NHS Mansfield and Ashfield CCG and NHS Newark and Sherwood CCG

Clinical Executive Committee

Terms of Reference

1. Purpose

The Clinical Executive is the key sub-committee for engagement with member practices and ensures that strategic decisions and outcomes are communicated to those delivery services.

The Clinical Executive acts as an assurance body and provides constructive challenge to and approval of business cases in line with the CCGs’ Schemes of Delegation.

2. Membership

The membership of the Clinical Executive Sub-Committee should combine clinical and managerial leadership across the organisation. There should also be public health and lay representation. The importance of consistent membership is recognised and members will make all efforts to attend at least 75% meetings.

Voting Membership / Designation / Nominated representative
Chair (to be rotated with the Clinical Chair of Newark and Sherwood CCG) / Governing Body Clinical Chair -
Mansfield and Ashfield CCG / Dr Gavin Lunn
Chair (to be rotated with the Clinical Chair of Mansfield and Ashfield CCG) / Governing Body Clinical Chair -
Newark and Sherwood CCG / Dr Thilan Bartholomew
GPs / Locality representatives covering:
  • Mansfield
  • Ashfield
  • Newark
  • Sherwood
/ Dr Peter MacDougall
(Deputy Chair)
Dr Hilary Lovelock
Dr Milind Tadpatrikar
Dr Jane Selwyn
Dr Subash Das
Non-clinical members / 1 Practice Manager per CCG / Rick Gooch
Nursing and Allied Health Professions / 1 Practice Nursestate 2016
ernance Committee Neewark and Sherwood CCGectors and hold to account those directorsinancial impact analysis of each per CCG / Luella Robb
Ian Jackson
Further specialist membership / Governing Body Public Health Consultant / Barbara Brady
CCG Officers /
  • Chief Officer
  • Director of Primary Care
  • Chief Finance Officer
  • Chief Nurse
  • Director of Contracting and Urgent Care
/
  • Amanda Sullivan
  • David Ainsworth
  • Sarah Bray
  • Elaine Moss
  • Ian Ellis

Other officers, deputies and specialist advisers may be invited to attend when the Governing Body is discussing items that fall within their areas of responsibility. These attendees will not have voting rights.

3. Chair and Deputy

The CCG Clinical Chairs will chair the Committee. A nominated GP will act as deputy.

If the Chair is unable to participate in any discussion due to registering a conflict of interest then the nominated deputy will chair the meeting.

4. Quorum and Voting Arrangements

To be deemed quorate, meetings shall consist:

  • Chair, Deputy Chair or Chief Officer
  • 2 Clinicians
  • 2 Directors of the CCG other than the Chief Officer.

Nominated deputies will not count towards the quorum, nor will any member that has declared a conflict of interest in relation to any matter being discussed or voted on.

Any question where it is deemed necessary by the Chair to require a vote at a meeting shall be determined by a majority of the votes of members present and voting on the question. If necessary, the Chair or Deputy will have the casting vote.

The Clinical Executive Committee will act as a committee of the Governing Body and consult with the Governing Body on all major decisions. The Clinical Executive will make decisions on business cases where the value does not exceed £500,000.

5. Frequency of Meetings

The Clinical Executive Committee meetings are held monthly. Additional meetings may be held to ensure that appropriate consideration is given to key decisions during particular times of the year. The Clinical Executive Committee meetings will be held at a variety of locations.

6. Duties

Commissioned Services

  • To provide clinical leadership of the commissioning and decommissioning of locally delivered high quality healthcare services, within the available resources on behalf of the Newark, Sherwood, Mansfield and Ashfield patient population.
  • To provide clinical oversight of commissioning plans, including significant service changes.
  • To facilitate and support collaboration and integrated care pathways with partner organisations and other associated groups.
  • To ensure the Newark & Sherwood CCG Stakeholder Reference Group, the Mansfield and Ashfield Citizens’ Reference Panel, patient groups, voluntary sector and local government are involved in the commissioning processes.
  • To ensure the CCGs have regard for the need to reducing health inequalities in access to, and outcomes from, healthcare and quality is given the highest priority in all commissioned services.
  • To work with member practices and local providers to deliver annual commissioning plans, developed in line with the overall vision and strategic direction.
  • To support the CCGs to develop and implement plans for service reconfiguration and care pathway redesign, ensuring appropriate clinical and patient/public involvement.
  • To examine clinical quality and financial performance in lead programme areas to support decisions on decommissioning and commissioning of services through the business case procurement process and providing a decision in respect of business cases up to the value of £500,000.
  • To consider recommendations and updates from the Area Prescribing Committee via the Medicines Management Team.

Clinical Leadership

  • To identify a clinical lead for key areas of commissioning and related activity.
  • To oversee the provision of high quality healthcare training to improve the skill sets within the CCG in order to improve existing services and develop new services for patients.
  • To support the development of supportive clinical networks with other CCG’s.
  • To lead the design and development of evidence-based care management programs for clinical priorities.
  • To lead compliance against clinical priorities and the Operating and Outcomes Frameworks.
  • To facilitate or support service redesign, clinical research and innovation.
  • To have due regard and promote the public sector equality duty and the CCG’s equality objectives.
  • To receive updates from the Education Forum and support clinical development through the Protected Learning Time (PLT) events.
  • Oversee Locality Group and practice clinical strategy and service delivery performance.
  • To identify successful practices, and services, and facilitate and to share best practice.
  • To establish and maintain effective communication between the CCG and member practices to ensure timely resolution of commissioning issue.

Governance

  • To maintain an overarching view of CCG risks to support commissioning and decommissioning decisions, taking a proactive stance on risks allocated to the Committee.
  • To consider and manage conflicts of interest in relation to business case discussions and procurement decisions.
  • To manage the sub-committee operational risks ensuring mitigating action plans are monitored and challenged.
  • To escalate high level risks to the Governing Body via the Governing Body Assurance Framework where appropriate.
  • To provide the Audit & Governance Sub-Committee and/or the Governing Body with additional assurance in relation to high level risks where needed.
  • To review and approve appropriate operational CCG policies. All policies would then be received for ratification by the Quality and Risk Committee.
  • The delegated authority to set up ‘task and finish’ groups to support time bound specific areas of development where appropriate. Regular reporting should be provided through a ‘standing’ agenda item on the Clinical Executive Committee.

7. Conduct of Business

The Committee will be expected to conduct itself as an exemplar organisation, working to the Nolan seven principles of public life, namely:

•Selflessness

•Integrity

•Objectivity

•Accountability

•Openness

•Honesty

•Leadership

Members of the Committee have a collective responsibility for the operation of the Committee. They will participate in discussion, review evidence and provide objective expert input to the best of their knowledge and ability, and endeavour to reach a collective view.

The Committee may delegate tasks to such individuals, sub-committees or individual members as it shall see fit, provided that any such delegations are consistent with the parties’ relevant governance arrangements, are recorded in a scheme of delegation, are governed by terms of reference as appropriate and reflect appropriate arrangements for the management of conflicts of interest.

Members of the Committee shall respect confidentiality requirements as set out in the CCG’s Standing Orders.

8. Administration of Meetings

The Director responsible for overseeing the administration of the Committee is Mr David Ainsworth.

Agendas and supporting papers will be circulated no later than 5 working days in advance of meetings.

Any items placed on the agenda will be sent to the Committee Administrator no later than 7 working days in advance of the meeting. Items that miss the deadline for inclusion on the agenda may be added on receipt of permission of the Chair.

Minutes will be taken at all meetings and circulated to the members of the Committee. The minutes will be approved by agreement of the Committee at the next meeting. The Chair of the Committee will agree minutes if they are to be submitted to the Governing Body prior to formal approval.

The Committee will present its minutes to the Governing Body for information and consideration.

The CCGs will also comply with any reporting requirements set out in its constitution.

9. Declaration of Interests

The NHS Newark and Sherwood Clinical Commissioning Group and NHS Mansfield and Ashfield Clinical Commissioning Group have a Conflict of Interest Policy and a register of member interests.

At the beginning of each formal meeting, members will be required to declare any personal interest if it relates specifically to a particular issue under consideration. Any such declaration shall be formally recorded in the minutes for the meeting in accordance with the provisions set out in the CCG policy.

All declared interests will be managed in line with the requirements of the CCG’s Conflict of Interests Policy.

The CCGs will not award a contract for the provision of NHS healthcare services where conflicts, or potential conflicts, between interests involved in commissioning such services and the interests involved in providing them appear to affect the integrity of that award and the CCGs will keep a record of how it manages any such conflict in relation to NHS commissioning contracts it has entered into.

Where a declaration of interest means that there is an actual or a suspected conflict of interest, the conflict must be identified by the Chair and Administrative Support at the agenda setting stage of meeting planning. This will enable the consideration of the provision of papers in preparation of the meeting to prevent those with direct conflicts from having access to information which they are not permitted to act in their capacity within the meeting to discuss, or decide.

10. Reporting Responsibilities

The Committee will report items for consideration by the Governing Body and Audit and Governance Committee through submission of minutes, papers and reports to relevant meetings.

The Committee will provide an annual report to the Governing Body setting out progress made and future developments.

11. Review of Terms of Reference

The Terms of Reference will be reviewed at least annually or when there is a material change to the contents of the Terms of Reference.

Any proposed amendments to the Terms of Reference will be submitted to the Governing Body for approval.

Whilst meeting papers and meeting notes are not actively published, all attendees should be aware that Mansfield and Ashfield CCG and Newark and Sherwood CCG are legally required to comply with the Freedom of Information Act 2000.

The notes and papers from this meeting could be released as part of a request made under the Freedom of Information Act.

Date: February 2017

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