 26 7.13 Director of Performance and Delivery ...... 26 7.14 Secondary Care Doctor ...... 27 7.15 Joint Appointments with other Organisations ...... 27 7.16 Indemnity ...... 27 8. STANDARDS OF BUSINESS CONDUCT AND MANAGING CONFLICTS OF INTEREST ...... 29 8.5 Transparency in Procuring Services ...... 31 9. THE GROUP AS EMPLOYER ...... 32 10. TRANSPARENCY, WAYS OF WORKING AND STANDING ORDERS ...... 33 10.1 General ...... 33 10.2 Standing Orders ...... 33 APPENDIX ...... 34 A: DEFINITIONS OF KEY DESCRIPTIONS USED IN THIS CONSTITUTION ...... 34 B: LIST OF MEMBER PRACTICES ...... 36 C: NOLAN PRINCIPLES ...... 39 D: THE SEVEN KEY PRINCIPLES OF THE NHS CONSTITUTION ...... 40 E: STANDING ORDERS ...... 41 F: (a) SCHEME OF RESERVATION & DELEGATION ...... 53 F: (b) RESERVATION AND DELEGATION SCHEDULE ...... 54 F: (c) DELEGATED FINANCIAL LIMITS ...... 64 G: PRIME FINANCIAL POLICIES ...... 66 H-K: COMMITTEE TERMS OF REFERENCE……………………………………………………134

1. INTRODUCTION AND COMMENCEMENT

1.1 Name

1.1.1 The name of this clinical commissioning group (CCG) is NHS East Lancashire Clinical Commissioning Group (the “Group”).

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 section 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 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); c) Financial duties (under sections 223G-K 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 and the Freedom of Information Act 2000).

1.2.3 Our status as a CCG is determined by the NHS Commissioning Board (hereafter known as 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 intervene where it is satisfied that the Group is failing or has failed to discharge any of its functions or that there is a significant risk that it will fail to do so.

1.2.5 The Group is a clinically led membership organisation made up of general practices. The members of the Group are responsible for determining the governing arrangements for their organisation including arrangements for clinical leadership, which are set out in this constitution.

1.3 Status of this Constitution

1.3.1 This constitution is made between the members of the Group and has effect from 18th day of January 2013, when NHS England established the Group.

The constitution is published on the Group’s website at http://www.eastlancsccg.nhs.uk/

This document is also available upon request for inspection at the Group’s headquarters:-

NHS East Lancashire CCG Walshaw House Regent Street Nelson Lancashire BB9 8QS

Upon application either by post (to the above address) or by e-mail – further details are available on the Group’s website.

1.4 Amendment and Variation of this Constitution

1.4.1 This constitution can only be varied in two circumstances.

a. Where the Group applies to NHS England and that application is granted;

b. Where in the circumstances set out in legislation NHS England varies the Group’s constitution other than on application by the Group.

2. AREA COVERED

2.1 The geographical area covered by NHS East Lancashire Clinical Commissioning Group is the Lancashire Boroughs of:-

 Burnley,  Hyndburn,  Pendle,  Rossendale and  Ribble Valley (excluding Longridge – Patients registered at Berry Lane Medical Centre, Longridge and The Stonebridge Surgery, Longridge)

3. MEMBERSHIP

3.1 Membership of the Clinical Commissioning Group

3.1.1 Appendix B to this constitution contains a list of the Members of the Group. Signatures of the Member Representatives confirming their agreement to this constitution are held by the group under its constitutional governance arrangements.

3.2 Eligibility

3.2.1 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, will be eligible to apply for membership of this Group.

3.2.2 Subject to the agreement of NHS England, a member will cease to be a member of the Group if it ceases to meet the eligibility criteria set out in Paragraph 3.2.1.

4. MISSION, VALUES AND AIMS

4.1 Mission, Values and Aims

4.1.1 The Group shall publish a statement setting out its mission, values and aims in its Annual Commissioning Plan (“Statement of Mission, Values and Aims”).

4.1.2 The Governing Body shall review the Statement of Mission, Values and Aims each year, as part of the process of producing the commissioning plan for the following year, and shall decide whether any changes are appropriate.

4.1.3 A copy of the Group’s Statement of Mission, Value and Aims shall be published on its website. http://www.eastlancsccg.nhs.uk/.

4.1.4 The Group will promote good governance and proper stewardship of public resources in pursuance of its goals and in meeting its statutory duties.

4.1.5 Good corporate governance arrangements are critical to achieving the Group’s objectives.

4.2 Principles of Good Governance

4.2.1 In accordance with section 14L (2) (b) of the 2006 Act, the Group will at all times observe “such generally accepted principles of good governance” in the way it conducts its business. These include:

a) The highest standards of propriety involving impartiality, integrity and objectivity in relation to the stewardship of public funds, the management of the organisation and the conduct of its business;

b) The Good Governance Standard for Public Services;

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

d) The seven key principles of the NHS Constitution;

e) The Equality Act 2010.

f) Standards for Members of NHS Boards and Governing Bodies in England

4.3 Accountability

4.3.1 The Group will demonstrate its accountability to its members, local people, stakeholders and NHS England in a number of ways, including by:

a) Publishing its constitution;

b) Appointing independent lay members and non GP clinicians to its Governing Body;

c) Managing 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;

d) Holding meetings of its Governing Body in public (except where the CCG considers that it would not be in the public interest in relation to all or part of a meeting);

e) Publishing annually a commissioning strategy that takes account of priorities in the health and wellbeing strategy;

f) Procuring services in a manner that is open, transparent, non-discriminatory and fair to all potential providers and publish a procurement strategy;

g) Involving the public, in accordance with duties under section 14Z2 of the 2006 Act, and as set out in more detail on the CCG’s website section “Get Involved”

h) Complying with local authority health overview and scrutiny requirements;

i) Meeting annually in public to publish and present its annual report (which must be published);

j) Producing annual accounts in respect of each financial year which must be externally audited;

k) Having a published and clear complaints process;

l) Complying with the Freedom of Information Act 2000;

m) Providing information to NHS England as required; and

n) Being an active member of the local Health and Wellbeing Board.

4.3.2 In addition to these statutory requirements, the Group will demonstrate its accountability by:

a) Publishing its principal commissioning and operational policies e.g. Funding Exceptional Cases Policy

b) Holding engagement events

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

4.4 Protected Disclosure

4.4.1 The group recognises and confirms that 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 group, 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 group or of any of its members, nor will it affect the rights of any worker (as defined in that Act) under that Act.

5. FUNCTIONS AND GENERAL DUTIES

5.1 Functions

5.1.1 The Group’s functions include:

a) Commissioning certain health services (where NHS England is not under a duty to do so) that meet the reasonable needs of:

i) All people registered with member GP practices, and ii) People who are usually resident within the area and are not registered with a member of any clinical commissioning group;

b) Commissioning emergency care for anyone present in the Group’s area;

c) Paying its employees’ remuneration, fees and allowances in accordance with the determinations made by its Governing Body and determining any other terms and conditions of service of the Group’s employees;

d) Determining the remuneration and travelling or other allowances of members of its Governing Body.

5.1.2 In discharging its functions the Group will:

e) Act, when exercising its functions to commission health services, consistently with the discharge by the Secretary of State and NHS England of their duty to promote a comprehensive health service and with the objectives and requirements placed on NHS England through the mandate published by the Secretary of State before the start of each financial year;

f) meet the public sector equality duty; and

g) work in partnership with its local authorities to develop joint strategic needs assessments and joint health and wellbeing strategies

5.2 General Duties - The Group will:

5.2.1 Promote awareness of, and act with a view to ensuring that health services are provided in a way that promotes awareness of, and due regard to the NHS Constitution;

5.2.2 Act effectively, efficiently and economically;

5.2.3 Act with a view to securing continuous improvement to the quality of services;

5.2.4 Assist and support NHS England in relation to the Board’s duty to improve the quality of primary medical services;

5.2.5 Have regard to the need to reduce inequalities;

5.2.6 Promote the involvement of patients, their careers and representatives in decisions about their healthcare; act with a view to enabling patients to make choices;

5.2.7 Obtain appropriate advice from persons who, taken together, have a broad range of professional expertise in healthcare and public health;

5.2.8 Promote innovation;

5.2.9 Promote research and the use of research;

5.2.10 Have regard to the need to promote education and training for persons who are employed, or who are considering becoming employed, in an activity which involves or is connected with the provision of services as part of the health service in England so as to assist the Secretary of State for Health in the discharge of his related duty;

5.2.11 Act with a view to promoting integration of both health services with other health services and health services with health-related and social care services where the group considers that this would improve the quality of services or reduce inequalities;

5.2.12 Provide strategic overview to ensure procurement obligations are met throughout the procurement process;

5.3 Public Involvement – The Group will:

5.3.1 Make arrangements to secure public involvement in the planning, development and consideration of proposals for changes and decisions affecting the operation of commissioning arrangements

5.3.2 Follow the principles set out below in implementing its arrangements to comply with its duty to secure public involvement:

a) Working in partnership with patients and the local community to secure the best care for them;

b) Adapting engagement activities to meet the specific needs of different patient groups and communities;

c) Publishing information about health services on the Group’s website and through other media; d) Encouraging and acting on feedback;

e) Engage with the Local Medical Committee as statutory representatives of the General Practitioner Profession locally.

5.3.3 The Group shall monitor its compliance against this statement of principles.

5.4 General Financial Duties – The Group will

5.4.1 Ensure its expenditure does not exceed the aggregate of its allotments for the financial year

5.4.2 Ensure its use of resources (both its capital resource use and revenue resource use) does not exceed the amount specified by NHS England for the financial year

5.4.3 Take account of any directions issued by NHS England, in respect of specified types of resource use in a financial year, to ensure the Group does not exceed an amount specified by NHS England;

5.4.4 Publish an explanation of how the Group spent any payment in respect of quality made to it by NHS England

5.5 Arrangements by the Group to comply with its functions – The Group shall exercise the functions set out in Part 5 of this Constitution by:

5.5.1 Delegating responsibility for their performance to the Governing Body, its committees and subcommittees which shall act in accordance with this Constitution, the Standing Orders and the Scheme of Delegation and Reservation;

5.5.2 Acting in accordance with the Group’s Statement of Policy for Compliance with General, Financial, Partnership Working and Public Sector Equality Duties that the Governing Body will adopt, keep under review and update for the Group; and

5.5.3 Monitoring delivery of the duties through the Group’s reporting mechanisms.

5.6 Other Relevant Regulations, Directions and Documents

5.6.1 The Group will:

a. Comply with all relevant regulations; b. Comply with directions issued by the Secretary of State for Health or NHS England; and c. Take account, as appropriate, of documents issued by NHS England.

5.6.2 The Group will develop and implement the necessary systems and processes to comply with these regulations and directions, documenting them as necessary in this constitution, its scheme of reservation and delegation and other relevant Group policies and procedures.

6. DECISION MAKING: THE GOVERNING STRUCTURE

6.1 Authority to act

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

a. Any of its members; b. Its Governing Body; c. Employees; d. A committee or sub-committee of the Group.

6.1.2 The extent of the authority to act of the respective bodies and individuals depends on the powers delegated to them by the Group as expressed through:

a. The Group’s scheme of reservation and delegation; and b. For committees, their terms of reference.

6.2 Scheme of Reservation and Delegation

6.2.1 The Group’s scheme of reservation and delegation sets out:

a. Those decisions that are reserved for the membership as a whole, acting through the Council of Members; b. Those decisions that are the responsibilities of its Governing Body (and its committees and sub-committees), the Group’s committees and sub-committees, individual members and employees.

6.2.2 The Group remains accountable for all of its functions, including those that it has delegated.

6.3 General

6.3.1 In discharging functions of the Group that have been delegated to them, its Governing Body (and its committees and sub-committees), committees, joint committees, sub committees and individuals must:

a. Comply with the Group’s Constitution, including the Group’s principles of good governance

b. Operate in accordance with the Group’s scheme of reservation and delegation,

c. Comply with the Group’s standing orders,

d. Comply with the Group’s arrangements for discharging its statutory duties as set out in Chapter 5,

e. Where appropriate, ensure that member practices have had the opportunity to contribute to the Group’s decision making process.

6.3.2 When discharging their delegated functions, committees, sub committees and joint committees must also operate in accordance with their approved terms of reference.

6.3.3 Where delegated responsibilities are being discharged collaboratively, the joint (collaborative) arrangements must:

a. Identify the roles and responsibilities of those clinical commissioning groups who are working together;

b. Identify any pooled budgets and how these will be managed and reported in annual accounts;

c. Specify under which clinical commissioning group’s scheme of reservation and delegation and supporting policies the collaborative working arrangements will operate;

d. Specify how the risks associated with the collaborative working arrangement will be managed between the respective parties;

e. Identify how disputes will be resolved and the steps required to terminate the working arrangements

f. Specify how decisions are communicated to the collaborative partners.

6.4 The Council of Members

6.4.1 The Council of Members shall comprise the Member Representatives from time to time.

6.4.2 The members of the Governing Body may attend any meeting of the Council of Members but they shall not have the right to vote at such meetings.

6.4.3 The Council of Members shall regulate their proceedings in accordance with the Standing Orders.

6.4.4 The Council of Members shall meet at least once per annum.

6.4.5 The Group may on or at any time after its establishment appoint such other committees as it considers may be appropriate.

6.4.6 A committee of the Group may consist of or include persons other than members or employees of the Group.

6.4.7 Committees will only be able to establish their own sub-committees, to assist them in discharging their respective responsibilities, if this responsibility has been delegated to them by the group or the committee they are accountable to.

6.4.8 All decisions taken in good faith at a meeting of any committee or sub-committee shall be valid even if there is any vacancy in its membership or it is discovered subsequently that there was a defect in the calling of the meeting, or the appointment of a member attending the meeting.

6.4.9 An individual shall be ineligible for appointment to or shall otherwise be disqualified from membership of a committee or sub-committee if is he or she is a person who is disqualified from membership of a clinical commissioning group’s Governing Body under Schedule 5 of the National Health Service (Clinical Commissioning Groups) Regulations 2012 (“CCG Regulations”).

6.5 Joint Arrangements

6.5.1 The Group may enter into joint arrangements with one or more other clinical commissioning groups as it considers appropriate.

6.5.2 The Group may establish a joint committee with one or more local authorities as it considers appropriate.

6.6 Joint Commissioning Arrangements

The CCG may wish to work together with other CCGs and/or NHS England in the exercise of its commissioning functions. This could include:

 joint commissioning arrangements with other CCGs  joint commissioning arrangements with NHS England in relation to CCG functions  joint commissioning arrangements with NHS England in relation to NHS England functions.

6.6.1 Joint commissioning arrangements with other Clinical Commissioning Groups

6.6.1.1 The clinical commissioning group (CCG) may wish to work together with other CCGs in the exercise of its commissioning functions.

6.6.1.2 The CCG may make arrangements with one or more CCG in respect of: 6.6.1.2.1 Delegating any of the CCG’s commissioning functions to another CCG; 6.6.1.2.2 Exercising any of the commissioning functions of another CCG; or 6.6.1.2.3 Exercising jointly the commissioning functions of the CCG and another CCG

6.6.1.3 For the purposes of the arrangements described at paragraph 6.6.1, the CCG may: 6.6.1.3.1 Make payments to another CCG; 6.6.1.3.2 Receive payments from another CCG; 6.6.1.3.3 Make the services of its employees or any other resources available to another CCG; or 6.6.1.3.4 Receive the services of the employees or the resources available to another CCG.

6.6.1.4 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.

6.6.1.5 For the purposes of the arrangements described at paragraph 6.6.1 above, the CCG may establish and maintain a pooled fund made up of contributions by any of the CCGs working together pursuant to paragraph 6.6.1.2.3 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.

6.6.1.6 Where the CCG makes arrangements with another CCG as described at paragraph 6.6.1.1 above, the CCG shall develop and agree with that CCG an agreement setting out the arrangements for joint working, including details of:

 How the parties will work together to carry out their commissioning functions;  The duties and responsibilities of the parties;

 How risk will be managed and apportioned between the parties;  Financial arrangements, including, if applicable, payments towards a pooled fund and management of that fund;  Contributions from the parties, including details around assets, employees and equipment to be used under the joint working arrangements.

6.6.1.7 The liability of the CCG to carry out its functions will not be affected where the CCG enters into arrangements pursuant to paragraph 6.6.1above.

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

6.6.1.9 Only arrangements that are safe and in the interests of patients registered with member practices will be approved by the governing body.

6.6.1.10 The governing body of the CCG shall require, in all joint commissioning arrangements that the lead clinician and lead manager of the lead CCG make a quarterly written report to the governing body and hold at least annual engagement events to review aims, objectives, strategy and progress and publish an annual report on progress made against objectives.

6.6.1.11 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, with new arrangements starting from the beginning of the next new financial year.

6.6.2 Joint commissioning arrangements with NHS England for the exercise of CCG functions

6.6.2.1 The CCG may wish to work together with NHS England in the exercise of its commissioning functions.

6.6.2.2 The CCG and NHS England may make arrangements to exercise any of the CCG’s commissioning functions jointly.

6.6.2.3 The arrangements referred to in paragraph 6.6.2.2 above may include other CCGs.

6.6.2.4 Where joint commissioning arrangements pursuant to 6.6.2.2 above are entered into, the parties may establish a joint committee to exercise the commissioning functions in question.

6.6.2.5 Arrangements made pursuant to 6.6.2.2 above may be on such terms and conditions (including terms as to payment) as may be agreed between NHS England and the CCG.

6.6.2.6 Where the CCG makes arrangements with NHS England (and another CCG if relevant) as described at paragraph 6.6.2.2 above, the CCG shall develop and agree with NHS England a framework setting out the arrangements for joint working, including details of:

 How the parties will work together to carry out their commissioning functions;  The duties and responsibilities of the parties;  How risk will be managed and apportioned between the parties;  Financial arrangements, including, if applicable, payments towards a pooled fund and management of that fund;  Contributions from the parties, including details around assets, employees and equipment to be used under the joint working arrangements; and

6.6.2.7 The liability of the CCG to carry out its functions will not be affected where the CCG enters into arrangements pursuant to paragraph 6.6.2.2 above.

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

6.6.2.9 Only arrangements that are safe and in the interests of patients registered with member practices will be approved by the governing body.

6.6.2.10 The governing body of the CCG shall require, in all joint commissioning arrangements that the lead clinician and lead manager of the lead CCG of the CCG make a quarterly written report to the governing body and hold at least annual engagement events to review aims, objectives, strategy and progress and publish an annual report on progress made against objectives.

6.6.2.11 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, with new arrangements starting from the beginning of the next new financial year after the expiration of the six months’ notice period.

6.6.3 Joint commissioning arrangements with NHS England for the exercise of NHS England’s functions

6.6.3.1 The CCG may wish to work with NHS England and, where applicable, other CCGs, to exercise specified NHS England functions.

6.6.3.2 The CCG may enter into arrangements with NHS England and, where applicable, other CCGs to:

● Exercise such functions as specified by NHS England under delegated arrangements; ● Jointly exercise such functions as specified with NHS England.

6.6.3.3 Where arrangements are made for the CCG and, where applicable, other CCGs to exercise functions jointly with NHS England a joint committee may be established to exercise the functions in question.

6.6.3.3 Arrangements made between NHS England and the CCG may be on such terms and conditions (including terms as to payment) as may be agreed between the parties.

6.6.3.4 For the purposes of the arrangements described at paragraph 6.6.3.2 above, NHS England and the CCG may establish and maintain a pooled fund made up of contributions by the parties working together. 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.

6.6.3.5 Where the CCG enters into arrangements with NHS England as described at paragraph 6.6.3.3 above, the parties will develop and agree a framework setting out the arrangements for joint working, including details of:

● How the parties will work together to carry out their commissioning functions; ● The duties and responsibilities of the parties; ● How risk will be managed and apportioned between the parties;

● Financial arrangements, including payments towards a pooled fund and management of that fund; ● Contributions from the parties, including details around assets, employees and equipment to be used under the joint working arrangements.

6.6.3.6 The liability of NHS England to carry out its functions will not be affected where it and the CCG enter into arrangements pursuant to paragraph 6.6.3.2 above.

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

6.6.3.8 Only arrangements that are safe and in the interests of patients registered with member practices will be approved by the governing body.

6.6.3.9 The governing body of the CCG shall require, in all joint commissioning arrangements that the lead clinician and lead manager of the lead CCG of the CCG make a quarterly written report to the governing body and hold at least annual engagement events to review aims, objectives, strategy and progress and publish an annual report on progress made against objectives.

6.6.3.10 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, with new arrangements starting from the beginning of the next new financial year after the expiration of the six months’ notice period.

6.7 The Governing Body and Sub Committees

6.7.1 Functions - the Governing Body has the following functions conferred on it by sections 14L(2) and (3) of the 2006 Act, inserted by section 25 the 2012 Act, together with any other functions connected with its main functions as may be specified in regulations or in this constitution. The Governing Body may also have functions of the Group delegated to it by the Group. The Governing Body’s functions include:

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

b. Determining the remuneration, fees and other allowances payable to employees or other persons providing services to the Group and the allowances payable under any pension scheme it may establish under paragraph 11(4) of Schedule 1A of the 2006 Act, inserted by Schedule 2 of the 2012 Act;

6.7.1.1 Subject to the 2006 Act, the Governing Body shall perform or delegate all those functions of the Group which have not been delegated to:

a. Any committee of sub-committee of the Group; b. Any Member of the Group; or c. Any employee of the Group;

Under this Constitution or otherwise.

Composition of the Governing Body - the Governing Body shall comprise of:

a. The Chair b. Five (5) representatives of member practices who shall be called “GP Clinical Advisors” c. Two (2) Voting Lay members: i. One to champion audit, remuneration and conflict of interest matters, ii. One to champion patient and public participation matters; One non-voting Lay Member: iii. To champion equality and Inclusion d. The Director of Quality and Chief Nurse e. One (1) Secondary Care Specialist Doctor; f. The Accountable Officer who shall be called the “Chief Officer”; g. The Chief Finance Officer; h. The Director of Performance and Delivery j. One Medical Director

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

6.7.3 Committees of the Governing Body

The Governing Body shall appoint the following committees and sub-committees:

Audit Committee Accountable to the Group’s Governing Body, provides the Governing Body with an independent and objective view of the Group’s financial systems, financial information and compliance with laws, regulations and directions governing the Group in so far as they relate to finance. The Governing Body has approved and keeps under review the terms of reference for the audit committee, which includes information on the membership of the audit committee

In addition the Governing Body shall confer or delegate the following functions, connected with the Governing Body’s main function to its audit committee:

i. Risk – To review the organisation’s risk management arrangements, systems and processes

ii. Internal Control and Corporate Governance – To review the framework of internal control and corporate governance & review the systems of financial control

iii. Internal Audit – To review and approve the Internal Audit Strategic and Annual Plans

iv. External Audit – To review the Annual Planning Memorandum including the Performance Audit programme

v. Code of Corporate Governance – To review the Code of Corporate Governance which includes Standing Orders, Schemes of Reservation and Delegation, Standing Financial Instructions and recommend amendments to the Governing Body

vi. Annual Accounts – To review the Annual Report for the Governing Body

vii. Best Value (VFM) – To review those aspects of the Best Value Work plan

Remuneration Committee

Accountable to the Group’s Governing Body, the Committee’s primary aim is to approve the appropriate remuneration and terms of service for the Accountable Officer, Lay members, Directors and other Very Senior Managers, and in addition to agree the hourly rate of pay to CCG clinical leads. The committee also makes recommendations to the Governing Body on determinations about the remuneration, fees and other allowances for employees and for people who provide services to the Group and on determinations about allowances under any pension scheme that the Group may establish as an alternative to the NHS pension scheme. The Governing Body has approved and keeps under review the terms of reference for the remuneration committee, which includes information on the membership of the remuneration committee

Pennine Lancashire Quality Committee This is a Joint committee accountable to both Blackburn with Darwen and East Lancashire CCG Governing Bodies. This committee has responsibility for all quality and safety issues for the organisations. The Governing Bodies have approved and keeps under review the terms of reference for the Pennine Lancashire Committee, which includes information on the membership of the Committee.

Primary Care Committee NHS England has delegated the exercise of certain specific primary care functions to the CCG and this committee is established as a sub-committee of the CCG’s Governing Body. The functions of the committee are undertaken to promote increased co-commissioning to increase quality, efficiency, productivity and value for money. 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:

● GMS, PMS and APMS contracts (including the design of PMS and APMS contracts, monitoring of contracts, taking contractual action such as issuing branch/remedial notices, and removing a contract);

● Newly designed enhanced services (“Local Enhanced Services” and “Directed Enhanced Services”);

● Design of local incentive schemes as an alternative to the Quality Outcomes Framework (QOF);

● Decision making on whether to establish new GP practices in an area;

● Approving practice mergers; and

● Making decisions on ‘discretionary’ payment (e.g., returner/retainer schemes).

Patient Partners Board Whilst not a formal committee with any formally delegated functions, the Patient Partners Board’s main focus is to provide strategic oversight of CCG patient engagement and involvement and to act as an advisory Board to the CCG Governing Body

The patient partner’s board will:

● Provide a forum to discuss strategic engagement and involvement issues and possible solutions to feed into the East Lancashire Clinical Commissioning Group (ELCCG) commissioning process

● Receive and consider reports from the Chairs of each Locality Patient Network

● Consider commissioning intentions and plans to support the engagement and involvement of patients

● Consider feedback and any issues that arise from patient feedback in localities or more generally across East Lancashire

● be an advocate for Patient and Public Involvement (PPI) and related service improvements throughout ELCCG commissioned services for local people

Sustainability Committee Accountable to the Governing Body, the chief function of the Sustainability Committee is to provide assurance to the Governing Body on the CCG’s financial position and progress against targets, including the Better Care Fund and QIPP. The committee will monitor income and expenditure and oversee the planning and approval of funds for investment. The Committee will ensure that plans clearly demonstrate where and how the CCG is working with local economy partners to meet the Pennine Lancashire and BCF sustainability (QIPP) targets.

6.7.4 The Governing Body may appoint such other committees as it considers may be appropriate.

6.7.5 The Audit Committee may include individuals who are not members of the Governing Body. Other committees of the Governing Body may include individuals who are not members of the Governing Body but who are:

a. Members, officers, or employees of the Group or another clinical commissioning group; b. Members of the governing body of another clinical commissioning group; c. Lay persons who are age 18 or over, reside within the Area and are not disqualified from being a member of the Governing Body under Schedule 5 of the CCG Regulations; d. Officers of NHS England.

6.7.6 Each such committee shall regulate its proceedings in accordance with its terms of reference.

6.7.7 Committees will only be able to establish their own sub-committees, to assist them in discharging their respective responsibilities, if this responsibility has been delegated to them by the Governing Body or the committee they are accountable to.

6.7.8 All decisions taken in good faith at a meeting of the Governing Body or any committee or subcommittee of it shall be valid even if there is any vacancy in its membership or it is discovered subsequently that there was a defect in the calling of the meeting, or the appointment of a member attending the meeting.

6.7.9 Copies of Terms of Reference for the Governing Body and sub committees available to view at http://www.eastlancsccg.nhs.uk, upon request at NHS East Lancashire CCG headquarters:-

c/o Chief Officer NHS East Lancashire CCG Walshaw House Regent Street Nelson Lancashire BB9 8QS

Upon application either by post (to the above address) or by e-mail - further details are available on the Group’s website.

7. ROLES AND RESPONSIBILITIES

7.1 Member Representatives

7.1.1 Each Member Representative represents the view of the practice that has appointed him/ her and acts on behalf of that practice in matters relating to the Group.

a. Each Member shall be required to nominate a representative of that Member who is a GP partner, a salaried GP or another healthcare professional in the nominating Member’s Practice. Each Member shall notify the Governing Body of the name of its Member Representative in writing. Each Member may remove and replace their Member Representative at any time and from time to time, by notice in writing to the Governing Body.

b. Each Member Representative shall represent the Member that has appointed it at meetings of the Council of Members in accordance with the Group’s Standing Orders.

c. Each Member authorises their Member Representative to receive notice of, attend and vote at any meetings of the Council of Members (whether an AGM or a General Meeting of the Council of Members), whether on a show of hands or on a poll

d. The Group (including the Governing Body) shall be entitled to treat any Member Representative as having the continuing authority given to him under Paragraph 7.1.1 a) of the Constitution until it is notified of the removal of that Member Representative in writing (notice shall be given to the Governing Body or an individual nominated by Governing Body) and any provision of this Constitution that requires delivery or notification to a Member shall be deemed to have been satisfied if delivery or notification is made to or served on the Member Representative.

7.2 Other GP and Primary Care Health Professionals

7.2.1 In addition to the Member Representatives identified in section 7.1 above, the Group may identify other GPs / primary care health professionals from member practices to either support the work of the Group and / or represent the Group rather than represent their own individual practices.

7.3 All Members of the Group’s Governing Body

7.3.1 Guidance on the roles of members of the Group’s Governing Body is set out in a separate document - Clinical commissioning group governing body members – Role outlines attributes and skills, NHS England, October 2012

7.3.2 In summary, each member of the Governing Body should share responsibility as part of a team to ensure that the Group exercises its functions effectively, efficiently and economically, with good governance and in accordance with the terms of this constitution. Each brings their unique perspective, informed by their expertise and experience.

7.4 The Chair of the Governing Body

7.4.1 The responsibilities of the Chair of the Governing Body include:

a. Leading the Governing Body, ensuring it remains continuously able to discharge its duties and responsibilities as set out in this constitution;

b. Building and developing the Group’s Governing Body and its individual members;

c. Ensuring that the Group has proper constitutional and governance arrangements in place;

d. Ensuring that, through the appropriate support, information and evidence, the Governing Body is able to discharge its duties;

e. Supporting the Chief Officer in discharging the responsibilities of the organisation;

f. Contributing to building a shared vision of the aims, values and culture of the organisation;

g. Leading and influencing to achieve clinical and organisational change to enable the Group to deliver its commissioning responsibilities;

h. Overseeing governance and particularly ensuring that the Governing Body and the wider Group behaves with the utmost transparency and responsiveness at all times;

i. Ensuring that public and patients’ views are heard and their expectations understood and, where appropriate as far as possible, met;

j. Ensuring that the organisation is able to account to its local patients, stakeholders and NHS England;

k. Ensuring that the Group builds and maintains effective relationships, particularly with the individuals involved in overview and scrutiny from the relevant local authorities.

7.5 The Deputy Chair of the Governing Body

7.5.1 The Deputy Chair of the Governing Body deputises for the chair of the Governing Body when he or she has a potential conflict of interest or is otherwise unable to act.

7.5.2 The Deputy Chair shall be appointed by the other Governing Body members and may be the lay member that is not the Chair of the Governing Body.

7.6 Lay Member with a Lead role in Overseeing Key elements of Governance

7.6.1 The Lay Member for Governance is a member of the Governing Body and their focus will be strategic and impartial, providing an external view of the work of the CCG that is removed from the day-to-day running of the organisation.

7.6.2 The Lay Member for Governance will oversee key elements of governance including audit, remuneration and managing conflicts of interest. They will Chair the Audit Committee.

7.6.3 As Chair of the Audit Committee, this lay member would be precluded from being the Chair of the governing body and the Chair of the Primary Care Committee – although they could be the Deputy Chair. This post will have a lead role in ensuring that the governing body and the wider CCG behaves with the utmost probity at all times.

7.6.4 The Lay Member for Governance will have a specific role in ensuring that appropriate and effective whistle blowing and anti-fraud systems are in place.

7.7 Lay Member with a Lead in Championing Patient and Public Involvement

7.7.1 The Lay Member for Patient and Public Involvement is a member of the Governing Body and their focus will be strategic and impartial, providing an external view of the work of the CCG that is removed from the day-to-day running of the organisation.

7.7.2 This role will help to ensure that, in all aspects of the CCG’s business the public voice of the local population is heard and that opportunities are created and protected for patient and public empowerment in the work of the CCG. In particular, they will ensure that:

a. public and patients’ views are heard and their expectations understood and met as appropriate;

b. the CCG builds and maintains an effective relationship with Local Healthwatch and draws on existing patient and public engagement and involvement expertise; and

c. The CCG has appropriate arrangements in place to secure public and patient involvement and responds in an effective and timely way to feedback and recommendations from patients, carers and the public.

7.8 Lay Member with a Lead in Championing Equality & Inclusion (non-voting)

7.8.1 The Lay Member for Equality & Inclusion is a non-voting member of the Governing Body and will bring specific expertise and experience, as well as their knowledge as a member of the local community, to the work of the governing body. Their focus will be strategic and impartial, providing an independent view of the work of the CCG that is removed from the day-to-day running of the organisation.

7.8.2 This person will be the ambassador for the CCG in its commitment to meeting the three aims of the Public Sector Equality Duty. In particular, they will ensure that the CCG:

 Effectively engages and involves local people in decision making, involving local people from protected groups in recruiting to CCG posts and working in partnership with citi- zens, local and county councils and other healthcare providers to work on improving health outcomes and eliminating health inequalities;

 Has appropriate arrangements in place to ensure that all the policies and practices implemented by the CCG have been informed by decisions based on equality analysis and assessment of outcomes that have identified if there are any effects on people; specifically with protected characteristics; within our community who may use our services or on the people we employ in line with the Equality Act 2010.

7.9 GP Clinical Advisors

7.9.1 The GP Clinical Advisors are members of the Governing Body and are responsible for providing leadership, and collective direction for decision making at CCG Governing Body level, and ensure key decisions are communicated effectively across the membership. They will:  work closely with the Medical Director, Primary Care Network Clinical Directors and Director of Performance and Delivery.  Lead the development of new models of care and support the delivery of the CCG’s Corporate Objectives and performance targets  Play an active part at the relevant groups and committees

7.9.2 The GP Clinical Advisors will work closely with other GPs, community providers, mental health, acute trusts, other health providers and professionals to ensure that high quality, accessible health care services are delivered across East Lancashire.

7.11 Medical Director

7.11.1 The Medical Director is a member of the Governing Body and will provide clinical leadership and lead the development of the Local Community Partnership, driving the development of Primary Care Networks and New Models of Care and promoting place-based systems of care.

7.11.2 The Medical Director will support and develop future clinical leadership and development cross both the local and Pennine Lancashire Integrated Care Partnerships.

7.11.3 A highly visible leader, the Medical Director will forge system-wide close working relationships, working closely with other clinical leaders, engaging with member practices, and will be a member of the Pennine Lancashire Integrated Care Partnership Board.

7.11.4 As a member of the Joint Executive Team, the Medical Director will play a full role in determining a way forward on the CCG issues which are the responsibility of the Executive function.

7.12 Role of the Accountable Officer

7.12.1 The Accountable Officer of the Group is a voting member of the Governing Body. The individual appointed to fulfil the role of Accountable Officer shall be called the “Chief Officer”.

7.12.2 The role and responsibilities of the Accountable Officer include:

a. Being responsible for ensuring that the Group fulfils its duties to exercise its functions effectively, efficiently and economically thus ensuring improvement in the quality of services and the health of the local population whilst maintaining value for money;

b. At all times ensuring that the regularity and propriety of expenditure is discharged, and that arrangements are put in place to ensure that good practice (as identified through such agencies as the Audit Commission and the National Audit Office) is embodied and that safeguarding of funds is ensured through effective financial and management systems.

c. Working closely with the chair of the Governing Body, the Accountable Officer will ensure that proper constitutional, governance and development arrangements are put in

place to assure the members (through the Governing Body) of the organisation’s ongoing capability and capacity to meet its duties and responsibilities. This will include arrangements for the on-going developments of its members and staff.

7.12.3 In addition to the Accountable Officer’s general duties, as the senior voice of the Group the Accountable Officer will take the lead in interactions with stakeholders, including NHS England.

7.13 Role of the Chief Finance Officer

7.13.1The Chief Finance Officer is a voting member of the Governing Body and is responsible for providing financial advice to the Group and for supervising financial control and accounting systems

7.13.2The role and responsibilities of the Chief Finance Officer include:

a. Being the Governing Body’s professional expert on finance and ensuring, through robust systems and processes, the regularity and propriety of expenditure is fully discharged;

b. Making appropriate arrangements to support, monitor and advise on the Group’s finances;

c. Overseeing robust audit and governance arrangements leading to propriety in the use of the Group’s resources;

d. Being able to advise the Governing Body on the effective, efficient and economic use of the Group’s allocation to remain within that allocation and deliver required financial targets and duties;

e. Producing the financial statements for audit and publication in accordance with the statutory requirements to demonstrate effective stewardship of public money and accountability to NHS England;

f. Overseeing the management and provision of a range of functions including, Information Governance, Emergency Planning and Estates: and

g. Overseeing the development, and monitoring of the CCG’s Operating Plan.

h. Key areas of responsibility for governance include:

i. Overseeing the organisations effective governance arrangements, and associated systems and processes

j. Leading on the development and implementation of corporate strategies and frame- works, including Risk Management, Equality and Inclusion, Communications and Engagement and Organisational Development

k. Ensuring effective management of the CCG Governing Body and its sub-committees to ensure effective handling and discharge of appropriate governance and business arrangements.

7.14 Role of Director of Quality and Chief Nurse

7.14.1 The Director of Quality and chief nurse is a voting member of the Governing Body and will be a registered nurse who has developed a high level of professional expertise and knowledge. This role will bring a broader view, from their perspective as a registered nurse, on health and care issues to underpin the work of the CCG especially the contribution of nursing to patient care. Key roles and responsibilities of the Registered Nurse include:

a. to give an independent strategic clinical view on all aspects of CCG business;

b. be highly regarded as a clinical leader across more than one clinical discipline and/or specialty – demonstrably able to think beyond their own professional viewpoint;

c. to take a balanced view of the clinical and management agenda and draw on their specialist skills to add value;

d. to contribute a generic view from the perspective of a registered nurse whilst putting aside specific issues relating to their own clinical practice or employing organisation’s circumstances; and

e. To bring detailed insights from nursing and perspectives into discussions regarding service re-design, clinical pathways and system reform.

7.15 Director of Performance and Delivery 7.15.1 The Director of Performance and Delivery is a voting member of the Governing Body and will have responsibility for the strategic and operational delivery of commissioning for East Lancashire Clinical Commissioning Group through the development and implementation of commissioning strategies and service redesign solutions for the health & social care economy. 7.15.2 Key aspects of this role include:

● Developing and delivering the CCG’s Commissioning Strategy and other plans, leading on relationships with partners (including providers, patients, practices, local authorities and independent sector).

● Lead on the execution of service and system change initiatives (including QIPP plan).

● Provide support to CCG Clinical Leads in developing and executing the Strategies.

● Ensure coherence between the CCG's vision and our providers’ and partners’ (LA) plans, thereby achieving the expenditure targets through leadership of relationships with providers and leadership of the annual planning round.

● Leading key service and system reviews and developing appropriate strategies across the health and social care community systematically, reviewing baseline spend across the strategic plan.

● Responsible for securing the best value from public health ‘offer’ from the local authorities including a comprehensive JSNA.

● Ensure that effective collaborative commissioning infrastructure, ways of working and implementation of health and well-being strategy is in place.

● Ensure that collaborative commissioning represents excellent value for money.

7.16 Secondary Care Doctor

7.16.1 The Secondary Care Doctor is a clinical member and will bring a broader view, on health and care issues to underpin the work of the CCG. In particular, they will bring to the governing body an understanding of patient care in the secondary care setting.

7.16.2 The role and responsibilities of the Secondary Care Doctor include:

a. The post holder will be a doctor who is, or has been, a secondary care specialist and will bring a high level of understanding of how care is delivered in a secondary care setting;

b. to give an independent strategic clinical view on all aspects of CCG business;

c. to take a balanced view of the clinical and management agenda, and draw on their in depth understanding of secondary care to add value;

d. to contribute a generic view from the perspective of a secondary care doctor whilst putting aside specific issues relating to their own clinical practice or their employing organisation’s circumstances; and

e. To provide an understanding of how secondary care providers work within the health system to bring appropriate insight to discussions regarding service re-design, clinical pathways and system reform.

7.17 Joint Appointments with other Organisations

7.17.1 The Group has established that the Accountable Officer is a joint appointment with NHS Blackburn with Darwen CCG. The contract of employment is held by NHS East Lancashire CCG.

7.17.2 Details of the joint working arrangements are detailed in a memorandum of understanding between the two organisations.

7.18 Indemnity

7.18.1 As a membership organisation the CCG confers the following indemnity upon nominated practice representatives, clinical leads, Lay Members, and the Independent Secondary Care Doctor (as defined in this Constitution) who are undertaking duties on behalf of the CCG as part of its governance arrangements.

7.18.2 Indemnity Statement – “such individuals, as specified in paragraph 7.1 and 7.2 above, who have acted honestly and in good faith will not have to meet out of his or her own personal resources any personal civil liability which is incurred in the execution or purported execution of his/her CCG function, save where the person has acted recklessly”.

7.18.3 Such individuals need to ensure they act in accordance with the CCG’s Constitution (including the Standing Orders, Prime Financial Policies and Scheme of Reservation and Delegation), the CCG’s policies and procedures, guidance issued by appropriate regulatory bodies, together with any appropriate statue or regulations.

7.18.4 The position of employees of the CCG is different to the individuals listed above as the CCG, as statutory body, is always liable for the actions of its employees in the course of their employment.

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

8.1 Conflicts of Interest

8.1.1 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

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

8.1.3 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 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.

8.1.4 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; c) Support the rigorous application of conflict of interest principles and policies; 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.

8.1.5 The registers will be published on the CCG’s website at http://www.eastlancsccg.nhs.uk/.

This document is also available upon request for inspection at the CCG’s headquarters:-

NHS East Lancashire CCG Walshaw House Regent Street Nelson Lancashire BB9 8QS

8.2 Declaring and Registering Interests

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

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

8.2.3 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.

8.2.4 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.

8.2.5 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.

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

8.3 Training in Relation to Conflicts of Interest

8.3.1 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.

8.4 Standards of Business Conduct

8.4.1 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, including the requirements set out in the policy for managing conflicts of interest which is available on the CCG’s website and will be made available on request.

8.4.2 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

8.5 Transparency in Procuring Services

8.5.1 The Group recognises the importance in making decisions about the services it procures in a way that does not call into question the motives behind the procurement decision that has been made. The Group will procure services in a manner that is open, transparent, non- discriminatory and fair to all potential providers.

8.5.2 The Group will publish a Procurement Strategy approved by its Governing Body which will ensure that:

8.5.2.1 All relevant clinicians (not just members of the Group) and potential providers, together with local members of the public, are engaged in the decision-making processes used to procure services;

8.5.2.2 Service redesign and procurement processes are conducted in an open, transparent, non-discriminatory and fair way.

Copies of this Procurement Strategy will be available on the Group’s website at http://www.eastlancsccg.nhs.uk/ This document is also available upon request for inspection at the Group’s headquarters:-

NHS East Lancashire CCG Walshaw House Regent Street Nelson Lancashire BB9 8QS Upon application either by post (to the above address) or by e-mail – further details are available on the Group’s website.

9. THE GROUP AS EMPLOYER

9.1 The Group recognises that its most valuable asset is its people. It will seek to enhance their skills and experience and is committed to their development in all ways relevant to the work of the Group.

9.2 The Group will seek to set an example of best practice as an employer and is committed to offering all staff equality of opportunity. It will ensure that its employment practices are designed to promote diversity and to treat all individuals equally.

9.3 The Group will ensure that it employs suitably qualified and experienced staff who will discharge their responsibilities in accordance with the high standards expected of staff employed by the Group. All staff will be made aware of this constitution, the commissioning strategy and the relevant internal management and control systems which relate to their field of work.

9.4 The Group will maintain and publish policies and procedures (as appropriate) on the recruitment and remuneration of staff to ensure it can recruit, retain and develop staff of an appropriate calibre. The Group will also maintain and publish policies on all aspects of human resources management, including grievance and disciplinary matters

9.5 The Group will ensure that its rules for recruitment and management of staff provide for the appointment and advancement on merit on the basis of equal opportunity for all applicants and staff.

9.6 The Group will ensure that employees' behaviour reflects the values, aims and principles set out above.

9.7 The Group will ensure that it complies with all aspects of employment law.

9.8 The Group will ensure that its employees have access to such expert advice and training opportunities as they may require in order to exercise their responsibilities effectively.

9.9 The Group will adopt a Code of Conduct for staff and will maintain and promote effective 'whistleblowing' procedures to ensure that concerned staff have means through which their concerns can be voiced.

9.10 Copies of the Standards of Business Conduct, together with the other policies and procedures outlined in this chapter, will be available on the Group’s website at http://www.eastlancsccg.nhs.uk/.

9.11 This document is also available upon request for inspection at NHS East Lancashire CCG headquarters:-

NHS East Lancashire CCG Walshaw House Regent Street Nelson Lancashire BB9 8QS

Upon application either by post (to the above address) or by e-mail – further details are available on the Group’s website.

10. TRANSPARENCY, WAYS OF WORKING AND STANDING ORDERS

10.1 General

10.1.1 The Group will publish annually a commissioning plan and an annual report, presenting the Group’s annual report to a public meeting.

10.1.2 Key communications issued by the Group, including the notices of procurements, public consultations, Governing Body meeting dates, times, venues, and certain papers will be published on the Group’s website at www.eastlancsccg.nhs.uk . This document is also available upon request for inspection at the Group’s headquarters:-

NHS East Lancashire CCG Walshaw House Regent Street Nelson Lancashire BB9 8QS

Upon application either by post (to the above address) or by e-mail – further details are available on the Group’s website

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

10.2 Standing Orders

10.2.1 This constitution is also informed by a number of documents which provide further details on how the Group will operate. They are the Group’s:

a. Standing orders (Appendix E) – which sets out the arrangements for meetings and the appointment processes to elect the Group’s representatives and appoint to the Group’s committees, including the Governing Body;

b. Scheme of reservation and delegation (Appendix F) - which sets out those decisions that are reserved for the membership as a whole and those decisions that are the responsibilities of the Group’s Governing Body, the Governing Body’s committees and sub-committees, the Group’s committees and sub-committees, individual members and employees;

c. Prime financial policies (Appendix G) - which sets out the arrangements for managing the Group’s financial affairs.

APPENDIX A: DEFINITIONS OF KEY DESCRIPTIONS USED IN THIS CONSTITUTION

2006 Act National Health Service Act 2006

2012 Act Health and Social Care Act 2012 (this Act amends the 2006 Act) Accountable Officer An individual, as defined under paragraph 12 of Schedule 1A of the 2006 Act (as inserted by Schedule 2 of the 2012 Act), appointed by NHS England, with responsibility for ensuring the Group:  complies with its obligations under: o sections 14Q and 14R of the 2006 Act (as inserted by section 26 of the 2012 Act), o sections 223H to 223J of the 2006 Act (as inserted by section 27 of the 2012 Act), o paragraphs 17 to 19 of Schedule 1A of the NHS Act 2006 (as inserted by Schedule 2 of the 2012 Act), and o any other provision of the 2006 Act (as amended by the 2012 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 Group has responsibility for, as defined in Chapter 2 of this constitution CCG Regulations The National Health Service (Clinical Commissioning Groups) Regulations 2012 Chair of the The individual appointed by the Group to act as chair of the Governing Governing Body Body Chief Officer The Group’s most senior manager, being the Accountable Officer Chief Finance Officer The qualified accountant employed by the Group with responsibility for financial strategy, financial management and financial governance clinical A body corporate established by NHS England in accordance with commissioning group Chapter A2 of Part 2 of the 2006 Act (as inserted by section 10 of the 2012 Act) Committee A committee or sub-committee created and appointed by: the membership of the Group a committee / sub-committee created by a committee created / appointed by the membership of the Group a committee / sub-committee created / appointed by the Governing Body Council of Members The committee of the Group established in accordance with this Constitution on which the Members are represented by their Member Representatives Financial year This usually runs from 1 April to 31 March, but under paragraph 17 of Schedule 1A of the 2006 Act (inserted by Schedule 2 of the 2012 Act), it can for the purposes of audit and accounts run from when a clinical commissioning group is established until the following 31 March

Group NHS East Lancashire Clinical Commissioning Group, whose constitution this is

Governing body The body appointed under section 14L of the NHS Act 2006 (as inserted by section 25 of the 2012 Act), 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 (as inserted by section 26 of the 2012 Act), and  such generally accepted principles of good governance as are relevant to it. Governing Body member any member appointed to the Governing Body of the Group

Lay member A lay member of the Governing Body, appointed by the Group. A lay member is an individual who is not a member of the Group or a healthcare professional (i.e. an individual who is a member of a profession regulated by a body mentioned in section 25(3) of the National Health Service Reform and Health Care Professions Act 2002) or as otherwise defined in regulations Locality Means an area of East Lancashire falling within the Group’s area in which a number of its Members are located Member A provider of primary medical services to a registered patient list, who is a member of this Group (see table in Appendix B) Member An individual appointed by a practice (who is a member of the Group) to Representatives act on its behalf in the dealings between it and the Group, under regulations made under section 89 or 94 of the 2006 Act (as amended by section 28 of the 2012 Act) or directions under section 98A of the 2006 Act (as inserted by section 49 of the 2012 Act) Registers of interests Registers a clinical commissioning group is required to maintain and make publicly available under section 14O of the 2006 Act (as inserted by section 25 of the 2012 Act), of the interests of:  the members of the clinical commissioning group;  the members of its Governing Body;  the members of its committees or sub-committees and committees or sub-committees of its Governing Body; and  its employees.

APPENDIX B: LIST OF MEMBER PRACTICES

Burnley Locality Practice Name Address Burnley Group Practice The Health Centre, Kiddrow Lane, Burnley BB12 6LH Briercliffe Surgery Briercliffe Primary Care Centre, Briercliffe Road, Burnley BB10 2EZ Burnley Wood Medical 50 Parliament Street, Burnley BB11 3JX Centre Burnley Group Practice St Peters Centre, 3rd Floor, Church Street, Burnley BB11 2DL Yorkshire Street 80 Yorkshire Street, Burnley BB11 3BT Medical Practice Ightenhill Medical Tabor Street, Burnley BB12 0HL Centre Colne Road Surgery 36 Colne Road, Burnley BB10 1LG Prestige Medical Group 25 Oxford Road, Burnley BB11 3BB Prestige Medical Group Prestige Park, Colne Road, Burnley BB11 1PS Padiham Group Burnley Road, Padiham BB12 8BP Practice Thursby Surgery 2 Browhead Road, Burnley BB10 3BF Rosegrove Surgery 225-227 Gannow Lane, Burnley BB12 6HY Riverside Family St Peters Centre, Church Street, Burnley BB11 2DL Practice Burnley Group Practice 187 Manchester Road, Burnley BB11 4HP

Hyndburn Locality Practice Name Address Clayton Medical Centre Wellington Street, Clayton Le Moors, Accrington BB5 5HU Dill Hall Surgery 6-8 Church Street, Church Accrington BB5 4LF Blackburn Road 257 Blackburn Road, Accrington BB5 OAL Medical Centre Oswald Medical Centre 154 Blackburn Road, Accrington BB5 OAE Peel House Medical Accrington Pals PHCC, 1 Paradise Street, Accrington, BB5 2EJ Centre

Dr Bhat’s Surgery Heys Lane, Oswaldtwistle BB5 3BP Oswald Medical 296 Union Road, Oswaldtwistle BB5 3JD Centre, 274 Union Road Oswaldtwistle BB5 3JB The Weavers Practice High Street, Rishton, Blackburn BB1 4LA Rishton & Great 32 High Street, Rishton, Blackburn BB1 4LD Harwood Surgery Great Harwood The Health Centre, Water Street, Great Harwood, Blackburn BB6 7QR Medical Group King Street Medical 43 King Street, Accrington BB5 1QE Centre The Weavers Practice The Health Centre, Water Street, Great Harwood, Blackburn BB6 7QR Richmond Medical Acorn Primary Health Care Centre, 421 Blackburn Road, Accrington BB5 1RT Dr Bello’s Practice 6-8 Church Street, Church, Accrington BB5 4LF Accrington Victoria Accrington Victoria Community Hospital, Haywood Road, Accrington Practice BB5 6AS

Pendle Locality Practice Name Address Barrowford Surgery Ridgeway, Barrowford BB9 8QP Barnoldswick Medical 1 Park Road, Barnoldswick, Colne BB18 5BF Centre PWE Brierfield Health Arthur Street, Brierfield, Nelson BB9 5SN Centre Richmond Hill Group Colne Health Centre, Craddock Road, Colne BB8 0JZ Practice Reedyford Health Care Yarnspinners Primary Health Care Centre, Yarnspinners Wharf, Carr Group Road, Nelson BB9 7SR Pendle View Medical 47 Arthur Street, Brierfield, Nelson BB9 5RZ Centre Dr Jehangir’s Practice Yarnspinners Primary Health Care Centre, Yarnspinners Wharf, Carr Road, Nelson BB9 7SR Whitefield Health Care Yarnspinners Primary Health Care Centre, Yarnspinners Wharf, Carr Road, Nelson BB9 7SR Nelson Medical Yarnspinners Primary Health Care Centre, Yarnspinners Wharf, Carr Practice Road, Nelson BB9 7SR Pendle Medical Colne Health Centre, Craddock Road, Colne BB8 0JZ Partnership Harambee Surgery 27 Skipton Road, Trawden, Colne BB8 8QU PWE Pendle Valley Mill Yarnspinners Primary Health Care Centre, Yarnspinners Wharf, Carr Practice Road, Nelson BB9 7SR Pendle Medical Colne Health Centre, Craddock Road, Colne, BB8 0JZ Partnership The Pendle Medical Edward Street, Earby, Barnoldswick BB18 6QT Partnership And Colne Health Centre, Craddock Road, Colne BB8 0JZ

Rossendale Locality Practice Name Address St James Medical Burnley Road, Rawtenstall, Rossendale BB4 8HH Centre Irwell Medical Practice Bacup Primary Health Care Centre, Irwell Mill, Rochdale Road, Bacup OL13 9NR Whitworth Medical Market Street, Whitworth, Nr Rochdale OL12 8QS Centre Dr MacKenzie & Haslingden Health Centre, Manchester Road, Haslingden, Partners Rossendale, BB4 5SL Ilex View Medical Rossendale Primary Health Care Centre, 161 Bacup Road, Practice Rawtenstall, Rossendale BB4 7PL Waterfoot Group of Waterfoot Health Centre, Cowpe Road, Waterfoot, Rossendale BB4 Doctors 7DN Waterfoot Medical Practice Dr Moujaes & Dr 7-9 Manchester Road, Haslingden, Rossendale BB4 5SL Mannan Rossendale Valley Haslingden Health Centre, Manchester Road, Haslingden, Rossendale Medical Practice BB4 5SL Fairmore Medical Rossendale Primary Health Care Centre, 161 Bacup Road, Practice Rawtenstall, Rossendale BB4 7PL (Also Branch at Nelson)

Ribblesdale Locality Practice Name Address Sabden & Whalley The Surgery, 42 King Street, Whalley, Clitheroe BB7 9SL Medical Group Pendleside Medical The Health Centre, Railway View Road, Clitheroe BB7 2JG Practice Castle Medical Group The Health Centre, Railway View Road, Clitheroe BB7 2JG Slaidburn Country Slaidburn Medical Centre, Slaidburn, Clitheroe BB7 3EP Practice

APPENDIX C: NOLAN PRINCIPLES

The ‘Nolan Principles’ set out the ways in which holders of public office should behave in discharging their duties. The seven principles are:

a) Selflessness – Holders of public office should act solely in terms of the public interest. They should not do so in order to gain financial or other benefits for themselves, their family or their friends.

b) Integrity – Holders of public office should not place themselves under any financial or other obligation to outside individuals or organisations that might seek to influence them in the performance of their official duties.

c) Objectivity – In carrying out public business, including making public appointments, awarding contracts, or recommending individuals for rewards and benefits, holders of public office should make choices on merit.

d) Accountability – Holders of public office are accountable for their decisions and actions to the public and must submit themselves to whatever scrutiny is appropriate to their office.

e) Openness – Holders of public office should be as open as possible about all the decisions and actions they take. They should give reasons for their decisions and restrict information only when the wider public interest clearly demands.

f) Honesty – Holders of public office have a duty to declare any private interests relating to their public duties and to take steps to resolve any conflicts arising in a way that protects the public interest.

g) Leadership – Holders of public office should promote and support these principles by leadership and example.

Source: The First Report of the Committee on Standards in Public Life (1995)1

1 Available at http://www.public-standards.gov.uk/

APPENDIX D: THE SEVEN KEY PRINCIPLES OF THE NHS CONSTITUTION The NHS Constitution sets out seven key principles that guide the NHS in all it does:

1. The NHS provides a comprehensive service, available to all - irrespective of gender, race, disability, age, sexual orientation, religion or belief. It has a duty to each and every individual that it serves and must respect their human rights. At the same time, it has a wider social duty to promote equality through the services it provides and to pay particular attention to groups or sections of society where improvements in health and life expectancy are not keeping pace with the rest of the population

2. Access to NHS services is based on clinical need, not an individual’s ability to pay - NHS services are free of charge, except in limited circumstances sanctioned by Parliament.

3. The NHS aspires to the highest standards of excellence and professionalism - in the provision of high-quality care that is safe, effective and focused on patient experience; in the planning and delivery of the clinical and other services it provides; in the people it employs and the education, training and development they receive; in the leadership and management of its organisations; and through its commitment to innovation and to the promotion and conduct of research to improve the current and future health and care of the population.

4. NHS services must reflect the needs and preferences of patients, their families and their carers - patients, with their families and carers, where appropriate, will be involved in and consulted on all decisions about their care and treatment.

5. The NHS works across organisational boundaries and in partnership with other organisations in the interest of patients, local communities and the wider population - the NHS is an integrated system of organisations and services bound together by the principles and values now reflected in the Constitution. The NHS is committed to working jointly with local authorities and a wide range of other private, public and third sector organisations at national and local level to provide and deliver improvements in health and well-being

6. The NHS is committed to providing best value for taxpayers’ money and the most cost- effective, fair and sustainable use of finite resources - public funds for healthcare will be devoted solely to the benefit of the people that the NHS serves

7. The NHS is accountable to the public, communities and patients that it serves - the NHS is a national service funded through national taxation, and it is the Government which sets the framework for the NHS and which is accountable to Parliament for its operation. However, most decisions in the NHS, especially those about the treatment of individuals and the detailed organisation of services, are rightly taken by the local NHS and by patients with their clinicians. The system of responsibility and accountability for taking decisions in the NHS should be transparent and clear to the public, patients and staff. The Government will ensure that there is always a clear and up-to-date statement of NHS accountability for this purpose. Source: The NHS Constitution: The NHS belongs to us all (March 2012)2

2 http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_132961

APPENDIX E: 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 East Lancashire Clinical Commissioning Group so that group can fulfil its obligations, as set out largely in the 2006 Act, as amended by the 2012 Act and related regulations. They are effective from the date the group is established.

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

a. The arrangements for conducting the business of the group;

b. The appointment of member practice representatives;

c. The procedure to be followed at meetings of the group, the governing body and any committees or sub-committees of the group 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 2006 Act (as amended by the 2012 Act) and related regulations and take account as appropriate3 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 group’s constitution. Group members, employees, members of the governing body, members of the governing body’s committees and sub-committees, members of the group’s committees and sub-committees and persons working on behalf of the group 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

3 Under some legislative provisions the group is obliged to have regard to particular guidance but under other circumstances guidance is issued as best practice guidance.

1.2.1 The 2006 Act (as amended by the 2012 Act) provides the group with powers to delegate the group’s functions and those of the governing body to certain bodies (such as committees) and certain persons. The group has decided that certain decisions may only be exercised by the group in formal session. These decisions and also those delegated are contained in the group’s scheme of reservation and delegation (see Appendix G).

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

2.1 Composition of membership

2.1.1 Chapter 3 of the group’s constitution provides details of the membership of the group.

2.1.2 Chapter 6 of the group’s constitution provides details of the governing structure used in the group’s decision-making processes, whilst Chapter 7 of the constitution outlines certain key roles and responsibilities within the group and its governing body, including the role of practice representatives (section 7.1 of the constitution).

2.2 Key Roles

2.2.1 Paragraph 6.7.2 of the group’s constitution sets out the composition of the group’s governing body whilst Chapter 7 of the group’s constitution identifies certain key roles and responsibilities within the group and its governing body. These standing orders set out how the group appoints individuals to these key roles.

2.2.2 The Chair, as listed in paragraph 7.4 of this constitution document, will be a clinician and will be a member of the CCG. The Chair is subject to the following appointment process:

a. Eligibility – preferably an East Lancashire resident within the CCG area and will be a GP within a member practice of the CCG. The Chair must be able to demonstrate that they meet the requirements as defined by NHS England4

b. Appointment process – Advertised and selection;

c. Term of office – 3 years from appointment;

d. Eligibility for reappointment – as per (a) above, but not allowed to serve more than 2 terms of office in same role;

e. Grounds for removal from office – Membership decision;

f. Notice period – 6 months

4 Clinical Commissioning Group governing body members: Role outlines, attributes, and skills.

2.2.3 The composition of the governing body (CCG Board) is detailed at section 6.7.2 of the Constitution, whilst the roles and responsibilities of each of these key roles are set out in Chapter 7 of that document. 3MEETINGS OF THE CLINICAL COMMISSIONING GROUP

3.1 Calling meetings

3.1.1 Ordinary meetings of the group shall be held at regular intervals at such times and places as the group may determine.

3.1.2 The Chair of the Clinical Commissioning group may call a meeting of the group at any time.

3.1.3 The CCG Governing Body or any Member (with written support of ten (10) other members can call an Extra Ordinary General Meeting of the Council of Members. If the Chair refuses, or fails, to call a meeting within seven (7) days of a requisition being presented, the members signing the requisition may forthwith call a meeting.

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 seven (7) 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 ten (10) working days before the meeting takes place. The agenda and supporting papers will be circulated to all members of a meeting at least five (5) working days before the date the meeting will take place.

3.2.2 Agendas and certain papers for the group’s governing body – including details about meeting dates, times and venues - will be published on the group’s website at http://www.eastlancsccg.nhs.uk/

3.2.2.1 These documents are also available:- a. Upon request for inspection at NHS East Lancashire CCG headquarters:- c/o Chief Officer NHS East Lancashire CCG Walshaw House Regent Street Nelson Lancashire BB9 8QS

b. Upon application either by post (to the above address) or further details are available on the Group’s website.

3.3 Petitions

3.3.1 Where a petition has been received by the group, the chair of the governing body shall include the petition as an item for the agenda of the next meeting of the governing body.

3.4 Chair of a Meeting

3.4.1 At any meeting of the group or its governing body or of a committee or sub-committee, the chair of the group, governing body, committee or sub-committee, 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 group, 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

3.5.1 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.

3.6 Quorum

3.6.1 The quorum for any Governing Body meeting shall be nine (9) voting members, the majority of whom must acting in the capacity of a clinical member i.e. the Chair, a GP Locality Clinical Lead, a Clinical Director, Chief Nurse or Secondary Care Consultant.

3.6.2 The Quorum for any Council of Members meeting shall be 35 members entitled to vote upon the business to be transacted, each being a Member Representative (one from each practice) or a proxy for a Member Representative.

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

3.6.4 No business shall be transacted at a meeting unless at least one-third of the whole number of the Chair and members (including at least one member who is also an Officer Member of the Group and one member who is not) is present.

3.6.5 An Officer in attendance for an Executive Director (Officer Member) but without formal acting up status may not count towards the quorum.

3.6.6 If the Chair or member has been disqualified from participating in the discussion on any matter and / or from voting on any resolution by reason of a declaration of a conflict of interest that person shall no longer count towards the quorum. If a quorum is then not available for the discussion and / or the passing of a resolution on any matter, that matter may not be discussed further or voted upon at that meeting. Such a position shall be recorded in the minutes of the meeting. The meeting must then proceed to the next business.

3.7 Decision Making

3.7.1 Chapter 6 of the group’s constitution, together with the scheme of reservation and delegation, sets out the governing structure for the exercise of the group’s statutory functions. Generally it is expected that at the groups / 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 – All those listed at 6.7.2 in the Constitution;

A manager who has been formally appointed to act up for an Officer Member during a period of incapacity or temporarily to fill an Executive Director vacancy shall be entitled to exercise the voting rights of the Officer Member.

A Manager attending the CCG meeting to represent an Officer Member during a period of incapacity or temporarily to fill an Executive director vacancy shall be entitled to exercise the voting rights of the Officer Member. An Officers status when attending a meeting shall be recorded in the minutes.

a. Majority necessary to confirm a decision – Simple majority providing the meeting is quorate;

Save as provided in Standing Orders 3.91 – Suspension of Standing Orders and 3.95 – Variation and Amendment of Standing Orders every question put to a vote at a meeting shall be determined by a majority of the votes of members present and voting on the question.

a. Casting vote – In the event of a tied vote the casting vote lies with the CCG Chair;

b. Dissenting views – If at least one-third of the members present so request, the voting on any question may be recorded so as to show how each member present voted or did not vote (except when conducted by paper ballot). If a member so requests, their votes shall be recorded by name, in no circumstances may an absent member vote by proxy. Absence is defined as being absent at the time of the vote.

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 group’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 The powers which the Governing Body has reserved to itself within these standing orders may in emergency or for an urgent decision to be exercised by the Chief Officer and the Chair after having consulted with at least two voting board members (listed at 6.7.2).

3.8.2 The exercise of such powers by the Chief Officer and Chair shall be reported to the next formal meeting of the CCG Governing Body in public session for ratification.

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 the NHS England, any part of these standing orders may be suspended at any meeting, provided nine (9) 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.

3.9.4 No formal business may be transacted whilst Standing Orders are suspended.

3.9.5 Variation and amendment of Standing Orders These Standing Orders shall not be varied except in the following circumstances: a. upon notice of motion under Standing Order 3.5 b. upon a recommendation of the Chair or Chief Officer included on the agenda of the meeting c. That two thirds of the CCG members are present at the meeting where the variation or amendment being discussed and that at least half of the CCG Non- Officer Members vote in favour of the amendment. d. Providing that any variation or amendment does not contravene a statutory provision or direction made by the Secretary of State.

3.10 Record of Attendance

3.10.1 The names of all individual members of the meeting present at the meeting shall be recorded in the minutes of the group’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 / sub-committees present shall be recorded in the minutes of the respective governing body committee / sub-committee meetings.

3.11 Minutes

3.11.1 The minutes of the proceedings of a meeting shall be drawn up and submitted for agreement at the next ensuing meeting where they shall be signed by the person presiding at it. Specifically: a. That identify the names of the persons present at the meeting and the organisation or groups or organisations that they are representing b. The decisions made at the meetings and c. Where appropriate the reasons for the decisions

3.11.2 All meeting minutes should be verified as to be being a true record, with those who had been present, at the next formal meeting of the Board, Committee or Group to which the minutes relate

3.11.3 No discussion shall take place upon the minutes except upon their accuracy or where the Chair considers discussion appropriate.

3.11.4 Minutes shall be circulated in accordance with members wishes. Where providing a record of a public meeting the minutes shall be made available to the public as required by Code of Practice on Openness in the NHS.

3.11.5 Unless agreed specifically to the contrary all CCG Governing Body minutes will be a matter of public record.

3.11.6 Any such Minutes agreed at the subsequent meeting shall be sufficient evidence without further proof of the facts stated in such minutes

3.12 Admission of Public and the Press

3.12.1 Public meetings of the CCG Governing Body are held regularly and provide the opportunity for staff, patients and the public to attend and ask questions.

3.12.2 Members of the public are welcome to attend meetings of the Governing Body but should be aware that although the meeting is being held in public, it is not a public meeting. Attendees will however be invited to ask relevant questions at the meeting during the 'questions from the public' section.

3.12.3 There are times when the CCG Governing Body will need to consider agenda items which are confidential and cannot be discussed in public. The Public Bodies (Admission to Meetings Act) 1960 permits a board of an NHS Organisation to pass a board resolution at the meeting to exclude the public and press from the meeting.

3.12.4 General disturbances The Chair (or Vice-Chair if one has been appointed) or the person presiding over the meeting shall give such directions as he / she thinks fit with regard to the arrangements for meetings and accommodation of the public and representatives of the press such as to ensure that the Group’s business shall be conducted without interruption and disruption and without prejudice to the power to exclude on grounds of the confidential nature of the business to be transacted, the public will be required to withdraw upon the Groups resolving as follows:

a. That in the interests of public order the meeting adjourn for (period to be specified) to enable the Group to complete its business without the presence of the public. Section1 (8) Public Bodies (Admissions to Meetings) Act.

3.12.5 Business proposed to be transacted when the press and public have been excluded from a meeting

a. Matters to be dealt with by the Group following the exclusion of representatives of the press and other members of the public, as provided in 3.12.1 to 13.12.4 above.

b. Members and Officers or any employee of the Group in attendance shall not reveal or disclose the contents of papers marked ‘In confidence’ or minutes headed ‘Items Taken in Private’ outside of the CCG, without the express permission of the Group. This prohibition shall apply equally to the content of any discussion during the Group meeting which may take place on such reports or papers.

3.12.6 Use of Mechanical or Electrical Equipment for Recording or Transmission of Meetings Nothing in these Standing Orders shall be construed as permitting the introduction by the public, or press representatives of recording, transmitting video or similar apparatus into meetings of the Group or Committee thereof such permission shall be granted only upon resolution of the Group.

3.12.7 Observers at CCG meetings The CCG will decide what arrangements and terms and conditions it feels are appropriate to offer in extending an invitation to observers to attend and address any of the CCGs meetings and may change, alter or vary these terms and conditions as it deems fit.

3.13 Notice of Motion

3.13.1 Subject to the provision of standing orders 3.15 ‘Motions: Procedure at and during a meeting and 3.15.7 ‘Motions to Rescind a Resolution’, a member of the Governing Body wishing to move a motion shall send a written notice to the Chief Officer who will ensure that it is brought to the immediate attention of the Chair.

3.13.2 The notice shall be delivered at least 7 (seven) clear days before the meeting. The Chief Officer shall include in the agenda for the meeting all notices so received that are in order

and permissible under governing regulations. This Standing Order shall not prevent any motion being withdrawn or moved without notice on any business mentioned on the agenda for the meeting.

3.14 Emergency Motions

3.14.1 Subject to the agreement of the Chairman and subject also to the provision of Standing Order 3.15 ‘Motions: Procedure at and during a meeting’, a member of the Governing Body may give written notice of an emergency motion after the issue of the notice of meeting and agenda, up to one hour before the time fixed for the meeting. The notice shall state on the grounds of urgency. If in order, it shall be declared to the Governing Body at the commencement of the business of the meeting as an additional item included in the agenda. The Chair’s decision to include the item shall be final.

3.15 Motions: Procedure at and During a Meeting

3.15.1 Who may propose A motion may be proposed by the Chair of the meeting or any member present. It must also be seconded by another member.

3.15.2 Contents of the Motions The Chair may exclude from the debate at their discretion any such motion of which notice was not given on the notice summoning the meeting other than a motion relating to:- The reception of a report a. Consideration of any item of business before the Governing Body b. The accuracy of minutes c. That the Board may proceed to next business d. The Governing Body may adjourn e. That the question be now put

3.15.3 Amendments to motions a. A motion for amendment shall not be discussed unless it has been proposed and seconded b. Amendments to motions shall be moved relevant to the motion and shall not have the effect of negating the motion before the Board c. If there are a number of amendments they shall be considered one at a time. When a motion has been amended the amended motion shall become the substantive motion before the meeting upon which any further amendment may be moved.

3.15.4 Rights of reply to motions a. Amendments The mover of an amendment may reply to the debate on their amendment immediately prior to the mover of the original motion who shall have the right of reply at the close of debate on the amendment but may not otherwise speak on it.

b. Substantial / original motion The member who proposed the substantive motion shall have a right of reply at the close of any debate on the motion.

3.15.5 Withdrawing a motion A motion or an amendment to a motion may be withdrawn

3.15.6 Motions once under debate When a motion is under debate, no motion may be moved other than:

 An amendment to the motion  The adjournment of the discussion, or the meeting  That the meeting proceed to the next business  That the question shall now be put  The appointment of an ‘ad hoc’ committee to deal with a specific item of business  That a member / director be not further heard  A motion under Section I (2) or Section I (8) of the Public Bodies (Admissions to Meetings) Act 1960 resolving to exclude the public including the press (see Standing Order 3.17).

In those cases where the motion is either that the meeting proceeds to the ‘next business’ or that the question be now put in the interests of objectivity these should be put forward by a member of the Governing Body who has not taken part in the debate and who is eligible to vote.

If a motion to proceed to the next business or that the question be now put, is carried, the Chair should give the mover or the substantive motion under debate a right to reply, if not already exercised. The matter should then be put to the vote.

3.15.7 Motion to Rescind a Resolution

a. Notice of motion to rescind any resolution (or the general substance of any resolution) which has been passed within the preceding six calendar months shall bear the signature of the member who gives it and also the signature of three other members, and before considering any such motion of which notice shall have been given, the CCG may refer the matter to any appropriate Committee or the Chief Officer for recommendation.

b. When any such motion has been dealt with by the CCG it shall not be competent for any director / member other than the Chair to propose a motion to the same effect within six months. This standing Order shall not apply to motions moved in pursuance of a report or recommendations of a CCG or the Chief Officer

4 APPOINTMENT OF COMMITTEES AND SUB-COMMITTEES

4.1 Appointment of committees and sub-committees

4.1.1 The group may appoint committees and sub-committees of the group, subject to any regulations made by the Secretary of State5, and make provision for the appointment of committees and sub-committees of its governing body. Where such committees and sub- committees of the group, or committees and sub-committees of its governing body, are appointed they are included in Chapter 6 of the group’s constitution.

4.1.2 Other than where there are statutory requirements, such as in relation to the governing body’s audit committee or remuneration committee, the group shall determine the membership and terms of reference of committees and sub-committees and shall, if it

5 See section 14N of the 2006 Act, inserted by section 25 of the 2012 Act

requires, receive and consider reports of such committees at the next appropriate meeting of the group.

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

4.2.1 Terms of reference shall have effect as if incorporated into the constitution.

4.3 Delegation of Powers by Committees to Sub-committees

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

4.4 Approval of Appointments to Committees and Sub-Committees

4.4.1 The group shall approve the appointments to each of the committees and sub-committees which it has formally constituted including those the governing body. The group shall agree such travelling or other allowances e.g. reimbursement for loss of earnings and / or expenses where appropriate within national guidance.

4.5 Committees Established by the CCG 4.5.1 The committees, sub committees and joint committees established by the Group are:

1. Audit Committee 2. Remuneration Committee 3. Pennine Lancashire Quality Committee 4. Primary Care Commissioning Committee 5. Patient Partners Board 6. Sustainability Committee

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

5.1 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 group and staff have a duty to disclose any non-compliance with these standing orders to the Chief Officer as soon as possible.

6 USE OF SEAL AND AUTHORISATION OF DOCUMENTS

6.1 Clinical Commissioning Group’s seal

6.1.1 The group may have a seal for executing documents where necessary.

6.1.2 The common seal of the Group shall be kept by the Chief Officer or a nominated manager by him / her in a secure place.

6.1.3 Where it is necessary that a document shall be sealed, the seal shall be affixed in the presence of two senior managers duly authorised by the Chief Officer and not also from the originating department and shall be attested by them.

6.1.4 Register of seal The Chief Officer shall keep a register in which he / she or another manager of the Group authorised by him / her shall enter a record of the sealing of every document.

6.1.5 Use of Seal – General guide a. All lease agreements where the annual lease charge exceeds £10,000 per annum and the period of the lease exceeds beyond five years. b. Any other lease agreement where the total payable under the lease exceeds £100,000. c. Any contract or agreement with organisations other than NHS or other government bodies including local authorities where the annual costs exceed or are expected to exceed £10,000.

6.2 Execution of a Document by Signature

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

a. The Chief Officer b. The Chair of the CCG c. The Chief Finance Officer

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

7.1 Policy statements: General Principles

7.1.1 The group will from time to time agree and approve policy statements / procedures which will apply to all or specific groups of staff employed by NHS East Lancashire 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 group’s standing orders.

7.1.2 Specific Policy Statements Notwithstanding the application of SO No 7.1 above, these Standing Orders and Prime Financial Policies must be read in conjunction with the following Policy statements:

The Standards of Business Conduct and Conflicts of Interest Policy for NHS East Lancashire CCG staff;

Code of Conduct for NHS Managers 2002;

ABPI Code of Professional Conduct relating to hospital / gifts from pharmaceutical / external industry;

The Staff Disciplinary and Appeals Procedures adopted by the CCG both of which shall have effect as if incorporated in these Standing Orders.

7.1.3 Prime Financial Policies Prime Financial Policies adopted by the CCG in accordance with the Financial Regulations shall have affect as if incorporated in these Standing Orders

7.1.4 Specific guidance Notwithstanding the application of SO No 7.1 above these Standing Orders and Prime Financial Policies must be read in conjunction with the following guidance and any other issued by the Secretary of State for Health:

a. Caldicott Guardian 1997 b. Human Rights Act 1998 c. Freedom of Information Act 2000

8 MISCELLANEOUS

8.1 Joint Finance Arrangements

The Board may confirm contracts to purchase from a voluntary organisation or a local authority using its powers under Section 256 of the 2006v Act. The Board may confirm contracts to transfer money from the NHS to the voluntary sector or the health related functions of local authorities where such a transfer is to fund services to improve the health of the local population more effectively than equivalent expenditure on NHS services, using its powers under section 256 of the 2006 Act.

APPENDIX F: (a) SCHEME OF RESERVATION & DELEGATION

1. SCHEDULE OF MATTERS RESERVED TO THE CLINICAL COMMISSIONING GROUP AND SCHEME OF DELEGATION

1.1 The arrangements made by the group as set out in this scheme of reservation and delegation of decisions shall have effect as if incorporated in the group’s constitution (Part 1).

1.2 Nothing in the scheme of reservation and delegation should impair the discharge of the direct accountability to the Council of Members or Governing Body of the Chief Financial Officer. Outside of these requirements the Chief Finance Officer shall be accountable to the group’s Chief Officer.

1.3 The Clinical Commissioning Group remains accountable for all of its functions, including those that it has delegated.

1.4 Unless stated in the groups constitution or in its scheme of reservation and delegation the group’s Chief Officer has responsibility for the operational management.

1.5 Delegated financial limits have been developed by the CCG and are shown in Appendix F.

APPENDIX F: (b) RESERVATION AND DELEGATION SCHEDULE

1. REGULATION AND CONTROL 1.1 Determine the arrangements by which the members of the group approve those Council of N/A N/A Chair N/A Chief Officer decisions that are reserved for the membership Members 1.2 Consideration and approval of applications to NHS England on matters Council of concerning changes to the group’s constitution, including proposed changes to N/A N/A N/A Governing Body Chief Officer Members the appendicies to its constitution. 1.3 Exercise or delegation of those functions of the clinical commissioning group which have not been retained as reserved by the group or delegated to the N/A N/A N/A Chief Officer N/A Chief Officer governing body or to a committee or sub-committee of the group or to one of its members or employees 1.4 Approval of the group’s overarching scheme of reservation and delegation, which sets out those decisions that are in statue the responsibility of the group and that Council of are reserved to the membership and those delegated to the N/A N/A N/A Governing Body Chief Officer Members group’s governing body committees, sub-committees, or advisory panels of the group or its members or employees 1.5 Prepare the scheme of reservation and delegation, which sets out those decisions that are in statue the responsibility of the governing body are reserved to the governing body and those delegated to the Governing governing body’s committees and sub-committees, N/A N/A N/A Chief Officer Chief Officer Body members of the governing body, an individual who is member of the group but not the governing body or a specified person 1.6 Promulgate the governance arrangements of the group to members, employees N/A N/A N/A Chief Officer Chief Officer of the group and to people working on behalf of the group N/A 1.7 Final authority on interpretation of the group’s constitution and supporting appendicies (i.e. standing orders, prime financial polices and scheme of N/A N/A N/A Chair N/A Chief Officer reservation and delegation) 1.8 Disclosure of non-compliance with the group’s constitution (incorporating its standing orders, prime financial policies and scheme of reservation and N/A N/A N/A All Staff N/A Chief Officer delegation)

Matter Delegated To Matter Responsible for Reserved to Ref Reserved to Recommending Operational Reserved or Delegated Matter the Governing Individual No the a course of Responsibility Governing Body or Member or Membership action Body Committee Officer 1.9 Suspension of standing orders Council of Governing N/A N/A N/A Members Body N/A 1.10 Review of suspension of standing orders Audit N/A N/A N/A N/A N/A Committee 1.11 Approval of the group’s operational scheme of delegation that underpins the Governing group’s ‘overarching scheme of reservation and delegation’ as set out in the N/A N/A N/A Chief Officer Chief Officer Body constitution 1.12 Approve the group’s prime financial policies Governing Chief Finance N/A N/A N/A Chief Finance Officer Body Officer 1.13 Approve detailed financial procedures Chief N/A N/A N/A Chief Officer Chief Finance Officer Finance Officer 1.14 Approve arrangements for managing exceptional funding requests Director of Governing N/A N/A N/A Sustainability Performance & Body Committee Delivery 1.15 Set out who can execute a document by signature / use of the seal Governing N/A N/A N/A Chief Officer Chief Officer Body 1.16 Prepare a Conflicts of Interest Policy Governing N/A N/A N/A Chief Officer Chief Officer Body 1.17 Approve the Conflicts of Interest Policy Governing N/A N/A N/A N/A Audit Committee Body 2 PRACTICE MEMBER REPRESENTATIVES AND MEMBERS OF THE GOVERNING BODY

2.1 Approve the arrangements for identifying practice members to represent Council of practices in matters concerning the work of the group; and appointing clinical N/A N/A N/A Chief Officer Chief Officer Members leaders to represent the group’s membership on the group’s governing body. 2.2 Approve the appointment of governing body members, the process for recruiting Council of and removing non-elected members to the governing body (subject to any N/A N/A N/A Chief Officer Chief Officer Members regulatory requirements) and succession planning 2.3 Approve arrangements for recruiting the group’s Chief Officer. Council of N/A N/A N/A Chair Chair Members 3 STRATEGY AND PLANNING

3.2 Approve the group’s operating structure Sustainability Committee taking into Governing account the N/A N/A N/A Chief Officer Body views of the Council of Members]

3.3 Approve the group’s commissioning plan Governing Sustainability N/A N/A N/A N/A Body Committee 3.4 Approve the group’s arrangements for engaging the public and key stakeholders Governing in the group’s planning and commissioning arrangements. N/A N/A N/A Sustainability Chief Officer Body Committee 3.5 Approve the group’s corporate budgets that meet the financial duties of the Governing Sustainability N/A N/A N/A Chief Finance Officer group as set out in Section 5.4 of the main body of the constitution. Body Committee 3.6 Approve variations to the approved budget where variation would have a Governing significant impact on the overall approved levels of income and expenditure or N/A N/A N/A Sustainability Chief Finance Officer Body the group’s ability to achieve its agreed strategic aims Committee 3.7 Promote a comprehensive health service (Ref 5.1.2 a) Governing Sustainability N/A N/A N/A Sustainability Body Committee Committee 3.8 Meet the public sector equality duty (Ref 5.1.2b) Governing Sustainability N/A N/A N/A Sustainability Body Committee Committee 4 ANNUAL REPORTS, ACCOUNTS AND GENERAL FINANCE

4.1 Approval of the group’s annual report and annual accounts Chief Officer & Chief Governing N/A N/A N/A Audit Committee Finance Officer Body Respectively

Matter Delegated To Matter Responsible for Reserved to Ref Reserved to Recommending Operational Reserved or Delegated Matter the Governing Individual No the a course of Responsibility Governing Body or Member or Membership action Body Committee Officer 4.2 Approval of the arrangements for discharging the group’s statutory financial Governing N/A N/A N/A Chief Officer Chief Finance Officer duties Body 4.3 Ensure CCG Expenditure does not exceed the aggregate of its allotments for the Governing financial year N/A N/A N/A Sustainability Chief Finance Officer Body Committee 4.4 Ensure the CCG use of resources (both its capital resource use and revenue Sustainability Governing resource use) does not exceed the amount specified by NHS England for the N/A N/A N/A Committee Chief Finance Officer Body financial year 4.5 Take account of any directions issued by NHS England, in respect of specified Sustainability Governing types of resources use in a financial year, to ensure the CCG does not exceed N/A N/A N/A Committee Chief Finance Officer Body an amount specified by NHS England 4.6 Publish an explanation of how the group spent any payment in respect of quality Governing Sustainability N/A N/A N/A Chief Finance Officer Body Committee 5 HUMAN RESOURCES & ORGANISATIONAL DEVELOPMENT

5.1 Approve the terms and conditions, remuneration and travelling or other Governing Remuneratio Remuneration Chief Officer N/A N/A allowances for governing body members, including pensions and gratuities Body n Committee Committee 5.2 Approve terms and conditions of employment for all employees of the group Chief Officer Governing Remuneratio Remuneration including, pensions, remuneration, fees and travelling or other allowances N/A N/A Body n Committee Committee payable to employees and to other persons providing services to the group 5.3 Approve any other terms and conditions of services for the group’s employees Governing Remuneratio Remuneration Chief Officer N/A N/A Body n Committee Committee 5.4 Approve disciplinary arrangements for employees, including the Chief Officer Governing Remuneration (where he/she is an employee or member of the clinical commissioning group) N/A N/A N/A Chief Officer Body Committee and for other persons working on behalf of the group 5.5 Approve disciplinary arrangements where the group has joint appointments with Governing Remuneration N/A N/A N/A Chief Officer another group and the individuals are employees of that group. Body Committee 5.6 Approval of the arrangements for discharging the group’s statutory duties as an Governing Remuneration N/A N/A N/A Chief Officer employer Body Committee Approve human resources policies for employees and for other persons Governing Remuneration 5.7 N/A N/A N/A Chief Officer working on behalf of the group Body Committee 5.8 Approve the group’s succession planning for elected members and other N/A N/A Governing N/A Governing Body Chief Officer

Matter Delegated To Matter Responsible for Reserved to Ref Reserved to Recommending Operational Reserved or Delegated Matter the Governing Individual No the a course of Responsibility Governing Body or Member or Membership action Body Committee Officer governing body nominations and members Body 5.9 Approve the group’s organisational development plans Remuneration Committee Governing N/A N/A N/A [taking into account Chief Officer Body the views of the Council of Members] 5.10 Determine the terms and conditions of employment for all employees of the N/A N/A N/A N/A N/A Chief Officer group. 5.11 Determine pensions, remuneration, fees and allowances payable to employees Governing Remuneration N/A N/A N/A Chief Officer and to other persons providing services to the group. Body Committee 5.12 Recommend pensions, remuneration, fees and allowances payable to Remuneration N/A N/A N/A N/A Chief Officer employees and to other persons providing services to the group. Committee 5.13 Review disciplinary arrangements where the Chief Officer is an employee or Governing Remuneration member of another clinical commissioning group N/A N/A N/A Chief Officer Body Committee

6 QUALITY AND SAFETY 6.1 Approve arrangements, including supporting policies, to minimise clinical risk, Pennine Lancs Governing Director of Quality maximise patient safety and to secure continuous improvement in quality and N/A N/A N/A Quality Body and Chief Nurse patient outcomes Committee 6.2 Approve the group’s arrangements for handling complaints Pennine Lancs Governing N/A N/A N/A Quality Chief Officer Body Committee 6.3 Approve the group’s arrangements for safeguarding children and vulnerable Pennine Lancs Governing adults N/A N/A N/A Quality Chief Officer Body Committee 6.4 Approve the group’s arrangements for engaging patients and their carers in Pennine Lancs Governing decisions concerning their healthcare N/A N/A N/A Quality Chief Officer Body Committee 6.5 Approve arrangements for supporting NHS England in discharging its Pennine Lancs Governing Body Governing responsibilities in relation to securing continuous improvement in the quality of N/A N/A N/A Quality Clinical Lead for Body general medical services Committee PMS Engagement

Matter Delegated To Matter Responsible for Reserved to Ref Reserved to Recommending Operational Reserved or Delegated Matter the Governing Individual No the a course of Responsibility Governing Body or Member or Membership action Body Committee Officer 7 OPERATIONAL AND RISK MANAGEMENT 7.1 Approve the group’s counter fraud arrangements. Governing N/A N/A N/A Audit Committee Chief Finance Officer Body 7.2 Approval of the group’s risk management arrangements Governing Audit Director of Quality N/A N/A Audit Committee Body Committee and Chief Nurse 7.3 Approve arrangements for risk sharing and or risk pooling with other

organisations (for example arrangements for pooled funds with other clinical Governing N/A N/A N/A Sustainability Chief Finance Officer commissioning groups or pooled budget arrangements under section 75 of the Body Committee NHS Act 2006). 7.4 Approve a comprehensive system of internal control, including budgetary control, Governing N/A N/A N/A Audit Committee Chief Finance Officer that underpin the effective, efficient and economic operation of the group. Body 7.5 Approve the thresholds above which quotations or formal tenders must be Governing N/A N/A N/A Audit Committee Chief Finance Officer obtained Body 7.6 Approve the arrangements for seeking professional advice regarding the supply Governing Chief Finance N/A N/A N/A Chief Finance Officer of goods and services Body Officer 7.7 Approve proposals for action on litigation against or on behalf of the clinical Governing Chief Finance N/A N/A N/A Chief Finance Officer commissioning group Body Officer 7.8 Approve the group’s arrangements for business continuity and emergency Governing N/A N/A N/A Audit Committee Chief Officer planning Body 7.9 Approve the group’s banking arrangements Governing N/A N/A N/A Audit Committee Chief Finance Officer Body 8 INFORMATION GOVERNANCE 8.1 Approve the arrangements for ensuring appropriate and safekeeping and Pennine Lancs Governing confidentiality of records and for the storage, management and transfer of N/A N/A N/A Quality Chief Officer Body information and data. Committee 8.2 Approve information sharing protocols with other organisations Governing Chief Finance Chief Finance Officer N/A N/A N/A Body Officer as SIRO 9 PARTNERSHIP, JOINT OR COLLABORATIVE WORKING (see also paragraph 7.3 above and paragraph 11.3 below of this Scheme of Reservation and Delegation)

9.1 Approve the arrangements governing joint or collaborative arrangements N/A Governing N/A N/A Chief Officer

Matter Delegated To Matter Responsible for Reserved to Ref Reserved to Recommending Operational Reserved or Delegated Matter the Governing Individual No the a course of Responsibility Governing Body or Member or Membership action Body Committee Officer between the group and another statutory body(ies), where those arrangements Body Sustainability incorporate decision making responsibilities Committee 9.2 Approve the delegated decision making responsibilities of individual members or Governing employees of the group who represent the group in joint or collaborative N/A N/A N/A Sustainability Chief Officer Body arrangements with another statutory body(ies) Committee 9.3 Receive the minutes of meetings of, or reports from, joint or collaborative Governing N/A N/A N/A N/A Chief Officer arrangements between the group and another statutory body(ies) Body 9.4 Authorise an individual to act on behalf of the group in discharging the group’s duty in respect of statutory and local joint working arrangements, within the

financial limits determined under sections 10 and 12 of this scheme of Governing N/A N/A N/A Sustainability Chief Officer reservation and delegation. For example: Body Committee Safeguarding (children’s and adult) Health & Wellbeing Board 9.5 Approve decisions delegated to joint committees established under section 75 of Governing the 2006 Act N/A N/A N/A Sustainability Chief Finance Officer Body Committee 9.6 Approve the delegated decision making responsibilities of individual employees Primary Care Director of Governing of the group who represent the group in joint or collaborative arrangements with N/A N/A N/A Commissioning Performance and Body another statutory body(ies) in relation to primary medical services. Committee Delivery 10 TENDERING 10.1 Approve the group’s tendering arrangements for any commissioning or corporate Governing N/A N/A N/A Audit Committee Chief Finance Officer support equal or in excess of £100,000. Body 10.2 Approve the group’s tendering arrangements for any commissioning or corporate N/A N/A N/A Chief Officer Audit Committee Chief Finance Officer support below a value of £100,000. 11 COMMISSIONING AND CONTRACTING FOR CLINICAL SERVICES

11.1 Approve the arrangements for discharging the group’s statutory duties Governing N/A N/A N/A Sustainability Chief Officer associated with its commissioning functions. Body Committee Primary Care Director of 11.1a Approve the arrangements for discharging the groups statutory duties Governing N/A N/A N/A Commissioning Performance and associated with the commissioning of primary medical services. Body Committee Delivery 11.2 Approve arrangements (including where appropriate, an individual’s N/A N/A Governing N/A Chief Officer 60

authority to act) for co-ordinating the commissioning of services with the Governing N/A N/A N/A Sustainability Chief Officer Body local authority(s) Committee

Approval of contracts for clinical services with a value equal or in Governing 11.4 N/A N/A N/A Chief Officer Chief Finance Officer excess of £250,000. Body 11.5 Approve contracts for clinical services with a value less than £250,000. N/A N/A N/A Chief Officer Chief Officer Chief Finance Officer

11.6 Approve arrangements (including where appropriate, an individual’s Primary Care Director of Governing authority to act) for coordinating the commissioning of primary medical N/A N/A N/A Commissioning Performance and Body services with NHS England. Committee Delivery 12 COMMISSIONING AND CONTRACTING FOR NON-CLINICAL SERVICES

12.1 Approve arrangements for co-ordinating the commissioning of non Governing N/A N/A N/A Sustainability Chief Officer clinical services with other groups Body Committee

12.2 Approve arrangements for co-ordinating the commissioning of non Governing N/A N/A N/A Sustainability Chief Officer clinical services with local authority(ies) Body Committee Approval of contracts for non clinical services with a value equal or in Governing 12.3 N/A N/A N/A Chief Officer Chief Officer excess of £500,000. Body Approve contracts for non clinical services with a value less than Chief Finance 12.4 N/A N/A N/A Chief Officer Chief Finance Officer £100,000. Officer 13 COMMUNICATIONS Pennine Lancs 13.1 Approve arrangements for handling Freedom of Information requests. Governing N/A N/A N/A Quality Chief Officer Body Committee 14 GENERAL DUTIES

14.1 Secure public involvement (Ref 5.5) N/A N/A Governing N/A Chief Officer 61

Matter Delegated To Matter Responsible for Reserved to Ref Reserved to Recommending Operational Reserved or Delegated Matter the Governing Individual No the a course of Responsibility Governing Body or Member or Membership action Body Committee Officer Body Sustainability Committee 14.2 Promote awareness of, and act with a view to ensuring that health Governing services are provided in a way that promotes awareness of, and due N/A N/A N/A Sustainability Chief Officer Body regard to the NHS Constitution (Ref 5.2.1) Committee

14.3 Promote working effectively, efficiently and economically (Ref 5.2.2) Governing N/A N/A N/A Sustainability Chief Officer Body Committee Pennine Lancs 14.4 Promote securing continuous improvement to the quality of services (Ref Governing N/A N/A N/A Quality Chief Officer 5.2.3) Body Committee Pennine Lancs 14.5 Promote the improvement in the quality of primary medical services (Ref Governing N/A N/A N/A Quality Chief Officer 5.2.4) Body Committee

14.6 Promote the reduction inequalities (Ref 5.2.5) Governing N/A N/A N/A Sustainability Chief Officer Body Committee Sustainability 14.7 Promote the involvement of patients, their carers and representatives in Governing N/A N/A N/A Committee Chief Officer decisions about their healthcare (Ref 5.2.6) Body

Sustainability 14.8 Promote the principles of enabling patients to make choices (Ref 5.2.7) Governing N/A N/A N/A Committee Chief Officer Body

Sustainability 14.9 Promote the principles of obtaining appropriate advice (Ref 5.2.8) Governing N/A N/A N/A Committee Chief Officer Body

Pennine Lancs 14.10 Promote innovation (Ref 5.2.9) Governing N/A N/A N/A Quality Chief Officer Body Committee Pennine Lancs 14.11 Promote research and the use of research (Ref 5.2.10) Governing N/A N/A N/A Quality Chief Officer Body Committee

Sustainability 14.13 Promoting integration (Ref 5.2.12) Governing N/A N/A N/A Committee Chief Officer Body

15 SAFEGUARDING

15.1 Promotion of Safeguarding responsibilities including co-operation with Pennine Lancs Governing Local Authority and securing representation onto the local Safeguarding N/A N/A N/A Quality Chief Officer Body Children Board and Safeguarding Adult Board Committee

APPENDIX F: (c) DELEGATED FINANCIAL LIMITS

Delegated Financial Limits Note these delegated limits form part of the Corporate Governance Manual and should be read together with the Standing Orders, Scheme of Delegation and Prime Financial Policies. All thresholds are exclusive of VAT irrespective of recovery arrangements Delegated Level Financial Limits Notes

1 Gifts & Hospitality Received Policy follows guidance contained in NHSE Managing Conflicts of Interest: Revised

Statutory Guidance for CCGs CCG staff, Governing body and committee members and Gifts from non-suppliers and individuals within GP member non-contractors less than All NHS Staff practices should refer to the less than £50 CCG’s Conflict of Interest Policy,

and the circumstances where gifts can be accepted 2 Litigation Claims Chief Officer Over £250,000 Chief Finance Officer Up to £250,000 3 Losses and Special Payments – To be reported to the CCG Audit Committee CCG Board Over £100,000 Chief Officer £50,001 - £100,000 Chief Finance Officer £5,001 - £100,000 Nominated Deputies Up to £5,000 4 Petty Cash Chief Finance Officer Up to £500 See petty cash procedures available from Finance Deputy Chief Finance Officer Up to £200 Department 5 Removal Expenses Chief Officer Up to £8,500 With Remuneration committee Chief Finance Officer Up to £8,500 approval 6 Signing of Contracts – Health Care Contracts (including primary care & public health) Chief Officer Over £250,000,000 Chief Finance Officer Over £250,000,000 Director of Performance & Delivery Up to £250,000,000 Chief Officer Chief Finance Officer Contract variations Director of Performance & Delivery 7 Approving Healthcare ad-hoc payments (including Continuing Healthcare, Bespoke Care, Non contract activity etc.) BUT over £500,000 requires Chief Officer Unlimited Chief Officer, Chair and Chief Finance Officer approval Chief Finance Officer Up to £500,000 Director of Performance & Delivery Up to £250,000 Director of Quality & Chief Nurse Up to £100,000 Nominated Deputies Up to £100,000

8 Requisitioning goods and services and approving payments: Non Healthcare – revenue and capital expenditure (including IT, Management Consultancy, Maintenance, Buildings – over lifetime contract, excluding removal expenses)

CCG Governing Body Over £500,000 Chair Up to £500,000 Chief Officer Up to £500,000 Chief Finance Officer Up to £250,000 Director of Performance & Delivery Up to £150,000 Director of Quality and Chief Nurse Up to £100,000 Nominated Deputies Up to £50,000 9 The requirement to obtain Quotations and Tenders (over lifetime of contract) – Also see Appendix E of the CCG Constitution which references the Prime Financial Policies – Tax linked transactions to be treated cumulatively In compliance with EU Obtain a minimum of 3 written Procurement thresholds: competitive tenders As at April 2016: EU Limit and over Supplies& Schedule 1 £106,047 Services Contract ) Service Contract Other £164,176 Service Contract Light touch £589,148 Works Contract regime £4,104,394 Obtain a minimum of 3 written Over £50,000 to EU Limit competitive tenders Obtain a minimum of 3 written Below EU Limit £10,000 up to £49,999 quotations £1,000 to £9,999 Obtain two verbal quotations Below £999 Obtain one verbal quotation 10 Virement (excluding new allocations and earmarked resources) CCG Board Over £5,000,000 Chief Officer Up to £5,000,000 Chief Finance Officer Up to £5,000,000 11 Disposals and Condemnations – All assets at Market Value CCG Board Over £100,000 per item Use of capital receipts must be Chief Officer Up to £100,000 per item authorised by NHS England Chief Finance Officer Up to £100,000 per item 12 Approving Monthly Contract payments / Service level agreement payments – Healthcare (Linked to section 7 above at 1/12th of annual contract value) Approval from two of the following: Chief Officer Over £50,000,000 Chief Finance Officer Approval from one of the following: Chief Officer Chief Finance Officer Up to £50,000,000 Director of Performance & Delivery

Lancashire Commissioning Support Unit

Delegated authority to commit/agree expenditure for defined items within defined limits to be agreed by Chief Finance Officer.

APPENDIX G: PRIME FINANCIAL POLICIES

INTRODUCTION

1.1 General

1.1.1 These prime financial policies and supporting detailed financial policies shall have effect as if incorporated into the group’s constitution.

1.1.2 The prime financial policies are part of the group’s control environment for managing the organisation’s financial affairs. They contribute to good corporate governance, internal control and managing risks. They enable sound administration, lessen the risk of irregularities and support commissioning and delivery of effective, efficient and economical services. They also help the Chief Officer and Chief Finance Officer to effectively perform their responsibilities. They should be used in conjunction with the scheme of reservation and delegation.

1.1.3 In support of these prime financial policies, the group has prepared more detailed policies, approved by the Chief Finance Officer known as detailed financial policies. The group refers to these prime and detailed financial policies together as the clinical commissioning group’s financial policies.

1.1.4 These prime financial policies identify the financial responsibilities which apply to everyone working for the group and its constituent organisations. They do not provide detailed procedural advice and should be read in conjunction with the detailed financial policies. The Chief Finance Officer is responsible for approving all detailed financial policies.

1.1.5 A list of the group’s detailed financial policies will be published and maintained on the group’s website at http://www.eastlancsccg.nhs.uk/

1.1.6 This document is also available:- i) Upon request for inspection at NHS East Lancashire CCG headquarters:- C/o Chief Officer NHS East Lancashire CCG Walshaw House Regent Street Nelson Lancashire BB9 8QS

ii) Upon application either by post (to the above address) or by e-mail – [email protected]

1.1.7 Should any difficulties arise regarding the interpretation or application of any of the prime financial policies then the advice of the Chief Finance Officer must be sought before acting. The user of these prime financial policies should also be familiar with and comply with the provisions of the group’s constitution, standing orders and scheme of reservation and delegation.

1.1.8 Failure to comply with prime financial policies and standing orders can in certain circumstances be regarded as a disciplinary matter that could result in dismissal.

1.1.9 Throughout these prime financial policies reference is made to the limits of financial authorities against the role of officers, Committees and Board. Delegated Financial Limits, as reflected in Part 2 C, provides a summary of the limits of financial authorities and responsibilities approved by the Board which will be reviewed and updated periodically.

1.2 Overriding Prime Financial Policies

If for any reason these prime financial policies 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’s audit committee for referring action or ratification. All of the group’s members and employees have a duty to disclose any non-compliance with these prime financial policies to the Chief Finance Officer as soon as possible.

1.3 Responsibilities and Delegation

The roles and responsibilities of group’s members, employees, members of the governing body, members of the governing body’s committees and sub-committees, members of the group’s committee and sub-committee (if any) and persons working on behalf of the group are set out in chapters 6 and 7 of the constitution.

The financial decisions delegated by members of the group are set out in the group’s scheme of reservation and delegation Part 1 and Part 2.

1.4 Contractors and Their Employees

Any contractor or employee of a contractor who is empowered by the group to commit the group to expenditure or who is authorised to obtain income shall be covered by these instructions. It is the responsibility of the Chief Officer to ensure that such persons are made aware of this.

1.5 Amendment of Prime Financial Policies

To ensure that these prime financial policies remain up-to-date and relevant, the Chief Finance Officer will review them at least annually. Following consultation with the Chief Officer and scrutiny by the Audit Committee, the Chief Finance Officer will recommend amendments, as fitting, to the governing body for approval.

2 INTERNAL CONTROL

POLICY – the group will put in place a suitable control environment and effective internal controls that provide reasonable assurance of effective and efficient operations, financial stewardship, probity and compliance with laws and policies

2.1 The governing body is required to establish an audit committee with terms of reference agreed by the governing body (see paragraph 6.6.3(a) of the group’s constitution for further information).

2.2 The Chief Officer has overall responsibility for the group’s systems of internal control.

2.3 The Chief Finance Officer will ensure that:

● Financial policies are considered for review and updated annually

● A system is in place for proper checking and reporting of all breaches of financial policies; and

● A proper procedure is in place for regular checking of the adequacy and effectiveness of the control environment.

3 AUDIT

POLICY – the group will keep an effective and independent internal audit function and fully comply with the requirements of external audit and other statutory reviews

3.1 In line with the terms of reference for the governing body’s audit committee the person appointed by the group to be responsible for internal audit and the Audit Commission appointed external auditor will have direct and unrestricted access to audit committee members and the chair of the governing body, Chief Officer and Chief Finance Officer for any significant issues arising from audit work that management cannot resolve, and for all cases of fraud or serious irregularity.

3.2 The person appointed by the group to be responsible for internal audit and the external auditor will have access to the audit committee and the Chief Officer to review audit issues as appropriate. All audit committee members, the chair of the governing body and the Chief Officer will have direct and unrestricted access to the head of internal audit and external auditors.

3.3 The Chief Finance Officer will ensure that:

● The group has a professional and technically competent internal audit function; and

● The CCG Audit Committee will approve any changes to the provision or delivery of assurance services to the group.

3.4 External Audit The External Auditor is appointed by the Audit Commission and paid for by the CCG. The Audit Committee must ensure a cost effective service.

4 FRAUD AND CORRUPTION

POLICY – the group requires all staff to always act honestly and with integrity to safeguard the public resources they are responsible for. The group will not tolerate any fraud perpetrated against it and will actively chase any loss suffered

4.1 The governing body’s audit committee will satisfy itself that the group 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.

4.2 The governing body’s audit committee will ensure that the group has arrangements in place to work effectively with NHS Counter Fraud Authority.

4.3 In line with their responsibilities the Chief Officer and the Chief Finance Officer shall monitor and ensure compliance with NHS Counter Fraud Authority's NHS Standards for Commissioners as outlined in Service Condition 24 of the NHS Standards Contract..

4.4 The CCG shall nominate a suitable person to carry out the duties of the Local Counter Fraud Specialist (LCFS) as specified in the NHS Standards Contract (service condition 24) and in accordance with NHS Counter Fraud Authority's Standards for Commissioners.

4.5 The LCFS shall report to the CCG Chief Finance Officer and shall work with staff in the NHS Counter Fraud Authority in accordance with service condition 24 of the NHS Standards Contract and the NHS Counter Fraud Authority's Standards for Commissioners.

4.6 The LCFS will provide a written report at least annually on counter fraud work within the CCG.

5 EXPENDITURE CONTROL

5.1 The group is required by statutory provisions6 to ensure that its expenditure does not exceed the aggregate of allotments from NHS England and any other sums it has received and is legally allowed to spend.

5.2 The Chief Officer has overall executive responsibility for ensuring that the group complies with certain of its statutory obligations, including its financial and accounting obligations, and that it exercises its functions effectively, efficiently and economically and in a way which provides good value for money.

5.3 The Chief Finance Officer will:

● Provide reports in the form required by NHS England;

● Ensure money drawn from NHS England as required for approved expenditure only is drawn down only at the time of need and follows best practice;

● Be responsible for ensuring that an adequate system of monitoring financial performance is in place to enable the group to fulfil its statutory responsibility not to exceed its expenditure limits, as set by direction of NHS England.

6 ALLOTMENTS7

6.1 The group’s Chief Finance Officer will:

● Periodically review the basis and assumptions used by NHS England for distributing allotments and ensure that these are reasonable and realistic and secure the group’s entitlement to funds;

● Prior to the start of each financial year submit to the governing body (CCG Board) for approval a report showing the total allocations received and their proposed distribution including any sums to be held in reserve; and

● Regularly update the governing body (CCG Board) on significant changes to the initial allocation and the uses of such funds.

6 See section 223H of the 2006 Act, inserted by section 27 of the 2012 Act 7 See section 223(G) of the 2006 Act, inserted by section 27 of the 2012 Act.

7 COMMISSIONING STRATEGY, BUDGETS, BUDGETARY CONTROL AND MONITORING

POLICY – the group will produce and publish an annual commissioning plan8 that explains how it proposes to discharge its financial duties. The group will support this with comprehensive medium term financial plans and annual budgets

7.1 The Chief Operating Officer will compile and submit to the CCG Governing Body a commissioning strategy which takes into account financial targets and forecast limits of available resources.

7.2 Prior to the start of the financial year the Chief Finance Officer will, on behalf of the Chief Officer, prepare and submit budgets for approval by the governing body (CCG Board).

7.3 The Chief Financial Officer shall monitor financial performance against budget and plan, periodically review them, and report to the governing body. This report should include explanations for variances. These variances must be based on any significant departures from agreed financial plans or budgets.

7.4 The Chief Officer is responsible for ensuring that information relating to the group’s accounts or to its income or expenditure, or its use of resources is provided to NHS England as requested.

7.5 The Chief Officer will approve consultation arrangements for the group’s commissioning plan9.

7.6 All budget holders shall provide information as required by the Chief Finance Officer to enable budgets to be complied.

7.7 The Chief Finance Officer has responsibility to ensure that adequate training is delivered in an on-going basis to budget holders to help them manage successfully.

8 ANNUAL ACCOUNTS AND REPORTS

POLICY – the group will produce and submit to NHS England accounts and reports in accordance with all statutory obligations10, relevant accounting standards and accounting best practice in the form and content and at the time required by NHS England

8.1 The Chief Finance Officer will ensure the group:

8 See section 14Z11 of the 2006 Act, inserted by section 26 of the 2012 Act. 9 See section 14Z13 of the 2006 Act, inserted by section 26 of the 2012 Act 10 See paragraph 17 of Schedule 1A of the 2006 Act, as inserted by Schedule 2 of the 2012 Act.

● Prepares a timetable for producing the annual report and accounts and agrees it with external auditors and the governing body;

● Prepares the accounts according to the timetable approved by the governing body;

● Complies with statutory requirements and relevant directions for the publication of annual report;

● Considers the external auditor’s management letter and fully address all issues within agreed timescales; and

● Publishes the external auditor’s management letter on the group’s website at http://www.eastlancsccg.nhs.uk/

i) This document is also available:- Upon request for inspection at NHS East Lancashire CCG headquarters:- C/o Chief Officer NHS East Lancashire CCG Walshaw House Regent Street Nelson Lancashire BB9 8QS

ii) Upon application either by post (to the above address) or by e-mail – [email protected]

● Prepares and submits financial returns in accordance with accounting policies and guidance given by the Department of Health and Treasury, the CCGs accounting policies and international financial reporting standards.

● The CCGs annual accounts must be audited by an auditor appointed by the Audit Commission. The CCGs audited annual accounts must be presented to a public meeting and made available to the public.

9 INFORMATION TECHNOLOGY

POLICY – the group will ensure the accuracy and security of the group’s computerised financial data

9.2 The Chief Finance Officer is responsible for the accuracy and security of the group’s computerised financial data and shall:

● Devise and implement any necessary procedures to ensure adequate (reasonable) protection of the group's data, programs and computer hardware from accidental or intentional disclosure to unauthorised persons, deletion or modification, theft or damage, having due regard for the Data Protection Act 1998;

● Ensure that adequate (reasonable) controls exist over data entry, processing, storage, transmission and output to ensure security, privacy, accuracy, completeness, and timeliness of the data, as well as the efficient and effective operation of the system;

● Ensure that adequate controls exist such that the computer operation is separated from development, maintenance and amendment;

● Ensure that an adequate management (audit) trail exists through the computerised system and that such computer audit reviews as the Chief Finance Officer may consider necessary are being carried out.

● In addition the Chief Finance Officer shall ensure that new financial systems and amendments to current financial systems are developed in a controlled manner and thoroughly tested prior to implementation. Where this is undertaken by another organisation, assurances of adequacy must be obtained from them prior to implementation.

10 ACCOUNTING SYSTEMS

POLICY – the group will run an accounting system that creates management and financial accounts

10.1 The Chief Finance Officer will ensure:

● The group has suitable financial and other software to enable it to comply with these policies and any consolidation requirements of NHS England;

● That contracts for computer services for financial applications with another health organisation or any other agency shall clearly define the responsibility of all parties for the security, privacy, accuracy, completeness, and timeliness of data during processing, transmission and storage. The contract should also ensure rights of access for audit purposes.

10.2 Where another health organisation or any other agency provides a computer service for financial applications, the Chief Finance Officer shall periodically seek assurances that adequate controls are in operation.

11 BANK ACCOUNTS

POLICY – the group will keep enough liquidity to meet its current commitments

11.1 The Chief Finance Officer will:

● Review the banking arrangements of the group at regular intervals to ensure they are in accordance with Secretary of State directions11, best practice and represent best value for money;

● Manage the group's banking arrangements and advise the group on the provision of banking services and operation of accounts;

● Repair detailed instructions on the operation of bank accounts.

11 See section 223H(3) of the NHS Act 2006, inserted by section 27 of the 2012 Act

11.2 The Chief Officer shall approve the banking arrangements.

11.3 GBS Accounts The Chief Finance Officer is responsible for:

● The Government Banking Service (GBS) accounts

● Ensuring payments from GBS Accounts do not exceed the amount credited to the account except where arrangements have been made.

● Reporting to the CCG Board all arrangements made with the GBS bankers for accounts to be overdrawn.

● Monitoring compliance with DH guidance on the level of cleared funds.

11.4 Banking Procedures The Chief Finance Officer will prepare detailed instructions on the operation of the GBS accounts which must include:

● The conditions under which the GBS account is to be operated

● Those authorised to sign cheques or other orders drawn on the CCGs accounts.

12. INCOME, FEES AND CHARGES AND SECURITY OF CASH, CHEQUES AND OTHER NEGOTIABLE INSTRUMENTS.

POLICY – the group will  operate a sound system for prompt recording, invoicing and collection of all monies due  seek to maximise its potential to raise additional income only to the extent that it does not interfere with the performance of the group or its functions12  ensure its power to make grants and loans is used to discharge its functions effectively13

12.1 The Chief Financial Officer is responsible for:

● Designing, maintaining and ensuring compliance with systems for the proper recording, invoicing, and collection and coding of all monies due;

● Establishing and maintaining systems and procedures for the secure handling of cash and other negotiable instruments;

12 See section 14Z5 of the 2006 Act, inserted by section 26 of the 2012 Act. 13 See section 14Z6 of the 2006 Act, inserted by section 26 of the 2012 Act.

● Approving and regularly reviewing the level of all fees and charges other than those determined by NHS England or by statute. Independent professional advice on matters of valuation shall be taken as necessary;

● For developing effective arrangements for making grants or loans.

13. TENDERING AND CONTRACTING PROCEDURE

POLICY – the group:  will ensure proper competition that is legally compliant within all purchasing to ensure we incur only budgeted, approved and necessary spending  will seek value for money for all goods and services  shall ensure that competitive tenders are invited for o the supply of goods, materials and manufactured articles; o the rendering of services including all forms of management consultancy services (other than specialised services sought from or provided by the Department of Health); and o for the design, construction and maintenance of building and engineering works (including construction and maintenance of grounds and gardens) for disposals

13.1 The group shall ensure that the firms / individuals invited to tender (and where appropriate, quote) are among those on approved lists or where necessary a framework agreement. Where in the opinion of the Chief Finance Officer it is desirable to seek tenders from firms not on the approved lists, the reason shall be recorded in writing to the Chief Officer or the group’s governing body.

13.2 The governing body may only negotiate contracts on behalf of the group, and the group may only enter into contracts, within the statutory framework set up by the 2006 Act, as amended by the 2012 Act. Such contracts shall comply with:

● The group’s standing orders; ● The Public Contracts Regulation 2006, any successor legislation and any other applicable law; and ● Take into account as appropriate any applicable NHS England or the Independent Regulator of NHS Foundation Trusts (Monitor) guidance that does not conflict with (b) above.

13.3 In all contracts entered into, the group shall endeavour to obtain best value for money. The Chief Officer shall nominate an individual who shall oversee and manage each contract on behalf of the group.

13.4 The procedure for making all contracts by or on behalf of the CCG shall comply with the standing orders and prime financial policies (except where standing order no 3.9 Suspension of Standing Orders is applied).

14. COMMISSIONING

POLICY – working in partnership with relevant national and local stakeholders, the group will commission certain health services to meet the reasonable requirements of the persons for whom it has responsibility

14.1 The group will coordinate its work with NHS England, other clinical commissioning groups, local providers of services, local authority(ies), including through Health & Wellbeing Boards, Commissioning Support Unit and patients and their carers and the voluntary sector and others as appropriate to develop robust commissioning plans.

14.2 The Chief Officer will establish arrangements to ensure that regular reports are provided to the governing body detailing actual and forecast expenditure and activity for each contract.

14.3 The Chief Finance Officer will maintain a system of financial monitoring to ensure the effective accounting of expenditure under contracts. This should provide a suitable audit trail for all payments made under the contracts whilst maintaining patient confidentiality.

15. RISK MANAGEMENT AND INSURANCE

POLICY – the group will put arrangements in place for evaluation and management of its risks

15.1 The Risk Management policy for NHS East Lancashire CCG sets out the policy for the identification and management of risk within the CCG. This document enables the organisation to have a clear view of the risks likelihood of occurrence and their potential impact on the successful achievement of the CCG objectives.

15.2 The CCG Governing Body will receive the Assurance Framework from the Pennine Lancashire Quality Committee with regard to the identification, management and mitigation of the risks associated with CCG activities.

15.3 The Risk Management Policy sets out the process for populating and scoring the assurance framework.

15.4 The Chief Officer shall ensure that the CCG has a programme of Risk management, in accordance with current Department of Health assurance framework requirements, which must be approved and monitored by the governing body (CCG Board).

15.5 The programme of risk management shall include:

a. A process for identifying and quantifying risks and potential liabilities b. Engendering among all levels of staff a positive attitude towards the control of risk c. Management processes to ensure all significant risks and potential liabilities are addressed including effective systems of internal control, cost effective insurance cover and decisions on the acceptance level of retained risk. d. Contingency plans to offset the impact of adverse events e. Audit arrangements including internal audit, clinical audit, health and safety review. f. A clear indication of which risks shall be insured g. Arrangements to review the risk management programme

15.6 The existence, integration and evaluation of the above elements will assist in providing a basis to make a statement on the effectiveness of internal control with the Annual Report and Accounts as required by the current Department of Health guidance.

16. PAYROLL

POLICY – the group will put arrangements in place for an effective payroll service

16.1 The Chief Finance Officer will ensure that the payroll service selected:

a. Is supported by appropriate (i.e. contracted) terms and conditions;

b. Has adequate internal controls and audit review processes;

c. Has suitable arrangements for the collection of payroll deductions and payment of these to appropriate bodies.

16.2 In addition the chief finance officer shall set out comprehensive procedures for the effective processing of payroll

17. NON-PAY EXPENDITURE

POLICY – the group will seek to obtain the best value for money goods and services received

17.1 The governing body (CCG Board) will approve the level of non-pay expenditure on an annual basis and the Chief Officer will determine the level of delegation to budget managers

17.2 The Chief Officer shall set out procedures on the seeking of professional advice regarding the supply of goods and services.

17.3 The Chief Finance Officer will:

a. Advise the governing body on the setting of thresholds above which quotations (competitive or otherwise) or formal tenders must be obtained; and, once approved, the thresholds should be incorporated in the scheme of reservation and delegation – Part 2 C Delegated Financial Limits.

b. Be responsible for the prompt payment of all properly authorised accounts and claims;

c. Be responsible for designing and maintaining a system of verification, recording and payment of all amounts payable. This will involve setting financial thresholds for verification.

18. CAPITAL INVESTMENT, FIXED ASSET REGISTERS AND SECURITY OF ASSETS

POLICY – the group will put arrangements in place to manage capital investment, maintain an asset register recording fixed assets and put in place polices to secure the safe storage of the group’s fixed assets

18.1 The Chief Officer will

a. Ensure that there is an adequate appraisal and approval process in place for determining capital expenditure priorities and the effect of each proposal upon plans;

b. Be responsible for the management of all stages of capital schemes and for ensuring that schemes are delivered on time and to cost;

c. Shall ensure that the capital investment is not undertaken without confirmation of purchaser(s) support and the availability of resources to finance all revenue consequences, including capital charges;

d. Be responsible for the maintenance of registers of assets, taking account of the advice of the Chief Finance Officer concerning the form of any register and the method of updating, and arranging for a physical check of assets against the asset register to be conducted once a year.

e. Prepare a detailed procedure for the disposal of assets.

18.2 Disposals and Condemnations

a. The Chief Finance Officer will prepare detailed procedures for the disposals of assets including condemnations and ensure that these are notified to managers.

b. When it is decided to dispose of a CCG asset, the Head of Department or authorised deputy will determine and advise the Chief Finance Officer of the estimated market value of the item, taking account of professional advice where appropriate.

c. All unserviceable articles shall be:- i. Condemned or otherwise disposed of by an employee authorised for that purpose by the Chief Finance Officer ii. Recorded by the Condemning Officer in a form approved by the Chief Finance Officer which will indicate whether the articles are to be converted, destroyed or otherwise disposed of. All entries shall be confirmed by the countersignature of a second employee authorised for the purpose by the Chief Finance Officer.

d. The Condemning Officer shall satisfy himself as to whether or not there is evidence of negligence in use and shall report any such evidence to the Chief Finance Officer who will take the appropriate action.

18.3 Losses and Special Payments

a. The Chief Finance Officer must prepare procedural instructions on the recording of and accounting for condemnations, losses and special payments.

b. Any employee or officer discovering or suspecting a loss of any kind must either immediately inform their Head of Department, who must immediately inform the Chief Officer and the Chief Finance Officer or inform an officer charged with responsibility for responding to concerns involving loss. The officer will then appropriately inform the Chief Finance Officer and or Chief Officer. Where a criminal offence is suspected the Chief Finance Officer must immediately inform the police if theft or arson is involved. In cases of fraud and corruption or if anomalies which may indicate fraud or corruption, the Chief Finance Officer must inform the relevant LCFS and NHS Counter Fraud Authority (NHS CFA) in accordance with service condition 24 of the NHS Standards Contract and NHS CFA's Standards for Commissioners..

18.4 Suspected Fraud

a. The Chief Finance Officer must notify the NHS CFA and the External Auditor of all frauds.

b. For losses apparently caused by theft, arson, neglect of duty or gross carelessness , except if trivial, the Chief Finance Officer must notify:- i. The clinical Commissioning Group ii. The External Auditor

c. Within limits delegated to it by the Department of Health, the CCG shall approve the writing off of losses.

d. The Chief Finance Officer shall be authorised to take any necessary steps to safeguard the CCG’s interests in bankruptcies and company liquidations.

e. For any loss, the Chief Finance Officer should consider whether any insurance claim can be made.

f. The Chief Finance Officer shall maintain a Losses and Special Payments Register in which write off action is recoded.

g. No special payments exceeding delegated limits shall be made without the prior approval of the Department of Health.

h. All losses and special payments must be reported to (Audit Committee at every meeting.

19. RETENTION OF RECORDS

POLICY – the group will put arrangements in place to retain all records in accordance with NHS Code of Practice Records Management 2006 and other relevant notified guidance

19.1 The Chief Officer shall:

a. Be responsible for maintaining all records required to be retained in accordance with NHS Code of Practice Records Management 2006 and other relevant notified guidance;

b. Ensure that arrangements are in place for effective responses to Freedom of Information requests;

c. Publish and maintain a Freedom of Information Publication Scheme.

19.2 The Chief Finance Officer will prepare detailed procedures for the disposals of assets.

Appendix H

Delegated Commissioning Model Terms of Reference East Lancashire CCG Primary Care Commissioning Committee

Introduction

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 East Lancashire CCG. The delegation is set out in Schedule 1.

2. The CCG has established the East Lancashire CCG Primary Care Commissioning Committee (“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.

Statutory Framework

3. 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 NHS Act.

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

5. 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:

a) Management of conflicts of interest (section 14O);

b) Duty to promote the NHS Constitution (section 14P);

c) Duty to exercise its functions effectively, efficiently and economically (section 14Q);

d) Duty as to improvement in quality of services (section 14R);

e) Duty in relation to quality of primary medical services (section 14S);

f) Duties as to reducing inequalities (section 14T);

g) Duty to promote the involvement of each patient (section 14U);

h) Duty as to patient choice (section 14V);

i) Duty as to promoting integration (section 14Z1);

j) Public involvement and consultation (section 14Z2).

6. The Committee is established as a sub-committee of the CCG’s Governing Body in accordance with Schedule 1A of the “NHS Act”.

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

Role of the Committee

8. 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 East Lancashire, under delegated authority from NHS England.

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

10. 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.

11. 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.

12. This includes the following:

 GMS, PMS and APMS contracts (including the design of PMS and APMS contracts, monitoring of contracts, taking contractual action such as issuing branch/remedial notices, and removing a contract);

 Newly designed enhanced services (“Local Enhanced Services” and “Directed Enhanced Services”);

 Design of local incentive schemes as an alternative to the Quality Outcomes Framework (QOF);

 Decision making on whether to establish new GP practices in an area;

 Approving practice mergers; and

 Making decisions on ‘discretionary’ payment (eg: returner/retainer schemes).

13. The CCG will also carry out the following activities:

a) To plan, including needs assessment, primary [medical] care services in East Lancashire;

b) To undertake reviews of primary [medical] care services in East Lancashire;

c) To co-ordinate a common approach to the commissioning of primary care services generally;

d) To manage the budget for commissioning of primary [medical] care services in East Lancashire.

Geographical Coverage

14. The Committee will comprise the East Lancashire CCG.

Membership

15. The Committee shall consist of: . Chair – Lay Member Quality & Patient Engagement . Lay Member - Equality & Inclusion/Deputy CCG Chair . Lay Member - Governance . Chief Finance Officer . Director of Commissioning . Director of Quality & Chief Nurse . Chief Officer . GP Locality Lead . EL GP Representative . EL Practice Manager Representative

16. In addition GP locality Chairs may be invited to discuss certain items but will have no voting rights and must not be involved in decision making. Meetings of the committee shall be managed in accordance with the Conflicts of Interest Policy.

17. The following will also be invited to attend in a non-voting capacity: . Local HealthWatch Representative . Local Health & Wellbeing Partnership Representative . Local Medical Committee . NHS England Representative . Head of Corporate Business . CCG Clinical Chair . Primary Care Development Manager . Head of Commissioning Integrated Care . Primary Care Clinical Lead

18. The Chair of the Committee shall be a Lay Member of the Governing Body.

19. The Vice Chair of the Committee shall be a Lay Member of the Governing Body and will be appointed by the other Primary Care Commissioning Committee members.

20. Should a member not be able to attend a meeting of the Committee, apologies in advance must be provided to the Secretary and the status of any formal acting up or deputising arrangements must be agreed by the Chair.

Meetings and Voting

21. The Committee will operate in accordance with the CCG’s Standing Orders. The Secretary to the Committee will be responsible for giving notice of meetings. This will be accompanied by an agenda and supporting papers and sent to each member representative no later than 5 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.

22. 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.

Quorum

23. A quorum shall consist of 6 members present, with a lay and executive majority of which at least two should be lay members.

Frequency of Meetings

24. The suggested frequency is monthly for the first year and then as agreed after that.

25. Meetings of the Committee shall:

a) be held in public, subject to the application of 24(b);

b) 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.

Examples of where it may be appropriate to exclude the public include:

 Information about individual patients or other individuals which includes sensitive personal data is to be discussed;

 Commercially confidential information is to be discussed, for example the detailed contents of a provider’s tender submission;

 Information in respect of which a claim to legal professional privilege could be maintained in legal proceedings is to be discussed;

 To allow the meeting to proceed without interruption and disruption.

26. 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.

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

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

29. Members of the Committee shall respect confidentiality requirements as set out in the CCG’s Constitution.

30. The CCG will also comply with any reporting requirements set out in its constitution. In addition, the Committee will present an executive summary report to the Governing Body and minutes to NHS England - Lancashire & Greater Manchester.

31. These Terms of Reference will be reviewed annually, reflecting experience of the Committee in fulfilling its functions. NHS England may also issue revised model terms of reference from time to time.

Decisions

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

33. The decisions of the Committee shall be within delegated limits.

Appendix I REMUNERATION AND TERMS OF SERVICE COMMITTEE TERMS OF REFERENCE

Membership

1. The Remuneration and Terms of Service Committee is a Sub-Committee of NHS East Lancashire Clinical Commissioning Group.

2. Membership of the Committee will consist of all Lay Members from the CCG Governing Body, as follows:

. Lay Member – Governance – Committee Chair . Lay Member - Quality & Patient Engagement . Secondary Care Consultant . Lay Member – Equality & Inclusion . CCG Chair

In Attendance . Head of Corporate Business . HR Representative

3. The CCG Chief Officer is not a member of the Remuneration and Terms of Service Committee but will be invited for discussions relating to Directors’ terms and conditions of service. The Chief Officer will not attend for discussions about his/her own remuneration and terms of service.

Attendance

4. Other persons relevant to the discussion may be invited to attend the meeting for the purpose of providing advice and/or clarification to the Committee.

Quorum

5. The meeting will be quorate if three of the Committee members are present.

6. Terms of Reference

The Remuneration and Terms of Service Committee’s primary aim is to make recommendations of the appropriate remuneration and terms of service for the Chief Officer, Directors and other Very Senior Managers, and in addition to review and make recommendations in relation to the sessional rate of pay to CCG clinical leads.

The responsibility for determining pay and allowances for lay members will sit with the CCG’s Governing Body.

No member of the Committee should be involved in deciding his or her own remuneration. The Committee will have delegated powers to act on behalf of the CCG within the approved Terms of Reference.

7 The Committee’s remit includes:

 All aspects of salary (including any performance-related elements, bonuses);

 Provisions for other benefits, including pensions and cars;  Arrangements for termination of employment and other contractual terms (decisions requiring dismissal shall be referred to the Governing Body);  Ensuring that officers are fairly rewarded for their individual contribution to the CCG – having proper regard to the CCG’s circumstances and performance and to the provisions of any national arrangements for such staff;  Proper calculation and scrutiny of termination payments taking account of such national guidance as is appropriate, advise on and oversee appropriate contractual arrangements for such staff;  Review of HR policies and procedures  Scrutinise systems for identifying and developing leadership and high potential

Relationship with and reporting to the Governing Body

8. The Committee will report in writing to the Governing Body following each of its meetings.

9. The actions taken will be recorded in the Governing Body’s minutes.

10. The Remuneration and Terms of Service Committee minutes will be copied to all members of the Committee.

Frequency of meeting

11. The Committee shall meet on a quarterly basis or as required, subject to agreement by the Chair of the Committee.

Meeting as Committees in Common

12. In recognition of East Lancashire and Blackburn with Darwen CCGs adopting a unified leadership team, the Remuneration and Terms of Service Committees will usually meet as “Committees in Common”. Arrangements for Charing each meeting in common will be at the Chairs’ discretion. Each committee retains responsibility for its own functions and remains accountable to its Governing Body.

Administrative support

13. The Head of Corporate Business will ensure the provision of secretarial support to the committee. The agenda for the meetings will be drawn up with the Chair of the Committee. The agenda and papers for meetings will be distributed five days in advance of the meeting.

The Secretary will monitor the compliance of the committee in terms of  Frequency of attendance by Members  Attendance records cross referred to quorum requirements  Reporting to the Governing Body.

Appendix J

EAST LANCASHIRE CLINICAL COMMISSIONING GROUP

AUDIT COMMITTEE Terms of Reference

1. Introduction

1.1 Codes of Conduct and Accountability require that NHS organisations establish an Audit Committee as a Sub-Committee of the Governing Body with clearly defined terms of reference, which will provide an independent and objective view relating to –

 the effective operation of the internal financial control matters, such as the safeguarding of assets,  the maintenance of proper accounting records  the reliability of financial information  the statement of internal control included in the annual report and accounts  independently monitoring, reviewing and reporting to the Governing Body on the processes of governance

2. Constitution

2.1 The Clinical Commissioning Group (CCG) Governing Body resolved to establish a Committee to be known as the Audit Committee and keep under review its terms of reference.  The Audit Committee is authorised by the Governing Body to investigate any activity within its terms of reference.  The Audit Committee Members shall be appointed from within the Governing Body.  The Governing Body shall appoint the Chair of the Audit Committee.  The Chair of the CCG shall not be a member of the Audit Committee.  The minutes of the Audit Committee meetings shall be presented in full without delay, to the Governing Body.  The Audit Committee will report to the Governing Body annually on its work.

3 Membership

3.1 Membership shall consist of not less than four members. The following will be Members of the Audit Committee: . Lay Member - Governance : Chair . Lay Member - Quality & Patient Engagement . Secondary Care Consultant . 1 GP Member of the Governing Body Members shall attend a minimum of 75% of meetings during the year.

In Attendance: . Chief Finance Officer . Head of Corporate Business

3.2 The Vice Chair is to be appointed by majority vote (with the Chair having the casting vote) at the inaugural Audit Committee meeting.

3.3 The Head of Corporate Business shall be in attendance at the invitation of the Chair. They shall also be responsible for drawing the Committee’s attention to best practice, national guidance and other relevant documents as appropriate.

3.4 Should a member not be able to attend a committee meeting, apologies in advance must be provided to the Secretary and the status of any formal acting up or deputising arrangements must be agreed by the Chair.

4. Quorum

4.1 A quorum shall be two members in attendance.

5. Attendees

5.1 The Chief Finance Officer will be invited to attend all meetings; Local Anti-Fraud Specialist, Internal and External Audit will be invited to attend meetings, but none will have voting rights.

5.2 In addition: . The Accountable Officer and other directors may be invited to attend, when the Audit Committee is discussing areas of risk or operation that are the responsibility of that Senior Officer.

. With the agreement of the Chair, other senior specialist managers may attend from time to time from inside and outside of the CCG to provide specialist advice and support, but will have no voting rights.

. At least once a year the Audit Committee will meet privately with the External and Internal Auditors.

. The Accountable Officer will be invited to attend on an annual basis to specifically discuss assurances regarding the annual governance statement.

6. Frequency

6.1 The Audit Committee will meet at least five times per annum in accordance with the Audit Committee Handbook.

6.2 The External Auditor or Head of Internal Audit may request a meeting if they consider that one is necessary.

7 Administration

7.1 The Committee shall be supported administratively by the Head of Corporate Business, whose duties in this respect will include –

. Agreement of agenda with Chair and collation of papers; . Arranging administration support for taking the minutes and keeping a record of matters arising and issues to be carried forward; 8. Authority

8.1 The Audit 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 employee and all employees are directed to co-operate with any request made by the Audit Committee.

8.2 The Audit Committee is authorised by the Governing Body to obtain outside legal or other independent professional advice and to secure the attendance of outsiders with relevant experience and expertise if it considers this necessary.

8.3 The Audit Committee may request and review reports and positive assurances from directors and managers on the overall arrangements for governance, risk management and internal control.

8.4 The Audit Committee may also request specific reports from individual functions within the organisation as may be appropriate to the overall arrangements.

9. Duties

The main duties of the Audit Committee encompass independent review, scrutiny and oversight of the following functions:  Financial reporting  Internal controls and risk management systems  Internal Audit  External Audit  Anti-Fraud Specialist  Board Assurance Framework  Whistle blowing, Quality and safeguarding  Emergency planning and resilience

9.1 Financial Reporting

9.1.1 The Audit Committee shall monitor the integrity of the financial statements of the CCG including the annual report, reviewing significant financial reporting issues and judgements which they contain, focussing specifically on major judgemental areas.

9.1.2 The Audit Committee shall review summary financial statements, significant financial returns to regulators and any financial information contained in other official documents, including the Annual Governance Statement; before they are issued, sent to regulators, or presented to the Governing Body

9.1.3 The Audit Committee will also ensure that the systems for financial reporting, including those of budgetary control, are subject to review as to completeness and accuracy of the information provided to the CCG’s governing body.

9.1.4 The Audit Committee shall review and challenge where necessary: a) The wording in the governance statement and other disclosures relevant to the terms of reference of the committee; b) The consistency of, and any changes to, accounting policies c) The methods used to account for significant or unusual transactions where different approaches are possible d) Unadjusted mis-statements in the financial statements e) Significant adjustments resulting from audit. f) The Letter of Representation

g) Whether the CCG has followed appropriate accounting standards and made appropriate estimates and judgements, taking into account the views of the external auditors h) The clarity of disclosure in the CCG’s financial reports and the context in which statements are made. i) All material information presented with the financial statements (insofar as it relates to audit and risk management).

9.2 Internal Controls and Risk Management Systems

9.2.1 The Audit Committee shall review the implementation and on-going quality of integrated governance, risk management and internal control, across the whole of the CCG’s activities (both clinical and non-clinical). In particular it shall:

a) Review the effectiveness of the CCG’s internal controls, board assurance framework, integrated governance and risk management systems including Quality, Innovation, Productivity and Prevention (QIPP). The Audit Committee shall review the CCG’s Corporate Risk Register twice yearly. b) Review the effectiveness of all risk and control related disclosure statements (in particular the annual governance statement), together with any accompanying head of internal audit opinion, external audit opinion or other appropriate independent assurances, prior to submission to the Governing Body. c) Review the statements to be included in the annual report concerning internal controls and risk management. d) Review the underlying assurance processes that indicate the degree of the achievement of corporate objectives, the effectiveness of the management of principal risks and the appropriateness of the above disclosure statements. e) Review the policies and procedures for all work related to fraud, bribery and corruption as set out within NHS Standard Contract Service Condition 24 and as required by NHS Counter Fraud Authority’s Standards for Commissioners f) Review the policies for ensuring compliance with relevant regulatory, legal and code of conduct requirements.

9.2.2 Review instances where the CCG’s Standing Orders and Prime Financial Policies are waived and investigate those issues that present a risk to the internal control functions of the CCG

9.2.3 Review at least annually the Governing Body’s Register of Gifts, Hospitality and Commercial Sponsorship and declaration of Governing Body Members’ interests.

9.3 Internal Audit

9.3.1 The Audit Committee will meet the Head of Internal Audit at least once a year, without management being present, to discuss their remit and any issues arising from the internal audits carried out. In addition, the head of internal audit shall be given the right of direct access to the Chairman of the CCG Governing Body and to the CCG Audit Committee members.

9.3.2 The Audit Committee shall ensure that there is an effective internal audit function that meets the Public Sector Internal Audit Standards, 2017 and provides appropriate independent assurance to the Audit Committee, Accountable Officer and Governing Body.

9.3.3 To provide appropriate independent assurance to the Governing Body the Audit Committee shall: a) Consider the provision of the internal audit service, the cost of the audit and any questions of resignation and dismissal.

b) Monitor and review the quality and effectiveness of CCG’s internal audit function in the context of the CCG’s overall risk management system as identified in the CCG Board assurance framework. c) Consider and approve the remit of the internal audit function and ensure it has adequate resources and appropriate access to information to enable it to perform its function effectively and in accordance with the relevant professional standards. The Audit Committee shall also ensure the function has adequate standing and is free from management or other restrictions. d) Review and assess the annual internal audit plans, ensuring these are consistent with the audit needs of the CCG as identified in the Assurance Framework. e) Evaluate promptly all reports giving limited or no assurance from the internal auditors. f) Assess and monitor management’s responsiveness to the findings and recommendations of the internal auditors.

9.4 External Audit

9.4.1 The Audit Committee shall review and monitor the external auditors’ independence and objectivity and the effectiveness of the audit process. In particular, the Committee will review the work and findings of the external auditors and consider the implications and management’s responses to their work.

9.4.2 This will be achieved by: a) Consideration of the appointment and performance of the external auditors and make recommendations to the governing body as far as the Audit Commissions rules permit. b) Discussion and agreement with the external auditor, before the audit commences, of the nature and scope of the audit as set out in the annual plan. c) Discussion with the external auditor of their local evaluation of audit risks and assessment of the CCG and associated impact on the audit fees. d) The Audit Committee shall meet the external auditor at least once a year, without management being present; to discuss their remit and any issues arising from the group’s audit. f) Ensure that there is in place a clear policy for the engagement of external auditors to supply non-audit services. 9.4.3 The Audit Committee will review all External Audit reports: including agreement of the annual audit letter, any work carried outside the annual audit plan; together with the appropriateness of management responses before submission to the Governing Body.

9.5 Anti-Fraud

9.5.1 The Audit Committee shall satisfy itself that the CCG has adequate arrangements in place for countering fraud. It shall also approve the counter fraud work programme.

9.5.2 The CCG Audit Committee shall ensure that there is effective review of the work of the Local Anti- Fraud Specialist as set out by the NHS Standard Contract Service Condition 24 and as required by NHS Counter Fraud Authority’s Standards for Commissioners, insofar as the areas delegated to CCGs are concerned. This will be achieved by:

a) Approval of the appointment of a Local Anti-Fraud Officer either directly or through the appointment of the internal audit services.

b) Review and approval of the CCG’s Anti-Fraud, Bribery and Corruption Policy, operational plans (including Annual Workplan and Annual Report) and detailed programme of work, through recurring progress reports, to ensure that the committee is satisfied with action taken throughout the year and that significant losses have been properly investigated and reported to the internal and external auditors and relevant external bodies including NHS Counter Fraud Authority.

c) Ensure that the Anti-Fraud functions are adequately resourced and have appropriate standing within the group.

9.6 Assurance

9.6.1 The Audit Committee shall review the findings of other significant assurance functions, both internal and external, and make recommendations to the governing body on matters affecting the governance of the CCG. These will include, but not be limited to, any reviews by Department of Health and Social Care arm’s length bodies or regulators/inspectors, or professional bodies with responsibility for the performance of staff or functions.

9.6.2 The Audit Committee will review the work of other committees of the governing body, whose work can provide relevant assurance to the CCG’s own scope of work.

9.6.3 The Audit Committee shall request and review reports and positive assurances from directors and managers on the overall arrangements for governance, risk management and internal control, and may request specific reports from individual functions within the group as they may be appropriate to the overall arrangements.

9.6.4 In reviewing the work of the Quality & Safety Committee and issues around clinical risk management, the Audit Committee will wish to satisfy themselves on the assurance that can be gained from the clinical audit function.

9.7 Whistle-blowing, Quality and Safeguarding

9.7.1 The Audit Committee shall review the CCG’s arrangements for their employees to raise concerns, in confidence, about possible wrongdoing in financial reporting, safety or other matters. The Audit Committee shall ensure that these arrangements allow proportionate and independent investigation of such matters and appropriate follow up action.

9.7.2 The Audit Committee’s work will dovetail with that of the Quality & Safety Committee which the clinical commissioning group has established to seek assurance that robust clinical quality is in place. The Audit Committee shall ensure that these arrangements allow proportionate and independent investigation of such matters and appropriate follow up action, referral and support is provided.

9.8 Emergency Planning and Resilience

9.8.1 The Audit Committee should seek assurance that the CCG is delivering against its category two responder status as defined under the Civil Contingencies Act 2004 and the Health and Social Care Act 2012. Specifically the Audit Committee should seek assurance that:

a) Contracts with provider organisations (including the Commissioning Support Unit) contain relevant emergency preparedness, resilience (including business continuity) and response elements. In addition ensuring the receipt of periodic assurance of delivering against their contractual obligations. b) In the event of a major incident, support is provided to NHS England in discharging its Emergency Planning Resilience and Response (EPRR) functions and duties locally.

c) The CCG is represented at the Local Health Resilience Partnership (LHRP) and escalates any failure of providers to maintain necessary EPRR capacity and capability. d) The CCG has up-to-date Business Continuity arrangements in place. 9.8.2 The Audit Committee should also seek assurance that the Emergency Planning and Resilience Policy, which includes a Major Incident and Business Continuity Plan, is reviewed and updated in a timely manner as detailed within the policies/plans.

9.8.3 The Audit Committee should also seek assurance that on-call arrangements for the CCG remain robust.

10. Accountability 10.1 In carrying out this work the Audit Committee will 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. 10.2 The Audit Committee will develop a work plan with specific objectives which will be reviewed regularly and formally on an annual basis. The Audit Committee will also review its performance against the ‘’effective committee’’ checklist on an annual basis. 10.3 The minutes of the Audit Committee meetings shall be formally recorded by the Head of Corporate Affairs and after approval will be submitted to the Governing Body. The Chair of the Audit Committee shall draw to the attention of the Governing Body any issues that require disclosure to the full Governing Body or require executive action. 10.4 The Audit Committee will report to the Governing Body annually on its work in support of the Annual Governance Statement, specifically commenting on the fitness for purpose of the Annual Governance Statement, the completeness and embeddedness of risk management in the organisation, the integration of governance arrangements and the appropriateness of the self- assessment against the Standards for Better Health. 10.5 The Audit Committee shall submit an annual report to the CCG Governing Body, incorporating progress, reporting arrangements, frequency of meetings and membership attendance.

11 Review

11.1 These Terms of Reference will be reviewed annually.