NHS Greater Huddersfield Clinical Commissioning Group CONSTITUTION Summary Document 1.
Introduction
The purpose of this document is to provide a summary of the content and meaning of the formal Constitution Document required by the CCG to establish the parameters within which the organisation will operate. The document is introduced by the Clinical Chair Dr S Ollerton who outlines his vision for the organisation and sets the tone of the culture which will operate. 2.
Background
The CCG will become a statutory organisation on 1 April 2013 and is formed from the 40 GP practices within the boundaries of Greater Huddersfield. The organisation will be accountable both to the practices and to the NHS Commissioning Board. 3.
Purpose
The CCG will commission a portfolio of clinical services from providers, both in the NHS and other sectors for the population it serves. 4.
Vision
The vision of the CCG is; “by being informed by our local population and clinicians, we will drive improvement of healthcare services through leadership, innovation and excellence.� Underneath this are a set of values and aims which set the context within which healthcare will be commissioned. These are detailed in Section 4.2 and 4.3 of the main document.
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5.
Governance
There follows a statement around the good governance of the organisation and the commitment to public accountability. As custodians of the public purse, the organisation may be challenged at any time by members of the public and therefore outlines the policies and procedures it will have in place to reflect this. A committee structure will be put in place which will cover all areas of operation and will be held to account by the governing body, these committees will have clear Terms of Reference and these will be regularly reviewed to ensure that they are conducted safely and appropriately. 6.
Functions
The main functions of the CCG will be; • Commissioning a defined range of health services for people registered with member practices and also people who are not registered but are usually resident within Greater Huddersfield • Commissioning emergency care for anyone present in Greater Huddersfield • Paying its employees remuneration in line with terms and conditions as agreed by the governing body • Determining remuneration and other allowances of governing body members 7.
General Duties
The main duties of the CCG will be; •
Act when exercising its functions to commission health services, consistently with the discharge of the Secretary of State and the NHS Commissioning Board of their duty to promote a comprehensive health service and with the objectives and requirements placed on the NHS Commissioning Board through the mandate published by the Secretary of State before the start of each financial year
•
Meet the public sector equality duty
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To work in partnership with its Local Authority to develop Joint Strategic Needs Assessments and Joint Health and Wellbeing Strategies
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•
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
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To act effectively, efficiently and economically
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To act with a view to securing continuous improvement to the quality of services
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Assist and support the NHS Commissioning Board in relation to the Board’s duty to improve the quality of primary medical services. This will include consulting with the LMC on any decision that significantly affects providers of General Practice.
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To have regard to the need to reduce inequalities
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Promote the involvement of patients, their representatives in decisions about their healthcare
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Act with a view to enabling patients to make choices
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To obtain appropriate advice from persons who, taken together, have a broad range of professional expertise in healthcare and public health.
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To promote innovation
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To promote research and the use of research
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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 actively 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
•
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
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These duties are listed in section 5.1 and 5.2 of the main document. •
Public Involvement and the detailed arrangements for securing this are articulated separately in Section 5.3.
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8.
General Financial Duties
The CCG will be accountable for a considerable sum of public money, this currently is in the region of some £350m and there are a number of additional requirements that will be active for the organisation, they are to; •
Ensure its expenditure does not exceed the aggregate if its allotments for the financial year
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Ensure its use of resources (both its capital and revenue resource use) does not exceed the amount specified by the NHS Commissioning Board for the financial year
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Take account of any directions issued by the NHS Commissioning Board in respect of specified types of resource use in a financial year, to ensure the group does not exceed an amount specified by the NHS Commissioning Board
•
Publish and explanation of how the group spent any payment in respect of quality made to it by the NHS Commissioning Board
The details around how each of these duties will be met are given in section 5.5 of the main document. 9.
Other Relevant Regulations, Directions and Documents
The group will; •
Comply with all relevant regulations
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Comply with directions issued by the Secretary of State for Health or the NHS Commissioning Board
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Take account, as appropriate, of documents issued by the NHS Commissioning Board
Additional duties to be undertaken by the governing body are specifically; • •
To meet in public To assign a board level officer to each area of operation and to each duty as specified
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• 10.
To ensure mandatory training is given to all employees Decision Making: The Governing Structure
The clinical commissioning group (member practice representatives) is accountable for exercising the statutory functions of the group. It may grant authority to act on its behalf to; • • • •
Any of its members Its governing body Employees A committee or sub-committee of the group
The documentation that clarifies these arrangements is called; The Scheme of Reservation and Delegation Whilst the group remains accountable, they may delegate certain responsibilities to committees, sub-committees or employees. Committees and sub-committees will have Terms of Reference which will articulate their responsibilities and employees will have job descriptions and individual objectives. These rules also apply when the CCG works jointly with other organisations and all operations must be in accord with the Scheme of Reservation and Delegation of the group. The Greater Huddersfield CCG members’ governing body is locally known as the Clinical Commissioning Executive. 11.
The Governing Body
The governing has a number of functions and these are; •
Ensuring that the group has appropriate arrangements in place to exercise its functions effectively, efficiently and economically and in accordance with the groups principles of good governance
•
Determining the remuneration, fees and other allowances payable to employees or other persons providing services to the group 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
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•
Approving any functions of the group that are specified by regulations
The composition of the governing body will be as follows; • • • • • • •
8 representatives of member practices, one of whom shall be appointed Chair 2 lay members (with specific disciplines detailed in sect 6.6.2) A registered nurse (who currently must be external to the organisation) A secondary care specialist doctor (who currently must be external to the organisation) The Accountable Officer The Chief Finance Officer The Senior Manager with responsibility for Quality
In attendance shall be; • •
A Public Health senior officer A Local Authority senior officer
The governing body will receive annual reports from its committees to give a level of assurance around operation and compliance with the constitution. In addition to this an Assurance Framework will be developed and regularly reported to the governing body in public session. If a number of practices (currently set at 30%) believe that their concerns have not been addressed or do not feel that their informal queries have been appropriately responded upon, they have a course of redress which is articulated at Section 3.8 of the constitution. The Framework will be centred upon the Strategic Objectives of the organisation which have already been approved by the governing body. 12.
Committee Structure
The governing body will have a number of committees to support its work; •
Audit and Governance Committee to provide and independent and objective view of the group’s internal control systems and compliance with law and regulation and to oversee Governance, Risk Management, Equality and Diversity and Emergency Preparedness & Business Continuity
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Remuneration Committee to provide advice in respect of the member representatives on the remuneration of employees
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•
Quality and Safety Committee to support the group in delivering its aims of ensuring that commissioned services are of a high quality and safe.
Each committee will have clear Terms of Reference and will be empowered to delegate to sub-committees and working groups in order to discharge its duties. The detail around each committee can be seen in Section 6.6.3 of the main document. In addition a number of groups will operate with the express mandate to delivering the main outcomes required by the governing body and committee structure; these will be empowered by the approval of annual plans by the governing body and will refer any issues outwith their express remit to the relevant committee for approval. 13.
Roles and Responsibilities
The roles and responsibilities for each of the governing body members are given in section 7 of the main document. 14.
Standards of Business Conduct and Managing Conflicts of Interest
The group will publish a document relating to the standards of business conduct and it will be called the Code of Conduct. This document will articulate the equity, transparency and openness which will be demonstrated by all members, employees, contractors and providers. Where the operation or decision-making of the organisation may compromise the objectivity of an individual member, employee or person charged with responsibility of discharging the duties of the group, there is an open process which must be followed and the detail of this is given in section 8 of the main document. All employees, members, committee and sub-committee members of the group and members of the governing body (and its committees) will at all times comply with the constitution and be aware of their responsibilities outlined in it. They should act in good faith in the interests of the group and should follow the Seven Principles of Life set out in the Committee on Standards in Public Life (the Nolan Principles). The Nolan Principles can be found at Appendix F of the main document.
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15.
Transparency in Procuring Services
The group will have a strategy for the procurement of services that will ensure that clinicians and potential providers, members of the local community in addition to members and employees are involved in the decision-making processes. In this way the group may ensure that they are open, transparent and nondiscriminatory in their service redesign and procurement duties. 16.
The Group as Employer
The group will value its employees and ensure that they are aware of their duties under the constitution. It will also provide appropriate guidance to officers to ensure that they can be compliant with areas relating to their field of work. All areas of regulation and compliance with employment law will be accommodated within policies, procedures and training for staff. More detail on this can be found at section 9 of the main document. 17.
Core Publications
In support of the public accountability of the group and in order that all members, employees and other stakeholders are entirely clear around both the operation of the group and assurances given to the governing body, the following is a list of the main publications that will be produced and be made available; •
Standing Orders this document outlines the regulation of proceedings of the NHS Greater Huddersfield Clinical Commissioning Group. They set out; o The arrangements for conducting the business of the group; o The appointment of member practice representatives o The procedure to be followed at meetings of the group, governing body and any committees and sub-committees o The process to delegate powers o The declaration of interests and standards of conduct The full document is attached at Appendix C of the constitution
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•
Scheme of Reservation and Delegation this document details which powers are reserved to the governing body and which ones delegated to committees, sub-committees and officers of the group and is attached at Appendix D of the constitution
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Prime Financial Policies this document gives the organisation the ability to ensure sound administration, lessen the risk of irregularity and support commissioning and delivery of effective, efficient and economical services. A copy is attached at Appendix E of the constitution
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Code of Business Conduct and Managing Conflicting Interests this document outlines the requirement of the governing body, committees, sub-committees, employees and third parties operating on behalf of the group to discharge their duties in line with the constitution of the group
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Financial Control and Budgetary Management this document operates in support of the Prime Financial Policies and gives more detail around the operation of the financial regime within the group
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Commissioning Intentions this annual document lays out the intentions of the group for the coming year including any planned transformation of services and development of the commissioning portfolio
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Business Cycle this document outlines the process which must be followed for all proposed developments or expenditure plans and includes all areas of operation
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Annual Integrated Operating Plan this document leads on from the commissioning intentions in that it declares the planned standards of quality, service development, finance and activity levels for the coming year
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Annual Financial Plan this document outlines the planned expenditure of the group and demonstrates how the organisation will secure financial balance and compliance with the financial duties in the constitution
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Annual Accounts this document is the statutory compliance with reporting the actual outcomes of the Financial Plan in that it shows the true and fair view of the financial operation of the group
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Annual Report this document follows all of the commissioning intentions, operating and financial planning and gives an overall assessment of the outcomes and performance against the plans of the group following the
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end of the financial year. The document will be presented in public at the Annual General meeting of the group •
Procurement Strategy this document will give the outline of the intention of the organisation to operate in an open and transparent way in procuring both goods and services including healthcare services
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Complaints Policy and Procedure this document gives a clear process to ensure that anyone who feels that they are not satisfied with the compliance of the group with their constitution may express their concern
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Individual Funding Requests this document gives clarity around the process for consideration of the funding of rare, complex or other procedures that do not sit within the usual commissioning portfolio of the organisation
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Communication and Public Engagement Policy this document clearly sets out exactly what all stakeholders, including the public can reasonably expect from the group in relation to their engagement, consultation and involvement with the organisation
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Equality and Diversity Policy this document clearly sets out the openness and transparency within which the organisation undertakes to ensure that it operates without prejudice in all areas of operation. This includes services commissioned, procurement processes, employment and all other involvement with the group.
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Joint Arrangements and Integration
The group actively works with other bodies and is promoting the integration of health and social care. The group’s values include reference to the part played by the group in the overall wellbeing of individuals and in pursuit of this aim; the group is actively engaged with the following; • • • • • •
Kirklees Council Other Clinical Commissioning Groups Academic Health Science Networks Primary Care Research Network Comprehensive Local Research Network Health and Wellbeing Board
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