Turnaround Board

Terms of Reference

1. Purpose

The role of the Board is to oversee the Turnaround Programme. It is responsible for improving the CCGs’ operational and financial control framework and functional efficiency, through which the CCGs will deliver their short and long term recovery plans. This is a joint Board of NHS Mansfield and Ashfield and NHS Newark and Sherwood CCGs.

The Board has responsibility for delivery of the requirements of the CCGs’statutory duties and performance standardsand has the executive powers conferred to it under the CCGs’ governing documents (Standing Orders, Standing Financial Instructions and Scheme of Delegation) and is authorised through that governance framework, by the Governing Bodies to act within its Terms of Reference.

As part of the delegation for oversight of the Turnaround Process from the Governing Bodies, the Turnaround Board has delegated authority within the CCGs Standing Financial Instructions, and operational scheme of delegation to take decisions with regard to financial spend of up to £500,000.

With respect to value, the Turnaround Board is aware of this limitation, and acknowledged that the assessment of cost is applicable to the lifetime of any contractual arrangements. All decisions relating to financial values above this level are escalated to the Governing Body with a recommendation from the Turnaround Board.

The Board is authorised to seek any information it requires from any employee/members of the CCGs in order to perform its duties.

The Boardcanrecommend tothe Governing Bodies that:

  • the Turnaround Programme continues as planned;
  • the Turnaround Programme continues with a changed plan;
  • the Turnaround Programme is stopped.

2. Membership

Voting membership comprises:

  • Chief Officer
  • Turnaround Director
  • Chief Finance Officer
  • Chief Commissioning Officer
  • Director of Primary Care
  • Chief Nurse and Director of Quality and Governance
  • Clinical Chair of Mansfield and Ashfield CCG
  • Clinical Chair of Newark and Sherwood CCG
  • Chair of Primary Care Commissioning Committee
  • Governing Body Lay Member nominated to Sub-Committee

In Attendance:

  • PMO Programme Director
  • Associate Turnaround Director
  • Associate Directors as required for Programme Reports
  • Chair of the Audit and Governance Committee (observer)
  • NHS England (attending as observers where this is felt appropriate)

The Board reserves to right to co-opt other officers of the CCG as required.

3. Chair and Deputy

The Chief Officer will chair all Turnaround Board meetings and the Turnaround Director will deputise in their absence.

In exceptional circumstances, the governing bodies may delegate specific decisions to the Turnaround Board to meet urgent national/local deadlines. If the Chair and Deputy Chair are not available, they may assign these duties to the Clinical Chairs who are voting members of the Turnaround Board and governing bodies.

4. Quorum and Voting Arrangements

Quorum will be the Chair or Deputy; the Chief Finance Officer (or nominated Deputy CFO);1 lay representative, 2 Directors of the CCG and 1 Clinical Chair (who are acting on behalf of either CCG in this capacity).

All Executive Directors are expected to attend the Turnaround Board or advise of a Deputy seven days prior to the meeting.

SROs for under-performing programmes are expected to attend the Turnaround Board or advise of a deputy seven days prior to the meeting.

5. Frequency of Meetings

The meetings will be held on a monthly basis, the meeting to take place one week before the Governing Body.

The Financial Recovery Group during week three of the month will focus on performance, therefore the Turnaround Board will receive items normally on the agenda for FRG by exception in support of business processes.

6. Duties

The Turnaround Board is responsible for improving the CCGs’ operational and financial control framework and functional efficiency, through which the CCGs will deliver their short and long term recovery plans.

Ithasresponsibilityfordeliveryofthe requirementsoftheCCGs’statutory duties with explicit regard to the short and long term recoveryplansandhastheexecutivepowers conferredtoitundertheCCGs’governanceframework,bytheGoverning Bodiesto actwithinitstermsofreferenceandtoreportdirectly totheGoverning Bodies.

The Turnaround board will take decisions on Business Cases, and Service Reviews in line with its financial limitations, and subject to the review and recommendations of supporting committees.

Specifically, its responsibilities are:

  • To be accountable for the delivery of the CCGs’Turnaround Plan ensuring that it provides the desired strategic outcomes for the CCGs in accordance with the short and long term recovery plans agreed with NHS England, ensuring delivery of in-year control totals agreed with NHS England;
  • To review exception reports on any material breaches of delivery of agreed QIPP Schemes, including Headroom Schemes, and the adequacy of proposed remedial action plans;To have responsibility to the Governing Bodies for oversight and advice on the current risk exposures with regard to the short and long term financial recovery plans and associated recovery strategies; to embed and maintain a challenging and supportive culture in relation to the control of costs across the CCGs, and to provide effective updates on the management of risks identified in the Risk Register and Assurance Framework.
  • Review available benchmarking information to understand the CCG’s relative position locally, regionally and nationally to aid the achievement of maximising best value from its resources. To actively engage with the NHS England QIPP Support Programme, including the Menu of Opportunities, and to formally receive any national or regional reports on the CCGs relative financial position and ensure that robust action plans are put into place and implemented in accordance with agreed timelines.
  • To review the CCG’s Integrated Performance Report and provide assurance to the CCG’s Governing Body that robust processes are in place and effectively managed, with regard to performance, activity, finance, quality, and QIPP and that any resultant variance or risk to the agreed CCG Operating Plan is identified and mitigated.
  • To consider recommendations, proposals and business cases that have any financial impact or require a refocus of resources and make appropriate recommendations to the Governing Body where necessary. This is in support of the process for Business Case approvals, via Clinical Executive and Primary Care Commissioning Committee where the Board provides a decision on the value to money element and financial impact analysis of each business case.
  • To provide and promote strong and effective leadership in relation to the use of resources, accountability for those resources and transparency in our utilisation and reporting of resources.
  • To safeguard the integrity of management information and financial reporting systems in connection with the QIPP Turnaround Plan;
  • To work and liaise as necessary with all other Governing Body Committees as necessary.
  • To work and liaise with the Alliance Leadership Board, in the oversight of Alliance Delivery Boards who are accountable for delivering QIPP Targets and Headroom Targets, as set out in the CCG’s Turnaround Plan. To receive formal reports and assurance from the Alliance Leadership Board in relation to the delivery of CCG QIPP Targets and Headroom Targets, being delivered through the Alliance. To ensure that corrective action is being taken to remedy under-performing Schemes, and to ensure that a contingency plan is established in circumstances where Alliance Schemes are not delivering the required financial impact for the CCGs.

7. Conduct of Business

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

•Selflessness

•Integrity

•Objectivity

•Accountability

•Openness

•Honesty

•Leadership

Members of the Board have a collective responsibility for the operation of the Board. 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 Board may delegate tasks to such individuals, sub-Boards 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 Board shall respect confidentiality requirements as set out in the CCGs’ Standing Orders.

8. Administration of Meetings

The Director responsible for overseeing the administration of the Board is theTurnaround Director.Agendas and supporting papers will be circulated no later than 5 working days in advance of meetings.

The timings for agendas will be structured to deal with finance and turnaround business in the first hour, with the remaining two hours dedicated to activity and performance business.

Any items placed on the agenda will be sent to the Turnaround Board Business Manager 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 Board. The minutes will be approved by agreement of the Board at the next meeting. The Chair of the Board will agree minutes if they are to be submitted to the Governing Body prior to formal approval.

The Board will present its minutes to the Governing Body for information and consideration. The CCGs will also comply with any reporting requirements set out in their constitutions.

9. Declaration of Interests

NHS Mansfield and Ashfield CCG and NHS Newark and Sherwood CCGhave a Conflict of Interest Policy and have 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.

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.

All declared interests will be managed in line with the requirements of the CCGs’ 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.

10. Reporting Responsibilities

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

TheBoard shallmake whateverrecommendationsto the Governing Body itdeemsappropriateonanyareawithinitsremit where action orimprovementisneeded.

11. Review of Terms of Reference

The Terms of Reference will be reviewedat 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 Bodies for approval.

Date: October 2017

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