NHS NORTH STAFFORDSHIRE CLINICAL COMMISSIONING GROUP CONSTITUTION V1.21
Approved for adoption by North Staffordshire Clinical Commissioning Group Governing Body
VERSION CONTROL
Version Date Author/Comments/Amendments Circulated to Final 2012 1.2 01.11.13 Alex Palethorpe/refresh to reflect proposed M Warnes, Governing Body changes, Committee revisions and model Constitution 08.11.13 Proposed amendments to Constitution Hayley Gresswell, Area Team 12.12.13 Clinical Commissioning Group Task & Finish T&F Group Group reviewed draft members 1.3 15.12.13 Amendments following T&F Group review December 13 Sent to members for approval GP Practices 16 January 14 Confirmation received from NHS England regarding amendments 1.4 October 14 Strengthen constitution with regard to equality LMC, HealthWatch, perspective and to include paragraph re joint Clinical committees following LRO 1 October 2014 Commissioning Group, Locality leads,Patient Congress 1.5 December 14 Model wording issued by NHSE re joint working LMC supersedes the above and included in document. Also feedback received re engagement included 1.6 March 15 NHS England asked for para 26.11 to be Approved at public changed remove and/or and replace with ‘and’. Governing Body 04 remove ‘make a minimum of one written report’ March 2015 and replace with ‘make a quarterly written report’ 1.7 October 2015 Alex Palethorpe, Head of Governance to refresh Chair, Interim and reflect the proposed Governing Body Accountable structure changes, sub-committee revision’s Officer, Lay Member Governance, LMC 5x Locality Leads October 2015 Submission to NHSE for approval NHSE
December 15 NHSE approval received NHSE
6 January Governing Body formally adopted Governing Body 2016 (held in public) 1.8 October 2016 Alex Palethorpe, Head of Governance to refresh Governing Body and reflect the proposed Governing Body Members event structure changes, in respect of additional posts
1.9 December Alex Palethorpe, Head of Governance 16/January 17 amendments made following feedback from NHSE in respect of clarity on dual roles 1.10 January 17 Schedules updated 1.11 March 17 Review of constitution line with NHSE feedback 1.12 April 17 Further feedback received from NHSE and updated
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1.13 July 17 Further feedback from Chief Operating Officer to align Constitution with that of Stoke-on-Trent Clinical Commissioning Group 1.14 August 2017 Alan Howgate, re-format document to align close National standard template. Creation of separate standing orders and updated SoRD in line with model Constitution. 1.15 November Constitution updated following feedback from 2017 NHSE E.Polgar
1.16 February Schedules updated following feedback received 2018 from NHSE E Polgar December 17
1.17 February Amendments following appointment of Governing th 2018 Accountable Bodies 6 Officer for the Six Staffordshire Clinical March 2018 Commissioning Groups. Amendments include revisions to the Scheme of Reservation and Delegation and the Committee structure. 1.18 December Revised to reflect joint working arrangements NHS England with Clinical Commissioning Groups in 2018 Staffordshire & Stoke on Trent, Single Leadership Team and revised ToRs 1.19 May 2018 Revised Governance structure to show reporting NHS England arrangements for Divisional Committees & F& P 1.20 November Joint Strategic Commissioning Committee is NHS England 2019 replaced by Governing Body Roles & Responsibilities of GB – to include same details for joint appointments of all 6 CCGs Joint appointment sections aligned Remuneration Committee amended to Remuneration & Terms of Service Committee Appended most up to date ToR Added Scheme of Financial Delegation to Prime Financial Policies NHS protect replaced with NHS Counter Fraud Authority Added ToR for Finance & Performance Committee Moved Schedule 2 “Election Procedures” into Standing Orders. 1.21 December Amendments to ToR of Rem Comm, Finance & NHS England 2019 Performance &Divisional Committee Updated Joint appointment of Secondary Care Consultant
Governing body composition 6.8 7.8.1 joint appointments with other organisations
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CONTENTS BACKGROUND ...... 1 INTERPRETATION ...... 1 DEFINITIONS ...... 2 1. INTRODUCTION AND COMMENCEMENT ...... 6 1.1 Name ...... 6 1.3 Status of this Constitution ...... 6 1.4 Variation and amendment to the Constitution ...... 7 2. AREA COVERED ...... 7 3. MEMBERSHIP ...... 8 3.1 Membership of the Clinical Commissioning Group ...... 8 3.2 Eligibility ...... 8 3.3 Application for membership of the Clinical Commissioning Group ...... 9 3.4 Role of the Member Practices ...... 9 3.5 Termination of membership of the Clinical Commissioning Group ...... 10 4. MISSION VISION AND GOALS ...... 10 4.1 Mission ...... 10 4.2 Vision ...... 11 4.3 Our Goals ...... 11 4.4 Principles of good governance ...... 11 4.5 Accountability ...... 11 5. FUNCTIONS AND GENERAL DUTIES ...... 12 5.1 Functions ...... 12 5.2 General Duties ...... 14 5.4 Other Relevant Regulations, Directions and Documents ...... 17 6. DECISION MAKING: THE GOVERNING STRUCTURE ...... 18 Authority to act ...... 18 6.2 Scheme of Reservation and Delegation ...... 19 6.3 General ...... 19 6.4 Joint Appointments with other Organisations ...... 20 6.6 Joint Commissioning Arrangements with NHS England for the exercise of NHS England’s functions ...... 23 6.7 The Governing Body ...... 24
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6.8 Composition of the Governing Body ...... 27 6.9 Committees of the Governing Body ...... 28 6.10 Meeting in Common ...... 30 6.11 Elections to the Governing Body ...... 30 6.12 Disqualification of Members of the Governing Body ...... 31 7 ROLES AND RESPONSIBILITIES ...... 32 7.1 Practice Representatives ...... 32 7.2 All Members of the Clinical Commissioning Group’s Governing Body ...... 33 7.3 The Chair of the Governing Body ...... 33 7.4 The Deputy Chair of the Governing Body ...... 34 7.5. Role of the Accountable Officer (AO) ...... 34 7.6 Role of the Chief Finance Officer (CFO) / Director of Finance...... 35 7.8 Joint Appointments with other Organisations ...... 36 7.9 Secondary Care Specialist...... 37 7.10 The Lay Member with a lead role in overseeing key elements of governance ...... 37 7.11 The Lay Member with a lead role in championing patient and public involvement and Primary Care matters ...... 38 7.12 Lay Member with lead role for overseeing patient Quality & Safety ...... 39 7.13 Additional Executive posts ...... 39 8.0 STANDARDS OF BUSINESS CONDUCT AND MANAGING CONFLICTS OF INTEREST ...... 39 8.1 Standards of business conduct ...... 39 8.2 Conflict of Interest ...... 40 8.3 Declaring and Registering Interests ...... 41 8.4 Managing Conflicts of Interest: General ...... 41 8.5 Managing Conflicts of Interest: Contractors and people who provide services to the Clinical Commissioning Group ...... 44 8.6 Transparency in Procuring Services ...... 44 9 THE CLINICAL COMMISSIONING GROUP AS EMPLOYER ...... 44 10 Public Disclosure ...... 45 11 TRANSPARENCY, WAYS OF WORKING AND STANDING ORDERS ...... 46 11.1 General ...... 46 11.2 Standing Orders ...... 46 12 PROCESS FOR CONSIDERATION OF MEMBER GRIEVANCES ...... 46 Constitution Schedules ...... 48 LIST OF MEMBER PRACTICES ...... 49
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STANDING ORDERS ...... 55 SCHEME OF RESERVATION & DELEGATION ...... 70 Prime Financial Policies ...... 81 STANDARDS OF BUSINESS CONDUCT ...... 107 GOVERNANCE STRUCTURE DIAGRAM ...... 114 COMMITTEE TERMS OF REFERENCE ...... Error! Bookmark not defined. NHS North Staffordshire CCG Audit Committee ...... 115 NHS North Staffordshire CCG Remuneration & Terms of Service Committee ...... 120 SCHEDULE 11 - NHS North Staffordshire CCG Primary Care Commissioning Committee ...... 122 NHS North Staffordshire CCG Quality & Safety Committee ...... 134 NHS North Staffordshire CCG Finance & Performance Committee ...... 142 NHS North Staffordshire CCG Communication, Engagement, Equality & Employment Committee .. 146 NHS North Staffordshire CCG Divisional Committee ...... 152 THE SEVEN PRINCIPLES OF PUBLIC LIFE (“NOLAN” PRINCIPLES) ...... 157 Signatories to the constitution ...... 158
North Staffordshire Clinical Commissioning Group Constitution: Version 2.3 FINAL Feb-20
This Constitution is the Constitution of the NHS North Staffordshire Clinical Commissioning Group
BACKGROUND
This Constitution sets out the terms on which the Clinical Commissioning Group through its elected and/or appointed Governing Body (the Governing Body) shall implement all statutory obligations including but not limited to commissioning of secondary health care and other services in the Area. This Constitution shall also contain the main governance rules of the Clinical Commissioning Group and its Governing Body.
Each Member, by its signature to this Constitution, shall agree that it is a member of the Clinical Commissioning Group and will adhere to, and work in accordance with its terms.
The Constitution applies to all of the member practices, the Clinical Commissioning Group’s employees, individuals working on behalf of the Clinical Commissioning Group and to anyone who is a member of the Governing Body (including the Governing Body’s Audit and Remuneration and Terms of Service Committees) and any other committees established by the Group or its Governing Body. Every Member Practice, employee or other person (including agency, contractors and Commissioning Support Unit Staff) working on behalf of the Clinical Commissioning Group, or member of the Governing Body or any Committees is responsible for knowing, complying with and for upholding the arrangements for the governance and operation of the Group as described in this Constitution.
This Constitution, and the functions of the Clinical Commissioning Group, are subject to the Health and Social Care Act 2012.
INTERPRETATION
In this Constitution document:
words importing the singular include, where the context so admits, the plural and vice versa;
words importing the masculine include the feminine and the neuter;
references to any person shall include natural persons and partnerships, firms and other incorporated bodies and all other legal persons of whatever kind and however constituted and their successors, permitted assigns or transferees;
references to any statute, enactment, order, regulation or other similar instrument shall be construed as a reference to the statute, enactment, order, regulation or instrument as amended by any subsequent enactment, modification, order, regulation or instrument as subsequently amended or re-enacted;
headings are included in this document for ease of reference only and shall not affect the interpretation or construction of this document; and
reference to a Clause is a reference to the whole of that Clause unless stated otherwise and in the event and to the extent only of any conflict between the Clauses and the Schedules, the Clauses shall prevail over the Schedules.
DEFINITIONS
2006 Act National Health Service Act 2006
2012 Act Health and Social Care Act 2012 (this Act amends the 2006 Act)
Accountable means an individual who is appointed by the NHS England following a Officer process of recruitment and consultation with the Governing Body of the Clinical Commissioning Group and who may be a member or employee of the Clinical Commissioning Group and whose duties and responsibilities are set out in Clause 18 herein
Any Qualified means the Any Qualified Provider principle to be applied by the Provider (AQP) Governing Body when engaging in the commissioning of health care services.
Area means the geographical area that NHS North Staffordshire Clinical Commissioning Group has responsibility for, as defined in clause 2 of this Constitution
Assistant Clinical The Assistant Clinical Chair (hereafter referred to as the Medical Chair Director) is a voting member of the Governing Body. The Medical Director provides support to the Clinical Chair (the Clinical Commissioning Group’s most senior strategic clinical lead) and assists in respect to driving improvements in systems and clinical pathways to deliver improved outcomes for patients . This post is a shared post with Stoke-on-Trent Clinical Commissioning Group
Budget means the financial resources delegated to the Governing Body for the purposes of commissioning and all relevant and related services and functions including, but not limited to, the responsibilities as set out in Clause 5 herein and any relevant legislation
Cannock Chase means NHS Cannock Chase Clinical Commissioning Group CCG
Chair of the means the individual appointed by the Group to act as Chair of the Governing Body Governing Body
Chief Financial a senior individual who is responsible for providing financial advice to Officer the Clinical Commissioning Group and supervising financial control and accounting systems, who must have a recognised professional accounting qualification. This post is a shared post with Stoke-on- Trent Clinical Commissioning Group
Chief Operating Very Senior Manager who will support the Accountable Officer with the Officer full breadth of duties/functions/responsibilities as outlined in the Health and Social Care Act 2012.
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CCG means the NHS North Staffordshire Clinical Commissioning Group formed in accordance with and approved by the NHS England
Commencement means the date of commencement of this Constitution when NHS Date England established the Clinical Commissioning Group, being 1 April 2013. Subsequent alterations are reflected and controlled through version control
Committee means a Committee or Subcommittee created and appointed by: the membership of the Group a Committee / Subcommittee created by a Committee created / appointed by the membership of the Group a Committee / Subcommittee created / appointed by the Governing Body Conflict of Interest means any conflict of interest as set out in Clause 8.2
Constitution means this Constitution as amended from time to time in accordance with its terms.
East Staffordshire means NHS East Staffordshire Clinical Commissioning Group CCG
Executive Clinical a clinician who is a voting member of the Governing Body and is a Director leader for a programme of work within the Clinical Commissioning Group
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
Functions functions and general duties of the Clinical Commissioning Group as defined in the Health and Social Care Act 2012, and set out in Clause 5
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.
GP means fully qualified General Practitioners of Member Practices working within the Area.
Group means the North Staffordshire Clinical Commissioning Group
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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
Local Authority means the administrative offices that are officially responsible for all the public services and facilities within the Area
Local Medical means the North Staffordshire Local Medical Committee as recognised Committee by the NHS Act 1977 and currently recognised by the NHS Act 2006
Locality means any of the localities in the NHS North Staffordshire locality structure
Medical Director a voting member of the Governing Body. The Medical Director (also known as Assistant Clinical Chair) provides support to the Clinical Chair (the Clinical Commissioning Group’s most senior strategic clinical lead) and assists in respect to driving improvements in systems and clinical pathways to deliver improved outcomes for patients.
Member means the Members of the Clinical Commissioning Group (which may change from time to time); being a provider of primary medical services to a registered list of patients under a General Medical Services (GMS), Personal Medical Services (PMS) or Alternative Provider Medical Services (APMS) contract.
Members of the refers to executive and clinical members of the Governing Body who all Governing Body have equal rights, Observers are not members of the Governing Body
NHS England means the body corporate as identified in the Health and Social Care Act 2012 as the NHS Commissioning Board.
Observer means a regular observer invited to attend Governing Body or committee meetings.
Performers List means a medical Performers List prepared and published by NHS England. Prime Financial means the financial policies that the Clinical Commissioning Group will adhere to. Provider means any company, partnership, voluntary organisation, social enterprise, charity or organisation which may from time to time enter or seek to enter or have entered into arrangements to provide secondary medical services or social care services or any other goods and services by virtue of being commissioned by the Clinical Commissioning Group.
Refresh where the Constitution needs to vary. In line with Clause 1.4 taking into
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account any national or local guidance
a Group is required to maintain and make publicly available under Register of section 140 of the 2006 Act (as inserted by section 25 of the 2012 Act), Interests of the interests of: the members of the 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, or individuals working on behalf of the Clinical Commissioning Group (which includes Agency, Contractors and Commissioning Support Unit staff)
S. E. Staffordshire means NHS South East Staffordshire & Seisdon Peninsula Clinical & Seisdon Commissioning Consortium Peninsula CCG
Stafford & means NHS Stafford and Surrounds Clinical Commissioning Group Surrounds CCG
Stoke on Trent means NHS Stoke-on-Trent Clinical Commissioning Group CCG
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1. INTRODUCTION AND COMMENCEMENT
1.1 Name The name of this Clinical Commissioning Group is NHS North Staffordshire Clinical Commissioning Group (“the Clinical Commissioning Group”)
1.2 Statutory Framework 1.2.1 Clinical Commissioning Groups are established under the Health and Social Care Act 2012 (“the 2012 Act”). It is a statutory body which has the function of commissioning services for the purposes of the health service in England. It is an NHS body for the purposes of the National Health Service Act 2006 (“the 2006 Act”). The duties of Clinical Commissioning Groups to commission certain health services are set out in section 3 of the 2006 Act, as amended by section 13 of the 2012 Act, and the regulations made under that provision.
1.2.2 NHS England undertakes an annual assessment of the Group. It has powers to intervene in a Group that 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.
1.2.3 The Clinical Commissioning Group is a clinically led membership organisations made up of general practices. The Members of the Group are responsible for determining the governing arrangements for their organisation, which they are required to set out in a Constitution.
1.3 Status of this Constitution 1.3.1 This Constitution is made between the members of NHS North Staffordshire Clinical Commissioning Group and has effect from when the NHS Commissioning Board established the Group. This Constitution shall commence on the 1st day of April 2013 and shall continue in force unless otherwise terminated in accordance with the provisions of this Constitution
1.3.2 This Constitution shall be treated as binding between Members with effect from the date the final Member agrees to it.
1.3.3 The Constitution is published on the Group’s website at: www.northstaffsccg.nhs.uk/governance/constitution
This document is available upon request for inspection at the Group’s headquarters:-
NHS North Staffordshire Clinical Commissioning Group Clinical Commissioning Group Headquarters Staffordshire Place 2 Stafford ST16 2LP
Upon application by post (to the address above) or by e-mail- further details are available on the Group’s website.
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1.4 Variation and amendment to the Constitution This Constitution can only be varied in two circumstances
a) Where the Clinical Commissioning Group applies, after due internal process, to NHS England and that application is granted; or b) Where in the circumstances set out in legislation NHS England varies the Clinical Commissioning Group’s Constitution other than on application by the Group.
1.5 On 01 November 2017 the Accountable Officer was appointed as the Single Accountable Officer for the six Clinical Commissioning Groups in Staffordshire, these are; Cannock Chase Clinical Commissioning Group East Staffordshire Clinical Commissioning Group North Staffordshire Clinical Commissioning Group Stafford and Surrounds Clinical Commissioning Group South East Staffordshire and Seisdon Peninsula Clinical Commissioning Group Stoke-on-Trent Clinical Commissioning Group
1.6 The Clinical Commissioning Group along with the five other Clinical Commissioning Groups in Staffordshire faces considerable financial challenges and the Clinical Commissioning Groups working together in Staffordshire and Stoke on Trent seek to develop a single strategic commissioning arrangement.
Structure and purpose of this Constitution
1.7 This Constitution sets out the governance structure that is designed to meet the challenges it faces.
2. AREA COVERED
The geographical area of the Clinical Commissioning Group shall be the geographical areas of Staffordshire Moorlands and Newcastle under Lyme and is coterminous with the Newcastle Borough Council and the Staffordshire Moorlands District Council, and shall be made up of the Members as set out in Schedule 1 of this Constitution.
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The Clinical Commissioning Group area is shown in the map below.
2.1 Whilst recognising our responsibilities to our population within our geographical area we also acknowledge the decision reached by the Clinical Commissioning Group members in September 2015 to work collaboratively with neighbouring Clinical Commissioning Groups, in particular NHS Stoke-on-Trent Clinical Commissioning Group and in November 2017 with NHS Cannock Chase Clinical Commissioning Group, East Staffordshire Clinical Commissioning Group, NHS Stafford & Surrounds Clinical Commissioning Group and South East Staffordshire & Seisdon Peninsula Clinical Commissioning Group.
3. MEMBERSHIP
3.1 Membership of the Clinical Commissioning Group
Schedule 1 of this Constitution contains a list of the Members of the Clinical Commissioning Group. Signatures of the Member Representatives confirming their agreement to this Constitution are held by the Group under its constitutional governance arrangements at the Clinical Commissioning Group’s headquarters.
3.2 Eligibility Providers of primary medical services to a registered list of practices under a General Medical Services, Personal Medical Services or Alternative Provider Medical Services contract, will be eligible to apply for membership of the Clinical Commissioning Group.
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3.3 Application for membership of the Clinical Commissioning Group
3.3.1 A body which is a provider of primary care services (holding a General Medical Services, Personal Medical Services or Alternative Provider Medical Services Contract) in the Area shall apply to become a Member of the Clinical Commissioning Group under the following conditions: a) if the provider holds a contract for the provision of primary medical services;
b) it is a primary care services provider in the relevant Area;
c) it is willing to abide by this Constitution and the rules of the Clinical Commissioning Group; and
d) is not currently a Member of another Clinical Commissioning Group (except where notice has been served).
3.3.2 Any applications to become a Member or to cease being a Member of the Clinical Commissioning Group are required to be submitted by the Clinical Commissioning Group to NHSE by the 30th June, to have effect from the following 1 April.
3.4 Role of the Member Practices
3.4.1 There is the expectation that members will work collaboratively and actively engage in the commissioning work of the Clinical Commissioning Group, which is likely to encompass the following areas of input, these are representative rather than a complete list;
a) provide a named commissioning lead as a link for the practice;
b) maintain awareness of the Clinical Commissioning Group’s work through the discussion of commissioning at practice and patient Group meetings and dissemination of newsletters and updates among practice staff;
c) understand and adhere to commissioning decisions made by the Clinical Commissioning Group, particularly in relation to commissioned care pathways and service policy where appropriate (e.g. The Commissioning policy for Excluded and Restricted Procedures);
d) endeavour to make available clinical and other staff to lead or participate in commissioning project work;
e) keep up to date on commissioning and related issues through the normal professional publications, educational events and networks; and
f) involvement with the Primary Care agenda via the practice engagement scheme.
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3.4.2 Communication is not the sole responsibility of the Governing Body; it is key that all Members engage with the Governing Body and a two way communication approach is adopted.
3.5 Termination of membership of the Clinical Commissioning Group
3.5.1 A Member ceases to be a Member where that Member no longer satisfies the criteria of membership as set out in Clause 3.2 herein or is disqualified from membership subject to the conditions set out in Clause 6.12 herein.
3.5.2 The Member shall give written notice to NHS England and the Governing Body as soon as practicable in the event of any of the circumstances which may give rise to termination of membership, and no later than the 30th June in any given financial year, together with a formal request that his membership is terminated. This would be on the 31st March following the formal notification of leaving.
3.5.3 Members who notify that they wish to leave the Clinical Commissioning Group will be subject to all Clinical Commissioning Group arrangements including use of saving and shared risk until the end of the financial year following their notice to leave.
3.5.4 The Governing Body shall remove the Member from the Clinical Commissioning Group and list of Members at Schedule 1.
3.5.5 The Governing Body and/or NHSE shall be entitled to terminate a Member’s membership of the Clinical Commissioning Group, if either becomes aware of any of the circumstances as set out in this Clause 8 and as applicable to any current Member.
3.5.6 Any Member, if served with a notice of termination of membership shall have the right of appeal against that decision by application to NHS England.
3.5.7 The decision of NHS England in consultation with the Clinical Commissioning Group, Local Medical Committee and any other relevant party shall be final.
3.5.8 NHS England shall make a decision as to whether permission will be granted for the Member to be assigned to another Clinical Commissioning Group, or to remain within their existing Clinical Commissioning Group.
4. MISSION VISION AND GOALS
4.1 Mission North Staffordshire Clinical Commissioning Group’s mission along with Stoke-on- Trent Clinical Commissioning Group is to commission safe, accessible, high quality services to improve the health outcomes and meet the clinical needs of the people of Stoke-on-Trent and North Staffordshire.
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4.2 Vision The Clinical Commissioning Group will be more effective and innovative commissioners of better health outcomes by delivering the principle of ‘Home First’ through care at home and community based services. We will commission joined up care for our local population (from health service providers and the voluntary sector), in a way that helps them to feel empowered to care for themselves, prevent illness and remain independent for as long as possible.
4.3 Our Goals a) Commissioning Safe, Accessible, High Quality Health Outcomes b) Seamless Integration & Partnerships c) Empowering Our Staff d) Responsible Use of Resources
4.4 Principles of good governance In accordance with Section 14L (2)(B) of the 2006 Act, the Clinical Commissioning Group will at all times observe ‘such generally accepted principles of good governance as are relevant to it’ in the way it conducts its business. These include:
4.4.1 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;
The Good Governance Standard for Public Services;
4.4.2 The standards of behaviour published by the Committee on standards in public life (1995) known as the Nolan Principles’;
4.4.3 Standards for members of NHS Boards and Clinical Commissioning Group Governing Bodies in England as detailed within the Professional Standards Authority (November 2012)
4.4.4 The seven key principles of the NHS Constitution;
4.4.5 The Equality Act 2010.
4.5 Accountability 4.5.1 The Clinical Commissioning Group will demonstrate its accountability to its members, local people, and stakeholders and to NHS England in a number of ways, including by:
a) publishing its Constitution;
b) appointing Independent Lay Members and Non- Executive GP Clinicians to its Governing Body;
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c) holding meetings of its Governing Body in public (except where the Group considers that it would not be in the public interest in relation to all or part of a meeting);
d) publishing annually a Commissioning Plan;
e) complying with Local Authority Health Overview and Scrutiny requirements;
f) meeting annually in public to publish and present its Annual Report (which must be published);
g) producing annual accounts in respect of each financial year which must be externally audited;
h) having a published and clear complaints process;
i) complying with the Freedom of Information Act 2000;
j) providing information to NHS England as required;
k) publishing annually an Equality and Inclusion report
4.5.2 In addition to these statutory requirements the Clinical Commissioning Group will demonstrate its accountability by:
a) Holding engagement and involvement events for patients, the public and stakeholders in line with the Clinical Commissioning Group’s Communication and Engagement Strategy, details of events will be published and will be included on the Clinical Commissioning Group website: www.northstaffsccg.nhs.uk
b) Having a dedicated email address that allows questions and comments from patients and members of the public to be put to the Clinical Commissioning Group. Contact us by email [email protected]
4.6 The Governing Body will throughout each year have an on-going role in reviewing the Group’s governance arrangements to ensure that the Group continues to reflect the principles of good governance.
5. FUNCTIONS AND GENERAL DUTIES
5.1 Functions
The Clinical Commissioning Group is responsible and accountable for commissioning the majority of NHS services for the area, including elective hospital care, rehabilitation care, maternity services, urgent and emergency care, including
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out of hours (until such time as the responsibility is returned to GPs as providers), community service, mental health and learning disabilities for:
all people registered with Member GP Practices, and people who are usually resident within the area and are not registered with a member of any Clinical Commissioning Group; commissioning emergency care for anyone present in the Group’s area
5.1.1 In discharging its functions the Group will:
a) 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:
b) Delegating responsibility to the Governing Body and associated sub- committees (as per the Governance Structure Diagram below), in order to work with the Membership of the Clinical Commissioning Group in discharging Clinical Commissioning Group Functions, as outlined in Section 5.1.1 (a) to (l) inclusive, and to deliver the strategic priorities
GOVERNANCE STRUCTURE DIAGRAM
5.1.2 meet the Public Sector Equality Duty by having due regard to the need to:
a) Eliminate unlawful discrimination harassment and victimisation and other conduct prohibited by the Equality Act 2010; b) Advance equality of opportunities between people who share a protected characteristic and those who do not; and
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c) Foster good relations between people who share a protected characteristic and those who do not.
5.1.3 work in partnership with its local authority to develop joint strategic needs assessments and joint health and wellbeing strategies by:
a) Being an active member of the local Health and Wellbeing Board; and b) Promoting integration of health services with health-related and social care services.
5.1.4 The Clinical Commissioning Group shall meet the Public Sector Equality Duty by delegating responsibility to the Governing Body of NHS North Staffordshire Clinical Commissioning Group so that the Governing Body shall:-
a) adopt an equality and diversity strategy so that the Clinical Commissioning Group has due regard to the need to b) Eliminate unlawful discrimination harassment and victimisation and other conduct prohibited by the Equality Act 2010; c) Advance equality of opportunities between people who share a protected characteristic and those who do not; and d) Foster good relations between people who share a protected characteristic and those who do not. e) Adopt the NHS Equality Delivery System to demonstrate compliance with the Equality Act 2010. f) Publish at least annually, sufficient information to demonstrate compliance with this general duty across all the Group’s functions. g) Report to the membership at least annually on the delivery of the duty
5.2 General Duties
The Clinical Commissioning Group shall ensure that while discharging its general duties and functions it shall:
5.2.1. Make arrangements to secure public involvement in planning, development and consideration of proposals for changes and decisions affecting the operation of commissioning arrangements the decision making of the Clinical Commissioning Group through established mechanisms including and not limited to the Patient Congress and Clinical Commissioning Group membership;
5.2.2. Responsibility shall be delegated by the Clinical Commissioning Group to the Governing Body who shall ensure that the duties described in s.14z of the NHS act 2006 are met.
5.2.3 Description of arrangement - the arrangements will be set out in the Clinical Commissioning Group’s Communication and Engagement Strategy as adopted by the Governing Body from time to time. These include that individuals may: a) Get involved in our consultations;
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The Clinical Commissioning Group will advertise all consultation and engagement exercises on its website www.northstaffsccg.nhs.uk, via patient Groups and local publications. The Clinical Commissioning Group will ensure that the necessary information is provided to enable people to take an informed view on the proposals under consideration and to explain how to give us opinions.
b) Tell the Clinical Commissioning Group about views and experiences; The Clinical Commissioning Group will provide a ‘contact us’ facility on the Clinical Commissioning Group website, www.northstaffsccg.nhs.uk to enable individuals to tell the Clinical Commissioning Group about their experiences and views on the provision of local health services
c) Give their time; Individuals can join their GP’s Patient Participation Group or be part of the Patient Congress and work with the Clinical Commissioning Group in a number of areas, such as being part of a Focus Group or workshop or attend Governing Body meetings which are held in public. Details of these are available on the Clinical Commissioning Group website, www.northstaffsccg.nhs.uk
d) Tell Healthwatch Staffordshire about the experiences on the quality of local services;
e) Ask the Clinical Commissioning Group to visit their group;
f) We are keen to visit community groups to hear what their members think. We are particularly keen to hear from people who have, historically, not been engaged in local health services.
g) Use of Customer Insight;
h) Participate in consultation and engagement events organised in respect of major commissioning processes;
5.2.4 The Clinical Commissioning Group has a duty to ensure that patients and the public are involved in the development of proposals by the Clinical Commissioning Group for changes in commissioning arrangements that would impact on the manner in which services are delivered or the range of health services available. For major commissioning projects, we will prepare individual detailed action plans which explain how the public and patients can be put forward their views and be involved throughout these processes. The level of public involvement will vary dependant on the complexity of the changes proposed. These detailed action plans will be published on the website.
5.2.5 The Governing Body shall report at least annually on the delivery of these arrangements through its annual report.
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5.2.6 Promote awareness of and have regard to the NHS Constitution
5.2.7 Act effectively, efficiently and economically;
5.2.8 Act with a view to securing continuous improvement to the quality of services;
5.2.9 Assist and support the NHS England in relation to the Governing Body’s duty to improve the quality of primary medical services;
5.2.10 Have regard to the need to reduce health inequalities;
5.2.11 Promote the involvement of patients, their carers and representatives in decisions about their healthcare;
5.2.12 Act with a view to enabling patients to make choices;
5.2.13 Obtain appropriate advice from persons who together, have a broad range of professional expertise in healthcare public health;
5.2.14 Promote innovation by accelerating the adoption and diffusion of new best practice in the NHS.
5.2.15 Promote research and the use of research for effective commissioning.
5.2.16 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 involved 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 duty.
5.2.17 Act with a view to promoting integration of both health services with other health services and health service with health-related and social care services where the Group considers that this would improve the quality of services or reduce inequalities.
5.2.18 Commission services to promote and protect individual human rights, independence and wellbeing and secure assurance that the child or adult thought to be at risk stays safe. Also that they are effectively safeguarded against abuse, neglect, discrimination, embarrassment or poor treatment, and treated with dignity and respect and enjoy a high quality of life.
5.2.19 Assist and support NHS England in relation to the Governing Board’s duty to improve the quality of specialised services
5.3 General Financial Duties
5.3.1 The Clinical Commissioning Group shall ensure that while discharging its financial duties and functions the Group shall:
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5.3.2 Ensure that expenditure does not exceed the aggregate of its allocations for the financial year;
5.3.3 Ensure its use of resources (both capital resource and revenue resource use) does not exceed the amount specified by NHS England for the financial year.
5.3.4 Take into account any directives issued by the NHS England, in respect of specified types of resource in a financial year, to ensure the Group does not exceed an amount specified by the NHS England; and
5.3.5 Publish an explanation of how the Group spent any payment in respect of quality made to it by the NHS England.
5.3.6 The Clinical Commissioning Group shall discharge its general financial duties by:
Appointing an appropriately qualified Accountable Officer and Chief Finance Officer; Reserving certain matters to the Member Practices and delegating responsibility for other matters to the Governing Body, committees of the Clinical Commissioning Group and/or Governing Body, the Accountable Officer, the Chief Finance Officer, and individual employees / officers of the Clinical Commissioning Group (in accordance with the Scheme of Reservation and Delegation set out in Schedule 4); The Accountable Officer preparing the Clinical Commissioning Group’s operational Scheme of Delegation and the Governing Body considering and approving it; The Chief Finance Officer preparing the prime financial policies and the Governing Body considering and approving them; The Accountable Officer approving the operating structure and day-to-day operations for the Group, through which the Commissioning Plan will be delivered; Publishing an annual report which will include annual accounts and a remuneration report; Actively participate in internal and external audit.
5.4 Other Relevant Regulations, Directions and Documents
5.4.1 The Group will: a) comply with 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
5.4.2 The Group will develop and implement the necessary systems and processes to comply with these regulations and directions, documenting them as necessary in this
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Constitution, its schemes of Reservation and Delegation and other relevant Group policies and procedures.
5.4.3 Children and Families Act 2014 processes by which the NHS, local authorities and partners assess / support children and young people with Special Educational Needs and Disability (SEND). The Clinical Commissioning Group is committed to fulfilling and maintaining its statutory duty to co-operate with the local authority in the following statutory areas:
5.4.3.1 Leadership: to establish a Designated Medical Officer (DMO) / Designated Clinical Officer (DCO) function
5.4.3.2 Identification of Needs: to ensure that providers support the early identification of children & young people with special educational needs and disabilities
5.4.3.3 Local Offer: to contribute to the development of the local offer website and ensure that providers of children and adult health services actively engage with its development to include information about health care provision
5.4.3.4 Education Health Care (EHC) Assessment & Planning Process: to support the planning and review of processes for Education Health & Care (EHC) Plans ensuring that providers respond to requests for advice for an EHC plan within required timescales and that they contribute to regular reviews of children & young people with EHC plans
5.4.3.5 Education Health Care (EHC) Provision: to make available healthcare provision specified in the EHC plan as commissioners
5.4.3.6 Joint Commissioning Arrangements: the SEND Reforms requires Clinical Commissioning Groups to co-operate with local authorities in the development of joint commissioning arrangements to ensure that a range of provision in the local area is purchased to best meet need
5.4.3.7 Mediation and Disagreement Resolution: to establish mediation arrangements and disagreement resolution for Clinical Commissioning Groups and ensure that health providers participate in mediation when asked to do so
6. DECISION MAKING: THE GOVERNING STRUCTURE
Authority to act The Governing Body has the authority to delegate any of its functions to either a properly constituted committee or sub-committee, in so far as the creation of those committees comply with the arrangements as set out in this Constitution.
6.1 The Clinical Commissioning Group is accountable for exercising its statutory functions. It may grant authority to act on its behalf to:
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6.1.1 Any of its members 6.1.2 Its Governing Body 6.1.3 Employees 6.1.4 A committee or sub-committee of the Group (Committee or Subcommittee shall be made up of members, employees, members of the Governing Body or any other person approved by the Governing Body).
6.1.5 The extent of the authority to act of the bodies mentioned at 6.1.2 depends on the powers delegated to them by the Group as expressed through:
The Group’s scheme of Reservation and Delegation (Schedule 4) For committees, their terms of reference as agreed by the Governing Body (Schedules 8-14)
6.2 Scheme of Reservation and Delegation
The CGG’s Scheme of Reservation and Delegation sets out:
6.2.1 Those decisions that are reserved for the membership as a whole;
6.2.2 Those decisions that are the responsibilities of its Governing Body (and its committees), the Group’s committees and sub-committees, individual members and employees.
6.2.3 The Clinical Commissioning Group remains accountable for all of its functions including those that it has delegated.
6.3 General
6.3.1 In discharging the functions of the Group that have been delegated to its Governing Body sub-committees, joint committees and individuals must:
Comply with the Group’s Principles of Good Governance Operate in accordance with the Group’s Scheme of Reservation and Delegation Comply with the Group’s standing orders Comply with the Group’s arrangements for discharging its statutory duties 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:
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Identify the roles and responsibilities of those Clinical Commissioning Groups who are working together Identify any pooled budgets and how these will be managed and reported in annual accounts Specify under which Clinical Commissioning Group’s Scheme of Reservation and Delegation and supporting policies the collaborative working arrangements will operate Specify how the risks associated with the collaborative working arrangement will be managed between the respective parties Identify how disputes will be resolved and the steps required to terminate the working arrangements Specify how decisions are communicated to the collaborative partners
6.3.4 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 Joint Appointments with other Organisations
6.4.1 Integrated Commissioning Arrangements for the six Staffordshire & Stoke on Trent Clinical Commissioning Groups:
a) A Single Accountable Officer was appointed to lead the six Clinical Commissioning Groups in Staffordshire in November 2017
b) A Single Leadership Team was appointed in December 2017
c) A single staffing structure for the six Staffordshire Clinical Commissioning Groups
d) To support the single integrated commissioning structure, a set of sub- committees has been developed for the six Clinical Commissioning Groups and these are referenced throughout this document with the Terms of Reference located in the Schedules.
6.4.2 Joint Commissioning Arrangements with other Clinical Commissioning Groups North Staffordshire Clinical Commissioning Group may wish to work together with other Clinical Commissioning Groups in the exercise of its commissioning functions.
6.4.3 The Clinical Commissioning Group may make arrangements with one or more Clinical Commissioning Groups in respect of:
a) Delegating any of the Clinical Commissioning Group’s commissioning functions to another Clinical Commissioning Group b) Exercising any of the commissioning functions of another Clinical Commissioning Group; or c) Exercising jointly the commissioning functions of the Clinical Commissioning Group and another Clinical Commissioning Group
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6.4.4 For the purposes of the arrangements described at paragraph 6.4.3 the Clinical Commissioning Group may:
a) Make payments to another Clinical Commissioning Group; b) Receive payments from another Clinical Commissioning Group; c) Make the services of its employees or any other resources available to another Clinical Commissioning Group; or d) Receive the services of the employees or the resources available to another Clinical Commissioning Group.
6.4.5 Where the Clinical Commissioning Group makes arrangements which involve all the Clinical Commissioning Groups exercising any of their commissioning functions jointly, a joint committee may be established to exercise those functions.
6.4.6 For the purposes of the arrangements described at paragraph 6.4.3 above, the Clinical Commissioning Group may establish and maintain a pooled fund made up of contributions by any of the Clinical Commissioning Groups 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.
6.4.7 Where the Clinical Commissioning Group makes arrangements with another Clinical Commissioning Group as described at paragraph 6.4.3 above, the Clinical Commissioning Group shall develop and agree with that Clinical Commissioning Group an agreement setting out the arrangements for joint working, which may be in the form of a Memorandum of Understanding between all parties with agreed timescales for review, including details of:
a) How the parties will work together to carry out their commissioning functions b) The duties and responsibilities of the parties; c) How risk will be managed and apportioned between the parties; d) Financial arrangements, including if applicable, payments towards a pooled fund and management of that fund; e) Contributions from the parties, including details around assets, employees and equipment to be used under the joint working arrangements.
6.4.8 The liability of the Clinical Commissioning Group to carry out its functions will not be affected where the Clinical Commissioning Group enters into arrangements pursuant to paragraph 6.4.3 above.
6.4.9 The Clinical Commissioning Group will act in accordance with any further guidance issued by NHS England on co-commissioning.
6.4.10 Only arrangements that are safe and in the interests of patients registered with member practices will be approved by the Governing Body.
6.4.11 The Governing Body of the Clinical Commissioning Group shall require, in all joint commissioning arrangements, that the lead clinician and lead officer of the lead Clinical Commissioning Group make a quarterly written report to the governing body
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and hold at least annual engagement events to review aims, objectives, strategy and progress and publish an annual report on progress made against objectives.
6.4.12 Should a joint commissioning arrangement prove to be unsatisfactory the Governing Body of the Clinical Commissioning Group 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.
6.5 Joint Commissioning Arrangements with NHS England for the exercise of Clinical Commissioning Group functions
6.5.1 The Clinical Commissioning Group may wish to work together with NHS England in the exercise of its commissioning functions.
6.5.2 The Clinical Commissioning Group and NHS England may make arrangements to exercise any of the Clinical Commissioning Group’s commissioning functions jointly.
6.5.3 The arrangements referred to in paragraph 6.5.1 above may include other Clinical Commissioning Groups.
6.5.4 Where joint commissioning arrangements pursuant to 6.5.1 above are entered into, the parties may establish a joint committee to exercise the commissioning functions in question.
6.5.5 Arrangements made pursuant to 6.5.1 above may be on such terms and conditions (including terms as to payment) as may be agreed between NHS England and the Clinical Commissioning Group.
6.5.6 Where the Clinical Commissioning Group makes arrangements with NHS England (and another Clinical Commissioning Group if relevant) as described at paragraph 6.5.1 above, the Clinical Commissioning Group shall develop and agree with NHS England a framework setting out the arrangements for joint working, including details of:
a) How the parties will work together to carry out their commissioning functions; b) The duties and responsibilities of the parties; c) How risk will be managed and apportioned between the parties; d) Financial arrangements, including if applicable, payments towards a pooled fund and management of that fund; e) Contributions from the parties, including details around assets, employees and equipment to be used under the joint working arrangements.
6.5.7 The liability of the Clinical Commissioning Group to carry out its functions will not be affected where the Clinical Commissioning Group enters into arrangements pursuant to paragraph 6.5.1 above.
6.5.8 The Clinical Commissioning Group will act in accordance with any further guidance issues by NHS England on co-commissioning 6.5.9 Only arrangements that are safe and in the interests of patients registered with member practices will be approved by the Governing Body.
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6.5.10 The Governing Body of the Clinical Commissioning Group shall require, in all joint commissioning arrangements that the lead clinician and/or lead officer of the Clinical Commissioning Group 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 Joint Commissioning Arrangements with NHS England for the exercise of NHS England’s functions
6.6.1 The Clinical Commissioning Group may wish to work with NHS England and, where applicable, other Clinical Commissioning Groups, to exercise specified NHS England functions.
6.6.2 The Governing Body will consider the views of its membership prior to any functions being agreed.
6.6.3 The Clinical Commissioning Group may enter into arrangements with NHS England and, where applicable, other Clinical Commissioning Groups to:
a) Exercise such functions as specified by NHS England under delegated arrangements; b) Jointly exercise such functions as specified with NHS England.
6.6.4 Where arrangements are made for the Clinical Commissioning Group and, where applicable, other Clinical Commissioning Groups to exercise functions jointly with NHS England a joint committee may be established to exercise the functions in question.
6.6.5 Arrangements made between NHS England and the Clinical Commissioning Group may be on such terms and conditions (including terms as to payment) as may be agreed between the parties.
6.6.6 For the purposes of the arrangements described at paragraph 6.6.1 above, NHS England and the Clinical Commissioning Group 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.
6.6.7 Where the Clinical Commissioning Group enters into arrangements with NHS England as described at paragraph 6.6.1 above, the parties will develop and agree a framework setting out the arrangements for joint working, which may be in the form of a Memorandum of Understanding between all parties with agreed timescales for review including details of:
a) How the parties will work together to carry out their commissioning functions; b) The duties and responsibilities of the parties c) How risk will be managed and apportioned between the parties;
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d) Financial arrangements, including payments towards a pooled fund and management of that fund; e) Contributions from the parties, including details around assets, employees and equipment to be used under the joint working arrangements.
6.6.8 The liability of NHS England to carry out its functions will not be affected where it and the Clinical Commissioning Group enter into arrangements pursuant to paragraph 6.6.1 above.
6.6.9 The Clinical Commissioning Group will act in accordance with any further guidance issued by NHS England on co-commissioning.
6.6.10 Only arrangements that are safe and in the interests of patients registered with Member Practices will be approved by the Governing Body.
6.6.11 The Governing Body of the Clinical Commissioning Group shall require, in all joint commissioning arrangements that the lead clinician and / or lead officer of the Clinical Commissioning Group 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.
6.6.12 Should a joint commissioning arrangement prove to be unsatisfactory the Governing Body of the Clinical Commissioning Group 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
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 of 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’s function shall include:
6.7.1.1 Ensuring that the Clinical Commissioning Group has appropriate arrangements in place to exercise its functions effectively, efficiently and economically and in accordance with the Clinical Commissioning Group’s principle of good governance (its main function);
6.6.1.2 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;
6.7.1.3 Approving any functions of the Clinical Commissioning Group that are specified in regulations;
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6.7.1.4 All other functions of the Clinical Commissioning Group as set out at section 5 and in the Scheme of Reservation and Delegation.
6.7.2 The Governing Body shall:
6.7.2.1 Ensure that all providers of primary medical services in the area are Members of the Clinical Commissioning Group, and shall keep up to date registers of the same.
6.7.2.2 Recognise where a Member who is a provider of primary medical services is a party to more than one contract for primary medical services, then that Member is to be treated as a separate provider in respect of each contract.
6.7.2.3 Commit to the principles of devolved responsibility for commissioning decisions across the health community in the relevant Area including elective hospital care, rehabilitation care, maternity services, urgent and emergency care, including out of hours (until such time as the responsibility is returned to GPs as providers), community service, mental health and learning disabilities.
6.7.2.4 Support a variety of diverse approaches to commissioning, particularly for practices to work proactively to improve quality, efficiency and value.
6.7.2.5 Encourage innovation by enabling and supporting practices and clinicians in creating changes.
6.7.2.6 Engage in a collaborative approach with the local NHS in securing new services for patients fully responsive to local health needs and rapidly influencing and improving services by working with Providers and Members.
6.7.2.7 Ensure that there are robust plans and responsibilities assigned to manage staff engagement, external relationships and communications.
6.7.2.8 Facilitate the delivery of the required management cost savings whilst ensuring sustainable functions
6.7.2.9 Facilitate the delivery and implementation of any guidance or standards issued by any relevant regulatory body including but not limited to the Care Quality Commission (CQC) or any successor bodies or their authorised assignees which is relevant to the functions of the Clinical Commissioning Group as set out in Clause 5 above.
6.7.2.10 Apply the principles contained within the Five Year Forward View to the extent that it remains in force and relevant during the period of this Constitution
6.7.2.11 Commit to ensuring that patients, public and stakeholders are engaged, consulted and involved in the discussions leading up to decisions and to
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take into account those views in determining local health care provision and the allocation of finance resources.
6.7.2.12 Work with all local stakeholders to achieve delivery of the targets, policies and standards.
6.7.2.13 Ensure effective liaison with and reporting to Members of the Clinical Commissioning Group, and NHS England (as appropriate).
6.7.2.14 Develop and keep under review robust governance arrangements which shall be complied with by all Members within the Clinical Commissioning Group.
6.7.2.15 Comply with all relevant procurement law and policy and adhere to the obligations placed on the Governing Body and Clinical Commissioning Group with regard to all Providers applying the following principles of:
a) Transparency and openness
b) Support and assistance and training so as to permit compliance with the procurement law, competition law and any relevant policies
c) Application of guidance “Procurement, Patient Choice and Competition Regulations (Nov, 13) and The Public Contracts Regulations 2015”
d) Equality of treatment
e) Application of the principle of ‘Any Qualified Provider’
6.7.2.16 Ensure that all decisions made in relation to commissioning are fully recorded and auditable.
6.7.2.17 Be engaged in the day to day management and application of commissioning and related activity in the Area and shall operate in good faith using all due skill and diligence.
6.7.2.18 Provide full reports of all activity including financial activity at all meetings. The reports shall be available to all Members prior to the Governing Body’s meetings and form part of the main agenda.
6.7.2.19 Ensure that all the Clinical Commissioning Group’s policies and procedures with regard to the involvement and consultation of patients and other relevant bodies are fully complied with at all times.
6.7.2.20 Fairly and equitably advertise any specific salaried posts.
6.7.2.21 Ensure that members of the Governing Body are informed in writing or covering email 10 days before any meeting of the Governing Body. An update report will be compiled and will include reporting of performance, activities, actions, forward planning and risks prior to each meeting.
6.7.2.22 Ensure that the Governing Body is assured of the business planning cycle and prioritisation process for business cases, and that any business case is duly considered by the appropriate sub-committee for approval before
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implementation. Stakeholder Members who are also members of the Governing Body shall be identified and policies with regard to conflict or potential conflict shall be applied as set out in Clause 8.2 below.
6.7.2.23 Adhere to any other obligations as set out in statute, regulation and/or direction.
6.7.2.24 Implement all processes required to comply with any regulation, direction or internal governance where relevant.
6.7.2.25 Keep an up-to-date list of all committees, sub-committees and joint working arrangements.
6.7.2.26 Agree a set of prime financial policies to govern the way the Clinical Commissioning Group operates financially.
6.7.2.27 The Governing Body shall consult with the Local Medical Committee on any decisions that affect general practice.
6.8 Composition of the Governing Body
The Governing Body shall consist of a maximum of 15 members, of whom at least four (4) shall be non-clinical members to achieve the correct balance, representation and expertise. At all times the number of the members of the Governing Body shall be no fewer than eight (8).
6.8.1 Chair (voting)
6.8.2 Deputy Chair: to support conflicts of interest management, who shall be the person also fulfilling the role outlined in (6.8.4.ii) below (voting)
6.8.3 Two Executive Clinical Directors
6.8.4 Two Non-Executive GP Board Member
6.8.5 Three Lay Members, to further support conflicts of interest management (voting):
(i) one to lead on audit, remuneration and conflict of interest matters (deputy Chair of GB) (ii) one to lead on patient and public participation matters & primary care (iii) one to lead on quality matters
6.8.6 Chief Nurse &Director of Quality & Safety (voting)
6.8.7 Secondary Care Specialist Doctor (voting)
6.8.8 Accountable Officer (voting)
6.8.9 Director of Finance (voting)
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6.8.10 Director of Strategy, Planning & Performance (voting)
6.8.11 Director of Commissioning & Operations (voting)
6.8.12 Medical Director
6.8.13 Regular Attenders
i. Managing Director – North (non-voting) ii. Director of Primary Care & Medicines Optimisation (non-voting) iii. Director of Corporate Services, Governance & Communications (voting) iv. Other members may be invited as attendees or co-opted, but will not have voting rights
Note: An LMC Representative may also attend on a Regular Attender basis (non-voting ) *
6.9 Committees of the Governing Body
6.9.1 The Governing Body shall have the authority to delegate any of its activities to a Committee or sub-committee of the Governing Body. Such committee or sub- committee shall be made up of members, employees, members of the Governing Body or any other person approved by the Governing Body.
6.9.2 Any committee and/or sub-committee shall operate in accordance with formal terms of reference as agreed by the Governing Body. Such terms of reference, shall in particular:
6.9.2.1 Identify any budget allocated to that committee including any management of the same; 6.9.2.2 Set out how reports shall be submitted to the Governing Body including frequency of submission; 6.9.2.3 Have a robust procedure to manage and resolve disputes and any termination procedures with regard to the dissolution of the relevant committee; and 6.9.2.4 Expressly set out any authority to any committee in respect of the establishment of any sub committees. Any terms of reference in relation to any sub-committee shall be in the same or similar format as the terms of reference of the main committee. 6.9.2.5 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 Clinical Commissioning Group. All Committees and subsequent sub committees should operate under the Standing Orders as detailed in Schedule 3. In the event of any conflict between any set of Standing Orders and this Constitution, the terms of this Constitution shall prevail.
6.9.3 The Governing Body delegates authority to the Committees detailed below to investigate and make decisions pertaining to any activity within their Terms of
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Reference, Schedules 8-14. The Governing Body has appointed the following committees:
a) Audit Committee, a committee held in common with the Staffordshire & Stoke-on-Trent Clinical Commissioning Groups
b) Remuneration and Terms of Service Committee a committee held in common with the Staffordshire & Stoke-on-Trent Clinical Commissioning Groups
c) Primary Care Commissioning Committee (PCCC) – responsible to NHS England as established by the NHSE-Clinical Commissioning Group Delegation Agreement and held in common with the Stoke-on- Trent Clinical Commissioning Group
In addition to these, there are four non-statutory committees:
d) Finance & Performance Committee: a committee held in common with the Staffordshire & Stoke-on-Trent Clinical Commissioning Groups
e) North Divisional Board: a joint committee shared with Stoke-on-Trent Clinical Commissioning Group
f) Quality & Safety Committee: a committee held in common with the Staffordshire & Stoke-on-Trent Clinical Commissioning Groups
g) Communications, Engagement, Equality & Employment Committee: a committee held in common with the Staffordshire & Stoke-on-Trent Clinical Commissioning Groups
6.9.4 All of the Committees may establish their own subcommittees to assist them in the discharging of their responsibilities
6.9.5 The establishment of any other committees or sub-committees by the Governing Body shall be authorised and approved by the Governing Body and shall be reflected in separate standing orders or terms of reference which shall include (but not be limited to), the following:
6.9.5.1 A clear mandate, summarising the responsibilities of the committee; 6.9.5.2 Processes with regard to internal governance and decision making identifying individual roles and responsibilities of the committee or sub-committee; 6.9.5.3 Details of how the committee or sub-committee shall be held to account; 6.9.5.4 A summary of membership of the committee; and 6.9.5.5 Any termination provisions
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6.9.6 Identifying clearly in its terms of reference where meetings ‘in common’ take place with other organisations, or Clinical Commissioning Groups and clearly setting out how the governance and decision making for each organisation will be managed.
6.9.7 The terms of reference of these committees can be found at Schedules 8 to 14, via the following link
https://www.northstaffsccg.nhs.uk/governance/constitution
6.10 Meeting in Common
6.10.1 The Group may hold its Governing Body meetings as a ‘meeting in common’ with other organisations. In the main this would be with the five other Staffordshire & Stoke-on-Trent Clinical Commissioning Groups. In these instances the role of lead ‘Chair’ for the meeting will rotate between each Clinical Commissioning Group’s Clinical Chairs. At no time will a meeting take place if the respective chair or nominated deputy for each Clinical Commissioning Group is not in attendance. The holding of a ‘meeting in common’ will not affect the individual terms of the Clinical Commissioning Group’s Governing Bodies as set out in their Constitution and the decisions of the North Staffordshire Clinical Commissioning Group Governing Body will be made and recorded in line with the clauses above.
6.10.2 Where items are pertinent to all Clinical Commissioning Groups, items will be discussed and reflected in the minutes accordingly with decisions reached being recorded respectively for each Clinical Commissioning Group.
6.10.3 Where items are pertinent to one Clinical Commissioning Group only, the respective Clinical Commissioning Group’s Chair or deputy will take that item, lead the discussion and ensure that the decision making is reached and recorded by those Governing Body members associated to the Clinical Commissioning Group
6.10.4 The Staffordshire & Stoke on Clinical Commissioning Group have in place collaborative working arrangements and a Single Leadership team, and it is anticipated that ‘in common’ meeting arrangements will support further alignment between the six Clinical Commissioning Groups. However, each governing body will continue to be accountable for its own decisions and North Staffordshire Clinical Commissioning Group may hold individual Governing Body meetings as appropriate, e.g. to discuss business specific to the Clinical Commissioning Group.
6.11 Elections to the Governing Body
6.11.1 Each GP Member Practice as set out in Schedule 1, shall be eligible to one vote to elect the Chair of the Clinical Commissioning Group’s Governing Body. Elections shall be conducted by the Local Medical Committee in accordance with the procedures as set out in in the Standing Orders, which can be found at Schedule 3. Individuals elected, nominated or co-opted to the Governing Body shall be eligible in accordance with the following criteria:
They shall either be an active Partner, a salaried GP or locum, of the practice or primary care services provider.
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For a locum to be eligible they must work a minimum of two sessions per week and be able to demonstrate commitment to the area; this will be ascertained through the selection process.
An individual who has not been a practising GP within the last twelve months at the point the Clinical Commissioning Group vacancy is advertised may be considered.
6.11.2 An individual shall not be eligible if they are:
Suspended by either the General Medical Council or the NHS England or any other such successor body;
If they have not been a practising GP for a period greater than twelve months at the point the Clinical Commissioning Group vacancy is advertised.
If the individual is a salaried GP, he shall not be eligible in the event that he is suspended from his employment or subject to grievance or disciplinary proceedings; and
For those individuals (stated above) who are not party to direct contractual arrangements for the provision of primary medical services, they must be on the Performers List.
6.12 Disqualification of Members of the Governing Body
6.12.1 Members of the Governing Body shall vacate their office:
If a receiving order is made against them or they make any arrangement with their creditors.
If in the opinion of the Governing Body (having taken appropriate professional advice in cases where it is deemed necessary) they become or are deemed to have developed mental or physical illness which prohibits or inhibits their ability to undertake their role.
If they cease to be a provider of primary medical services, or engaged in or employed to deliver primary medical services (excluding, non-GP Board Members and lay members of the Governing Body who have been duly appointed by the Governing Body). This does not apply for those individuals appointed to the Governing Body who are non-practising GPs or subsequently cease practising from being a GP during their Governing Body appointment.
If they are suspended from providing primary medical services in which case the removal or suspension from the Governing Body shall be at the discretion of the Governing Body. The Governing Body shall take into account the circumstances of any individual before a decision is made.
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If they shall for a period of any 5 consecutive meetings of the Governing Body have been absent and shall at the discretion of the Governing Body be vacated from their office.
If they shall be convicted of a criminal offence: the Governing Body shall take into account the circumstances of the offence in relation to the individual before a decision is made.
If they shall have behaved in a manner or exhibited conduct which in the opinion of the Governing Body, has or is likely to be detrimental to the honour and interest of the Governing Body or the Clinical Commissioning Group and is likely to bring the Governing Body and/Clinical Commissioning Group into disrepute. This includes but is not limited to dishonesty, misrepresentation (either knowingly or fraudulently), defamation of any member of the Governing Body (being slander or libel), abuse of position, non-declaration of a known conflict of interest, seeking to lead or manipulate a decision of the Governing Body in a manner that would ultimately be in favour of that member whether financially or otherwise.
Where they have become ineligible to stand for a position as a result of the declaration of any Conflict of Interest under Clause 8.2.
7 ROLES AND RESPONSIBILITIES
7.1 Practice Representatives
Practice Representatives represent their Practice’s views and act on behalf of the Practice in matters relating to the Clinical Commissioning Group. The role of each Practice Representative is to:
a) Influence, determine and arrange provision of services whose commissioning has been delegated by the NHS England
b) Engage with local communities through Practice Participation Groups and other relevant partners, to identify required services for commissioning
c) Identify within their Practice and share with others best practice, quality / value outcomes by assessing clinical effectiveness, cost effectiveness and quality standards
a) Establish and support Remuneration and Terms of Service / Audit Committees, and any other statutory governance procedures, as per national guidance
b) Develop relationships with other Practices to maximise engagement with the Clinical Commissioning Group’s aims for the benefit of the population
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c) Undertake pathway and service redesign, working in partnership with the Business Support Unit and/or Commissioning Support Unit, and all stakeholders, to ensure new pathways reduce health inequalities and improve the health of the people of North Staffordshire
d) Take accountability for access, quality, safety and responsiveness
e) Monitoring delivery of the objectives within Clinical Commissioning Group- wide plans
f) Support the delivery of the objectives in the Primary Care Development Plan
7.2 All Members of the Clinical Commissioning Group’s Governing Body Guidance on the roles of members of the Clinical Commissioning Group’s Governing Body is set out in a separate document1. In summary, each member of the Governing Body should share responsibility as part of a team to ensure that the Clinical Commissioning 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.
7.3 The Chair of the Governing Body
The Chair of the Governing Body is responsible for:
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 Clinical Commissioning Group’s Governing Body and its individual members
c) Ensuring that the Clinical Commissioning 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 Accountable Officer in discharging the responsibilities of the Clinical Commissioning Group
f) Contributing to building a shared vision of the aims, values and culture of the Clinical Commissioning Group
1 Draft Clinical Commissioning Group Governing Body Members – Roles Attributes and Skills, NHS Commissioning Board Authority, March 2012
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g) Leading and influencing to achieve clinical and organisational change to enable the Clinical Commissioning Group to deliver its commissioning responsibilities
h) Overseeing governance and particularly ensuring that the Governing Body and the wider Clinical Commissioning Group behave 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
g) Ensuring that the Clinical Commissioning Group is able to account to its local patients, stakeholders and NHS England
h) Ensuring that the Clinical Commissioning Group builds and maintains effective relationships, particularly with Health & Well-Being Boards and Overview & Scrutiny Committees
i) Where the Chair of the Governing Body is also the senior clinical voice of the Clinical Commissioning Group they will take the lead in interactions with stakeholders, including NHS England.
7.4 The Deputy Chair of the Governing Body
The Deputy Chair of the Governing Body, who will be the Lay Member with expertise in financial matters and audit, deputises for the Chair of the Governing Body where he or she has a conflict of interest or is otherwise unable to act.
7.5. Role of the Accountable Officer (AO)
The Accountable Officer of the Group is a member of the Governing Body.
7.5.1 This role of AO has been summarised in a national document2 as:
a) Being responsible for ensuring that the Clinical Commissioning 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
2 See the latest version of the NHS Commissioning Board Authority’s Clinical Commissioning Group Governing Body members: Role outlines, attributes and skills
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c) Working closely with the Chair of the Governing Body, the AO 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 ongoing developments of its members and staff
7.5.2 In addition to the AO’s general duties, where the AO is also the senior clinical voice of the Group they will take the lead in interactions with stakeholders, including NHS England.
7.6 Role of the Chief Finance Officer (CFO) / Director of Finance
7.6.1 The CFO / Director of Finance is a member of the Governing Body and is responsible for providing financial advice to the Clinical Commissioning Group and for supervising financial control / accounting systems.
7.6.2 This role has been summarised in a national document3 as:
a) Being the Governing Body’s professional expert on finance and ensuring, through robust systems / processes, the regularity and propriety of expenditure is fully discharged
b) Making appropriate arrangements to support and monitor the Clinical Commissioning Group’s finances
c) Overseeing robust audit and governance arrangements leading to propriety in the use of the Clinical Commissioning Group’s resources
d) Being able to advise the Governing Body on the effective, efficient and economic use of the Clinical Commissioning 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
7.6.3 Contributing to the development of the Clinical Commissioning Group and ensure delivery of the strategic and operational business plans; and
3 See the latest version of the NHS Commissioning Board Authority’s Clinical Commissioning Group Governing Body members: Role outlines, attributes and skills
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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;
in addition to the general duties, the Chief Finance Officer has the duties set out in the scheme of Reservation and Delegation .
7.6.4 Ensuring best value is achieved from clinical support services by acting as an ‘intelligent client’ in shaping service requirements and securing effective delivery.
7.6.5 The Chief Finance Officer must be suitably qualified (with a recognised CCAB qualification) and an experienced individual.
7.6.6 The Chief Finance Officer shall report directly to the Accountable Officer of the Clinical Commissioning Group.
7.7 Registered Nurse (fulfilled by the Director of Nursing and Quality)
7.7.1 In addition to general responsibilities of all Governing Body members the registered nurse on the Governing Body is responsible for bringing a broader view as a Registered Nurse on health and social care issues to underpin the work of the Clinical Commissioning Group, especially the contribution of nursing knowledge for improvements in patient care.
7.7.2 The additional obligations and liabilities of the Registered Nurse (fulfilled by the Director of Quality & Safety) are set out below:
7.7.3 Organisational responsibility for safeguarding, continuous quality improvement and patient experience;
7.7.4 Setting and leading the direction for nursing and good patient care across all commissioned services and the guardianship of the patient care across all settings;
7.7.5 Responsible for all safeguarding issues across the Clinical Commissioning Group, including fulfilment of the statutory requirement to safeguard and promote the wellbeing of children and adults.
7.8 Joint Appointments with other Organisations
7.8.1 The Clinical Commissioning Group has the following joint appointments with other organisations:
a) The Accountable Officer shall work on behalf of the Staffordshire & Stoke-on- Trent Clinical Commissioning Groups
b) The CFO / Director of Finance shall work on behalf of the Staffordshire & Stoke- on-Trent Clinical Commissioning Groups
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c) The Chief Nurse (Director of Quality & Safety) shall work on behalf of the Staffordshire & Stoke-on-Trent Clinical Commissioning Groups
d) Secondary Care Consultants works on behalf Cannock Chase, North Staffordshire, South East Staffordshire & Seisdon Peninsula, Stafford & Surrounds, Stoke on Trent Clinical Commissioning Groups.
e) The Clinical Commissioning Group has a Single Leadership Team (SLT) that shall work on behalf of the Staffordshire & Stoke on Trent Clinical Commissioning Groups. The SLT also includes the following posts, which are non-voting members of the Governing Body:
Director of Strategy, Planning & Performance Director of Primary Care & Medicines Optimisation Director of Corporate Services, Governance & Communications Director of Commissioning & Operations Manging Director – North Division
f) The Executive Clinical Leads will be shared posts with Stoke on Trent CCG.
g) The Non-Executive GP Board Members will be shared with Stoke on Trent CCG.
7.9 Secondary Care Specialist
In addition to general responsibilities of all Governing Body members, the Secondary Care Consultant on the Governing Body is responsible for bringing a broader view of Secondary Care health and social care issues to underpin the work of the Clinical Commissioning Group, especially the contribution of secondary care knowledge for improvements in patient care.
7.10 The Lay Member with a lead role in overseeing key elements of governance
7.10.1 In addition to general responsibilities of all Governing Body members, the lay member of the Governing Body with the lead role for overseeing key elements of governance is responsible for:
Bringing specific expertise and experience to the work of the Governing Body as well as his/her knowledge as a member of the local community;
Providing strategic and impartial focus, so as to provide an external view of the work of the Clinical Commissioning Group that is removed from the day to day running of the Clinical Commissioning Group;
Overseeing key elements of governance including audit, remuneration and managing conflicts of interest;
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Chairing the Audit Committee; this Lay Member is precluded from being the Chair of the Governing Body, Remuneration & Terms of Service Committee and the Chair of the Primary Care Commissioning. This post will have a lead role in ensuring that the governing body and the wider Clinical Commissioning Group behaves with the utmost probity at all times
7.10.2 The Lay Member for Governance will have a specific role in ensuring that
Appropriate and effective whistleblowing and antifraud systems are in place.
Being the Conflicts of Interest Guardian.
7.11 The Lay Member with a lead role in championing patient and public involvement and Primary Care matters
7.11.1 In addition to the general responsibilities of all Governing Body members, the Lay Member of the Governing Body with the lead role in championing patient and public involvement and Primary Care matters is responsible for:
a) Deputising for the Chair of the Governing Body where he/she has a conflict of interest or is otherwise unable to act.
b) Bringing specific expertise and experience to the work of the Governing Body, as well as his/her knowledge as a member of the community;
c) Providing strategic and impartial focus, so as to provide an external view of the work of the Clinical Commissioning Group that is removed from the day to day running of the organisation;
d) Helping to ensure patient and public are involved and that the public voice of the local population is heard in all aspects of the Clinical Commissioning Group business and that opportunities are created and protected for patient and public empowerment in the work of the Clinical Commissioning Group;
e) Ensuring that patients and public views are heard and their expectations understood and met as appropriate;
- Chair Patient Congress Meetings and the Primary Care Commissioning Committee;
- Ensuring that the Clinical Commissioning Group builds and maintains an effective relationship with local Healthwatch and draws on existing patient and public engagement and involvement expertise;
- Ensuring that the Clinical Commissioning Group has appropriate arrangements in place to secure public and patient consultation and involvement in the services provided and on potential changes in its provision of services;
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- Championing the patient voice being heard and considered when the Clinical Commissioning Group is deciding what services to provide in their areas and who should provide it;
- Ensuring the Clinical Commissioning Group has due regard to the Public Sector Equality Duty (PSED) need to eliminate discrimination, advance equality of opportunity and foster good relations between different people when carrying out its activities.
7.12 Lay Member with lead role for overseeing patient Quality & Safety
7.12.1 In addition to the general responsibilities of all Governing Body members, the third Lay Member of the Governing Body is responsible for:
- Bringing specific expertise and experience to the work of the Governing Body, as well as his/her knowledge as a member of the community;
- Providing strategic and impartial focus, so as to provide an external view of the work of the Clinical Commissioning Group that is removed from the day to day running of the organisation.
- Chair the Quality & Safety Committee
7.13 Additional Executive posts
In addition, the Governing Body will be supported by the following executive management (voting) positions
Director of Commissioning & Operations Executive Clinical Directors Director of Strategy Planning & Performance Medical Director 8.0 STANDARDS OF BUSINESS CONDUCT AND MANAGING CONFLICTS OF INTEREST
(Section 8 to be read in conjunction with Clinical Commissioning Group’s Conflict of Interest policy)
8.1 Standards of business conduct
a) Employees, members, committee and sub-committee members of the Clinical Commissioning Group and members of the Governing Body (and is committees) will at all times comply with this Constitution and be aware of their responsibilities as outlined in it. They should act in good faith and in the interest of the Group and should follow the seven principles of public life, set out by the Committee on Standards in Public Life (the Nolan principles). The Nolan principles are incorporated into this Constitution at Schedule 15.
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They must comply with the Clinical Commissioning Group’s policies on business conduct, including the requirements set out in the Clinical Commissioning Group‘s policy for conflicts of interest. This will be available on the Clinical Commissioning Group’s website at
https://www.northstaffsccg.nhs.uk/governance/policies/human-resources- policies/2091-conflict-of-interest-policy/file
Individuals contracted to work on behalf of the Clinical Commissioning Group or otherwise providing services or facilities to the Clinical Commissioning Group will be made aware of their obligation with regard to declaring conflicts or potential conflicts of interest. This requirement will be written into contracts for services.
8.2 Conflict of Interest
8.2.1 As required by Section 140 of the 2006 Act, as1 inserted by Section 25 of the 2012 Act, the Clinical Commissioning Group will make arrangements to manage conflicts and potential conflicts of interests to ensure that decisions made by the Clinical Commissioning Group will be taken and seen to be taken without any possibility of the influence of external or private interest.
8.2.2 Where an individual, i.e. an employee, Member Practice, member of the Governing Body, or a member of a committee or a sub-committee has an interest, or becomes aware of an interest or within 28 days, which could lead to a conflict of interests in the event of the Clinical Commissioning Group 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.
8.2.3 A conflict of interests will include:
Financial interests: This is where individuals may directly benefit financially from the consequences of a commissioning decision e.g. being a partner in a practice that is commissioned to provide primary care services
Non-financial professional interests: This is where an individual may benefit professionally from the consequences of a commissioning decision e.g. having an unpaid advisory role in a provider organisation that has been commissioned to provide services by the Clinical Commissioning Group.
Non-financial personal interests: This is where an individual may benefit personally (but not professionally or financially) from a commissioning decision e.g. if they suffer from a particular condition that requires individually funded treatment.
Indirect interests: This is where there is a close association with an individual who has a financial interest, non-financial professional interest or a non-financial personal interest in a commissioning decision e.g. spouse, close relative (parent, grandparent, child etc) close friend or business partner.
8.2.4 If in doubt, the individual concerned should assume that a potential conflict of interest exists.
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8.3 Declaring and Registering Interests
8.3.1 The Clinical Commissioning Group will maintain one or more registers of the interests of: The Member Practices of the Clinical Commissioning Group, which includes all GP’s including partners and salaried GPs;
Any other practice employees involved in Clinical Commissioning Group commissioning work;
The members of its Governing Body;
Its employees.
8.3.2 The registers will be published on the Clinical Commissioning Group’s Website https://www.northstaffsccg.nhs.uk/governance/declaration-of-interests
8.3.3 Individuals will declare any interest that they have, in relation to a decision to be made in the exercise of the commissioning functions of the Clinical Commissioning Group, in writing to the Governance team; SASClinical Commissioning [email protected] as soon as they are aware of it and in any event no later than 28 days after becoming aware.
8.3.4 Where an individual is unable to provide a declaration in writing, for example, if a conflict becomes apparent in the course of a meeting, they will make an oral declaration before witnesses, and provide a written declaration as soon as possible. The declaration will be noted in the minutes of the meeting and transferred to the register thereafter
8.3.5 The Accountable Officer will ensure that the registers of interests are reviewed regularly, and updated as necessary.
8.4 Managing Conflicts of Interest: General
8.4.1 Individual members of the Clinical Commissioning Group, the Governing Body, committees or sub- committees, the committees or sub-committees of its Governing Body and employees will comply with the arrangements determined by the Clinical Commissioning Group for managing conflicts or potential conflicts of interest.
8.4.2 The Accountable Officer will ensure that for every interest declared, either in writing or by oral declaration, arrangements are in place to manage the conflict of interests or potential conflict of interests, to ensure the integrity of the Clinical Commissioning Group’s decision making processes.
8.4.3 Arrangements for the management of conflicts of interest are to be determined by the Accountable Officer and will include the requirement to put in writing to the relevant individual arrangements for managing the conflict of interests or potential conflicts of interests, within a week of declaration. The arrangements will confirm the following:
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When an individual should withdraw from a specified activity, on a temporary or permanent basis;
Monitoring of the specified activity undertaken by the individual, either by a line manager, colleague or other designated individual.
8.4.4 Where an interest has been declared, either in writing or by oral declaration, the declarer will ensure that before participating in any activity connected with the Clinical Commissioning Group’s exercise of its commissioning functions, they have received confirmation of the arrangements to manage the conflict of interest or potential conflict of interest from the Accountable Officer.
8.4.5 Where an individual member, employee or person providing services to the Clinical Commissioning Group is aware of an interest which: Has not been declared, either in the register or orally, they will declare this at the start of the meeting;
Has previously been declared, in relation to the scheduled or likely business of the meeting, the individual concerned will bring this to the attention of the chair of the meeting, together with details of arrangements which have been confirmed for the management of the conflict of interests or potential conflict of interests.
The chair of the meeting will then determine how this should be managed and inform the member of their decision. Where no arrangements have been confirmed, the chair of the meeting may require the individual to withdraw from the meeting or part of it. The individual will then comply with these arrangements, which must be recorded in the minutes of the meeting.
8.4.6 Where the chair of any meeting of the Clinical Commissioning Group, including committees, sub- committees, the Membership Board, or the Governing Body and the Governing Body’s committees and sub-committees, has a personal interest, previously declared or otherwise, in relation to the scheduled or likely business of the meeting, they must make a declaration and the deputy chair will act as chair for the relevant part of the meeting. Where arrangements have been confirmed for the management of the conflict of interests or potential conflicts of interests in relation to the chair, the meeting must ensure these are followed. Where no arrangements have been confirmed, the deputy chair may require the chair to withdraw from the meeting or part of it. Where there is no deputy chair, the members of the meeting will select one.
8.4.7 Any declarations of interests, and arrangements agreed in any meeting of the Clinical Commissioning Group, the Membership Board, committees or sub- committees, or the Governing Body, the Governing Body’s committees or sub- committees, will be recorded in the minutes, including how the matter was dealt with and transferred onto the register thereafter.
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8.4.8 Where more than 50% of the members of a meeting are required to withdraw from a meeting or part of it, owing to the arrangements agreed for the management of conflicts of interests or potential conflicts of interests, the chair (or deputy) will determine whether or not the discussion can proceed.
8.4.9 In making this decision the chair will consider whether the meeting is Group’s Standing Orders. Where the meeting is not quorate, owing to the absence of certain members, the discussion will be deferred until such time as a quorum can be convened. Where a quorum cannot be convened from the membership of the meeting, owing to the arrangements for managing conflicts of interest or potential conflicts of interests, the chair of the meeting shall consult with [Accountable Officer] on the action to be taken.
8.4.10 This may include: requiring another of the Clinical Commissioning Group’s committees or sub- committees, the Governing Body or the Governing Body’s committees or sub- committees (as appropriate) which can be quorate to progress the item of business, or if this is not possible,
inviting on a temporary basis one or more of the following to make up the quorum (where these are permitted members of the governing body or committee / sub-committee in question) so that the Clinical Commissioning Group can progress the item of business:
i) A member of the Clinical Commissioning Group who is an individual; ii) An individual appointed by a member to act on its behalf in the dealings between it and the Clinical Commissioning Group; iii) A member of a relevant Health and Wellbeing Board; iv) A member of a Governing Body of another Clinical Commissioning Group
These arrangements must be recorded in the minutes.
8.4.11 In any transaction undertaken in support of the Clinical Commissioning Group’s exercise of its commissioning functions (including conversations between two or more individuals, e-mails, correspondence and other communications), individuals must ensure, where they are aware of an interest, that they conform to the arrangements confirmed for the management of that interest. Where an individual has not had confirmation of arrangements for managing the interest, they must declare their interest at the earliest possible opportunity in the course of that transaction, and declare that interest as soon as possible thereafter. The individual must also inform either their line manager (in the case of employees), or the Accountable Officer of the transaction.
8.4.12 The Accountable Officer will take such steps as deemed appropriate, and request information deemed appropriate from individuals, to ensure that all conflicts of interest and potential conflicts of interest are declared
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8.5 Managing Conflicts of Interest: Contractors and people who provide services to the Clinical Commissioning Group
8.5.1 Anyone seeking information in relation to a procurement, or participating in a procurement, or otherwise engaging with the Clinical Commissioning Group in relation to the potential provision of services or facilities to the Group, will be required to make a declaration of any relevant conflict / potential conflict of interest and will be recorded on the procurement register.
8.5.2 Anyone contracted to provide services or facilities directly to the Clinical Commissioning Group will be subject to the same provisions of this Constitution in relation to managing conflicts of interests. This requirement will be set out in the contract for their services.
8.6 Transparency in Procuring Services
8.6.1 The Clinical Commissioning 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 Clinical Commissioning Group will procure services in a manner that is open, transparent, non-discriminatory and fair to all potential providers.
8.6.2 The Clinical Commissioning Group will publish a procurement strategy approved by its Governing Body which will ensure that: all relevant clinicians (not just Members Practices) and potential providers, together with local members of the public, are engaged in the decision- making processes used to procure services;
service redesign and procurement processes are conducted in an open, transparent, non-discriminatory and fair way.
8.6.3 Copies of this procurement strategy will be available on the Clinical Commissioning Group’s Website.
9 THE CLINICAL COMMISSIONING GROUP AS EMPLOYER
9.1 The Clinical Commissioning 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 Clinical Commissioning Group.
9.2 The Clinical Commissioning 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 Clinical Commissioning 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
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this Constitution, the commissioning strategy and the relevant internal management and control systems which relate to their field of work.
9.4 The Clinical Commissioning 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 Clinical Commissioning Group will also maintain and publish policies on all aspects of human resources management, including grievance and disciplinary matters.
9.5 The Clinical Commissioning 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 Clinical Commissioning Group will ensure that employees' behaviour reflects the values, aims and principles set out above.
9.7 The Clinical Commissioning Group will ensure that it complies with all aspects of employment law.
9.8 The Clinical Commissioning 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 Clinical Commissioning 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 this Code of Conduct, together with the other policies and procedures outlined in this chapter, will be available on the Clinical Commissioning Group’s website at www.northstaffsccg.nhs.uk
10 PUBLIC DISCLOSURE
10.1 Each Member Practice, member of the Governing Body, member of a committee of the Clinical Commissioning Group, officer and employee of the Clinical Commissioning Group is responsible to ensure that patient safety is paramount. if any such person has good reason to think that patient safety is or may be seriously compromised they must ensure that this is brought to the attention of a member of the Governing Body who will escalate the matter to the Chair and /or Accountable Officer who will fully investigate the matter and take appropriate action.
10.2 Anyone hesitating about reporting a concern for any reason, the following should be borne in mind:
Everyone has a duty to put patients’ interests first and act to protect them, which overrides personal and professional loyalties.
The law provides legal protection against victimisation or dismissal for individuals who reveal information to raise genuine concerns and expose malpractice in the workplace.
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You do not need to wait for proof - Individuals will be able to justify raising a concern if they do so honestly, on the basis of reasonable belief and through appropriate channels, even if the individual is mistaken.
10.3 If this matter is not resolved within a reasonable period the member should follow the GMC process and notify the Chair accordingly.
11 TRANSPARENCY, WAYS OF WORKING AND STANDING ORDERS
11.1 General
11.1.1 The Clinical Commissioning Group will publish annually an Operational plan and an annual report, presenting the Clinical Commissioning Group’s annual report to a public meeting.
11.1.2 Key communications issued by the Clinical Commissioning Group, including the notices of procurements, public consultations, Governing Body meeting dates, times, venues, and certain papers will be published on the Clinical Commissioning Group’s website.
11.1.3 The Clinical Commissioning Group may use other means of communication, including circulating information by post, or making information available in venues or services accessible to the public.
11.2 Standing Orders
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:
Standing Orders (Schedule 3) – which sets out the arrangements for meetings and the appointment processes to elect the Clinical Commissioning Group’s representatives and appoint to the Clinical Commissioning Group’s committees and the Governing Body;
Scheme of Reservation and Delegation (Schedule 4) – which sets out those decisions that are reserved for the Member Practices as a whole and those decisions that are the responsibilities of the Governing Body, the Governing Body’s committees and sub-committees, the Clinical Commissioning Group’s committees and sub-committees, individual members and employees;
Prime Financial Policies (Schedule 5) – which sets out the arrangements for managing the Clinical Commissioning Group’s financial affairs.
12 PROCESS FOR CONSIDERATION OF MEMBER GRIEVANCES
12.1 The Clinical Commissioning Group is a Members organisation so all Members recognise the importance of the Members being able to raise concerns about how the Clinical Commissioning Group, the Governing Body or any Committee of the Governing Body, or any other employee or representative of the Clinical Commissioning Group is discharging its duties and functions. The following
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processes are designed to encourage active involvement of all Members of the Clinical Commissioning Group, which the parties recognise will be critical to the success of the Group.
12.2 Members should initially raise any concerns about the matters set out in paragraph 12.1 above with the Chair or with any member of the Governing Body of the Clinical Commissioning Group.
12.3 Members may also raise any concerns covered by paragraph 12.1 with the elected members of the Clinical Commissioning Group Membership Board.
12.4 Any Member may make a formal request in writing, supported by reasonable details of the matter of concern, to the Chair of the Governing Body, copied to the Chief Accountable Officer for a matter to be reviewed by either the full Governing Body or one of the formal committees of the Governing Body. In addition the Chair of the Membership Board may also make a request for a matter referred to it by a Member to be formally reviewed by the Governing Body or if appropriate a committee of the Governing Body. Such a formally reported matter must be reviewed by the Governing Body (or the formal committee) at its next scheduled formal meeting and a response provided to the Member within 21 days of the date of the meeting. Where it is clear the review will take longer than 21 days the members will be notified accordingly.
12.5 In addition, if more than 75% of the Members request in writing that a matter of concern within the areas of concern covered by paragraph 12.1, then the Governing Body must review that matter at its next scheduled meeting and must report the outcome of that review to all Members within 14 days of the date of the meeting. Where it is clear the review will take longer than 14 days the members will be notified accordingly.
12.6 The Governing Body will only be relieved of a duty to report the outcome of any review under this Clause 12 if the circulation of the report would in the opinion of the Chair of the Governing Body, acting reasonably adversely affect the rights of an individual or organisation, or be in breach of any legal rights of an affected individual or organisation, and the matter would not otherwise come into the public domain otherwise than by an unlawful disclosure by the Member or by any other third party.
12.7 If a Member is not satisfied by the results of any review under this Clause 12 the Member may within 14 days of being informed of the decision of the review by the Governing Body request an independent investigation by a suitably qualified individual, and the Governing Body must request such an investigation if the request is made under Clause 12.5. The costs of any such investigation shall be met by the Clinical Commissioning Group, unless at least 75% of the Members direct otherwise.
12.8 In addition to the rights of Members to raise concerns under Clause 12 Members will also have the right to raise matters of concern with the Governing Body either to the Chair of the Governing Body.
12.9 The Clinical Commissioning Group will endeavour to ensure any matters of dispute will be resolved at a local level.
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North Staffordshire Clinical Commissioning Group
CONSTITUTION SCHEDULES
Schedule 1 List of Member Practices
Schedule 2 Declarations of interests
Schedule 3 Standing Orders
Schedule 4 Scheme of Reservation and Delegation
Schedule 5 Prime Financial Policies
Schedule 6 Standards of Business Conduct
Schedule 7 Governance Diagram
Schedule 8 Terms of reference – Audit Committees
Terms of reference – Remuneration and Terms of Schedule 9 Service Committee Terms of reference – Primary Care Commissioning Schedule 10 Committee Terms of reference – Finance & Performance Schedule 11 Committee
Schedule 12 Terms of reference – North Divisional Committee
Schedule 13 Terms of Reference Quality & Safety Committee
Terms of reference – Communication, Engagement, Schedule 14 Equality & Employment Committee
Schedule 15 Nolan principles
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Schedule 1
LIST OF MEMBER PRACTICES North Staffordshire Clinical Commissioning Group (as at January 2018)
Practice Practice Name Address Senior No Partner
M83005 Heathcote Street Surgery 2 Heathcote Street, Chesterton, Dr H Singh Newcastle-under-Lyme, ST5 7EB
M83007 The Village Surgery 49 High Street, Wolstanton, Newcastle- Dr S Manian under-Lyme, ST5 0ET
M83011 Werrington Village Surgery Ash Bank Road, Werrington, Stoke-on- Dr J Turnidge Trent, ST9 0JS
M83012 Leek Health Centre Fountain Street, Leek , ST13 6JB Dr S Robinson
M83015 Moss Lane Surgery Moss Lane, Madeley, CW3 9NQ Dr C Oleshko
M83017 Ashley Surgery School Lane, Ashley, Market Drayton, Dr J Shilvock TF9 4LF
M83023 Kidsgrove Medical Centre Kidsgrove Medical Centre, Mount Road, Dr C Kidsgrove, Stoke-on-Trent, ST7 4AY Harbidge
M83025 Miller Street Surgery Off King Street, Newcastle-under-Lyme, Dr J Ahmed ST5 1JD
M83034 Silverdale Village Surgery Vale Pleasant, Silverdale, Newcastle- Dr P Scott under-Lyme ST5 6PS
M83046 Biddulph Valley Biddulph Primary Care Centre, Wharf Dr P Road, Biddulph, Stoke-on-Trent, ST8 Lightfoot 6AG
M83054 Audley Health Centre Church Street, Audley, Stoke-on-Trent, Dr R Page ST7 8EW
M83056 Wolstanton Medical Centre Palmerston Street, Wolstanton, Dr M Shapley Newcastle-under-Lyme, ST5 8BN
M83067 Lyme Valley Medical Centre Lyme Valley Road, Newcastle-under- N/A Lyme, ST5 3TF NHSolutions
M83071 Park Medical Centre Ball Haye Road, Leek, ST13 6QR Dr S Somerville
M83079 Moorland Medical Centre Dyson House, Regent Street, Leek, Dr J Greig ST13 6LU
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Practice Practice Name Address Senior No Partner
M83084 Dr Robinson's & Partners Kidsgrove Medical Centre, Mount Road, Dr M Kidsgrove, Stoke-on-Trent, ST7 4AY Robinson
M83089 Biddulph Doctors Biddulph Primary Care Centre, Wharf Dr P Turner Road, Biddulph, Stoke-on-Trent, ST8 6AG
M83096 Tardis Surgery 5-9 Queen Street, Cheadle, Stoke-on- Dr K Upton Trent, ST10 1BH
M83103 Allen Street Allen Street, Cheadle, Stoke-on-Trent, Dr P Craven ST10 1HJ
M83108 Well Street Surgery Well Street, Cheadle, Stoke-on-Trent, Dr D Yates ST10 1EY
M83121 Tean Surgery Old Road, Tean, Stoke-on-Trent, ST10 Dr V Tiguti 4EG
M83122 Waterhouses Surgery Waterfall Lane, Waterhouses, Stoke-on- Dr U Tiguti Trent, ST10 3HY
M83140 Higherland Surgery 3 Orme Road, Poolfields, Newcastle- Dr A Alvarez under-Lyme, ST5 2UE
M83141 Kingsbridge Medical Kingsbridge House, Kingsbridge Avenue, Dr W Cooper Practice Clayton, Newcastle-under-Lyme, ST5 3HP
M83640 Alton Hurstons Lane, Alton, ST10 4AP Dr M Brown
M83670 Keele University Practice University of Keele, Keele, ST5 5BG Dr E O'Byrne
M83691 Betley Surgery Main Road, Betley, Wrinehill, Crewe, Dr N Patel CW3 9BL
M83697 Milehouse Medical Practice Milehouse Primary Care Centre, Millrise Dr L Hussain Village, Lymebrook Way, Milehouse, Newcastle-under-Lyme, ST5 9GA
M83701 Talke Clinic High Street, Talke Pits, Stoke-on-Trent, Dr P Unyolo ST7 1QQ
M83723 Loomer Road Surgery Loomer Road, Chesterton, Newcastle- Dr J Aw under-Lyme, ST5 7JS
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SCHEDULE 2
DECLARATIONS OF INTEREST for Clinical Commissioning Group members and employees
Name:
Position within, or relationship with, the Clinical Commissioning Group (or NHS England in the event of joint committees):
Detail of interests held (complete all that are applicable):
Type of Description of Interest (including for Date interest Actions to be Interest* indirect Interests, details of the relates taken to relationship with the person who has the mitigate risk *See interest) From & To reverse (to be agreed of form with line for manager or a details senior CCG manager)
The information submitted will be held by the Clinical Commissioning Group for personnel or other reasons specified on this form and to comply with the organisation’s policies. This information may be held in both manual and electronic form in accordance with the Data Protection Act 1998. Information may be disclosed to third parties in accordance with the Freedom of Information Act 2000 and published in registers that the Clinical Commissioning Group holds.
I confirm that the information provided above is complete and correct. I acknowledge that any changes in these declarations must be notified to the Clinical Commissioning Group as soon as practicable and no later than 28 days after the interest arises. I am aware that if I do not make full, accurate and timely declarations then civil, criminal, or internal disciplinary action may result. North Staffordshire Clinical Commissioning Group Constitution: Version 2.3 FINAL Feb-20 Page 51 of 164
I do / do not [delete as applicable] give my consent for this information to be published on registers that the Clinical Commissioning Group holds. If consent is NOT given please give reasons:
Signed: Date:
Signed: Position: Date:
(Line Manager or Senior Clinical Commissioning Group Manager)
Please return to Head of Governance or Quality and Governance Manager
Types of interest
Type of Description Interest
Financial This is where an individual may get direct financial benefits from the consequences of a commissioning decision. This could, for example, include Interests being:
A director, including a non-executive director, or senior employee in a private company or public limited company or other organisation which is doing, or which is likely, or possibly seeking to do, business with health or social care organisations;
A shareholder (or similar owner interests), a partner or owner of a private or not-for-profit company, business, partnership or consultancy which is doing, or which is likely, or possibly seeking to do, business with health or social care organisations.
A management consultant for a provider;
In secondary employment (see paragraph 56 to 57);
In receipt of secondary income from a provider;
In receipt of a grant from a provider;
In receipt of any payments (for example honoraria, one off payments, day allowances or travel or subsistence) from a provider
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Type of Description Interest
In receipt of research funding, including grants that may be received by the individual or any organisation in which they have an interest or role; and
Having a pension that is funded by a provider (where the value of this might be affected by the success or failure of the provider).
Non- This is where an individual may obtain a non-financial professional benefit from the consequences of a commissioning decision, such as increasing their Financial professional reputation or status or promoting their professional career. This Profession may, for example, include situations where the individual is:
Interests An advocate for a particular Group of patients;
A GP with special interests e.g., in dermatology, acupuncture etc.
A member of a particular specialist professional body (although routine GP membership of the RCGP, BMA or a medical defence organisation would not usually by itself amount to an interest which needed to be declared);
An advisor for Care Quality Commission (CQC) or National Institute for Health and Care Excellence (NICE);
A medical researcher.
Non- This is where an individual may benefit personally in ways which are not
Financial directly linked to their professional career and do not give rise to a direct
Personal financial benefit. This could include, for example, where the individual is:
Interests A voluntary sector champion for a provider;
A volunteer for a provider;
A member of a voluntary sector board or has any other position of
authority in or connection with a voluntary sector organisation;
Suffering from a particular condition requiring individually funded
treatment;
A member of a lobby or pressure Groups with an interest in health.
Indirect This is where an individual has a close association with an individual who has a
Interests financial interest, a non-financial professional interest or a non-financial
personal interest in a commissioning decision (as those categories are
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Type of Description Interest
described above). For example, this should include:
Spouse / partner;
Close relative e.g., parent, grandparent, child, grandchild or sibling;
Close friend;
Business partner.
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Schedule 3
STANDING ORDERS
1. STATUTORY FRAMEWORK AND STATUS
1.1 Introduction
1.1.1 These Standing Orders have been drawn up to regulate the proceedings of the Clinical Commissioning Group so that it 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 Clinical Commissioning Group is established.
1.1.2 The Standing Orders, together with the Clinical Commissioning Group’s Scheme of Reservation and Delegation and its Prime Financial Policies, provide a procedural framework within which the Clinical Commissioning Group discharges its business. They set out:
a) The arrangements for conducting the business of the Clinical Commissioning Group; b) The appointment of Practice Representatives; c) The appointment of the GP Leaders; d) The procedure to be followed at meetings of the Clinical Commissioning Group, the Membership Board, the Governing Body and any committees or sub- committees of the Clinical Commissioning Group or the Governing Body; e) The process to delegate powers, f) 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 appropriate of any relevant guidance.
1.1.3 The Standing Orders, Scheme of Reservation and Delegation and Prime Financial Policies have effect as if incorporated into the Clinical Commissioning Group’s Constitution. Members, employees, members of the Membership Board, members of the Governing Body, members of the Governing Body’s committees and sub- committees, members of the Clinical Commissioning Group’s committees and sub- committees and persons working on behalf of the Clinical Commissioning 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
1.2.1 The 2006 Act (as amended by the 2012 Act) provides the Clinical Commissioning Group with powers to delegate the Clinical Commissioning Group’s functions and those of the Governing Body to certain bodies (such as committees) and certain persons. The Clinical Commissioning Group has decided that certain decisions may only be exercised by the Clinical Commissioning Group in formal session. These decisions and also those delegated are contained in the Clinical Commissioning Group’s Scheme of Reservation and Delegation (see Schedule 6 to the Constitution).
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1.3 THE CLINICAL COMMISSIONING GROUP: COMPOSITION OF MEMBERSHIP, KEY ROLES AND APPOINTMENT PROCESS
1.3.1 Composition of Membership
1.3.2 Section 3 of the Constitution and Schedule 1 provide details of the Membership of the Group.
1.3.3 Section 6.6 of the Constitution provides details of the governing structure used in the Group’s decision making processes, whilst section 7 of the Constitution outlines the statutory positions of the Governing Body, their roles and responsibilities.
1.4 Key Roles
1.4.1 Clause 7 of the Clinical Commissioning 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.
1.5 The Chair
1.5.1 The Chair shall be a selected and elected position. In order to maintain fairness and equality during the electoral process if more than one candidate, the election shall be conducted by the Local Medical Committee. The Group shall announce 3 months before the Governing Body elections the position available to be filled and shall thereafter be open to receive nominations from appropriate candidates.
1.5.2 The Governing Body shall conduct an election for the position set out in clause 2.3.1, every 4 years in accordance with the principles as set out in Election Procedure at the end of this document.
1.5.3 Any individual wishing to stand for election to the Governing Body, in respect of the position of Clinical Chair as set out in Clause 2.3.1 above, shall do so in accordance with the criteria as detailed below.
a) Nominations - the Group shall announce 3 months before the Governing Body elections the position available to be filled and shall thereafter be open to receive nominations from appropriate candidates.
b) Eligibility – any eligible GP can put themselves forward for election preferably a local resident within the area and will be a GP within a Member Practice of the Clinical Commissioning Group. The Chair must be able to demonstrate that they meet the requirements as defined by NHS England (Clinical Commissioning Group governing body members: Role outlines, attributes and skills)
c) Appointment Process – advertised within Stoke-on-Trent and selection by approved panel;
d) Term of Office – four years from appointment
e) Eligibility for Reappointment – as per a) above, but not allowed to serve more than two terms of office in same role
f) Grounds for Removal from Office – no longer being a member of the Governing Body or failure to perform to the required standard
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g) Notice Period – six months to be served in writing to the Accountable Officer
1.6 The Deputy Chair of the Governing Body
1.6.1 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. Where the Chair is a health professional, then the deputy chair’s position is to be held by a Lay Member.
1.6.2 The Lay Member with a lead role in championing patient and public involvement shall be the deputy chair unless he or she has a potential conflict of interest or is otherwise unable to act. If such a case arises the third lay member (not the Lay member for Governance) will act as deputy chair.
1.6.3 Lay Member appointment
The Lay Members are subject to the following:
a) Nominations – persons who meet the requirements of and are not disqualified by regulations, will be invited to apply for these positions
b) Eligibility - further qualification criteria for each of the positions will be clearly set out and only applicants who meet those criteria will be considered, subject to sections 6.12, 7.10.1 & 7.11 of the Constitution and schedule 4 and 5 of the NHS (Clinical Commissioning Group) Regulations 2012
c) Appointment Process - eligible applicants will be shortlisted and selected by interview using further criteria designed to identify the candidates best suited to each position
d) Terms of Office - will be for a maximum of four years from appointment
e) Eligibility for Reappointment - no individual will serve more than two terms of office
f) Grounds for Removal from Office - no longer being eligible as defined at b) above, failure to perform to the required standard or any proven misconduct that would in the case of an employee of the Group result in their dismissal
g) Notice Period - three months to be served in writing to the chair
1.7 Non-Executive GP Body Members
a) Nominations - the Group shall announce 3 months before the Governing Body elections the position available to be filled and shall thereafter be open to receive nominations from appropriate candidates. Confirmation of support will be required from the practice confirming they are happy to release the applicant from practice to deliver the role. This is not applicable to single handed or retired GPs.
b) Eligibility – any eligible GP can put themselves forward for election preferably a local resident within the area and will be a GP within a Member Practice of the Clinical Commissioning Group. The qualifying criteria for the position will be clearly set out and only applicants who meet those criteria and are not disqualified by regulations (schedule 5 of the NHS (Clinical Commissioning Group) Regulations 2012) will be considered subject to section 6.10 of the Constitution
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c) Appointment Process - Advertised and selection;
d) Term of Office will be a maximum four years from appointment
e) Eligibility for Reappointment - as per a) above, but not allowed to serve more than two terms of office in same role
f) Grounds for Removal from Office – no longer being a member of the governing body or failure to perform to the required standard
g) Notice period – three months to be served in writing to the Chair
1.8 Accountable Officer
The Accountable Officer, see section 7.5 of the Constitution, is subject to the following:
a) Membership of the Governing Body will rest with the individual appointed as the Group’s Chief Officer and applications will be sought by advertising that position;
b) Eligibility - The qualifying criteria for the position will be clearly set out and only applicants who meet those criteria and are not disqualified by regulations (schedule 5 of the NHS (Clinical Commissioning Group) Regulations 2012) will be considered subject to section 6.10 of the Constitution
c) Appointment Process - eligible applicants will be shortlisted and selected by interview using further criteria designed to identify the candidates best suited to each position. The appointment will then be formally confirmed by NHS England.
d) Terms relating to tenure in post, including cessation provisions will be determined by the post-holders contract of employment with the Group.
1.9 Chief Finance Officer
The Chief Finance Officer, see section 7.6 of the Constitution, is subject to the following:
a) Nominations – applications for post as employee of the Group. Applications will be sought by advertising that position;
b) Eligibility – holder of recognised accountancy qualification with current membership of the relevant professional body who meets the other specified criteria and is not disqualified by regulations (Schedule 5 of the NHS (Clinical Commissioning Group) Regulations 2012) will be considered subject to section 6.10 of the Constitution
c) Appointment Process – eligible applicants will be shortlisted and selected by interview using further criteria designed to identify the candidates best suited to each position.
d) Terms relating to tenure in post, including cessation provisions will be determined by the post-holders contract of employment with the Group.
1.10 Registered Nurse (Director of Quality & Safety)
The Registered Nurse, see section 7.7 of the Constitution, is subject to the following:
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a) Membership of the Governing Body will rest with the individual appointed as the Groups Executive Nurse and application will be sought by advertising that position;
b) Eligibility - a Registered Nurse who will not, once appointed, also be employed in general practice or by any organisation from which the Group secures any significant volume of provision, is not otherwise disqualified by regulations and who meets the specific criteria identified for the position, subject to section 6.12 of the constitution and Schedule 5 of the NHS (Clinical Commissioning Group) Regulations 2012.
c) Appointment Process – eligible applicants will be shortlisted and selected by interview using further criteria designed to identify the candidates best suited to each position
d) Terms relating to tenure in post, including cessation provisions will be determined by the post-holders contract of employment with the Group.
1.11 Secondary Care Doctor
The Secondary Care Specialist, see section 7.10 of the Constitution, is subject to the following:
a) applications will be sought by advertising the position
b) Eligibility – a doctor who is/has been a Secondary Care Specialist with a high level of understanding of how care is delivered in a Secondary Care setting, who is not employed in a Member Practice or an organisation from which the Group secures any significant volume of provision, is not otherwise disqualified by regulations and who meets the specific criteria identified for the position, subject to section 6.10 of the Constitution and schedule 5 of the NHS (Clinical Commissioning Group) Regulations 2012.
c) Appointment Process – eligible applicants will be shortlisted and selected by interview using further criteria designed to identify the candidates best suited to the position
d) Terms of Office – will be for a maximum of four years from appointment
e) Eligibility for Reappointment – no individual will serve more than two years of office
f) Grounds for Removal from Office – no longer being eligible as defined at b) above, failure to perform to the required standard or any proven misconduct that would in the case of an employee of the Group result in their dismissal
g) Notice Period - three months to be served in writing to the chair
1.12 Other Governing Body voting Executive Member positions
The Governing Body is supported by the following Executive Director Management positions:
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Chief Operating Officer Medical Director
The above posts are subject to the following:
a) Applications for post as employee of the Group;
b) Eligibility – the qualifying criteria for the position will be clearly set out and only applicants who meet those criteria and are not disqualified by regulations (schedule 5 of the NHS (Clinical Commissioning Group) Regulations 2012) will be considered subject to section 6.10 of the Constitution
c) Appointment Process – eligible applicants will be shortlisted and selected by interview using further criteria designed to identify the candidate best suited to the position.
d) Terms relating to tenure in post, including cessation provisions will be determined by the post holder’s contract of employment with the Group.
1.13 Joint Appointments with other Organisations
The Group may agree joint appointments with other organisations as it considers appropriate. Those appointments that are a joint appointment are set out in the Constitution section 7.9. The Group will agree which organisation is the lead employer and who will issue the contract of employment.
2. MEETINGS OF THE CLINICAL COMMISSIONING GROUP
2.1 Membership Meetings
2.1.1 The Governing Body will call a Membership Meeting at least once a year, all member practices will be invited to attend.
2.1.2 The Governing Body will give at least 21 days’ notice in writing of the Membership Meeting specifying the place, day and time of the meeting
2.1.3 The Governing Body shall give at least 5 days’ notice in writing, of the Membership Meeting, any significant alterations or proposed changes to this Constitution on which practices will be asked to vote.
2.1.4 No business shall be transacted unless a quorum is present when the meeting proceeds to business. One third of Member Practices personally present shall constitute a quorum. There must be representation from all Localities present.
2.1.5 Each Member Practice shall have a vote which shall be exercised on its behalf by one of its Practice Representatives which shall be weighted based on the quality and outcomes framework (QOF) average practice list size as at the 1st April of that financial year.
2.1.6 Member Practices attending the Membership Meeting shall be entitled to vote on the proposals through the use of voting slips, either personally or by proxy as set out in Schedule 1. Voting slips will be sent out to all Member Practices 5 days prior to the vote.
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2.1.8 The Governing Body, reserves the right to hold an extraordinary Membership Meeting as required in line with emergency and urgent decisions.
2.1.9 The Member Practices will be able to call for an extraordinary Membership Meeting by submitting a formal request to the Chair, which has been supported by a two thirds majority of practices.
2.2 Meetings of the Governing Body
2.2.1 Annual General Meeting
a) The Clinical Commissioning Group shall hold an Annual General Meeting (AGM) of the Governing Body once in each year provided that not more than 15 months shall elapse between the date of one AGM and that of the next.
b) The AGM shall be held in publically accessible premises within the geographical area of the Clinical Commissioning Group.
c) The Governing Body shall give at least fourteen days’ notice in writing of every AGM, specifying the place, day and the hour of the meeting.
d) The Governing Body shall publish an annual report in line with statute for the AGM.
2.2.2 Meetings of the Governing Body held in common with other CCGs
a) The Group may hold its Governing Body meetings as a ‘meeting in common’ with other organisations. In the main this would be with Cannock Chase Clinical Commissioning Group, East Staffordshire Clinical Commissioning Group, South East Staffordshire & Seisdon Peninsula Clinical Commissioning Group, Stafford and Surrounds Clinical Commissioning Group and Stoke-on-Trent Clinical Commissioning Group with whom it shares an executive team. In these instances the role of lead ‘Chair’ for the meeting will rotate between each Clinical Commissioning Groups’ Clinical Chair. At no time will a meeting take place if the respective chair or nominated deputy for each Clinical Commissioning Group is not in attendance. The holding of a ‘meeting in common’ will not affect the individual terms of the Clinical Commissioning Groups Governing Bodies as set out in their constitution and the decisions of the Cannock Chase Clinical Commissioning Group, East Staffordshire Clinical Commissioning Group, South East Staffordshire & Seisdon Peninsula Clinical Commissioning Group, Stafford and Surrounds Clinical Commissioning Group and Stoke-on-Trent Clinical Commissioning Groups’ Governing Body will be made and recorded in line with the clauses above.
b) Where items are pertinent to all Clinical Commissioning Groups items will be discussed and reflected in the minutes accordingly with decisions reached being recorded respectively for each Clinical Commissioning Group.
c) Where items are pertinent to one Clinical Commissioning Group only, the respective Clinical Commissioning Group Chair or deputy will take that item, lead the discussion and ensure that the decision making is reached and recorded by those Governing Body members associated to the Clinical Commissioning Group.
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d) Cannock Chase Clinical Commissioning Group, East Staffordshire Clinical Commissioning Group, North Staffordshire Clinical Commissioning Group, South East Staffordshire and Seisdon Peninsula Clinical Commissioning Group, Stafford and Surrounds Clinical Commissioning Group and Stoke-on-Trent Clinical Commissioning Group have in place collaborative working arrangements and a joint management team, and it is anticipated that ‘in common’ meeting arrangements will support further alignment between the six Clinical Commissioning Groups. However, each Governing Body will continue to be accountable for its own decisions and each Clinical Commissioning Group may hold individual Governing Body meetings as appropriate, for example to discuss business specific to the Clinical Commissioning Group.
2.2.3 The Governing Body shall meet on a monthly basis. It will hold a minimum of six meetings in public each year. The remaining meetings will be used to undertake Governing Body development sessions or extraordinary Governing Body meetings as required. Every Governing Body member shall be given at least 10 days’ notice to attend.
2.3 Agenda, Supporting Papers and Business to be transacted
2.3.1 Items of business to be transacted for inclusion on the agenda of a meeting need to be notified to the Chair at least 10 working days prior to the meeting. Supporting papers need to be submitted at least 7 working days prior to the meeting.
2.3.2 The date, time and venue of all Governing Body meetings will be made public with at least 5 days’ notice on the Clinical Commissioning Group website. The notice shall include the agenda and papers related to the agenda.
2.4 Petitions
2.4.1 Where a petition, with significant support (with a minimum of 1000 signatures), 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.
2.5 Chair of a Meeting
2.5.1 No meeting of the Governing Body shall be held without either the Chair or Vice Chair being present. If the Chair or Vice Chair is not present, the meeting can proceed if a temporary Chair is elected from the remaining Governing Body members who do not hold an executive position on the Governing Body. For clarity this means only the Secondary Care Specialist, a Lay Member, or non-executive GP Board members are eligible.
2.5.2 At any meeting of a committee or sub-committee, its chair as defined in its terms of reference will preside. If the designated chair is absent from any meeting, the designated deputy chair, if any and if present, shall preside. Otherwise a member of the forum will be chosen by the members present, or by a majority of them, and shall preside.
2.5.3 If the chair is absent temporarily on the grounds of a declared conflict of interest the deputy chair, if present, will preside for the relevant business of the meeting. If both the chair and deputy chair are absent or disqualified from participating, a member of the forum who is able to participate will be chosen by the members present, or by a majority of them, and will preside.
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2.6 Chair’s Ruling
2.6.1 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.
2.7 Quorum
2.7.1 The quorum necessary for the transaction of business of the Governing Body shall be 8 voting members comprising of at least:
The Chair or Vice Chair At least three of the following: the Accountable Officer, Chief Operating Officer, Chief Financial Officer, Director of Nursing and Quality, Director of Commissioning, and Director of Strategy, Planning and Performance. At least four clinicians (who can include the Chair, Medical Director, Director of Nursing and Quality, Secondary Care Specialist an Executive Clinical Director or non-executive GP Board member) At least one Lay Member (which can include the Vice Chair).
2.7.2 In the case of an equality of votes, the Chair shall carry the casting vote.
2.7.3 Any quorum shall exclude any member of the Governing Body or a sub-committee affected by a Conflict of Interest under Clause 8.2 of the Constitution. If this Clause has the effect of rendering the meeting inquorate then the Chair of the meeting shall decide whether to adjourn the meeting to permit the co-option of additional members.
2.7.4 For all of the Group’s committees and sub-committees, including the Governing Body’s committees and sub-committees, and meetings held in common, the details of the quorum for these meetings for each Clinical Commissioning Group and status of representatives are set out in the appropriate terms of reference and are governed by the constitution at 8.4 if declared interests reduce the membership for any item of business.
2.8 Decision Making Process of the Governing Body
2.8.1 Chapter 6 of the Group’s Constitution, together with the Scheme of Reservation and Delegation (Schedule 6), sets out the governing structure for the exercise of the Group’s statutory functions. Generally it is expected that at the Group’s / Clinical Commissioning Group 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:
i) Only members of the Clinical Commissioning Group Governing Body, or their nominated deputy in the case of the Chair or appointed Clinical Commissioning Group Officers, are eligible to vote, as set out in the Constitution. If members send a deputy in their place then the Chair may deem that deputy to count towards quorum and that deputy shall also be eligible to vote in the member’s place.
ii) The Chair or Vice Chair must be present in the case of a vote. Should they be unavailable the vote should be held at the earliest practicable time, when they are available. Page 63 of 164
b) Majority necessary to confirm a decision: All voting will be by a show of hands and decision decided by a simple majority
c) Casting vote: In the case of an equality of votes, the Chair shall have a second or casting vote
d) Dissenting views: Governing Body Members taking a dissenting view to the result of a vote may take the opportunity, should they choose, to have their dissent recorded in the minutes of the meeting. Should such request not be made, the minutes will record a statement of the outcome of the vote, including the numbers of votes for and against.
2.8.2 For all of the Governing Body’s committees and sub-committees, the details of the process for holding a vote are set out in the appropriate terms of reference.
2.9 Emergency Powers and Urgent Decisions
2.9.1 The Governing Body reserves the right to hold extraordinary Governing Body meetings, taking into consideration the timetable indicated at 3.4.1, to vote on any urgent decisions.
2.9.2 If timetable dictates that urgent decisions will not allow time for an extraordinary Governing Body meeting, the Chair of the Governing Body and Accountable Officer shall have the power to make urgent decisions on any matter delegated to the Governing Body, and must take into account the advice of the Chief Finance Officer and at least one additional Executive Director. All such decisions will be recorded and presented to the next available Governing Body meeting held in public, for ratification and formal recording in the minutes.
2.10 Suspension of Standing Orders
2.10.1 Except where it would contravene any statutory provision or any direction made by the Secretary of State for Health or NHS England, any part of these Standing Orders may be suspended at a meeting provided that the meeting is quorate and the members are in agreement.
2.10.2 A decision to suspend standing orders together with the reasons for doing so shall be recorded in the minutes of the meeting.
2.10.3 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.
2.11 Records of Attendance and Minutes
2.11.1 The Governing Body shall keep accurate attendance records and proper minutes of all resolutions, recording of voting outcomes and business conducted. Minutes of all formal meetings will be a matter of public record.
2.12 Admission of Public and the Press
2.12.1 Subject to Standing Order 3.13.2, meetings of the Clinical Commissioning Group Governing Body shall be open to the public.
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2.12.2 The Clinical Commissioning Group Governing Body 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.
2.12.3 In the event the public could be excluded from a meeting of the Clinical Commissioning Group Governing Body pursuant to Standing Order 3.13.2 above, the Group shall consider whether the subject matter of the meeting would in any event be subject to disclosure under the Freedom of Information Act 2000, and if so, whether the public should be excluded in such circumstances.
2.12.4 The Chair, Lay Vice Chair or other person presiding over the meeting shall give such directions as they 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 Clinical Commissioning Group Governing Body’s business shall be conducted without interruption and disruption.
2.12.5 Without prejudice to the power to exclude the public pursuant to Standing Order 3.13.2 above the Clinical Commissioning Group Governing Body may resolve (as permitted by Section 1(8) Public Bodies (Admissions to Meetings) Act 1960 as amended from time to time) to exclude the public from a meeting (whether during whole or part of the proceedings) to suppress or prevent disorderly conduct or behaviour.
2.12.6 Matters to be dealt with by the Clinical Commissioning Group Governing Body following the exclusion of representatives of the press, and other members of the public shall be confidential to the members of the Governing Body.
2.12.7 Members and officers or any employee of the Clinical Commissioning Group Governing Body in attendance shall not reveal or disclose the contents of minutes or papers indicated as either ‘Private’ or ‘In-Confidence’ without the express permission of the Chair of the Clinical Commissioning Group Governing Body. This prohibition shall apply equally to the content of any discussion during the Clinical Commissioning Group Governing Body meeting which may take place on such reports or papers.
3. APPOINTMENT OF COMMITTEES AND SUB-COMMITTEES
3.1 Appointment of Committees and Sub-Committees
3.1.1 The Clinical Commissioning Group may appoint committees and sub-committees of the Clinical Commissioning Group, subject to any regulations made by the Secretary of State for Health, and make provision for the appointment of committees and sub- committees of its Governing Body. Where such committees and sub-committees of the Clinical Commissioning Group, or committees and sub-committees of its Governing Body, are appointed they are included in clause 6 of the Constitution.
3.1.2 Other than where there are statutory requirements, such as in relation to the Governing Body’s Audit Committee or Remuneration and Terms of Service Committee, the Group shall determine the membership and terms of reference of committees and sub-committees and shall, if it requires, receive and consider reports of such committees at the next appropriate meeting of the Group.
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3.1.3 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.
3.2 Terms of Reference
3.2.1 Terms of reference shall have effect as if incorporated into the Constitution and shall be added to this document as schedules 9 to 16.
3.3 Delegation of Powers by Committees to Sub-committees
3.3.1 Where committees are authorised to establish sub-committees they may not delegate executive powers to the sub-committee unless expressly authorised by the Clinical Commissioning Group.
3.4 Approval of Appointments to Committees and Sub-Committees
3.4.1 The Clinical Commissioning Group shall approve the appointments to each of the committees and sub-committees which it has formally constituted including those the Governing Body. The Clinical Commissioning Group shall agree such travelling or other allowances as it considers appropriate.
4. DUTY TO REPORT NON-COMPLIANCE WITH STANDING ORDERS AND PRIME FINANCIAL POLICIES
4.1 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 Clinical Commissioning Group and staff have a duty to disclose any non-compliance with these Standing Orders to the Chief Officer as soon as possible.
5. USE OF SEAL AND AUTHORISATION OF DOCUMENTS
5.1 The Clinical Commissioning Group may have a seal for executing documents where necessary, two of the following individuals are authorised to authenticate its use by their signature:
Accountable Officer Chair of the Governing Body Chief Finance Officer One other Executive Director A Lay Member
5.1.2 The following individuals are authorised to execute a document on behalf of the Governing Body by their signature:
Accountable Officer Chair of the Governing Body Chief Finance Officer One other Executive Director A Lay Member
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6. OVERLAP WITH OTHER CLINICAL COMMISSIONING GROUP POLICY STATEMENTS / PROCEDURES AND REGULATIONS
6.1 Policy Statements: general principles
6.1.1 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 it. The decisions to approve such policies and procedures will be recorded in an appropriate minute and will be deemed where appropriate to be an integral part of the Standing Orders.
7. PROCEDURE FOR RECRUITMENT TO ELECTED POST OF CLINICAL CHAIR (previously Schedule 2)
7.1 An elected Board Member will be notified at least 3 months in advance of their end of tenure in writing.
7.2 The elected Board Member must give at least 6 months’ notice of resignation to the Chair of the Group or to the Chair of NHS England.
7.3 On receipt of the notification of the end of an elected Board tenure or the resignation of a Board Member, the Group will enact the process highlighted below
7.4 Advert Stage
7.4.1 The Group will announce to all local practising GPs the elected position available and copies of the outline job role and ask for expressions of interest.
7.4.2 Two weeks following the initial announcement, the Group will formally publish the position available and the applicant pack including a job description and application form will be sent out to the candidates. These will need to be returned to the Clinical Commissioning Group by an agreed and published date giving at least two weeks’ notice.
7.5 Stage One
7.5.1 The smaller panel will shortlist the applications received and agree the final candidates to be put through to interview.
7.6 Stage Two
7.6.1 The interview and stakeholder panel review of the candidates, the first part of stage two is that of a stakeholder panel which will be made up of the following key stakeholders, which would be an opportunity for the stakeholders to have an informal discussion with proposed candidates
1. Members from the Localities 2. Member Staffordshire and Stoke on Trent Partnership Trust 3. Member from University hospital of North Staffordshire 4. Member from Combined Health Care 5. Patient Representative 6. Member from Local Authority
7.6.2 Following the stakeholder panel the candidate will have a structured interview with a smaller panel which will consist of 1. Accountable Officer 2. Either Accountable Officer or Chief Finance Officer 3. Chair of the LMC or another suitable member as identified by the LMC Chair 4. Allocated Lay Member 5. NHS England Representative Page 67 of 164
7.7 Stage Three 7.7.1 Candidates that pass through stage one and two will stand for election by local GPs. Each GP of a Member Practice as set out in Schedule 1 shall be eligible to one vote.
7.7.2 Should there only be a single candidate that passes through stage 1 & 2, the post will be automatically selected as the successful candidate, and member practices will be asked to endorse the candidate.
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Membership Meeting
Proxy Form
[NAME AND ADDRESS OF MEMBER GP]
I being a GP Member of North Staffordshire Clinical Commissioning Group, appoint the Chairman of the meeting or [insert name of individual] as my proxy to attend, speak and vote on my behalf at the Clinical Commissioning Group Membership Meeting to be held on [DATE] at [TIME] and at any adjournment of the meeting.
I direct our proxy to vote on the following resolutions as I have indicated by marking the appropriate box with an 'X'. If no indication is given, my proxy will vote or abstain from voting at his or her discretion and I authorise my proxy to vote (or abstain from voting) as he or she thinks fit in relation to any other matter which is properly put before the meeting.
RESOLUTIONS For Against
[Ordinary business]
1. [Insert text of resolution]
2. [Insert text of resolution]
3. [Insert text of resolution]
[Special business]
4. [Insert text of resolution]
5. [Insert text of resolution]
Signature: ______
Date: ______
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SCHEDULE 4
SCHEME OF RESERVATION & DELEGATION
1. SCHEDULE OF MATTERS RESERVED TO THE CLINICAL COMMISSIONING GROUP AND SCHEME OF DELEGATION
1.1 The decision-making 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.
1.2 The Clinical Commissioning Group remains accountable for all of its functions, including those that it has delegated.
1.3 The table below indicates which decisions have been reserved to the Group membership and these decisions can only be taken at a quorate meeting of the Group itself, as described in the constitution and Standing Orders, or under 3.9 of Standing Orders in emergency or unforeseen circumstances.
1.4 Other decisions have been delegated to the governing body and these must be taken at a quorate meeting of that body, as described in the constitution and Standing Orders, or under 3.9 of Standing Orders in emergency or unforeseen circumstances.
1.5 Decisions delegated to the Accountable Officer or the Chief Finance Officer must be taken by the relevant individual or someone with express, written authority to do so on their behalf.
1.6 Decisions delegated to committees or sub-committees must be taken at a quorate meeting of that body, as described in the Constitution, Standing Orders and the relevant terms of reference
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Delegated to Responsible Matter Committee Individual for Ref Reserved to Governing Operational Reserved or Delegated Matter or Sub- Member or recommending No the Body Responsibility Committee Officer a course of Membership action
1 Regulations & Control
Determine the arrangements by which the members of the 1.1 Clinical Commissioning Group (CCG) approve those decisions that are reserved for the Membership
Consideration and approval of applications to NHS England (NHSE) on any matter concerning changes to the CCG’s Constitution, including for the Governing Body, its 1.2 committees, terms of reference + membership of committees, the overarching Scheme of Reservation and delegated powers, arrangements for taking urgent decisions, Standing Orders + Prime Financial Policies
1.3 Approve Constitution subject to NHSE sign off
Exercise or Delegation of those functions of the CCG which have not been retained as reserved by the Group, delegated Accountable 1.4 to the Governing Body, to a committee or sub-committee or to Officer one of its members or employees
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Delegated to Responsible Matter Committee Individual for Ref Reserved to Governing Operational Reserved or Delegated Matter or Sub- Member or recommending No the Body Responsibility Committee Officer a course of Membership action
Prepare the CCG’s overarching Scheme of Reservation & Delegation, which sets out those decisions reserved to the Membership and those delegated to: Governing Body Committees and sub-committees, or Its members or employees
1.5 And sets out those decisions reserved to the Governing Body and those delegated to: Committees and sub-committees Members of the Governing Body An individual who is member of the CCG but not the Governing Body or a specified person
For inclusion in the Constitution
Recommend approval of the CCG’s overarching Scheme of 1.6 Reservation & Delegation to the Membership Prepare the CCG’s operational Scheme of Delegation, which sets out those key operational decisions delegated to Accountable 1.7 individual employees of the CCG, not for inclusion in the Officer Group’s Constitution Approval of the CCG’s operational Scheme of Delegation that 1.8 underpins the Group’s ‘overarching Scheme of Reservation & Delegation’ as set out in its Constitution Prepare detailed financial policies that underpin the CCG’s Chief Finance 1.9 Prime Financial Policies including the financial Scheme of Officer Delegation
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Delegated to Responsible Matter Committee Individual for Ref Reserved to Governing Operational Reserved or Delegated Matter or Sub- Member or recommending No the Body Responsibility Committee Officer a course of Membership action
1.10 Approve detailed Prime Financial Policies
Approve arrangements for managing exceptional funding 1.11 requests
Approve arrangements for managing exceptional funding 1.12 requests (within financial limits)
Set out who can execute a document by signature / use of the 1.13 seal
Approves any changes to the provision or delivery of Audit 1.14 assurance services to the CCG (internal & external audit) Committee 2 Practice Member Representatives and Members of the Clinical Commissioning Group Governing Body Approve arrangements for identifying Practice members to represent Practices in matters concerning the work of the 2.1 CCG; and appointing clinical leaders to represent the CCG’s membership on the Governing Body, through election Approve the appointment of Governing Body members, the process for recruiting and removing non-elected members to 2.2 Chair the Governing Body (subject to any regulatory requirements and succession planning)
Approve arrangements for appointing the CCG’s proposed 2.3 Accountable Officer
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Delegated to Responsible Matter Committee Individual for Ref Reserved to Governing Operational Reserved or Delegated Matter or Sub- Member or recommending No the Body Responsibility Committee Officer a course of Membership action
3 Strategy and Planning Agree the vision, values and overall strategic direction of the 3.1 All 6 CCGs CCG Accountable 3.2 Approval of the CCG’s operating structure Officer
Approval of the CCG’s Commissioning Plan (Operational 3.3 Plan) Approval of the CCG’s corporate budgets that meet the 3.4 financial duties as set out in section 5.3 of the main body of the Constitution Approval of variations to the approved budget where variation would have a significant impact on the overall 3.5 approved levels of income and expenditure or the CCG’s ability to achieve its agreed strategic aims Ensure there is regular and reliable monitoring of the QIPP Finance and 3.6 programme, with regular reports on progress and risks to the Performance Governing Body Review all commissioning development proposals (the ‘what’); ensuring proposals for investment have a robust 3.7A business case that enables the Governing Body to make investment decisions (NEW) Review all commissioning development proposals (the ‘how’); ensuring proposals for investment have a robust Divisional 3.7B business case that enables the Divisional Committee to Committee make investment decisions (NEW) Page 74 of 164
Delegated to Responsible Matter Committee Individual for Ref Reserved to Governing Operational Reserved or Delegated Matter or Sub- Member or recommending No the Body Responsibility Committee Officer a course of Membership action
Approval of clinical commissioning decisions pertaining to 3.8 pathways, service redesign and new models of care.
4 Annual Report and Accounts Approval of the CCG’s Annual Report and Financial Audit 4.1 Statements prior to Governing Body ratification Committee
Approval of the arrangements for discharging the CCG’s 4.2 statutory financial duties 5 Human Resources Approve the arrangements for determining terms and conditions, remuneration and travelling or other allowances Remuneration & 5.1 Terms of Service for CCG Governing Body members and clinical leads, Committee including pensions and gratuities
Approve the terms and conditions, remuneration and Remuneration & 5.2 travelling or other allowances for Governing Body members Terms of Service and clinical leads including pension and gratuities Committee Approve terms and conditions of employment for all employees of the CCG including, pensions, remuneration, Remuneration & 5.3 Terms of Service fees and travelling or other allowances payable to employees Committee and to other persons providing services to the CCG (A4C)
Approve any other terms and conditions of service for the Remuneration & 5.4 Terms of Service CCG’s employees Committee
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Delegated to Responsible Matter Committee Individual for Ref Reserved to Governing Operational Reserved or Delegated Matter or Sub- Member or recommending No the Body Responsibility Committee Officer a course of Membership action
Determine the terms and conditions of employment for all Remuneration & 5.5 Terms of Service employees of the CCG Committee
Determine pensions, remuneration, fees and allowances Remuneration & 5.6 payable to all employees and to other persons providing Terms of Service services to the CCG Committee Approve disciplinary arrangements for CCG employees, including the Accountable Officer (where he/she is an CEEE 5.7 employee or member of the CCG) and for other persons Committee working on behalf of the CCG Approval of the arrangements for discharging the CCG’s CEEE 5.8 statutory duties as an employer Committee
Approval of the arrangements for discharging the CCG’s CEEE 5.8 statutory duties as an employer Committee
Approve the schedule and process for Human Resources CEEE 5.9 policies for employees and for other persons working on Committee behalf of the CCG
Approve Human Resources policies for employees and for CEEE 5.10 other persons working on behalf of the CCG Committee 6 Quality and Safety Approve arrangements to minimise clinical risk, maximise patient safety and to secure continuous improvement in Director of 6.1 quality and patient outcomes Nursing & Quality
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Delegated to Responsible Matter Committee Individual for Ref Reserved to Governing Operational Reserved or Delegated Matter or Sub- Member or recommending No the Body Responsibility Committee Officer a course of Membership action Approve arrangements for supporting NHS England in discharging its responsibilities in relation to securing Quality & Safety 6.2 continuous improvement in the quality of general medical Committee services Quality & Safety 6.3 Approval of clinical, quality and safety strategies and policies Clinical Committee 7 Operational and Risk Management Approve the CCG’s counter-fraud and security management Audit 7.1 arrangements Committee
Audit 7.2 Approval of the CCG’s risk management arrangements Committee Review the findings of external audit and other significant Audit 7.3 assurance functions, both internal and external and consider Committee the implications for the governance of the CCG Approve arrangements for risk sharing and or risk pooling 7.4 with other organisations (e.g. arrangements for pooled funds
with other CCGs or pooled budget arrangements under section 75 of the NHS Act 2006)
Approval of a comprehensive system of internal control, Audit 7.5 including budgetary control that underpins the effective, Committee efficient and economic operation of the CCG Director of Approve proposals for action on litigation against or on behalf 7.6 Corporate of the CCG Services Delegated to Page 77 of 164
Responsible Matter Committee Individual for Ref Reserved to Governing Operational Reserved or Delegated Matter or Sub- Member or recommending No the Body Responsibility Committee Officer a course of Membership action
Approve the CCG’s arrangements for business continuity and Director of 7.7 emergency planning Strategy 8 Information Governance Accountable 8.1 Approve the CCG’s arrangements for handling complaints Officer
Approval of the arrangements for ensuring appropriate and Chief Finance Officer in their 8.2 safekeeping and confidentiality of records and for the capacity as storage, management and transfer of information and data SIRO 9 Tendering and Contracting Approval of the CCG’s contracts for any commissioning 9.1 support
Approval of the CCG’s contracts for corporate support (e.g. 9.2 finance provision) Approval to award any contract of a higher value than that 9.3 specified in Prime Financial Policy or the Operational Scheme of Delegation 10 Partnership Working Approve decisions that individual members or employees of the CCG participating in joint arrangements on behalf of the 10.1 CCG can make. Such delegated decisions must be disclosed in this Scheme of Reservation & Delegation
Approve decisions delegated to joint committees established 10.2 under section 75 of the 2006 Act
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Delegated to Responsible Matter Committee or Individual for Ref Reserved to Governing Operational Reserved or Delegated Matter Sub- Member or recommending No the Body Responsibility Committee Officer a course of Membership action 11 Commissioning and Contracting for Clinical Services
Approval of the arrangements for discharging the CCG’s statutory duties associated with its commissioning functions, including but not limited to promoting the involvement 11.1 patients and carers, patient choice, reducing inequalities, improvement in the quality of services, obtaining appropriate advice and public engagement / consultation
Approve arrangements for co-ordinating the commissioning 11.2 of services with other CCGs and or with the Local Authority(ies) where appropriate
12 Communications and Engagement Approving arrangements for handling Freedom of Information 12.1 requests
Director of Determining arrangements for handling Freedom of Accountable 12.2 Corporate Information requests Officer Services 13 Primary Care Commissioning
Decisions delegated from NHS England in relation to Primary Primary Care 13.1 Commissioning Medical Care Committee
13.2 Approve CCG policy for engagement with Member Practices
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Delegated to Responsible Matter Committee or Individual for Ref Reserved to Governing Operational Reserved or Delegated Matter Sub- Member or recommending No the Body Responsibility Committee Officer a course of Membership action
Primary Care 13.3 Approve Practice procurement decisions Commissioning Committee
13.4 Approve Primary Care Strategy
Primary Care 13.5 Approve Practice Estates Commissioning Committee 14 Divisional Committee
14.1 Non-delegated Primary Care spend
Tactical deployment of the relevant CCG’s Statutory 14.2 Commissioning Duties (as to the function of the Committee being assigned responsibility)
Delegated financial spending in line with the separate 14.3 Financial Scheme of Delegation
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SCHEDULE 5
PRIME FINANCIAL POLICIES
1. GENERAL
1.1. These Prime Financial Policies (PFPs) and supporting detailed financial policies shall have effect as if incorporated into the Group’s constitution.
1.2 The PFPs 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 Accountable Officer and Chief Finance Officer to effectively perform their responsibilities. They should be used in conjunction with the Scheme of Reservation and Delegation found at Schedule 6.
1.3 In support of these 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.
1.4 These PFPs identify the financial responsibilities which apply to everyone working for the Group or operating on behalf of it. 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.
1.5 A list of the Group’s detailed financial policies will be published and maintained on the Group’s website at www.north staffs.nhs.uk
1.6 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.
1.7 Failure to comply with the PFPs and Standing Orders can in certain circumstances be regarded as a disciplinary matter that could result in dismissal.
2. OVERRIDING PRIME FINANCIAL POLICIES
2.2 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 policies to the Chief Finance Officer as soon as possible.
3. RESPONSIBILITIES AND DELEGATION
3.2 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 the Constitution.
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3.3 The financial decisions delegated by members of the Group are set out in the Group’s scheme of Reservation and Delegation (see Schedule 6).
4. CONTRACTORS AND THEIR EMPLOYEES
4.1 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 Accountable Officer to ensure that such persons are made aware of this.
5 AMENDMENT OF PRIME FINANCIAL POLICIES
5.1 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 Accountable Officer the Chief Finance Officer will recommend amendments, as fitting, to the Audit Committee for approval.
6 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
6.1 The Governing Body is required to establish an Audit Committee with terms of reference agreed by the Governing Body (see Clause 6.7.3a of the Constitution for further information).
6.2 The Accountable Officer has overall responsibility for the Group’s systems of internal control.
6.3 The Chief Finance Officer will ensure that:
6.3.1 Financial policies are considered for review and update annually;
6.3.2 A system is in place for proper checking and reporting of all breaches of financial policies; and
6.3.3 A proper procedure is in place for regular checking of the adequacy and effectiveness of the control environment.
7 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.
7.1 The Chief Finance Officer as 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 and the Accountable Officer for any significant issues arising from audit work that management cannot resolve, and for all cases of fraud or serious irregularity.
7.2 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 Accountable Officer to review audit issues as appropriate. All Audit Committee members, the Chair of the Governing Body and the Accountable Officer will have direct and unrestricted access to the head of internal audit and external auditors. Page 82 of 164
7.3 The Chief Finance Officer will ensure that:
7.3.1.1 The Group has a professional and technically competent internal audit function; and
7.3.1.2 The Governing Body’s Audit Committee approves any changes to the provision or delivery of assurance services to the Group.
7.4 Role of Internal Audit
7.4.1 Internal Audit shall independently review, appraise and report upon:
7.4.1.1 The extent of compliance with, and the financial effect of, relevant established policies, plans and procedures;
7.4.1.2 The adequacy and application of financial and other related management controls, and risk of management and risk based planning;
7.4.1.3 The suitability of financial and other related management data;
7.4.1.4 The extent to which the Group’s assets and interests are accounted for and safeguarded from loss of any kind, arising from fraud and other offences, waste, extravagance, inefficient administration, poor value for money or other causes
7.4.2 Internal Audit shall also independently verify the Assurance Framework statements in accordance with guidance from the DOH.
7.5 External Audit
7.5.1 The external auditor is appointed by the Audit Commission and paid for by the Group. The Audit Committee must ensure a cost-efficient service. If there are any problems relating to the service provided, then this should be raised with the external auditor and referred onto the Audit Commission if the issue cannot be resolved.
8 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.
8.1 The 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.
8.2 The Audit Committee will ensure that the Group has arrangements in place to work effectively with NHS Counter Fraud Authority.
8.3 The Group shall nominate a suitable person to carry out the duties of the Local Counter Fraud Specialist (LCFS) as specified by the DH Fraud and Corruption Manual.
8.4 The LCFS will provide a written report, at least annually, on counter fraud work within the Group.
8.5 The LCFS will report to the Chief Finance Officer.
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9 EXPENDITURE CONTROL
9.1 The Group is required by statutory provisions4 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.
9.2 The Accountable Officer has overall executive responsibility for ensuring that the Group complies with 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.
9.3 The Chief Finance Officer will:
9.3.1 Provide reports in the form required by NHS England;
9.3.2 Ensure money drawn from NHS England is required for approved expenditure only and is drawn down only at the time of need and follows best practice;
9.3.3 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.
10 ALLOTMENTS5
10.1 The Group’s Chief Finance Officer will:
10.1.1.1 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;
10.1.1.2 Prior to the start of each financial year submit to Governing Body for approval a report showing the total allocations received and their proposed distribution including any sums to be held in reserve; and
10.1.1.3 Regularly update the Governing Body on significant changes to the initial allocation and the uses of such funds.
11 COMMISSIONING STRATEGY, BUDGETS, BUDGETARY CONTROL AND MONITORING
POLICY - The Group will produce and publish an annual commissioning plan6 that explains how it proposes to discharge its financial duties. The Group will support this with comprehensive medium term financial plans and annual budgets
11.1 The Accountable Officer will compile and submit to the Governing Body a commissioning strategy which takes into account financial targets and forecast limits of available resources.
11.2 Prior to the start of the financial year the Chief Finance Officer will, on behalf of the Accountable Officer, prepare and submit budgets for approval by Governing Body.
4 See section 223H of the 2006 Act, inserted by section 27 of the 2012 Act 5 See section 223(G) of the 2006 Act, inserted by section 27 of the 2012 Act. 6 See section 14Z11 of the 2006 Act, inserted by section 26 of the 2012 Act. Page 84 of 164
11.3 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.
11.4 The Accountable 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 the NHS England as requested.
11.5 All budget holders are responsible for ensuring that:
11.5.1 Any likely overspending or reduction of income which cannot be met by virement is not incurred without the prior consent of the Governing Body;
11.5.2 The amount provided in the approved budget is not used in whole or in part for any purpose other than that specifically authorised, subject to the rules of virement;
11.5.3 No permanent members of staff are appointed without approval of the Accountable Officer, other than those provided for within available resources and any manpower establishment approved by Governing Body.
11.6 The Director of Commissioning and Operations will approve consultation arrangements for the Group’s Commissioning Plan7.
11.7 Capital Expenditure
11.7.1 The general rule applying to delegation and reporting shall also apply to capital expenditure.
12 ANNUAL ACCOUNTS AND REPORTS
POLICY - The Group will produce and submit to NHS England accounts and reports in accordance with all statutory obligations8, relevant accounting standards and accounting best practice in the form and content and at the time required by NHS England
12.1 The Chief Finance Officer will ensure that the Clinical Commissioning Group:
12.1.1 Prepares a timetable for producing the annual report and accounts and agrees it with external auditors and the Audit Committee;
12.1.2 Prepares the accounts according to a timetable approved by Audit Committee
12.1.3 Complies with statutory requirements and relevant directions for the publication of an annual report
12.1.4 Considers the external auditor’s management letter and fully address all issues within agreed timescales; and
12.1.5 Publishes the letter on the website www.north staffs.nhs.uk at and makes it available upon request for inspection at the Group’s office.
7 See section 14Z13 of the 2006 Act, inserted by section 26 of the 2012 Act 8 See paragraph 17 of Schedule 1A of the 2006 Act, as inserted by Schedule 2 of the 2012 Act. Page 85 of 164
13 INFORMATION TECHNOLOGY
POLICY - The Group will ensure the accuracy and security of computerised financial data
13.1 The Chief Finance Officer is responsible for the accuracy and security of the Group’s computerised financial data and shall:
13.1.1 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 2018
13.1.2 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
13.1.3 Ensure that adequate controls exist such that the computer operation is separated from development, maintenance and amendment
13.1.4 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.
13.2 In addition they 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.
13.3 The Chief Finance Officer will be the Senior Information Responsible Officer (SIRO) for the Clinical Commissioning Group.
14 ACCOUNTING SYSTEMS
POLICY - The Group will run an accounting system that creates management and financial accounts
14.1 The Chief Finance Officer will ensure:
14.1.1 The Group has suitable financial and other software to enable it to comply with these policies and any consolidation requirements of NHS England
14.1.2 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
14.1.3 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.
15 BANK ACCOUNTS
POLICY - The Group will keep enough liquidity to meet its current commitments
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15.1 The Chief Finance Officer will:
15.1.1 Review the banking arrangements of the Group at regular intervals to ensure they are in accordance with Secretary of State directions9, best practice and represent best value for money
15.1.2 Manage the Group's banking arrangements and advise the Group on the provision of banking services and operation of accounts
15.1.3 Prepare detailed instructions on the operation of bank accounts.
15.2 The Audit Committee shall approve the banking arrangements.
16 INCOME, FEES and CHARGES / 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 functions10 ensure its power to make grants and loans is used to discharge its functions effectively11.
16.1 The Chief Financial Officer is responsible for:
16.1.1 Designing, maintaining and ensuring compliance with systems for the proper recording, invoicing, and collection and coding of all monies due
16.1.2 Establishing and maintaining systems and procedures for the secure handling of cash and other negotiable instruments
16.1.3 Approving and regularly reviewing the level of all fees and charges other than those determined by the NHS England or by statute
16.1.4 Independent professional advice on matters of valuation shall be taken as necessary
16.1.5 For developing effective arrangements for making grants or loans.
16.2 Debt Recovery
16.2.1 The Chief Finance Officer is responsible for the appropriate recovery action on all outstanding debts
16.2.2 Income not received should be dealt with in accordance with losses procedures
16.2.3 Overpayments should be detected (and preferably prevented) and recovery initiated.
9 See section 223H(3) of the NHS Act 2006, inserted by section 27 of the 2012 Act 10 See section 14Z5 of the 2006 Act, inserted by section 26 of the 2012 Act. 11 See section 14Z6 of the 2006 Act, inserted by section 26 of the 2012 Act. Page 87 of 164
16.3 Security of Cash, Cheques and other Negotiable Instruments
16.3.1 The Chief Finance Officer is responsible for:
16.3.1.1 Approving the form of all receipt books, agreement forms, or other means of officially acknowledging or recording monies received or receivable
16.3.1.2 Ordering and securely controlling any such stationery
16.3.1.3 The provision of adequate facilities and systems for staff whose duties include collecting and holding cash, including the provision of safes or lockable cash boxes, the procedures for keys and for coin-operated machines
16.3.1.4 Prescribing systems and procedures for handling cash and negotiable securities on behalf of the Group
16.3.2 Official money shall not under any circumstances be used for the encashment of private cheques or IOUs.
16.3.3 All cheques, postal orders, cash etc., shall be banked intact. Disbursements shall not be made from cash received, except under arrangements approved by the Chief Finance Officer.
16.3.4 The holders of safe keys shall not accept unofficial funds for depositing in their safes unless such deposits are in special sealed envelopes or locked containers. It shall be made clear to the depositors that the Group is not to be held liable for any loss, and written indemnities must be obtained from the organisation or individuals absolving the Group from responsibility for any loss.
17 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
- The supply of goods, materials and manufactured articles; - The rendering of services including all forms of management consultancy services (other than specialised services sought from or provided by the DoH; and - For the design, construction and maintenance of building and engineering works (including construction and maintenance of grounds and gardens) for disposals
17.1 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.
17.2 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:
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17.2.1 The Group’s Standing Orders;
17.2.2 The Public Contracts Regulations 2015, any successor legislation and any other applicable law; and
17.2.3 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.
17.3 In all contracts entered into, the Group shall endeavour to obtain best value for money. The Accountable Officer shall nominate an individual who shall oversee and manage each contract on behalf of the Group.
17.4 Quotations: Competitive and Non-Competitive
17.4.1 General Position on Quotations – these are required where formal tendering procedures are not adopted and where the intended expenditure or income exceeds, or is reasonably expected to exceed £10,000 (this figure to be reviewed periodically).
17.4.2 Competitive Quotations – where quotations are required under PFP 17.4.1 and the intended expenditure or income does not exceed, or is reasonably expected not to exceed £24,999, they should be obtained from at least two firms/individuals based on specifications or terms of reference prepared by or on behalf of the Group. Where the intended expenditure or income exceeds this threshold, or is reasonably expected to exceed it, at least three quotations should be obtained, subject to the threshold for formal tendering procedures as set out on PFP 17.5.
17.4.3 Quotations should be in writing unless it is impractical to do so in which case they may be obtained by telephone or electronically. Confirmation of telephone or electronic quotations should be obtained in writing without delay, and the reasons why the non-written quotation was obtained should be set out in a permanent record.
17.4.4 All quotations should be treated as confidential and should be retained for inspection.
17.4.5 The quotations should be evaluated and the one selected should provide the best value for money. If this is not the lowest quotation, then the choice made and the reasons why should be recorded in a permanent record, and pre-approved by the Chief Finance Officer.
17.4.6 Non-Competitive Quotations in writing (i.e. from a limited range of providers) may be obtained in the following circumstances:
17.4.6.1 The supply of proprietary or other goods of a special character and the rendering of services of a special character, for which it is not possible or desirable to obtain competitive quotations
17.4.6.2 The supply of goods or manufactured articles of any kind which are required quickly and are not obtainable under existing contracts
17.4.6.3 Where the goods or services are for building and engineering maintenance the responsible works manager must certify that the first two conditions of this SFI apply.
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17.4.7 Quotations to be within Financial Limits – no quotation shall be accepted which will commit expenditure in excess of that which has been allocated by the Clinical Commissioning Group and which is not in accordance with PFPs except with the authorisation of the Chief Finance Officer.
17.5 Formal Competitive Tendering
17.5.1 General Applicability – the Group shall ensure that competitive tenders are invited for:
17.5.1.1 The supply of goods, materials and manufactured articles
17.5.1.2 The rendering of services including all forms of management consultancy services (other than specialised services sought from or provided by the DoH); for special arrangements governing the engagement of management consultants
17.5.1.3 For the design, construction and maintenance of building and engineering works (including construction and maintenance of grounds and gardens);
17.5.2 Healthcare Services – where the Group elects to invite tenders for the supply of healthcare services these PFPs shall apply as far as they are applicable to the tendering procedure, and need to be read in conjunction with the Prime Financial Policies covering commissioning.
17.5.3 Exceptions and Instances where Formal Tendering need not be applied
Formal tendering procedures need not be applied where:
17.5.3.1 The estimated expenditure or income does not, or is not reasonably expected to, exceed £75,000 (this figure to be reviewed periodically); or
17.5.3.2 Where the supply is proposed under special arrangements negotiated by the DoH in which event these arrangements must be complied with;
Formal tendering procedures may be waived in the following circumstances:
17.5.3.3 In exceptional circumstances where the Accountable Officer decides that formal tendering procedures would not be practicable or the estimated expenditure or income would not warrant formal tendering procedures, and the circumstances are detailed in an appropriate record
17.5.3.4 Where the requirement is covered by an existing contract
17.5.3.5 Where NHS Purchasing and Supply Agency agreements are in place
17.5.3.6 Where a consortium arrangement is in place and a lead organisation has been appointed to carry out tendering activity on behalf of consortium members
17.5.3.7 Where the timescale genuinely precludes competitive tendering but failure to plan the work properly would not be regarded as a justification for a single tender
17.5.3.8 Where specialist expertise is required and is available from only one source Page 90 of 164
17.5.3.9 When the task is essential to complete the project, and arises as a consequence of a recently completed assignment and engaging different consultants for the new task would be inappropriate
17.5.3.10 There is a clear benefit to be gained from maintaining continuity with an earlier project. However in such cases the benefits of continuity must outweigh any potential financial advantage to be gained by competitive tendering
17.5.3.11 For the provision of legal advice and services providing that any legal firm or partnership commissioned by the Trust is regulated by the Law Society for England and Wales for the conduct of their business (or by the Bar Council for England and Wales in relation to the obtaining of Counsel’s opinion) and is generally recognised as having sufficient expertise in the area of work for which they are commissioned. The Chief Finance Officer shall ensure that any fees paid are reasonable and within commonly accepted rates for the costing of such work
17.5.3.12 In respect of any procurement undertaken by a collaborative procurement hub (or similar organisation) on behalf of the Group – a single tender limit of £90,000 applies.
The waiving of competitive quotations or tendering procedures must not be used to avoid competition nor for administrative convenience nor simply to award further work to a consultant originally appointed through a competitive procedure.
Where it is decided that competitive quotations or tendering is not applicable and may be waived, the fact of the waiver and the reasons should be documented and recorded in an appropriate record (‘Single Tender Action (STA)’) which must receive prior authorisation from the Accountable Officer or Chief Finance Officer. All STAs shall be reported to the Audit Committee.
17.5.4 Fair and Adequate Competition – where the exceptions set out in PFP 17.4.1 and 17.4.2 apply, the Group shall ensure that invitations to tender are sent to sufficient number of firms/individuals to provide fair and adequate competition as appropriate, having regard to their capacity to supply the goods or materials or to undertake the services or works required, and in no case shall be less than two.
17.5.5 List of Approved Firms – the Accountable Officer or Chief Finance Officer shall ensure that normally the firms/individuals invited to tender (and where appropriate, quote) are among those on approved lists. 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 Accountable Officer.
17.5.6 Items which subsequently breach thresholds after original approval – items estimated to be below the limits set in this PFP for which formal tendering procedures are not used, but which subsequently prove to have a value above such limits, shall be reported to the Accountable Officer, and be recorded in an appropriate record.
17.6 Tendering and Contracting Procedure
Where the function of contracting on behalf of the Group is delegated or subcontracted to any other person, body, or organisation, then such delegate or sub-contractor shall observe the Group’s tendering procedure.
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17.6.1 Invitation to Tender
All invitations to tender shall state the date and time as being the latest time for the receipt of tenders
All invitations to tender shall state that no tender will be accepted unless submitted in either: o A plain sealed package or envelope bearing a pre-printed label supplied by the Group (or the word "Tender" followed by the subject to which it relates) and the latest date and time for the receipt of such tender; or o A special envelope supplied by the Group to prospective tenderers; and that o Tender envelopes / packages shall not bear any names or marks indicating the sender. The use of courier/postal services must not identify the sender on the envelope or on any receipt so required by the deliverer
Every tender for goods, materials, services or disposals shall embody such of the NHS Standard Contract Conditions as are applicable. Every tenderer must give a written undertaking not to engage in collusive tendering or other restrictive practice
17.6.2 Receipt of Safe Custody Tenders
Formal competitive tenders shall be addressed to the Accountable Officer or his nominated manager
The Accountable Officer or his nominated representative will be responsible for the receipt, endorsement and safe custody of tenders received until the time appointed for their opening
The date and time of receipt of each tender shall be endorsed on the tender envelope / package
17.6.3 Opening Tenders and Register of Tenders
As soon as practicable after the date and time stated as being the latest time for the receipt of tenders, they shall be opened in the presence of two senior officers as follows and not from the originating department:
o Where the total contract value (including sub-contracts) at the last reported estimate stage is £1,000,000 or more, any two Directors (Executive or Lay Member) of the Body
o Where the total contract value (including sub-contracts) at the last reported estimate stage is less than £1,000,000, any two Directors (Executive or Lay Member) of the Body, or their nominated deputies
o The originating department will be taken to mean the department sponsoring or commissioning the tender
o All Directors are authorised to open tenders regardless of whether they are from the originating department provided that the other authorised person also opening the tenders is not from the originating department
o Every tender received shall be marked with the date of opening and initialled by two of those present at the opening Page 92 of 164
A register shall be maintained by the Head of Governance to show for each set of competitive tender invitations despatched:
o The names of all firms/individuals invited o The names of firms/individuals from which tenders have been received o The date the tenders were opened o The persons present at the opening o The price shown on each tender o Date and time of opening o A note where price alterations have been made on the tender. Every price alteration appearing on a tender and the record should be initialled by two of those present at the opening.
The register shall be signed by those present at the opening.
A note shall be made in the register if any one tender price has had so many alterations that it cannot be readily read or understood
Qualified tenders, i.e. where a contractor proposes conditions which differ from those specified by the Group, incomplete tenders, i.e. those from which information necessary for the adjudication of the tender is missing, and amended tenders, i.e. those amended by the tenderer upon his own initiative either orally or in writing after the due time for receipt, but prior to the opening of other tenders, should be dealt with in the same way as late tenders. (PFP 17.6.5 below).
17.6.4 Admissibility
If for any reason the designated officers are of the opinion that the tenders received are not strictly competitive (for example, because their numbers are insufficient or any are amended, incomplete or qualified) no contract shall be awarded without the approval of the Accountable Officer
Where only one tender is sought and/or received, the Chief Finance Officer shall be advised and, as far practicable, he shall ensure that the price to be paid is fair and reasonable and will ensure value for money for the Group
Where examination of tenders reveals errors which would affect the tender price, the tenderer is to be given details of the errors and afforded the opportunity of confirming or withdrawing the offer
17.6.5 Late Tenders
Tenders received after the due time and date, but prior to the opening of the other tenders, may be considered only if the Accountable Officer or his nominated officer decides that there are clear exceptional circumstances i.e. despatched in good time but delayed through no fault of the tenderer
Only in the most exceptional circumstances will a tender be considered which is received after the opening of the other tenders and only then if the tenders that have been duly opened have not left the custody of the Accountable Officer or his nominated officer or if the process of evaluation and adjudication has not started
Such tenders may be considered only if the Accountable Officer or his nominated officer decides that there are exceptional circumstances, e.g. where significant financial, technical or delivery advantages would accrue, and is satisfied that there is no reason to doubt the bona fides of the tender concerned. The Accountable Officer or nominated Page 93 of 164
officer shall decide whether such tenders are admissible or whether re-tendering is desirable. Re-tendering may be limited to those tenders reasonably in the field of consideration in the original competition
While decisions as to the admissibility of late, incomplete or amended tenders are under consideration and while re-tenders are being obtained, the tender documents shall be kept strictly confidential, recorded, and held in safe custody by the Accountable Officer or his nominated officer.
17.6.6 Acceptance of Formal Tenders (see overlap with PFP 17.4.2)
Any discussions with a tenderer which are deemed necessary to clarify technical aspects of his tender before the award of a contract will not disqualify the tender. Information provided by a tenderer under these circumstances shall not be acted upon by the Group until it has been confirmed in writing by the tenderer
The lowest tender (if payment is to be made by the Group) or the highest (if payment is to be received by the Group) shall be accepted unless there are good and sufficient reasons to the contrary. Such reasons shall be set out in the contract file, or other appropriate record
It is accepted that for professional services such as management consultancy, the lowest price does not always represent the best value for money. Other factors affecting the success of a project include: o Experience and qualifications of team members; o Understanding of client’s needs; o Feasibility and credibility of proposed approach; o Ability to complete the project on time.
Where other factors are taken into account in selecting a tenderer, these must be clearly recorded and documented in the contract file, and the reason(s) for not accepting the lowest tender clearly stated
Acceptance under such circumstances for contracts of any will require the endorsement of the Accountable Officer or Chief Finance Officer
No tender shall be accepted which will commit expenditure in excess of that which has been allocated by the Clinical Commissioning Group and which is not in accordance with these PFPs except with the authorisation of the Accountable Officer
The use of these procedures must demonstrate that the award of the contract: o Was not in excess of the going market rate/price current at the time the contract was awarded o Achieved the best value for money o All tenders shall be treated as confidential and shall be retained for inspection.
17.6.7 Tender Reports to the Clinical Commissioning Group Governing Body
Reports to the Governing Body will be made in exceptional circumstances only.
17.6.8 List of Approved Firms (see PFP 17.1)
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Responsibility for Maintaining List - a manager nominated by the Accountable Officer shall on behalf of the Group maintain lists of approved firms from which tenders and quotations may be invited. Such lists may be compiled by the Group or procured from another health body or organisation approved by the DOH.
These shall be kept under frequent review. The list shall include all firms who have applied for permission to tender and as to whose technical and financial competence the Group is satisfied. All suppliers must be made aware of the Group’s terms and conditions of contract.
17.6.9 Financial Standing and Technical Competence of Contractors
The Chief Finance Officer may make or institute any enquiries they deem appropriate concerning the financial standing and financial suitability of approved contractors
17.6.10 Exceptions of Using Approved Contractors
If in the opinion of the Accountable Officer and the Chief Finance Officer, it is impractical to use a potential contractor from the list of approved firms/individuals (for example where specialist services or skills are required and there are insufficient suitable potential contractors on the list), or where a list for whatever reason has not been prepared, the Accountable Officer should be satisfied that appropriate checks are carried out as to the technical and financial capability of those firms that are invited to tender or quote.
17.6.11 Authorisation of Tenders and Competitive Quotations
Providing all the conditions and circumstances set out in these PFPs have been fully complied with, and the intended expenditures or income falls within the relevant budget, formal authorisation and awarding of a contract may be decided by the following officers or staff to the gross value (this includes VAT only if it is not recoverable):
Budget Holder Expenditure
Designated budget holders Up to £25,000
Executive Directors Up to £75,000
Accountable Officer Up to £150,000
Clinical Commissioning Over £150,000 Group Governing Body
These levels of authorisation will be reviewed periodically, and may be varied at any time; they need to be read in conjunction with the Joint Scheme of Delegation.
Signing and, where appropriate, sealing of contracts and other documents shall be in accordance with Clause 6 of the Standing Orders
18 INSTANCES WHERE FORMAL COMPETITIVE TENDERING AND COMPETITIVE QUOTATION IS NOT REQUIRED
Where competitive tendering or a competitive quotation is not required, the Group shall use NHS Supply Chain or other public sector procurement hub arrangements for procurement of all goods and services unless the Accountable Officer or Chief Finance Officer deem it Page 95 of 164
inappropriate, in which case the Chief Finance Officer shall determine an alternative procurement process. The decision to use alternative sources must be documented and reported to the Audit Committee.
19 COMPLIANCE REQUIREMENTS FOR ALL CONTRACTS
The Body may only enter into contracts on behalf of the Group within the statutory powers delegated to it by the Secretary of State and shall comply with:
The Clinical Commissioning Group's Constitution and PFPs
All relevant EU Directives and other statutory provisions
Any relevant directions including the Capital Investment Manual, specific DH guidance and guidance on the Procurement and Management of Consultants
Such of the NHS Standard Contract Conditions as are applicable
Contracts with Foundation Trusts must be in a form compliant with appropriate NHS guidance
Where appropriate contracts shall be in or embody the same terms and conditions of contract as was the basis on which tenders or quotations were invited
In all contracts made by the Group, the Governing Body shall endeavour to obtain best value for money by use of all systems in place. The Accountable Officer shall nominate an officer who shall oversee and manage each contract on behalf of the Group.
20 ADOPTION OF THE TENDERING PROCESS CONDUCTED BY ANOTHER ORGANISATION
20.1 The Group may, on the express approval of the Accountable Officer or the Chief Finance Officer, adopt the tendering process of another organisation provided that organisation is either:
NHS England, Clinical Commissioning Group, FT or other NHS Trust, or
A LIFT company
A partner organisation where the basis of partnership is a Section 75 agreement; and provided specifically that:
o Such process has not proceeded to contract stage, and
o The process would satisfy the Group’s own Constitution and PFPs with regard to procedure and competition, and
o The Group’s authorisation limits for acceptance of tenders and letting of contracts are observed
20.2 In all such instances, the Body shall be informed by formal report at its next scheduled meeting.
21 PERSONNEL AND INTERIM, AGENCY AND TEMPORARY STAFF CONTRACTS
21.1 The Accountable Officer shall nominate officers with delegated authority to enter into contracts of employment, regarding staff, interim, agency staff or temporary staff service contracts. Page 96 of 164
22 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
22.1 The Group will coordinate its work with NHS England, other Clinical Commissioning Groups, local providers of services, local authority (including through Health & Wellbeing Boards), patients and their carers and the voluntary sector and others as appropriate to develop robust commissioning plans.
22.2 The Accountable 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.
22.3 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 whilst maintaining patient confidentiality.
23 RISK MANAGEMENT
POLICY - The Group will put arrangements in place for evaluation and management of its risks
23.1 The Group’s risk management arrangements shall comprise:
23.1.1 A Risk Management Strategy which sets out how risks will be identified, quantified, managed and reported on
23.1.2 A Corporate Risk Register setting out the significant risks facing the Group, together with mitigating actions
23.1.3 An Assurance Framework which provides assurance to the Governing Body on the management and mitigation of significant risks
23.1.4 Review of the Corporate Risk Register / Assurance Framework by the Audit Committee on a quarterly basis and by the Governing Body at least annually
23.1.5 An annual Statement on Internal Control within the annual report and accounts, as required by the Department of Health.
24 PAYROLL
POLICY - The Group will put arrangements in place for an effective payroll service
24.1 The Chief Finance Officer will ensure that the payroll service selected:
24.1.1 Is supported by appropriate (i.e. contracted) terms and conditions
24.1.2 Has adequate internal controls and audit review processes;
24.1.3 Has suitable arrangements for the collection of payroll deductions and payment of these to appropriate bodies.
24.2 In addition the Chief Finance Officer shall set out comprehensive procedures for the effective processing of payroll.
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25 NON-PAY EXPENDITURE
POLICY - The Group will seek to obtain the best value for money goods and services received
25.1 The Governing Body will approve the level of non-pay expenditure on an annual basis and the Accountable Officer will determine the level of Delegation to budget managers.
25.2 The Accountable Officer shall set out procedures on the seeking of professional advice regarding the supply of goods and services.
25.3 The Chief Finance Officer will:
25.3.1 Advise the Audit Committee 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
25.3.2 Be responsible for the prompt payment of all properly authorised accounts and claims
25.3.3 Be responsible for designing and maintaining a system of verification, recording and payment of all amounts payable
25.4 Delegated financial limits for non-pay expenditure will be determined by the Chief Finance Officer and reviewed annually and approved by the Audit Committee.
25.5 Official orders must:
25.5.1 Be consecutively numbered
25.5.2 Be in a form approved by the Chief Finance Officer
25.5.3 State the Group's terms and conditions of trade
25.5.4 Only be issued to, and used by, those duly authorised by the Accountable Officer
25.6 Officers and managers must ensure that they comply fully with the guidance and limits specified by the Chief Finance Officer and that:
25.6.1 All contracts (except as otherwise provided for in the Scheme of Delegation), leases, tenancy agreements and other commitments which may result in a liability are notified to the Chief Finance Officer in advance of any commitment being made
25.6.2 Contracts above specified thresholds are advertised and awarded in accordance with EU rules on public procurement;
25.6.3 Where consultancy advice is being obtained, the procurement of such advice must be in accordance with DoH guidance;
25.6.4 No order shall be issued for any item or items to any firm which has made an offer of gifts, reward or benefit to Directors or members of staff, other than:
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. isolated gifts of a modest nature or inexpensive seasonal gifts, such as calendars
. conventional hospitality, such as lunches in the course of working visits
25.6.5 No requisition / order is placed for any item or items for which there is no budget provision unless authorised by the Chief Finance Officer on behalf of the Accountable Officer
25.6.6 All goods, services, or works are ordered on an official order except works and services executed in accordance with a contract, purchases from petty cash, and goods or services purchased via the Group’s approved purchasing card scheme
25.6.7 Other than for purchases made via the Group’s approved purchasing card scheme, verbal orders must only be issued only in cases of emergency or urgent need, by a member of staff designated by the Accountable Officer - only in cases of genuine emergency or urgent necessity. These must be confirmed by an official order and clearly marked "Confirmation Order"
25.6.8 Orders are not split or otherwise placed in a manner devised so as to avoid the financial thresholds
25.6.9 Goods are not taken on trial or loan in circumstances that could commit the Group to a future uncompetitive purchase or other liability
25.6.10 Changes to the list of officers authorised to certify invoices are notified to the Chief Finance Officer
25.6.11 Purchases from petty cash are restricted in value and by type of purchase in accordance with instructions issued by the Chief Finance Officer
25.6.12 Petty cash records are maintained in a form as determined by the Chief Finance Officer
25.7 Joint Finance Arrangements with Local Authorities and Voluntary Bodies – payments to local authorities and voluntary organisations made under the powers of Sections 256 and 257 of the NHS Act 2006 shall comply with procedures laid down by the Chief Finance Officer which shall be in accordance with these Acts and the 2000 Directions of the Secretary of State.
26 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
26.1 The Accountable Officer will:
26.1.1 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
26.1.2 Be responsible for the management of all stages of capital schemes and for ensuring that schemes are delivered on time and to cost
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26.1.3 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
26.1.4 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.
26.2 The Chief Finance Officer will prepare detailed procedures for the disposals of assets.
27 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
27.1 The Accountable Officer shall:
27.1.1 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
27.1.2 Ensure that arrangements are in place for effective responses to Freedom of Information requests;
27.1.3 Publish and maintain a Freedom of Information Publication Scheme.
28 TRUST FUNDS AND TRUSTEES
POLICY - The Group will put arrangements in place to provide for the appointment of trustees if the Group holds property on trust
28.1 The Chief Finance Officer shall ensure that each Trust Fund which the Group is responsible for managing is managed appropriately with regard to its purpose and to its requirements.
29 ACCEPTANCE OF GIFTS BY STAFF AND LINK TO STANDARD OF BUSINESS CONDUCT
29.1 The Chief Finance Officer shall ensure that all staff are made aware of Clinical Commissioning Group policy on acceptance of gifts and other benefits in kind by staff. This policy follows the guidance contained in the DH circular HSG (93) 5 “Standards of Business Conduct for NHS Staff‟, which is attached as Annex A to these PFPs. The Code of Conduct for NHS Managers 2002 and the ABPI Code of Professional Conduct, which are deemed to be part of the Constitution and PFPs.
29.2 Details of all hospitality received by staff shall be entered in a register maintained by the Head of Governance.
30 COMMISSIONING SUPPORT SERVICE
30.1 The Chief Finance Officer will be responsible for ensuring a comprehensive Service Level Agreement is in place for services provided by the Commissioning Support Service.
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30.2 The Chief Finance Officer will ensure that the contract for such services provides value for money.
30.3 The Chief Finance Officer will ensure the Governing Body can be assured as to the accuracy and quality of services delivered by the Commissioning Support Service.
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Ref Matter delegated Delegate to 1 Bank accounts a) Executive Director of Finance
a) Maintenance and operation in accordance with mandate b) Financial Controller/Financial Accountant in accordance approved by Governing Board with the Clinical Commissioning Group Cash Limit Resource and provision of cash flow reports b) Cash Requisitions / Draw Down c) Management Accountant – within available cash c) Payment Requests – outside of normal process/routines d) Urgent – CHAPS d) Only Payroll – agreed via SCSU
e) RFT/BACS e) Financial Controller/Financial Accountant within available cash/payment code f) Cash Advances to Commissioning Providers f) Executive Director of Finance 2 Budget management
Responsibility for maintaining expenditure within approved budgets a) At individual budget level (pay and non-pay) a) Designated budget holder b) For the totality of services covered by the directorate b) Clinical Commissioning Group Director
3 Business Cases
a) Business cases cost neutral or a non-recurrent cost not exceeding a) Accountable Officer and the Executive Director of Finance £25,000 b) Executive Committee b) Business cases with a cost (recurrent or non-recurrent) exceeding £25,000 but not exceeding £249,999 c) Business cases c) Governing Body approval. exceeding £250,000
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4 Commissioning contracts including with Foundation Trusts, the private or voluntary sector, Service Level Agreements including with CSU or NHS Trusts, Primary Care partnership agreements with Local Authorities, grants a) Up to 250,000 a) Clinical Commissioning Group Director b) £250,000 to £1,000,000 b) Accountable Officer or Executive Director of Finance c) Over £1,000,000 c) Accountable Officer
5 Monthly Orders and Invoices for healthcare services with signed contracts under section 4 above, in line with agreed payments profiles as specified in the contract: a) Up to £250,000 a) Budget Holder or nominated representative b) Over £250,000 b) Clinical Commissioning Group Director or nominated 6 Commissioning and other healthcare orders and invoices for non- representative contracted activity including over performance above signed contracted sums: a) Up to £25,000 a) Budget holder b) £25,000 to£250,000 b) Clinical Commissioning c) £250,000 to £1,000,000 Group Director d) Over £1,000,000 c) Executive Director of Finance d) Accountable Officer
7 Orders and requisitions for admin and corporate costs
a) Up to £1,000 a) Budget holder b) £1,000 to £25,000 b) Clinical Commissioning Group Director c) Over £25,000 c) Executive Director of Finance
8 Fees and charges
a) Overseas visitors, income generation and other patient related services a) Executive Director of Finance b) All other income sources b) Executive Director of Finance 9 Hospitality
Declaration in Hospitality Register where value for any hospitality All Staff received exceeds £25 per individual per instance
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10 Invoice certification; excluding commissioning expenditure covered by section 5
a) Up to £24,999 a) Designated Budget Holder b) £25,000 to £74,999 b) Executive Director of Finance c) £75,000 to £249,999 c) Accountable Officer d) Over £250,000 d) Accountable Officer & Executive Director of Finance
11 Losses, write-offs and compensation: Executive Director of Finance & Accountable Officer Any write offs of any value
12 Management Consultancy
a) Where aggregate commitment in any one year or total commitment is £24,999 or less a) Executive Director of Finance b) Where aggregate commitment in any one year is £25,000 or b) Accountable Officer above
13 Primary Care Delegated Commissioning Schedule of GP Payments
a) Up to £29,999 a) Primary Care Accountant – NHS England b) £30,000 to £89,999 b) Assistant Head of Finance – NHS England c) £90,000 to £149,999 c) Primary Care Finance Manager – CCG d) £150,000 to £249,999 d) Head of Commissioning Finance – CCG e) £250,000 to £1,000,000 e) Executive Director of Finance
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Appendix A
14 Personal & Pay
a) Authority to fill funded posts on the establishment with permanent staff a) Designated Budget Holder b) Authority to appoint staff to post not on the formal establishment b) Accountable Officer c) The granting of additional increment to staff within budget c) Executive Director of d) Staff upgrades Finance e) Additional staff to the agreed establishment within specifically d) Accountable Officer allocated finance e) Executive Director of Finance f) Additional staff to the agreed establishment without specifically f) Accountable Officer allocated finance g) Pay g) Pay i. Executive Director of Finance i. Authority to complete standing date forms affecting pay, ii. Designated Budget Holder new starters, variations and leavers iii. Executive Director of Finance ii. Authority to complete and authorise positive iv. Designated Budget Holder reporting forms h) Leave iii Authority to authorise overtime i. Immediate line manager iv. Authority to authorise travel and subsistence expenses ii. Immediate line manager h) Leave iii. Executive Director of Finance i. Approval annual leave and study leave iv. Immediate line manager ii. Compassionate leave up to 3 days v. Executive Director of Finance iii. Compassionate leave up to 6 days vi. Immediate line manager iv. Special leave arrangements up to 3 days vii. Immediate line manager v. Special leave arrangements up to 6 days viii. Automatic approval with guidance vi. Leave without pay i) Sick leave vii. Time off in lieu i. Executive Director of Finance viii. Maternity leave – paid and unpaid ii. Remuneration committee i) Sick leave iii. Remuneration committee i. Extension of sick leave on half pay up to 3 months ii. Return to work part-time on full pay to assist recovery iii. Extension of sick leave on full pay
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15 (a) Petty Cash disbursements up to £50 per item a) Designated budget holder (b) Petty cash float replenishment up to £500 per week b) Executive Director of Finance
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SCHEDULE 6
STANDARDS OF BUSINESS CONDUCT
Part A
Prevention of Corruption Acts 1906 and 1916 - summary of main provisions
Acceptance of gifts by way of inducements or rewards
Under the Prevention of Corruption Acts, 1906 and 1916, it is an offence for members of staff to accept any gifts or consideration as an inducement or reward for:
Doing, or refraining from doing, anything in their official capacity; or Showing favour or disfavour to any person in their official capacity
Under the Prevention of Corruption Act 1916, any money, gift or consideration received by a member of staff in public service from a person or organisation holding or seeking to obtain a contract will be deemed by the courts to have been received corruptly unless the member of staff proves the contrary.
Part B
NHS Management Executive (NHSME) - General Guidelines
Introduction
These guidelines, which are intended by the NHSME to be helpful to all NHS employers and their staff, re-state and reinforce the guiding principles previously set out in Circular HM(62)21 (now cancelled), relating to the conduct of business in the NHS.
Responsibility of NHS employers
NHS employers are responsible for ensuring that these guidelines are brought to the attention of all staff; also that machinery is put in place for ensuring that they are effectively implemented (in these guidelines "NHS employer" means all "for action” addressees listed on the title page of HSG (93)5).
Responsibility of NHS staff
It is the responsibility of staff to ensure that they are not placed in a position which risks, or appears to risk, conflict between their private interests and their NHS duties. This primary responsibility applies to all NHS Staff, i.e. those who commit NHS resources directly (e.g. by the ordering of goods) or those who do so indirectly (e.g. by the prescribing of medicines). A further example would be staff who may have an interest in a private nursing home and who are involved with the discharge of patients to residential facilities.
Guiding principle in conduct of public business
It is a long established principle that public sector bodies, which include the NHS, must be impartial and honest in the conduct of their business, and that their staff members should remain beyond suspicion. It is also an offence under the Prevention of Corruption Acts 1906 NHS North Staffordshire Clinical Commissioning Group – Constitution v2.3 Feb-20
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and 1916 for a member of staff corruptly to accept any inducement or reward for doing, or refraining from doing anything, in his or her official capacity, or corruptly showing favour, or disfavour, in the handling of contracts (see Part A).
Staff will need to be aware that a breach of the provisions of these Acts renders them liable to prosecution and may also lead to loss of their employment and superannuation rights in the NHS.
NHS staff are expected to:
Ensure that the interest of patients remains paramount at all times; Be impartial and honest in the conduct of their official business; Use the public funds entrusted to them to the best service, always ensuring value for money
It is also the responsibility of staff to ensure that they do not:
abuse their official position for personal gain or to benefit their family or friends; seek to advantage or further private business or other interests, in the course of their official duties
Implementing the Guiding Principles
Casual gifts - gifts offered by contractors or others, e.g. at Christmas time, may not in any way be connected with the performance of duties so as to constitute an offence under the Prevention of Corruption Acts. Such gifts should nevertheless be politely but firmly declined. Articles of low intrinsic value such as diaries or calendars, or small tokens of gratitude from patients or their relatives, need not necessarily be refused. In cases of doubt staff should either consult their line manager or politely decline acceptance.
Hospitality
Modest hospitality, provided it is normal and reasonable in the circumstances, e.g. lunches in the course of working visits, may be acceptable, though it should be similar to the scale of hospitality which the NHS as an employer would be likely to offer.
Staff should decline all other offers of gifts, hospitality or entertainment. If in doubt they should seek advice from their line manager.
Declaration of interests
NHS employers need to be aware of all cases where a member of staff, or his or her close relative or associate, has a controlling and/or significant financial interest in a business (including a private company, public sector organisation, other NHS employer and/or voluntary organisation), or in any other activity or pursuit, which may compete for an NHS contract to supply either goods or services to the employing authority.
All NHS staff should therefore declare such interests to their employer, either on starting employing authority, employment or on acquisition of the interest, in order that it may be known to, and in no way promoted to the detriment of, either the employing authority or the patients whom it serves. NHS North Staffordshire Clinical Commissioning Group – Constitution v2.3 Feb-20
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One particular area of potential conflict of interest which may directly affect patients is when NHS staff hold a self-beneficial interest in private care homes or hostels. While it is for staff to declare such interest to their employing authority, the employing authority has a responsibility to introduce whatever measures it considers necessary to ensure that its interests and those of patients are adequately safeguarded. This may for example take the form of a contractual obligation on staff to declare any such interests. Advice on professional conduct issued by the General Medical Council recommends that when a doctor refers a patient to a private care home or hostel in which he or she has an interest, the patient must be informed of that interest before referral is made.
In determining what needs to be declared, employers and staff will wish to be guided by the principles set out in paragraph 5 above.
NHS Employers should:
Ensure that staff are aware of their responsibility to declare relevant interests (perhaps by including a clause to this effect in staff contracts) Consider keeping registers of all such interested and making them available for inspection by the public Develop a local policy, in consultation with staff and local staff interests, for implementing this guidance. This may include the disciplinary action to be taken if a member of staff fails to declare a relevant interest, or is found to have abused his or her official position, or knowledge, for the purpose of self-benefit, or that of family or friends.
Preferential Treatment in Private Transactions
Individual staff must not seek or accept preferential rates or benefits in kind for private transactions carried out with companies with which they have had, or may have, official dealings on behalf of their NHS employer (this does not apply to concessionary agreements negotiated with companies by NHS management, or by recognised staff interests, on behalf of all staff – for example, NHS staff benefits schemes).
Contracts
All staff who are in contact with suppliers and contractors (including external consultants), and in particular those who are authorised to sign purchase orders, or place contracts for goods, materials or services, are expected to adhere to professional standards of the kind set out in the Ethical Code of the Institute of Purchasing and Supply (IPS), reproduced at Part C.
Favouritism in Awarding Contracts
Fair and open competition between prospective contractors or suppliers for NHS contracts is a requirement of NHS Standing Orders, EU Directives on Public Purchasing for Works and Supplies and the Public Contracts Regulations 2015. This means that:
No private, public or voluntary organisation or company which may bid for NHS business should be given any advantage over its competitors, such as advance notice of NHS
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requirements. This applies to all potential contractors, whether or not there is a relationship between them and the NHS employer, such as a long-running series of previous contracts
Each new contract should be awarded solely on merit, taking into account the requirements of the NHS and the ability of the contractors to fulfil them.
NHS employers should ensure that no special favour is shown to current or former members of staff or their close relatives or associates in awarding contracts to private or other businesses run by them or employing them in a senior or relevant managerial capacity. Contracts may be awarded to such businesses where they are won in fair competition against other tenders, but scrupulous care must be taken to ensure that the selection process is conducted impartially, and that staff that are known to have a relevant interest play no part in the selection.
Warning to Potential Contractors
NHS employers will wish to ensure that all invitations to potential contractors to tender for NHS business include a notice warning tenderers of the consequences of engaging in any corrupt practices involving members of staff of public bodies.
Outside Employment
NHS employees are advised not to engage in outside employment which may conflict with their NHS work, or be detrimental to it. They are advised to tell their NHS employing authority if they think they may be risking a conflict of interest in this area: the NHS employer shall be responsible for judging whether the interests of patients could be harmed, in line with the principles in paragraph 5 above. NHS employers may wish to consider the preparation of local guidelines on this subject.
Private Practice
Consultants (and associate specialists) employed under the Terms and Conditions of Service of Hospital Medical and Dental Staff are permitted to carry out private practice in NHS hospitals subject to the conditions outlined in the handbook "A Guide to the Management of Private Practice in the NHS". (See also PM (79)11). Consultants who have signed new contracts with Trusts shall be subject to the terms applying to private practice in those contracts.
Other grades may undertake private practice or work for outside agencies, providing they do not do so within the time they are contracted to the NHS, and they observe the conditions in paragraph 20 above. All hospital doctors are entitled to fees for other work outside their NHS contractual duties under "Category 2" (paragraph 37 of the TCS of Hospital Medical and Dental staff), e.g. examinations and reports for life insurance purposes. Hospital doctors and dentists in training should not undertake locum work outside their contracts where such work would be in breach of their contracted hours. Career grade medical and dental staff employed by NHS Trusts may agree terms and conditions different from the National Terms and Conditions of Service.
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Rewards for Initiative
NHS employers should ensure that they are in a position to identify potential intellectual property rights (IPR), as and when they arise, so that they can protect and exploit them properly, and thereby ensure that they receive any rewards or benefits (such as royalties) in respect of work commissioned from third parties, or work carried out by their staff in the course of their NHS duties. Most IPR are protected by statute; e.g. patents are protected under the Patents Act 1977 and copyright (which includes software programmes) under the Copyright Designs and Patents Act 1988. To achieve this, NHS employers should build appropriate specifications and provisions into the contractual arrangements which they enter into before the work is commissioned, or begins. They should always seek legal advice if in any doubt in specific cases.
With regard to patents and inventions, in certain defined circumstances the Patents Act gives staff a right to obtain some reward for their efforts, and employers should see that this is affected. Other rewards may be given voluntarily to staff who within the course of their employment has produced innovative work of outstanding benefit to the NHS. Similar rewards should be voluntarily applied to other activities such as giving lectures and publishing books and articles.
In the case of collaborative research and evaluative exercises with manufacturers, NHS employers should see that they obtain a fair reward for the input they provide. If such an exercise involves additional work for a NHS staff member outside that paid for by the NHS employer under his contract of employment, arrangements should be made for some share of any rewards or benefits to be passed on to the staff member(s) concerned from the collaborating parties. Care should however be taken that involvement in this type of arrangement with a manufacturer does not influence the purchase of other supplies from that manufacturer.
Part C
Chartered Institute of Purchasing and Supply - Ethical Code
(Reproduced by kind permission of CIPS)
The personal ethical code set out below was approved by the Institute's Council on 16 October 1999 and is binding on CIPS members.
Introduction
Members of the Institute undertake to work to exceed the expectations of the following Code and will regard the Code as the basis of best conduct in the purchasing and supply profession.
Members should seek the commitment of their employer to the Code and seek to achieve wide spread acceptance of it amongst their fellow employees.
Members should raise any matter of concern of an ethical nature with their immediate supervisor or another senior colleague if appropriate, irrespective of whether it is explicitly addressed in the Code.
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Principles
Members shall always seek to uphold and enhance the standing of the purchasing and supply profession and will always act professionally and selflessly by:
Maintaining the highest possible standard of integrity in all their business relationships both inside and outside the organisations where they work
Rejecting any business practice which might reasonably be deemed improper and never using their authority for personal gain;
Enhancing the proficiency and stature of the profession by acquiring and maintaining current technical knowledge and the highest standards of ethical behaviour;
Fostering the highest possible standards of professional competence amongst those for whom they are responsible;
Optimising the use of resources which they influence and for which they are responsible to provide the maximum benefit to their employing organisation;
Complying both with the letter and the spirit of:
The law of the country in which they practise Institute guidance on professional practice Contractual obligations
Members should never allow themselves to be deflected from these principles.
Guidance
In applying these principles, members should follow the guidance set out below:
Declaration of interest - any personal interest which may affect or be seen by others to affect a member's impartiality in any matter relevant to his or her duties should be declared.
Confidentiality and accuracy of information – the confidentiality of information received in the course of duty should never be issued for personal gain. Information given in the course of duty should be honest and clear
Competition - the nature and length of contracts and business relationships with suppliers can vary according to circumstances. These should always be constructed to ensure deliverables and benefits. Arrangements which might in the long term prevent the effective operation of fair competition should be avoided.
Business gifts - business gifts, other than items of very small intrinsic value such as business diaries or calendars, should not be accepted.
Hospitality - the recipient should not allow him or herself to be influenced or be perceived by others to have been influenced in making a business decision as a consequence of accepting hospitality. The frequency and scale of hospitality accepted should be managed openly and with care and should not be greater than the member's employer is able to reciprocate. NHS North Staffordshire Clinical Commissioning Group – Constitution v2.3 Feb-20
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Decisions and Advice
When it is not easy to decide between what is and is not acceptable, advice should be sought from the member's supervisor, another senior colleague or the Institute as appropriate. Advice on any aspect of the Code is available from the Institute
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SCHEDULE 7
GOVERNANCE STRUCTURE DIAGRAM
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SCHEDULE 8
These are based upon “best practice” Terms of Reference, as recommended by the NHS CB for Clinical Commissioning Group Governing Body committees. They acted as the initial baseline from which the finalised versions were ultimately agreed by the committee in question and ratified formally by the Governing Body.
NHS NORTH STAFFORDSHIRE CCG AUDIT COMMITTEE A Committee held in common with Cannock Chase, East Staffordshire, North Staffordshire, South East Staffordshire & Seisdon Peninsula, Stafford and Surrounds and Stoke on Trent Clinical Commissioning Group
Introduction
The Audit Committee (the committee) is established in accordance with North Staffordshire Clinical Commissioning Group’s Constitution. These Terms of Reference set out the membership, the remit, responsibilities and reporting arrangements of the committee and shall have effect as if incorporated into the Constitution.
Membership
The committee shall be appointed by the Clinical Commissioning Group as set out in the Clinical Commissioning Group’s Constitution and may include individuals who are not on the Governing Body. The Lay Member on the Governing Body, with a lead role in overseeing key elements of governance, will chair the Audit Committee. In the event of the Chair of the committee being unable to attend all or part of the meeting, the Deputy Chair will take over. The remaining (quorate) members will nominate a temporary replacement from within the membership to deputise for any items where the Deputy is unable to chair: e.g. owing to potential conflicts of interest. Membership will also comply with the same applicable and relevant Governing Body provisions set out in Constitution’s regulations with regard to:
Qualification and Disqualification for membership and appointment of Chairs Appointment of members The tenure of members will reference Terms of Office for Lay Members Eligibility for re-appointment
It would be good practice not to include full-time employees or individuals who claim a significant proportion of their income from the Clinical Commissioning Group in the membership of the committee. The Member Practices should not be in the majority. The membership shall be made up of the following persons. These shall all have voting rights and will be the, independent members of the committee:
Lay Member for Governance: Chair Lay Member for Quality: Vice Chair Lay Member for Patient & Public Involvement Secondary Care Specialist Doctor
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Other regular attender (non-voting) will be:
Chief Finance Officer Director of Corporate Service, Governance & Communications Deputy Director of Governance Internal Audit representative(s) External Audit representative(s)
Attendance
In addition to the members set out above, the committee will also require attendance on a less frequent basis the following:
At least once a year the committee should meet privately with the external and internal auditors Local Counter Fraud Specialist (LCFS) Representatives may be invited to attend meetings and will normally attend at least one meeting each year Regardless of attendance, External Audit, Internal Audit, local Counter Fraud and Security Management providers will have full and unrestricted rights of access to the Audit Committee The Accountable Officer will normally be invited to attend and discuss, at least annually with the committee, the process for assurance that supports the Annual Governance Statement. He or she would also normally attend when the committee considers the draft Internal Audit Plan and the Annual Accounts Any other Directors (clinical or similar) may be invited to attend, particularly when the committee is discussing areas of risk or operation that are their responsibility The Chair of the Governing Body may also be invited to attend one meeting each year in order to gain an understanding of, the committee’s operations
Secretary
Secretarial support will be provided by the PA to the Chief Finance Officer, unless otherwise agreed. The Secretary will be responsible for supporting the Chair in the management of the committee’s business and for drawing the committee’s attention to best practice, national guidance and other relevant documents, as appropriate.
Quorum
Quoracy will be a minimum of one member being present.
Frequency and Notice of Meetings
The frequency will be a minimum five times per year (i.e. quarterly with one flexible month for Clinical Commissioning Group Final Accounts); to be held on the same days as Clinical Commissioning Group Governing Body meetings wherever possible to ensure maximum member attendance. Arrangements for calling meetings and the minimum number of days’ notice will mirror those for the Governing Body, in Appendix C Sections 3.1 and 3.2. Furthermore, the External Auditors or Head of Internal Audit may request a meeting if they consider that necessary.
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Remit and Responsibilities
The committee shall critically review the Clinical Commissioning Group’s financial reporting and internal control principles and ensure an appropriate relationship with both internal and external auditors is maintained. The duties of the committee will be driven by the priorities identified by the Clinical Commissioning Group (Governing Body), and the associated risks. It will operate to a programme of business, agreed by the Clinical Commissioning Group, which will be flexible to new and emerging priorities and risks. The key duties of the committee will broadly be as follows:
Integrated governance, risk management and internal control
The committee shall review the establishment and maintenance of an effective system of integrated governance, risk management and internal control, across the whole of the Clinical Commissioning Group’s activities that support the achievement of the Clinical Commissioning Group’s objectives. Its work will dovetail with that of the Quality & Safety Committee to seek assurance that robust clinical quality is in place. In particular, the committee will review the adequacy and effectiveness of:
All risk and control related disclosure statements (in particular the governance statement), together with any appropriate independent assurances, prior to endorsement by the Clinical Commissioning Group The underlying assurance processes that indicate the degree of achievement of clinical commissioning Group objectives, the effectiveness of the management of principal risks and the appropriateness of the above disclosure statements The policies for ensuring compliance with relevant regulatory, legal and code of conduct requirements and related reporting and self-certification The policies and procedures for all work related to fraud / corruption as set out in Secretary of State Directions and as required by the NHS Counter Fraud Authority
In carrying out this work the 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 / assurance functions that report to it.
Internal audit
The committee shall ensure that there is an effective internal audit function that meets mandatory NHS Internal Audit Standards and provides appropriate independent assurance to the committee, Accountable Officer and Clinical Commissioning Group. The committee will make appropriate inquiries of management and the Chief Audit Executive to determine whether there are any inappropriate scope or resource limitations.
This will be achieved by:
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Consideration of the provision of the internal audit service, the cost of the audit and any questions of resignation and dismissal Review and approval of the internal audit strategy, operational plan and more detailed programme of work, ensuring that this is consistent with the audit needs of the organisation, as identified in the Assurance Framework Consider major findings of internal audit work (and management’s response), ensuring co-ordination between the internal / external auditors to optimise audit resources Ensuring that the internal audit function is adequately resourced and has appropriate standing within the Clinical Commissioning Group An annual review of the effectiveness of internal audit
External audit
The committee shall review the work and findings of external auditors and consider the implications and management’s responses to their work. This will be achieved by:
Consideration of the performance of the external auditors, as far as the rules governing the appointment permit Discussion and agreement with the external auditors, before the audit commences, on the nature and scope of the audit as set out in the annual plan, and ensuring co- ordination, as appropriate, with other external auditors in the local health economy Discussion with the external auditors of their local evaluation of audit risks / Value for Money assessment and assessment of the Clinical Commissioning Group and associated impact on the audit fee Review of all external audit reports, including the report to those charged with governance, agreement of the annual audit letter before submission to the Clinical Commissioning Group and any work undertaken outside the annual audit plan, together with the appropriateness of management responses
Other assurance functions
The Audit Committee shall review the findings of other significant assurance functions, both internal and external, and consider the implications for governance of the Clinical Commissioning Group.
These will include, but will not be limited to, any reviews by Department of Health arm’s length bodies or regulators / inspectors: e.g. National Audit Office (PbR reviews), or NHS Resolution; and professional bodies with responsibility for the performance of staff or functions (e.g. Royal Colleges and accreditation bodies).
Counter Fraud
The committee shall ensure that there is an effective Counter Fraud function that meets the NHS Counter-Fraud Standards for NHS Commissioners and provides appropriate independent assurance to the committee and CFO on fraud related matters. This will be achieved by:
Review and approval of the annual work plan Review the annual Self Review Toolkit submission to NHS Counter Fraud
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Consider any findings of the counter fraud function that affect the Clinical Commissioning Group resources
Management
The committee shall request and review reports and assurances from directors and managers on the overall arrangements for governance, risk management and internal control. The committee may also request specific reports from individual functions within the Clinical Commissioning Group as they may be appropriate to the overall arrangements.
Financial reporting
The Audit Committee shall monitor the integrity of the financial statements of the Clinical Commissioning Group and any formal announcements relating to the Clinical Commissioning Group’s financial performance. The committee shall ensure that the systems for financial reporting to the Clinical Commissioning Group, including those of budgetary control, are subject to review as to completeness and accuracy of the information provided. The committee shall review the Annual Report and financial statements before submission to the Governing Body / the Clinical Commissioning Group, focusing particularly on:
The wording in the Governance Statement and other disclosures relevant to the Terms of Reference of the committee Changes in / compliance with accounting policies, practices and estimation techniques Unadjusted mis-statements in the Financial Statements Significant judgements in preparing of the Financial Statements Significant adjustments resulting from the audit Letter of representation and Qualitative aspects of financial reporting
Relationship with the Governing Body
Reporting arrangements, for example, the format of reporting, frequency and approaches to exception reporting will be determined by agreement with the Governing Body and will be referenced here once agreed.
Policy and Best Practice
The committee will apply best practice in decision-making processes. The committee would have full authority to commission any reports or surveys it deems necessary to help it fulfil its obligations.
Conduct of the Committee
The committee will conduct its business in accordance with any national guidance and relevant codes of conduct / good governance practice, e.g. Nolan principles of public life and recording conflicts of interest. The committee will annually review its own performance, membership and terms of reference. Any resulting changes to the terms of reference or membership should be approved by the Governing Body.
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SCHEDULE 10
NHS NORTH STAFFORDSHIRE CCG REMUNERATION & TERMS OF SERVICE COMMITTEE A Committee held in common with Cannock Chase, East Staffordshire, North Staffordshire, South East Staffordshire & Seisdon Peninsula, Stafford and Surrounds and Stoke on Trent Clinical Commissioning Group
Introduction
The Remuneration and Terms of Service Committee (the committee) is established in accordance with NHS North Staffordshire Clinical Commissioning Group’s Constitution, Standing Orders and Scheme of Delegation. These Terms of Reference set out the membership, the remit, responsibilities and reporting arrangements of the committee and shall have effect as if incorporated into the Clinical Commissioning Group’s Constitution and Standing Orders.
Membership
The committee shall be appointed from amongst its Governing Body members, as set out in Section 6.8 – the three Lay Members and the Secondary Care Consultant. The Lay Member with responsibility for PPI will chair the committee. Only these members of the Governing Body may be members of the committee. It is good practice not to include full-time employees or individuals who claim a significant proportion of their income from the Group in the membership of the committee; and Member Practices should not be in the majority.
Only members of the committee have the right to attend committee meetings. However, other individuals such as the Accountable Officer (AO), HR lead and external advisers may be invited to attend for all or part of any meeting as and when appropriate, however, should not be in attendance for discussions about their own remuneration and terms of service.
Secretary
Secretarial support will be provided by the PA to the Chief Operating Officer and Clinical Commissioning Group Execs, unless otherwise agreed. The Secretary will be responsible for supporting the Chair in the management of the committee’s business and for drawing the committee’s attention to best practice, national guidance and other relevant documents, as appropriate.
Quorum
Quoracy will be any 2 from the Clinical Commissioning Group Lay Members & Secondary Care Consultant. Wherever possible the Clinical Commissioning Group will endeavour to have all four present through the use of tele-conferencing or other remote access facilities. To manage Conflict of Interest complications regarding quoracy, any items and recommendations relating to remuneration or terms & conditions of the Lay Members and the Secondary Care Consultant will be considered by the Clinical Commissioning Group Clinical Chair and Accountable Officer,
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who will make recommendations to the Governing Body, subject to national guidelines on payment authorisation levels for these posts.
Frequency and notice of meetings
The frequency of meetings will be a minimum four times per year (i.e. quarterly). Arrangements for calling meetings and the minimum number of days’ notice will mirror those for the Governing Body.
Remit and responsibilities of the committee
The committee shall make recommendations to the Governing Body on determinations about pay and remuneration for employees of the Clinical Commissioning Group and people who provide services to the Clinical Commissioning Group and allowances under any pension scheme it might establish as an alternative to the NHS pension scheme. In addition to this, it may include:
Making recommendations to the Governing Body on the remuneration and conditions of service of the senior team Reviewing the performance of the AO / other senior team members and make recommendations to the Governing Body on determining annual salary awards, if appropriate Making recommendations to the Governing Body on the severance payments of the AO and usually of other senior staff, seeking HM Treasury approval as appropriate in accordance with the guidance ‘Managing Public Money’ (c/o HM Treasury.gov.uk website)
Relationship with the Governing Body
The minutes and items of importance for escalation (as raised by the Chair) will be submitted to the confidential agenda of the Governing Body.
Policy and best practice
The committee will apply best practice in the decision making processes. The committee would have full authority to commission any reports or surveys it deems necessary to help it fulfil its obligations
Conduct of the committee
The committee will conduct its business in accordance with any national guidance and relevant codes of conduct / good governance practice, e.g. Nolan principles of public life. The committee will annually review its own performance, membership and terms of reference. Any resulting changes to the terms of reference or membership should be approved by the Governing Body.
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SCHEDULE 11
NHS North Staffordshire CCG Primary Care Commissioning Committee
A Committee held in common with North Staffordshire and Stoke on Trent Clinical Commissioning Group
1. Introduction
1.1 The individual Primary Care Commissioning Committee (the Committees) of North Staffordshire and Stoke-on-Trent CCGs are established in accordance with each CCG’s Constitution, Prime Financial Policies and Scheme of Delegation. These terms of reference set out the membership, remit, responsibilities and reporting arrangements of each Committee and shall have effect as if incorporated into each Clinical Commissioning Group’s Constitution and Prime Financial Policies enabling the Committees to meet ‘in common’.
1.2 As per the CCGs constitutions, in the interest of partnership working, the Committees will operate as a ‘committee in common’ with representatives from both CCGs to jointly plan for North Staffordshire and Stoke-on-Trent. In accordance with each CCGs Constitution, the accountability and decision making of the Committees has been delegated to the Committees by each individual Clinical Commissioning Group’s Body.
2. Statutory Framework
2.1 NHS England has delegated to each CCG authority to exercise the primary care commissioning functions set out in schedule 2 of the delegated agreement in accordance with section 13Z of the NHS Act. (See appendix 1 to these terms of reference)
2.2 Arrangements made under section 13Z may be on such terms and conditions (including terms as to payment) as may be agreed between NHS England and each CCG.
2.3 Arrangements made under section 13Z do not affect the liability of NHS England for the exercise of any of its functions. However, the CCG acknowledges that in exercising its functions (including those delegated to it), it must comply with the statutory duties set out in Chapter A2 of the NHS Act and including:
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 14Z1) i) Public involvement and consultation (section 14Z2)
2.4 The North Staffordshire and Stoke-on-Trent CCGs will also need to specifically, in respect of the delegated functions from NHS England, exercise those set out below:
• Duty to have regard to impact on services in certain areas (section 13O); • Duty as respects variation in provision of health services (section 13P).
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2.5 The Primary Care Commissioning committees of NHS North Staffordshire and NHS Stoke-on-Trent CCG Governing Bodies are established as a committee of each Governing Body in accordance with Schedule 1A of the “NHS Act”.
2.6 The members acknowledge that the Committees are subject to any direction made by NHS England or by the Secretary of State.
3. Role of the Committees
3.1 The committees have 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 North Staffordshire and Stoke-on-Trent, under delegated authority from NHS England.
3.2 In performing its role the Committees will exercise its management of the functions in accordance with the agreement entered into between NHS England and NHS North Staffordshire and Stoke-on-Trent CCGs, which will sit alongside the delegation and terms of reference.
3.3 The functions of the Committees are undertaken in the context of a desire to promote increased co-commissioning to increase quality, efficiency, productivity and value for money and to remove administrative barriers.
3.4 The role of the Committees shall be to carry out the functions relating to the commissioning of primary medical services under section 83 of the NHS Act.
3.5 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 (e.g., returner/retainer schemes)
3.6 The CCGs will also carry out the following activities:
(a) To plan, including needs assessment, primary care services in North Staffordshire and Stoke-on-Trent;
(b) To undertake reviews of primary care services in North Staffordshire and Stoke-on- Trent;
(c) To co-ordinate a common approach to the commissioning of primary care services generally in North Staffordshire and Stoke-on-Trent;
(d) To manage the budget for commissioning of primary care services in North Staffordshire and Stoke-on-Trent
3.7 The Committees provide the level of assurance to the Governing Bodies to ensure all matters related to Primary Care are well governed and well managed.
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3.8 The Committees are authorised by each Governing Body to investigate any activity within its terms of reference. The Committees are authorised to seek any information it requires from any employee, or interim and temporary members of staff, who are directed to co-operate with any request made by the Committee. The Committee is authorised by the Governing Body to obtain outside legal, or other independent professional, advice and to secure the attendance of outsiders with relevant experience and expertise if it considers this necessary.
3.9 To support the collaborative working across Stoke-on-Trent and North Staffordshire CCGs, the Committee will hold meetings ‘in common’, where appropriate, to discuss items of common interest. This will be agreed in advance with the Chair of each Committee and a Chair’s Report submitted to each CCG Governing Body in line with normal processes.
4. Geographical Coverage
4.1 The Committee will comprise of North Staffordshire CCG and Stoke-on-Trent CCG. It will undertake the function of commissioning primary medical services for both CCGs.
5. Membership
5.1 The Committee shall be appointed by each Governing Body and shall consist of:
Voting Members
Joint CCG Posts
Accountable Officer Chief Finance Officer, or nominated deputy Director of Commissioning, or nominated deputy Director of Strategy, Planning and Performance, or nominated deputy Director of Nursing and Quality, or nominated deputy
NSCCG Lay member x 3 (includes Chair*)
Stoke-on-Trent CCG Lay member x 3 (includes Chair*)
*The role of Chair and Vice Chair must be undertaken by a Lay Member (who is not the Audit Chair and Conflicts of Interest Guardian)
Non-Voting Members
Medical Director* Clinical representatives (to be sourced from Clinical Chairs, Clinical Directors or Non- Executive GP Board Members)* Secondary Care Consultant* Head of Governance (or deputy) Head of Primary Care Commissioning or nominated deputy Representative from NHS England – Head of Primary Care or nominated deputy
*Whilst clinical members cannot be voting members, they are actively encouraged to attend to participate and ensure sufficient clinical input, Therefore a minimum of two are required for quoracy, 1 from each CCG (a non-executive GP board member represents both CCGs) .
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5.2 A standing non-voting invitation will be open to the following observers to attend and participate in discussions:
Healthwatch Stoke-on-Trent Healthwatch Staffordshire Health and Wellbeing Board Representative (Stoke-on-Trent City Council) Health and Wellbeing Board Representative (Staffordshire County Council) LMC
The standing invitation will enable all observers to attend the open and closed section of the meetings. The value of observers contributing to discussions is recognised and valued, however the Chair of the Committees reserves the right to request observers leave the closed meeting should it be required (as set out in section 8.2)
5.3 The Committees may also extend invitations to other personnel with relevant skills, experience or expertise as necessary to enable it to address matters before the Committee or as part of the Committees’ cycle of business to support with the decision making process. These representatives will be noted in the minutes as ‘in attendance’. All other senior managers may be invited to attend by exception, particularly when the Committee are discussing areas of risk or operation within their area of responsibility.
5.4 Development sessions will be put in place, as appropriate, for committee members so members fully understand its roles and functions.
5.5 Membership will be reviewed regularly to adjust for changes as required by the purpose of the Committee. If at such time the two CCGs have any shared Lay Members, the representation from lay members may be reviewed accordingly.
6. Quoracy
6.1 The meeting shall be deemed quorate when:
A minimum of two of the three lay members from each CCG (including the Committee Chair) are present (noting that the Chair of the meeting cannot be the Lay Member for Governance); and A minimum of three executives or their deputy are present A minimum of 2 GP representatives, 1 from each CCG
Whilst clinical members cannot be voting members, they are actively encouraged to attend to participate and ensure sufficient clinical input, but must not be in the majority.
7. Voting
7.1 Each voting member of the Committees shall have one vote. The Committees 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 Committees will be to achieve consensus decision-making wherever possible.
7.2 Certain items will be pertinent to one CCG only, and will only be voted on by voting members of that CCG.
8. Frequency and Notice of Meetings
8.1 Meetings shall routinely be held on a monthly basis, but not less than nine times a year.
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(a) be held in public , subject to the application of (b)
(b) the Committees 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
8.3 Members of the Committees have a collective responsibility for the operation of the Committees. They will participate in discussion, review evidence and provide objective expert input to the best of their knowledge and ability, and endeavour to reach a collective view.
8.4 The Committees 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 on a scheme of delegation, are governed by terms of reference as appropriate and reflect appropriate arrangements for the management of conflicts of interest.
8.5 The Committees may call additional experts to attend meetings on an adhoc basis to inform discussions.
8.6 Members of the Committees, including observers, shall respect confidentiality requirements as set out in the CCG’s constitution and will be required to complete declaration of interest forms
8.7 The Committees will present its minutes to North Midlands Sub-regional Team of NHS England and the North Staffordshire CCG Governing Body and Stoke-on-Trent Governing Body following each meeting for information, including the minutes of any sub-committees to which responsibilities are delegated under paragraph 8.4 above.
8.8 The CCGs will also comply with any reporting requirements set out in their constitutions.
9 Accountability of the Committees
9.1 The Committees have delegated authority from North Staffordshire CCG Governing Body and Stoke-on-Trent CCG Governing Body:
To carry out the functions relating to the commissioning of primary medical services under section 83 of the NHS Act To assist and support NHS England in discharging its duty under section13E of the NHS Act 2006 (as amended by the Health and Social Care Act 2012) so far as relating to securing continuous improvement in the quality of primary medical services
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To work with NHS England to agree rules for areas such as the collection of data for national data sets, equivalent of what is collected under QOF, and IT intra-operability To comply with public procurement regulations and with statutory guidance on conflicts of interest To consult with Local Medical Committee and demonstrate improved outcomes reduced inequalities and value for money when developing a local QOF scheme or DES To approve the arrangements for discharging the group’s statutory duties associated with its GP practice commissioning functions, including but not limited to promoting the involvement of each patient, patient choice, reducing inequalities, improvement in the quality of services, obtaining appropriate advice and public engagement and consultation
10. Procurement of Agreed Services
10.1 The below is taken from the Next Steps in Primary Care Co-commissioning document.
10.2 The Committees must comply with public procurement regulations and with statutory guidance on conflicts of interest. The Committees may vary or renew existing contracts for primary care provision or award new ones, depending on local circumstances. If the Committees fail to secure an adequate supply of high quality primary medical care, NHS England may direct the CCG to act.
10.3 If Committees are found to have breached public procurement regulations and/or statutory guidance on conflicts of interest, NHS Improvement may direct the CCG or NHSE to act. NHS England may, ultimately, revoke the CCG’s delegation. Any proposed new incentive schemes should be subject to consultation with the Local Medical Committee and be able to demonstrate improved outcomes, reduced inequalities and value for money.
11. Decisions
11.1 The Committees will make decisions within the bounds of its remit.
11.2 The decisions of the Committees shall be binding on NHS England and either North Staffordshire CCG or Stoke- on-Trent CCG.
11.3 The Committees will produce an executive summary report which will be presented to NHS North Midlands England and the governing body of each CCG monthly [could be longer period] for information.
Date Approved by Committees: Date Approved by Governing Bodies: Review on an annual basis or earlier if required
Appendix 1 – Schedule 2 from Delegation Agreement between CCG and NHSE
Schedule 2 – Delegation
Part 1: Delegated Functions: Specific Obligations
1. Introduction
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2. Primary Medical Services Contract Management
2.1 The CCG must:
Manage the Primary Medical Services Contracts on behalf of NHS England and perform all of NHS England’s obligations under each of the Primary Medical Services Contracts in accordance with the terms of the Primary Medical Services Contracts as if it were named in the contract in place of NHS England; Actively manage the performance of the counter-party to the Primary Medical Services Contracts in order to secure the needs of people who use the services, improve the quality of services and improve efficiency in the provision of the services including by taking timely action to enforce contractual breaches and serve notice; Ensure that it obtains value for money under the Primary Medical Services Contracts on behalf of NHS England and avoids making any double payments under any Primary Medical Services Contracts; Comply with all current and future relevant national Guidance regarding PMS reviews and the management of practices receiving Minimum Practice Income Guarantee (MPIG) (including without limitation the Framework for Personal Medical Services (PMS) Contracts Review guidance published by NHS England in September 2014 (http://www.england.nhs.uk/wp-content/uploads/2014/09/pms-review-guidance- sept14.pdf)); Notify NHS England immediately (or in any event within two (2) Operational Days) of any breach by the CCG of its obligations to perform any of NHS England’s obligations under the Primary Medical Services Contracts; Keep a record of all of the Primary Medical Services Contracts that the CCG manages on behalf of NHS England setting out the following details in relation to each Primary Medical Services Contract:
- name of counter-party; - location of provision of services; and - amounts payable under the contract (if a contract sum is payable) or amount payable in respect of each patient (if there is no contract sum)
2.2 For the avoidance of doubt, all Primary Medical Services Contracts will be in the name of NHS England.
2.3 The CCG must comply with any Guidance in relation to the issuing and signing of Primary Medical Services Contracts in the name of NHS England.
2.4 Without prejudice to clause 13 (Financial Provisions and Liability) or paragraph 2.1 above, the CCG must actively manage each of the relevant Primary Medical Services Contracts including by:
managing the relevant Primary Medical Services Contract, including in respect of quality standards, incentives and the QOF, observance of service specifications, and monitoring of activity and finance; assessing quality and outcomes (including clinical effectiveness, patient experience and patient safety); managing variations to the relevant Primary Medical Services Contract or services in accordance with national policy, service user needs and clinical developments; agreeing information and reporting requirements and managing information breaches (which will include use of the NHS Digital IG Toolkit SIRI system); agreeing local prices, managing agreements or proposals for local variations and local modifications;
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conducting review meetings and undertaking contract management including the issuing of contract queries and agreeing any remedial action plan or related contract management processes; and complying with and implementing any relevant guidance issued from time to time
2.5 The CCG must manage the design and commissioning of Enhanced Services, including re-commissioning these services annually where appropriate.
2.6 The CCG must ensure that it complies with any Guidance in relation to the design and commissioning of Enhanced Services.
2.7 When commissioning newly designed Enhanced Services, the CCG must:
consider the needs of the local population in the Area; support Data Controllers in providing ‘fair processing’ information as required by the DPA; develop the necessary specifications and templates for the Enhanced Services, as required to meet the needs of the local population in the Area; when developing the necessary specifications and templates for the Enhanced Services, ensure that value for money will be obtained; consult with Local Medical Committees, each relevant Health and Wellbeing Board and other stakeholders in accordance with the duty of public involvement and consultation under section 14Z2 of the NHS Act; obtain the appropriate read codes, to be maintained by NHS Digital; liaise with system providers and representative bodies to ensure that the system in relation to the Enhanced Services will be functional and secure; and support GPs in entering into data processing agreements with data processors in the terms required by the DPA
2.8 Design of Local Incentive Schemes - the CCG may design and offer Local Incentive Schemes for GP practices, sensitive to the needs of their particular communities, in addition to or as an alternative to the national framework (including as an alternative to QOF or directed Enhanced Services), provided that such schemes are voluntary and the CCG continues to offer the national schemes.
2.9 There is no formal approvals process that the CCG must follow to develop a Local Incentive Scheme, although any proposed new Local Incentive Scheme:
is subject to consultation with the Local Medical Committee; must be able to demonstrate improved outcomes, reduced inequalities and value for money; and must reflect the changes agreed as part of the national PMS reviews
2.10 The ongoing assurance of any new Local Incentive Schemes will form part of the CCG’s assurance process under the CCG Assurance Framework.
2.11 Any new Local Incentive Scheme must be implemented without prejudice to the right of GP practices operating under a GMS Contract to obtain their entitlements which are negotiated and set nationally.
2.12 NHS England will continue to set national standing rules, to be reviewed annually, and the CCG must comply with these rules which shall for the purposes of this Agreement be Guidance.
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2.13 Making Decisions on Discretionary Payments - the CCG must manage and make decisions in relation to the discretionary payments to be made to GP practices in a consistent, open and transparent way.
2.14 The CCG must exercise its discretion to determine the level of payment to GP practices of discretionary payments, in accordance with the Statement of Financial Entitlements Directions.
2.15 Making Decisions about Commissioning Urgent Care for Out of Area Registered Patients - the CCG must manage the design and commissioning of urgent care services (including home visits as required) for its patients registered out of area (including re- commissioning these services annually where appropriate).
2.16 The CCG must ensure that it complies with any Guidance in relation to the design and commissioning of these services.
3. Planning the Provider Landscape
3.1 The CCG must plan the primary medical services provider landscape in the Area, including considering and taking decisions in relation to:
establishing new GP practices in the area; managing GP practices providing inadequate standards of patient care; the procurement of new Primary Medical Services Contracts (in accordance with any procurement protocol issued by NHS England from time to time); closure of practices and branch surgeries; dispersing the lists of GP practices; agreeing variations to the boundaries of GP practices; and co-ordinating and carrying out the process of list cleansing in relation to GP practices, according to any policy or Guidance issued by NHS England from time to time
3.2 In relation to any new Primary Medical Services Contract to be entered into, the CCG must, without prejudice to any obligation in Schedule 2, Part 2, paragraph 3 (Procurement and New Contracts) and Schedule 2, Part 1, paragraph 2.3:
consider and use the form of Primary Medical Services Contract that will ensure compliance with NHS England’s obligations under Law including the Public Contracts Regulations 2015/102 and the National Health Service (Procurement, Patient Choice and Competition) (No. 2) Regulations 2013/500 taking into account the persons to whom such Primary Medical Services Contracts may be awarded; provide to NHS England confirmation as required from time to time that it has considered and complied with its obligations under this Agreement and the Law; and for the avoidance of doubt, Schedule 5 (Financial Provisions and Decision Making Limits) deals with the sign off requirements for Primary Medical Services Contracts
4. Approving GP Practice Mergers and Closures
4.1 The CCG is responsible for approving GP practice mergers and GP practice closures in the area.
4.2 The CCG must undertake all necessary consultation when taking any decision in relation to GP practice mergers or GP practice closures in the Area, including those set out under section 14Z2 of the NHS Act (duty for public involvement and consultation). The consultation undertaken must be appropriate and proportionate in the circumstances and should include consulting with the Local Medical Committee.
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4.3 Prior to making any decision in accordance with this paragraph 4 (Approving GP Practice Mergers and Closures), the CCG must be able to clearly demonstrate the grounds for such a decision and must have fully considered any impact on the GP practice’s registered population and that of surrounding practices. The CCG must be able to clearly demonstrate that it has considered other options and has entered into dialogue with the GP contractor as to how any closure or merger will be managed.
4.4 In making any decisions pursuant to paragraph 4 (Approving GP Practice Mergers and Closures), the CCG shall also take account of its obligations as set out in Schedule 2, part 2, paragraph 3 (Procurement and New Contracts), where applicable.
5. Information Sharing with NHS England in relation to the Delegated Functions
5.1 This paragraph 5 (Information Sharing with NHS England) is without prejudice to clause 9.4 or any other provision in this Agreement. The CCG must provide NHS England with:
such information relating to individual GP practices in the Area as NHS England may reasonably request, to ensure that NHS England is able to continue to gather national data regarding the performances of GP practices; such data/data sets as required by NHS England to ensure population of the primary medical services dashboard; any other data/data sets as required by NHS England; and the CCG shall procure that providers accurately record and report information so as to allow NHS England and other agencies to discharge their functions
5.2 The CCG must use the NHS England approved primary medical services dashboard, as updated from time to time, for the collection and dissemination of information relating to GP practices.
5.3 The CCG must (where appropriate) use the NHS England approved GP exception reporting service (as notified to the CCGs by NHS England from time to time).
5.4 The CCG must provide any other information, and in any such form, as NHS England considers necessary and relevant.
5.5 NHS England reserves the right to set national standing rules (which may be considered Guidance for the purpose of this Agreement), as needed, to be reviewed annually. NHS England will work with CCGs to agree rules for, without limitation, areas such as the collection of data for national data sets and IT intra-operability. Such national standing rules set from time to time shall be deemed to be part of this Agreement.
6. Making Decisions in relation to Management of Poorly Performing GP Practices
6.1 The CCG must make decisions in relation to the management of poorly performing GP practices and including, without limitation, decisions and liaison with the CQC where the CQC has reported non-compliance with standards (but excluding any decisions in relation to the performers list).
6.2 In accordance with paragraph 6.1 above, the CCG must:
ensure regular and effective collaboration with the CQC to ensure that information on general practice is shared and discussed in an appropriate and timely manner; ensure that any risks identified are managed and escalated where necessary; respond to CQC assessments of GP practices where improvement is required; where a GP practice is placed into special measures, lead a quality summit to ensure the development and monitoring of an appropriate improvement plan (including a NHS North Staffordshire Clinical Commissioning Group – Constitution v2.3 Feb-20
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communications plan and actions to manage primary care resilience in the locality); and take appropriate contractual action in response to CQC findings
7. Premises Costs Directions Functions
7.1 The CCG must comply with the Premises Costs Directions and will be responsible for making decisions in relation to the Premises Costs Directions Functions.
7.2 In particular, but without limiting the generality of paragraph 7.1, the CCG shall make decisions concerning:
applications for new payments under the Premises Costs Directions (whether such payments are to be made by way of grants or in respect of recurring premises costs); and revisions to existing payments being made under the Premises Costs Directions
7.3 The CCG must comply with any decision-making limits set out in Schedule 5 (Financial Provisions and Decision Making Limits) when taking decisions in relation to the Premises Costs Directions Functions.
7.4 The CCG will comply with any guidance issued by the Secretary of State or NHS England in relation to the Premises Costs Directions, including the Principles of Best Practice, and any other Guidance in relation to the Premises Costs Directions.
7.5 The CCG must work cooperatively with other CCGs to manage premises and strategic estates planning. The CCG must liaise where appropriate with NHS Property Services Limited and Community Health Partnerships Limited in relation to the Premises Costs Directions Functions.
Part 2 – Delegated Functions: General Obligations
1. Introduction
1.1 This Part 2 of Schedule 2 (Delegated Functions) sets out general provisions regarding the carrying out of the Delegated Functions.
2. Planning and reviews
2.1 The CCG is responsible for planning the commissioning of primary medical services.
2.2 The role of the CCG includes:
carrying out primary medical health needs assessments (to be developed by the CCG) to help determine the needs of the local population in the area; recommending and implementing changes to meet any unmet primary medical service needs; and undertaking regular reviews of the primary medical health needs of the local population in the area
3. Procurement and New Contracts
3.1 The CCG will make procurement decisions relevant to the exercise of the Delegated Functions and in accordance with the detailed arrangements regarding procurement set out in the procurement protocol issued and updated by NHS England from time to time.
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3.2 In discharging its responsibilities set out in clause 6 (Performance of the Delegated Functions) of this Agreement and paragraph 1 of this Schedule 2 (Delegated Functions), the CCG must comply at all times with Law including its obligations set out in the National Health Service (Procurement, Patient Choice and Competition) (No. 2) Regulations 2013/500 and any other relevant statutory provisions. The CCG must have regard to any relevant guidance, particularly Monitor’s guidance Substantive guidance on the Procurement, Patient Choice and Competition Regulations
3.3 Where the CCG wishes to develop and offer a locally designed contract, it must ensure that it has consulted with its Local Medical Committee in relation to the proposal and that it can demonstrate that the scheme will:
improve outcomes; reduce inequalities; and provide value for money
4. Integrated working
4.1 The CCG must take an integrated approach to working and co-ordinating with stakeholders including NHS England, Local Professional Networks, local authorities, Healthwatch, acute and community providers, the Local Medical Committee, Public Health England and other stakeholders.
4.2 The CCG must work with NHS England and other CCGs to co-ordinate a common approach to the commissioning of primary medical services generally.
4.3 The CCG and NHS England will work together to coordinate the exercise of their respective performance management functions.
5. Resourcing
5.1 NHS England may, at its discretion provide support or staff to the CCG. NHS England may, when exercising such discretion, take into account, any relevant factors (including without limitation the size of the CCG, the number of Primary Medical Services Contracts held and the need for the Local NHS England Team to continue to deliver the Reserved Functions).
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SCHEDULE 12
NHS NORTH STAFFORDSHIRE CCG QUALITY & SAFETY COMMITTEE
A Committee held in common with Cannock Chase, East Staffordshire, North Staffordshire, South East Staffordshire & Seisdon Peninsula, Stafford and Surrounds and Stoke on Trent Clinical Commissioning Group
Introduction and Purpose
1.1 The Quality & Safety Committee (‘the Committee’) is established in accordance with the CCG’s Constitution. These Terms of Reference set out the membership, remit, responsibilities and reporting arrangements and shall have effect as if incorporated into the specified Constitution.
1.2 The main objectives of the Committee are to support the Governing Body in fulfilling their statutory functions / duties in terms of quality and safety and to provide through detailed scrutiny and analysis of information received, assurance to Governing Body on the quality and safety of services commissioned and the delivery of improved outcomes for patients. The Committee shall promote a culture of continuous improvement and innovation with respect to safety of services, clinical effectiveness and patient experience.
Appointment and Membership
2.1 The Committee is appointed by the CCG from the members of its Governing Body, Membership and Staff.
2.2 Chair and Vice Chair
The Chair and Vice Chair shall be appointed by the Committee:
Lay Member Chair Lay Member for Quality & Safety Lay Member Vice-Chair for PPI
Note: in the absence of the Chair, meetings will be chaired by the Vice Chair as nominated and agreed by the Committee. The Vice Chair will not be an executive member of the CCG. In the absence of both, another, non-conflicted voting member - who cannot be an executive member - shall fulfil these roles.
2.3 Membership
2.3.1 In order to perform his or her role effectively, each member should obtain an understanding of the detailed responsibilities of Committee membership as well as the CCG’s business, operations and risks. Membership shall comprise Members, who will be expected to attend the entirety of each meeting, ‘’ and ‘Expert Representatives’ who will only be required to attend to discuss the items for which they are responsible.
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2.3.2 Members shall be as follows:
Lay Member Chair Lay Member for Quality & Safety Lay Member Vice-Chair for PPI CCG Secondary Care Consultant Clinical GP Lead for Quality or Medical Director Executive Director of Nursing & Quality Deputy Director of Nursing, Quality & Patient Safety Head of Quality & Safety (and Nursing where appropriate) Strategic Leads for Nursing, Maternity, Quality and Safety Deputy Director of Corporate Services, Governance & Communications Deputy Director of Commissioning & Operations or nominated Managing Director
2.3.4 Expert Representatives shall be as follows:
Designated Nurses Adult Safeguarding Designated Nurses for Safeguarding Children Designated Nurse Looked after Children Quality Improvement Managers in exceptional circumstances Heads of Medicines Management Commissioning Support Unit Complaints Manager Patient and Public Engagement Representative Primary Care Representatives
2.3.5 External Organisation – Healthwatch
2.4 The Secretariat to the Committee (secretarial support) will be provided by the Executive Assistant to the Executive Director of Nursing & Quality; and in their absence an alternative administrative officer will be allocated by the Admin Team.
2.5 If the Committee determines that input is required from a CCG function, the Committee may invite personnel from that line of service to attend relevant Committee meetings. Other members of CCG Management may also be invited to attend meetings.
2.6 Members are required to attend a minimum of 70% of meetings each year. If this number is not reached, a meeting with the Chair / Executive Director of Nursing & Quality may be required to seek and understand reasons for non-attendance. A record of attendance will be kept from each meeting and this will be monitored in line with these requirements. Other representatives may attend on an ad hoc basis as requested or authorised by the Chair.
2.7 Quorum
2.7.1 Quoracy shall be no fewer than four Members for any meeting at which the Committee’s delegated powers are to be exercised, of which there will be at least:
1 Lay Member Clinical GP Lead or Secondary Care Consultant Executive Director of Nursing & Quality or nominated deputy
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2.7.2 In the event of difficulty in achieving a quorum, Governing Body members who are not members of the Committee may be co-opted as members for individual meetings, provided the majority of the quorum are full members of the Committee. Single Leadership Team (Executive Team) or Governing Body members who are not members of the Committee may attend meetings where relevant after first liaising with the Committee Chair.
2.7.3 Otherwise where the Committee is not quorate, business may proceed as normal. However decisions taken will be subject to confirmation of the draft minutes by the majority of members present at the next meeting. Roll-forward of approval to the next meeting as outlined above can only occur provided that a quorum is present at the subsequent meeting. If this is not feasible (or where more appropriate / urgent), approval of the original decision can be obtained instead by written approval of the minutes by all voting members.
2.7.3 Where the meeting is not quorate the actions taken to mitigate this will be recorded in the minutes. If approval is required from a voting member who is not present the email confirming their approval or otherwise will be saved with the minutes of the meeting.
2.8 Voting Rights
The voting members of the Committee are:
One vote for each Member The Chair of the Committee will have the casting vote
2.9 Members taking a dissenting view but losing a vote can have their dissent recorded in the minutes, if so desired.
3 Frequency of Meetings
3.1 Meetings shall be held at least ten times a year and, where appropriate, will coincide with key dates in the CCG’s annual business cycle.
3.2 The Chair or the Vice Chair may request an extraordinary meeting if they consider that one is necessary.
3.3 Outside of the ten meetings per year; the Chair, Executive Director of Nursing & Quality and other members as required may hold an informal meeting. Minimum attendance at these will be the Chair plus another Lay Member and the Executive Director of Nursing & Quality (or nominated Deputy).
3.4 Where considered necessary, a confidential section may be added to the agenda, to allow the Membership to discuss information which should not be in the public domain in the interests of confidentiality or public interest. For example details or matters relating to specific patients, patient Groups or healthcare professionals. When meetings involve a confidential section minutes, agendas, supporting papers etc will be stored separately to standard papers. Any confidential papers will be subject to the same information governance standards as applied to any other confidential information held by the CCG.
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4 Accountability and Delegated Authority
4.1 The Committee is authorised by and accountable to CCG Governing Body to investigate any activity within these Terms of Reference and, within its scope of responsibilities as determined by CCG Schemes of Delegation, to seek any information it requires and to ensure the attendance of management representatives at meetings as appropriate.
4.2 As the Executive with the lead responsibility for Quality and Safety matters, the Executive Director of Nursing & Quality is accountable for providing assurance to the Governing Body.
4.3 The Executive Director of Nursing & Quality will also be responsible for supporting the Chair in the organisation and management of the committee, its business and for drawing attention to Quality Management best practice, national guidance and other relevant documents as appropriate.
4.4 With the approval of the Director of Nursing & Quality, and to the limit of any expenditure delegated to them in their capacity as an Executive Director, the Committee has the authority to obtain outside legal or independent professional advice. Any expenditure which exceeds or is likely to exceed any limits above must first be agreed by the CCG in line with operating procedures. Where obtained, advisers may attend meetings as necessary.
4.5 Items of business to be transacted for inclusion on the agenda of a meeting need to be notified to the Chair at least ten working days before the meeting; with supporting papers for such items submitted at least ten working days before the meeting takes place. Any exceptions to this MUST be agreed jointly with the Chair and Director of Nursing & Quality before the deadline.
4.6 The agenda and supporting papers will be circulated to all members of a meeting at least five working days before the meeting takes place. Participants will be expected to have read all the circulated information prior to attending the meeting to ensure that any necessary decision can be made at the meeting.
4.7 Any changes to these Terms of Reference must be approved by the Governing Body.
5 The Committee’s Responsibilities
5.1 The responsibilities of the Committee are set out in the Appendix to these Terms.
6 Reporting Procedures
6.1 All reports submitted to the Committee must be accompanied by a fully completed cover sheet which must effectively summarise the report, explain all acronyms used and clearly specify whether the report is for approval, assurance or discussion (one only).
6.2 All attendees presenting reports, can assume that their reports have been read and that no verbal summary of these reports is needed. The Committee will proceed direct to questions, except when the report author wishes to advise the Committee about new or updated information or areas of concern.
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6.3 Confirmed minutes of meetings shall be circulated to all members and to the Governing Body. In addition, the Committee will summarise matters from each meeting for presentation at Governing Body, highlighting key actions, concerns and areas requiring further escalation.
6.4 If the Committee deems it appropriate, certain matters may be reported to the Governing Body and/or escalated to the Accountable Officer in advance of the minutes being formally agreed, or as an exception report.
6.5 A section of the CCG Annual Report will also describe the work of the Committee in discharging its responsibilities. To enable this, the Committee shall, at least once a year, review its performance, constitution and Terms of Reference to ensure it is operating at maximum effectiveness, recommending any changes it considers necessary to the Governing Body for approval.
7 Conflicts of Interest
7.1 The provisions of Managing Conflicts of Interest: Statutory Guidance for CCGs, CCG policy or any successor document will apply at all times.
7.2 The Committee shall hold and publish a Register of Interests. This shall record all relevant and material, personal or business interests as set out within the CCG’s policy. Each member and attendee of the Committee shall be under a duty to declare any such interests. Any change to these should be notified immediately to the Chair. Failure to disclose an interest, whether intentional or otherwise, will be treated in line with the CCG’s policy and may result in suspension.
7.3 Any interest relating to an agenda item should be brought to the attention of the Chair in advance of the meeting, or notified as soon as the interest arises and recorded in the minutes with the actions taken to mitigate this. The Chair (or Vice Chair in their absence or where the Chair is conflicted) will then determine the arrangements for the management of any conflicts that arise in the meeting, and also outside it in consultation (to the extent deemed appropriate) with the CCG Head of Governance and/or CCG Conflicts of Interest Guardian.
Date Agreed = December 2019 TBC
APPENDIX
The Responsibilities of the Committee shall be:
The main objective is to comprehensively review data and information in order to provide assurance to Governing Body regarding clinical quality and safety of services commissioned for local patients (including those commissioned by other CCGs where the CCG is an Associate Commissioner). The areas in which assurance will be sought, first in relation to safety and then to quality, are as follows:
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Commissioned Clinical Providers including Acute Trusts, Community Providers, Private Providers and Mental Health Providers – an in depth quality assessment of each relevant Provider Organisational assurance – relating to the quality aspects of the CCG Commissioning processes and decision making Non-clinical services, including Commissioning Support Unit – including KPIs relating to complaints resolution, Patient Advice and Liaison Services (PALS) and other relevant functions
In assessing assurance in respect of Providers the Committee will use system built around a decision making tool and consideration of the recommendation made by the report author. The Executive Director of Nursing and Quality will then declare one of the following levels of assurance:
Full Assurance Partial Assurance Limited Assurance No Assurance
In order to deliver these objectives, the Committee shall undertake activity as follows:
Strategy:
Develop a programme of business which is flexible and responsive to new / emerging priorities and risks Drive and ensure the delivery of improved outcomes for patients Develop, approve and regularly review the CCG Quality Strategy to ensure continuous improvement is delivered in quality and safety – the strategy will require approval by the Committee then to Governing Body for final ratification Ensure active engagement of patients, staff and other key stakeholders on quality and safety issues
Assurance:
Seek assurance that commissioning strategies for the CCG fully reflects all elements of quality (patient experience, effectiveness and patient safety), keeping in mind that the strategy and response may need to adapt and change Provide assurances that commissioned services (and may be extended to jointly- commissioned services) are being delivered in a high quality and safe manner, ensuring that quality sits at the heart of everything the CCG does Provide assurance to Governing Body that there are robust systems / processes in place across the CCGs to monitor, measure and improve quality, acting on shortfalls when these are identified. Receive assurance and relevant notifications regarding any identified concerns in respect of Provider regulation with relevant bodies such as Care Quality Commission, NHS England/ Improvement, etc
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Where required in respect of each CCG’s local arrangements, to provide additional challenge and scrutiny to the Quality Reports presented by Primary Care representatives, prior to submission to Primary Care Commissioning Committee
Process:
Receive reports relating to each key provider, to be delivered by the relevant Clinical or Non- Clinical Quality Improvement Expert or Advisor – no verbal summary of these shall be required; the Committee will proceed direct to questions, except when the author wishes to advise of new or updated information or specific areas of concern Review the content and effectiveness of the structures, systems and processes in place for quality assurance, clinical information, clinical risk management and clinical / quality governance Review current and anticipate future risks to quality and safety across all Providers As lead responsible committee for quality and safety risks the Committee will receive and review the clinical risk register, ensuring action is taken to address these and to oversee and be assured that effective risk management is in place to manage / address clinical governance issues Review QIPP plans with a focus on Quality Impact Assessments, receiving assurance that quality is not compromised by key QIPP-related commissioning decisions; and where this may be the case, to require further risk assessments to be completed on areas of concern
Information and Action:
Review and monitor provider compliance with key quality indicators Report compliance against necessary external assessments and reporting including, but not limited to CQC, NHS England/Improvement Have oversight of the process and compliance issues concerning Serious Incidents (SIs); being informed of all SIs and ‘Never Events’, and informing the Governing Body of any escalation or sensitive issues promptly Ensure that learning from incidents, SIs, complaints and other forms of patient, staff and member practice feedback is used to ensure that the risk of recurrence is minimised Receive and scrutinise independent investigation reports relating to patient safety issues and agree publication plans as appropriate Ensure a clear escalation process (including appropriate trigger points), is in place to enable appropriate referral to / engagement of external bodies on areas of concern; this may include asking for contractual fines to be applied to Providers via the relevant contract management route Ensure regular complaints update and analyses of trends are received via the CSU Seek assurance that complaints, PALS and other forms of patient feedback are accurately and efficiently tracked, monitored and any necessary actions taken Have regard for, and receive assurance on safeguarding children / safeguarding vulnerable adult’s issues, ensuring appropriate action is taken when required Receive regular updates on key Medicines Management issues The committee may delegate responsibility to individuals to investigate quality matters: in such circumstances the Committee shall require assurance in respect of appropriate action being taken
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Ensure that good practice is recognised, celebrated and shared The Committee will be empowered to set up specific sub-Groups to explore specialist areas when required To receive regular updates in relation to Infection Prevention & Control as part of the Provider report submissions and also at CCG level where available The Committee has delegated authority to approve policies related to its remit on behalf of the Governing Body and supplemented by appropriate CCG governance mechanisms as required by policy approval procedures; such decisions will then be communicated to the Governing Body within the Quality Report
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SCHEDULE 13
NHS NORTH STAFFORDSHIRE CCG FINANCE & PERFORMANCE COMMITTEE
A Committee held in common with Cannock Chase, East Staffordshire, North Staffordshire, South East Staffordshire & Seisdon Peninsula, Stafford and Surrounds and Stoke on Trent Clinical Commissioning Group
Introduction and Purpose
1.1 The Terms of Reference for the Finance & Performance Committees in Common have been developed to support the Staffordshire CCGs have oversight and gain assurance on individual and collective CCG Financial and Operational Performance from the development of the Financial Strategy through to the monitoring of Performance against Plans and the management of risk.
1.2 The role of the Committee is to provide assurance to the Governing Body on all matters relating to the management of risk associated with the implementation of the Financial and Operational Performance of the CCG including the development of remedial action to avoid identified risks crystallising.
1.3 The Committee does not have any executive powers conferred to it under CCG governing documents (Standing Orders, Standing Financial Instructions, Scheme of Delegation).
Appointment and Membership
Executive:
Accountable Officer Finance Director Divisional Managing Directors Director of Strategy Director of Commissioning
Non-executive (elected or lay):
Chair of each Divisional Committee Lay Member from each CCG GP Member representative from each Division
Note: The membership should include at least 3 Clinical Members to avoid circumstances where there is no clinical representation. Nominated 1st line deputies are acceptable subject to agreement by the Chair in advance of the meeting. It is expected that attendance of deputies will be minimal and membership attendance will be recorded.
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Chair
Both Chair and Vice Chair to be drawn from the Lay Membership
Officers and Advisors (in attendance):
Only members of the Committee and CCG Chairs or their nominated deputies have the right to attend Committee meetings. However, officers and other individuals, including external advisers, may be invited to attend for all or part of any meeting as and when appropriate and at the discretion of the Chair.
Secretary
Secretarial support will be provided by the Executive Assistant to the Chief Finance Officer.
Quorum
Minimum 1 Lay Member or Chair from each Division, Director of Finance plus 1 other Executive Director, 2 Managing Directors. The non-executive members must include at least 1 Clinical member.
Voting rights
The Committee does not have any decision making rights within its Terms of Reference. It acts as an assurance committee providing recommendations to Governing Bodies.
Frequency of meetings
Monthly
Operation of the Committee
The secretary will prepare an agenda for meetings with the Chair in the context of an annual plan of business that the secretary shall produce. The secretary will collate papers and circulate papers to those required to be at the meeting usually one week before the meeting but no less than five working days before the meeting. Late papers will not be permitted except in exceptional circumstances and at the discretion of the meeting Chair.
Minutes will be drafted for approval by the Chair and circulated to members within seven days of the meeting.
Accountability and Delegated Authority
The Finance & Performance Committees in Common is accountable to the CCGs’ Governing Bodies.
The Committee’s Responsibilities
Duties
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Oversee the development of an Integrated Performance Report that triangulates Finance, Contracting, Performance and Quality. Monitor progress against the CCGs’ financial and operational plans and approved budgets through review and scrutiny of the integrated performance report, identifying risks and ensuring that corrective actions are in place where delivery is off target. To receive regular reports on the performance of NHS contracts and the management of significant risks associated within each contract. Oversee the development, implementation and monitoring of the CCGs’ Financial Strategy and its consistency with the overarching STP Financial Strategy and that of its partners. To review performance of QIPP and triangulate against overall financial performance and contracting delivery. Triangulate finance, contracting and performance information across the 6 Staffordshire CCGs. To scrutinise infrastructure, running cost and programme spend. This will include reviewing significant spend in areas that contribute to productivity and efficiency, including IT and estates. Oversee the development of the reporting hierarchy and structure of financial reporting at Group, CCG, Divisional and Corporate level to ensure that it is fit for purpose in supporting financial management within the organisation(s). Oversee arrangements for ensuring the timeliness, accuracy, validity, reliability, relevance and completeness of finance, activity and contractual information being used for monitoring and reporting purposes (in line with data quality standards). To review and have oversight of procurement plans through the quarterly review of the contracts register to ensure appropriate plans and resources are in place to review, renew and procure services. Oversee the identification and management of financial risks in line with the Assurance Framework. Approval and monitoring of policies within the Committee’s remit. Oversee development of a Financial Framework to share and manage risk in an open and transparent manner across the Staffordshire CCGs to avoid any single organisation carrying an unnecessary burden that would otherwise impact on patient care. To review the governance and decision making arrangements for the pooling of budgets with Local Authorities and be assured of value for money and the management of risk. To review business cases for significant investment of Capital and Revenue expenditure to ensure they are fit for purpose prior to Governing Bodies’ approval.
Reporting Procedures
The Chair of the Committee shall report to each Governing Bodies in Common meeting on proceedings of The Finance & Performance Committees in Common and on matters of financial and operational assurance and outstanding actions with respect to the management of significant risk.
Minutes of the meetings will be made available to Governing Body members.
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The Finance Director shall report the Committee’s findings on matters of financial assurance to those bodies that have sought it, for instance the Staffordshire and Stoke-on-Trent Joint Committee Conflicts of Interest Management Committee.
In instances where an agreed resolution / approach is not possible to reach at the meeting, or where a unanimous decision of the CCGs is required, the Finance & Performance Committees in Common will escalate the matter to the Staffordshire and Stoke-on-Trent CCGs’ Governing Bodies in Common for resolution.
Conflicts of Interest
In accordance with the CCGs’ Conflict of Interest Policy, all members and attendees have a duty to keep their declaration of interests up to date and to notify the Chair in advance of any potential conflicts and specific agenda items, agreeing a handling strategy that may include not attending all or part of the meeting.
Conduct of Committee
The Committee shall, at least annually, review its own performance, membership and terms of reference. Any resulting changes to the terms of reference should be approved by the six (6) CCG Governing Bodies.
Date Agreed = 18 June 2019
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SCHEDULE 14
NHS NORTH STAFFORDSHIRE CCG COMMUNICATION, ENGAGEMENT, EQUALITY & EMPLOYMENT COMMITTEE
A Committee held in common with Cannock Chase, East Staffordshire, North Staffordshire, South East Staffordshire & Seisdon Peninsula, Stafford and Surrounds and Stoke on Trent Clinical Commissioning Group
Introduction and Purpose
The Communication, Engagement, Equality & Employment Committee (the Committee) meets in common with the Communication, Engagement, Equality & Employment Committees of Cannock Chase, East Staffordshire, South East Staffordshire & Seisdon Peninsula, Stafford & Surrounds and Stoke-on-Trent Clinical Commissioning Groups. The Committee is a sub-Group of the Governing Body. The Committee has responsibility for assuring the Governing Body that the Clinical Commissioning Group is able to fully deliver:
The statutory duty of candour which requires openness, transparency and candour as highlighted by the Francis Recommendation (2013) All respective statutory duties in relation to general equality duty, arising from the 2010 Equality Act which requires Clinical Commissioning Groups, in the exercise of their functions, to have due regard to the need to; “eliminate discrimination, harassment and victimisation and any other conduct that is prohibited under the Act”. The duty relates to our patients, our staff and our partners Provide meaningful and timely communication to our community and stakeholders Engagement with our communities, clinicians and staff. This includes arrangements for consultation on changes to healthcare services in line with legislation (e.g. Clinical Commissioning Groups are required to involve patients and the public in service planning, operation and in the development of proposals for changes) Oversight of a joint OD plan to develop and empower our Governing Body, Single Leadership Team and staff, to work with Partners, to deliver the Clinical Commissioning Group’s strategic objectives Oversight of aspects of employment including compliance with labour law, employment standards, employee relations
The Committee will achieve its function by developing a clear strategy and implementation plan for compliance with these duties, as part of our wider commissioning and employment responsibilities.
For clarity this is meaningful engagement, the application of excellent human resources and effective organisational development; where the patient is at the heart of all we do and to help us be an excellent employer of choice.
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The Committee will operate as a ‘committees in common’, with representatives from all six Clinical Commissioning Groups to plan for Staffordshire as a whole. Accountability and decision making shall remain the responsibility of each individual Clinical Commissioning Group and its Governing Body / Board; with any changes to be approved by them.
These Terms of Reference (TORs) set out the membership, remit, responsibilities and reporting arrangements and shall have effect as if incorporated into each Clinical Commissioning Group’s Constitution.
Appointment and Membership
The Communication, Engagement, Equality & Employment Committee (the “Committee”) is appointed by the Clinical Commissioning Group from the members of their Governing Body, Memberships and Staff.
Chair and Vice Chair
The Chair and Vice Chair shall be appointed by the Committee.
Note: in the absence of the Chair, meetings will be chaired by the Vice Chair as nominated and agreed by the Committee. The Vice Chair will not be an executive member of the Clinical Commissioning Groups. In the absence of both, another, non-conflicted voting member of the Committee - who cannot be an executive member - shall fulfil these roles.
Membership
In order to perform his or her role effectively, each member should obtain an understanding of the detailed responsibilities of Committee membership as well as the Clinical Commissioning Group’s business, operations and risks. The members of the Committee are:
Clinical Commissioning Group Lay Member – PPI Chair Non-PPI Lay Member Vice Chair Clinical Director for Partnerships & Engagement or other clinical representative Staff Engagement Reps x2 Director of Corporate Services, Governance & Communications Director of Commissioning & Operations Deputy Director of Corporate Services & Governance Non-Exec GP Board Member or Secondary Care Consultant Associate Director of Communications & Engagement Clinical Commissioning Group Head of HR & OD CSU Health & Safety Advisor
Regular attenders:
Equality & Inclusion Officer (CSU) Head of Governance CSU Communications & Engagement representatives A CSU HR Representative
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All Exec Directors invited (minimum one for quoracy, with each to attend on a rolling quarterly basis and the Accountable Officer to attend at least once a year minimum)
The Secretary to the Committee is the Executive Assistance to the Director of Corporate Services, Governance and Communications.
If the Committees determine that input is required from a Clinical Commissioning Group or CSU function, the Committee may invite personnel from that line of service to attend relevant Committees meetings. Other members of management may also be invited to attend meetings.
Quorum
A quorum shall be two voting members, one of which shall be a Lay Member.
In the event of difficulty in achieving a quorum, Governing Body members, who are not members of the Committee, may be co‑opted as members for individual meetings, provided the majority of the quorum are full members of the Committee. Single Leadership Team (Exec Team) or Governing Body members who are not members of the Committee may attend meetings, where relevant, after first liaising with the Committees’ Chair.
Where the meeting is not quorate the actions taken to mitigate this will be recorded in the minutes. If approval is required from a voting member who is not present the email confirming their approval or otherwise will be saved with the minutes of the meeting.
Voting Rights
Where possible, to avoid concerns that Clinical Leadership may be diluted, and unless Clinicians are conflicted (e.g. for the Primary Care Commissioning Committee), there should be a voting majority of clinicians on Joint Committees and sub-Committees, as required for the Governing Bodies. However, owing to the make-up of the Committees, this principle cannot be supported, and the voting majority is will be made up of a combination of Clinicians and Lay Members. The voting members of the Committee are:
Lay Member – Chair, Clinical Commissioning Group - to hold the casting vote in cases of split decisions Lay Member – Vice Chair, Clinical Commissioning Group Clinical Commissioning Group Lay Member Clinical Director for Partnerships & Engagement or other clinical representative Staff Engagement Reps x2 - Clinical Commissioning Groups Non-Exec GP Board Member, or Secondary Care Consultant – Clinical Commissioning Groups
Frequency of Meetings
Meetings shall be held at least six times a year and, where appropriate, will coincide with key dates in the Clinical Commissioning Group’s annual business cycle.
The Chair or the Vice Chair may request an extraordinary meeting if they consider that one is necessary.
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Accountability and Delegated Authority
The Committee is authorised by and accountable to the Clinical Commissioning Group Governing Bodies to investigate any activity within these Terms of Reference and, within its scope of responsibilities as determined by Clinical Commissioning Group’s Schemes of Delegation, to seek any information it requires and to ensure the attendance of management representatives at meetings as appropriate.
The Committee has the authority to obtain outside legal or independent professional advice. The advisers may attend meetings as necessary and the cost of the advisers shall be borne by the Clinical Commissioning Groups collectively (on an equal shares basis).
The Committee’s Responsibilities
The responsibilities of the Committees’ are set out in the Appendix to these Terms.
Reporting Procedures
The confirmed minutes of meetings of the Committees shall be circulated to all members of the Governing Bodies along with a routine Update and Escalation Report prepared by the Chair and Secretariat on a bi-monthly basis. The bi-monthly report should include:
The significant issues that the Committees have considered in relation to its responsibilities and any decisions reached (including any areas for formal ratification by the Governing Bodies) An explanation of how it has assessed the effectiveness of the Committees’ delegated powers decision-making process and the approach taken to these; and Any items formally escalated to the Governing Bodies for resolution
A section of Clinical Commissioning Groups Annual Reports will also describe the work of the Committees in discharging their responsibilities. To enable this, the Committees shall, at least once a year, review their performance, constitution and Terms of Reference to ensure they is operating at maximum effectiveness, recommending any changes it considers necessary to the Governing Bodies for approval.
Conflicts of Interest
The provisions of Managing Conflicts of Interest: Statutory Guidance for Clinical Commissioning Groups, Clinical Commissioning Group policy or any successor document will apply at all times.
The Committees shall hold and publish a Register of Interests. This shall record all relevant and material, personal or business interests as set out within the Clinical Commissioning Groups’ policies. Each member and attendee of the Committees shall be under a duty to declare any such interests. Any change to these should be notified immediately to the Chair. Failure to disclose an interest, whether intentional or otherwise, will be treated in line with the Clinical Commissioning Groups’ policy and may result in suspension.
Any interest relating to an agenda item should be brought to the attention of the Chair in advance of the meeting, or notified as soon as the interest arises and recorded in the minutes with the actions taken to mitigate this. The Chair (or Vice Chair in their absence or where the Chair is conflicted) will then determine the arrangements for the management of any conflicts NHS North Staffordshire Clinical Commissioning Group – Constitution v2.3 Feb-20
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that arise in the meeting, and also outside it in consultation (to the extent deemed appropriate) with the Clinical Commissioning Group Head of Governance and/or Clinical Commissioning Group Conflicts of Interest Guardian(s).
[Date Agreed – November 2018]
APPENDIX
The Responsibilities of the Committee shall be:
Equality and Diversity
To ensure the Clinical Commissioning Groups demonstrate due regard to Equality & Human Rights Legislation and the Public Sector Equality Duty (PSED), including the development of strategy, relevant training and robust systems for Equality Impact Risk Assessments (EIRAs) oversight To provide oversight and monitoring of delivery of the development of the Equality & Diversity Framework, Strategy and associated action plan Ensure Clinical Commissioning Group and external providers’ compliance with Equality & Human Rights legislation and the Public Sector Duty (PSED)
(b) Engagement and Communications
To provide assurance to Governing Bodies that the Clinical Commissioning Groups are fulfilling their statutory duty to ensure meaningful engagement with their communities, including arrangements for consultation on changes to health care services in line with national guidance in line with the Brown Principles and the Gunning Principles To provide assurance to Governing Bodies that the Clinical Commissioning Groups are effectively communicating with their local populations, clinical membership and staff, including internal and external stakeholders To monitor delivery of an aligned pan-Clinical Commissioning Group Communications & Engagement Strategy that is fully inclusive and meets the requirements of the Equalities Act 2010 and the Specific Duties and Public Authorities Regulations 2017 To ensure effective communications and engagement activities are being adopted to support delivery of the Clinical Commissioning Groups’ goals and priorities
Alignment with the Staffordshire Transformation Partnership priorities (STP) will be a key requirement for the Clinical Commissioning Groups and their plans for communication and engagement. These are:
Focused prevention Enhanced primary and community care Improved children, young people and maternity services Increased effectiveness and efficiency of planned care Simplified urgent and emergency care Enhanced mental health care NHS North Staffordshire Clinical Commissioning Group – Constitution v2.3 Feb-20
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(c) Human Resources (inc. Health & Safety)
To ensure the delivery of the overall human resources agenda i.e. staff monitoring reports, training statistics, appraisal process, staff survey results, recruitment and retention and contracts etc To receive, any reports relating to health and safety issues and, by exception, oversee the delivery of any associated action plans To receive reports on issues and concerns, and ensure that these are taken forward to senior management To ensure there is a sustainable workforce with the right levels, capacity and capability to deliver their statutory responsibilities and commission high quality modernised services within running costs To be assured that staff engagement is a two-way process To provide oversight of a joint OD plan to support effective Governing Bodies, Single Leadership Team and staff.
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SCHEDULE 14
NHS NORTH STAFFORDSHIRE CCG DIVISIONAL COMMITTEE
A Joint Committee for North Staffordshire & Stoke on Trent Clinical Commissioning Groups
Introduction and Purpose
1.1 The Staffordshire Clinical Commissioning Groups have agreed to establish three Divisional Committees (“the Committee”) as a joint committee to manage, to the extent permitted under s.14Z3 NHS Act 2006 (as amended), the local, transactional activities of the six Clinical Commissioning Groups to exercise their commissioning functions at a divisional level as follows:
North Divisional Committee - covering North Staffordshire & Stoke-on-Trent Clinical Commissioning Groups South East Divisional Committee - covering East Staffordshire & SE Staffs Clinical Commissioning Groups (minus Seisdon Peninsula) South West Divisional Committee - covering Stafford & Surrounds, Cannock Chase and the Seisdon Locality of SE Staffordshire Clinical Commissioning Group
1.2 The Committee is established in accordance with each Clinical Commissioning Group’s Constitution, Standing Orders and Scheme of Delegation.
1.3 As per the Clinical Commissioning Groups’ Constitutions, and in the interest of partnership working, this Committee will operate with representatives from Clinical Commissioning Groups and their Memberships to jointly plan the locally-relevant, transactional implementation items as aligned to the STP and the Clinical Commissioning Group’s commissioning plans for their Divisional area as a whole. As per each Constitution, the accountability and decision making of the Committee shall remain the responsibility of the individual Clinical Commissioning Group and its Governing Body / Board.
Note: any reference to the term STP is used to refer to all partner organisations in the Sustainability & Transformation Partnership, whereas the Committee is only used to refer to the six Clinical Commissioning Groups.
Appointment and Membership
2.1 The Committee is appointed by the six Staffordshire Clinical Commissioning Groups from the members of the Governing Bodies (Boards), Memberships and Staff
2.1.1 Chair and Vice Chair
The Chair and Vice Chair shall be appointed by the Committee.
Chair (Clinical Chair: alternating, rotational basis between the two participant Clinical Commissioning Groups)
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Vice-Chair (Lay Member: alternating, rotational basis between the two participant Clinical Commissioning Groups)
Note: in the absence of the Chair, meetings will be chaired by the Vice Chair as nominated and agreed by the Committee. The Vice Chair will not be an executive member of the Clinical Commissioning Groups. In the absence of both, another non-conflicted voting member of the Committee - who cannot be an executive member - shall fulfil these roles.
2.1.2 Membership
In order to perform his or her role effectively, each Committee member should obtain an understanding of the detailed responsibilities of Committee membership as well as the Clinical Commissioning Groups’ business, operations and risks. The members of the Committee are:
Two Chairs (of the participant Clinical Commissioning Groups, bar the SW Division whose Chair shall cover the SE Division) All Governing Body Clinical Member / GP Exec Representatives from each of the Divisions Managing Director of the Division Medical Directors for North, SE & SW (OR appropriate, alternative clinical lead role) All Lay Members from each of the Divisions (three from each Division’s Clinical Commissioning Groups) Two of the Directors from the Clinical Commissioning Groups’ Single Leadership Team (two serving all six, rolling basis)
A standing invitation will be extended to the following individuals in a non-voting capacity, where they are not already nominated or a member, to be in attendance at meetings:
Other senior managers from the Division as required (e.g. Head of Locality Commissioning) A Governance Lead on behalf the Clinical Commissioning Groups
Note: Deputies will only be permitted with Chair’s approval. Approved deputies are entitled to exercise voting functions at the Committee meeting as are held by the officer they are acting as deputy to.
Note: The Committee shall be authorised to co-opt other members, to ensure it has sufficient expertise to enable it to deal with its agenda. The Committee may also permit or require the attendance of officers of the Clinical Commissioning Groups to attend meetings, and may permit observers from the public.
Note: The Committee shall agree with the Clinical Commissioning Groups, support for the operations of the Committee, including the provision of administrative support for its activities.
2.1.3 Quorum
A quorum shall be a minimum of four Governing Body members from each Clinical Commissioning Group. It is expected that at least two Clinicians from each Clinical Commissioning Group will be present to uphold clinically-led decision making, unless management of conflict of interests prevent this. A duly convened, quorate meeting of the Committee shall be deemed competent to exercise all or any of the authorities, powers and discretions vested in or exercisable by it.
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In the event of difficulty in achieving a quorum, Governing Body members who are not members of the Committee may be co-opted as members for individual meetings, provided the majority of the quorum are full members of the Committee. Exec Team or Governing Body members who are not members of the Committee may attend meetings where relevant after first liaising with the Committee Chair.
Where the meeting is not quorate the actions taken to mitigate this will be recorded in the minutes. If approval is required from a voting member who is not present the email confirming their approval or otherwise will be saved with the minutes of the meeting.
Voting Rights
3.1 Committee Members have a collective responsibility for its operation. Both members and attendees will participate in discussions, review evidence and provide or seek objective expert input to the best of their knowledge and ability, endeavouring to support the Committee in reaching a collective view.
3.2 The Committee will use its best endeavours to make decisions by reaching a consensus, which should take into account the views shared by the non-voting attendees. Exceptionally, where this is not possible, the Chair (or in their absence Vice Chair) may call a vote, using the following process:
To avoid concerns that Clinical Leadership may be diluted, there will be a voting majority of Clinicians, as required for the Governing Bodies The meeting must be confirmed as quorate, once conflicts of interest have been accounted for, by the Chair, or in their absence the Vice Chair A decision will be made by a simple majority of votes cast; in the event of a draw, the Chair (or in their absence the Vice Chair) will have a final and casting vote
Frequency of Meetings
4.1 Meetings shall be held at least ten times a year and, where appropriate, will coincide with key dates in the Clinical Commissioning Group’s annual business cycle.
4.2 The Chair or Vice Chair may request an extraordinary meeting if they consider that one is necessary. Such a meeting may be called at any time upon not less than seven working days’ notice, or by exception with three working days’ notice being given to the other members of the Committee of the matters to be discussed.
Accountability and Delegated Authority
5.1 The Committee is authorised by and accountable to the Clinical Commissioning Group Governing Bodies to investigate any activity within these Terms of Reference and, within its scope of responsibilities as determined by Clinical Commissioning Group Schemes of Delegation, to seek any information it requires and to ensure the attendance of management representatives at meetings as appropriate.
The Committee’s Responsibilities
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6.1 The responsibilities of the Committee to the extent permitted by each Clinical Commissioning Group’s Scheme of Delegation are set out in the Appendix to these Terms.
Reporting Procedures
7.1 A schedule of meetings 12 months in advance will be published. Notices of the meeting shall be given not less than five working days in advance and where possible seven days in advance of the meeting, together with the agenda and agenda papers.
7.2 The confirmed minutes of meetings of the Committee shall be circulated to the Governing Body; along with a monthly Update and Escalation Report prepared by the Chair and Secretariat. The report should include:
The significant issues that the Committee has considered in relation to its responsibilities and any decisions reached by the Committee (including any areas for formal ratification by Governing Bodies);
An explanation of how it has assessed the effectiveness of the Committee’s delegated powers decision-making process and the approach taken to these;
Any items formally escalated to the Governing Body for resolution; and
In cases of emergency, the Chair may take urgent action to decide any matter within the remit of the Committee, subject to consultation with at least three other members, including a representative from each Clinical Commissioning Group unless conflicts of interest prevent this: any such urgent action shall be reported to the next meeting and to Governing Bodies
7.3 A section of the Clinical Commissioning Group’s Annual Report will also describe the work of the Committee in discharging its responsibilities. To enable this, the Committee shall, at least once a year, review its performance, constitution and Terms of Reference to ensure it is operating at maximum effectiveness, recommending any changes it considers necessary to the Governing Bodies for approval.
7.4 However in the first instance and owing to the developing nature of this Committee, these Terms of Reference will be reviewed within at least three months of their approval. They may be amended by mutual agreement of between the Clinical Commissioning Group Governing Bodies as required to reflect changes in circumstances which may arise.
Conflicts of Interest
8.1 The provisions of Managing Conflicts of Interest: Statutory Guidance for Clinical Commissioning Groups, Clinical Commissioning Group policy or any successor document will apply at all times.
8.2 The Committee shall hold and publish a Register of Interests. This shall record all relevant and material, personal or business interests; and each member and attendee of the Committee shall be under a duty to declare any such interests. Any change to these should be notified immediately to the Chair. Failure to disclose, whether intentional or otherwise, will be treated in line with the Clinical Commissioning Groups’ policy and may result in suspension. NHS North Staffordshire Clinical Commissioning Group – Constitution v2.3 Feb-20
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8.3 Any interest relating to an agenda item should be brought to the attention of the Chair in advance of the meeting, or notified as soon as the interest arises and recorded in the minutes with the actions taken to mitigate this. The Chair (or Vice Chair in their absence or where the Chair is conflicted) will then determine the arrangements for the management of any conflicts that arise in the meeting, and also outside it in consultation (to the extent deemed appropriate) with the Clinical Commissioning Group Director of Corporate Services, Governance and Communications or Deputy and/or Clinical Commissioning Group Conflicts of Interest Guardian(s).
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SCHEDULE 16
THE SEVEN PRINCIPLES OF PUBLIC LIFE (“NOLAN” PRINCIPLES)
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 material benefits for themselves, their family, or their friends.
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.
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.
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.
OPENNESS
Holders of public office should be as open as possible about all the decisions and actions that they take. They should give reasons for their decisions and restrict information only when the wider public interest clearly demands.
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.
LEADERSHIP
Holders of public office should promote and support these principles by leadership and example.
These principles apply to all aspects of public life. These are set out above for the benefit of all who serve the public in any way.
(For retention in personal file)
I hereby confirm that I have read, understood and agree to abide by the 7 Principles of Public Life.
Name (print)………………………………………
Signature…………………………………………..
Date…………………………………………………
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SCHEDULE 17
SIGNATORIES TO THE CONSTITUTION On behalf of the practice (listed below) by signing this agreement we have agreed to the principles contained in the Constitution of the North Staffordshire Clinical Commissioning Group .
Practice Name Practice Address
Senior Partner Name
Signature
Date
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