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Agenda Item 11 Enclosure CKWCB/12/11

NHS Calderdale, Kirklees and Wakefield District Cluster Board Report To:

Cluster Board

Title:

Governance and Risk Report

FOI Exemption Category

Open

Lead Director and contact details:

Sue Cannon, Executive Director of Quality and Governance (Nursing) Tel: 01484 464240 email: sue.cannon@calderdale.nhs.uk

Author Name and contact details:

Vicky Pickles, Head of Corporate Affairs, NHS Calderdale Tel: 01422 281418 email: victoria.pickles@calderdale.nhs.uk

Key Points to Note:

Since the last Board meeting, Towards Establishment – Responsive and Accountable Clinical Commissioning Groups has been published by the Department of Health – a summary of the main points is included in this report. At its meeting in December, the Governance Committee approved the Policy on Policies setting out where decisions would be made. As part of this, the Board is being asked to consider delegation of some policy sign off directly to the subgroups of the Clinical Commissioning Executive. The Committee also approved the Risk Management Policy. This paper sets out the impact of the Policy on reports to the Board. Proposed amendments to the terms of reference of the Governance Committee were also made and they are presented to the Board for approval.

Recommendation:

It is recommended that the Board: i. ii. iii. iv.

Receives the report Considers the proposal for delegation of some powers to sub groups of the Clinical Commissioning Executives. Notes the changes to the risk reporting cycles across the Cluster Approves the terms of reference of the Governance Committee. 12/01/2012


1.

2.

Purpose of Report 1.1. Since the last Board meeting, Towards Establishment – Responsive and Accountable Clinical Commissioning Groups has been published by the Department of Health. The main points in the document are summarised here along with the actions which need to be considered as the next stage of the development of the governance arrangements for clinical commissioning groups (CCGs). Some of this work will be included as part of the development of CCGs described in the Commissioning Development report at agenda item 15. 1.2.

At its meeting in December, the Governance Committee approved the Policy on Policies setting out where decisions would be made. The Board is being asked to consider whether authority to approve some policies could be delegated directly to the sub-groups of the Clinical Commissioning Executives (CCEs) to reduce the governance burden on emerging CCEs.

1.3.

The Committee also approved the Risk Management Policy. This report sets out the new reporting timetable across the Cluster and what will come to the Board in future.

1.4.

Proposed amendments to the terms of reference of the Governance Committee were also made and they are presented to the Board for approval.

Towards Establishment 2.1. In December, the Department of Health published Towards Establishment – Creating responsive and accountable clinical commissioning groups. This document sets out the arrangements CCGs would need to put in place to ensure they can be authorised. 2.2.

The document focuses on the governance required, setting out three main principles:  CCGs are clinically led with full ownership and engagement of their practices  CCGs can demonstrate probity and governance  There are open, robust and transparent decision making processes

2.3.

It is reassuring that the document describes much of what we have already done in relation to putting in place clear governance arrangements. A summary is provided at appendix 1.There are a number of actions we need to consider over the coming months: - A clear constitution setting out how decisions will be made - Holding key meetings in public - Publishing details of contracts, remuneration of senior staff, a register of interests - Resolving the appointment of an acute doctor and a nurse all of the CCG Boards - Setting in place a remuneration committee for each of the CCEs.

2.4.

These actions will be built into the project plan and will be discussed in development sessions over the coming months. 12/01/2012


2.5.

An update to the document is expected at the end of January along with a model constitution. The final guidance is expected in the spring with the Bill.

3. Items escalated from the Governance Committee 3.1.

At its meeting in December, the Governance Committee received and approved a number of documents, some of which were referred to the Cluster Board either for a decision or for information.

3.2.

Policy on Policies (for decision) – As part of the new governance arrangements, each Clinical Commissioning Executive has a number of sub-groups. The governance arrangements don’t currently allow any Board sub-committee to further delegate responsibility, which would result in double delegation. To reduce the administrative burden on the CCEs, the Head of Corporate Affairs was asked to seek legal advice on whether double delegation is allowable. The legal advice stated that a Board sub-committee cannot further delegate responsibility without express approval by the Board. The Governance Committee considered the Policy and agreed that the Board should be asked to allow CCEs the power to delegate responsibility for the approval of policies to its subgroups as follows: Audit and Governance Group approves policies relating to governance and fraud and corruption. It also approves the Risk Management Policy and policies relating to incident reporting, complaints and safety. It has the power to review the application of any PCT policy or procedure. Quality Group approves policies relating to clinical issues and clinical governance. It should be noted that there will only be a small number of policies to be approved over the next 15 months and a register of these would be kept as part of the Legacy arrangements of each PCT.

3.3.

Terms of reference (for approval) – a number of small amendments have been suggested by the Governance Committee to their terms of reference (Appendix 2) and are presented to the Board for approval.

3.4.

Risk Management Policy (for information) – A Risk Management Policy for the Cluster was presented to the Governance Committee setting out a cluster-wide timetable for the identification of risks, risk register closure and review and update of the Board Assurance Framework. This process will provide the first report to the Board in March, alongside the approved Board Assurance Framework (presented to the Board at agenda item 12). Risks of 15 or below will also be reported to the CCEs through their Audit and Governance Group. The new policy and reporting timelines have been share on the Cluster Intranet.

3.5.

Chairs Action Policy (for information) – The Policy sets out the arrangements whereby the Chairs of the Board and its sub-committee can take action outside of a meeting for urgent matters. This new Policy has been posted to the Cluster Intranet governance section.

4. Recommendations It is recommended that the Board: 12/01/2012


i. ii. iii. iv.

Receives the report Considers the proposal for delegation of some powers to sub groups of the Clinical Commissioning Executives. Approves the terms of reference of the Governance Committee. Notes the changes to the risk reporting cycles across the Cluster

12/01/2012

/CKWCB-12-11a_Governance___Risk_Report  

http://www.kirklees.nhs.uk/uploads/media/CKWCB-12-11a_Governance___Risk_Report.pdf

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