/CKWCB-12-163_Commissioning_Deve

DATE OF MEETING: 3 July 2012

Agenda Item: 15 Enclosure: CKWCB/12/163 Category of Paper Tick()

Paper Title: Commissioning Development Report and Public Health Transition Update

Decision and Approval

Responsible Director: Ann Ballarini, Executive Director of Commissioning and Service Development

Discussion

Paper Author: Louise Auger, Head of Performance Improvement and Commissioning Development

FOI Status: Open

Executive Summary:

This report provides an update on the latest transition milestones the Cluster Board is responsible for ensuring delivery against and progress in key areas such as the Authorisation of Clinical Commissioning Groups.

Position statement

Information

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It also presents the newly designed and adopted framework for reporting progress against the Public Health transition plans which is being used across the Cluster.

Outcome of Equality Impact Assessment:

No issues identified

Sub Group/Committee:

Not applicable

Recommendation (s):

It is recommended the Board: i)

ii)

Note the progress made against the transition milestones; and update on progress towards transition; and Receive the Public Health exception report.

1.0

Purpose of Report The paper has three purposes: 1.1 To provide an update on the revised transition milestones for 2012/2013 that the Cluster is responsible for and our current position against these; 1.2 To provide an update on the emerging Clinical Commissioning Groups (eCCGs); and 1.3 To report in more detail on the progress towards the milestones relating specifically to Public Health transition.

2.0

Revised Transition Milestones 2.1 Transition Tracker As part of the planning guidance from the Department of Health, for the development of Cluster Operational Plans, a revised set of transition milestones and associated deadlines for achievement were issued. These are provided as Appendix A and following a review of our position based on where we need to be by the end of quarter 1 we are currently on track to achieve the key transition dates. The Program Management Office continues to review progress against all transition milestones. The Department of Health has featured the following transition milestones on the tracker: Developing CCGs Commissioning Support Direct Commissioning Any Qualified Provider Health and Wellbeing Boards Public Health Transfer to the Local Authority Public health Transfer to Public Health England

3.0

Emerging Clinical Commissioning Groups (eCCGs) 3.1 Board to Board Meetings with eCCGs In December 2011 a series productive Board to Board meetings were set up with emerging CCGs. A follow up series of meetings took place at the end of May 2012 to review progress made by each eCCG since December in terms of the establishment and preparation for Authorisation. The approach was aimed to be developmental and to identify how the Cluster could further support the eCCGs. The key positive themes included: There is strong practice engagement; There are clear roles for clinical leads; Good engagement with Public Health Good recognition of the wider determinants of health and the use of Public Health and Social Care inputs to realise better outcomes; Positive view of the role of West Yorkshire Commissioning Support Services as a provider of future commissioning support;

Good CCG leadership of QIPP; Progress made in the further development of the strategic vision and associated risks; A stronger partnership role on the Health and Wellbeing Boards; Development of CCG board members; Good links between primary and secondary care clinicians; and Strong commitment to involving local people.

Areas identified where the eCCGs would welcome further Cluster support included: A quick resolution to the alignment of staff to the eCCGs; Support to the application process such as setting up mock panels and reviewing case studies on request; and Continued support through the local Cluster network meeting.

Common themes for the further development of the eCCGS identified by Cluster Board members included: Further clarity on the top strategic priorities; Succession planning within the eCCG -specifically relating to Board tenure; Wider focus on the commissioning role across the whole system and not just primary care; Further development of relationships with the Third Sector; and A more detailed development of financial risk sharing arrangements.

3.2 Confirmation of eCCG Wave Authorisation Application Submission Dates The application submission dates for Authorisation are set out in the table below: Wave 1

23:59 on 2 July 2012

Wave 2

23:59 on 3 September 2012

Wave 3

23:59 on 1 October 2012

Wave 4

23:59 on 1 November 2012

A copy of the application form that eCCGs are currently populating and recent guidance on the process and measures panel members will use to review the application information can be found at the following link: http://www.commissioningboard.nhs.uk/resources/resources-for-ccgs/ 3.3 Revised Functions of Clinical Commissioning Groups The Department of Health has published 'Functions of clinical commissioning groups' following the revisions to the Health and Social Care Act 2012. This document provides an accessible guide for emerging clinical commissioning groups (CCGs) and sets out the key statutory duties of CCGs – the ‘must dos’ and the key statutory powers – the things that CCGs have the freedom to do, if they wish, to help meet these duties. A copy of the document is provided as Appendix B.

The paper sets out the proposed range of Clinical Commissioning Group (CCG) functions, in relation to: commissioning responsibilities general duties of CCGs planning, agreeing and monitoring services financial duties governance specific duties of cooperation general duties applying to public or NHS bodies.

The paper distinguishes between: the duties for which CCGs will be legally responsible; legal powers available to CCGs to help them carry out their duties.

The duties and powers described in the document are those that will apply to CCGs, subject to any conditions imposed or directions given to individual CCGs by the NHS CB as part of the authorisation process. All the key statutory duties arising from the Health and Social Care Act 2012 are given, but the list of statutory powers is not intended to be exhaustive.

3.4 Establishing CCGs Guidance has been published with a set of frequently-asked questions (FAQs) about the remuneration for the roles of chief officer and chief finance officer in a CCG. ‘Chief Officer’ is the term used to describe the most senior manager in a CCG when this individual also takes the role of accountable officer.

The Health and Social Care Act 2012 makes clear that a CCG when established may appoint employees as it considers appropriate, and is able to pay its employees and employ them on terms and conditions in accordance with the determinations of its governing body.

CCGs are encouraged to follow the guidance, which has been approved by the Remuneration and Terms of Service Committee at the Board Authority, to ensure that there is consistency and transparency in the use of public money and that the principles set out in the Will Hutton Fair Pay Review are applied.

The guidance offers flexibility for CCGs to reflect local circumstances and the shape and nature of individual organisations. As with the Clinical commissioning group HR guide, published in April 2012, it is intended to support CCGs to recruit, retain and motivate high calibre staff, while at the same time helping to minimise redundancies.

The guidance, which will apply from the point CCGs become employing bodies on 1 April 2013, covers: proposed pay rates, joint management arrangements, development pay, recruitment and retention premiums, additional payments for additional responsibilities or complexity factors, the role of CCG remuneration committees, and reporting arrangements. It also describes how these designate appointments can be hosted by a PCT using their terms and conditions for the interim period to 1 April 2013.

The papers can be accessed through the following links: http://www.commissioningboard.nhs.uk/files/2012/06/Remuneration-guidancefinal.pdf and FAQs: http://www.commissioningboard.nhs.uk/files/2012/06/Remuneration-FAQsFinal.pdf Finally, the Cluster Remuneration and Terms of Service (RATS) committee has provided some guidance on pay for lay members of CCGs. This has been shared with eCCGs as guidance and the eCCGs will have to agree the terms themselves through their own RATS committees when they are established.

4.0

Public Health Transition 4.1 Reporting Against Transition Milestones The three Public Health (PH) functions in Calderdale, Kirklees and Wakefield District each have a transition plan that was developed in partnership with the Local Authority that clearly reflects the components of the national PH transition checklist. The PH functions continue to be accountable to the NHS Cluster Board during the transition year. Locally the governance of the process is being overseen by the joint Transition Board meetings with each Local Authority.

Locally, the Public Health teams have worked together with performance colleagues to develop a standard approach to performance reporting to the Cluster Board using a common reporting template. Following on from the information received at the May Cluster Board this will provide a greater level of detail and assurance in a common format that will also suffice the reporting requirements of the SHA and DoH. Although the framework is based on the national checklist there is also scope for each of the PCTs to include ‘other’ risks that may be outside of the key lines of enquiry but equally fundamental to delivery of the Transition Plan that may have evolved from when the original plans were produced.

Each Public Health team has agreed to review progress against the checklist, traffic light this and provide an exception report for areas where progress is not on track for delivery so support from the Cluster can be sought where necessary.

The following provides a summary performance report against the checklist:

CKW Cluster

2012/13 Public Health Transition Plans – Executive Summary

NHS Calderdale

Ensuring a robust transfer of systems and services (6/7)

Delivering public health responsibilities during transition and preparing for 2013/14 (9/11)

NHS Kirklees

Ensuring a robust transfer of systems and services (5/7)

Delivering public health responsibilities during transition and preparing for 2013/14 (9/11)

NHS Wakefield District

Ensuring a robust transfer of systems and services (6/7)

Delivering public health responsibilities during transition and preparing for 2013/14 (10/11)

Workforce

Governance

(1/1)

(7/9)

Workforce

Governance

(1/1)

(8//9)

Workforce

Governance

(1/1)

(8/9)

Enabling Infrastructure (3/7)

Communication & Engagement (3/3)

Enabling Infrastructure (1/7)

Communication & Engagement (3/3)

Enabling Infrastructure (2/7)

Risk Assessment Key • • •

Green Amber Red

- Key lines of enquiry being achieved/no risk to delivery; - minor concern, situation needs reviewing, remedial action needs investigation; and - serious deviation from target, corrective action plan required.

Communication & Engagement (3/3)

The Care Quality Commission’s assessment scoring methodology as used in the performance scorecard for the Periodic Review has been used to provide the summary traffic lights in the diagram as each button reflects performance around more than one indicator from the checklist.

All areas are currently rated as green except for ‘Enabling Infrastructure’ and for this reason a detailed exception report for this area is provided as Appendix C. 4.2 Public Health Funding An update on public health funding for local government has been published by the Department of Health. The document, which is aimed at public health specialists, sets out current thinking on local authority public health finance and in particular: the next steps on moving from the estimates of baseline spending published in February 2012 to actual allocations for 2013-14 which are expected to be published by the end of 2012; provides further information on the high level design of the health premium which will be targeted towards areas with the worst health outcomes and most need; and conditions on the ring fenced public health grant which state how the grant may be used, including proposals for local authority financial reporting requirements on public health spend.

A period of engagement and consultation is taking place following publication of Advisory Committee of Resource Allocations (ACRA’s) interim recommendations.

The Department welcomes feedback on the approach used and the proposed formula which will inform ACRA’s continuing work to finalise their recommendations for 2013-14 public health allocations.

Locally across NHS Calderdale, Kirklees and Wakefield District, Public Health colleagues are working on the information in the consultation to understand the implications of the formula on resource allocations and will produce a response to the consultation by the deadline of 14 August 2012.

The full report is available at the following link: http://www.dh.gov.uk/health/2012/06/ph-funding-la/ 5.0

Recommendations It is recommended the Board: i) ii)

Note the progress made against the transition milestones; and update on progress towards transition; and Receive the Public Health exception report.

Ann Ballarini Executive Director of Commissioning & Service Development

Louise Auger Head of Performance Improvement & Commissioning Development

June 2012 6.0

Appendices

Appendix A YH 2012 13 Milestone Tracker - Narratives for each deadline v2.docx

Appendix B

dh_134569.pdf

Appendix C

CKW Exception Report July Meeting.xlsx