NHS CANTERBURY AND COASTAL CLINICAL COMMISSIONING GROUP CONSTITUTION

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1 NHS CANTERBURY AND COASTAL CLINICAL COMMISSIONING GROUP CONSTITUTION NHS England Effective Date: 31 August 2017 Version: V.1.26

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3 CONTENTS Part Description Page Foreword 3 1 Introduction and Commencement Name Statutory framework Status of this Constitution Amendment and Variation of this Constitution 5 2 Area Covered 6 3 Membership Membership of the Group Eligibility 7 4 Mission, Values and Aims Mission Vision and Values Aims Principles of Good Governance Accountability Dispute Resolution 11 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 Group Joint Arrangements Joint commissioning arrangements with NHS England for the exercise of 31 CCG functions 6.7 Joint commissioning arrangements with NHS England for the exercise of 32 NHS England s functions 6.8 The Governing Body 33 7 Roles and Responsibilities The Members, Practice Clinical Leads and Practice Support Team Other GPs and 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 Chief Finance Officer Role of the Chief Operating Officer Role of GP Town Representatives Role of Salaried GP Lead 45 NHS Canterbury & Coastal Clinical Commissioning Group s Constitution - 1 -

4 Part Description Page 7.11 Role of Practice Nurse Lead Joint Appointments with other Organisations 46 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 51 Services to the Group 8.6 Transparency in Procuring Services 51 9 The Group as Employer Transparency, Ways of Working and Standing Orders General Standing Orders 53 Appendix Description Page A Definitions of Key Descriptions used in this Constitution 54 B List of Member Practices 59 C Standing Orders 60 Annex 1: Meetings of the Governing Body 82 Annex 2A: Towns 88 Annex 2B: Patient and Public Representation 91 Attachment to Annex 2 92 Annex 3: Joint Audit, Governance and Risk Committee Terms of Reference 93 Annex 4: Remuneration and Nominations Committee Terms of Reference 101 Annex 5: Ashford and Canterbury CCG Primary Care Commissioning 119 Committee-in-common terms of reference D Scheme of Reservation and Delegation 125 E Prime Financial Policies 151 F The Nolan Principles 162 G The Seven Key Principles of the NHS Constitution 163 H Dispute Resolution Process 164 I East Kent Federation Principles of Working 166 Standing Financial Instructions (SFIs) 167 ANNEX A Currently established committees of the Governing Body 199 ANNEX B Joint arrangements currently entered in to 249 NHS Canterbury & Coastal Clinical Commissioning Group s Constitution - 2 -

5 FOREWORD Welcome to the Constitution of the Canterbury and Coastal Clinical Commissioning Group (referred to as the CCG in this document.) This Constitution outlines how we will govern the CCG to ensure that our mission to work collaboratively with partner organisations, locally led by clinicians, to commission and monitor the highest quality cost effective and compassionate care as close to home for patients as possible to deliver the best quality outcomes for all - is achieved through careful stewardship of public resources. The CCG is a membership organisation and this Constitution involves all of our 19 member practices. Our Constitution has been developed through engagement with our members, partners and stakeholders and recognises the statutory duties placed upon us as a Clinical Commissioning Group. It sets out how our member practices will be engaged in our commissioning activities and the procedures, rules and principles of good governance that the Group will follow to ensure probity and accountability. We will use our in-depth knowledge of our communities and understanding of our patients, making changes which improve the planning, commissioning and delivery of healthcare, to make a real difference to the quality of care and health of local residents. Our patients and their carers, the people who rely on local health services, are uniquely placed to help us make better commissioning decisions by advising us on what works best for them and the areas that could be improved upon. We are committed to meaningful, two way engagement with the public, patients and all of our key stakeholders. NHS Canterbury & Coastal Clinical Commissioning Group s Constitution - 3 -

6 1. INTRODUCTION AND COMMENCEMENT 1.1. Name The name of this clinical commissioning group is NHS Canterbury and Coastal Clinical Commissioning Group Statutory Framework Clinical commissioning groups are established under the Health and Social Care Act 2012 ( the 2012 Act ). 1 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 ). 2 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 groups to be established as Clinical Commissioning Groups 4 and undertakes an annual assessment of each established group. 5 It has powers to intervene in a Clinical Commissioning Group where it is satisfied that a group is failing or has failed to discharge any of its functions or that there is a significant risk that it will fail to do so Clinical Commissioning Groups are clinically led membership organisations made up of general practices. The Members of the Clinical Commissioning 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 Canterbury and Coastal Clinical Commissioning Group and has effect from the 31st day of August The Constitution is published on the Group s website. This version supersedes the version that came into effect on the 1 st day of April This document will be made available upon request for inspection at the Group's headquarters at the following address: Canterbury & Coastal Clinical Commissioning Group Canterbury City Council Offices Military Road Canterbury Kent. CT1 1YW The group 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 See section 1I of the 2006 Act, inserted by section 10 of the 2012 Act See section 275 of the 2006 Act, as amended by paragraph 140(2)(c) of Schedule 4 of the 2012 Act 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 See section 14C of the 2006 Act, inserted by section 25 of the 2012 Act See section 14Z16 of the 2006 Act, inserted by section 26 of the 2012 Act See sections 14Z21 and 14Z22 of the 2006 Act, inserted by section 26 of the 2012 Act See in particular sections 14L, 14M, 14N and 14O of the 2006 Act, inserted by section 25 of the 2012 Act and Part 1 of Schedule 1A to the 2006 Act, inserted by Schedule 2 to the 2012 Act and any regulations issued NHS Canterbury & Coastal Clinical Commissioning Group s Constitution - 4 -

7 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 sub-committees 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 A copy can be provided upon application in writing to the Group at its headquarters or by at c4.ccg@nhs.net Amendment and Variation of this Constitution This Constitution can only be varied in two circumstances. 8 a) where the Group applies to NHS England and that application is granted; b) where in the circumstances set out in legislation NHS England varies the Group s Constitution other than on application by the Group. 8 See sections 14E and 14F of the 2006 Act, inserted by section 25 of the 2012 Act and any regulations issued NHS Canterbury & Coastal Clinical Commissioning Group s Constitution - 5 -

8 2. AREA COVERED The geographical areas covered by NHS Canterbury and Coastal Clinical Commissioning Group are the City of Canterbury, Faversham, Whitstable, Herne Bay, Sandwich & Ash, and surrounding rural areas. The Group consists of (at the date of commencement of this Constitution) 19 Member practices providing services under GMS & PMS arrangements to approximately 215,000 patients A map of the Area and Member practice locations is provided in the attachment to Annex 2 of Appendix C All patients of the Member practices live in the upper tier local authority area of Kent. 2.2 The Area of the Group shall be divided into Towns. The initial Towns of the Group are set out in Annex 2A to Appendix C (Standing Orders). NHS Canterbury & Coastal Clinical Commissioning Group s Constitution - 6 -

9 3. MEMBERSHIP 3.1. Membership of the Clinical Commissioning Group The following Member practices comprise the Members of NHS Canterbury and Coastal Clinical Commissioning Group. Practice Name Ash Surgery Canterbury Health Centre Canterbury Medical Practice Coach House Surgery Cossington House Faversham Medical Practice Market Place Surgery New Dover Road Surgery Newton Place Surgery Northgate Medical Centre Old School Surgery Park Surgery Saddleton Road St Annes Group Practice Sturry Surgery The Butchery University Medical Centre Whitstable Medical Practice William Street Address Chilton Place Ash, Canterbury, Kent, CT3 2HD 26 Old Dover Road Canterbury, Kent CT1 3JH Bridge Health Centre, Patrixbourne Road, Bridge, Canterbury Kent. CT4 5BL 27 Canterbury Road, Herne Bay, Kent, CT65DQ 51 Cossington Road Canterbury Kent, CT1 3HX Faversham Health Centre, Bank Street Faversham, Kent, ME13 8QR The Market Place Surgery, Cattle Market, Sandwich, Kent, CT13 9ET 10 New Dover Rd, Canterbury, Kent CT1 3AP Newton Road, Faversham, Kent, ME138FH 1 Northgate, Canterbury, Kent, CT1 1WL Bolts Hill, Chartham, Canterbury, Kent, CT4 7JY 116 King's Road, Herne Bay, Kent, CT6 5RE 32 Saddleton Road, Whitstable, Kent, CT5 4JQ 161 Station Road, Hernebay, Kent, CT6 5NF 53 Island Road Sturry, Canterbury, Kent CT2 0EF The Butchery, Sandwich, Kent, CT13 9DL University Medical Centre, Giles Lane, Canterbury, Kent, CT2 7PB Estuary View Medical Centre, Boorman Way, Whistable, Kent. CT53SE 67 William Street, Herne Bay, Kent, CT6 5NR Appendix B of this Constitution contains the list of Member practices Eligibility Providers of primary medical services to a registered list of patients under a General Medical Services, Personal Medical Services or Alternative Provider Medical Services contract that meet the requirements of the Regulations, will be eligible to apply for membership of this Group Any body which is a provider of primary care services in the Area shall apply to become a Member of the Group under the following conditions: the provider holds a contract for the provision of essential primary medical services to registered patients during core hours (as those terms are defined in regulation 2(2) of the Regulations); 9 See section 14A(4) of the 2006 Act, inserted by section 25 of the Regulations to be made NHS Canterbury & Coastal Clinical Commissioning Group s Constitution - 7 -

10 most of the persons who are to be provided with primary medical services by the Member usually reside in the Area; and it has duly submitted an application to NHS England for membership of the Group, and such membership having been approved Any eligible entity wishing to join the Group must submit an application to NHS England for approval and must notify the Group in writing of such application at the Group's address set out at paragraph above Any Member wishing to leave the Group must submit an application to NHS England for approval and must give a minimum of 3 months notice, in writing to the Group in advance of submitting such application Membership of the Group will automatically terminate where a Member no longer meets the eligibility criteria for membership of the Group as set out in paragraphs above or the provisions of paragraph 1.4 above result in cessation of membership The Group shall notify NHS England in the event that it becomes aware that any Member no longer meets the requirements of paragraphs above or is proposing to merge with another Member or a member of another Clinical Commissioning Group and shall propose any such amendments to this Constitution under the terms of paragraph 1.4 as are appropriate to reflect the circumstances Membership of the Group is not transferable and any proposed changes to the membership (including those arising from a merger of Members) shall be subject to the approval of NHS England. NHS Canterbury & Coastal Clinical Commissioning Group s Constitution - 8 -

11 4. MISSION, VALUES AND AIMS 4.1. Vision and Mission The vision of the Group is to provide the highest quality health and wellbeing for our communities The mission of the group is to work collaboratively with partner organisations, locally led by clinicians, to commission and monitor the highest quality cost effective and compassionate care as close to home for patients as possible to deliver the best quality outcomes for all The Group 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 Group s objectives The values that lie at the heart of the Group s work are: a) Caring - we actively demonstrate care and compassion for others b) Population focused our patients are the focus of all we do c) Reliable we are competent, and take responsibility for our actions and the resources we use d) Respect we act with due regard and consideration for others e) Transparency we act with openness, honesty and clarity 4.3. Principles of Good Governance In accordance with section 14L(2)(b) of the 2006 Act, 10 the Group will at all times observe such generally accepted principles of good governance as are relevant to it 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; 11 c) the standards of behaviour published by the Committee on Standards in Public Life (1995) known as the Nolan Principles 12 d) the seven key principles of the NHS Constitution; Inserted by section 25 of the 2012 Act The Good Governance Standard for Public Services, The Independent Commission on Good Governance in Public Services, Office of Public Management (OPM) and The Chartered Institute of Public Finance & Accountability (CIPFA), 2004 See Appendix F See Appendix G NHS Canterbury & Coastal Clinical Commissioning Group s Constitution - 9 -

12 e) the Equality Act Accountability The Group 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 Group considers that it would not be in the public interest in relation to all or part of a meeting); d) publishing annually a commissioning plan; e) complying with local authority health overview and scrutiny requirements; f) meeting annually in public to publish and present its annual report (which must be published); g) producing annual accounts in respect of each Financial Year which must be externally audited; h) having a published and clear complaints process; i) complying with the Freedom of Information Act 2000; j) providing information to NHS England as required In addition to these statutory requirements, the Group will demonstrate its accountability by: a) communicating all decisions and developments relevant to commissioning and other matters to all Members and GPs employed or engaged by Members (including principals, sessional GPs and GPs in training) in a timely fashion; b) ensuring that all decisions made in relation to commissioning are fully recorded and auditable; c) providing summary reports of all activity including financial activity to all Members prior to the Governing Body s meetings, such reports to form part of the main agenda of those meetings (with detailed reports being available upon request); d) holding patient and public engagement events where, for example, commissioning intentions, budgets, spending, risks and annual planning will be discussed; e) ensuring the Governing Body is accountable to its Members via the Consortium Meetings and the Town arrangements; 14 See NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

13 f) identifying a named Lay Member with responsibility for public and patient engagement; g) supporting the Public Reference Group The Governing Body of the Group will throughout each year have an ongoing role in reviewing the Group s governance arrangements to ensure that the Group continues to reflect the principles of good governance Dispute resolution The Group shall apply the Dispute Resolution Procedure set out at Appendix H to this Constitution in regard to disputes relating to the Group: a) with Practice Clinical Leads and/or members of the Governing Body in relation to matters of eligibility, disqualification and termination of tenure; and b) between the Members and the Governing Body in relation to any allegation of failure to comply with the processes and procedures set out in this Constitution. NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

14 5. FUNCTIONS AND GENERAL DUTIES 5.1. Functions The functions that the Group 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 or where NHS England has delegated to the CCG authority to commission health services on its behalf) 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 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 Group s employees; d) determining the remuneration and travelling or other allowances of members of its Governing Body In discharging its functions the Group will: a) act 15, 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 16 and with the objectives and requirements placed on NHS England through the mandate 17 published by the Secretary of State before the start of each financial year by: i) delegating responsibility to the Group s Governing Body for this function; ii) iii) iv) identifying and evaluating commissioning requirements with a broad perspective, so that commissioning strategy comprehensively takes into account the wide range of health needs of the Group's population; adopting an annual commissioning plan which complies with the requirements of the Secretary of State and NHS England; requiring the Governing Body to regularly monitor performance against the annual commissioning plan; v) ensuring active participation at local Health and Wellbeing Boards; See section 3(1F) of the 2006 Act, inserted by section 13 of the 2012 Act See section 1 of the 2006 Act, as amended by section 1 of the 2012 Act See section 13A of the 2006 Act, inserted by section 23 of the 2012 Act NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

15 vi) vii) ensuring effective liaison with and reporting to Members and NHS England as appropriate; engaging with the Local Medical Committee (LMC) on matters likely to impact on member practices as local statutory representatives of the profession; viii) having the authority to engage, employ or appoint any consultant, employee or private contractor in order to facilitate the performance of its duties b) meet the public sector equality duty 18 by: i) delegating responsibility for seeking assurance on the robustness of arrangements relating to equality and human rights to the Group s Governing Body; ii) iii) iv) delegating responsibility for the review of arrangements relating to equality and human rights to the Quality Committee; preparing and publishing specific and measurable equality objectives, revising these at least every four years; engaging, employing or appointing any consultant, employee or private contractor in order to facilitate the performance of its duties in relation to this function; and v) publishing, at least annually, sufficient information to demonstrate compliance with this general duty across all functions. c) work in partnership with its local authorities to develop joint strategic needs assessments 19 and joint health and wellbeing strategies 20 by: i) ensuring (where appropriate) multi-professional engagement and involvement with organisations including local authority, the voluntary sector and secondary, community and private providers, in commissioning decisions; ii) iii) developing local strategies to support, implement and deliver health economy productivity and efficiency initiatives and manage the Group's operational performance in line with the Group's QIPP plan; developing commissioning plans that reflect Joint Strategic Needs Assessments (JSNAs) and Joint Health and Wellbeing Strategies (JHWSs); See section 149 of the Equality Act 2010, as amended by paragraphs 184 and 186 of Schedule 5 of the 2012 Act See section 116 of the Local Government and Public Involvement in Health Act 2007, as amended by section 192 of the 2012 Act See section 116A of the Local Government and Public Involvement in Health Act 2007, as inserted by section 191 of the 2012 Act NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

16 iv) building close working relationships with the Healthwatch and relevant locally elected representatives; v) ensuring active participation at local Health and Wellbeing Governing Bodys; vi) vii) developing the Group's commissioning plan with a focus on the high-level needs of the population, where appropriate, working in partnership with the local authority and other public health organisations to identify how best to address these needs; ensuring the ongoing involvement of Clinical Programme Leads in ensuring that the views of GPs are represented and that actions are tailored to the specific population where work is delivered on a throughout Kent and Medway General Duties - in discharging its functions the Group 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 21 by: a) implementing the plans and initiatives as set out in the Group's communications and engagement strategy, which supports the Group's annual operational plan, its strategic commissioning plan and its organisational development plan, and which sets out how the Group will engage and communicate with those who support it. In particular the Group shall communicate and engage with the public so that: i) the public know what it is and what its does; ii) iii) iv) the public know what services it commissions and how to access them; the public can make informed choices about their health and lifestyle; it promotes the effective use of health services; v) the Group can be held to account; vi) vii) there is no decision about me, without me through better involvement and engagement of those who use services; the Group's strategic objectives and the delivery of its plans are supported through engaging people, partners and stakeholders; viii) planning and service provision is joined up; ix) quality of care improves; and x) the Group's values are clear and reinforced; 21 See section 14Z2 of the 2006 Act, inserted by section 26 of the 2012 Act NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

17 b) supporting the development of active patient participation groups through the Patient Reference Groups; in each Member practice; c) operating a Public Reference Group which, along with the Friends of NHS Canterbury and Coastal Clinical Commissioning Group, will enable these stakeholders to: i) review and feedback on commissioning intentions; ii) provide feedback on and flag issues regarding quality and safety issues; d) continuously developing means and methods of patient participation over time; e) ensuring that all the Group s policies and procedures with regard to the involvement and consultation of patients and other relevant bodies are fully complied with at all times; and f) ensuring that its Member practices are engaged in facilitating public involvement and fulfil their responsibilities to the Group with respect to patient and public engagement including: i) ensuring that the views of patients on the Group's commissioning plans are captured locally where the opportunity arises and fed back into the Group; ii) ensuring that the implications of the Group's commissioning activity are communicated with patients where opportunities arise (e.g. in Patient Reference Groups, Town Patient Reference Groups, newsletters, etc). g) building close working relationships with the Healthwatch and Kent area Health and Wellbeing Governing Bodys 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 22 by: a) delegating responsibility for promoting awareness of and having regard to the NHS Constitution to the Governing Body; b) where appropriate, delegating responsibility to the Group's representatives on the NHS Kent & Medway Contracting & Procurement team to have regard to the obligations set out within the NHS Constitution; c) delegating responsibility for ensuring commissioning takes place in accordance with the NHS Constitution to the Operational Leadership Team; d) engaging, employing or appointing any consultant, employee or private contractor in order to facilitate the performance of its duties in relation to this function; e) implementing the Group's communications and engagement strategy which sets out the Group's approach to fulfilling the following commitments to patients and patients rights as laid out in the NHS Constitution, in particular: 22 See section 14P of the 2006 Act, inserted by section 26 of the 2012 Act and section 2 of the Health Act 2009 (as amended by 2012 Act) NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

18 i) with respect to improving patient awareness of NHS services, to inform you about the healthcare services available to you, locally and nationally ; ii) iii) with respect to patient and public engagement, to be involved, directly or through representatives, in the planning of healthcare services, the development and consideration of proposals for changes in the way those services are provided, and in decisions to be made affecting the operation of those services. organising stakeholder engagement events and Consortium Meetings which are open to the public and provide transparency with respect to commissioning priorities, plans, budgets, spending and other key information in order to provide patients with the information you need to influence and scrutinise the planning and delivery of NHS services ; f) ensuring that commissioning priorities and plans are informed by the findings of regular local needs assessment processes in order to ensure that NHS services [ ] reflect the needs and preferences of patients, their families and their carers and that patients rights to expect your local NHS to assess the health requirements of the local community and to commission and put in place the services to meet those needs as considered necessary are respected; g) working jointly with Kent local authorities, social services and a wide range of other private, public and third sector organisations at a local level to commission health services which provide and deliver improvements in health and well-being in line with the NHS Constitution; h) ensuring, where appropriate, that contracting & procurement teams use the current NHS standard contract with Providers, which includes as at the date that this Constitution takes effect (amongst other items) the following terms and requirements thus reflecting the NHS commitments to patients as set out in the NHS Constitution, under the following headings: Access to health services (including unlawful discrimination) i) Quality Requirements including response times, rates of recovery, waiting times and for specified conditions; ii) iii) Nationally Specified Events including operating standards for response, transportation, referral and treatment waiting times, and Never Events; Equity of access, equality and no discrimination, including equality of access for patients with protected characteristics; Quality of care and environment i) Nationally Mandated (quality) Incentive Schemes; ii) iii) iv) Commissioning for Quality and Innovation (CQUIN) incentive scheme; Locally Agreed Incentive Schemes; Service user, carer and staff surveys; NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

19 v) Reporting and Information Management including national and local requirements, for reporting centrally and locally; vi) Plans for service development and improvement, in order to monitor, and make efforts to improve, the quality of healthcare ; Nationally approved treatments, drugs and programmes i) Clinical networks and screening programmes, with a view to providing screening programmes as recommended by the UK National Screening Committee Respect, consent and confidentiality i) Compliance with Patient Choice guidance; Act effectively, efficiently and economically 23 by: a) delegating responsibility for securing effective, efficient and economical arrangements to the Group s Governing Body; b) delegating responsibility for seeking assurance on the effectiveness, efficiency and economy of arrangements to the Audit, Governance and Risk Committee; c) engaging, employing or appointing any consultant, employee or private contractor in order to facilitate the performance of its duties in relation to this function; d) ensuring the responsiveness and cost effectiveness of the Group's resources by maintaining the flexibility to scale such human resources according to the demands of commissioning activities and projects; e) incentivising and supporting Members to work proactively to improve efficiency and value; f) ensuring that the Governing Body approves business cases where appropriate; g) monitoring the implementation of the operational plan and QIPP plan to ensure that these are delivered effectively, efficiently and economically; and h) monitoring, reporting on and adjusting the allocation of the Group's budget to ensure that the Group is aware of and works within the allocated budget at all times Act with a view to securing continuous improvement to the quality of services 24 by: a) delegating responsibility for acting with a view to ensuring continuous improvements to the quality of services to the Group s Governing Body; b) delegating responsibility to the Quality Committee for: See section 14Q of the 2006 Act, inserted by section 26 of the 2012 Act See section 14R of the 2006 Act, inserted by section 26 of the 2012 Act NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

20 i) the review of quality of services; ii) iii) iv) capturing, analysing, interpreting and acting on patient experience data; and undertaking regular patient-centred monitoring and performance management; developing and overseeing the implementation of the Group s complaints procedure, working alongside the Kent & Medway Commissioning Support Service (KMCS); c) engaging, employing or appointing any consultant, employee or private contractor in order to facilitate the performance of its duties in relation to this function; d) seeking input and feedback from GPs via (i) the Practice Clinical Leads through their attendance at the Consortium Meetings and (ii) the mechanisms outlined in the Group s Communications and Engagement Strategy, which will be used to inform commissioning decision making, identify service quality issues and identify opportunities for service improvement; e) working with all stakeholders to ensure awareness and achieve the delivery of targets, policies and standards; and f) ensuring that, where appropriate, contracting & procurement teams use the current NHS standard contract with Providers, which includes, as at the date this Constitution takes effect, (amongst other items) the following terms and requirements which reflect the NHS commitments to ensuring the quality and improvement of care: i) Nationally Mandated (quality) Incentive Schemes; ii) iii) iv) Commissioning for Quality and Innovation (CQUIN) incentive scheme; Locally Agreed Incentive Schemes; Service user, carer and staff surveys; v) Reporting and Information Management including national and local requirements, for reporting centrally and locally; vi) Plans for service development and improvement, in order to monitor, and make efforts to improve, the quality of healthcare Assist and support NHS England in relation to the Governing Body s duty to improve the quality of primary medical services 25 by: a) delegating responsibility for acting with a view to ensuring continuous improvements to the quality of services to the Group s Governing Body; 25 See section 14S of the 2006 Act, inserted by section 26 of the 2012 Act NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

21 b) delegating responsibility to the Quality Committee, in conjuction with the Primary Care Commissioning Committee, to determine how the Group will meet this duty and to submit plans to the Governing Body for approval. c) d) delegating responsibility for assisting and supporting NHS England in relation to NHS England's duty to improve the quality of primary medical services to the Group s Governing Body; e) delegating operational lead responsibility for assisting and supporting NHS England in relation to NHS England's duty to improve the quality of primary medical services to the Operational Leadership Team; f) engaging, employing or appointing any consultant, employee or private contractor in order to facilitate the performance of its duties in relation to this function; Assist and support NHS England in relation to the Governing Body s duty to commission Specialised Services by: a) working closely with NHS England to ensure there is increased efficiency and consistency around the planning and delivery of high quality specialised services for patients across England; and b) working with the NHS CB to ensure there is no division of care where different elements of the patient pathway are commissioned by different bodies Have regard to the need to reduce inequalities by: a) delegating responsibility for this function to the Group s Governing Body; b) engaging, employing or appointing any consultant, employee or private contractor in order to facilitate the performance of its duties in relation to this functions; c) championing the reduction in health inequalities through the annual commissioning plan and committing to improve health promotion and public involvement; d) working to ensure greater equality of access across the Area in relation to services; e) in commissioning services, the Group shall take into account of the needs of everyone in the community regardless of age, gender, sexual orientation, faith, ethnicity, and ability; f) gaining a clear understanding of cultural needs and any barriers that exist to achieving better health; g) considering the impact on different communities of commissioning decisions, so that the Group can take corrective action where necessary; h) identifying and acting to address health inequalities via the needs assessment process; i) implementing the strategies outlined in the Group's communications & engagement strategy to improve public awareness of health issues and services available, particularly amongst disadvantaged groups or those lacking an understanding of NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

22 health issues and health care services by: i) supporting and encouraging community leaders to be communications champions and ensure people from different backgrounds and faiths, with different languages and different communication needs have access to information and can get involved with the Group's plans; ii) iii) iv) ensuring that the Group communicates and engages in ways that are accessible to everyone in the community; reaching out into the different communities in innovative ways and working with those communities; targeting services effectively to areas of particular need by using information and research about different communities needs; and v) increasing reach into communities where evidence shows further engagement is needed Promote the involvement of patients, their carers and representatives in decisions about their healthcare 26 by: a) delegating responsibility for promoting patient, carer and representative involvement in decisions about healthcare to the Governing Body; b) engaging, employing or appointing any consultant, employee or private contractor in order to facilitate the performance of its duties in relation to this function; c) establishing and fully engaging with the Public Reference Group; and d) acting with a view towards the objective of No decision about me without me, by providing patients with the opportunity to make decisions about what healthcare they want and need Act with a view to enabling patients to make choices 27 by: a) delegating responsibility for enabling patients to make choices to the Governing Body; b) engaging, employing or appointing any consultant, employee or private contractor in order to facilitate the performance of its duties in relation to this function; c) raising awareness amongst the public and patients, through education and information, about common health conditions and how to manage one's own health better, which shall enable patients to make better choices about staying healthy and managing their health. This will take place via a wide range of communication channels including: i) practice based Patient Reference Groups; See section 14U of the 2006 Act, inserted by section 26 of the 2012 Act See section 14V of the 2006 Act, inserted by section 26 of the 2012 Act NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

23 ii) iii) the Public Reference Group; and the Group's newsletter; d) informing and raising awareness of the different services and options available to patients, and publicising the various places and ways that these services can be accessed, for example via the Group's website, newsletter, campaigns (posters and flyers), etc.; e) encouraging GPs from Member practices to take responsibility for making patients aware of their healthcare choices at the point of referral; f) publicising the full array of the Group's health services via the Group's website; and g) in preparing an annual commissioning plan, and delivering the Group's commissioning responsibilities, having regard to the requirement for patient choice Obtain appropriate advice 28 from persons who, taken together, have a broad range of professional expertise in healthcare and public health by: a) delegating responsibility for obtaining appropriate advice to the Group s Governing Body; b) having a secondary care specialist doctor and registered nurse as members of the Governing Body; c) seeking input and feedback from GPs from Member practices, Members and the local profession to inform clinical commissioning decision making in line with the strategy set out in the Group's communications & engagement strategy and clinical engagement plan. In particular the Group will: i) ensure service redesign is led by clinicians and is in the best interests of the public by basing it on clinical evidence, local need and funds available; ii) iii) iv) ensure commissioning decisions are based on clinical views by having clinicians leading the Clinical Strategy Committee; improve the quality of public messages about health by using the expertise of clinicians when developing and communicating key messages to the public; appointing the registered nurse on the Governing Body to the role of "Head of Safety and Quality"; v) include clinicians in commissioning decisions by providing a range of opportunities and mechanisms for them to do so; and vi) make it is easy for clinicians to be aware of changes to services being commissioned by the Group by communicating through a range of channels including a dedicated area of the Group's website. 28 See section 14W of the 2006 Act, inserted by section 26 of the 2012 Act. NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

24 d) co-ordinating cross-clinical Commissioning Group activities and knowledge sharing via the East Kent Federation 29 ; e) working collaboratively with other Clinical Commissioning Groups in Kent & Medway and East Kent when appropriate, particularly in the development of commissioning strategy; f) developing and supporting a wide range of task & finish groups designed to bring experts together in order to undertake specific projects, keeping expertise fresh and focused Promote innovation 30 by: a) delegating responsibility for the promotion of innovation to the Group s Governing Body; b) designating the Accountable Officer as lead Governing Body member for innovation; c) engaging, employing or appointing any consultant, employee or private contractor in order to facilitate the performance of its duties in relation to this function; d) participating in the East Kent Federation; e) using new technologies that support communications and engagement; f) welcoming and evaluating ideas submitted by individual GPs and Member practices in order to identify projects to develop outside of the operating plan; g) developing and supporting a wide range of projects keeping expertise fresh and focused; and h) supporting a varied and diverse approach to commissioning Promote research and the use of research 31 by: a) delegating responsibility for the promotion and use of research to the Governing Body; b) designating the Accountable Officer as lead Governing Body member for research; and c) adopting a research policy that is approved by the Governing Body Have regard to the need to promote education and training 32 for persons who are employed, or who are considering becoming employed, in an activity which involves or Further detail relating to the East Kent Federation can be found in Appendix I. See section 14X of the 2006 Act, inserted by section 26 of the 2012 Act See section 14Y of the 2006 Act, inserted by section 26 of the 2012 Act NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

25 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 33 by: a) delegating responsibility for this function to the Group s Governing Body; b) having the authority to engage, employ or appoint any consultant, employee or private contractor in order to facilitate the performance of its duties; c) developing and implementing an Education & Training policy for the Group's staff; d) running clinically focused education sessions for GPs and practice nurses employed or engaged by Members, known as Practice Learning Time (PLT); e) supporting GP trainees within the Group; ensuring ongoing 'Governing Body development work aimed at developing and strengthening the individual soft skills required by Governing Body members to fulfil their roles and developing effectiveness to ensure that the Governing Body works together efficiently and effectively as a group 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 34 by: a) delegating responsibility for promoting integration to the Accountable Officer; b) engaging, employing or appointing any consultant, employee or private contractor in order to facilitate the performance of its duties in relation to this function and delegating authority to do so to the Governing Body; c) ensuring that it encourages partners and stakeholders to be engaged by working as a whole system to improve health and healthcare in the Group through operational and decision making Governing Bodys; d) developing commissioning strategy, where appropriate, which support the East Kent Federation; e) ensuring that plans are co-ordinated and informed by effective engagement with partners and robust structures such as the Health and Wellbeing Governing Bodys in Kent; f) delivering effective joined-up communication and engagement between health, social and community care and other local services; g) implementing effective integration programmes with local authorities and Providers based on the integration of community health and social care based around Member practices, to deliver better outcomes to people and deliver more efficient See section 14Z of the 2006 Act, inserted by section 26 of the 2012 Act See section 1F(1) of the 2006 Act, inserted by section 7 of the 2012 Act See section 14Z1 of the 2006 Act, inserted by section 26 of the 2012 Act NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

26 and cost-effective delivery models General Financial Duties The Group will perform its functions so as to: Ensure its expenditure does not exceed the aggregate of its allotments for the financial year 35 by: a) delegating responsibility for ensuring expenditure does not exceed aggregated allotments to the Group s Governing Body; b) ensuring the Group develops and implements a detailed financial plan that delivers financial balance, which is integrated with the Group's annual and strategic commissioning plan; c) having detailed QIPP schemes that are recognised and understood by the Members and Providers. Where possible and appropriate these QIPP schemes shall be jointly designed with Providers and wider stakeholders; d) ensuring monthly, quarterly and annual reporting processes are robust, timely and accurate; e) managing the cash flow of the Group whilst achieving the Better Payment Policy (BPP) requirements; f) ensuring that any outsourced functions provide services as per contracts and that the requisite governance arrangements and in place and adhered to; g) ensuring that robust systems and processes are in place, such as the Scheme of Reservation and Delegation, and that these are embedded and complied with within the day to day working of the Group; h) delegating responsibility for reviewing and challenging monthly financial information, QIPP delivery and proposed business developments to the Finance, Investment and Performance Committee; i) delegating responsibility for ensuring robust financial strategies, policies, systems, processes and governance arrangements are in place to the Chief Finance Officer; and j) reviewing detailed activity and finance and QIPP information to identify trends and issues, resolving where possible and escalating to the Audit, Governance and Risk Committee as appropriate 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 36 by: a) delegating responsibility for ensuring its use of resources does not exceed the amount specified by NHS England for the Financial Year to the Governing Body; See section 223H(1) of the 2006 Act, inserted by section 27 of the 2012 Act See sections 223I(2) and 223I(3) of the 2006 Act, inserted by section 27 of the 2012 Act NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

27 b) delegating responsibility for ensuring robust financial strategies, policies, systems, processes and governance arrangements are in place to the Chief Finance Officer; c) delegating responsibility for seeking assurance on the robustness of financial arrangements to the Audit, Governance and Risk Committee; d) developing a detailed financial plan that delivers financial balance to the RRL (Revenue Resource Limit) and CRL (Capital Resource Limit) as appropriate, which is integrated with the annual and strategic commissioning plan; e) having detailed QIPP schemes that are recognised and understood by the Members and Providers. Where possible and appropriate these QIPP schemes will be jointly designed with Providers and wider stakeholders; f) ensuring monthly, quarterly and annual reporting processes are robust, timely and accurate; g) ensuring that any outsourced functions provide services as per contracts and that the requisite governance arrangements are in place and adhered to; h) ensuring that robust systems and processes are in place, such as the Scheme of Reservation and Delegation, and that these are embedded within the day to day working of the Group; i) delegating responsibility to the Audit, Governance and Risk Committee to review and challenge monthly financial information, QIPP delivery and proposed business developments; and j) putting processes in place for the review of detailed activity and finance and QIPP information to identify trends and issues, resolving where possible or escalating to the Audit, Governance and Risk Committee as appropriate Take account of any directions issued by NHS England, in respect of specified types of resource use in a financial year, to ensure the group does not exceed an amount specified by NHS England 37 by: a) delegating responsibility for complying with directions issued by NHS England in respect of specified types of resource use to the Governing Body; b) delegating responsibility for ensuring robust financial strategies, policies, systems, processes and governance arrangements are in place to enable the Group to fulfil its statutory responsibility not to exceed its expenditure limits, as set by direction of NHS England, to the Chief Finance Officer; and c) delegating responsibility for seeking assurance on the robustness of financial arrangements to the Audit, Governance and Risk Committee who shall: i) engage, employ or appoint any consultant, employee or private contractor in order to facilitate the performance of its duties; and 37 See section 223J of the 2006 Act, inserted by section 27 of the 2012 Act NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

28 ii) monitor separately any hypothecated funds against specific project plans, to provide assurance to NHS England that the funds are utilised appropriately and desired outcomes are secured Publish an explanation of how the group spent any payment in respect of quality made to it by NHS England 38 by: a) delegating operational responsibility for payments in respect of quality made to it by NHS England, to the Chief Finance Officer; b) delegating responsibility for seeking assurance on the use of such payments to the Audit, Governance and Risk Committee; c) requiring the Chief Finance Officer to regularly monitor and review payments in respect of quality made to the Group by NHS England, and report on the same to the Governing Body; d) engaging, employing or appointing any consultant, employee or private contractor in order to facilitate the performance of its duties in relation to this function; e) monitoring and recording separately within the financial ledger all quality initiatives to allow detailed in year and year end reporting of schemes; and f) accompanying any bid for resource with a robust business case that is deliverable and has measurable outcomes that can be monitored and reported against Other Relevant Regulations, Directions and Documents The Group 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 Group 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 Group policies and procedures. 38 See section 223K(7) of the 2006 Act, inserted by section 27 of the 2012 Act NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

29 6. DECISION MAKING: THE GOVERNING STRUCTURE 6.1. Authority to act The Group is accountable for exercising the statutory functions of the Group. It may grant authority to act on its behalf to: a) any of its Members; b) its Governing Body; c) employees; d) a committee (including a joint committee) or sub-committee of the Group, and enter into contracts with consultants and contractors, as appropriate The extent of the authority to act of the respective bodies and individuals depends on the powers delegated to them by the Group as expressed through: a) the Group s Scheme of Reservation and Delegation; and b) for committees, their terms of reference Scheme of Reservation and Delegation The Group s Scheme of Reservation and Delegation sets out: a) those decisions that are reserved for the membership as a whole; b) those decisions that are the responsibilities of its Governing Body (and its committees), the Group s committees and sub-committees, individual Members and employees The Group remains accountable for all of its functions, including those that it has delegated General In discharging functions of the Group that have been delegated to its Governing Body and its committees any committees, joint committees, sub-committees and individuals must: a) comply with the Group s principles of good governance, 40 b) operate in accordance with the Group s Scheme of Reservation and Delegation, 41 c) comply with the Group s Standing Orders, See Appendix D See section 4.3 on Principles of Good Governance above See appendix D NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

30 d) comply with the Group s arrangements for discharging its statutory duties, 43 e) where appropriate, ensure that Member practices have had the opportunity to contribute to the Group s decision making process When discharging their delegated functions, committees, sub-committees and joint committees 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 those Clinical Commissioning Groups who are working together; b) identify any pooled budgets and how these will be managed and reported in annual accounts; c) specify under which Clinical Commissioning Group s Scheme of Reservation and Delegation and supporting policies the collaborative working arrangements will operate; d) specify how the risks associated with the collaborative working arrangement will be managed between the respective parties; e) identify how disputes will be resolved and the steps required to terminate the working arrangements; f) specify how decisions are communicated to the collaborative partners Committees of the Group The Governing Body, on behalf of the Group, may appoint such committees of the Group as it considers may be appropriate and delegate to them the exercise of any functions of the Group which in its discretion it considers to be appropriate except insofar as this Constitution has reserved or delegated the exercise of the Group s functions to its members, employees or a committee or sub-committee of the Group or Governing Body. A committee of the CCG includes a joint committee of the CCG and one or more other clinical commissioning groups and/or one or more local authorities and/or NHS England To enable establishment of a Committee, the terms of reference for that Committee must be approved by the Governing Body. Established Committees may then approve terms of reference for sub-committees/groups as deemed appropriate. Committees may be established and disbanded from time to time, at the discretion of the Governing Body. For the avoidance of doubt, establishment, disbandment of committees or amendments to their terms of reference does not require an amendment to this constitution See appendix C See chapter 5 above NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

31 The CCG has established the following statutory committees (as required by section 14M of the 2006 Act, as amended by section 25 of the 2012 Act): a) Audit, Governance and Risk Committee b) Remuneration and Nominations Committee c) Primary Care Commissioning Committee In addition to these statutory committees, the CCG has also established a number of nonstatutory committees to discharge its responsibilities. The terms of reference for all (both statutory and non-statutory) committees currently established are defined within Annex A of this document (as amended from time to time) which does not form part of the Group s Constitution. The committees detailed within Annex A have effect as if incorporated into the Group s Constitution 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 Group 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; NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

32 6.5.7 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 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 [6.5..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. Wherever possible six months notice of termination will be given but in any event the notice period will run until the end of the financial year in which it is given, at which point any new arrangements will take effect. NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

33 Joint arrangements currently entered into are detailed within Annex B of this document (as amended from time to time) which does not form part of the Group s constitution. The joint arrangements detailed within Annex B have effect as if incorporated into the Group s constitution. 6.6 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 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 [6.6.2] 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. NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

34 The governing body of the CCG shall require, in all joint commissioning arrangements that the Chief Operating Officer (or delegate) 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. Wherever possible six months notice of termination will be given but in any event the notice period will run until the end of the financial year in which it is given, at which point any new arrangements will take effect. 6.7 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 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; NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

35 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 [6.7.2] 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 Chief Operating Officer (or delegate) 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. Wherever possible six months notice of termination will be given but in any event the notice period will run until the end of the financial year in which it is given, at which point any new arrangements will take effect. 6.8 The Governing Body 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 this Constitution. 44 The Governing Body may also have functions of the Group delegated to it by the Group. Where the Group has conferred additional functions on the Governing Body connected with its main functions, or has delegated any of the Group s functions to its Governing Body, these are set out from paragraph 6.6.1(d) below. The Governing Body has responsibility for: a) ensuring that the Group has appropriate arrangements in place to exercise its functions effectively, efficiently and economically and in accordance with the Group's principles of good governance 45 (its main function); b) 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; c) setting, communicating and implementing the Group's commissioning vision, mission and strategy; d) directing and leading the Group's commissioning activity in line with the strategy and commissioning intentions, being consulted on the day to day management and See section 14L(3)(c) of the 2006 Act, as inserted by section 25 of the 2012 Act See section 4.4 on Principles of Good Governance above NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

36 application of commissioning and related activity in the Area ; e) informing and supporting the operational management of the Group; f) informing and supporting delivery of the Group's operational plan; g) managing the Group's' financial performance; h) providing assurance that the Group is discharging its statutory duties including ensuring that the Group is commissioning safe, effective and high quality services within its resource limits; i) establishing and overseeing appropriate collaborative arrangements with third parties; j) approving any functions of the Group that are specified in regulations; 46 k) approving a report, received from the Chief Finance Officer, showing the total allocations received and their proposed distribution including any sums to be held in reserve 47 ; l) approving budgets prepared and submitted by the Chief Finance Officer prior to the start of the Financial Year; 48 ; m) receiving and approving (where necessary) reports from the Chief Finance Officer which monitor financial performance against budget and plan 49 ; n) recommending to the Group the annual commissioning plan, annual report and annual accounts by presentation of the same to the Members at a Consortium Meeting; o) approving the timetable for producing the annual report and preparing the accounts; 50 p) performing any of the functions in paragraph 5.2 and/or any other paragraph of this Constitution and the Scheme of Reservation and Delegation, which have been identified as being delegated to the Governing Body; and q) such other functions as may be conferred or delegated to the Governing Body from time to time Composition of the Governing Body the Governing Body shall not have less than 6 members and, subject to the rights of the Group to determine otherwise in accordance with paragraph of Appendix C, comprises of: a) the Chair (who shall be a GP or Healthcare Professional); b) 8 representatives of Member practices, consisting of: See section 14L(5) of the 2006 Act, inserted by section 25 of the 2012 Act See paragraph 6.1 of Appendix E See paragraph 7.2 of Appendix E See paragraph 7.3 of Appendix E See paragraph 8.1 of Appendix E NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

37 i) 6 GP Town Representatives, consisting of one (1) such representative from each Town with the exception of Canterbury & Rural, which shall be represented by two (2) GP Town Representatives; ii) the Salaried GP Lead; and iii) the Practice Nurse Lead; c) two (2) Lay Members (one of whom shall hold the role of Deputy Chair): i) one to lead on audit, remuneration and conflict of interest matters; and ii) one to lead on patient and public participation matters; d) one (1) registered nurse; e) one (1) secondary care specialist doctor; f) the Accountable Officer; g) the Chief Finance Officer; and h) the Chief Operating Officer. Committees of the Governing Body The Governing Body has appointed the following statutory committees: a) Audit, Governance and Risk Committee the Audit, Governance and Risk Committee, which is accountable to the 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, Governance and Risk Committee, which includes information on the membership and role of the Audit, Governance and Risk Committee. In addition the Group or the Governing Body has conferred or delegated the following functions, connected with the Governing Body s main function 51, to its Audit, Governance and Risk Committee: i) performing any functions in paragraph 5.2, which are conferred or delegated to the Audit, Governance and Risk Committee; ii) iii) iv) seek assurance that the Group's financial reporting, and more broadly the internal controls of the Group, are working effectively; take a comprehensive view of governance, risk management and internal control across the Group including clinical, financial and all operational risks; focus on achieving strong financial management across the Group, which will underpin the Group's operational developments; v) ensure that the Group operates within its agreed financial and performance parameters; 51 See section 14L(2) of the 2006 Act, inserted by section 25 of the 2012 Act NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

38 vi) maintain a systematic approach to financial management which takes into account and measures the potential impact of proposed cost reductions on the quality of healthcare, in the context of future funding constraints; vii) have explicit authority to receive full access to information and the ability to investigate any matters within its terms of reference, including the right to independent professional advice; viii) approve the banking arrangements of the Group; ix) performing any of the functions in any paragraph of this Constitution, the Scheme of Reservation and Delegation and/or the Audit, Governance and Risk Committee terms of reference, which have been identified as being delegated to the Audit, Governance and Risk Committee; x) the right to establish such sub-committees as the Audit, Governance and Risk Committee deems appropriate in order to assist the committee in discharging its responsibilities; and xi) such other functions as may be conferred or delegated to the Audit, Governance and Risk Committee from time to time. b) Remuneration and Nominations Committee the Remuneration and Nominations Committee, which is accountable to the Governing Body, makes recommendations to the Governing Body on determinations about the remuneration, fees and other allowances for employees 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 and Nominations Committee, which includes information on the membership and role of the Remuneration and Nominations Committee 52. In addition the Group or the Governing Body has conferred or delegated the following functions, connected with the Governing Body s main function, to its Remuneration and Nominations Committee: i) setting the terms of office for Independent Members and other members of the Governing Body; ii) iii) performing any of the functions in paragraph 5.2 and/or any other paragraph of this Constitution, the Scheme of Reservation and Delegation, and the Remuneration and Nominations Committee terms of reference, which have been identified as being delegated to the Remuneration and Nominations Committee; the right to establish such sub-committees as the Remuneration and Nominations Committee deems appropriate in order to assist the committee in discharging its responsibilities; and NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

39 iv) such other functions as may be conferred or delegated to the Remuneration and Nominations Committee from time to time. c) Primary Care Commissioning Committee the Primary Care Commissioning Committee is responsible for making collective decisions on the review, planning and procurement of primary care services in Canterbury under delegated authority from NHS England. The Committee will meet in common with the NHS Ashford Primary Care Commissioning Committee. The role of the Committee is to oversee the procurement, review, planning and strategic development of primary care services in the CCG area under delegated authority from NHS England. This includes: GMS, PMS and APMS contracts (including the design of PMS and APMS contracts, monitoring of contracts, taking contractual action, such as issuing branch/remedial notices, and removing a contract); Newly designed enhanced services (LES and DES) Design of local incentive schemes as an alternative to the QOF; The ability to establish new GP practices in an area; Approving practice mergers; and Making decisions on discretionary payments (e.g., returner/retainer schemes) Committees currently established by the Governing Body are defined within Annex A as amended from time to time. The Governing Body must: approve and keep under review the terms of reference for each committee, which includes information on their membership and purpose. Ensure the approved scheme of delegation and reservation is kept up to date with the responsibilities delegated to each committee. Each of the Governing Body committees has the right to establish and delegate responsibility to such sub-committees as it deems appropriate in order to assist in discharging its duties. 7 ROLES AND RESPONSIBILITIES 7.1 The Members, the Practice Clinical Leads and Practice Support Team The Members Each Member shall agree to carry out commissioning responsibilities that may include but are not limited to referral management, prescribing, budget management, data review and validation, information sharing, and public and patient engagement, as agreed with the CCG from time to time All employees of Member practices shall have a role to play in communication, feedback and engagement with the Group. NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

40 Each Member practice will identify the following individuals to represent the Member practice and contribute to Group activities: a) the Practice Clinical Lead who shall be a member of the Consortium and attend Consortium Meetings; and b) the Practice Support Team, comprising: i) the Deputy Practice Clinical Lead who will deputise for the Practice Clinical Lead where appropriate by attending the Consortium Meetings in the Practice Clinical Lead s absence; and ii) the Practice Administrative Lead who shall be entitled to attend the Consortium Meetings in a non-voting capacity and who shall attend the Administrative Meetings. The Practice Clinical Leads Practice Clinical Leads are the practice representatives for their Members and represent their Member practice s views and act on behalf of their Member practice in matters relating to the Group. Each Practice Clinical Lead shall: a) represent their appointing Member's views and act on behalf of it in respect of Group matters; b) be the representative of their appointing Member at Consortium Meetings and Town Meetings; c) ensure that its Member agrees (by its signature) and adheres to those obligations and responsibilities documented in writing and agreed by the Group as appropriate from time to time; d) constructively support the governance arrangements of the Group including attending the Consortium Meetings and Town Meetings; e) share information (both hard and soft) between Members; f) engage with their relevant GP Town Representative both individually and as part of the Town activities, and with Clinical Programme Leads and others who have a specific Group wide clinical leadership role; g) engage with the Governing Body via attendance at the Consortium Meetings and Town Meetings; and h) will accept any responsibilities assigned to him/her by the Governing Body in accordance with paragraph (b) of Appendix C. The Practice Support Team Each Deputy Practice Clinical Lead shall NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

41 subject to paragraph of Appendix C, be the representative of their appointing Member at Consortium Meetings and Town Meetings where the Practice Clinical Lead is unable to attend; Each Practice Administrative Lead shall: a) represent their appointing Member in discussions relating to administrative issues of the Group; and b) attend Consortium Meetings and Administrative Meetings; 7.2 Other GP and Primary Care Health Professionals In addition to the Practice Clinical Leads and Deputy Practice Leads identified above, the Group has identified a number of other GPs / primary care health Professionals from Member practices to either support the work of the Group and / or represent the Group, rather than represent their own individual Member practices. These GPs and primary care health professionals include: Clinical Programme Leads: The Group has appointed a number of GPs or other Healthcare Professionals as Clinical Programme Leads, in accordance with the appointments process set out at of Appendix C, across the speciality areas of urgent care, planned care, mental health, long term conditions and children. The Clinical Programme Leads shall work closely with the Members and will be accountable to the Group. The role of each Clinical Programme Lead, in relation to the clinical programme for which he/ she is responsible, is to: a) lead the clinical strategy and delivery within the Group; b) engage the views of Members and patients to identify key quality outcomes and care pathway improvements, and represent those views via membership of the Clinical Strategy Committee; and c) provide senior clinical leadership and oversight of the implementation of the relevant clinical programme. 7.3 All Members of the Group s Governing Body Guidance on the roles of members of the Group s Governing Body is set out in a separate document 53. In summary, each member of the Governing Body should share responsibility as part of a team 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 All members of the Governing Body shall: a) attend the arranged meetings of the Governing Body, having read all papers beforehand; 53 Clinical commissioning group Governing Body Members Roles Attributes and Skills, NHS Commissioning Governing Body Authority, March 2012 NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

42 b) attend (and feedback) at other relevant meetings as agreed with the Governing Body; c) have responsibility for and report on work streams and initiatives to the extent agreed within the Governing Body; d) disseminate information and good practice throughout the Group as appropriate. 7.4 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 Governing Body and its individual members; c) ensuring that the Group has proper constitutional and governance arrangements in place; d) ensuring that, through the appropriate support, information and evidence, the Governing Body is able to discharge its duties; e) supporting the Accountable Officer in discharging the responsibilities of the organisation; f) contributing to building a shared vision of the aims, values and culture of the organisation; g) leading and influencing to achieve clinical and organisational change to enable the Group to deliver its commissioning responsibilities; h) overseeing governance and particularly ensuring that the Governing Body and the wider Group behaves with the utmost transparency and responsiveness at all times; i) ensuring that public and patients views are heard and their expectations understood and, where appropriate as far as possible, met; j) ensuring that the organisation is able to account to its local patients, stakeholders and NHS England; k) ensuring that the Group builds and maintains effective relationships, particularly with the individuals involved in overview and scrutiny from the relevant local authority(ies); l) chairing and leading the Governing Body and Consortium Meetings; and m) representing the Group at NHS, local authority and public meetings Where the Chair of the Governing Body is also the senior clinical voice of the group they will take the lead in interactions with stakeholders, including NHS England. NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

43 7.5 The Deputy Chair of the Governing Body 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 Chair is a GP or other Healthcare Professional, the Deputy Chair shall be one of the Lay Members. 7.6 Role of the Accountable Officer The Accountable Officer of the Group is a member of the Governing Body This role of Accountable Officer has been summarised in a national document 54 as: a) being responsible for ensuring that the Group 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 organisation s ongoing capability and capacity to meet its duties and responsibilities. This will include arrangements for the ongoing development of its Members and staff The Group has also specified the responsibilities of the Accountable Officer to include: a) ensuring that the Group exercises its functions effectively, efficiently and economically; b) ensuring that the Group complies with its financial duties and duties in relation to accounts, audit and provision of information to NHS England; c) ensuring that the Group maintains continuous improvements in the quality of the services it commissions; d) ensuring that the Group provides good value for money when commissioning services; e) performing any of the functions and/or duties in paragraph 5.2and/or any other paragraph of this Constitution, and the Scheme of Reservation and Delegation, which have been identified as being delegated to, or performed by, the Accountable Officer; and 54 See the latest version of the NHS Commissioning Governing Body Authority s Clinical commissioning group governing body members: Role outlines, attributes and skills NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

44 f) such other functions or duties as may be conferred on the Accountable Officer from time to time In addition to the Accountable Officer s general duties, where the Accountable Officer is also the senior clinical voice of the Group they will take the lead in interactions with stakeholders, including NHS England. 7.7 Role of the Chief Finance Officer The Chief Finance Officer is a member of the Governing Body and is responsible for providing financial advice to the Group and for supervising financial control and accounting systems This role of Chief Finance Officer has been summarised in a national document 55 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, monitor on the Group s finances; c) overseeing robust audit and governance arrangements leading to propriety in the use of the Group s resources; d) being able to advise the Governing Body on the effective, efficient and economic use of the Group 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 The Group has also specified the responsibilities of the Chief Finance Officer to include: i) performing any of the functions and/or duties in paragraphs 5.2, 5.3and/or any other paragraphs of this Constitution, which have been identified as being delegated to the Chief Finance Officer; and ii) such other functions or duties as may be conferred or delegated to the Chief Finance Officer from time to time. 7.8 Role of the Chief Operating Officer The Chief Operating Officer of the Group is a member of the Governing Body The Chief Operating Officer is responsible for: supporting the Governing Body to develop and deliver a robust commissioning strategy and plan, meeting national required outcomes and statutory requirements; 55 See the latest version of the NHS Commissioning Governing Body Authority s Clinical commissioning group governing body members: Role outlines, attributes and skills NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

45 ensuring that the commissioning activity of the Group is undertaken in line with national and statuary requirements; ensuring the Group operates in the context of statutory and regulatory compliance with accountability for delivery of nationally mandated, and locally agreed targets and standards; ensuring knowledge of operational practice is communicated appropriately to the Governing Body; working with the Chief Finance Officer and the Accountable Officer to ensure an effective strategy for contract and performance management is established and delivered; working closely with the Chief Finance Officer to ensure CCG commissioning decisions are value for money and within statutory requirements; and f) such other functions or duties as may be conferred or delegated to the Chief Operating Officer from time to time. 7.9 Role of GP Town Representatives GP Town Representatives The Group has appointed a number of GPs who are elected by the Members and endorsed by the Town that they will represent, and shall take on the roles set out in paragraph 6.3 of Annex 2A to Appendix C Role of Salaried GP Lead Salaried GP Lead The Group has appointed a salaried GP who is elected by the Members in accordance with paragraph of Appendix C to represent the views of GPs employed or engaged by Members, on the Governing Body Role of Practice Nurse Lead Practice Nurse Lead The Group has appointed a practice nurse who is elected by the Members in accordance with paragraph Appendix C to represent the views of practice nurses employed or engaged by Members, on the Governing Body Joint Appointments with other Organisations The Group may enter into joint appointments with other organisations from time to time in accordance with the provisions of its Standing Orders. Where the Group makes joint appointments these will be supported by a memorandum of understanding between the organisations which are party to the joint appointments. NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

46 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 Group and members of the Governing Body (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 Group 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 They must comply with the Group 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 Group s website Individuals contracted to work on behalf of the Group or otherwise providing services or facilities to the Group will be made aware of their obligation with regard to declaring conflicts or potential conflicts of interest. This requirement will be written into their contract for services. 8.2 Conflicts of Interest As required by section 14O of the 2006 Act, as inserted by section 25 of the 2012 Act, the Group will make arrangements to manage conflicts and potential conflicts of interest to ensure that decisions made by the Group 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, member of the Governing Body, or a member of a committee or a sub-committee of the Group 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 Group considering an action or decision in relation to that 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 NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

47 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. 8.3 Declaring and Registering Interests The Group will maintain a Registers of the Interests of: a) the Members of the Group; b) the members of its Governing Body; c) the members of its committees or sub-committees and the committees or subcommittees of its Governing Body; and d) its employees The Register of Interests will be published on the Group s website 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 Head of Corporate Services will ensure that the Register of Interests is reviewed regularly, and updated as necessary. 8.4 Managing Conflicts of Interest: general Individual Members of the Group, the Governing Body, committees or sub-committees, 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 Head of Corporate Services 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 Head of Corporate Services 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: NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

48 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 Head of Corporate Services 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; 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, including the option of advice from the Head of Corporate Services and/or the Deputy Chair being the Lay Member with responsibility for governance, and inform the individual concerned 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. In the case of any exclusion on the grounds of conflict, steps will be taken to ensure input for the individual so excluded. These can include, but are not limited to, the following: i. a thorough consideration of whether exclusion is absolutely necessary, to maintain a balanced debate. ii. the chair may, at his discretion, offer for another Member, employee or person providing services to the group to take the place of the excluded individual iii. in order to maintain transparency and trust, a detailed minute of the debate shall be made available to the excluded individual subject to it not including information that may be of commercial sensitivity Where the chair of any meeting of the Group, including committees, sub-committees, or the Governing Body and the Governing Body s committees and sub-committees, 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 Group, committees or sub-committees, or the Governing Body, the Governing Body s committees or NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

49 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 Head of Corporate Services 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, 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 / subcommittee in question) so that the Group can progress the item of business: i) a Member of the 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 Group; a member of a relevant Health and Wellbeing Governing Body; 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 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 Head of Corporate Services of the transaction The Head of Corporate Services 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 The Group will have regard to the Department of Health Code of Conduct: Managing conflicts of interest where Member practices are potential providers of Group-commissioned services as amended from time to time. NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

50 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 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 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. 8.6 Transparency in Procuring Services The Group 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 Group will procure services in a manner that is open, transparent, nondiscriminatory and fair to all potential Providers The Group will publish a Procurement Strategy approved by its Governing Body which will ensure that: a) all relevant clinicians (not just Members of the Group) 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 Group s website. NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

51 9 THE GROUP AS EMPLOYER The Group 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 Group The Group 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 Group 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 Group. 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 Group 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 Group will also maintain and publish policies on all aspects of human resources management, including grievance and disciplinary matters The Group 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 Group will ensure that employees' behaviour reflects the values, aims and principles set out above The Group will ensure that it complies with all aspects of employment law The Group 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 Group 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 Group s website. NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

52 10 TRANSPARENCY, WAYS OF WORKING AND STANDING ORDERS 10.1 General The Group will publish annually a commissioning plan and an annual report, presenting the Group's annual report to a public meeting Key communications issued by the Group, including the notices of procurements, public consultations, Governing Body meeting dates, times, venues, and certain papers will be published on the Group s website The Group 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 Group will operate but which do not form part of the Group s Constitution. They are the Group s: a) Standing Orders (Appendix C) which sets out the arrangements for meetings and the appointment processes to elect the Group s representatives and appoint to the Group 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 Group s Governing Body, the Governing Body s committees and sub-committees, the Group s committees and sub-committees, individual Members and employees; c) Prime Financial Policies (Appendix E) which sets out the arrangements for managing the Group s financial affairs. NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

53 APPENDIX A DEFINITIONS OF KEY DESCRIPTIONS USED IN THIS CONSTITUTION 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 Group: complies with its obligations under: o sections 14Q and 14R of the 2006 Act (as inserted by section 26 of the 2012 Act), o sections 223H to 223J of the 2006 Act (as inserted by section 27 of the 2012 Act), o paragraphs 17 to 19 of Schedule 1A of the NHS Act 2006 (as inserted by Schedule 2 of the 2012 Act), and o any other provision of the 2006 Act (as amended by the 2012 Act) specified in a document published by NHS England for that purpose; exercises its functions in a way which provides good value for money. Administrative Meetings Area Audit, Governance and Risk Committee Business Day Chair Chief Finance Officer Clinical Commissioning Group Clinical Programme Lead Clinical Strategy and Investment Committee (CSIC) Committee meetings of the Practice Administrative Leads, which it is anticipated will take place immediately prior to every ordinary Consortium Meeting the geographical area that the Group has responsibility for, as defined in Chapter 2 of this Constitution a committee of the Governing Body set up in accordance with paragraph 6.6.3(a) 9.00am until 5.00pm on a day (other than a Saturday or Sunday) on which clearing banks in the City of London are open for the transaction of normal sterling banking business the individual appointed by the Group to act as chair of the Governing Body the qualified accountant employed by the Group who has the expertise or experience to lead the financial management of the Group and who has responsibility for financial strategy, financial management and financial governance a body corporate established by NHS England in accordance with Chapter A2 of Part 2 of the 2006 Act (as inserted by section 10 of the 2012 Act) an individual appointed in accordance with paragraph of Appendix C to lead on clinical strategy and delivery within the Group in respect of the clinical programme for which they are responsible a committee of the Governing Body set up in accordance with paragraph 0 a committee or sub-committee created and appointed by: the membership of the group NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

54 a committee / sub-committee created by a committee created / appointed by the membership of the group a committee / sub-committee created / appointed by the governing body Consortium Consortium Meeting Consortium Voting Process Constitution Deputy Practice Clinical Lead Dispute Resolution Procedure East Kent Federation Finance and Performance Committee Financial Year Friends of NHS Canterbury and Coastal Clinical Commissioning Group GP GP Town the consortium of Practice Clinical Leads as set out in this Constitution to carry out the functions set out in this Constitution any meeting of the Practice Clinical Leads called in accordance with the process set out in paragraph 3.2 of Appendix C the process for allocating votes at a Consortium Meeting, whether in relation to an Ordinary Resolution or a Special Resolution, with each Practice Clinical Lead having (i) one vote for every 1,500 persons on their practice list, and (ii) where relevant, one vote for any additional persons on their practice list over and above each multiple of 1,500 persons. For example, a practice with 1,505 persons on their list will have 2 votes, a practice with 4560 persons on their list will have 4 votes. The currency of which list is solely to be determined by the Governing Body this constitution as amended from time to time in accordance with its terms an individual appointed by a practice (who is a Member of the Group) to deputise for the Practice Clinical Lead the procedure for resolving disputes as referred to in paragraph and as set out in Appendix H the federation made up of the Group, NHS Ashford Clinical Commissioning Group, NHS Thanet Clinical Commissioning Group and NHS South Kent Coast Clinical Commissioning Group with the purpose of working collaboratively to ensure the effective and efficient commissioning of services, in accordance with the principles set out in Appendix I (as the same may be amended from time to time) and the East Kent Federation's Memorandum of Understanding. a committee of the Governing Body set up in accordance with clause 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 Group is established until the following 31 March a Group wide network made up of members of the public from within the Area, with the purpose of keeping the public informed as to the activities of the Group and encouraging feedback from the public in relation to the provision of healthcare in the Area a medical practitioner whose name is included in the General Practice Register kept by the General Medical Council who is either a Member or engaged by a Member of the Group an individual appointed by the Group to hold the position of GP town NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

55 Representative Group Governing Body Head of Corporate Services Healthcare Professional Independent Members Lay Member Local Medical Committee Member NHS Kent and Medway Contracting and Procurement Team Observer Operational Leadership Team Ordinary Resolution representative on the Governing Body NHS Canterbury and Coastal Clinical Commissioning Group, whose Constitution this is the body appointed under section 14L of the NHS Act 2006 (as inserted by section 25 of the 2012 Act), and comprised as set out in paragraph 6.6, with the main function of ensuring that the Group has made appropriate arrangements for ensuring that it complies with: its obligations under section 14Q under the NHS Act 2006 (as inserted by section 26 of the 2012 Act), and such generally accepted principles of good governance as are relevant to it. the person appointed to conduct activities as described in the Standing Orders for which the Head of Corporate Services is identified as being responsible, which may include ensuring the efficient administration of the body corporate, particularly with regard to ensuring compliance with statutory and regulatory requirements, ensuring that decisions of the Governing Body are implemented and keeping the Governing Body informed of its legal responsibilities. 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 Healthcare Professions Act 2002 those members of the Governing Body that are independent of the Members and which shall comprise the two (2) Lay Members, the secondary care specialist doctor and the registered nurse a lay member of the Governing Body, appointed by the Group. A lay member is an individual who is not a Member of the Group 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 committee formed under section 97 of the 2006 Act a provider of primary medical services to a registered patient list during core hours that meets the requirements of the Regulations, who is a member of this Group (see tables in Chapter 3 and Appendix B) the contracting and procurement team that functions across Kent and Medway and is responsible for overseeing tendering processes and performance management a non-voting appointed or co-opted member of the Group's Governing Body a committee of the Governing Body set up in accordance with paragraph 6.6.3(d) a resolution of the Members passed by a simple majority of the votes cast NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

56 by those Members attending (by their Practice Clinical Leads or by proxy) at a Consortium Meeting or by the execution of a written resolution by Members holding at least a simple majority of the total voting rights of all the Members with voting rights being allocated in accordance with the Consortium Voting Process Public Reference Group Patient Reference Group Patient Representative Patient Representative Lead Practice Administrative Lead Practice Clinical Lead Practice Nurse Lead Practice Support Team Primary Care Commissioning Committee Prime Financial Policies Provider Quality Committee Registers of Interests a group of patients and representatives from local stakeholder organisations representing the interests of patients of each Member and the public set up in accordance with paragraph 2 of Annex 2B of Appendix C the group made up of the patients whose role is more fully described in paragraph 1 of Annex 2B to Appendix C (Standing Orders) an individual elected, nominated or appointed as a member of the Public Reference Group in accordance with paragraph 2 of Annex 2B of Appendix C by the Patient Reference Groups of each Town A patient representative who has been nominated by the Public Reference Group to act as an Observer an individual who is employed or engaged by a Member in an administrative role who has been appointed to the role of practice administrative lead by that Member an individual appointed by a practice (who is a Member of the Group) as its practice representative to act on its behalf in the dealings between it and the Group, 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) the individual appointed by the Group to hold the role of practice nurse lead on the Governing Body a team of individuals comprising the Deputy Practice Clinical Lead and the Practice Administrative Lead, appointed by a Member of the Group a committee of the Governing Body set up in accordance with paragraph the prime financial policies of the Group from time to time set out in Appendix E of this Constitution any company, partnership, voluntary organisation, social enterprise, charity, NHS body or other organisation which may from time to time enter or seek to enter or have entered into arrangements to provide secondary medical services or social care services or any other goods and services by virtue of being commissioned by the Group a committee of the Governing Body set up in accordance with paragraph registers a Group 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 Group; NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

57 the members of its Governing Body; the members of its committees or sub-committees and committees or sub-committees of its Governing Body; and its employees. Regulations Remuneration and Nominations Committee Salaried GP Lead Scheme of Reservation and Delegation Special Resolution Standing Orders Town Town Meeting Town Patient Reference Group The National Health Service (Clinical Commissioning Groups) Regulations 2012 a committee of the Governing Body set up in accordance with paragraph 6.6.3(e) of the Constitution; an individual appointed by the Group to the role of salaried GP lead on the Governing Body the scheme of reservation and delegation of the Group as amended from time to time and set out in Appendix D of this Constitution a resolution of the Members passed by at least seventy-five percent (75%) of the votes cast by those Members attending (by their Practice Clinical Leads or by proxy) at a Consortium Meeting or by the execution of a written resolution by Members holding at least seventy-five per cent (75%) of the votes of all the Members with votes being allocated in accordance with the Consortium Voting Process the standing orders of the Group as amended from time to time and set out in Appendix C A sub-divided area of the Area as set out in paragraph 1 of Annex 2A of Appendix C meetings held by a Town in accordance with paragraph 3 of Annex 2A to Appendix C (Standing Orders) the group made up of patients of Member practices located within each Town, as further described in paragraph 2 of Annex 2B to Appendix C NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

58 APPENDIX B - LIST OF MEMBER PRACTICES Practice Name Address Town Ash Surgery Chilton Place Ash, Canterbury, Kent, CT3 2HD Canterbury Health 26 Old Dover Road Canterbury, Centre Kent CT1 3JH Canterbury Medical Bridge Health Centre, Patrixbourne Practice Road, Bridge, Canterbury Kent. CT4 5BL Coach House Surgery 27 Canterbury Road, Herne Bay, Kent, CT65DQ Cossington House 51 Cossington Road Canterbury Kent, CT1 3HX Faversham Medical Faversham Health Centre, Bank Practice Street Faversham, Kent, ME13 8QR Market Place Surgery The Market Place Surgery, Cattle Market, Sandwich, Kent, CT13 9ET New Dover Road 10 New Dover Rd, Canterbury, Surgery Kent CT1 3AP Newton Place Surgery Newton Road, Faversham, Kent, ME138FH Northgate Medical 1 Northgate, Canterbury, Kent, Centre CT1 1WL Old School Surgery Bolts Hill, Chartham, Canterbury, Kent, CT4 7JY Park Surgery 116 King's Road, Herne Bay, Kent, CT6 5RE Saddleton Road 32 Saddleton Road, Whitstable, Kent, CT5 4JQ St Annes Group 161 Station Road, Hernebay, Kent, Practice CT6 5NF Sturry Surgery 53 Island Road Sturry, Canterbury, Kent CT2 0EF The Butchery The Butchery, Sandwich, Kent, CT13 9DL University Medical University Medical Centre, Giles Centre Lane, Canterbury, Kent, CT2 7PB Whitstable Medical Estuary View Medical Centre, Practice Boorman Way, Whistable, Kent. CT53SE William Street 67 William Street, Herne Bay, Kent, CT6 5NR Practice Clinical Lead's Signature & Date Signed NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

59 APPENDIX C STANDING ORDERS 1. STATUTORY FRAMEWORK AND STATUS 1.1. Introduction These Standing Orders have been drawn up to regulate the proceedings of NHS Canterbury & Coastal 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 3 rd April The Standing Orders, together with the Group's Scheme of Reservation and Delegation 56 and the Group's Prime Financial Policies 57, 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 Clinical Leads; 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 of any relevant guidance The Standing Orders, Scheme of Reservation and Delegation and Prime Financial Policies do not form part of the Group s Constitution but 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 Schedule of matters reserved to the 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 See Appendix D See Appendix E NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

60 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 Constitution provides details of the membership of the Group (also see Appendix B) Chapter 6 of the 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 Clinical Leads (paragraph 7.1of the Constitution) Key Roles Paragraph of the Constitution sets out the composition of the Governing Body whilst Chapter 7 of the 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 Chair of the Governing Body, as listed in paragraph a) of the Constitution, is subject to the following appointment process: a) Nominations Interested candidates may apply for the role, demonstrating how they meet the essential requirements of the person specification and how they would undertake the role. A panel consisting of the Remuneration and Nominations Committee and any others deemed appropriate may assess the candidates' suitability for the role of Chair by holding screening interviews and produce a shortlist of suitable candidates for the role; b) Eligibility the Chair must: i) not be the Accountable Officer, the Chief Finance Officer; the registered nurse, the secondary care specialist doctor or a Lay Member who leads on audit, remuneration and conflict of interest matters; ii) iii) iv) subject to paragraph , be a GP or a Healthcare Professional; have passed any nationally mandated assessment process for Clinical Commissioning Group chairs; and not be an individual of the description set out in paragraph below; c) Appointment process Election process for all short listed candidates, with election by Ordinary Resolution of all Members of the Group in accordance with the Consortium Voting Process. d) Term of Office The Chair may hold office for a period of up to three (3) years; NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

61 e) Eligibility for reappointment The Chair shall be eligible for re-appointment at the end of his/her term but may not serve more than two (2) consecutive terms or six (6) years whichever is the lesser; f) Grounds for removal from office The Chair shall cease to hold office if: i) he/she ceases to meet the eligibility criteria set out in sub-paragraph 2.2.2(b) (Eligibility) above; and/or ii) if any of the grounds set out in paragraph below apply; g) Notice Period - The Chair shall give three (3) months' notice in writing to the Governing Body of his/her resignation from office at any time during his/her terms of office The Lay Members as listed in paragraph c) of the Constitution are subject to the following appointment process: a) Nominations n/a; b) Eligibility : i) a Lay Member must be an individual who is not: a Member of the Group or employed or engaged by a Member of the Group; a Healthcare Professional; an individual of the description set out in Schedule 4 to the Regulations; an individual of the description set out in paragraph below; ii) iii) the Lay Member who is to lead on audit, remuneration and conflict of interest matters must have qualifications, expertise or experience such as to enable the person to express informed views about financial management and audit matters; and the Lay Member who is to lead on patient and public participation matters must be a person who has knowledge about the Area such as to enable the person to express informed views about the discharge of the Group's functions. c) Appointment process Open advert. Selection against competencies based on current national guidance on NHS England's website by the Governing Body; d) Term of Office A Lay Member may hold office for a period of up to three (3) years; e) Eligibility for reappointment A Lay Member shall be eligible for re-appointment at the end of his term but may not serve more than two (2) consecutive terms or six (6) years whichever is the lesser; f) Grounds for removal from office A Lay Member shall cease to hold office if: NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

62 i) he/she ceases to meet the eligibility criteria set out in sub-paragraph 2.2.3b)(Eligibility) above; and/or ii) if any of the grounds set out in paragraph below apply; g) Notice Period - A Lay Member shall give three (3) months' notice in writing to the Governing Body of his/her resignation from office at any time during his/her term of office The registered nurse as listed in paragraph d) of the Group's Constitution is a joint appointment between the Group and NHS Ashford Clinical Commissioning Group and is subject to the following appointment process: a) Nominations n/a; b) Eligibility the registered nurse must: i) be a current registered nurse, other than one who is an employee or member (including shareholder) of, or a partner in, any of the following: a person who is a provider of primary medical services for the purposes of Chapter A2 of the 2006 Act; a body which provides any relevant service to a person for whom the Group has responsibility as provided for in the subsection (1A), and regulations made under subsections (1B) and (1D) of section 3 of the 2006 Act; ii) iii) not be an individual of the description set out in paragraph below; and have no conflicts of interest as defined by national guidance on NHS England website; c) Appointment process Appointments, to be made by the Governing Bodies of the Group and NHS Ashford Clinical Commissioning Group, shall be via open advert and selection against competencies based on current national guidance by NHS England. d) Term of Office Notwithstanding any concurrent appointment as an employee of the Group, the registered nurse as listed in paragraph d) of the Group's Constitution may (unless the Governing Body determines otherwise from time to time) hold office only for a period which is the shorter of (i) the duration of his/her contract of employment with the Group and (ii) up to three (3) years (or as otherwise provided pursuant to paragraph 2.2.4e) below); e) Eligibility for reappointment A registered nurse shall be eligible for reappointment at the end of his/her term but may not serve more than two (2) consecutive terms or six (6) years whichever is the lesser; f) Grounds for removal from office A registered nurse shall cease to hold office if: i) he/she ceases to meet the eligibility criteria set out in sub-paragraph 2.2.4(b) (Eligibility) above; and/or NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

63 ii) iii) if any of the grounds set out in paragraph below apply; and/ or where he/she was also appointed as an employee of the Group, he/she is no longer an employee of the Group (unless the Governing Body determines otherwise from time to time). g) Notice Period - A registered nurse shall give three (3) months' notice in writing to the Governing Body of his/her resignation from office at any time during his/her term of office The secondary care specialist doctor as listed in paragraph 6.6.2(e) of the Group's Constitution is subject to the following appointment process: a) Nominations n/a; b) Eligibility the secondary care specialist doctor must: i) be a registered medical practitioner who is, or has been at any time in the period of ten (10) years ending with the date of the individual's appointment to the Governing Body, an individual who fulfils (or fulfilled) all the following conditions: the individual's name is included in the Specialist Register kept by the General Medical Council under section 34D of the Medical Act 1983, or the individual is eligible to be included in that Register by virtue of the scheme referred to in subsection (2)(b) of that section; the individual holds a post as an NHS consultant (as defined in section 55(1) of the Medical Act 1983) or in a medical speciality in the armed forces (meaning the naval, military, or air forces of the Crown, and includes the reserve forces within the meaning of section 1(2) of the Reserve Forces Act 1996 (power to maintain reserve forces); the individual's name is not included in the General Practitioner Register kept by the General Medical Council under section 34C of the Medical Act 1983 ii) not be an employee or member (including shareholder) of, or a partner in, any of the following: a person who is a provider of primary medical services for the purposes of Chapter A2 of the 2006 Act; a body which provides any Relevant Service to a person for whom the Group has responsibility as provided for in the subsection (1A), and regulations made under subsections (1B) and (1D) of section 3 of the 2006 Act iii) iv) not be an individual of the description set out in paragraph below; and have no conflicts of interest as defined by national guidance on NHS England website; NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

64 c) Appointment process Open advert. Selection against competencies based on current national guidance from NHS England by the Governing Body; d) Term of Office A secondary care specialist doctor may hold office for a period of up to three (3) years; e) Eligibility for reappointment A secondary care specialist doctor shall be eligible for re-appointment at the end of his term but may not serve more than two (2) consecutive terms or six (6) years whichever is the lesser; f) Grounds for removal from office A secondary care specialist doctor shall cease to hold office if: i) he ceases to meet the eligibility criteria set out in sub-paragraph 2.2.5b) (Eligibility) above; and/or ii) if any of the grounds set out in paragraph below apply; g) Notice Period - A secondary care specialist doctor shall give three (3) months' notice in writing to the Governing Body of his/her resignation from office at any time during his/her term of office The GP Town Representatives as listed in paragraph b)i) of this Constitution, are subject to the following appointment process: a) Nominations Interested candidates may apply for the role of GP Town Representative for the Town in which its Member practice is located, demonstrating how they meet the essential requirements of the person specification and how they would undertake the role. A panel consisting of the Remuneration and Nominations Committee and any others deemed appropriate may assess the candidates' suitability for the role of GP Town Representative by holding screening interviews and produce, in respect of each Town, a shortlist of suitable candidates for the roles; b) Eligibility each GP Town Representative must: i) be a Member of the Group or employed or engaged by a Member of the Group which falls within the Town that the GP Town Representative will represent; ii) iii) not be the Salaried GP Lead; and not be an individual of the description set out in paragraph below; c) Appointment process Election processes for all short listed candidates within the Towns in which those candidates' Member practices are located, with election by an Ordinary Resolution of all the Members in accordance with the Consortium Voting Process, following which they will be endorsed by the Town to whom the GP Town Representative is assigned; d) Term of Office a GP Town Representative may hold office for a period of up to three (3) years; NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

65 e) Eligibility for reappointment a GP Town Representative shall be eligible for reappointment at the end of his/ her term but may not serve more than two (2) consecutive terms or six (6) years whichever is the lesser; f) Grounds for removal from office a GP Town Representative shall cease to hold office if: i) he/ she ceases to meet the eligibility criteria set out in sub-paragraph 2.2.6b)(Eligibility) above; and/or ii) if any of the grounds set out in paragraph below apply; g) Notice Period - A GP Town Representative shall give three (3) months' notice in writing to the Governing Body of his/her resignation from office at any time during his/her term of office the Practice Nurse Lead as listed in paragraph b)iii) of the Group's Constitution, is subject to the following appointment process: a) Nominations Interested candidates may apply for the role, demonstrating how they meet the essential requirements of the person specification and how they would undertake the role. A panel consisting of the Remuneration and Nominations Committee and any others deemed appropriate may assess the candidates' suitability for the role of Practice Nurse Lead by holding screening interviews and produce a shortlist of suitable candidates for the role b) Eligibility the Practice Nurse Lead must: i) be employed or engaged by a Member of the Group; ii) not be an individual of the description set out in paragraph below; and c) Appointment process Election process for all short listed candidates, with election by an Ordinary Resolution of all Members of the Group in accordance with the Consortium Voting Process; d) Term of Office a Practice Nurse Lead may hold office for a period of up to three (3) years; e) Eligibility for reappointment a Practice Nurse Lead shall be eligible for reappointment at the end of his/ her term but may not serve more than two (2) consecutive terms or six (6) years whichever is the lesser; f) Grounds for removal from office a Practice Nurse Lead shall cease to hold office if: i) he/ she ceases to meet the eligibility criteria set out in sub-paragraph 2.2.7b) (Eligibility) above; and/or ii) if any of the grounds set out in paragraph below apply; g) Notice Period - A Practice Nurse Lead shall give three (3) months' notice in writing to the Governing Body of his/her resignation from office at any time during his/her term of office. NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

66 The Salaried GP Lead as listed in paragraph b)ii) of the Group's Constitution, is subject to the following appointment process: a) Nominations Interested candidates may apply for the role, demonstrating how they meet the essential requirements of the person specification and how they would undertake the role. A panel consisting of the Remuneration and Nominations Committee and any others deemed appropriate may assess the candidates' suitability for the role of Salaried GP Lead by holding screening interviews and produce a shortlist of suitable candidates for the role; b) Eligibility the Salaried GP Lead must: i) be employed or engaged by a Member of the Group in the role of salaried GP; ii) iii) iv) not be a locum not be a partner or sole practitioner of a Member of the Group]; not be a GP Town Representative; v) not be an individual of the description set out in paragraph below; and c) Appointment process Election process for all short listed candidates, with election by an Ordinary Resolution of all Members of the Group in accordance with the Consortium Voting Process; d) Term of Office a Salaried GP Lead may hold office for a period of up to three (3) years; e) Eligibility for reappointment a Salaried GP Lead shall be eligible for reappointment at the end of his/ her term but may not serve more than two (2) consecutive terms or six (6) years whichever is the lesser; f) Grounds for removal from office a Salaried GP Lead shall cease to hold office if: i) he/ she ceases to meet the eligibility criteria set out in sub-paragraph 2.2.8b) (Eligibility) above; and/or ii) if any of the grounds set out in paragraph below apply; g) Notice Period - A Salaried GP Lead shall give three (3) months' notice in writing to the Governing Body of his/her resignation from office at any time during his/her term of office The Accountable Officer as listed in paragraph f) of the Group s Constitution, is a joint appointment with the NHS Ashford Clinical Commissioning Group and is subject to the following appointment process: a) Nominations Interested candidates may apply for the role, demonstrating how they meet the essential requirements of the person specification and how they would undertake the role. A panel consisting of the Remuneration and Nominations NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

67 Committees of the Group and NHS Ashford Clinical Commissioning Group and any others deemed appropriate may assess the candidates' suitability for the role of Accountable Officer by holding screening interviews and produce a shortlist of suitable candidates for the role; following short-listing the Governing Bodies of the Group and the NHS Ashford Clinical Commissioning Group shall agree by an appropriate means on the preferred candidate and shall nominate the selected Accountable Officer to NHS England; b) Eligibility The Accountable Officer must: i) either be: an individual who is a Member of the Group or of any body that is a Member of the Group or, in the case of a joint appointment, an individual who is a member of any of the Clinical Commissioning Groups in question or of any body that is a member of any of those Clinical Commissioning Groups; or an employee of the Group or of any Member of the Group or, in the case of a joint appointment, an employee of any of the Clinical Commissioning Groups in question or of any member of those Clinical Commissioning Groups; ii) iii) not be an individual of the description set out in paragraph below; and have passed any nationally mandated assessment process. c) Appointment process The Accountable Officer shall be appointed by NHS England. d) Term of Office Substantive appointment e) Eligibility for reappointment n/a f) Grounds for removal from office The Accountable Officer shall cease to hold office if: i) he ceases to meet the eligibility criteria set out in sub-paragraph 2.2.9b) (Eligibility) above; and/or ii) if any of the grounds set out in paragraph below apply; g) Notice period in accordance with his/her contract of employment terms The Chief Finance Officer as listed in paragraph g) of the Group's Constitution is a joint appointment with the NHS Ashford Clinical Commissioning Group and is subject to the following appointment process: a) Nominations n/a; b) Eligibility The Chief Finance Officer must: i) not be the Group's Accountable Officer; NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

68 ii) iii) iv) hold a qualification of one of the individual CCAB bodies or CIMA; not be an individual of the description set out in paragraph below; and have passed any nationally mandated assessment process. c) Appointment process Appointments, to be made by the Governing Bodies of the Group and NHS Ashford Clinical Commissioning Group, shall be via open advert and selection against competencies based on current national guidance by NHS England. d) Term of Office Substantive appointment e) Eligibility for reappointment n/a f) Grounds for removal from office in accordance with his/her contract of employment terms. g) Notice Period - in accordance with his/her contract of employment terms The Chief Operating Officer as listed in paragraph g) h) of the Group's Constitution is a joint appointment with the NHS Ashford Clinical Commissioning Group and is subject to the following appointment process: a) Nominations n/a; b) Eligibility The Chief Operating Officer must: i) not be an individual of the description set out in paragraph below; and c) Appointment process Appointments, to be made by the Governing Bodies of the Group and NHS Ashford Clinical Commissioning Group, shall be via open advert; d) Term of Office Substantive appointment e) Eligibility for reappointment n/a f) Grounds for removal from office in accordance with his/her contract of employment terms. g) Notice Period - in accordance with his/her contract of employment terms Practice Clinical Leads and Practice Support Teams as referred to in paragraph 7.1 of the Constitution are subject to the following appointment process: a) each Member shall nominate: i) one (1) Practice Clinical Lead who is either a GP or Healthcare Professional of the practice that appoints it; and ii) one Practice Support Team, comprising: NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

69 one (1) Deputy Practice Clinical Lead who is either a GP or a Healthcare Professional of the practice that appoints it; and one (1) Practice Administrative Lead who is employed or engaged in an administrative role (which may be the role of practice manager) by the practice that appoints it. The name and role of all Practice Clinical Leads and Deputy Practice Clinical Leads must be submitted to the Governing Body; b) Practice Clinical Leads may be assigned to such clinical and other areas as the Governing Body shall determine from time to time including but not limited to: Commissioning Responsibilities, Referral Management, Emergency Admissions and A&E Attendances, Prescribing, Budget Management, Data Validation, Information Sharing & Communication, and Public & Patient Engagement and will perform such tasks and activities as are assigned to them by the Governing Body in that regard. c) each Member may permanently remove and replace any of their Practice Clinical Leads or Deputy Practice Clinical Leads at any time, by notice to the Governing Body. Each Member may permanently remove or replace its Practice Administrative Leads at any time without notice to the Governing Body; d) for the avoidance of doubt, the Governing Body shall be entitled to treat any Practice Clinical Lead or Deputy Practice Clinical Lead as having continuing authority given to him/her until it is notified in writing of the removal of that individual in accordance with Paragraph (c); and e) any provision of this Constitution that requires delivery or notification to a Member shall be deemed to have been satisfied if delivery or notification is made to or served on the relevant Practice Clinical Lead Clinical Programme Leads as referred to in paragraph of the Constitution are subject to the following appointment process: a) Nominations Interested candidates may apply for the role, demonstrating how they meet the essential requirements of the person specification and how they would undertake the role. A panel consisting of the Remuneration and Nominations Committee and any others deemed appropriate may assess the candidates' suitability for the role of Clinical Programme Lead by holding screening interviews and produce a shortlist of suitable candidates for the role; b) Eligibility the Clinical Programme Lead must be an individual who is a Member of the Group or who is employed or engaged as a GP or other Healthcare Professional by a Member of the Group; c) Appointment process Election process for all short listed candidates, with election by an Ordinary Resolution of all Members of the Group in accordance with the Consortium Voting Process; d) Term of Office a Clinical Programme Lead may hold office for a period of up to three (3) years; NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

70 e) Eligibility for reappointment a Clinical Programme Lead shall be eligible for reappointment at the end of his/ her term but may not serve more than two (2) consecutive terms or six (6) years whichever is the lesser; f) Grounds for removal from office a Clinical Programme Lead shall cease to hold office if he/ she ceases to meet the eligibility criteria set out in sub-paragraph b) (Eligibility) above; g) Notice Period - A Clinical Programme Lead shall give three (3) months' notice in writing to the Governing Body of his/her resignation from office at any time during his/her term of office A member of the Governing Body shall not be eligible to become or continue in office as a member of the Governing Body if he/she: a) is a Member of Parliament, Member of the European Parliament or member of the London Assembly; b) is a member of a local authority in England and Wales or of an equivalent body in Scotland or Northern Ireland; c) is an individual who, by arrangement with the Group, provides it with any service or facility in order to support the Group in discharging its commissioning functions in arranging for the provision of services as part of the health service, or an employee or member (including shareholder) of, or a partner in, a body which does so save that services and facilities do not include services commissioned by the Group in the exercise of its commissioning functions; d) is a person who, within the period of five (5) years immediately preceding the date of the proposed appointment, has been convicted- i) in the United Kingdom of any offence, or ii) outside the United Kingdom of an offence which, if committed in any part of the United Kingdom, would constitute a criminal offence in that part, and, in either case, the final outcome of the proceedings was a sentence of imprisonment (whether suspended or not) for a period of not less than three (3) months without the option of a fine; e) is a person who is subject to a bankruptcy restrictions order or an interim bankruptcy restrictions order under Schedule 4A to the Insolvency Act 1986, sections 56A to 56K of the Bankruptcy (Scotland) Act 1985 or Schedule 2A to the Insolvency (Northern Ireland) Order 1989 (which relate to bankruptcy restrictions orders and undertakings); f) is a person who, has been dismissed within the period of five (5) years immediately preceding the date of the proposed appointment, otherwise than because of redundancy, from paid employment by any of the bodies referred to in Regulation 6(1) of Schedule 5 to the Regulations. For the purposes of this paragraph (f), a person is not to be treated as having been in paid employment if any of the criteria in Regulation 6(2) of Schedule 5 to the Regulations apply. NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

71 g) is a GP or other Healthcare Professional or other professional person who has at any time been subject to an investigation or proceedings, by any body which regulates or licenses the profession concerned (the "regulatory body"), in connection with the person's fitness to practise or alleged fraud, the final outcome of which was: i) the person's suspension from a register held by the regulatory body, where that suspension has not been terminated; ii) iii) iv) the person's erasure from such a register, where the person has not been restored to the register; a decision by the regulatory body which had the effect of preventing the person from practising the profession in question, where that decision has not been superseded; or a decision by the regulatory body which had the effect of imposing conditions on the person's practice of the profession in question, where those conditions have not been lifted; h) is subject to: i) a disqualification order or disqualification undertaking under the Company Directors Disqualification Act 1986 or the Company Directors Disqualification (Northern Ireland) Order 2002; ii) an order made under section 429(2) of the Insolvency Act 1986 (disabilities on revocation of administration order against an individual); i) has at any time been removed from the office of charity trustee for a charity or trustee for a charity by an order made by the Charity Commissioners for England and Wales, the Charity Commission, the Charity Commission for Northern Ireland or the High Court, on the grounds of misconduct or mismanagement in the administration of the charity for which the person was responsible, to which the person was privy, or which the person by their conduct contributed to or facilitated; j) has at any time been removed, or is suspended, from the management or control of any body under: i) section 7 of the Law Reform (Miscellaneous Provisions) (Scotland) Act 1990 (powers of the Court of Session to deal with management of charities), ii) section 34(5)(e) or (ea) of the Charities and Trustee Investment (Scotland) Act 2005 (powers of Court of Session to deal with the management of charities), k) is not eligible to work in the British Isles; l) has for a period of five (5) consecutive meetings of the Governing Body been absent and a simple majority of the Governing Body requires that he/she be vacated from his/her office; m) in the reasonable opinion of the Governing Body (having taken appropriate professional advice in cases where it is deemed necessary) becomes or is deemed NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

72 to have developed mental or physical illness which prohibits or inhibits his/her ability to undertake his/her role; or n) shall have behaved in a manner or exhibited conduct which in the opinion of the Governing Body has or is likely to be detrimental to the honour and interest of the Governing Body or the Group and is likely to bring the Governing Body and/or the Group into disrepute. This includes but is not limited to dishonesty, misrepresentation (either knowingly or fraudulently), defamation of any member of the Governing Body (being slander or libel), abuse of position, non declaration of a known conflict of interest, seeking to lead or manipulate a decision of the Governing Body in a manner that would ultimately be in favour of that member whether financially or otherwise The roles and responsibilities of each of these key roles are set out either in paragraph or Chapter 7 of the Group s Constitution The first appointment into Governing Body roles that are subject to a fixed term (as opposed to a substantive appointment) shall continue for two (2) years following the date on which this Constitution takes effect but with any second or subsequent appointment (whether a re-appointment or a new appointment) then being for three (3) years Having regard to the Group's intention to always appoint into those of its Governing Body member roles which require Group election, those persons that it considers are the most suitably qualified and experienced persons for the role, the Group shall be entitled (save to the extent required otherwise by law or where such action would result in the composition of the Governing Body no longer having a clinical majority) from time to time and by passing a Special Resolution to disapply any particular qualification or limitation referred to in this Constitution in respect of any such election For the avoidance of doubt, those members of the Governing Body who are appointed pursuant to an election process (or, in the case, of the Accountable Officer, the selection process) by the Members of the Group may also be removed from the Governing Body by the Members of the Group passing a Special Resolution applying the Consortium Voting Process in accordance with paragraph 3.8A of this Appendix C Without in any way delegating its responsibilities in respect of the same, the Group shall be entitled, from time to time, to request that the Remuneration and Nomination Committee observe and oversee its election processes in respect of those members of the Governing Body that are appointed by such election processes. 3. MEETINGS OF THE CLINICAL COMMISSIONING GROUP 3.1. Remit of the Consortium The remit of the Consortium may include: a) reviewing and agreeing the Group's commissioning strategy; b) informing and supporting the operational management of the Group; c) informing and supporting delivery of the Group's operational plan; NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

73 d) working as the prime operational link between the Governing Body and the Members; and e) where appropriate, updating its members as to: i) the commissioning budget position; ii) iii) iv) the prescribing budget position; the management budget position; and the position regarding QIPP and operating plan progress Calling Consortium Meetings and Administrative Meetings Ordinary meetings of the Group shall be held at regular intervals at such times and places as the Group may determine but not less than six (6) times per year. One of the Consortium Meetings per year shall be designated as the Group's annual general meeting It is anticipated that an Administrative Meeting shall be held in advance of every ordinary Consortium Meeting The Chair or one third of the total number of Members can call a special Consortium Meeting by giving all Members at least twenty-one (21) days' notice Planned ordinary dates of the Consortium Meetings will be notified to Members at least annually. Planned meeting dates will be published on the Group s website and a hard copy posted at the Group's headquarters Not later than three (3) days prior to an ordinary Consortium Meeting, notice of any business to be transacted and any resolutions to be passed shall be published at the offices of the Group and on the Group's website 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 fifteen (15) Business Days before the meeting takes place. Supporting papers for such items need to be submitted at least seven (7) Business Days before the meeting takes place. The agenda and supporting papers will be circulated to all members of a meeting at least five (5) Business Days before the date the meeting will take place. Important items will not normally be discussed under any other business unless the majority of the attendees agree it is an urgent business need Agendas and certain papers for the Consortium Meetings including details about meeting dates, times and venues - will be published on the Group s website. Alternatively, interested persons will be able to obtain a hard copy upon application to the Group's headquarters at Canterbury City Council, Council Offices, Military Road, Canterbury, Kent, CT1 1YW NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

74 3.4. Petitions Where a petition has been received by the Group, the Chair shall include the petition as an item for the agenda of the next meeting of the Governing Body Chair of a meeting The Chair, if present, shall chair Consortium Meetings 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 Practice Clinical Lead present at the Consortium Meeting shall be chosen by the Members present, or by a majority of them, and shall preside Where the Chair deems it appropriate, in his sole discretion, he may require any nonvoting attendees at a Consortium Meeting to leave for all or part of that meeting Chair's ruling The decision of the Chair 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 One half of the persons entitled to vote upon the business to be transacted, each being a Practice Clinical Lead, shall be a quorum for the Consortium Meeting Any Deputy Practice Clinical Leads validly appointed in accordance with paragraph 3.9 below present at a Consortium Meeting will count towards the quorum If any Practice Clinical Lead is disqualified from participating in discussions or decisionmaking on any matter due to their having declared a conflict of interest, they shall not count towards the quorum for that specific matter. If the quorum as set out in paragraph is not then met for the specific matter, no further discussion or decision-making may take place on that matter If any member is disqualified from participating in discussion or decision-making on any matter due to their having declared a conflict of interest, they shall not count towards the quorum for that specific matter. If the quorum as set out in is not then met for the specific matter, no further discussion or decision-making may take place on that matter For all other meetings 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 Consortium Meeting decisions will be NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

75 reached by consensus. Should this not be possible then a vote of members will be required, the process for which is set out below: At any Consortium Meeting a resolution put to the vote of the meeting shall be decided by applying the Consortium Voting Process and shall be decided by an Ordinary Resolution unless the subject matter qualifies for a Special Resolution. The mechanism by which such votes shall be collected shall be determined by the chair of the meeting, having regard to the nature of the issue and any confidentiality or other issues that, in his reasonable opinion, would militate against a simple show of hands At Consortium Meetings resolutions shall be put to the vote by the chair of the meeting and there shall be no requirement for the resolution to be proposed or seconded by any person A declaration by the chair at a Consortium Meeting that a resolution has been carried or lost and an entry into the minutes of the meeting shall be conclusive evidence of the fact Should a vote be taken the outcome of the vote, and any dissenting views, must 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. Special Resolutions 3.8A.1 The following matters are considered by the Group to be of such significance that, in place of passing an Ordinary Resolution, they require a Special Resolution to be passed: a) any change to the Constitution which also requires the approval of NHS England; b) any resolution proposed by a Member to remove any member of the Governing Body. In these circumstances, the Member proposing such a resolution must notify the Governing Body not less then 40 days in advance of the next Consortium Meeting of such proposal, a separate resolution must be proposed in respect of each member of the Governing Body and not more than one such resolution may be voted upon at any Consortium Meeting. Where resolutions are proposed in respect of multiple members of the Governing Body, they will be presented, in a phased manner, at successive Consortium Meetings, in the same order as they are received. The member of the Governing Body that is the subject of such resolution shall be entitled to circulate written representations to any or all Members of the Group before the Consortium Meeting at which such resolution is to be voted upon and shall also be entitled to address the Members at such meeting, in advance of any such vote. If a vote is carried in respect of such removal, that person shall accept the termination of their appointment on the same period of notice as would have applied had they voluntarily resigned (to afford the Group the opportunity to then elect a replacement); c) dis-applying any qualification or limitation otherwise applicable to an applicant for a Governing Body role, as described in paragraph ; d) suspension of any of the Standing Orders at Consortium Meetings, as described at paragraph 3.12 below. NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

76 3.9. Proxies and Proxy Notices Unless the Member in question notifies the Governing Body otherwise, where a Deputy Practice Clinical Lead attends a Consortium Meeting in place of the Practice Clinical Lead for a Member practice, he shall be deemed (without the requirement of a proxy notice) by the Governing Body to be the Practice Clinical Lead for the purposes of that Consortium Meeting and as such shall have discretion as to how to vote on any ancillary or procedural resolutions put to the meeting A Practice Clinical Lead from a Relevant Member may be validly appointed as proxy for any other Practice Clinical Lead by a notice in writing (a "proxy notice"): a) which states the name and address of the Practice Clinical Lead appointing the proxy; b) which is signed by or on behalf of the Practice Clinical Lead appointing the other Practice Clinical Lead as proxy, or is authenticated by the relevant Member; c) which is delivered to the Consortium Meeting in accordance with this Constitution and any instructions contained in the notice of the Consortium Meeting to which they relate; and d) provided that not more than one sixth of all Consortium Meetings in any one Financial Year has previously been the subject of a proxy notice under this paragraph in respect of that Relevant Member For the purposes of paragraph above, "Relevant Member" shall be defined as a Member practice with a list size of less than 5500 (the currency of such list is solely to be determined by the Governing Body) The Governing Body may require proxy notices to be delivered in a particular form, and may specify different forms for different purposes Proxy notices may specify how the proxy appointed under them is to vote (or that the proxy is to abstain from voting) on one or more resolutions Unless a proxy notice indicates otherwise, it must be treated as: a) allowing the person appointed under it as a proxy discretion as to how to vote on any ancillary or procedural resolutions put to the meeting; and b) appointing that person as a proxy in relation to any adjournment of the Consortium Meeting to which it relates as well as the meeting itself An appointment under a proxy notice may be revoked by delivering to the Governing Body a notice in writing given by or on behalf of the Practice Clinical Lead by whom or on whose behalf the proxy notice was given A notice revoking a proxy appointment only takes effect if it is delivered before the start of the meeting or adjourned meeting to which it relates. NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

77 If a proxy notice is not executed by the Practice Clinical Lead appointing the proxy, it must be accompanied by written evidence of the authority of the person who executed it to execute it on the relevant Member s behalf Resolutions in writing A resolution in writing signed or approved by a sufficient number of Practice Clinical Leads that would have been required to pass a resolution had it been voted on at a Consortium Meeting shall be as valid and effective as if it had been passed at a Consortium Meeting duly convened and held. The resolution may consist of more than one document in the same form each signed or approved by one or more persons Emergency powers and urgent decisions Emergency meetings may be called by the Chair on provision of at least three (3) Business Days notice to Members. Emergency meeting dates will be published on the Group s website and a hard copy posted at the Group s headquarters The powers which are reserved to the Governing Body may in an emergency or for an urgent decision be exercised by the Chair and the Accountable Officer, after consultation with at least one (1) Lay Member and one other member of the Governing Body. This shall be reported to the next meeting of the Governing Body for 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, subject to a Special Resolution applying the Consortium Voting Process 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, Governance and Risk Committee for review of the reasonableness of the decision to suspend Standing Orders Record of Attendance The names of all members present at the Consortium Meeting shall be recorded in the minutes of the Consortium Meeting Minutes The Chair will identify a suitable individual to record the minutes of each Consortium Meeting The minutes of each Consortium Meeting shall record the names of those in attendance. Where an attendee is present as a representative of a Member or Town this shall also be recorded. NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

78 The draft minutes of a Consortium Meeting shall be submitted at the next meeting for review as to accuracy. Acceptance of the minutes, with any amendments, shall be recorded in the minutes of the Consortium Meeting at which they are presented for review Draft minutes will be made available to members no later than five (5) Business Days after the Consortium Meeting to which they relate Where appropriate, approved minutes will be made available to the public by publishing them with the agenda and papers of the meeting to which they relate. Minutes or sections of minutes which are of a confidential nature which would not be disclosed under the Freedom of Information Act 2000 will not be made available on the Group's website Admission of public and the press All Consortium Meetings shall be public unless the Chair resolves that the public be excluded from the meeting, whether for the whole or part of the proceedings on the grounds that publicity would be prejudicial to the public interest or the interests of the Group 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 the business to be transacted or the proceedings Discussions and decision-making following exclusion of the public and representatives of the press shall be minuted in accordance with paragraph 3.14, except that such minutes shall be treated in accordance with the confidential nature of the business Where the public and representatives of the press are excluded, Members, employees and other persons remaining present at the Consortium Meeting are required not to disclose confidential information from papers, minutes or discussions outside of the Group, without the express permission of the Governing Body The Group may decide what arrangements and terms and conditions it feels are appropriate to offer in extending an invitation to observers to attend and address any of the Group's meetings and may change, alter or vary these terms as it sees fit. 4. APPOINTMENT OF COMMITTEES AND SUB-COMMITTEES 4.1. Appointment of committees and sub-committees The Group may appoint committees and sub-committees of the Group, including joint committees with other Clinical Commissioning Groups, subject to any regulations made by the Secretary of State 58, 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 sub-committees of its Governing Body, are appointed they are included in Annex A to the Group s Constitution Other than where there are statutory requirements, such as in relation to the Governing Body s Audit, Governance and Risk Committee or Remuneration and Nominations Committee, the Group shall determine the membership and terms of reference of 58 See section 14N of the 2006 Act, inserted by section 25 of the 2012 Act NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

79 committees and sub-committees 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-committees and all committees and sub-committees (including joint committees with other Clinical Commissioning Groups and or NHS England) unless stated otherwise in the committee or sub-committee s terms of reference Terms of Reference Terms of reference (as amended from time to time) 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 Group Approval of Appointments to Committees and Sub-Committees The Governing Body shall approve the appointments to each of the committees which it has formally constituted. Committees shall approve appointments to any sub committee(s) they have established. The Group s Remuneration and Nomination Committee 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 noncompliance and any justification for non-compliance and the circumstances around the non-compliance, shall be reported to the next formal meeting of the Governing Body for action or ratification. All Members of the Group 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 Group 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 Accountable Officer; b) the Chair; c) the Chief Finance Officer; d) the Head of Corporate Services 6.2. Execution of a document by signature NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

80 The following individuals are authorised to execute a document on behalf of the Group by their signature. a) the Accountable Officer; b) the Chair; c) the Chief Finance Officer; d) the Head of Corporate Services 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 NHS Canterbury and Coastal Clinical Commissioning Group. 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. NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

81 ANNEX 1 Meetings of the Governing Body 1. Calling Meetings 1.1 The Governing Body shall meet on a regular basis at least six (6) times per year and no more than two (2) months apart. 1.2 Meetings of the Governing Body must be open to the public unless the Governing Body resolves that the public be excluded from the meeting, whether for the whole or part of the proceedings on the grounds that publicity would be prejudicial to the public interest or the interests of the Group 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 the business to be transacted or the proceedings. 1.3 The Head of Corporate Services (on receiving a request from five (5) members of the Governing Body to call a meeting of the Governing Body or, if no Head of Corporate Services has been appointed, any member of the Governing Body receiving such a request, shall call a meeting of the Governing Body by issuing a notice within five (5) Business Days of being requested to do so. 2. Notice of Meetings 2.1 Notice of any Governing Body meeting must indicate: its proposed date and time, which must be at least four (4) weeks after the date of the notice, except where a meeting to discuss an urgent issue is required (in which case as much notice as reasonably practicable in the circumstances should be given); where it is to take place; an agenda of the items to be discussed at the meeting and any supporting papers; and if it anticipated that members of the Governing Body participating in the meeting will not be in the same place, how it is proposed that they should communicate with each other during the meeting. 2.2 Where possible, and in addition to the process set out in paragraph 1.3 above, the dates of all planned Governing Body meetings in any Financial Year will be communicated to the Governing Body members in advance of that Financial Year. 3. Agenda & Supporting Papers NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

82 3.1 The agenda will be agreed between the Accountable Officer and the Chair. 3.2 The date, time, venue, agenda and all papers related to the agenda of all Governing Body meetings will be made public with at least seven (7) days' notice on the Group's website. Important items will not normally be discussed under any other business unless it is agreed by the majority of the Governing Body that it is an urgent business need. 3.3 Notice of a Governing Body meeting must be given to each member of the Governing Body in writing. 3.4 Failure to effectively serve notice on all members of the Governing Body does not affect the validity of the meeting, or of any business conducted at it. 3.5 The Chair can determine items that need to be discussed in private in line with statute and national guidance for example matters of staff discipline, or where patient or commercial confidentiality is likely to be breached. 3.6 As a minimum the agenda of each ordinary meeting of the Governing Body shall contain the following: a. review minutes of previous Governing Body meeting; b. declarations of interest; c. a review of finance and activity d. a review of quality and safety issues 4. Quorum 4.1 The quorum of the meeting of the Governing Body shall be not less than one third of the members of the Governing Body present, at least one of whom shall be an Independent Member, one an employee of the Group and three (3) clinical members. 4.2 If the total number of members of the Governing Body for the time being is less than the quorum required, the Governing Body must not take any decision other than a decision to call a Consortium Meeting so as to enable the Members acting through their Practice Clinical Leads to appoint further members of the Governing Body to fill any vacancies. 4.3 The Governing Body may co-opt such other person(s) to attend all or any of its meetings, or part(s) of a meeting, in order to observe and/ or assist in its decision making and in its discharge of its functions as it sees fit. This may include (without limitation): v) a Clinical Programme Lead; NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

83 vi) vii) a Practice Administrative Lead; a local councillor; viii) the Patient Representative; ix) a Consultant in Public Health, and any such person may speak and participate in debate but may not vote. 4.4 A representative in attendance on behalf of a member of the Governing Body will count towards the quorum if notified one (1) week in advance to the Chair as acting in a formal deputising capacity, provided that the Chair accepts the deputising arrangements. 4.5 If any member of the Governing Body is disqualified from participating in discussions or decision-making on any matter due to their having declared a conflict of interest, they shall not count towards the quorum for that specific matter. If the quorum as set out in paragraph 4.1 is not then met for the specific matter, no further discussion or decision-making may take place on that matter. 5. Chair of Meeting 5.1 At any meeting of the Governing Body, the Chair, if present, shall preside. If the Chair is absent from the meeting, the Deputy Chair, if any, will preside. 6. Chair's Ruling 6.1 The decision of the Chair 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. 7. Voting at Governing Body meetings 7.1 Any decision of the Governing Body must be decided by a simple majority decision. 7.2 At any meeting of the Governing Body, on a show of hands, every member of the Governing Body present shall have one vote. If the numbers of votes for and against a proposal are equal, the Chair or other person chairing the meeting has a casting vote. 7.3 At any Governing Body meeting a resolution put to a vote of the meeting shall be decided on a show of hands. 7.4 At Governing Body meetings resolutions shall be put to the vote by the chair of the meeting and there shall be no requirement for the resolution to be proposed or seconded by any person. 7.5 A declaration by the chair of the meeting that a resolution has on a show of hands been carried or lost and an entry into the minutes of the meeting shall be conclusive evidence of the fact. NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

84 8. Written Resolutions 8.1 A resolution in writing signed or approved by the required majority of the members of the Governing Body entitled to receive notice of a meeting of the Governing Body. The resolution may consist of more than one document in the same form each signed or approved by one or more persons. 9. Emergency Powers and Urgent Decisions 9.1 Emergency meetings may be called by the Chair on provision of at least three (3) Business Days notice to members of the Governing Body. Emergency meeting dates will be published on the Group s website and a hard copy posted at the Group s headquarters. 9.2 The powers which reserved to the Governing Body may in an emergency or for an urgent decision be exercised by the Chair and the Accountable Officer, after consultation with at least one (1) Lay Member and one other member of the Governing Body. This shall be reported to the next meeting of the Governing Body for ratification. 10. Record of Attendance 10.1 The names of all members present at the meeting of the Governing Body shall be recorded in the minutes of the Governing Body meetings. 11. Minutes 11.1 The Chair will identify a suitable individual to record the minutes of each Governing Body meeting The minutes of each Governing Body meeting shall record the names of those in attendance The draft minutes of a Governing Body meeting shall be submitted at the next meeting for review as to accuracy. Acceptance of the minutes, with any amendments, shall be recorded in the minutes of the Governing Body meeting at which they are presented for review Draft minutes will be made available to members of the Governing Body no later than three (3) Business Days before the Governing Body meeting at which they are to be reviewed Where appropriate, approved minutes will be made available to the public by publishing them with the agenda and papers of the meeting to which they relate on the Group's website. Minutes will also be held ready for inspection at the Group's headquarters at Canterbury City Council, Council Offices, Military Road, Canterbury, NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

85 Kent, CT1 1YW. Minutes or sections of minutes which are of a confidential nature which would not be disclosed under the Freedom of Information Act will not be made available on the Group's website. 12. Suspension of Standing Orders 12.1 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 members of the Governing Body present 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, Governance and Risk Committee for review of the reasonableness of the decision to suspend Standing Orders. 13. Transparency 13.1 The Governing Body will publish papers considered at meetings of the Governing Body, except where the Governing Body considers that it would not be in the public interest to do so in relation to a particular paper or part of a paper Subject to paragraphs 13.3 and 13.4, the Governing Body shall publish the following information relating to determinations made under subsection (3)(a) and (b) of section 14L of the 2006 Act (which relates to remuneration, fees and allowances, including allowances payable under certain pension schemes): in relation to each senior employee of the Group, any determination of the employee's salary or of any travelling and other allowances payable to the employee, including any allowances payable under a pension scheme established under paragraph 11(4) of Schedule 1A to the 2006 Act; any recommendation of the remuneration committee in relation to any such determination Information as to the determination of a senior employee's salary need specify only a band of 5,000 into which the salary determined falls The Governing Body must not publish any information referred to in paragraph 13.2 if the Governing Body considers that it would not be in the public interest to publish it In paragraph a 'senior employee' means an employee who has authority over or responsibility for directing or controlling the exercise of the Group's functions. 14. Admission of public and the press NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

86 14.1 All Governing Body Meetings shall be public unless the Chair resolves that the public be excluded from the meeting, whether for the whole or part of the proceedings on the grounds that publicity would be prejudicial to the public interest or the interests of the Group 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 the business to be transacted or the proceedings Discussions and decision-making following exclusion of the public and representatives of the press shall be minuted, except that such minutes shall be treated in accordance with the confidential nature of the business Where the public and representatives of the press are excluded, members, employees and other persons remaining present at the Governing Body Meeting are required not to disclose confidential information from papers, minutes or discussions, without the express permission of the Governing Body. 15. Indemnity 15.1 Members of the Governing Body who act honestly and in good faith will not have to meet out of their personal resources any personal civil liability which is incurred in the execution or purported execution of their Governing Body functions, save where they have acted recklessly. NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

87 ANNEX 2A Towns 1. Configuration of Towns 1.1 The Area of the Group shall initially be divided into five (5) Towns or such other configuration of Towns as the Governing Body may agree from time to time in accordance with paragraph 1.3 below. The initial Towns shall be referred to as: Canterbury and Rural; Faversham; Herne Bay; Sandwich & Ash; and Whitstable, and, for ease of reference, a map indicating the boundaries of the same is included in the Attachment to this Annex 2 of Appendix C. 1.2 Each Member of the Group shall also be a member of the Town in which their practice is based subject to the ability of NHS England to determine otherwise. 1.3 The Governing Body shall determine the boundaries of the Towns and the configuration of Member practices within each Town provided that any Town must fall within the Area. Any Member of the Group shall be entitled to request a change to the boundary of a Town but all such changes shall be considered by the Governing Body and either confirmed or amended but not more than once annually. 2. Role of Towns 2.1 The proposed role of Towns is to: in accordance with Paragraph of Appendix C (Standing Orders), endorse GP Town Representatives elected by the Members on to the Governing Body; contribute to shaping the commissioning strategy for the Group, including early idea generation, and contributing Town-level input to the Consortium and the working groups for clinical programmes and the related pathway design; engage with and hear perspectives from patients, through the Town Patient Reference Groups; implement agreed Group strategies and priorities at Town level, including the Town delivering on the agreements in relation to patient pathways, referral and prescribing formulary; NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

88 3. Town Meetings offer peer review and challenge in relation to Member performance in respect of their duties and responsibilities as Members of the Group; create opportunities for exchanges of ideas between Members and encourage a positive learning environment, to encourage GPs and clinical leaders to learn from and with each other to continually improve practice; act as a conduit by which Members' views can be taken into account, where appropriate, as part of the work of the Governing Body; engage with Clinical programme leads in testing and disseminating new service delivery options; be a locus for understanding community health needs at the Town level; provide an opportunity for emerging clinical leaders to develop strategy and leadership skills and to provide a talent management pool for Group leadership in the future. Each Town will hold Town Meetings at least every other month, which may be attended by the following: 3.1 the GP Town Representative(s) for the Town (who shall chair the Town Meetings); 3.2 the Practice Clinical Leads from Member practices located within the relevant Town; 3.3 practice managers from Member practices located within the relevant Town; 3.4 practice nurses from Member practices located within the relevant Town; and 3.5 patient representatives from the Town Patient Reference Group and the Patient Reference Groups of Member practices located within the relevant Town. 4. Towns shall have the power to co-opt other non-voting persons from Members to attend Town Meetings as he sees fit. 5. Towns shall have access to general management and professional leadership support of the Group to carry out administrative tasks on behalf of the Towns. 6. GP Town Representatives 6.1 The six (6) GP Town Representatives each shall be responsible for representing the Town in which their Member practice is situated. The GP Town Representatives shall be elected in accordance with paragraph of Appendix C (Standing Orders). 6.2 The GP Town Representatives shall sit on the Governing Body. 6.3 The role of the GP Town Representatives is to: ensure a two-way communication channel with their Member practices; NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

89 6.3.2 within one week feed back to their members the discussions of the Governing Body from Governing Body meetings and, where appropriate, that of the Consortium in the absence of the Practice Clinical Lead and the Deputy Practice Lead; represent the Members within their Town, by collecting the views of their Member practices in order to represent their views at Town Meetings; lead on, and ensure fulfilment of, the role of the Town as referred to in paragraph 2 above; be part of any Town team that is agreed to be established and chair team meetings; ensure all Members' views and priorities are taken into account in the recommendations of the Consortium to the Governing Body; perform the additional clinical or corporate leadership functions for which they are responsible as may be determined by the Governing Body from time to time; and perform any other function as the Group determines appropriate from time to time, including but not limited to visiting Member practices in neighbouring Towns to assist and support problem Member practices. NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

90 1. Patient Reference Groups ANNEX 2B Patient and Public Representation 1.1 Each Member shall set up a Patient Reference Group to encourage feedback from its patients. A Patient Reference Group may initially exist in a virtual capacity with members communicating with each other the relevant Member and other relevant parties via or other electronic modes of communication. 2. Public Reference Group 2.1 The Public Reference Group shall comprise the following membership: six (6) representatives from the voluntary sector or other stakeholder organisations (such organisations being identified by the Governing Body from time to time) within the Area; and six (6) Patient Representatives, one (1), or in the case of Canterbury and Rural, two (2), elected, nominated or appointed from the Practice Reference Groups in each Town. 2.2 The role of the Public Reference Group will be to: contribute to shaping the commissioning intentions at specially dedicated workshops; engage with the Governing Body via the Lay Member for patient and public engagement; and elect or appoint an individual who will act as an Observer to the Governing Body, in accordance with paragraph 4.3 of Annex 1 to Appendix C (Standing Orders). 2.3 The Public Reference Group will meet on a quarterly basis. NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

91 ATTACHMENT TO ANNEX 2 OF APPENDIX C Map of the Area and practice locations Source: CCG Data Profile NHS Canterbury & Coastal Clinical Commissioning Group s Constitution

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