NHS SHEFFIELD CLINICAL COMMISSIONING GROUP CONSTITUTION

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1 NHS SHEFFIELD CLINICAL COMMISSIONING GROUP CONSTITUTION Version: 5.2 NHS Commissioning Board Effective Date: October

2 CONTENTS Part Description Page Foreword 3 1 Introduction and Commencement Name Statutory framework Status of this Constitution Amendment and variation of this Constitution 4 / 5 2 Area Covered 6 3 Membership Membership of the clinical commissioning group Eligibility Application for Membership Rights and Responsibilities of Members Cessation of Membership Disputes 7 4 Mission, Values and Aims Mission Values Aims Principles of good governance Accountability All member council meeting 11 5 Functions and General Duties Functions General duties General financial duties Other relevant regulations, directions and documents 18 6 Decision Making: The Governing Structure Authority to act Scheme of reservation and delegation General Committees of the CCG Joint and collaborative arrangements The Governing Body 25 7 Roles and Responsibilities Practice representatives Locality Arrangements Other GPs or primary care health professionals All Members of the CCG s Governing Body The Chair of the Governing Body

3 Part Description Page 7.6 The Deputy Chair of the Governing Body Role of the Accountable Officer Role of the Director of Finance Role of the Secondary Care Specialist Doctor Role of the Registered Nurse (as undertaken by the Chief Nurse) Role of Director of Delivery Care Outside of Hospital Role of the Medical Director Role of the Director of Strategy and Integration Role of Director of Commissioning and Performance Role of the Lay Members 38 8 Standards of Business Conduct and Managing Conflicts of Interest Standards of business conduct Conflicts of interest Declaring and registering interests 40 9 The CCG as Employer Transparency, Ways of Working and Standing Orders General Standing Orders 42 Appendix A B C D E F G H Description Definitions of Key Descriptions used in this Constitution List of Member Practices Standing Orders Scheme of Reservation and Delegation Prime Financial Policies The Nolan Principles The Seven Key Principles of the NHS Constitution Map of the Area and the Localities of the CCG 3 2

4 FOREWORD NHS Sheffield Clinical Commissioning Group is supported by four strong localities. We aim to commission high quality services in an affordable and sustainable local health system. We are a fully authorised Clinical Commissioning Group from 1 April 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 Signed... Signed... Chair Accountable Officer 4 3

5 INTRODUCTION AND COMMENCEMENT 1.1. Name The name of this clinical commissioning group is NHS Sheffield Clinical Commissioning Group Statutory Framework 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, and the regulations made under that provision The NHS Commissioning Board (hereafter referred to as the 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 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 Status of this Constitution 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 Director of Finance or by to sheccg.membershipoffice@nhs.net 1.4. Amendment and Variation of this Constitution This Constitution can only be varied in two circumstances. 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; 5 4

6 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. 6 5

7 2. AREA COVERED 2.1. The geographical area covered by the CCG is represented in Appendix H. 3. MEMBERSHIP 3.1 Membership of the CCG 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 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 CCG Application for Membership 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 Members are entitled to the following benefits: 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 city-wide elected and locality nominated clinical leads of the Governing Body; d) access to centrally managed savings for ongoing service development. 1 See section 14A(4) of the 2006 Act 7 6

8 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 within and between practices, across localities and to and from the Governing Body, its committees and groups including the Members Council; 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 A Member ceases to be a Member if they cease to be eligible for membership through non-compliance with paragraph 3.2 above 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 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. 3.6 Disputes 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. 8 7

9 4. MISSION, VALUES AND AIMS 4.1 Mission 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 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 Good corporate governance arrangements are critical to achieving the CCG s objectives The values that lie at the heart of the CCG s work are: 2 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 and the Professional Standards Authority Standards for members of NHS Boards and Clinical Commissioning Group Governing Bodies.2 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; 8 9

10 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; ix) develop strong collaborative relationships with partner organisations, including the local NHS Foundation Trusts, Sheffield City Council, 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; 4.3 Aims 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 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. 10 9

11 4.4 Principles of Good Governance 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 c) the seven key principles of the NHS Constitution;6 d) the Equality Act Accountability The CCG will demonstrate its accountability to its Members, local people, stakeholders and the 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; Inserted by section 25 of the 2012 Act 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 See Appendix F See Appendix G See

12 i) complying with the Freedom of Information Act 2000; and j) providing information to the Board as required 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 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 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 Director of Finance 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

13 5 FUNCTIONS AND GENERAL DUTIES 5.1 Functions The functions that the CCG are responsible for exercising are largely set out in the 2006 Act An outline of these appears in the Board s Functions of Clinical Commissioning Groups 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. 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 Board of their duty to promote a comprehensive health service9 and with the objectives and requirements placed on the Board through the mandate10 published by the Secretary of State before the start of each financial year by: i) ii) iii) iv) v) delegating responsibility for complying with this duty to: the Accountable Officer; and the Director of Finance delegating responsibility for complying with duties in the relevant areas to the: Audit and Integrated Governance Committee; Remuneration Committee; Quality Assurance Committee; maintaining robust Standing Orders and a Scheme of Reservation and Delegation; 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 requiring progress against delivery of this duty to be reported regularly to the Governing Body and committees of the Governing Body. See section 3(1F) of the 2006 Act, inserted by section 13 of the 2012 Act See section 1 of the 2006 Act, as amended by section 1 of the 2012 Act See section 13A of the 2006 Act, inserted by section 23 of the 2012 Act 12 13

14 b) meet the public sector equality duty 11 by: i) delegating delivery of this duty to the Public Equality Engagement Experience Group (PEEEG); 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 assessments 12 and joint health and wellbeing strategies 13 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: Make arrangements to secure public involvement in the planning, development and consideration of proposals for changes and decisions affecting the operation of commissioning arrangements 14 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; 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 Clinical Commissioning Committee annually; and See section 149 of the Equality Act 2010 See section 116 of the Local Government and Public Involvement in Health Act 2007 See section 116A of the Local Government and Public Involvement in Health Act 2007 See section 14Z2 of the 2006 Act 14 13

15 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; Act effectively, efficiently and economically16 by: Reporting on engagement activity annually to the Clinical Commissioning Committee. ensuring compliance with the CCG s Standing Orders and Scheme of Reservation and Delegation; delegating responsibility for oversight of this duty to the Audit and 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. Act with a view to securing continuous improvement to the quality of services17 by: Appointment of a Chief Nurse; Appointment of a Medical 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. See section 14P of the 2006 Act See section 14Q of the 2006 Act See section 14R of the 2006 Act 14 15

16 Assist and support the NHS Commissioning Board in relation to the Board s duty to improve the quality of primary medical services18 by: 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. Have regard to the need to reduce inequalities19 by: Promote the involvement of patients, their carers and representatives in decisions about their healthcare20 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. Obtain appropriate advice22 from persons who, taken together, have a broad range of professional expertise in healthcare and public health for example: 18 the appointment of a Governing Body member with lead responsibility for patient involvement; and the development of a strategy for patient involvement. Act with a view to enabling patients to make choices21 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. 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; Professional Local Committees (ie the L.M.C., L.O.P., L.D.C., L.P.C.); Leads for safeguarding, infection control, professional standards; See section 14S of the 2006 Act See section 14T of the 2006 Act See section 14U of the 2006 Act See section 14V of the 2006 Act See section 14W of the 2006 Act 15 16

17 The Medicines Management Team; Area Prescribing Group; Dental Advisors and the Dental Public Health Unit; and Locality Groups and Constituent practices Promote innovation 23 by: Clinical engagement in devising new services and patient pathways coordinated through the Clinical Reference Group which engages the wider health system and a range of clinical professionals, under the leadership of the Medical Director. Promote through integrated health and social care summits, which take place 2 or 3 times per year, convened by the CCG's Medical Director, 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 Clinical Commissioning Committee (CCC) having 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 Promote research and the use of research 24 by: Commissioning a specialist 'Research Management and 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' Have regard to the need to promote education and training 26 for persons who are employed, or who are considering becoming employed, in an activity which See section 14X of the 2006 Act See section 14Y of the 2006 Act To support the Board lead, deputise for him, capacity build, deal with FSF, perhaps even write a strategy to promote research etc

18 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/her related duty27 by: Responsibility for the identification of learning needs of employees being that of the line manager and the employee; 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 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: 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 and 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 ; See section 14Z of the 2006 Act See section 1F(1) of the 2006 Act See section 14Z1 of the 2006 Act See section 223H(1) of the 2006 Act 17 18

19 5.3.2 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 CCC on the position against budgets and key contracts and delivery against all financial duties Ensure its use of resources (both capital and revenue) does not exceed the amount specified by the 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 Take account of any directions issued by the 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 Board 31 Through its Governing Body and governance structures it will principally discharge this function in the same way as set out in paragraph Publish an explanation of how the CCG spent any payment in respect of quality made to it by the 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 Director of Finance; periodic reports to the Governing Body. 5.4 Other Relevant Regulations, Directions and Documents The CCG will: comply with all relevant regulations; comply with directions issued by the Secretary of State for Health or the Board; and take account, as appropriate, of documents issued by the Board 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 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 See sections 223I(2) and 223I(3) of the 2006 Act See section 223J of the 2006 Act See section 223K(7) of the 2006 Act 18 19

20 6. DECISION MAKING: THE GOVERNING STRUCTURE 6.1 Authority to act 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; d) a committee or sub-committee of the CCG. 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 Delegation 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 The CCG remains accountable for all of its functions, including those that it has delegated. 6.3 General 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 See Appendix D See section 4.4 on Principles of Good Governance above See appendix D See appendices C and E 19 20

21 6.3.2 d) comply with the CCG s arrangements for discharging its statutory duties,37 e) Where appropriate, ensure that Member practices have had the opportunity to contribute to the CCG s decision making process. Where the CCG has delegated a function of the group to the Governing Body, the Governing Body may make arrangements for the following to exercise the function on the Governing Body s behalf: a) a committee or sub-committee of the Governing Body (including the audit committee or the remuneration committee); b) a member of the Governing Body; c) a member of the CCG who is an individual and not a member of the Governing Body; d) an individual of a description described in the constitution or in accordance with the relevant terms of reference When discharging their delegated functions of the CCG, the committees and subcommittees of the Governing Body must also operate in accordance with their approved terms of reference Where delegated responsibilities are being discharged collaboratively, the (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 The following committees have been established by the CCG: 37 See chapter 5 above 20 21

22 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; d) Primary Care Commissioning Committee accountable to the Governing Body; and e) Governance sub-committee accountable to the Audit and Integrated Governance Committee. Terms of Reference for the above Committees and Sub-committees are available on the CCG s website Committees will only be able to establish their own sub-committees, to assist them in discharging their respective responsibilities, if this is permitted by their Terms of Reference. 6.5 Joint and Collaborative Arrangements 6.5A Joint commissioning arrangements with other Clinical Commissioning Groups 6.5A.1 6.5A.2 The Clinical Commissioning Group (CCG) may wish to work together with other CCGs in the exercise of its commissioning functions. The CCG may make arrangements with one or more CCG in respect of: 6.5A.2.1 delegating any of the CCG s commissioning functions to another CCG; 6.5A.2.2 exercising any of the commissioning functions of another CCG; or 6.5A.2.3 exercising jointly the commissioning functions of the CCG and another CCG 6.5A.3 For the purposes of the arrangements described at paragraph 6.5A.2, the CCG may: 6.5A.3.1 make payments to another CCG; 6.5A.3.2 receive payments from another CCG; 6.5A.3.3 make the services of its employees or any other resources available to another CCG; or 6.5A.3.4 receive the services of the employees or the resources available to another CCG. 6.5A.4 6.5A.5 Where the CCG makes arrangements which involve all the CCGs exercising any of their commissioning functions jointly, a joint committee may be established to exercise those functions. For the purposes of the arrangements described at paragraph 6.5A.2 above, the CCG may establish and maintain a pooled fund made up of contributions by any 22 21

23 of the CCGs working together pursuant to paragraph 6.5A.2.3 above. Any such pooled fund may be used to make payments towards expenditure incurred in the discharge of any of the commissioning functions in respect of which the arrangements are made. 6.5A.6 Where the CCG makes arrangements with another CCG as described at paragraph 6.5A.2 above, the CCG shall develop and agree with that CCG an agreement setting out the arrangements for joint working, including details of: How the parties will work together to carry out their commissioning functions; The duties and responsibilities of the parties; How risk will be managed and apportioned between the parties; Financial arrangements, including, if applicable, payments towards a pooled fund and management of that fund; Contributions from the parties, including details around assets, employees and equipment to be used under the joint working arrangements. 6.5A.7 6.5A.8 6.5A.9 6.5A A.11 The liability of the CCG to carry out its functions will not be affected where the CCG enters into arrangements pursuant to paragraph 6.5A.2 above. The CCG will act in accordance with any further guidance issued by the NHS Commissioning Board on co-commissioning. Only arrangements that are safe and in the interests of patients registered with member practices will be approved by the Governing Body. The Governing Body of the CCG shall require, in all joint commissioning arrangements, that the lead clinician and lead manager of the lead CCG make a quarterly written report to the governing body and hold at least annual engagement events to review aims, objectives, strategy and progress and publish an annual report on progress made against objectives. Should a joint commissioning arrangement prove to be unsatisfactory the governing body of the CCG can decide to withdraw from the arrangement, but has to give six months notice to partners, with new arrangements starting from the beginning of the next new financial year. 6.5B Joint commissioning arrangements with the NHS Commissioning Board for the exercise of CCG functions 6.5B.1 6.5B.2 The CCG may wish to work together with the Board in the exercise of its commissioning functions. The CCG and the Board may make arrangements to exercise any of the CCG s commissioning functions jointly

24 6.5B.3 6.5B.4 6.5B.5 6.5B.6 The arrangements referred to in paragraph 6.5B.2 above may include other CCGs. Where joint commissioning arrangements pursuant to 6.5B.2 above are entered into, the parties may establish a joint committee to exercise the commissioning functions in question. Arrangements made pursuant to 6.5B.2 above may be on such terms and conditions (including terms as to payment) as may be agreed between the Board and the CCG. Where the CCG makes arrangements with the Board (and another CCG if relevant) as described at paragraph 6.5B.2 above, the CCG shall develop and agree with the Board a framework setting out the arrangements for joint working, including details of: How the parties will work together to carry out their commissioning functions; The duties and responsibilities of the parties; How risk will be managed and apportioned between the parties; Financial arrangements, including, if applicable, payments towards a pooled fund and management of that fund; and Contributions from the parties, including details around assets, employees and equipment to be used under the joint working arrangements. 6.5B.7 6.5B.8 6.5B.9 6.5B B.11 The liability of the CCG to carry out its functions will not be affected where the CCG enters into arrangements pursuant to paragraph 6.5B.2 above. The CCG will act in accordance with any further guidance issued by the Board on co-commissioning. Only arrangements that are safe and in the interests of patients registered with member practices will be approved by the governing body. The Governing Body of the CCG shall require, in all joint commissioning arrangements that the Accountable Officer of the CCG make a quarterly written report to the Governing Body and hold at least annual engagement events to review aims, objectives, strategy and progress and publish an annual report on progress made against objectives. Should a joint commissioning arrangement prove to be unsatisfactory the governing body of the CCG can decide to withdraw from the arrangement, but has to give six months notice to partners, with new arrangements starting from the beginning of the next new financial year after the expiration of the six months notice period

25 6.5C Joint commissioning arrangements with the NHS Commissioning Board for the exercise of the Board s functions 6.5C.1 6.5C.2 The CCG may wish to work with the Board and, where applicable, other CCGs, to exercise specified Board functions. The CCG may enter into arrangements with the Board and, where applicable, other CCGs to: Exercise such functions as specified by the Board under delegated arrangements; Jointly exercise such functions as specified with the Board. 6.5C.3 6.5C.4 6.5C.5 6.5C.6 Where arrangements are made for the CCG and, where applicable, other CCGs to exercise functions jointly with the Board a joint committee may be established to exercise the functions in question. Arrangements made between the Board and the CCG may be on such terms and conditions (including terms as to payment) as may be agreed between the parties. For the purposes of the arrangements described at paragraph 6.5C.2 above, the Board and the CCG may establish and maintain a pooled fund made up of contributions by the parties working together. Any such pooled fund may be used to make payments towards expenditure incurred in the discharge of any of the commissioning functions in respect of which the arrangements are made. Where the CCG enters into arrangements with the Board as described at paragraph 6.5C.2 above, the parties will develop and agree a framework setting out the arrangements for joint working, including details of: How the parties will work together to carry out their commissioning functions; The duties and responsibilities of the parties; How risk will be managed and apportioned between the parties; Financial arrangements, including payments towards a pooled fund and management of that fund; Contributions from the parties, including details around assets, employees and equipment to be used under the joint working arrangements. 6.5C.7 6.5C.8 The liability of the Board to carry out its functions will not be affected where it and the CCG enter into arrangements pursuant to paragraph 6.5C.2 above. The CCG will act in accordance with any further guidance issued by the Board on co-commissioning

26 6.5C.9 Only arrangements that are safe and in the interests of patients registered with member practices will be approved by the governing body. 6.5C.10 The Governing Body of the CCG shall require, in all joint commissioning arrangements that the Accountable Officer of the CCG make a quarterly written report to the governing body and hold at least annual engagement events to review aims, objectives, strategy and progress and publish an annual report on progress made against objectives. 6.5C.11 Should a joint commissioning arrangement prove to be unsatisfactory the governing body of the CCG can decide to withdraw from the arrangement, but has to give six months notice to partners, with new arrangements starting from the beginning of the next new financial year after the expiration of the six months notice period. 6.5D Collaborative Arrangements 6.5D.1 The CCG has entered into collaborative arrangements with the Clinical Commissioning Groups from South Yorkshire and Bassetlaw, Hardwick and North Derbyshire, for the CCG Collaborative Commissioning Arrangements (known as "CCGCOM"). The CCG has entered into a Memorandum of Understanding to support this arrangement. NHS Sheffield CCG will formally establish a Joint Committee with other CCGs under section 6.5A of this Constitution under the wider Commissioners Working Together arrangements. The Joint Committee will have Terms of Reference and a Scheme of Delegation which will be approved by the Governing Bodies of those CCGs who will be members of the Joint Committee. The Terms of Reference for the Joint Committee will be available on the CCG s website. 6.5D.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 collaborative 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 Functions - the Governing Body has the following functions conferred on it by sections 14L(2) and (3) of the 2006 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: 38 See section 14L(3)(c) of the 2006 Act 25 26

27 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; 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; 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 Annual Public Meeting (APM); j) prepare the annual report to present to the Members and the public at the APM; 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) o) co-ordinate and plan for demand, financial and investment needs of the CCG; approve the CCG s arrangements for business continuity and emergency planning. See section 4.4 on Principles of Good Governance above See section 14L(5) of the 2006 Act 26 27

28 6.6.2 Composition of the Governing Body - the Governing Body shall not have less than 15 voting Members, of which the biggest group will be GPs made up of Locality nominated GPs and Elected GPs. The Governing Body will comprise: 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 the practices in each Locality) to represent all Members in that Locality); c) Four other GPs who are elected by Member practices; d) Four Lay Members: i) one to lead on audit, governance, strategy and act as the Audit and Integrated Governance Committee (AIGC) Chair, Conflicts of Interest and Whistleblowing Guardian and the Lay Member to oversee NHS Security Management services (as per PFP 4.5); ii) two to lead on patient and public participation matters; iii) one to lead on primary care commissioning (who should not be the Audit and Integrated Governance Committee Chair); Iv) one to lead on remuneration; v) one to lead on quality assurance and act as the Chair of the Quality Assurance Committee; iv) The Governing Body s Deputy Chair as set out in paragraph 7.6, will also be the Chair of the Primary Care Commissioning Committee. e) one registered nurse; f) one secondary care specialist doctor; g) the Accountable Officer; h) the Director of Finance; i) other individuals: i) ii) iii) iv) 41 the Director of Delivery Care Outside of Hospital; the Director of Strategy and Integration; the Director of Commissioning and Performance; and the Medical Director41 See Appendix C section of the Standing Orders

29 The Governing Body may invite such other person(s) to attend all or any of its meetings, or part(s) of a meeting, in order to assist it in its decision-making and in its discharge of its functions as it sees fit. Any such person may speak and participate in debate, but may not vote 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 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 and requirements 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 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 AIGC will also act as the CCG s Auditor Panel. The Governing Body approves and keeps under review the terms of reference for the committee, which includes information on its membership. 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 is 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 membership. 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 29 28

30 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 membership. 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 membership. d) Primary Care Commissioning Committee - is accountable to the CCG s Governing Body. The Committee has been established to enable the members to make collective decisions on the review, planning and procurement of primary care services in Sheffield under delegated authority from the Board. In performing its role, the Committee will exercise its management of the functions in accordance with the agreement entered into between the Board and the CCG which will sit alongside the delegation and terms of reference of the Committee. The role of the Committee shall be to carry out the functions relating to the commissioning of primary medical services under section 83 of the NHS Act. This includes the following: i) GMS, PMS and APMS contracts (including the design of PMS and APMS contracts, monitoring of contracts, taking contractual action such as issuing branch/remedial notices, and removing a contract); ii) Newly designed enhanced services ( Local Enhanced Services and Directed Enhanced Services ); iii) Design of local incentive schemes as an alternative to the Quality Outcomes Framework (QOF); iv) Decision making on whether to establish new GP practices in an area; v) Approving practice mergers; and vi) Making decisions on discretionary payment (e.g., returner/retainer schemes). The CCG will also carry out the following activities: vii) To plan, including needs assessment, primary medical care services in Sheffield; viii) To undertake reviews of primary medical care services in Sheffield; ix) To co-ordinate a common approach to the commissioning of primary care services generally; x) To manage the budget for commissioning of primary medical care services in Sheffield; and xi) Approval of the recommendations from the special cases advisory group

31 7. ROLES AND RESPONSIBILITIES 7.1 Practice Representatives 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 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 Director of Finance of the CCG by an authorised representative of the relevant practice Each Member may remove and replace their practice representative at any time, by notice in writing to the Director of Finance of the CCG signed by an authorised representative of the relevant practice For the avoidance of doubt, the Governing Body shall be entitled to treat any Practice Representative as having the continuing authority given to him/her until it is notified in writing of the removal of that Practice Representative in accordance with paragraph 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 Locality Arrangements The CCG is supported by four strong localities: a) North Locality b) Central Locality c) West Locality d) Hallam and South Locality Each Locality shall nominate one Clinical Lead to sit on the Governing Body to represent and act on behalf of its local membership. The role of each Locality Lead is to maintain a balance of work as a member of the Governing Body and within the Locality in order to: e) Contribute to the leadership and development of the Group commensurate with the delegated functions of the Governing Body, including the development and approval of a Strategic Plan and ensuring that financial controls and systems of risk management are robust and effective. f) Undertake a portfolio of designated clinical commissioning strategic work 31 30

32 g) Adhere to and contribute to the development of high standards of probity and governance within the Governing Body and the Locality and ensure that activities remain within the terms of its authorisation as agreed and as defined in this Constitution and accompanying Scheme of Delegation. h) Represent the views of Member Practices on the Governing Body, bringing an understanding of those Member Practices to the discussion and decision making of the Governing Body. i) Ensure effective two-way communication between Member Practices and the Governing Body and any Committees of the Governing Body. 7.3 Other GP and Primary Care Healthcare Professionals 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. 7.4 Members of the CCG s Governing Body 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. 7.5 Chair of the Governing Body The Chair of the Governing Body is responsible for: a) leading the Governing Body, ensuring it remains continuously able to discharge its duties and responsibilities as set out in this Constitution; b) building and developing the 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 Accountable Officer in discharging the responsibilities of the organisation; f) contributing to building a shared vision of the aims, values and culture of the organisation; 32 31

33 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 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) 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 Board. 7.6 Deputy Chair of the Governing Body Whilst the Chair is a clinician, the Deputy Chair of the Governing Body shall be the Lay Member of the Governing Body who leads on primary care commissioning and s/he shall deputise for the Chair of the Governing Body where the chair has a conflict of interest or is otherwise unable to act. 7.7 Role of the Accountable Officer The Accountable Officer of the CCG is a member of the Governing Body This role of Accountable Officer has been summarised in a national document46 as: 46 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 National Audit Office) is embodied and that safeguarding of funds is ensured through effective financial and management systems; c) working closely with the chair of the Governing Body, the Accountable Officer will ensure that proper constitutional, governance and development NHS Commissioning Board Authority s Clinical commissioning CCG Governing Body Members: Role outlines, attributes and skills 32 33

34 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 In addition to the Accountable Officer's general duties, where the Accountable Officer is also the senior clinical voice of the CCG, they will take the lead in interactions with stakeholders, including the Board The Governing Body may authorise the Accountable Officer to fulfil this role for more than one clinical commissioning group (such appointment is referred to as a "joint appointment") at its discretion. 7.8 Role of the Director of Finance The Director of Finance 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 This role of Director of Finance has been summarised in a national document47 as: 47 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; 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 Board; and f) ensuring the discharge of obligations by the CCG under relevant financial directions including: See the latest version of the NHS Commissioning Board Authority s Clinical commissioning CCG Governing Body Members: Role outlines, attributes and skills 33 34

35 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; 7.9 Role of the Secondary Care Specialist Doctor The Secondary Care Specialist Doctor is a member of the Governing Body and brings a broader view on health and care issues to underpin the work of the CCG, specifically an understanding of patient care in the secondary care setting The role of the Secondary Care Specialist Doctor is summarised in the NHS Commissioning Board Authority s Clinical Commissioning Group Governing Body members: Role outlines, attributes and skills as: a) Must be a secondary care specialist either currently or recently employed in a secondary care setting, and who has a high level of understanding of how care is delivered in a secondary care setting. b) Be highly regarded as a clinical leader, preferably with experience working as a leader across more than one clinical discipline and/or specialty with a track record of collaborative working. c) Be competent, confident and willing to give an independent strategic clinical view on all aspects of CCG clinical and management agenda, and draw on their in depth understanding of secondary care to add value. d) Able to contribute a generic view from the perspective of a secondary care doctor whilst putting aside specific issues relating to their own clinical practice or their employing organisation s circumstances; and be able to provide an understanding of how secondary care providers work within the health system to bring appropriate insight to discussions regarding service re-design, clinical pathways and system reform. e) Able to provide an understanding of how secondary care providers work within the health system to bring appropriate insight to discussions regarding service re-design, clinical pathways and system reform Role of the Registered Nurse (as undertaken by the Chief Nurse) As well as sharing responsibility with the other members of the Governing Body for all aspects of the CCG Governing Body business, as a registered nurse, this 34 35

36 person will bring a broader view, from their perspective on health care issues to underpin the work of the CCG, especially the contribution of nursing to patient care The role of the Registered Nurse is undertaken by the Chief Nurse and is summarised as: a) Being a registered nurse who has developed a high level of professional expertise and knowledge. b) Competent, confident and willing to give an independent strategic clinical view on all aspects of CCG business. c) Highly regarded as a clinical leader, demonstrably able to think beyond their own professional viewpoint. d) Able to take a balanced view of the clinical and management agenda and draw on their specialist skills to add value. e) Able to contribute a generic view from the perspective of a registered nurse whilst putting aside specific issues relating to their own clinical practice or employing organisation s circumstances. f) Able to bring detailed insights from nursing perspectives into discussions regarding service re-design, clinical pathways and system reform and develop a culture of continual quality improvement. g) Maintain general oversight of research and development; h) Ensure that services commissioned by the CCG are effectively performance managed and quality assured; i) Ensure that appropriate management processes are in place for commissioned services such that the CCG can be assured that quality standards are met and that there is full compliance with contractual expectations, statutory requirements and economic regulation and that where necessary, effective remedial action is taken swiftly Role of the Director of Delivery Care Outside of Hospital The Director of Delivery Care Outside of Hospital is a member of the Governing Body The role can be summarised as: a) Being responsible for ensuring the implementation of the CCG s plans for care outside of hospital and the integration of services across health, social care and the voluntary sector

37 b) Leading the development and delivery of the Primary Care Strategy and the sustainability of Primary Care. c) Leading on aging better, long term conditions and the management of the intermediate care and community contracts d) Ensuring that the operational delivery of the CCG s care outside of hospital programme is effective and supports the practices and Localities with effective commissioning support. e) Leading on communications, engagement and equality on behalf of the CCG, including any requirements for formal consultation. f) Ensuring collaborative working across multiple agencies specifically leading and influencing across health and social care demonstrating a broad understanding of the interdependencies and interrelationships between primary care, community and Local Authority. g) Being the CCG s lead officer for Emergency Preparedness, Resilience and Response (EPRR) 7.12 Role of the Medical Director The Medical Director is a member of the Governing Body The role of the Medical Director will focus on the development of strong and effective clinical relationships and the ongoing accountability relationship within the Governing Body and the Board. The role can be summarised as: a) Ability to support the clinical leaders of the CCG to develop and maintain a systematic approach to ensuring the CCG remains clinically led and clinically accountable. b) Contribute to the senior leadership of the CCG, supporting the Chair and other members to ensure that the Governing Body remains properly constituted and delivers its functions as required by the NHS Act 2006 as amended by the Health and Social Care Act 2012 c) Develop and maintain collaborative and partnering relationships that will further the objectives of the CCG to enable the CCG to work collaboratively with other CCGs and other partners to achieve shared outcomes, where appropriate; 7.13 Role of the Director of Strategy and Integration The Director of Strategy and Integration is a member of the Governing Body The role is summarised as: a) Production and delivery of the Sheffield Place based plan 37 36

38 b) The CCG lead for Better Care Fund c) Acting as the CCG s representative on the Transforming Sheffield Board d) Leading the Health and Wellbeing agenda e) Leading the Whole System Urgent Care, Flow and A & E Delivery Board f) Acting as the lead for Children s Commissioning, including transition g) Acting as the lead for Transforming Care (Learning Disabilities), Inclusion Board and Mental Health/Learning Disability Commissioning h) Acting as the CCG s link with Public Health 7.14 Role of the Director of Commissioning and Performance The Director of Commissioning and Performance will be a member of the Governing Body The role is summarised as: a) Acting as the Senior Information Risk Owner (SIRO) as detailed in Appendix E - Prime Financial Policies section 15.3 and having responsibility for business intelligence, IT and digital road maps b) Having responsibility for the delivery of the CCG s Quality, Innovation, Productivity and Prevention (QIPP) schemes c) Act as lead for external commissioning partnerships including the Sustainability and Transformation Plan d) Lead Strategic/Specialised Commissioning for Sheffield and across South Yorkshire e) Act as the lead for the Yorkshire Ambulance Service contract, cancer services and Right Care and commissioning support providers f) Developing new contracting mechanisms g) Leading on procurement h) Managing the Project Management Office i) Having responsibility for corporate performance, performance link to NHS Commissioning Board and Governing Body reporting and overseeing NHS Commissioning Board Assurance process 38 37

39 7.15 Role of the Lay Members The Lay Members are members of the Governing Body. They bring a strategic, but impartial external view to the work of the CCG that is removed from the dayto-day running of the organisation. There are four Lay Members, each with lead roles as well as sharing responsibility with the other members for all aspects of Governing Body business. These roles are detailed in section (d) of the Constitution) The role of the Lay Member with a lead role in overseeing key elements of financial management, audit and governance is summarised in the national document Clinical Commissioning Group Governing Body Members: Role outlines, attributes and skills; April 2012 as: a) Bringing specific expertise and experience to the work of the Governing Body, as well as his/her knowledge as a member of the local community; b) Providing strategic and impartial focus, so as to provide an external view of the work of the CCG that is removed from the day to day running of the CCG; c) Overseeing key elements of governance including audit and managing conflicts of interest and act as Conflicts of Interest Guardian as detailed in the Conflicts of Interest Protocol sections 2.1 and 4.6; d) Having the ability to chair meetings effectively, including chairing the Audit and Integrated Governance Committee; e) Being able to give an independent view on possible internal conflicts of interest; and f) Having recent and relevant financial and audit experience to enable engagement with financial management and reporting in the organisation and associated assurances. g) Ensuring the Governing Body and CCG members behave with the utmost probity at all times In addition to the general responsibilities of all Governing Body members, the Lay Member of the Governing Body with the lead role in championing patient and public participation is responsible for: a) bringing specific expertise and experience to the work of the Governing Body, as well as his/her knowledge as a member of the community; b) providing strategic and impartial focus, so as to provide an external view of the work of the CCG that is removed from the day-to-day running of the organisation; 39 38

40 c) helping to ensure that the public voice of the local population is heard in all aspects of CCG business and those opportunities are created and protected for patient and public empowerment in the work of the CCG; d) ensuring that patients and public views are heard and their expectations understood and met as appropriate; e) ensuring that the CCG builds and maintains an effective relationship with Healthwatch and draws on existing patient and public engagement and involvement expertise; f) ensuring that the CCG has appropriate arrangements in place to secure public and patient involvement As well as sharing responsibility with the other members for all aspects of Governing Body business, Lay Members will be identified to support and oversee key arrangements in respect of primary care commissioning. Their focus will be strategic and impartial, providing an external view of the work of the CCG that is removed from the day-to-day running of the organisation. The Lay Member primary care commissioning support role can be summarised as: a) bringing specific expertise and experience of Primary Care Commissioning together with wider healthcare leadership experience to the work of the Governing Body, as well as his/her knowledge as a member of the local community; b) facilitating the development of primary care as an integral part of the healthcare system, ensuring objectivity and impartiality as the non-clinical Chair of the Primary Care Commissioning Committee; c) providing strategic and impartial focus, so as to provide an external view of the work of the CCG that is removed from the day-to-day running of the CCG; d) chairing the Primary Care Commissioning Committee; e) ensuring the Primary Care Commissioning Committee conforms with best practice on managing conflicts of interest at all times 40 39

41 8. STANDARDS OF BUSINESS CONDUCT AND MANAGING CONFLICTS OF INTEREST 8.1 Standards of Business Conduct 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 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 available on the CCG s website 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 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 which is available on the CCG s website. 8.3 Register of Interests 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 The registers will be published on the CCG s website The Director of Finance will ensure that the registers of interest are reviewed regularly, and updated as necessary

42 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 recognises and confirms that nothing in or referred to in this Constitution (including in relation to the issue of any press release or other public statement or disclosure) will prevent or inhibit the making of any protected disclosure (as defined in the Employment Rights Act 1996, as amended by the Public Interest Disclosure Act 1998, and as amended by the Enterprise and Regulatory Reform Act 2013) by any member of the CCG, any member of its Governing Body, any member of any of its committees or sub-committees or the committees or sub-committees of its Governing Body, or any employee of the CCG or of any of its Members, nor will it affect the rights of any worker (as defined in that Act) under that Act 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

43 10. TRANSPARENCY, WAYS OF WORKING AND STANDING ORDERS 10.1 General The CCG will publish annually a commissioning plan and an annual report, presenting the CCG s annual report to a public meeting 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 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 Standing Orders 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 set out the arrangements for managing the CCG s financial affairs

44 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); "Accountable 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 Group" The Sheffield Area Prescribing Group (APG) is a sub-group of the Clinical Commissioning Committee (CCC) which makes recommendations on local prescribing practice. "Audit and Integrated Governance Committee" the Committee of the CCG accountable to the Governing Body as set out at paragraph 6.6.5(a) of this Constitution; "Board" The term Board in these documents refers to the NHS Commissioning Board, which is also known as NHS England; 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, whose Constitution this is; "CCGCOM" South Yorkshire and Bassetlaw CCG Commissioning Network; "Chair of the Governing Body" the individual appointed by the CCG to act as chair of the Governing Body; 1 44

45 "Clinical Commissioning Committee" or CCC The Clinical Commissioning Committee (CCC) brings together CCG localities, QIPP programme leads and account managers for the major provider contracts. The Committee considers performance against the annual QIPP plan and contracts and considers business cases. "Clinical Commissioning Group" a body corporate established by the NHS Commissioning Board in accordance with Chapter A2 of Part 2 of the 2006 Act (as inserted by section 10 of the 2012 Act); "Clinical Reference Group" The Clinical Reference Group supports the decision making and governance processes of the Clinical Commissioning Group, by providing advice and recommendations, via the CCC. The Clinical Reference Group and its associated Forum seeks to underpin clinically led commissioning through work on service redesign, education and governance. Commissioning Means the process for determining the need for and for obtaining the supply of healthcare and related services by the CCG within available resources. "Committee" or Sub 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 Protocol" the CCG's Protocol for managing conflicts of interest which is available on the CCGs website; "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 Unit" Provides consultant led specialist expertise relating to dental services, oral health improvement and health protection. Deputy-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 "Director of Finance" The Director of Finance will perform the duties of the Chief Finance Officer as set out in Regulation 11 (5) of the National Health Service (Clinical Commissioning Groups) Regulations They are the qualified accountant employed by the CCG with responsibilities for financial strategy, financial management and financial governance. The Director of Finance will also act as Governing Body Secretary. "Equality Act" the Equality Act 2010; 2 45

46 Financial Directions "Financial Year" General Practitioner or GP "Governing Body" "Governing Body Member" Means any and all Directions made by the Secretary of State from time to time which relate to financial entitlements and/or requirements 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; a medical practitioner whose name is included in the General 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 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; any Member appointed to the Governing Body of the CCG; Healthcare Professional "Lay Member" Locality "Locality Executive Group" or "LEG" "Medical Director" "Medicines Management Team" "Member" 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 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; A largely geographical grouping of Member practices Each Locality has a Locality Executive Group whose membership and terms of reference is determined by its Member practices Medical Director appointed to the Governing Body in accordance with paragraph of the Standing Orders; A team that includes pharmacists and technicians and provides advice and support on the safe, clinically effective and cost efficient use of medicines 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; 46 3

47 "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 NHS Commissioning Board Also referred to in these documents as the Board or NHS England 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 Accountable Officer, the Director of Finance, the Chief Nurse, the Medical Director, the Director of Delivery Care Outside of Hospital, the Director of Strategy and Integration and the Director of Commissioning and Performance "Public Sector Equality Duty" the duty set out in Section 149 of the Equality Act 2010; "Practice Representatives" an individual appointed by a practice (who is a Member of the 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); Primary Care Commissioning Committee the Committee of the CCG accountable to the Governing Body as set out at paragraph 6.6.5(d) of this Constitution; Prime Financial Policies or PFPs Means the main financial policies the CCG will adhere to. They are supported by detailed financial policies. "Public Health Core Offer" The offer from Sheffield City Council in relation to Public Health 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 Committee" the Committee of the CCG accountable to the Governing Body as set out at paragraph 6.6.5(c) of this Constitution; "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 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 Committee" the Committee of the CCG accountable to the Governing Body as set out at paragraph 6.6.5(b) of this Constitution; SOs Means Standing Orders 4 47

48 "Special Resolution" a resolution of 67% or more of Member practices through their Practice Representatives either at a Members Council meeting or by written resolution 48 5

49 Appendix B List of Members 85 practices listed by localities Locality PRACTICE_NAME PRACTICE ADDRESS Town PCode Central Abbey Lane Surgery 23 Abbey Lane Sheffield S8 0BJ Central Baslow Road,Shoreham Street and York Road 148 Baslow Road, Totley Sheffield S17 4DR Surgeries Central Carrfield Medical Centre Carrfield Street Sheffield S8 9SG Central Clover City Practice 1 Mulberry Street Sheffield S1 2PJ Central Clover Group Practice Highgate Surgery, Highgate, Sheffield S9 1WN Tinsley Central Darnall Health Centre (Mehrotra) 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 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 Veritas Health Centre Chesterfield Rd Sheffield S8 0RT Central White House Surgery 1 Fairfax Rise Sheffield S2 1SL Central Woodseats Medical Centre 4 Cobnar Road Sheffield S8 8QB HAS Avenue Medical Practice 7 Reney Avenue Sheffield S8 7FH HAS Birley Health Centre 120 Birley Lane Sheffield S12 3BP HAS Carterknowle And Dore Medical Practice 1 Carterknowle Road Sheffield S7 2DW HAS Charnock Health Primary Care Centre White Lane Sheffield S12 3GH HAS Falkland House 2a Falkland Road Sheffield S11 7PL HAS Greystones Medical Centre 33 Greystones Rd Sheffield S11 7BJ HAS Hackenthorpe Medical Centre Main Street, Hackenthorpe Sheffield S12 4LA HAS Jaunty Springs Health Centre 53 Jaunty Way Sheffield S12 3DZ HAS Manchester Road Surgery 484 Manchester Road Sheffield S10 5PN HAS Meadowgreen Health Centre Old School Medical Centre, Sheffield S8 7RL School Lane HAS Mosborough Health Centre 34 Queen Street Sheffield S20 5BQ HAS Nethergreen Surgery Nethergreen Road Sheffield S11 7EJ HAS Owlthorpe Medical Centre Moorthorpe Bank Sheffield S20 6PD HAS Richmond Medical Centre 462 Richmond Road Sheffield S13 8NA HAS Rustlings Road Medical Centre 105 Rustlings Road Sheffield S11 7AB HAS Selborne Road Medical Centre 1 Selborne Road Sheffield S10 5ND HAS Sothall Medical Centre 24 Eckington Road Sheffield S20 1HQ HAS Stonecroft Medical Centre 871 Gleadless Road Sheffield S12 2LJ HAS The Hollies Medical Centre 20 St Andrews Road Sheffield S11 9AL HAS The Medical Centre Crystal Peaks 15 Peaks Mount Sheffield S20 7HZ HAS Totley Rise Medical Centre 96 Baslow Road Sheffield S17 4DQ HAS Westfield Health Centre Westfield Northway Sheffield S20 8NZ HAS Woodhouse Health Centre 5-7 Skelton Lane, Woodhouse Sheffield S13 7LY North Barnsley Road Surgery 899 Barnsley Road Sheffield S5 0QJ 49 1

50 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 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, Sheffield S35 8NX Grenoside 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 Upperthorpe Medical Centre 30 Addy Street, Upperthorpe Sheffield S6 3FT 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 Stannington Medical Centre (Shurmer) Uppergate Road Sheffield S6 6BX West Stocksbridge Medical Group Johnson Street, Stocksbridge Sheffield S36 1BX 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 Walkley House Medical Centre 23 Greenhow Street Sheffield S6 3TN 50 2

51 85 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 HAS Barnsley Road Surgery 899 Barnsley Road Sheffield S5 0QJ North Baslow Road, Shoreham Street and York 148 Baslow Road, Totley Sheffield S17 4DR Central Road Surgeries Birley Health Centre 120 Birley Lane Sheffield S12 3BP HAS 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 HAS Charnock Health Primary Care Centre White Lane Sheffield S12 3GH HAS Clover City GP Practice 1 Mulberry Street Sheffield S1 2PJ Central 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 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 HAS Far Lane Medical Centre 1 Far Lane Sheffield S6 4FA West Firth Park Surgery 400 Firth Park Road Sheffield S5 6HH North Foxhill Medical Centre 363 Halifax Road Sheffield S6 1AF North Gleadless Medical Centre 636 Gleadless Road Sheffield S14 1PQ Central Grenoside Surgery 60 Greno Crescent, Grenoside Sheffield S35 8NX North Greystones Medical Centre 33 Greystones Rd Sheffield S11 7BJ HAS Hackenthorpe Medical Centre Main Street, Hackenthorpe Sheffield S12 4LA HAS 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 HAS Manchester Road Surgery 484 Manchester Road Sheffield S10 5PN HAS 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 Meadowgreen Health Centre Old School Medical Centre, Sheffield S8 7RL HAS School Lane Mill Road Surgery 98a Mill Road Sheffield S35 9XQ North Mosborough Health Centre 34 Queen Street Sheffield S20 5BQ HAS Nethergreen Surgery Nethergreen Road Sheffield S11 7EJ HAS 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 HAS Page Hall Medical Centre 101 Owler Lane Sheffield S4 8GB North 51 3

52 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 HAS Rustlings Road Medical Centre 105 Rustlings Road Sheffield S11 7AB HAS Selborne Road Medical Centre 1 Selborne Road Sheffield S10 5ND HAS Sharrow Lane Medical Centre 129 Sharrow Lane Sheffield S11 8AN Central 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 HAS Southey Green Medical Centre 281 Southey Green Road Sheffield S5 7QB North Stannington Medical Centre (Shurmer) Uppergate Road Sheffield S6 6BX West Stocksbridge Medical Group Johnson Street, Stocksbridge Sheffield S36 1BX West Stonecroft Medical Centre 871 Gleadless Road Sheffield S12 2LJ HAS 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 HAS The Mathews Practice Belgrave Belgrave MC, 22 Asline Road Sheffield S2 4UJ Central The Medical Centre 1a Ingfield Avenue Sheffield S9 1WZ Central The Medical Centre Crystal Peaks 15 Peaks Mount Sheffield S20 7HZ HAS Totley Rise Medical Centre 96 Baslow Road Sheffield S17 4DQ HAS 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 North Upwell Street Surgery 93 Upwell Street Sheffield S4 8AN North Veritas Health Centre Chesterfield Rd Sheffield S8 0RT Central Walkley House Medical Centre 23 Greenhow Street Sheffield S6 3TN West Westfield Health Centre Westfield Northway Sheffield S20 8NZ HAS 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 HAS Woodseats Medical Centre 4 Cobnar Road Sheffield S8 8QB Central 52 4

53 APPENDIX C STANDING ORDERS For NHS SHEFFIELD CLINICAL COMMISSIONING GROUP 53 1

54 CONTENTS SECTION A INTERPRETATION AND DEFINITIONS FOR STANDING ORDERS, SCHEME OF RESERVATION AND DELEGATION AND PRIME FINANCIAL POLICIES SECTION B STANDING ORDERS INTRODUCTION Statutory Framework NHS Framework Delegation of Powers CCG: COMPOSITION OF MEMBERSHIP, TENURE AND ROLE OF MEMBERS Composition of Membership Key Roles eligibility, appointments process, term of office etc a) Chair b) Locality GP representatives c) Elected GP representatives d) Lay Members e) Accountable Officer f) Director of Finance g) Chief Nurse h) Secondary Care specialist doctor i) Medical Director j) Director of Delivery Care Outside of Hospital, Director of Strategy and Integration and Director of Commissioning and Performance k) Deputy Chair Joint Members MEETINGS OF THE CCG AND CCG S GOVERNING BODY Calling meetings Notice of meetings agendas, supporting papers and business to be transacted Petitions Chair of meeting Chair s ruling Quorum of Governing Body Decision making including voting of the Governing Body Emergency powers and urgent decisions Suspension of Standing Orders Record of Attendance Minutes Admission of public and the press Page

55 CONTENTS Page 3.13 Observers at CCG and Governing Body meetings APPOINTMENT OF COMMITTEES AND SUB-COMMITTEES Appointment of Committees and Sub-committees Terms of Reference Delegation of powers by Committees to Sub-committees Approval of appointments to Committees and Sub-committees DUTY TO REPORT NON COMPLIANCE WITH STANDING ORDERS AND PRIME FINANCIAL POLICIES CUSTODY OF SEAL AND AUTHORISATION OF DOCUMENTS CCG s seal Signature of documents OVERLAP WITH OTHER CCG POLICY STATEMENTS/PROCEDURES, REGULATIONS Policy statements: general principles DUTIES AND OBLIGATIONS OF GOVERNING BODY MEMBERS AND CCG SENIOR MANAGERS UNDER THE STANDING ORDERS Requirements for declaring interests Register of Interests INDEMNITY FOR GOVERNING BODY MEMBERS

56 SECTION A 1. INTERPRETATION AND DEFINITIONS FOR STANDING ORDERS, SCHEME OF RESERVATION AND DELEGATION AND PRIME FINANCIAL POLICIES 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 Accountable Officer or Director of Finance). 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); "Accountable 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 Group" The Sheffield Area Prescribing Group (APG) is a sub-group of the Clinical Commissioning Committee (CCC) which makes recommendations on local prescribing practice. "Audit and Integrated Governance Committee" The Committee of the CCG accountable to the Governing Body as set out at paragraph 6.6.5(a) of the Constitution; "Board" The term Board in these documents refers to the NHS Commissioning Board, which is also known as NHS England; 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. 4 56

57 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 Body" The individual appointed by the CCG to act as chair of the 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 Deputy-Chair of the CCG if the Chair is absent from the meeting or is otherwise unavailable. "Clinical Commissioning Committee" or "CCC The advisory executive team to the Governing Body "Clinical Commissioning Group" A body corporate established by the NHS Commissioning Board in accordance with Chapter A2 of Part 2 of the 2006 Act (as inserted by section 10 of the 2012 Act); "Clinical Reference Group" The Clinical Reference Group supports the decision making and governance processes of the Clinical Commissioning Group, by providing advice and recommendations, via the CCC. The Clinical Reference Group and its associated Forum seeks to underpin clinically led commissioning through work on service redesign, education and governance. Commissioning Means the process for determining the need for and for obtaining the supply of healthcare and related services by the CCG within available resources. "Committee or Subcommittee" 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 Protocol" The CCG's Protocol for managing conflicts of interest "Constitution" The CCG s 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 Unit" Provides consultant led specialist expertise relating to dental services, oral health improvement and health protection. 5 57

58 Deputy-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 "Director of Finance" The Director of Finance will perform the duties of the Chief Finance Officer as set out in Regulation 11 (5) of the National Health Service (Clinical Commissioning Groups) Regulations They are the qualified accountant employed by the CCG with responsibilities for financial strategy, financial management and financial governance. The Director of Finance will also act as Governing Body Secretary. "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 GP A medical practitioner whose name is included in the General 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 Member" Any member appointed to the Governing Body of the CCG; Healthcare Professional 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 "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 Group" or "LEG" Each Locality has a Locality Executive Group whose membership and terms of reference is determined by its Member practices "Medical Director" Medical Director appointed to the Governing Body in accordance with paragraph of the Standing Orders; 6 58

59 "Medicines Management Team" A team that includes pharmacists and technicians and provides advice and 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 the CCG s 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 NHS Commissioning Board Also referred to in these documents as the Board or NHS England 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 Accountable Officer, the Director of Finance, the Chief Nurse, the Medical Director, the Director of Delivery Care Outside of Hospital, the Director of Strategy and Integration and the Director of Commissioning and Performance "Public Sector Equality Duty" The duty set out in Section 149 of the Equality Act 2010; "Practice Representatives" An individual appointed by a practice (who is a Member of the 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); Primary Care Commissioning Committee the Committee of the CCG accountable to the Governing Body as set out at paragraph 6.6.5(d) of this Constitution; Prime Financial Policies or PFPs Means the main financial policies the CCG will adhere to. They are supported by detailed financial policies. "Public Health Core Offer" The offer from Sheffield City Council in relation to Public Health 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 Committee" The Committee of the CCG accountable to the Governing Body as 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; 7 59

60 "Registers of Interests" "Remuneration Committee" SOs "Special Resolution" 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; The Committee of the CCG accountable to the Governing Body as set out at paragraph 6.6.5(b) in the Constitution; Means Standing Orders a resolution of 67% or more of Member practices through their Practice Representatives either at a Members Council meeting or by written resolution 60 8

61 SECTION B STANDING ORDERS 1. INTRODUCTION 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 business conduct. e) The process for appointment of Governing Body Members. 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 Statutory Framework 1.5 NHS Sheffield Clinical Commissioning Group is a statutory body which came into existence on 1 April 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. 61 9

62 1.8 The CCG will also be bound by such other statutes and legal provisions which govern the conduct of its affairs. 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 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 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 2.1 Composition of Membership Chapter 3 of the CCG s Constitution provides details of the membership of the CCG 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). 2.2 Key Roles Paragraph 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 Chair a) Nomination One nomination from each of the four localities 62 10

63 b) Eligibility The individual must be a GP from a member practice, must meet the required competencies for the role as set out in paragraph 7.5 of the Constitution and in terms of the initial appointment have passed the national assessment centre for CCG Clinical Leaders. c) Appointment process Where there is more than one nomination, appointment would be by private ballot with a candidate having over 50% of the votes from the Governing Body Members present and voting at a meeting called in accordance with Paragraph 3.7 below. Each member eligible to vote may only vote for one candidate. If there is an equal vote between candidates the voting will be re-opened. If there is an equal vote between candidates, or no candidate has over 50% of the votes, then the voting will be re-opened with the two highest rated nominees alone. The returning officer for all election results is the Accountable Officer only. The Remuneration Committee will oversee the process d) Term of office The Chair will be appointed for a term of office up to three years e) Eligibility for reappointment Post to be advertised before end of term of office. The post holder is eligible for reappointment as long as they still meet the eligibility criteria set out in paragraph 7.5 of the constitution and continue to meet the requirements of the person specification and job role, and are re-elected by a vote of the Members as described in paragraph 3.7 Decision Making including Voting of the Governing Body, and that they have not served more than 9 consecutive years on the Governing Body. f) Grounds for removal from office On application of the disqualification criteria set out below, the Governing Body may remove the Chair from post immediately; i) If a receiving order is made against them or they make any arrangement with their creditors. ii) iii) If in the opinion of the Governing Body (having taken appropriate professional advice in cases where it is deemed necessary) they become or are deemed to have developed mental or physical illness which prohibits or inhibits their ability to undertake their role. If they cease to be a provider of primary medical services, or be engaged in or employed to deliver primary medical services with a member practice. iv) Where the level of competence is questioned and the vote indicated at least 67% of the Governing Body lacked confidence. v) Where they are no longer a GP on the Governing Body as described in below 63 11

64 g) Notice period The Chair must give at least 3 months notice in writing to the Accountable Officer on behalf of the Governing Body Locality GP representatives a) Nomination As set out in paragraph 7.2 of the Constitution. b) Eligibility The individual must be a GP with a member practice in the relevant locality and meet the job description and person specification for the role previously approved by the Governing Body. They should not be disqualified from membership of a CCG under the 2012 Regulations. c) Appointment process i) Request for nominations from the relevant locality by the Governing Body ii) iii) iv) Completion of application documentation Candidates will be formally assessed by an Assessment Panel, against a list of essential and desirable competencies drawn from relevant national guidance. If more than one candidate in the relevant locality meets the specified competencies an election will take place. v) Election by a simple majority of votes cast with one vote per member practice within each locality. Members will only be able to vote for a GP in their locality. vi) Should only one candidate in the relevant locality meet the specified competencies apply, an election will not take place. v) Localities to confirm nomination to Governing Body d) Term of office Appointment will be for a term of office up to three years. Where a Locality Lead has an extended period of maternity leave, sickness absence or equivalent during their term of office, the Locality will be asked to nominate a representative to cover the Locality Lead position during the identified period and should meet the essential criteria for the role. Any nomination of an individual should be managed by the Locality in accordance with the Nolan Principles. e) Eligibility for reappointment The GP may be re-nominated by the relevant Locality as long as they continue to meet the eligibility criteria and have not served more than 9 consecutive years on 64 12

65 the Governing Body. Re-appointment is subject to approval by locality member practice. f) 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) iii) iv) If in the opinion of the Governing Body (having taken appropriate professional advice in cases where it is deemed necessary) they become or are deemed to have developed mental or physical illness which prohibits or inhibits their ability to undertake their role. If they cease to be a provider of primary medical services, or be engaged in or employed to deliver primary medical services with a Member practice in the Locality which they represent. Where level of competence and performance is below agreed levels v) Disqualification from membership of a CCG Governing Body under the 2012 Regulations. vi) vii) viii) Breach of the Nolan principles (as determined by majority vote of Governing Body members). Gross misconduct as defined in the CCG s disciplinary procedures Non attendance at Governing Body meetings (six in any 12 month period) g) Notice Period The Locality GP representative must give at least 3 months notice in writing to the Chair of the Governing Body, but immediately if the GP is removed from office on any of the grounds set out above. Suspension from the Performers List or GMC register will result in an immediate review of the post holder s position on the Governing Body Elected GP representatives Representatives of member practices on the Governing Body, are subject to the following appointment process, which may be undertaken by an external body such as the LMC at the request of the electorate: a) Nomination The body conducting the election will write to all the eligible electorate seeking nominations. If it is subsequently discovered that the current list of eligible members is incomplete as a result of the body receiving incomplete information it shall not invalidate this process or any other element of the process described herein

66 b) Eligibility The individual must be a GP with a member practice and not disqualified from membership of a CCG under the 2012 Regulations. They must meet the person specification for the role approved by the Governing Body. c) Appointment process i) Selection The purpose of selection is to identify the pool of potential candidates that have an acceptable level of knowledge, skill and experience to stand for election. The Job Description and Person Specification for the role will be used to make the assessment. Candidates will be asked to complete an application form and attend an interview. Assessment will be made on the basis of the person specification taking into account both the written application and interview. Assessment will be made by a panel including external assessors with in-depth understanding of the clinical leadership role in commissioning and governance processes and an external GP leader with no local conflicts of interest. The assessment panel will decide whether an individual can be put forward for election ii) Election process All GPs that are successful in the selection process may put themselves forward for election. Where there is the same number or fewer candidates than there are vacancies appointment shall be automatic, otherwise an election shall be undertaken. Where there is more than one vacancy each GP on the electorate shall have 1 vote per vacancy. The electorate is as described in b) Eligibility above. Candidates will be given 2 weeks for a holding period when they can promote themselves to the electorate. The election process shall be by secret ballot. d) Term of office Will be elected for a term of office up to three years e) Eligibility for reappointment GPs may put themselves forward for re-election as long as the eligibility criteria continue to be met and they have not served more than 9 consecutive years on the Governing Body

67 f) Grounds for removal from office i) If a receiving order is made against them or they make any arrangement with their creditors. ii) iii) iv) If in the opinion of the Governing Body (having taken appropriate professional advice in cases where it is deemed necessary) they become or are deemed to have developed mental or physical illness which prohibits or inhibits their ability to undertake their role. If they cease to be a provider of primary medical services, or be engaged in or employed to deliver primary medical services with a Member practice. Where level of competence and performance is below agreed levels v) Disqualification from membership of a CCG Governing Body under the 2012 Regulations. vi) vii) viii) Breach of the Nolan principles (as determined by majority vote of Governing Body members). Gross misconduct as defined in the CCG s disciplinary procedures Non attendance at Governing Body meetings (six in any 12 month period) g) Notice Period An elected GP representative must give at least 3 months notice in writing to the Chair of the Governing Body, but immediately if the GP is removed from office on any of the grounds set out above. Suspension from the Performers List or GMC register will result in an immediate review of the post holder s position on the Governing Body Lay Members a) Nomination Not applicable b) Eligibility 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. Lay Members should not be disqualified from membership of a CCG under the 2012 Regulations

68 c) Appointment process Advertisement and application d) Term of office up to 3 years e) Eligibility for reappointment Lay Members may put themselves forward for re-appointment as long as eligibility criteria continue to be met and they have not served more than 9 consecutive years on the Governing Body. The process will be overseen by the Remuneration Committee. f) Grounds for removal from office i) If a receiving order is made against them or they make any arrangement with their creditors. ii) iii) If in the opinion of the Governing Body (having taken appropriate professional advice in cases where it is deemed necessary) they become or are deemed to have developed mental or physical illness which prohibits or inhibits their ability to undertake their role. Where level of competence and performance is below agreed levels iv) Disqualification from membership of a CCG Governing Body under the 2012 Regulations. v) Breach of the Nolan principles (as determined by majority vote of Governing Body members). vi) vii) Gross misconduct as defined in the CCG s disciplinary procedures Non attendance at Governing Body meetings (six in any 12 month period) g) Notice period At least 3 months notice in writing to the Chair of the Governing Body, but immediately if removed from office on any of the grounds set out above Accountable Officer a) Nomination Not applicable b) 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

69 c) Appointment process NHS Commissioning Board is responsible for appointing the Accountable Officer following nomination by the CCG. Appointment will be by selection against Job Description and Person Specification. The Remuneration Committee will determine the detail of the process. d) Term of Office Substantive appointment e) Notice Period and Grounds for Removal from Office As set out within the Terms and Conditions of Employment for this post Director of Finance a) Nomination Not applicable b) Eligibility The individual must meet the required competencies of the role as set out in paragraph 7.8 of the Constitution and in terms of the initial appointment have successfully completed the national assessment process. c) Appointment process Selection against job description and person specification. Committee will determine the detail of the process. The Remuneration d) Term of Office Substantive appointment e) Notice Period and Grounds for Removal from Office As set out within the Terms and Conditions of Employment for this post Chief Nurse a) Nomination Not applicable b) Eligibility The individual must be a suitably qualified registered nurse and have the relevant competencies as set out in the job description

70 c) Appointment process Selection against job description and person specification. Committee will determine the detail of the process. The Remuneration d) Term of Office Substantive appointment e) Notice Period and Grounds for Removal from Office As set out within the Terms and Conditions of Employment for the post Secondary Care Specialist Doctor a) Nomination Not applicable b) Eligibility Must be a suitably qualified doctor and have the relevant competencies as set out in the job description for the post. c) Appointment process i) Selection against job description and person specification. ii) iii) Panel competency assessment of applications Interview and selection by a panel of the CCG against required competencies. d) Term of office For a period up to 3 years e) Eligibility for reappointment Post to be advertised before end of term of office. The post holder is eligible for reappointment as long as the eligibility criteria continue to be met and they have not served more than 9 consecutive years on the Governing Body. f) 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 Body (having taken appropriate professional advice in cases where it is deemed necessary) they become or are deemed to have developed mental or physical illness which prohibits or inhibits their ability to undertake their role

71 g) iii) Where level of competence and performance is below agreed levels iv) No longer eligible to be a secondary care specialist member of a CCG Governing Body under the 2012 Regulations and disqualified from membership of a CCG Governing Body under the 2012 Regulations v) Breach of the Nolan principles (as determined by majority vote of Governing Body members). vi) Gross misconduct as defined in the CCG s disciplinary procedures vii) Non attendance at Governing Body meetings (six in any 12 month period) Notice period 3 months notice in writing to the Chair of the Governing Body, but immediately if removed from office on any of the grounds set out above Medical Director a) Nomination Not applicable b) Eligibility The individual must be a GP and have all relevant competencies as set out in the job description. c) Appointment process Selection against job description and person specification. Committee will determine the detail of the process. d) The Remuneration Term of office Substantive appointment e) Grounds for removal from office As set out within the Terms and Conditions of Employment for the post. f) Notice period As set out within the Terms and Conditions of Employment

72 Director of Strategy and Integration, Director of Commissioning and Performance and Director of Delivery Care Outside of Hospital a) Nomination Not applicable b) Eligibility Must meet the required competencies and experience as set out in the relevant job descriptions. c) Appointment process Selection against job description and person specification. Committee will determine the detail of the process. The Remuneration d) Term of Office Substantive appointments e) Grounds for removal As set out within the Terms and Conditions of Employment for the posts f) Notice Period and Grounds for Removal from Office As set out within the Terms and Conditions of Employment Deputy Chair of the Governing Body Paragraph 7.6 of the Constitution sets out arrangements for appointment of the Deputy 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 Deputy-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 Deputy Chair. 2.3 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; (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; 72 20

73 (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 and 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. (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 Deputy-Chair, if present, shall preside

74 (2) If the Chair is absent temporarily on the grounds of a declared conflict of interest the Deputy-Chair, if present, shall preside. If the Chair and Deputy-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 (1) No meeting of the Governing Body shall be held unless at least one-third of the whole number of voting members is present (Paragraph of the Constitution sets out the voting members of the Governing Body), which must include at least four GPs from the Locality GP representatives or Elected GP representatives, one Lay Member and either the Accountable Officer or Director of Finance. (2) If neither the Chair nor Deputy Chair is present, the meeting can proceed if a temporary Chair is elected from the remaining Governing Body Members. (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 which is available on the CCG s website. (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 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

75 (2) Majority necessary to confirm a decision - Save as provided in Standing Orders 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. (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. 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 The powers which the Governing Body has retained to itself within these Standing Orders may in emergency be exercised by the Accountable Officer and the Chair after having consulted at least one Lay Member and either one Locality GP representative or one Elected GP representative. The exercise of such powers by the Accountable Officer and Chair shall be reported to the next formal meeting of the Governing Body for ratification. 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 Governing Body 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 75 23

76 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 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 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 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'. 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: `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'

77 (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 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 and the Governing Body 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. (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 Subcommittees 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 available on the CCG s website

78 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, as the statutory legal entity, shall approve the appointments to each of the committees and sub committees which it has formally constituted, under section 6.1 of the Constitution, and will decide on such travel or other allowances as it considers appropriate. The Governing Body shall approve the appointments to each of its Committees and Sub-committees and the Remuneration Committee 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 noncompliance and any justification for non-compliance and the circumstances around the non-compliance, shall be reported to the next formal meeting of the Governing Body for action or ratification. All Members of the CCG, Members of the Governing Body and employees have a duty to disclose any non-compliance with these Standing Orders to the Accountable Officer as soon as possible. 6. CUSTODY OF SEAL AND AUTHORISATION OF DOCUMENTS 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 Accountable Officer, the Director of Finance, 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 Accountable 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 Accountable Officer or the Director of Finance or as detailed in either the Scheme of Reservation and Delegation (Appendix D) or the Operational Scheme of Delegation. 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 78 26

79 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. However, the Governing Body may delegate this responsibility to one or more of its committees / sub-committees as detailed in the Scheme of Reservation and Delegation

80 8 DUTIES AND OBLIGATIONS OF GOVERNING BODY MEMBERS AND CCG SENIOR MANAGERS 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. 8.2 Register of Interests The Accountable 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. The Accountable Officer will ensure that as a minimum there is an annual review of the Register of Interests. The Chair of the Audit and Integrated Governance Committee will act as Conflicts of Interest Guardian and will perform the functions as detailed in Conflicts of Interest Protocol available on the CCG s website. 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

81 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. 1 81

82 Constitution, Standing Orders or Prime Financial Policies Ref Decision / Responsibilities Reserved to the Membership Reserved or delegated to Governing Body Delegated to Audit & Integrated Governance Committee Delegated to Governance Sub- Committee Delegated to Remuneration Committee Delegated to Quality Assurance Committee Delegated to Chair of Governing Body Delegated to Accountable Officer Delegated to Director of Finance All Members and Employees Regulation and Control Constitution 4.6 Determine the arrangements by which the Members of the CCG approve those decisions that are reserved for the membership. Constitution and 4.6 Constitution PFP 1.4 and AIGC PFP 5.4 and PFP 7.5 Constitution 7.7 Consideration and approval of applications to the Board on changes to the CCG s Constitution Recommendations to CCG Members on changes to the Constitution covering the overall operating arrangements 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. Initially by Director of Finance and then by AIGC who will make recommendations to the Governing Body on required changes. Overall responsibility for ensuring the CCG complies with certain of its statutory obligations including its financial and accounting obligations Exercise or delegation of those functions of the CCG which have not been retained as reserved by the CCG or delegated to the Governing Body and its Committees and sub-committees or delegated to named other individuals as set out in this document. 2 82

83 Constitution, Standing Orders or Prime Financial Policies Ref Decision / Responsibilities Reserved to the Membership Reserved or delegated to Governing Body Delegated to Audit & Integrated Governance Committee Delegated to Governance Sub- Committee Delegated to Remuneration Committee Delegated to Quality Assurance Committee Delegated to Chair of Governing Body Delegated to Accountable Officer Delegated to Director of Finance All Members and Employees PFP 7.6 PFP 7.6 AICG TofR Prepare the CCG s operational scheme of delegation, which sets out those key operational decisions delegated to individual employees of the CCG not for inclusion in the CCG s Constitution. Prepare detailed financial policies that underpin the CCG s Prime Financial Policies not for inclusion in the CCG s Constitution. Approve the CCG s detailed financial policies. Constitution PFP 3 and AIGC TofR Approve of the CCG s annual report and annual accounts, these first having been reviewed by the Audit and Integrated Governance Committee. Approval of the internal and external audit arrangements Constitution 8 Recommend to CCG Members any changes to the Conflicts of Interest Protocol SO 4.4 Approval of appointments to Governing Body Committees and sub-committees SO 3.1(3) SO 3.3 May call a meeting of the Governing Body at any time Management of Petitions to the Governing Body 3 83

84 Constitution, Standing Orders or Prime Financial Policies Ref Decision / Responsibilities Reserved to the Membership Reserved or delegated to Governing Body Delegated to Audit & Integrated Governance Committee Delegated to Governance Sub- Committee Delegated to Remuneration Committee Delegated to Quality Assurance Committee Delegated to Chair of Governing Body Delegated to Accountable Officer Delegated to Director of Finance All Members and Employees SO 3.5 Chair s Ruling ie interpretation of the Constitution including SOs, scheme of reservation and PFPs SO 3.8 Emergency powers and urgent meetings of Governing Body SO 3.12 Admission of public and press to Governing Body meetings Strategy and Planning Constitution 4.2 Agree the vision, values and overall strategic direction of the CCG. Constitution 6.6.1; PFP 7.1 Constitution 5.2 PFP 7.2 PFP 7.4 Constitution to 5.2.4; Approval of the CCG s annual commissioning plan and supporting financial plan, including any consultation arrangements Approval of the CCG s commissioning and corporate (running cost) budgets to meet the CCGs financial duties Approval of changes to budgets where variation would have a significant impact on the overall approved levels of income and expenditure or the CCG s ability to achieve its agreed strategic aims. Approval of the arrangements for discharging the CCG s statutory duties associated with its commissioning 4 84

85 Constitution, Standing Orders or Prime Financial Policies Ref Decision / Responsibilities Reserved to the Membership Reserved or delegated to Governing Body Delegated to Audit & Integrated Governance Committee Delegated to Governance Sub- Committee Delegated to Remuneration Committee Delegated to Quality Assurance Committee Delegated to Chair of Governing Body Delegated to Accountable Officer Delegated to Director of Finance All Members and Employees 5.2.6; 5.2.7; 5.2.8; Constitution ; ; Constitution functions, including but not limited to promoting the involvement of each patient; patient choice; reducing inequalities; improvement in the quality of services; obtaining appropriate advice and public engagement and consultation; obtain advice from persons who taken together have a broad range of professional expertise and acting effectively, efficiently and economically. Approval of arrangements for discharging the CCG s statutory duties in relation to promoting innovation, promoting research and the use of research and promoting education and training Approve arrangements for supporting the Board in discharging its responsibilities in relation to securing continuous improvement in the quality of general medical services. Partnership Working Constitution 5.1.2(c)(ii); Constitution Constitution ( c)(ii) and Nominate representatives from the CCG to be the CCG s representatives on the Sheffield Health and Wellbeing Board Promote integration across health and social care services where the CCG considers that this would improve quality of services and reduce inequalities Approve the Memorandum of Understanding and annual plan for the Public Health Core Offer from Sheffield City Council 5 85

86 Constitution, Standing Orders or Prime Financial Policies Ref Decision / Responsibilities Reserved to the Membership Reserved or delegated to Governing Body Delegated to Audit & Integrated Governance Committee Delegated to Governance Sub- Committee Delegated to Remuneration Committee Delegated to Quality Assurance Committee Delegated to Chair of Governing Body Delegated to Accountable Officer Delegated to Director of Finance All Members and Employees PFP 22.1 following recommendations by CET Constitution 6.5 Constitution 6.5 Approve arrangements for coordinating the commissioning of 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 arrangements under section 75 of the NHS Act 2006). CCG as an employer and remuneration issues Constitution section 9 Have oversight of the CCG s responsibilities as an employer including adopting a Code of Conduct for staff ToR Remuneration Committee Constitution Approve the terms and conditions, remuneration and travelling or other allowances for Governing Body Members, including pensions and gratuities. Approve terms and conditions of employment for all employees of CCG and to other persons providing services to the CCG ToR Remuneration Committee Make recommendations on the terms and conditions of employment for senior employees of CCG and to other persons providing services to the CCG, taking into account best practice information and statutory requirements 6 86

87 Constitution, Standing Orders or Prime Financial Policies Ref Decision / Responsibilities Reserved to the Membership Reserved or delegated to Governing Body Delegated to Audit & Integrated Governance Committee Delegated to Governance Sub- Committee Delegated to Remuneration Committee Delegated to Quality Assurance Committee Delegated to Chair of Governing Body Delegated to Accountable Officer Delegated to Director of Finance All Members and Employees Constitution 6.6.1(b) Governance Sub Committee ToR PFP 16.1;16.2 The Governing body has responsibility for 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 para 11 (4) Schedule 1A of the 2006 Act Approve human resources policies for employees and for other persons working on behalf of the group Ensure an effective payroll service and that there are comprehensive procedures for effective processing of payroll PFP 16.3 Approval of the CCG s detailed operating structure including at the start of each financial year the funded staffing establishment. PFP 16.4 Approve in year variations to funded staffing establishment 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 7 87

88 Operational Business and Risk Management Governance Sub Committee ToR Quality Assurance Committee ToR PFP 4 PFP 15.1 PFP 15.2 Constitution 6.6.1(o) SO 6.1 SO 6.2 Approve CCG operational policies (ie excluding those defined as clinical or financial) Approve CCG clinical policies and clinical pathways Approve the CCG s counter fraud arrangements. Approve the CCG s risk management arrangements Preparation and review of Assurance Framework and Risk Register with recommendations for action to AIGC and Governing Body as appropriate Approve the group s arrangements for business continuity and emergency planning. Execution of a document by use of the seal Signature of document which is part of legal proceedings on behalf of CCG Duty to comply with the Constitution and be aware of the responsibilities in it. Duty to disclose non compliance with SOs to Accountable Officer Constitution 8.1 SO 8.1and Duty to declare interests Constitution 8.3 SO 8.2 Ensure the CCG maintains up to date Register(s) of Interests, to ensure its Register(s) are regularly reviewed Constitution 8.1 SO

89 PFP 1.3 PFP 2.2 Any contractor empowered by the CCG to commit expenditure or authorised to obtain income is covered by the PFPs and the Accountable Officer should ensure such persons are made aware of this. Overall responsibility of CCG s systems of internal control and preparation of Annual Governance Statement PFP 2.3b) and c) PFP 3.3 PFP 4.3;4.5 Ensuring that the CCG has in place a system for proper checking and reporting of all breaches of financial policies; and a proper procedure for regular checking of the adequacy and effectiveness of the control environment Ensuring professional and technically competent internal audit service; that AIGC approves changes to the provision of assurance services to CCG and that minutes of AICG are formally recorded and submitted to the Governing Body Ensure appropriate security management arrangements PFP 5.3 PFP 6.1 PFP 7.7 Re. expenditure control provide reports in the form required by the Board, ensure money drawn down from the Board is only at 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 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 managers PFP 8.1 PFP 9.1;9.2 A range of actions per PFP 8.1 to ensure the CCG prepares annual accounts and an annual report which are audited and published A range of actions per PFP 9.1 and 9.2 to ensure the accuracy and security of CCG computerised financial data PFP 10.1 Ensure the CCG has an accounting system that creates management and financial accounts 9 89

90 PFP 11.1 Manage the CCG s banking arrangements PFP 11.2 Approve the CCG s banking arrangements PFP PFP 13.2 A range of actions to ensure a sound system of recording, collection and management of income and cash Prepare a detailed financial policy on tendering including authorization limits for quotations and tendering PFP 13.3 Approve detailed financial policy on tendering including authorisation limits for quotations and tendering PFP 13.5 PFP 14.2 Nominate an individual who shall oversee and manage each contract on behalf of the CCG Ensure arrangements for regular reports to Governing Body on contract expenditure PFP 14.3 Maintain a system of financial monitoring to ensure effective accounting of expenditure under contracts PFP 15.3 Nomination of a senior officer to be the SIRO PFP 15.4 Decide if the CCG will insure through risk pooling arrangements administered via NHS LA PFP 15.5; 15.6 If the decision is to use the NHS LA ensure arrangements are appropriate and complementary to the risk management 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 basis PFP 17.2 Set out procedures for seeking professional advice regarding the supply of goods and services 10 90

91 PFP 17.3 PFP 18.1 PFP 18.2 Advise on the setting of thresholds for quotations and tenders; 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, maintain an asset register and polices to ensure safe storage of fixed assets Prepare detailed procedures for the disposal of assets PFP 19.1 PFP 20 Information Governance: Ensure appropriate arrangements for the retention of records; and arrangements for effective responses to Freedom of Information requests Re. any property held on trust and any Charitable Funds ensure appropriate management arrangements in place PFP 21 Ensure all staff are made aware of the CCG s policy on acceptance of gifts and other benefits in kind PFP 22.1 Approval of the CCG s contracts for any commissioning support and the Public Health Core Offer PFP 22.2 Nominating senior officers to manage both the contract for commissioning support and the Public Health Core Offer 11 91

92 APPENDIX E PRIME FINANCIAL POLICIES CONTENTS INTRODUCTION General Responsibilities and Delegation Contractors and their employees Amendment of Prime Financial Policies Page INTERNAL CONTROL 4 3. AUDIT 4 4. FRAUD AND CORRUPTION 5 5. EXPENDITURE CONTROL 5 6. ALLOCATIONS COMMISSIONING STRATEGY, BUDGETS, BUDGETARY CONTROL AND MONITORING Commissioning Strategy and Plan Budgets, Budgetary control and monitoring ANNUAL ACCOUNTS AND REPORTS 7 9. INFORMATION TECHNOLOGY ACCOUNTING SYSTEMS BANK ACCOUNTS INCOME, FEES AND CHARGES AND SECURITY OF CASH, CHEQUES AND OTHER NEGOTIABLE INSTRUMENTS

93 TENDERING AND CONTRACTING Tendering arrangements Financial Limits for Quotations and Tendering Contracting procedures COMMISSIONING RISK MANAGEMENT AND INSURANCE Risk Management Insurance: Risk pooling schemes administered by NHSLA PAYROLL AND PAY EXPENDITURE Payroll Funded Establishment Staff Appointments NON-PAY EXPENDITURE CAPITAL INVESTMENT, FIXED ASSET REGISTERS & SECURITY OF ASSETS RETENTION OF RECORDS TRUST AND CHARITABLE FUNDS ACCEPTANCE OF GIFTS BY STAFF AND LINK TO STANDARDS OF BUSINESS CONDUCT 22. COMMISSIOING SUPPORT SERVICES and PUBLIC HEALTH CORE OFFER

94 1 INTRODUCTION 1.1. General These Prime Financial Policies (PFPs) shall have effect as if incorporated into the CCG s Constitution 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 Accountable Officer and Director of Finance to effectively perform their responsibilities. They should be used in conjunction with the scheme of reservation and delegation 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 Director of Finance and approved by the Governing Body and which are known as the Detailed Financial Policies 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 Should any difficulties arise regarding the interpretation or application of any of the PFPs or Detailed Financial Policies then the advice of the Director of Finance 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 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 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 noncompliance 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 Director of Finance as soon as possible Responsibilities and delegation 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 The financial decisions delegated by Members are set out in the CCG s scheme of reservation and delegation. 94 3

95 1.3. Contractors and their employees 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 Accountable Officer to ensure that such persons are made aware of this Amendment of Prime Financial Policies To ensure that these Prime Financial Policies remain up-to-date and relevant, the Director of Finance will review them at least annually. Following scrutiny by the Governing Body s Audit and Integrated Governance Committee, the Director of Finance 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 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 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) The Accountable 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 The Director of Finance will ensure that: 3. AUDIT 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. 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 The Head of Internal Audit from the internal audit service appointed by the Audit and Integrated Governance Committee (AIGC) and the Audit Panel appointed external auditor will have direct and unrestricted access to AIGC members, the Chair of the Governing Body, Accountable Officer and Director of Finance for any significant issues arising from audit work that management cannot resolve, and for all cases of fraud or serious irregularity. 95 4

96 3.2. All AIGC members, the Chair of the Governing Body and the Accountable Officer will have direct and unrestricted access to the head of internal audit and external auditors The Director of Finance will ensure that: 4. 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. 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 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 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 Accountable Officer will monitor and ensure compliance with Directions issued by the Secretary of State for Health on NHS security management. 4.4 The Accountable 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 provisions1 to ensure that its expenditure does not exceed the aggregate of allotments from the Board and any other sums it has received and is legally allowed to spend. 1 See section 223H of the 2006 Act, inserted by section 27 of the 2012 Act 5 96

97 5.2 The Accountable 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 Director of Finance will: provide reports in the form required by the Board; ensure money drawn from the 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 Board. 6 ALLOCATIONS2 6.1 The Director of Finance will: a) periodically review the basis and assumptions used by the 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 MONITORING STRATEGY, BUDGETS, BUDGETARY CONTROL AND POLICY the CCG will produce and publish an annual commissioning plan3 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 plan The Accountable 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. 2 See section 223(G) of the 2006 Act, inserted by section 27 of the 2012 Act. See section 14Z11 of the 2006 Act, inserted by section 26 of the 2012 Act. See section 14Z13 of the 2006 Act, inserted by section 26 of the 2012 Act

98 Budgets, Budgetary Control and Budgetary Monitoring 7.3 Prior to the start of the Financial Year the Director of Finance will, on behalf of the Accountable Officer, prepare and submit commissioning and infrastructure (running cost) budgets for approval by the Governing Body. 7.4 The Director of Finance 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 Accountable Officer and Director of Finance. 7.5 The Accountable 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 Accountable 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 Director of Finance and approved by the Governing Body. 7.7 The Director of Finance has a responsibility to ensure that adequate training is delivered on an ongoing basis to budget holders and their budget managers to help them manage successfully. 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 obligations 5, 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 Director of Finance 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. 5 See paragraph 17 of Schedule 1A of the 2006 Act, as inserted by Schedule 2 of the 2012 Act. 7 98

99 9 INFORMATION TECHNOLOGY POLICY the CCG will ensure the accuracy and security of the CCG s computerised financial data. 9.1 The Director of Finance 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 Director of Finance may consider necessary are being carried out. 9.2 In addition, the Director of Finance shall ensure that new financial systems and amendments to current financial systems are developed in a controlled manner and thoroughly tested prior to implementation. Where this is undertaken by another organisation, assurances of adequacy must be obtained from them prior to implementation. 10 ACCOUNTING SYSTEMS POLICY the CCG will run an accounting system that creates management and financial accounts The Director of Finance 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 Director of Finance shall annually seek assurances that adequate controls are in operation. 99 8

100 11 BANK ACCOUNTS POLICY the CCG will keep enough liquidity to meet its current commitments The Director of Finance will: a) review the banking arrangements of the CCG at regular intervals to ensure they are in accordance with Secretary of State directions6, 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 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 functions7; ensure its power to make grants and loans is used to discharge its functions effectively The Director of Finance 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; 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 See section 223H(3) of the NHS Act 2006, inserted by section 27 of the 2012 Act See section 14Z5 of the 2006 Act, inserted by section 26 of the 2012 Act. See section 14Z6 of the 2006 Act, inserted by section 26 of the 2012 Act

101 13 TENDERING AND CONTRACTING PROCEDURE Tendering 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 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 Director of Finance it is desirable to seek tenders from firms not on the approved lists, the reason shall be recorded in writing to the Accountable Officer The Director of Finance 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 Accountable Officer or Director of Finance must approve all such waivers and these must be reported to the next meeting of the AIGC 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;

102 b) the Public Contracts Regulation 2006, any successor legislation and any other applicable law; and 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 In all contracts entered into, the CCG shall endeavour to obtain best value for money. The Accountable Officer shall nominate an individual who shall oversee and manage each contract on behalf of the 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 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 and Wellbeing Boards, patients and their carers and the voluntary sector and others as appropriate to develop robust commissioning plans The Accountable Officer will establish arrangements to ensure that regular reports are provided to the Governing Body detailing actual and forecast expenditure and activity for each contract The Director of Finance 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 Risk Management POLICY the CCG will put arrangements in place for evaluation and management of its risks and will put insurance arrangements are in place The Accountable 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 The Accountable 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 The Accountable Officer will nominate a senior officer to be the Senior Information Risk Owner (SIRO). The SIRO will provide board-level accountability and greater assurance that risks are addressed. The SIRO ensures information risks are treated

103 as a priority for business outcomes. The SIRO also plays a vital role in getting the organisation to recognise the value of its information enabling them to use it effectively. The Director of Commissioning and performance will be the SIRO for the CCG. 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 Where the Governing Body decides to use the risk pooling schemes administered by the NHS Litigation Authority the Director of Finance shall ensure that the arrangements entered into are appropriate and complementary to the risk management programme. The Director of Finance shall ensure that documented procedures cover these arrangements 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 Director of Finance 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 Director of Finance 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 Payroll POLICY the CCG will put arrangements in place for an effective payroll service and the management of its staffing establishment and staffing costs The Director of Finance 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 In addition, the Director of Finance 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 During the Financial Year the funded establishment of any department may not be varied without the approval of the Accountable Officer or Director of Finance

104 Staff Appointments 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) and (b) unless authorised to do so by the Accountable Officer or Director of Finance; within the limit of their approved budget and funded establishment The Accountable Officer will: (a) ensure that all employees are issued with a Contract of Employment which complies with employment legislation; and (b) ensure there are arrangements for dealing with variations to, or termination of, contracts of employment 17 NON-PAY EXPENDITURE POLICY the CCG will seek to obtain the best value for money goods and services received The Governing Body will approve the level of non-pay expenditure on an annual basis and the Accountable Officer will determine the level of delegation to budget managers The Accountable Officer shall set out procedures on the seeking of professional advice regarding the supply of goods and services The Director of Finance will: a) advise 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 The Accountable 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;

105 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 Director of Finance 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 The Director of Finance 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 The Accountable Officer shall: a) be responsible for maintaining all records required to be retained in accordance with NHS Code of Practice Records Management 2006 and other relevant notified guidance; b) ensure that arrangements are in place for effective responses to Freedom of Information requests; c) publish and maintain a Freedom of Information Publication Scheme. 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 The Director of Finance 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 The Director of Finance 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 Director of Finance 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

106 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. 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 providers and the memorandum of understanding with Sheffield City Council for the Public Health Core Offer The Accountable 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 Accountable 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

107 APPENDIX F - NOLAN PRINCIPLES The Nolan Principles set out the ways in which holders of public office should behave in discharging their duties. The seven principles are: a) Selflessness Holders of public office should act solely in terms of the public interest. They should not do so in order to gain financial or other benefits for themselves, their family or their friends. b) Integrity Holders of public office should not place themselves under any financial or other obligation to outside individuals or organisations that might seek to influence them in the performance of their official duties. c) Objectivity In carrying out public business, including making public appointments, awarding contracts, or recommending individuals for rewards and benefits, holders of public office should make choices on merit. d) Accountability Holders of public office are accountable for their decisions and actions to the public and must submit themselves to whatever scrutiny is appropriate to their office. e) Openness Holders of public office should be as open as possible about all the decisions and actions they take. They should give reasons for their decisions and restrict information only when the wider public interest clearly demands. f) Honesty Holders of public office have a duty to declare any private interests relating to their public duties and to take steps to resolve any conflicts arising in a way that protects the public interest. g) Leadership Holders of public office should promote and support these principles by leadership and example. Source: The First Report of the Committee on Standards in Public Life (1995)9 9 Available at

108 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 Source: The NHS Constitution: The NHS belongs to us all (March 2012)

109 Appendix H Map of GP Practices across Sheffield City GP Practices across Sheffield City Chapelgreen Practice 60 Ecclesfield Group Practice 21 Foxhill Medical Centre 59 Grenoside Surgery Deepcar Medical Centre Oughtibridge Surgery Valley Medical Centre Broomhill Surgery Manchester Road Surgery Selborne Road Medical Centre Stannington Medical Centre (Shurmer) 53 The Crookes Practice Walkley House Medical Centre Dykes Hall Medical Centre Far Lane Medical Centre Tramways Medical Centre (Milner) Tramways Medical Centre (O'Connell) University Health Service Health Centre Crookes Valley Medical Centre Devonshire Green Medical Centre Harold Street Medical Centre Porter Brook Medical Centre Upperthorpe Medical Centre Clover City Practice Falkland House Greystones Medical Centre Nethergreen Surgery Rustlings Road Medical Centre The Hollies Medical Centre Carrfield Medical Centre Gleadless Medical Centre Heeley Green Surgery Sharrow Lane Medical Centre The Mathews Practice Abbey Lane Surgery Carterknowle And Dore Medical Practice Sloan Medical Centre Veritas Health Centre Woodseats Medical Centre Avenue Medical Practice 35 Baslow Road And Shoreham Street Surgeries 23 The Meadowgreen Group Practice Totley Rise Medical Centre Mill Road Surgery 64 Burngreave Surgery Dunninc Road Surgery Firth Park Surgery Page Hall Medical Centre Pitsmoor Surgery Sheffield Medical Centre Shiregreen Medical Centre The Flowers Health Centre Upwell Street Surgery Wincobank Medical Centre Barnsley Road Surgery Buchanan Road Surgery Elm Lane Surgery Norwood Medical Centre Southey Green Medical Centre The Health Care Surgery Dovercourt Surgery Duke Medical Centre East Bank Medical Centre Manor Park Medical Centre Norfolk Park Medical Practice Park Health Centre White House Surgery Clover Group Practice Darnall Health Centre (Mehrotra) Handsworth Medical Practice The Medical Centre Birley Health Centre Charnock Health Primary Care Centre Jaunty Springs Health Centre Richmond Medical Centre Stonecroft Medical Centre Woodhouse Health Centre Crystal Peaks Medical Centre Mosborough Health Centre Owlthorpe Medical Centre Sothall and Beighton Health Centres 36 Hackenthorpe Medical Centre

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