NHS MANSFIELD AND ASHFIELD CLINICAL COMMISSIONING … · 1.2.1. Clinical Commissioning Groups are...

NHS MANSFIELD AND ASHFIELD CLINICAL COMMISSIONING GROUP

CONSTITUTION

Version 6: Approved by NHS England

NHS Commissioning Board Effective Date: 27 January 2017

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CONTENTS

Part Description Page

Foreword 5 1 Introduction and Commencement 6

1.1 Name 6 1.2 Statutory framework 6 1.3 Status of this constitution 6 1.4 Amendment and variation of this constitution 7 2 Area Covered 8 3 Membership 9

3.1 Membership of the clinical commissioning Group 9 3.2 Eligibility 10 4 Mission, Values and Aims 11

4.1 Mission 11 4.2 Values 11 4.3 Aims 11 4.4 Principles of good governance 12 4.5 Accountability 13 5 Functions and General Duties 14

5.1 Functions 14 5.2 General duties 15 5.3 General financial duties 22 5.4 Other relevant regulations, directions and documents 23 6 Decision Making: The Governing Structure 24

6.1 Authority to act 24 6.2 Scheme of reservation and delegation 24 6.3 General 24 6.4 Committees of the Group 25 6.5 The Governing Body 26 6.6 Joint Commissioning Arrangements with NHS England for the

Exercise of CCG Functions 34

6.7 Joint Commissioning Arrangements with NHS England for the exercise of NHS England’s functions

35

6.8 Joint commissioning arrangements with other Clinical Commissioning Groups

36

6.9 Joint Arrangements 37 7 Roles and Responsibilities 39

7.1 Member practices 39 7.2 All members of the Group’s Governing Body 40 7.3 The chair of the Governing Body 40 7.4 The deputy chair of the Governing Body 41 7.5 Role of the Accountable Officer 41

Description Page 7.6 Role of the Chief Finance Officer 41 7.7 Joint appointments with other organisations 42 8 Standards of Business Conduct and Managing Conflicts of Interest 42

8.1 Standards of business conduct 42 8.2 Conflicts of interest 43 9 The Group as Employer 44 10 Transparency, Ways of Working and Standing Orders 46

10.a General 46 10.b Standing orders 46

Appendix Description Page A Definitions of Key Descriptions used in this Constitution 47 B Map of Mansfield and Ashfield Area 49 C List of Member Practices 50 D Standing Orders 52 E Scheme of Reservation and Delegation 70 F The Nolan Principles 92 G The Seven Key Principles of the NHS Constitution 93 H Prime Financial Policies 94 I Conflicts of Interest Policy 106

FOREWORD

The NHS Mansfield and Ashfield Clinical Commissioning Group (CCG) was formed in April 2011 from the 31 GP practices which made up the former Mansfield and Ashfield Practice Based Commissioning Group (known as High Point Health). We cover all of the Mansfield and Ashfield areas with the exception of Hucknall. GP practices in Mansfield and Ashfield first came together to work as commissioners when the Ashfield and Mansfield PCTs were created in 2001. Throughout a series of changes to the NHS we have retained continuity as like-minded practices that are committed to working together for the best interests of patients in our area. We see this as a strength going forward.

This constitution sets out the arrangements made by the NHS Mansfield and Ashfield CCG to meet its responsibilities for commissioning care for the people within our area. It describes the governing principles, rules and procedures that the CCG will establish to ensure probity and accountability in the day to day running of the CCG; to ensure that decisions are taken in an open and transparent way and that the interests of patients and the public remain central to the goals of the CCG.

Above all we want to be known as an organisation that contributes to making a real difference to improving the health and wellbeing of people living in Mansfield and Ashfield.

1. INTRODUCTION AND COMMENCEMENT

1.1. Name 1.1.1. The name of this clinical commissioning Group is NHS Mansfield and

Ashfield Clinical Commissioning Group.

1.2. Statutory Framework 1.2.1. Clinical Commissioning Groups are established under the Health and Social

Care Act 2012 (“the 2012 Act”).1 They are statutory bodies which have the function of commissioning services for the purposes of the health service in England and are treated as NHS bodies for the purposes of the National Health Service Act 2006 (“the 2006 Act”).2 The duties of Clinical Commissioning Groups to commission certain health services are set out in section 3 of the 2006 Act, as amended by section 13 of the 2012 Act, and the regulations made under that provision.3

1.2.2. The NHS Commissioning Board is responsible for determining applications

from prospective Groups to be established as Clinical Commissioning Groups4

and undertakes an annual assessment of each established Group.5 It has powers to intervene in a Clinical Commissioning Group where it is satisfied that a Group is failing or has failed to discharge any of its functions or that there is a significant risk that it will fail to do so.6

1.2.3. Clinical Commissioning Groups are clinically led membership organisations

made up of general practices. The members of the Clinical Commissioning Group are responsible for determining the governing arrangements for their organisations, which they are required to set out in a constitution.7

1.3. Status of this Constitution

1.3.1. This constitution is made between the members of NHS Mansfield and

Ashfield Clinical Commissioning Group and has effect from 19 February 2013, when the NHS Commissioning Board established the Group.8

1.3.2. This constitution is published on the Group’s website at

www.mansfieldandashfieldccg.nhs.uk and may also be inspected upon request

1 See section 1I of the 2006 Act, inserted by section 10 of the 2012 Act 2 See section 275 of the 2006 Act, as amended by paragraph 140(2)(c) of Schedule 4 of the 2012 Act 3 Duties of clinical commissioning groups to commission certain health services are set out in section

3 of the 2006 Act, as amended by section 13 of the 2012 Act 4 See section 14C of the 2006 Act, inserted by section 25 of the 2012 Act 5 See section 14Z16 of the 2006 Act, inserted by section 26 of the 2012 Act 6 See sections 14Z21 and 14Z22 of the 2006 Act, inserted by section 26 of the 2012 Act 7 See in particular sections 14L, 14M, 14N and 14O of the 2006 Act, inserted by section 25 of the

2012 Act and Part 1 of Schedule 1A to the 2006 Act, inserted by Schedule 2 to the 2012 Act and any regulations issued

8 See section 14D of the 2006 Act, inserted by section 25 of the 2012 Act 6

(addressed to the Head of Corporate Governance) at the CCG Headquarters which are located at:

NHS Mansfield and Ashfield CCG Hawthorn House Ransom Wood Business Park Southwell Road West Rainworth Mansfield Nottinghamshire NG21 0HJ

Tel: 01623 673143

1.4. Amendment and Variation of this Constitution

1.4.1. This constitution can only be varied in two circumstances.9

a) where the Group applies to the NHS Commissioning Board and

that application is granted;

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

9 See sections 14E and 14F of the 2006 Act, inserted by section 25 of the 2012 Act and any regulations issued

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2. AREA COVERED

2.1. The geographical area covered by NHS Mansfield and Ashfield Clinical Commissioning Group is largely coterminous with the area covered by the District Council of Ashfield (www.ashfield-dc.gov.uk) and the District Council of Mansfield (www.mansfield.gov.uk). See appendix B for a map of the area.

2.2. The town of Hucknall, whilst within the District of Ashfield, is covered by

the NHS Nottingham North and East Clinical Commissioning Group.

2.3. The following list of lower super output areas are covered by the NHS Mansfield and Ashfield CCG:

E01028238 E01027963 E01027982 E01027950 E01028228 E01027956 E01027992 E01027970 E01028248 E01027983 E01027962 E01027960 E01028229 E01027993 E01028242 E01027951 E01028258 E01027988 E01028252 E01028232 E01028249 E01028273 E01028272 E01027952 E01028278 E01028226 E01028262 E01028222 E01028259 E01028263 E01028260 E01027953 E01028279 E01028256 E01027985 E01028223 E01028269 E01028236 E01028227 E01028230 E01027989 E01028234 E01027995 E01028220 E01027998 E01028224 E01028247 E01028243 E01027979 E01027994 E01028237 E01028233 E01027969 E01028244 E01028257 E01028253 E01027958 E01028254 E01027975 E01028221 E01027948 E01028274 E01028225 E01028240 E01027978 E01028264 E01027965 E01028250 E01027959 E01027977 E01028245 E01028270 E01027968 E01028275 E01028255 E01028231 E01027949 E01027967 E01027981 E01028241 E01028235 E01028265 E01027991 E01028251 E01028219 E01027980 E01027971 E01028271 E01027954 E01027990 E01027987 E01028276 E01027974 E01027955 E01027976 E01028246 E01027964 E01027945 E01027961 E01028261 E01028281 E01027947 E01027997 E01028266 E01027946 E01028280 E01027966 E01027984 E01028239 E01027957 E01027986 E01028277 E01028268 E01028282 E01027996 E01028267 E01028283 E01027972 E01027973 E01028284

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MEMBERSHIP 3. Membership of the Clinical Commissioning Group

3.1.1. The following practices comprise the members of NHS Mansfield and

Ashfield Clinical Commissioning Group.

Practice Name Address Acorn Medical Practice 11-13 Wood Street, Mansfield, NG18 1QA

Ashfield House 194 Forest Road, Annesley Woodhouse, NG17 9JB

Ashfield Medical Centre King Street, Sutton in Ashfield, NG17 1AT

Bull Farm Primary Care Resource Centre

Concorde Way, Millennium Business Park, Mansfield,NG19 7JZ

Churchside Medical Practice (Ward & Pearce)

Wood Street, Mansfield, NG18 1QB

Forest Medical Centre Rosemary Street, Mansfield, NG19 6AB Jubilee Way South, Mansfield, NG18 3SF

Harwood Close Surgery Skegby Road, Sutton in Ashfield, NG17 4PD

Skegby Family Medical Centre Mansfield Road, Skegby, NG17 3EE

Brierley Park Medical Centre 127 Sutton Road, Huthwaite, NG17 2NF

Jacksdale Medical Centre Main Road, Jacksdale, NG16 5JW

Kirkby Community Primary Care Centre

Ashfield Health Village, Portland Street, Kirkby in Ashfield, NG17 7AE

Kirkby Family Medical Centre 56a Lowmoor Road, Kirkby in Ashfield, NG17 7BG

Kirkby Health Care Complex 52 Lowmoor Road, Kirkby in Ashfield, NG17 7BG

Kirkby Health Centre Lowmoor Road, Kirkby in Ashfield, NG17 7LG

Kirkby Surgery Lowmoor Road, Kirkby in Ashfield, NG17 7BQ

Meden Vale Medical Centre Egmanton Road, Meden Vale, NG20 9QN

Millview Surgery 1a Goldsmith Street, Mansfield, NG18 5PF

Oakwood Surgery Church Street, Mansfield, NG19 8BL

Orchard Medical Practice Stockwell Gate, Mansfield, NG18 5GG

Pleasley Surgery

Chesterfield Road, Pleasley, NG19 7PE

Riverbank Medical Services Church Street, Warsop, NG20 0BP

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Practice Name Address Roundwood Surgery Wood Street, Mansfield, NG18 1QQ

Sandy Lane Surgery Sandy Lane, Mansfield, NG18 2LT

Selston Surgery 139 Nottingham Road, Selston, NG16 6BT

St Peter’s Medical Practice Commercial Street, Mansfield, Notts, NG18 1EE

Willowbrook Medical Practice Brook Street, Sutton in Ashfield, NG17 1ES

Woodlands Medical Practice Bluebell Wood Way, Sutton in Ashfield, NG17 1JW

3.1.2. Appendix C of this constitution contains the list of practices, together with

the signatures of the practice representatives confirming their agreement to this constitution.

3.2. Eligibility

3.2.1. Providers of primary medical services to a registered list of patients under

a General Medical Services, Personal Medical Services or Alternative Provider Medical Services contract, will be eligible to apply for membership of this Group10.

10 See section 14A(4) of the 2006 Act, inserted by section 25 of the 2012. Regulations to be made

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4. MISSION, VALUES AND AIMS

4.1. Mission 4.1.1. NHS Mansfield and Ashfield Clinical Commissioning Group wants to be

known as an organisation that contributes to making a real difference to improving the health and wellbeing of people in Mansfield and Ashfield.

4.1.2. The Group will promote good governance and proper stewardship of

public resources in pursuance of its goals and in meeting its statutory duties.

4.2. Values

4.2.1. Good corporate governance arrangements are critical to achieving the

Group’s objectives. 4.2.2. The values that lie at the heart of the Group’s work are:

Patient Our focus will always be on our service to patients

Accountable We will be accountable for, and honest and open about, the decisions we make

Responsive We will listen and respond to what people tell us about the services we commission

True partners We will work collaboratively with all of our partners who can help to Improve the Health and Wellbeing of People in Mansfield and Ashfield

Near to home Services Near to home, so long as they are Safe, Clinically Effective and Cost Effective

Equitable We will recognise the diverse needs of our population and ensure services are available on a fair and equitable basis

Respect We will be mindful of how we work and of the impact our actions might have on others

Seamless We will work hard with others to provide integrated services to improve the patient experience

4.3. Aims

4.3.1. The Group’s aims* are to:

*approved by the Governing Body in March 2014 Aim 1. Best quality within available resources (incorporating safety, effectiveness and patient experience)

Strategic objectives: Reduce avoidable acute hospital attendances and stays

• 15.1% reduction in A&E attendances • 19.5% reduction in non-elective acute admissions • 9.8% reduction in secondary care elective referrals

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• 20% reduction in paediatric admissions to hospital

• Achieve financial balance Aim 2. System sustainability through service integration and community provision

Strategic objectives:

• Ensure residential or inpatient care is not a default model of care • 30.5% reduction in acute bed days • 25% reduction in admissions to nursing and residential homes • Design, procure and monitor services to ensure clinically and financial

sustainable services • Work in partnership with local authorities, commissioners and providers to

maximise use of public sector resources • Deliver transformational service models • Ensure appropriate programme management to deliver transformational schemes • Ensure appropriate organisational development to enable change • Develop and deliver workforce change plan, coordinated across the system • Develop and deliver estates strategy across the system

Aim 3. Improve health outcomes

Strategic objectives:

• Enable self-care where possible • Enable people to die at home where that is their choice • Commission services to reduce health inequalities • Decrease potential years of life lost • Improve the health related quality of life for people with long-term conditions

4.4. Principles of Good Governance

4.4.1. In accordance with section 14L(2)(b) of the 2006 Act,11 the Group will at all

times observe “such generally accepted principles of good governance” in the way it conducts its business. These include:

a) the highest standards of propriety involving impartiality, integrity and

objectivity in relation to the stewardship of public funds, the management of the organisation and the conduct of its business;

b) The Good Governance Standard for Public Services;12

c) the standards of behaviour published by the Committee on Standards in Public Life (1995) known as the ‘Nolan Principles;’13

d) the seven key principles of the NHS Constitution;14

11 Inserted by section 25 of the 2012 Act 12 The Good Governance Standard for Public Services, The Independent Commission on Good

Governance in Public Services, Office of Public Management (OPM) and The Chartered Institute of Public Finance & Accountability (CIPFA), 2004

13 See Appendix G

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e) the Equality Act 2010.15

4.5. Accountability

4.5.1. The Group will demonstrate its accountability to its members, local people,

stakeholders and the NHS Commissioning Board in a number of ways, including by:

a) publishing its constitution;

b) appointing independent lay members and non GP clinicians to its

Governing Body;

c) holding meetings of its Governing Body and Primary Care Commissioning Committee in public (except where the Group considers that it would not be in the public interest in relation to all or part of a meeting);

d) publishing annually a commissioning plan;

e) complying with local authority health overview and scrutiny requirements;

f) meeting annually in public to publish and present its annual report

(which must be published);

g) producing annual accounts in respect of each financial year which must be externally audited;

h) having a published and clear complaints process;

i) complying with the Freedom of Information Act 2000;

j) providing information to the NHS Commissioning Board as required.

4.5.2. In addition to these statutory requirements, the Group will demonstrate its

accountability by: 4.5.3.

Adhering to the Better Together Agreement to support and enable the provision of integrated urgent, proactive, elective care, mental health and various social services for mid Nottinghamshire a) producing an inter-practice agreement for all members;

b) producing a communications and engagement strategy which will

be approved by the CCG Governing Body;

c) producing an integrated assurance framework which manages corporate, financial and clinical risk;

d) working in partnership with key partners and stakeholders such as

the Health and Wellbeing Board 14 See Appendix H

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15 See http://www.legislation.gov.uk/ukpga/2010/15/contents

e) taking account of the views of Mansfield and Ashfield residents through consultation events and the established Citizens’ Reference Panel.

4.5.4. The Governing Body of the Group will throughout each year have an on-going

role in reviewing the Group’s governance arrangements to ensure that the Group continues to reflect the principles of good governance.

5. FUNCTIONS AND GENERAL DUTIES

5.1. Functions 5.1.1. The functions that the Group is responsible for exercising are largely set out in

the 2006 Act, as amended by the 2012 Act. An outline of these appears in the Department of Health’s Functions of clinical commissioning Groups. They relate to:

a) commissioning certain health services (where the NHS

Commissioning Board is not under a duty to do so) that meet the reasonable needs of:

i) all people registered with member GP practices, and ii) people who are usually resident within the area and are not

registered with a member of any clinical commissioning Group;

b) commissioning emergency care for anyone present in the Group’s area; c) paying its employees’ remuneration, fees and allowances in accordance

with the determinations made by its Governing Body and determining any other terms and conditions of service of the Group’s employees;

d) determining the remuneration and travelling or other allowances of members of its Governing Body.

5.1.2. In discharging its functions the Group will:

a) act16, when exercising its functions to commission health services,

consistently with the discharge by the Secretary of State and the NHS Commissioning Board of their duty to promote a comprehensive health service17 and with the objectives and requirements placed on the NHS Commissioning Board through the mandate18 published by the Secretary of State before the start of each financial year by:

i) delegating this overall duty to the Governing Body; ii) the production, and approval by the Governing Body, of a strategic plan; iii) the production, and approval by the Governing Body, of

annual commissioning intentions and plan.

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b) meet the public sector equality duty19 by:

i) delegating responsibility for this duty to the CCG Communication and Engagement meeting;

16 See section 3(1F) of the 2006 Act, inserted by section 13 of the 2012 Act 17 See section 1 of the 2006 Act, as amended by section 1 of the 2012 Act 18 See section 13A of the 2006 Act, inserted by section 23 of the 2012 Act 19 See section 149 of the Equality Act 2010, as amended by paragraphs 184 and 186 of Schedule 5

of the 2012 Act

ii) producing an equality and diversity strategy, which will be approved by the Governing Body;

iii) the completion, publication and monitoring of achievement of the CCG equality delivery objectives.

c) work in partnership with its local authority[ies] to develop joint

strategic needs assessments20 and joint health and wellbeing strategies21 by:

i) continuing to be an active member of the Nottinghamshire Health

and Wellbeing Board, with the clinical lead being the CCG representative and a voting member of this board;

ii) contributing through the Health and Wellbeing Board to the development of the Nottinghamshire Joint Strategic Needs Assessment and subsequently to the Nottinghamshire Health and Wellbeing Strategy as well as supporting its implementation as appropriate;

iii) ensuring that the views and opinions of the entire CCG are taken into account.

5.2. General Duties - in discharging its functions the Group will:

5.2.1. Make arrangements to secure public involvement in the planning,

development and consideration of proposals for changes and decisions affecting the operation of commissioning arrangements22 by:

a) working with the Group’s Citizens’ Reference Panel to provide a two

way communication channel between patients, carers and the public;

b) working in partnership with patients and the local community to secure the best care for them;

c) adapting engagement activities to meet the specific needs of different

patient Groups and communities;

d) publishing information about health services in Mansfield and Ashfield on the Group’s website;

e) encouraging and acting on feedback we receive;

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f) monitoring and reporting the Group’s compliance against this statement of principles to the Governing Body on an annual basis.

Where it is intended that services will change, the CCG will engage with the Nottinghamshire Health Overview and Scrutiny committees and, where we have to formally consult on changes, we will take account of the Cabinet Office’s code of practice on consultation.

20 See section 116 of the Local Government and Public Involvement in Health Act 2007, as amended

by section 192 of the 2012 Act 21 See section 116A of the Local Government and Public Involvement in Health Act 2007, as inserted

by section 191 of the 2012 Act 22 See section 14Z2 of the 2006 Act, inserted by section 26 of the 2012 Act

5.2.2. Promote awareness of, and act with a view to securing that health services are provided in a way that promotes awareness of, and have regard to the NHS Constitution23 by:

a) delegating this responsibility to the Group’s Governing Body to

ensure compliance;

b) ensuring that the Group’s strategic and commissioning plans meet this requirement.

5.2.3. Act effectively, efficiently and economically24 by:

a) the Group determining the Governing Body duties to approve the

Standing Orders and Scheme of Delegation and Reservation;

b) the Governing Body establishing an Audit and Governance Committee to provide financial reassurance;

c) the Governing Body determining lead responsibilities for

service commissioning with available resource;

d) establishing the Accountable Officer to manage within financial resources

e) establishing a governance committee structure which oversees the effective, and efficient use of resources;

f) establishing lead responsibilities to commission the best services

within budget to meet public need;

g) establishing lead responsibilities to review contract activity and reviewing contract performance;

h) establishing lead responsibilities to monitor quality and maintain

patient safety activity carried out by provider organisations;

i) establishing the standing financial instructions and the system of financial control.

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5.2.4. Act with a view to securing continuous improvement to the quality of services25 by:

a) delegating responsibility for overseeing continuous quality improvements

to the Quality and Risk Committee shared with NHS Newark and Sherwood CCG which will report to and provide assurance to the Group’s Governing Body;

23 See section 14P of the 2006 Act, inserted by section 26 of the 2012 Act and section 2 of the Health Act 2009 (as amended by 2012 Act)

24 See section 14Q of the 2006 Act, inserted by section 26 of the 2012 Act 25 See section 14R of the 2006 Act, inserted by section 26 of the 2012 Act

b) delegating responsibility to the Quality and Risk Committee for patient safety, risk management, equality and diversity, information governance, complaints and PALS;

c) providing the Group’s Governing Body with quality and

performance information to identify quality performance issues;

d) delegating the responsibility for overseeing safeguarding to the Safeguarding Committee, chaired by NHS Newark and Sherwood Clinical Commissioning Group;

e) working in partnership to improve safeguarding;

f) ensuring all service providers have regular contract management

meetings, as stipulated in their contract, at which performance is reviewed. 5.2.5. Assist and support the NHS Commissioning Board in relation to the Board’s

duty to improve the quality of primary medical services26 by:

a) delegating responsibility to the Governing Body for the strategic oversight and improvement of primary care quality;

b) the production of a primary care strategy for Mansfield and Ashfield.

c) assist and support NHS England in discharging its duties relating to

individual GP performance management (medical performers’ list for GPs, appraisal and revalidation), administration of payments and list management

5.2.6. Carry out the functions relating to the commissioning of primary medical

service under section 83 of the NHS Act as outlined within the NHS Delegated Agreement by: a) delegating the commissioning of primary medical services to the NHS

Mansfield & Ashfield CCGs Primary Care Commissioning Committee

b) promoting increased co-commissioning to increase quality, efficiency, productivity and value for money to remove administrative burdens

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c) monitoring of contracts, taking contractual action such as issuing branch/remedial notices

d) designing local incentive schemes as an alternative to Quality Outcomes

Framework (QOF)

e) approving practice mergers

f) undertaking reviews of primary care services

g) managing the budget for commissioning of primary care services

26 See section 14S of the 2006 Act, inserted by section 26 of the 2012 Act

5.2.7. Have regard to the need to reduce inequalities27 by:

a) delegating strategic responsibility for addressing this to the Group’s Governing body;

b) working in partnership with the local authorities to identify health

inequalities within the joint strategic needs assessment;

c) Supporting the delivery of the priorities articulated in the Health and Wellbeing Strategy;

d) Working with partners to have a positive influence on the wider

determinants of health;

e) Ensuring that services are commissioned against an evidenced base and that they secure equitable outcomes; and

f) Improving the quality of primary care delivery within the CCG.

5.2.8. Promote the involvement of patients, their carers and representatives

in decisions about their healthcare28 by:

a) delegating responsibility to the Group’s Governing Body to promote the involvement of patients, their carers and representatives in decisions about their healthcare;

b) developing a two way dialogue with the Group’s Citizens’ Reference Panel;

ensuring a Better Together Citizens’ Board is established through the Better Together Alliance Agreement

c) promoting patient choice, through the Group’s communication

and engagement strategy;

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d) producing a procurement strategy which will encourage choice;

e) ensuring the wide involvement of all stakeholder Groups in service redesign;

f) ensuring the Group’s website contains relevant, up-to-date information for patients and carers.

5.2.9. Act with a view to enabling patients to make choices29 by:

a) delegating responsibility to the Governing Body to ensure that patient

choice is built into the Group’s commissioning activity;

b) ensuring that patient choice is built into the CCG procurement strategy.

27 See section 14T of the 2006 Act, inserted by section 26 of the 2012 Act 28 See section 14U of the 2006 Act, inserted by section 26 of the 2012 Act 29 See section 14V of the 2006 Act, inserted by section 26 of the 2012 Act

5.2.10. Obtain appropriate advice30 from persons who, taken together, have a broad range of professional expertise in healthcare and public health by:

a) delegating responsibility to the Group’s Governing Body, ensuring attention

is being paid to any of the following consultation and involvement mechanisms:

i) direct consultation with member practices ii) the Group’s Locality Groups led by elected GPs iii) Clinical forums iv) the Group’s Executive Team v) local authorities including Public Health, the Health and Wellbeing

Board and HealthWatch vi) clinical senates vii) strategic clinical networks viii) the Local Medical Committee

5.2.11. Promote innovation31 by:

a) delegating strategic responsibility to the Governing Body for the promotion of

innovation;

b) delegating operational responsibility to the care design groups;

c) Identifying a clinical champion (GP) of innovation;

d) collaborative working with local and regional research networks, such as the Academic Health Science Network and the Clinical Senate;

e) Collaborative working with local organisations, including the local authority through the Better Together Alliance Agreement

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f) developing and implementing the Group organisational development plan to assist innovative working and adoption of best practice;

g) communicating good practice via the Executive Team and Locality

Groups;

h) Ensuring innovation activity is linked to the Group’s Quality, Innovation, Productivity (QIPP) workstreams;

i) encouraging the adoption of innovation through local meetings and forums;

j) engaging with patients and carers to seek new and innovative ways of

working;

k) using contract levers to support innovation.

30 See section 14W of the 2006 Act, inserted by section 26 of the 2012 Act 31 See section 14X of the 2006 Act, inserted by section 26 of the 2012 Act

5.2.12. Promote research and the use of research32 by:

a) Delegating strategic responsibility to the Governing Body for the promotion of research;

b) Delegating operational responsibility to the Quality and Risk Committee;

c) Identifying a clinical champion (GP) of research;

d) Establishing close links with the local National Institute for Health

Research (NIHR) networks including the Primary Care Research network (PCRN), Comprehensive Local Research network (CLRN) and Collaboration for Leadership in Applied Health Research and Care (CLARHC);

e) Ensuring research activity is linked to the Group’s Quality,

Innovation, Productivity and Prevention (QIPP) workstreams;

f) Ensuring that research base is a key part of any scoping work in the Group’s workstreams and all commissioned activity has a strong evidence base;

g) Working collaboratively with CLARHC to recruit patients through its

Primary Care research projects and increase engagement with the local NIHR funded studies through co-production of recruitment strategies;

h) Engaging with CLARHC to increase its research capacity

through mechanisms such as research into practice awards;

i) Working with CLARHC, PCRN, and CLRN to also provide research insight events for NHS staff research to improve the opportunities for

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patients to become aware of research activity;

j) Capturing current research activity in the Group’s area through use of links to the research networks;

k) Influencing and promotion of research in the local area through intelligence

gathered across the Trent network through meetings, conferences, research forums.

5.2.13. Have regard to the need to promote education and training33 for persons

who are employed, or who are considering becoming employed, in an activity which involves or is connected with the provision of services as part of the health service in England so as to assist the Secretary of State for Health in the discharge of his related duty34 by:

32 See section 14Y of the 2006 Act, inserted by section 26 of the 2012 Act 33 See section 14Z of the 2006 Act, inserted by section 26 of the 2012 Act 34 See section 1F(1) of the 2006 Act, inserted by section 7 of the 2012 Act

a) Delegating strategic responsibility to the Governing Body for the promotion of education and training;

b) Delegating operational responsibility to the Group’s Accountable Officer to

present to the Governing Body with an annual organisation development and training plan;

c) Delegating operating responsibility to the Group’s Education Forum

the responsibility for the management of a funded annual programme of protected learning time (PLT) activity;

d) making it a requirement, set out in the Inter-Practice Agreement, for all

members of the Group to actively engage in and promote education and training;

e) monitoring the attendance of Group managed training events;

f) regularly reviewing training needs, including consulting with members

to ensure content or organised sessions is valued;

g) evaluating the effectiveness of training events;

h) preparing and presenting an annual report of PLT activity to the Executive Team;

i) Participating in the Nottinghamshire GP and Practice Staff Education

and Training Board. 5.2.14. Act with a view to promoting integration of both health services with other

health services and health services with health-related and social care services where the Group considers that this would improve the quality of

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services or reduce inequalities35 by:

a) delegating strategic responsibility to the Governing Body to have due regard for promoting integration;

b) delegating responsibility to the Accountable Officer to present an

annual report and action plan to the Governing Body on progress;

c) requiring clinical workstream leads to contribute to the development of this report;

d) ensuring that membership of clinical workstreams reflects the

integrated aims of the CCG;

35 See section 14Z1 of the 2006 Act, inserted by section 26 of the 2012 Act

e) ensuring the Governing Body’s membership to reflect partnership opportunities for progressing integration. Establishing a Better Together Alliance Leadership Board with membership including Nottinghamshire County Council.

5.3. General Financial Duties – the Group will perform its functions so as to:

5.3.1. Ensure its expenditure does not exceed the aggregate of its allotments

for the financial year36 by:

a) Establishing robust budget setting arrangements. The Group’s Accountable Officer will compile and submit to the Governing Body a medium term plan which takes into account financial targets and forecast limits of available resources. The plan will contain:

i) a statement of the significant assumptions on which the plan is based; ii) details of major changes in workload, delivery of services or

resources required to achieve the plan.

b) 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 Body. These will:

i) be in accordance with the aims and objectives set out in the plan; ii) accord with workload and resource plans; iii) be produced following discussion with appropriate budget holders; iv) be prepared within the limits of available allotments and income; v) identify potential risks.

c) the Governing Body delegating authority to spend to appropriately

placed and trained budget holders who will be responsible for committing and managing resources. The role of the budget holder is specified in the budget management framework.

22

d) the Chief Financial Officer producing a budget management manual or equivalent which will describe the role and responsibilities of budget holders and managers and the budgetary control process. The Chief Finance Officer will monitor allotments, income and expenditure and produce a monthly monitoring report for the Governing Body and executive both of which will be responsible for detailed examination and understanding of the outcome of the monitoring reports.

e) Budget holders/managers identifying variances and the reasons for them

and informing the Chief Finance Officer of the remedial action they are taking. In the event that the budget manager cannot identify sufficient remedial action to bring the budget back into balance, the budget holder will identify further remedial action. This iterative process will be undertaken until the Accountable Officer is assured the total CCG budget is in balance and this can be reported to the Governing Body.

5.3.2. Ensure its use of resources (both its capital resource use and revenue resource use) does not exceed the amount specified by the NHS Commissioning Board for the financial year37 by:

a) ensure the arrangements set out in 5.3.1 are followed to ensure the

Group works within agreed financial limits. 5.3.3. Take account of any directions issued by the NHS Commissioning

Board, in respect of specified types of resource use in a financial year, to ensure the Group does not exceed an amount specified by the NHS Commissioning Board 38 by:

a) the Accountable Officer ensuring the Governing Body is aware of any

directions issued by the NHS Commissioning Board and updating the Group’s plans/budgets accordingly so that any specified amounts are not exceeded.

5.3.4. Publish an explanation of how the Group spent any payment in respect of

quality made to it by the NHS Commissioning Board39 by:

a) including a note in the Group’s annual report on how any payment was spent.

5.4. Other Relevant Regulations, Directions and Documents 5.4.1. The Group will:

a) comply with all relevant regulations;

b) comply with directions issued by the Secretary of State for Health or

the NHS Commissioning Board; and

c) take account, as appropriate, of documents issued by the NHS Commissioning Board.

23

5.4.2. The Group will develop and implement the necessary systems and processes to comply with these regulations and directions, documenting them as necessary in this constitution, its scheme of reservation and delegation and other relevant Group policies and procedures.

37 See sections 223I(2) and 223I(3) of the 2006 Act, inserted by section 27 of the 2012 Act 38 See section 223J of the 2006 Act, inserted by section 27 of the 2012 Act

24

6. DECISION MAKING: THE GOVERNING STRUCTURE

6.1. Authority to act 6.1.1. The clinical commissioning Group is accountable for exercising the

statutory functions of the Group. It may grant authority to act on its behalf to:

a) any of its members;

b) its Governing Body;

c) employees;

d) a committee or sub-committee of the Group.

6.1.2. The extent of the authority to act of the respective bodies and individuals

depends on the powers delegated to them by the Group as expressed through:

a) the Group’s scheme of reservation and delegation; and

b) for committees, their terms of reference.

6.2. Scheme of Reservation and Delegation40

6.2.1. The Group’s scheme of reservation and delegation sets out:

a) those decisions that are reserved for the membership as a whole;

b) those decisions that are the responsibilities of its Governing Body (and

its committees), the Group’s committees and sub-committees, individual members and employees.

6.2.2. The clinical commissioning Group remains accountable for all of its

functions, including those that it has delegated.

6.3. General 6.3.1. In discharging functions of the Group that have been delegated to its Governing

Body and its committees, (including joint committees and sub committees) these committees and individuals must:

a) comply with the Group’s principles of good governance;41

b) operate in accordance with the Group’s scheme of reservation

and delegation;42

40 See Appendix E

25

41 See section 4.4 on Principles of Good Governance above

c) comply with the Group’s standing orders;43

d) comply with the Group’s arrangements for discharging its statutory duties;44

e) where appropriate, ensure that member practices have had the

opportunity to contribute to the Group’s decision making process. 6.3.2. When discharging their delegated functions, committees and joint

committees must also operate in accordance with their approved terms of reference.

6.3.3. Where delegated responsibilities are being discharged collaboratively, the

joint (collaborative) arrangements must:

a) identify the roles and responsibilities of those clinical commissioning Groups who are working together;

b) identify any pooled budgets and how these will be managed and reported

in annual accounts;

c) specify under which clinical commissioning Group’s scheme of reservation and delegation and supporting policies the collaborative working arrangements will operate;

d) specify how the risks associated with the collaborative working

arrangement will be managed between the respective parties;

e) identify how disputes will be resolved and the steps required to terminate the working arrangements;

f) specify how decisions are communicated to the collaborative partners.

6.4. Committees of the Group

6.4.1. The following committees and sub committees have been established by

the Group:

a) Audit and Governance Committee

b) Remuneration and Terms of Service Committee

c) Quality and Risk Committee

d) Clinical Executive

e) Activity and Finance Committee 43 See appendix D 44 See chapter 5 above

f) Citizens’ Reference Panel 26

g) Information Governance, Management and Technology Committee

h) Safeguarding Adult Committee

i) Safeguarding Children Committee

j) Commissioning Committee

k) Primary Care Commissioning Committee

l) Affiliated Commissioning Committee

m) Auditor Panel

6.4.2. Committees will only be able to establish their own sub-committees, to assist

them in discharging their respective responsibilities, if this responsibility has been delegated to them by the Group or the committee they are accountable to.

6.5. The Governing Body

6.5.1. Functions - the Governing Body has the following functions conferred on it by

sections 14L(2) and (3) of the 2006 Act, inserted by section 25 the 2012 Act, together with any other functions connected with its main functions as may be specified in regulations or in this constitution.45 . The Governing Body has responsibility for:

a) ensuring that the Group has appropriate arrangements in place to exercise

its functions effectively, efficiently and economically and in accordance with the Groups principles of good governance46 (its main function);

b) determining the remuneration, fees and other allowances payable to

employees or other persons providing services to the Group and the allowances payable under any pension scheme it may establish under paragraph 11(4) of Schedule 1A of the 2006 Act, inserted by Schedule 2 of the 2012 Act;

c) approving any functions of the Group that are specified in regulations;47

d) those functions which it is conferring on the Governing Body which have

been delegated by the Group’s membership as set out in the Scheme of reservation and delegation at Appendix E.

e) Ensuring that the register of interest and register of decisions are reviewed

regularly and updated as necessary.

27

6.5.2. Composition of the Governing Body - the Governing Body shall not have less than 16 members and comprises of:

45 See section 14L(3)(c) of the 2006 Act, as inserted by section 25 of the 2012 Act 46 See section 4.4 on Principles of Good Governance above 47 See section 14L(5) of the 2006 Act, inserted by section 25 of the 2012 Act

a) the Chair, (Clinical Lead)

b) the Deputy Clinical Lead

c) The Deputy Chair

d) five representatives of member practices;

e) five lay members (one to include the Deputy Chair): i) one to lead on audit and governance ii) one to advise on strategic health and social care issues iii) two appointed through Citizens’ Reference Panel with a focus on

patient and public participation matters iv) one to lead on activity and finance

f) CCG Chief Nurse;

g) one secondary care specialist doctor;

h) the Accountable (Chief) Officer;

i) the Chief Finance Officer;

j) a specialist adviser

i) a practice nurse

The individuals as noted below are in attendance at Governing Body meetings in an advisory capacity as non-voting members;

i) Director of Primary Care ii) Director of Programme Delivery iii) CCG clinical advisors iii) Director of Contracting and Urgent Care iv) Director of Procurement and Market Development v) Consultant in Public Health vi) Director of Transformation vii) Senior manager from Nottinghamshire County Council viii) Chair of the CCG’s Primary Care Commissioning Committee

Other officers may be invited to attend as appropriate.

The CCG Head of Corporate Governance will attend meetings of the Governing Body to provide a secretariat function.

28

6.5.3. Committees of the Governing Body - the Governing Body has appointed the

following committees and sub-committees:

a) Audit and Governance Committee – the Audit and Governance Committee, which is accountable to the Group’s Governing Body, provides the Governing Body with an independent and objective view of the Group’s financial systems, financial information and compliance with laws, regulations and directions governing the Group in so far as they relate to finance.

The committee will provide the Governing Body with assurance on the effectiveness of the Group’s Assurance Framework and the underlying assurance processes. The committee will review achievement of strategic objectives and will provide assurance that significant risks to the Group’s strategic objectives are being appropriately managed and will give guidance to the Governing Body on required remedial actions. The committee shall review the establishment and maintenance of an effective system of integrated governance, risk management and internal control (both clinical and non-clinical).

The Governing Body has approved and keeps under review the terms of reference for the Audit and Governance Committee, which includes information on the membership of the committee48.

b) Remuneration and Terms of Service Committee – the Remuneration and

Terms of Service Committee, which is accountable to the Group’s Governing Body makes recommendations to the Governing Body on determinations about the remuneration, fees and other allowances for employees of the Group and people who provide services to the Group and on determinations on pension’s arrangements.

The main duties of the committee will be:

i) to advise the Governing Body (and seek approval/guidance from

any external body if necessary) on the remuneration and terms of service of the Chief Officer, Directors and other senior employees and any staff in new, specialist or unique roles, to ensure they are fairly rewarded for their individual contribution, having proper regard to the organisation’s circumstances and to the provisions of any national arrangements for such staff.

ii) to monitor and evaluate the performance of the Chief Officer, Executive Directors and other senior employees for the operation of any annual performance bonus scheme as appropriate.

iii) to advise on and oversee appropriate contractual arrangements for senior staff, including the proper calculation and scrutiny of termination payments, taking account of such national guidance as is appropriate.

iv) To advise the Governing Body on any proposed remuneration for 29

the GP Chair, GP Governing Body members and Clinical Leads in connection with their leadership roles within the CCG, ensuring that this is in line with national guidance and with due regard to the CCG’s circumstances.

v) To advise the Governing Body on pay and pensions arrangements for other staff subject to any national arrangements for such staff.

vi) To consider any other remuneration or compensation issue referred to the committee by either the Chair or the Chief Officer.

48 See terms of reference of the Audit and Governance Committee to be included in the Financial Management and Governance Manual

The Governing Body has approved and keeps under review the terms of reference for the Remuneration and Terms of Service Committee, which includes information on the membership of the committee49.

c) Quality and Risk Committee (shared with NHS Newark and Sherwood

CCG) – the Quality and Risk Committee, which is accountable to the Group’s Governing Body, will provide assurances to both governing bodies that systems for the management and performance of all aspects of quality are properly established and remain effective. The committee will also provide assurance that the systems for the management and performance of all aspects of risk management are properly established and remain effective. The committee will performance manage the sub-groups of the sub-committee tasked to carry out the functions on its behalf (including the management and performance of the Equality and Diversity and the Infection Prevention and Control (HCAI) agendas).

The Governing Body has approved and keeps under review the terms of reference for the Quality and Risk Committee, which includes information on the membership of the committee 50.

d) The Citizens’ Reference Panel, which is accountable to the

Governing Body is responsible for the following functions:

1. provide a two way communication channel between patients, carers, the public and the Group;

2. co-ordinate the engagement of patients, carers and the public who

wish to be involved in the consultation, planning and commissioning of health services in Mansfield and Ashfield;

3. encourage and support active participation in health and wellbeing in the

community;

4. ensure wider participation with partner agencies.

The Governing Body has approved and keeps under review the terms of reference for the Citizens’ Reference Panel, which includes information on the membership of the panel.

30

e) The Activity and Finance Committee, which is accountable to the Governing Body is responsible for the following functions

1. Oversee the delivery of the key financial metrics identified in

the CCG’s financial plan and financial strategy 2. To identify and monitor risks as a result of performance and

financial position

49 the terms of reference of the Remuneration and Terms of Service committee to be included in the Financial Management and Governance Manual 50 the terms of reference of the Quality and Risk Committee to be included in the Financial Management and Governance Manual

3. Review and oversee activity and financial performance of GP practices and contracted service level agreements

4. Review benchmarking information to understand the CCG’s relative position locally, regionally and nationally to aid the achievement of maximising best value from resources

5. Consider recommendations, proposals and business cases that have financial impact or a re-focus of resources and make appropriate recommendations to the Governing Body where necessary

6. Provide and promote strong and effective leadership on use of resources, accountability for resources and transparency in utilisation and reporting of resources

7. Ensure effective and proactive communication as part of general awareness, corrective action and mitigation plans and as part of decision making to ensure best practice and full engagement in delivering the committee’s remit.

8. Provide assurance to the Governing Body that robust processes are

in place and effectively managed with regard to performance and any resulting variance or risk is identified and mitigated

9. Review and oversee progress and achievement of the CCG’s QIPP

target

10. Review financial reporting to ensure an integrated approach to finance, activity, quality and workforce across all areas of expenditure

The Governing Body has approved and keeps under review the terms of reference of the Activity and Finance Committee, which includes information on the membership of the committee.

f) Information Governance, Management and Technology Committee

(shared with NHS Ashfield and Mansfield and other CCGs within Nottinghamshire) which is accountable to the Governing Body is responsible for:

1. Driving the broader information governance, information management and technology agendas including

a. Ensuring risks relating to information governance and health 31

information is identified and managed b. Leading the development of community-wide information governance,

information management and technology strategies c. Developing information management and technology to improve

communication between services for the benefit of patients.

The Governing Body has approved and keeps under review the terms of reference for the Information Governance, Management and Technology Committee, which includes information on the membership of the committee.

32

g) Commissioning Committee – the joint Mansfield & Ashfield CCG and Newark & Sherwood CCG Commissioning Committee, which is accountable to the Group’s governing bodies, provides assurance in relation to carrying out CCGs commissioning intentions except that of primary medical services. It ensures compliance with the requirements as outlined within the mid-Notts Alliance Agreement, carries out the functions relating to the review and performance management of the CCG’s membership of the Alliance and ensures compliance with public procurement regulations. The Committee receives regular reporting from the Alliance Leadership Board which is a collaboration of local commissioners and providers whose aim is to transform local services through partnership working.

The Governing Body has approved and keeps under review the terms of reference for the Commissioning Committee, which includes information on the membership of the committee.

h) Safeguarding Adult Committee (shared with other Nottinghamshire CCGs) is accountable to the Governing Body and is responsible for ensuring that robust systems and processes are in place to safeguard vulnerable adults as a core component of services provided and commissioned by the Nottinghamshire CCGs including promoting, monitoring and taking actions with regard to vulnerable adults, disseminating learning, developing, reviewing and approving policies, monitoring and approving reports as required by the Care Commission, overseeing and embedding safeguarding practices and identifying, monitoring and reporting risks in connection with the remit of the committee.

The Governing Body has approved and keeps under review the terms of reference for the Safeguarding Adults Committee, which includes information on the membership of the committee.

i) Safeguarding Children Committee (shared with other Nottinghamshire CCGs) is accountable to the Governing Body and is responsible for ensuring that robust systems and processes are in place to safeguard children as a core component of services provided and commissioned by the Nottinghamshire CCGs which include promoting, monitoring and taking actions with regard to children, disseminating learning, developing, reviewing and approving policies, monitoring and approving reports as required by the Care Commission, overseeing and embedding safeguarding practices and identifying, monitoring and reporting risks in connection with the remit of the committee.

The Governing Body has approved and keeps under review the terms of reference for the Safeguarding Children Committee, which includes information on the membership of the committee.

33

j) Primary Care Commissioning Committee - the Primary Care Commissioning Committee is accountable to the NHS Mansfield & Ashfield CCG’s governing body. The function of the committee is undertaken in the context of a desire to promote increased co-commissioning to ensure on- going quality, efficiency, productivity and value for money and to remove administrative barriers. 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.

k) The Clinical Executive, which is accountable to the Governing Body is responsible for the following functions:

1. providing clinical vision, leadership and an overview in the

development and delivery of the Group’s strategies, policies and service delivery implementation aims, objectives and processes ensuring they provide value for money and lead to improvements in services for patients and better health outcomes for the population of the CCG

2. ensuring clinical plans and strategies include appropriate public

engagement and consultation and have regard to equality matters

3. holding lead officers and clinicians to account for progress and delivery of clinical strategy and service delivery plans

4. take action to ensure financial balance, contract performance and

improvements in service quality.

l) The East Midlands Affiliated Commissioning Committee (shared with other CCGs within the East Midlands) The East Midlands Affiliated Commissioning Committee is accountable to the NHS Mansfield & Ashfield CCG’s governing body. The function of the committee is to develop and maintain joint commissioning policies to maximise resources, reduce duplication and ensure the development of clinical and cost effective policies that improve the quality of care for patients. m) Auditor Panels (shared panel with Newark and Sherwood CCG) The function of the Auditor Panel is to advise the CCG Governing Body on the selection and appointment of external auditors.

34

6.6 Joint Commissioning Arrangements with NHS England for the Exercise of CCG Functions

6.6.1 The CCG may wish to work together with NHS England in the exercise of its

commissioning functions. 6.6.2 The CCG and NHS England may make arrangements to exercise any of the

CCG’s commissioning functions jointly. 6.6.3 The arrangements referred to in paragraph [6.6.2] above may include other

CCGs. 6.6.4 Where joint commissioning arrangements pursuant to [6.6.2] above are entered into, the parties may establish a joint committee to exercise the commissioning functions in question.

6.6.5 Arrangements made pursuant to [6.6.2] above may be on such terms and

conditions (including terms as to payment) as may be agreed between NHS England and the CCG.

6.6.6 Where the CCG makes arrangements with NHS England (and another CCG if

relevant) as described at paragraph [6.6.2] 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;

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; and

6.6.7 The liability of the CCG to carry out its functions will not be affected where

the CCG enters into arrangements pursuant to paragraph [6.6.2] above. 6.6.8 The CCG will act in accordance with any further guidance issued by NHS

England on co-commissioning. 6.6.9 Only arrangements that are safe and in the interests of patients

registered with member practices will be approved by the governing body.

6.6.10 The governing body of the CCG shall require, in all joint commissioning arrangements that the Accountable Officer of the CCG make a quarterly written report to the Governing Body and hold at least annual engagement events to review aims, objectives, strategy and progress and publish an annual report on progress made against objectives.

35

6.6.11 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, with new arrangements starting from the beginning of the next new financial year after the expiration of the six months’ notice period.

6.7 Joint Commissioning Arrangements with NHS England for the exercise

of NHS England’s functions 6.7.1 The CCG may wish to work with NHS England and, where applicable, other

CCGs, to exercise specified NHS England functions. 6.7.2 The CCG may enter into arrangements with NHS England and, where

applicable, other CCGs to:

a) Exercise such functions as specified by NHS England under delegated arrangements;

b) Jointly exercise such functions as specified with NHS England.

6.7.3 Where arrangements are made for the CCG and, where applicable, other

CCGs to exercise functions jointly with NHS England a joint committee may be established to exercise the functions in question.

6.7.4 Arrangements made between NHS England and the CCG may be on such

terms and conditions (including terms as to payment) as may be agreed between the parties.

6.7.5 For the purposes of the arrangements described at paragraph [6.7.2]

above, NHS England and the CCG may establish and maintain a pooled fund made up of contributions by the parties working together. 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.

6.7.6 Where the CCG enters into arrangements with NHS England as described

at paragraph [4.8.2] above, the parties will develop and agree 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; 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.

6.7.7 The liability of NHS England to carry out its functions will not be affected

where it and the CCG enter into arrangements pursuant to paragraph [6.7.2] above.

36

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

6.7.9 Only arrangements that are safe and in the interests of patients

registered with member practices will be approved by the Governing Body. 6.7.10 The Governing Body of the CCG shall require, in all joint

commissioning arrangements that the Accountable Officer of the CCG make a quarterly written report to the Governing Body and hold at least annual engagement events to review aims, objectives, strategy and progress and publish an annual report on progress made against objectives.

6.7.11 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, with new arrangements starting from the beginning of the next new financial year after the expiration of the six months’ notice period.

6.8 Joint commissioning arrangements with other Clinical Commissioning Groups

6.8.1 The clinical commissioning group (CCG) may wish to work together with

other CCGs in the exercise of its commissioning functions. 6.8.2 The CCG may make arrangements with one or more CCG in respect of:

6.8.2.1 delegating any of the CCG’s commissioning functions to another

CCG;

6.8.2.2 exercising any of the commissioning functions of another CCG; or

6.8.2.3 exercising jointly the commissioning functions of the CCG and another CCG

6.8.3 For the purposes of the arrangements described at paragraph [6.7.2],

the CCG may:

6.8.3.1 make payments to another CCG;

6.8.3.2 receive payments from another CCG;

6.8.3.3 make the services of its employees or any other resources available to another CCG; or

6.8.3.4 receive the services of the employees or the resources available to another CCG.

6.8.4 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.

37

6.8.5 For the purposes of the arrangements described at paragraph [6.8.2]

above, the CCG may establish and maintain a pooled fund made up of contributions by any of the CCGs working together pursuant to paragraph 6.8.2.3 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.

6.8.6 Where the CCG makes arrangements with another CCG as described at

paragraph [6.8.2] above, the CCG shall develop and agree with that CCG an agreement setting 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;

• How risk will be managed and apportioned between the parties;

• Financial arrangements, including, if applicable, payments towards a pooled fund and management of that fund;

• Contributions from the parties, including details around assets,

employees and equipment to be used under the joint working arrangements.

6.8.7 The liability of the CCG to carry out its functions will not be affected where

the CCG enters into arrangements pursuant to paragraph [6.8.2] above. 6.8.8 The CCG will act in accordance with any further guidance issued by NHS

England on co-commissioning. 6.8.9 Only arrangements that are safe and in the interests of patients

registered with member practices will be approved by the governing body. 6.8.10 The governing body of the CCG shall require, in all joint commissioning

arrangements that the lead clinician and lead manager of the lead CCG make a quarterly written report to the governing body and hold at least annual engagement events to review aims, objectives, strategy and progress and publish an annual report on progress made against objectives.

6.8.11 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, with new arrangements starting from the beginning of the next new financial year.

38

6.9 Joint arrangements 6.9.1 The Group has entered into joint arrangements with the following clinical commissioning groups:-

(a) Rushcliffe, Nottingham North and East, Nottingham West and Newark and

Sherwood CCGs in respect of Safeguarding Adult Committee and Safeguarding Children Committee;

(b) Rushcliffe, Nottingham North and East, Nottingham West, Newark and Sherwood CCGs in respect of Individual Funding Request Panel;

(c) Newark and Sherwood CCG in respect of the Quality and Risk Committee; (d) Rushcliffe, Nottingham North and East, Nottingham West and Newark and

Sherwood CCGs in respect of Information Governance and Information Management Committee;

(e) Newark and Sherwood CCG in respect of the Auditor Panel (f) Southern Derbyshire CCG, North Derbyshire CCG, Erewash CCG,

Hardwick CCG, Nottingham City CCG, Nottingham West CCG, Nottingham North and East CCG, Rushcliffe CCG, Mansfield and Ashfield CCG, Corby CCG, Nene CCG, West Leicestershire CCG, Leicester City CCG, East Leicestershire and Rutland CCG, Lincolnshire West CCG, South West Lincolnshire CCG, South Lincolnshire CCG in respect of the Affiliated Commissioning Committee.

(g)

A joint Memorandum of Understanding in relation to these arrangements has been developed;

(h) Bassetlaw CCG in respect of emergency planning and safeguarding; (i) A joint Memorandum in relation to Collaborative Commissioning

has been developed; (j) Nottingham County Council and Newark and Sherwood CCG in respect of

Commissioning Committee and programme board to ensure alignment and integration of health and social care services.

6.9.2 The Group is a member of other partnership boards with local councils:-

(a) Nottinghamshire County Council in respect of Mental Health, Learning

Disability, Autism Joint Commissioning Group; (b) Nottinghamshire Adults Safeguarding Board where Newark and

Sherwood CCG represents all five Nottinghamshire CCGs; (c) Nottinghamshire Children’s Safeguarding Board where Newark and

Sherwood CCG represents all five Nottinghamshire CCGs; (d) Rushcliffe, Nottingham North and East, Nottingham West and Newark and

Sherwood CCG in respect of prescribing. A mandate is in place for Nottinghamshire Area Prescribing Committee. This Committee also includes other organisations providing NHS services within the Nottinghamshire health community.

39

Joint Alliance Agreement with local commissioners and provider participants Joint Alliance Agreement with local commissioners and provider participants 6.8.1 In 2013, leaders signed up to a system “blueprint”, Better Together setting out the services that will be needed in the future – with a 5 year planning horizon to 2018/19. This set the foundations for how commissioners and providers work together across organisational boundaries to best match and manage projected population demand. A clear shared vision has been adopted across the system, with detailed plans to implement transformational interventions that impact on whole system quality, cost of provision and sustainability. The clinical commissioning group (CCG) has agreed to form an Alliance with local commissioners and provider participants to progress the work of the Better Together programme and wider system transformation and, in particular, to establish an improved financial, governance and contractual framework for the delivery of the services for mid-Nottinghamshire. An independently chaired Board, the Alliance Leadership Board, is in place to oversee the delivery of the Better Together strategy. This collaboration comprises senior leaders who are empowered to make decisions and drive forward change in their constituent organisations. This is referred to as ‘the Alliance’ in this constitution. Membership is as follows: Organisation

Category Of Membership

1. Mansfield and Ashfield CCG

Full Alliance Member

2. Newark and Sherwood CCG


3. NCC


4. EMAS


5. NHCT


6. NUH


7. SFHT


8. NEMS Full Alliance Member

6.8.2 An Alliance Agreement has been approved by all participating organisations including the CCG Governing Body and will supplement and operate in conjunction with:

a. The Services Contracts b. The Nottingham County Council Services Contracts c. Any other local partnering arrangements to the Services; and d. The joint commissioning arrangements between the mid-Notts CCGs and

Nottinghamshire County Council

40

6.8.3 The Alliance Agreement came into force on 1 April 2016 with an Initial Period until 31 March 2019 with an option to extend for a period of 7 years from the expiry of the Initial Period. From 1 April 2016 a ‘transitional year’ will take place with participants agreeing to work together to develop and evolve the Alliance further. 6.8.4 As a Commissioner participant the CCG shall identify the health and social care needs and priorities of the mid-Notts population, provide links to other relevant services such as housing and education and seek to put in place contractual arrangements with other third party providers to incentivise the Outcomes. 6.8.5 The Alliance Agreement sets out the Alliance governance, decision making, delegated authority and reserved matters, rectification, exclusion, termination and dispute resolution clauses. It also outlines the scope of services, outcomes and payment mechanisms. 6.8.6 The Alliance Agreement outlines the role the commissioner participants will undertake where a Change is proposed. The Commissioner participants will be entitled in their sole discretion to declare in the Notice of Change that a proposed change is a Mandatory Change and the date from which the Mandatory Change will be effective. 6.8.7 The CCG Governing Body has approved the CCG becoming a Full Member of the Alliance and, as such, will be entitled to vote at the Alliance Leadership Board. The CCG will nominate one member and one deputy member to join the Alliance Leadership Board from its Governing Body membership. 6.8.8 The CCG Governing Body has approved delegated authority to their nominated member and deputy member as set out within the CCG scheme of delegation 6.8.9 The CCGs Commissioning Committee, a sub-committee of the CCG Governing Body, has the responsibility of carrying out the functions relating to the CCGs commissioning intentions except that of primary medical services. It will monitor the Alliance Leadership Board to ensure compliance with the requirements as set out in the Alliance Agreement is maintained. It will provide regular reporting to the CCG Governing Body.

7. ROLES AND RESPONSIBILITIES

7.1. Member Practices 7.1.1. Practice representatives represent their practice’s views and act on behalf

of the practice in matters relating to the Group. The role and responsibilities of practices and the Group are set out fully in the Inter-Practice Agreement. The CCG requires all Mansfield and Ashfield GPs to sign this agreement.

7.2. All Members of the Group’s Governing Body

7.2.1. Guidance on the roles of members of the Group’s Governing Body is set

out in a separate document55. In summary, each member of the Governing Body should share responsibility as part of a team to ensure that the Group exercises its functions effectively, efficiently and economically, with good governance and in accordance with the terms of this constitution. Each brings their unique perspective, informed by their expertise and experience.

41

7.3. The Chair of the Governing Body

7.3.1. The Chair (Clinical Lead) of the Governing Body is responsible for:

a) leading the Governing Body, ensuring it remains continuously

able to discharge its duties and responsibilities as set out in this constitution;

b) building and developing the Group’s Governing Body and its

individual members;

c) ensuring that the Group has proper constitutional and governance arrangements in place;

d) ensuring that, through the appropriate support, information and

evidence, the Governing Body is able to discharge its duties;

e) supporting the Accountable Officer in discharging the responsibilities of the organisation;

f) contributing to building a shared vision of the aims, values and culture

of the organisation;

g) leading and influencing to achieve clinical and organisational change to enable the Group to deliver its commissioning responsibilities;

h) overseeing governance and particularly ensuring that the Governing Body and the wider Group behaves with the utmost transparency and responsiveness at all times;

i) ensuring that public and patients’ views are heard and their

expectations understood and, where appropriate as far as possible, met;

j) ensuring that the organisation is able to account to its local

patients, stakeholders and the NHS Commissioning Board;

k) ensuring that the Group builds and maintains effective relationships, particularly with the individuals involved in overview and scrutiny from the relevant local authority(ies).

7.3.2. Where the Chair of the Governing Body is also the senior clinical voice of

the Group they will take the lead in interactions with stakeholders, including the NHS Commissioning Board.

7.4 The Deputy Clinical Lead The Deputy Clinical Lead supports the Clinical Lead in the discharge of his or her responsibilities as detailed above.

42

7.4. The Deputy Chair of the Governing Body

7.4.1. The Deputy Chair of the Governing Body deputises for the Chair of the

Governing Body where he or she has a conflict of interest or is otherwise unable to act.

7.5. Role of the Accountable Officer

7.5.1. The Accountable Officer of the Group is a member of the Governing Body.

7.5.2. This role of Accountable Officer has been summarised in a national

document56 as:

a) being responsible for ensuring that the clinical commissioning Group fulfils its duties to exercise its functions effectively, efficiently and economically thus ensuring improvement in the quality of services and the health of the local population whilst maintaining value for money;

b) at all times ensuring that the regularity and propriety of expenditure

is discharged, and that arrangements are put in place to ensure that good practice (as identified through such agencies as the Audit Commission and the National Audit Office) is embodied and that safeguarding of funds is ensured through effective financial and management systems;

c) working closely with the Chair of the Governing Body, the

Accountable Officer will ensure that proper constitutional, governance and development arrangements are put in place to assure the members (through the Governing Body) of the organisation’s on going capability and capacity to meet its duties and responsibilities. This will include arrangements for the on-going developments of its members and staff.

7.6. Role of the Chief Finance Officer

7.6.1. The Chief Finance Officer is a member of the Governing Body and is

responsible for providing financial advice to the clinical commissioning Group and for supervising financial control and accounting systems

7.6.2. This role of Chief Finance Officer has been summarised in a national

document57 as:

a) being the Governing Body’s professional expert on finance and ensuring, through robust systems and processes, the regularity and propriety of expenditure is fully discharged;

b) making appropriate arrangements to support, monitor on the

Group’s finances; 43

c) overseeing robust audit and governance arrangements leading to

propriety in the use of the Group’s resources;

d) being able to advise the Governing Body on the effective, efficient and economic use of the Group’s allocation to remain within that allocation and deliver required financial targets and duties; and

e) producing the financial statements for audit and publication in

accordance with the statutory requirements to demonstrate effective stewardship of public money and accountability to the NHS Commissioning Board.

7.7. Joint Appointments with other Organisations

7.7.1. The Group has the following joint appointments with NHS Newark and

Sherwood CCG:

a) To enable the CCG to function effectively the CCGs share a number of key posts which are as follows:

i) Chief Officer/Accountable Officer ii) Chief Finance Officer iii) Director for Quality, Performance Information and Governance iv) Executive Lead for Contracting

7.7.2. All these joint appointments are supported by a memorandum of

understanding between the organisations who are party to these joint appointments.

57 See the latest version of the NHS Commissioning Board Authority’s Clinical

commissioning group Governing Body members: Role outlines, attributes and skills

44

59

8. STANDARDS OF BUSINESS CONDUCT AND MANAGING CONFLICTS OF INTEREST

8.1. Standards of Business Conduct

8.1.1. Employees, members, committee and sub-committee members of the

Group and members of the Governing Body (and its committees) will at all times comply with this constitution and be aware of their responsibilities as outlined in it. They should act in good faith and in the interests of the Group and should follow the Seven Principles of Public Life, set out by the Committee on Standards in Public Life (the Nolan Principles) The Nolan Principles are incorporated into this constitution at Appendix G.

8.1.2. Should any CCG member feel that the expectations as described of the

Governing Body Members are not observed, the matter must be raised with the CCG’s Clinical Chair (via the Head of Corporate Governance). The CCG’s Clinical Chair will consider the nature of the issue raised and, if required, convene a meeting between the individual to whom the issue relates, the Clinical Chair, the Chief Officer and the Audit Chair, in order to discuss the matter further and appropriate course of action. Where this is undertaken, an overview of the meeting and associated outcome will be reported to the next confidential session of the Governing Body. Where this is deemed not to be required, a response will be provided to the requestor.

8.2 8.2.1. They must comply with the Group’s policy on business conduct, including

the requirements set out in the policy for managing conflicts of interest. This policy will be available on the Group’s website at www.mansfieldandashfieldccg.nhs.uk

8.2.2. This policy may also be inspected upon request (addressed to the

Head of Corporate Governance) at the CCG Headquarters which are located at:


Tel: 01623 673143

8.2.3. Individuals contracted to work on behalf of the Group or otherwise

providing services or facilities to the Group will be made aware of their obligation with regard to declaring conflicts or potential conflicts of

45

interest. This requirement will be written into their contract for services.

8.2. Conflicts of Interest 8.2.1 Section 14O of the Health and Social Care Act 2012 sets out the

minimum requirements in terms of what both NHS England and CCGs must do in terms of managing conflicts of interest. For the CCG, this means the following:

• Maintain appropriate registers of interests; • Publish or make arrangements for the public to access

those registers; • Make arrangements requiring the prompt declaration of interests

by the persons specified (members and employees) and ensure that these interests are entered into the relevant register;

• Make arrangements for managing conflicts and potential conflicts of interest (e.g. developing appropriate policies and procedures); and

• Have regard to guidance published by NHS England and Monitor in relation to conflicts of interest.

8.2.2 The CCG Conflicts of Interest Policy is available on the Group’s website

at www.mansfieldandashfieldccg.nhs.uk or upon request (addressed to the H e a d o f Corporate Governance) at the CCG Headquarters which are located at:


Tel: 01623 673143

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9. THE GROUP AS EMPLOYER

a. The Group recognises that its most valuable asset is its people. It will seek to enhance their skills and experience and is committed to their development in all ways relevant to the work of the Group.

b. The Group will seek to set an example of best practice as an

employer and is committed to offering all staff equality of opportunity. It will ensure that its employment practices are designed to promote diversity and to treat all individuals equally.

c. The Group will ensure that it employs suitably qualified and

experienced staff who will discharge their responsibilities in accordance with the high standards expected of staff employed by the Group. All staff will be made aware of this constitution, the commissioning strategy and the relevant internal management and control systems which relate to their field of work.

d. The Group will maintain and publish policies and procedures

(as appropriate) on the recruitment and remuneration of staff to ensure it can recruit, retain and develop staff of an appropriate calibre. The Group will also maintain and publish policies on all aspects of human resources management, including grievance and disciplinary matters.

e. The Group will ensure that its rules for recruitment and

management of staff provide for the appointment and advancement on merit on the basis of equal opportunity for all applicants and staff.

f. The Group will ensure that employees' behaviour reflects the

values, aims and principles set out above.

g. The Group will ensure that it complies with all aspects of employment law.

h. The Group will ensure that its employees have access to such

expert advice and training opportunities as they may require in order to exercise their responsibilities effectively.

i. The Group will adopt a code of conduct for staff and will

maintain and promote effective 'whistleblowing' procedures to ensure that concerned staff have means through which their concerns can be voiced.

j. Copies of this code of conduct, together with the other

47

policies and procedures outlined in this chapter, will be available on the Group’s website at: www.mansfieldandashfieldccg.nhs.uk

k. his code of conduct may also be inspected upon request (addressed to the Head of Corporate Governance) at the CCG Headquarters which are located at:


Tel: 01623 673143

l. The group recognises and confirms that 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 group, any member of its governing body, any member of its committees or sub-committees or the committees or sub- committees of its governing body, or any employee of the group or of any of its members, nor will it affect the rights of any worker (as defined in that Act) under that Act

48

10. TRANSPARENCY, WAYS OF WORKING AND

STANDING ORDERS

a. General

i. The Group will publish annually a commissioning plan and an annual report, presenting the Group’s annual report to a public meeting.

ii. Key communications issued by the Group, including the notices of procurements, public consultations, Governing Body and Primary Care Commissioning Committee meeting dates, times, venues, and certain papers will be published on the Group’s website at:

www.mansfieldandashfieldccg.nhs.uk

iii. These documents may also be inspected upon request (addressed to the Corporate Governance Manager) at the CCG Headquarters which are located at:


Tel: 01623 673143

iv. The Group may use other means of communication,

including circulating information by post, or making information available in venues or services accessible to the public.

b. Standing Orders

i. This constitution is also informed by a number of

documents which provide further details on how the Group will operate. They are the Group’s:

1. Standing orders (Appendix D) – which sets

out the arrangements for meetings and the appointment processes to elect the Group’s representatives and appoint to the Group’s committees, including the Governing Body;

49

2. Scheme of reservation and delegation (Appendix E) – which sets out those decisions that are reserved for the membership as a whole and those decisions that are the responsibilities of the Group’s Governing Body, the Governing Body’s committees and sub- committees, the Group’s committees and sub- committees, individual members and employees;

50

APPENDIX A

DEFINITIONS OF KEY DESCRIPTIONS USED IN THIS CONSTITUTION

2006 Act National Health Service Act 2006

2012 Act Health and Social Care Act 2012 (this Act amends the 2006 Act)

Accountable Officer an individual, as defined under paragraph 12 of Schedule 1A of the 2006 Act (as inserted by Schedule 2 of the 2012 Act), appointed by the NHS Commissioning Board, with responsibility for ensuring the Group: • complies with its obligations under:

o sections 14Q and 14R of the 2006 Act (as inserted by section 26 of the 2012 Act),

o sections 223H to 223J of the 2006 Act (as inserted by section 27 of the 2012 Act),

o paragraphs 17 to 19 of Schedule 1A of the NHS Act 2006 (as inserted by Schedule 2 of the 2012 Act), and

o any other provision of the 2006 Act (as amended by the 2012 Act) specified in a document published by the Board for that purpose;

• exercises its functions in a way which provides good value for money.

Area the geographical area that the Group has responsibility for, as defined in Chapter 2 of this constitution

Chair of the Governing Body

the individual appointed by the Group to act as chair of the Governing Body

Chief Finance Officer the qualified accountant employed by the Group with responsibility for financial strategy, financial management and financial governance

Clinical commissioning Group

a body corporate established by the NHS Commissioning Board in accordance with Chapter A2 of Part 2 of the 2006 Act (as inserted by section 10 of the 2012 Act)

Committee a committee or sub-committee created and appointed by: • the membership of the Group • a committee / sub-committee created by a committee created / appointed

by the membership of the Group • a committee / sub-committee created / appointed by the Governing Body

Financial year this usually runs from 1 April to 31 March, but under paragraph 17 of Schedule 1A of the 2006 Act (inserted by Schedule 2 of the 2012 Act), it can for the purposes of audit and accounts run from when a clinical commissioning Group is established until the following 31 March

Group

NHS Mansfield and Ashfield Clinical Commissioning Group, whose constitution this is

Governing Body the body appointed under section 14L of the NHS Act 2006 (as inserted by section 25 of the 2012 Act), with the main function of ensuring that a clinical commissioning Group has made appropriate arrangements for ensuring that it complies with: • its obligations under section 14Q under the NHS Act 2006 (as inserted by

section 26 of the 2012 Act), and • such generally accepted principles of good governance as are relevant to it.

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Governing Body member

any member appointed to the Governing Body of the Group

Lay member a lay member of the Governing Body, appointed by the Group. A lay member is an individual who is not a member of the Group or a healthcare professional (i.e. an individual who is a member of a profession regulated by a body mentioned in section 25(3) of the National Health Service Reform and Health Care Professions Act 2002) or as otherwise defined in regulations

Member a provider of primary medical services to a registered patient list, who is a members of this Group (see tables in Chapter 3 and Appendix B)

Practice representatives

an individual appointed by a practice (who is a member of the Group) to act on its behalf in the dealings between it and the Group, under regulations made under section 89 or 94 of the 2006 Act (as amended by section 28 of the 2012 Act) or directions under section 98A of the 2006 Act (as inserted by section 49 of the 2012 Act)

Registers of interests a Group is required to maintain and make publicly available under section 14O of the 2006 Act (as inserted by section 25 of the 2012 Act), of the interests of: • the members of the Group; • the members of its Governing Body; • the members of its committees or sub-committees and committees or sub-

committees of its Governing Body; and • its employees.

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APPENDIX B Map of NHS Mansfield and Ashfield CCG Area

53

APPENDIX C - LIST OF MEMBER PRACTICES

Practice Name

Address Practice Representative’s Signature & Date Signed

Acorn Medical Practice 11-13 Wood Street, Mansfield, NG18 1QA

Ashfield House 194 Forest Road, Annesley Woodhouse, NG17 9JB

Ashfield Medical Centre

King Street, Sutton in Ashfield, NG17 1AT

Bull Farm Primary Care Resource Centre

Concorde Way, Millennium Business Park, Mansfield,NG19 7JZ

Churchside Medical Practice (Ward & Pearce)

Wood Street, Mansfield, NG18 1QB

Forest Medical Centre Rosemary Street, Mansfield, NG19 6AB Jubilee Way South, Mansfield, NG18 3SF

Harwood Close Surgery

Skegby Road, Sutton in Ashfield, NG17 4PD

Skegby Family Medical

Mansfield Road, Skegby, NG17 3EE

Brierley Park Medical Centre

127 Sutton Road, Huthwaite, NG17 2NF

Jacksdale Medical Centre

Main Road, Jacksdale, NG16 5JW

Kirkby Community Primary Care Centre

Ashfield Health Village, Portland Street, Kirkby in Ashfield, NG17 7AE

Kirkby Family Medical Centre

56a Lowmoor Road, Kirkby in Ashfield, NG17 7BG

Kirkby Health Care Complex

52 Lowmoor Road, Kirkby in Ashfield, NG17 7BG

Kirkby Health Centre Lowmoor Road, Kirkby in Ashfield, NG17 7LG

Kirkby Surgery Lowmoor Road, Kirkby in Ashfield, NG17 7BQ

Meden Vale Medical Centre

Egmanton Road, Meden Vale, NG20 9QN

Millview Surgery 1a Goldsmith Street, Mansfield, NG18 5PF

Oakwood Surgery Church Street, Mansfield, NG19 8BL

Orchard Medical Practice

Stockwell Gate, Mansfield, NG18 5GG

Pleasley Surgery Chesterfield Road, Pleasley, NG19 7PE

Riverbank Medical Services

Church Street, Warsop, NG20 0BP

54

Roundwood Surgery Wood Street, Mansfield, NG18 1QQ

Sandy Lane Surgery Sandy Lane, Mansfield, NG18 2LT

Selston Surgery 139 Nottingham Road, Selston, NG16 6BT

St Peter’s Medical Practice

Commercial Street, Mansfield, Notts, NG18 1EE

Willowbrook Medical Practice

Brook Street, Sutton in Ashfield, NG17 1ES

Woodlands Medical Practice

Bluebell Wood Way, Sutton in Ashfield, NG17 1JW

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APPENDIX D – STANDING ORDERS 1. STATUTORY FRAMEWORK AND STATUS

1.1. Introduction

1.1.1. These standing orders have been drawn up to regulate the proceedings of

the NHS Mansfield and Ashfield Clinical Commissioning Group so that Group can fulfil its obligations, as set out largely in the 2006 Act, as amended by the 2012 Act and related regulations. They are effective from the date the Group is established.

1.1.2. The standing orders, together with the Group’s scheme of reservation and

delegation58 and the Group’s prime financial policies59, provide a procedural framework within which the Group discharges its business. They set out:

a) the arrangements for conducting the business of the Group;

b) the appointment of Member Practice Representatives;

c) the procedure to be followed at meetings of the Group, the

Governing Body and any committees or sub-committees of the Group or the Governing Body;

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 appropriate60 of any relevant guidance.

1.1.3. The standing orders, scheme of reservation and delegation and prime

financial policies have effect as if incorporated into the Group’s constitution. Group members, employees, members of the Governing Body, members of the Governing Body’s committees and sub-committees, members of the Group’s committees and sub-committees and persons working on behalf of the Group 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.

1.2. Schedule of matters reserved to the clinical commissioning Group

and the scheme of reservation and delegation 1.2.1. The 2006 Act (as amended by the 2012 Act) provides the Group with

powers to delegate the Group’s functions and those of the Governing Body

60 See Appendix D 61 See Appendix E

56

62 Under some legislative provisions the group is obliged to have regard to particular guidance but under other circumstances guidance is issued as best practice guidance.

to certain bodies (such as committees) and certain persons. The Group has decided that certain decisions may only be exercised by the Group in formal session. These decisions and also those delegated are contained in the Group’s scheme of reservation and delegation (see Appendix E).

2. THE CLINICAL COMMISSIONING GROUP: COMPOSITION

OF MEMBERSHIP, KEY ROLES AND APPOINTMENT PROCESS

2.1. Composition of membership

2.1.1. Chapter 3 of the Group’s constitution provides details of the membership of

the Group (see also Appendix C). 2.1.2. Chapter 6 of the Group’s constitution provides details of the governing

structure used in the Group’s decision-making processes, whilst Chapter 7 of the constitution outlines certain key roles and responsibilities within the Group and its Governing Body, including the role of practice representatives (section 7.1 of the constitution).

2.2. Key Roles

2.2.1. Paragraph 6.5.2 of the Group’s constitution sets out the composition of the

Group’s Governing Body whilst Chapter 7 of the Group’s constitution identifies certain key roles and responsibilities within the Group and its Governing Body. These standing orders set out how the Group appoints individuals to these key roles.

2.2.2. The Clinical Lead (Chair), as listed in paragraph 6.5.2 of the Group’s

constitution, is subject to the following appointment process which is managed by the Nottinghamshire Local Medical Committee (LMC):

a) Nominations from eligible GPs (see below) who must secure a

seconder. Candidates submit a written statement in support of their candidacy;

b) Eligibility – current GP partners or salaried GPs of a Mansfield and

Ashfield practice;

c) Appointment process – After the close of nominations the experience and skills of candidates is judged against an agreed list of competencies. Candidates undergo an interview and selection process that includes senior GPs and members from the LMC. All candidates that successfully meet the criteria will be put forward for election by all Mansfield and Ashfield GPs (partners and salaried) in a first past the post-election ;

a) Term of office – 2 years initially then 3 years thereafter; with an option

to extend the term for up to six months subject to approval of the Governing Body

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d) Grounds for removal from office: i) Gross misconduct; ii) Becoming disqualified from office; iii) ceasing to fulfil the eligibility criteria for the role of GP

representative set out at standing order 2.2.2 (b) above; iv) Losing General Medical Council registration and license

to practice; v) Not attending Governing Body meetings for three

consecutive months (except under extenuating circumstances, such as illness);

vi) Failing to disclose a pecuniary interest regarding matters under discussion within the organisation;

vii) Following the passing of a vote of no confidence by member practices at a meeting duly convened in accordance with standing orders 3 below (meetings and Resolutions of the Clinical Commissioning Group).

e) Notice period – The chair may resign from office with immediate effect

by giving written notice to the Governing Body at any time. Any such resignation shall not affect their continuing role as a GP representative on the Governing Body.

2.2.3 The Deputy Clinical Lead The Deputy Clinical Lead, as listed in paragraph 6.5.2 of the Group’s constitution, is subject to the following appointment process which is managed by the Nottinghamshire Local Medical Committee (LMC):

f) Nominations from eligible GPs (see b) below) who must secure a


g) Eligibility – current GP partners or salaried GPs of a Mansfield and

Ashfield practice;

h) Appointment process – After the close of nominations the experience and skills of candidates is judged against an agreed list of competencies. Candidates undergo an interview and selection process that includes senior GPs and members from the LMC. All candidates that successfully meet the criteria will be put forward for election by all Mansfield and Ashfield GPs (partners and salaried) in a first past the post-election ;

b) Term of office – 2 years initially then 3 years thereafter; with an option

to extend the term for up to six months subject to approval of the Governing Body

i) Grounds for removal from office:

i) Gross misconduct; ii) Becoming disqualified from office; iii) ceasing to fulfil the eligibility criteria for the role of GP

representative set out at standing order 2.2.2 (b) above; iv) Losing General Medical Council registration and license

58

to practice; v) Not attending Governing Body meetings for three




j) Notice period – The Deputy Clinical Lead may resign from office with

immediate effect by giving written notice to the Governing Body at any time. Any such resignation shall not affect their continuing role as a GP representative on the Governing Body.

2.2.3. The five Practice GPs, as listed in paragraph 6.5.2 of the

Group’s constitution, are subject to the following appointment process:

Following the passing of a vote of no confidence by member practices

at a meeting duly convened in accordance with standing orders 3 below (meetings and Resolutions of the Clinical Commissioning Group).

a) Notice period – The chair may resign from office with immediate effect

by giving written notice to the Governing Body at any time. Any such resignation shall not affect their continuing role as a GP representative on the Governing Body.

2.2.4. The five Practice GPs, as listed in paragraph 6.5.2 of the

Group’s constitution, are subject to the following appointment process:

a) Nominations – Nominations from eligible GPs (see b) below) who

must secure a seconder. Candidates submit a written statement in support of their candidacy;

b) Eligibility – current GP partners or salaried GP of a Mansfield

and Ashfield practice;

c) Appointment process – After the close of nominations the experience and skills of candidates is judged against an agreed list of competencies. Candidates then undergo an interview and selection process that includes senior GPs and members from the LMC. All candidates that successfully meet the criteria will be put forward for election by all Mansfield and Ashfield GPs (partners and salaried) in a first past the post-election;

d) Term of office – a rolling programme of 2 or 3 years has been agreed

by the Governing Body to ensure a balance between continuity and the need to refresh the Governing Body membership:

e) Grounds for removal from office;

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i) Gross misconduct; ii) Becoming disqualified from office; iii) Ceasing to fulfil the eligibility criteria for the role of GP

representative set out at standing order 2.2.3 (b) above; iv) Losing General Medical Council registration and license to

practice; v) Not attending Governing Body meetings for three consecutive

months (except under extenuating circumstances, such as illness);


vii) Following the passing of a vote of no confidence by member practices at a GP FCG meeting duly convened in accordance with standing orders 3 below (meetings and Resolutions of the Clinical Commissioning Group).

f) Notice period – A GP representative may resign from the Governing

Body with immediate effect by giving written notice to the Governing Body at any time.

2.2.5. The, Lay Members as listed in paragraph 6.5.2 of the Group’s constitution,

are subject to the following appointment process:

a. Lay member with responsibility for audit and governance – openly advertised; lay member with responsibility for providing advice on strategic health and social care issues - openly advertised; lay member with responsibility for activity and finance – openly advertised; lay members (x2) with responsibility for patient involvement to be elected through a ballot of the Citizens’ Reference Panel;

a) Eligibility – according to the criteria set out in the NHS Commissioning

Board “Role outlines, attributes and skills” document;

b) Appointment process;

Lay member with responsibility for audit and governance – written application to demonstrate competence against published criteria, followed by an interview with the Group’s senior clinicians and managers.

Lay member with responsibility for providing advice on strategic health and social care issues - – written application to demonstrate competence against published criteria, followed by an interview with the Group’s senior clinicians and managers.

Lay member with responsibility for providing advice on activity and finance – written application to demonstrate competence against published criteria, followed by an interview with the Group’s senior clinicians and managers.

Lay members (x2) with responsibility for patient involvement – citizens’ reference panel members to self-nominate against agreed criteria. If

60

more than two members put themselves forward then a ballot will be conducted.

c) Term of office;

Lay member with responsibility for audit and governance – 2 years initially then 3 years thereafter.

Two lay members with responsibility for patient involvement – 3 years. Grounds for removal from office –

i) Gross misconduct; ii) Not attending Governing Body meetings for three


iii) Failing to disclose a pecuniary interest regarding matters under discussion within the organisation;

iv) Following the passing of a vote of no confidence by member practices at a meeting duly convened in accordance with standing orders 3 below (meetings and Resolutions of the Clinical Commissioning Group).

d) Notice period – A Lay Member may resign from the Governing Body

by giving not less than 1 month’s written notice to the Governing Body at any time.

One of the appointed Lay Members shall be elected as the Deputy Chair for the Group. Upon the post becoming vacant the elected Lay Members shall nominate themselves for the position and it is a requirement they be seconded. In the event of more than one Lay Member being nominated a vote shall be taken at a Governing Body meeting. The Lay Member appointed to the position of Deputy Chair shall undertake the role for the same period of time as their original appointment.

2.2.6. The Chief Nurse as listed in paragraph 6.5.2 of the Group’s constitution

is subject to the following appointment process: For one of the roles the Executive Nurse post will be taken up by the Group’s Director of Quality, Performance, Information and Governance.

For the Special Nurse Advisor role the following process will apply:

a) Nominations – the role will be advertised openly;

b) Eligibility – any individual who is a registered nurse, with a high level

of professional expertise and knowledge, and is not employed by an organisation from which the Group secures any significant volume of provision, may apply for this role;

c) Appointment process – the role will be openly advertised.

Candidates will need to demonstrate how they meet the criteria for the role. All applications will be judged against the skills and experience in the job description and person specification. Candidates will undergo an interview with senior clinicians and

61

managers from the Governing Body;

d) Term of office – initially 2 year then 3 years thereafter;

e) Eligibility for reappointment – a person cannot be appointed to the role of Registered Nurse on the Governing Body for more than three consecutive terms of office.

f) Grounds for removal from office –

i) Gross misconduct; ii) Becoming disqualified from office; iii) Ceasing to fulfil the eligibility criteria for the role of registered

Nurse on the Governing Body as set out at Standing Order 2.2.5 (b) above

iv) Losing nursing and midwifery council registration v) Not attending Governing Body meetings for three consecutive

months (except under extenuating circumstances, such as illness);



g) Notice period – The registered nurse may resign from the Governing

Body by giving not less than 3 months written notice to the Governing Body at any time.

2.2.7. The, Secondary Care Specialist Doctor as listed in paragraph 6.5.2 of the

Group’s constitution, is subject to the following appointment process:


b) Eligibility – Any individual who is a registered medical practitioner who is, or has been within the last five years, an individual who fulfils all of the following conditions can apply for this role when advertised:

i) The individual’s name must be included in the Specialist

Register kept by the General Medical Council under section 34D of the medical Act 1983 (c), or the individual is eligible to be included in that register by virtue of the scheme referred to in subsection (2)(b) of that section;

ii) The individual must hold a post as an NHS consultant or in a medical speciality in the armed forces;

iii) The individuals name must not be included in the General Practitioner Register kept by the General Medical Council under section 34(c) of the Medical Act 1983;

iv) Individuals must not be an employee or member (including shareholder) of, or a partner in, a provider of primary medical services for the purposes of Chapter A2 of the 2006 Act, or a body that provides any relevant service to a person for whom the Group has responsibility.

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c) Appointment process – the role will be openly advertised. Candidates

will need to demonstrate how they meet the criteria for the role. All applications will be judged against the skills and experience in the job description and person specification. Candidates will undergo an interview with senior clinicians and managers from the Governing Body;

d) Term of office – initially 2 years then 3 years thereafter;

e) Grounds for removal from office –

i) Gross misconduct; ii) Becoming disqualified from office; iii) Ceasing to fulfil the eligibility criteria for the role of

Secondary Care specialist doctor on the Governing Body as set out at Standing Order 2.2.6 (b) above;

iv) Losing General Medical Council registration and license to practice;

v) Not attending Governing Body meetings for three consecutive months (except under extenuating circumstances, such as illness);


vi) Following the passing of a vote of no confidence by member practices at a meeting duly convened in accordance with standing orders 3 below (meetings and Resolutions of the Clinical Commissioning Group).

f) Notice period – The secondary care specialist doctor may resign

from the Governing Body by giving not less than 3 months written notice to the Governing Body at any time.

2.2.8. The Chief Officer (who shall also be the Group’s Accountable Officer

as listed in paragraph 6.5.2 of the Group’s constitution), is subject to the following appointment process:


b) Eligibility – any individual with the qualifications, expertise and

experience and meets the required skills and competencies set out in the NHS Commissioning Board “Role outlines, attributes and skills” document;

c) Appointment process – The role will be appointed in line with national

NHS recruitment and selection policies and guidance and is subject to formal confirmation from the NHS Commissioning Board;

d) Term of office - set out in agreed contract;


i) Termination of employment in accordance with the Chief

Officer’s contract of employment; ii) Following the passing of a vote of no confidence by

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member practices within the Group at a meeting duly convened in accordance with standing order 3 below (Meetings and Resolutions of the Clinical Commissioning Group).

f) Notice period – as deemed by the contract of employment.

2.2.9. The, Chief Finance Officer as listed in paragraph 6.5.2 of the

Group’s constitution, is subject to the following appointment process:

a) Nominations – the role will be advertised openly; b) Eligibility – any individual with the qualifications, expertise and

experience and meets the required skills and competencies set out in the NHS Commissioning Board “Role outlines, attributes and skills” document;

c) Appointment process – The role will be appointed in line with national

NHS recruitment and selection policies and guidance and is subject to formal confirmation from the NHS Commissioning Board;

d) Term of office - set out in agreed contract;

e) Grounds for removal from office:

i) Termination of employment in accordance with the Chief Finance

Officer’s contract of employment; ii) Following the passing of a vote of no confidence by member

practices within the Group at a meeting duly convened in accordance with standing order 3 below (Meetings and Resolutions of the Clinical Commissioning Group).

f) Notice period – as deemed by the contract of employment.

2.2.10. The specialist adviser as listed in paragraph 6.5.2 of the Group’s

constitution. If a suitable candidate(s) cannot be readily identified the CCG may also choose to openly advertise the role(s) required. The role(s) is/are subject to the following appointment process:

a) Nominations – the role(s) will be advertised openly if a

suitable candidate(s) cannot be readily identified;

b) Eligibility – This can be any individual who meets the eligibility criteria as set out in Standing Orders 2.2.6 or 2.2.9. Any such individuals must not be an employee or member (including shareholder) of, or a partner in, a provider of primary medical services for the purposes of Chapter A2 of the 2006 Act, or a body that provides any relevant service to a person for whom the Group has responsibility.

c) Appointment process – Whether or not the role is openly advertised,

any candidate will need to demonstrate how they meet the criteria for the role and they will be judged against the skills and experience in the job description and person specification or the role outline. Any candidate will undergo an interview with senior clinicians and

64

managers from the Governing Body;

d) Term of office – initially 2 years then 3 years thereafter;

e) Grounds for removal from office –

i) Gross misconduct; ii) Becoming disqualified from office; iii) Ceasing to fulfil the eligibility criteria appropriate to the role as

set out in the eligibility criteria referred in Standing Order 2.2.6 or 2.2.9;

iv) Losing General Medical Council registration and license to practice where the eligibility criteria set out in Standing Order 2.2.6 applies;

v) Not attending Governing Body meetings for three consecutive months (except under extenuating circumstances, such as illness);


vi) Following the passing of a vote of no confidence by member practices at a meeting duly convened in accordance with Standing Order 3 below (meetings and Resolutions of the Clinical Commissioning Group).

f) Notice period – The specialist adviser may resign from the

Governing Body by giving not less than 3 months written notice to the Governing Body at any time.

The Practice Nurse as listed in paragraph 6.5.2 of the Group’s constitution, are subject to the following appointment process: a) Nominations – Nominations from practice nurses who must secure a


b) Eligibility – current practice nurses of a Mansfield and Ashfield practice;

c) Appointment process – After the close of nominations the experience and skills of candidates is judged against an agreed list of competencies. Candidates then undergo an interview and selection process that includes senior GPs. All candidates that successfully meet the criteria will be put forward for election by all Mansfield and Ashfield practice nurses in a first past the post-election;

d) Term of office – a rolling programme of 2 or 3 years has been agreed by

the Governing Body to ensure a balance between continuity and the need to refresh the Governing Body membership:


i) Gross misconduct; ii) Becoming disqualified from office;

65

iii) Ceasing to fulfill the eligibility criteria for the role of practice nurse representative set out at standing order 2.2.3 (b) above;

3 3.2.1. The roles and responsibilities of each of these key roles are set out

in Chapter 7 of the Group’s constitution.

3. MEETINGS AND RESOLUTION OF THE CLINICAL COMMISSIONING GROUP

3.1 A formal meeting of the Group’s membership as a whole (a Member’s

Meeting) will be held on at least an annual basis at such times and places as the Group may determine.

3.2 In normal circumstance members will be given not less than 2 months’

notice in writing of any Members meetings to be held. However:

a) The Chair of the Governing Body as the Group’s Clinical Leader (“the Chair”) may call a Member’s Meeting at any time by giving not less than 15 working days’ notice in writing.

b) The Group’s membership may request the Chair to convene a Member’s Meeting by notice in writing to the chair signed by Member Practice Representatives representing not less than one third of the member practices, specifying in reasonable detail the matter that the petitioners wish to be considered at the meeting. If the Chair refuses, or fails, to call a Member’s Meeting within 5 working days of such a request being presented, the member practices representatives signing the requisition may forthwith call a members meeting by giving not less than 15 working days’ notice in writing to all members practices specifying the matter which the petitioners wish to be considered at the meeting.

3.3 Agenda, supporting papers and business to be transacted

3.3.1 Terms of business to be transacted for inclusion on the agenda of a

member’s meeting need to be notified to the Corporate Governance Manager at least 10 working days before the meeting takes place.

3.3.2 The Corporate Governance manager will be responsible for drawing up and

agreeing the agenda for each member’s meeting with the Chair. Where a notice requesting a member’s meeting to be convened has been received by the Chair in accordance with standing order 3.1b, the Chair shall include the matters specified in the notice on the agenda of the next Members Meeting.

3.3.3 Supporting papers for all items need to be submitted at least 5 working

days before the meeting takes place. 3.3.4 Before each Member’s Meeting the agenda and supporting papers will be

circulated to all member practices, so as to be available to member practices at least 3 working days before the date of the meeting taking place.

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3.3.5 Subject to the agreement of the Chair, any Member Practice Representative (who shall be a GP) may give written notice of an emergency motion up to 1 hour before the time fixed for a Member’s Meeting. The notice shall state the grounds of urgency. If in order, it shall be declared to the members at the commencement of the business of the meeting as an additional item included in the agenda. The Chair’s decision to include the item will be final.

3.4 Every person who is employed or engaged as a healthcare professional at a member practice as at the date of the relevant member’s meeting shall be entitled to attend and speak at a Members Meeting. However, only the Member Practice Representative or, in their absence, an authorised deputy (subject to standing order 3.5) for each member practice will be entitled to vote at a Member’s Meeting.

3.5 A Member Practice Representative who is unable to attend a Members’

Meeting must notify the Chair in writing before the start of the meeting if they wish to appoint a deputy to attend the meeting who is authorised to cast a vote of the relevant member practice.

3.6 No business shall be conducted at a Member’s Meeting unless a quorum

is present. A quorum will be two thirds of member practices present by their Member Practice Representative or their authorised deputy

3.7 The Chair of the Governing Body as the Group’s Clinical Leader will

preside at all Members’ Meetings. If the Chair is absent from the meeting a GP member of the Governing Body will be chosen by the Member Practice Representatives (including authorised deputies) present, or by a majority of them, and will preside.

3.8 Generally it is expected that decisions will be reached by consensus at

member’s meeting. Should this not be possible then a vote of the Member Practice Representatives (including authorised deputies) will be required, with the votes to be cast weighted according to practice registered list size, as follows:

a) Each Member Practice Representative (or their authorised deputy)

representing a member practice shall be entitled to cast one vote. Each vote will be weighted in proportion to their practices’ registered list size as a percentage of the total CCG registered list population

3.9 The process for voting at a Member’s Meeting is set out below:

a) Eligibility – each Member Practice Representative (or their

authorised deputy) will be eligible to vote on behalf of their member practice on every resolution which is put to a vote at the meeting

b. Majority necessary to pass a resolution:

i) If the resolution relates to a Specified Reserved Matter then the

resolution will only be passed if at least seventy five per cent of the votes which are cast on the resolution are cast in favour of it;

67

ii) If the resolution relates to any other matter then it will be passed if more votes are cast for the resolution than against it.

c) Casting vote – if an equal number of votes are cast for and against a

resolution which does not relate to a Specified Reserved matter then the Chair will have a casting vote. For the avoidance of doubt the Chair is not entitled to a casting vote in relation to a resolution which relates to a Specified Reserved Matter.

3.10 Should a vote be taken on a resolution the outcome of the vote, and

any dissenting views, must be recorded in the minutes of the meeting. 3.11 A resolution in writing signed by Member Practice Representatives who are

between them entitled to cast a majority of the votes capable of being cast in aggregate by all Member Practice Representatives shall be deemed as passed as if that resolution as if that resolution had been proposed and passed at a duly convened Member’s Meeting, providing the resolution does not relate to a Specified Reserved Matter. For the avoidance of doubt a resolution which relates to a Specified Reserved Matter can only be passed at a members’ meeting in accordance with standing order 3.9.

3.12 The names of all the Member Practice Representatives (or authorised

deputies) present at a Members’ Meeting, including the Chair of the meeting, will be recorded within the minutes of the meeting. The minutes of the proceedings of a meeting will be drawn up and circulated in accordance of the members’ wishes.

4. MEETINGS OF THE GOVERNING BODY

4.1. Calling meetings

4.1.1. Ordinary meetings of the Group shall be held at regular intervals at

such times and places as the Group may determine. 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 30 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 14 working days before the meeting takes place. The agenda and supporting papers will be circulated to all members of a meeting at least 7 working days before the date the meeting will take place.

4.2.2. Agendas and certain papers for the Group’s Governing Body –

including details about meeting dates, times and venues - will be published on the Group’s website at www.mansfieldandashfieldccg.nhs.uk

4.2.3. These documents may also be inspected upon request (addressed to

the Head of Corporate Governance) at the CCG Headquarters which are located at:

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NHS Mansfield and Ashfield CCG Hawthorn House Ransom Wood Business Park Southwell Road West Rainworth Mansfield Nottinghamshire NG21 0HJ Tel: 01623 673143

4.3. Petitions 4.3.1. Where a petition has been received by the Group, the Chair of the

Governing Body shall include the petition as an item for the agenda of the next meeting of the Governing Body.

4.4. Chair of a meeting

4.4.1. At any meeting of the Group or its Governing Body or of a committee or

sub-committee, the Chair of the Group, Governing Body, committee or sub- committee, 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 or Deputy Chair a member of the Group, Governing Body, committee or sub-committee respectively shall be chosen by the members present, or by a majority of them, and shall preside.

4.5. Chair's ruling

4.5.1. The decision of the Chair of the Governing Body 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. A quorum will be 7 members (with a clinical majority). The quorum should

include all of the following:

a. The Clinical Lead, Deputy Clinical Lead or the Accountable Officer

b. A lay member 4.6.2. For all other of the Group’s committees and sub-committees, including

the Governing Body’s committees and sub-committees, the details of the quorum for these meetings and status of representatives are set out in the appropriate terms of reference

4.7. Decision making

4.7.1. Chapter 6 of the Group’s constitution, together with the scheme of

reservation and delegation, sets out the governing structure for the

69

exercise of the Group’s statutory functions. Generally it is expected that at the Group’s Governing Body’s meetings decisions will be reached by consensus. Should this not be possible then a vote of members will be required, the process for which is set out below and in the Governing Body terms of reference (Appendix K):

a) the members of the Governing Body set out in Chapter 6

(paragraph 6.5.2) will be eligible to vote; b) a majority is necessary to confirm a decision c) if necessary the chair will have the casting vote;

d) All dissenting views will be recorded.

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 Group’s committees and sub-committees, including the

Governing Body’s committees and sub-committee, 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. The powers which the Governing Body has reserved to itself within these

Standing Orders may in emergency or for an urgent decision be exercised by the Accountable Officer and the Clinical Lead having consulted at least two other Governing Body members. The exercise of such powers by the Accountable Officer and the Clinical Lead shall be reported to the next formal meeting of the Governing Body in public session for formal ratification.

4.8.2. In the event of the Clinical Lead being conflicted the Accountable Officer will consult with the Deputy Chair and one other non-conflicted Governing Body GP member. In the event that all Governing Body GPs are conflicted the Accountable Officer will consult with the Deputy Chair and one other voting member.

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 the NHS Commissioning Board, any part of these standing orders may be suspended at any meeting, provided 7 Group members 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 Body’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 meeting present at the meeting shall be

recorded in the minutes of the Group’s meetings. The names of all 70

members of the Governing Body present shall be recorded in the minutes of the Governing Body meetings. The names of all members of the Governing Body’s committees / sub-committees present shall be recorded in the minutes of the respective Governing Body committee / sub- committee meetings.

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 meeting where they shall be signed by the person presiding at it.

4.11.2. No discussion shall take place upon the minutes except upon their

accuracy or where the Group’s Chair considers discussion appropriate.

4.11.3. Minutes shall be circulated in accordance with members’ wishes.

4.11.4. 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.

4.12. Admission of public and the press

4.12.1. Admission and exclusion on grounds of confidentiality of business to

be transacted.

a) The public and representatives of the press may attend all meetings of the clinical commissioning Group, but shall be required to withdraw upon the Governing Body resolving as follows:-

b) “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”, Section 1 (2) Public Bodies (Admission to Meetings) Act 1960.

Guidance should be sought from the Governing Body’s Corporate Governance Manager to ensure correct procedure is followed on matters to be included in the exclusion.

5. APPOINTMENT OF COMMITTEES AND SUB-COMMITTEES

5.1. Appointment of committees and sub-committees

5.1.1. The Group may appoint committees and sub-committees of the

Group, subject to any regulations made by the Secretary of State61, and make provision for the appointment of committees and sub-committees of its Governing Body. Where such committees and sub-committees of the Group, or committees and sub-committees of its Governing Body, are appointed they are included in Chapter 6 of the Group’s constitution.

5.1.2. Other than where there are statutory requirements, such as in relation to

the Governing Body’s audit committee or remuneration committee, the 71

Group shall determine the membership and terms of reference of committees and sub-committees and shall, if it requires, receive and consider reports of such committees at the next appropriate meeting of the Group.

61 See section 14N of the 2006 Act, inserted by section 25 of the 2012 Act

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

5.2. Terms of Reference

5.2.1. Terms of reference shall have effect as if incorporated into the

constitution. Terms of reference for the Governing Body and its key committees can be found on the CCG’s website at: http://www.mansfieldandashfieldccg.nhs.uk/index.php/maaboutus/2015-02-18-12-04-56/committee-terms-of-reference

5.3. Delegation of Powers by Committees to Sub-committees

5.3.1. Where committees are authorised to establish sub-committees they

may not delegate executive powers to the sub-committee unless expressly authorised by the Group.

5.4. Approval of Appointments to Committees and Sub-Committees

5.4.1. The Group shall approve the appointments to each of the committees and

sub-committees which it has formally constituted including those the Governing Body. The Group shall agree such travelling or other allowances as it considers appropriate.

6. DUTY TO REPORT NON-COMPLIANCE WITH STANDING

ORDERS AND PRIME FINANCIAL POLICIES 6.1. 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 Body for action or ratification. All members of the Group and staff have a duty to disclose any non-compliance with these standing orders to the Accountable Officer as soon as possible.

7. USE OF SEAL AND AUTHORISATION OF DOCUMENTS

7.1. Clinical Commissioning Group’s seal

7.1.1. The Group 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;

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b) the Chair of the Governing Body;

c) the Chief Finance Officer;

7.2. Execution of a document by signature

7.2.1. The following individuals are authorised to execute a document on

behalf of the Group by their signature.

a) the Accountable Officer

b) the Chair of the Governing Body c) the Chief Finance Officer

8. OVERLAP WITH OTHER CLINICAL COMMISSIONING

GROUP POLICY STATEMENTS / PROCEDURES AND REGULATIONS

8.1. Policy statements: general principles

8.1.1. The Group will from time to time agree and approve policy statements /

procedures which will apply to all or specific groups of staff employed by NHS Mansfield and Ashfield Clinical Commissioning Group. The decisions to approve such policies and procedures will be recorded in an appropriate group minute and will be deemed where appropriate to be an integral part of the Group’s standing orders.

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APPENDIX E – SCHEME OF RESERVATION & DELEGATION 1. SCHEDULE OF MATTERS RESERVED TO THE CLINICAL COMMISSIONING GROUP AND SCHEME OF

DELEGATION 1.1. The arrangements made by the Group as set out in this scheme of reservation and delegation of decisions shall have effect as if

incorporated in the Group’s constitution. 1.2. The Clinical Commissioning Group remains accountable for all of its functions, including those that it has delegated.

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Policy Area

Decision

Reserved to the Membership

Reserved or delegated to Governing Body

Accountable Officer

Audit & Governance Committee

Remuneration & Terms of Services Committee

Other

REGULATION AND CONTROL

Determine the arrangements by which the members of the Group approve those decisions that are reserved for the membership.


Consideration and approval of applications to the NHS Commissioning Board on any matter concerning material changes to the Group’s constitution, Including: terms of reference for the Group’s Governing Body, its committees, membership of committees, the overarching scheme of reservation and delegated powers, arrangements for taking urgent decisions, standing orders and prime financial policies.

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Policy Area

Decision



Accountable Officer



Other


Exercise or delegation of those functions of the clinical commissioning Group which have not been retained as reserved by the Group, delegated to the Governing Body or other committee or sub-committee or [specified] member or employee


Prepare the Group’s overarching scheme of reservation and delegation, which sets out those decisions of the Group reserved to the membership and those delegated to the

o Group’s Governing Body

o committees and sub-committees of

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Policy Area

Decision



Accountable Officer



Other

the Group, or o its members or

employees and sets out those decisions of the Governing Body reserved to the Governing Body and those delegated to the

o Governing Body’s committees and sub-committees,

o members of the Governing Body,

o an individual who is member of the Group but not the Governing Body or a specified person

for inclusion in the Group’s constitution.


Approval of the Group’s overarching scheme of reservation and delegation.


Prepare the Group’s operational scheme of

77

Policy Area

Decision



Accountable Officer



Other

delegation, which sets out those key operational decisions delegated to individual employees of the clinical commissioning Group, not for inclusion in the Group’s constitution.


Approval of the Group’s operational scheme of delegation that underpins the Group’s ‘overarching scheme of reservation and delegation’ as set out in its constitution.


Prepare detailed financial policies that underpin the clinical commissioning Group’s prime financial policies.

Chief Finance Officer


Approve detailed financial policies.


Approve arrangements for managing exceptional funding requests.


Set out who can execute a document by signature/use of the seal.

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Policy Area

Decision



Accountable Officer



Other


Authority to sign documents on behalf of the Group

Chair of the GB Chief Finance Officer


Authority to sign documents on behalf of the Group

Chair of the GB

Chief Finance

Officer


Emergency or urgent decisions – in an emergency or urgency to exercise the powers of the Governing Body having consulted with at least two other Governing Body members and provided it is reported to the next meeting of the Governing Body. In the event of the Clinical Chair being conflicted, the Accountable Officer will consult the Deputy Chair of the Governing Body and one other non-conflicted GP

In conjunction with GB members as stated

In line with the Account- able Officer and GB Members as stated

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Policy Area

Decision



Accountable Officer



Other

member. If all Governing Body GPs are conflicted, the Accountable Officer will consult with the Deputy Chair and one other voting member.

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Commissioning & Contracting within an Alliance

All matters relating to the work of the Alliance Leadership Board as set out in the Alliance Agreement dated 1st April 2016 and the Alliance Leadership Board Terms of reference dated 19th May 2016 with the exception of:

a) Matters reserved for governing bodies as outlined in clause 11.4 of the Alliance Agreement dated 1st April 2016

b) Other key strategic matters as listed below:

• Risk share • Payment

mechanisms • Outcomes • Proposed

changes to the governance arrangements of the Alliance

Chief Officer/ CCG Clinical Chair

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PRACTICE MEMBER REPRESENTATIVES & MEMBERS OF THE GOVERNING BODY

Approve the arrangements for o identifying practice

members to represent practices in matters concerning the work of the Group; and

o appointing clinical leaders to represent the Group’s membership on the Group’s Governing Body, for example through election (if desired).

PRACTICE MEMBER Approve the appointment of

Policy Area

Decision



Accountable Officer



Other

REPRESENTATIVES & MEMBERS OF THE GOVERNING BODY

Governing Body members, the process for recruiting and removing non-elected members to the Governing Body (subject to any regulatory requirements) and succession planning.

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PRACTICE MEMBER REPRESENTATIVES & MEMBERS OF THE GOVERNING BODY

Approve arrangements for identifying the Group’s proposed Accountable Officer.

STRATEGY & PLANNING

Agree the vision, values and overall strategic direction of the Group.

STRATEGY & PLANNING

Approval of the Group’s operating structure.

STRATEGY & PLANNING

Approval of the Group’s commissioning plan.

STRATEGY & PLANNING

Approval of the Group’s corporate budgets that meet the financial duties as set out in section 5.3 of the main body of the constitution.

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Policy Area

Decision



Accountable Officer



Other

STRATEGY & PLANNING

Approval of variations to the approved budget where variation would have a significant impact on the overall approved levels of income and expenditure or the Group’s ability to achieve its agreed strategic aims.

ANNUAL REPORTS & ACCOUNTS

Approval of the Group’s annual report and annual accounts.

ANNUAL REPORTS & ACCOUNTS

Approval of the arrangements for discharging the Group’s statutory financial duties.

HUMAN RESOURCES Approve the terms and conditions, remuneration and travelling or other allowances for Governing Body members, including pensions and gratuities.

HUMAN RESOURCES Approve terms and conditions of employment for all employees of the Group including, pensions,

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Policy Area

Decision



Accountable Officer



Other

remuneration, fees and travelling or other allowances payable to employees and to other persons providing services to the Group.

HUMAN RESOURCES Approve any other terms and conditions of services for the Group’s employees.

HUMAN RESOURCES Advise the Governing Body on the terms and conditions of employment for all employees of the Group including allowances, pensions, bonuses and/or termination arrangements.

HUMAN RESOURCES Advise the Governing Body on pensions, remuneration, fees and allowances payable to employees and to other persons providing services to the Group.

85

Policy Area

Decision



Accountable Officer



Other

HUMAN RESOURCES Consider and advise the Governing Body on other remuneration and compensation issues referred by the Chair of the Governing Body or Chief Officer

HUMAN RESOURCES Approve disciplinary arrangements for employees, including the Accountable Officer (where he/she is an employee or member of the clinical commissioning Group) and for other persons working on behalf of the Group.

HUMAN RESOURCES Review disciplinary arrangements where the Accountable Officer is an employee or member of another clinical commissioning Group.

HUMAN RESOURCES Approval of the arrangements for discharging the Group’s statutory duties as an

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Policy Area

Decision



Accountable Officer



Other

employer.

HUMAN RESOURCES Approval of disciplinary arrangements/ policy(ies) arrangements for employees and for other persons working on behalf of the Group.

HUMAN RESOURCES Approve human resources policies for employees and for other persons working on behalf of the Group (excluding disciplinary arrangements/policy(ies)).

QUALITY & SAFETY Approve arrangements, including supporting policies, to minimise clinical risk, maximise patient safety and to secure continuous improvement in quality and patient outcomes.

QUALITY & SAFETY Approve arrangements for supporting the NHS Commissioning Board in discharging its responsibilities in relation to securing continuous improvement in the quality of general medical

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Policy Area

Decision



Accountable Officer



Other

services.

OPERATONAL & RISK MANAGEMENT

Approve and oversee implementation plans for clinical strategy and service delivery including public engagement, consultation and equality.

Clinical Executive

OPERATIONAL & RISK MANAGEMENT

Prepare and recommend an operational scheme of delegation that sets out who has responsibility for operational decisions within the Group.

Q&R Committee


Approve the Group’s counter fraud and security management arrangements.


Approval of the Group’s risk management arrangements.


Approve arrangements for risk sharing and or risk pooling with other organisations (for example arrangements for pooled funds with other clinical

88

Policy Area

Decision



Accountable Officer



Other

commissioning Groups or pooled budget arrangements under section 75 of the NHS Act 2006).


Approval of a comprehensive system of internal control, including budgetary control that underpins the effective, efficient and economic operation of the Group.


Approve proposals for action on litigation against or on behalf of the clinical commissioning Group.


Approve the Group’s arrangements for business continuity and emergency planning.

NFORMATION GOVERNANCE

Approve the Group’s arrangements for handling complaints.

NFORMATION GOVERNANCE

Approval of the arrangements for ensuring appropriate and

89

Policy Area

Decision



Accountable Officer



Other

safekeeping and confidentiality of records and for the storage, management and transfer of information and data.

TENDERING & CONTRACTING

Approval of the Group’s contracts for any commissioning support

in line with the financial

limits set out in the operational scheme of delegation

in line with the financial limits set out in the operational scheme of delegation

TENDERING & CONTRACTING

Approval of the Group’s contracts for corporate support (for example finance provision).

in line with financial limits set out in the

operational scheme of delegation

in line with the financial limits set out in the operational scheme of delegation

PARTNERSHIP WORKING

Approve decisions that individual members or employees of the Group participating in joint arrangements on behalf of the Group can make. Such delegated decisions must be disclosed in this scheme of reservation and delegation.

PARTNERSHIP WORKING

Approve decisions delegated to joint committees established under section 75

90

Policy Area

Decision



Accountable Officer



Other

of the 2006 Act.

COMMISSIONING & CONTRACTING FOR CLINICAL SERVICES

Approval of the arrangements for discharging the Group’s statutory duties associated with its commissioning functions, including but not limited to promoting the involvement of each patient, patient choice, reducing inequalities, improvement in the quality of services, obtaining appropriate advice and public engagement and consultation.

COMMISSIONING & CONTRACTING FOR GP PRACTICE SERVICES

Approval of the arrangements for discharging the group’s statutory duties associated with its GP practice commissioning functions, including but not limited to promoting the involvement of each patient, patient choice, reducing inequalities, improvement in the quality of services, obtaining appropriate advice and public engagement and consultation.

Primary Care Commis- sioning

Committee

COMMISSIONING & CONTRACTING FOR CLINICAL SERVICES

Approve arrangements for co- ordinating the commissioning of services with other Groups and or with the local

91

Policy Area

Decision



Accountable Officer



Other

authority(ies), where appropriate.

COMMUNICATIONS Approving arrangements for handling Freedom of Information requests.

Q&R Committee

COMMUNICATIONS Determining arrangements for handling Freedom of Information requests.

92

APPENDIX F - NOLAN PRINCIPLES 1. The ‘Nolan Principles’ set out the ways in which holders of public office should

behave in discharging their duties. The seven principles are:

a) Selflessness – Holders of public office should act solely in terms of the public interest. They should not do so in order to gain financial or other benefits for themselves, their family or their friends.

b) Integrity – Holders of public office should not place themselves under any

financial or other obligation to outside individuals or organisations that might seek to influence them in the performance of their official duties.

c) Objectivity – In carrying out public business, including making public

appointments, awarding contracts, or recommending individuals for rewards and benefits, holders of public office should make choices on merit.

d) Accountability – Holders of public office are accountable for their decisions

and actions to the public and must submit themselves to whatever scrutiny is appropriate to their office.

e) Openness – Holders of public office should be as open as possible about all the

decisions and actions they take. They should give reasons for their decisions and restrict information only when the wider public interest clearly demands.

f) Honesty – Holders of public office have a duty to declare any private interests

relating to their public duties and to take steps to resolve any conflicts arising in a way that protects the public interest.

g) Leadership – Holders of public office should promote and support these

principles by leadership and example. Source: The First Report of the Committee on Standards in Public Life (1995)70

70 Available at http://www.public-standards.gov.uk/

APPENDIX G – NHS CONSTITUTION 93

The NHS Constitution sets out seven key principles that guide the NHS in all it does:

the NHS provides a comprehensive service, available to all - irrespective of gender, race, disability, age, sexual orientation, religion or belief. It has a duty to each and every individual that it serves and must respect their human rights. At the same time, it has a wider social duty to promote equality through the services it provides and to pay particular attention to Groups or sections of society where improvements in health and life expectancy are not keeping pace with the rest of the population

access to NHS services is based on clinical need, not an individual’s ability to pay - NHS services are free of charge, except in limited circumstances sanctioned by Parliament.

the NHS aspires to the highest standards of excellence and professionalism - in the provision of high-quality care that is safe, effective and focused on patient experience; in the planning and delivery of the clinical and other services it provides; in the people it employs and the education, training and development they receive; in the leadership and management of its organisations; and through its commitment to innovation and to the promotion and conduct of research to improve the current and future health and care of the population.

NHS services must reflect the needs and preferences of patients, their families and their carers - patients, with their families and carers, where appropriate, will be involved in and consulted on all decisions about their care and treatment.

the NHS works across organisational boundaries and in partnership with other organisations in the interest of patients, local communities and the wider population - the NHS is an integrated system of organisations and services bound together by the principles and values now reflected in the Constitution. The NHS is committed to working jointly with local authorities and a wide range of other private, public and third sector organisations at national and local level to provide and deliver improvements in health and well-being

the NHS is committed to providing best value for taxpayers’ money and the most cost-effective, fair and sustainable use of finite resources - public funds for healthcare will be devoted solely to the benefit of the people that the NHS serves

the NHS is accountable to the public, communities and patients that it serves - the NHS is a national service funded through national taxation, and it is the Government which sets the framework for the NHS and which is accountable to Parliament for its operation. However, most decisions in the NHS, especially those about the treatment of individuals and the detailed organisation of services, are rightly taken by the local NHS and by patients with their clinicians. The system of responsibility and accountability for taking decisions in the NHS should be transparent and clear to the public, patients and staff. The Government will ensure that there is always a clear and up-to-date statement of NHS accountability for this purpose. Source: The NHS Constitution: The NHS belongs to us all (March 2012)71

94

Appendix H PRIME FINANCIAL POLICIES

OF

NEWARK AND SHERWOOD CCG

PRIME FINANCIAL POLICIES Updated on 10 March 2016

1. INTRODUCTION

1.1. General

1.1.1. These Prime Financial Policies and any supporting policies or procedures issued from time to time by or on behalf of the Chief Finance Officer 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 Delegation within Constitution (see Appendix E of the Constitution).

1.1.3. Number not used

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 any detailed financial policies issued by or on behalf of the Chief Finance Officer from time to time. 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.mansfieldandashfield.nhs.uk and on www.newarkandshwerood .nhs.uk

Hard copies can also be requested by writing to the Corporate Governance Team at: NHS Mansfield and Ashfield CCG. Hawthorn House, Ransomwood Business Park, Southwell Road, Mansfield, NG21 0HJ NHS Newark and Sherwood CCG, Balderton Primary Care Centre, Lowfield Lane, Balderton, Nottinghamshire, NG24 3HJ Or email [email protected] or call 01623 673143. 1.1.6. Should any difficulties arise regarding the interpretation or application of the Prime Financial Policies or any other supporting financial policies or procedures then the advice of the Accountable Officer must be sought before acting. The user should also be familiar with and comply with the provisions of the CCG’s Constitution, Standing Orders and Scheme of Delegation.

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Conflicts of Interest Policy

NHS Mansfield and Ashfield and NHS Newark and Sherwood Clinical Commissioning Groups Based on the national guidance and recommended framework from NHS England – this information builds/strengthens the CCGs existing conflicts of interest policy

January 2016

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