North East Essex

Clinical Commissioning Group

Constitution

V3.3 Approved by Board 29th March 2016

CONTENTS

Part / Description / Page
Foreword / 3
Definitions of key descriptions used in this constitution / 4
1 / Introduction, commencement and duration / 7
2 / Amendment and Variation & Locality / 9
3 / Mission, values and aims / 9
4 / Functions, general duties and engagement / 12
5 / Membership / 23
6 / Roles and Responsibilities / 30
7 / Decision making – The Governing Structure / 37
8 / Standards of business conduct and managing conflicts / 43
9 / Disqualification of members of the board / 50
10 / Accountability and rules of engagement / 51
11 / Group as an employer / 54
12 / Notices / 56
13 / Transparency, ways of working and standing orders / 57
Appendix / Description / Page
1 / List of member practices and signatures / 58
2 / Nolan Principles / 60
3 / Terms of reference / 61
4 / Standing Orders / 70
5 / Scheme of Reservation and delegation / 85
6 / Standing financial instructions / 111
7 / NHS Constitution / 166
8 / CCG Board lead roles / 167
9 / Memorandum of Agreement / 170
10 / CCG Governance structure / 176
11 / Prospectus for elected members / 177
12 / Specific Delegated powers / 190
Schedule / Description / Page
1 / Register of Interests Declaration Form / 201
2 / Lay members appointment process / 203
3 / Practice members appointment process / 205
4 / Proxy form / 210
5 / Dispute Resolution Procedures / 213
6 / Process for Appointment Chair / 216
7 / Procurement Strategy / 218

FOREWORD

The North East Essex Clinical Commissioning Group (CCG) Constitution sets out how the CCG intends to do business as a statutory body through its Governance structure. The constitution is based upon the national template recommended by the National Commissioning Board.

As a CCG we take seriously our role on commissioning health care on behalf of our population. Fundamentally, this requires a governance arrangement that ensures we execute our statutory duties in a safe and considered manner.

This Constitution will be reviewed yearly.

The CCG’s Constitution sets out the arrangements made by the CCG to meet its responsibilities for commissioning care for the people for which it is responsible. 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.

The Constitution meets with the requirements of the General Practitioners Committee as outlined in the GPC guidance: GPC Constitution Guidance.pdf.

The Constitution applies tothe following, all of whom are required to adhere to it as a condition of their appointment:

  • the group’s member practices;
  • the group’s employees;
  • individuals working on behalf of the group;
  • anyone who is a member of the Clinical Commissioning GroupBoard
  • anyone who is a member of any of the committee(s) or sub-committees established by the group or its Clinical Commissioning Group Board.

NHS North East Essex Clinical Commissioning Group would like to acknowledge and thank the Essex Local Medical Committee for their contribution in the production of this constitution. We would also like to thank the memberpractices, the staff and the Board for their contribution.

Definitions of key descriptions used in this constitution

Accountable officer / An individual who is appointed by the NHS Commissioning Board and who may be a member or employee of the Clinical Commissioning Group or of anybody who is a member of the Clinical Commissioning Group and who duties and responsibilities are set out in paragraph 6.4 herein.
Any Qualified Provider (AQP) / The Any Qualified Provider principle to be applied by the Board when engaging in the commissioning of health care services
Area / The geographical area this group has responsibility for when providing healthcare services to patients not register with a practice
Board / The appointed and/or elected members of the Clinical Commissioning Group having the duties and responsibilities as set out in part 6
Budget / The financial resources delegated to the Board for the purposes of commissioning and all relevant and related services and functions.
Chair of the governing body / An individual who has been bee appointed in line with the process as outlined in schedule 6
Chief Finance Officer / An individual who has been selected by member practices and who may be a member or employee of the Clinical Commissioning Group or of anybody who is a member of the Clinical Commissioning Group and who duties and responsibilities are set out in paragraph 6.5 herein.
Clinical / Many roles described within the Constitution refer to the terms "Clinical" and "Health Professional". We regard these terms as interchangeable, and prefer to use this definition as it is the one referred to in Section14 of the National Health Service Act, in regard to the appointment to CCG Boards, as per the NHS Clinical Commissioning Group Regulations 2012.
“health care professional” means an individual who is a member of a profession regulated by a body mentioned in section 25(3) of the National Health Service Reform and Health Care Professions Act 2002.
Section 25(3) of the above Act list the following:-
(a)the General Medical Council,
(b)the General Dental Council,
(c)the General Optical Council,
(d)the General Osteopathic Council,
(e)the General Chiropractic Council,
(f)subject to section 26(5), the Royal Pharmaceutical Society of Great Britain,
(g)subject to section 26(6), the Pharmaceutical Society of Northern Ireland,
(h)until their abolition by virtue of section 60(3) of the 1999 Act—
(i)the United Kingdom Central Council for Nursing, Midwifery and Health Visiting, and each of the National Boards for Nursing, Midwifery and Health Visiting, and
(ii)the Council for Professions Supplementary to Medicine and each Board established by or by virtue of the Professions Supplementary to Medicine Act 1960 (c. 66),
(i)any regulatory body (within the meaning of Schedule 3 to the 1999 Act) established by an Order in Council under section 60 of that Act as the successor to a body mentioned in paragraph (h), and
(j)any other regulatory body (within that meaning) established by an Order in Council under that section.
Please note in addition:
The person should be registered at the time of appointment to the role for which this definition is relevant, and that registration should be then recognised as sufficient to meet the requirements of that role for the duration of the appointment, or for up to 3 years, whichever is the shorter period. For General Practitioners this requires the person to be on the “NHS Performers List” at the time of appointment. Also for the absence of doubt, Nurses should be registered at the time of appointment with the Nursing and Midwifery Council.
Clinical commissioning group / NHS North East Essex Clinical Commissioning Group formed in accordance with and approved by the NHS Commissioning Board
Clinical leaders / Individuals who have been elected and selected by member practices and who duties and responsibilities are set out in schedule 3
Commencement Date / The date of commencement of this Constitution being 1st April 2013
Committee / A committee or sub-committee created and appointed by:
  • the membership of the group
  • a committee / sub-committee created by the membership of the group
  • a committee / sub-committee by the governing body

Conflict of Interest / Any conflict of interest as set out in paragraph 8.2
Constitution / This Constitution as amended from time to time in accordance with its terms.
Deputy chair of the governing body / The individual who has been selected by the CCG chair to act as deputy chair of the governing body
Financial year / Will run from 1 April to 31 March
He / him / his / These pronouns should be taken to refer to both genders
Healthcare Professional / See ‘Clinical’
Joint Commissioning / Joint commissioning is the term used to describe when two or more commissioners come together to commission healthcare services. In this context it means NHS England working with clinical commissioning groups (CCGs) to commission primary care services.
Lay members / The four members of the governing body that will be selected following a recruitment process and will have a lead role in overseeing key elements of governance and championing patient and public involvement.
Locality / The locality of North East Essex
Local Medical Committee (LMC) / means the Essex Local Medical Committee as recognised by the NHS Act 1977 and currently recognised by NHS North East Essex Clinical Commissioning Group
Member / membership / Those practices which constitute the group
NHS Commissioning Board (NHS England) / The body corporate as identified in the Health and Social Care Act 2012 known as NHS England
Performers List / Medical performers list prepared and published by NHS England
Practice Member / The practice, rather than the individual clinicians within a practice, which are members of the clinical commissioning group
Register of interests / A register of all interests held by the votingmembers of the governing body and sub-committees of the Board. The register records the interest of any related party as part of the disclosure of interests.
Role and job titles / These should always be read according to the most recent guidance from the NHS England.
  1. INTRODUCTION, COMMENCEMENT AND DURATION

1.1 NAME

1.1.1The name of this clinical commissioning group is the NHS North East Essex Clinical Commissioning Group

1.2 STATUTORY FRAMEWORK

1.2.1Clinical Commissioning Groups were established under the Health and Social Care Act 2012 (“the 2012 Act”). They are NHS 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 Services Act 2006 (“the 2006 Act). 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.

1.2.2 NHS England is responsible for determining applications from prospective groups to be established as clinical commissioning groups and undertakes an annual assessment of each established group. 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.

1.2.3Clinical Commissioning Groups are clinically led membership organisations made up of general practices. The members of the clinical commissioning group are responsible for determining the governing arrangements for their organisations, which they are required to set out in their constitution.

1.3STATUS OF THIS CONSTITUTION

1.3.1This constitution is made between the practice members of NHS North East Essex Clinical Commissioning Group and in addition between the body of the membership and the governing body of NHS NEE Clinical Commissioning Group. The constitution came into force on 23rd January 2013, when NHS England established the group and shall continue in force until 1st April 2016, with yearly reviews, unless otherwise terminated in accordance with the provisions of this constitution.The constitution is published on the group’s website at

1.3.2This document will be made available upon request for inspection at the North East Essex Clinical Commissioning Group Headquarters as set out under 1.3.3

1.3.3Copies will also be made available on application to;

NHS North East Essex Clinical Commissioning Group

Aspen House

Stephenson Road

Severalls Business Park

Colchester

CO4 9QR

1.4AMENDMENT AND VARIATION OF THIS CONSTITUTION

1.4.1 This constitution can only be varied in two circumstances:

a)where the group applies to NHS England, which is the only body with the authority to grant this application and that application is granted and that this is agreed with the member practices

b)where in the circumstances set out in legislation NHS England varies the group’s constitution other than on application by the group.

  1. LOCALITY

2.1The locality of the CGG shall be North East Essex and shall be made up of the member practices as set out in Part 5 of this Constitution.

2.2 The locality of the CCG is fully coterminous with Essex County Council.

2.3 The locality of the CCG is also fully coterminous with the Borough and District Councils of Colchester and Tendring.

  1. MISSION, VALUES AND AIMS

3.1MISSION

3.1.1 The mission of the NHS North East Clinical Commissioning Group is to:

‘Embrace Better Health for All’

3.1.2 In all of our activities the group will promote good governance and proper stewardship of public resources in pursuance of its goals and in meeting its statutory duties.

3.2 VALUES

3.2.1Good corporate governance arrangements are critical to achieving the clinical commissioning group’s objectives

3.2.2The values that lie at the heart of all of the work of the clinical commissioning group align with those of the NHS Constitution:

  • Working together for patients
  • Respect and Dignity
  • Everyone counts
  • Commitment to quality of care
  • Compassion
  • Improving lives

3.3AIMS

3.3.1 Through its governance arrangements, the clinical commissioning group aims are:

  • To make a difference to individuals by encouraging people to feel valued and supported to make the right choices and use services appropriately
  • To improve the health and wellbeing of our population
  • To be accountable for the decision we take
  • As leaders within NEE we will be respected and trusted by our peers and the communities we serve by demonstrating compassion, care, dignity and respect towards all
  • To be ground breaking by focusing on innovation in quality, productivity and prevention

3.4PRINCIPLES OF GOOD GOVERNANCE

3.4.1In accordance with section 14L (2) (b) of the 2006 Act 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 clinical commissioning group and the conduct of its business

  1. the good governance standards for public services

c. the seven key principles of the NHS Constitution (appendix 7)

  1. the standards of behaviour published by the Committee on Standards in Public Life (1995) known as the ‘Nolan Principles’ (appendix 2)
  1. the Equality Act 2010
  1. Managing Conflicts of Interest: Statutory Guidance for CCGs

3.5 ACCOUNTABILITY

The clinical commissioning group will demonstrate its accountability to its members, local people, stakeholders and the NHS Commissioning Board in a number of ways, including by:

3.5.1publishing its constitution, standing orders and standing financial instructions

3.5.2appointing independent lay members and non GP clinicians to its governing body

3.5.3holding 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)

3.5.4complying with local authority(ies) health overview and scrutiny committee requirements

3.5.5publishing its annual report, annual accounts, annual commissioning plan and holding its annual general meeting in public

3.5.6having a published and clear complaints process which complies with NHS Complaints Regulations

3.5.7complying with the Freedom of Information Act 2000

3.5.8providing information to the NHS Commissioning Board as required

3.5.9publishing its principal commissioning and operational policies

3.5.10The governing body of the group will throughout the year have an on-going role in reviewing the group’s governance arrangements to ensure that it continues to reflect the principles of good governance.

3.6In addition to these statutory requirements, the group will demonstrate its accountability by:

a)Holding additional stakeholder events as part of its Communication and Engagement and Patient and Public Engagement (PPE) strategies.

3.7The Clinical Commissioning Group governing body, 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.

  1. FUNCTIONS AND GENERAL DUTIES

4.1 FUNCTIONS

4.1.1The functions that the group is responsible for exercising are set out in the 2006 Act, as amended by the 2012 Act. These are contained in the Department of Health’s Functions of clinical commissioning groups; a working document. In summary they are:

acommissioning certain health services (where NHS England is not under a duty to do so) that meet the reasonable needs of:

  • all people registered with member practices and
  • people who are resident in the area and are not registered with a member of any clinical commissioning group

bCommissioning emergency care for anyone present in the group’s area;

cdetermining the remuneration and travelling or other allowances of members of its governing body;

dpaying 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 groups employees

4.1.2In discharging its functions the group will:

  1. When exercising its functions to commission health services, the group will act consistently with the discharge by the Secretary of State and NHS England of their duty to promote a comprehensive health service and with the objectives and requirements placed on NHS England through the mandate published by the Secretary of State.

Accountability remains with the Governing Body however delivery is delegated to all sub-committees via the governance structure. This is explicit in the Terms of Reference of the various sub-committees within the structure

  1. meet the public sector equity duty, holding the board accountable and responsible for the delivery of this duty. This will be ensured via the terms of reference of the board and within the sub-committees

Under the Equality Act 2010, NHS North East Essex Clinical Commissioning Group will exercise their functions, and have due regard to the:

  • Need to eliminate unlawful discrimination harassment and victimisation and other conduct prohibited by the 2010 Act.
  • Advance equality of opportunity between people who share a protected characteristic and those who do not;
  • Foster good relations between people who share a protected characteristic and those who do not

NHS North East Essex Clinical Commissioning group will deliver this public sector duty by:

  • Publishing annually sufficient information to demonstrate compliance with this general duty across all their functions
  • By the end of April 2013, prepare and publish specific and measurable equality objectives, with a commitment to reviewing and publishing an annual review for the March Board.
  1. work in partnership with our local authority to develop joint strategic needs assessments and joint health and wellbeing strategies by:
  • Active participation in informing the Health and Wellbeing Board and assisting with the completion of their county wide efforts.
  • In addition we will work in partnership to develop a NEE JSNA to inform our commissioning priorities.

This responsibility has been included in the Terms of Reference for the Operational Executive in conjunction with the Executive function of the Health and Wellbeing Board, as approved by the Governing Body.