NHS Portsmouth Clinical Commissioning Group Constitution

1.1 Name

The name of this clinical commissioning group is NHS Portsmouth Clinical Commissioning Group (“the CCG”).

1.2 Statutory Framework

1.2.1 CCGs are established under the NHS Act 2006 (“the 2006 Act”), as amended by the Health and Social Care Act 2012. The CCG is a statutory body with the function of commissioning health services in England and is treated as an NHS body for the purposes of the 2006 Act. The powers and duties of the CCG to commission certain health services are set out in sections 3 and 3A of the 2006 Act. These provisions are supplemented by other statutory powers and duties that apply to CCGs, as well as by regulations and directions (including, but not limited to, those issued under the 2006 Act).

1.2.2 When exercising its commissioning role, the CCG must act in a way that is consistent with its statutory functions. Many of these statutory functions are set out in the 2006 Act but there are also other specific pieces of legislation that apply to CCGs, including the Equality Act 2010 and the Children Acts. Some of the statutory functions that apply to CCGs take the form of statutory duties, which the CCG must comply with when exercising its functions. These duties include things like:

a) Acting in a way that promotes the NHS Constitution (section 14P of the 2006 Act);
b) Exercising its functions effectively, efficiently and economically (section 14Q of the 2006 Act);
c) Financial duties (under sections 223G-K of the 2006 Act);
d) Child safeguarding (under the Children Acts 2004,1989);
e) Equality, including the public-sector equality duty (under the Equality Act 2010); and
f) Information law, (for instance under data protection laws, such as the EU General Data Protection Regulation 2016/679, and the Freedom of Information Act 2000).

1.2.3 Our status as a CCG is determined by NHS England. All CCGs are required to have a constitution and to publish it.

1.2.4 The CCG is subject to an annual assessment of its performance by NHS England which has powers to provide support or to intervene where it is satisfied that a CCG is failing, or has failed, to discharge any of our functions or that there is a significant risk that it will fail to do so.

1.2.5 CCGs are clinically-led membership organisations made up of general practices. The Members of the CCG are responsible for determining the governing arrangements for the CCG, including arrangements for clinical leadership, which are set out in this Constitution.

1.3 Status of this Constitution

1.3.1 This CCG was first authorised on 1 April 2013

1.3.2 Changes to this constitution are effective from the date of approval by NHS England.

1.3.3 The constitution is published on the CCG website at http://www.portsmouthccg.nhs.uk

1.4 Amendment and Variation of this Constitution

1.4.1 This constitution can only be varied in two circumstances.
a) where the CCG applies to NHS England and that application is granted; and
b) where in the circumstances set out in legislation NHS England varies the constitution other than on application by the CCG.

1.4.2 The Accountable Officer may periodically propose amendments to the constitution which shall be considered and approved by the Governing Body unless:

• Changes are thought to have a material impact
• Changes are proposed to the reserved powers of the members
• At least half (50%) of all the Governing Body Members formally request that the amendments be put before the membership for approval.

1.5 Related documents

1.5.1 This Constitution is also informed by a number of documents which provide further details on how the CCG will operate. They are the CCG’s:

a) Standing Orders – which set out the arrangements for meetings and the selection and appointment processes for the CCG’s Committees, and the CCG Governing Body (including Committees).
b) The Scheme of Reservation and Delegation – sets out those decisions that are reserved for the membership as a whole and those decisions that have been delegated by the CCG or the Governing Body
c) Prime financial policies – which set out the arrangements for managing the CCG’s financial affairs.
d) Standing Financial Instructions – which set out the delegated limits for financial commitments on behalf of the CCG.
e) The CCG Governance Map which includes:

• Standards of business conduct including the arrangements the CCG has made compliance against the management of conflicts of interest;
• Non-statutory Committee terms of reference;
• Lay Member portfolio information

f) Governing Body Sub-Committee Terms of Reference – which includes the following:

• Remuneration Committee
• Audit Committee
• Primary Care Commissioning Committee

1.6 Accountability and transparency

1.6.1 The CCG will demonstrate its accountability to its members, local people, stakeholders and NHS England in a number of ways, including by being transparent. We will meet our statutory requirements to:

a) publish our constitution and other key documents including

• Registers of Interests
• Registers of Procurement Information
• Registers of Gifts and Hospitality
• The CCG Management of Conflicts of Interest Policy
• The CCG Gifts & Hospitality Policy
• The CCG Working with Pharmaceutical Industry Policy
• The CCG Governance Map

1. appoint independent lay members and non-GP clinicians to our Governing Body;

2. manage actual or potential conflicts of interest in line with NHS England’s statutory guidance Managing Conflicts of Interest: Revised Statutory Guidance for CCGs 2017 and expected standards of good practice (see also part 6 of this constitution);

3. hold Governing Body meetings in public (except where we believe that it would not be in the public interest);

4. publish an annual commissioning strategy (titled the Operating Plan) that takes account of national and local priorities;

5. procure services in a manner that is open, transparent, non-discriminatory and fair to all potential providers and publish a Procurement Framework;

6. involve the public, in accordance with its duties under section 14Z2 of the 2006 Act.

7. When discharging its duties under section 14Z2, the CCG will ensure that it will act in an open, fair and non-discriminatory way, involving patients and stakeholders in all aspects of healthcare, including:

8. complying with local authority health overview and scrutiny requirements;

9. meeting annually in public to present an annual report which is then published;

10. producing annual accounts which are externally audited;

11. publishing a clear complaints process;

12. complying with the Freedom of Information Act 2000 and with the Information Commissioner Office requirements regarding the publication of information relating to the CCG;

13. providing information to NHS England as required; and

14. being an active member of the local Health and Wellbeing Body.

1.7 Liability and Indemnity

1.7.1 The CCG is a body corporate established and existing under the 2006 Act. All financial or legal liability for decisions or actions of the CCG resides with the CCG as a public statutory body and not with its Member practices. No Member or former Member, nor any person who is at any time a proprietor, officer or employee of any Member or former Member, shall be liable (whether as a Member or as an individual) for the debts, liabilities, acts or omissions, howsoever caused by the CCG in discharging its statutory functions. No Member or former Member, nor any person who is at any time a proprietor, officer or employee of any Member of former Member, shall be liable on any winding-up or dissolution of the CCG to contribute to the assets of the CCG, whether for the payment of its debts and liabilities or the expenses of its winding-up or otherwise. The CCG may indemnify any Member practice representative or other officer or individual exercising powers or duties on behalf of the CCG in respect of any civil liability incurred in the exercise of the CCGs’ business, provided that the person indemnified shall not have acted recklessly or with gross negligence.

2.1.1 We are an NHS organisation responsible for commissioning (planning buying, and ensuring the quality of) healthcare services in Portsmouth including hospital care, primary care (provided in local GP surgeries), urgent and emergency care, and most community health services, including mental health and learning disabilities.

2.1.2 We commission for a population of around 224,500 people spending in excess of £300 million per annum. Our geographical boundaries match those of Portsmouth City Council.

2.1.3 We are a membership organisation, led by healthcare professionals elected to represent all the GP practices in the city.

3.1 Membership of the Clinical Commissioning Group

3.1.1 The CCG is a membership organisation.

3.1.2 All practices that provide primary medical services to a registered list of patients under a General Medical Services, Personal Medical Services or Alternative Provider Medical Services contract in our area are eligible for membership of this CCG.

3.1.3 The 13 practices which make up the membership of the CCG are listed below.

3.2 Nature of Membership and Relationship with CCG

3.2.1 The CCG’s Members are integral to the functioning of the CCG. Those exercising delegated functions on behalf of the Membership, including the Governing Body, remain accountable to the Membership.

3.3 Speaking, Writing or Acting in the Name of the CCG

3.3.1 Members are not restricted from giving personal views on any matter. However, Members should make it clear that personal views are not necessarily the view of the CCG.

3.3.2 Nothing in or referred to in this constitution (including in relation to the issue of any press release or other public statement or disclosure) will prevent or inhibit the making of any protected disclosure (as defined in the Employment Rights Act 1996, as amended by the Public Interest Disclosure Act 1998) by any member of the CCG, any member of its Governing Body, any member of any of its Committees or Sub-Committees or the Committees or Sub-Committees of its Governing Body, or any employee of the CCG or of any of its members, nor will it affect the rights of any worker (as defined in that Act) under that Act.

3.4 Members’ Rights

3.4.1 Rights reserved to the membership are detailed in the Scheme of Reservation and Delegation and include:

• Calling and attending a general meeting of the Members;
• Submitting a proposal for amendment of the Constitution.
• Putting themselves forward for election to the Governing Body.
• Removing the Chair (or other elected members) of the Governing Body

3.5 Members’ Meetings

3.5.1 The CCG has established a range of mechanisms in order to ensure ongoing, regular communication and involvement of our membership:

• Individual Practice visits by the Clinical Executive on a rolling basis.
• Regular and frequent CCG Newsletters including prescribing and key messages.
• Practice Information Portal (PIP) and IT-based system hosting a range of Primary Care information including guidelines and pathways
• Face-to-face events such as commissioning & prescribing events support communication and engagement, as does Time for Audit, Research, Governance, Education & Training (TARGET) which promotes cost effective primary care through education, whilst linking to our commissioning needs.
• Using Clinical Commissioning Leads as ambassadors for the CCG working with member practices.
• Maintaining close links with the Practice Managers Group to capture their knowledge and expertise.
• Utilising IT systems, the Primary Care Engagement Team work with practices to understand variation in practice and provide support in activities which may reduce demand.
• Practice support pharmacists work with practices to support safe and cost effective prescribing.

3.6 Practice Representatives

3.6.1 Each Member practice has nominated lead healthcare professionals who represent the practice in the dealings with the CCG.

3.6.2 Practice representatives represent their practice’s views and act on behalf of the practice in matters relating to the CCG. Three key leadership roles have been identified:

• Practice Commissioning Lead GP
• Practice Prescribing Lead GP
• Practice Lead Manager

3.6.3 Practice representatives will be selected by the chosen method of each member practice and notified to the CCG’s Clinical Leader.

3.6.4 Practice Commissioning Lead GP: Each practice has a nominated commissioning GP lead. This individual is the key clinical contact within the practice and will work with their practice manager in its relationship with the CCG. Roles include:

• Practice clinical representative with the CCG with overall responsibility for the relationship between the practice and the CCG.
• Lead for quality improvement within the practice
• Leading on the practice’s role in referral management and review
• Ensuring the practice is briefed and engaged with CCG activities and is clear on its role as a practice in the stewardship of NHS funds
• Participates in commissioning educational events run by the CCG and ensures key messages and learning are shared with other members of the practice
• Providing feedback from the practice on its views and comments on CCG work priorities and specific proposals
• Working with clinical leads on the commissioning work programme to ensure the views of the practice are reflected
• Raising with the CCG issues identified by the practice to consider from a clinical commissioning perspective
• Where there are significant changes proposed, or where a change is proposed which is directly relevant to primary care as a provider ensuring the practice is aware and able to respond to these proposals
• Come together as members of the Practice Members Forum to oversee the work of the Governing Body

3.6.5 Practice Prescribing Lead GP: Each practice has a nominated prescribing GP lead. This role:

• Leads programme of quality improvement in relation to prescribing within the practice
• Acts as key point of contact for the practice based prescribing support pharmacists to agree and develop prescribing action plans
• Provides clinical leadership for the practice in respect of ensuring cost effective prescribing and engagement with the prescribing incentive scheme as part of the primary care CQUIN
• Ensure practice is reviewing its prescribing activities regularly and ensuring practices are current and in line with recommended practice, and comply with local formulary and best practice in the broader sense.
• Participates in prescribing educational events run by the CCG medicines management team and ensures key messages and learning are shared with other members of the practice
• Support prescribing advisors to have access to the practice to help them review prescribing behaviour and to facilitate audit.

3.6.6 Practice Lead Manager: Practice Lead managers (sometimes referred to as practice managers, business managers or business practice managers) play a pivotal role in the relationship between the CCG and the individual practice. They work alongside, and in support of, the nominated commissioning GP lead as well as with the prescribing GP lead in respect of their clinical portfolios. Specific roles include:

• Ensuring effective two way communications between the practice and the CCG
• Supporting the Practice Commissioning Lead GP to ensure communications with all members (clinical and non-clinical) of the practice regarding CCG business
• Supporting the Practice Commissioning Lead GP to ensure the practice is aware of its responsibilities as a member of the CCG
• Providing feedback to the CCG generated by the practice or its practice population
• Supporting the Practice Commissioning Lead GP to lead the process for the practices engagement in commissioning such as participation in the primary care CQUIN, audit, data gathering, using DOCC to interrogate and analyse practice population usage of commissioned services
• Working with the Practice Commissioning Lead GP to put in place arrangements for engagement of the practice population using PPGs, individual consultations, and other communications, to obtain meaningful patient and public involvement in the priorities of the CCG both generally and in specific aspects of the commissioning work programme – to inform CCG decision making
• Reviewing with the Practice Commissioning Lead GP, where relevant, proposed services changes to identify impact on the practice as a provider and informing the CCG of any opportunities, issues or alternative approaches to be considered before decisions are taken

3.6.7 Clinical Leaders

A number of key clinical leadership roles have been identified to provide specific support to commissioning. These include:

• Clinical Executives (who sit on the Governing Body)
• Clinical Commissioning Leads
• ‘Task and Finish’ Clinical Leads (for specific programmes of work)

3.6.8 In addition the CCG also has a Practice Manager representative. They will be elected by vote from each practice manager from member practices within the City and are also a member of the Governing Body.

3.6.9 Clinical Executive – These are elected clinical leaders who have an active role in the management and operation of the CCG. As members of the CCG’s governing body, they bring their unique understanding of the CCG’s member practices to the discussion and decision making of the governing body.

3.6.10 These elected healthcare professionals form the clinical executive, one of which is selected by the remaining clinical executive to be the clinical leader of the CCG and one to be the CCG Chair. The clinical leader role can be held be either the accountable officer or chair where both are healthcare professionals.

The role of clinical executive includes:

• Fulfil the role of a member of the CCG’s governing body as set out in national guidance
• Ensures CCG clinical representatives have access to appropriate leadership development including succession planning for the future
• CCG representation at national and regional events and committees as appropriate
• Advise the Governing Body, from a clinical perspective on the formation of vision and strategies and to oversee the delivery of the Governing Body’s and its subcommittees decisions and plans.

3.6.11 Both Clinical Commissioning Leads and ‘Task and Finish’ Clinical Leads will support the CCG’s Clinical Executive in developing and delivering its commissioning work programme, including full engagement with its member GP practices. Clinical Commissioning Leads and ‘Task and Finish’ Clinical Leads will be selected on the basis of interest and expertise against the business needs of the CCG.

4.1 Good Governance

4.1.1 The CCG will, at all times, observe generally accepted principles of good governance. These include:

a) Use of the governance toolkit for CCGs www.ccggovernance.org;
b) Undertaking regular governance reviews;
c) Adoption of standards and procedures that facilitate speaking out and the raising of concerns including a freedom to speak up guardian if one is appointed;
d) Adopting CCG values that include standards of propriety in relation to the stewardship of public funds, impartiality, integrity and objectivity;
e) The Good Governance Standard for Public Services;
f) the standards of behaviour published by the Committee on Standards in Public Life (1995) known as the ‘Nolan Principles’;
g) the seven key principles of the NHS Constitution;
h) relevant legislation including such as the Equality Act 2010; and
i) the standards set out in the Professional Standard Authority’s guidance ‘Standards for Members of NHS Boards and Clinical Commissioning Group Governing Bodies in England’.

4.2 General

4.2.1 The CCG will:

a) comply with all relevant laws, including regulations;
b) comply with directions issued by the Secretary of State for Health or NHS England;
c) have regard to statutory guidance including that issued by NHS England; and
d) take account, as appropriate, of other documents, advice and guidance.

4.2.2 The CCG will develop and implement the necessary systems and processes to comply with (a)-(d) above, documenting them as necessary in this constitution, its scheme of reservation and delegation and other relevant policies and procedures as appropriate.

4.2 Authority to Act: the CCG

4.3.1 The CCG is accountable for exercising its statutory functions. It may grant authority to act on its behalf to:

a) any of its members or employees;
b) its Governing Body;
c) a Committee or Sub-Committee of the CCG.

4.3 Authority to Act: the Governing Body

4.3.1 The Governing Body may grant authority to act on its behalf to:

a) any Member of the Governing Body;
b) a Committee or Sub-Committee of the Governing Body;
c) a Member of the CCG who is an individual (but not a Member of the Governing Body); and
d) any other individual who may be from outside the organisation and who can provide assistance to the CCG in delivering its functions.

5.1 Scheme of Reservation and Delegation

5.1.1 The CCG has agreed a scheme of reservation and delegation (SoRD) which is published in full and is included in the Governance Map which can be found on our website: www.portsmouthccg.nhs.uk

5.1.2 The CCG’s SoRD sets out:

• 5.1.2.1 those decisions that are reserved for the membership as a whole;
• 5.1.2.2 those decisions that have been delegated by the CCG, the Governing Body or other individuals.

5.1.3 The CCG remains accountable for all of its functions, including those that it has delegated. All those with delegated authority, including the Governing Body, are accountable to the Members for the exercise of their delegated functions.

5.2 Standing Orders

5.2.1 The CCG has agreed a set of Standing Orders which describe the processes that are employed to undertake its business. They include procedures for:

• conducting the business of the CCG;
• the appointments to key roles including Governing Body members;
• the procedures to be followed during meetings;
• and the process to delegate powers.

5.2.2 A full copy of the standing orders is included in appendix 3. The standing orders form part of this constitution.

5.3 Standing Financial Instructions (SFIs)

5.3.1 The CCG has agreed a set of SFIs which include the delegated limits of financial authority set out in the SoRD.

5.3.2 A copy of the SFIs is included at Appendix 4 and form part of this constitution.

5.4 The Governing Body: Its Role and Functions

5.4.1 The Governing Body has statutory responsibility for:

a) ensuring that the CCG has appropriate arrangements in place to exercise its functions effectively, efficiently and economically and in accordance with the CCG’s principles of good governance (its main function); and for
b) determining the remuneration, fees and other allowances payable to employees or other persons providing services to the CCG and the allowances payable under any pension scheme established.

5.4.2 The detailed procedures for the Governing Body, including voting arrangements, are set out in the standing orders.

5.5 Composition of the Governing Body

5.5.1 This part of the constitution describes the make-up of the Governing Body roles. Further information about the individuals who fulfil these roles can be found on our website www.portsmouthccg.nhs.uk

The National Health Service (Clinical Commissioning Groups) Regulations 2012 set out a minimum membership requirement of the Governing Body of:

• • The Chair
  • The Accountable Officer
  • The Chief Finance Officer
  • A Secondary Care Specialist
  • A registered nurse
  • Two lay members:

– one who has qualifications expertise or experience to enable them to lead on finance and audit matters; and another who has knowledge about the CCG area enabling them to express an informed view about discharge of the CCG functions

5.5.2 The CCG has agreed the following additional members:

a) two additional Lay members, one of whom is the Chair of the Primary Care Commissioning Committee and the other with oversight of patient and public engagement and communication.
b) Five GPs drawn from member practices (Clinical Executives)
c) Chief Executive Officer of the Local Authority
d) Director of Public Health
e) Chief of Health & Care Portsmouth as chief operating officer
f) Practice Manager Representative

5.5.3 A Deputy Chair (Lay Member) will be selected by the Governing Board from the lay members on the Governing Board

5.6 Additional Attendees at the Governing Body Meetings

5.6.1 The CCG Governing Body may invite other person(s) to attend all or any of its meetings, or part(s) of a meeting, in order to assist it in its decision-making and in its discharge of its functions as it sees fit. Any such person may be invited by the chair to speak and participate in debate, but may not vote.

5.7 Appointments to the Governing Body

5.7.1 The process of appointing GPs to the Governing Body, the selection of the Chair and the procedures for the appointment of other Governing Body Members are set out in the Standing Orders.

5.7.2 Also set out in standing orders are the details regarding the tenure of office for each role and the procedures for resignation and removal from office.

5.8 Committees and Sub-Committees

5.8.1 The CCG may establish Committees and Sub-Committees of the CCG.

5.8.2 The Governing Body may establish Committees and Sub-Committees.

5.8.3 Each Committee and Sub-Committee established by either the CCG or the Governing Body operates under terms of reference and membership agreed by the CCG or Governing Body as relevant. Appropriate reporting and assurance mechanisms must be developed as part of agreeing terms of reference for Committees and Sub-Committees.

5.8.4 With the exception of the Remuneration Committee, any Committee or Sub-Committee established in accordance with clause 5.8 may consist of or include persons other than Members or employees of the CCG.

5.8.5 All members of the Remuneration Committee will be members of the CCG Governing Body.

5.9 Committees of the Governing Body

5.9.1 The Governing Body will maintain the following statutory or mandated Committees:

5.9.2 Audit Committee: This Committee is accountable to the Governing Body and provides the Governing Body with an independent and objective view of the CCG’s compliance with its statutory responsibilities. The Committee is responsible for arranging appropriate internal and external audit.

5.9.3 The Audit Committee will be chaired by a Lay Member who has qualifications, expertise or experience to enable them to lead on finance and audit matters and members of the Audit Committee may include people who are not Governing Body members.

5.9.4 Remuneration Committee: This Committee is accountable to the Governing Body and makes recommendations to the Governing Body about the remuneration, fees and other allowances (including pension schemes) for employees and other individuals who provide services to the CCG.

5.9.5 The Remuneration Committee will be chaired by a lay member other than the audit chair and only members of the Governing Body may be members of the Remuneration Committee.

5.9.6 Primary Care Commissioning Committee: This committee is required by the terms of the delegation from NHS England in relation to primary care commissioning functions. The Primary Care Commissioning Committee reports to the Governing Body and to NHS England. Membership of the Committee is determined in accordance with the requirements of Managing Conflicts of Interest: Revised statutory Guidance for CCGs 2017. This includes the requirement for a lay member Chair and a lay Vice Chair.

5.9.7 None of the above Committees may operate on a joint committee basis with another CCG(s).

5.9.8 The terms of reference for each of the above committees are included in Appendix 2 to this constitution and form part of the constitution.

5.9.9 The Governing Body has also established a number of other Committees to assist it with the discharge of its functions. These Committees are set out in the SoRD and further information about these Committees, including terms of reference, are published in the CCG’s Governance Map on the CCG website: www.portsmouthccg.nhs.uk

5.10 Collaborative Commissioning Arrangements

5.10.1 The CCG wishes to work collaboratively with its partner organisations in order to assist it with meeting its statutory duties, particularly those relating to integration. The following provisions set out the framework that will apply to such arrangements.

5.10.2 In addition to the formal joint working mechanisms envisaged below, the Governing Body may enter into strategic or other transformation discussions with its partner organisations, on behalf of the CCG.

5.10.3 The Governing Body must ensure that appropriate reporting and assurance mechanisms are developed as part of any partnership or other collaborative arrangements. This will include:

a) reporting arrangements to the Governing Body, at appropriate intervals;
b) engagement events or other review sessions to consider the aims,
objectives, strategy and progress of the arrangements; and
c) progress reporting against identified objectives.

5.10.4 When delegated responsibilities are being discharged collaboratively, the collaborative arrangements, whether formal joint working or informal collaboration, must:

a) identify the roles and responsibilities of those CCGs or other partner
organisations that have agreed to work together and, if formal joint working is being used, the legal basis for such arrangements;
b) specify how performance will be monitored and assurance provided to the Governing Body on the discharge of responsibilities, so as to enable the Governing Body to have appropriate oversight as to how system integration and strategic intentions are being implemented;
c) set out any financial arrangements that have been agreed in relation to the collaborative arrangements, including identifying any pooled budgets and how these will be managed and reported in annual accounts;
d) specify under which of the CCG’s supporting policies the collaborative working arrangements will operate;
e) specify how the risks associated with the collaborative working arrangement will be managed and apportioned between the respective parties;
f) set out how contributions from the parties, including details around assets, employees and equipment to be used, will be agreed and managed;
g) identify how disputes will be resolved and the steps required to safely terminate the working arrangements;
h) specify how decisions are communicated to the collaborative partners.

5.11 Joint Commissioning Arrangements with Local Authority Partners

5.11.1 The CCG will work in partnership with its Local Authority partners to reduce health and social inequalities and to promote greater integration of health and social care.

5.11.2 Partnership working between the CCG and its Local Authority partners might include collaborative commissioning arrangements, including joint commissioning under section 75 of the 2006 Act, where permitted by law. In this instance, and to the extent permitted by law, the CCG delegates to the Governing Body the ability to enter into arrangements with one or more relevant Local Authority in respect of:

a) Delegating specified commissioning functions to the Local Authority;
b) Exercising specified commissioning functions jointly with the Local Authority;
c) Exercising any specified health -related functions on behalf of the Local Authority.

5.11.3 For purposes of the arrangements described in 5.11.2, the Governing Body may:

a) agree formal and legal arrangements to make payments to, or receive payments from, the Local Authority, or pool funds for the purpose of joint commissioning;
b) make the services of its employees or any other resources available to the Local Authority; and
c) receive the services of the employees or the resources from the Local Authority.
d) where the Governing Body makes an agreement with one or more Local Authority as described above, the agreement will set out the arrangements for joint working, including details of:

• how the parties will work together to carry out their commissioning functions;
•  the duties and responsibilities of the parties, and the legal basis for such arrangements;
• how risk will be managed and apportioned between the parties;
• financial arrangements, including payments towards a pooled fund and management of that fund;
• contributions from each party, including details of any assets, employees and equipment to be used under the joint working arrangements; and
• the liability of the CCG to carry out its functions, notwithstanding any joint arrangements entered into.

5.11.4 The liability of the CCG to carry out its functions will not be affected where the CCG enters into arrangements pursuant to paragraph 5.11.2 above.

5.12 Joint Commissioning Arrangements – Other CCGs

5.12.1 The CCG may work together with other CCGs in the exercise of its Commissioning Functions.

5.12.2 The CCG delegates its powers and duties under 5.12 to the Governing Body and all references in this part to the CCG should be read as the Governing Body, except to the extent that they relate to the continuing liability of the CCG under any joint arrangements.

5.12.3 The CCG may make arrangements with one or more other CCGs in respect of:

a) delegating any of the CCG’s commissioning functions to another CCG;
b) exercising any of the Commissioning Functions of another CCG; or
c) exercising jointly the Commissioning Functions of the CCG and another CCG.

5.12.4 For the purposes of the arrangements described at 5.12.3, the CCG may:

a) make payments to another CCG;
b) receive payments from another CCG; or
c) make the services of its employees or any other resources available to another CCG; or
d) receive the services of the employees or the resources available to another CCG.

5.12.5 Where the CCG makes arrangements which involve all the CCGs exercising any of their commissioning functions jointly, a joint committee may be established to exercise those functions.

5.12.6 For the purposes of the arrangements described above, the CCG may establish and maintain a pooled fund made up of contributions by all of the CCGs working together jointly pursuant to paragraph 5.12.3 above. Any such pooled fund may be used to make payments towards expenditure incurred in the discharge of any of the commissioning functions in respect of which the arrangements are made.

5.12.7 Where the CCG makes arrangements with another CCG as described at paragraph 5.12.3 above, the CCG shall develop and agree with that CCG an agreement setting out the arrangements for joint working including details of:

a) how the parties will work together to carry out their commissioning functions;
b) the duties and responsibilities of the parties, and the legal basis for such arrangements;
c) how risk will be managed and apportioned between the parties;
d) financial arrangements, including payments towards a pooled fund and management of that fund;
e) contributions from the parties, including details around assets, employees and equipment to be used under the joint working arrangements.

5.12.8 The responsibility of the CCG to carry out its functions will not be affected where the CCG enters into arrangements pursuant to paragraph 5.12.1 above.

5.12.9 The liability of the CCG to carry out its functions will not be affected where the CCG enters into arrangements pursuant to paragraph 5.12.1 above.

5.12.10 Only arrangements that are safe and in the interests of patients registered with Member practices will be approved by the Governing Body.

5.12.11 The Governing Body shall require, in all joint commissioning arrangements, that the lead Governing Body Member for the joint arrangements:

a) make a quarterly written report to the Governing Body;
b) hold at least one annual engagement event to review the aims, objectives, strategy and progress of the joint commissioning arrangements; and
c) publish an annual report on progress made against objectives.

5.12.12 Should a joint commissioning arrangement prove to be unsatisfactory the Governing Body of the CCG can decide to withdraw from the arrangement, but has to give six months’ notice to partners to allow for credible alternative arrangements to be put in place, with new arrangements starting from the beginning of the next new financial year after the expiration of the six months’ notice period.

5.13 Joint Commissioning Arrangements with NHS England

5.13.1 The CCG may work together with NHS England. This can take the form of joint working in relation to the CCG’s functions or in relation to NHS England’s functions.

5.13.2 The CCG delegates its powers and duties under 5.13 to the Governing Body and all references in this part to the CCG should be read as the Governing Body, except to the extent that they relate to the continuing liability of the CCG under any joint arrangements.

5.13.3 In terms of either the CCG’s functions or NHS England’s functions, the CCG and NHS England may make arrangements to exercise any of their specified commissioning functions jointly.

5.13.4 The arrangements referred to in paragraph 5.13.3 above may include other CCGs, a combined authority or a local authority.

5.13.5 Where joint commissioning arrangements pursuant to 5.13.3 above are entered into, the parties may establish a Joint Committee to exercise the commissioning functions in question. For the avoidance of doubt, this provision does not apply to any functions fully delegated to the CCG by NHS England, including but not limited to those relating to primary care commissioning.

5.13.6 Arrangements made pursuant to 5.13.3 above may be on such terms and conditions (including terms as to payment) as may be agreed between NHS England and the CCG.

5.13.7 Where the CCG makes arrangements with NHS England (and another CCG if relevant) as described at paragraph 5.13.3 above, the CCG shall develop and agree with NHS England a framework setting out the arrangements for joint working, including details of:

a) how the parties will work together to carry out their commissioning functions;
b) the duties and responsibilities of the parties, and the legal basis for such arrangements;
c) how risk will be managed and apportioned between the parties;
d) financial arrangements, including, if applicable, payments towards a pooled fund and management of that fund;
e) contributions from the parties, including details around assets, employees and equipment to be used under the joint working arrangements.

5.13.8 Where any joint arrangements entered into relate to the CCG’s functions, the liability of the CCG to carry out its functions will not be affected where the CCG enters into arrangements pursuant to paragraph 5.13.3 above. Similarly, where the arrangements relate to NHS England’s functions, the liability of NHS England to carry out its functions will not be affected where it and the CCG enter into joint arrangements pursuant to 5.13.

5.13.9 The CCG will act in accordance with any further guidance issued by NHS England on co-commissioning.

5.13.10 Only arrangements that are safe and in the interests of patients registered with member practices will be approved by the Governing Body.

5.13.11 The Governing Body of the CCG shall require, in all joint commissioning arrangements that the lead Governing Body Member for the joint arrangements make;

a) make a quarterly written report to the Governing Body;
b) hold at least one annual engagement event to review the aims, objectives, strategy and progress of the joint commissioning arrangements; and
c) publish an annual report on progress made against objectives.

5.13.12 Should a joint commissioning arrangement prove to be unsatisfactory the Governing Body of the CCG can decide to withdraw from the arrangement but has to give six months’ notice to partners to allow for credible alternative arrangements to be put in place, with new arrangements starting from the beginning of the next new financial year after the expiration of the six months’ notice period.

6.1 Conflicts of Interest

6.1.1 As required by section 14O of the 2006 Act, the CCG has made arrangements to manage conflicts and potential conflicts of interest to ensure that decisions made by the CCG will be taken and seen to be taken without being unduly influenced by external or private interest.

6.1.2 The CCG has agreed policies and procedures for the identification and management of conflicts of interest.

6.1.3 Employees, Members, Committee and Sub-Committee members of the CCG and members of the Governing Body (and its Committees, Sub-Committees, Joint Committees) will comply with the CCG policy on conflicts of interest. Where an individual, including any individual directly involved with the business or decision-making of the CCG and not otherwise covered by one of the categories above, has an interest, or becomes aware of an interest which could lead to a conflict of interests in the event of the CCG considering an action or decision in relation to that interest, that must be considered as a potential conflict, and is subject to the provisions of this constitution.

6.1.4 The CCG has appointed the Audit Chair to be the Conflicts of Interest Guardian. In collaboration with the CCG’s governance lead, their role is to:

a) Act as a conduit for GP practice staff, members of the public and healthcare professionals who have any concerns with regards to conflicts of interest;
b) Be a safe point of contact for employees or workers of the CCG to raise any concerns in relation to conflicts of interest;
c) Support the rigorous application of conflict of interest principles and policies;
d) Provide independent advice and judgment to staff and members where there is any doubt about how to apply conflicts of interest policies and principles in an individual situation
e) Provide advice on minimising the risks of conflicts of interest.

6.2 Declaring and Registering Interests

6.2.1 The CCG will maintain registers of the interests of those individuals listed in the CCG’s policy.

6.2.2 The CCG will, as a minimum, publish the registers of conflicts of interest and gifts and hospitality of decision making staff at least annually on the CCG website and make them available at our headquarters upon request.

6.2.3 All relevant persons for the purposes of NHS England’s statutory guidance Managing Conflicts of Interest: Revised Statutory Guidance for CCGs 2017 must declare any interests. Declarations should be made as soon as reasonably practicable and by law within 28 days after the interest arises. This could include interests an individual is pursuing. Interests will also be declared on appointment and during relevant discussion in meetings.

6.2.4 The CCG will ensure that, as a matter of course, declarations of interest are made and confirmed, or updated at least annually. All persons required to, must declare any interests as soon as reasonable practicable and by law within 28 days after the interest arises.

6.2.5 Interests (including gifts and hospitality) of decision making staff will remain on the public register for a minimum of six months. In addition, the CCG will retain a record of historic interests and offers/receipt of gifts and hospitality for a minimum of six years after the date on which it expired. The CCG’s published register of interests states that historic interests are retained by the CCG for the specified timeframe and details of whom to contact to submit a request for this information.

6.2.6 Activities funded in whole or in part by 3rd parties who may have an interest in CCG business such as sponsored events, posts and research will be managed in accordance with the CCG policy to ensure transparency and that any potential for conflicts of interest are well-managed.

6.3 Training in Relation to Conflicts of Interest

6.3.1 The CCG ensures that relevant staff and all Governing Body members receive training on the identification and management of conflicts of interest and that relevant staff undertake the NHS England Mandatory training.

6.4 Standards of Business Conduct

6.4.1 Employees, Members, Committee and Sub-Committee members of the CCG and members of the Governing Body (and its Committees, Sub-Committees, Joint Committees) will at all times comply with this Constitution and be aware of their responsibilities as outlined in it. They should:

a) act in good faith and in the interests of the CCG;
b) follow the Seven Principles of Public Life; set out by the Committee on Standards in Public Life (the Nolan Principles);
c) comply with the standards set out in the Professional Standards Authority guidance – Standards for Members of NHS Bodys and Clinical Commissioning Group Governing Bodies in England; and
d) comply with the CCG’s standards of business conduct, including the requirements set out in the policy for managing conflicts of interest which is available on the CCG’s website and will be made available on request.

6.4.2 Individuals contracted to work on behalf of the CCG or otherwise providing services or facilities to the CCG will be made aware of their obligation with regard to declaring conflicts or potential conflicts of interest. This requirement will be written into their contract for services and is also outlined in the CCG’s policies and procedures.

Audit Committee
Remuneration Committee
Primary Care Commissioning Committee

Audit Committee
Terms of Reference

1.0 CONSTITUTION

1.1 The Audit Committee (the Committee) is a Committee of the Governing Board and has those powers specifically delegated to it by the Governing Board within the Scheme of Reservation and Delegation and in these Terms of Reference, which will be reviewed annually by the Governing Board.

1.2 In line with requirements of the NHS Audit Committee Handbook, NHS Codes of Conduct and Accountability, and the Higgs report, an Audit Committee will be established and constituted to provide the group with an independent and objective review of its financial systems, financial information and compliance with laws, guidance, and regulations governing the NHS.

2.0 PURPOSE

2.1 The Audit Committee, which is accountable to the Governing Board, will support the Governing Board in discharging its functions related to overseeing efficiency, effectiveness, economy and governance.

2.2 The Committee will review the establishment and maintenance of an effective system of integrated governance, risk management and internal control, across the CCG’s activities that support the achievement of the group’s objectives.

2.3 This will include providing the Governing Board with an independent and objective view of the CCG’s financial systems, financial information and compliance with laws, regulations and directions governing the group in so far as they relate to finance.

2.4 The Committee will:

• support the Governing Board in its governance and oversight role;
• provide assurance and scrutiny on objectives and risks;
• monitor the effectiveness of systems;
• oversee the CCG’s Risk Management Processes and Assurance Framework;
• oversee external audit, internal audit, local counter fraud services and other external assurance functions;
• review and approve the CCG’s Annual Report and Annual Accounts in accordance with the Governing Board’s Scheme of Delegation;
• oversee the CCG’s systems and processes for managing conflicts of interests including the review of the following registers; interests, gifts & hospitality and procurement;
• ensure agreed internal audit recommendations are enacted by CCG
• review policies for ensuring compliance with regulatory, legal and code of conduct reporting requirements;
• review of risk and control related disclosure statements

3.0 RESPONSIBILITIES

3.1 The Committee has a number of principle responsibilities as follows:

3.2 INTEGRATED GOVERNANCE, RISK MANAGEMENT AND INTERNAL CONTROL

3.2.1 The Committee shall approve effective system of integrated governance, risk management and internal control, across the whole of the CCG’s activities that support the achievement of the CCG’s objectives.

3.2.3 In particular, the Committee will review the adequacy and effectiveness of:

• Financial planning, reporting and controls;
• Integrated governance systems and processes;
• All risk and control related disclosure statements (in particular the annual governance statement), together with any accompanying Head of Internal Audit statement and declarations of compliance with External Audit opinion any other appropriate independent assurances, prior to endorsement or approval by the Governing Board;
• The underlying assurance processes that indicate the degree of achievement of CCG corporate objectives, the effectiveness of the management of principal risks and the appropriateness of the above disclosure statements;
• The policies for ensuring compliance with relevant regulatory, legal and code of conduct requirements and related reporting and self-certification; and
• The policies and procedures for all work related to fraud and corruption. There is a requirement for each NHS organisation to have clear counter fraud arrangements and access to appropriate accredited counter fraud support. The policies and procedures for all work related to fraud and corruption will be conducted in accordance with relevant legislation and NHS Counter Fraud Authority guidance
• In carrying out this work the Committee will primarily utilise the work of Internal Audit, External Audit and other assurance functions, but will not be limited to these sources. It will also seek reports and assurances from CCG employees as appropriate, concentrating on the over-arching systems of integrated governance, risk management and internal control, together with indicators of their effectiveness. This will be evidenced through the Committee’s use of an effective assurance framework to guide its work and that of the audit and assurance functions that report to it.

3.3 EXTERNAL AUDIT

3.3.1 The Committee shall review the work and findings of the external auditors and consider the implications and management’s responses to their work. This will be achieved by:

• Consideration of the performance of the external auditors, as far as the rules governing the appointment permit;
• Discussion and agreement with the external auditors, before the audit commences, on the nature and scope of the audit as set out in the annual plan, and ensure co-ordination, as appropriate, with other external auditors in the local health economy;
• Discussion with the external auditors of their local evaluation of audit risks and assessment of the CCG and associated impact on the audit fee;
• Review of all external audit reports, including agreement of the annual audit letter before submission to the Governing Board and any work undertaken outside the annual audit plan, together with the appropriateness of management responses.
• Discussing any problems and/or reservations arising from the external auditors work and any other matters the external auditor may wish to discuss (in the absence of CCG officers, as necessary).

3.4 INTERNAL AUDIT

3.4.1 The Committee shall ensure that there is an effective internal audit function that meets mandatory NHS Internal Audit Standards and provides appropriate independent assurance to the Audit Committee, Chief Clinical Officer and Governing Board. This will be achieved by

• Consideration of the provision of the internal audit service, the cost of the audit and any questions of resignation and dismissal.
• Review and approval of the internal audit strategic plan and annual audit plan, ensuring it is consistent with the audit needs of the organisation, as identified in the assurance framework.
• Considering the major findings of internal audit work (and management’s response) and ensuring co-ordination between the internal and external auditors to optimise audit resources.
• Ensuring that the internal audit function is adequately resourced and has appropriate standing within the clinical commissioning group.
• Undertaking an annual review of the effectiveness of internal audit.

3.4.2 The Committee shall receive a report from the Head of Internal Audit on any internal audit reports completed and the management response to these. It shall also review an annual report from the Head of Internal Audit.

3.5 OTHER ASSURANCE FUNCTIONS

3.5.1 The Audit Committee shall review the findings of other significant assurance functions, both internal and external to the organisation, and consider the implications for the governance of the CCG.

3.5.2 These will include, but will not be limited to, any reviews by Department of Health, NHS England, arm’s length bodies or regulators/inspectors (for example, the Care Quality Commission and NHS Resolution) and professional bodies with responsibility for the performance of staff or functions (for example, Royal Colleges and accreditation bodies).

3.5.3 In addition, the Committee will review the work, function and terms of reference of other committees within the CCG, whose work can provide relevant assurance to the Audit Committee’s own scope of work.

3.6 COUNTER FRAUD

3.6.1 The Committee shall satisfy itself that the CCG has adequate arrangements in place for countering fraud, which it shall approve, and shall review the outcomes of counter fraud work. It shall also approve the counter fraud work programme.

3.7 FINANCIAL REPORTING

3.7.1 The Audit Committee shall monitor the integrity of the financial statements of the CCG and any formal announcements relating to the CCG’s financial performance.

3.7.2 The Committee shall ensure that the systems for financial reporting to the CCG, including those of budgetary control, are subject to review as to completeness and accuracy of the information provided to the Governing Board.

3.7.3 The Committee shall review and approve the Annual Report and Annual Accounts and approve these in accordance with the CCG’s Scheme of Delegation, focusing particularly on:
The annual governance statement and other disclosures relevant to the terms of reference of the Committee;

• Changes in, and compliance with, accounting policies, practices and estimation techniques;
• Unadjusted mis-statements in the financial statements;
• Significant judgements in preparing of the financial statements;
• Significant adjustments resulting from the audit;
• Letter of representation; and
• Qualitative aspects of financial reporting.

4.0 SCOPE OF AUTHORITY AND DECISION-MAKING

4.1 The Committee is required to work in accordance with these Terms of Reference and the CCG’s Standing Orders, Prime Financial Policies and Scheme of Reservation and Delegation.

4.2 The Committee will work to the professional and legal standards required of its members.

4.3 The Committee will ensure that it reports to the Governing Board on any matters which properly fall within the Board’s ‘Schedule of Matters Reserved to the Governing Board’.

4.4 The Committee is authorised by the Governing Board to investigate any activity within its terms of reference.

4.5 It is authorised to seek any information it requires from any employee of the CCG and all employees are required to co-operate with any request made by the Committee.

4.6 Matters for consideration by the Committee may be nominated by any member of the Governing Board or the Chief Clinical Officer, or the Chief Finance Officer of the CCG.

4.7 The Committee is authorised by the Governing Board to obtain outside legal or other independent professional advice and to secure the attendance of outsiders with relevant experience and expertise if it considers this necessary.

4.8 The following actions can be undertaken on behalf of the CCG Governing Board:

• receive the External Audit Plan with the external auditor before the Audit commences and agree the extent of reliance to be placed upon the Annual Internal Audit Report;
• review the external audit Annual Audit Letter and management response
• agree, on an annual basis, the programme of internal audit review for the coming year and endorse any subsequent variation in this programme
• review the Annual Governance Statement which should reflect the findings of relevant self assessments or inspections for example, Care Quality Commission reports, internal audit reports and the Assurance Framework
• review the work plan and periodic reports of the local counter fraud service and consider actions necessary by the CCG to combat fraud and corruption
• consider any other issues relating to internal control, such as variations to Standing Orders and Prime Financial Policies, schedules of losses & compensations, and receive details pertaining to the use of CCG’s official Seal
• a review of every decision to suspend Standing Orders, as required by Standing Orders.

5.0 MEMBERSHIP, QUORUM AND ATTENDANCE

5.1 The Committee will comprise three Lay Members, and the Governing Board Registered Nurse representative.

5.2 The Committee will be chaired by the lay member for governance.

5.3 The Chief Clinical Officer, the Chief Finance Officer, the Chief of Health and Care Portsmouth, Managing Director Officer, Head of Governance and appropriate external and internal auditors and local counter fraud service representatives shall be invited to attend meetings. However, at least once a year the Committee should meet privately with the external and internal auditors.

5.4 The Committee has the power to invite others to attend (including other CCG employees) when it believes this would provide it with relevant and necessary expertise and experience that otherwise would not be available to it, particularly when the Committee is discussing areas of risk or operation that are the responsibility of that individual.

5.5 Representatives from the NHS Counter Fraud Authority may be invited to attend meetings.

5.6 Regardless of attendance, external audit, internal audit, local counter fraud and security management providers will have full and unrestricted rights of access to the audit committee.

5.7 The Chief Clinical Officer would normally be invited to attend and discuss, at least annually with the Committee, the process for assurance that supports the statement on internal control. The Chief Clinical Officer would also normally attend when the Committee considers the draft internal audit plan and the annual accounts.

5.8 The Chair of the Governing Board will not be a member of the Committee, but may be invited to attend (in that capacity) for the full duration of one meeting each year in order to form a view on, and understanding of, the Committee’s operations. At the time of writing the Chair is the Clinical Executive with the lead for information governance and in that capacity she attends meetings of the committee when, and only for as long as, it discusses those matters.

5.9 The meetings will be quorate when there are two voting members present.

5.10 The Committee must be quorate when any decisions are made or votes taken.

6.0 FREQUENCY

6.1 Meetings shall be held a minimum of four times a year.

6.2 The External Auditor, Internal Audit or Local Counter Fraud Service may request a meeting should they consider that one is necessary.

6.3 Additional meetings may be called by the Committee Chair if required.

7.0 MANAGEMENT

7.1 Decisions will generally be made on the basis of consensus.

7.2 In the case of an equality of votes, the Chair shall have a second vote which will be the casting vote.

7.3 The Chair will provide reports on the work of the Committee to Part I or Part II of the Governing Board meeting according to the nature of the business to be reported.

7.4 The agenda and any papers shall normally be circulated to members five working days before the date of the meeting.

7.5 The Committee will be permitted to meet, for the whole or part of any meeting, without any officers being present. The Chair of the Committee will raise any issues with the Governing Board and this could mean excluding anyone normally present from that meeting.

7.6 The Committee shall request and review reports and positive assurances from the Chief Clinical Officer and Chief Finance Officer on the overall arrangements for governance, risk management and internal control. They may also request specific reports from individual functions within the organisation.
7.7 The Committee should conduct its business in accordance with any national guidance and relevant codes of conduct/good governance practice e.g. the Nolan report.

7.8 The Committee should review its own performance in line with the Audit Committee Handbook, membership and terms of reference on an annual basis. Any resulting changes to the terms of reference or membership should be approved by the Governing Board.

8.0 REPORTING

8.1 The minutes of Committee meetings shall be formally recorded and be submitted to the Governing Board.

8.2 The Chair of the Committee shall draw to the attention of the Governing Board any issues that require disclosure to the full Board.

8.3 The Committee will ensure that it monitors the adequacy and effectiveness of its work in support of the Annual Governance Statement, specifically commenting on the fitness for purpose of the Assurance Framework, the completeness and embeddedness of risk management in the organisation and the integration of governance arrangements.

Remuneration Committee
Terms of Reference

1.0 CONSTITUTION

1.1 The Remuneration Committee (the Committee) is a Committee of the CCG Governing Board and has those powers specifically delegated to it by the CCG Governing Board within the Scheme of Reservation and Delegation and in these Terms of Reference, which will be kept under regular review by the CCG Governing Board.

2.0 PURPOSE

2.1 In line with requirements of the law, the NHS Audit Committee Handbook, NHS Codes of Conduct and Accountability, and more recently the Higgs report, a Remuneration Committee has been established and constituted.

The Remuneration Committee, which is accountable to the group’s Governing Board, makes recommendations to the Governing Board on determinations about the:

• remuneration, fees and other allowances for CCG employees;
• remuneration, fees and other allowances for people who provide services to the group; and
• allowances under any pension scheme that the group may establish as an alternative to the NHS pension scheme.

3.0 RESPONSIBILITIES

3.1 The responsibilities of the Committee are to:

• Review and recommend pay and contractual arrangements for employees of the CCG to the Governing Board;
• Review and recommend remuneration and contractual arrangements for non-employee members of the Governing Board, to the Governing Board to ensure compliance with HMRC regulations;
• Consider national guidance and requirements in relation to pay and remuneration;
• Consider reports on workforce numbers, costs and key performance indicators;
• Review and consider staff survey (or equivalent), process and reports, recognising that people are the group’s most valuable asset;
• Scrutinise matters related to remuneration, obtaining advice/approval from other agencies as appropriate (i.e. HM Treasury for termination payments).
• Oversee succession planning in respect of roles on the Governing Board and in the CCG’s senior management structure.
• Monitor arrangements in respect of appraisal and professional development for Governing Board members and senior managers.

4.0 SCOPE OF AUTHORITY AND DECISION-MAKING

4.1 The Committee is required to work in accordance with these Terms of Reference and the CCG’s Standing Orders, Prime Financial Policies and Scheme of Reservation and Delegation.

4.2 The Committee will work to the professional and legal standards required of its members.

4.3 The Committee will ensure that it reports to the CCG Governing Board on any matters which properly fall within the CCG Governing Board’s ‘Schedule of Matters Reserved to the Board’.

4.4 In order to facilitate the achievement of good governance the Committee is authorised by the CCG Governing Board to help the CCG Governing Board discharge its functions relating to CCG financial duties and its main function of overseeing efficiency, effectiveness, economy and governance to investigate any activity within its terms of reference. It is authorised to seek any information it requires from any employee and all employees are directed to co-operate with any request made by the Committee.

4.5 Matters for consideration by the Committee may be nominated by any member of the Committee or the Chair of the CCG Governing Board.

4.6 The Committee is authorised by the CCG Governing Board to obtain outside legal or other independent professional advice and to secure the attendance of outsiders with relevant experience and expertise if it considers this necessary.

5.0 MEMBERSHIP, QUORUM AND ATTENDANCE

5.1 Only members of the Governing Board may be members of the Remuneration Committee. The member practices should not be in the majority.

5.2 The Committee will comprise:

• Three Lay Members of the Governing Board.
• The Secondary Care Doctor member of the Governing Board
• The Chair of the Governing Board

5.3 The Committee will be chaired by the lay member with a lead for workforce matters.

5.4 The Accountable Officer, Chief Finance Officer, Chief of Health and Care Portsmouth and Managing Director will normally attend Committee meetings, but will not be present for matters involving their personal remuneration.

5.5 The meetings will be quorate when there are two voting members present, one of which must be a lay member.

5.6 The Committee must be quorate when any decisions are made or votes taken.

5.7 Other attendees may be invited to attend for specific items with the prior agreement of the Chair.

6.0 FREQUENCY

6.1 Meetings shall be held a minimum of twice a year. Additional meetings may be called by the Chair if deemed necessary.

7.0 MANAGEMENT

7.1 The Committee shall operate in line with the requirements of the NHS Codes of Conduct and Accountability, the NHS Constitution and the CCG Constitution, reflecting the Nolan Principles.

7.2 Decisions will generally be made on the basis of consensus. In certain circumstances it may be necessary for all members to vote, normally by a show of hands.

7.3 In the case of an equality of votes, the chair shall have a second vote which will be the casting vote.

7.4 The Committee will report in writing to the CCG Governing Board the basis for its decisions and recommendations.

7.5 Minutes of the CCG Governing Board’s meetings should record such decisions. Where reports to the CCG Governing Board contain confidential information about individuals, these should be considered in Part II of the CCG Governing Board meeting.

7.6 The Committee shall receive secretarial support from the CCG’s administrative team.

7.7 The agenda and any papers shall normally be circulated to members five working days before the date of the meeting.

8.0 REPORTING

8.1 The Committee will report to the CCG Governing Board. The minutes of the Committee shall be formally recorded and submitted to the Governing Board.

8.2 The Committee Chair will provide reports on the work of the Committee to Part I or Part II of the CCG Governing Board meeting according to the nature of the business to be reported.

8.3 The Committee Chair shall draw to the attention of the CCG Governing Board any issues which require full disclosure to the CCG Governing Board.

Primary Care Commissioning Committee
Terms of Reference

1.0 INTRODUCTION

1.1 Simon Stevens, the Chief Executive of NHS England, announced on 1 May 2014 that NHS England was inviting CCGs to expand their role in primary care commissioning and to submit expressions of interest setting out the CCG’s preference for how it would like to exercise expanded primary medical care commissioning functions. One option available was that NHS England would delegate the exercise of certain specified primary care commissioning functions to a CCG.

1.2 In accordance with its statutory powers under section 13Z of the National Health Service Act 2006 (as amended), NHS England has delegated the exercise of the functions to these Terms of Reference to NHS Portsmouth CCG.

1.3 The CCG has established the NHS Portsmouth 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 the delegated powers.

2 STATUTORY FRAMEWORK

2.1 NHS England has delegated to the CCG authority to exercise the primary care commissioning functions set out in Schedule 2 in accordance with section 13Z of the NHS Act.

2.2 Arrangements made under section 13Z may be on such terms and conditions (including terms as to payment) as may be agreed between the NHS England Board and the CCG.

2.3 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 statutory duties set out in Chapter A2 of the NHS Act and including:

• Management of conflicts of interest (section 14O);
• Duty to promote the NHS Constitution (section 14P);
• Duty to exercise its functions effectively, efficiently and economically (section 14Q);
• Duty as to improvement in quality of services (section 14R);
• Duty in relation to quality of primary medical services (section 14S);
• Duties as to reducing inequalities (section 14T);
• Duty to promote the involvement of each patient (section 14U);
• Duty as to patient choice (section 14V);
• Duty as to promoting integration (section 14Z1);
• Public involvement and consultation (section 14Z2).

2.4 The CCG will also need to specifically, in respect of the delegated functions from NHS England, exercise those set out below:

• Duty to have regard to impact on services in certain areas (section 13O);
• Duty as respects variation in provision of health services (section 13P).

2.5 The Committee is established as a committee of the Governing Board of NHS Portsmouth CCG in accordance with Schedule 1A of the “NHS Act”.

2.6 The members of the CCG and its Governing Board acknowledge that the Committee is subject to any directions made by NHS England or by the Secretary of State.

2.7 The CCG has entered into a Delegation Agreement with NHS England setting out obligations upon the CCG in respect of the exercise of the delegated functions (“Delegation Agreement”). One such obligation is for the CCG to establish a committee to exercise the delegated functions (clause 7.3 of the Delegation Agreement), and the establishment of this Committee discharges that obligation.

3.0 RESPONSIBILITIES

3.1 The Committee has been established in accordance with the above statutory provisions to enable the members to make decisions on the review, planning and procurement of primary care services in Portsmouth under delegated authority from NHS England. Decisions will be made within the context of the overall commissioning strategy of NHS Portsmouth CCG.

3.2 In performing its role the Committee will exercise its management of the functions in accordance with the agreement entered into between NHS England and NHS Portsmouth CCG, which will sit alongside the delegation and these terms of reference.

3.3 The functions of the Committee are undertaken in the context of a desire to promote increased co-commissioning to increase quality, efficiency, productivity and value for money and to remove administrative barriers.

3.4 The role of the Committee shall be to carry out the functions relating to the commissioning of primary medical services under section 83 of the NHS Act.

3.5 This includes the following:

• GMS, PMS and APMS contracts (including the design of PMS and APMS contracts, monitoring of contracts, taking contractual action such as issuing branch/remedial notices, and removing a contract);
• Newly designed enhanced services (“Local Commissioned Services” and “Directed Enhanced Services”);
• Design of local incentive schemes as an alternative to the Quality Outcomes Framework (QOF);
• Decision making on whether to establish new GP practices in an area;
• Approving practice mergers; and
• Making decisions on ‘discretionary’ payment (e.g., returner/retainer schemes).

3.6 The CCG will also carry out the following activities:

a) To undertake strategic planning, (including local needs assessment) of primary medical care services in Portsmouth and the identification of key objectives for delivery
b) To undertake reviews of primary medical care services in Portsmouth
c) To co-ordinate a common approach to the commissioning of primary care services, including by approving a commissioning strategy or plan for these services
d) Ensuring that appropriate account is taken of services commissioned by partner organisations (including but not limited to Portsmouth City Council), to ensure that there is an integrated approach to commissioning primary medical and other services.
e) The development and investment in primary care services as a core CCG responsibility, affording primary care equal weighting with other sectors
f) To approve and monitor the procurement of primary medical services commissioned by the CCG to ensure that providers are identified and engaged such that services will be delivered to meet objectives set by the CCG
g) To ensure meaningful engagement of patients and the public in decision making
h) To ensure access to consistently high quality care, with improved health outcomes, equity of access and reduced health inequalities
i) To ensure the budget for commissioning of primary medical care services in Portsmouth is appropriately managed
j) To monitor the identification and management of strategic and operational risk associated with the commissioning of primary medical services and other matters which are material to the delivery of those services in Portsmouth

4.0 GEOGRAPHICAL COVERAGE

4.1 The Committee will comprise the area of NHS Portsmouth CCG as defined in the CCG’s Constitution.

5.0 MEMBERSHIP

5.1 The Committee shall comprise the following voting members:

• Three lay member representatives from the Governing Board
• One Registered Nurse representative from the Governing Board
• Chief Finance Officer
• Director of Quality & Commissioning
• Director of Public Health, Portsmouth City Council
• Director of New Models of Care
• Deputy Director of Primary Care
• Deputy Director of Transformation
• Practice Manager Representative
• LMC Representative

5.2 The Chair of the Committee shall be the Lay Member with responsibility for primary care

5.3 The Vice Chair of the Committee shall be a lay representative from the Governing Board

5.4 The CCG’s Conflicts of Interest Guardian may be one of the Lay Members who are members of the Committee but is not able to assume the position of Chair or vice chair

5.5 A standing invitation will be offered to representatives of NHS England and Healthwatch to attend the committee’s meetings. Neither representative will be a member.

5.6 The Committee may ask other clinical members and non-clinical officers of the CCG (including those hosted by other organisations providing services to it e.g. other CCGs, Local Authority or CSU) to attend any meeting as required to provide expert clinical and/or non-clinical advice/input to the Committee as required. It is anticipated that members of the Primary Care will be in attendance at each meeting to support the work of the Committee

5.7 The CCG will notify NHS England of all Committee meetings at least seven days in advance of such meetings and representatives from NHS England will be entitled to attend at their discretion. This is an obligation upon the CCG under the Delegation Agreement (clause 9.3).

6.0 MEETINGS AND VOTING

6.1 The Committee will operate in accordance with the CCG’s Standing Orders. The Secretary to the Committee will be responsible for giving notice of meetings. This will be accompanied by an agenda and supporting papers and sent to each member representative no later than 5 days before the date of the meeting. When the Chair of the Committee deems it necessary in light of the urgent circumstances to call a meeting at short notice, the notice period shall be such as s/he shall specify.

6.2 Each member of the Committee shall have one vote. The Committee shall reach decisions by a simple majority of members present, but with the Chair having a second and deciding vote, if necessary. However, the aim of the Committee will be to achieve consensus decision-making wherever possible. Individuals ‘in attendance’ at meetings ie. Individuals who are not members of the committee, shall have no vote.

6.3 The Committee will operate in accordance with the CCGs Policies and Procedures including conflicts of interest management and associated arrangements to ensure compliance with the law and good practice (including that published by NHS England).

6.4 In accordance with the CCG’s Managing Conflicts of Interest Policy where a member has an actual or potential conflict of interest then the chair of the meeting will determine whether the person concerned can remain in the meeting or whether the person must be excluded from discussions and/or decisions for the specific item of business in respect of which the conflict of interest arises. Where possible, actual or potential conflicts of interests will be identified (and arrangements made to manage them) in advance of committee meetings.

7.0 QUORUM

7.1 The quorum for a meeting of the Committee shall be four members, and must include at least one lay member.
7.2 The committee must be quorate when any decisions are made or any votes taken.
7.3 No person who has been excluded from any decision on the grounds of a conflict of interests shall count in the quorum.

8.0 FREQUENCY OF MEETINGS

8.1 The meetings of the Committee shall be held at least four times per annum and, subject to 8.2 below, shall be held in public. Additional meetings of the Committee may be held on an exceptional basis at the request of the Chair, supported by two members of the Committee.

8.2 Meetings of the Committee shall:

a) be held in public, subject to the application of 8.2(b);
b) the Committee may resolve to exclude the public from a meeting that is open to the public (whether during the whole or part of the proceedings) whenever publicity would be prejudicial to the public interest by reason of the confidential nature of the business to be transacted or for other special reasons stated in the resolution and arising from the nature of that business or of the proceedings or for any other reason permitted by the Public Bodies (Admission to Meetings) Act 1960 as amended or succeeded from time to time.

8.3 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.

8.4 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.

8.5 The Committee may call additional experts to attend meetings on an ad hoc basis to inform discussions.

8.6 Members of the Committee shall respect confidentiality requirements as set out in the CCG’s Constitution

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

8.8 It is envisaged that these Terms of Reference will be reviewed from time to time, reflecting experience of the Committee in fulfilling its functions. NHS England may also issue revised model terms of reference from time to time.

9.0 ACCOUNTABILITY OF THE COMMITTEE

9.1 The Committee will make recommendations for the annual Primary care budgets.

9.2 Decisions will be made in accordance with the CCG’s Scheme of Delegation.

9.3 For the avoidance of doubt, in the event of any conflict between the Terms of Reference of this Committee and the Standing Orders and Prime Financial Policies of the CCG, the latter will prevail.

9.4 The Committee shall have due regard to the legal responsibilities of the CCG:

• As set out in paragraph 2.3 and;
• The duties under the Equality Act 2010, including those relating to the public sector equality duty.

10.0 PROCUREMENT OF AGREED SERVICES

10.1 The detailed arrangements for procurement of agreed services are set out in the Delegation Agreement.

11.0 DECISIONS

11.1 The Committee will make decisions within the bounds of its remit and delegated authority.

11.2 The decisions of the Committee shall be binding on NHS England and NHS Portsmouth CCG, subject to the Committee complying with the CCG’s statutory duties and its financial obligations (for which the Chief Clinical Officer and the Governing Board remain accountable), and the requirement above to ensure that there is an integrated approach to commissioning across all services.

11.3 The agenda, papers and minutes for each meeting shall be sent to NHS England and the committee shall prepare an annual report for submission to NHS England.

11.4 After each meeting the Committee will report via its minutes (and the minutes of any sub-committees to which responsibilities are delegated under paragraph 8.4 above) to the Governing Board.

STANDING ORDERS
STATUTORY FRAMEWORK AND STATUS

1. Introduction

1.1. These standing orders have been drawn up to regulate the proceedings of NHS Portsmouth Clinical Commissioning Group (hereafter referred to as CCG) so that the CCG can fulfil its obligations, as set out largely in the 2006 Act, as amended by the 2012 Act and related regulations.

1.2. The standing orders, together with the CCG’s scheme of reservation and delegation and the CCG’s prime financial policies, provide a procedural framework within which the CCG discharges its business. They set out:

a) the arrangements for conducting the business of the CCG;
b) the appointment of member practice representatives;
c) the procedure to be followed at meetings of the CCG, the governing body (hereafter referred to as governing board the local terminology for its governing body) and any committees or sub-committees of the CCG or the governing board;
d) the process to delegate powers,
e) The declaration of interests and standards of conduct.

These arrangements must comply, and be consistent where applicable, with requirements set out in the 2006 Act (as amended by the 2012 Act) and related regulations and take account as appropriate of any relevant guidance.

1.3. The standing orders, scheme of reservation and delegation and prime financial policies have effect as if incorporated into the CCG’s constitution. CCG members, employees, members of the governing board, members of the governing board’s committees and sub-committees, members of the CCG’s committees and sub-committees and persons working on behalf of the CCG should be aware of the existence of these documents and, where necessary, be familiar with their detailed provisions. Failure to comply with the standing orders, scheme of reservation and delegation and prime financial policies may be regarded as a disciplinary matter that could result in dismissal.

2.  Scheme of reservation and delegation
2.1. The 2006 Act (as amended by the 2012 Act) provides the CCG with powers to delegate the CCG’s functions and those of the governing board to certain bodies (such as committees) and certain persons. The CCG has decided that certain decisions may only be exercised by the CCG in formal session. These decisions and also those delegated are contained in the CCG’s scheme of reservation and delegation.

3. COMPOSITION OF GOVERNING BOARD MEMBERSHIP, KEY ROLES AND APPOINTMENT PROCESS

3.1. Key Roles

3.1.1. The CCG’s constitution sets out the composition of the CCG’s governing board and identifies certain key roles and responsibilities within the CCG and its governing board. These standing orders set out how the CCG appoints individuals to these key roles.

3.1.2. The Chair is subject to the following appointment process:

a) Eligibility – the Chair shall be a GP who is an elected member of the member practices on the Governing Board;
b) Nomination and appointment process – selection by the Governing Board and appointment supported by NHS England;
c) Term of office – the Chair shall remain in post for an initial period of no more than three years;
d) Eligibility for reappointment – reappointment will be via the re-election as a representative of member practices on the Governing Board and subsequent re-selection by the Governing Board; each term of office shall be three years
e) Notice period – three months prior written notice to the Governing Board
f) Grounds for removal from office – the Chair could be removed from office by NHS England or if they are or subsequently become:

• Retired from the practice or primary care service provider;
• Suspended by either the GMC or NHS England;
• Subject to serious misconduct proceedings;
• the practice ceases to be eligible for membership to the governing board;
• That Member ceases to hold a contract for the provision of primary medical services within the Area of the CCG.

They may also be removed from office by the Accountable Officer of the CCG under circumstances described in the CCG’s HR policies in line with their terms and conditions of appointment or as set out within their secondment agreement with their main employer (as applicable).

3.1.3 The Deputy Chair is subject to the following appointment process:

a) Eligibility – must be a lay member representative;
b) Nomination and appointment process – the Deputy Chair will be selected by the Governing Board from the lay members on the Governing Board;
c) Term of office – shall remain in post for an initial period of no more than three years;
d) Eligibility for reappointment – reappointment as a lay member on the Governing Board and re-selected by the Governing Board as deputy chair; each term of office shall be three years
e) Notice period – three months prior written notice to the Governing Board.
f) Grounds for removal from office – as stated for lay members (see section 2.1.8)

3.1.4 The Accountable Officer is subject to the following appointment process:

a) Nominations – formal application;
b) Eligibility – must be at the time of application be an elected clinical executive (see section 2.1.5)
c) Appointment process – selection and appointment by the Governing Board and approval by NHS England. Should no appointment be made that meets the eligibility requirements then the Remuneration Committee would consider appropriate alternative arrangements;
d) Term of office – substantive appointment;
e) Grounds for removal from office –the Accountable Officer may be removed from office by the Governing Board of the CCG under circumstances described in the CCG’s policies or by NHS England (on behalf of the Secretary of State)
f) Notice period – as stipulated in their contract of employment

3.1.5 The Clinical Executives (Representatives of Member Practices) are subject to the following appointment process:

a) Nominations – by voting by the members of the CCG;
b) Eligibility – must be a GP employed by a member practice of the CCG;
c) Appointment process – elections shall be conducted by the Local Medical Committee or other organisation approved by members;
d) Term of office – shall remain in post for an initial period of no more than three years;
e) Eligibility for reappointment –re-election as a representative of member practices; each term of office shall be three years
f) Notice period – three months prior written notice to the governing board.
g) Grounds for removal from office – A Clinical Executive could be removed from office by NHS England if they are, or subsequently become:

• Retired from the practice or primary care service provider;
• Suspended by either the GMC or the NHS Commissioning Board;
• subject to serious misconduct proceedings;
• the Practice ceases to be eligible for membership;
• That Member ceases to hold a contract for the provision of primary medical services within the Area of the Clinical Commissioning Group.

They may also be removed from office by the Accountable Officer of the CCG under circumstances described in the CCG’s HR policies in line with their terms and conditions of appointment or as set out within their secondment agreement with their main employer (as applicable).

3.1.6 The Clinical Leader is subject to the following appointment process:

a) Eligibility

• Must be a GP who is elected by member practices as a clinical executive on the Governing Board

b) Nomination and Appointment process – selection by the Governing Board;
c) Term of Office – shall remain in post for an initial period of no more than three years whilst always remaining as an elected clinical executive;
d) Eligibility for reappointment – reappointment will be via re-election as a clinical executive representative by member practices on the Governing Board and subsequent re-selection by the Governing Board; each term of office shall be three years
e) Notice period – three months prior written notice to the governing board.
f) Grounds for removal from office – could be removed from office if they are, or subsequently become:

• Retired from the practice or primary care service provider
• Suspended by either the GMC or the NHS Commissioning Board;
• subject to serious misconduct proceedings;
• the Practice ceases to be eligible for membership;
• That Member ceases to hold a contract for the provision of primary medical services within the Area of the Clinical Commissioning Group.
• The individual ceases to hold the position of Clinical Executive on the Governing Board.

They may also be removed from office by under circumstances described in the CCG’s HR policies in line with their terms and conditions of appointment or as set out within their secondment agreement with their main employer (as applicable).

3.1.7 The Practice Manager representative is subject to the following appointment process:

a) Nominations – through voting by member practices;
b) Eligibility – must be a practice manager or recognised equivalent of a member practice or practices;
c) Appointment process – via elections administered by the CCG;
d) Term of Office – shall remain in post for an initial period of no more than three years;
e) Eligibility for reappointment – re-election as representative by member practices; each term of office shall be three years
f) Notice period – three months prior written notice to the governing board.
g) Grounds for removal from office –

• left member practice;
• practice ceases to be eligible for membership;
• member practice ceases to hold a contract for the provision of primary medical services within the area of the CCG;
• suspended by the practice;
• Subject to serious misconduct proceedings.

They may also be removed from office by the Accountable Officer of the CCG under circumstances described in the CCG’s HR policies in line with their terms and conditions of appointment or as set out within their secondment agreement with their main employer (as applicable).

3.1.8 The Lay Members are subject to the following appointment process:

a) Nominations – selection process from members of the local community;
b) Eligibility – the lay members shall be residents within the area covered by the CCG. One lay member will have recent financial and audit experience and another member will have expertise and knowledge of the local community. One of the lay members will have the additional role of Deputy Chair of the Governing Board;
c) Appointment process – appointment by the Chair;
d) Term of office – the lay members shall serve on the governing board of the CCG for an initial period of no more than three years;
e) Eligibility for reappointment – reselection by the Chair; each term of office shall be three years
f) Notice period – three months prior written notice to the governing board.
g) Grounds for removal from office – if they are, or subsequently become:

• a serving civil servant within the Department of Health, or members /employees of the Care Quality Commission;
• Serving as a Chair or non-executive of another NHS body beyond the formal establishment of the relevant CCG
• not eligible to work in the UK;
• subject to a bankruptcy restrictions order or an interim bankruptcy restrictions order;
• in the last five years been dismissed from employment by a health service body otherwise than because of redundancy;
• a person who has received a prison sentence or suspended sentence of three months or more in the last five years;
• a person who has been dismissed by a former employer (within or outside the NHS) on the grounds of misconduct within the last 5 years;
•  a health care professional whose registration is subject to conditions, or who is subject to proceedings before a fitness to practise committee of the relevant regulatory body, or who is the subject of an allegation or investigation which could lead to such proceedings;
• a person who is under a disqualification order under the Company Directors Disqualification Act 1986 or the Company Directors Disqualification (Northern Ireland) Order 2002, or an order made under section 429(2) of the Insolvency Act 1986 (disabilities on revocation of administration order against an individual);
• a person who has at any time been removed from the management or control of a charity.

They may also be removed from office by the Chair of the CCG under circumstances described in the CCG’s HR policies in line with their terms and conditions of appointment or as set out within their secondment agreement with their main employer (as applicable).

3.1.9 The Registered Nurse is subject to the following appointment process:

a) Nominations – formal application;
b) Eligibility – a registered nurse who has developed a high level of professional expertise and knowledge. The individual should have no conflicts of interest i.e. they should not be employed by any organisation from which the CCG secures any significant volume of provision. The individual should bring significant additional perspectives beyond primary care and should not be a general practice employee;
c) Appointment process – formal application and interview by the Chair;
d) Term of office – shall serve on the governing board of the CCG for an initial period of no more than three years;
e) Eligibility for reappointment – re-appointment by the Chair of the Governing Board; each term of office shall be three years
f) Notice period – three months prior written notice to the governing board.
g) Grounds for removal from office –

• retired from practice;
• suspended by the NMC, or NHS England;
• subject to serious misconduct proceedings;
• the individual becomes employed in an organisation from which the CCG commissions;

They may also be removed from office by the Chair of the CCG under circumstances described in the CCG’s HR policies in line with their terms and conditions of appointment or as set out within their secondment agreement with their main employer (as applicable).

3.1.10 The Secondary Care Specialist Doctor is subject to the following appointment process:

a) Nominations – formal application;
b) Eligibility – a doctor who is, or has been, a secondary care specialist, who has a high level of understanding of how care is delivered in a secondary care setting. Whilst the individual may no longer practise medicine, they will need to demonstrate that they still have a relevant understanding of care in the secondary setting. The individual should have no conflicts of interest i.e. they should not be employed by any organisation from which the CCG secures any significant volume of provision;
c) Appointment process – formal application and interview by the Chair;
d) Term of office – shall serve on the governing board of the CCG for an initial period of no more than three years;
e) Eligibility for reappointment – re-appointment by the Chair of the Governing Board; each term of office shall be three years
f) Notice period – three months prior written notice to the governing board.
g) Grounds for removal from office –

• retired from practice;
• suspended by the GMC;
• subject to serious misconduct proceedings;
• The individual becomes employed in an organisation from which the CCG commissions.
• They may also be removed from office by the Chair of the CCG under circumstances described in the CCG’s HR policies in line with their terms and conditions of appointment or as set out within their secondment agreement with their main employer (as applicable).

3.1.11 The Chief Finance Officer is subject to the following appointment process:

a) Nominations – formal application;
b) Eligibility – someone with a recognised professional accounting qualification meeting the job specification;
c) Appointment process – formal application and interview by the Chair and Accountable Officer;
d) Grounds for removal from office – the Chief Finance Officer can be removed from office by the Accountable Officer of the CCG under circumstances described in CCG policies;
e) Notice period – as stipulated in their contract of employment.

3.1.12 The chief operating officer (Chief of Health & Care Portsmouth) is subject to the following appointment process:

a) Nominations – formal application;
b) Eligibility – as per job specification;
c) Appointment process – formal application and interview by the Chair and Accountable Officer;
d) Grounds for removal from office – the Chief Operating Officer can be removed from office by the Accountable Officer of the CCG under circumstances described in CCG policies;
e) Notice period – as stipulated in their contract of employment.

3.1.13 The Representative of Portsmouth City Council (PCC) will be the Portsmouth City Council Chief Executive.

3.1.14 The Director of Public Health will be the appointed Director of Public Health employed by Portsmouth City Council.

3.1.15 The roles and responsibilities of each of these key roles are set out in the CCG’s constitution.

3.1.16 The Practice Members Forum may pass a motion of no-confidence in any member of the governing body by virtue of a 2/3rds majority, with each member practice having an equal single vote.

3.1.17 Following any vote of no-confidence nominated representatives of the forum would need to discuss the consequences and available remedies with either the Accountable Officer or Chair.

3.1.18 Should such vote be in relation to the entire Governing Board then contact would need to be made with the local Director of NHS England.

4. MEETINGS OF THE CCG

4.1. Calling meetings

4.1.1. Meetings of the CCG shall be held at regular intervals at such times and places as the CCG may determine.

4.1.2. The Chair of the committees and sub committees can call any additional meetings as required. Other members of the committees may request additional meetings from the appropriate chair person.

4.1.3. The meetings of the Governing Board shall be held at least twice per annum and shall be open to the public.

4.1.4. The date, time and venue of all meetings of the Governing Board will be made public with at least five working days’ notice on the CCG website.

4.1.5. The CCG shall hold an Annual General Meeting (AGM) of the Governing Board once in each year provided not more than fifteen months shall elapse between the date of one AGM and the next.

4.1.6. All members of the Governing Board whether elected or appointed shall be permitted to carry a vote on any decision of the Board unless determined by a conflict of interest whereby the Chair of the Governing Board will specify the action to be taken. No observer shall carry a vote.

4.1.7. All members of the Governing Board whether elected or appointed shall be permitted to carry a vote on any decision of the Board. No observer shall carry a vote.

4.1.8. In the case of an equality of votes, the Chair shall carry the casting vote.

4.1.9. A special meeting may be called at any time by the Chair or any two members of the Governing Board upon not less than two clear days written notice given to the other members of the Governing Board of matters to be discussed.

4.2. Agenda, supporting papers and business to be transacted

4.2.1. Items of business to be transacted for inclusion on the agenda of a meeting need to be notified to the Chair of the meeting at least seven working days (i.e. excluding weekends and bank holidays) before the meeting takes place. Supporting papers for such items need to be submitted at least eleven working days before the meeting takes place.
The Agenda and supporting papers for the meeting will be circulated to all members of a meeting at least five working days before the date the meeting takes place.

4.2.2. The names of the Chair and Members present at the meeting shall be recorded.

4.2.3. Agendas and certain papers for the CCG’s governing board – including details about meeting dates, times and venues – will be published on the CCG’s website at www.portsmouthccg.nhs.uk and will be available on request either in person, by letter of e-mail to the CCG’s Headquarters at:

Post – NHS Portsmouth CCG
CCG Headquarters
4th Floor
1 Guildhall Square (Civic Offices)
Portsmouth
Hampshire
PO1 2GJ

E-mail – pccg.enquiries@nhs.net

4.3. Petitions

4.3.1. Where a petition has been received by the CCG, the chair of the governing board shall include the petition, where they consider appropriate, as an item for the agenda of the next meeting of the governing board.

4.4. Chair of a meeting

4.4.1. At any meeting of the CCG the chair of the meeting, if any and if present, shall preside. If the chair is absent from the meeting, the deputy chair, if any and if present, shall preside.

4.4.2. If the chair is absent temporarily on the grounds of a declared conflict of interest the deputy chair, if present, shall preside. If both the chair and deputy chair are absent, or are disqualified from participating, or there is neither a chair nor deputy a member of the CCG, governing board, or committee respectively shall be chosen by the members present, or by a majority of them, shall preside.

4.5. Chair’s ruling

4.5.1. The decision of the chair of the governing board on questions of order, relevancy and regularity and their interpretation of the constitution, standing orders, scheme of reservation and delegation and prime financial policies at the meeting, shall be final.

4.6. Quorum

4.6.1. The Governing Board shall be quorate when there are nine members in attendance including;

• four clinical representatives (from the five Clinical Executives, registered nurse, secondary care doctor and Director of Public Health),
• two Lay Members

4.6.2. In order to ensure a quorate board when a conflict of interest arises in primary care, the definition of clinical representatives includes the non-elected clinical representatives on the board.

4.6.3. Deputies may attend meetings in the absence of members subject to prior approval by the Chair, but may not vote or be included in the quorum numbers unless a formal acting-up arrangement is in place.

4.6.4. Where any of the positions are occupied on a shared basis by more than one individual that position shall only exercise one vote.

4.6.5. Others may be invited to attend for specific items with the prior agreement of the chair.

4.6.6. For all other of the CCG’s committees, the details of the quorum for these meetings and status of representatives are set out in the appropriate terms of reference for those committees.

4.7. Decision Making

4.7.1. The CCG’s constitution, together with the scheme of reservation and delegation, sets out the governing structure for the exercise of the CCG’s statutory functions. The Chair will work to establish consensus as the basis for decisions of the governing board. If, exceptionally, the governing board cannot reach a decision, the chair will put the matter to a vote usually by a show of hands. The process for which is set out below:

a) Eligibility – only designated members of the governing board may vote. Deputies for members may not vote unless a formal acting-up arrangement is in place;
b) Majority necessary to confirm a decision – majority of one;
c) Casting vote – the Chair shall have a second vote;
d) Dissenting views – all dissenting views to be recorded in the minutes.

4.7.2. Should a vote be taken, the outcome of the vote, and any dissenting views, must be recorded in the minutes of the meeting.

4.7.3. For all other of the CCG’s committees, the details of the process for holding a vote are set out in the appropriate terms of reference.

4.8. Emergency powers and urgent decisions

4.8.1. A member of the governing board may give written notice of an emergency motion after the issue of the notice of meeting and agenda, up to one hour before the time fixed for the meeting, subject to agreement of the Chair, and provided the motion is seconded by another member of the governing board. The notice shall state the grounds of urgency. If in order, it shall be declared to the governing board at the commencement of business of the meeting as an additional item included on the agenda. The Chair’s decision to include the item shall be final.

4.8.2. The Chair may call an emergency meeting.

4.8.3. Urgent decisions (those matters that need to be concluded within five working days) may be taken by the Chair (or in their absence, the Deputy Chair), the Accountable Officer (or in their absence, one of their chief officer deputies) and one other member of the governing board. Any decisions of this nature will be conveyed to the Governing Board members via e-mail and a record made of the decision, rationale and the communications.

4.9. Suspension of Standing Orders

4.9.1. Except where it would contravene any statutory provision or any direction made by the Secretary of State for Health or NHS England, any part of these standing orders may be suspended at any meeting, provided half of the Governing Board members present are in agreement.

4.9.2. A decision to suspend standing orders together with the reasons for doing so shall be recorded in the minutes of the meeting.

4.9.3. A separate record of matters discussed during the suspension shall be kept. These records shall be made available to the governing board’s audit committee for review of the reasonableness of the decision to suspend standing orders.

4.10. Record of Attendance

4.10.1. The names of all members of the governing board present shall be recorded in the minutes of the governing board meetings.

4.10.2. The names of all members of the governing board’s committees present shall be recorded in the minutes of the respective governing board committee meetings.

4.10.3. Where a member is representing a member practice, the name of the practice shall also be recorded.

4.11. Minutes

4.11.1. The minutes of the proceedings of a meeting shall be drawn up and submitted for agreement at the next ensuing meeting. Approval will be recorded.

4.11.2. The minutes will include a record of any real or perceived conflicts of interests identified by or for any Member along with action taken by the Chair to manage each individual conflict.

4.11.3. No discussion shall take place upon the minutes except upon their accuracy or where the Chair considers discussion appropriate.

4.11.4. Minutes shall be circulated in accordance with members’ wishes. Where providing a record of a public meeting the minutes shall be made available to the public as required by Code of Practice on Openness in the NHS.

4.11.5. The name of the person recording and drafting the minutes shall also be recorded in the minutes.

4.11.6. The minutes will be published on the CCG’s website at www.portsmouthccg.nhs.uk and will be available on request either in person, letter or e-mail to the CCGs Headquarters at:

Post – NHS Portsmouth CCG
CCG Headquarters
4th Floor
1 Guildhall Square (Civic Offices)
Portsmouth
Hampshire
PO1 2GJ

E-Mail – enquiries@portsmouthccg.nhs.uk

4.11.7. Members will receive minutes via e-mail and will also have access via the CCG’s website.

5. ADMISSION OF PUBLIC AND THE PRESS

5.1. Admission and exclusion on grounds of confidentiality of business to be transacted.

5.1.1 The public and representatives of the press may attend all meetings of the governing board, but shall be required to withdraw when it is determined that representatives of the press, and other members of the public, be excluded from the remainder of this meeting having regard to the confidential nature of the business to be transacted, publicity on which would be prejudicial to the public interest’, as stated in Section 1 (2), Public Bodies (Admission to Meetings) Act 1960.

5.2 General Disturbances

5.2.1 The Chair or the person presiding over the meeting shall give such directions as they think fit with regard to the arrangements for meetings and accommodation of the public and representatives of the press such as to ensure that the business shall be conducted without interruption and disruption. In addition to the power to exclude members of the public and representatives of the press on grounds of the confidential nature of the business to be transacted, they may also be when the governing body resolves ‘that in the interests of public order the meeting adjourn for (the period to be specified) to enable the governing board to complete its business without the presence of the public’ as stated in Section 1 (8) Public Bodies (Admission to Meetings) Act 1960.

5.3 Business Proposed to be transacted when the press and public have been excluded from a meeting

5.3.1 Matters to be dealt with by the governing board following exclusion of representatives of the press, and members of the public, as provided in (3.6.1) and (3.6.2) above shall be confidential to the members of the governing board.

5.4 Use of Mechanical or Electrical Equipment for Recording or Transmission of Meetings

5.4.1 Nothing in these Standing Orders shall be construed as permitting the introduction by the public, or press representatives, of recording, transmitting, video or similar apparatus into meetings of the governing board or committee thereof. Such permission shall be granted only upon resolution of the governing board.

6. APPOINTMENT OF COMMITTEES AND SUB-COMMITTEES

6.1. Appointment of committees and sub-committees

6.1.1. The CCG may appoint committees and sub-committees of the CCG, subject to any regulations made by the Secretary of State and make provision for the appointment of committees and sub-committees of its governing board.

6.1.2. Committees established by the CCG are set out within its Constitution

6.1.3. The provisions of these standing orders shall apply where relevant to the operation of the governing board, the governing board’s committees and sub-committee and all committees and sub-committees unless stated otherwise in the committee or sub-committee’s terms of reference.

6.2. Delegation of Powers by Committees to Sub-committees

6.2.1. Where committees are authorised to establish sub-committees they may not delegate executive powers to the sub-committee unless expressly authorised by the Governing Board.

6.3. Approval of Appointments to Committees and Sub-Committees

6.3.1. The CCG shall approve the appointments to each of the committees and sub-committees which it has formally constituted including those of the governing board.

7. DUTY TO REPORT NON-COMPLIANCE WITH STANDING ORDERS AND PRIME FINANCIAL POLICIES

7.1. If for any reason these standing orders are not complied with, full details of the non-compliance and any justification for non-compliance and the circumstances around the non-compliance, shall be reported to the next formal meeting of the governing board for action or ratification. All members of the CCG and staff have a duty to disclose any non-compliance with these standing orders to the Accountable Officer and Chief Finance Officer as soon as possible.

8. USE OF SEAL AND AUTHORISATION OF DOCUMENTS

8.1. Custody of seal

8.1.1 The seal shall be kept in a secure place by the Chief Finance Officer.

8.2. Sealing of Documents

8.2.1 Where it is necessary that a document shall be sealed, the seal shall be affixed (by one member of the Governing Board as denoted in section 6.4.1) in the presence of one other who can be a member of the Governing Board, but not also from the originating department and shall be attested by them.

8.3. Register of Sealing

The Chief Finance Officer shall keep a register and shall enter a record of the sealing of every document.

8.4. CCG seal

8.4.1. The CCG may have a seal for executing documents where necessary. The following individuals or officers are authorised to authenticate its use by their signature:

a) the accountable officer;
b) the chair of the governing board;
c) the chief finance officer;
d) the Chief of Health & Care Portsmouth (chief operating officer);
e) the managing director

8.5. Use of Seal – General Guide

8.5.1. The Seal shall be used in the following circumstances. This may not be a complete list:

(i) All contracts for the lease of land and/or building;
(ii) Any other lease agreement where the total payable under the lease exceeds £100,000;
(iii) Any contract or agreement with organisations other than NHS or other government bodies including local authorities where the annual costs exceed or are expected to exceed £100,000.

8.6. Execution of a document by signature

8.6.1. Where any document will be a necessary step in legal proceedings on behalf of the CCG, it shall, unless enactment or otherwise requires or authorises, be signed by the Chief Operating Officer/Accountable Officer, or any /Officer.

8.6.2. The following individuals are authorised to execute a document on behalf of the CCG by their signature.

a) the accountable officer;
b) the chair of the governing board;
c) the chief finance officer;
d) the Chief of Health & Care Portsmouth (chief operating officer);
e) the chief strategic officer

9. OVERLAP WITH OTHER CCG POLICY STATEMENTS/ PROCEDURES AND REGULATIONS

9.1. Policy statements: general principles

9.1.1. The governing board and its committees and sub-committees will from time to time agree and approve policy statements/procedures which will apply to all or specific groups of staff employed by NHS Portsmouth Clinical Commissioning Group. The decisions to approve such policies and procedures will be recorded in an appropriate CCG minute and will be deemed where appropriate to be an integral part of the CCG’s standing orders.

PRIME FINANCIAL POLICIES

1. INTRODUCTION

1.1. General

1.1.1. These prime financial policies and supporting detailed financial policies shall have effect as if incorporated into the CCG’s constitution.

1.1.2. The prime financial policies are part of the CCG’s control environment for managing the organisation’s financial affairs. They contribute to good corporate governance, internal control and managing risks. They enable sound administration, lessen the risk of irregularities and support commissioning and delivery of effective, efficient and economical services. They also help the accountable officer and chief finance officer to effectively perform their responsibilities. They should be used in conjunction with the scheme of reservation and delegation.

1.1.3. In support of these prime financial policies, the CCG has prepared more detailed policies, approved by the Audit Committee.

1.1.4. These prime financial policies identify the financial responsibilities which apply to everyone working for the CCG and its constituent organisations. They do not provide detailed procedural advice and should be read in conjunction with the detailed financial policies. The chief finance officer is responsible for approving all detailed financial policies.

1.1.5. A list of the CCG’s detailed financial policies will be published and maintained on the CCG’s website at www.portsmouthccg.nhs.uk.

1.1.6. Should any difficulties arise regarding the interpretation or application of any of the prime financial policies then the advice of the chief finance officer must be sought before acting. The user of these prime financial policies should also be familiar with and comply with the provisions of the CCG’s constitution, standing orders and scheme of reservation and delegation.

1.1.7. Failure to comply with prime financial policies and standing orders can in certain circumstances be regarded as a disciplinary matter that could result in dismissal.

1.2. Overriding Prime Financial Policies

1.2.1. If for any reason these prime financial policies are not complied with, full details of the non-compliance and any justification for non-compliance and the circumstances around the non-compliance shall be reported to the next formal meeting of the governing board’s audit committee for referring action or ratification. All of the CCG’s members and employees have a duty to disclose any non-compliance with these prime financial policies to the chief finance officer as soon as possible.

1.3. Responsibilities and delegation

1.3.1. The roles and responsibilities of CCG’s members, employees, members of the governing board, members of the governing board’s committees and sub-committees, members of the CCG’s committee and sub-committee (if any) and persons working on behalf of the CCG are set out in chapters 6 and 7 of this constitution.

1.3.2. The financial decisions delegated by members of the CCG are set out in the CCG’s scheme of reservation and delegation.

1.4. Contractors and their employees

1.4.1. Any contractor or employee of a contractor who is empowered by the CCG to commit the CCG to expenditure or who is authorised to obtain income shall be covered by these instructions. It is the responsibility of the accountable officer to ensure that such persons are made aware of this.

1.5. Amendment of Prime Financial Policies

1.5.1. To ensure that these prime financial policies remain up-to-date and relevant, the chief finance officer will review them at least annually. Following consultation with the accountable officer and scrutiny by the governing board’s audit committee, the chief finance officer will recommend amendments, as fitting, to the governing board for approval.

2. INTERNAL CONTROL

POLICY – the CCG will put in place a suitable control environment and effective internal controls that provide reasonable assurance of effective and efficient operations, financial stewardship, probity and compliance with laws and policies

2.1. The governing board is required to establish an audit committee with terms of reference agreed by the governing board (see section 8.7.4a of the CCG’s constitution for further information).

2.2. The accountable officer has overall responsibility for the CCG’s systems of internal control.

2.3. The chief finance officer will ensure that:

a) financial policies are considered for review every three years by the Audit Committee;
b) a system is in place for proper checking and reporting of all breaches of financial policies; and
c) a proper procedure is in place for regular checking of the adequacy and effectiveness of the control environment.

3. AUDIT

POLICY – the CCG will keep an effective and independent internal audit function and fully comply with the requirements of external audit and other statutory reviews

3.1. The person appointed by the CCG to be responsible for internal audit and the appointed external auditor will have direct and unrestricted access to audit committee members and the chair of the governing board, accountable officer and chief finance officer for any significant issues arising from audit work that management cannot resolve, and for all cases of fraud or serious irregularity.

3.2. The person appointed by the CCG to be responsible for internal audit and the external auditor will have access to the audit committee and the accountable officer to review audit issues as appropriate. All audit committee members, the chair of the governing board and the accountable officer will have direct and unrestricted access to the head of internal audit and external auditors.

3.3. The chief finance officer will ensure that:

a) the CCG has a professional and technically competent internal audit function; and
b) the governing board’s audit committee approves any changes to the provision or delivery of assurance services to the CCG.

4. FRAUD AND CORRUPTION

POLICY – the CCG requires all staff to always act honestly and with integrity to safeguard the public resources they are responsible for. The CCG will not tolerate any fraud perpetrated against it and will actively chase any loss suffered

4.1. The governing board’s audit committee will satisfy itself that the CCG has adequate arrangements in place for countering fraud and shall review the outcomes of counter fraud work. It shall also approve the counter fraud work programme.

4.2. The governing board’s audit committee will ensure that the CCG has arrangements in place to work effectively with NHS Protect.

5. EXPENDITURE CONTROL

5.1. The CCG is required by statutory provisions¹ to ensure that its expenditure does not exceed the aggregate of allotments from NHS England and any other sums it has received and is legally allowed to spend.

5.2. The accountable officer has overall executive responsibility for ensuring that the CCG complies with certain of its statutory obligations, including its financial and accounting obligations, and that it exercises its functions effectively, efficiently and economically and in a way which provides good value for money.

5.3. The chief finance officer will:

a) provide reports in the form required by NHS England;
b) ensure money drawn from NHS England is required for approved expenditure only and is drawn down only at the time of need and follows best practice;
c) be responsible for ensuring that an adequate system of monitoring financial performance is in place to enable the CCG to fulfil its statutory responsibility not to exceed its expenditure limits, as set by direction of NHS England.

¹ See section 223H of the 2006 Act, inserted by section 27 of the 2012 Act

6. ALLOTMENTS²

6.1. The CCG’s chief finance officer will:

a) periodically review the basis and assumptions used by NHS England for distributing allotments and ensure that these are reasonable and realistic and secure the CCG’s entitlement to funds;
b) prior to the start of each financial year submit to the governing board for approval a report showing the total allocations received and their proposed distribution including any sums to be held in reserve; and
c) regularly update governing board on significant changes to the initial allocation and the uses of such funds.

² See section 223(G) of the 2006 Act, inserted by section 27 of the 2012 Act.

7. OPERATING PLAN, BUDGETS, BUDGETARY CONTROL AND MONITORING

POLICY – the CCG will produce and publish an annual Operating plan³ that explains how it proposes to discharge its financial duties. The CCG will support this with comprehensive medium term financial plans and annual budgets.

7.1. The accountable officer will compile and submit to the governing board an Operating Plan which takes into account financial targets and forecast limits of available resources.

7.2. Prior to the start of the financial year the chief finance officer will, on behalf of the accountable officer, prepare and submit budgets for approval by the governing board.

7.3. The chief financial officer shall monitor financial performance against budget and plan, periodically review them, and report to the governing board. This report should include explanations for variances. These variances must be based on any significant departures from agreed financial plans or budgets.

7.4. The accountable officer is responsible for ensuring that information relating to the CCG’s accounts or to its income or expenditure, or its use of resources is provided to NHS England as requested.

7.5. The governing board will approve consultation arrangements for the CCG’s Operating Plan⁴

³ See section 14Z11 of the 2006 Act, inserted by section 26 of the 2012 Act.
⁴ See section 14Z13 of the 2006 Act, inserted by section 26 of the 2012 Act

8. ANNUAL ACCOUNTS AND REPORTS

POLICY – the CCG will produce and submit to NHS England accounts and reports in accordance with all statutory obligations⁵, relevant accounting standards and accounting best practice in the form and content and at the time required by NHS England.

8.1. The chief finance officer will ensure the CCG:

a) prepares a timetable for producing the annual report and accounts and shares it with external auditors;
b) prepares the accounts according to the timetable:
c) complies with statutory requirements and relevant directions for the publication of annual report;
d) considers the external auditor’s management letter and fully address all issues within agreed timescales; and
e) publishes the external auditor’s management letter on the CCG’s website at www.portsmouthccg.nhs.uk.

⁵See paragraph 17 of Schedule 1A of the 2006 Act, as inserted by Schedule 2 of the 2012 Act.

9. INFORMATION TECHNOLOGY

POLICY – the CCG will ensure the accuracy and security of the CCG’s computerised financial data.

9.1. The chief finance officer is responsible for the accuracy and security of the CCG’s computerised financial data and shall

a) devise and implement any necessary procedures to ensure adequate (reasonable) protection of the CCG’s data, programs and computer hardware from accidental or intentional disclosure to unauthorised persons, deletion or modification, theft or damage, having due regard for the Data Protection Act 1998;
b) ensure that adequate (reasonable) controls exist over data entry, processing, storage, transmission and output to ensure security, privacy, accuracy, completeness, and timeliness of the data, as well as the efficient and effective operation of the system;
c) ensure that adequate controls exist such that the computer operation is separated from development, maintenance and amendment;
d) ensure that an adequate management (audit) trail exists through the computerised system and that such computer audit reviews as the chief finance officer may consider necessary are being carried out.

9.2. In addition the chief finance officer shall ensure that new financial systems and amendments to current financial systems are developed in a controlled manner and thoroughly tested prior to implementation. Where this is undertaken by another organisation, assurances of adequacy must be obtained from them prior to implementation.

10. ACCOUNTING SYSTEMS

POLICY – the CCG will run an accounting system that creates management and financial accounts.

10.1. The chief finance officer will ensure:

a) the CCG has suitable financial and other software to enable it to comply with these policies and any consolidation requirements of NHS England;
b) that contracts for computer services for financial applications with another health organisation or any other agency shall clearly define the responsibility of all parties for the security, privacy, accuracy, completeness, and timeliness of data during processing, transmission and storage. The contract should also ensure rights of access for audit purposes.

10.2. Where another health organisation or any other agency provides a computer service for financial applications, the chief finance officer shall periodically seek assurances that adequate controls are in operation.

11. BANK ACCOUNTS

POLICY – the CCG will keep enough liquidity to meet its current commitments.

11.1. The chief finance officer will:

a) review the banking arrangements of the CCG at regular intervals to ensure they are in accordance with Secretary of State directions⁶, best practice and represent best value for money;
b) manage the CCG’s banking arrangements and advise the CCG on the provision of banking services and operation of accounts;
c) prepare detailed instructions on the operation of bank accounts.

11.2. The audit committee shall approve the banking arrangements.

⁶ See section 223H(3) of the NHS Act 2006, inserted by section 27 of the 2012 Act

12. INCOME, FEES AND CHARGES AND SECURITY OF CASH, CHEQUES AND OTHER NEGOTIABLE INSTRUMENTS.

POLICY – the CCG will

• operate a sound system for prompt recording, invoicing and collection of all monies due
• seek to maximise its potential to raise additional income only to the extent that it does not interfere with the performance of the CCG or its functions⁷
• ensure its power to make grants and loans is used to discharge its functions effectively⁸

12.1. The Chief Financial Officer is responsible for:

a) designing, maintaining and ensuring compliance with systems for the proper recording, invoicing, and collection and coding of all monies due;
b) establishing and maintaining systems and procedures for the secure handling of cash and other negotiable instruments;
c) approving and regularly reviewing the level of all fees and charges other than those determined by NHS England or by statute. Independent professional advice on matters of valuation shall be taken as necessary;
d) developing effective arrangements for making grants or loans.

⁷ See section 14Z5 of the 2006 Act, inserted by section 26 of the 2012 Act.
⁸ See section 14Z6 of the 2006 Act, inserted by section 26 of the 2012 Act.

13. TENDERING AND CONTRACTING PROCEDURE

POLICY – the CCG:

• will demonstrate adherence to current EU/UK, NHS England / NHS Improvement procurement, competition and collaboration law and regulations
• will ensure we incur only budgeted, approved and necessary spending
• will seek value for money for all goods and services

13.1. All Procurement will be in accordance with the CCG’s approved Procurement Framework.

13.2. The CCG shall ensure that the firms / individuals invited to tender (and where appropriate, quote) are among those on approved lists or where necessary a framework agreement. Where in the opinion of the chief finance officer it is desirable to seek tenders from firms not on the approved lists, the reason shall be recorded in writing to the accountable officer.

13.3. The governing board may only negotiate contracts on behalf of the CCG, and the CCG may only enter into contracts, within the statutory framework set up by the 2006 Act, as amended by the 2012 Act. Such contracts shall comply with:

a) the CCG’s standing orders;
b) the Public Contracts Regulation 2006, any successor legislation and any other applicable law; and
c) take into account as appropriate any applicable NHS England / NHS Improvement guidance that does not conflict with (b) above.

13.4. In all contracts entered into, the CCG shall endeavour to obtain best value for money. The accountable officer shall nominate an individual who shall oversee and manage each contract on behalf of the CCG.

14. COMMISSIONING

POLICY – working in partnership with relevant national and local stakeholders, the CCG will commission certain health services to meet the reasonable requirements of the persons for whom it has responsibility

14.1. The CCG will coordinate its work with NHS England, other clinical commissioning CCGs, local providers of services, local authority (ies), including through Health & Wellbeing Boards, patients and their carers and the voluntary sector and others as appropriate to develop robust commissioning plans.

14.2. The accountable officer will establish arrangements to ensure that regular reports are provided to the governing board detailing actual and forecast expenditure and activity for each contract.

14.3. The chief finance officer will maintain a system of financial monitoring to ensure the effective accounting of expenditure under contracts. This should provide a suitable audit trail for all payments made under the contracts whilst maintaining patient confidentiality.

15. RISK MANAGEMENT AND ASSURANCE

POLICY – the CCG will put arrangements in place for evaluation and management of its risks.

15.1 Portsmouth Clinical Commissioning CCG will manage risk by:

• Clarifying strategic objectives, management and delivery arrangements
• Identifying strategic and operational risks and challenges to those objectives
• Assessing risks
• Managing risks and issues
• Reviewing and reporting on risks and issues

15.2 Portsmouth Clinical Commissioning CCG will operate an assurance framework. This is a structure of recording identified risks at all levels of the CCG’s activities using a Risk Register. At the CCG Governing board level this includes a summary of the Significant Risks to the Strategic Objectives of the CCG. This public facing summary incorporates a description of the CCG Governing board’s assurances that they receive to confirm whether or not these risks are effectively controlled.

15.3 All significant corporate risks will be reported to the Governing Board through the Integrated Performance, Quality and Assurance Framework report.

16. PAYROLL

POLICY – the CCG will put arrangements in place for an effective payroll service.

16.1. The chief finance officer will ensure that the payroll service selected:

a) is supported by appropriate (i.e. contracted) terms and conditions;
b) has adequate internal controls and audit review processes;
c) has suitable arrangements for the collection of payroll deductions and payment of these to appropriate bodies.

16.2. In addition the chief finance officer shall set out comprehensive procedures for the effective processing of payroll

17. NON-PAY EXPENDITURE

POLICY – the CCG will seek to obtain the best value for money goods and services received.

17.1. The Governing board will approve the level of non-pay expenditure on an annual basis and the accountable officer will determine the level of delegation to budget managers

17.2. The accountable officer shall set out procedures on the seeking of professional advice regarding the supply of goods and services.

17.3. The chief finance officer will:

a) advise the governing board on the setting of thresholds above which quotations (competitive or otherwise) or formal tenders must be obtained; and, once approved, the thresholds should be incorporated into the detailed financial policies;
b) be responsible for the prompt payment of all properly authorised accounts and claims;
c) be responsible for designing and maintaining a system of verification, recording and payment of all amounts payable.

18. CAPITAL INVESTMENT, FIXED ASSET REGISTERS AND SECURITY OF ASSETS

POLICY – the CCG will put arrangements in place to manage capital investment, maintain an asset register recording fixed assets and put in place polices to secure the safe storage of the CCG’s fixed assets.

18.1. The accountable officer will:

a) ensure that there is an adequate appraisal and approval process in place for determining capital expenditure priorities and the effect of each proposal upon plans;
b) be responsible for the management of all stages of capital schemes and for ensuring that schemes are delivered on time and to cost;
c) shall ensure that the capital investment is not undertaken without confirmation of support and the availability of resources to finance all revenue consequences, including capital charges;
d) be responsible for the maintenance of registers of assets, taking account of the advice of the chief finance officer concerning the form of any register and the method of updating, and arranging for a physical check of assets against the asset register to be conducted once a year.

18.2. The chief finance officer will prepare detailed procedures for the disposals of assets.

19. RETENTION OF RECORDS

POLICY – the CCG will put arrangements in place to retain all records in accordance with NHS Code of Practice Records Management 2006 and other relevant notified guidance

19.1. The Accountable Officer shall:

a) be responsible for maintaining all records required to be retained in accordance with NHS Code of Practice Records Management 2006 and other relevant notified guidance;
b) ensure that arrangements are in place for effective responses to Freedom of Information requests;
c) publish and maintain a Freedom of Information Publication Scheme.

20. TRUST FUNDS AND TRUSTEES

POLICY – the CCG will put arrangements in place to provide for the appointment of trustees if the CCG holds property on trust

20.1. The chief finance officer shall ensure that each trust fund which the CCG is responsible for managing is managed appropriately with regard to its purpose and to its requirements.

Delegated Approval Limits:

* In the absence of the Accountable Officer, authority may be delegated to the Chief Finance Officer or Chief Operating Officer

Version: V 6.1

Effective Date: December 2020

Changes:

Main Body of the Constitution:
3.1.3 – The number of practices has been updated.

Standing Orders: Reappointment into roles – a term of 3 years has been included.
3.1.6 – the post of Clinical Leader, this is now separated from the role of AO/Chair and states that the Clinical Leader must also be a Clinical Executive.
4.1.3 – the frequency of GB meetings (in public) has been reduced from a minimum of 6 to a minimum of 2 per year.
4.1.6 – voting rights. This now includes a statement on Conflicts of Interest.
4.6.1 – Quoracy. This has been increased to 9 members to include: four clinical representatives (from the five Clinical Executives, registered nurse, secondary care doctor and Director of Public Health) and two Lay Members
4.11.2 Conflicts of interest – this paragraph has been added.