SUMMARY OF THE NHS SHEFFIELD CLINICAL COMMISSIONING GROUP CONSTITUTION Document B GUIDE FOR GENERAL PRACTICE
1. Introduction
The Health and Social Care Bill received Royal Assent and has become law as the Health and Social Care Act 2012. This provides the legislative basis for the new CCG commissioning arrangements. It is a legal requirement under the Act for the CCG to have a constitution and for this to include certain key provisions. Whilst the form adopted here follows the structure and provisions of the model constitution produced by the NHS Commissioning Board (the "NHSCB") (which is intended to meet the requirements under the Act and the guidance from the NHSCB) it still reflects local variations where appropriate.
The Constitution will be a key document for the CCG as it sets out key structural details around how you1 (as a member Practice) will operate, such as the arrangements to discharge your functions and those of your Governing Body; key processes for taking decisions and arrangements for managing any conflicts of interest that may emerge.
In terms of your Authorisation, the NHSCB will need to be satisfied that your Constitution complies with the requirements of the Act and is otherwise appropriate with regard to their guidance and requirements to meet the criteria for the Authorisation process.
1 For the purpose of this document the words “you”, “your” and “member” refer to the Member Practice.
Please note that we have not commented on every clause in the Constitution within this summary but instead have focussed on what have been the material provisions in our discussions. This summary should therefore be taken as general guidance and should always be considered in conjunction with the specific wording in the Constitution and not in isolation.
2. Key themes from the CCG Constitution
There are some key themes within the legal structure of the CCG which are helpful to clarify at the outset:
2.1 Member organisation
The CCG will be a member organisation fundamentally comprising of the member practices. The constitution reflects how your organisation will operate though it is important to note that ultimately the members, through the Members Representative, can determine most of the activities of the CCG.
2.2 Transparency
Your CCG will need to be transparent in its decision making with a requirement for meetings of the Governing Body to be held in public (except where the CCG considers that it would not be in the public interest to permit members of the public to attend a meeting or part of a meeting) and for the disclosure of the Constitution itself as well as associated registers of interests and Members, meeting agendas and minutes through the CCG website.
2.3 Accountability
It is important to understand that the CCG may be accountable in a number of ways. The main line of accountability will be to the NHSCB but as a public body the CCG will also be accountable to the local population (involvement with Health and Wellbeing Board as well as demonstrating public and patient involvement in decision making).
The CCG will be different to other NHS bodies as a statutory body built around membership (of the Member Practices). Therefore it is key to determine the accountability structure between the Governing Body and the Member Practices and this is set out in the Constitution. The Governing Body will need to demonstrate to the Member Practices that it is delivering its functions and the responsibilities which the Member Practices have delegated to it. The Constitution sets out how and which powers are delegated to the Governing Body as well as the basis of appointment of GP members as part of the Governing Body. The CCG will need to ensure that you have the appropriate balance of skills, experience, independence and knowledge to discharge the functions delegated to the Governing Body.
2.4 Behaviours
You will note that there is a strong emphasis on moral standards as reflected in the use of the seven principles of public life (the Nolan Principles) in the Constitution together with a detailed conflict of interest process.
2.5 Sustainability
This is the view of the organisation in terms of the setting of objectives and commissioning plans with a view to the longer term implications of your decisions.
3. Summary of the Main Provisions in the Constitution The diagram at Appendix 1 provides an overview of the component structures within the CCG that are required in order for it to exercise its functions. It shows the relationship of the member practices through the Practice Representatives, Member Representative Council and the Locality Executive Groups, and the Commissioning Executive Team and the Governing Body. The Governing Body has the overall responsibility for ensuring that the CCG delivers its objectives and duties (6.6):
Section Title Comment
1 Introduction & The Constitution must state the name of the CCG which should include the prefix "NHS" and reflect your Commencement geographical area to comply with requirements as may be set by the NHSCB. This section also sets out the circumstances in which the Constitution may be varied, either by an application from the CCG to the NHSCB (after a special resolution of the members has been passed) or by the NHSCB varying the Constitution itself where you have not applied for a variation. It is not possible for you to amend the Constitution without the involvement of the NHSCB and this currently includes any changes to the list of Member Practices or changes to joint commissioning arrangements (such as those with Local Authorities or other Clinical Commissioning Groups).
2 and 3 Area covered and You are required to set out the geographical area covered by the CCG and to list the Member Practices Membership within the Constitution.
Your CCG currently consists of 88 Member Practices all of whom hold contracts for the provision of primary medical services. Paragraph 3 also sets out the eligibility criteria for membership and the NHSCB has a duty to ensure that each provider of primary medical services with a list of registered patients is a member of a CCG. The NHSCB is responsible for changes to the membership (including any removal of a practice) but the CCG will want to satisfy itself that the Member Practices are engaged and working to the terms of the Constitution.
Paragraph 3.4 sets out the rights and responsibilities of Member Practices.
To the extent that there are disputes over a proposed member this would be sensibly resolved through referral to the NHSCB if required (save where the dispute relates the allocation of a practice to a particular Locality, in which case the Governing Body will determine the dispute).
4 Mission and Values These paragraphs set out at a high level the principles which your CCG will observe, what the organisation is, what influences your decision making and how you will demonstrate the accountability to patients and Members.
5 Functions and General Paragraph 5.1 sets out the functions of the CCG and in particular the ways in which the CCG will meet its Duties statutory duties. Paragraph 5.1.2 then sets out the arrangements you have made to discharge all of these functions. These arrangements are where appropriate then flowed down into the CCG Standing Orders/Scheme of Reservation and Delegation annexed to the Constitution.
At Paragraphs 5.2 and 5.3 against the areas of the relevant legislation and guidance with which your CCG must comply you have set out the arrangements that the CCG has made to discharge these general duties and financial duties, which include delegating responsibility to the Governing Body.
There is also (5.4) a general requirement for the CCG to comply with regulations and directions/guidance from the NHSCB.
6 Decision Making – The This is a key section in terms of the operation of the CCG as it sets out the mechanics as to how the CCG will Governing Structure operate internally. This includes setting out who the CCG may allow to act on its behalf (6.1) whilst highlighting that the CCG will remain responsible ultimately for all its functions including those which you may have delegated (6.2). In terms of the operation of your committees, these should be run according to the stated terms of reference (annexed to the Constitution). There are also clear rules as to how you should collaborate with other CCGs to ensure that these arrangements are clear and detailed as to areas such as pooled budgets and risk management (6.3).
The committee structure of the CCG is set out as well as details as to where the accountability of these committees rests. The statutory requirement is to have audit and remuneration committees (accountable to the Governing Body) whilst the guidance also suggests the inclusion of quality. Your committees will be an Audit and Integrated Governance Committee, the Remuneration and Terms of Service Committee and the Assurance/Quality Committee. The Audit and Integrated Governance Committee will also have a sub- committee: the Governance Sub-Committee. The Governing Body This section also details the functions and composition of the Governing Body. This body is required by statute and is not a committee of the CCG so this section then specifies the arrangements made by the CCG for the discharge of a list of functions by the Governing Body (6.6.1). There are a number of these functions which are set out in the Act (and so are not capable of amendment) but at 6.6.1 (d) onwards the functions are those additionally granted to the Governing Body by the CCG.
The main function of the Governing Body is to ensure that the CCG makes appropriate arrangements for compliance with your obligations to act with effectiveness, efficiency and economy, and relevant principles of good governance. It is also responsible for determining the remuneration, fees and allowances payable to the employees of the CCG, or to other service providers and the allowances payable under any pension scheme it may establish. In addition paragraph 6.6.2 clarifies the composition of the Governing Body and sets out the roles of the Accountable Officer, Chief Finance Officer and Chair/Vice Chair. This is set up to provide a clinical majority and the decisions of the Governing Body will in general be via a simple majority (Standing Orders, paragraph 3.7). Whilst there is no requirement in statute for this it is consistent with the CCG being a clinically led organisation. In addition to the Governing Body the CCG has made specific provision for four Locality Executive Groups ("LEGs") (6.7), accountable to the Members of the relevant Locality (not the Governing Body) to provide views from the membership to the Commissioning Executive Team and the Governing Body amongst other specific functions.
7 Roles and These provisions define the roles within the organisation. Of note are that Practice Responsibilities Representatives will be the individuals appointed by a Member Practice and they should secure the effective participation by each member of the group in delivering its functions. It is expected that the regulations will require that the Practice Representative will be a GP or other healthcare professional. The remaining roles set out here reflect the governance structure of the CCG and relevant NHSCB guidance – it should be noted that the Governing Body shares collective responsibility to exercise the functions (7.3).
The key roles are: (a) the Accountable Officer; (b) the Chair of the Governing Body (also note the inclusion of a Deputy Chair); and (c) the Chief Finance Officer.
In addition to the model requirements the CCG has incorporated new roles for a Chief of Operations and two Clinical Directors (though with one vote only)
8 Standards of Business It is a statutory requirement to include the mechanism for how the CCG will manage conflicts of interest. Conduct and Managing These provisions provide for dealing with conflicts of interests of members or employees of the CCG or Conflicts of Interest members of its Governing Body as well as contractors of the CCG. (8.2).
The NHSCB is obliged to issue guidance on managing conflicts which the CCG will be obliged to comply with.
There are also requirements for the CCG to be transparent in procuring services which includes the development of a Procurement Strategy via the Governing Body.
9 The CCG as Employer This section consists of high level guidelines as to how the CCG will act as an employer of staff including compliance with employment legislation, equal opportunities and policies and procedures.
10 Transparency, Ways of This specifies that the CCG will produce a Commissioning Plan and Annual Report to its public meeting and Working and Standing that in line with the transparency theme material will be posted on the website or through other means of Orders communication.
It also makes reference to the other key documents which form part of and inform the main terms of the Constitution which are: (a) Standing Orders, (b) Scheme of Reservation and Delegation and (c) Prime Financial Policies which are described below:
Appendix C Standing Orders The Standing Orders provide a procedural framework within which the CCG discharges its business. They set out: the arrangements for conducting the business of the CCG; the appointment of Practice Representatives and to the other roles within the CCG (which remain the CCG's responsibility); the procedure to be followed at meetings of the CCG (which includes relevant detail around calling them, agenda, quorum, taking decisions, emergency matters and admission of the public/press which will have a practical impact upon the members), the Governing Body and any committees or sub-committees of the CCG or the Governing Body; the process to delegate powers, the declaration of interests and standards of conduct. They also reflect the requirements of procedures for the Governing Body and the Governing Body's committees (Audit & Integrated Governance; Remuneration & Terms of Service; and Assurance/Quality). The detail around the roles in the Standing Orders includes the details of selection/election to roles within the CCG, eligibility criteria, terms of office and specific grounds for removal from office. Failure to comply with the processes set out in the Standing Orders will be reported to the CCG and could be regarded a disciplinary matter.
Appendix D Scheme of Reservation The CCG’s scheme of reservation and delegation sets out (i) decisions that are reserved for the Members as and Delegation a whole, (ii) decisions that are the responsibilities of the Governing Body and its committees and (iii) decisions that are for any sub-committees, individual members and employees of the CCG. Your CCG is accountable for exercising the statutory functions of the CCG. In order to undertake this, you are granting authority to the Governing Body to act on your behalf for the majority of the functions as set out above and as further clarified in this scheme. It is worth noting that the CCG still remains accountable for all of its functions, including those that it delegates under this Scheme. The Governing Body remains accountable to its Member Practices; this could be described as being something like how a company would be held accountable by its shareholders and the relationship is further described in the Scheme of Reservation and Delegation and Standing Orders.
Appendix E Prime Financial These prime financial policies identify the financial responsibilities which apply to everyone working for the Policies CCG and its constituent organisations. This is a key element of governance and the ability of your CCG to demonstrate financial control and probity as part of the authorisation process.
The wording here follows the model suggested by the NHSCB.
Version History
Date Version Status Comments
25/07/12 1.0 Draft EDV
4 October 1.0 Draft Comment from LMC incorporated
16/07/13 1.0 Final Update to reflect authroisation Appendix 1
NHS SHEFFIELD CLINICAL COMMISSIONING GROUP
CONSTITUTION
Version: 1.14; 16. April 2013
NHS Commissioning Board Effective Date: 17th January 2013.
NHS SHEFFIELD CLINICAL COMMISSIONING GROUP
CONSTITUTION
Document Owner Linda Tully
Client NHS Sheffield Clinical Commissioning Group
Title NHS Sheffield Clinical Commissioning Group Constitution
DAC Beachcroft Document 109485537-7 Reference
Version History
Date Version Status Comments
2/5/12 1 Draft Received from Carol Henderson
15/5/12 2 Draft Amendments by DACB, including amendment from Carol Henderson re Section 5.2.12 and CCG Area plan
18/5/12 3 Draft Further amends – comments on governing body
25/5/12 4-6 Draft Review based on comments and emails from SL 28/5/12 7 Draft RM/RW review following SL comments and emails
19/7/12 8 Draft Received from Sue Laing
27/7/12 9 Draft – EV review following SL comments and emails. issued to client
06/08/12 9 Amends Updates to definitions; include ToRs and Constitution as appendices
9/8/12 10 JN amends Version for CCG committee on 16 August
13/8/12 11 JN amends Version after completing work on SOs etc to ensure consistency
15/8/12 12 LT amend Appendix 1 of summary document changed 7.1.2 b) remove “Locality Council” 17/8/12 12 JN amend To reflect discussions at CCG Committee meeting re. authorisation on 16/8/12
27/9/12 13 LT amend Comments from Rachel Dillon
4/10/12 13 LT amend Comments form LMC
16/04/13 14 LT amend To reflect date of authorisation
CONTENTS
Part Description Page
Foreword 3
1 Introduction and Commencement 4
1.1 Name 4
1.2 Statutory framework 4
1.3 Status of this Constitution 4
1.4 Amendment and variation of this Constitution 4 / 5
2 Area Covered 6
3 Membership 6
3.1 Membership of the clinical commissioning group 6
3.2 Eligibility 6
3.3 Application for Membership 6
3.4 Rights and Responsibilities of Member 6
3.5 Cessation of Membership 7
3.6 Disputes 7
4 Mission, Values and Aims 8
4.1 Mission 8
4.2 Values 8
4.3 Aims 9
4.4 Principles of good governance 9
4.5 Accountability 10
4.6 All member council meeting 11
5 Functions and General Duties 12
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Part Description Page
5.1 Functions 12
5.2 General duties 13
5.3 General financial duties 17
5.4 Other relevant regulations, directions and documents 18
6 Decision Making: The Governing Structure 19
6.1 Authority to act 19
6.2 Scheme of reservation and delegation 19
6.3 General 19
6.4 Committees of the CCG 20
6.5 Joint arrangements 21
6.6 The Governing Body 21
6.7 Locality Executive Groups and the Commissioning Executive Team 24
7 Roles and Responsibilities 27
7.1 Practice representatives 27
7.2 Other GPs or primary care health professionals 27
7.3 All Members of the CCG’s Governing Body 27
7.4 The chair of the Governing Body 27
7.5 The deputy chair of the Governing Body 28
7.6 Role of the Chief Officer 28
7.7 Role of the chief finance officer 29
8 Standards of Business Conduct and Managing Conflicts of Interest 31
8.1 Standards of business conduct 31
8.2 Conflicts of interest 31
8.3 Declaring and registering interests 31
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Part Description Page
9 The CCG as Employer 32
10 Transparency, Ways of Working and Standing Orders 33
10.1 General 33
10.2 Standing Orders 33
Appendix Description
A Definitions of Key Descriptions used in this Constitution
B List of Member Practices
C Standing Orders
D Scheme of Reservation and Delegation
E Prime Financial Policies
F The Nolan Principles
G The Seven Key Principles of the NHS Constitution
H Map of the Area and the Localities of the CCG
I Conflicts of Interest Protocol
J Terms of Reference
- Audit and Integrated Governance Committee - Remuneration Committee - Quality Assurance Committee - Governance Sub-Committee
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1. FOREWORD
NHS Sheffield Clinical Commissioning Group is supported by four strong localities.
We aim to be an organisation capable of commissioning high quality services in an affordable and sustainable local health system. We are authorised to operate as a Committee of the South Yorkshire and Bassetlaw Cluster of PCTs, and will operate in shadow form, with delegated responsibility for the majority of NHS Sheffield’s statutory obligations, until we become a statutory body in April 2013.
This Constitution sets out the arrangements made by the CCG to meet its responsibilities for commissioning care for the people to whom it is accountable. It describes the governing principles, rules and procedures that the CCG will establish to ensure probity and accountability in the day to day running of the CCG; to ensure that decisions are taken in an open and transparent way and that the interests of patients and the public remain central to our four priority aims:
1. To improve patient experience and access to care
2. To improve the quality and equality of healthcare in Sheffield
3. To work with the City Council to continue to reduce health inequalities in Sheffield
4. To ensure there is a sustainable, affordable healthcare system in Sheffield
NHS Sheffield Clinical Commissioning Group commits to:
Involve all GP practices in clinical commissioning through the mandate offered to CCG committee representative and engagement in our strong localities.
Citywide implementation of effective innovations and opportunities for improvement
Placing patients at the heart of all our commissioning decisions and seeking their views
Healthcare decisions led by Doctors, nurses and other health professionals.
Collaborative working across practices, through strong locality arrangements
Strengthening relationships and partnership work between organisations and clinicians
Improvement that is well managed and benefits all parties
4 NHS Sheffield Clinical Commissioning Group’s Constitution - - Version: 1.14 | NHS Commissioning Board Effective Date: 17 January 2013.
Signed ...... Signed ......
Chair Chief Officer
5 NHS Sheffield Clinical Commissioning Group’s Constitution - - Version: 1.14 | NHS Commissioning Board Effective Date: 17 January 2013.
INTRODUCTION AND COMMENCEMENT
1.1. Name
1.1.1. The name of this clinical commissioning group is NHS Sheffield 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”). They are statutory bodies which have the function of commissioning services for the purposes of the health service in England and are treated as NHS bodies 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. The NHS Commissioning Board is responsible for determining applications from prospective groups to be established as clinical commissioning groups and undertakes an annual assessment of each established group. It has powers to intervene in a clinical commissioning group where it is satisfied that a group is failing or has failed to discharge any of its functions or that there is a significant risk that it will fail to do so.
1.2.3. Clinical commissioning groups are clinically led Membership organisations made up of general practices. The Members of the clinical commissioning groups are responsible for determining the governing arrangements for their organisations, 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 Sheffield Clinical Commissioning Group and has effect from 17th day of January 2013, when the NHS Commissioning Board established the CCG. The Constitution is published on the CCG’s website. This document is also available upon request at the Headquarters of Sheffield CCG, 722 Prince of Wales Road, Darnall, Sheffield S9 4EU via post to the same address please mark for the attention of the CCG Secretary or by email to [email protected]
1.4. Amendment and Variation of this Constitution
1.4.1. This Constitution can only be varied in two circumstances.
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a) where, following the passing of a Special Resolution by the Members, agreeing to propose the variation (or where the change is approved by the Governing Body it having been delegated the approval by the Members under the Scheme of Reservation and Delegation) the CCG applies to the NHS Commissioning Board and that application to vary the Constitution is granted; b) where in the circumstances set out in legislation the NHS Commissioning Board varies the CCG’s Constitution other than on application by the CCG.
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2. AREA COVERED
2.1. The geographical area covered by the CCG and the boundaries of the four Localities of the CCG are represented in Appendix H.
3. MEMBERSHIP
3.1 Membership of the CCG
3.1.1 The Practices listed at Appendix B comprise the Members of NHS Sheffield CCG together with the signatures of the Practice Representatives confirming their agreement to this Constitution.
3.2 Eligibility
3.2.1 Providers of primary medical services to a registered list of patients in the Area under a General Medical Services, Personal Medical Services or Alternative Provider Medical Services contract, will be eligible to apply for Membership of the CCG2.
3.3 Application for Membership
3.3.1 No practice shall become a Member of the CCG unless that practice:
a) is eligible to become a Member in accordance with paragraph 3.2 above;
b) has confirmed its acceptance of this Constitution; and
c) has been entered into the Register of Members set out in Appendix B to this Constitution.
Any dispute between a practice and the CCG in respect of eligibility for Membership of the CCG shall be referred to the NHS Commissioning Board for determination.
3.4 Rights and Responsibilities of Members
3.4.1 Members are entitled to the following benefits:
2 See section 14A(4) of the 2006 Act, inserted by section 25 of the 2012. Regulations to be made 8 NHS Sheffield Clinical Commissioning Group’s Constitution - - Version: 1.14 | NHS Commissioning Board Effective Date: 17 January 2013.
a) access to a pooled budget for management of high risk and high cost patients;
b) access to a range of commissioning support services to ensure achievement of key objectives;
c) representation of interests via the Locality Leads in the Commissioning Executive Team and Governing Body;
d) access to centrally managed savings for ongoing service development.
3.4.2 Members are required to comply with the following Membership obligations:
a) to nominate a Practice Representative for the Member;
b) to attend via their Practice Representative (or their proxy) relevant Locality meetings and meetings of the Members Representative Council;
c) to adhere to pathways, policies and protocols including the prescribing formulary as agreed by the CCG;
d) to share relevant information via Locality Executive Groups, the Member Council and the Governing Body
e) endeavour to make available clinical and other staff to lead or participate in commissioning project work
f) keep up to date on commissioning and related issues through the normal professions publications, educational events and networks
3.5 Cessation of Membership
3.5.1 A Member ceases to be a Member if they cease to be eligible for membership through non-compliance with paragraph 3.2 above.
3.5.2 The CCG shall notify the NHS Commissioning Board in the event that it becomes aware that any Member has ceased to meet the requirements of paragraph 3.2 and shall propose any such amendments to this Constitution under the terms of paragraph 1.4 as are appropriate to reflect the circumstances.
3.5.3 Membership of the CCG is not transferable and any proposed changes to the membership (including those arising from a merger of Members) shall be subject to the approval of the NHS Commissioning Board.
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3.6 Disputes
3.6.1 Any dispute between the practice and the CCG in respect of eligibility for Membership of the CCG shall be referred to the NHS Commissioning Board for determination. The Governing Body shall determine any disputes in terms of allocation of the practices to a Locality.
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4. MISSION, VALUES AND AIMS
4.1 Mission
4.1.1 The mission of the CCG is to improve the quality, equality and sustainability of the NHS in Sheffield through clinical leadership of commissioning, engaging practices and clinicians to make a real difference for the people of Sheffield.
4.1.2 The CCG will promote good governance and proper stewardship of public resources in pursuance of its goals and in meeting its statutory duties.
4.2 Values
4.2.1 Good corporate governance arrangements are critical to achieving the CCG’s objectives.
4.2.2 The values that lie at the heart of the CCG’s work are:
a) The CCG will be a strong and forward thinking organisation. Its success will depend on working with partner organisations, constituent practices and local communities. It will work through clinical collaboration with its providers, underpinned by strong contracts. The localities within the CCG will be the principle vehicles charged with leading local implementation and delivery in key priority areas. Engagement of patients, public and communities will be embedded within the CCG's commissioning process.
b) The CCG will work to the following set of values and principles in pursuit of its aims. It will:
i) have effective corporate governance systems in place and, as a minimum, adhere to the requirements of the Nolan Principles (listed below) and the NHS Constitution, the Equality Act and the Public Sector Equality Duty;
ii) be sound custodians of Sheffield’s health care budget, ensuring that it achieves a balanced outcome at the end of each year;
iii) place patients' interests at the heart of all its discussions with providers of healthcare and all its commissioning decisions;
iv) empower its clinical leaders in motivating and influencing the wider clinical population to ensure health improvement and healthcare for our population;
v) strive to achieve the best possible health and the highest quality health services for all the people of Sheffield, taking account of the different needs of local communities and the groups covered by the Equality Act;
vi) seek evidenced based best practice and share knowledge to ensure that it delivers the best possible individual care across care pathways;
vii) work together, engaging staff, patients and the public in its local and collective decisions;
viii) work with its local communities to ensure jointly owned approaches to local needs and concerns;
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ix) develop strong collaborative relationships with partner organisations, including the local NHS Foundation Trusts, Sheffield City Council, the NHS Commissioning Board, HealthWatch, the voluntary community and faith sector, local politicians, and local professional committees;
x) support practices, through its localities, to engage in clinical commissioning and to implement improvements in care;
xi) support its staff to fully contribute to its work, drawing upon their expertise and knowledge to support clinical leaders;
xii) support clinicians to innovate and to adopt best practice;
xiii) work with communities, with public health and with primary care to help people to maintain their health and prevent illness or health crises; and
xiv) above all, work to benefit the population of Sheffield.
4.3 Aims
4.3.1 The CCG’s aims are:
a) To improve patient experience and access to care;
b) To improve the quality and equality of healthcare in Sheffield;
c) To work with Sheffield City Council to continue to reduce health inequalities in Sheffield; and
d) To ensure that there is a sustainable, affordable healthcare system in Sheffield.
4.4 Principles of Good Governance
4.4.1 In accordance with section 14L (2)(b) of the 2006 Act,3 the CCG will at all times observe “such generally accepted principles of good governance” in the way it conducts its business. These include:
a) the highest standards of propriety involving impartiality, integrity and objectivity in relation to the stewardship of public funds, the management of the organisation and the conduct of its business;
a) The Good Governance Standard for Public Services;4
b) the standards of behaviour published by the Committee on Standards in Public Life (1995) known as the ‘Nolan Principles’5
3 Inserted by section 25 of the 2012 Act 4 The Good Governance Standard for Public Services, The Independent Commission on Good Governance in Public Services, Office of Public Management (OPM) and The Chartered Institute of Public Finance & Accountability (CIPFA), 2004 5 See Appendix F 12 NHS Sheffield Clinical Commissioning Group’s Constitution - - Version: 1.14 | NHS Commissioning Board Effective Date: 17 January 2013.
c) the seven key principles of the NHS Constitution;6
d) the Equality Act.7
4.5 Accountability
4.5.1 The CCG will demonstrate its accountability to its Members, local people, stakeholders and the NHS Commissioning Board in a number of ways, including by:
a) publishing its Constitution;
b) appointing independent Lay Members and non GP clinicians to its Governing Body;
c) holding meetings of its Governing Body in public (except where the CCG considers that it would not be in the public interest in relation to all or part of a meeting);
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; and
j) providing information to the NHS Commissioning Board as required.
4.5.2 In addition to these statutory requirements, the CCG will demonstrate its accountability by:
a) Publication of the Annual Report b) Convening a public Annual General Meeting c) Governing Body meetings held in public d) Governing Body papers available to the public.
6 See Appendix G 7 See http://www.legislation.gov.uk/ukpga/2010/15/contents 13 NHS Sheffield Clinical Commissioning Group’s Constitution - - Version: 1.14 | NHS Commissioning Board Effective Date: 17 January 2013.
4.5.3 The Governing Body of the CCG will throughout each year have an ongoing role in reviewing the CCG’s governance arrangements to ensure that the CCG continues to reflect the principles of good governance.
4.6. Members Council Meeting
The Governing Body will call a membership meeting at least once a year which will include reviewing the Constitution and the decisions reserved to Members as set out in the Scheme of reservation and delegation. The principles behind the Members Council meeting are;
a) All Member practices will be invited to attend b) The Practice Representatives will be the formal voting members at the meeting. They can send a nominated deputy provided this information is sent in writing to the Company Secretary in advance of the meeting. c) Other Healthcare Professionals and managers from Member practices may attend the meeting but with no formal voting rights; d) The Governing Body will give at least 30 days notice in writing of the Members Council meeting specifying the place, day and time of the meeting and proposed agenda. e) The Governing Body shall give at least 14 days notice in writing of the meeting of any significant alterations or proposed changes to the Constitution on which Member practices will be asked to vote. f) Practice Representatives shall be entitled to vote on the proposals to change the Constitution through the use of voting slips whether or not in attendance at the meeting. Voting slips will be sent out to all Practice Representatives 14 days prior to the vote. g) All proposals put to a vote will be determined to be agreed based on a two thirds majority (67%) or more of votes cast. h) The Governing Body, reserves the right to hold an extraordinary Members Council meeting as required in line with emergency and urgent decisions. i) The Member practices through their Practice Representatives will be able to call for an extraordinary Members Council meeting by submitting a formal request to the Chair, which has been supported by a two third majority (67%) of Member practices.
14 NHS Sheffield Clinical Commissioning Group’s Constitution - - Version: 1.14 | NHS Commissioning Board Effective Date: 17 January 2013.
5 FUNCTIONS AND GENERAL DUTIES
5.1 Functions
5.1.1 The functions that the CCG are responsible for exercising are largely set out in the 2006 Act, as amended by the 2012 Act. An outline of these appears in the Department of Health’s Functions of Clinical Commissioning Groups: a working document. They relate to:
a) commissioning certain health services (where the NHS Commissioning Board is not under a duty to do so) that meet the reasonable needs of: i) all people registered with Member GP practices, and ii) people who are usually resident within the area and are not registered with a Member of any clinical commissioning group;
b) commissioning emergency care for anyone present in the CCG’s area;
c) paying its employees’ remuneration, fees and allowances in accordance with the determinations made by its Governing Body and determining any other terms and conditions of service of the CCG’s employees;
d) determining the remuneration and travelling or other allowances of Members of its Governing Body.
5.1.2 In discharging its functions the CCG will:
a) act8, when exercising its functions to commission health services, consistently with the discharge by the Secretary of State and the NHS Commissioning Board of their duty to promote a comprehensive health service9 and with the objectives and requirements placed on the NHS Commissioning Board through the mandate10 published by the Secretary of State before the start of each financial year by:
i) delegating responsibility for complying with this duty to: the Chief Officer; and the Chief Finance Officer ii) delegating responsibility for complying with duties in the relevant areas to the: Audit and Integrated Governance Committee; Remuneration Committee; Quality Assurance Committee; iii) maintaining robust Standing Orders and a Scheme of Reservation and Delegation; iv) maintaining a range of policies and procedures for the operational management of the business of the CCG which will include delegating responsibilities in key areas to individuals
8 See section 3(1F) of the 2006 Act, inserted by section 13 of the 2012 Act 9 See section 1 of the 2006 Act, as amended by section 1 of the 2012 Act 10 See section 13A of the 2006 Act, inserted by section 23 of the 2012 Act 15 NHS Sheffield Clinical Commissioning Group’s Constitution - - Version: 1.14 | NHS Commissioning Board Effective Date: 17 January 2013.
v) requiring progress against delivery of this duty to be reported regularly to the Governing Body and committees of the Governing Body.
b) meet the public sector equality duty11 by:
i) delegating delivery of this duty to the Equalities Group;
ii) delegating aspects of meeting the duty to an executive officer with direct responsibility for equality, accountable to the CCG Governing Body;
iii) appointment of a CCG Governing Body Member with responsibility for oversight of equality work and a requirement for this Member to report on delivery of the duty to the Governing Body; and
iv) publishing equalities information, equality objectives and an action plan to ensure compliance with the duty on the CCG website.
c) work in partnership with its local authority to develop joint strategic needs assessments12 and joint health and wellbeing strategies13 by:
i) nominating representatives from the CCG to be its representatives on the Sheffield Health and Wellbeing Board; ii) Public Health Core Offer to the CCG (and Public Health Intelligence specified as part of the Memorandum of Understanding); iii) Membership of the Joint Health and Wellbeing Strategy Development Group.
5.2 General Duties - in discharging its functions the CCG will:
5.2.1 Make arrangements to secure public involvement in the planning, development and consideration of proposals for changes and decisions affecting the operation of commissioning arrangements14 by:
Following the principles outlined in the CCG's Communications and Engagement Strategy. These principles include:
Working in partnership with patients and the local community to secure the best care for them; Working with the Sheffield Health and Wellbeing Board, the Overview and Scrutiny Committee of Sheffield City Council, Healthwatch and other local engagement partners to ensure a thorough city-wide approach to engagement; Adapting engagement activities to meet the specific needs of the different patient groups and communities;
11 See section 149 of the Equality Act 2010, as amended by paragraphs 184 and 186 of Schedule 5 of the 2012 Act 12 See section 116 of the Local Government and Public Involvement in Health Act 2007, as amended by section 192 of the 2012 Act 13 See section 116A of the Local Government and Public Involvement in Health Act 2007, as inserted by section 191 of the 2012 Act 14 See section 14Z2 of the 2006 Act, inserted by section 26 of the 2012 Act 16 NHS Sheffield Clinical Commissioning Group’s Constitution - - Version: 1.14 | NHS Commissioning Board Effective Date: 17 January 2013.
Publishing information about health services on the CCG's website and through other media; Positively encouraging and acting upon feedback; Reporting the outcome of local consultations to the Commissioning Executive Team annually; and Reporting on engagement activity annually to the Commissioning Executive Team.
5.2.2 Promote awareness of, and act with a view to securing that health services are provided in a way that promotes awareness of, and have regard to the NHS Constitution15 by
delegating responsibility for complying with this duty to the CCG's Governing Body;
5.2.3 Act effectively, efficiently and economically16 by:
ensuring compliance with the CCG’s Standing Orders and Scheme of Reservation & Delegation; delegating responsibility for oversight of this duty to the Audit & Integrated Governance Committee; responding to internal and external audit reports and reviews; and providing monthly reports on the position against financial duties to the Governing Body.
5.2.4 Act with a view to securing continuous improvement to the quality of services17 by:
Appointment of a Chief Nurse; Appointment of a Clinical Director; Appointment of the Quality Assurance Committee and forming the following advisory groups which will support the Quality Assurance Committee in discharging its responsibilities: Safeguarding Children’s Group Safeguarding Adults Group Contract Quality Review Groups Quality in Care Homes Group
Develop policies and procedures to meet its responsibilities for quality and contract management of providers of health care; and Put in place arrangements for the reporting of delivery of this duty through the Governing Body and relevant committees of the Governing Body.
5.2.5 Assist and support the NHS Commissioning Board in relation to the Board’s duty to improve the quality of primary medical services18 by:
15 See section 14P of the 2006 Act, inserted by section 26 of the 2012 Act and section 2 of the Health Act 2009 (as amended by 2012 Act) 16 See section 14Q of the 2006 Act, inserted by section 26 of the 2012 Act 17 See section 14R of the 2006 Act, inserted by section 26 of the 2012 Act 18 See section 14S of the 2006 Act, inserted by section 26 of the 2012 Act 17 NHS Sheffield Clinical Commissioning Group’s Constitution - - Version: 1.14 | NHS Commissioning Board Effective Date: 17 January 2013.
The appointment of the Chief Nurse who will have overall responsibility for quality improvement, and will work closely with the designated GP who leads on quality in general practice; and
Delegating responsibility for securing continuous improvement for the quality of services to the Quality Assurance Committee.
5.2.6 Have regard to the need to reduce inequalities19 by:
Working with Sheffield City Council to address the factors leading to inequality, including but not limited to the delivery of relevant sections of the Health and Wellbeing Strategy; and Addressing any inequalities in access to healthcare in the Equalities Action Plan.
5.2.7 Promote the involvement of patients, their carers and representatives in decisions about their healthcare20 by:
the appointment of a Governing Body Member with lead responsibility for patient involvement; and the development of a strategy for patient involvement.
5.2.8 Act with a view to enabling patients to make choices21 by:
the adoption of the any qualified provider approach to procurements to facilitate patient choice for appropriate services unless the CCG considers that it is inappropriate to do so; ensuring all commissioning strategies support patient choice; ensuring all referrers have the information required to support patients to make choices about their care; and publicising and promoting patients' right to choice.
5.2.9 Obtain appropriate advice22 from persons who, taken together, have a broad range of professional expertise in healthcare and public health by:
engagement with the following:
Sheffield Health and Wellbeing Board; public health consultants via the memorandum of understanding between the CCG and Sheffield City Council for the public health core offer of public health support provided to the CCG; Clinical Reference Group; the joint Clinical Directors; Professional Local Committees (ie the L.M.C., L.O.P., L.D.C., L.P.C.); Leads for safeguarding, infection control, professional standards; The Medicines Management Team; Area Prescribing Committee;
19 See section 14T of the 2006 Act, inserted by section 26 of the 2012 Act 20 See section 14U of the 2006 Act, inserted by section 26 of the 2012 Act 21 See section 14V of the 2006 Act, inserted by section 26 of the 2012 Act 22 See section 14W of the 2006 Act, inserted by section 26 of the 2012 Act 18 NHS Sheffield Clinical Commissioning Group’s Constitution - - Version: 1.14 | NHS Commissioning Board Effective Date: 17 January 2013.
Dental Advisors and the Dental Public Health Unit; and Locality Executive Groups.
5.2.10 Promote innovation23 by:
Clinical engagement in devising new services and patient pathways co-ordinated through the Clinical Reference Group which engages the wider health system and a range of clinical professionals, under the leadership of the Joint Clinical Directors. Promote through integrated health and social care summits, which take place 2 or 3 times per year, convened by the CCG's Joint Clinical Directors, together with senior GP leaders, FT medical directors and Sheffield City Council colleagues. Ensure innovation is at the heart of the CCG's commissioning plans and investment each year. The CCG support staff will work with clinicians and managers in primary care to look at how services can be made more efficient, accessible and clinically effective. Locality based pilots will be supported to test out ideas where appropriate. Through the Planning and Delivery Group, chaired by one of the four Locality Leads, have responsibility for ensuring that appropriate innovation proposals are translated into business cases, investment decisions and reflected in contracts with providers as appropriate. Ensure innovation is at the heart of QIPP and managers will work closely with clinicians to look at how services can be made more efficient, accessible and clinically effective. The CCG will, where appropriate, draw on expertise of public health teams through the Core Offer to ensure that innovations are based on best available clinical evidence, for example Map of Medicine and NICE and support the CCG to realise its vision to reduce health inequalities.
5.2.11 Promote research and the use of research24 by:
Commissioning a specialist 'Research Management & Governance Service'; Membership of the South Yorkshire Comprehensive Local Research Network Board; Membership of the Collaboration for Leadership in Applied Health Research and Care - South Yorkshire (CLAHRC-SY); Membership of the East Midlands and South Yorkshire Primary Care Research Network; and
Commissioning a specialist 'Research and Evaluation Service'25.
5.2.12 Have regard to the need to promote education and training26 for persons who are employed, or who are considering becoming employed, in an activity which involves or is connected with the provision of services as part of the health service in England so as to assist the Secretary of State for Health in the discharge of his related duty27 by:
Responsibility for the identification of learning needs of employees being that of the line manager and the employee;
23 See section 14X of the 2006 Act, inserted by section 26 of the 2012 Act 24 See section 14Y of the 2006 Act, inserted by section 26 of the 2012 Act 25 To support the Board lead, deputise for him, capacity build, deal with FSF, perhaps even write a strategy to promote research etc. 26 See section 14Z of the 2006 Act, inserted by section 26 of the 2012 Act 27 See section 1F(1) of the 2006 Act, inserted by section 7 of the 2012 Act 19 NHS Sheffield Clinical Commissioning Group’s Constitution - - Version: 1.14 | NHS Commissioning Board Effective Date: 17 January 2013.
Responsibility for the delivery of appropriate education and training to meet the identified needs of employees being delegated to the human resources lead in the CCG. The CCG will have Learning and Development Protocol in place to describe the processes needed to ensure the promotion of education and training. Monitoring of the delivery of this duty will be carried out by the CCG, based on quarterly workforce reports.
5.2.13 Act with a view to promoting integration across health and social care services where the CCG considers that this would improve the quality of services or reduce inequalities28 by:
`Establishing a partnership approach to strategic planning that involves all providers of health and social care; Contributing to existing partnership arrangements between providers; Paying regard to the totality of patient’s needs in service planning; Involving patients in service planning; and Establishing formal partnership and contractual arrangements that support integration, including pooled budget arrangements and integrated commissioning arrangements where appropriate.
5.3 General Financial Duties – the CCG will perform its functions so as to:
5.3.1 Ensure its expenditure does not exceed the aggregate of its allocations for the Financial Year29
Through its Governing Body and governance structures, it will particularly discharge this duty through the following:
ensuring compliance with the CCG’s Standing Orders, Scheme of Reservation & Delegation and Prime Financial Policies; ensuring robust financial processes and systems set out in detailed policies and procedures as relevant and ensuring a strong internal control environment. This to be kept under review particularly by the Audit and Integrated Governance Committee. maintaining a medium term financial plan to support delivery of the CCG's strategic aims and annual commissioning plan prior to the start of each Financial Year establishing a detailed financial plan and accompany QIPP plan for the year ahead, including up and down side risk management scenarios ; approving at the start of the new Financial Year initial budgets for each area of commissioning and the CCG’s running costs; and monthly reports to the Governing Body and CET on the position against budgets and key contracts and delivery against all financial duties
5.3.2 Ensure its use of resources (both capital and revenue) does not exceed the amount specified by the NHS Commissioning Board for the financial year30
Through its Governing Body and governance structures it will principally discharge this function in the same way as set out in paragraph 5.3.1.
28 See section 14Z1 of the 2006 Act, inserted by section 26 of the 2012 Act 29 See section 223H(1) of the 2006 Act, inserted by section 27 of the 2012 Act 30 See sections 223I(2) and 223I(3) of the 2006 Act, inserted by section 27 of the 2012 Act 20 NHS Sheffield Clinical Commissioning Group’s Constitution - - Version: 1.14 | NHS Commissioning Board Effective Date: 17 January 2013.
5.3.3 Take account of any directions issued by the NHS Commissioning Board, in respect of specified types of resource use in a financial year, to ensure the CCG does not exceed an amount specified by the NHS Commissioning Board 31
Through its Governing Body and governance structures it will principally discharge this function in the same way as set out in paragraph 5.3.1.
5.3.4 Publish an explanation of how the CCG spent any payment in respect of quality made to it by the NHS Commissioning Board32
Through its Governing Body and governance structures it will particularly discharge this duty through the following: the Governing Body will delegate responsibility for delivery of this duty to the Chief Finance Officer; periodic reports to the Governing Body.
5.4 Other Relevant Regulations, Directions and Documents
5.4.1 The CCG will: comply with all relevant regulations; comply with directions issued by the Secretary of State for Health or the NHS Commissioning Board; and take account, as appropriate, of documents issued by the NHS Commissioning Board.
5.4.2 The CCG will develop and implement the necessary systems and processes to comply with these regulations and directions, documenting them as necessary in this Constitution, its scheme of reservation and delegation and other relevant CCG policies and procedures.
5.4.3 Where it considers it appropriate for the effective discharge of its functions the CCG will engage with local stakeholder bodies including the Local Medical Committee (LMC) for the Area in its role as the local representative body for GPs. 6. DECISION MAKING: THE GOVERNING STRUCTURE
6.1 Authority to act
6.1.1 The CCG is accountable for exercising the statutory functions of the CCG. It may grant authority to act on its behalf to:
a) any of its Members;
b) its Governing Body (and its Committees and sub-committees);
c) employees;
31 See section 223J of the 2006 Act, inserted by section 27 of the 2012 Act 32 See section 223K(7) of the 2006 Act, inserted by section 27 of the 2012 Act 21 NHS Sheffield Clinical Commissioning Group’s Constitution - - Version: 1.14 | NHS Commissioning Board Effective Date: 17 January 2013.
d) a committee or sub-committee of the CCG.
6.1.2 The extent of the authority to act of the respective bodies and individuals depends on the powers delegated to them by the CCG as expressed through:
a) the CCG’s Scheme of Reservation and Delegation; and
b) for Committees, their terms of reference.
6.2 Scheme of Reservation and Delegation33
6.2.1 The CCG’s scheme of reservation and delegation sets out:
a) those decisions that are reserved for the Membership as a whole;
b) those decisions that are the responsibilities of its Governing Body (and its Committees), individual Members and employees.
6.2.2 The CCG remains accountable for all of its functions, including those that it has delegated.
6.3 General
6.3.1 In discharging functions of the CCG that have been delegated to them, the Governing Body (and its Committees) and individuals must:
a) comply with the CCG’s principles of good governance,34
b) operate in accordance with the CCG’s Scheme of Reservation and Delegation,35
c) comply with the CCG’s Standing Orders and Prime Financial Policies36
d) comply with the CCG’s arrangements for discharging its statutory duties,37
33 See Appendix D 34 See section 4.4 on Principles of Good Governance above 35 See appendix D 36 See appendices C and E 37 See chapter 5 above 22 NHS Sheffield Clinical Commissioning Group’s Constitution - - Version: 1.14 | NHS Commissioning Board Effective Date: 17 January 2013.
e) Where appropriate, ensure that Member practices have had the opportunity to contribute to the CCG’s decision making process.
6.3.2 When discharging their delegated functions of the CCG, the committees and sub- committees of the Governing Body must also operate in accordance with their approved terms of reference.
6.3.3 Where delegated responsibilities are being discharged collaboratively, the joint (collaborative) arrangements must:
a) identify the roles and responsibilities of those clinical commissioning groups who are working together;
b) identify any pooled budgets and how these will be managed and reported in annual accounts;
c) specify under which clinical commissioning group’s scheme of reservation and delegation and supporting policies the collaborative working arrangements will operate;
d) specify how the risks associated with the collaborative working arrangement will be managed between the respective parties;
e) identify how disputes will be resolved and the steps required to terminate the working arrangements; and
f) specify how decisions are communicated to the collaborative partners.
6.4 Committees of the CCG
6.4.1 The following committees are established by the CCG:
a) Audit and Integrated Governance Committee accountable to the Governing Body; b) Remuneration Committee accountable to the Governing Body; c) Quality Assurance Committee accountable to the Governing Body; and d) Governance sub-committee accountable to the Audit and Integrated Governance Committee.
Terms of Reference for the above Committees and Sub-committees are available at Appendix J.
6.4.2 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 CCG or the committee they are accountable to the Governing Body.
23 NHS Sheffield Clinical Commissioning Group’s Constitution - - Version: 1.14 | NHS Commissioning Board Effective Date: 17 January 2013.
6.5 Joint Arrangements
6.5.1 The CCG has entered into joint arrangements with the following clinical commissioning groups:
a) NHS Rotherham CCG; b) NHS Doncaster CCG; c) NHS Bassetlaw CCG; and d) NHS Barnsley CCG;
for the CCG Collaborative Commissioning Arrangements (known as "CCGCOM").
The CCG has entered into a Memorandum of Understanding to support this arrangement.
6.5.2 The CCG has joint arrangements with the following local authorities:
a) the 2012 Act makes provision for clinical commissioning groups to make section 75 agreements with local authorities and the CCG has joint arrangements with Sheffield City Council which are managed through partnership arrangements. The CCG does not have a formal joint committee with Sheffield City Council.
6.6 The Governing Body
6.6.1 Functions - the Governing Body has the following functions conferred on it by sections 14L(2) and (3) of the 2006 Act, inserted by section 25 the 2012 Act, together with any other functions connected with its main functions as may be specified in regulations or in this Constitution.38 Additional functions conferred on the Governing Body by the CCG connected with its main functions, are set out from paragraph 6.6.1(d) below. The Governing Body has responsibility for:
a) ensuring that the CCG has appropriate arrangements in place to exercise its functions effectively, efficiently and economically and in accordance with the CCG's principles of good governance39 (its main function);
b) determining the remuneration, fees and other allowances payable to employees or other persons providing services to the CCG and the allowances payable under any pension scheme it may establish under paragraph 11(4) of Schedule 1A of the 2006 Act, inserted by Schedule 2 of the 2012 Act;
c) approving any functions of the CCG that are specified in regulations;40
d) promote the involvement of all Members in the work of the CCG in securing improvements in commissioning of care and services;
38 See section 14L(3)(c) of the 2006 Act, as inserted by section 25 of the 2012 Act 39 See section 4.4 on Principles of Good Governance above 40 See section 14L(5) of the 2006 Act, inserted by section 25 of the 2012 Act 24 NHS Sheffield Clinical Commissioning Group’s Constitution - - Version: 1.14 | NHS Commissioning Board Effective Date: 17 January 2013.
e) engage in a collaborative approach within the local health system with patients, the public and other stakeholders and promote the involvement of patients and their carers and representatives (if any) in decisions about the provision of health services to patients;
f) engage with each relevant Health and Wellbeing Board and nominate Members of the Governing Body to act as its representatives in relation to each such Health and Wellbeing Board;
g) secure effective clinical engagement in the decisions of the CCG;
h) prepare the annual commissioning plan;
i) keep proper accounts and proper records and prepare the Accounts to present to the Members and the public at the AGM;
j) prepare the Annual Report to present to the Members and the public at the AGM;
k) ensure quality governance systems are working effectively;
l) establish any links and working arrangements with other clinical commissioning groups or strategic, regional or other commissioning groups, as may from time to time be deemed appropriate;
m) ensure that the registers of interest are reviewed, regulated and updated as necessary;
n) co-ordinate and plan for demand, financial and investment needs of the CCG;
6.6.2 Composition of the Governing Body - the Governing Body shall not have less than 15 voting Members and comprises:
a) the Chair, (who will be chosen from either (b) or (c) below, and elected by the Governing Body);
b) Four GPs (with one nominated by each Locality to represent all Members in that Locality);
c) Four other GPs who are elected by Member practices;
d) Two Lay Members: i) one to lead on audit, remuneration and conflict of interest matters, who will also be the Governing Body’s Vice-Chair as set out in paragraph 7.5.1), ii) one to lead on patient and public participation matters;
e) one registered nurse;
f) one secondary care specialist doctor;
g) the Chief Officer;
25 NHS Sheffield Clinical Commissioning Group’s Constitution - - Version: 1.14 | NHS Commissioning Board Effective Date: 17 January 2013.
h) the Chief Finance Officer;
i) other individuals:
i) the Chief Operating Officer; ii) the Chief of Business Planning and Partnerships; and iii) Two Clinical Directors who shall have a single vote41
The Governing Body shall have the power to co-opt other non-voting Members as it sees fit from time to time.
6.6.3 The Members of the Governing Body shall be required to abide by the Nolan Principles as befits the CCG being a public body and shall abide by any other values and behaviours agreed by the Governing Body.
6.6.4 In acting as a Member of the Governing Body, each Member of the Governing Body shall:
a) promote the success of the CCG for the benefit of the Members as a whole;
b) act within the powers set out in this Constitution;
c) exercise independent judgement;
d) exercise reasonable care, skill and diligence;
e) declare any interest (and, if relevant, of the Member they represent) in any proposed transaction or arrangement with or being considered by the CCG;
f) avoid conflicts of interest; and
g) not accept benefits from third parties.
6.6.5 Committees of the Governing Body - the Governing Body has appointed the following committees and sub-committees:
a) Audit and Integrated Governance Committee (AIGC) – is accountable to the CCG’s Governing Body and primarily provides the Governing Body with an independent and objective view of the CCG’s financial systems, financial information and compliance with laws, regulations and directions governing the CCG in so far as they relate to finance. The Governing Body approves and keeps under review the terms of reference for the committee, which includes information on its membership42. The Governing Body has also approved the establishment of a Governance sub committee to the Audit and Integrated Governance Committee. The Sub- Committee’s main purpose it to monitor internal organisational governance and risk management arrangements, promote a culture of sound governance and ensure appropriate controls are in place. AIGC approves and keeps under review the terms of reference for the sub committee, which includes information on its membership43.
41 See Appendix C section 2.3 of the Standing Orders. 42 See Appendix K the terms of reference of the Audit and Integrated Governance Committee 43 See Appendix K the terms of reference of the Governance Sub Committee 26 NHS Sheffield Clinical Commissioning Group’s Constitution - - Version: 1.14 | NHS Commissioning Board Effective Date: 17 January 2013.
b) Remuneration Committee – is accountable to the CCG’s Governing Body. Its functions include overseeing the appointment process for Members of the Governing Body; making determinations on the remuneration, fees and other allowances for Members of the Governing Body and in relation to CCG employees making recommendations to the Governing Body on potential alternative remuneration and conditions of service to those set out in the national Agenda for Change arrangements and NHS Pension Scheme. The Governing Body approves and keeps under review the terms of reference for the Remuneration Committee, which includes information on its membership44.
c) Quality Assurance Committee – is accountable to the CCG’s Governing Body. It is principally responsible for ensuring that the population of Sheffield receives safe, high quality care. The Governing Body approves and keeps under review the terms of reference for the Quality Assurance Committee, which includes information on its membership45.
6.7 The four Locality Executive Groups (LEGs) established by the relevant Members for each Locality, are accountable to the Members of the CCG. Relevant Members approve and keep under review their LEG terms of reference. The LEGs are responsible for the following:
(a) Delivering an advisory role to the Governing Body to reflect the views of the Locality Members through nominating one GP representative to sit on the Commissioning Executive Team (CET) and one GP representative to be a Governing Body Member;
(b) Encouraging and supporting practice ownership of the commissioning agenda, reporting into city wide discussions and vice versa;
(c) Monitoring and managing the commissioning performance of constituent practices and primary care services where appropriate;
(d) Supporting practices in commissioning incentive schemes;
(e) Ensuring that the matters delegated to it by the CET are being delivered robustly. Put risk management system in place as appropriate;
(f) Providing robust communication mechanisms with practices to ensure city wide messages are relayed and vice versa;
(g) Encouraging best use and value for money of resources;
(h) Ensuring sign up from practices to this Constitution, strategy and prospectus, commissioning plan and responsibilities;
(i) Encouraging and facilitating positive contribution from practices to the overall business of the CCG;
(j) Providing a forum where all practices can meet discuss and contribute to locality and citywide business;
(k) Developing and maintaining a public and patient relationship;
44 See Appendix K for the terms of reference of the Remuneration Committee 45 See Appendix K the terms of reference of the Quality Assurance Committee 27 NHS Sheffield Clinical Commissioning Group’s Constitution - - Version: 1.14 | NHS Commissioning Board Effective Date: 17 January 2013.
(l) Providing quality clinical leadership;
(m) Supporting and developing future clinical leaders;
(n) Supporting practices in developing ideas to develop primary care contribution in clinical commissioning;
(o) Sharing learning across Sheffield and identifying potential for city wide roll out;
(p) Working across the CCG to maximise use of resources in developing pilots/prototypes and engaging with the broader arena of clinicians;
(q) Working together with other clinicians and Members to achieve mutual benefit underpinned by respect, integrity and honesty;
(r) Where possible, do once and share across the CCG.
6.7.1 The Commissioning Executive Team, which through the Chief Officer is accountable to the Governing Body, is responsible for:
a) recommending to the Governing Body the strategic, business, financial and QIPP plans for the CCG taking into account the input of the Localities and Patient Engagement Panel, implementing the business plan within the constraints of the financial plan;
b) ensuring the organisation is aware of and complies with its legal and statutory obligations;
c) managing day to day risks and issues for the CCG as they arise;
d) securing and aligning the necessary managerial and clinical resources to bring about reform and improve quality in line with the CCG’s strategy;
e) identifying, securing and aligning the necessary resources needed to deliver the functions of the CCG;
f) engaging with service providers and other key local stakeholders including public and patients, to shape patient pathways and services for the CCG; and
g) managing communications and consultation processes within the CCG and with the public and organisations outside the CCG.
28 NHS Sheffield Clinical Commissioning Group’s Constitution - - Version: 1.14 | NHS Commissioning Board Effective Date: 17 January 2013.
7. ROLES AND RESPONSIBILITIES
7.1 Practice Representatives
7.1.2 The role of each Practice Representative is to:
a) represent their appointing Member practice views and act on behalf of them in respect of CCG matters; and
b) be the representative of their appointing Member on the Members Council.
7.1.3 Each Member shall nominate one Practice Representative who is either a GP partner / salaried GP / Healthcare Professional of that Member practice. The name of the Practice Representative must be submitted in writing to the Locality Executive Group and Company Secretary of the CCG by an authorised representative of the relevant practice.
7.1.4 Each Member may remove and replace their Practice Representative at any time, by notice in writing to the Locality Executive Group and Company Secretary of the CCG signed by an authorised representative of the relevant practice.
7.1.5 For the avoidance of doubt, the Governing Body shall be entitled to treat any Practice Representative as having the continuing authority given to him until it is notified in writing of the removal of that Practice Representative in accordance with paragraph 7.1.4 and any provision of this Constitution that requires delivery or notification to a Member shall be deemed to have been satisfied if delivery or notification is made to or served on the relevant Practice Representative.
7.2 Other GP and Primary Care Healthcare Professionals
7.2.1 In addition to the Practice Representatives identified in paragraph 7.1 above, the CCG will from time to time, identify a number of other GPs / primary care Healthcare Professionals from Member practices to either support the work of the CCG and / or represent the CCG rather than represent their own individual practices.
7.3 Members of the CCG’s Governing Body
7.3.1 Each Member of the Governing Body should share responsibility as part of a team to ensure that the CCG exercises its functions effectively, efficiently and economically, with good governance and in accordance with the terms of this Constitution. Each brings their unique perspective, informed by their expertise and experience.
7.4 Chair of the Governing Body
7.4.1 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;
29 NHS Sheffield Clinical Commissioning Group’s Constitution - - Version: 1.14 | NHS Commissioning Board Effective Date: 17 January 2013.
b) building and developing the CCG’s Governing Body and its individual Members;
c) ensuring that the CCG has proper constitutional and governance arrangements in place;
d) ensuring that, through the appropriate support, information and evidence, the Governing Body is able to discharge its duties;
e) supporting the Chief Officer in discharging the responsibilities of the organisation;
f) contributing to building a shared vision of the aims, values and culture of the organisation;
g) leading and influencing to achieve clinical and organisational change to enable the CCG to deliver its commissioning responsibilities;
h) overseeing governance and particularly ensuring that the Governing Body and the wider CCG behaves with the utmost transparency and responsiveness at all times;
i) ensuring that public and patients’ views are heard and their expectations understood and, where appropriate as far as possible, met;
j) ensuring that the organisation is able to account to its local patients, stakeholders and the NHS Commissioning Board;
k) ensuring that the CCG builds and maintains effective relationships, particularly with the individuals involved in overview and scrutiny from the relevant local authority(ies).
7.4.2 Where the chair of the Governing Body is also the senior clinical voice of the CCG they will take the lead in interactions with stakeholders, including the NHS Commissioning Board.
7.5 Vice-Chair of the Governing Body
7.5.1 Whilst the Chair is a clinician, the Vice-Chair of the Governing Body shall be the Lay Member of the Governing Body who leads on audit, remuneration and conflict of interest matters and he shall deputise for the Chair of the Governing Body where the chair has a conflict of interest or is otherwise unable to act.
7.6 Role of the Chief Officer
7.6.1 The Chief Officer of the CCG is a Member of the Governing Body.
7.6.2 This role of Chief Officer has been summarised in a national document46 as:
46 See the latest version of the NHS Commissioning Board Authority’s Clinical commissioning CCG Governing Body Members: Role outlines, attributes and skills 30 NHS Sheffield Clinical Commissioning Group’s Constitution - - Version: 1.14 | NHS Commissioning Board Effective Date: 17 January 2013.
a) being responsible for ensuring that the CCG fulfils its duties to exercise its functions effectively, efficiently and economically thus ensuring improvement in the quality of services and the health of the local population whilst maintaining value for money;
b) at all times ensuring that the regularity and propriety of expenditure is discharged, and that arrangements are put in place to ensure that good practice (as identified through such agencies as the Audit Commission and the National Audit Office) is embodied and that safeguarding of funds is ensured through effective financial and management systems;
c) working closely with the chair of the Governing Body, the Chief Officer will ensure that proper constitutional, governance and development arrangements are put in place to assure the Members (through the Governing Body) of the organisation’s ongoing capability and capacity to meet its duties and responsibilities. This will include arrangements for the ongoing developments of its Members and staff; and
d) ensuring the CCG complies with its obligations under:
section 14P of the 2006 Act to promote the NHS Constitution; sections 223H to 223J of the 2006 Act; and paragraphs 16 to 18 of Part 1 of Schedule 1A of the 2006 Act.
7.6.3 In addition to the Chief Officer's general duties, where the Chief Officer is also the senior clinical voice of the CCG the will take the lead in interactions with stakeholders, including the NHS Commissioning Board.
7.6.4 The Governing Body may authorise the Chief Officer to fulfil this role for more than one clinical commissioning group (such appointment is referred to as a "joint appointment") at its discretion.
7.7 Role of the Chief Finance Officer
7.7.1 The Chief Finance Officer is a Member of the Governing Body and is responsible for providing financial advice to the CCG and for supervising financial control and accounting systems
7.7.2 This role of Chief Finance Officer has been summarised in a national document47 as:
a) being the Governing Body’s professional expert on finance and ensuring, through robust systems and processes, the regularity and propriety of expenditure is fully discharged;
b) making appropriate arrangements to monitor the CCG’s finances;
47 See the latest version of the NHS Commissioning Board Authority’s Clinical commissioning CCG Governing Body Members: Role outlines, attributes and skills 31 NHS Sheffield Clinical Commissioning Group’s Constitution - - Version: 1.14 | NHS Commissioning Board Effective Date: 17 January 2013.
c) overseeing robust audit and governance arrangements leading to propriety in the use of the CCG’s resources;
d) being able to advise the Governing Body on the effective, efficient and economic use of the CCG’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 the NHS Commissioning Board; and
f) ensuring the discharge of obligations by the CCG under relevant financial directions including:
implementing the CCG's financial policies and for co-coordinating any corrective action necessary to further these policies; maintaining an effective system of internal financial control including ensuring that detailed financial procedures and systems incorporating the principles of separation of duties and internal checks are prepared, documented and maintained to supplement these instructions; ensuring that sufficient records are maintained to show and explain the CCG's transactions, in order to disclose, with reasonable accuracy, the financial position of the CCG at any time; and the preparation and maintenance of such accounts, certificates, estimates, records and reports as the CCG may require for the purpose of carrying out its statutory duties;
32 NHS Sheffield Clinical Commissioning Group’s Constitution - - Version: 1.14 | NHS Commissioning Board Effective Date: 17 January 2013.
8. STANDARDS OF BUSINESS CONDUCT AND MANAGING CONFLICTS OF INTEREST
8.1 Standards of Business Conduct
8.1.1 Members, Governing Body Members, Practice Representatives and employees of the CCG will at all times comply with this Constitution and be aware of their responsibilities as outlined in it.
8.1.2 All Members, Governing Body Members, Practice Representatives and employees of the CCG must comply with the CCG’s arrangements managing conflicts or potential conflicts of interest including the Conflicts of Interest Protocol. The Conflicts of Interest Protocol is included as Appendix I of this Constitution and shall be available on the CCG’s website.
8.1.3 Individuals contracted to work on behalf of the CCG or otherwise providing services or facilities to the CCG will be made aware of their obligation with regard to declaring conflicts or potential conflicts of interest. This requirement will be written into their contract for services.
8.2 Conflicts of Interest
8.2.1 Where a Member that is an individual, Governing Body Member, Practice Representative or employee of the CCG has an interest (including pecuniary, personal or family interest whether actual or potential and whether that interest is direct or indirect), or becomes aware of an interest which could lead to a conflict of interests in the event of the CCG considering an action or decision in relation to that interest, such interest must be considered as a potential conflict, and is subject to the provisions of this Constitution and the Conflicts of Interest Protocol. Appendix I.
8.3 Register of Interests
8.3.1 The CCG will maintain one or more registers of the interests which shall record all relevant personal or business interests or positions of influence of:
a) the Members of the CCG;
b) the Governing Body Members;
c) Practice Representatives; and
d) employees of the CCG.
8.3.2 The registers will be published on the CCG’s website.
8.3.3 The Company Secretary will ensure that the registers of interest are reviewed regularly, and updated as necessary.
33 NHS Sheffield Clinical Commissioning Group’s Constitution - - Version: 1.14 | NHS Commissioning Board Effective Date: 17 January 2013.
9. THE CCG AS EMPLOYER
9.1 The CCG 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 CCG.
9.2 The CCG 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 CCG 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 CCG. All staff will be made aware of this Constitution, the commissioning strategy and the relevant internal management and control systems which relate to their field of work.
9.4 The CCG 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 CCG will also maintain and publish policies on all aspects of human resources management, including grievance and disciplinary matters
9.5 The CCG 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 CCG will ensure that employees' behaviour reflects the values, aims and principles set out above.
9.7 The CCG will ensure that it complies with all aspects of employment law.
9.8 The CCG 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 CCG 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 CCG’s website.
34 NHS Sheffield Clinical Commissioning Group’s Constitution - - Version: 1.14 | NHS Commissioning Board Effective Date: 17 January 2013.
10. TRANSPARENCY, WAYS OF WORKING AND STANDING ORDERS
10.1 General
10.1.1 The CCG will publish annually a commissioning plan and an annual report, presenting the CCG’s annual report to a public meeting.
10.1.2 Key communications issued by the CCG, including the notices of procurements, public consultations, Governing Body meeting dates, times, venues, and certain papers will be published on the CCG’s website.
10.1.3 The CCG may use other means of communication, including circulating information by post, or making information available in venues or services accessible to the public.
10.2 Standing Orders
10.2.1 This Constitution is also informed by a number of documents which provide further details on how the CCG will operate. They are the CCG’s:
Standing Orders (Appendix C) – which provide a procedural framework within which the CCG discharges its business including arrangements and procedures for formal meetings of CCG and the Governing Body
Scheme of reservation and delegation (Appendix D) – which sets out those decisions that are reserved for the Membership as a whole and those decisions that are the responsibilities of the CCG’s Governing Body, the Governing Body’s committees and sub-committees, individual Members and employees;
Prime financial policies (Appendix E) – which sets out the arrangements for managing the CCG’s financial affairs.
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APPENDIX A DEFINITIONS OF KEY DESCRIPTIONS USED IN THIS CONSTITUTION
"2006 Act" National Health Service Act 2006 as amended by the 2012 Act;
"2012 Act" Health and Social Care Act 2012 (this Act amends the 2006 Act);
"Chief Officer" Means the accountable officer as defined under paragraph 12 of Schedule 1A of the 2006 Act (as inserted by Schedule 2 of the 2012 Act), appointed by the NHS Commissioning Board, with responsibility for ensuring the Group:
complies with its obligations under: o sections 14Q and 14R of the 2006 Act (as inserted by section 26 of the 2012 Act); o sections 223H to 223J of the 2006 Act (as inserted by section 27 of the 2012 Act); o paragraphs 17 to 19 of Schedule 1A of the NHS Act 2006 (as inserted by Schedule 2 of the 2012 Act); and o any other provision of the 2006 Act (as amended by the 2012 Act) specified in a document published by the Board for that purpose; and exercises its functions in a way which provides good value for money; "Area" the geographical area that the CCG has responsibility for, as defined in paragraph 2 of this Constitution;
"Area Prescribing the Sheffield Area Prescribing Committee (APC) is a sub-group of the CET which Committee" makes recommendations on local prescribing practice.
"Audit and Integrated the Committee of the CCG accountable to the Governing Body as set out at Governance paragraph 6.6.5(a) of this Constitution; Committee"
"Board" the National Health Service Commissioning Board;
"CCG" NHS Sheffield Clinical Commissioning Group, whose Constitution this is;
"CCGCOM" South Yorkshire and Bassetlaw CCG Commissioning Network;
"Company Secretary" the secretary of the CCG or any other person appointed to perform the duties of the secretary of the CCG
"Chair of the the individual appointed by the CCG to act as chair of the Governing Body; Governing Body"
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"Chief Finance the qualified accountant employed by the CCG with responsibility for financial Officer" strategy, financial management and financial governance;
"Clinical a body corporate established by the NHS Commissioning Board in accordance Commissioning with Chapter A2 of Part 2 of the 2006 Act (as inserted by section 10 of the 2012 Group" Act);
"Clinical Reference The Clinical Reference Group supports the decision making and governance Group" processes of the Clinical Commissioning Group, by providing advice and recommendations, via the Commissioning Executive Team. The Clinical Reference group and its associated Forum seeks to underpin clinically led commissioning through work on service redesign, education and governance.
"Commissioning the advisory executive team to the Governing Body as referred to in paragraph Executive Team" or 6.7.1 "CET"
"Committee" a committee or sub-committee created and appointed by either:
the Membership of the CCG; a committee / sub-committee created by a committee created / appointed by the Membership of the CCG; or a committee / sub-committee created / appointed by the Governing Body;
"Conflicts of Interest the CCG's Protocol for managing conflicts of interest which is included as Protocol" Appendix I to this Constitution;
"Constitution" this constitution as amended from time to time in accordance with its terms;
"Dental Advisors" local dentists in general practice whose function is primarily to monitor and advise local general dental practitioners about the safety, quality and governance of their services.
"Dental Public Health provides consultant led specialist expertise relating to dental services, oral health Unit" improvement and health protection.
"Equality Act" the Equality Act 2010;
"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;
“General a medical practitioner whose name is included in the General Practice Register Practitioner” or “GP” kept by the General Medical Council who is either a Member or employed or engaged on a regular basis by Member(s) of the CCG
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"Governing Body" the body appointed under section 14L of the NHS Act 2006 (as inserted by section 25 of the 2012 Act), with the main function of ensuring that a clinical commissioning group has made appropriate arrangements for ensuring that it complies with:
its obligations under section 14Q under the NHS Act 2006 (as inserted by section 26 of the 2012 Act); and such generally accepted principles of good governance as are relevant to it; "Governing Body Member" any Member appointed to the Governing Body of the CCG;
“Healthcare an individual who is a member of a profession regulated by a body mentioned in Professional” section 25(3) of the National Health Service Reform and Health Care Professions Act 2002
"Joint Clinical one of two clinical directors appointed jointly to the Governing Body in Director" accordance with paragraph 2.6 of the Standing Orders;
"Lay Member" a lay Member of the Governing Body, appointed by the CCG. A Lay Member is an individual who is not a Member of the CCG or a healthcare professional
(i.e. an individual who is a Member of a profession regulated by a body mentioned in section 25(3) of the National Health Service Reform and Health Care Professions Act 2002) or as otherwise defined in regulations;
“Locality” A largely geographical grouping of Member practices
"Locality Executive Each Locality has a Locality Executive Group whose membership and terms of Group" or "LEG" reference is determined by its Member practices
"Medicines A team that includes pharmacists and technicians and provides advice and Management Team" support on the safe, clinically effective and cost efficient use of medicines
"Member" a provider of primary medical services to a registered patient list, who is a Member of this CCG in accordance with paragraph 3.1 and Appendix B of this Constitution;
"Members Council" A formal meeting between the Governing Body and Member practices represented by the Practice Representatives which will take place at least once a year
"Planning and The planning and delivery group brings together CCG localities, QIPP Delivery Group" programme leads and account managers for the major provider contracts. Reporting directly to the CET the group considers performance against the annual QIPP plan and contracts and considers business cases.
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"Public Sector the duty set out in Section 149 of the Equality Act 2010; Equality Duty"
"Practice an individual appointed by a practice (who is a Member of the CCG) to act on its Representatives" behalf in the dealings between it and the CCG, under regulations made under section 89 or 94 of the 2006 Act (as amended by section 28 of the 2012 Act) or directions under section 98A of the 2006 Act (as inserted by section 49 of the 2012 Act);
"Public Health Core The ‘offer’ from Sheffield City Council in relation to Public Health agreed through Offer" a Memorandum of Understanding between the City Council and the CCG, and which covers health care public health, health improvement and health protection areas of Public Health practice. An annual work plan will be agreed.
"Quality Assurance the Committee of the CCG accountable to the Governing Body as set out at Committee" paragraph 6.6.5(c) of this Constitution;
"Registers of registers a CCG is required to maintain and make publicly available under section Interests" 14O of the 2006 Act (as inserted by section 25 of the 2012 Act), of the interests of: the Members of the CCG; 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; "Remuneration the Committee of the CCG accountable to the Governing Body as set out at Committee" paragraph 6.6.3(b) of this Constitution;
"Special Resolution" a resolution of 67% of more of Member practices through their Practice Representatives either at a Members Council meeting or by written resolution
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Appendix B
List of Members
88 practices listed by localities
Locality PRACTICE_NAME PRACTICE ADDRESS Town PCode
Central Abbey Lane Surgery 23 Abbey Lane Sheffield S8 0BJ
Central Baslow Road And Shoreham Street Surgeries 148 Baslow Road, Totley Sheffield S17 4DR
Central Carrfield Medical Centre Carrfield Street Sheffield S8 9SG
Central Clover Group Practice Highgate Surgery, Highgate, Sheffield S9 1WN Tinsley
Central Darnall Health Centre (Mehrotra) 2 York Road Sheffield S9 5DH
Central Darnall Health Centre (Swinden) 2 York Road Sheffield S9 5DH
Central Dovercourt Surgery 3 Skye Edge Avenue Sheffield S2 5FX
Central Duke Medical Centre 28 Talbot Road Sheffield S2 2TD
Central East Bank Medical Centre 555 East Bank Road Sheffield S2 2AG
Central Gleadless Medical Centre 636 Gleadless Road Sheffield S14 1PQ
Central Handsworth Medical Practice 432 Handsworth Road Sheffield S13 9BZ
Central Heeley Green Surgery 302 Gleadless Road Sheffield S2 3AJ
Central Manor Park Medical Centre 204 Harborough Avenue Sheffield S2 1QU
Central Manor Top Medical Centre (Read) Rosehearty Ridgeway Rd Sheffield S12 2SS
Central Manor Top Medical Centre (Sharma) Rosehearty Ridgeway Rd Sheffield S12 2SS
Central Meersbrook Medical Centre 243-245 Chesterfield Rd Sheffield S8 0RT
Central Norfolk Park Medical Practice Tower Drive Sheffield S2 3RE
Central Park Health Centre 190 Duke Street Sheffield S2 5QQ
Central Sharrow Lane Medical Centre 129 Sharrow Lane Sheffield S11 8AN
Central Sloan Medical Centre 2 Little London Road Sheffield S8 0YH
Central The Mathews Practice Belgrave Belgrave MC, 22 Asline Road Sheffield S2 4UJ
Central The Medical Centre 1a Ingfield Avenue Sheffield S9 1WZ
Central White House Surgery 1 Fairfax Rise Sheffield S2 1SL
Central Woodseats Medical Centre 4 Cobnar Road Sheffield S8 8QB
HASC Avenue Medical Practice 7 Reney Avenue Sheffield S8 7FH
1 NHS Sheffield Clinical Commissioning Group’s Constitution Version: 1.14 | NHS Commissioning Board Effective Date: 17 January 2013
HASC Bents Green Surgery 98 Bents Road Sheffield S11 9RL
HASC Birley Health Centre 120 Birley Lane Sheffield S12 3BP
HASC Carterknowle And Dore Medical Practice 1 Carterknowle Road Sheffield S7 2DW
HASC Charnock Health Primary Care Centre White Lane Sheffield S12 3GH
HASC Falkland House 2a Falkland Road Sheffield S11 7PL
HASC Greenhill Health Centre 482 Lupton Road Sheffield S8 7NP
HASC Greystones Medical Centre 33 Greystones Rd Sheffield S11 7BJ
HASC Hackenthorpe Medical Centre Main Street, Hackenthorpe Sheffield S12 4LA
HASC Jaunty Springs Health Centre 53 Jaunty Way Sheffield S12 3DZ
HASC Manchester Road Surgery 484 Manchester Road Sheffield S10 5PN
HASC Mosborough Health Centre 34 Queen Street Sheffield S20 5BQ
HASC Nethergreen Surgery 34-36 Nethergreen Road Sheffield S11 7EJ
HASC Owlthorpe Medical Centre Moorthorpe Bank Sheffield S20 6PD
HASC Richmond Medical Centre 462 Richmond Road Sheffield S13 8NA
HASC Rustlings Road Medical Centre 105 Rustlings Road Sheffield S11 7AB
HASC Selborne Road Medical Centre 1 Selborne Road Sheffield S10 5ND
HASC Sothall Medical Centre 24 Eckington Road Sheffield S20 1HQ
HASC Stonecroft Medical Centre 871 Gleadless Road Sheffield S12 2LJ
HASC The Hollies Medical Centre 20 St Andrews Road Sheffield S11 9AL
HASC The Meadowhead Group Practice Old School Medical Centre, Sheffield S8 7RL School Lane
HASC The Medical Centre Crystal Peaks 15 Peaks Mount Sheffield S20 7HZ
HASC Totley Rise Medical Centre 96 Baslow Road Sheffield S17 4DQ
HASC Upperthorpe Medical Centre 30 Addy Street, Upperthorpe Sheffield S6 3FT
HASC Westfield Health Centre Westfield Northway Sheffield S20 8NZ
HASC Woodhouse Health Centre 5-7 Skelton Lane, Woodhouse Sheffield S13 7LY
North Barnsley Road Surgery 899 Barnsley Road Sheffield S5 0QJ
North Bluebell Medical Centre 356 Bluebell Road Sheffield S5 6BS
North Buchanan Road Surgery 72 Buchanan Road Sheffield S5 8AL
North Burncross Surgery 1 Bevan Way, Chapeltown Sheffield S35 1RN
North Burngreave Surgery 5 Burngreave Road Sheffield S3 9DA
North Crookes Valley Medical Centre 1 Barber Road Sheffield S10 1EA
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North Dunninc Road Surgery 28 Dunninc Road, Shiregreen Sheffield S5 0AE
North Elm Lane Surgery 104 Elm Lane Sheffield S5 7TW
North Firth Park Surgery 400 Firth Park Road Sheffield S5 6HH
North Foxhill Medical Centre 363 Halifax Road Sheffield S6 1AF
North Grenoside Surgery 60 Greno Crescent, Grenoside Sheffield S35 8NX
North Mill Road Surgery 98a Mill Road Sheffield S35 9XQ
North Norwood Medical Centre 360 Herries Road Sheffield S5 7HD
North Page Hall Medical Centre 101 Owler Lane Sheffield S4 8GB
North Pitsmoor Surgery 151 Burngreave Road Sheffield S3 9DL
North Sheffield Medical Centre 21 Spital Street Sheffield S3 9LB
North Shiregreen Medical Centre 492 Bellhouse Road Sheffield S5 0RG
North Southey Green Medical Centre 281 Southey Green Road Sheffield S5 7QB
North The Ecclesfield Group Practice 96a Mill Road, Ecclesfield Sheffield S35 9XQ
North The Health Care Surgery 63 Palgrave Road Sheffield S5 8GS
North Upwell Street Surgery 93 Upwell Street Sheffield S4 8AN
North Wincobank Medical Centre 205 Tyler Street Sheffield S9 1DJ
West Broomhill Surgery 5 Lawson Road Sheffield S10 5BU
West Deepcar Medical Centre 271 Manchester Rd, Deepcar Sheffield S36 2RA
West Devonshire Green Medical Centre 126 Devonshire Street Sheffield S3 7SF
West Dykes Hall Medical Centre 156 Dykes Hall Road Sheffield S6 4GQ
West Far Lane Medical Centre 1 Far Lane Sheffield S6 4FA
West Harold Street Medical Centre 2 Harold Street Sheffield S6 3QW
West Oughtibridge Surgery Church Street, Oughtibridge Sheffield S35 0FW
West Porter Brook Medical Centre 9 Sunderland Street Sheffield S11 8HN
West Sheffield City GP HC (REG) Rockingham House, 75 Broad Sheffield S1 3PB Lane
West Stannington Medical Centre (Shurmer) Uppergate Road Sheffield S6 6BX
West The Crookes Practice 203 School Road Sheffield S10 1GN
West Tramways Medical Centre (Milner) 54a Holme Lane Sheffield S6 4JQ
West Tramways Medical Centre (O'Connell) 54 Holme Lane Sheffield S6 4JQ
West University Health Service Health Centre 53 Gell Street Sheffield S3 7QP
West Valley Medical Centre Johnson Street, Stocksbridge Sheffield S36 1BX
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West Walkley House Medical Centre 23 Greenhow Street Sheffield S6 3TN
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88 practices listed in alphabetical order
PRACTICE_NAME PRACTICE ADDRESS Town PCode Locality
Abbey Lane Surgery 23 Abbey Lane Sheffield S8 0BJ Central
Avenue Medical Practice 7 Reney Avenue Sheffield S8 7FH HASC
Barnsley Road Surgery 899 Barnsley Road Sheffield S5 0QJ North
Baslow Road And Shoreham Street Surgeries 148 Baslow Road, Totley Sheffield S17 4DR Central
Bents Green Surgery 98 Bents Road Sheffield S11 9RL HASC
Birley Health Centre 120 Birley Lane Sheffield S12 3BP HASC
Bluebell Medical Centre 356 Bluebell Road Sheffield S5 6BS North
Broomhill Surgery 5 Lawson Road Sheffield S10 5BU West
Buchanan Road Surgery 72 Buchanan Road Sheffield S5 8AL North
Burncross Surgery 1 Bevan Way, Chapeltown Sheffield S35 1RN North
Burngreave Surgery 5 Burngreave Road Sheffield S3 9DA North
Carrfield Medical Centre Carrfield Street Sheffield S8 9SG Central
Carterknowle And Dore Medical Practice 1 Carterknowle Road Sheffield S7 2DW HASC
Charnock Health Primary Care Centre White Lane Sheffield S12 3GH HASC
Clover Group Practice Highgate Surgery, Highgate, Sheffield S9 1WN Central Tinsley
Crookes Valley Medical Centre 1 Barber Road Sheffield S10 1EA North
Darnall Health Centre (Mehrotra) 2 York Road Sheffield S9 5DH Central
Darnall Health Centre (Swinden) 2 York Road Sheffield S9 5DH Central
Deepcar Medical Centre 271 Manchester Rd, Deepcar Sheffield S36 2RA West
Devonshire Green Medical Centre 126 Devonshire Street Sheffield S3 7SF West
Dovercourt Surgery 3 Skye Edge Avenue Sheffield S2 5FX Central
Duke Medical Centre 28 Talbot Road Sheffield S2 2TD Central
Dunninc Road Surgery 28 Dunninc Road, Shiregreen Sheffield S5 0AE North
Dykes Hall Medical Centre 156 Dykes Hall Road Sheffield S6 4GQ West
East Bank Medical Centre 555 East Bank Road Sheffield S2 2AG Central
Elm Lane Surgery 104 Elm Lane Sheffield S5 7TW North
Falkland House 2a Falkland Road Sheffield S11 7PL HASC
Far Lane Medical Centre 1 Far Lane Sheffield S6 4FA West
Firth Park Surgery 400 Firth Park Road Sheffield S5 6HH North
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Foxhill Medical Centre 363 Halifax Road Sheffield S6 1AF North
Gleadless Medical Centre 636 Gleadless Road Sheffield S14 1PQ Central
Greenhill Health Centre 482 Lupton Road Sheffield S8 7NP HASC
Grenoside Surgery 60 Greno Crescent, Grenoside Sheffield S35 8NX North
Greystones Medical Centre 33 Greystones Rd Sheffield S11 7BJ HASC
Hackenthorpe Medical Centre Main Street, Hackenthorpe Sheffield S12 4LA HASC
Handsworth Medical Practice 432 Handsworth Road Sheffield S13 9BZ Central
Harold Street Medical Centre 2 Harold Street Sheffield S6 3QW West
Heeley Green Surgery 302 Gleadless Road Sheffield S2 3AJ Central
Jaunty Springs Health Centre 53 Jaunty Way Sheffield S12 3DZ HASC
Manchester Road Surgery 484 Manchester Road Sheffield S10 5PN HASC
Manor Park Medical Centre 204 Harborough Avenue Sheffield S2 1QU Central
Manor Top Medical Centre (Read) Rosehearty Ridgeway Rd Sheffield S12 2SS Central
Manor Top Medical Centre (Sharma) Rosehearty Ridgeway Rd Sheffield S12 2SS Central
Meersbrook Medical Centre 243-245 Chesterfield Rd Sheffield S8 0RT Central
Mill Road Surgery 98a Mill Road Sheffield S35 9XQ North
Mosborough Health Centre 34 Queen Street Sheffield S20 5BQ HASC
Nethergreen Surgery 34-36 Nethergreen Road Sheffield S11 7EJ HASC
Norfolk Park Medical Practice Tower Drive Sheffield S2 3RE Central
Norwood Medical Centre 360 Herries Road Sheffield S5 7HD North
Oughtibridge Surgery Church Street, Oughtibridge Sheffield S35 0FW West
Owlthorpe Medical Centre Moorthorpe Bank Sheffield S20 6PD HASC
Page Hall Medical Centre 101 Owler Lane Sheffield S4 8GB North
Park Health Centre 190 Duke Street Sheffield S2 5QQ Central
Pitsmoor Surgery 151 Burngreave Road Sheffield S3 9DL North
Porter Brook Medical Centre 9 Sunderland Street Sheffield S11 8HN West
Richmond Medical Centre 462 Richmond Road Sheffield S13 8NA HASC
Rustlings Road Medical Centre 105 Rustlings Road Sheffield S11 7AB HASC
Selborne Road Medical Centre 1 Selborne Road Sheffield S10 5ND HASC
Sharrow Lane Medical Centre 129 Sharrow Lane Sheffield S11 8AN Central
Sheffield City GP HC (REG) Rockingham House, 75 Broad Sheffield S1 3PB West Lane
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Sheffield Medical Centre 21 Spital Street Sheffield S3 9LB North
Shiregreen Medical Centre 492 Bellhouse Road Sheffield S5 0RG North
Sloan Medical Centre 2 Little London Road Sheffield S8 0YH Central
Sothall Medical Centre 24 Eckington Road Sheffield S20 1HQ HASC
Southey Green Medical Centre 281 Southey Green Road Sheffield S5 7QB North
Stannington Medical Centre (Shurmer) Uppergate Road Sheffield S6 6BX West
Stonecroft Medical Centre 871 Gleadless Road Sheffield S12 2LJ HASC
The Crookes Practice 203 School Road Sheffield S10 1GN West
The Ecclesfield Group Practice 96a Mill Road, Ecclesfield Sheffield S35 9XQ North
The Health Care Surgery 63 Palgrave Road Sheffield S5 8GS North
The Hollies Medical Centre 20 St Andrews Road Sheffield S11 9AL HASC
The Mathews Practice Belgrave Belgrave MC, 22 Asline Road Sheffield S2 4UJ Central
The Meadowhead Group Practice Old School Medical Centre, Sheffield S8 7RL HASC School Lane
The Medical Centre 1a Ingfield Avenue Sheffield S9 1WZ Central
The Medical Centre Crystal Peaks 15 Peaks Mount Sheffield S20 7HZ HASC
Totley Rise Medical Centre 96 Baslow Road Sheffield S17 4DQ HASC
Tramways Medical Centre (Milner) 54a Holme Lane Sheffield S6 4JQ West
Tramways Medical Centre (O'Connell) 54 Holme Lane Sheffield S6 4JQ West
University Health Service Health Centre 53 Gell Street Sheffield S3 7QP West
Upperthorpe Medical Centre 30 Addy Street, Upperthorpe Sheffield S6 3FT HASC
Upwell Street Surgery 93 Upwell Street Sheffield S4 8AN North
Valley Medical Centre Johnson Street, Stocksbridge Sheffield S36 1BX West
Walkley House Medical Centre 23 Greenhow Street Sheffield S6 3TN West
Westfield Health Centre Westfield Northway Sheffield S20 8NZ HASC
White House Surgery 1 Fairfax Rise Sheffield S2 1SL Central
Wincobank Medical Centre 205 Tyler Street Sheffield S9 1DJ North
Woodhouse Health Centre 5-7 Skelton Lane, Woodhouse Sheffield S13 7LY HASC
Woodseats Medical Centre 4 Cobnar Road Sheffield S8 8QB Central
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APPENDIX C
STANDING ORDERS
For
NHS SHEFFIELD CLINICAL COMMISSIONING GROUP
1
CONTENTS Page
SECTION A
INTERPRETATION AND DEFINITIONS FOR STANDING ORDERS, 4 SCHEME OF RESERVATION AND DELEGATION AND PRIME FINANCIAL POLICIES
8
SECTION B – STANDING ORDERS
1. INTRODUCTION 8
1.5 Statutory Framework 8
1.9 NHS Framework 8
1.11 Delegation of Powers 9
2. CCG: COMPOSITION OF MEMBERSHIP, TENURE AND ROLE OF MEMBERS 9
2.1 Composition of Membership 9
2.3 Key Roles – eligibility, appointments process, term of office etc 9
a) Chair b) Locality GP representatives c) Elected GP representatives d) Lay Members e) Chief Officer f) Chief Finance Officer g) Chief Nurse h) Secondary Care specialist doctor i) Clinical Director j) Chief Operating Officer and Chief of Business Planning & Partnerships k) Vice Chair Joint Members
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CONTENTS Page
2.4 12
3. 2. MEETINGS 12 Calling meetings 3.1 12 Notice of meetings agendas, supporting papers and business to be transacted 3.2 13 Petitions 3.3 13 Chair of meeting 3.4 13 Chair’s ruling 3.5 13 Quorum of Governing Body 3.6 13 Decision making including voting of the Governing Body 3.7 14 Emergency powers and urgent decisions 3.8 14 Suspension of Standing Orders 3.9 15 Record of Attendance 3.10 15 Minutes 3.11 15 Admission of public and the press 3.12 15 Observers at CCG and Governing Body meetings 3.13 16
4. APPOINTMENT OF COMMITTEES AND SUB-COMMITTEES 16
2.1.1. Appointment of Committees and Sub-committees 4.1 16 Terms of Reference 4.2 16 Delegation of powers by Committees to Sub-committees 4.3 17 Approval of appointments to Committees and Sub-committees 4.4 17
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CONTENTS Page
5. DUTY TO REPORT NON COMPLIANCE WITH STANDING ORDERS AND PRIME 17 FINANCIAL POLICIES
6. CUSTODY OF SEAL AND AUTHORISATION OF DOCUMENTS 17
6.1 CCG’s seal 17
6.2 Signature of documents 17
7. OVERLAP WITH OTHER CCG POLICY STATEMENTS/PROCEDURES, 17 REGULATIONS
Policy statements: general principles 7.1 17
8. DUTIES AND OBLIGATIONS OF GOVERNING BODY MEMBERS AND CCG 17 SENIOR MANAGERS UNDER THE STANDING ORDERS
Requirements for declaring interests 8.1 17 Register of Interests 8.2 17
3. INDEMINTY FOR GOVERNING BODY MEMBERS 9. 17
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SECTION A
1. INTERPRETATION AND DEFINITIONS FOR STANDING ORDERS, SCHEME OF RESERVATION AND DELEGATION AND PRIME FINANCIAL POLICIES
3.1. 1.1 Save as otherwise permitted by law, at any meeting the Chair of the CCG shall be the final authority on the interpretation of Standing Orders (on which they should be advised by the Chief Officer or Company Secretary).
1.2 Any expression to which a meaning is given in the National Health Service Act 2006, and other Acts relating to the National Health Service or in the Financial Regulations made under the Acts shall have the same meaning in these Standing Orders and Standing Financial Instructions and in addition the following definitions shall apply:
"2006 Act" National Health Service Act 2006 as amended by the 2012 Act;
"2012 Act" Health and Social Care Act 2012 (this Act amends the 2006 Act);
"Audit and Integrated The Committee of the CCG accountable to the Governing Body as Governance set out at paragraph 6.6.5(a) of the Constitution; Committee"
"Board" The National Health Service Commissioning Board;
“Budget” means a resource, expressed in financial terms, proposed by the Governing Body for the purpose of carrying out, for a specific period, any or all of the functions of the CCG.
“Budget holder” means the employee with delegated authority to manage finances (Income and Expenditure) for a specific area of the organisation
"CCG" NHS Sheffield Clinical Commissioning Group
"CCGCOM" South Yorkshire and Bassetlaw CCG Commissioning Network;
"Chair of the Governing the individual appointed by the CCG to act as chair of the Body" Governing Body and to ensure that it successfully discharges its overall responsibility for the CCG as a whole. The expression “the Chair of the CCG” shall be deemed to include the Vice-Chair of the CCG if the Chair is absent from the meeting or is otherwise unavailable.
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"Chief Finance Officer" the qualified accountant employed by the CCG with responsibility for financial strategy, financial management and financial governance
"Chief Officer" Means the accountable officer as defined under paragraph 12 of Schedule 1A of the 2006 Act (as inserted by Schedule 2 of the 2012 Act), appointed by the NHS Commissioning Board, with responsibility for ensuring the Group:
complies with its obligations under: o sections 14Q and 14R of the 2006 Act (as inserted by section 26 of the 2012 Act); o sections 223H to 223J of the 2006 Act (as inserted by section 27 of the 2012 Act); o paragraphs 17 to 19 of Schedule 1A of the NHS Act 2006 (as inserted by Schedule 2 of the 2012 Act); and o any other provision of the 2006 Act (as amended by the 2012 Act) specified in a document published by the Board for that purpose; and exercises its functions in a way which provides good value for money;
"Clinical Commissioning a body corporate established by the NHS Commissioning Board in Group" accordance with Chapter A2 of Part 2 of the 2006 Act (as inserted by section 10 of the 2012 Act);
"Commissioning the advisory executive team to the Governing Body Executive Team" or "CET"
“Commissioning” means the process for determining the need for and for obtaining the supply of healthcare and related services by the PCT within available resources.
"Committee or Sub- a committee or sub-committee created and appointed by either: committee" the membership of the CCG; a committee / sub-committee created by a committee created / appointed by the membership of the CCG; or a committee / sub-committee created / appointed by the Governing Body
"Company Secretary" the secretary of the CCG or any other person appointed to perform the duties of the secretary of the CCG
"Conflicts of Interest the CCG's Protocol for managing conflicts of interest Protocol"
"Constitution" The CCG’s constitution as amended from time to time in accordance with its terms
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"Equality Act" the Equality Act 2010;
“Financial Directions” Means any and all Directions made by the Secretary of State from time to time which relate to financial entitlements and/or requirements
"Financial Year" this runs from 1 April to 31 March;
“General Practitioner” or a medical practitioner whose name is included in the General “GP” Practice Register kept by the General Medical Council who is either a Member or employed or engaged on a regular basis by Member(s) of the CCG
"Governing Body" the body appointed under section 14L of the NHS Act 2006 (as inserted by section 25 of the 2012 Act), with the main function of ensuring that a clinical commissioning group has made appropriate arrangements for ensuring that it complies with:
its obligations under section 14Q under the NHS Act 2006 (as inserted by section 26 of the 2012 Act); and such generally accepted principles of good governance as are relevant to it;
"Governing Body any member appointed to the Governing Body of the CCG; Member"
“Healthcare an individual who is a member of a profession regulated by a body Professional” mentioned in section 25(3) of the National Health Service Reform and Health Care Professions Act 2002
"Lay Member" a lay member of the Governing Body, appointed by the CCG. A lay member is an individual who is not a member of the CCG 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;
"Member" a provider of primary medical services to a registered patient list, who is a member of this CCG in accordance with paragraph 3.1 and Appendix B of the CCG’s Constitution;
“Officer” means employee of the CCG or any other person holding a paid appointment or office with the CCG.
“Officer Member” means the following individuals who are appointed to the Governing Body: the Chief Officer, the Chief Finance Officer, the
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Chief Operating Officer, the Chief Nurse and the Chief of Business Planning and Partnerships.
"Public Sector Equality the duty set out in Section 149 of the Equality Act 2010; Duty"
"Practice an individual appointed by a practice (who is a Member of the Representatives" CCG) to act on its behalf in the dealings between it and the CCG, under regulations made under section 89 or 94 of the 2006 Act (as amended by section 28 of the 2012 Act) or directions under section 98A of the 2006 Act (as inserted by section 49 of the 2012 Act);
“Prime Financial Means the main financial policies the CCG will adhere to. They are Policies” or PFPs supported by “detailed financial policies”.
"Public Health Core The ‘offer’ from Sheffield City Council in relation to Public Health Offer" agreed through a Memorandum of Understanding between the City Council and the CCG, and which covers health care public health, health improvement and health protection areas of Public Health practice. An annual work plan will be agreed.
"Quality Assurance The Committee of the CCG accountable to the Governing Body as Committee" set out at paragraph 6.6.5(c) of the Constitution and whose functions are concerned with the arrangements for the purpose of monitoring and improving the quality of healthcare for which the CCG has responsibility;
"Registers of Interests" registers a CCG is required to maintain and make publicly available under section 14O of the 2006 Act (as inserted by section 25 of the 2012 Act), of the interests of: the Members of the CCG; the Governing Body Members; the members of its Committees or sub-committees and Committees or sub-committees of its Governing Body; and its employees;
"Remuneration the Committee of the CCG accountable to the Governing Body as Committee" set out at paragraph 6.6.5(b) in the Constitution;
“SOs” means Standing Orders
“Vice-Chair” means the Lay Member appointed by the Governing Body to take on the Chair’s duties if the Chair is absent for any reason
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3.2. SECTION B – STANDING ORDERS 3.3. 1. INTRODUCTION 4. 1.1 These Standing Orders have been drawn up to regulate the proceedings of the NHS Sheffield Clinical Commissioning Group so that the CCG 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 CCG is established.
1.2 The Standing Orders, together with the CCG’s scheme of reservation and delegation and the CCG’s Prime Financial Policies, provide a procedural framework within which the CCG discharges its business. They set out:
a) the arrangements for conducting the business of the CCG;
b) the procedure to be followed at formal meetings of the CCG, the Governing Body and any Committees or sub-committees of the Governing Body;
c) the process to delegate powers,
d) the declaration of interests and standards of conduct.
5. 1.3 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
1.4 The Standing Orders, scheme of reservation and delegation and Prime Financial Policies have effect as if incorporated into the CCG’s Constitution. CCG Members, employees, Members of the Governing Body, members of the Governing Body’s Committees and sub-committees and persons working on behalf of the CCG should be aware of the existence of these documents and, where necessary, be familiar with their detailed provisions. Failure to comply with the SOs, scheme of reservation and delegation and PFPs may be regarded as a disciplinary matter that could result in dismissal
6. 7. Statutory Framework
1.5 NHS Sheffield Clinical Commissioning Group is a statutory body which came into existence on 1 April 2013
1.6 The principal place of business of the CCG is 722 Prince of Wales Road, Darnall, Sheffield, S9 4EU.
1.7 As a statutory body, the CCG has specified powers to contract in its own name. The CCG also has statutory powers to fund projects jointly planned with local authorities, voluntary organisations and other bodies. The CCG is not exercising its power to appoint a Corporate Trustee. All funds received in Trust (charitable funds) by the CCG shall be held by Sheffield Hospitals Charitable Trust and related charities (SHCT) as Trustee and earmarked as such.
1.8 The CCG will also be bound by such other statutes and legal provisions which govern the conduct of its affairs.
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NHS Framework
1.9 In addition to the statutory requirements the Secretary of State through the Department of Health issues further directions and guidance. These are normally issued under cover of a circular or letter.
1.10 The Code of Practice on Openness in the NHS sets out the requirements for public access to information on the NHS.
Delegation of Powers
1.11 The 2006 NHS Act (as amended by the 2012 Act) provides the CCG with powers to delegate CCG functions and those of the Governing Body to certain bodies such as Committees and certain persons and make arrangements for delegation.
1.12 The Governing Body has resolved that certain powers and decisions may only be exercised by the Governing Body in formal session. These powers and decisions are set out in the scheme of reservation and delegation and shall have effect as if incorporated into the Standing Orders. Those powers which it has delegated to Committees, sub committees and Officers are contained in the Scheme of Delegation.
2. CCG: COMPOSITION OF MEMBERSHIP, TENURE AND ROLE OF MEMBERS
Composition of Membership
7.1. 2.1 Chapter 3 of the CCG’s Constitution provides details of the membership of the CCG.
7.2. 2.2 Chapter 6 of the CCG’s Constitution provides details of the governing structure used in the CCG’s decision-making processes, whilst Chapter 7 of the Constitution outlines certain key roles and responsibilities within the CCG and its Governing Body, including the role of Practice Representatives (section 7.1 of the Constitution).
7.3. Key Roles
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7.4. 2.3 Paragraph 6.6.2 of the CCG’s Constitution sets out the composition of the CCG’s Governing Body whilst Chapter 7 of the CCG’s Constitution identifies certain key roles and responsibilities within the CCG and its Governing Body. These Standing Orders set out how the CCG appoints individuals to these key roles.
a) Chair
i) Nomination – n/a ii) Eligibility – The individual must be a GP from a Member practice, must meet the required competencies for the role as set out in paragraph 7.4 of the Constitution and in terms of the initial appointment have passed the national assessment centre for CCG Clinical Leaders. iii) Appointment process – The Remuneration Committee will oversee the process. iv) Term of office – The Chair will be nominated for a term of office up to three years v) Eligibility for reappointment – the Chair may be reappointed by the Governing Body vi) Grounds for removal from office – (i) If a receiving order is made against them or they make any arrangement with their creditors.
(ii) If in the opinion of the Governing Board (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.
(iii) If they cease to be a provider of primary medical services, or be engaged in or employed to deliver primary medical services with a Member practice
(iv) Where the level of competence is questioned and vote indicating 67% of the Governing Body lacks confidence. (vii) Notice period – Chair must give at least three months notice of resignation to the Governing Body.
b) Locality GP representatives
i) Nomination – As set out paragraph 6.7 of the Constitution ii) Eligibility – The individual must be a GP with a Member practice in the relevant Locality iii) Appointment process – n/a. iv) Term of office – Will be nominated for a term of office up to three years v) Eligibility for reappointment – the GP may be re-nominated by the relevant Locality vi) Grounds for removal from office by the Governing Body – (i) If a receiving order is made against them or they make any arrangement with their creditors.
(ii) If in the opinion of the Governing Board (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.
(iii) If they cease to be a provider of primary medical services, or be engaged in or employed to deliver primary medical services with a Member practice in the Locality which they represent
(iv) where level of competence and performance is below agreed levels (Governing Body to agree a performance framework for Members)
vii) Notice Period – The member must give at least 3 months notice
c) Elected GP representatives
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i) Nomination – n/a ii) Eligibility – The individual must be a GP with a Member practice iii) Appointment process – An election process involving GPs from Member practices. iv) Term of office – Will be elected for a term of office up to three years v) Eligibility for reappointment – GPs can put themselves forward for re-election vi) Grounds for removal from office – (i) If a receiving order is made against them or they make any arrangement with their creditors.
(ii) If in the opinion of the Governing Board (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.
(iii) If they cease to be a provider of primary medical services, or be engaged in or employed to deliver primary medical services with a Member practice (iv) where level of competence and performance is below agreed levels (Governing Body to agree a performance framework for Members)
vii) Notice Period – The member must give at least 3 months notice to the Chair
d) Lay Members i) Nomination – n/a ii) Eligibility – the Lay Members must have specific expertise, experience and knowledge as a member of the local community. Individuals will not be eligible if they are a serving civil servant within the Department of Health or member/employee of the Care Quality Commission or serving as a Chair or Non-Executive of another NHS body if successfully appointed to the CCG. iii) Appointment process - The appointment process will operate under best guidance. The Remuneration Committee will determine the detail of the process. iv) Term of office –up to 3 years v) Eligibility for reappointment – Lay Members can put themselves forward for re-appointment. Process to be overseen by Remuneration Committee. vi) Grounds for removal from office – i) Gross misconduct in breach of the Nolan principles ii) Non-attendance at meetings (six in any 12 month period) iii) where level of competence and performance is below agreed levels (Governing Body to agree a performance framework for Members)
vii) Notice period – Member must give at least 3 months notice to the Chair.
e) Chief Officer
i) Nomination – n/a ii) Eligibility – the individual must meet the required competencies of the role as set out in paragraph 7.6. of the Constitution and in terms of the initial appointment have successfully completed the national assessment process. iii) Appointment process – The appointment process will operate under best guidance. The Remuneration Committee will determine the detail of the process. iv) Term of Office – N/A This is a substantive appointment
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v) Notice Period & Grounds for removal from Office - As per Terms and Conditions of Employment f) Chief Finance Officer
i) Nomination – n/a ii) Eligibility – the individual must meet the required competencies of the role as set out in paragraph 7.7. of the Constitution and in terms of the initial appointment have successfully completed the national assessment process. iii) Appointment process – The appointment process will operate under best guidance. The Remuneration Committee will determine the detail of the process. iv) Term of Office – N/A This is a substantive appointment v) Notice Period & Grounds for removal from Office - As per Terms and Conditions of Employment g) Chief Nurse
i) Nomination – n/a ii) Eligibility – the individual must be a suitably qualified registered nurse and have the other relevant competencies as set out in the job description. iii) Appointment process – The appointment process will operate under best guidance. The Remuneration Committee will determine the detail of the process. iv) Term of Office – N/A This is a substantive appointment v) Notice Period & Grounds for removal from Office - As per Terms and Conditions of Employment
h) Secondary Care Specialist Doctor
i) Nomination – n/a ii) Eligibility – the individual must be a suitably qualified doctor and have the other relevant competencies as set out in the job description. iii) Appointment process – The appointment process will operate under best guidance. The Remuneration Committee will determine the detail of the process. iv) Term of office –up to 3 years v) Eligibility for reappointment – the Member can put themselves forward for re-appointment. Process to be overseen by Remuneration Committee. vi) Grounds for removal from office – i) Gross misconduct in breach of the Nolan principles ii) Non-attendance at meetings (six in any 12 month period) iii) where level of competence and performance is below agreed levels (Governing Body to agree a performance framework for Members)
vii) Notice period – Member must give at least 3 months notice to the Chair.
i) Clinical Director
i) Nomination – n/a ii) Eligibility – the individual must be a GP and have the other relevant competencies as set out in the job description. iii) Appointment process – The appointment process will operate under best guidance. The Remuneration Committee will determine the detail of the process.
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iv) Term of office –up to 3 years v) Eligibility for reappointment – the Member can put themselves forward for re-appointment. Process to be overseen by Remuneration Committee. vi) Grounds for removal from office – (i) If a receiving order is made against them or they make any arrangement with their creditors.
(ii) If in the opinion of the Governing Board (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.
(iii) If they cease to be a provider of primary medical services, or be engaged in or employed to deliver primary medical services with a Member practice in the Locality which they represent
(iv) where level of competence and performance is below agreed levels (Governing Body to agree a performance framework for Members)
vii) Notice period – Member must give at least 3 months notice to the Chair.
J) Chief Operating Officer and Chief of Business Partnerships
i) Nomination – n/a ii) Eligibility – the individuals must meet the required competencies and experience as set out in the relevant job descriptions. iii) Appointment process – The appointment process will operate under best guidance. The Remuneration Committee will determine the detail of the process. iv) Term of Office – N/A This is a substantive appointment v) Notice Period & Grounds for removal from Office - As per Terms and Conditions of Employment
k) Vice Chair
Paragraph 7.5.1 of the Constitution sets out arrangements for appointment of the Vice Chair who will be a Lay Member if the Chair is a clinician. Where the Chair of the CCG has died or has ceased to hold office, or where they have been unable to perform their duties as Chair owing to illness or any other cause, the Vice-Chair shall act as Chair until a new Chair is appointed or the existing Chair resumes their duties, as the case may be; and references to the Chair in these Standing Orders shall, so long as there is no Chair able to perform those duties, be taken to include references to the Vice-Chair.
2.4 Joint Members
Where more than one person is appointed jointly to a Governing Body Member’s post.
(a) Either or both of those persons may attend or take part in meetings of the Governing Body;
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(b) If both are present at a meeting they should cast one vote if they agree;
(c) In the case of disagreements no vote should be cast;
(d) The presence of either or both of those persons should count as the presence of one person for the purposes of Standing Order 3.6 Quorum.
3. MEETINGS OF THE CCG & CCG’s GOVERNING BODY
3.1 Calling meetings
(1) Arrangements for meetings of CCG Members are set out in paragraph 4.6 of the Constitution.
(2) Ordinary meetings of the Governing Body shall be held at regular intervals at such times and places as the Governing Body may determine.
(3) The Chair of the CCG may call a meeting of the Governing Body at any time.
(4) One-third or more members of the Governing Body may requisition a meeting in writing. If the Chair refuses, or fails, to call a meeting within seven days of a requisition being presented, the members signing the requisition may forthwith call a meeting.
3.2 Notice of meetings, agendas, supporting papers and business to be transacted
(1) Before each meeting of the CCG’s Governing Body a written notice specifying the business proposed to be transacted shall be delivered to every member so as to be available to members at least five days before the meeting. Supporting papers, whenever possible, shall accompany the agenda, but will certainly be despatched no later than three days before the meeting, save in emergency.
(2) In the case of a meeting called by members in default of the Chair calling the meeting, the notice shall be signed by those members.
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(3) No business shall be transacted at the meeting other than that specified on the agenda, or emergency motions allowed under Standing Order 3.8.
(4) A member desiring a matter to be included on an agenda shall make his/her request in writing to the Chair at least 10 days before the meeting. The request should state whether the item of business is proposed to be transacted in the presence of the public and should include appropriate supporting information. Requests made less than 10 days before a meeting may be included on the agenda at the discretion of the Chair.
(5) Agendas and certain papers for the CCG’s Governing Body – including details about meeting dates, times and venues - will be published on the CCG’s website
3.3 Petitions
Where a petition has been received by the CCG, the Chair shall include the petition as an item for the agenda of the next meeting of the Governing Body.
3.4 Chair of meeting
(1) At any meeting of the CCG or its Governing Body the Chair if present, shall preside. If the Chair is absent from the meeting, the Vice-Chair, if present, shall preside.
(2) If the Chair is absent temporarily on the grounds of a declared conflict of interest the Vice- Chair, if present, shall preside. If the Chair and Vice-Chair are absent, or are disqualified from participating, members present shall choose who shall preside.
3.5 Chair's ruling
The decision of the Chair of the Governing Body on questions of order, relevancy and regularity (including procedure on handling motions) and their interpretation of the Constitution, Standing Orders, scheme of reservation and delegation and Prime Financial Policies at the meeting, shall be final.
3.6 Quorum of the Governing Body
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(1) No meeting of the Governing Body shall be held without as a minimum two of the following: the Chair, Vice Chair, Chief Officer and Chief Finance Officer present. If neither the Chair or Vice Chair is present, the meeting can proceed if a temporary Chair is elected from the remaining Governing Body Members.
(2) No business shall be transacted at a meeting unless at least one-third of the whole number voting members is present. Paragraph 6.6.2 of the Constitution sets out the voting members of the Governing Body. In addition clinical Governing Body Members present will be in the majority
7.5. (3) An Officer in attendance but without formal acting up status may not count towards the quorum.
(4) If the Chair or other Governing Body Members have been disqualified from participating in the discussion on any matter and/or from voting on any resolution by reason of a declaration of a conflict of interest that person shall no longer count towards the quorum. If a quorum is then not available for the discussion and/or the passing of a resolution on any matter, that matter may not be discussed further or voted upon at that meeting. Such a position shall be recorded in the minutes of the meeting. The meeting must then proceed to the next business. The position can be resolved by following the arrangements set out in paragraph 8.3 of the Conflicts of Interest Protocol incorporated into the Constitution as Appendix I.
(5) For all other of the CCG’s Committees and sub-committees, including the Governing Body’s Committees and sub-committees, the details of the quorum for these meetings and status of representatives are set out in the appropriate terms of reference.
3.7 Decision Making including Voting of the Governing Body
Chapter 6 of the CCG’s Constitution, together with the scheme of reservation and delegation, sets out the governing structure for the exercise of the CCG’s statutory functions. Generally it is expected that at the CCG’s and 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:
(1) Eligibility Members who are eligible to vote are set out in paragraph 6.6.2 of the Constitution. A manager who has been formally appointed to act up for an Officer Member shall be entitled to exercise the voting rights of the Officer Member.
(2) Majority necessary to confirm a decision - Save as provided in Standing Orders 3.9 - Suspension of Standing Orders every question put to a vote at a meeting shall be determined by a majority of the votes of members present and voting on the question. Members excluded due to a declared conflict of interest may not vote.
(3) Casting vote - . In the case of an equal vote, the person presiding (ie: the Chair of the meeting) shall have a second, and casting vote.
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(4) Dissenting views – Should a vote be taken the outcome of the vote, and any dissenting views, must be recorded in the minutes of the meeting
(5) At the discretion of the Chair all questions put to the vote shall be determined by oral expression or by a show of hands, unless the Chair directs otherwise, or it is proposed, seconded and carried that a vote be taken by paper ballot.
(6) If at least one-third of the members present so request, the voting on any question may be recorded so as to show how each member present voted or did not vote (except when conducted by paper ballot).
(7) In no circumstances may an absent member vote by proxy. Absence is defined as being absent at the time of the vote.
(8) For all Governing Body’s Committees and sub-committee, the details of the process for holding a vote are set out in the relevant terms of reference if appropriate and for the CCG’s Members Council in paragraph 4.6 of the Constitution.
7.6. 3.8 Emergency powers and urgent decisions
Subject to the agreement of the Chair, a Governing Body Member may give written notice of an emergency motion after the issue of the notice of meeting and agenda, up to one hour before the time fixed for the meeting. The notice shall state the grounds of urgency. If in order, it shall be declared to the CCG Governing Body at the commencement of the business of the meeting as an additional item included in the agenda. The Chair's decision to include the item shall be final.
3.9 Suspension of Standing Orders
(1) Except where this would contravene any statutory provision or any direction made by the Secretary of State any one or more of the Standing Orders may be suspended at any meeting, provided that at least two-thirds of the whole number of the members of the Board are present (including at least one member who is an Officer Member of the CCG and one member who is not) and that at least two-thirds of those members present signify their agreement to such suspension. The reason for the suspension shall be recorded in the Governing Body’s minutes. The Audit and Integrated Governance Committee shall review every decision to suspend Standing Orders
(2) A separate record of matters discussed during the suspension of Standing Orders shall be made.
(3) No formal business may be transacted while Standing Orders are suspended.
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3.10 Record of Attendance
The names and designation of all members present at meetings of the Governing Body and its Committees or Sub-committees will be recorded in the minutes of the relevant meetings.
3.11 Minutes
The minutes of the proceedings of a meeting shall be drawn up and submitted for agreement at the next meeting where they shall be signed by the person presiding at it. Minutes shall be circulated in accordance with members' wishes. Where providing a record of a public meeting the minutes shall be made available to the public as required by the Code of Practice on Openness in the NHS.
3.12 Admission of public and the press
(1) Admission and exclusion on grounds of confidentiality of business to be transacted
The public and representatives of the press may attend meetings of the CCG’s Governing Body, except where the Governing Body passes the following resolution to exclude the public on the grounds of confidentiality:
'that representatives of the press, and other members of the public, be excluded from the remainder of this meeting having regard to the confidential nature of the business to be transacted, publicity on which would be prejudicial to the public interest', Section 1 (2), Public Bodies (Admission to Meetings) Act l960
Members of the public or representatives of the press who attend public meetings of the Governing Body have no right to speak other than by invitation from the Chair.
(2) General disturbances
The Chair or the person presiding over the meeting shall give such directions as he/she thinks fit with regard to the arrangements for meetings and accommodation of the public and representatives of the press such as to ensure that the CCG’s business shall be conducted without interruption and disruption and, without prejudice to the power to exclude on grounds of the confidential nature of the business to be transacted, the public will be required to withdraw upon the Governing Body resolving as follows:
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`That in the interests of public order the meeting adjourn for (the period to be specified) to enable the CCG Governing Body to complete its business without the presence of the public'. Section 1(8) Public Bodies (Admissions to Meetings) Act l960.
(3) Business proposed to be transacted when the press and public have been excluded from a meeting
Matters to be dealt with by the Governing Body following the exclusion of representatives of the press, and other members of the public, as provided in (1) and (2) above, shall be confidential to Governing Body members.
Members and any other persons in attendance shall not reveal or disclose the contents of papers marked 'In Confidence' or minutes headed 'Items Taken in Private' outside of the CCG, without the express permission of the CCG. This prohibition shall apply equally to the content of any discussion during the Governing Body meeting which may take place on such reports or papers.
(4) Use of Mechanical or Electrical Equipment for Recording or Transmission of Meetings
Nothing in these Standing Orders shall be construed as permitting the introduction by the public, or press representatives, of recording, transmitting, video or similar apparatus into meetings of the CCG, its Governing Body and its Committees. Such permission shall be granted only by the Chair of the meeting.
3.13 Observers at CCG and Governing Body meetings
The CCG will decide what arrangements and terms and conditions it feels are appropriate to offer in extending an invitation to observers to attend and address any of the CCG’s meetings and may change, alter or vary these terms and conditions as it deems fit.
4. APPOINTMENT OF COMMITTEES AND SUB-COMMITTEES
4.1 Appointment of Committees and Sub-Committees
(1) The CCG may appoint Committees and Sub-committees of the CCG subject to any regulations made by the Secretary of State and make provision for the appointment of Committees and Sub-committees of its Governing Body. Where appointed details of these are included in Chapter 6 of the Constitution.
20
(2) Other than where there are statutory requirements, the CCG or its Governing Body shall determine the membership and terms of reference of the Committees and Sub-committees and shall, if it requires receive and consider minutes and reports from such Committees at the next appropriate meeting.
4.2 Terms of Reference
Terms of reference shall have effect as if incorporated into the Constitution and shall be added to the Constitution as an appendix.
4.3 Delegation of powers by Committees to Sub-Committees
Where Committees are authorised to establish sub-committees they may not delegate executive powers to the sub-committee unless expressly authorised by the CCG or Governing Body as relevant.
4.4 Approval of Appointments to Committees and Sub-committees
The CCG shall approve the appointments to each of the Committees and Sub-committees which it has formally constituted and will decide on such travelling or other allowances as is considered appropriate. The Governing Body shall approve the appointments to each of its Committees and Sub-committees and will decide on any travelling or other allowances as considered appropriate.
5 DUTY TO REPORT NON COMPLIANCE WITH STANDING ORDERS AND PRIME FINANCIAL POLICIES
5.1 If for any reason these Standing Orders are not complied with, full details of the non-compliance and any justification for non-compliance and the circumstances around the non-compliance, shall be reported to the next formal meeting of the Governing Body for action or ratification. All members of Members of the CCG and employees have a duty to disclose any non-compliance with these Standing Orders to the Chief Officer as soon as possible.
6. CUSTODY OF SEAL AND AUTHORISATION OF DOCUMENTS
21
6.1 CCG’s Seal
The CCG may have a seal for executing documents where necessary which must be kept in a secure place. The following individuals are authorised to authenticate its use by their signature: the Chief Officer, the Chief Finance Officer, the Chair of the Governing Body. They will enter a record of the sealing of every document in a register to be kept by the Chief Officer or nominated Officer.
6.2 Signature of documents
Where any document will be a necessary step in legal proceedings on behalf of the CCG it shall, unless any enactment otherwise requires, be signed by the Chief Officer or the Chief Finance Officer or the Chief Operating Officer.
7 OVERLAP WITH OTHER CCG POLICY STATEMENTS/PROCEDURES, REGULATIONS
7.1 Policy statements: general principles
The Governing Body will from time to time agree and approve policy statements/ procedures which will apply to all or specific groups of staff employed by the CCG. The decisions to approve such policies and procedures will be recorded in an appropriate Governing Body minute and will be deemed where appropriate to be an integral part of the CCG's Standing Orders and Prime Financial Policies.
8 DUTIES AND OBLIGATIONS OF GOVERNING BODY MEMBERS AND CCG SENIOR MANAGERS 7.7. 8.1 Requirements for declaring interests and applicability to CCG and Governing Body Members
The NHS Code of Conduct of Accountability requires CCG Members and Members of the Governing Body to declare any personal or business interest which may influence or may be perceived to influence their judgement including without limitation interests which are “relevant and material”. The policy document setting out full requirements is included as an appendix to the Constitution.
7.8. 8.2 Register of Interests
22
7.9. The Chief Officer will ensure that a Register of Interests is established to record formally declarations of interests of Members of the CCG, Governing Body Members, Practice Representatives and employees of the CCG.
9. INDEMNITY FOR GOVERNING BODY MEMBERS
9.1 Governing Body Members who act honestly and in good faith will not have to meet out of their personal resources any personal civil liability which is incurred in the execution or purported execution of their Governing Body functions, save where they have acted recklessly.
23
APPENDIX D
SCHEME OF RESERVATION AND DELEGATION
As set out in paragraph 10.2 of the Constitution, the Scheme of reservation and delegation summarises based on information contained in the Constitution and in particular the Standing Orders and Prime Financial Policies which decisions are reserved to CCG membership ( for example via the Members Council) and which are delegated to the Governing Body, its Committees and sub-committees and key Officers of the CCG.
Still to be confirmed whether CCG accountable officer (ie Chief Officer per our local definitions) is to be issued with a separate Accountable Officer Memorandum from the Board along the lines of that currently issued to PCT accountable officers. It may be necessary to revisit this scheme of reservation and delegation if such a memorandum is issued.
1
-
Constitution,
Standing
Orders or
Prime Decision / Responsibilities Financial
Policies Ref Officer
Committee Committee Committee GoverningBody
Delegatedto Chair
GovernanceCommittee
Reservedor delegated to
Delegatedto Chief Officer
Delegatedto Chief Finance
Delegatedto Remuneration
All Members All and Employees
Reservedto the Membership
Delegatedto Governance Sub
Delegatedto Audit Integrated & Delegatedto Quality Assurance Regulation and Control
Constitution Determine the arrangements by which the Members of the CCG 4.6 approve those decisions that are reserved for the membership.
Constitution Consideration and approval of applications to the NHS Commissioning Board on changes to the CCG’s Constitution 1.4.1 and 4.6
Recommendations to CCG Members on changes to the Constitution Constitution covering the overall operating arrangements
1.4.1 including those for Localities, the Standing Orders, scheme of reservation and delegation and Prime Financial Policies
Annual Review of the Standing Orders, Scheme of reservation and delegation and Prime Financial Policies PFP 1.4 making recommendations to the Governing Body on required changes
2
-
Constitution,
Standing
Orders or
Prime Decision / Responsibilities Financial
Policies Ref Officer
Committee Committee Committee GoverningBody
Delegatedto Chair
GovernanceCommittee
Reservedor delegated to
Delegatedto Chief Officer
Delegatedto Chief Finance
Delegatedto Remuneration
All Members All and Employees
Reservedto the Membership
Delegatedto Governance Sub
Delegatedto Audit Integrated & Delegatedto Quality Assurance Overall responsibility for ensuring the CCG complies with certain PFP 5.1 and of its statutory obligations including its financial and accounting PFP 7.5 obligations
Exercise or delegation of those functions of the CCG which have not been retained as reserved by the CCG or delegated to the Constitution 7.6 Governing Body and its Committees and sub-committees or delegated to named other individuals as set out in this document.
Prepare the CCG’s operational scheme of delegation, which sets out those key operational decisions delegated to individual PFP 7.6 employees of the CCG not for inclusion in the CCG’s Constitution.
Prepare detailed financial policies that underpin the CCG’s PFP 7.6 Prime Financial Policies not for inclusion in the CCG’s Constitution.
PFP 3 Approve the CCG’s detailed financial policies.
Approve of the CCG’s annual report and annual accounts, Constitution these first having been reviewed by the Audit & Integrated 6.6.1 Governance Committee.
3
-
Constitution,
Standing
Orders or
Prime Decision / Responsibilities Financial
Policies Ref Officer
Committee Committee Committee GoverningBody
Delegatedto Chair
GovernanceCommittee
Reservedor delegated to
Delegatedto Chief Officer
Delegatedto Chief Finance
Delegatedto Remuneration
All Members All and Employees
Reservedto the Membership
Delegatedto Governance Sub
Delegatedto Audit Integrated & Delegatedto Quality Assurance
PFP 3 Approval of the internal and external audit arrangements
Recommend to CCG Members any changes to the Conflicts of Constitution Interest Protocol contained within the Constitution at appendix I
Approval of appointments to Governing Body Committees and SO 4.4 sub-committees
May call a meeting of the Governing Body at any time
SO 3.1(3)
Management of Petitions to the Governing Body SO 3.3
Chair’s Ruling – ie interpretation of the Constitution including SO 3.5 SOs, scheme of reservation and PFPs
4
-
Constitution,
Standing
Orders or
Prime Decision / Responsibilities Financial
Policies Ref Officer
Committee Committee Committee GoverningBody
Delegatedto Chair
GovernanceCommittee
Reservedor delegated to
Delegatedto Chief Officer
Delegatedto Chief Finance
Delegatedto Remuneration
All Members All and Employees
Reservedto the Membership
Delegatedto Governance Sub
Delegatedto Audit Integrated & Delegatedto Quality Assurance SO 3.8 Emergency powers and urgent meetings of Governing Body
Admission of public and press to Governing Body meetings SO 3.12
Strategy and Planning
Constitution Agree the vision, values and overall strategic direction of the 6.6.1 CCG.
Constitution Approval of the CCG’s annual commissioning plan and 6.6.1; supporting financial plan, including any consultation arrangements PFP 7.1
Constitution 5.1 Approval of the CCG’s commissioning and corporate (running cost) budgets to meet the CCGs financial duties PFP 7.2
Approval of changes to budgets where variation would have a PFP 7.4 significant impact on the overall approved levels of income and expenditure or the CCG’s ability to achieve its agreed strategic
5
-
Constitution,
Standing
Orders or
Prime Decision / Responsibilities Financial
Policies Ref Officer
Committee Committee Committee GoverningBody
Delegatedto Chair
GovernanceCommittee
Reservedor delegated to
Delegatedto Chief Officer
Delegatedto Chief Finance
Delegatedto Remuneration
All Members All and Employees
Reservedto the Membership
Delegatedto Governance Sub
Delegatedto Audit Integrated & Delegatedto Quality Assurance aims.
Approval of the arrangements for discharging the CCG’s statutory duties associated with its commissioning
Constitution functions, including but not limited to promoting the involvement of each patient; patient choice; reducing
5.2.1 to 5.2.4; inequalities; improvement in the quality of services; obtaining 5.2.6; 5.2.7; appropriate advice and public engagement and consultation; 5.2.8; 5.2.9 obtain advice from persons who taken together have a broad range of professional expertise and acting effectively, efficiently and economically.
Constitution Approval of arrangements for discharging the CCG’s statutory duties in relation to promoting innovation, promoting 5.2.10; 5.2.11; research and the use of research and promoting education and training 5.2.12
Approve arrangements for supporting the NHS Commissioning Board in discharging its responsibilities in relation to securing Constitution continuous improvement in the quality of general medical 5.2.5 services.
6
-
Constitution,
Standing
Orders or
Prime Decision / Responsibilities Financial
Policies Ref Officer
Committee Committee Committee GoverningBody
Delegatedto Chair
GovernanceCommittee
Reservedor delegated to
Delegatedto Chief Officer
Delegatedto Chief Finance
Delegatedto Remuneration
All Members All and Employees
Reservedto the Membership
Delegatedto Governance Sub
Delegatedto Audit Integrated & Delegatedto Quality Assurance
Partnership Working
Constitution Nominate representatives from the CCG to be the CCG’s 5.1(c); 6.6.1 representatives on the Sheffield Health and Wellbeing Board
Promote integration across health and social care services Constitution where the CCG considers that this would improve quality of 5.2.13 services and reduce inequalities
Constitution Approve the Memorandum of Understanding and annual plan 5.1( c) and PFP for the Public Health Core Offer from Sheffield City Council 22.1 following recommendations by CET
Approve arrangements for coordinating the commissioning of Constitution 6.5 services with other CCGs and or with the local authority, where appropriate.
Approve arrangements for risk sharing and /or risk pooling with other organisations (for example arrangements for pooled funds with other clinical commissioning groups or pooled budget Constitution 6.5 arrangements under section 75 of the NHS Act 2006).
7
-
Constitution,
Standing
Orders or
Prime Decision / Responsibilities Financial
Policies Ref Officer
Committee Committee Committee GoverningBody
Delegatedto Chair
GovernanceCommittee
Reservedor delegated to
Delegatedto Chief Officer
Delegatedto Chief Finance
Delegatedto Remuneration
All Members All and Employees
Reservedto the Membership
Delegatedto Governance Sub
Delegatedto Audit Integrated & Delegatedto Quality Assurance
CCG as an employer and remuneration issues
Constitution Have oversight of the CCG’s responsibilities as an employer including adopting a Code of Conduct for staff section 9
ToR Approve the terms and conditions, remuneration and travelling Remuneration or other allowances for Governing Body Members, including Committee pensions and gratuities.
Approve terms and conditions of employment for all employees Constitution of CCG and to other persons providing services to the CCG
Make recommendations on the terms and conditions of ToR employment for all employees of CCG and to other persons Remuneration providing services to the CCG, taking into account best practice Committee information and statutory requirements
Governance Approve human resources policies for employees and for other Committee ToR persons working on behalf of the group
Ensure an effective payroll service and that there are PFP 16.1;16.2 comprehensive procedures for effective processing of payroll
8
-
Constitution,
Standing
Orders or
Prime Decision / Responsibilities Financial
Policies Ref Officer
Committee Committee Committee GoverningBody
Delegatedto Chair
GovernanceCommittee
Reservedor delegated to
Delegatedto Chief Officer
Delegatedto Chief Finance
Delegatedto Remuneration
All Members All and Employees
Reservedto the Membership
Delegatedto Governance Sub
Delegatedto Audit Integrated & Delegatedto Quality Assurance Approval of the CCG’s detailed operating structure including at PFP 16.3 the start of each financial year the funded staffing establishment.
Approve in year variations to funded staffing establishment PFP 16.4
PFP 16.5 Approve arrangements for staff appointments
PFP 16.6 Ensure all employees are issued with a contract of employment and that there are arrangements for dealing with variations/ terminations of contract
Operational Business and Risk Management
Governance Approve CCG operational policies (ie excluding those defined Committee ToR as clinical or financial)
Quality Approve CCG clinical policies and clinical pathways Assurance
9
-
Constitution,
Standing
Orders or
Prime Decision / Responsibilities Financial
Policies Ref Officer
Committee Committee Committee GoverningBody
Delegatedto Chair
GovernanceCommittee
Reservedor delegated to
Delegatedto Chief Officer
Delegatedto Chief Finance
Delegatedto Remuneration
All Members All and Employees
Reservedto the Membership
Delegatedto Governance Sub
Delegatedto Audit Integrated & Delegatedto Quality Assurance Committee ToR
PFP 4 Approve the CCG’s counter fraud arrangements.
PFP 15.1 Approve the CCG’s risk management arrangements
Preparation and review of Assurance Framework and Risk PFP 15.2 Register with recommendations for action to AIGC and Governing Body as appropriate
Approve the group’s arrangements for business continuity Constitution 6.6 and emergency planning.
Execution of a document by use of the seal SO 6.1
Signature of document which is part of legal proceedings on SO 6.2 behalf of CCG
Duty to comply with the Constitution and be aware of the Constitution 8.1 responsibilities in it.
10
-
Constitution,
Standing
Orders or
Prime Decision / Responsibilities Financial
Policies Ref Officer
Committee Committee Committee GoverningBody
Delegatedto Chair
GovernanceCommittee
Reservedor delegated to
Delegatedto Chief Officer
Delegatedto Chief Finance
Delegatedto Remuneration
All Members All and Employees
Reservedto the Membership
Delegatedto Governance Sub
Delegatedto Audit Integrated & Delegatedto Quality Assurance
SO 5.1 Duty to disclose non compliance with SOs to Chief Officer
Constitution 8.1
SO 8.1 Duty to declare interests
Constitution 8.3 Ensure the CCG maintains up to date Register(s) of Interests , delegating responsibility to Company Secretary to ensure it SO 8.2 Register(s) are reqularly reviewed
Any contractor empowered by the CCG to commit expenditure or authorised to obtain income is covered by the PFPs and the PFP 1.3 Chief Officer should ensure such persons are made aware of this.
Overall responsibility of CCG’s systems of internal control and PFP 2.2 preparation of Annual Governance Statement
Ensuring that the CCG has in place a system for proper PFP 2.3b) and checking and reporting of all breaches of financial policies; and c) a proper procedure for regular checking of the adequacy and effectiveness of the control environment
11
-
Constitution,
Standing
Orders or
Prime Decision / Responsibilities Financial
Policies Ref Officer
Committee Committee Committee GoverningBody
Delegatedto Chair
GovernanceCommittee
Reservedor delegated to
Delegatedto Chief Officer
Delegatedto Chief Finance
Delegatedto Remuneration
All Members All and Employees
Reservedto the Membership
Delegatedto Governance Sub
Delegatedto Audit Integrated & Delegatedto Quality Assurance Ensuring professional and technically competent internal audit service; that AIGC approves changes to the provision of PFP 3.3 assurance services to CCG and that minutes of AICG are formally recorded and submitted to the Governing Body
PFP 4.3;4.5 Ensure appropriate security management arrangements
Re. expenditure control provide reports in the form required by the Board, ensure money drawn down from the Board is only at PFP 5.3 a time of need and that an adequate system of monitoring financial performance is in place
Re allocations periodically review the basis and assumptions used by the Board to ensure these are reasonable and realistic; prior to the start of the financial year submit a report to PFP 6.1 the Governing Body showing allocations received and their proposed distribution; and regularly update the Governing Body on significant changes in year
Ensure adequate training is delivered to budget holders and PFP 7.7 managers
PFP 8.1 A range of actions per PFP 8.1 to ensure the CCG prepares annual accounts and an annual report which are audited and
12
-
Constitution,
Standing
Orders or
Prime Decision / Responsibilities Financial
Policies Ref Officer
Committee Committee Committee GoverningBody
Delegatedto Chair
GovernanceCommittee
Reservedor delegated to
Delegatedto Chief Officer
Delegatedto Chief Finance
Delegatedto Remuneration
All Members All and Employees
Reservedto the Membership
Delegatedto Governance Sub
Delegatedto Audit Integrated & Delegatedto Quality Assurance published
A range of actions per PFP 9.1 and 9.2 to ensure the accuracy PFP 9.1;9.2 and security of CCG computerised financial data
Ensure the CCG has an accounting system that creates PFP 10.1 management and financial accounts
PFP 11.1 Manage the CCG’s banking arrangements
PFP 11.2 Approve the CCG’s banking arrangements
A range of actions to ensure a sound system of recording, PFP 12. 1 collection and management of income and cash
Prepare a detailed financial policy on tendering including PFP 13 .2 authorization limits for quotations and tendering
Approve detailed financial policy on tendering including PFP 13.3 authorisation limits for quotations and tendering
Nominate an individual who shall oversee and manage each PFP 13.5 contract on behalf of the CCG
13
-
Constitution,
Standing
Orders or
Prime Decision / Responsibilities Financial
Policies Ref Officer
Committee Committee Committee GoverningBody
Delegatedto Chair
GovernanceCommittee
Reservedor delegated to
Delegatedto Chief Officer
Delegatedto Chief Finance
Delegatedto Remuneration
All Members All and Employees
Reservedto the Membership
Delegatedto Governance Sub
Delegatedto Audit Integrated & Delegatedto Quality Assurance Ensure arrangements for regular reports to Governing Body on PFP 14.2 contract expenditure
Maintain a system of financial monitoring to ensure effective PFP 14.3 accounting of expenditure under contracts
PFP 15.3 Nomination of a senior officer to be the SIRO
Decide if the CCG will insure through risk pooling arrangements PFP 15.4 administered via NHS LA
If the decision is to use the NHS LA ensure arrangements are appropriate and complementary to the risk management PFP 15.5; 15.6 programme; or if the Governing Body decides not to use these arrangements, ensure that it is informed of the nature and extent of the risks that are self insured
PFP 17.1 Approve the level of non pay expenditure on an annual
14
-
Constitution,
Standing
Orders or
Prime Decision / Responsibilities Financial
Policies Ref Officer
Committee Committee Committee GoverningBody
Delegatedto Chair
GovernanceCommittee
Reservedor delegated to
Delegatedto Chief Officer
Delegatedto Chief Finance
Delegatedto Remuneration
All Members All and Employees
Reservedto the Membership
Delegatedto Governance Sub
Delegatedto Audit Integrated & Delegatedto Quality Assurance basis
PFP 17.2 Set out procedures for seeking professional advice regarding the supply of goods and services
Advise on the setting of thresholds for quotations and tenders; PFP 17.3 be responsible for prompt payment of all properly authorized accounts and for designing and maintaining a system of verification, recording and payment
Put in place arrangements to manage capital investment, PFP 18.1 maintain an asset register and polices to ensure safe storage of fixed assets
PFP 18.2 Prepare detailed procedures for the disposal of assets
Information Governance: Ensure appropriate arrangements for PFP 19.1 the retention of records; and arrangements for effective responses to Freedom of Information requests
15
-
Constitution,
Standing
Orders or
Prime Decision / Responsibilities Financial
Policies Ref Officer
Committee Committee Committee GoverningBody
Delegatedto Chair
GovernanceCommittee
Reservedor delegated to
Delegatedto Chief Officer
Delegatedto Chief Finance
Delegatedto Remuneration
All Members All and Employees
Reservedto the Membership
Delegatedto Governance Sub
Delegatedto Audit Integrated & Delegatedto Quality Assurance Re. any property held on trust and any Charitable Funds PFP 20 ensure appropriate management arrangements in place
Ensure all staff are made aware of the CCG’s policy on PFP 21 acceptance of gifts and other benefits in kind
Approval of the CCG’s contracts for any commissioning PFP 22.1 support and the Public Health Core Offer
Nominating senior officers to manage both the contract for PFP 22.2 commissioning support and the Public Health Core Offer
16
7.9.1.1. APPENDIX E 7.9.1.2. PRIME FINANCIAL POLICIES
CONTENTS Page
1 INTRODUCTION 3
1.1 General 3
1.2 Responsibilities and Delegation 3
1.3 Contractors and their employees 3
1.4 Amendment of Prime Financial Policies 4
2. INTERNAL CONTROL 4
3. AUDIT 4
4. FRAUD AND CORRUPTION 5
5. EXPENDITURE CONTROL 5
6. ALLOCATIONS 5
COMMISSIONING STRATEGY, BUDGETS, BUDGETARY CONTROL
1
7. AND MONITORING 6
Commissioning Strategy and Plan
7.1 Budgets, Budgetary control and monitoring 6
7.3 6
8. ANNUAL ACCOUNTS AND REPORTS 7
9. INFORMATION TECHNOLOGY 7
10. ACCOUNTING SYSTEMS 8
11. BANK ACCOUNTS 8
12. INCOME, FEES AND CHARGES AND SECURITY OF CASH, CHEQUES 8 AND OTHER NEGOTIABLE INSTRUMENTS
13. TENDERING AND CONTRACTING 9
13.1 Tendering arrangements 9
13.3 Financial Limits for Quotations and Tendering 9
13.4 Contracting procedures 9
14. COMMISSIONING 10
2
15. RISK MANAGEMENT AND INSURANCE 10
15.1 Risk Management 10
15.4 Insurance: Risk pooling schemes administered by NHSLA 10
16. PAYROLL AND PAY EXPENDITURE 11
16.1 Payroll 11
16.3 Funded Establishment 11
16.5 Staff Appointments 11
17. NON-PAY EXPENDITURE 12
18. CAPITAL INVESTMENT, FIXED ASSET REGISTERS & SECURITY OF 12 ASSETS
19. RETENTION OF RECORDS 12
20. TRUST AND CHARITABLE FUNDS 13
21. ACCEPTANCE OF GIFTS BY STAFF AND LINK TO STANDARDS OF 13 BUSINESS CONDUCT
3
22. COMMISSIOING SUPPORT SERVICES and PUBLIC HEALTH CORE 13 OFFER
4
7.9.1.3. 1 INTRODUCTION
1.1. General
1.1.1. These Prime Financial Policies (PFPs) shall have effect as if incorporated into the CCG’s Constitution.
1.1.2. The PFPs are part of the CCG’s control environment for managing the organisation’s financial affairs. They contribute to good corporate governance, internal control and managing risks. They enable sound administration, lessen the risk of irregularities and support commissioning and delivery of effective, efficient and economical services. They also help the Chief Officer and Chief Finance Officer to effectively perform their responsibilities. They should be used in conjunction with the scheme of reservation and delegation.
1.1.3. These PFPs identify the financial responsibilities which apply to everyone working for the CCG. They do not provide detailed procedural advice and hence should be read in conjunction with the more detailed policies which have been prepared by the Chief Finance Officer and approved by the Governing Body and which are known as the “Detailed Financial Policies.
1.1.4. The Detailed Financial Policies which include, but are not limited to, budget management; tendering and procurement, counter fraud and treatment of losses and special payments will be published and maintained on the CCG’s website
1.1.5. Should any difficulties arise regarding the interpretation or application of any of the PFPs or Detailed Financial Policies then the advice of the Chief Finance Officer must be sought before acting. The user of these PFPs should also be familiar with and comply with the provisions of the CCG’s Constitution, Standing Orders and scheme of reservation and delegation.
1.1.6. Failure to comply with Prime Financial Policies and Standing Orders can in certain circumstances be regarded as a disciplinary matter that could result in dismissal.
1.1.7. If for any reason these PFPs 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 and Integrated Governance Committee for referring action or ratification. All of the CCG’s Members and employees have a duty to disclose any non-compliance with these PFPs to the Chief Finance Officer as soon as possible.
1.2. Responsibilities and delegation
1.2.1. The roles and responsibilities of Members, Governing Body Members, Committee and sub- committee members and persons working on behalf of the CCG are set out in chapters 6 and 7 of this Constitution.
1.2.2. The financial decisions delegated by Members are set out in the CCG’s scheme of reservation and delegation.
1.3. Contractors and their employees
1.3.1. Any contractor or employee of a contractor who is empowered by the CCG to commit the CCG to expenditure or who is authorised to obtain income shall be covered by these PFPs. It is the responsibility of the Chief Officer to ensure that such persons are made aware of this.
1.4. Amendment of Prime Financial Policies
5
1.4.1. To ensure that these Prime Financial Policies remain up-to-date and relevant, the Chief Finance Officer will review them at least annually. Following scrutiny by the Governing Body’s Audit & Integrated Governance Committee, the Chief Finance Officer will recommend amendments, as fitting, to the Governing Body for approval. As these PFPs are an integral part of the CCG’s Constitution, any amendment will not come into force until the CCG applies to the NHS Commissioning Board and that application is granted.
2. INTERNAL CONTROL
POLICY – the CCG will put in place a suitable control environment and effective internal controls that provide reasonable assurance of effective and efficient operations, financial stewardship, probity and compliance with laws and policies.
2.1. The Governing Body is required to establish an Audit and Integrated Governance Committee with terms of reference agreed by the Governing Body (see paragraph 6.6.5(a) of the CCG’s Constitution for further information).
2.2. The Chief Officer has overall responsibility for the CCG’s systems of internal control and will ensure that an Annual Governance Statement is prepared in line with national requirements.
2.3. The Chief Finance Officer will ensure that:
a) financial policies are considered for review and update annually;
b) a system is in place for proper checking and reporting of all breaches of financial policies; and
c) a proper procedure is in place for regular checking of the adequacy and effectiveness of the control environment.
3. AUDIT
POLICY – the CCG will have an effective and independent internal audit function and fully comply with the requirements of external audit and other statutory reviews.
3.1. The head of internal audit from the internal audit service appointed by the Audit and Integrated Governance Committee (AIGC) and the Audit Commission appointed external auditor will have direct and unrestricted access to AIGC members, the Chair of the Governing Body, Chief Officer and Chief Finance Officer for any significant issues arising from audit work that management cannot resolve, and for all cases of fraud or serious irregularity.
3.2. All AIGC members, the Chair of the Governing Body and the Chief Officer will have direct and unrestricted access to the head of internal audit and external auditors.
3.3. The Chief Finance Officer will ensure that:
a) the CCG has a professional and technically competent internal audit function as set out in more detail in the Terms of Reference of the AIGC; and
b) the AIGC approves any changes to the provision or delivery of assurance services to the CCG.
c) the minutes of the AIGC meetings shall be formally recorded and submitted to the Governing Body. The Chair of AIGC shall draw to the attention of the Governing Body any issues that require disclosure to the full Governing Body, or require executive action.
6
4. FRAUD AND CORRUPTION
POLICY – the CCG requires all staff to always act honestly and with integrity to safeguard the public resources they are responsible for. The CCG will not tolerate any fraud perpetrated against it and will actively chase any loss suffered.
4.1. The Governing Body’s AIGC will satisfy itself that the CCG has adequate arrangements in place for countering fraud and shall review the outcomes of counter fraud work. It shall also approve the counter fraud annual work programme and review the annual report produced by the local counter fraud specialist.
4.2. The Governing Body’s AIGC will ensure that the CCG has arrangements in place to work effectively with NHS Protect.
Security Management
4.3 The Chief Officer will monitor and ensure compliance with Directions issued by the Secretary of State for Health on NHS security management.
4.4 The Chief Officer shall nominate a suitable person to carry out the duties of the Local Security Management Specialist (LSMS) as specified by the Secretary of State for Health guidance on NHS Security Management.
4.5 The Governing Body shall nominate a Lay Member to oversee the NHS Security Management service who will report to the Governing Body.
5 EXPENDITURE CONTROL
5.1 The CCG is required by statutory provisions48 to ensure that its expenditure does not exceed the aggregate of allotments from the NHS Commissioning Board and any other sums it has received and is legally allowed to spend.
5.2 The Chief Officer has overall executive responsibility for ensuring that the CCG complies with certain of its statutory obligations, including its financial and accounting obligations, and that it exercises its functions effectively, efficiently and economically and in a way which provides good value for money.
5.3 The Chief Finance Officer will:
provide reports in the form required by the NHS Commissioning Board; ensure money drawn from the NHS Commissioning Board is required for approved expenditure only is drawn down only at the time of need and follows best practice; and be responsible for ensuring that an adequate system of monitoring financial performance is in place to enable the CCG to fulfil its statutory responsibility not to exceed its expenditure limits, as set by direction of the NHS Commissioning Board.
6 ALLOCATIONS49
6.1 The Chief Finance Officer will:
48 See section 223H of the 2006 Act, inserted by section 27 of the 2012 Act 49 See section 223(G) of the 2006 Act, inserted by section 27 of the 2012 Act.
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a) periodically review the basis and assumptions used by the NHS Commissioning Board for distributing allocations (also known as allotments) and ensure that these are reasonable and realistic and secure the CCG’s entitlement to funds;
b) prior to the start of each Financial Year submit to the Governing Body for approval a report showing the total allocations received and their proposed distribution including any sums to be held in reserve; and
c) regularly update the Governing Body on significant changes to the initial allocation and the uses of such funds.
7 COMMISSIONING STRATEGY, BUDGETS, BUDGETARY CONTROL AND MONITORING
POLICY – the CCG will produce and publish an annual commissioning plan50 that explains how it proposes to discharge its financial duties. The CCG will support this with comprehensive medium term financial plans and annual budgets.
Commissioning Strategy and Plan
7.1 The Governing Body. will approve consultation arrangements for the CCG’s annual commissioning plan51.
7.2 The Chief Officer will compile and submit to the Governing Body a commissioning strategy and annual commissioning plan which takes into account financial targets and forecast limits of available resources.
Budgets, Budgetary Control and Budgetary Monitoring
7.3 Prior to the start of the Financial Year the Chief Finance Officer will, on behalf of the Chief Officer, prepare and submit commissioning and infrastructure (running cost) budgets for approval by the Governing Body.
7.4 The Chief Finance Officer shall monitor financial performance against budget and plan, regularly review them, and report to the Governing Body on at least a monthly basis. This report should include explanations for variances. These variances must be based on any significant departures from agreed financial plans or budgets. The report should also document requests for changes to budgets where these are in excess of the limits delegated to the Chief Officer and Chief Finance Officer.
7.5 The Chief Officer is responsible for ensuring that information relating to the CCG’s accounts or to its income or expenditure, or its use of resources is provided to the NHS Commissioning Board as requested.
7.6 The Chief Officer is responsible for putting in place a detailed scheme of delegation which sets out in writing budgetary authorisation limits for individual committees and individuals and the responsibilities of budget holders and budget managers. This will be incorporated into a Detailed Financial Policy on budget management prepared by the Chief Finance Officer and approved by the Governing Body.
7.7 The Chief Finance Officer has a responsibility to ensure that adequate training is delivered on an on- going basis to budget holders and their budget managers to help them manage successfully.
50 See section 14Z11 of the 2006 Act, inserted by section 26 of the 2012 Act. 51 See section 14Z13 of the 2006 Act, inserted by section 26 of the 2012 Act
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8 ANNUAL ACCOUNTS AND REPORTS
POLICY – the CCG will produce and submit to the NHS Commissioning Board accounts and reports in accordance with all statutory obligations52, relevant accounting standards and accounting best practice in the form and content and at the time required by the NHS Commissioning Board.
8.1 The Chief Finance Officer will ensure the CCG:
a) prepares a timetable for producing the annual report and accounts and agrees it with external auditors and the Audit and Integrated Governance Committee;
b) prepares the accounts according to the agreed timetable;
c) complies with statutory requirements and relevant directions for the publication of the externally audited annual accounts and annual report;
d) considers the external auditor’s management letter and fully address all issues within agreed timescales, ensuring it is presented to the AIGC for consideration; and
e) publishes the external auditor’s management letter on the CCG’s website and makes it available upon request for inspection at the CCG’s head office.
9 INFORMATION TECHNOLOGY
POLICY – the CCG will ensure the accuracy and security of the CCG’s computerised financial data.
9.1 The Chief Finance Officer is responsible for the accuracy and security of the CCG’s computerised financial data and shall:
a) devise and implement any necessary procedures to ensure adequate (reasonable) protection of the CCG's data, programs and computer hardware from accidental or intentional disclosure to unauthorised persons, deletion or modification, theft or damage, having due regard for the Data Protection Act 1998;
b) 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;
c) ensure that adequate controls exist such that the computer operation is separated from development, maintenance and amendment;
d) 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.
9.2 In addition the Chief Finance Officer shall ensure that new financial systems and amendments to current financial systems are developed in a controlled manner and thoroughly tested prior to implementation. Where this is undertaken by another organisation, assurances of adequacy must be obtained from them prior to implementation.
52 See paragraph 17 of Schedule 1A of the 2006 Act, as inserted by Schedule 2 of the 2012 Act.
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10 ACCOUNTING SYSTEMS
POLICY – the CCG will run an accounting system that creates management and financial accounts.
10.1 The Chief Finance Officer will ensure:
a) The CCG has suitable financial and other software to enable it to comply with these policies and any consolidation requirements of the NHS Commissioning Board;
b) that contracts for computer services for financial applications with another health organisation or any other agency shall clearly define the responsibility of all parties for the security, privacy, accuracy, completeness, and timeliness of data during processing, transmission and storage. The contract should also ensure rights of access for audit purposes.
c) Where another health organisation or any other agency provides a computer service for financial applications, the Chief Finance Officer shall periodically seek assurances that adequate controls are in operation.
11 BANK ACCOUNTS
POLICY – the CCG will keep enough liquidity to meet its current commitments.
11.1 The Chief Finance Officer will:
a) review the banking arrangements of the CCG at regular intervals to ensure they are in accordance with Secretary of State directions53, best practice and represent best value for money;
b) manage the CCG's banking arrangements and advice the CCG on the provision of banking services and operation of accounts;
c) prepare detailed instructions on the operation of bank accounts.
11.2 The Audit and Integrated Governance Committee shall approve the banking arrangements.
12 INCOME, FEES AND CHARGES AND SECURITY OF CASH, CHEQUES AND OTHER NEGOTIABLE INSTRUMENTS.
POLICY – the CCG 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 CCG or its functions54; ensure its power to make grants and loans is used to discharge its functions effectively55.
12.1 The Chief Financial Officer is responsible for:
a) designing, maintaining and ensuring compliance with systems for the proper recording, invoicing, and collection and coding of all monies due;
b) establishing and maintaining systems and procedures for the secure handling of cash and other negotiable instruments;
53 See section 223H(3) of the NHS Act 2006, inserted by section 27 of the 2012 Act 54 See section 14Z5 of the 2006 Act, inserted by section 26 of the 2012 Act. 55 See section 14Z6 of the 2006 Act, inserted by section 26 of the 2012 Act.
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c) approving and regularly reviewing the level of all fees and charges other than those determined by the NHS Commissioning Board or by statute. Independent professional advice on matters of valuation shall be taken as necessary;
d) for developing effective arrangements for making grants or loans.
e) appropriate recovery action on all outstanding debts
13 TENDERING AND CONTRACTING PROCEDURE
POLICY – the CCG: will ensure proper competition that is legally compliant within all purchasing to ensure we incur only budgeted, approved and necessary spending; will seek value for money for all goods and services; shall ensure that competitive tenders are invited for: o the supply of goods, materials and manufactured articles; o the rendering of services including all forms of management consultancy services (other than specialised services sought from or provided by the Department of Health); and o for the design, construction and maintenance of building and engineering works (including construction and maintenance of grounds and gardens) for disposals.
Tendering
13.1 The CCG shall ensure that the firms / individuals invited to tender (and where appropriate, quote) are among those on approved lists or where necessary a framework agreement. Where in the opinion of the Chief Finance Officer it is desirable to seek tenders from firms not on the approved lists, the reason shall be recorded in writing to the Chief Officer.
13.2 The Chief Finance Officer will prepare a supporting Detailed Financial Policy setting out the detailed arrangements for competitive and non competitive quotations; formal competitive tendering including authorisation and confirming where formal competitive tendering is not required. The detailed financial policy will set out in detail the limits and circumstances for when quotations and tenders are not required and the circumstances when a quotation or tender waiver may be requested. The Chief Officer or Chief Finance Officer must approve all such waivers and these must be reported to the next meeting of the AIGC.
13.3 The Audit and Integrated Governance Committee will approve the detailed financial policy on quotations and tendering including financial limits for when these are not required. These limits will be kept under review but will initially be as follows:
a) Quotations – These are required where formal tendering procedures are not adopted and where the intended expenditure or income for the whole life of the proposed contract exceeds or is reasonably expected to exceed £10,000 (including VAT unless recoverable)
b) Tenders - These are required where the estimated expenditure or income for the proposed whole life of the contract is expected to exceed £50,000 (including VAT unless recoverable).
Contracting Procedures
13.4 The Officer Members may only negotiate contracts on behalf of the CCG, and the CCG 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:
a) the CCG’s Standing Orders;
b) the Public Contracts Regulation 2006, any successor legislation and any other applicable law; and
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c) take into account as appropriate any applicable NHS Commissioning Board or the Independent Regulator of NHS Foundation Trusts (Monitor) guidance that does not conflict with (b) above.
13.5 In all contracts entered into, the Group shall endeavour to obtain best value for money. The Chief Officer shall nominate an individual who shall oversee and manage each contract on behalf of the CCG.
14 COMMISSIONING
POLICY – working in partnership with relevant national and local stakeholders, the CCG will commission certain health services to meet the reasonable requirements of the persons for whom it has responsibility.
14.1 The CCG will coordinate its work with the NHS Commissioning Board, other clinical commissioning groups, local providers of services, local authority(ies), including through Health & Wellbeing Boards, patients and their carers and the voluntary sector and others as appropriate to develop robust commissioning plans.
14.2 The Chief Officer will establish arrangements to ensure that regular reports are provided to the Governing Body detailing actual and forecast expenditure and activity for each contract.
14.3 The Chief Finance Officer will maintain a system of financial monitoring to ensure the effective accounting of expenditure under contracts. This should provide a suitable audit trail for all payments made under the contracts whilst maintaining patient confidentiality.
15 RISK MANAGEMENT AND INSURANCE
POLICY – the CCG will put arrangements in place for evaluation and management of its risks and will put insurance arrangements are in place.
Risk Management
15.1 The Chief Officer shall ensure that the CCG has a programme of risk management, in accordance with prevailing NHS Commissioning Board and Department of Health assurance framework requirements, which will be monitored by the AIGC and its Governance sub-committee and approved by the Governing Body..
15.2 The Chief Officer will also ensure that a risk register is maintained which will assess risks for their probability and impact. The risk register will be regularly reviewed by the Governance Sub- committee of the AIGC and regular reports will be made to both the AIGC and Governing Body.
15.3 The Chief Officer will nominate a senior Officer to be the Senior Information Risk Owner (SIRO).
Insurance: Risk Pooling Schemes administered by NHSLA
15.4 The Governing Body shall decide if the CCG will insure through the risk pooling schemes administered by the NHS Litigation Authority or self insure for some or all of the risks covered by the risk pooling schemes. If the Governing Body decides not to use the risk pooling schemes for any of the risk areas (clinical, property and employers/third party liability) covered by the scheme this decision shall be reviewed annually.
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15.5 Where the Governing Body decides to use the risk pooling schemes administered by the NHS Litigation Authority the Chief Finance Officer shall ensure that the arrangements entered into are appropriate and complementary to the risk management programme. The Chief Finance Officer shall ensure that documented procedures cover these arrangements.
15.6 Where the Governing Body decides not to use the risk pooling schemes administered by the NHS Litigation Authority for one or other of the risks covered by the schemes, the Chief Finance Officer shall ensure that the Governing Body is informed of the nature and extent of the risks that are self insured as a result of this decision. The Chief Finance Officer will draw up formal documented procedures for the management of any claims arising from third parties and payments in respect of losses which will not be reimbursed.
16 PAYROLL AND PAY EXPENDITURE
POLICY – the CCG will put arrangements in place for an effective payroll service and the management of its staffing establishment and staffing costs.
Payroll
16.1 The Chief Finance Officer will ensure that the payroll service selected:
a) is supported by appropriate (i.e. contracted) terms and conditions;
b) has adequate internal controls and audit review processes;
c) has suitable arrangements for the collection of payroll deductions and payment of these to appropriate bodies.
16.2 In addition the Chief Finance Officer shall set out comprehensive procedures for the effective processing of payroll.
Funded Establishment
16.3 The Governing Body will approve the staffing funded establishment of the CCG at the start of each Financial Year as part of the approval of initial budgets . It will then monitor variations as part of financial reports in year.
16.4 During the Financial Year the funded establishment of any department may not be varied without the approval of the Chief Officer or Chief Finance Officer.
Staff Appointments
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16.5 No Governing Body Member or employee may engage, re-engage, or re-grade employees, either on a permanent or temporary nature, or hire agency staff, or agree to changes in any aspect of remuneration:
(a) unless authorised to do so by the Chief Officer or Chief Finance Officer; and
(b) within the limit of their approved budget and funded establishment.
16.6 The Chief Officer will:
(a) ensure that all employees are issued with a Contract of Employment and which complies with employment legislation; and
(b) ensure there are arrangements for dealing with variations to, or termination of, contracts of employment
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17 NON-PAY EXPENDITURE
POLICY – the CCG will seek to obtain the best value for money goods and services received.
17.1 The Governing Body will approve the level of non-pay expenditure on an annual basis and the Chief Officer will determine the level of delegation to budget managers.
17.2 The Chief Officer shall set out procedures on the seeking of professional advice regarding the supply of goods and services.
17.3 The Chief Finance Officer will:
a) advise the on the setting of thresholds above which quotations (competitive or otherwise) or formal tenders must be obtained;
b) be responsible for the prompt payment of all properly authorised accounts and claims;
c) be responsible for designing and maintaining a system of verification, recording and payment of all amounts payable.
18 CAPITAL INVESTMENT, FIXED ASSET REGISTERS AND SECURITY OF ASSETS
POLICY – the CCG 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 CCG’s fixed assets.
18.1 The Chief Officer will
a) ensure that there is an adequate appraisal and approval process in place for determining capital expenditure priorities and the effect of each proposal upon plans;
b) be responsible for the management of all stages of capital schemes and for ensuring that schemes are delivered on time and to cost;
c) shall ensure that the capital investment is not undertaken without confirmation of purchaser(s) support and the availability of resources to finance all revenue consequences, including capital charges;
d) be responsible for the maintenance of registers of assets, taking account of the advice of the Chief Finance Officer concerning the form of any register and the method of updating, and arranging for a physical check of assets against the asset register to be conducted once a year.
18.2 The Chief Finance Officer will prepare detailed procedures for the disposals of assets.
19 RETENTION OF RECORDS
POLICY – the CCG will put arrangements in place to retain all records in accordance with NHS Code of Practice Records Management 2006 and other relevant notified guidance.
19.1 The Chief Officer shall:
a) be responsible for maintaining all records required to be retained in accordance with NHS Code of Practice Records Management 2006 and other relevant notified guidance;
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b) ensure that arrangements are in place for effective responses to Freedom of Information requests;
c) publish and maintain a Freedom of Information Publication Scheme.
20 TRUST AND CHARITABLE FUNDS
POLICY – the CCG will put arrangements in place to provide for the appointment of trustees if the CCG holds any property in trust or will put arrangements in place for the management of any charitable funds.
20.1 The Chief Finance Officer shall ensure that each trust fund which the CCG is responsible for managing is managed appropriately with regard to its purpose and to its requirements.
20.2 The Chief Finance Officer shall ensure that appropriate arrangements are in place with Sheffield Hospitals Charitable Trust to manage any charitable funds relating to the CCG.
21 ACCEPTANCE OF GIFTS BY STAFF AND LINK TO STANDARDS OF BUSINESS CONDUCT
21.1 The Chief Finance Officer shall ensure that all staff are made aware of the CCG’s policy on acceptance of gifts and other benefits in kind by staff. This policy follows the guidance contained in the Department of Health circular HSG (93) 5 ‘Standards of Business Conduct for NHS Staff’; the Code of Conduct for NHS Managers 2002; and the ABPI Code of Professional Conduct relating to hospitality/gifts from pharmaceutical/external industry and is also deemed to be an integral part of these Standing Orders and PFPs.
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22 COMMISSIONING SUPPORT SERVICES AND PUBLIC HEALTH CORE OFFER
22.1 The Governing Body will approve the contract(s) for commissioning support services provided by the commissioning support unit(s) and the memorandum of understanding with Sheffield City Council for the Public Health Core Offer.
22.2 The Chief Officer will be responsible for nominating a senior Officer to ensure a comprehensive contract is in place for commissioning support services which also delivers value for money. The Chief Officer will also be responsible for nominating a senior Officer to ensure the memorandum of understanding and annual plan of work is agreed with Sheffield City Council for the Public Health Core Offer.
.
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APPENDIX F - NOLAN PRINCIPLES
1. The ‘Nolan Principles’ set out the ways in which holders of public office should behave in discharging their duties. The seven principles are:
a) Selflessness – Holders of public office should act solely in terms of the public interest. They should not do so in order to gain financial or other benefits for themselves, their family or their friends.
b) Integrity – Holders of public office should not place themselves under any financial or other obligation to outside individuals or organisations that might seek to influence them in the performance of their official duties.
c) Objectivity – In carrying out public business, including making public appointments, awarding contracts, or recommending individuals for rewards and benefits, holders of public office should make choices on merit.
d) Accountability – Holders of public office are accountable for their decisions and actions to the public and must submit themselves to whatever scrutiny is appropriate to their office.
e) Openness – Holders of public office should be as open as possible about all the decisions and actions they take. They should give reasons for their decisions and restrict information only when the wider public interest clearly demands.
f) Honesty – Holders of public office have a duty to declare any private interests relating to their public duties and to take steps to resolve any conflicts arising in a way that protects the public interest.
g) Leadership – Holders of public office should promote and support these principles by leadership and example.
Source: The First Report of the Committee on Standards in Public Life (1995)56
56 Available at http://www.public-standards.gov.uk/
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APPENDIX G – NHS CONSTITUTION
The NHS Constitution sets out seven key principles that guide the NHS in all it does:
1. the NHS provides a comprehensive service, available to all - irrespective of gender, race, disability, age, sexual orientation, religion or belief. It has a duty to each and every individual that it serves and must respect their human rights. At the same time, it has a wider social duty to promote equality through the services it provides and to pay particular attention to groups or sections of society where improvements in health and life expectancy are not keeping pace with the rest of the population
2. access to NHS services is based on clinical need, not an individual’s ability to pay - NHS services are free of charge, except in limited circumstances sanctioned by Parliament.
3. the NHS aspires to the highest standards of excellence and professionalism - in the provision of high-quality care that is safe, effective and focused on patient experience; in the planning and delivery of the clinical and other services it provides; in the people it employs and the education, training and development they receive; in the leadership and management of its organisations; and through its commitment to innovation and to the promotion and conduct of research to improve the current and future health and care of the population.
4. NHS services must reflect the needs and preferences of patients, their families and their carers - patients, with their families and carers, where appropriate, will be involved in and consulted on all decisions about their care and treatment.
5. the NHS works across organisational boundaries and in partnership with other organisations in the interest of patients, local communities and the wider population - the NHS is an integrated system of organisations and services bound together by the principles and values now reflected in the Constitution. The NHS is committed to working jointly with local authorities and a wide range of other private, public and third sector organisations at national and local level to provide and deliver improvements in health and well-being
6. the NHS is committed to providing best value for taxpayers’ money and the most cost-effective, fair and sustainable use of finite resources - public funds for healthcare will be devoted solely to the benefit of the people that the NHS serves
7. the NHS is accountable to the public, communities and patients that it serves - the NHS is a national service funded through national taxation, and it is the Government which sets the framework for the NHS and which is accountable to Parliament for its operation. However, most decisions in the NHS, especially those about the treatment of individuals and the detailed organisation of services, are rightly taken by the local NHS and by patients with their clinicians. The system of responsibility and accountability for taking decisions in the NHS should be transparent and clear to the public, patients and staff. The Government will ensure that there is always a clear and up-to-date statement of NHS accountability for this purpose
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Source: The NHS Constitution: The NHS belongs to us all (March 2012)57
57 http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_132961
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Appendix [H]
Map of the Area and the Localities of the CCG
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APPENDIX I
CONFLICTS OF INTEREST PROTOCOL
1. Introduction
1.1 As required by section 14O of the 2006 Act, this Conflicts of Interest Protocol (the "Protocol") sets out the arrangements made by the CCG to identify, manage and record conflicts and potential conflicts of interest to ensure that decisions made by the CCG will be taken and seen to be taken without any possibility of the influence of external or private interest. The CCG recognises that a conflict of interest, or perceived conflict of interest, in its role as a commissioner of healthcare services is a key risk that requires careful management and handling whether this is a direct or indirect conflict, pecuniary or otherwise.
1.2 The CCG is committed to upholding the principles of openness, transparency, fairness and integrity in its role as a commissioner of healthcare services for the Sheffield community. Individuals and their employees and subcontractors, Governing Body Members and members of committees and subcommittees of the Governing Body and CCG, Practice Representatives and employees of the CCG will need to be aware of the standards of conduct which are required from the CCG as a publicly funded body which carries out public functions. They will have a duty to act with integrity, impartiality and honesty regarding their access to public funds and their private interests and should follow the Seven Principles of Public Life as set out by the Committee on Standards in Public Life (the "Nolan Principles") which are set out at Appendix F to the Constitution.
1.3 In addition to the Nolan Principles, this Protocol should be seen in the context of the regulatory framework which governs the policies and operations of the CCG including the ‘Code of Conduct: Code of Accountability in the NHS (DH 2004)’, the ‘Code of Accountability for NHS Boards' and the ‘Code of Conduct for NHS Managers’ (DH 2002) and standards of good business and practice.
2. Definitions
2.1 For the purpose of this Protocol the following terms shall have the meanings set out as follows:
"CCG Business" means any subject of discussion or debate relating to the duties and roles of the CCG or direct commissioning and any contract entered into by the CCG for goods or services either existing or potential;
"Close Association" means someone with whom the Individual is in regular contact over a period of time so that the person is more than an acquaintance;
"Declaration of Interests has the meaning given to it at paragraph 5.5 below; Form"
"Individual" means a person to whom this Conflict of Interest Protocol shall apply in accordance with paragraph 3;
"NHS Body" has the meaning given in section 275(1) of the Act;
"Non-Conflicted Individuals" means those Individuals on the Governing Body, or relevant committee or sub-committee of the
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Governing Body or CCG (as applicable) who have no conflicting interests, either directly or indirectly, in the matters of CCG Business which are subject to discussion and/or decision by the CCG in accordance with this Protocol;
"Personal Interest" has the meaning given to it at paragraph 5.3 below;
"Prejudicial Interest" means an interest that a member of the public, who knew the relevant facts, would reasonably consider to be so significant that it is likely to prejudice the Individual's judgement of what is in the public interest and as may be further described in Annex 1;
"Register of Interests" has the meaning given to it at paragraph 5.8 below;
"Register of Gifts and means the register maintained in accordance with Hospitality" paragraph 6.1; and
"Relevant Person" means a Member of the CCG or their representative family, including:
a partner (someone who is married to, a civil partner or someone with whom the Individual lives with in a similar capacity);
a parent or parent in law;
a son or daughter or stepson or step daughter;
the child of a partner;
a brother or sister;
a brother or sister of the Individual's partner;
a grandparent and/ or a grandchild;
an uncle or aunt;
a nephew or niece; and
the partners of the above.
3. Scope
3.1 Adherence to this Conflict of Interest Protocol will be mandatory for:
3.1.1 Members, Practice Representatives, Governing Body Members, employees of the CCG and appointed individuals working for the CCG; and
3.1.2 Members of any committees or sub-committees appointed by the Governing Body (including the Audit and Integrated Governance Committee and the Remuneration Committee) or the CCG. This includes temporary members that the Governing Body and its committees may, from time to time, appoint.
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4. Accountability and Responsibilities
4.1 The Chief Officer (Accountable Officer) will be responsible for ensuring there is an effective system in place to manage conflicts, or potential conflicts, of interest and along with the Company Secretary, will retain an overview of the Protocol to ensure adherence in accordance with the CCG's governance arrangements.
4.2 The Company Secretary will ensure that adequate records are kept including the Register of Interests and that information is publicly available.
4.3 All Members and officers of the CCG must also comply with their own professional codes of conduct in relation to conflicts of interest.
4.4 The Company Secretary, on behalf of Chief Officer, has responsibility for ensuring these arrangements are put into place within the supporting committee, and sub-committee structures.
5. The Declaration of Interests
5.1 Conflicts of interest may arise where an individual, personal, or a connected person’s interests and/or loyalties conflict with those of the CCG. Such conflicts may create problems such as inhibiting free discussion which could:
5.1.1 result in decisions or actions that are not in the interests of the CCG and the public it was established to serve; and
5.1.2 risk the impression that the CCG has acted improperly.
5.2 Individuals will take all reasonable steps to identify conflicts of interest (including without limitation, any conflict which may arise by virtue of an Individual also holding a role within any other NHS Body) that arises or may arise in the course of the CCG providing any services or the delivery of the CCG Business. Individuals are not required to declare all interests they may have outside of the CCG, but rather those interests which relate to or could impact upon the CCG Business. Individuals should register all relevant interests in accordance with paragraph 5.5 below and should also declare any Personal Interest when dealing with or discussing a matter to which it is pertinent.
5.3 Individuals are required to declare any Personal Interest in any matter of CCG Business which may directly or indirectly give rise to a conflict or a potential for conflict of interest or duty. Additionally all Individuals and committee members of the CCG are required to comply with its Standing Orders (SOs), Terms of Reference (if applicable) and Prime Financial Policies (PFPs). Compliance with SOs and PFPs is mandatory. An Individual is considered to have a Personal Interest in a matter of CCG Business where that Individual or any Relevant Person and/or Close Association to the Individual:
5.3.1 is a director (including non-executive directorships), shareholder, partner or employee or otherwise has a position of ownership (all or part), control or management of a Private Company or PLC, including a business which holds a contract with the CCG or has the potential to enter into contracts with the CCG;
5.3.2 is likely to make a financial gain, or avoid a financial loss, through the matter;
5.3.3 has an interest in the outcome of a matter which is distinct from the CCG's interest; or
5.3.4 has a financial or other incentive to favour the interest of another party or group over the interests of the CCG.
5.4 It is not possible, or desirable, to define all instances in which an interest may be a real or perceived conflict. It is for each Individual to exercise their judgement in deciding whether to register any interests that may be construed as a conflict. If any Individual is unsure as to whether an interest should be declared then he or she should seek guidance from the CCG
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Secretary or if relevant from the committee or sub-committee chair. Annex 1 sets out examples of what may be considered a conflict of interest.
5.5 Any declaration of interest made pursuant to this Conflicts of Interest Protocol should be made by completing the form attached at Annex 2 (the "Declaration of Interests Form") and sending this to the Company Secretary. The relevant Individual should carefully consider whether they feel they could participate in a meeting to discuss the relevant matter in which they have a Personal Interest without being influenced by their other interest to the detriment of patients, the taxpayer, or the CCG.
5.6 Where an Individual becomes aware of a Personal Interest which:
5.6.1 has not been declared, either in the Register of Interests or orally, they will declare this at the start of any meeting where the CCG Business to which that Personal Interest relates is to be discussed; or
5.6.2 has previously been declared, in relation to the scheduled or likely business of any meeting where the CCG Business to which that Personal Interest relates is to be discussed, 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 Personal Interest,
and provide a written declaration to the Company Secretary as soon as possible thereafter.
5.7 Following receipt of the Declaration of Interests Form or oral declaration in accordance with paragraph 5.6 above, the CCG shall consider the nature, scale or complexity of the interest declared and the risk that the conflict of interest may adversely influence the interests of patients, taxpayers or the CCG, in order to determine whether the interest is:
5.7.1 non-prejudicial to the public interest so as to allow the Individual to remain a Member of the CCG and to continue to be involved in discussions regarding that element of the CCG Business in which the Individual has an interest;
5.7.2 a Prejudicial Interest, however that the CCG is willing to authorise the Individual to remain involved in the CCG Business on a conditional basis as set out in paragraph 7 below;
5.7.3 so significant so as to be deemed as a Prejudicial Interest and to require the Individual to be prohibited from all discussions related to the issue of CCG Business which gave rise to the conflict (and therefore paragraph 8 shall apply); or
5.7.4 except in the case of a Member, a Prejudicial Interest such that the CCG considers that the only option available to resolve the conflict is that the Individual should be removed from the CCG.
5.8 When first appointed to the CCG, Individuals will be asked to read and comply with this Protocol and complete and sign a Declaration of Interests Form if relevant. A register will be held by the CCG to record disclosures (the "Register of Interests") in accordance with the Constitution. Individuals who appear on the Register of Interests will be required to ensure that entries relating to them in the Register of Interests are accurate, complete and up to date. Individuals will declare interests where appropriate during the course of their duties and must notify the Company Secretary immediately or at the earliest opportunity of all changes to the information disclosed. Following any changes in circumstances Individuals will be asked to complete and sign a new Declaration of Interests Form if relevant.
5.9 The Register of Interests will be kept by the CCG and will set out:
5.9.1 names of Individuals and details of the interest which were declared on appointment, as the interest first arises or through an annual declaration update; and
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5.9.2 names of Individuals who have declared interests at meetings giving dates, details of the interest declared and whether the Individual took part in the relevant part of the meeting.
5.10 The Register of Interests will be kept up to date by the Company Secretary and reviewed by the CCG annually. The Company Secretary will take such steps and request such information as appropriate from Individuals, to ensure all conflicts and potential conflicts of interest are declared. The Register of Interests will be available to the public and will be published on the CCG's website.
5.11 When a declared interest ceases to be relevant, the respective Individual should inform the Company Secretary so that it can be removed from the Register of Interests.
6. Register of Gifts and Hospitality
6.1 An Individual is required to declare any gift or hospitality offered or received in connection with their role in the CCG. Gifts and hospitality will be recorded on a separate register (the "Register of Gifts and Hospitality"), which will be maintained by the Company Secretary.
6.2 Individuals shall not use confidential information acquired in the pursuit of their role to benefit themselves or a Relevant Person or Close Association.
7. Authorisation of a Individual with a Prejudicial Interest
7.1 The CCG may, by way of a majority vote of the Non-Conflicted Individuals (provided that they constitute a quorum), authorise a Individual who has a Prejudicial Interest in an aspect of CCG Business to continue to be involved in that matter of CCG Business subject to the terms of this paragraph 7.
7.2 Where the CCG grants authorisation pursuant to paragraph 7.1 above the Non-Conflicted Individuals may impose conditions upon the relevant Individual's attendance and involvement at any meetings at which the CCG Business, in which they have a Prejudicial Interest, may be discussed, which may include the following:
7.2.1 that they shall be entitled to make representations, answer questions and give evidence, however, they will be expected to leave the room as soon as they have finished making representations, giving evidence or answering questions and before any debate starts; and/or
7.2.2 they shall not be entitled to cast a vote on that item of CCG Business in which they have an interest; and/or
7.2.3 that they will sign a confidentiality agreement with the CCG to confirm that they will not discuss any issues regarding that matter of CCG Business with any Close Association or Relevant Person; and/or
7.2.4 such other terms for the purposes of dealing with the conflict as the Non-Conflicted Individuals think fit.
7.3 The Individual who is the subject of the conflict shall be obliged to conduct themselves in accordance with any terms and conditions imposed by the Non-Conflicted Individuals in respect of the conflict.
7.4 The Non-Conflicted Individuals may revoke or vary the authorisation granted under paragraph 7.1 above at any time.
8. Withdrawal from a meeting due to a conflict of interest
8.1 Where an Individual has a Prejudicial Interest to which paragraph 5.7.3 or paragraph 5.7.2 which is not authorised by the Non-Conflicted Individuals in accordance with paragraph 7 above, the chair of the relevant meeting may require the Individual to withdraw from the meeting or part of it (such requirement must be recorded in the minutes of the meeting).
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8.2 It is the responsibility of the chair to monitor whether the meeting is quorate to ensure it is maintained throughout the discussion and decision of the relevant agenda item. Should the withdrawal of any conflicted Individual result in the loss of quorum, the item will not be decided upon at that meeting.
8.3 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 the Company Secretary on the action to be taken. This may include:
8.3.1 requiring another of the CCG’s committees or sub-committees, the CCG’s 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,
8.3.2 inviting on a temporary basis one or more of the following to make up the quorum of the Governing Body or its Committees or sub-committees so that the CCG can progress the item of business:
(a) a Member of the CCG who is an Individual;
(b) an Individual appointed by a Member practice to act on its behalf in the dealings between it and the CCG;
(c) a member of a relevant Health and Wellbeing Board;
(d) a member of a Governing Body of another clinical commissioning group.
8.4 All declarations of interest and arrangements agreed in any meeting of the CCG, committees or sub-committees, or the Governing Body, the Governing Body’s committees or sub- committees, will be recorded in the minutes, including:
8.4.1 the nature and extent of the conflict;
8.4.2 an outline of the discussion; and
8.4.3 the actions taken to manage the conflict.
8.5 All payments or benefits in kind to Governing Body Members will be reported in the CCG’s accounts and Annual Report, with amounts for each Governing Body Member listed for the year in question.
9. Breaches of this Protocol
9.1 Failure to adhere to this Conflict of Interest Protocol may constitute the criminal offence of fraud, as an individual could be gaining unfair advantages or financial rewards for himself or a family member, friend or associate. Any suspicion that a relevant Personal Interest may not have been declared should be reported to the Company Secretary.
9.2 Breaches of the Protocol may result in the relevant Individual being removed from the CCG.
10. Managing contracts
An Individual must not be involved in procuring, tendering, managing or monitoring a contract in which the Individual has a Personal Interest.
11. Monitoring and Review
This Protocol will be monitored and reviewed annually by the CCG Secretary or at such time as there is a relevant change in law (including the issuing of new regulations) which impact upon this Protocol.
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Annex 1
Examples of Prejudicial Interests Scenario Declaration of Prejudicial Authorisation by Non- Disqualification from Removal Interest Required Interest? Conflicted Members Involvement in matter (Y/N) Appropriate? of Interest appropriate? An Individual (or a Relevant Yes – when matter or Yes. Yes, in part. The Individual Yes – depending on No - situational conflict Person or Close Association) is a any related issues may be able to provide circumstances this director, shareholder, employee arise or are discussed. valuable insight into the should be considered. or partner of an entity which has development of a service an interest in bidding for a specification at the outset contract for services which is of the process – but this being put out to tender by the could create procurement CCG. issues if the Individual subsequently bids against this specification. The CCG is considering whether Yes – when matter or Yes No – unlikely to be able to Yes, the circumstances No - situational conflict. to close down a service any related issues be seen to have given un- should be considered commissioned by the CCG which arise or are discussed. conflicted advice on this but this may be an Individual, Relevant Person or matter or related issues. appropriate. person with a Close Association to the Individual is a partner/employee/ shareholder of a company which delivers services which the CCG is commissioning. An Individual is an existing Yes - on appointment. Yes, No. Yes – on situation by Where it is likely that director or partner in one or more potentially. situation basis there is a potential for a potential providers of services to depending on their high number of conflicts the CCG. interest and the matter to arise in respect of a
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Scenario Declaration of Prejudicial Authorisation by Non- Disqualification from Removal Interest Required Interest? Conflicted Members Involvement in matter (Y/N) Appropriate? of Interest appropriate? being discussed. The particular Individual Individual should be which will have a required to re-declare detrimental impact on their interest prior to any their involvement, the such discussion each CCG should consider time the conflict arises. whether it is appropriate and in the interests of the CCG for that person to remain a Member of the relevant committee/sub- committee/Governing Body (in accordance with the CCG's Standing Orders) or if there are practical steps that can be taken to manage the conflicts on a longer term basis. An Individual or Relevant Person Yes – on appointment. Yes - No. Yes No – situational conflict. or Close Association holds a situational contract with or is a interest in director/shareholder/employee of relation to a company or party to a matters partnership which holds a relating to contract with the CCG. that contract.
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Annex 2 Sheffield Clinical Commissioning Group
DECLARATION OF INTEREST FORM
8. NAME______(BLOCK CAPITALS)
DESIGNATION______
CONTACT DETAILS (Base, Telephone No, Email) ______
Name of Company or Organisation Description of Position Held Comments (including NHS organisation) Business
Please identify any actual or potential Personal Interest that may arise as a consequence of your role in the CCG and how you propose that these will be dealt with.
The information provided in this Declaration Form will be processed in accordance with data protection principles as set out in the Data Protection Act 1998. Data will be processed only to ensure that the Individuals act in the best interests of the CCG and the public and patients the CCG was established to serve. Information will not be used for any other purpose.
Signatories should be aware that the CCG is subject to the Freedom of Information Act 2000 and therefore that details of their declaration may be made public in response to a request.
To the best of my knowledge these are the only interests I need to divulge.
Signed ……………………………………….... Date ………………………………..
Signed ………………………………………… Date ………………………………..
CCG Secretary
Please return completed form to: Company Secretary,
722 Prince of Wales Road, Darnall, Sheffield, S9 4EU
Please retain a copy for your files and ensure your line manager has a copy.
APPENDIX J
Sheffield Clinical Commissioning Group
Quality Assurance Committee
Terms of Reference
9. CONSTITUTION AND AUTHORITY 9.1. The Governing Body hereby resolves to establish a committee of the Governing Body to be known as the Quality Assurance Committee (the "Committee") in accordance with the CCG's Constitution. These terms of reference set out the membership, remit responsibilities and reporting arrangements of the Committee and shall have effect as if incorporated into the Constitution. 9.2. The Committee is authorised by the Governing Body to investigate any activity within its terms of reference. It is authorised to seek any information it requires from any Member, officer or employee who is directed to co-operate with any request made by the Committee. 9.3. The Committee is authorised to create working groups as necessary to fulfil its responsibilities within these terms of reference. The Committee may not delegate executive powers (unless expressly authorised by the Governing Body) and remains accountable for the work of any such group. 10. Purpose 10.1. The Committee shall:
10.1.1. gain assurance that there is an effective and consistent process to commissioning for quality and safety across the CCG's activities, ensuring that concerns and underperformance are identified and high standards of care and treatment are delivered. This will include areas regarding patient safety, effectiveness of care and patient /and staff experience; and
10.1.2. gain assurance of quality and safety indicators within the contracts commissioned by the CCG and across clinical patient pathways, approving the latter under delegated authority from the Governing Body. 11. Duties
11.1. The Committee shall:
11.1.1. receive reports from regulatory and other competent bodies (including the Care Quality Commission, Monitor and the Audit Commission) and ensure action plans are delivered;
11.1.2. receive quarterly thematic exception reports from the directly commissioned and contracted services regarding quality and safety legislative and contractual requirements as follows:
11.1.2.1. Patient Safety: (a) serious Incidents, never events and homicide investigations; (b) infection prevention and control; (c) safeguarding adults and children and domestic homicide; (d) Mental Capacity and Deprivation of Liberty; (e) medicines safety, Controlled Drugs Management and prescribing (including assurance of the effectiveness of APC); (f) Deaths in custody; and (g) Patient Safety Alerts.
11.1.2.2. Effectiveness (a) NICE Technology Appraisal, guidance and Quality Standards compliance; (b) Clinical Audit performance; (c) PROMS; (d) CQUIN performance; (v) Research and Evaluation
11.1.2.3. Patient / Staff Experience (a) receive reports on patient surveys and reports; (b) Eliminating Mixed Sex Accommodation reports; (c) Complaints reports of providers and complaints relating to commissioning decisions, interface/partner complaints and the quality of primary care: (d) receive reports on staff surveys in relation to quality and patient safety; (e) professional issues and whistleblowing in commissioned services, linked to quality and patient safety;
(f) receive exception reports on any other significant high level quality and patient safety concerns regarding providers; and (g) ensure significant clinical risks are identified and reported on the risk register, escalating to the Assurance Framework where necessary.
11.1.3. approve under delegated authority from the Governing Body the CCG’s clinical policies such as the Adult and Child Protection policies. Policies will be published on the CCG’s web site and new and revised policies will be circulated to Governing Body Members for information. 3.1.4 approve under delegated authority from the Governing Body patient clinical pathways for adoption by the CCG. Such pathways will first have been considered by the Clinical Reference Group and Commissioning Executive Team, who will make recommendations on the approval of the pathways. However where proposed pathways are likely to be contentious with stakeholders including patients and local providers, the pathways will be referred to the Governing Body for a decision. The Committee will ensure that approved pathways are then appropriately published and promoted.
12. MEMBERSHIP 12.1. The Committee shall consist of the following members:
the Lay Member of the Governing Body with responsibility for patient and public engagement (who shall chair the Committee);
Chief Nurse
Deputy Chief Nurse
One of the Joint Clinical Directors;
Head of Medicines Management;
CCG GP nominated Lead
12.2. The Committee can co-opt other members as required.
13. Quorum A quorum shall be one Lay Member (the Chair or nominated Lay Deputy Chair), the Chief Nurse or Deputy Chief Nurse and one other member.
14. Attendance at Meetings
14.1. In addition to the Committee members, the following persons shall generally attend routine meetings of the Committee: The Chief Operating Officer, the Senior Quality Manager and a representative from Internal Audit. 14.2. Members of the Governing Body shall be invited to attend those meetings in which the Committee will consider areas of risk or operation that are their responsibility. 14.3. Other CCG employees shall also attend by request of the chair of the Committee. The Chair of the Governing Body may be invited to attend meetings of the Committee as required.
15. Frequency of Meetings 15.1. Meetings of the Committee shall be held quarterly, with additional meetings where necessary. 15.2. The Committee members shall be afforded the opportunity to meet at least once per year with no others present. 15.3. The Deputy Chief Nurse will be responsible for preparing and discussing the agenda for each meeting with the Chair of the Committee (or in his absence the Deputy Chair). The agenda and papers will be distributed to members of the Committee at least 5 days in advance of the meeting, unless otherwise agreed by the Chair of the Committee. 16. ACCOUNTABILITY AND REPORTING ARRANGEMENTS 16.1. The minutes of all meetings of the Committee shall be formally recorded and submitted, together with recommendations where appropriate, to the Governing Body. The submission to the Governing Body shall include details of any matters in respect of which actions or improvements are needed. This will include details of any evidence of potentially ultra vires, otherwise unlawful or improper transactions, acts, omissions or practices or any other important matters. To the extent that such matters arise, the chair of the Committee shall present details to a meeting of the Governing Body. 16.2. A report from the Quality Assurance Committee will be presented to the Audit and Integrated Governance Committee following each meeting to provide assurance that the systems and processes of clinical governance are in place across the organisation. 16.3. An Annual Report of the Quality Assurance Committee will be presented to the Governing Body. 16.4. The CCG's annual report shall include a section describing the work of the Sub-Committee in discharging its responsibilities.
17. OTHER MATTERS
17.1. The Committee will review its Terms of Reference at least annually making recommendations on any changes to the Governing Body. 17.2. Members of the Committee must attend at least two meetings each financial year but should aim to attend all scheduled meetings.
APPENDIX J
Sheffield Clinical Commissioning Group
Governance Sub-Committee
Terms of Reference
18. CONSTITUTION AND AUTHORITY 18.1. The Governance Sub-Committee (the "Sub-Committee") of the Audit and Integrated Governance Committee ("AIGC") is established in accordance with the Constitution of the NHS Sheffield Clinical Commissioning Group (the "CCG'"). These terms of reference set out the membership, remit, responsibilities and reporting arrangements of the Sub-Committee and shall have effect as if incorporated into the Constitution. 18.2. The Committee is authorised by the Governing Body to investigate any activity within its terms of reference. It is authorised to seek any information it requires, from any Member, officer or employee who is directed to co-operate with any request made by this Sub-Committee. 18.3. The Sub-Committee is authorised to create working groups as necessary to fulfil its responsibilities within these terms of reference and shall also have the ability to establish advisory groups as and when required. 19. Purpose 19.1. The Sub-Committee shall ensure that a sound system of integrated governance, risk management and internal control is in place which supports the achievement of the CCG’s objectives and provides the AIGC and ultimately the CCG with assurance as both an employer and a statutory body. The Sub-Committee shall:
19.1.1. ensure that strategic governance risks are identified and aligned to the strategic objectives;
19.1.2. monitor governance and risk management arrangements to ensure that risks are reported to the AIGC and CCG and actions taken to eliminate or minimise risks;
19.1.3. promote and demonstrate the values of sound governance and risk management to staff ensuring that this is imbedded in the culture of the organisation; and
19.1.4. ensure that the CCG operates within a controlled environment which is underpinned by sound assurances on the design and operation of governance and risk management process. 20. DUTIES 20.1. The duties of the Sub-Committee are to:
20.1.1. provide advice and assurance to the AIGC, the Governing Body and the CCG on all issues relating to governance including compilation of the Annual Governance Statement (AGS) and development and monitoring of the Assurance Framework;
20.1.2. review the Risk Register and receive a report on high level risks and any new organisational risk which will include risk assessments;
20.1.3. ensure that a robust system is in place to monitor incidents and complaints relating to CCG employees and on a quarterly basis to receive information on these, ensuring that actions are taken and lessons learned;
20.1.4. ensure that a robust system for the management of health and safety is in place and to monitor progress on action plans. This will include general health and safety, fire, security and estates issues linked to health and safety;
20.1.5. receive the minutes of the CCG's advisory Health and Safety Group.
20.1.6. ensure that claims and litigation issues are dealt with appropriately and learning shared as a result of claims or litigation;
20.1.7. gain assurance that the CCG has business continuity plans in place which have been reviewed and tested;
20.1.8. ensure that the CCG reviews its information governance processes to make sure that they are fit for purpose, be advised of any breaches of data security, monitor progress against Information Governance Toolkit targets, be assured about data quality and records management;
20.1.9. ensure that a system of HR and workforce development is established to receive quarterly updates on human resource issues;
20.1.10. ensure that systems are in place for the governance arrangements in relation to research and development;
20.1.11. have an overview of equality and human rights issues;
20.1.12. ensure that the CCG complies with all regulatory frameworks. This could include the Health and Safety Executive and NHS Protect; and
20.1.13. ensure the CCG has effective communication systems in place and that key governance information is made available to all staff of the CCG.
20.2. The Governance Sub-Committee will review non-clinical policies and will advise the AIGC on a quarterly basis of policies which have been approved by the Sub-Committee under the delegated powers set out in the Scheme of Reservation and Delegation. 21. Membership 21.1. The members of the Sub-Committee shall include:
Company Secretary (who shall chair the Sub-committee)
Clinical Director (who is also the Caldicott Guardian)
Chief Finance Officer or nominated deputy
Chief Operating Officer (who is also the Senior Information Risk Owner and deputy chair of the Sub-committee )
Chief Nurse or nominated deputy
Chief of Business Planning & Partnerships
representative from Internal Audit
Staff Side Representative 21.2. Members of the Sub-Committee can nominate deputies to attend a meeting of the Sub-Committee if the member is unable to attend. 21.3. The sub – committee can co-opt other members on to the Sub-committee such as members of staff from the South Yorkshire & Bassetlaw Commissioning Support Unit to provide advice on Risk and Health & Safety; Human Resources and other governance issues. 4.4 An administrator will be in attendance at the meetings and take formal minutes.
22. Quorum 22.1. The Sub-Committee shall be deemed quorate if the following members are present: The Company Secretary or nominated deputy The Chief Operating Officer or nominated deputy.
And one other Member 23. Frequency of Meetings 23.1. The Sub-Committee shall meet at least once every quarter in advance of the AIGC. 6.2 The Company Secretary will be responsible for preparing the agenda for each meeting. The agenda and papers will be distributed to members of the Sub -
Committee at least 3 days in advance of the meeting, unless otherwise agreed by the Chair of the Sub-Committee
24. Accountability 24.1. The minutes of all meetings of the Sub-Committee shall be formally recorded and submitted, together with recommendations where appropriate, to the AIGC. The submission to the AIGC shall include details of any matters in respect of which actions or improvements are needed 24.2. The Sub-Committee will report annually to the AIGC in respect of the fulfilment of its functions in connection with these terms of reference and its annual work plan. 24.3. The CCG's annual report shall include a section describing the work of the Sub-Committee in discharging its responsibilities. 25. Policy and best practice The Committee is authorised to obtain such internal information as is necessary and expedient to the fulfilment of its functions.
26. Conduct of the Committee 26.1. The terms of reference and work plan of the Sub-Committee shall be reviewed by the AIGC at least annually. 26.2. Members of the Sub-Committee must attend at least two meetings each financial year but should aim to attend all scheduled meetings.
Document C2
APPENDIX J
Sheffield Clinical Commissioning Group
Audit and Integrated Governance Committee
Terms of Reference
27. Constitution AND AUTHORITY 27.1. The Governing Body resolves to establish a committee of the Governing Body to be known as the Audit and Integrated Governance Committee (the "Committee") in accordance with the CCG's Constitution. These terms of reference set out the membership, remit, responsibilities and reporting arrangements of the Committee and shall have effect as if incorporated into the Constitution. 27.2. The Committee is authorised by the Governing Body to investigate any activity within its terms of reference. It is authorised to seek any information it requires, from any Member, officer or employee who is directed to co-operate with any request made by this Committee. 27.3. The Committee is authorised to create working groups as necessary to fulfil its responsibilities within these terms of reference. The Committee may not delegate executive powers (unless expressly authorised by the Governing Body) and remains accountable for the work of any such group. 28. PURPOSE and Duties 28.1. The Committee shall critically review the CCG’s financial reporting and internal control principles and ensure an appropriate relationship with both internal and external auditors is maintained.
Governance, Risk Management and Internal Control
28.2. The Committee shall review the establishment and maintenance of an effective system of integrated governance, risk management and internal control across the whole of the CCG's activities. 28.3. In particular, the Committee shall review the adequacy and effectiveness of:
28.3.1. all risk and assurance related disclosure statements (in particular the annual governance statement) together with any appropriate assurances from Internal Audit or other independent sources prior to endorsement by the CCG;
28.3.2. the underlying assurance processes that indicate the degree of the achievement of CCG objectives, the effectiveness of the management of principal risks and the appropriateness of the above disclosure statements;
28.3.3. the policies for ensuring compliance with relevant regulatory, legal and code of conduct requirements and related reporting and self- certification;
28.3.4. the CCG’s Standing Orders, Scheme of Delegation and Reservation and Prime Financial Policies at least annually
28.3.5. the policies and procedures for all work related to fraud and corruption as set out in Secretary of State Directions and as required by the NHS Counter Fraud and Security Management Service (NHS Protect). 28.4. In carrying out this work, the Committee will primarily utilise the work of Internal Audit, the work delegated to the Governance Sub Committee and other internal control functions, but will not be limited to these sources. It shall also seek reports and assurances from members of the Governing Body and senior employees as appropriate, concentrating on the over-arching systems of integrated governance, risk management and internal control, together with indicators of their effectiveness. This will be evidenced through the Committee’s use of an effective assurance framework to guide its work and that of the audit and assurance functions that report to it.
Internal Audit
28.5. 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, Chief Officer (Accountable Officer) and the CCG’s Governing Body. 28.6. The Committee shall ensure an effective internal audit function by:
28.6.1. Approving the appointment of the internal audit service and resolving any issues from resignation and dismissal;
28.6.2. review and approval of the internal audit strategy and annual operational plan ensuring that this is consistent with the audit needs of the organisation, as identified in the assurance framework;
28.6.3. considering the findings of internal audit work (and the response from relevant senior officers) and ensuring co-ordination between the internal and external auditors to optimise audit resources. This will
include consideration of the annual report of the Head of Internal Audit.
28.6.4. monitoring the responsiveness of the CCG to the findings and recommendations of Internal Audit.
External Audit
28.7. The Committee shall review the work and findings of the external auditors (including annual plan and progress reports and annual audit letter) and consider the implications and the senior executive responses to their work. 28.8. The Committee shall achieve this by:
28.8.1. consideration of the performance of the external auditors, as far as the rules governing the appointment permit;
28.8.2. 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;
28.8.3. discussion with the external auditors of their local evaluation of audit risks and assessment of the CCG and associated impact on the audit fee;
28.8.4. review of all external audit reports, including the report to those charged with governance, agreement of the annual audit letter before submission to the CCG’s Governing Body and any work undertaken outside the annual audit plan, together with the appropriateness of management responses;
28.8.5. oversee within any nationally agreed framework for CCGs, the conducting of a market testing exercise for the appointment of an auditor at least once every 5 years and, based on the outcome, make a recommendation to the Governing Body with respect to the appointment of the auditor; and resolving any issues from resignation and dismissal
Counter Fraud
28.9. The Committee shall satisfy itself that the CCG has adequate arrangements in place for countering fraud and shall review the outcomes of counter fraud work. It shall also approve the annual counter fraud work programme.
Financial Reporting
28.10. The Committee shall monitor the integrity of the financial statements of the CCG and any formal announcements relating to the CCG's financial performance.
28.11. The Committee shall review the financial statements before submission to the Governing Body and the CCG, focusing particularly on:
28.11.1. changes in, and compliance with, accounting policies, practices and estimation techniques;
28.11.2. unadjusted mis-statements in the financial statements;
28.11.3. significant judgements in preparing of the financial statements;
28.11.4. significant adjustments resulting from the audit;
28.11.5. letter of representation; and
28.11.6. qualitative aspects of financial reporting. 28.12. The Committee shall ensure that the systems for financial reporting to the CCG, including those of budgetary control are subject to review as to completeness and accuracy of the information provided to the CCG. 28.13. The Committee shall:
28.13.1. examine the circumstances associated with each occasion when the Standing Orders of the CCG are waived;
28.13.2. review the schedule of losses and compensation payments;
28.13.3. review the schedule of tender waivers; and
28.13.4. review schedules of debtor and creditor balances over 6 months old and consider explanations and action plans.
Other Assurance Functions
28.14. The Committee shall review the findings of other significant assurance functions, both internal and external to the CCG, and consider the implications for the governance of the CCG. 28.15. In addition, the Committee will review the work of other groups/Committees within the CCG, whose work can provide relevant assurance to the Committee’s own scope of work. This will particularly include:
28.15.1. the Quality Assurance Committee from which a report will be provided to the Committee at each meeting highlighting any matters of particular relevance; and
28.15.2. the Governance Sub-Committee. The minutes of the meetings of this Sub –Committee will be presented for review along with a report on key activities and actions. 29. Membership 29.1. The Committee shall consist of the following members:
29.1.1. two Lay Members of the Governing Body;
29.1.2. two GPs who are Members of the Governing Body; 29.2. Neither the Chair of the Governing Body nor the Chief Finance Officer shall be a member of the Committee. 29.3. The Lay Member on the Governing Body, with a lead role in overseeing key elements of governance, shall be the chair of the Committee. The second lay member shall be the deputy chair.
30. Quorum 30.1. A quorum shall be two members, of whom one shall be a Lay Member and one shall be a GP. 31. Attendance at Meetings 31.1. In addition to the Committee members, the Chief Finance Officer, Company Secretary and representatives from Internal Audit and External Audit shall normally attend meetings. 31.2. Members of the Governing Body shall be invited to attend those meetings in which the Committee will consider areas of risk or operation that are their responsibility. 31.3. Other CCG or South Yorkshire and Bassetlaw Commissioning Support Unit employees such as relevant finance and HR managers shall also attend by request of the chair of the Committee. The Chief Officer and Chair of the Governing Body may be invited to attend meetings of the Committee as required. 31.4. A representative of the local counter fraud service may be invited to attend meetings of the Committee. 5.5 An employee of the CCG will administer the meetings and take formal minutes.
32. Frequency of Meetings 32.1. Meetings will be held at least quarterly, with additional meetings where necessary. 32.2. The External Auditor and Head of Internal Audit Services shall each be afforded the opportunity at least once per year to meet with the Committee Chair and Deputy Chair. 32.3. The Chief Finance Officer will be responsible for preparing and discussing the agenda for each meeting with the Chair of the Committee (or in his absence the Deputy Chair). The agenda and papers will be distributed to members of the Committee at least 5 days in advance of the meeting, unless otherwise agreed by the Chair of the Committee.
33. Accountability and Reporting Arrangements 33.1. The minutes of all meetings of the Committee shall be formally recorded and submitted, together with recommendations where appropriate, to the Governing Body. 33.2. The Committee will report annually to the Governing Body in respect of the fulfilment of its functions in connection with these terms of reference. 33.3. The CCG's annual report shall include a section describing the work of the Committee in discharging its responsibilities. 34. OTHER MATTERS 34.1. The Committee will agree an Annual Work Plan at its March meeting each year. 34.2. The Committee will review its terms of reference at least annually making recommendations on any changes to the Governing Body. 34.3. The Committee will review the terms of reference of the Governance Sub- committee including any recommendations from the Sub-Committee for changes. The Committee will then make recommendations on any changes to the Governing Body. 34.4. Members of the Committee must attend at least two meetings each financial year but should aim to attend all scheduled meetings.
APPENDIX J
Sheffield Clinical Commissioning Group
Governing Body Remuneration Committee
Terms of Reference
1. CONSTITUTION AND AUTHORITY
34.5. The Governing Body resolves to establish a committee of the Governing Body to be known as the Remuneration Committee (the "Committee") in accordance with the CCG's Constitution. These terms of reference set out the membership, remit, responsibilities and reporting arrangements of the Committee and shall have effect as if incorporated into the Constitution.
34.6. The Committee is authorised by the Governing Body to undertake any activity within its terms of reference. It is authorised to seek any information it requires, from any Member, officer or employee who is directed to co-operate with any request made by this Committee.
34.7. The Committee is authorised to create working groups as necessary to fulfil its responsibilities within these terms of reference. The Committee may not delegate executive powers (unless expressly authorised by the Governing Body) and remains accountable for the work of any such group.
2. PURPOSE AND DUTIES
2.1 The Committee will oversee the appointment of all Governing Body Members.
2.2 The Committee will have delegated authority to determine the remuneration and conditions of service for all the Governing Body Members, taking into account any national Directions or guidance on these matters.
2.3 The Committee will have the delegated authority to review the performance of the Chief Officer (Accountable Officer) and other senior CCG employees and determine any financial awards as appropriate.
2.4 The Committee will have the delegated authority to consider the severance payments of the Chief Officer (Accountable Officer) and of other senior staff, seeking HM Treasury approval as appropriate in accordance with the guidance ‘Managing Public Money’ (available on the HM Treasury.gov.uk website).
2.5 The Committee shall make recommendations to the Governing Body on determinations about allowances under any pension scheme it might establish as an alternative to the NHS pension scheme and on any other potential alternative
remuneration and conditions of service for CCG employees outside of or in place of national Agenda for Change arrangements.
3. MEMBERSHIP
3.1 The Committee shall be appointed by the Clinical Commissioning Group from amongst its Governing Body Members.
3.2 The Chair of the Governing Body, two Lay Members and two GP Members of the Governing Body will be members of the Committee but relevant members will not be present where discussions relate to their remuneration, fees or allowances.
3.3 The Chief Officer will also be a member of the Committee but will not be present where discussions relate to his/her own remuneration and terms of service.
3.4 The Vice-Chair of the Governing Body will chair the Committee and the other Lay Member will be the deputy chair. When the Lay Members remuneration is considered, however, one of the GP Members of the Governing Body will chair the Committee.
4. QUORUM
4.1 In order to undertake its work the Committee will generally be quorate when one of the Governing Body Lay Members and two of the GPs are present.
4.2 Due to the conflict of interest issues, when the Committee is considering the appointment and remuneration for GPs involved in CCG business quoracy will exist if both of the Lay Members and the Chief Officer are present. Similarly when the Committee is considering Lay Member appointments and remuneration the Committee will be quorate if two of the GPs and the Chief Officer are present.
5. ATTENDANCE AT MEETINGS
5.1 The Chief Finance Officer, Company Secretary and other external advisors such as a Human Resources Manager from the Commissioning Support Unit may be invited to attend for all or part of any meeting as and when appropriate. However, relevant CCG employees should not be in attendance for discussions about their own remuneration and terms of service.
5.2 The Company Secretary will act as secretary to the Committee and will be responsible for supporting the Chair in the management of remuneration business and for drawing the committee’s attention to best practice, national guidance and other relevant documents as appropriate.
6. FREQUENCY AND NOTICE OF MEETINGS
6.1 The Committee will meet as a minimum twice in a calendar year and at other times as deemed necessary.
6.2 Where possible, meetings will take place just prior to a meeting of the Governing Body and any papers will be distributed confidentially to members along with the governing body papers thereby giving members five working days notice.
7 ACCOUNTABILITY AND REPORTING ARRANGEMENTS
7.1 The decisions of the Committee will be recorded in an appropriate minute and the Governing Body will be advised in writing of the meeting and any decisions or recommendations made.
7.2 The business of the Committee is confidential.
7.3 The Committee will provide an annual report for the Governing Body on the remuneration and conditions of service for the members of the Governing Body and ensure this information is published in the annual report.
8 POLICY AND BEST PRACTICE
8.1 The Committee will apply best practice in its decision making processes and will take into account both national guidance and any local commitments made such as, “Employer of Choice”. The Committee will ensure that when considering individual remuneration it:-
complies with current disclosure requirements for remuneration; will seek independent advice about remuneration for individuals and will ensure that decisions are based on clear and transparent criteria.
8.2 The Committee will commission any reports or surveys deemed necessary to help fulfill its obligations.
9 CONDUCT OF THE COMMITTEE
9.1 The Committee will operate at all times in accordance with the Governing Body’s Standing Orders and Prime Financial Policies. It will ensure that it conducts its business in accordance with the principles of good governance and the Nolan seven principles of public life.
9.2 The Committee will review its own performance, membership and terms of reference at least annually. Any resulting changes to the terms of reference will be approved by the Governing Body.
Document D
SIGNATORIES TO THE CONSTITUTION
Sheffield Clinical Commissioning Group
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 NHS Sheffield Clinical Commissioning Group.
Practice Name ______
Practice Address
______
Nominated practice representative (who should be either a GP or other health professional)
______
Signature ______
Date ______
Dr Tim Moorhead
Chair, NHS Sheffield Clinical Commissioning Group
Please complete this form and return to
Linda Tully, Company Secretary
722 Prince of Wales Road, Darnall, Sheffield S9 4EU
SIGNATORIES TO THE CONSTITUTION
Sheffield Clinical Commissioning Group
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 NHS Sheffield Clinical Commissioning Group.
Practice Name ______
Practice Address
______
Nominated practice representative (who should be either a GP or other health professional)
______
Signature ______
Date ______
Dr Tim Moorhead
Chair, NHS Sheffield Clinical Commissioning Group
PRACTICE COPY
Please complete this form and retain at your practice
Document E
Sheffield Clinical Commissioning Group
DECLARATION OF INTEREST FORM
35. NAME ______(BLOCK CAPITALS)
DESIGNATION______
CONTACT DETAILS (Base, Telephone No, Email)
______
Name of Company or Organisation Description of Position Held Comments (including NHS organisation) Business
Please identify any actual or potential Personal Interest that may arise as a consequence of your role in the CCG and how you propose that these will be dealt with.
The information provided in this Declaration Form will be processed in accordance with data protection principles as set out in the Data Protection Act 1998. Data will be processed only to ensure that the Individuals act in the best interests of the CCG and the public and patients the CCG was established to serve. Information will not be used for any other purpose.
Signatories should be aware that the CCG is subject to the Freedom of Information Act 2000 and therefore that details of their declaration may be made public in response to a request.
To the best of my knowledge these are the only interests I need to divulge.
Signed ……………………………………….... Date ………………………………..
Signed ………………………………………… Date ………………………………..
CCG Secretary
Please return completed form to: Company Secretary,
722 Prince of Wales Road, Darnall, Sheffield, S9 4EU
Please retain a copy for your files and ensure your line manager has a copy