NHS NORWICH CLINICAL COMMISSIONING GROUP CONSTITUTION Version: 6.2 Effective Date: 8th February 2017
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Document Control Sheet Name of document: Version: 6.2 Status: Owner: NHS Norwich CCG Constitution Final Date of this version: 4 th January 2017 Produced by: Nikki Cocks, Director of Operations & Delivery Jean Clark, Head of Governance CCG Approval by: Council of members 15 th December 2016 Approved by (Committee): NHS England Date ratified: 8 th February 2017 Next review due: Enquiries to: Revision History Revision Date Summary of changes Author(s) Version Number 19/02/13 Date of Authorisation inserted Carl Gosling 1 01/03/13 Paragraph 6.5 and SOD amended to reflect decision making Carl Gosling 2 arrangements and attendance at Collaborative Commissioning Boards 7/11/14 Updated to reflect new logo and updated terms of references Carl Gosling 3 03/12/14 Updated to reflect recommendations from the Governance Nikki Cocks 4 Review 03/05/15 Updated to allow non-elected members a second term of Nikki Cocks 5 office 20/06/16 Inclusion of Roundwell Medical Practice; revision of Jean Clark 6 Committee TOR; addition of Joint Committee for Primary Care Commissioning TOR, addition of 3 rd Lay Member; changes to collaborative commissioning arrangements; Clinical Vice Chair; update Section 8 COI in light of new guidance 15/11/16 Minor amendments to V6 made as suggested by NHS England Jean Clark 6.1 4/1/17 Changes to LSOAs as recommended by NHS England. Revision to Mission, Vision and Aims, approved by CoM 15 th December 2016 Jean Clark 6.2 NHS Norwich Clinical Commissioning Group s Constitution - 3 -
CONTENTS Part Description Page Foreword 6 1 Introduction and Commencement 7 1.1 Name 7 1.2 Statutory framework 7 1.3 Status of this constitution 7 1.4 Amendment and variation of this constitution 8 2 Area Covered 9 3 Membership 10 3.1 Membership of the clinical commissioning group 10 3.2 Eligibility 11 3.3 Application for membership 11 3.4 Termination of membership 11 3.5 Voluntary withdrawal 12 3.6 LMC and CCG engagement 12 4 Mission, Values, Vision and Aims 13 4.1 Mission 13 4.2 Values 13 4.3 Vision 14 4.4 Aims 14 4.5 Principles of good governance 14 4.6 Accountability 15 5 Functions and General Duties 16 5.1 Functions 16 5.2 General duties 19 5.3 General financial duties 24 5.4 Other relevant regulations, directions and documents 27 6 Decision Making: The Governing Structure 28 6.1 Authority to act 28 6.2 Scheme of reservation and delegation 28 6.3 General 28 6.4 Committees of the group 29 6.5 Joint arrangements 29 6.6 The Governing Body 34 6.7 The Council of Members 40 7 Roles and Responsibilities 42 7.1 Practice Representatives (known as GP Councillors) 42 NHS Norwich Clinical Commissioning Group s Constitution - 4 -
Part Description Page 7.2 Other GPs or Primary Care Health Professionals 42 7.3 All members of the group s Governing Body 43 7.4 The Chair of the Governing Body 43 7.5 The Deputy Chair of the Governing Body 44 7.6 Role of the Chief Officer 44 7.7 Role of the Chief Finance Officer 45 7.8 Joint appointments with other Organisations 45 8 Standards of Business Conduct and Managing Conflicts of Interest 46 8.1 Standards of business conduct 46 8.2 Conflicts of interest 46 8.3 Declaring and registering interests 47 8.4 Managing conflicts of interest: general 47 8.5 Managing conflicts of interest: contractors and people who provide 50 services to the group 8.6 Transparency in procuring services 50 9 The Group as Employer 52 10 Transparency, Ways of Working and Standing Orders 54 10.1 General 54 10.2 Standing orders 54 Appendix Description Page A Definitions of Key Descriptions used in this Constitution 55 B List of Member Practices 57 C Standing Orders 57 D Scheme of Reservation and Delegation 73 E Prime Financial Policies 85 F The Nolan Principles 97 G The Seven Key Principles of the NHS Constitution 98 H Terms of reference of the Audit Committee 100 I Terms of reference of the Remuneration Committee 106 J Terms of reference of the Quality Committee 109 K Terms of reference of the Finance Committee 113 L Terms of reference of the Executive Committee 116 M Terms of reference of the Council of Members 118 N Terms of reference of the Joint Primary Care Commissioning 122 Committee O Memorandum of Understanding for CCG and LMC engagement 126 FOREWORD NHS Norwich Clinical Commissioning Group (NHS Norwich CCG) is compiled of 24 GP member practices and serves a GP registered population of 212,800. Its long term goal is too efficiently and effectively plan, buy and monitor the health services that address the NHS Norwich Clinical Commissioning Group s Constitution - 5 -
needs of the population of Norwich in order to improve health outcomes and quality of services year on year for all the people of Norwich. This Constitution sets out NHS Norwich CCG s responsibilities for commissioning care for its patients. It describes the governing principles, rules and procedures that the group will establish to ensure probity and accountability in the day to day running of the clinical commissioning group; to ensure that decisions are taken in an open and transparent way and that the interests of patients and the public remain central to the goals of the group. It confirms:- the group s legal position the group s mission, values and aims the group s membership and the decisions reserved for the how the membership relates to the group s Governing Body the group s leaders, their roles and how they are selected and expected to behave the powers of the Governing Body, committees and individuals the group s meeting arrangements the group s prime financial policies The Constitution applies to all of the member practices; the group s employees, individuals working on behalf of the group and to anyone who is a member of the group s Governing Body (including the Governing Body s audit, remuneration, Quality and Finance committees) and any other committees established by the group or its Governing Body. Every member practice, employee or other person working on behalf of the group, or members of the Governing Body or any committees is responsible for knowing, complying with and for upholding the arrangements for the governance and operation of the group as described in this constitution. NHS Norwich Clinical Commissioning Group s Constitution - 6 -
1. INTRODUCTION AND COMMENCEMENT 1.1. Name 1.1.1. The name of this clinical commissioning group is NHS Norwich Clinical Commissioning Group. 1.2. Statutory Framework 1.2.1. 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. 3 1.2.2. The NHS Commissioning Board, known as 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. 6 1.2.3. Clinical commissioning groups are clinically led membership organisations whose members are the constituent 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. 7 1.3. Status of this Constitution 1.3.1. This constitution is made between the members of NHS Norwich CCG and has effect from 19 th day of February 2013, when NHS England established the group. 8 The constitution is published on the group s website at www.norwichccg.nhs.uk. 1 2 3 4 5 6 7 8 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 See section 14D of the 2006 Act, inserted by section 25 of the 2012 Act NHS Norwich Clinical Commissioning Group s Constitution - 7 -
A copy of the constitution will also be made available upon request for inspection at NHS Norwich CCG s headquarters at City Hall, Norwich. The constitution will also be made available upon application, either by post to NHS Norwich CCG, Room 202, City Hall, St. Peter s Street, Norwich NR2 1NH or via email to norwich.ccg@nhs.net. 1.4. Amendment and Variation of this Constitution 1.4.1. This constitution can only be varied in two circumstances. 9 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. 9 See sections 14E and 14F of the 2006 Act, inserted by section 25 of the 2012 Act and any regulations issued NHS Norwich Clinical Commissioning Group s Constitution - 8 -
2. AREA COVERED 2.1. The geographical area covered by NHS Norwich CCG includes the following LSOAs situated within the Norwich and Broadland local authorities:- Norwich 00G, Norwich 001A, Norwich 001B, Norwich 001C, Norwich 001D, Norwich 001E, Norwich 001F, Norwich 002A, Norwich 002B, Norwich 002C, Norwich 002D, Norwich 002E, Norwich 002F, Norwich 002G, Norwich 003A, Norwich 003B, Norwich 003C, Norwich 003D, Norwich 003E, Norwich 003F, Norwich 004A, Norwich 004B, Norwich 004C, Norwich 004D, Norwich 004E, Norwich 004F, Norwich 004G, Norwich 005A, Norwich 005B, Norwich 005C, Norwich 005D, Norwich 005E, Norwich 005F, Norwich 005H, Norwich 006A, Norwich 006B, Norwich 006C, Norwich 006D, Norwich 006E, Norwich 006F, Norwich 006G, Norwich 007A, Norwich 007B, Norwich 007C, Norwich 007D, Norwich 007E, Norwich 007F, Norwich 008A, Norwich 008B, Norwich 008C, Norwich 008D, Norwich 008E, Norwich 009A, Norwich 009B, Norwich 009C, Norwich 009D, Norwich 009E, Norwich 009F, Norwich 010A, Norwich 010B, Norwich 010C, Norwich 010D, Norwich 010E, Norwich 011A, Norwich 011B, Norwich 011C, Norwich 011D, Norwich 011E, Norwich 011F, Norwich 011G, Norwich 011H, Norwich 012A, Norwich 012B, Norwich 012C, Norwich 012D, Norwich 012E, Norwich 012F, Norwich 013A, Norwich 013B, Norwich 013C, Norwich 013D, Norwich 013E, Norwich 013F, Norwich 014A, Norwich 014B, Norwich 014C, Norwich 014D, Norwich 015A, Norwich 015B, Norwich 015C, Broadland 006A, Broadland 006B, Broadland 006C, Broadland 006D, Broadland 006E, Broadland 006F, Broadland 006G, Broadland 007C, Broadland 007D, Broadland 009A, Broadland 009B, Broadland 009C, Broadland 009D, Broadland 009E, Broadland 010A, Broadland 010B, Broadland 010C, Broadland 010D, Broadland 011A, Broadland 011B, Broadland 011C, Broadland 012A, Broadland 012B, Broadland 012C, Broadland 012D, Broadland 013A, Broadland 013B, Broadland 013C, Broadland 013D, Broadland 013E, Broadland 015A, Broadland 015B, Broadland 015C, Broadland 015D, Broadland 015E, Broadland 016A, Broadland 016B, Broadland 016C, Broadland 016D and the following LSOAs situated within the South Norfolk local authority: South Norfolk 002D (E01026895), South Norfolk 001A (E01026916), South Norfolk 001B, South Norfolk 001C (E01026918), South Norfolk 001E (E01026924), South Norfolk 001F (E01026925), South Norfolk 001G (E01033538), South Norfolk 001H (E01033540) NHS Norwich Clinical Commissioning Group s Constitution - 9 -
3. MEMBERSHIP 3.1. Membership of the Clinical Commissioning Group 3.1.1. The following practices comprise the members of NHS Norwich CCG. 3.1.2. Practice Name Address Bacon Road Medical Centre 16 Bacon Road, Norwich, Norfolk NR2 3QX Beechcroft Surgery* 23 Beechcroft, New Costessey, Norwich NR5 0RS Castle Partnership Gurney Surgery, 101-103 Magdalen Street, Norwich, Norfolk NR3 1LN East Norwich Medical Partnership St. Williams Way, Thorpe St. Andrew, Norwich, Norfolk NR7 0AJ Hellesdon Medical Practice 343 Reepham Road, Hellesdon, Norwich, Norfolk NR6 5QJ Lakenham Surgery The Lakenham Surgery, Ninham Street, Norwich, Norfolk NR1 3JJ Lawson Road Surgery Lawson Road, Norwich, Norfolk NR3 4LE Magdalen Medical Practice Lawson Road, Norwich, Norfolk NR3 4LF Newmarket Road Surgery 7 Newmarket Road, Norwich, Norfolk NR2 2HL Oak Street Medical Practice Oak Street, Norwich, Norfolk NR3 3DL Old Catton Medical Practice 55 Lodge Lane, Old Catton, Norwich, Norfolk NR6 7HQ Old Palace Medical Practice 148 Old Palace Road, Norwich, Norfolk NR2 4JA Prospect Medical Practice 95 Aylsham Road, Norwich, Norfolk NR3 2HW Roundwell Medical Centre 25-27 Dr Torrens Way, Costessey, Norwich NR5 0GB St Stephens Gate Medical 55 Wessex Street, Norwich, Norfolk NR2 2TJ Practice Taverham Partnership Sandy Lane, Taverham, Norwich, Norfolk NR8 6JR Thorpewood Medical Group Woodside Road, Thorpe St. Andrew, Norwich, Norfolk NR7 9QL Norwich Practices Health Centre Rouen House, Rouen Road, Norwich NR1 1RB Trinity and Bowthorpe Medical Practice The Surgery, 1 Trinity Street, Norwich, Norfolk NR2 2BQ UEA Medical Centre UEA Medical Centre, University of East Anglia, Earlham Road, Norwich, Norfolk NR4 7TJ Wensum Valley Medical Practice The Health Centre, Adelaide Street, Norwich, Norfolk NR2 4JL West Pottergate Medical Practice The Health Centre, West Pottergate, Norwich, Norfolk NR2 4BX Woodcock Road Surgery 29 Woodcock Road, Norwich, Norfolk NR3 3UA Lionwood Practice 30A Wellesley Avenue North, Norwich, NR1 4NU. *practice had been branch surgery of another Norwich CCG practice 3.1.3. Appendix B of this constitution contains the list of practices, together with the signatures of the practice representatives confirming their agreement to this constitution. 3.2. Eligibility NHS Norwich Clinical Commissioning Group s Constitution - 10 -
3.2.1. 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, will be eligible to apply for membership of this group 10. 3.3. Application for Membership 3.3.1. In order to become a member of NHS Norwich CCG each practice must ensure that it: is eligible to become a member; has completed an application for membership in a form required by the Governing Body; has executed and delivered to the Governing Body a signed copy of the constitution; has had its application approved by the Governing Body; has been entered into the Register of Members. 3.3.2. Paragraph 3.3.1. is without prejudice to the general power of NHS England to add to practices as members of the CCG in accordance with the 2012 Act (including in particular under section 14F of the 2006 Act as amended by section 21 (1) of the 2012 Act) and any such practice shall be admitted as a member so directed by NHS England. 3.3.3. Membership of the group is not transferable. 3.4 Termination of Membership 3.4.1. A member ceases to be a member if: a) the member resigns as a member by giving at least three months prior written notice of their resignation to the governing body; b) the member is a sole practitioner GP and he or she; dies; or is declared bankrupt; ceases to be registered as a medical practitioner enters into partnership with any other medical practitioner and existing contracts are merged. c) the member is two or more individuals practising in partnership and: the conditions in section 86 (2) of the 2012 Act are no longer satisfied; or the partnership is dissolved. d) the member is a company limited by shares and: 10 See section 14A (4) of the 2006 Act, inserted by section 25 of the 2012 Act. NHS Norwich Clinical Commissioning Group s Constitution - 11 -
the conditions in section 86 (3) of the 2012 Act are no longer satisfied; or in respect of that company any one of the following occurs: o a resolution is passed for voluntary winding up by reason of insolvency; o a winding up order is granted; o a resolution by its directors or members is passed to apply for an administration order o an administrator is appointed under the Insolvency Act 1986; o a receiver or an administrative receiver is appointed over any of its assets or income; o a statutory demand is issued under the Insolvency Act 1986 which is not discharged before it is advertised o it is unable to pay its debts as they fall due as determined by section 123 of the Insolvency Act 1986. If the member operates under an APMS contract and any of the relevant termination provisions apply: o NHS England removes a member of the CCG in accordance with the 2012 Act; o if a practice merges with any other practice, unless that other practice is an existing member; or A member practice will cease to be a member of the group, with immediate effect, if it ceases to provide primary medical services under a GMS, PMS or APMS contract or any subsequent primary care contract. 3.5. Voluntary Withdrawal 3.5.1 Any member practice may voluntarily leave the group by writing formally to the chair of the governing body giving three months prior notice of their intention to leave. The member practice will also be required to inform NHS England. 3.5.2 If a practice leaves the group and then wishes to re-join, it will go through the application process set out in paragraph 3.3.1 of the constitution as if it were a practice that had no previous relationship with the group. 3.6. LMC and CCG Engagement 3.6.1 NHS Norwich CCG will engage with the Local Medical Committee, as statutory representatives of the profession. The detail of this agreement is appended to the Constitution at Appendix N. 3.6.2 Disputes between a practice and NHS Norwich CCG, or between practices who are members of NHS Norwich CCG, will be addressed in accordance with the disputes resolution process. The detail of this agreement is included within Appendix O. NHS Norwich Clinical Commissioning Group s Constitution - 12 -
4. MISSIONS, VALUES, VISION AND AIMS 4.1 Vision 4.1.1 The group s vision is to improve health outcomes and quality of services year on year for all the people of Norwich. The Group s vision is an accessible, good quality and financially sustainable health and care system for the people of Norwich 4.2 Mission 4.2.1 To bring that vision into reality, the mission of the CCG is to efficiently and effectively plan, commission and monitor the delivery of services to address the needs of the population. 4.2.2 This mission will be underpinned by robust governance and proper stewardship of public resources in pursuance of the CCG s vision and in meeting its statutory duties. 4.3 Aims 4.3.1. The group s aims are 4.4 Values a) Improvement in the quality and safety of care. a) Transformation and integration of health and care services in the communities of Norwich b) Improvement in the health and wellbeing of the population of Norwich accompanied by a reduction in health inequalities c) Management of resources responsibly and ethically, to deliver best value for the taxpayer d) Increased participation of local people in health and care decisions, both public and personal. 4.4.1 The CCG s organisation values: a) embrace the values of the wider NHS; b) pertain to staff, partners and stakeholders as much as they do to patients and the wider public c) will be demonstrated through our actions, behaviours and decision making processes d) support an organisational culture in which we hold each other to account for behaving in such a way as to uphold these values. These values are: a) Commitment to quality of care as the main organising principle for Norwich CCG. NHS Norwich Clinical Commissioning Group s Constitution - 13 -
b) Open, transparent, accountable decision-making c) Delivery mindedness we are action focused and see tasks through d) Respect and dignity for each other and ensuring that this is a priority for patients within our commissioned services. e) Everyone counts we aim to ensure that all walks of society have access to quality. We also encourage and embrace diversity as a means of maximising innovation and creativity. 4.5 Principles of Good Governance 4.5.1 In accordance with section 14L (2) (b) of the 2006 Act, 11 the group will at all times observe such generally accepted principles of good governance in the way it conducts its business. These include: a) the highest standards of propriety involving impartiality, integrity and objectivity in relation to the stewardship of public funds, the management of the organisation and the conduct of its business; b) The Good Governance Standard for Public Services; 12 c) the standards of behaviour published by the Committee on Standards in Public Life (1995) known as the Nolan Principles 13 d) the seven key principles of the NHS Constitution; 14 e) the Equality Act 2010. 15 f) the Standards for Members of NHS Boards and Governing Bodies. 16 4.6 Accountability 4.6.1 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; 11 12 13 14 15 16 Inserted by section 25 of the 2012 Act The Good Governance Standard for Public Services, The Independent Commission on Good Governance in Public Services, Office of Public Management (OPM) and The Chartered Institute of Public Finance & Accountability (CIPFA), 2004 See Appendix F See Appendix G See http://www.legislation.gov.uk/ukpga/2010/15/contents See http://www.chre.org.uk/satellite/413/ NHS Norwich Clinical Commissioning Group s Constitution - 14 -
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. 4.6.2 In addition to these statutory requirements, the group will demonstrate its accountability by: a) publishing its principle commissioning and operational policies b) holding engagements events 4.6.3 The Governing Body of the group will throughout each year have an on-going role in reviewing the group s governance arrangements to ensure that the group continues to reflect the principles of good governance. NHS Norwich Clinical Commissioning Group s Constitution - 15 -
5. FUNCTIONS AND GENERAL DUTIES 5.1. Functions 5.1.1. 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 NHS Commissioning Board s (NHS England) The functions of clinical commissioning groups, March 2013. They relate to: a) commissioning certain health services (where NHS England is not under a duty to do so) that meet the reasonable needs of: i) all people registered with member GP practices, and ii) people who are usually resident within the area and are not registered with a member of any clinical commissioning group; b) commissioning emergency care for anyone present in the group s area; c) paying its employees remuneration, fees and allowances in accordance with the determinations made by its Governing Body and determining any other terms and conditions of service of the group s employees; d) determining the remuneration and travelling or other allowances of members of its Governing Body. 5.1.2 In discharging its functions the group will: a) act 17, 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 18 and with the objectives and requirements placed on NHS England through the mandate 19 published by the Secretary of State before the start of each financial year by: i) establishing a Governing Body which has functions conferred on it by sections 14L(2) and (3) of the 2006 Act, inserted by section 25 of the 2012 Act, together with any other functions connected with its main functions as may be specified in regulations or in the constitution; ii) iii) drawing up a schedule of decisions reserved to the Governing Body, and ensuring that management arrangements are in place to enable responsibility to be clearly delegated to Governing Body committees and senior officers (a scheme of delegation); establishing appropriate committees of the Governing Body with which to enact the schemes of reservation and delegation; 17 18 19 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 Norwich Clinical Commissioning Group s Constitution - 16 -
iv) developing a commissioning plan before the start of each financial year in accordance with the 2006 Act (as amended) (the commissioning plan ) and any guidance published by NHS England. The commissioning plan must set out how NHS Norwich CCG proposes to exercise its functions during the relevant financial year; v) publish the commissioning plan and supply a copy to NHS England before any date specified by the Board in a direction, and to any relevant Health and Wellbeing Board of which NHS Norwich CCG is a member; vi) making copies of the commissioning plan, as amended from time to time, available on the group s website at www.norwichccg.nhs.uk. Copies of the commissioning plan will also be made available upon request for inspection at NHS Norwich CCG s headquarters at City Hall, Norwich. The commissioning plan will also be made available upon application, either by post to NHS Norwich CCG, Room 202, City Hall, St. Peter s Street, Norwich NR2 1NH or via email to norwich.ccg@nhs.net. vii) where NHS Norwich CCG is preparing a commissioning plan or revising a commissioning plan in a way NHS Norwich CCG considers significant, NHS Norwich CCG will consult individuals for whom it has responsibility for the purposes of Section 3 of the NHS Act 2006, and involve any relevant Health and Wellbeing Board in revising or preparing the commissioning plan; viii) in drafting the commissioning plan, the CCG must have regard to the Procurement Guide for Commissioners of NHS-Funded Services published on 30 July 2010and any document which supersedes it; Operational Guidance to the NHS Extending Patient Choice of Provider published on 19 July 2011 and any document which supersedes it; and any other documentation setting out how Any Qualified Provider model is to function. ix) when commissioning services from those providers who are qualified to do so under the national list of services, NHS Norwich CCG must ensure that those qualified still meet the requirements, namely that they; are registered with the Care Quality Commission and licensed by Monitor (from 2013) where required, or meet equivalent requirements; will meet the Terms and conditions of the NHS Standard Contract which includes the requirement to have regard to the NHS Constitution, relevant guidance and law; accept NHS prices; can provide assurances that they are capable of delivering the agreed service requirements and comply with referral protocols; NHS Norwich Clinical Commissioning Group s Constitution - 17 -
reach agreement with local commissioners on supporting schedules to the standard contract including any local referral thresholds or patient protocols. b) meet the public sector equality duty 20 by: i) delegating responsibility for ensuring that NHS Norwich CCG meets the public sector equality duty to the Group s Governing Body; ii) iii) iv) developing and implementing a comprehensive equality strategy, that sets out how the CCG will eliminate unlawful discrimination, victimisation and other conduct prohibited by the Equality Act 2010; using the Equality Delivery System as a tool to advance equality and opportunity between people who share protected characteristics and those who do not foster good relations between people who share protected characteristics and those who do not; publishing, at least annually, sufficient information to demonstrate compliance with this general duty across all functions; preparing and publishing specific and measurable equality objectives, revising these regularly as is appropriate; v) using the Equality Delivery System toolkit to assist NHS Norwich CCG in delivering these duties; vi) having regard to any guidance or requirements published by NHS England. c) work in partnership with its local authority[ies] to develop joint strategic needs assessments 21 and joint health and wellbeing strategies 22 by: i) by being members of the Norfolk Health and Wellbeing Board which will act as focus of leadership and coordination of strategic commissioning for Norwich City Council s Cabinet and NHS Norwich CCG in relation to spending and service priorities of those bodies and the advantages and opportunities of joint working; ii) iii) giving the Health and Wellbeing Board a draft of the commissioning plan or, as the case may be, a copy of the revised commissioning plan; consulting the Health and Wellbeing Board on whether the draft Commissioning Plan takes proper account of the Joint Health and Wellbeing Strategy, published by the Health and Wellbeing Board, 20 21 22 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 Norwich Clinical Commissioning Group s Constitution - 18 -
which relates to the period (or any part of the period) to which the commissioning plan relates; iv) including in the published commissioning plan or, in circumstances where NHS Norwich CCG revises a published plan in a way in which the NHS Norwich CCG considers significant, the revised commissioning plan, a summary of the views expressed by the individuals consulted; an explanation of how NHS Norwich CCG took account of these views; and a statement of the final opinion of the Health and Wellbeing Board consulted in relation to the commissioning plan. 5.2. General Duties - in discharging its functions the group will: 5.2.1. Make arrangements to secure public involvement in the planning, development and consideration of proposals for changes and decisions affecting the operation of commissioning arrangements 23 by: a) Delegating responsibility to the Group s Governing Body; b) Developing and implementing a comprehensive communications and engagement strategy which sets out how patients and the public will be involved in decisions about local health services, including: i) adapting engagement activities to meet specific needs of the different patient groups and communities, wherever possible taking a direct and personalised approach; ii) iii) publishing information about health services, the group s aims and ambitions on the group s website and through other media; demonstrating how the group is effectively involving patients, the public and other stakeholders through quarterly reports to the Governing Body, and through publication of an annual review of all communications and engagement activity. 5.2.2. Promote awareness of, and act with a view to securing that health services are provided in a way that promotes awareness of, and have regard to the NHS Constitution 24 by: a) delegating responsibility to the Group s Governing Body who will discharge this responsibility by establishing a quality committee and delegating responsibility for ensuring discharge of the duty b) progress will be reported to the Governing Body on a six monthly basis. 23 24 See section 14Z2 of the 2006 Act, inserted by section 26 of the 2012 Act 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 Norwich Clinical Commissioning Group s Constitution - 19 -
c) having regard to any guidance or requirements published by NHS England 5.2.3. Act effectively, efficiently and economically 25 by: a) delegating responsibility to the Group s Governing Body to oversee how it discharges this duty, including; i) ensuring that the group operates within the corporate governance framework (i.e. its standing order, scheme of delegations and standing financial instructions) ii) establishing an audit committee to assist the Governing Body in delivering its responsibilities for the conduct of public business, and the stewardship of funds under its control. In particular, providing assurance to the Governing Body that an appropriate system of internal control is in place to ensure that: business is conducted in accordance with the law and proper standards; public money is safeguarded and properly accounted for; affairs are managed to secure economic, efficient and effective use of resources; reasonable steps are taken to prevent and detect fraud and other irregularities. iii) iv) holding meetings of the Governing Body in public to ensure appropriate scrutiny and accountability; publishing, at least annually sufficient information to demonstrate compliance with this general duty across all functions; v) holding an annual general meeting in public; vi) having regard to any guidance or requirements published by NHS England. 5.2.4. Act with a view to securing continuous improvement to the quality of services 26 by: a) delegating responsibility to the Group s Governing Body who will discharge this responsibility by establishing a quality committee and delegating responsibility for ensuring discharge of the duty b) the quality committee will ensure that the duty is discharged by: i) developing and implementing a comprehensive quality strategy that sets out how NHS Norwich CCG will be assured that commissioned 25 26 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 Norwich Clinical Commissioning Group s Constitution - 20 -
services are being delivered in a high quality and safe manner, ensuring that quality sits at the heart of everything NHS Norwich CCG does; ii) iii) iv) ensuring that the principles of quality assurance and governance are integral to performance monitoring arrangements for all NHS Norwich CCG commissioned services and are embedded within consultation, service development and redesign, evaluation of services and decommissioning of services; leading the development and implementation of the NHS Norwich CCG quality strategy and quality assurance framework; providing regular reports to the Governing Body at agreed intervals covering the activities of the committee and demonstrating progress; v) having regard to any guidance or requirements published by NHS England. 5.2.5 Assist and support NHS England in relation to the Board s duty to improve the quality of primary medical services 27 by: a) delegating responsibility to the group s Governing Body who will discharge this responsibility by establishing a quality committee and delegating responsibility for ensuring discharge of the duty. b) the quality committee will ensure that progress is reported regularly to the Governing Body c) having regard to any guidance or requirements published by NHS England. 5.2.6. Have regard to the need to reduce inequalities 28 by: a) delegating responsibility to the Group s Governing Body who will i) develop and implement a commissioning strategy that sets out how NHS Norwich CCG will commission services and provide assurance that NHS Norwich CCG is commissioning services in line with the needs of the local population and strategic objectives of the group in order to reduce health inequalities. ii) have regard to any guidance or requirements published by NHS England. 5.2.7. Promote the involvement of patients, their carers and representatives in decisions about their healthcare 29 and act with a view to enabling patients to make choices 30 by: 27 28 See section 14S of the 2006 Act, inserted by section 26 of the 2012 Act See section 14T of the 2006 Act, inserted by section 26 of the 2012 Act NHS Norwich Clinical Commissioning Group s Constitution - 21 -
a) delegating responsibility to the Group s Governing Body who will discharge this responsibility by establishing a quality committee and delegating responsibility for ensuring discharge of the duty b) the Quality Committee will ensure that patients, carers and representatives are given the right to choose a GP and change to another if they are not happy; the right to choose, if applicable, which hospital they go to if referred to a specialist; and the right to be involved in decisions about their healthcare and to be given the information they need to do this; c) reporting progress to the Governing Body on a regular basis by the Quality Committee; d) having regard to any guidance or requirements published by NHS England. 5.2.8. Obtain appropriate advice 31 from persons who, taken together, have a broad range of professional expertise in healthcare and public health by: a) delegating responsibility to the group s Governing Body to ensure that NHS Norwich CCG has a properly constituted Governing Body which includes a mix of clinical and non-clinical expertise, including but not limited to GP s, secondary care clinicians, registered nurses, experienced and capable officers and independent lay members with a range of skills and expertise; b) ensuring that local healthcare professionals and others with experience and expertise are widely consulted on the development of NHS Norwich CCG s commissioning plan and in the development and implementation of any other commissioning or decommissioning plans; c) ensuring that the views of a range of clinicians from different specialisms and areas of expertise are taken into account when considering issues relating to quality and quality improvement. 5.2.9. Promote innovation 32 and Promote research and the use of research 33 by: 29 30 31 32 33 See section 14U of the 2006 Act, inserted by section 26 of the 2012 Act See section 14U of the 2006 Act, inserted by section 26 of the 2012 Act See section 14W of the 2006 Act, inserted by section 26 of the 2012 Act 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 Norwich Clinical Commissioning Group s Constitution - 22 -
a) delegating responsibility to the Group s Governing Body to ensure that innovation in the provision of health services and research on matters relevant to health service and the use in the health service of evidence obtained by research, are core to the way which NHS Norwich CCG operates. The constitution sets out the core requirements delegated by the governing body in respect of delivery of research duties for NHS Norwich CCG. The key elements of this are a commitment to: a) championing a research culture by adopting policy and annual plans in respect of research to oversee discharge of this duty b) requiring progress of delivery of the duty to be monitored through the governing body reporting mechanism c) maintain a strategic overview of local and national research by carrying out board activities with research identified as a major substantive item on the quarterly Governing Council agenda s d) interpreting, adopting and implementing research evidence through commissioning processes to meet the objectives of the CCG Supported by: a) Clear arrangements under the Research and Development agreement with the designated Research Service hosting body b) CCG committees considering regular reports from the Research Service Provider c) Supporting Research plans for delivering research, encouraging patient engagement and the use of research evidence. With NHS England encourage appropriate primary care services learning from research audit and incident management. d) Encouraging and directing research ideas from commissioners, providers and patients into local research development mechanisms e) Ensuring that appropriate facilities are made available, through the commissioning process, to universities which have a medical or dental school in connection with research. f) Agreeing a mechanism to ensure that the NHS meets statutory requirements for awarding treatment costs for patients who are taking part in research funded by Government and research charity partner organisations. 5.2.10 Have regard to the need to promote education and training 34 for persons who are employed, or who are considering becoming employed, in an activity which involves or is connected with the provision of services as part of the health 34 See section 14Z of the 2006 Act, inserted by section 26 of the 2012 Act NHS Norwich Clinical Commissioning Group s Constitution - 23 -
service in England so as to assist the Secretary of State for Health in the discharge of his related duty 35 by: a) delegating responsibility to the Group s Governing Body who will develop and implement an organisational development plan, implementation of which will be monitored by the Governing Body, with regular updates on progress reported to the group. 5.2.11 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 36 by: a) delegating responsibility to the Group s Governing Body for ensuring that services (health and social care) are provided in an integrated way: i) improve the quality of services, including the outcomes that are achieved from their provision; ii) reduce inequalities between persons with respect to their ability to access those services or with respect to the outcomes achieved for them by the provision of those services. b) Having regard to any guidance or requirements published by NHS England. 5.3. General Financial Duties the group will perform its functions so as to: 5.3.1. Ensure its expenditure does not exceed the aggregate of its allotments for the financial year 37 by a) delegating responsibility to the Chief Finance Officer, who is accountable to the Governing Body, to provide a performance framework which proactively manages NHS Norwich CCG s financial, performance and quality, innovation, productivity and prevention (QIPP) agenda. Regular reports on the in-year position and year end forecasts will be presented to the Governing Body; b) delegating responsibility to the Audit Committee to assist NHS Norwich CCG to deliver its responsibilities for the conduct of public business and the funds under its control. In particular the committee will seek to provide assurance to the Governing Body on at least an annual basis that an appropriate system of internal control is in place to ensure that; i) business is conducted in accordance with the law and proper standards; ii) public money is safeguarded and properly accounted for; 35 36 37 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 See section 223H(1) of the 2006 Act, inserted by section 27 of the 2012 Act NHS Norwich Clinical Commissioning Group s Constitution - 24 -
iii) iv) financial statements are prepared in a timely fashion, and give a true and fair view of the financial position of the group; affairs are managed to secure economic, efficient and effective use of resources; v) reasonable steps are taken to prevent and detect fraud and other irregularities. vi) having regard to any guidance or requirements published by NHS England. 5.3.2. 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 38 by a) delegating responsibility to the Chief Finance Officer, who is accountable to the Governing Body, to provide a performance framework which proactively manages NHS Norwich CCG s financial, performance and quality, innovation, productivity and prevention (QIPP) agenda. Regular reports on the in-year position and year end forecasts will be presented to the Governing Body; b) Delegating responsibility to the Audit Committee to assist NHS Norwich CCG to deliver its responsibilities for the conduct of public business and the funds under its control. In particular the committee will seek to provide assurance to the Governing Body on at least an annual basis that an appropriate system of internal control is in place to ensure that; i) business is conducted in accordance with the law and proper standards; ii) iii) iv) public money is safeguarded and properly accounted for; financial statements are prepared in a timely fashion, and give a true and fair view of the financial position of the group; affairs are managed to secure economic, efficient and effective use of resources; v) reasonable steps are taken to prevent and detect fraud and other irregularities. vi) having regard to any guidance or requirements published by NHS England. 5.3.3. 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 39 by 38 See sections 223I(2) and 223I(3) of the 2006 Act, inserted by section 27 of the 2012 Act NHS Norwich Clinical Commissioning Group s Constitution - 25 -
a) delegating responsibility to the Chief Finance Officer, who is accountable to the Governing Body, to provide a performance framework which proactively manages NHS Norwich CCG s financial, performance and quality, innovation, productivity and prevention (QIPP) agenda. Regular reports on the in-year position and year end forecasts will be presented to the Governing Body; b) delegating responsibility to the Audit Committee to assist NHS Norwich CCG to deliver its responsibilities for the conduct of public business and the funds under its control. In particular the committee will seek to provide assurance to the Governing Body on at least an annual basis that an appropriate system of internal control is in place to ensure that; i) business is conducted in accordance with the law and proper standards; ii) iii) iv) public money is safeguarded and properly accounted for; financial statements are prepared in a timely fashion, and give a true and fair view of the financial position of the group; affairs are managed to secure economic, efficient and effective use of resources; v) reasonable steps are taken to prevent and detect fraud and other irregularities. vi) having regard to any guidance or requirements published by NHS England. 5.3.4. Publish an explanation of how the group spent any payment in respect of quality made to it by NHS England 40 by a) delegating responsibility to the Chief Finance Officer, who is accountable to the Governing Body, to provide a performance framework which proactively manages NHS Norwich CCG s financial, performance and quality, innovation, productivity and prevention (QIPP) agenda. Regular reports on the in-year position and year end forecasts will be presented to the Governing Body; b) delegating responsibility to the audit committee to assist NHS Norwich CCG to deliver its responsibilities for the conduct of public business and the funds under its control. In particular the committee will seek to provide assurance to the Governing Body on at least an annual basis that an appropriate system of internal control is in place to ensure that; 39 40 See section 223J of the 2006 Act, inserted by section 27 of the 2012 Act See section 223K(7) of the 2006 Act, inserted by section 27 of the 2012 Act NHS Norwich Clinical Commissioning Group s Constitution - 26 -
i) business is conducted in accordance with the law and proper standards; ii) iii) iv) public money is safeguarded and properly accounted for; financial statements are prepared in a timely fashion, and give a true and fair view of the financial position of the group; affairs are managed to secure economic, efficient and effective use of resources; v) reasonable steps are taken to prevent and detect fraud and other irregularities. vi) having regard to any guidance or requirements published by NHS England. 5.4. Other Relevant Regulations, Directions and Documents 5.4.1. 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. 5.4.2. 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. NHS Norwich Clinical Commissioning Group s Constitution - 27 -