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AGENDA ITEM NO: 003/20
Updated Committee Terms of Reference Warrington CCG Governing Body Meeting 8th January 2020
GOVERNING BODY MEETING:
Governing Body Meeting
DATE OF MEETING:
8th January 2020
REPORT AUTHOR AND JOB TITLE:
Rebecca Knight Head of Assurance & Risk
REPORT TITLE:
Updated Committee Terms of Reference
STRATEGIC OBJECTIVES:
Please tick which strategic objectives the paper relates to
Improve quality of services
x
Sustained financial balance
x
Build an effective and motivated whole system workforce
x
Sound governance arrangements
x
Ensure integration and joint working arrangements
x
OUTCOME REQUIRED (tick)
Approval
x
Assurance
Discussion
Information
x
EXECUTIVE SUMMARY
• The terms of reference for Audit, Finance & Performance, Quality and Primary Care Commissioning Committees have been updated and approved by each relevant committee
• Terms of reference for Remuneration Committee and Commissioning Service Development Committee are currently under review
RECOMMENDATIONS
The Governing Body is asked to:
• Approve the terms of reference for Audit Committee, Finance & Performance Committee, Quality Committee and Primary Care Commissioning Committee, so that they can be implemented with immediate effect.
AGENDA ITEM NO: 003/20
Updated Committee Terms of Reference Warrington CCG Governing Body Meeting 8th January 2020
Outline any engagement – staff, clinical, stakeholder and patient / public
All terms of reference for each committee identified have been shared and approved with existing committee members. Terms of reference have taken account of comments made and amendments made if necessary
Are there any conflicts of interest which may be associated with this paper?
No conflicts of interest have been identified
Does this paper address any existing risks which are included on the Assurance Framework or Risk Register?
All strategic risks with the exception of A3, A4 and C1
Have the following areas been considered whilst producing this report?
Yes
N/A
Equality Impact Assessment (if yes, attach to paper)
x
Quality Impact Assessment (if yes, attach to paper)
x
Regulation, legal, governance and assurance implications (reference in the report if applicable)
x
Procurement process (reference in the report if applicable)
x
Document development
Has this document been presented to any other Committee or Forum? If yes, please list which meeting, date and outcome of presentation
Terms of reference approved by Committees on the following dates: Audit Committee – approved virtually by members following meeting on 9th October 2019 Finance & Performance Committee – approved at committee meeting on 30th October 2019 Quality Committee – approved at committee meeting on 27th November 2019 Primary Care Commissioning Committee – approved at committee meeting on 9th January 2019
AGENDA ITEM NO: 003/20
Updated Committee Terms of Reference Warrington CCG Governing Body Meeting 8th January 2020
Strategic Objectives and Risks 2019/20
Continually improve the quality of services to the population of Warrington
A1 – Failure to ensure clear arrangements are in place for the monitoring of quality, safety and patient experiences of commissioned services in the NHS
A2 - Failure to ensure clear arrangements are in place for the monitoring of quality, safety and patient experiences of non-commissioned services in the independent sector
A3 – Failure to deliver digitally enhanced care
A4 - Failure to deliver the Commissioning Plan to meet the needs of the population for 2019/20
Achieve financial balance
B1 – Failure to implement the financial strategy
B2 – Failure to deliver against the system recovery plan
B3 – Failure to secure best value
B4 - Failure to adequately provide for external factors, which impact on financial sustainability
B5 - Failure to reduce CCG running costs by 20% for 2020/21 onwards
Build an effective and motivated whole system workforce
C1 - Failure to continuously develop the organisational culture, that meets the changing need of our workforce
Ensure sound governance arrangements are in place
D1 – Failure to ensure we evidence compliance with our statutory duties
D2 – Failure to ensure patient and public engagement
D3 – Failure to improve the CCG rating as a result of monitoring performance via the Improvement and Assessment Framework
Ensure integration and joint working arrangements for the benefit of local people
E1 - Failure to ensure that a health and care infrastructure is in place, which retains the local needs-based commissioning approach
AGENDA ITEM NO: 003/20
Updated Committee Terms of Reference Warrington CCG Governing Body Meeting 8th January 2020
UPDATED COMMITTEE TERMS OF REFERENCE BACKGROUND 1. Clinical Commissioning Groups are legally required by the Health and Social Care
Act 2012 to have a governing body in place. The Governing Body is required in statute to have a remuneration committee and an audit committee in place. In addition, there is a requirement to have a primary care commissioning committee in place due to having delegated responsibility from NHS England for the commissioning of primary care.
2. The Governing Body is required to approve and keep under review the terms of reference for its statutory committees. In addition, it is required to approve the terms of reference for any additional committees formed to provide assurance to the Governing Body.
PURPOSE 3. The purpose of this report is to present the updated terms of reference for the
following committees for approval:
a. Audit Committee b. Finance & Performance Committee c. Quality Committee d. Primary Care Commissioning Committee
4. The terms of reference have been reviewed, amended and approved by the
relevant committees. All updated terms of reference have been included in the appendix for further information where required.
KEY ITEMS TO NOTE Audit Committee 5. The Terms of Reference have been cross referenced with the NHS Audit
Committee Handbook to ensure that they reflect the latest requirements. The workplan has also been updated to reflect any amendments.
6. Key amendments include: a. The need for all lay members to be Audit Committee members; b. Inclusion of the gifts and hospitality register and declaration of interests
register as a regular agenda item; c. Inclusion of cyber security; and d. Receipt of assurance from other committees
Finance & Performance Committee 7. The updated Terms of Reference have predominantly been strengthened to
include an increased oversight of all areas of performance, including primary care. Membership was discussed and it was agreed that the terms of reference should clarify the meaning of a clinician and who could and could not fulfil that role.
AGENDA ITEM NO: 003/20
Updated Committee Terms of Reference Warrington CCG Governing Body Meeting 8th January 2020
Quality Committee 8. The updated Terms of Reference include the following key amendments:
a. Chair to be a lay member; b. Invite to be extended to a local authority representative; c. Inclusion of infection, prevention and control oversight reports;
Primary Care Commissioning Committee 9. The committee Terms of Reference reflect the model terms of reference issued
by NHS England for all CCGs with delegated responsibilities for primary care commissioning.
10. The Terms of Reference were updated following an internal audit recommendation made by Mersey Internal Audit Agency (MIAA) regarding primary care finance being reported to Finance & Performance Committee as well as Primary Care Commissioning Committee.
Other Committees 11. The Terms of Reference for Remuneration Committee and Commissioning
Service Development Committee are currently under review and will be brought to Governing Body for approval once they have been updated and approved by the committee first.
Risk Reference 12. All updated terms of reference that have been included will support the receipt of
assurance (via reports) to mitigate the CCG strategic risks. Strategic risk A4 will be cross referenced within the review of terms of reference for the Commissioning Service Development Committee. Strategic risks A3 and C1 are not currently captured within any committee terms of reference and consideration will need to be given to where assurance is received regarding these risks.
RECOMMENDATION 13. The Governing Body is asked to:
a. Approve the updated terms of reference for the following committees, so
that they can be implemented with immediate effect; i. Audit Committee ii. Finance & Performance Committee iii. Primary Care Commissioning Committee iv. Quality Committee
Audit Committee Terms of Reference
1.0 Constitution
1.1 The Audit Committee is a standing committee formally established by the CCG’s Governing Body.
1.2 The Committee is a non-executive committee of the CCG and has no executive powers, other than those specifically delegated in these terms of reference.
1.3 These terms of reference have been produced in line with the guidance contained within the Healthcare Financial Management Association (HFMA) NHS Audit Committee Handbook (2018).
2.0 Membership and Quorum
2.1 The Committee will be appointed by the Governing Body from among the Lay Members of the CCG and will consist of not less than three members. One of the members will have recent relevant financial experience.
2.2 A quorum will be two of the three members.
2.3 One of the lay members will be appointed Chair of the Audit Committee by the Governing Body. The lay member for governance will chair the Audit Committee and must have qualifications, expertise or experience that enables them to express informed views about financial management and audit matters. The Chair of the Audit Committee will not chair any other CCG committee in order to retain independence.
2.4 The Chair of the CCG will not be a member of the Audit Committee and will not normally attend meetings, unless invited. This is outlined in Monitor’s Code of Governance
3.0 Attendance at Meetings
3.1 The Chief Finance Officer and internal and external audit representatives will normally attend meetings. The Deputy Chief Finance Officer will deputise for the Chief Finance Officer in the event that the Chief cannot attend.
3.2 The Head of Assurance and Risk will normally attend meetings, as will the Chief of Corporate Services.
3.3 The Clinical Chief Officer should be invited to attend to discuss at least annually with the Audit Committee the process for assurance that supports the Annual Governance Statement. The CCG Chair should also attend when the Committee considers the draft Annual Governance Statement and the annual report and accounts.
3.4 Other Executive Directors/managers should be invited to attend, particularly when the Committee is discussing areas of risk or operation that are the responsibility of that Director/manager.
3.5 The Local Counter Fraud Specialist will attend to report upon and discuss counter fraud matters.
3.6 Representatives from other organisations (e.g. NHS Counter Fraud Authority (NHS CFA)) and other individuals may be invited to attend on occasion.
3.7 The Secretary to the Committee will attend to take minutes of the meeting and provide appropriate support to the Chair and Committee members.
3.8 At least once a year, usually at its May meeting, members of the Committee will meet privately with the External and Internal Auditors. Other meetings will take place at the request of members or auditors.
4.0 Access
The Head of Internal Audit, representatives of External Audit and the Local Counter Fraud Specialist have a right of direct access to the Chair of the Committee.
5.0 Frequency of Meetings
5.1 The Committee should meet five times per year at appropriate times in the audit cycle to allow it to discharge all of its responsibilities in line with its annual work-plan. Additional meetings, including any focus working group, may be called as required. The Committee will review this annually.
5.2 The Accountable Officer, External Auditors and/or Head of Internal Audit may request a meeting if they consider that one is necessary.
6.0 Authority
6.1 The Committee is authorised by the Governing Body to investigate any activity within its terms of reference. It is authorised to seek any information it requires from any employee and all employees are directed to co-operate with any request made by the Committee.
6.2 The Committee is authorised by the Governing Body to obtain outside legal or other independent professional advice and to secure the attendance of outsiders with relevant experience and expertise if it considers this necessary.
7.0 Responsibilities
7.1 The Committee supports the Governing Body by:
• Assessing the CCG’s overarching framework of governance, risk and control
• Obtaining assurances about the design and operation of internal controls
• Seeking assurances about the underlying data (upon which assurances are based) to assess their reliability and accuracy
• Challenging poor and/or unreliable sources of assurance
• Challenging relevant managers when controls are not working or data are unreliable
The duties/responsibilities of the Committee are categorised as follows:
7.2 Integrated Governance, Risk Management and Internal Control
7.2.1 The Committee will review the establishment and maintenance of an effective system of integrated governance, risk management and internal control, across the whole of the organisation’s activities, that supports the achievement of the organisation’s objectives.
7.2.2 In particular, the Committee will review the adequacy and effectiveness of:
• All risk and control related disclosure statements (in particular the Annual Governance Statement), together with any accompanying Head of Internal Audit Opinion, external audit opinion or other appropriate independent assurances, prior to submission to the Governing Body.
• The underlying assurance processes that indicate the degree of achievement of corporate objectives, the effectiveness of the management of principal risks and the appropriateness of the above disclosure statements.
• The policies for ensuring compliance with relevant regulatory, legal and code of conduct requirements and related reporting and self-certifications.
• The policies and procedures for all work related to counter fraud and corruption as required by the NHS Counter Fraud Authority.
7.2.3 In carrying out this work the Committee will use the work of Internal Audit, External Audit and other assurance functions, but will not be limited to these sources. It will also seek reports and assurances from directors and managers.
7.2.4 This will be evidenced through the Committee’s use of an effective Assurance Framework to guide its work and that of the audit and assurance functions that report to it.
7.2.5 As part of its integrated approach, the Committee will have effective relationships with other CCG Governing Body Sub Committees (which may include reciprocal membership) to provide an understanding of processes and linkages. This will include the exchange of Chair’s action logs and highlight reports to the CCG Governing Body.
7.3 Internal Audit
The Committee will assure itself that there is an effective internal audit function that meets Public Sector Internal Audit Standards (PSIAS) and provides independent assurance to the Committee, Chief Executive and Governing Body. This will be achieved by:
• Considering the provision of the internal audit service and the costs involved
• Reviewing and approving the internal audit strategy, the annual internal audit plan and more detailed programme of work, that is consistent with the audit needs of the CCG as identified in the Assurance Framework
• Considering the major findings of internal audit work (and management’s response), and ensuring co-ordination between the internal and external auditors to optimise the use of audit resources
• Monitoring the implementation of agreed internal audit recommendations in line with agreed timescales, and where concerns exist in relation to the lack of implementation in a particular area the Committee can request the relevant operational manager to attend a meeting and give explanation
• Considering whether the internal audit function is adequately resourced and has appropriate standing within the organisation
• Reviewing the Internal Auditor’s annual report before its submission to the Governing Body
• Monitoring the effectiveness of internal audit and carrying out an annual review and obtaining independent assurance that Internal Audit complies with PSIAS
7.4 External Audit
The Committee will review and monitor the External Auditor’s independence and objectivity and the effectiveness of the audit process. In particular, the Committee will
review the work and findings of the External Auditors and consider the implications and management’s responses to their work. This will be achieved by:
• Assisting and advising the Governing Body in its appointment of the External Auditors (and make recommendations to the Governing Body when appropriate)
• Discussing and agreeing with the External Auditors, before the audit commences, the nature and scope of the audit as set out in the annual plan
• Discussing with the External Auditors their evaluation of audit risks and assessment of the organisation and the impact on the audit fee
• Reviewing all External Audit reports, including the report to those charged with governance, agreement of the annual audit letter before submission to the Governing Body and any work undertaken outside the annual audit plan, together with the appropriateness of management responses
• Establishing a clear policy for the engagement of external auditors to supply non-audit services
7.5 Financial Reporting
7.5.1 The Committee will monitor the integrity of the financial statements of the CCG and any formal announcements relating to its financial performance.
7.5.2 The Committee should ensure that the systems for financial reporting to the Governing Body, including those of budgetary control, are subject to review as to completeness and accuracy of the information provided.
7.5.3 The Committee will review the annual report and financial statements before submission to the Governing Body, focusing particularly on:
• The wording in the Annual Governance Statement and other disclosures relevant to the terms of reference of the Committee
• Changes in, and compliance with, accounting policies, practices and estimation techniques
• Unadjusted mis-statements in the financial statements
• Significant judgements in preparation of the financial statements
• Significant adjustments resulting from the audit
• Letters of representation
• Explanations for significant variances
7.6 Risk Management
7.6.1 The Committee will request and review reports and assurance from directors and managers as to the effectiveness of arrangements to identify and monitor risk. This will include:
• Inviting the CCG’s IT team to explain the organisation’s cyber security arrangements, in order to provide assurance to the Governing Body that the organisation is properly managing its cyber risk and has appropriate risk mitigation strategies
• Reviewing arrangements for new mergers and acquisitions, in order to seek assurance on processes in place to identify significant risks, risk owners and subsequent management of such risks
• Providing the Governing Body with assurance over developing partnership arrangements (e.g. accountable care organisations) and mitigation of risks which may arise at the borders between such organisations
7.6.2 The Governing Body will however retain the responsibility for routinely reviewing specific risks.
7.7 Counter Fraud and Security
7.7.1 The Committee will satisfy itself that the organisation has adequate arrangements in place for counter fraud that meet the NHS CFA’s standards and will review the outcomes of work in these areas. The Committee will receive the annual report and annual work plan from the Local Counter Fraud Specialist and will also receive regular progress reports on counter fraud activities.
7.8 Management
7.8.1 The Committee will request and review reports, evidence and assurances from Directors and managers on the overall arrangements for governance, risk management and internal control.
7.8.2 The Committee may also request specific reports from individual functions within the organisation (e.g. clinical audit).
7.9 Other Assurance Functions
7.9.1 The Committee will review the findings of other significant assurance functions, both internal and external to the organisation, and consider the implications for the governance of the organisation.
7.9.2 These will include, but not be limited to, any reviews by Department of Health arm’s length bodies or regulators/inspectors (e.g. the Care Quality Commission, NHS Improvement, NHS Resolution, etc.) and professional bodies with responsibility for the performance of staff or functions (e.g. Royal Colleges, accreditation bodies, etc.).
7.9.3 In addition, the Committee will review the work of other committees within the CCG, whose work can provide relevant assurance to the Committee’s own areas of responsibility. The Committee will receive the action logs and highlight reports to the CCG Governing Body of the following Governing Body committees for information:
• Finance and Performance Committee
• Quality Committee
• Commissioning and Service Development Committee
• Primary Care Commissioning Committee
• Remuneration Committee
7.9.4 The Committee will review Standing Financial Instructions, Scheme of Delegation and those elements of the CCG Constitution (Standing Orders) that provide assurances on the internal management of procurement and financial matters. It will also review the CCG’s Standards of Business Conduct Policy.
8.0 Reporting
8.1 Minutes of each meeting will be submitted to the next meeting for formal approval and signature by the Chair as a true record of that meeting. A Chair’s log and the minutes will be submitted to the next meeting of the Governing Body.
8.2 The Chair will draw to the attention of the Governing Body (via a highlight report) any issues that require disclosure to the Governing Body, or require executive action.
8.3 The Committee will report to the Governing Body annually on its work in support of the Annual Governance Statement specifically commenting on the fitness for purpose of the Assurance Framework, the completeness and 'embeddedness' of risk management in the organisation, the integration of governance arrangements, the appropriateness of the evidence that shows the organisations is fulfilling regulatory requirements relating to its existence as a functioning business and the robustness of the processes behind the quality accounts.
8.4 The annual report should also describe how the Committee has fulfilled its terms of reference and give details of any significant issues that the Committee considered in relation to the financial statements and how they were addressed. The report will also outline its work-plan for the coming year.
8.5 The Committee’s annual report and work-plan will also be submitted to the Governing Body for information.
9.0 Whistleblowing / Freedom to Speak Up Guardian
9.1 The Committee will review the effectiveness of the arrangements in place for allowing staff to raise (in confidence) concerns about possible improprieties in financial, clinical or safety matters and ensures that any such concerns are investigated proportionately and independently.
9.2 The CCG’s Freedom to Speak Up Guardian, or his or her nominated deputy, will attend the Committee at least annually to provide assurance on the design and operation of the function.
10.0 Administrative Support
10.1 The agenda for the Committee will be approved by the Chair of the Committee (or his or her nominated deputy).
10.2 Secretarial support (including distribution of agenda and papers to the Committee and noting of apologies) will be arranged by the Chief Finance Officer (or his or her nominated deputy).
10.3 Agenda papers will be circulated to all members of the Committee no less than five working days prior to each meeting. Late papers may only be circulated, or tabled at the meeting, with the prior approval of the Chair.
11.0 Review
11.1 The Committee will review its Terms of Reference annually, or as necessary in the intervening period, to ensure that they remain fit for purpose and best facilitate the discharge of its duties. It will recommend any changes to the CCG Governing Body for approval.
11.2 The Committee will carry out an annual self-assessment (Appendix A) that is based on the good practice guide found in the HFMA’s NHS Audit Committee Handbook.
12.0 Equality Act (2010)
12.1 The CCG is committed to promoting a pro-active and inclusive approach to equality which supports and encourages an inclusive culture which values diversity.
12.2 The CCG is committed to building a workforce which is valued and whose diversity reflects the community it serves, allowing the CCG to deliver the best possible healthcare service to the community. In doing so, the CCG will enable all staff to achieve their full potential in an environment characterised by dignity and mutual respect.
12.3 The CCG aims to design and provide services, implement policies and make decisions that meet the diverse needs of our patients and their carers the general population we serve and our workforce, ensuring that none are placed at a disadvantage.
12.4 We therefore strive to ensure that in both employment and service provision no individual is discriminated against or treated less favourably by reason of age, disability, gender, pregnancy or maternity, marital status or civil partnership, race, religion or belief, sexual orientation or transgender (Equality Act 2010).
_________________________________________________________________________
Appendix A
HFMA NHS Audit Committee Handbook, 2018 – Checklist
This checklist is designed to elicit a simple yes or no answer to each question. Where ‘no’ answers have been given, the issues should be debated to determine if any further action is needed.
Area/Question Yes No Comments/Action
Composition, establishment and duties
Does the audit committee have written terms of reference and have they been approved by the governing body?
Are the terms of reference reviewed annually?
Has the committee formally considered how it integrates with other committees that are reviewing risk?
Are committee members independent of the management team?
Are the outcomes of each meeting and any internal control issues reported to the next governing body meeting?
Does the committee prepare an annual report on its work and performance for the governing body?
Has the committee established a plan of matters to be dealt with across the year?
Are committee papers distributed in sufficient time for members to give them due consideration?
Has the committee been quorate for each meeting this year?
Internal control and risk management
Has the committee reviewed the effectiveness of the organisation’s assurance framework?
Does the committee receive and review the evidence required to demonstrate compliance with regulatory requirements - for example, as set by the Care Quality Commission?
Has the committee reviewed the accuracy of the draft annual governance statement?
Has the committee reviewed key data against the data quality dimensions?
Annual report and accounts and disclosure statements
Does the committee receive and review a draft of the organisation’s annual report and accounts?
Does the committee specifically review:
• The going concern assessment
• Changes in accounting policies
• Changes in accounting practice due to changes in accounting standards
• Changes in estimation techniques
• Significant judgements made in preparing the accounts
• Significant adjustments resulting
from the audit
• Explanations for any significant
variances?
Is a committee meeting scheduled to discuss any proposed adjustments to the accounts and audit issues?
Does the committee ensure it receives explanations for any unadjusted errors in the accounts found by the external auditors?
Internal audit
Is there a formal ‘charter’ or terms of reference, defining internal audit’s objectives and responsibilities?
Does the committee review and approve the internal audit plan, and any changes to the plan?
Is the committee confident that the audit plan is derived from a clear risk assessment process?
Does the committee receive periodic progress reports from the head of internal audit?
Does the committee effectively monitor the implementation of management actions arising from internal audit reports?
Does the head of internal audit have a right of access to the committee and its chair at any time?
Is the committee confident that internal audit is free of any scope restrictions, or operational responsibilities?
Has the committee evaluated whether internal audit complies with the Public Sector Internal Audit Standards?
Does the committee receive and review the head of internal audit’s annual opinion?
External audit
Do the external auditors present their audit plan to the committee for agreement and approval?
Does the committee review the external auditor’s ISA 260 report (the report to those charged with governance)?
Does the committee review the external auditor’s value for money conclusion?
Does the committee review the external auditor’s opinion on the quality account when necessary?
[Note: this question is not relevant for CCGs]
Area/Question Yes No Comments/Action
Does the committee hold periodic private discussions with the external auditors?
Does the committee assess the performance of external audit?
Does the committee require assurance from external audit about its policies for ensuring independence?
Has the committee approved a policy to govern the value and nature of non-audit work carried out by the external auditors?
Clinical audit [Note: this section is only relevant for providers]
If the committee is NOT responsible for monitoring clinical audit, does it receive appropriate assurance from the relevant committee?
If the committee is responsible for monitoring clinical audit has it:
• Reviewed an annual clinical audit plan?
• Received regular progress reports?
• Monitored the implementation of
management actions?
• Received a report over the quality
assurance processes covered by
clinical audit activity?
Counter fraud
Does the committee review and approve the counter fraud work plans, and any changes to the plans?
Is the committee satisfied that the work plan is derived an appropriate risk assessment and that coverage is adequate?
Does the audit committee receive periodic reports about counter fraud activity?
Area/Question Yes No Comments/Action
Does the committee effectively monitor the implementation of management actions arising from counter fraud reports?
Do those working on counter fraud activity have a right of direct access to the committee and its chair?
Does the committee receive and review an annual report on counter fraud activity?
Does the committee receive and discuss reports arising from quality inspections by NHSCFA?
FINANCE & PERFORMANCE COMMITTEE
(approved following F & P Committee 30th October 2019)
Terms of Reference
The Committee will provide assurance to the Governing Body on all aspects of:
• the CCG’s finances • the delivery of the CCG’s operational performance • the performance of commissioned services
The Committee is established in accordance with NHS Warrington Clinical Commissioning Group’s (CCG) constitution, standing orders (SO) and scheme of reservation and delegation (SORD).
These terms of reference set out the membership, remit, responsibilities and reporting arrangements of the Committee.
1. Membership (voting)
• Governing Body secondary care doctor (Chair)
• Governing Body lay member (Vice chair)
• Lay member
• Chief Finance Officer
• Chief of Commissioning
• Two other Governing Body clinicians including 1 GP Member and 1 other clinician
NB. A clinician is considered to be a GP, secondary care doctor or nurse. This does
not include the Chair or Accountable Officer, in the event that they hold clinical
qualifications.
In Attendance
• Deputy Chief Finance Officer
• Head of Performance & Contracts
• Other officers will be invited to attend in line with agenda items
2. Quorum
The quorum of the Committee will be 3 voting members including the Committee chair (or vice chair), Chief Finance Officer (or nominated deputy), and at least one other member.
3. Remit and responsibilities
The Committee will provide assurance to the Governing Body on:
• the delivery of the CCG’s strategic plan
• all aspects of the financial management of the CCG
• the delivery of NHS Constitutional standards in commissioned services
• the performance of CCG-commissioned services
4. Duties
The Governing Body has delegated responsibility the following duties to the Committee:
• approve and monitor the delivery of the CCG’s annual financial plan
• monitor contract planned expenditure against actual spend for commissioned
services
• consider the priority, affordability and value for money of business cases for any
clinical service or pathway following a recommendation by the Commissioning
Service Development Committee; (in line with the standing orders, schemes of
reservation and delegation and standing financial instructions (SFIs))
• review monthly reports detailing performance of commissioned services against core
standards, national and local targets and the CCG’s Strategic Plans
• make recommendations to the Governing Body on all decisions that will exceed its
financial limits as detailed in the Standing Financial Instructions and Governance
Manual
Specifically, the Committee will monitor, on behalf of the CCG Governing Body, delivery of the CCG’s financial, operational and performance targets. The Committee will:
• Provide assurance and advise the Governing Body on the contractual and national standard performance of all CCG commissioned services with the exception of clinical quality indicators. Issues to be reported on an exception basis
• Provide the Governing Body with advice and assurance on financial performance
• Receive and comment on financial forecasts, analysis of financial risk and financial planning
• Oversee and ensure remedial action when activity/performance issues/variances arise either against targets or key assumptions made in drawing up activity/finance plans
• Receive best value reports/benchmarking identifying outliers/issues and make recommendations regarding necessary action
• Receive and advise on medium term financial and savings planning including the refresh of the Financial Recovery Plan and any other Recovery Plans as required
• Ensure that there are appropriate mechanisms in place to assure the Governing Body
that systems, policies and people in place are operating in a way that is effective,
focused on key risks and driving the delivery of the CCG’s objectives
• Receive reports from Contract and Performance meetings on an exception basis and agree appropriate action
• Receive activity and finance performance progress for all material contracted providers
• Note by exception or on a cyclical basis, performance against contracts for Providers where the CCG is not the lead commissioner
• Review and monitor the procurement programme and the plan/process/outcomes of key programmed procurements
• Consider the procurement route for business cases and recommend appropriate action
• Review and challenge the delivery of financial savings, activity impacts and other benefits from QIPP projects
• Set for the authorised projects/programmes financial, risk and quality tolerances, beyond which exception reporting and renewed approval is required.
• Receive regular reports from Finance, Programme Management Office and Performance staff on the overall level of achieved and projected savings, activity impacts and other benefits for the programme and, at summary level, the projects comprising it
• Obtain an understanding from Executive leads and Project Managers of any additional actions required to ensure the achievement of the financial recovery plan objectives and identified benefits
• Review risks to delivery and to approve proposed remedial action as required
• Where a project or programme exceeds set financial, risk or quality tolerances, to assess whether there is continued business justification for the project or programme and if not to agree corrective action or decide that it should cease
• Identify and manage interdependencies by ensuring programme and project teams co-ordinate work and avoid duplication
• Receive assurance from PMO team that the actions required to deliver the projects are on track including assurance in respect of Equality Impact Assessments and Quality Impact Assessments
• Receive Closure/lessons reports on projects prepared by Project Managers and the Annual Programme Lessons report prepared by the Head of PMO, to consider all learning related to the more effective achievement of financial and other benefits
• The Committee has the authority to approve minor amendments on behalf of the
Governing Body or endorse new and/or significant amendments for approval by the
Governing Body of policies and procedures within its remit
5. Establishing supporting work streams
• The Committee is able to establish supporting work streams and subgroups to support it in the discharge its duties and responsibilities
• The Committee can only delegate to the supporting work streams or subgroups
the responsibilities that are set out within its own terms of reference as approved
by the Governing Body.
• The Committee shall at all times remain accountable to the Governing Body for all duties and responsibilities set out in its terms of reference
6. Decision making
Wherever possible members of the Committee will seek to make decisions and recommendations based on consensus. If this is not possible, the Chair will ask members to vote. If a simple majority is not achieved, the Chair has a casting vote.
Only the members of the Committee present at the meeting will be eligible to vote.
7. Frequency of meetings
The Committee will meet at least ten times a year.
8. Reporting
The Committee will submit a Chair’s log of the key issues to the Governing Body and
Audit Committee. Committee minutes will be submitted to the Governing Body for information.
9. Responsibilities of Committee members and attendees Members of the Committee and attendees must:
• make open and honest declarations of their interests at the commencement of each meeting notifying the Committee Chair of any agreed management arrangements, or to notify the Committee Chair of any actual, potential or perceived conflict at the start of the meeting
• uphold the Nolan Principles and all other relevant NHS Code of Conduct
requirements
• identify agenda items to the secretary at least 15 working days before the meeting
• submit papers to the Committee Secretary at least seven working days before the
meeting (N.B to be reviewed in line with updated Committee Standards and ways
of working)
10. Administrative arrangements
The Committee will be supported by a secretary who will be responsible for supporting
the Chair in the management of the Committee’s business. The secretary will:
• take minutes of the meeting to be agreed by the Chair
• produce a key Issues report following the meeting and submitted to the next
meeting of the Governing Body
• produce an action log following each meeting containing any outstanding actions
• distribute the agenda and accompanying papers to members at least five working
days before the meeting
• provide support to the Chair and Committee members
• file committee papers in accordance with NHS Warrington CCG policies
A work plan will be agreed at the start of each financial year and will be approved by the Governing Body.
11 Equality Act (2010)
The CCG is committed to promoting a pro-active and inclusive approach to equality which supports and encourages an inclusive culture which values diversity.
The CCG is committed to building a workforce which is valued and whose diversity reflects the community it serves, allowing the CCG to deliver the best possible healthcare service to the community. In doing so, the CCG will enable all staff to achieve their full potential in an environment characterised by dignity and mutual respect.
The CCG aims to design and provide services, implement policies and make decisions that meet the diverse needs of our patients and their carers the general population we serve and our workforce, ensuring that none are placed at a disadvantage.
We therefore strive to ensure that in both employment and service provision no individual is discriminated against or treated less favourably by reason of age, disability, gender, pregnancy or maternity, marital status or civil partnership, race, religion or belief, sexual orientation or transgender (Equality Act 2010).
12. Date and review
These terms of reference were accepted by NHS Warrington CCG Governing Body on
xxxxx.
Date of review: 1 year later.
Standing agenda items at each meeting
Review PMO Report including progress and exception reporting against schemes and actions in relation to the Quality, Innovation, Prevention and Productivity (QIPP) programme.
Monitor compliance with statutory financial duties (N.B to review frequency in work plan).
Review delivery of NHS constitutional targets across all commissioned services.
Ensure that the performance and finance plans are consistent with and complementary to
the CCGs annual budget, commissioning plan and strategy.
Approving any variations to planned investment within the limits set out in the detailed
financial policies of the CCG, ensuring that any amended plans remain within the overall
CCG budget and do not adversely affect the strategic performance of the CCG.
Monitoring Key Performance Indicators relating to CCG performance
Overall financial management of the organisation including the delivery of investment
plans, monitoring of reserves, delivery of financial recovery plans and cost improvement
plans.
Page 1 of 5
Quality Committee
Terms of Reference
The Committee will provide assurance to the Governing Body on all aspects of service quality within the CCG’s remit. This will include:
• clinical effectiveness; • safety; and • service user experience.
The Committee is established in accordance with NHS Halton Clinical Commissioning Group’s (CCG) and NHS Warrington Clinical Commissioning Group’s Constitution, Standing Orders and Scheme of Reservation & Delegation.
1. Membership (voting members)
• Lay Member (Chair)
• Chief Nurse (Vice Chair)
• Governing Body GP
• Governing Body Secondary Care doctor
• Clinical lead for primary care quality
• Deputy Chief Nurse
• Healthwatch or patient representative
• Chief Commissioner or Senior commissioning manager representative
Attendance required (non-voting)
• Chief of Corporate Services
• Head of Medicines Management
• Head of Quality and Safety Managers
• Chief of Corporate Affairs and Engagement
• Local Authority representation in relation to care quality and safeguarding (Adults and
Children)
• Designated Nurse for Safeguarding Adults
• Designated Nurse for Safeguarding Children
• Chair of the Governing Body (will attend once per year)
Other officers, including clinical leads, will be invited to attend in line with agenda items.
2. Quorum
A quorum will be 4 voting members:
• Chair or Vice Chair
• 2 Clinicians (1 of whom should be a Governing Body Clinician)
• 1 other voting member.
Page 2 of 5
3. Remit and responsibilities
The Quality Committee has delegated responsibility from the Governing Body for
securing continuous improvements for the quality of commissioned services. The
Committee shall:
• gain assurance that there is an effective and consistent process to commissioning
for quality and safety across the CCG's activities, ensuring that concerns and
underperformance are identified, and high standards of care and treatment are
delivered. This will include areas regarding patient safety, effectiveness of care and
patient /and staff experience;
• gain assurance of quality and safety indicators within the contracts commissioned
by the CCG and across clinical patient pathways.
• monitor achievement of the strategic aims for quality via the Quality & Safeguarding
Strategy and action plan.
3.1 Clinical Effectiveness
The Committee will assure the Governing Body of the effectiveness and efficacy of all commissioned services. The Committee will:
• receive an update on any quality issues for all providers of commissioned
services
• review the delivery of the Quality & Safeguarding Strategy 2018 – 2021
• establish Working Groups as necessary to fulfil its Terms of Reference and receive
reports from such groups.
• commission regular reports using the Early Warning Quality and Safety
Framework/Dashboard for the Governing Body
• receive and review for approval completed Quality Impact Assessments, Equality
Impact Assessments and Health Impact Assessments
• receive assurance regarding the management of Contract Quality key performance indicators relating to commissioned services through receipt of reports from Contract and Quality meetings
• identify areas of improvement in care delivery through the analysis of
complimentary data sources including programme budgeting, mortality rates and
outcomes
• seek assurance that Quality Schedules, Quality Risk Profiles and
Commissioning for Quality and Innovation schemes deliver continuous quality
improvements
• review any information, notification or advice received from the NHS England, NHS Improvement, Quality Surveillance Groups, National Quality Board, CQC, or any external regulator which relates to or has a bearing on an NHS care provider’s
Page 3 of 5
provision including the results of national clinical audit information and confidential enquiries
• review joint Clinical Investigation Reports which may be commissioned from time
to time
• review and advise the Governing Body as appropriate in relation to new or
reviewed national guidelines
3.2 Service User Safety
The Committee will assure the Governing Body of the safety of all service users in all commissioned services. The Committee will:
• co-ordinate, prioritise, agree and monitor actions to minimise risks across Warrington and Halton CCG commissioned services
• receive and report on any Serious Incidents and/or reports or investigations of
Significant Events Analysis/audits
• receive and report on infection, prevention and control and health care acquired
infections
• receive summary reports and ensure actions are delivered upon patient safety incidents or reports or investigations of Patient Safety Incidents
• receive and review reports into death rates through HSMR and SHMI reporting for all appropriate providers and advise action as appropriate
• receive and review any CQC reports for local providers and seek assurance that
action is taken to manage any issues identified
• receive overviews and outcomes of any independent investigation or reviews carried out on any local providers and seek assurance that findings and actions are in place to manage any issues identified
• review lessons learnt from any unexpected deaths investigated by the coroner and
share learning across providers
• seek assurance that there are appropriate arrangements in place in all
commissioned services in respect of Safeguarding as recommended by the Quality
Committee
• receive and act upon outcomes of reviews of Safeguarding Incidents - trends,
themes and lessons learnt
• receive reports to evidence that complaints and incidents are properly investigated,
lessons learned and feedback given, and that all appropriate details are analysed
alongside patient safety indicators by the Committee
Page 4 of 5
• receive regular reports and assurance in relation to safeguarding activity in Warrington and Halton and the performance of providers in relation to safeguarding KPIs
• receive, review and advise appropriate actions in relation to medicines related
incidents and medicines safety
• receive, review and advise as appropriate, incidents in relation to health equipment
3.3 Experience & Engagement
The Committee will assure the Governing Body of the experience and engagement of all service users in all commissioned services. The Committee will:
• seek assurance that lessons are learnt from patient experience intelligence
and serious untoward incidents
• receive and act upon findings of patient experience reports undertaken
locally, regionally or nationally
• receive regular reports in relation to Friends and Families test results
• consider whether there are appropriate policies and procedures in place for the handling of patient complaints, concerns or enquiries in accordance with relevant regulations
• review and approve CCG engagement plans both CCG specific and in
partnership with others including local authorities
• receive and review reports on the outcome of engagement and stakeholder events and provide assurance to the Governing Body in relation to service user and other stakeholder engagement
3.4 NHS Constitution
The Committee will assure the Governing Body of the performance of all commissioned services in respect of the rights set out in the NHS constitution, which relate to quality.
4. Decision making
Wherever possible members of the Committee will seek to make decisions and recommendations based on consensus. If this is not possible, the Chair will ask members to vote. If a simple majority is not achieved, the Chair has a casting vote.
Only the members of the Committee present at the meeting will be eligible to vote.
5. Establishing supporting work streams
• The Committee is able to establish supporting work streams and sub groups to
support it in the discharge its duties and responsibilities.
Page 5 of 5
• The Committee can only delegate to the supporting work streams or sub groups the responsibilities that are set out within its own terms of reference as approved by the Governing Body.
• The Committee shall at all times remain accountable to the Governing Body for all duties and responsibilities set out in its terms of reference
6. Frequency of meetings
The Committee will meet at least ten times a year.
7. Reporting
The Committee will submit a Chair’s log of the key issues to the Governing Body
and Audit Committee. Committee minutes will be submitted to the Governing Body
for information.
8. Responsibilities of Committee members and attendees
Members of the Committee and attendees must:
• make open and honest declarations of their interests at the commencement of each meeting notifying the Committee Chair of any agreed management arrangements, or to notify the Committee Chair of any actual, potential or perceived conflict at the start of the meeting
• uphold the Nolan Principles and all other relevant NHS Code of Conduct
requirements
• identify agenda items to the secretary at least 15 working days before the
meeting
• submit papers at least ten working days before the meeting
8. Administrative arrangements
The Committee will be supported by a secretary who will be responsible for
supporting the Chair in the management of the Committee’s business. The secretary
will:
• take minutes of the meeting to be agreed by the Chair
• produce a key issues report following the meeting and submit to the next meeting
of the Audit Committee and Governing Body
• produce an action log following each meeting containing any outstanding actions
• distribute the agenda and accompanying papers to members at least five working
days before the meeting
• file Committee papers in accordance with NHS Warrington policies
A work plan will be agreed at the start of each financial year and will be approved by
the Governing Body.
9 Equality Act (2010)
The CCG is committed to promoting a pro-active and inclusive approach to equality which supports and encourages an inclusive culture which values diversity.
Page 6 of 5
The CCG is committed to building a workforce which is valued and whose diversity reflects the community it serves, allowing the CCG to deliver the best possible healthcare service to the community. In doing so, the CCG will enable all staff to achieve their full potential in an environment characterised by dignity and mutual respect.
The CCG aims to design and provide services, implement policies and make decisions that meet the diverse needs of our patients and their carers, the general population we serve and our workforce, ensuring that none are placed at a disadvantage.
We therefore strive to ensure that in both employment and service provision no individual is discriminated against or treated less favourably by reason of age, disability, gender, pregnancy or maternity, marital status or civil partnership, race, religion or belief, sexual orientation or transgender (Equality Act 2010).
10. Date and review
These terms of reference were accepted by NHS Warrington and Halton CCG
Governing Body on xxxxx.
Date of review: 1 year later.
Version no. [7]
Review date [XXX 2020]
Terms of reference – NHS Warrington CCG Primary Care
Commissioning Committee
Introduction
1. Simon Stevens, the Chief Executive of NHS England, announced on 1 May 2014
that NHS England was inviting CCGs to expand their role in primary care
commissioning and to submit expressions of interest setting out the CCG’s
preference for how it would like to exercise expanded primary medical care
commissioning functions. One option available was that NHS England would
delegate the exercise of certain specified primary care commissioning functions
to a CCG.
2. In accordance with its statutory powers under section 13Z of the National Health
Service Act 2006 (as amended), NHS England has delegated the exercise of the
functions specified in Schedule 2 to these Terms of Reference to NHS Warrington
CCG. The delegation is set out in Schedule 1.
3. The CCG has established the NHS Warrington CCG Primary Care Commissioning
Committee (“Committee”). The Committee will function as a corporate decision-
making body for the management of the delegated functions and the exercise of
the delegated powers.
4. It is a committee comprising representatives of the following organisations:
• NHS Warrington CCG
• NHS England
• GPs/Primary Care (Warrington)
• Healthwatch Warrington or successor organisation
• Local Medical Committee (LMC)
Statutory Framework
5. NHS England has delegated to the CCG authority to exercise the primary care
commissioning functions set out in Schedule 2 in accordance with section 13Z of
the NHS Act.
Review: 30/09/19
6. Arrangements made under section 13Z may be on such terms and conditions
(including terms as to payment) as may be agreed between the Board and the
CCG.
7. Arrangements made under section 13Z do not affect the liability of NHS England
for the exercise of any of its functions. However, the CCG acknowledges that in
exercising its functions (including those delegated to it), it must comply with the
statutory duties set out in Chapter A2 of the NHS Act and including:
a) Management of conflicts of interest (section 14O);
b) Duty to promote the NHS Constitution (section 14P);
c) Duty to exercise its functions effectively, efficiently and economically
(section 14Q);
d) Duty as to improvement in quality of services (section 14R);
e) Duty in relation to quality of primary medical services (section 14S);
f) Duties as to reducing inequalities (section 14T);
g) Duty to promote the involvement of each patient (section 14U);
h) Duty as to patient choice (section 14V);
i) Duty as to promoting integration (section 14Z1);
j) Public involvement and consultation (section 14Z2).
8. The Committee is established as a committee of the Governing Body of NHS
Warrington CCG in accordance with Schedule 1A of the “NHS Act”.
9. The members acknowledge that the Committee is subject to any directions made
by NHS England or by the Secretary of State.
Role of the Committee
10. The Committee has been established in accordance with the above statutory
provisions to enable the members to make collective decisions on the review,
Review: 30/09/19
planning and procurement of primary care services in Warrington, under delegated
authority from NHS England.
11. In performing its role the Committee will exercise its management of the functions
in accordance with the agreement entered into between NHS England and NHS
Warrington CCG, which will sit alongside the delegation and terms of reference.
12. The functions of the Committee are undertaken in the context of a desire to
promote increased co-commissioning to increase quality, efficiency, productivity
and value for money and to remove administrative barriers.
13. 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.
14. This includes, but is not limited, to the following:
• GMS, PMS and APMS contracts (including the design of PMS and APMS contracts, monitoring of contracts, taking contractual action such as issuing branch/remedial notices, and removing a contract);
• Newly designed enhanced services (“Local Enhanced Services” and “Directed Enhanced Services”);
• Design of local incentive schemes as an alternative to the Quality Outcomes Framework (QOF);
• Primary Care Finances – the committee will ensure that the commissioning of primary care will always seek to increase quality, efficiency, productivity and value for money and to remove administrative barriers. The committee should, where it deems appropriate, escalate financial issues to either the Finance & Performance Committee or to the Governing Body
• Approval to commit resources from the PMS Premium Redistribution Fund
• Decision making on whether to establish new GP practices in an area;
• Approving practice mergers; and
• Making decisions on ‘discretionary’ payment (e.g., returner/retainer schemes).
• Delegating actions and receiving recommendations from the Primary Care
Operational Group
Review: 30/09/19
• Ratifying decisions of the Primary Care Operational Group.
• Ratifying decisions referred from formal committees of the CCG
• Risk Management including committee assurance in relation to risks identified
and controls and processes put in place with respect to Primary Care
Commissioning and Contracting
15. The CCG will also carry out the following activities:
• Commissioning of primary care services delivered by non-GMS/PMS/APMS
contracts
• Making decisions on “discretionary” payment (for example returner/retainer
schemes)
• Overseeing the undertaking of needs assessment when and where
appropriate
• Deciding on whether to pool budgets
• Deciding on how to commit the PMS Premium Redistribution Funding
• To plan, including needs assessment, primary [medical] care services in
Warrington;
• To undertake reviews of primary medical care services in Warrington;
• To co-ordinate a common approach to the commissioning of primary care
services generally;
• To manage the budget for commissioning of primary [medical] care services
in Warrington.
Geographical Coverage
16. The Committee will comprise the NHS Warrington CCG area.
Membership
17. The Committee shall consist of:
Position Vote
Review: 30/09/19
Lay Chair
1 vote (or in the case of a tie, has the casting vote)
NHS England Cheshire & Merseyside Representative Non Voting Member
NHS WCCG Chief Nurse
1 vote
NHS WCCG Senior Management Representative
1 vote
NHS WCCG Chief Finance Officer or their appointed Deputy
1 vote
GP representatives x 2 (GP Primary Care Clinical Lead and the Primary Care Quality Committee GP Chair)
1 vote
Lay Vice Chair
1 vote
18. The Chair of the Committee shall be a Lay Member. In the position of Chair, the
post holder will:
• encourage contributions from all members/attendees
• promote a culture of openness, transparency, constructive challenge and
honesty
• Facilitate discussion to ensure the outcomes are concise and focussed and that
the meetings run to time.
19. The Vice Chair of the Committee shall also be a Lay Member.
20. A representative from the Local Medical Committee, Healthwatch Warrington (or
any successor body) and a representative from the Warrington Health and
Wellbeing Board have a standing invite to attend each meeting of the Committee
meeting as non-voting attendees.
21. The Committee may call additional experts to attend meetings on an ad hoc basis
to inform discussions.
22. The Committee may call additional lay members or CCG members to attend
meetings as and when required so at to mitigate any possibility of decision making
being unable to take place due to arising conflict of interests
Meetings and Voting
Review: 30/09/19
23. The Committee will operate in accordance with the CCG’s Standing Orders. The
Secretary of the Committee will be responsible for giving notice of meetings. This
will be accompanied by an agenda and supporting papers and sent to each
member representative no later than four working days before the date of the
meeting. When the Chair of the Committee deems it necessary in light of the
urgent circumstances to call a meeting at short notice, the notice period shall be
such as s/he shall specify.
24. Voting members of the committee are detailed in paragraph 17. The Committee
shall reach decisions by a simple majority of members present, but with the Chair
having a second and deciding vote, if necessary. However, the aim of the
Committee will be to achieve consensus decision-making wherever possible.
Refer to voting table in section 3.
Quorum
25. A quorum necessary for the Committee to undertake its business is defined as at
least 3 of the following members:
• Committee Chair (or nominated Vice Chair)
• NHS WCCG Senior Management Team Representative (or nominated Deputy who should also be a member of the NHS Warrington CCG management team)
• NHS WCCG Deputy Chief Finance Officer (or nominated Deputy who should work for the NHS WCCG finance team)
• General Practice representative (who should work for an NHS Warrington CCG practice)
• NHS England representative
26. Where the meeting is not quorate, owing to the absence of certain members, the
meeting will be deferred until such time as a quorum can be convened. Where a
quorum cannot be convened from the membership of the meeting, owing to the
arrangements for managing conflicts of interest or potential conflicts of interests,
the Chair of the meeting shall consult with the CCG Accountable Officer in the
action to be taken.
Conflict of Interest
27. Members must declare any conflict of interest in writing at the beginning of
the meeting.
Review: 30/09/19
28. The Chair will request any conflict of interests relating to individual agenda
items. Any noted conflicts of interest will be managed in accordance with
CCGs conflict of interest policy. The management of conflict of interest and
any actions taken to mitigate the conflict will be recorded in the minutes.
Frequency of meetings
29. The Committee shall meet on a bi-monthly basis during the financial year.
Additional Meetings may be called by the Chair of the Committee as and when
required.
30. Meetings of the Committee shall:
a) be held in public, subject to the application of 23(b);
b) the Committee may resolve to exclude the public from a meeting that is open
to the public (whether during the whole or part of the proceedings) whenever
publicity would be prejudicial to the public interest by reason of the
confidential nature of the business to be transacted or for other special
reasons stated in the resolution and arising from the nature of that business
or of the proceedings or for any other reason permitted by the Public Bodies
(Admission to Meetings) Act 1960 as amended or succeeded from time to
time.
31. Members of the Committee have a collective responsibility for the operation of the
Committee. They will participate in discussion, review evidence and provide
objective expert input to the best of their knowledge and ability, and endeavour to
reach a collective view.
32. The Committee may delegate tasks to such individuals, sub-committees or
individual members as it shall see fit, provided that any such delegations are
consistent with the parties’ relevant governance arrangements, are recorded in a
scheme of delegation, are governed by terms of reference as appropriate and
reflect appropriate arrangements for the management of conflicts of interest..
33. The Committee may call additional experts to attend meetings on an ad hoc basis
to inform discussions.
Review: 30/09/19
34. Members of the Committee shall respect confidentiality requirements as set out in
the CCG’s Constitution and/or Standing Orders.
35. The Committee will present its minutes to NHS England and to the Governing
Body of NHS Warrington CCG for information, including the minutes of any sub-
committees to which responsibilities are delegated.
36. The CCG will also comply with any reporting requirements set out in its
constitution.
37. It is envisaged that these Terms of Reference will be reviewed from time to time,
reflecting experience of the Committee in fulfilling its functions. NHS England may
also issue revised model terms of reference from time to time.
Review: 30/09/19
Accountability of the Committee
For the avoidance of doubt, in the event of any conflict between the terms of the
Delegation and Terms of Reference and the Standing Orders of Standing Financial
Instructions of any of the members, the Delegation will prevail.
Procurement of Agreed Services
The committee will ensure that all procurements are undertaken in a fair and
transparent way in accordance with
i. Public procurement law and statutory guidance (as issued)
ii. The Principles and Rules of Co-operation and Competition published by
the Department of Health.
iii. The Primary Medical Care Policy and Guidance Manual
Decisions
38. The Committee will make decisions within the bounds of its remit.
39. The decisions of the Committee shall be binding on NHS England and NHS
Warrington CCG.
40. The Committee will produce an executive summary report which will be
presented to the Cheshire & Merseyside Area Team of NHS England and the
Governing Body of NHS Warrington CCG of the CCG for information.
[Signature provisions]
Review: 30/09/19
Schedule 1 – Delegation
Delegation Agreement
1. Particulars
1.1. This Agreement records the particulars of the agreement made between NHS England and the Clinical Commissioning Group named below.
Area Warrington
Clinical Commissioning Group NHS Warrington Clinical
Commissioning Group
CCG Representative Nick Armstrong
Chief Operating Officer
CCG Address for Notices Arpley House, 110 Birchwood
Boulevard, Birchwood, Warrington
WA3 7QH
Date of Agreement [Leave Blank]
Delegation means the delegation made by NHS
England to the CCG of certain
functions relating to primary medical
services under section 13Z of the NHS
Act and effective from 1 April 2018 (as
amended pursuant to the Delegation)
NHS England Representative [Insert details of name of manager of
this Agreement for NHS England]
Local NHS England Team Cheshire and Merseyside
NHS England Address for Notices Regatta Place, Summers Road,
Brunswick Business Park, Liverpool,
Merseyside, L3 4BL
Review: 30/09/19
1.2. This Agreement comprises:
1.2.1. the Particulars (Clause 1); 1.2.2. the Terms and Conditions (Clauses 2 to 24 and Schedule 1 to
Schedule 6 and Schedule 8 to this Agreement); and 1.2.3. the Local Terms (Schedule 7).
Signed by
NHS England
Paul Baumann (for and on behalf of NHS England)
Signed by
NHS Warrington Clinical Commissioning Group
Dr Andrew Davies, Clinical Chief Officer
(for and on behalf of NHS Warrington Clinical
Commissioning Group)
Review: 30/09/19
Schedule 2 - List of Members
Practice Name
Address
Birchwood Medical Centre 15 Benson Road, Birchwood, Warrington WA3 7PJ
Brookfield Surgery Whitbarrow Road, Lymm, Warrington WA13 9DB
Causeway Medical Centre 166-170 Wilderspool Causeway, Warrington WA4 6QA
Chapelford Primary Care
Chapelford Healthcare, Burtonwood Road, Great Sankey, Warrington, WA5 3AN
Cockhedge Medical Centre 7 Cockhedge Way, Cockhedge Shopping Centre, Warrington, WA1 2QQ
Culcheth Medical Centre
Jackson Avenue, Culcheth, Warrington WA3 4DZ
Dallam Lane Medical Centre 20 Dallam Lane, Warrington WA2 7NG
Eric Moore Partnership 74 Bewsey Street, Warrington WA2 7LY
Fairfield Surgery 278 Manchester Road, Warrington WA1 3RB
Fearnhead Cross Medical Centre 25 Fearnhead Cross, Fearnhead, Warrington WA2 0HD
Folly Lane Medical Centre The Medical Centre, Folly Lane, Bewsey, Warrington WA5 0LU
Four Seasons Medical Centre Orford Jubilee Health Centre, Jubilee Way, Orford, Warrington WA2 8HE
Greenbank Surgery 274 Manchester Road, Warrington WA1 3RB
Guardian Street Medical Centre Guardian Street, Warrington WA5 1UD
Helsby Street Medical Centre 2 Helsby Street, Warrington WA1 3AW
Holes Lane Surgery 28 Holes Lane, Woolston, Warrington WA1 4NE
Lakeside Surgery Lakeside Road, Lymm, Warrington WA13 0QE
Latchford Medical Centre Thelwall Lane, Latchford, Warrington WA4 1LJ
Manchester Road Surgery
The Surgery, 280 Manchester Road, Warrington WA1 3RB
Padgate Medical Centre 12 Station Road, Padgate, Warrington WA2 0RX
Parkview Medical Centre Jubilee Way, Orford, Warrington WA2 8HE
Penketh Health Centre Honiton Way, Penketh, Warrington WA5 2EY
Springfields Medical Bath Street Health & Wellbeing Centre, Bath Street, Warrington WA1 1UG
Stockton Heath Medical Centre The Forge, London Road, Stockton Heath, Warrington WA4 6HJ
Stretton Medical Centre 5 Hatton Lane, Stretton, Warrington WA4 4NE
Westbrook Medical Centre 301/302 Westbrook Centre, Westbrook, Warrington WA5 8UF
