NHS SOUTH DEVON AND TORBAY CLINICAL COMMISSIONING GROUP CONSTITUTION

Transcription

1 NHS SOUTH DEVON AND TORBAY CLINICAL COMMISSIONING GROUP CONSTITUTION Version: August 2017 NHS England Effective Date: 29 November 2017 Page 1 of 98

2 Version Control DATE VERSION COMMENTS W&Co first draft to map CCG version dated 11 May 2012 into model constitution Changes made by Mark Procter 8/7/12 2a Changes made by Mark Sandford-Wood, LMC 11/7/12 3 Changes made by Mark Procter following SMC feedback 19/7/12 3a Changes made by Mark Procter following discussion at the Council of Members 18 th July /7/12 3b Clause (c) added by Mark Procter following LMC recommendation and SMC approval 1/8/12 3c Changes made by Mark Procter following feedback after Board meeting 31/7/12: Membership removed from section 3 and now referenced to Appendix A Paragraph changed to reflect new clinical lead titles SMC added to Paragraph Paragraph list reordered Page typo s corrected and duplication removed 14/8/12 3d Changes made by Mark Procter following SHA feedback: Appendix H Governance Structure Diagram added Contents section completed Councils & CCG map included in Appendix B 16/8/12 4 Final Draft 19/11/12 4a Changes made by Phil Stimpson following move to new HQ and practice manager comments HQ address added (1.1.1) Pages 15(4.1.2a), 19(5.1.2c), 22(5.2.9b), 56(2.2.2b), 59(3.8.1) typo s corrected 23/01/13 5 Changes made by Phil Stimpson following changes to Governing Body membership at section (as agreed by Governing Body 17/01/2013 and Remuneration Committee 07/01/2013) and formal approval of the CCG by NHS England on 18/01/2013 at section 1.3. Pages 5(page numbers), 16(4.3.1), 21(5.2.5), 26(6.3.3), 32(7.1.2), 33(7.3.2), 34(7.5.1), 35(7.8.1), 36(7.9.1, ), 37(7.11.1, , , ), 40(8.3.5, 8.4.2,3,4), 42(8.4.11,12), 56(1.1.1), 58(2.2.2.b), 59(2.2.2.f), 64(6.1.1, 6.2.1), 81(5.2), 82(7.1, 7.3, 7.4, 7.5), 86(15.3), 87(17.1, 18.1), 88(19.1) typo s corrected and job/organisation titles amended 23/05/ Changes made by Phil Stimpson in line with NHS England gateway letter 00053, 2 May amendments to the Constitution can be made by agreement with the Regional Director for Operations and Delivery at section 1.4.1; to include new whistleblowing statement approved by Governing Body at section Pages 11(1.3.2), 12(1.1.4.a) 31/01/ Changes made by Phil Stimpson following internal review and external audit of the CCG s financial structure and decision making. Appendix D Scheme of Reservation & Delegation: page 66 new section 1.3 to highlight that the CCG has an Operational Scheme of Delegation in addition to the top level Scheme outlined here in the Constitution; page 71 Decision on Approval of the group s corporate budgets that meet the financial duties as set out in section 5.3 of the main body of the constitution expanded to Prepare and recommend the group s corporate budgets that meet the financial duties as set out in section 5.3 of the main body of the constitution and changed from Audit Committee to Finance Committee; page 71 add All changes to NHS England resource transfer amount must be reported to the Governing Body to Approval of variations to the approved budget where variation would have a significant impact on the overall approved levels of income and expenditure or the group s ability to achieve its agreed strategic aims Decision and changed from Governing Body to Chief Finance Officer; page 71 Decision on Approval of the arrangements for discharging the group s statutory financial duties changed from Audit Committee to Finance Committee; page 74 Decision on Prepare and recommend an operational scheme of delegation that sets Page 2 of 98

3 out who has responsibility for operational decisions within the group changed from Governing Body to Finance Committee; page 76 Decision on Approval of the group s contracts for any commissioning support changed from Governing Body to the CCG s operational scheme of delegation; page 76 Decision on Approval of the group s contracts for corporate support (for example finance provision) changed from Governing Body to the CCG s operational scheme of delegation; page 76 Decision on Approve decisions delegated to joint committees established under section 75 of the 2006 Act changed from Governing Body to the CCG s operational scheme of delegation. 23/05/ Change made by Phil Stimpson following review of the CCG s prime financial policy on fraud and corruption. Page 80 (4) change chase to pursue. 18/08/ Changes made by Phil Stimpson. To reflect Practice mergers Mayfield and Cherrybrook merged to become Mayfield & Cherrybrook Medical Partnership; Bishops Place and Grosvenor merged to become Paignton Medical Partnership: Page 57 (Appendix A). To reflect change of CCG Committee name from Senior Management Committee to Senior Leadership Committee : Pages 27 (6.4.1), 30 (6.6.5 e), 87 (Appendix E 15.3). To reflect change of CCG Committee structure with the Clinical Commissioning Committee and Finance Committee merging to become the Commissioning and Finance Committee: Pages 22 (5.2.3 a), 22 (5.2.5 a), 23 (5.2.6 a), 24 ( a), (25 (5.3.1 a), 27 (6.4.1), 30 (6.6.5), 66 (Appendix D 1.3), 68 (Appendix D table row heading), 72 (Appendix D table, 6 entries). Updated CCG meeting structure diagram: Page 92 (Appendix H). 31/3/15 6 Formatting Changed NHS Commissioning Board references to NHS England Reflecting changes to Governing Body committees Reflecting changes to Director posts and titles Reflecting Governing Body voting changes Adds a new Non-Executive Director post Adds the Deputy Accountable Officer Includes the joint commissioning regulations recently published by NHS England Changes to who can use the CCG seal and execute documents Updated CCG footprint map Updated Meeting diagram 09/08/ To replace the term Chief Clinical Officer with Chief Officer throughout the document Section Eligibility and Appointments, paragraph v. replace the paragraph: accountable officer an individual member within the CCG who is on the GP performers list, and has been for a minimum of two years, may nominate themselves for a clinical governing body position when advertised. If it is not possible to appointment form within the CCG membership then a national recruitment process will be run and open to clinical and non-clinical applicants. This appointment will be subject to national NHS recruitment and selection policies and guidance. It is not subject to fixed term appointments. The candidate must be nationally approved and accredited and will Page 3 of 98

4 be appointed using the NHS England approved appointment process. Toi be replaced with the following accountable officer this appointment will be subject to national NHS recruitment and selection policies and guidance. The candidate must be nationally approved and accredited and will be appointed using the NHS England approved appointment process. Update the Clinical Chair from Dr Derek Greatorex to Dr Paul Johnson Section replace? with on the date outlined on the front cover sheet Add further detail to Executive posts (in brackets) Page 4 of 98

5 CONTENTS Part Description Page Foreword 6 1 Introduction and Commencement Name Statutory framework Status of this Constitution Amendment and variation of this Constitution 13 2 Area Covered 13 3 Membership Membership of the clinical commissioning group Eligibility Applications for membership Termination of membership Appeals process General 16 4 Vision, Values and Aims Vision Values Aims Principles of good governance Accountability 18 5 Functions and General Duties Functions General duties General financial duties Other relevant regulations, directions and documents 26 6 Decision Making: The Governing Structure Authority to act Scheme of reservation and delegation General Committees of the CCG Joint arrangements with other clinical commissioning groups Joint arrangement with NHS England for exercise of CCG functions Joint arrangement with NHS England for exercise of NHS England 32 functions 6.8 The governing body 33 7 Roles and Responsibilities Practice representatives Localities and Locality Groups Council of Members 39 Page 5 of 98

6 Part Description Page 7.4 Other GPs or primary care health professionals All members of the group s governing body The chair of the governing body The deputy chair of the governing body Role of the accountable officer Role of the deputy accountable officer Role of the chief finance officer Role of the non-medical practitioner Role of the secondary care clinician Role of the independent lay members Role of the director of commissioning & transformation Role of the director of wellbeing & family services Role of the director of corporate affairs and medicines optimisation Role of the director of quality assurance & improvement 43 8 Standards of Business Conduct and Managing Conflicts of Interest Standards of business conduct Conflicts of interest Declaring and registering interests Managing conflicts of interest: general Managing conflicts of interest: contractors and people who provide 48 services to the CCG 8.6 Transparency in procuring services 49 9 The Clinical Commissioning Group as Employer Transparency, Ways of Working and Standing Orders General Standing orders 51 Appendix Description Page A List of Member Practices 52 B CCG Area Map 61 C Standing Orders 64 D Scheme of Reservation and Delegation 74 E Prime Financial Policies 86 F The Nolan Principles 97 G The Seven Key Principles of the NHS Constitution 98 H Governance Structure Diagram 99 Page 6 of 98

7 FOREWORD As the Clinical Chair for the South Devon and Torbay Clinical Commissioning Group (CCG), I would like to extend a warm welcome to the Constitution. It is a vital document and what you will read is the culmination of a process of engagement, questioning, listening, co-working and consulting. At the leading edge of NHS reform Clinical Commissioning Groups are membership organisations, bringing with them unique opportunities to shape the healthcare landscape well into the future. But with opportunity comes responsibility and the Constitution details this responsibility through a system of clear engagement and connection throughout the organisation. In focusing on clinical leadership as the engine-room of design, this Constitution offers the locality of South Devon and Torbay a means through which it can shape and deliver its vision, and this is expressed throughout our organisation, through terms of reference, governance documents, strategies and plans. It is offered here because we recognise that without this vision the mechanics will have little value. Commissioning excellent, joined-up care for everyone. Fresh, innovative and population-focused we are led by doctors, healthcare professionals and by the views of our local people. Small enough to respond: big enough to deliver. The components of this Constitution demonstrate that we have paid attention to both the requirements of the Health and Social Care Act (2012) and to our local mandate to involve local Practices who in turn will be the keepers of our endeavours. The Constitution allows us to enshrine in a statutory document the governance which will both facilitate our vision to create a joined-up healthcare system, and support us through change and into the future. It is my hope that this Constitution will form the bedrock of the CCG s operations well beyond the tenure of my own appointment, although it is a privilege for me to be the holder of the Chair at the point of the CCG s inception. Dr Paul Johnson Clinical Chair, South Devon and Torbay Clinical Commissioning Group Page 7 of 98

8 INTERPRETATION In this Constitution, unless the context requires otherwise, the following words or phrases shall have the following meanings: 2006 Act National Health Service Act Act Health and Social Care Act 2012 (this Act amends the 2006 Act) Accountable officer an individual, as defined under paragraph 12 of Schedule 1A of the 2006 Act (as inserted by Schedule 2 of the 2012 Act), appointed by NHS England, with responsibility for ensuring the CCG: complies with its obligations under: o sections 14Q and 14R of the 2006 Act (as inserted by section 26 of the 2012 Act), o sections 223H to 223J of the 2006 Act (as inserted by section 27 of the 2012 Act), o paragraphs 17 to 19 of Schedule 1A of the NHS Act 2006 (as inserted by Schedule 2 of the 2012 Act), and o any other provision of the 2006 Act (as amended by the 2012 Act) specified in a document published by the Board for that purpose; exercises its functions in a way which provides good value for money. AGM The CCG s annual CCG meeting. Area The geographical area covered by the Clinical Commissioning Group as set out in Section 2 (Area Covered); Bill The Health and Social Care Bill 2011; CCG CCG Annual Operating Plan CCG Annual Report NHS South Devon and Torbay Clinical Commissioning Group governed by this Constitution. A plan prepared by the Governing Body each Year describing those actions planned to fulfil the Objectives of the CCG An annual report to be approved by the CCG Governing Body each Year [to report on achievement of the Objectives, key decisions taken by the Governing Body, performance against the CCG Annual Operating Plan for the previous Year and any recommended changes to the Constitution] and which shall be published on the website of the Clinical Commissioning Group following the AGM of the Council of Members for that Year. Page 8 of 98

9 CCG Headquarters CCG Governing Body Chair Chief finance officer Chief Officer Committee Conflict of interest Pomona House, Oak View Close, Torquay TQ2 7FF Telephone: Fax: the CCG s 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 the CCG 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. The person appointed as chair of the Governing Body for the CCG the qualified accountant employed by the CCG with responsibility for financial strategy, financial management and financial governance The title used for the Accountable Officer or Chief Officer of the organisation a committee or sub-committee created and appointed by: the membership of the CCG a committee / sub-committee created by a committee created / appointed by the membership of the CCG a committee / sub-committee created / appointed by the governing body A conflict of interest occurs where an individual s ability to exercise judgment or act in one role is or could be impaired or otherwise influenced by his or her involvement in another role or relationship. A potential for competing interests and/or a perception of impaired judgment or undue influence can also be conflicts of interest Constitution This constitution as amended from time to time in accordance with its terms Council of Members The group of the five locality member representatives formed as set out in this Constitution to carry out the functions set out in this Constitution; Financial year this usually runs from 1 April to 31 March, but under paragraph 17 of Schedule 1A of the 2006 Act (inserted by Schedule 2 of the 2012 Act), it can for the purposes of audit and accounts run from when the CCG is established until the following 31 March General Meeting Governing Body Member Any meeting of the Council of Members, including an AGM; any member appointed to the governing body of the CCG Page 9 of 98

10 Healthcare Professional A member of a profession that is regulated by one of the following bodies: the General Medical Council; the General Dental Council; the General Optical Council; the General Osteopathic Council; the General Chiropractic Council; the General Pharmaceutical Council; the Pharmaceutical Society of Northern Ireland; the Nursing and Midwifery Council; the Health Professions Council; or Lay member Locality Locality Group Member any other regulatory body established by an Order in Council under Section 60 of the Health Act 1999; 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 defined geographical area within the CCG s overall geographical area as set out in Section 7.3. The group of Members within a Locality, as indicated in Appendix A (List of Practice Members). The members from time to time of the CCG, being in each case a Practice holding a contract for the provision of primary medical services (whether a GMS, PMS or APMS contract) with the NHS England as listed in Appendix A of this Constitution and recorded in the Register of Members at the relevant time and Member shall mean one of them; Page 10 of 98

11 Member Representative Month Nolan Principles Practice Practice List Registers of interests Register of Members Risk appetite statement Special Resolution an individual appointed by a Member to act on its behalf in the dealings between it and the CCG and represent that Member at AGMs and General Meetings of the Council(s) of Members, 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) A calendar month; The seven principles of public life established by and set out in the Nolan Committee s First Report on Standards in Public Life as amended by the Committee of Standards in Public Life from time to time: Selflessness, Integrity, Objectivity, Accountability, Openness, Honesty, Leadership A sole practitioner GP, two or more individuals practising in partnership where the conditions in Section 86(2) of the Act are satisfied or a company limited by shares that satisfies the conditions set out in Section 86(3) of the Act [holding a Practice List] or any organisation providing services pursuant to an APMS Contract. Those persons who are provided with primary medical services by a Member, as listed on the practice list of each Member provided to the Executive Committee from time to time; Registers the 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 subcommittees and committees or subcommittees of its governing body; and its employees. The register of the Members of the Clinical Commissioning Group to be maintained by the Governing Body. A statement by the CCG Governing Body outlining the organisation s attitude to risk, providing guidance to the whole organisation on the level of acceptable risk in relation to finance, capability, performance and reputation. A special resolution is a resolution passed by the members or governing body by a greater majority than is required to pass an ordinary resolution. A special resolution must be affirmed by not less than 75% of member s casting votes, whereas an ordinary resolution only requires a bare majority. Page 11 of 98

12 Vice Chair The person confirmed as Vice Chair of the CCG s Governing Body in accordance with this Constitution. 1. Words in the singular include the plural and in the plural include the singular. 2. A reference to any gender includes a reference to the other gender. 3. A reference to a statute or statutory provision is a reference to it as it is in force for the time being taking account of any amendment, extension, or re-enactment and includes any subordinate legislation for the time being in force made under it. 4. Writing or written includes faxes and but not text messaging or any form of social media. 5. Where the words include(s) or including are used in this Constitution, they are deemed to have the words without limitation following them. 6. Reference to any person shall include natural persons and partnerships, firms and other incorporated bodies and all other legal persons of whatever kind and however constituted and their successors, permitted assigns or transferees. Page 12 of 98

13 1. INTRODUCTION AND COMMENCEMENT 1.1. Name The name of this clinical commissioning group is NHS South Devon and Torbay Clinical Commissioning Group. The headquarters are at Pomona House, Oak View Close, Torquay, Devon TQ2 7FF 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, as amended by section 13 of the 2012 Act, and the regulations made under that provision NHS England is responsible for determining applications from prospective CCGs to be established as clinical commissioning groups and undertakes an annual assessment of each established CCG. It has powers to intervene in a clinical commissioning group where it is satisfied that a CCG 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 group 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 South Devon and Torbay Clinical Commissioning Group and has effect from 18 th January 2013, when NHS England established the CCG. The Constitution is published on the CCG s website at Copies of the constitution are also available from the CCG Headquarters by postal request or by ing sdtccg@nhs.net. The updated version of the Constitution has been approved by NHS England on on the date outlined on the front cover sheet 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) by any member of the group, any member of its governing body, any member of any of its committees or sub-committees or the committees or subcommittees of its governing body, or any employee of the group or of any of its members, nor will it affect the rights of any worker (as defined in that Act) under that Act. Page 13 of 98

14 1.4. Amendment and Variation of this Constitution This Constitution can only be varied in two circumstances: a) where the CCG applies to NHS England Regional Director of Operations and Delivery and that application is granted; b) where in the circumstances set out in legislation NHS England varies the CCG s Constitution other than on application by the CCG. 2. AREA COVERED 2.1. The area covered by NHS South Devon and Torbay Clinical Commissioning Group is as follows: Torbay is defined by the three town areas of Brixham, Paignton and Torquay. Population projections estimate Torbay s resident population to grow by around 7.5% over the next 10 years, from 134,000 in 2010 to 144,000 in South Devon, as defined by the town areas of Newton Abbot, Teignmouth, Dawlish, Ashburton, Buckfastleigh, Bovey Tracey, Dartmouth and Totnes. There are a number of smaller town areas and parishes which cover a wide geographical area; rural isolation and deprivation are evident in some areas. The population in South Devon is projected to increase and there are plans for growth of the town areas The CCG area incorporates fully the boundaries of the unitary authority, Torbay Council and the following electoral divisions of the Upper tier authority, Devon County Council (Appendix B contains a map showing the relevant boundaries): 3. MEMBERSHIP Ashburton & Buckfastleigh, Bovey Tracey, Chudleigh, Dawlish, Kingsteignton, Newton Abbot North & South, Teignbridge South, Teignmouth, Teign Estuary and Totnes Membership of the Clinical Commissioning Group Appendix A contains the list of practices that comprise the members of NHS South Devon and Torbay Clinical Commissioning Group, together with the signatures of the practice representatives confirming their agreement to this Constitution Membership of the CCG is not transferable Eligibility Page 14 of 98

15 Any Practice situated within the Area which holds a contract for the provision of primary medical services is eligible to be a member of the CCG Applications for membership No Practice shall become a Member of the CCG unless that Practice: a) Is eligible to become a Member; b) The Practice lies within the agreed area for the CCG (see map attached in Appendix B); c) Has signed a Memorandum of Understanding with its respective Locality Group; or d) Has been entered into the Register of Members e) Is a member of and pays the statutory levy to Devon Local Medical Committee, unless a holder of an Alternative Provider Medical Services contract Any practice or locality wanting to join the CCG from outside its approved area, can only become a member if: a) Its geographical boundary is contiguous with the CCG; b) It has obtained written approval from its Health and Wellbeing Board and its current CCG; or c) Its application for membership has been approved by the CCG Governing Body d) It becomes a member of and pays the statutory levy to Devon Local Medical Committee, unless a holder of an Alternative Provider Medical Services contract If another locality outside the CCG footprint wanted to join, then all practices within that joining locality would be deemed to have become members of the CCG providing they have satisfied the criteria laid down in and Termination of membership A Member ceases to be a Member if: a) that Member gives not less than 6 months (from their acceptance as a Member) prior written notice to the CCG s Governing Body of their intention to cease being a Member of the CCG, the termination date will be aligned to the end of the financial year; b) subject to written confirmation of their acceptance into another clinical commissioning group (unless otherwise agreed by the CCG Governing Body); Page 15 of 98

16 c) that Member is a sole practitioner GP and he/she: i) Dies, following which, under NHS (GMS Contracts) Regs 2004 Sch 6 para 107 A and NHS (PMS Agreements) Regs 2004 Sch 5 para 99 A and as applicable in APMS, the contract will terminate at the end of the period of 7 days after the death of the GP, unless NHS England and the Contractors Practice Representatives agree (in writing) that it can continue for up to 28 days after the end of the initial 7 days; ii) iii) iv) Is declared bankrupt, Ceases to be registered as a medical practitioner; Enters into partnership with any other medical practitioner, except where that medical practitioner or the partnership is an existing Member; v) Ceases to be named on the performers list of the CCG other than in the event of a contingent removal; vi) Is contingently removed from the performers list, where the CCG Governing Body, in its absolute discretion, determines that the conditions placed on the Member s continued inclusion in the performers list would prevent or inhibit his/her ability to fulfil effectively his/her functions as a Member; or vii) Is suspended from the performers list of the CCG but only during the period of such suspension. d) that Member is two or more individuals practising in partnership and: i) The conditions in Section 86(2) of the Act are no longer satisfied; ii) iii) iv) The partnership is dissolved; That Member is a company limited by shares and: The conditions in Section 86(3) of the Act are no longer satisfied; v) In respect of that company any one of the following occurs: vi) A resolution is passed for voluntary winding up by reason of insolvency; vii) A winding up order is granted; viii) A resolution by its directors or members is passed to apply for an administration order; ix) An administrator is appointed under the Insolvency Act 1986; Page 16 of 98

17 x) A receiver or an administrative receiver is appointed over any of its assets or income; xi) A statutory demand is issued under the Insolvency Act 1986 which is not discharged before it is advertised; 3.5. Appeal process xii) It is unable to pay its debts as they fall due as determined by section 123 of the Insolvency Act 1986; xiii) The Practice ceases to be eligible for membership; xiv) That Member ceases to hold a contract for the provision of primary medical services within the Area of the South Devon and Torbay CCG; xv) That Practice merges with any other practice, unless that other practice is an existing Member On termination of membership the respective Member Practice shall have access to appeal to the Council of Members General The CCG recognises Devon Local Medical Committee as the statutory representative body of general practice for provider purposes in relation to local primary care contracts. 4. VISION, VALUES AND AIMS 4.1. Vision South Devon and Torbay CCG: commissioning excellent, joined-up care for everyone. Fresh, innovative and population-focused we are led by the views of our local people, doctors and healthcare professionals. Small enough to respond: big enough to deliver Our CCG will: a) Engage with its constituent Members through five localities, which are Torquay, Paignton and Brixham, Moor to Sea (Dartmouth, Totnes, Bovey Tracey, Ashburton, and Buckfastleigh), Newton Abbot (including Kingskerswell and Kingsteignton) and Coastal (Teignmouth and Dawlish). b) Strongly focus towards innovation and being different; to commissioning and ensuring great and seamless care for our population and to remain committed to quality in all that we do We see the vision for our CCG as two interdependent cogs : one which drives continuous improvement of our CCG, and the other our people. Page 17 of 98

18 The CCG will promote good governance and proper stewardship of public resources in pursuance of its goals and in meeting its statutory duties Values Good corporate governance arrangements are critical to achieving the CCG s objectives The values that lie at the heart of our CCG s work are: 4.3. Aims a) Clinical leadership: anything less is a dilution of innovation and purpose b) Loyalty, to our brand and our purpose c) Openness and communication between ourselves and to our constituent population d) Collaboration and integration (whatever it takes) The CCG s aims are to: a) Develop and integrate community, primary and secondary services - to provide focused and robust alternatives to admission at a local level. We are striving for true integration, not just between health and social care but between our providers and general practice. Integration for our CCG will also focus on South Devon Healthcare NHS Foundation Trust (SDHFT), with whom we strive to build an increasingly collaborative relationship in the context of integration. b) Referral Refinement - we wish to build on the success of the Devon Access and Referral Team (DART) referral management system, which has now been expanded to cover the Torbay area practices and also to provide referral refinement schemes within the pathways such as clinical referral triage services and access to community based diagnostics. c) Clinically effective pathways - our vision is to create seamless patient pathways through the use of experienced based design and participation, where the most appropriate professional provides care to the patient in the most appropriate place. We continue to work closely with our local providers and are pursuing the option of a virtual model of care that is free from traditional organisational boundaries. d) Promote innovation - we continue to strive to be at the front end of innovation utilising our learning from pilots such as COPD telehealth, working with community teams to create virtual wards for complex patients, and the development of technologies and support for those who require assisted living The detail of these aims, our commissioning intentions and our modus operandi for achieving the plan is detailed in our planning documents available from our website or from the corporate office contactable at corporate.sdtccg@nhs.net. Page 18 of 98

19 4.4. Principles of Good Governance In accordance with section 14L(2)(b) of the 2006 Act, 1 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; b) The Good Governance Standard for Public Services; c) the standards of behaviour published by the Committee on Standards in Public Life (1995) known as the Nolan Principles d) the seven key principles of the NHS Constitution e) the Equality Act 2010 f) the Standards for members of NHS boards and CCG governing bodies in England Accountability The CCG will demonstrate its accountability to its members, local people, stakeholders and NHS England in a number of ways, including by: a) publishing its Constitution; b) appointing independent lay members and non GP clinicians to its Governing Body; c) 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) to annually in public publish and present its annual report (which must be published); 1 Inserted by section 25 of the 2012 Act Page 19 of 98

20 g) producing annual accounts in respect of each financial year which must be externally audited; h) having a published and clear complaints process; i) complying with the Freedom of Information Act 2000; j) providing information to NHS England as required The CCG Governing Body will throughout each year have an on-going role in reviewing the CCG s governance arrangements to ensure that the CCG continues to reflect the principles of good governance. 5. FUNCTIONS AND GENERAL DUTIES 5.1. Functions The functions that the CCG is responsible for exercising are largely set out in the 2006 Act, as amended by the 2012 Act. An outline of these appears in the Department of Health s Functions of clinical commissioning groups: a working document. They relate to: a) commissioning certain health services (where NHS England is not under a duty to do so) that meet the reasonable needs of: i) all people registered with member GP practices, and ii) people who are usually resident within the area and are not registered with a member of any clinical commissioning group; b) commissioning emergency care for anyone present in the 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) act, when exercising its functions to commission health services, consistently with the discharge by the Secretary of State and NHS England of their duty to promote a comprehensive health service and with the objectives and requirements placed on NHS England through the mandate published by the Secretary of State before the start of each financial year by: i. establishing a governing body which has functions conferred on it by sections 14L(2) and (3) of the 2006 Act, inserted by section 25 the 2012 Act, together with any other functions connected with its main functions as may be specified in regulations or in this constitution; Page 20 of 98

21 ii. drawing up a schedule of decisions reserved to the governing body, and ensuring that management arrangements are in place to enable responsibility to be clearly delegated to governing body committees and senior officers (a scheme of delegation); iii. establishing appropriate committees of the governing body with which to enact the schemes of reservation and delegation; iv. developing a commissioning plan before the start of each financial year in accordance with the Act (the commissioning plan ) and any guidance published by NHS England. The commissioning plan must set out how the CCG proposes to exercise its functions during the relevant financial year; v. publish the commissioning plan and supply a copy to the NHS Commissioning Board before any date specified by the Board in a direction, and to any relevant Health and Wellbeing Board of which the CCG is a member; vi. making copies of the commissioning plan, as amended from time to time, available on the CCG s website. Copies of the commissioning plan will also available from the CCG headquarters, by postal request to the above address, or by ing sdtccg@nhs.net vii. where the CCG is preparing a commissioning plan or revising a commissioning plan in a way which the CCG considers significant, the CCG will consult individuals for whom it has responsibility for the purposes of Section 3 of the NHS Act 2006, and involve any relevant Health and Wellbeing Board in revising or preparing the commissioning Plan; viii. in drafting the commissioning plan, the CCG must have regard to the Procurement Guide for Commissioners of NHS-funded Services published on 30 July 2010 and any document which supersedes it; Operational Guidance to the NHS - Extending Patient Choice of Provider published on 19 July 2011 and any document which supersedes it; and any other documentation setting out how the Any Qualified Provider model is to function; ix. when commissioning services from those providers who are qualified to do so under the national list of services, the CCG must ensure that those qualified still meet the requirements, namely that they: are registered with the Care Quality Commission and licensed by Monitor (from 2013) where required, or meet equivalent assurance requirements; will meet the Terms and Conditions of the NHS Standard Contract which includes a requirement to have regard to the NHS Constitution, relevant guidance and law; Page 21 of 98

22 accept NHS prices; can provide assurances that they are capable of delivering the agreed service requirements and comply with referral protocols; reach agreement with local commissioners on supporting schedules to the standard contract including any local referral thresholds or patient protocols. b) meet the public sector equality duty by: i) delegating responsibility for ensuring that the CCG meets the public sector equality duty to the Quality Governance Committee; ii) iii) iv) developing and implementing a comprehensive equality strategy, that sets out how the CCG will eliminate unlawful discrimination, victimisation and other conduct prohibited by the Equality Act 2010; advance equality and of opportunity between people who share a protected characteristic and those who do not; and foster good relations between people who share a protected characteristic and those who do not; publishing, at least annually, sufficient information to demonstrate compliance with this general duty across all functions; preparing and publishing specific and measurable equality objectives, revising these at least every four years; v) using the Equality Delivery System toolkit to assist the CCG in delivering these duties; vi) having regard to any guidance or requirements published by NHS England. c) work in partnership with its local authorities to develop joint strategic needs assessments and joint health and wellbeing strategies by: i) being members of the Torbay Health and Wellbeing Board and the Devon Health and Wellbeing Board, which will act as the focus of leadership and coordination of strategic commissioning in relation to the spending and service priorities of these bodies. and the advantages and opportunities of joint working; ii) iii) giving the Health and Wellbeing Boards a draft of the commissioning plan or, as the case may be, a copy of the revised commissioning plan; consulting the Health and Wellbeing Boards on whether the draft Commissioning Plan takes proper account of the Joint Health and Wellbeing Strategies, published by the Health and Wellbeing Boards, Page 22 of 98

23 which relates to the period (or any part of the period) to which the commissioning plan relates; iv) including in the published commissioning plan or, in circumstances where the CCG revises a published plan in a way in which the CCG considers significant, the revised commissioning plan, a summary of the views expressed by individuals consulted; an explanation of how the CCG took account of those views; and a statement of the final opinion of the Health and Wellbeing Board consulted in relation to the commissioning plan 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 by: a) developing and implementing a comprehensive communications and engagement strategy which sets out how patients and the public will be involved in decisions about local health services, including: i) adapting engagement activities to meet specific needs of the different patient groups and communities, wherever possible taking a direct and personalised approach; ii) iii) publishing information about health services, the group s aims and ambitions and its performance on the group s website and through other media; demonstrating how the group is effectively involving patients, the public and other stakeholders through quarterly reports to the Governing Body, and through the publication of an annual review of all communication and engagement activity 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 Constitution by: a) establishing a Quality Governance Committee and delegating responsibility for ensuring the discharge of the duty, with progress reported to the governing body on a six monthly basis; b) having regard to any guidance or requirements published by NHS England Act effectively, efficiently and economically by: a) delegating responsibility to the governing body to oversee how it discharges this duty, including: Page 23 of 98

24 i) ensuring that the group operates within the corporate governance framework (i.e., its standing orders, scheme of delegations and standing financial instructions) ii) establishing an Audit Committee to assist the governing body in delivering its responsibilities for the conduct of public business, and the stewardship of funds under its control. In particular, providing assurance to the Governing body that an appropriate system of internal control is in place to ensure that: business is conducted in accordance with the law and proper standards; public money is safeguarded and properly accounted for; affairs are managed to secure economic, efficient and effective use of resources; reasonable steps are taken to prevent and detect fraud and other irregularities. III. IV. establishing a Commissioning & Finance Committee to provide a performance framework which proactively manages the CCG s financial, performance and quality, innovation, productivity and prevention (QIPP) agenda; holding meetings of the governing body in public to ensure appropriate scrutiny and accountability; V. publishing via the group s website and other media regular information about the aims, ambitions and performance of the group; VI. VII. VIII. publishing, at least annually, sufficient information to demonstrate compliance with this general duty across all functions; holding an annual general meeting in public; having regard to any guidance or requirements published by NHS England Act with a view to securing continuous improvement to the quality of services by: a) delegating responsibility to the Quality Governance Committee for ensuring the discharge of the duty by: i) developing and implementing a comprehensive quality strategy that sets out how the CCG will be assured that commissioned services are being delivered in a high quality and safe manner, ensuring that quality sits at the heart of everything the CCG does; Page 24 of 98

25 ii) iii) iv) ensuring the principles of quality assurance and governance are integral to performance monitoring arrangements for all CCG commissioned services, and are embedded within consultation, service development and redesign, evaluation of services and decommissioning of services; leading the development and implementation the CCG quality strategy and quality assurance framework; providing regular reports to the governing body at agreed intervals covering the activities of the committee and demonstrating progress; v) having regard to any guidance or requirements published by NHS England Assist and support NHS England in relation to the Board s duty to improve the quality of primary medical services by: a) delegating responsibility for the discharge of this duty to the Commissioning & Finance Committee, which is accountable to the governing body, with progress reported regularly to the governing body; b) having regard to any guidance or requirements published by NHS England Have regard to the need to reduce inequalities by: a) establishing a commissioning & finance committee and delegating responsibility for ensuring the discharge of the duty by: i) developing and implementing a commissioning strategy that sets out how the CCG will commission services, and provide assurance that the CCG is commissioning services in line with the needs of the local population and the strategic objectives of the group in order to reduce health inequalities; ii) iii) iv) providing assurance to the governing body that commissioning and decommissioning of services is evidence based and is inclusive of national and local requirements; providing regular reports to the governing body at agreed intervals covering the activities of the committee and demonstrating progress; having regard to any guidance or requirements published by NHS England Promote the involvement of patients, their carers and representatives in decisions about their healthcare and act with a view to enabling patients to make choices by: a) Actively seeking the views of patients, carers and the wider community about the services they need and how they can be improved; Page 25 of 98

26 b) delegating responsibility to the Quality Governance Committee, which is accountable to the governing body, for ensuring that patients, carers and representatives are given the right to choose a GP and change to another if they are not happy; the right to choose which hospital they go to if referred to a specialist; and the right to be involved in decisions about their healthcare and to be given the information they need to do this; c) reporting progress to the governing body on a regular basis; d) having regard to any guidance or requirements published by NHS England Obtain appropriate advice from persons who, taken together, have a broad range of professional expertise in healthcare and public health by: a) delegating responsibility to the governing body to ensure that the group has a properly constituted governing body which includes a mix of clinical and nonclinical expertise, including but not limited to GPs, secondary care clinicians, nurses, public health consultants, experienced and capable officers and independent lay members with a range of skills and expertise; b) ensuring that local healthcare professionals and others with experience and expertise are widely consulted on the development of the group s commissioning plan and in the development and implementation of any other commissioning or decommissioning plans; c) ensuring that the views of a range of clinicians from different specialisms and areas of expertise are taken into account when considering issues relating to quality and quality improvement Promote innovation and Promote research and the use of research by: a) Ensuring systems and processes are in place that secure continuous learning throughout the commissioning cycle; b) delegating responsibility to the governing body, through its committees, to ensure that innovation in the provision of health services and research, including research on matters relevant to the health service and the use in the health service of evidence obtained by research, are core to the way in which the CCG operates Have regard to the need to promote education and training for persons who are employed, or who are considering becoming employed, in an activity which involves or is connected with the provision of services as part of the health service in England so as to assist the Secretary of State for Health in the discharge of his related duty by: a) developing and implementing an organisational development plan, implementation of which will be monitored by the governing body, with regular updates on progress reported to the group. Page 26 of 98

27 Act with a view to promoting integration of both health services with other health services and health services with health-related and social care services where the group considers that this would improve the quality of services or reduce inequalities by: a) delegating responsibility to the commissioning & finance committee, which is accountable to the governing body, for ensuring that services (health and social care) are provided in an integrated way to: i) improve the quality of services, including the outcomes that are achieved from their provision; ii) reduce inequalities between persons with respect to their ability to access those services or with respect to the outcomes achieved for them by the provision of those services. b) reporting progress to the Governing Body on a regular basis; c) having regard to any guidance or requirements published by NHS England General Financial Duties the CCG will perform its functions so as to: Ensure its expenditure does not exceed the aggregate of its allotments for the financial year and ensure its use of resources (both its capital resource use and revenue resource use) does not exceed the amount specified by NHS England for the financial year; take account of any directions issued by NHS England, in respect of specified types of resource use in a financial year, to ensure the CCG does not exceed an amount specified by NHS England and publish an explanation of how the CCG spent any payment in respect of quality made to it by NHS England 2 by; a) delegating responsibility to the Chief Finance Officer in line with the role outlined in paragraph 7.9 and the Commissioning & Finance Committee in line with the role outlined in paragraph 6.6.5; b) delegating responsibility to the Audit Committee in line with the role outlined in paragraph In particular the committee will seek to provide assurance to the governing body on at least an annual basis that an appropriate system of internal control is in place to ensure that: i) business is conducted in accordance with the law and proper standards; ii) public money is safeguarded and properly accounted for; iii) financial statements are prepared in a timely fashion, and give a true and fair view of the financial position of the group; iv) affairs are managed to secure economic, efficient and effective use of resources; v) reasonable steps are taken to prevent and detect fraud and other irregularities. 2 See section 223K(7) of the 2006 Act, inserted by section 27 of the 2012 Act Page 27 of 98

28 c) having regard to any guidance or requirements published by NHS England Other Relevant Regulations, Directions and Documents The CCG will: a) comply with all relevant regulations; b) comply with directions issued by the Secretary of State for Health or NHS England; and c) take account, as appropriate, of documents issued by NHS England 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. 6. DECISION MAKING: THE GOVERNING STRUCTURE 6.1. Authority to act The CCG is accountable to NHS England for exercising its statutory functions and for the delivery of securing the best value and quality of care for the population it serves whilst also promoting health and wellbeing. It may grant authority to act on its behalf to: a) any of its Members; b) its Governing Body; c) employees; d) a Committee or Sub-Committee of the 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 Scheme of Reservation and Delegation The CCG s Scheme of Reservation and Delegation is at Appendix D (Scheme of Reservation and Delegation). It sets out: a) those decisions that are reserved for the Members as a whole; Page 28 of 98

29 b) those decisions that are the responsibilities of the CCG Governing Body, the CCG s Committees and Sub-Committees, individual Members and employees The CCG remains accountable to NHS England for all of its functions, including those that it has delegated General In discharging functions of the CCG that have been delegated to its Governing Body, committees, sub-committees, joint arrangements and individuals must: a) comply with the CCG s principles of good governance, b) operate in accordance with the CCG s scheme of reservation and delegation, c) comply with the CCG s standing orders, d) comply with the CCG s arrangements for discharging its statutory duties, e) where appropriate, ensure that Members have had the opportunity to contribute to the CCG s decision making process When discharging their delegated functions, committees, sub-committees and joint arrangements must also operate in accordance with their approved terms of reference Where delegated responsibilities are being discharged collaboratively, the joint (collaborative) arrangements must: a) identify the roles and responsibilities of Northern Eastern Western Devon Clinical Commissioning Group, Torbay Health & Wellbeing Board and Devon Health & Wellbeing Board and the CCG who are working together; b) identify any pooled budgets and how these will be managed and reported in annual accounts; c) specify under which CCG s scheme of reservation and delegation and supporting policies the collaborative working arrangements will operate; d) specify how the risks associated with the collaborative working arrangement will be managed between the respective parties; e) identify how disputes will be resolved and the steps required to terminate the working arrangements; f) specify how decisions are communicated to the collaborative partners Committees of the CCG Page 29 of 98

30 The following committees have been established by the CCG, this shown diagrammatically in Appendix H: a) Audit Committee; b) Strategic HR and Remuneration Committee; c) Quality Governance Committee; d) Commissioning & Finance Committee; e) Senior Leadership Committee; f) Engagement Committee Committees will only be able to establish their own sub-committees, to assist them in discharging their respective responsibilities, if this responsibility has been delegated to them by the CCG or the committee they are accountable to. 6.5 Joint commissioning arrangements with other Clinical Commissioning Groups 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: delegating any of the CCG s commissioning functions to another CCG; exercising any of the commissioning functions of another CCG; or exercising jointly the commissioning functions of the CCG and another CCG For the purposes of the arrangements described at paragraph [6.5.2], the CCG may: make payments to another CCG; receive payments from another CCG; make the services of its employees or any other resources available to another CCG; or receive the services of the employees or the resources available to another CCG 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 [6.5.2] above, the CCG may establish and maintain a pooled fund made up of contributions by any of the CCGs working together pursuant to paragraph 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 Where the CCG makes arrangements with another CCG as described at paragraph [6.5.2] 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 Page 30 of 98

31 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 The liability of the CCG to carry out its functions will not be affected where the CCG enters into arrangements pursuant to paragraph [1.2] above The CCG will act in accordance with any further guidance issued by NHS England 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 Joint commissioning arrangements with NHS England for the exercise of CCG functions The CCG may wish to work together with NHS England in the exercise of its commissioning functions The CCG and NHS England may make arrangements to exercise any of the CCG s commissioning functions jointly The arrangements referred to in paragraph [6.6.2] above may include other CCGs Where joint commissioning arrangements pursuant to [6.6.2] above are entered into, the parties may establish a joint committee to exercise the commissioning functions in question Arrangements made pursuant to [6.6.2] above may be on such terms and conditions (including terms as to payment) as may be agreed between NHS England and the CCG Where the CCG makes arrangements with NHS England (and another CCG if Page 31 of 98

32 relevant) as described at paragraph [6.6.2] above, the CCG shall develop and agree with NHS England a framework setting out the arrangements for joint working, including details of: How the parties will work together to carry out their commissioning functions; The duties and responsibilities of the parties; How risk will be managed and apportioned between the parties; Financial arrangements, including, if applicable, payments towards a pooled fund and management of that fund; Contributions from the parties, including details around assets, employees and equipment to be used under the joint working arrangements; and The liability of the CCG to carry out its functions will not be affected where the CCG enters into arrangements pursuant to paragraph [2.2] above The CCG will act in accordance with any further guidance issued by NHS England 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 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 Joint commissioning arrangements with NHS England for the exercise of NHS England s functions The CCG may wish to work with NHS England and, where applicable, other CCGs, to exercise specified NHS England functions The CCG may enter into arrangements with NHS England and, where applicable, other CCGs to: Exercise such functions as specified by NHS England under delegated arrangements; Jointly exercise such functions as specified with NHS England Where arrangements are made for the CCG and, where applicable, other CCGs to exercise functions jointly with NHS England a joint committee may be Page 32 of 98

33 established to exercise the functions in question Arrangements made between NHS England and the CCG may be on such terms and conditions (including terms as to payment) as may be agreed between the parties For the purposes of the arrangements described at paragraph [6.7.2] above, NHS England and the CCG may establish and maintain a pooled fund made up of contributions by the parties working together. Any such pooled fund may be used to make payments towards expenditure incurred in the discharge of any of the commissioning functions in respect of which the arrangements are made Where the CCG enters into arrangements with NHS England as described at paragraph [6.7.2] 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 The liability of NHS England to carry out its functions will not be affected where it and the CCG enter into arrangements pursuant to paragraph [3.2] above The CCG will act in accordance with any further guidance issued by NHS England 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 The Governing Body Page 33 of 98

34 Functions - the Governing Body has the following functions conferred on it by sections 14L(2) and (3) of the 2006 Act, inserted by section 25 the 2012 Act, together with any other functions connected with its main functions as may be specified in regulations or in this Constitution. The Governing Body has responsibility for: a) ensuring that the CCG has appropriate arrangements in place to exercise its functions effectively, efficiently and economically and in accordance with the CCGs principles of good governance (its main function); b) determining the remuneration, fees and other allowances payable to employees or other persons providing services to the CCG and the allowances payable under any pension scheme it may establish under paragraph 11(4) of Schedule 1A of the 2006 Act, inserted by Schedule 2 of the 2012 Act; c) approving any functions of the CCG that are specified in regulations; d) creating a culture of openness and transparency, values and behaviours which support continuous improvements in clinical effectiveness, safety and experience of the services the CCG commissions; e) ensuring an assurance framework is in place linked to strategic objectives and risks; f) approving the CCG s code of conduct outlining, the organisation s culture, values and behaviours based on the principles of good governance, the Nolan Principles and other codes of conduct (for NHS Managers and clinical professions); lead by example and be assured of awareness of and compliance with the code of conduct by all staff; g) determining the CCG s risk appetite; h) monitoring management of significant risk and seek assurance that management decisions balance performance within the defined risk tolerance limits; i) understanding the implications of actions taken by Locality Groups and management in pursuit of better outcomes, and their potential impact on local communities, other Localities, partner organisations, strategic providers and other stakeholders; j) performing effectively in clearly defined functions and roles; k) promoting an open and transparent learning culture and values for the whole organisation, demonstrating the values of good governance through behaviour; l) taking informed, transparent decisions and managing risk; m) developing the capacity and capability of the Governing Body and management resource to be effective; Page 34 of 98

35 n) engaging stakeholders and making accountability real Composition of the Governing Body - the Governing Body shall not have less than thirteen voting members and comprises of: a) the Chair (Clinical Chair); b) five Member Representatives with clinical leadership roles: i) Clinical lead for Commissioning ii) Clinical lead for Innovation, Engagement and Communication and Medicines Optimisation iii) Clinical Lead for Finance and Governance iv) Clinical lead for Integration v) Clinical lead for Patient Safety and Quality c) three independent lay non-executive Director members: i) one to lead on audit, remuneration and conflict of interest matters, ii) one to lead on patient and public engagement and participation matters, iii) one to lead on financial sustainability; d) one non-executive Director registered non-medical practitioner; e) one non-executive Director secondary care specialist consultant; f) the Chief Officer (Accountable Officer); g) the Director of Finance (Chief Finance Officer); h) the Director of Commissioning & Transformation (Chief Operating Officer); i) the Director of Wellbeing & Family Services j) Director of Corporate Affairs and Medicines Optimisation; k) Director of Quality Assurance & Improvement (Chief Nursing Officer); l) Chair of the localities group (Executive Director roles naming conventions may change with approval from Governing Body and NHS England. Descriptions and portfolios are therefore version/date controlled and held outside of the constitution by HR) There are additional members with non-voting rights: m) Co-opted member Director of Public Health for Torbay n) Co-opted member Director of Public Health for Devon Governing Body Members collectively share corporate responsibility for all CCG Governing Body decisions. Page 35 of 98

36 The Governing Body s Chair, lay persons and clinical members are responsible for monitoring the CCG s executive management Committees of the Governing Body - the Governing Body has appointed the following Committees and Sub-Committees: a) Audit Committee the audit committee, which is accountable to the group s governing body, provides the governing body with an independent and objective view of the group s financial systems, financial information and compliance with laws, regulations and directions governing the group in so far as they relate to finance. The governing body has approved and keeps under review the terms of reference for the audit committee, which includes information on the membership of the audit committee. b) Strategic HR and Remuneration Committee the strategic HR and remuneration committee, which is accountable to the group s governing body and provides the Governing Body with assurance and oversight of all aspects of strategic people management and organisation development, including the approval of the appointment, remuneration, terms of service and severance for the Accountable Officer, Directors, employees, clinicians and for people who provide services to the group and on determinations about allowances under any pension scheme that the group may establish as an alternative to the NHS pension scheme.the governing body has approved and keeps under review the terms of reference for the remuneration committee, which includes information on the membership of the remuneration committee. c) Commissioning & Finance Committee the commissioning & finance committee, which is accountable to the group s governing body, is responsible for providing a performance framework which proactively manages the CCG s financial, performance and quality, innovation, productivity and prevention (QIPP) agenda, and is responsible for providing assurance to the governing body that the CCG is commissioning services that are safe in line with the needs of the local population and the strategic objectives of the CCG. It also provides assurance to the governing body that commissioning and decommissioning of services is evidence based and is inclusive of national and local requirements. The Committee will have an oversight of budget and financial plans. The governing body has approved and keeps under review the terms of reference for the commissioning & finance committee, which includes information on the membership of the committee. d) Quality Governance Committee the quality governance committee, which is accountable to the CCG s Governing Body, help the board develop and understand service quality and safety issues, (including primary care) and provide assurance to the Governing Body on these matters. On occasions the committee may test the quality approach by deep-dive type interest in areas of service quality. The aim of this committee is to ensure that the Governing Body mainstreams consideration of service and clinical issues; identify and manage risks to safety and quality; act against poor performance; and implement plans to drive continuous improvement, including the focus on patient feedback and its direct relationship to commissioning decisions. The Governing Body has Page 36 of 98

37 approved and keeps under review the terms of reference for the quality governance committee, which includes information on the membership of the Committee. e) Senior Leadership Committee the committee, which is accountable to the group s governing body, is responsible for handling complex, major organisational issues and operational matters relating to business continuity, as well as any matters for which a strategic, business or operational decision is required. The Governing Body has approved and keeps under review the terms of reference for the senior management committee, which includes information on the membership of the Committee. f) Engagement Committee - the committee, which is accountable to the group s governing body, will oversee engagement activity relating to all aspects of the CCG s business. It will support the implementation of the CCG s Procurement, Engagement and Experience Strategies, taking a whole commissioning-cycle view and planning key engagement activities accordingly, bringing together centrally, issues and areas of success and learning from locality engagement forum representatives. This will enable a stronger link between the CCG and our public and local communities. 7. ROLES AND RESPONSIBILITIES 7.1. Practice Representatives Practice representatives are named by their practice and represent their practice s views and act on behalf of the practice in matters relating to the group. The role of each practice representative is identified as being to: a) maintain awareness of the group s work through CCG communication, attendance at meetings, discussion of commissioning at practice and patient group meetings, and dissemination of newsletters and updates among practice staff; b) enable and facilitate two-way communications between individual practices, their localities and the group, particularly in relation to CCG business; c) discuss and debate the views and wishes of the practices in relation to matters regarding the group; d) provide feedback from patients and carers that might inform commissioning decisions and / or intentions of the group; e) relay information on provider quality issues to practices; f) provide practice-level input in the development of the commissioning strategy and any other commissioning or decommissioning intentions; g) assist the CCG in taking forward developments and improvements in Page 37 of 98

38 relation to primary care services, including improving the performance of primary care services within the group; h) adhere to commissioning decisions made by the governing body, particularly in relation to commissioned care pathways and service policy; i) participate in specific pathway redevelopments, providing insight and feedback as appropriate; j) endeavour to make available clinical and other staff to lead or participate in commissioning project work as far as is reasonably possible; k) keep up to date on commissioning and related issues through the normal professional publications, educational events and networks; l) provide feedback on the performance of the governing body and its members. m) Promote the success of the CCG for the benefit of the Members as a whole; n) Act within the powers set out in this Constitution and as enshrined in the CCG s (as accountable body) Scheme of Reservation and Delegation; 0) Exercise independent judgement; p) Exercise reasonable care, skill and diligence; q) Declare any interest of that Member Representative (and, if relevant, the Member he represents) in any proposed transaction or arrangement with or being considered by the CCG; r) Avoid conflicts of interest; and s) Not accept benefits from third parties Each Member authorises their Member Representatives in their role to: a) receive notice of, attend and vote at any meetings of the Locality, Council of Members (whether an AGM or General Meeting of the Council of Members (whether on a show of hands or on a poll)), or sign any written resolution on behalf of that Member; b) appoint a proxy, complete and return proxy cards, consents to short notice and any other documents required to be signed by the Member; c) receive distributions on behalf of the Member; Page 38 of 98

39 d) deal with and giving directions as to resources, securities, benefits, documents, notices or other communications (in whatever form) arising by right of or received in connection with the Member s membership of the CCG For the avoidance of doubt, the CCG Governing Body shall be entitled to treat any Member Representative as having the continuing authority given to him under Clause until it is notified of a change of that Member Representative. Any provision of this Constitution that requires delivery or notification to a Member shall be deemed to have been satisfied if delivery or notification is made to or served on the Member Representative Localities and Locality Groups The CCG has the following five defined Localities within the CCG s overall geographical area: a) Torquay b) Paignton and Brixham c) Moor to Sea d) Newton Abbot e) Coastal Composition and membership: Locality Groups will represent the five determined areas of the CCG. They: a) will have a clinical and managerial representative from each constituent practice with mandates from constituent Members; b) can co-opt Members Representatives to ensure appropriate competencies; c) will appoint or select a Clinical and a Managerial lead from the locality group members; d) The management of the Locality Groups can be determined by each Locality to build on existing practice and geographical requirements. However, the CCG Governing Body and constituent sub-committees must be assured that the Locality Groups will have the appropriate skills, competencies, level of challenge, processes and procedures, in order to fulfil the Locality s duties and accountabilities to the standards expected. Primarily, these will be concerned with engagement and Member commissioning performance The Council of Members The Council of Members consists of all Locality Members and defines the comingtogether of the five localities at least twice per annum at which certain decisions and resolutions are agreed The members will hold the CCG to account through the Council of Members. In case the members feel they have not been heard sufficiently, the members shall have the following rights: Page 39 of 98

40 a) By a vote of a simple majority within the council of members the CCG Governing Body or locality as appropriate will agenda for discussion and, where necessary, decision any business deemed worthy by the council of members to be subject to this clause. Where this clause is invoked for a locality the CCG will ensure that all other localities and the council members relating to them are made aware of the invoking of this clause and the subject matter to which it relates. b) The members may call a special meeting of the CCG Governing Body at which the members may be present on the basis of a written request from at least a third of the members. c) The members may instigate a vote of no confidence in the Governing Body, with notification to NHS England, on the basis of written notice from at least 75% of the members The Council of Members will receive appeals against termination of CCG membership as per section Other GP and Primary Care Healthcare Professionals In addition to the Member Representatives identified in section 7.1 above, the CCG has identified a number of other GPs / primary care Healthcare Professionals from its Members to either support the work of the CCG and / or represent the CCG rather than represent their own Member. These roles will be subject to the CCG staff policies as appropriate including appraisals. These GPs and Primary Care Healthcare Professionals undertake the following roles on behalf of the CCG: a) Locality clinical lead responsible for improving the performances of the locality they lead for in relation to primary care services. They will be held to account by the governing body to ensure that the Locality 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. b) GP Governing Body members assume responsibility at the governing body for specific portfolios considered to be important to the success of the group s aims. They also share responsibility as part of the governing body to ensure that the group exercises its functions effectively, efficiently and economically, with good governance and in accordance with the terms of this constitution. Each brings their unique perspective, informed by their expertise and experience. c) Leadership Roles assume responsibility below the governing specific roles in leading identified important areas All Members of the CCG Governing Body Page 40 of 98

41 Guidance on the roles of Governing Body Members is set out in a separate document, the current version of which is entitled Clinical Commissioning Group Governing Body Members Roles Attributes and Skills, NHS England Authority, October In summary, each Governing Body Member 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 The Chair of the Governing Body The Chair of the Governing Body is responsible for: a) leading the Governing Body, ensuring it remains continuously able to discharge its duties and responsibilities as set out in this Constitution; b) building and developing the 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 CCG; f) contributing to building a shared vision of the aims, values and culture of the CCG; 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 to ensure that; public and patients views are heard and their expectations understood and, where appropriate as far as possible, met; the CCG is able to account to its local patients, stakeholders and NHS England; the CCG builds and maintains effective relationships with its stakeholders 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 NHS England The Deputy Chair of the Governing Body Page 41 of 98

42 The Deputy Chair of the Governing Body deputises for the Chair of the Governing Body where he or she has a conflict of interest or is otherwise unable to act Where the CCG Chair is a clinician the role of Deputy Chair will be undertaken by one of the Lay Members who will be appointed by the Chair Role of the Accountable Officer The Accountable Officer (Chief Officer) is a full Governing Body Member of the CCG The role of Accountable Officer has been summarised as: a) being responsible for ensuring that the CCG fulfils its duties to exercise its functions effectively, efficiently and economically thus ensuring improvement in the quality of services and the health of the local population whilst maintaining value for money; b) at all times ensuring that the regularity and propriety of expenditure is discharged, and that arrangements are put in place to ensure that good practice (as identified through such agencies as the Audit Commission and the National Audit Office) is embodied and that safeguarding of funds is ensured through effective financial and management systems. c) working closely with the Chair of the Governing Body, the Accountable Officer will ensure that proper constitutional, governance and development arrangements are put in place to assure the Members (through the Governing Body) of the CCG s on-going capability and capacity to meet its duties and responsibilities. This will include arrangements for the on-going developments of its members and staff Role of the Deputy Accountable Officer The Deputy Accountable Officer will be appointed from one of the existing CCG Executive Directors and deputises for the CCG Accountable Officer where he or she is unable to act Role of the Chief Finance Officer The Chief Finance Officer (Director of Finance) is a full Governing Body Member and is responsible for providing financial advice to the CCG and for supervising financial control and accounting systems This role of Chief Finance Officer has been summarised in a national document as: a) being the Governing Body s professional expert on finance and ensuring, through robust systems and processes, the regularity and propriety of expenditure is fully discharged; b) making appropriate arrangements to support and monitor the CCG s finances; Page 42 of 98

43 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; and e) producing the financial statements for audit and publication in accordance with the statutory requirements to demonstrate effective stewardship of public money and accountability to NHS England; f) responsibility for the CCG's compliance with its financial, accounting and auditing obligations and related duties resting with the Accountable Officer; g) Day-to-day responsibility for the financial strategy and financial governance of the CCG, and possibly its financial management Role of the Non-Medical Practitioner The non-executive Director Non-Medical Practitioner as an advisor to the governing body, bringing a broader view on health and care issues to underpin the work of the CCG. In particular, they will bring to the governing body an understanding of the role of non-medical professionals in patient care Role of the Secondary Care Clinician The non-executive Director Secondary Care Clinician acts as an advisor to the governing body, bringing a broader view on health and care issues to underpin the work of the CCG. In particular, they will bring to the governing body an understanding of patient care in the secondary care setting Role of the Independent Lay Members The role of the non-executive Director independent lay members is to bring specific expertise and experience to the work of the governing body. 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. Their role will be to oversee key elements of governance including audit, remuneration and managing conflicts of interest. They will ensure that the governing body and the wider CCG behaves with the utmost probity at all times. They will also ensure that, in all aspects of the CCG s business the public voice of the local population is heard and that opportunities are created and protected for patient and public empowerment in the work of the CCG Role of the Director of Commissioning & Transformation (Chief Operating Officer) The Director of Commissioning & Transformation is responsible for developing and delivering the CCG s local commissioning plan achieving agreed QIPP Page 43 of 98

44 objectives, delivering improved health, clinical outcomes, patient experience, and productivity. Working closely with the Chief Finance Officer, Director of Wellbeing & Family Services and other members of the management team, this role will take responsibility for ensuring that all financial, legal and contractual requirements are met within the commissioning process Role of the Director of Wellbeing & Family Services The focus of this role is on wellbeing and holistic care, in line with the CCG s aspiration to create a service of wellbeing for patients, carers and its population which knows no boundaries and which does not differentiate between people with a mental or a physical illness. The Director of Wellbeing & Family Services will carry executive and Governing Body responsibility for safeguarding children and safeguarding adults and will be the governing body s nursing representative Role of the Director of Corporate Affairs and Medicines Optimisation The Director of Corporate Affairs & Medicines Optimisation will have responsibility for the sound corporate governance of the Clinical Commissioning Group as well as the Collaborative Commissioning Support arrangements and Back Office Functions for the CCG. The Director of Corporate Affairs & Medicines Optimisation will be responsible for Medicines optimisation, IT and Information Governance requirements for the CCG including fulfilling the role of Senior Information Risk Owner (SIRO) as well as the HR requirements for the CCG Role of the Director of Quality Assurance & Improvement (Chief Nursing Officer) The Director of Quality Assurance & Improvement will have responsibility for clinical governance, innovation and sustainability arrangements for the CCG and that the 3 domains of quality (patient safety, patient experience and clinical effectiveness) underpin all commissioning decisions and processes. They will also act as the CCGs Caldicott Guardian. 8. STANDARDS OF BUSINESS CONDUCT AND MANAGING CONFLICTS OF INTEREST 8.1. Standards of Business Conduct Employees, Members, Committee and Sub-committee members of the CCG and Governing Body Members (and its Committees) will at all times comply with this Constitution and be aware of their responsibilities as outlined in it. They should act in good faith and in the interests of the CCG and should follow the Seven Principles of Public Life, set out by the Committee on Standards in Public Life (the Nolan Principles) The Nolan Principles are incorporated into this Constitution at Appendix F. Page 44 of 98

45 They must comply with the CCG s policy on business conduct, including the requirements set out in the policy for managing conflicts of interest. This policy will be available on the CCG s website at Copies of the policy are also available from the CCG Headquarters by postal request or by ing sdtccg@nhs.net 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 In case any of the above is compromised through a Locality Groups actions, the CCG Governing Body will have the following powers: a) Initiate an assessment of the potential impact of the Locality Group s proposed actions or failure to work within its budget; b) Request a special meeting between Governing Body Members and the Locality Group; c) Call an extraordinary meeting of the Council of Members; d) Draw up with the Locality Group a plan which would avoid or remedy the proposed actions; e) Hold the Locality Group to account for the implementation of the remedial plan; In case of non-compliance or persistent and wilful lack of engagement, the CCG Governing Body will be entitled to: a) Revoke the delegated authority from the relevant Locality Group b) In extremis, stop the funding stream to the Locality Group and make alternative arrangements for the relevant population. c) Communicate relevant matters to the whole of the CCG Members as appropriate Conflicts of Interest As required by section 14O of the 2006 Act, as inserted by section 25 of the 2012 Act, the CCG will make arrangements to manage conflicts and potential conflicts of interest to ensure that decisions made by the CCG will be taken and seen to be taken without any possibility of the influence of external or private interest Where an individual, i.e. an employee, Member, Governing Body Member, or a member of a Committee or a Sub-Committee of the CCG or its Governing Body has an interest, or becomes aware of an interest which could lead to a conflict of interests in the event of the CCG considering an action or decision in relation to that Page 45 of 98

46 interest, that must be considered as a potential conflict, and is subject to the provisions of this Constitution A conflict of interest will include: a) a direct pecuniary interest: where an individual may financially benefit from the consequences of a commissioning decision (for example, as a provider of services); b) an indirect pecuniary interest: for example, where an individual is a partner, member or shareholder in an organisation that will benefit financially from the consequences of a commissioning decision; c) a non-pecuniary interest: where an individual holds a non-remunerative or not-for profit interest in an organisation, that will benefit from the consequences of a commissioning decision (for example, where an individual is a trustee of a voluntary provider that is bidding for a contract); d) a non-pecuniary personal benefit: where an individual may enjoy a qualitative benefit from the consequence of a commissioning decision which cannot be given a monetary value (for example, a reconfiguration of hospital services which might result in the closure of a busy clinic next door to an individual s house); e) where an individual is closely related to, or in a relationship, including friendship, with an individual in the above categories If in doubt, the individual concerned should assume that a potential conflict of interest exists Declaring and Registering Interests The CCG will maintain one or more registers of the interests: a) the members of the group; b) the members of its governing body; c) Locality Groups; d) Council of members; e) the members of its committees or sub-committees and the committees or subcommittees of its governing body; and f) its employees Copies of the register are available from CCG s website at Copies of the register are also available from the CCG Headquarters by postal request or by ing sdtccg@nhs.net. Page 46 of 98

47 Individuals will declare any interest that they have, in relation to a decision to be made in the exercise of the commissioning functions of the group, in writing to the governing body, as soon as they are aware of it and in any event no later than 28 days after becoming aware Where an individual is unable to provide a declaration in writing, for example, if a conflict becomes apparent in the course of a meeting, they will make an oral declaration before witnesses, and provide a written declaration as soon as possible thereafter The Director of Corporate Affairs and Medicines Optimisation, reporting to the Chief Officer, will ensure that the register of interest is reviewed regularly, and updated as necessary Managing Conflicts of Interest: general Individual members of the group, the governing body, committees or subcommittees, the committees or sub-committees of its governing body and employees will comply with the arrangements determined by the group for managing conflicts or potential conflicts of interest The Director of Corporate Affairs and Medicines Optimisation will ensure that for every interest declared, either in writing or by oral declaration, arrangements are in place to manage the conflict of interests or potential conflict of interests, to ensure the integrity of the group s decision making processes Arrangements for the management of conflicts of interest are to be determined by the Director of Corporate Affairs and Medicines Optimisation and will include the requirement to put in writing to the relevant individual arrangements for managing the conflict of interests or potential conflicts of interests, within a week of declaration. The arrangements will confirm the following: a) when an individual should withdraw from a specified activity, on a temporary or permanent basis; b) monitoring of the specified activity undertaken by the individual, either by a line manager, colleague or other designated individual Where an interest has been declared, either in writing or by oral declaration, the declarer will ensure that before participating in any activity connected with the group s exercise of its commissioning functions, they have received confirmation of the arrangements to manage the conflict of interest or potential conflict of interest from the Director of Corporate Affairs and Medicines Optimisation Where an individual member, employee or person providing services to the group is aware of an interest which: a) has not been declared, either in the register or orally, they will declare this at the start of the meeting; Page 47 of 98

48 b) has previously been declared, in relation to the scheduled or likely business of the meeting, the individual concerned will bring this to the attention of the chair of the meeting, together with details of arrangements which have been confirmed for the management of the conflict of interests or potential conflict of interests. The chair of the meeting will then determine how this should be managed and inform the member of their decision. Where no arrangements have been confirmed, the chair of the meeting may require the individual to withdraw from the meeting or part of it. The individual will then comply with these arrangements, which must be recorded in the minutes of the meeting Where the chair of any meeting of the group, including committees, subcommittees, or the governing body and the governing body s committees and subcommittees, has a personal interest, previously declared or otherwise, in relation to the scheduled or likely business of the meeting, they must make a declaration and the deputy chair will act as chair for the relevant part of the meeting. Where arrangements have been confirmed for the management of the conflict of interests or potential conflicts of interests in relation to the chair, the meeting must ensure these are followed. Where no arrangements have been confirmed, the deputy chair may require the chair to withdraw from the meeting or part of it. Where there is no deputy chair, the members of the meeting will select one Any declarations of interests, and arrangements agreed in any meeting of the clinical commissioning group, committees or sub-committees, or the governing body, the governing body s committees or sub-committees, will be recorded in the minutes Where more than 50% of the members of a meeting are required to withdraw from a meeting or part of it, owing to the arrangements agreed for the management of conflicts of interests or potential conflicts of interests, the chair (or deputy) will determine whether or not the discussion can proceed In making this decision the chair will consider whether the meeting is quorate, in accordance with the number and balance of membership set out in the group s standing orders. Where the meeting is not quorate, owing to the absence of certain members, the discussion will be deferred until such time as a quorum can be convened. Where a quorum cannot be convened from the membership of the meeting, owing to the arrangements for managing conflicts of interest or potential conflicts of interests, the chair of the meeting shall consult with Director of Corporate Affairs on the action to be taken This may include: a) requiring another of the group s committees or sub-committees, the group s governing body or the governing body s committees or sub-committees (as appropriate) which can be quorate to progress the item of business, or if this is not possible, Page 48 of 98

49 b) inviting on a temporary basis one or more of the following to make up the quorum (where these are permitted members of the governing body or committee / sub-committee in question) so that the group can progress the item of business: i) a member of the clinical commissioning group who is an individual; ii) iii) iv) an individual appointed by a member to act on its behalf in the dealings between it and the clinical commissioning group; a member of a relevant Health and Wellbeing Board; a member of a governing body of another clinical commissioning group. These arrangements must be recorded in the minutes In any transaction undertaken in support of the clinical commissioning group s exercise of its commissioning functions (including conversations between two or more individuals, s, correspondence and other communications), individuals must ensure, where they are aware of an interest, that they conform to the arrangements confirmed for the management of that interest. Where an individual has not had confirmation of arrangements for managing the interest, they must declare their interest at the earliest possible opportunity in the course of that transaction, and declare that interest as soon as possible thereafter. The individual must also inform either their line manager (in the case of employees), or the Director of Corporate Affairs and Medicines Optimisation of the transaction The Director of Corporate Affairs and Medicines Optimisation will take such steps as deemed appropriate, and request information deemed appropriate from individuals, to ensure that all conflicts of interest and potential conflicts of interest are declared 8.5. Managing Conflicts of Interest: contractors and people who provide services to the group Anyone seeking information in relation to a procurement, or participating in a procurement, or otherwise engaging with the clinical commissioning group in relation to the potential provision of services or facilities to the group, will be required to make a declaration of any relevant conflict / potential conflict of interest Anyone contracted to provide services or facilities directly to the clinical commissioning group will be subject to the same provisions of this constitution in relation to managing conflicts of interests. This requirement will be set out in the contract for their services Transparency in Procuring Services The CCG recognises the importance in making decisions about the services it procures in a way that does not call into question the motives behind the procurement decision that has been made. The CCG will procure services in a Page 49 of 98

50 manner that is open, transparent, non-discriminatory and fair to all potential providers The CCG will publish a Procurement Strategy approved by its Governing Body which will ensure that: a) all relevant clinicians (not just members of the CCG) and potential providers, together with local members of the public, are engaged in the decision-making processes used to procure services; b) service redesign and procurement processes are conducted in an open, transparent, non-discriminatory and fair way Copies of this Procurement Strategy will be available on the CCG s website at or from the CCG Headquarters by postal request or by ing sdtccg@nhs.net. 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 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 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 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 The CCG will ensure that employees' behaviour reflects the values, aims and principles set out above The CCG will ensure that it complies with all aspects of employment law. Page 50 of 98

51 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 The CCG will adopt a Code of Conduct for staff and will maintain and promote effective 'whistleblowing' procedures to ensure that concerned staff have means through which their concerns can be voiced 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 at or from the CCG Headquarters by postal request or by ing sdtccg@nhs.net. 10. TRANSPARENCY, WAYS OF WORKING AND STANDING ORDERS General The Governing Body must present through the timely publication of an annual commissioning plan, an annual report, annual accounts and annual governance statement, a balanced assessment of the CCG s performance 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 at or from the CCG Headquarters by postal request or by ing sdtccg@nhs.net 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: a) Standing orders (Appendix C) which sets out the arrangements for meetings and the appointment processes to elect the CCG s representatives and appoint to the CCG s committees, including the governing body; b) 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, the CCG s committees and sub-committees, individual members and employees; c) Prime financial policies (Appendix E) which sets out the arrangements for managing the CCG s financial affairs. Page 51 of 98

52 APPENDIX A - LIST OF MEMBER PRACTICES Locality Practice Details Practice Address Commissioning GP Signature Date Coastal Barton Surgery Barton Surgery Barton Terrace Dawlish Devon EX7 9QH Telephone: Fax: enquiries.bartondawlish2@nhs.net Coastal Channel View Surgery Channel View Surgery Courtenay Place Teignmouth Devon TQ14 8AY Telephone: Fax: Coastal Richmond House Surgery Richmond House Surgery 26 Brunswick Street Teignmouth Devon TQ14 8AF Telephone: Fax: Page 52 of 98

53 Coastal Coastal Moor to Sea Moor to Sea Teign Estuary Medical Group Teignmouth Medical Practice Ashburton Surgery Buckfastleigh Medical Centre Teign Estuary Medical Group Glendevon Medical Centre 3 Carlton Place Teignmouth Devon TQ14 8AB Telephone: Fax: Teign.estuary@nhs.net Teignmouth Medical Practice Flat 2 2 Den Crescent Teignmouth Devon TQ14 8BG Telephone: Ashburton Surgery 1 Eastern Road Ashburton Devon TQ13 7AP Telephone: Fax: Buckfastleigh Medical Centre Bossell Road Buckfastleigh Devon TQ11 0DD Telephone: Page 53 of 98

54 Moor to Sea Moor to Sea Moor to Sea Moor to Sea Catherine House Surgery Chillington Health Centre Dartmouth Medical Practice Leatside Surgery Catherine House Surgery New Walk The Plains Totnes TQ9 5HA Telephone: Fax: (01803) Chillington Health Centre Orchard Way Chillington Devon TQ7 2LB Telephone: Fax: The Clifton Surgery 35 Victoria Road Dartmouth Devon TQ6 9RT Telephone: Leatside Surgery Babbage Road Totnes Devon TQ9 5JA Telephone: Fax: Page 54 of 98

55 Moor to Sea Newton Abbot Newton Abbot Newton Abbot The Bovey Tracey & Chudleigh Practice Albany Surgery Buckland Surgery Cricketfield Surgery The Bovey Tracey & Chudleigh Practice Riverside Surgery Le Molay Littry Way Bovey Tracey TQ13 9QP Telephone: Fax: Albany Surgery Albany Street Newton Abbot TQ12 2TX Telephone: Fax: Buckland Surgery Buckland Newton Abbot TQ12 4HG Telephone: Fax: Cricketfield Surgery Cricketfield Road Newton Abbot TQ12 2AS Telephone: Fax: Page 55 of 98

56 Newton Abbot Devon Square Newton Abbot Kingskerswell & Ipplepen Health Centres Newton Abbot Kingsteignton Medical Practice Paignton & Brixham Compass House Medical Centres Paignton & Brixham Corner Place Surgery Devon Square Surgery 44 Devon Square Newton Abbot TQ12 2HH Telephone: Fax: Kingskerswell Medical Practice School Road Kingskerswell Newton Abbot TQ12 5DJ Telephone: Fax: Kingsteignton Medical Practice Whiteway Road Kingsteignton Newton Abbot TQ12 3HN Telephone: Compass House Medical Centres King Street Brixham TQ5 9TF Telephone: Corner Place Surgery 46A Dartmouth Road Paignton TQ4 5AH Telephone: Page 56 of 98

57 Paignton & Brixham Mayfield & Cherrybrook Medical Partnership Paignton & Brixham Old Farm Surgery Paignton & Brixham Paignton Medical Partnership Mayfield Medical Centre 37 Totnes Road Paignton TQ4 5LA Telephone: Cherrybrook Medical Centre Hookhills Road Paignton TQ4 7SH Telephone: Old Farm Surgery 67 Foxhole Road Paignton TQ3 3TB Telephone: Bishop's Place Surgery 1 & 2 Bishop's Place Paignton TQ3 3DZ Telephone: Grosvenor Road Surgery 17 Grosvenor Road Paignton TQ4 5AZ Telephone: / Page 57 of 98

58 Paignton & Brixham Pembroke House Surgery Paignton & Brixham St. Luke's Medical Centre Paignton & Brixham The Greenswood Surgery Paignton & Brixham Withycombe Lodge Surgery Torquay Abbey Road Surgery Pembroke House Surgery Torquay Road Paignton TQ3 2EZ Telephone: St. Luke's Medical Centre 17 New Road Brixham TQ5 8NA Telephone: The Greenswood Surgery 1 Greenswood Road Brixham TQ5 9HN Telephone: Withycombe Lodge Surgery 123 Torquay Road Paignton TQ3 2SG Telephone: Abbey Road Surgery & Shiphay Surgery Abbey Road Torquay TQ2 5NH Telephone: Page 58 of 98

59 Torquay Torquay Torquay Torquay Torquay Barton Surgery Brunel Medical Practice Chelston Hall Surgery Chilcote Surgery Croft Hall Medical Practice Barton Surgery Lymington House Barton Hill Way Torquay TQ2 8JG Telephone: Brunel Medical Practice St. Alban's Road Babbacombe Torquay TQ1 3SL Telephone: Chelston Hall Surgery & Old Mill Surgery Old Mill Road Torquay TQ2 6HW Telephone: Chilcote Surgery Dewerstone Practice Hampton Avenue Torquay TQ1 3LA Telephone: Croft Hall Medical Practice 19 Croft Road Torquay TQ2 5UA Telephone: Page 59 of 98

60 Torquay Torquay Parkhill Medical Practice Southover Medical Practice Parkhill Medical Practice Parkhill Road Torquay TQ1 2AR Telephone: Southover Medical Practice Bronshill Road Torquay TQ1 3HD Telephone: Page 60 of 98

61 APPENDIX B CCG AREA MAP Page 61 of 98

62 Page 62 of 98

63 APPENDIX C STANDING ORDERS 1. STATUTORY FRAMEWORK AND STATUS 1.1. Introduction These standing orders have been drawn up to regulate the proceedings of the NHS South Devon and Torbay Clinical Commissioning Group so that the group can fulfil its obligations, as set out largely in the 2006 Act, as amended by the 2012 Act and related regulations. They are effective from the date the group is established The standing orders, together with the group s scheme of reservation and delegation 1 and the group s prime financial policies 2, provide a procedural framework within which the group discharges its business. They set out: a) the arrangements for conducting the business of the group; b) the appointment of member practice representatives; c) the procedure to be followed at meetings of the group, the governing body and any committees or sub-committees of the group or the governing body; d) the process to delegate powers, e) the declaration of interests and standards of conduct. These arrangements must comply, and be consistent where applicable, with requirements set out in the 2006 Act (as amended by the 2012 Act) and related regulations and take account as appropriate 3 of any relevant guidance The standing orders, scheme of reservation and delegation and prime financial policies have effect as if incorporated into the group s constitution. Group members, employees, members of the governing body, members of the governing body s committees and sub-committees, members of the group s committees and sub-committees and persons working on behalf of the group should be aware of the existence of these documents and, where necessary, be familiar with their detailed provisions. Failure to comply with the standing orders, scheme of reservation and delegation and prime financial policies may be regarded as a disciplinary matter that could result in dismissal See Appendix D See Appendix E Under some legislative provisions the group is obliged to have regard to particular guidance but under other circumstances guidance is issued as best practice guidance. Page 63 of 98

64 1.2. Schedule of matters reserved to the clinical commissioning group and the scheme of reservation and delegation The 2006 Act (as amended by the 2012 Act) provides the group with powers to delegate the group s functions and those of the governing body to certain bodies (such as committees) and certain persons. The group has decided that certain decisions may only be exercised by the group in formal session. These decisions and also those delegated are contained in the group s scheme of reservation and delegation (see Appendix D). 2. THE CLINICAL COMMISSIONING GROUP: COMPOSITION OF MEMBERSHIP, KEY ROLES AND APPOINTMENT PROCESS 2.1. Composition of membership Chapter 3 of the group s constitution provides details of the membership of the group (also see Appendix B) Chapter 6 of the group s constitution provides details of the governing structure used in the group s decision-making processes, whilst Chapter 7 of the constitution outlines certain key roles and responsibilities within the group and its governing body, including the role of practice representatives (section 7.1 of the constitution) Key Roles Paragraph of the group s constitution sets out the composition of the group s governing body whilst Chapter 7 of the group s constitution identifies certain key roles and responsibilities within the group and its governing body. These standing orders set out how the group appoints individuals to these key roles The roles as listed in paragraph 7.1 to 7.5 of the group s constitution, is subject to the following appointment process: a) E ligibility and Appointment process; i. chair - any individual member within the CCG who is on the GP performers list, and has been for a minimum of two years, or has recently retired without a fitness to practice review may nominate themselves for a clinical governing body position when advertised. The chair must be nationally approved and accredited and elected by the CCG membership. ii. GP clinical lead members - any individual member within the who is on the CCG GP performer list, or has recently retired without a fitness to practice review, may nominate themselves for a clinical governing position when advertised. These posts will be appointed using the CCG recruitment policy and process. Page 64 of 98

65 iii. iv. secondary care clinician any practicing or recently practicing secondary care clinician not connected with the CCG s primary providers of secondary care may nominate themselves for the position of secondary care clinician when advertised. This post will be appointed using the CCG recruitment policy and process. independent lay members any member of the local communities, or with knowledge of the local communities, served by the CCG may nominate themselves for this position when advertised. These posts will be appointed using the CCG recruitment policy and process. v. accountable officer this appointment will be subject to national NHS recruitment and selection policies and guidance. The candidate must be nationally approved and accredited and will be appointed using the NHS England approved appointment process.. vi. vii. viii. chief finance officer - this appointment will be subject to national NHS recruitment and selection policies and guidance. It is not subject to fixed term appointments. The candidate must be nationally approved and accredited. This post will be appointed using the CCG recruitment policy and process. registered non-medical practitioner - this appointment will be subject to national NHS recruitment and selection policies and guidance. It is not subject to fixed term appointments. This post will be appointed using the CCG recruitment policy and process. director of commissioning & transformation - this appointment will be subject to national NHS recruitment and selection policies and guidance. It is not subject to fixed term appointments. This post will be appointed using the CCG recruitment policy and process. ix. director of wellbeing &family services commissioning - this appointment will be subject to national NHS recruitment and selection policies and guidance. It is not subject to fixed term appointments. This post will be appointed using the CCG recruitment policy and process. x. director of corporate affairs - this appointment will be subject to national NHS recruitment and selection policies and guidance. It is not subject to fixed term appointments. This post will be appointed using the CCG recruitment policy and process. xi. director of quality assurance & improvement - this appointment will be subject to national NHS recruitment and selection policies and guidance. It is not subject to fixed term appointments. This post will be appointed using the CCG recruitment policy and process. b) Term of office; i. chair until establishment and then four years ii. chief officer - permanent Page 65 of 98

66 iii. GP clinical lead members determined by the chief officer iv. independent lay members until establishment and then for three years v. chief finance officer - permanent vi. director of commissioning & transformation permanent vii. director of wellbeing & family services - permanent viii. secondary care clinician until establishment and then for three years ix. non-medical practitoner three years. x. director of corporate affairs & medicines optimisation - permanent xi. director of quality assurance & improvement permanent c) Eligibility for reappointment; i. chair the chair of the CCG can nominate themselves to stand for reappointment. They will be expected to have upheld the Nolan Principles and their professional Codes of Conduct. Even if selfnominating the chair will be subject to re-election by the membership. The chair must be nationally approved and accredited. ii. GP clinical lead members, secondary care clinician, non-medical practitioner and independent lay members can self-nominate to stand for reappointment. They will be expected to have upheld the Nolan Principles and their professional Codes of Conduct. Even if selfnominating the positions will be subject to appropriate appointment procedures. d) Grounds for removal from office / post; i. all governing body roles gross misconduct; becoming disqualified from office, losing clinical registration, not attending board meetings for 3 months (except under extenuating circumstances., such as illness); failing to disclose a pecuniary interest regarding matters under discussion within the organisation, continuation in office is not in the interests of the body or the public. f) Notice period; i. chair 3 months notice in writing. ii. GP clinical leads members - 3 months notice in writing. iii. secondary care clinician - 3 months notice in writing. iv. non-medical practitioner 3 months notice in writing. v. independent lay members - 3 months notice in writing. vi. chief officer - as determined by contract. vii. chief finance officer - as determined by contract. viii. director of commissioning & transformation as determined by contract ix. director of wellbeing & family services as determined by contract x. director of corporate affairs & medicines optimisation as determined by contract xi. director of quality assurance & improvement as determined by contract 3. MEETINGS OF THE CLINICAL COMMISSIONING GROUP Page 66 of 98

67 3.1. Calling meetings Ordinary meetings of the group shall be held at regular intervals and at such times and places as the group may determine The chair of the CCG may call a meeting of the governing body at any time 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 Before each meeting of the governing body a public notice of the time and place of the meeting, and the public part of the agenda, shall be displayed at the governing body's principal offices at least three clear days before the meeting, (required by the Public Bodies (Admission to Meetings) Act 1960 Section 1 (4) (a)) Agenda, supporting papers and business to be transacted Items of business to be transacted for inclusion on the agenda of a meeting need to be notified to the chair at least 15 working days (i.e. excluding weekends and bank holidays) before the meeting takes place. Supporting papers for such items need to be submitted at least 10 working days before the meeting takes place. The agenda and supporting papers will be circulated to all members of a meeting at least 3 working days before the date the meeting will take place Agendas and certain papers for the group s governing body including details about meeting dates, times and venues - will be published on the group s website at Petitions Where a petition has been received by the group, the chair of the governing body shall include the petition as an item for the agenda of the next meeting of the governing body Chair of a meeting At any meeting of the group or its governing body or of a committee or subcommittee, the chair of the group, governing body, committee or sub-committee, if any and if present, shall preside. If the chair is absent from the meeting, the deputy chair, if any and if present, shall preside If the chair is absent temporarily on the grounds of a declared conflict of interest the deputy chair, if present, shall preside. If both the chair and deputy chair are absent, or are disqualified from participating, or there is neither a chair or deputy a member of the group, governing body, committee or sub-committee respectively shall be chosen by the members present, or by a majority of them, and shall preside. Page 67 of 98

68 3.5. Chair's ruling The decision of the chair of the governing body on questions of order, relevancy and regularity and their interpretation of the constitution, standing orders, scheme of reservation and delegation and prime financial policies at the meeting, shall be final Quorum The meeting will be quorate when at least 5 voting members of the governing body are present. Decisions will be made based on a simple majority of voting members. In the case of an equal vote, the chair will have a second and casting vote. There will be no proxy votes For all other of the group s committees and sub-committees, including the governing body s committees and sub-committees, the details of the quorum for these meetings and status of representatives are set out in the appropriate terms of reference Decision making Chapter 6 of the group s constitution, together with the scheme of reservation and delegation, sets out the governing structure for the exercise of the group s statutory functions. Generally it is expected that at the CCG / governing body s meetings decisions will be reached by consensus. Should this not be possible then a vote of members will be required, the process for which is set out below: a) Eligibility the members of the governing body, including those with voting rights, are set out in section of the Constitution. There will be no proxy voting under any circumstances; b) Majority necessary to confirm a decision - decisions will be made based on a simple majority of voting members; c) Casting vote - in the case of an equal vote, the chair will have a second and casting vote; d) Dissenting views members taking a dissenting view to the result of the vote may request for their dissent to be recorded in the minutes of the meeting For all other of the group s committees and sub-committees, including the governing body s committees and sub-committee, the details of the process for holding a vote are set out in the appropriate terms of reference Emergency powers and urgent decisions The powers which the governing body has reserved to itself within these Standing Orders may in emergency or for an urgent decision be exercised by the chair and chief officer after having consulted at least two GP members and one Page 68 of 98

69 lay member. The exercise of such powers shall be reported to the next formal meeting of the governing body in public session for formal ratification Suspension of Standing Orders Except where it would contravene any statutory provision or any direction made by the Secretary of State for Health or NHS England, any part of these standing orders may be suspended at any meeting, provided two-thirds of the Governing Body s members are in agreement A decision to suspend standing orders together with the reasons for doing so shall be recorded in the minutes of the meeting A separate record of matters discussed during the suspension shall be kept. These records shall be made available to the governing body s audit committee for review of the reasonableness of the decision to suspend standing orders Record of Attendance The names of all members of the meeting present at the meeting shall be recorded in the minutes of the group s meetings. The names of all members of the governing body present shall be recorded in the minutes of the governing body meetings. The names of all members of the governing body s committees / sub-committees present shall be recorded in the minutes of the respective governing body committee / sub-committee meetings Minutes The names of the chairman and members present at the meeting shall be recorded The minutes of the proceedings of a meeting shall be drawn up and submitted for agreement at the next ensuing meeting where they shall be signed by the person presiding at it. No discussion shall take place upon the minutes except upon their accuracy or where the chair considers discussion appropriate 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 Subject to Standing Order below, meetings of the governing body shall be open to the public The governing body may, by resolution, exclude the public from a meeting that is open to the public (whether during the whole or part of the proceedings) wherever publicity would be prejudicial to the public interest by reason of the confidential nature of the business to be transacted or for other special reasons stated in the resolution and arising from the nature of that business or of the proceedings or for any other reason permitted by the Public Bodies (Admission Page 69 of 98

70 to Meetings) Act 1960 as amended or succeeded from time to time In the event the public could be excluded from a meeting of the governing body pursuant to Standing Order above, the group shall consider whether the subject matter of the meeting would in any event be subject to disclosure under the Freedom of Information Act 2000, and if so, whether the public should be excluded in such circumstances The chair (or deputy chair if one has been appointed) or the person presiding over the meeting shall give such directions as he/she thinks fit with regard to the arrangements for meetings and accommodation of the public and representatives of the press such as to ensure that the governing body s business shall be conducted without interruption and disruption Without prejudice to the power to exclude the public pursuant to Standing Order above the governing body may resolve (as permitted by Section 1(8) Public Bodies (Admissions to Meetings) Act 1960 as amended from time to time) to exclude the public from a meeting (whether during whole or part of the proceedings) to suppress or prevent disorderly conduct or behaviour Matters to be dealt with by the governing body following the exclusion of representatives of the press, and other members of the public shall be confidential to the members of the governing body Members and officers or any employee of the governing body in attendance shall not reveal or disclose the contents of papers marked 'In Confidence' or minutes headed 'Items Taken in Private' outside of the Governing Body, without the express permission of the governing body. 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. APPOINTMENT OF COMMITTEES AND SUB-COMMITTEES 4.1. Appointment of committees and sub-committees The CCG may appoint committees and sub-committees of the group, 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 such committees and sub-committees of the group, or committees and subcommittees of its governing body, are appointed they are included in Chapter 6 of the group s constitution Other than where there are statutory requirements, such as in relation to the governing body s audit committee or remuneration committee, the group shall determine the membership and terms of reference of committees and subcommittees and shall, if it requires, receive and consider reports of such committees at the next appropriate meeting of the group The provisions of these standing orders shall apply where relevant to the operation of the governing body, the governing body s committees and sub- Page 70 of 98

71 committee and all committees and sub-committees unless stated otherwise in the committee or sub-committee s terms of reference Terms of Reference Terms of reference shall have effect as if incorporated into the constitution and shall be added to this document as an appendix 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 Approval of Appointments to Committees and Sub-Committees The CCG shall approve the appointments to each of the committees and subcommittees which it has formally constituted including those the governing body. The CCG shall agree such travelling or other allowances as it considers appropriate. 5. DUTY TO REPORT NON-COMPLIANCE WITH STANDING ORDERS AND PRIME FINANCIAL POLICIES 5.1. If for any reason these standing orders are not complied with, full details of the non-compliance and any justification for non-compliance and the circumstances around the non-compliance, shall be reported to the next formal meeting of the governing body for action or ratification. All members of the CCG and staff have a duty to disclose any non-compliance with these standing orders to the accountable officer as soon as possible. 6. USE OF SEAL AND AUTHORISATION OF DOCUMENTS 6.1. Clinical Commissioning Group s seal The CCG may have a seal for executing documents where necessary. The following individuals or officers are authorised to authenticate its use by their signature: a) the chief officer; b) the chair of the governing body; d) the chief finance officer; e) the director of corporate affairs & medicines optimisation f) the deputy accountable officer 6.2. Execution of a document by signature Page 71 of 98

72 The following individuals are authorised to execute a document on behalf of the group by their signature. a) the chief officer; b) the chair of the governing body; c) the chief finance officer; d) the director of corporate affairs & medicines optimisation e) the deputy accountable officer 7. OVERLAP WITH OTHER CLINICAL COMMISSIONING GROUP POLICY STATEMENTS / PROCEDURES AND REGULATIONS 7.1. Policy statements: general principles The group will from time to time agree and approve policy statements / procedures which will apply to all or specific groups of staff employed by the CCG. The decisions to approve such policies and procedures will be recorded in an appropriate group minute and will be deemed where appropriate to be an integral part of the group s standing orders. Page 72 of 98

73 APPENDIX D - SCHEME OF RESERVATION & DELEGATION 1. SCHEDULE OF MATTERS RESERVED TO THE CLINICAL COMMISSIONING GROUP AND SCHEME OF DELEGATION 1.1. The arrangements made by the group as set out in this scheme of reservation and delegation of decisions shall have effect as if incorporated in the group s constitution The clinical commissioning group remains accountable for all of its functions, including those that it has delegated. 1.3 The clinical commissioning group will produce and regularly update an Operational Scheme of Delegation, which will be approved by the Commissioning & Finance Committee. Page 73 of 98

74 Decision Membership Governing Body Audit Committee Remuneration Committee Commissioning & Finance Committee Chief Officer Localities Chief Finance Officer Determine the arrangements by which the members of the group approve those decisions that are reserved for the membership. Consideration and approval of applications to NHS England on any matter concerning changes to the group s constitution, including terms of reference for the group s governing body, its committees, membership of committees, the overarching scheme of reservation and delegated powers, arrangements for taking urgent decisions, standing orders and prime financial policies. Exercise or delegation of those functions of the clinical commissioning group which have not been retained as reserved by the group, delegated to the governing body or other committee or sub-committee or [specified] member or employee as approved by NHS England Page 74 of 98

75 Decision Membership Governing Body Audit Committee Remuneration Committee Commissioning & Finance Committee Chief Officer Localities Chief Finance Officer Prepare the group s overarching scheme of reservation and delegation, which sets out those decisions of the group reserved to the membership and those delegated to the o group s governing body o committees and sub-committees of the group, or o its members or employees and sets out those decisions of the governing body reserved to the governing body and those delegated to the o o o governing body s committees and sub-committees, members of the governing body, an individual who is member of the group but not the governing body or a specified person for inclusion in the group s constitution. Approval of the group s overarching scheme of reservation and delegation. as approved by NHS England Page 75 of 98

76 Decision Prepare the group s operational scheme of delegation, which sets out those key operational decisions delegated to individual employees of the clinical commissioning group, not for inclusion in the group s constitution. Approval of the group s operational scheme of delegation that underpins the group s overarching scheme of reservation and delegation as set out in its constitution. Prepare detailed financial policies that underpin the clinical commissioning group s prime financial policies. Membership Governing Body Approve detailed financial policies. Approve arrangements for managing exceptional funding requests. Audit Committee Remuneration Committee Commissioning & Finance Committee Chief Officer Localities Chief Finance Officer Set out who can execute a document by signature / use of the seal as approved by NHS England Page 76 of 98

77 Decision Approve the arrangements for identifying practice members to represent practices in matters concerning the work of the group; and appointing clinical leaders to represent the group s membership on the group s governing body, for example through election (if desired). Approve the appointment of governing body members, the process for recruiting and removing non-elected members to the governing body (subject to any regulatory requirements) and succession planning. Membership Governing Body Audit Committee Remuneration Committee Commissioning & Finance Committee Chief Officer Localities Approve arrangements for identifying the group s proposed accountable officer. Agree the vision, values and overall strategic direction of the group. Approval of the group s operating structure. Approval of the group s commissioning plan Chief Finance Officer as approved by NHS England Page 77 of 98

78 Decision Membership Governing Body Adopt the Local Commissioning Plans Audit Committee Remuneration Committee Commissioning & Finance Committee Chief Officer Localities Develop CCG commissioning plan Approve the Locality Commissioning Plan Develop the Locality Commissioning Plan Prepare and recommend the group s corporate budgets that meet the financial duties as set out in section 5.3 of the main body of the constitution. Approval of variations to the approved budget where variation would have a significant impact on the overall approved levels of income and expenditure or the group s ability to achieve its agreed strategic aims. Approval of the group s annual report and annual accounts. Chief Finance Officer Approval of the arrangements for discharging the group s statutory financial duties. as approved by NHS England Page 78 of 98

79 Decision Membership Governing Body Audit Committee Remuneration Committee Commissioning & Finance Committee Chief Officer Localities Chief Finance Officer 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 the group including, pensions, remuneration, fees and travelling or other allowances payable to employees and to other persons providing services to the group. Approve any other terms and conditions of services for the group s employees. Determine the terms and conditions of employment for all employees of the group. Determine pensions, remuneration, fees and allowances payable to employees and to other persons providing services to the group. as approved by NHS England Page 79 of 98

80 Decision Recommend pensions, remuneration, fees and allowances payable to employees and to other persons providing services to the group. Membership Governing Body Audit Committee Remuneration Committee Commissioning & Finance Committee Chief Officer Localities Chief Finance Officer Approve disciplinary arrangements for employees, including the accountable officer (where he/she is an employee or member of the clinical commissioning group) and for other persons working on behalf of the group. Review disciplinary arrangements where the accountable officer is an employee or member of another clinical commissioning group Approval of the arrangements for discharging the group s statutory duties as an employer. Approve human resources policies for employees and for other persons working on behalf of the group as approved by NHS England Page 80 of 98

81 Decision Membership Governing Body Audit Committee Remuneration Committee Commissioning & Finance Committee Chief Officer Localities Chief Finance Officer Approve arrangements, including supporting policies, to minimise clinical risk, maximise patient safety and to secure continuous improvement in quality and patient outcomes. Approve arrangements for supporting NHS England in discharging its responsibilities in relation to securing continuous improvement in the quality of general medical services. Prepare and recommend an operational scheme of delegation that sets out who has responsibility for operational decisions within the group. Approve the group s counter fraud and security management arrangements. Appoint the Internal Auditors Approves the Internal Audit Plan Approval of the group s risk management arrangements. as approved by NHS England Page 81 of 98

82 Decision Membership Governing Body Audit Committee Remuneration Committee Commissioning & Finance Committee Chief Officer Localities Chief Finance Officer 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). Approval of a comprehensive system of internal control, including budgetary control, that underpins the effective, efficient and economic operation of the group. Approve proposals for action on litigation against or on behalf of the clinical commissioning group. Approve the group s arrangements for business continuity and emergency planning. Approve the group s arrangements for handling complaints. Approval of the arrangements for ensuring appropriate and safekeeping and confidentiality of records and for the storage, management and transfer of information and data. as approved by NHS England Page 82 of 98

83 Decision Approval of the group s contracts for any commissioning support, as per operational scheme of delegation. Approval of the group s contracts for corporate support (for example finance provision), as per operational scheme of delegation. Membership Governing Body Audit Committee Remuneration Committee Commissioning & Finance Committee Chief Officer Localities Chief Finance Officer Approve decisions that individual members or employees of the group participating in joint arrangements on behalf of the group can make. Such delegated decisions must be disclosed in this scheme of reservation and delegation. Approve decisions delegated to joint committees established under section 75 of the 2006 Act, as per operational scheme of delegation. as approved by NHS England Page 83 of 98

84 Decision Membership Governing Body Audit Committee Remuneration Committee Commissioning & Finance Committee Chief Officer Localities Chief Finance Officer Approval of the arrangements for discharging the group s statutory duties associated with its commissioning functions, including but not limited to promoting the involvement of each patient, patient choice, reducing inequalities, improvement in the quality of services, obtaining appropriate advice and public engagement and consultation. Approve arrangements for coordinating the commissioning of services with other groups and or with the local authority(ies), where appropriate Approving arrangements for handling Freedom of Information requests. Determining arrangements for handling Freedom of Information requests as approved by NHS England Page 84 of 98

85 1. INTRODUCTION 1.1. General APPENDIX E PRIME FINANCIAL POLICIES These prime financial policies and supporting detailed financial policies shall have effect as if incorporated into the CCG s Constitution The prime financial policies are part of the CCG s control environment for managing the organisation s financial affairs. They contribute to good corporate governance, internal control and managing risks. They enable sound administration; lessen the risk of irregularities and support commissioning and delivery of effective, efficient and economical services. They also help the chief officer and chief finance officer to effectively perform their responsibilities. They should be used in conjunction with the scheme of reservation and delegation found at Appendix D In support of these prime financial policies, the CCG has prepared more detailed policies, approved by the chief finance officer known as detailed financial policies. The CCG refers to these prime and detailed financial policies together as the CCG s financial policies These prime financial policies identify the financial responsibilities which apply to everyone working for the CCG and its constituent organisations. They do not provide detailed procedural advice and should be read in conjunction with the detailed financial policies. The Audit Committee is responsible for approving all detailed financial policies A list of the CCG s detailed financial policies will be published and maintained on the CCG s website at Copies of the policies are also available from the CCG Headquarters by postal request or by ing sdtccg@nhs.net Should any difficulties arise regarding the interpretation or application of any of the prime financial policies then the advice of the chief finance officer must be sought before acting. The user of these prime financial policies should also be familiar with and comply with the provisions of the 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 Overriding Prime Financial Policies If for any reason these prime financial policies are not complied with, full details of the non-compliance and any justification for non-compliance and the circumstances around the non-compliance shall be reported to the next formal meeting of the governing body s audit committee for referring action or ratification. All of the CCG s members and employees have a duty to disclose as approved by NHS England Page 85 of 98

86 any non-compliance with these prime financial policies to the chief finance officer as soon as possible Responsibilities and delegation The roles and responsibilities of CCG s members, employees, members of the governing body, members of the governing body s committees and subcommittees, members of the CCG s committee and sub-committee (if any) 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 of the CCG are set out in the CCG s scheme of reservation and delegation (see Appendix D) 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 instructions. It is the responsibility of the chief 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 chief finance officer will review them at least annually. Following consultation with the chief officer and scrutiny by the governing body s audit committee, the chief finance officer will recommend amendments, as fitting, to the Governing Body for approval. As these prime financial policies are an integral part of the CCG s Constitution, any amendment will not come into force until the CCG applies to NHS England and that application is granted. 2. INTERNAL CONTROL POLICY the group will put in place a suitable control environment and effective internal controls that provide reasonable assurance of effective and efficient operations, financial stewardship, probity and compliance with laws and policies 2.1. The governing body is required to establish an audit committee with terms of reference agreed by the governing body (see paragraph 6.6.3(a) of the CCG s Constitution for further information) The chief officer has overall responsibility for the CCG s systems of internal control The chief finance officer will ensure that: a) financial policies are considered for review and update annually; as approved by NHS England Page 86 of 98

87 3. AUDIT 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 keep an effective and independent internal audit function and fully comply with the requirements of external audit and other statutory reviews 3.1. In line with the terms of reference for the governing body s audit committee, the person appointed by the CCG to be responsible for internal audit and the appointed external auditor will have direct and unrestricted access to audit committee members and the chair of the governing body, chief officer and chief finance officer for any significant issues arising from audit work that management cannot resolve, and for all cases of fraud or serious irregularity The person appointed by the CCG to be responsible for internal audit and the external auditor will have access to the audit committee and the chief officer to review audit issues as appropriate. All audit committee members, the chair of the governing body and the chief officer will have direct and unrestricted access to the head of internal audit and external auditors The chief finance officer will ensure that: a) the CCG has a professional and technically competent internal audit function; and b) the governing body s audit committee approves any changes to the provision or delivery of assurance services to the CCG. 4. FRAUD AND CORRUPTION POLICY the CCG requires all staff to always act honestly and with integrity to safeguard the public resources they are responsible for. The CCG will not tolerate any fraud perpetrated against it and will actively pursue any loss suffered 4.1. The governing body s audit committee 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 work programme The governing body s audit committee will ensure that the CCG has arrangements in place to work effectively with NHS Protect. as approved by NHS England Page 87 of 98

88 5. EXPENDITURE CONTROL 5.1. The CCG is required by statutory provisions 3 to ensure that its expenditure does not exceed the aggregate of allotments from NHS England and any other sums it has received and is legally allowed to spend The chief officer has overall executive responsibility for ensuring that the CCG complies with certain of its statutory obligations, including its financial and accounting obligations, and that it exercises its functions effectively, efficiently and economically and in a way which provides good value for money The chief finance officer will: a) provide reports in the form required by NHS England; b) ensure money drawn from NHS England is required for approved expenditure only is drawn down only at the time of need and follows best practice; c) 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 NHS England. 6. ALLOTMENTS The CCG s chief finance officer will: a) periodically review the basis and assumptions used by NHS England for distributing allotments and ensure that these are reasonable and realistic and secure the CCG s entitlement to funds; b) prior to the start of each financial year submit to the governing body for approval a report showing the total allocations received and their proposed distribution including any sums to be held in reserve; and c) regularly update the governing body on significant changes to the initial allocation and the uses of such funds. 7. COMMISSIONING STRATEGY, BUDGETS, BUDGETARY CONTROL AND MONITORING POLICY the CCG will produce and publish an annual commissioning plan 5 that explains how it proposes to discharge its financial duties. The CCG will support this with comprehensive medium term financial plans and annual budgets See section 223H of the 2006 Act, inserted by section 27 of the 2012 Act 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. as approved by NHS England Page 88 of 98

89 7.1. The chief officer will compile and submit to the governing body a commissioning strategy which takes into account financial targets and forecast limits of available resources Prior to the start of the financial year the chief finance officer will, on behalf of the chief officer, prepare and submit budgets for approval by the governing body The chief finance officer shall monitor financial performance against budget and plan, periodically review them, and report to the governing body. This report should include explanations for variances. These variances must be based on any significant departures from agreed financial plans or budgets The chief officer is responsible for ensuring that information relating to the CCG s accounts or to its income or expenditure, or its use of resources is provided to NHS England as requested The director of commissioning & transformation will approve consultation arrangements for the CCG s commissioning plan ANNUAL ACCOUNTS AND REPORTS POLICY the CCG will produce and submit to NHS England accounts and reports in accordance with all statutory obligations 7, relevant accounting standards and accounting best practice in the form and content and at the time required by NHS England 8.1. The chief finance officer will ensure the CCG: a) prepares a timetable for producing the annual report and accounts and agrees it with external auditors and the audit committee; b) prepares the accounts according to the timetable approved by the audit committee; c) complies with statutory requirements and relevant directions for the publication of annual report; d) considers the external auditor s management letter and fully address all issues within agreed timescales; and e) publishes the external auditor s management letter on the CCG s website at Copies of the constitution are also available from the CCG Headquarters by postal request or by ing sdtccg@nhs.net. 9. INFORMATION TECHNOLOGY 6 7 See section 14Z13 of the 2006 Act, inserted by section 26 of the 2012 Act See paragraph 17 of Schedule 1A of the 2006 Act, as inserted by Schedule 2 of the 2012 Act. as approved by NHS England Page 89 of 98

90 POLICY the CCG will ensure the accuracy and security of the CCG s computerised financial data 9.1. The chief finance officer is responsible for the accuracy and security of the CCG s computerised financial data and shall a) devise and implement any necessary procedures to ensure adequate (reasonable) protection of the CCG's data, programs and computer hardware from accidental or intentional disclosure to unauthorised persons, deletion or modification, theft or damage, having due regard for the Data Protection Act 1998; b) ensure that adequate (reasonable) controls exist over data entry, processing, storage, transmission and output to ensure security, privacy, accuracy, completeness, and timeliness of the data, as well as the efficient and effective operation of the system; c) ensure that adequate controls exist such that the computer operation is separated from development, maintenance and amendment; d) ensure that an adequate management (audit) trail exists through the computerised system and that such computer audit reviews as the chief finance officer may consider necessary are being carried out In addition the chief finance officer shall ensure that new financial systems and amendments to current financial systems are developed in a controlled manner and thoroughly tested prior to implementation. Where this is undertaken by another organisation, assurances of adequacy must be obtained from them prior to implementation. 10. ACCOUNTING SYSTEMS POLICY the CCG will run an accounting system that creates management and financial accounts The chief finance officer will ensure: a) the CCG has suitable financial and other software to enable it to comply with these policies and any consolidation requirements of NHS England; 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 Where another health organisation or any other agency provides a computer service for financial applications, the chief finance officer shall periodically seek assurances that adequate controls are in operation. as approved by NHS England Page 90 of 98

91 11. BANK ACCOUNTS POLICY the CCG will keep enough liquidity to meet its current commitments The chief finance officer will: a) review the banking arrangements of the CCG at regular intervals to ensure they are in accordance with Secretary of State directions 8, best practice and represent best value for money; b) manage the CCG's banking arrangements and advise the CCG on the provision of banking services and operation of accounts; c) prepare detailed instructions on the operation of bank accounts The audit 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 functions 9 ensure its power to make grants and loans is used to discharge its functions effectively The chief finance officer is responsible for: a) designing, maintaining and ensuring compliance with systems for the proper recording, invoicing, and collection and coding of all monies due; b) establishing and maintaining systems and procedures for the secure handling of cash and other negotiable instruments; c) approving and regularly reviewing the level of all fees and charges other than those determined by NHS England or by statute. Independent professional advice on matters of valuation shall be taken as necessary; d) for developing effective arrangements for making grants or loans. 13. TENDERING AND CONTRACTING PROCEDURE 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. as approved by NHS England Page 91 of 98

92 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 chief finance officer it is desirable to seek tenders from firms not on the approved lists, where they exist, the reason shall be recorded in writing to the chief officer or the CCG s audit committee The governing body may only negotiate contracts on behalf of the CCG, and the CCG may only enter into contracts, within the statutory framework set up by the 2006 Act, as amended by the 2012 Act. Such contracts shall comply with: a) the CCG s standing orders; b) the Public Contracts Regulation 2006, any successor legislation and any other applicable law; and c) take into account as appropriate any applicable NHS England or the Independent Regulator of NHS Foundation Trusts (Monitor) guidance that does not conflict with (b) above In all contracts entered into, the CCG shall endeavour to obtain best value for money. The chief officer shall nominate an individual who shall oversee and manage each contract on behalf of the CCG. 14. COMMISSIONING POLICY working in partnership with relevant national and local stakeholders, the CCG will commission certain health services to meet the reasonable requirements of the persons for whom it has responsibility The CCG will coordinate its work with NHS England, other clinical commissioning CCGs, local providers of services, local authority(ies), including through Health & Wellbeing Boards, patients and their carers and the voluntary sector and others as appropriate to develop robust commissioning plans. as approved by NHS England Page 92 of 98

93 14.2. The chief officer will establish arrangements to ensure that regular reports are provided to the governing body detailing actual and forecast expenditure and activity for each contract The chief finance officer will maintain a system of financial monitoring to ensure the effective accounting of expenditure under contracts. This should provide a suitable audit trail for all payments made under the contracts whilst maintaining patient confidentiality. 15. RISK MANAGEMENT AND INSURANCE POLICY the CCG will put arrangements in place for evaluation and management of its risks The process of risk management within the CCG will be determined by the Risk Management Strategy. Risks will be identified against the CCG objectives. Mitigation actions and associated assurances will be managed and escalated to the governing body based on the risk tolerance set out in the Strategy. Managers will be responsible for ensuring that risks are reviewed on a regular basis and that action plans are implemented and monitored Risks will be scored using a 5 x 5 matrix with impact and likelihood scores being based on risk tolerances set out in the Risk Management Strategy The Senior Leadership Committee will review the corporate risk register at least monthly In addition, the Assurance Framework and Risk Register will be presented to the Audit Committee for scrutiny throughout the year The Governing Body will approve the Assurance Framework at least quarterly. 16. PAYROLL POLICY the CCG will put arrangements in place for an effective payroll service The chief finance officer will ensure that the payroll service selected: a) is supported by appropriate (i.e. contracted) terms and conditions; b) has adequate internal controls and audit review processes; c) has suitable arrangements for the collection of payroll deductions and payment of these to appropriate bodies In addition the chief finance officer shall set out comprehensive procedures for the effective processing of payroll as approved by NHS England Page 93 of 98

94 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 chief officer will determine the level of delegation to budget managers The chief officer shall set out procedures on the seeking of professional advice regarding the supply of goods and services The chief finance officer will: a) advise the governing body on the setting of thresholds above which quotations (competitive or otherwise) or formal tenders must be obtained; and, once approved, the thresholds should be incorporated in the scheme of reservation and delegation; 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 chief officer will a) ensure that there is an adequate appraisal and approval process in place for determining capital expenditure priorities and the effect of each proposal upon plans; b) be responsible for the management of all stages of capital schemes and for ensuring that schemes are delivered on time and to cost; c) shall ensure that the capital investment is not undertaken without confirmation of purchaser(s) support and the availability of resources to finance all revenue consequences, including capital charges; d) be responsible for the maintenance of registers of assets, taking account of the advice of the chief finance officer concerning the form of any register and the method of updating, and arranging for a physical check of assets against the asset register to be conducted once a year. as approved by NHS England Page 94 of 98

95 18.2. The chief finance officer will prepare detailed procedures for the disposals of assets. 19. RETENTION OF RECORDS POLICY the CCG will put arrangements in place to retain all records in accordance with NHS Code of Practice Records Management 2006 and other relevant notified guidance The chief officer shall: a) be responsible for maintaining all records required to be retained in accordance with NHS Code of Practice Records Management 2006 and other relevant notified guidance; b) ensure that arrangements are in place for effective responses to Freedom of Information requests; c) publish and maintain a Freedom of Information Publication Scheme. 20. TRUST FUNDS AND TRUSTEES POLICY the CCG will put arrangements in place to provide for the appointment of trustees if the CCG holds property on trust The chief finance officer shall ensure that each trust fund which the CCG is responsible for managing is managed appropriately with regard to its purpose and to its requirements. as approved by NHS England Page 95 of 98

96 APPENDIX F - NOLAN PRINCIPLES 1. The Nolan Principles set out the ways in which holders of public office should behave in discharging their duties. The seven principles are: a) Selflessness Holders of public office should act solely in terms of the public interest. They should not do so in order to gain financial or other benefits for themselves, their family or their friends. b) Integrity Holders of public office should not place themselves under any financial or other obligation to outside individuals or organisations that might seek to influence them in the performance of their official duties. c) Objectivity In carrying out public business, including making public appointments, awarding contracts, or recommending individuals for rewards and benefits, holders of public office should make choices on merit. d) Accountability Holders of public office are accountable for their decisions and actions to the public and must submit themselves to whatever scrutiny is appropriate to their office. e) Openness Holders of public office should be as open as possible about all the decisions and actions they take. They should give reasons for their decisions and restrict information only when the wider public interest clearly demands. f) Honesty Holders of public office have a duty to declare any private interests relating to their public duties and to take steps to resolve any conflicts arising in a way that protects the public interest. g) Leadership Holders of public office should promote and support these principles by leadership and example. Source: The First Report of the Committee on Standards in Public Life (1995) Available at as approved by NHS England Page 96 of 98

97 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) as approved by NHS England Page 97 of 98

98 APPENDIX H GOVERNANCE STRUCTURE DIAGRAM as approved by NHS England Page 98 of 98