NHS Dudley
ClinicalCommissioning Group
GoverningBody’s
Primary CareCommissioningCommittee
Terms ofReference
Introduction
1. ThePrimaryCareCommissioningCommittee(the‘Committee’)isestablishedinaccordance withparagraph6.9.3(h) ofNHSDudleyClinicalCommissioningGroup’s(CCG)constitution. These termsofreferencesetoutthe membership,remit,responsibilitiesandreporting arrangementsoftheCommitteeandwillhaveeffectasifincorporatedintotheconstitution. TheCommitteetermsofreferencewillbereviewedannually.Anychangestothetermsof reference will be approved bythe GoverningBody.
2. TheChiefExecutiveofNHSEngland,announcedon1May2014thatNHSEnglandwas invitingCCGstoexpandtheirroleinprimarycarecommissioningandtosubmitexpressions ofinterestsettingouttheCCG’spreferenceforhowitwouldliketoexerciseexpanded primary medicalcarecommissioningfunctions. OneoptionavailablewasthatNHSEngland woulddelegatetheexerciseofcertainspecifiedprimary carecommissioningfunctionstoa CCG.
3. Inaccordancewithitsstatutorypowersundersection13ZoftheNationalHealthServiceAct
2006(asamended).NHSEnglandhasdelegatedtheexerciseofthefunctionsspecifiedin
Schedule2tothesetermsofreferencetoNHSDudleyCCG.Thedelegationissetoutin
Schedule1.
4. The CCG has established the NHS Dudley CCG Primary Care Commissioning Committee (“Committee”). The Committee will function as a corporate decision- making body for the management of the delegated functions and the exercise of thedelegatedpowers.
5. Itisacommitteecomprisingrepresentativesofthefollowingorganisations:
NHSDudleyCCG;and
TheOfficeofPublicHealth,DudleyMetropolitanBoroughCouncil
- A representative from NHS England will also be in attendance
StatutoryFramework
6. NHS England hasdelegatedtothe CCG authorityto exercise theprimarycarecommissioning functionssetout in Schedule 2in accordancewith section13Z of the NHS Act.
7. Arrangements made under section 13Z may be on such terms and conditions (including terms as to payment) as may be agreed between NHS England and the CCG.
8. Arrangements made under section 13Z do not affect the liability of NHS England for the exercise of any of its functions. However, the CCG acknowledges that in exercising its functions (including those delegated to it), it must comply with the statutoryduties setoutinChapter A2 of the NHSAct, including:
a)Managementof conflictsof interest (section14O);
b)DutytopromotetheNHSConstitution(section14P);
c)Dutytoexerciseitsfunctionseffectively,efficientlyandeconomically (section14Q);
d)Dutyastoimprovementinqualityof services(section14R);
e)Duty in relationtoqualityofprimarymedical services (section14S);
f) Dutiesastoreducinginequalities(section14T);
g)Dutytopromotetheinvolvementofeachpatient (section14U);
h)Dutyastopatient choice(section14V);
i) Dutyastopromotingintegration(section14Z1);
j) Publicinvolvementandconsultation(section14Z2).
9. TheCCGwillalsoneedtospecifically,inrespectofthedelegatedfunctions fromNHSEngland, exercisethosefunctions setoutbelow:
Dutytohaveregardtoimpactonservicesincertainareas(section13O);
Dutyasrespectsvariation inprovisionof healthservices(section13P).
10.TheCommitteeisestablishedasacommitteeoftheGoverningBodyofNHSDudleyCCGin
accordancewith Schedule1Aofthe“NHSAct”.
11.TheCCG(andCommittee)issubjecttodirectionsmadebyNHSEnglandorbytheSecretary ofStateforHealth.
RoleoftheCommittee
12.TheCommitteehasbeenestablishedinaccordancewiththeabovestatutoryprovisionsto enabledecisionsonthereview,planningandprocurementofprimary careservicesinDudley, underdelegatedauthorityfromNHSEngland.
13.In performing its role the Committee will exercise its management of the functions in accordancewiththeagreementbetweenNHSEnglandandNHSDudleyCCG.
14.ThefunctionsoftheCommitteeareundertakeninthecontextofcontinuallyimprovingthe quality ofcareprovidedtopatientswithintheresourcesavailable.Thisisunderpinnedby equality ofaccesstoservices,increasedefficiency,productivity,valueformoney andto minimisebureaucracy.
15.The Committee will have at its heart three key principles, of shared ownership, shared responsibilityand shared benefits to createjointlythebest healthcarefor theregisteredpatients ofDudley.
16.TheroleoftheCommitteeshallbetocarryoutthefunctionsrelatingtothecommissioningof primarymedicalservicesundersection83oftheNHSAct.
17.Thisincludesthefollowing:
GMS,PMS and APMS contracts(including the design ofPMS and APMScontracts,monitoring ofcontracts,takingcontractualactionsuchasissuingbranch/remedial notices,and removinga contract);
Newly designed enhanced services (“Local Enhanced Services” and “Directed Enhanced
Services”);
DesignoflocalincentiveschemesasanalternativetotheQualityOutcomesFramework
(QOF);
Decisionmakingon whethertoestablishnewGPpracticesinanarea;
Approvingpracticemergers;and
Makingdecisionson‘discretionary’payment (e.g.,returner/retainerschemes).
18. TheCCGwillalsocarryoutthefollowingactivities:
a)ToplanforsustainableprimarymedicalcareservicesinDudley;
b)ToreviewprimarymedicalcareservicesinDudleywiththeaimoffurtherimprovingthe careprovidedtopatients
c)Toco-ordinatethe approachtothecommissioningofprimarycareservicesgenerally;
d)Tomanagethebudgetforcommissioningof primarymedicalcareservicesin Dudley.
GeographicalCoverage
19.The Committee will be responsible for commissioning primary care medical services coterminouswiththegeographicalboundariesof NHSDudleyCCG.
Partnership
20. TheCommitteewillberesponsibleforworkingwithotherstatutoryandvoluntaryagenciesto maximisethebenefits frominvestmentinprimary careservices forthepeopleservedby the CCG.
Membership
21.TheCommitteeshallconsistofthoseindividualsincludedasSchedule3.Allindependent membersofthegoverningbodyexcepttheChairoftheAuditCommitteewillbeeligiblefor membership.Thatis,thelaymembersforGovernance andQualitySafetyandtheSecondary CareSpecialistDoctor.TheChiefFinanceOfficer,ChiefQualityNursingOfficer,andaPublicHealthrepresentativewillalsobemembers of theCommittee.
22. TheChairoftheCommitteewillbeappointedbytheGoverningBody.Unlessthereareany materialreasons fornotdoingsothispersonwillbetheGoverningBodylaymember responsibleforgovernancematters. Wherethelatterisnotthecasethematerialreasonsmust bedocumented.
23. TheViceChair oftheCommitteewillbeappointedbytheCommitteemembers.
24.Otherpeoplethatwillnormallybeinattendance(butnon-voting)willincludeaHealthWatchrepresentative,aHealthandWellbeingBoardrepresentative,arepresentativeofthePatient OpportunityPanelandanLMC representative.
25.GoverningBodyelectedGPs,ClinicalExecutivesorotherGPmemberswillbeinattendancefor thoseagendaitems thatthe Committee membershiphasdeemed appropriate fortheirinput. Thiswillbeinanadvisory andnon-votingcapacity.TheCCG’s “RegisteringInterestsand ManagingConflictsofInterestPolicy”willbeobservedandcomplied withatalltimes.
MeetingsandVoting
26.TheCommitteewilloperateinaccordancewiththeCCG’sStandingOrdersand“Registering InterestsandManagingConflictsofInterestPolicy”.TheSecretarytotheCommitteewillbe responsibleforgivingnoticeofmeetings.Thiswillbeaccompanied byanagendaand supportingpapersandsenttoeachmemberrepresentative nolater than 5 workingdaysbefore thedateofthe meeting.WhentheChairoftheCommitteedeemsitnecessary inlightofthe urgentcircumstances to calla meetingatshortnotice,the notice period shallbesuch ass/he shall specify.Thereasonsfor calling ameeting at short noticewillbe recordedinthe minutesof themeeting.
27. EachmemberoftheCommittee as defined in Schedule 3shallhaveonevote. TheCommitteeshallreachdecisionsby a simple majorityofmemberspresent,butwith theChairhavingasecond and decidingvote,if necessary.
Quorum
28.AmeetingoftheCommitteewillbequorateprovidedthatatleast4membersarepresentof which:
Onemustbeeither the Chair orVice-Chair oftheCommittee
OnemustbetheChiefFinanceOfficer orChiefNursingOfficer
Frequencyofmeetings
29.TheCommitteewillformallymeetonamonthlybasis.There maybeaneed fortheCommittee tomeetinformally fromtimetotime.Anyinformalmeetingswillsupporttheworkofthe Committeeandwillhavenodelegateddecision-makingauthority.
30.MeetingsoftheCommitteeshall:
a) Beheldinpublic, subjecttotheapplicationof27
b) theCommitteemayresolvetoexcludethepublicfromameetingthatisopentothepublic
(whetherduringthe wholeorpart oftheproceedings)wheneverpublicity wouldbeprejudicial to thepublicinterestbereason oftheconfidential natureofthebusinessto betransactedor forotherspecial reasonsstated inthe resolutionand arisingfrom thenatureofthatbusiness oroftheproceedingsorforanyotherreasonpermittedby thePublicBodies(Admissionto Meetings)Act1960as amendedorsucceededfromtimetotime.
OperationoftheCommittee
31.GPsandpatientsarerepresentedinthecommitteethroughthe inclusionofnon-votingmembers fromtheLMC;HealthwatchandthePatientOpportunity Panel.
32.MembersoftheCommittee haveacollectiveresponsibilityfortheoperationof theCommittee.
33.TheCommitteemaydelegatetaskstosuch people,sub-committeesorindividualmembersas itshall seefit,providedthatany such delegations are consistentwiththeCCG’s relevant governance arrangements,arerecordedin ascheme ofdelegation,are governedby terms of referenceasappropriateandreflectappropriatearrangements forthemanagementofconflicts ofinterest.
34.TheCommitteemaycallexperts,asrequired,toattendmeetingsandinformdiscussions.
35.MembersoftheCommitteeshallrespectconfidentialityrequirementsassetout
intheCCG’sConstitution, and complywithSection8oftheConstitution: Standardsof Business
Conduct and ManagingConflictsofInterest.
36. Followingeachmeeting,theCommitteewillpresentitsminutestoNHS Englandandreporttothe governingbodyoftheCCG(includingtheminutesofanysub- committeesto whichtaskshavebeen delegatedunderparagraph32above).
37.The Committee will also comply with any reporting requirements set out in the CCG Constitution.
AccountabilityoftheCommittee
38.TheCommitteewillbedirectlyaccountableforthecommitmentoftheresources/budget delegatedtotheCCG byNHSEnglandfor thepurposeofcommissioning primarycare medical services.Thisincludesaccountability fordeterminingappropriatearrangements forthe assessmentandprocurementofprimary caremedicalservices,andensuringthattheCCG’s responsibilitiesforconsulting withits GP membersandthepublicareproperlyaccountedfor as partoftheestablishedcommissioningarrangements.
39. Fortheavoidanceofdoubt,theCCG’sSchemeofReservationDelegation,StandingOrders andPrimeFinancialPolicieswillprevailintheeventofanyconflictbetweenthesetermsof referenceandtheaforementioneddocuments.
Relationship with the Governing Body
40. The Committee is accountable to the governing body to ensure that it is effectively discharging its functions.
40. For the next meeting of the governing body following each meeting of the Committee, the Chair of the Committee will provide a written summary of the key matters covered by the meeting, including any action or decisions reserved for the governing body.
41. A report from of each meeting of the Committeewill be presented to the next meeting of the governing body for information by the Chair of the Committee.
ProcurementofAgreedServices
42.Theprocurementarrangementswillbesetoutinthedelegationagreement(Schedule1and
Schedule2tothisTermsofReference) betweenNHSDudleyCCGandNHSEngland.
Decisions
43. TheCommitteewillmakedecisions withintheboundsofitstermsofreference.
44.ThedecisionsoftheCommitteeshallbebindingonNHSEnglandandNHSDudleyCCG
wheretheyarewithintheboundsofthetermsof reference.
ReviewofCommitteeEffectiveness
45.TheCommitteewillannuallyself-assessand report tothegoverning bodyandNHSEngland on itsperformanceinthedeliveryofitsobjectives.
ReviewofTermsofReference
46.TheCommittee’stermsof reference will be reviewed annually.
47.Anychangestothetermsofreferencewill be approved bythegoverning body.
[Signatureprovisions] Schedule1- Delegation
TheroleoftheCommitteeshallbetocarryoutthefunctionsrelatingtothecommissioningof primarymedicalservicesundersection83oftheNHSAct.Thisincludesthefollowing:
GMS,PMS and APMS contracts(including the design ofPMS and APMScontracts,monitoring ofcontracts,takingcontractualactionsuchasissuingbranch/remedial notices,and removinga contract);
Newly designed enhanced services (“Local Enhanced Services” and “Directed Enhanced
Services”);
DesignoflocalincentiveschemesasanalternativetotheQualityOutcomesFramework
(QOF);
Decisionmakingon whethertoestablishnewGPpracticesinanarea;
Approvingpracticemergers;and
Makingdecisionson‘discretionary’payment (e.g.,returner/retainerschemes).
Schedule2-Delegatedfunctions-tobeaddedwhenfinalarrangementconfirmed
Schedule3
Members
ChiefFinanceOfficer
ChiefQualityNursingOfficer
LayMemberfor Governance
LayMemberfor Quality Safety SecondaryCare Specialist Doctor
OfficeofPublic Health DudleyMBC representative
Attendees
HealthWatch representative
Health and Wellbeing Board representative
Patient Opportunity Panel representative
Dudley Local Medical Committee representative
Lay GP member