GREATER MANCHESTER HEALTH AND SOCIAL CARE DEVOLUTION STRATEGIC PARTNERSHIP BOARD. Establishing Leadership and Accountability in Shadow Form

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1 6 GREATER MANCHESTER HEALTH AND SOCIAL CARE DEVOLUTION STRATEGIC PARTNERSHIP BOARD Date: 23 rd October 2015 Subject: Report of: Establishing Leadership and Accountability in Shadow Form Liz Treacy PURPOSE OF REPORT: The purpose of this document, and the attached Governance work plan, is to update the Strategic Partnership on progress made towards establishing the governance and accountability framework that will be required to support a devolved health an d social care economy in Greater Manchester. RECOMMENDATIONS: The Strategic Partnership are asked to: Note the contents of this paper and attached draft work plan. To agree and provide the necessary support to the delivering the next steps. To consider and approve the Terms of Reference appended to this report. CONTACT OFFICERS: Liz Treacy Liz.treacy@manchester.gov.uk 1

2 1. INTRODUCTION 1.1 The purpose of this document, and the attached Governance work plan, is to update the Strategic Partnership on progress made towards establishing the governance and accountability framework that will be required to support a devolved health an d social care economy in Greater Manchester. 1.2 The report sets out progress made, and identified the key next steps, building upon the governance principles which were agreed by Greater Manchester at the Standing Conference on 10 th September A work plan for the Governance workstream is appended to this report for information. The work plan is regularly reviewed and updated by the group. 2. CONTEXT 2.1 The Governance Group has a membership that is representative of the four main stakeholder groups (GMCA, NHSE, CCGs, and NHS Trust Providers): Liz Treacy GMCA - Chair Tim Griffiths GMCA Darren Banks CMFT Rob Bellingham NHSE Sandra Stewart Tameside Council Hamish Stedman Salford CCG Su Long Bolton CCG Paul Pallister Tameside and Glossop CCG Ben Tomlinson GM H&SC Devolution PMO Kath Ibbotson NHSE 2.2 The work plan that has been produced to support the delivery of the Governance, Leadership and Accountability workstream is detailed, and has therefore been broken into four distinct work packages: Strategic Partnership and utive Joint Commissioning Legal and Accountability Framework Development of Memorandums of Understanding 2.3 Each of the deliverables and activities has been further prioritised: high; medium; and low. This is to enable the group and the PMO to prioritise resource, and is not intended to indicative of the relative importance of the work packages. The Strategic Partnership are reminded that the majority of the work has to be completed by January In agreeing the principles by which the governance will developed it was recognised that due to its complexity, it would be an iterative process, and the governance structures would be reviewed and refined throughout the shadow period. 2.5 In order to make significant and quick progress, a number of priority next steps have been identified and agreed by the Strategic Partnership utive, these are set out at Section 3 of this report. 2

3 3. NEXT STEPS 3.1 As identified above, the principles that will support the governance arrangements to be put in place were agreed at the Standing Conference on 10 th September, and the Programme on 18 th September. To ensure that progress continues to be made at pace, the immediate priorities have been identified as follows: i. Agree a schedule of meetings for the Strategic utive Working Party (Strategic Partnership utive), confirm its membership, and develop Terms of Reference. ii. iii. iv. Finalise a schedule of meetings for the Strategic Partnership, confirm its membership, and develop Terms of Reference for the. Draft Terms of Reference are appended to this report. Finalise the decision making framework and scheme of delegation for the Strategic Partnership. The decision making framework/scheme of delegation will be finalised through a focus session encompassing relevant stakeholders. To support this focus session a straw man document has been produced which outlines key challenges that need to be overcome and that outstanding issues that require resolution. This focus session will be run in conjunction with the focus session for the Joint Commissioning Progress the establishment of a Joint Commissioning. This will be achieved by holding a focus session with relevant practitioners in early November. To support this focus session a straw man document has been produced which outlines key challenges that need to be overcome and that outstanding issues that require resolution. This focus session will be run in conjunction with focus session for the decision making framework/scheme of delegation. v. Make progress with regard to the establishment of an overarching Provider Forum. This will include defining its core membership, the criterion that will define its membership, the function of the Forum, and establishing how the Forum links back into the wider governance arrangements. vi. Further work will be required with officers leading on the development of MoU s: Katy Calvin Thomas Monitor Yvonne Rogers HEE Rob Bellingham CQC Warren Heppolette NICE It is expected that the MoU s are developed in conjunction/through the Governance Group. An update on this work will be brought to a future meeting of the Strategic Partnership. 3

4 vii. viii. ix. Develop the processes by which the third sector, patient groups, and primary care are engaged with the governance structures. This work, as with the MoU work, will need to be supported by DMT members. Leads have been identified: Rob Bellingham Primary Care Warren Heppolette/Claire Norman Patient Groups Warren Heppolette/Tim Griffiths Third Sector. Work with the PMO to undertake a due diligence exercise to establish a clear schedule of existing meetings and groups that are supporting the health and social care agenda, with a view to rationalising where possible. This work is now underway, and an update will be taken to a future meeting of the Strategic Partnership utive. Develop the assurance framework within which GM will operate, recognising that any process followed will need to be led by GM. This work is now progressing, and is being led by the Governance Group. The initial work that has taken place is being supported by CCGs and NHSE. 4. FOCUS SESSIONS 4.1 As identified above the Governance Group will be facilitating a two part focus session to further develop the Joint Commissioning, and the decision making framework/scheme of delegation. 4.2 The purpose of these sessions, building upon the success of the session held to develop the governance principles, is to ensure that the precise function of the Joint Commissioning Bard are identified and agreed collectively; likewise the decision making framework/scheme of delegation. Decision making framework/scheme of delegation 4.3 There are number of outstanding issues that will need to be resolved with respect to decision making capabilities of the various groups and boards. Whilst the principles that have been agreed broadly define the functions of the boards, further work is required to establish how decisions will be taken around issues such as: organisational change; use of capital and estate; transformational funding; and, setting of clinical standards. Joint Commissioning 4.4 There is a need to develop a clear framework of what is currently, and will be commissioned at the following levels: Greater Manchester; Integrated local level; CCG only; and, local authority only. 4.5 In addition to the above it will be important to understand and agree which of the Specialist Services will be commissioned on a wider than Greater Manchester footprint, ie North West, North, National. Greater Manchester, via representatives of the Joint Commissioning, will need to establish how such decisions are taken with Greater Manchester. 4

5 4.6 The focus session will also need to identify whether the Joint Commissioning has an assurance role with respect of commissioning decisions and the outcomes associated with the same at a local level. 5. PROVIDER GOVERNANCE 5.1 As was reported to the GM Health and Social Care Devolution Programme in September the Greater Manchester provider NHS trusts have made significant progress in moving to new governance in shadow form. Work has continued at pace, and both terms of reference and decision making procedures will be taken to the Federation on 20 th November for discussion and agreement. Proposals relating to both financial efficiencies and common pay rates for medical locum staff, developed by collaborative finance and HR sub groups respectively, will also be taken to the Federation in November. 5.2 As part of the new governance arrangements, the Federation will be independently chaired, and it is anticipated that the appointment for this post will be made in March The Federation have also agreed their nominations to the Strategic Partnership utive, with one year terms agreed for members. 5.3 Work also continues to progress with regard to Organisational Development which both the Director of Workforce and OD, and Head of OD, of Stockport FT are leading on behalf of Provider Trusts with the Kings Fund. Engagement with NHS England on arrangements for commissioning specialised services in GM remains ongoing. 6. RECOMMENDATIONS 6.1 The Strategic Partnership are asked to: Note the contents of this paper and attached draft work plan. To agree and provide the necessary support to the delivering the next steps. To consider and approve the Terms of Reference appended to this report. 5

6 Appendix One Draft Terms of Reference (Strategic Partnership ) The Greater Manchester Health and Social Care Standing Strategic Partnership AUTHORITY In February 2015 the Association of Greater Manchester Authorities (AGMA) and the Association of Greater Manchester Clinical Commissioning Groups (CCGs) signed a Memorandum of Understanding (MoU) with NHS England to create a framework for achieving the delegation and ultimate devolution of health and social care responsibilities to accountable and statutory bodies in Greater Manchester (GM). The MoU outlined a process for collaborative working across health and social care making provision for arrangements to be in place (in shadow form) from November 2015 It also made provision for a programme of work to be undertaken during 2015/16 to move to fully devolved system from April 2016.This includes work to develop and agree the supporting governance Following the creation of the Standing Conference in April 2015, it was agreed in subsequently agreed that the from the beginning of the Shadow Period this would be superseded by the formal establishment of a Strategic Partnership. PURPOSE AND OBJECTIVES The Strategic Partnership will be responsible for setting the overarching strategic vision for the Greater Manchester Health and Social Care economy. As it is not a legal body, its decisions are not binding, but recommendations for its members to formally adopt following their own governance procedures which may include delegation to a group of its members where possible. RESPONSIBILITIES The key responsibilities of the Partnership are: To set the framework within which the Strategic Partnership utive will operate. To agree the GM Health and Social Care Strategic priorities in accordance with the NHS five year forward view. The priorities and vision as defined by the Strategic Partnership will be delivered by the GM Joint Commissioning and the localities. To approve the content of the GM Strategic Plan (for financial and clinical sustainability), and note the content of the 10 locality plans to deliver the Strategic Plan locally and the matters remaining for the GM Joint Commissioning s remit. To agree the criteria that determine access to the transformation funding and ask the fund allocators (NHS England and GMCA) and fund recipients (Local Authorities and CCGs) to adopt them. To ensure that there remains ongoing and significant organisational commitment across the GM health economy to both the devolution agenda and a devolved health system. To be responsible to the people of Greater Manchester and to each other for the financial and clinical sustainability of the Greater Manchester health 6

7 economy, through the agreement and the delivery of the Strategic Plan. The will receive regular update reports from the utive on the ongoing progress of the delivery of the Strategic Plan. To provide a mutual assurance function over the outcomes linked to the commissioning decisions taken by members to deliver the Strategic Plan. The will receive regular reports from the utive about the commissioning decisions of the GM Commissioning, and the performance (via agreed outcomes) linked to those decisions. To agree an assurance framework, developed jointly with regulators where required, that reflects the outcomes required by Greater Manchester, because the formal assurance that each individual party is delivering on their commitments to the Strategic Plan will be provided in the usual way by the relevant statutory body. The will receive regular reporting of GM s performance against agreed assurance metrics. To provide leadership across the GM health economy to ensure that the key strategic priorities for a GM health system are achieved. MEMBERSHIP The membership of the Strategic Partnership is not a closed membership at this point but will include: GMCA (The Chair of the GMCA) 10 AGMA authorities (Leaders or Lead Members) 12 Clinical Commissioning Groups ( Chairs or Chief Officers) 15 providers - all acute NHS Trusts and Foundation Trusts, mental health and community providers and NWAS ( Chairs or Chief Officers) NHS England (as they determine). OTHER MEMBERS Monitor/TDA (NHS Improvement), CQC, Public Health England, Health Education England, Greater Manchester Fire and Rescue Service (Chair), and Greater Manchester Police and Crime Commissioner will be invited to attend as non-voting members of the. From October 2015 Primary care partners will be represented at the through the GMLMC. Further work will be undertaken from October to April 2016 the outcome of which will inform and determine the representation of primary care in the governance framework. This work will ensure that primary care is appropriately represented by accountable and representative bodies on an ongoing basis. GMCVO will attend to represent the voluntary sector pending further discussion on third sector representation as set out below. Any amendments to the membership of the Strategic Partnership will be agreed (by majority vote where necessary) by the. CHAIR The Strategic Partnership will have an independent chair. However, Lord Peter Smith (AGMA/GMCA) will act as chair until such time that a process to appoint an independent chair is completed. 7

8 QUORUM The quoracy of the meeting has yet to be defined. SUPPORT Officers from the Greater Manchester Integrated Support Team (GMIST) will provide policy and administrative support to the Partnership. MEETING FREQUENCY The Partnership will meet monthly or more frequently if required. ACCOUNTABILITY The Strategic Partnership is accountable to Greater Manchester. members are accountable to their own organisations and stakeholder grouping. It s REVIEW OF TERMS OF REFERENCE These terms of reference will be formally reviewed by the Partnership by mutual agreement of the membership. Such review will take place at any time to reflect changes in circumstances which may arise. 8

9 Appendix Two Governance Work Plan DRAFT Work plan Establishing Leadership Governance & Accountability 2015/16 September October November December January February March Establishing Leadership Governance & Accountability GM Strategic Partnership / utive GM Joint Commissioning / utive Other important Dates Final deliverable Draft deliverable Internal deliverable 02/10 Standing Conference Prog 12/11 Prog Prog Establish Primary Care, Patient, Third Sector, and Private Sector representation at the Strategic Partnership as per ToR Appoint Independent Chair through NHS independent commission process 1) Strategic Partnership / utive Produce Decision Making Framework / scheme of delegation Develop and agree an assurance framework for use by the (or utive) and Agree and implement regular update reports from the utive to the Develop and agree a set of Terms of Reference & meeting protocols First draft Lock-in Final draft 2) Joint Commissioning Produce Decision Making Framework Agree Joint Chair Develop and agree a set of Terms of Reference & meeting protocols First draft Lock-in Consider any issues arising from amendments to the Devolution Bill during its progress through the Commons. 3) Legal Accountability Framework Planning Identify and agree the exact range of legal functions and decisions to be exercised by the, utive and JCB set Agree the mechanism for how funds are to be held by one on behalf of all and how those funds are to be allocated to recipients. Develop a monitoring and assurance framework to underpin the contractual arrangements HEE Governance Group to review draft MOU Sign off at Prog 12/11 4) Development of MOU s Monitor/TDA Governance Group to review draft MOU CGC Governance Group to review draft MOU NICE Governance Group to review draft MOU 9