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Enclosure: MAgenda item: 16

GOVERNING BODY

Title of paper: Corporate Governancei. Terms of Reference GP Executive Groupii. Scheme of Reservation and Delegation

Date of meeting: 23 March 2016

Presented by: Diane Jones Title: Director of Integrated Governance& email contact: [email protected]

Prepared by: Colin Nash Title: Corporate Secretary& email contact: [email protected]

1. To commission high quality, cost effective services to meet the needs of local people whichimprove health outcomes and reduce inequalities.2. To ensure that the patients’ and the public’s voice is heard so that we improve the qualityof the services that we commission for the diverse needs of our population.

3. To develop Greenwich CCG as a clinically driven organisation with effective memberengagement, that can attract and retain excellent staff, deliver effective governance and itsfull statutory and financial duties.

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4. To create and optimise a data and intelligence rich environment to inform commissioningdecisions at CCG, Transformation Steering Group, Syndicate and practice level.5. To develop a long term approach to improving healthcare and delivering more integratedservices for the population of Greenwich delivered by sustainable providers throughpartnership working with RBG, local providers, the community and voluntary sector.

Please provide a summary of the paper being presented

Purpose of the report:This paper asks the Governing Body to approve revised terms of reference for the GP ExecutiveGroup and a revised Scheme of Reservation and delegation.

Issues Arising:Terms of Reference GP Executive Group

i. The Chair changed the structure of GP Executive Group meetings to allow for separatemeetings with the Senior Management Team, Syndicate Leads and the SeniorManagement Team and Syndicate Leads together.

ii. The GP Executive Group is a discursive group which does not make decisions on behalf ofthe CCG. The current terms of reference refers to “approval” of clinical aspects of thearrangements for discharging the statutory duties associated with NHS Greenwich ClinicalCommissioning Group’s commissioning functions. This has been amended to “consider”.

iii. Part of the CCG’s Project Train Tracks review of Governance, aimed to ensure a degree ofconsistency in the governance standards expected from Governing Body Committees.Standard clauses to cover this were drafted for inclusion in terms of reference.

Appendix 1 addresses these three points in a tracked changes version, so Governing bodymembers can see how the terms of reference have been changed.

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Scheme of Reservation and Delegationi. This has been reviewed to ensure it reflects the CCG’s current committee structure and

Constitution, including reference to the Greenwich Financial Recovery Board.Appendix 2 sets out the amendments made in a tracked changes version so Governing bodyMembers can see how the document has changed.

Summary of Actions, if any, following this meeting:If approved by the Governing Body the CCG will work to these new terms of reference and revisedScheme.

Previous committee involvement:None.

Recommendations to the Governing Body: Approve the terms of reference Approve the scheme of Reservation and Delegation

(Please provide details below where Yes is indicated below)

Impact on Governing Body Assurance Framework (x) Yes No X N/AImpact on Environment (x) Yes No X N/ALegal Implications (x) Yes No X N/AResource and or financial implications (x) Yes No X N/AEquality impact assessment (x) Yes No X N/APrivacy impact assessment (x) Yes No X N/AImpact on current NHS Outcomes Framework areas (x) Yes No X N/APatient and Public Involvement (x) Yes No X N/ACommunications and Engagement (x) Yes No x N/AImpact on CCG Constitution (x) Yes x No N/A

Attachments:

(i) Terms of Reference for GP Executive Group

(ii) Scheme of Reservation and Delegation

Chair Dr Hany Wahba Chief Officer Annabel BurnPage 1 of 3

DRAFT V3.0

DRAFT TERMS OF REFERENCEGP Executive Group

1. Constitution & Purpose

Constitution

The GP Executive Group (GPE) is a committee of the Governing Body.

Purpose

The GP Executive (GPE) approves considers clinical aspects of thearrangements for discharging the statutory duties associated with NHSGreenwich Clinical Commissioning Groups commissioning functions,including but not limited to, promoting the involvement of each patient,patient choice, reducing inequalities, quality improvement of services,obtaining appropriate advice and ensuring public engagement andconsultation.

It has also been agreed that part of the GPE will meet separately withthe Senior Management Team, Syndicate Leads and the with theSenior Manangement Team and Syndicate Leads together. beattended by members of the Senior Management Team (SMT) oroOther officers of NHS Greenwich CCG will attend as appropriate andbe utilised so the meeting can be used as a forum to increaseawareness, shared learning and enhance corporate understandingabout current business and issues facing the CCG.

This meeting structure will continue for as long as both the GPE andthe SMT agree that it is useful and mutually beneficial.

2. Duties/ Roles and Responsibilities

See above.

3. Accountability

The GPE is accountable to Governing Body.

4. Committee Membership

a. Membership will include all GP Members of the Governing Body


DRAFT V3.0

b. The GPE will be chaired by the GP Chair of the Governing Bodyor in his / her absence one of the other GP Members of theGoverning Body.

c. The GPE may invite other officers of the CCG or any otherperson to attend their meetings to assist their deliberations.

d. When the GPE is meeting with the SMT that part of the meetingwill be chaired by the Chief Officer or in their absence anothermember of the SMT.

5. Standards expected

a. The Chair will confirm the agenda for the meeting 14 days inadvance.

b. A person presenting a paper at a meeting will be responsible forensuring that the papers and covering sheet for the meeting isavailable for circulation by the 9 days before the meeting.

c. Agenda and papers should normally be circulated to committeemembers 7 days in advance of the meeting.

d. Members are required to attend a minimum of 75% of meetings.e. Declaration of interests will be a standing item on the agenda

and members must declare, at the start of the meeting, anyinterest which conflicts with the business on the agenda

6. Quorum Rules

A quorum shall be four GP Members of the Governing Body.

The meeting between the GPE and the SMT is a discussion forum andno decisions binding the CCG will be made.

7. Reporting Arrangements and Supporting Structures

a. As a discussion forum minutes of these meetings will be for internalreference and not formally reported to the Governing Body.

b. The chair of the GPE will be responsible for determining whethermatters discussed at the GPE need also to be brought to theGoverning Body and placing those items on the governing Governingbody Body agenda.

c. The GPE will receive administrative support from the corporate teamwithin the CCG.


DRAFT V3.0

8. Frequency of Meetings

a. The Group will meet at a frequency determined by the GPEMembers.

9. Monitoring Adherence to the Terms of Reference / Review

a. The Terms of Reference and membership will be reviewed asrequired, and at least on an annual basis. Any changes must beapproved by the Governing Body.

10. Equality Statement

NHS Greenwich CCG is committed to promoting equality in all itsresponsibilities – as commissioner of services, as a partner in the localeconomy and as an employer. All committees of the Governing Bodyhave a duty to ensure that it contributes to ensuring that all users andpotential users of services and employees are treated fairly andrespectfully with regard to the protected characteristics of age, disability,gender, reassignment, marriage or civil partnership, pregnancy andmaternity, race, religion, sex and sexual orientation.

APPENDIX D C - SCHEME OF RESERVATION & DELEGATION

1 SCHEDULE OF MATTERS RESERVED TO THE CCG AND SCHEME OF DELEGATION

1.1 The arrangements made by the Group as set out in this Scheme of Reservation andDelegation of decisions shall have effect as if incorporated in the Group’sConstitution.

1.2 The Group remains accountable for all of its functions, including those that it hasdelegated.

1.3 Subject to such directions as may be given by the Secretary of State, the GoverningBody may make arrangements for the exercise, on behalf of the Group, of any of itsfunctions by a committee, sub-committee appointed by virtue of Standing OrderNo. 5, or by a member of the Governing Body or an individual member of theGroup.

1.4 The current scheme of Reservation and Delegation is set out in the table thatfollows.

Policy Area DecisionReserved to the

Membership

Reserved ordelegated to

Governing Body

DesignatedCommittee

AccountableOfficer

Chief FinancialFinance Officer

1REGULATION AND

CONTROL

Determine the arrangements by which themembers of the Group approve those decisionsthat are reserved for the membership.

2 REGULATION ANDCONTROL

Consideration and approval of applications to theNHS Commissioning Board on any matterconcerning changes to the Group’s constitution,including terms of reference for the Group’sgoverning body, its committees, membership ofcommittees, the overarching scheme of reservationand delegated powers, arrangements for takingurgent decisions, standing orders and primefinancial policies.


Consideration and approval of terms of referencefor the Group’s governing body, its committees,membership of committees, the overarchingscheme of reservation and delegated powers,arrangements for taking urgent decisions, standingorders and prime financial policies.


Exercise or delegation of those functions of theGroup which have not been retained as reserved bythe Group, delegated to the governing body orother committee or sub-committee or specifiedmember or employee.


Prepare the Group’s overarching scheme ofreservation and delegation, which sets out thosedecisions of the Group reserved to the membershipand those delegated to the:

Group’s governing body; committees and sub-committees of the Group,

or its members or employees ,

and sets out those decisions of the governing bodyreserved to the governing body and thosedelegated to the:


Membership


Governing Body

DesignatedCommittee

AccountableOfficer


governing body’s committees and sub-committees,

members of the governing body, an individual who is member of the Group

but not the governing body or a specifiedperson;

joint commissioning arrangements for inclusion in the Group’s constitution.


Approval of the Group’s overarching scheme ofreservation and delegation.


Prepare the Group’s operational scheme ofdelegation, which sets out those key operationaldecisions delegated to individual employees of theGroup, not for inclusion in the Group’sconstitution.


Approval of the Group’s operational scheme ofdelegation that underpins the Group’s ‘overarchingscheme of reservation and delegation’ as set out inits constitution.


Prepare detailed financial policies that underpinthe Group’s prime financial policies.


Approve detailed financial policies. GreenwichExecutive Group


Approve arrangements for managing exceptionalfunding requests.

GreenwichExecutive Group


Set out who can execute a document by signature/ use of the seal.

13 PRACTICE MEMBERREPRESENTATIVESAND MEMBERS OF

Approve the arrangements for

identifying practice members to representpractices in matters concerning the work of


Membership


Governing Body

DesignatedCommittee

AccountableOfficer


THE GOVERNINGBODY

the Group; and

appointing clinical leaders to represent theGroup’s membership on the Group’s governingbody, for example through election (ifdesired).

14 PRACTICE MEMBERREPRESENTATIVESAND MEMBERS OFTHE GOVERNING

BODY

Approve the appointment of governing bodymembers, the process for recruiting and removingnon-elected members to the governing body(subject to any regulatory requirements) andsuccession planning.

15 PRACTICE MEMBERREPRESENTATIVESAND MEMBERS OFTHE GOVERNING

BODY

Approve arrangements for identifying the Group’sproposed accountable officer.

16 STRATEGY ANDPLANNING

Agree the vision, values and overall strategicdirection of the Group.


Approval of the Group’s operating structure.


Approval of the Group’s commissioning plan.


Approval of the Group’s corporate budgets thatmeet the financial duties as set out in Section 5.3of the main body of the constitution.


Approval of variations to the approved budgetwhere variation would have a significant impact onthe overall approved levels of income andexpenditure or the Group’s ability to achieve itsagreed strategic aims.

21 ANNUAL REPORTSAND ACCOUNTS

Approval of the Group’s annual report and annualaccounts.

AuditCommittee

22 ANNUAL REPORTS Approval of the arrangements for discharging the


Membership


Governing Body

DesignatedCommittee

AccountableOfficer


AND ACCOUNTS Group’s statutory financial duties.

23 HUMAN RESOURCES Approve the terms and conditions, remunerationand travelling or other allowances for governingbody members, including pensions and gratuities.

RemunerationCommittee

24 HUMAN RESOURCES Approve terms and conditions of employment forall employees of the Group including, pensions,remuneration, fees and travelling or otherallowances payable to employees and to otherpersons providing services to the Group.


25 HUMAN RESOURCES Approve any other terms and conditions of servicesfor the Group’s employees.


26 HUMAN RESOURCES Determine the terms and conditions ofemployment for all employees of the Group.


27 HUMAN RESOURCES Determine pensions, remuneration, fees andallowances payable to employees and to otherpersons providing services to the Group.


28 HUMAN RESOURCES Recommend pensions, remuneration, fees andallowances payable to employees and to otherpersons providing services to the Group.


29 HUMAN RESOURCES Approve disciplinary arrangements for employees,including the accountable officer (where he/she isan employee or member of the Group) and forother persons working on behalf of the Group.

30 HUMAN RESOURCES Review disciplinary arrangements where theaccountable officer is an employee or member ofanother clinical commissioning group.

31 HUMAN RESOURCES Approval of the arrangements for discharging theGroup’s statutory duties as an employer.

32 HUMAN RESOURCES Approve human resources policies for employeesand for other persons working on behalf of theGroup.

Greenwich

Executive Group


Membership


Governing Body

DesignatedCommittee

AccountableOfficer


33 QUALITY AND SAFETY Approve arrangements, including supportingpolicies, to minimise clinical risk, maximise patientsafety and to secure continuous improvement inquality and patient outcomes.

QualityCommittee

34 QUALITY AND SAFETY Approve arrangements for supporting the NHSCommissioning BoardNHS England in discharging itsresponsibilities in relation to securing continuousimprovement in the quality of general medicalservices.

QualityCommittee

35 OPERATIONAL ANDRISK MANAGEMENT

Prepare and recommend an operational scheme ofdelegation that sets out who has responsibility foroperational decisions within the Group.


Approve the Group’s counter fraud and securitymanagement arrangements.

AuditCommittee


Approval of the Group’s risk managementarrangements.

Audit

Committee


Approve arrangements for risk sharing and or riskpooling with other organisations (for examplearrangements for pooled funds with other clinicalcommissioning groups or pooled budgetarrangements under Section 75 of the NHS Act2006).

QualityCommittee


Approval of a comprehensive system of internalcontrol, including budgetary control, thatunderpins the effective, efficient and economicoperation of the Group.

Finance,Performance

and QIPPCommitteeGreenwichFinancial

Recovery Board


Approve proposals for action on litigation againstor on behalf of the Group.

QualityCommittee


Approve the Group’s arrangements for businesscontinuity and emergency planning.



Membership


Governing Body

DesignatedCommittee

AccountableOfficer


42 INFORMATIONGOVERNANCE

Approve the Group’s arrangements for handlingcomplaints.

QualityCommittee

43 INFORMATIONGOVERNANCE

Approval of the arrangements for ensuringappropriate and safekeeping and confidentiality ofrecords and for the storage, management andtransfer of information and data.

QualityCommittee

44 TENDERING ANDCONTRACTING

Approval of the Group’s contracts for anycommissioning support.



Approval of the Group’s contracts for corporatesupport (for example finance provision).



Approval of changes to the provision opr deliveryof assurance services to the groups includinginternal audit and counter fraud

AuditCommittee

47 PARTNERSHIPWORKING

Approve decisions that individual members oremployees of the Group participating in jointarrangements on behalf of the Group can make.

Greenwich

Executive Group

48 PARTNERSHIPWORKING

Approve decisions delegated to joint committeesestablished under Section 75 of the 2006 Act.


49 COMMISSIONING ANDCONTRACTING FORCLINICAL SERVICES

Approval of the arrangements for discharging theGroup’s statutory duties associated with itscommissioning functions, including but not limitedto promoting the involvement of each patient,patient choice, reducing inequalities, improvementin the quality of services, obtaining appropriateadvice and public engagement and consultation.

GP ExecutiveGroup

Quality

Committee

50 COMMISSIONING ANDCONTRACTING FORCLINICAL SERVICES

Approve arrangements for co-ordinating thecommissioning of services with other groups and orwith the local authority(ies), where appropriate


51 COMMUNICATONS Approving arrangements for handling Freedom ofInformation requests.

QualityCommittee

52 COMMUNICATONS Determining arrangements for handling Freedom ofInformation requests.

QualityCommittee


Membership


Governing Body

DesignatedCommittee

AccountableOfficer


53 COMMUNICATONS/INFORMATION

GOVERNANCE

Approving a comprehensive Publication Scheme forthe Group

GreenwichExecutiveCommittee

54 PRIMARY CARECOMMISSIONING

Approve primary care commissioning arrangementsin Greenwich and in common with other local CCGs

55 PRIMARY CARECOMMISSIONING

Approval of the arrangements for discharging theGroup’s statutory duties associated with itsprimary care commissioning functions, includingbut not limited to promoting the involvement ofeach patient, patient choice, reducinginequalities, improvement in the quality ofservices, obtaining appropriate advice and publicengagement and consultation.

Primary CareJoint

Committee

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