draft standing orders for nwl ccg: v16 18 november 2020€¦ · 18/11/2020 · standing orders...

DRAFT Standing Orders for NWL CCG: V16 18 November 2020

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Version Date Amendments Distribution

5 20/07/2020 Draft to CCG

Governing

Bodies and LMC

6 22/07/2020 LMC feedback of

17/07/2020

7 31/07/2020 Inclusion of election

Clinical Lead roles

Practice Nurse &

Practice Manager as

appointed

LA rep to DPH

8 10/08/2020 Removal of simple

majority from voting on

p20

9 18/08/2020 Amends to GB and

clinical representation

post Chairs meeting

17/08/2020

10 25/08/2020 Amends post Chairs’

meeting 25/08/2020

11 03/09/2020 Amends post Single

CCG working group

meeting 03/09/2020:

5.1.2 change ‘if’ to ‘as’

4.1.7.1 inclusion

reference of the

Constitution for

disputes resolution.

5.1.2 typo amended

and revision from

clinical to Primary Care

Clinical

Representative.

5.2.3 amendment to

Primary Care Clinical

Representative.

5.2.7 inclusion of A

non-conflicted LMC

representative from

outside of NWL area

will have the right to

observe any part of the

appointment and

election process to


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ensure objectivity.

5.2.9d inclusion of right

to appeal

5.8-5.13 addition of

roles and

responsibilities: other

Governing Body

members

12 20/09/2020 Changes following

NHSE review.

13 28 October Inclusion of LMC

attendance and two LA

officer representatives

at GB meetings,

eligibility criteria for

elected Borough GB

members restricted to

salaried and Partner

GPs only

14 3 November Changes following

NHSE review.

15 18 November 2020 Inclusion of Disputes

Resolution procedures

at section 14

16 18 November 2020 Addition of clarification

on confidential at

8.2.27-8.2.30


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Contents 1. Introduction ......................................................................................................... 4

2. Amendment and review ...................................................................................... 4

3. Interpretation, application and compliance .......................................................... 5

4. Membership ........................................................................................................ 5

5. Appointments to the Governing Body .................................................................. 9

6 Governing Body Role summaries ...................................................................... 19

8. Meetings of the clinical commissioning group ................................................... 25

9 Suspension of Standing Orders ........................................................................ 32

10 Appointment of committees and sub-committees ........................................... 32

11 Use of seal and authorisation of documents ................................................... 33

12 Policy statements: general principles ............................................................. 33

13 Common to all meetings ................................................................................. 33

14. Disputes Resolution Procedure ...................................................................... 34


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NHS North West London (NWL) CCG

Standing Orders

V16

1. Introduction 1.1. These Standing Orders have been drawn up to regulate the proceedings of

NHS North West London (NWL) CCG so that the CCG can fulfil its

obligations as set out largely in the 2006 Act (as amended by the 2012 Act)

and related regulations. They form part of the CCG’s Constitution.

1.2. The Standing Orders, together with the CCG’s Scheme of Reservation and

Delegation and the CCG’s Standing Financial Instructions (as contained

within the CCG’s Governance Handbook) provide a procedural framework

within which the CCG discharges its business. They set out:

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

b) how the CCG will make appointments to key roles, including the process

for appointing Governing body members;

c) the procedures used by the membership, for making decisions;

d) how meetings of the CCG, the Governing Body and their respective

committees and sub-committees will operate and make decisions;

e) the arrangements for the appointment of committees; and

f) the arrangements for managing the CCG’s financial affairs and the

delegated limits for financial commitments on behalf of the CCG.

2. Amendment and review 2.1. The Standing Orders are effective from xxx (Date of establishment)

2.2. Standing Orders will be reviewed on an annual basis or sooner if required.

A log of review dates can be found in the CCG Governance Handbook

published on the website.

2.3. Amendments to these Standing Orders will be made as per Clause 1.4 of

the Constitution.

2.4. All changes to these Standing Orders will require an application to NHS

England for variation to the CCGs constitution and will not be implemented

until the constitution has been approved.


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3. Interpretation, application and compliance 3.1. Except as otherwise provided, words and expressions used in these

Standing Orders shall have the same meaning as those in the main body of

the CCG Constitution and as per the definitions in Appendix 1.

3.2. These standing orders apply to all meetings of the CCG and Governing

Body, including their respective committees and sub-committees unless

otherwise stated.

3.3. All members of the CCG, employees, members of the Governing Body and

committees and sub-committees should be aware of the Standing Orders

and comply with them. Failure to comply may be regarded as a disciplinary

matter.

3.4. In the case of conflicting interpretation of the standing orders, the Chair,

supported with advice from the relevant senior officer of the CCG will

provide a settled view which shall be final.

3.5. 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 CCG and staff have a duty to disclose any non-compliance with

these Standing Orders to the Accountable Officer as soon as possible.

4. Membership 4.1. Composition of membership

4.1.1. The CCG is a membership body comprised of Providers of Primary

Medical Services in the North West London area. Full details of the

area covered is included in section 2 of the constitution.

4.1.2. The list of member practices and the nature of the membership its

relationship with the CCG are set out in section 3 of the constitution.

4.1.3. 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 the CCG.

4.1.4. Application for Membership

4.1.4.1 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 in the CCG

area on 01 April 2021 will automatically become members of the

CCG.


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4.1.4.2 After 01 April 2021: no Practice shall become a Member of

the CCG unless that Practice:

a) is eligible to become a Member in accordance with paragraph

4.1.3 above;

b) has completed the application form for membership;

c) has had its application approved by NHS England; and

d) (following approval of the application in accordance with point

(c)) has been entered into the Register of Members set out in

section 3 of the Constitution.

4.1.5. Role of Members

Members are required to nominate a Member Representative and

have the right to:

a) attend meetings of the Council of Members:

i. meetings may be held for all CCG members or at a sub-

regional level, usually on a Borough basis;

b) call meetings of Members;

i. meetings may be held for all CCG members or at a sub-

regional level usually on a Borough basis;

c) submit a proposal for amendment of the Constitution;

d) put themselves forward for election to the Governing Body;

e) elect members of the Governing Body;

f) remove elected members of the Governing Body through a

majority vote; and

g) participate in the development of the Corporate Governance

documents including the Handbook and, where applicable,

their approval.

4.1.6. Cessation of Membership

4.1.6.1. A member of the CCG ceases to be a member if they represent

a contract held by a sole practitioner and he/she:

4.1.6.1.1. is no longer eligible for membership through non-

compliance with 4.1.4.1 above;

4.1.6.1.2. represents a contract held by a sole practitioner and

he/she:

a) dies;

b) is declared bankrupt;

c) ceases to be registered as a medical practitioner;

d) enters into partnership with any other medical practitioner,

except where that medical practitioner or the partnership is an

existing Member;

e) may have received conditions from the performers’ panel, but

they may put into place arrangements for the contract to remain

in place;


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f) If the contract is still in existence, despite the performers list

status of the single-handed contract holder, then that practice

would not cease to be a member;

g) that Member is two or more individuals practising in partnership;

and

h) the conditions in Section 86(2) of the 2006 Act are no longer

satisfied;

4.1.6.1.3 that Member is a company limited by shares and:

a) the conditions in Section 86(3) of the 2006 Act are no longer

satisfied; or

b) in respect of that company any one of the following occurs:

i. a resolution is passed for voluntary winding up by reason of

insolvency;

ii. a winding up order is granted;

iii. a resolution by its directors or members is passed to apply for

an administration order;

iv. an administrator is appointed under the Insolvency Act 1986;

v. a receiver or an administrative receiver is appointed over any of

its assets or income;

vi. a statutory demand is issued under the Insolvency Act 1986

which is not discharged before it is advertised; or

vii. it is unable to pay its debts as they fall due as determined by

section 123 of the Insolvency Act 1986;

c) the Practice ceases to be eligible for membership;

d) that Practice merges with any other practice, unless that other

practice is an existing Member (and for the avoidance of doubt

where two Practices that are Members merge they shall be one

Member thereafter for the purposes of this Constitution); or

e) a Notice of Termination is served on the Member by NHS England

or other relevant regulating body.

4.1.6.2. The CCG shall notify NHS England in the event that it becomes

aware that any Member Practice no longer meets the requirements

of paragraph 4.1.3 or is proposing to merge with another Member

Practice or a Member Practice of another Clinical Commissioning

Group and shall propose any such amendments under the terms of

paragraph 1.4 of the Constitution as are appropriate to reflect the

circumstances.

4.1.6.3. Membership of the CCG is not transferable and any proposed

changes to the membership (including those arising from a merger

of Member practices) shall be subject to the approval of NHS

England.


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4.1.6.4. In the instance of practice mergers or practice splits, the new

practice(s) will automatically be entitled to become Members of the

CCG and the list of practices at Appendix B will be amended

accordingly.

4.1.7. Disputes

4.1.7.1. Any dispute between a practice and the CCG in respect of

eligibility for membership of the Group will follow the Dispute

Resolution Procedure at 1.8 of the Constitution..

4.2. Member practice representatives

4.2.1. Full meetings of the membership are known as The Council of

Members.

4.2.2. Members are represented at the Council of Members, or Borough

groupings thereof, by the healthcare professional that they nominate

to deal with the CCG on their behalf. This individual must be a

healthcare professional as defined in the legislation. For avoidance of

doubt, whilst the Member Practice Representative must be a

healthcare professional, they need not be a GP. It is also permitted for

a practice to nominate a healthcare professional employed by another

Member practice if they choose to do so.

4.2.3. Each practice is free to determine how they select their practice

representative provided the individual fulfils the requirement of being a

healthcare professional.

4.2.4. The Chair of the Council of Members will be the Chair of the CCG

Governing Body. Meetings of Practice Members focused on one

particular borough / locality will usually be chaired by the CCG

Governing Body Member elected to lead on that Borough / locality’s

issues.

4.2.5. Upon selection of a Member Practice Representative, the nominating

member practice shall confirm in writing to the CCG:

a) the full name and contact details of the Member Practice

Representative;

b) the Member Practice Representative’s position, confirming that

the individual is a Healthcare Professional as per the definition in

Appendix 1 of the CCG’s Constitution; and

c) that the Member Practice Representative is authorised by the

member practice to act on its behalf concerning CCG business as

set out in Section 3.4 of the CCG’s Constitution and the provisions

of these Standing Orders.


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4.2.6. A Member Practice Representative who is unable to attend a Member

Practice Meeting, including Council of Members’ meetings, may

nominate a deputy to attend the meeting who is authorised to cast a

vote on behalf of the relevant Member Practice. Such deputies

should be notified in advance of the meeting to the Chair..

4.2.7. Each Member may remove and replace their Member Representative

at any time, by giving notice, in writing, to the Chair of the Borough

Committee, who will in turn inform the Chair of the Governing Body.

4.2.8. For the avoidance of doubt, the Borough Committee shall be entitled

to treat any Member Representative as having the continuing

authority given to him/her until it is notified in writing of the removal of

that Member Representative in accordance with paragraph 4.2.7, and

any provision of the Constitution that requires delivery or notification

to a Member shall be deemed to have been satisfied if delivery or

notification is made to or served on the relevant Member

Representative.

5. Appointments to the Governing Body

5.1. For all Governing Body appointments

5.1.1. The CCG’s Constitution sets out the composition of the CCG’s

Governing Body in section 5.5.

5.1.2. Members of the Governing Body comprise individuals elected by the

Membership, appointed members, and executive members.

a) Elected members of the Governing Body include:

The Chair

Elected GP Borough Member (from Brent Borough)

Elected GP Borough Member (from Central London Borough)

Elected GP Borough Member (from Ealing Borough)

Elected GP Borough Member (from Hammersmith and Fulham

Borough)

Elected GP Borough Member (from Harrow Borough )

Elected GP Borough Member (from Hillingdon Borough)

Elected GP Borough Member (from Hounslow Borough)

Elected GP Borough Member (from West London Borough

footprint)

Sessional GP from across NWL (see Standing Order 5.1.3)

b) Appointed members of the Governing Body include:


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a Lay member with qualifications expertise or experience to

enable them to lead on finance and audit matters;

a Lay Member with knowledge about the CCG area

enabling them to express an informed view about

discharge of the CCG functions;

a Lay Member whom is the chair or vice chair of the

Primary Care Commissioning Committee;

two additional Lay Members appointed across NWL;

a Secondary Care Specialist.

c) Executive members of the Governing Body include:

The Accountable Officer;

The Chief Finance Officer; and

The Registered Nurse (known the Chief Nurse)

5.1.3. Each role on the Governing Body is defined by a role description at

5.8 of the Standing Orders.

5.1.4. A person specification is drafted at the point of recruitment to aid the

selection process.

5.1.5. All members elected and appointed to the Governing Body will fulfil

the requirements set out in the NHS (CCG) Regulations 2012 as

relevant to their role.

5.1.6. The NHS (CCG) Regulations 2012 also include extensive exclusion

criteria Schedule 4 applies to Lay Members and Schedule 5 to all

members of governing bodies regardless of their role or appointment

method.

5.1.7. All individuals elected and appointed to roles on the Governing Body

are responsible for familiarising themselves with the eligibility and

ineligibility requirements, confirming their eligibility prior to

appointment and immediately notifying the Accountable Officer of a

change of circumstances that may render them no longer eligible.

5.1.8. All members of the Governing Body, committees and sub-committees

will abide by the seven principles of public life; the ‘Nolan Principles’

which are detailed in the Governance Handbook, and adhere to the

Standards of Business Conduct Policy which includes information on

Conflict of Interest and how these should be handled during meetings.

5.1.9. Members of the Governing Body serve a specified term of office (this

does not apply to executive members):

a) The initial term of office is up to 3 years.


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b) Initial appointments may be for a shorter period in order to avoid

all members of the Governing Body retiring at once. Thereafter,

new appointees will ordinarily retire on the date that the individual

they replaced was due to retire in order to provide continuity.

c) Governing Body members may serve up to three full terms in

total, after which they will no longer be eligible for re-election / re-

appointment.

5.1.10. Reappointment is subject to satisfactory appraisal by the Chair and no

objections having been received from the Council of Members. The

Governing Body may approve re-appointment of appointed members

only. Other members will go through the full recruitment process.

5.1.11. Arrangements for the removal from office of Governing Body

members is subject to any terms set out in contracts of appointment

or employment, and application of the relevant CCG policies and

procedures.

5.1.12. Members of the Governing Body and its committees shall vacate their

office if any of the following occurs:

a) If they fail to attend a minimum of 75% of the meetings to which

they are invited.

b) If they are deemed to not meet the expected standards of

performance at their annual appraisal.

c) If they no longer fulfil the requirements of their role or become

ineligible for the role as set out in The CCG regulations (2012)

Schedules 4 and 5.

d) If they have behaved in a manner or exhibited conduct which has

or is likely to be detrimental to the honour and interest of the

Governing Body or the CCG and is likely to bring the Governing

Body or the CCG into disrepute. This includes but it is not limited

to dishonesty; misrepresentation (either knowingly or

fraudulently); defamation of any member of the Governing Body

(being slander or libel); abuse of position; non-declaration of a

known conflict of interest; seeking to manipulate a decision of the

Governing Body in a manner that would ultimately be in favour of

that member whether financially or otherwise.

e) Are subject to disciplinary proceedings by a regulator or

professional body.


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5.1.13. Members may be suspended pending the outcome of an investigation

including, for example, if they are suspended or under investigation by

a regulator or professional body.

Notice period:

5.1.14. Executive members’ notice period is defined in their contract of

employment.

5.1.15. For all other members, a three-month notice period is required to be

given in writing to the Chair, unless and in line with all relevant CCG

documentation, the grounds for dismissal are of such severity that the

Chair believes dismissal should be immediate.

5.2. Elected members of the Governing Body

5.2.1. The Members of the CCG will elect up to ten (10) primary care

clinicians to the Governing Body to represent the voice of the

membership. Eight of those members will each be a salaried or

Partner GP drawn from the CCG’s constituent boroughs to lead on

their respective borough’s issues (GP Borough Members), one will be

a sessional GP elected by all NW London practice members and the

tenth will be elected as Chair of the Governing Body, as set out in

5.2.2.

5.2.2. The elected Governing Body members will, between them, further

elect one of their number to serve as Chair of the Governing Body.

Upon election as Chair, that member’s previous position on the

Governing Body will become vacant and filled either by:

5.2.2.1. holding a new election for just that vacancy; or, where such

an election has been held in the previous six months,

5.2.2.2. appointing the recipient of the next highest vote count.

Eligibility:

5.2.3. An individual wishing to be considered for the elected role of GP

Borough Member must be:

a) a GP partner, or GP employee.

b) Have worked at least two (2) sessions per week in the borough for

six (6) of the preceding twelve (12) months and continue to work

in a member practice.

5.2.4. In order to ensure that one member of the Governing Body is elected

from each Borough there may be occasions when eligibility for a

particular election is limited to a sub-set of practices.


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5.2.5. An individual wishing to be considered for the Sessional GP role must

be:

a) working as a locum GP or as a salaried GP, (includes GPs on the

returner scheme and GP retainees);

b) be working in the NWL CCG area

Exclusion criteria:

5.2.6. An individual is excluded if they are of a description included in

schedule 5 of the CCG Regulations 2012

5.2.7. An individual who has a major conflict of interest (such as the clinical

directors of the Primary Care Networks) may not be appointed.

Application:

5.2.8. Individuals who meet the criteria will complete an application process

which will include setting out their key characteristics against a

published specification.

Assessment:

5.2.9. An appointment panel appointed by the Governing Body and

supported by suitably qualified and experienced advisers will assess

the applications using, as a minimum, a paper-based screen and

interview.

5.2.10. A non-conflicted LMC representative from outside of NWL area will

have the right to observe any part of the appointment and election

process to ensure objectivity.

5.2.11. Only applicants assessed to be “above the bar” (i.e. have

demonstrated the minimum full range of competencies and

characteristics detailed in the specification) will be nominated for

election.

5.2.12. Applicants who are assessed “above the bar” will retain this status

until there is a change to the specification (in line with the CCG annual

appraisal and review system), or two years, whichever is shorter.

5.2.13. For the panel to decide that a person does not meet the minimum

requirements and will not be put to the electorate:


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a) all members of the panel must be in agreement;

b) The LMC observer’s opinion must be noted (if present); and

c) Unsuccessful candidates will be given the opportunity to have a

full debrief from the Chair of the panel as to why they have been

unsuccessful. If there are development areas the CCG will offer a

support package to assist the candidate in the future;

d) Unsuccessful candidates may appeal the decision of the panel on

grounds of the process for the interview and submit an appeal

within 5 working days. Full details of the appeals process is set out

in the Governance Handbook.

Election:

5.2.14 In line with and 1.4.3 c) ii. of the Constitution, Members’ votes are

weighted by each practice’s raw patient list size’s relationship with the

median raw patient list size for NW London practices.The voting

forms, or other invitations to vote, will be sent to the agreed Member

Practice Representatives that are eligible to vote in the election in

question. Voting forms are returned electronically via a specified

process for that election and are counted and verified independently.

5.2.16 A practice is eligible to vote in an election when:Their GP Borough

Member is being selected; and

b) the NW London Sessional GP is being selected

5.2.17 The outcome is determined by vote count, having taken into

consideration any weighting that applies by virtue of 5.2.11 above.

The candidate(s) with the highest vote count will be deemed elected.

5.2.18 The Governing Body will assure itself of the independence of the

election voting arrangements and is authorised to appoint external

independent organisations to undertake elections on the CCG’s behalf

when it deems such appropriate.

Removal from office

5.2.19 Grounds for removal from office will be material failure to comply with

the terms of the Constitution or a vote of no confidence by the

Members.

5.2.20 If grounds for removal from office are a material failure to comply with

the terms of the Constitution, the Chair of the Governing Body will be

advise the member of the CCG’s concerns, given the opportunity to

respond to those concerns and state his or her case before any

decision is made by the Governing Body. If the concerns relate to the

Governing Body Chair, they will be informed by the Deputy Chair or

Accountable Officer.


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Vote of no confidence:

5.2.21 The GP Borough Members can only be removed from the Governing

Body by a 60% majority of the available votes from among the

member practices in their Borough.

5.2.22 The Sessional GP member can only be removed by a 60% majority of

the available votes from among the member practices in the CCG.

5.2.23 The CCG Chair can only be removed by a 60% majority of the

available votes from among Borough Elected Governing Body GP

members.

5.2.24 A Vote of no confidence may be called by the relevant members in

accordance with standing order 8.1.7.

5.3 CCG Chair

5.3.1 The GP Borough Members will further elect one of their number to

serve as Chair of the Governing Body. This will be via a process of

self-nomination and closed ballots, overseen by the Accountable

Officer.

5.3.2 An individual wishing to be considered for the role of Chair or Vice

Clinical Chair of the CCG must be:

a) A GP Borough Member of the Governing body

5.3.3 Upon the election of the Chair, that person’s elected position for their

Borough becomes vacant. Another member from the Chair’s locality

will then be elected to fill the position vacated by the Chair. This will

be either by:

a) (If this occurs within six months of an election for Governing

Body membership for that locality) appointing the candidate

that received the second highest number of votes; or

b) (where no such candidate exists or the election was more

than six months previous) through running an election to

the Governing Body for that locality alone.

5.3.4 The provision at 5.2.14 for the removal from office applies. If the

Chair stands down from their position, they must stand down from the

Governing Body, so to avoid over-representation of any one Borough.

The Governing Body then elects a new Chair, in line with 5.5.1 and

5.5.2 thereafter.


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5.4 The Vice Clinical Chair

5.4.1 The Governing Body may also appoint a Vice Clinical Chair to

deputise for the Chair in respect of their clinical leadership

responsibilities when they are absent or otherwise unavailable.

5.4.2 To be eligible for the role of Vice Clinical Chair an individual must be a

Borough Governing Body Member.

5.4.3 In the event of there being more than one self-nomination, the Vice

Clinical Chair will be appointed via a closed ballot of the GP Borough

Members.

5.4.4 The role of Vice Clinical Chair will be in addition to the role of GP

Borough Member.

5.5 Appointed Members of the Governing Body

5.5.1 The CCG shall appoint individuals to the roles of: Secondary Care

Specialist, and Lay Member (five) on the Governing Body.

5.5.2 The appointments will be made following an openly advertised

application and assessment process.

5.5.3 Each role will be described in a role description and have an

accompanying specification that describes the skills, experience and

characteristics required to fulfil the role.

Application:

5.5.4 Individuals will complete an application process which will include

setting out their key characteristics against a published specification.

Assessment:

5.5.5 An appointments panel appointed by the Governing Body and

supported by suitably qualified and experienced advisers will assess

the applications using, as a minimum, a paper-based screen and

interview.

Eligibility and exclusion:

5.5.6 One Lay Member will have qualifications, expertise or experience

such as to enable them to express informed views about financial

management and audit matters. This Lay Member will chair the audit

committee and will fulfil the role of conflicts of interest guardian. One

other lay member will be similarly qualified in order to enable them to

deputise for this member.


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5.5.7 One Lay Member will have knowledge about the CCG area such as to

enable them to express informed views about the discharge of the

CCG’s functions. One other lay member will be similarly qualified in

order to enable them to deputise for this member.

5.5.8 One Lay Member, who is not the chair of the Audit Committee, will be

the Chair of the Primary Care Commissioning Committee (PCCC).

5.5.9 All Lay Members will have a demonstrated connection with the NW

London CCG area (see section 2 of the constitution) such as living or

working in the area.

5.5.10 The secondary care doctor will fulfil the requirements of regulations

11(6 &, 7) and 12 in the NHS CCG regulations 2012.

5.5.11 Individuals will not be appointed unless they meet the relevant

requirements (including the exclusion criteria) set out in schedules 4

and 5 of CCG Regulations 2012 as relevant.

5.6 The Deputy Chair

5.6.1 To be eligible for the role of Deputy Chair individuals must have been

appointed as a lay member of the Governing Body.

5.6.2 The Lay member who has qualifications, expertise or experience such

as to enable them to express informed views about financial

management and audit matters and who chairs the audit committee is

ineligible.

5.6.3 Expressions of interest will be sought from the Lay Members and, in the

event of there being more than one self-nomination, the Deputy Chair

will be appointed via a closed ballot of all Governing Body members.

5.6.4 The tenure will be commensurate with the Lay Member length of tenure,

subject to any re-appointments.

5.7 Executive Members of the Governing Body

5.7.1 Executive members of the Governing Body become members by

virtue of their employment into a management role in the CCG.

These roles include:

a) Accountable Officer;

b) Chief Finance Officer; and

c) The Chief Nurse.


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5.7.2 Each role will be described in a role description and have an

accompanying specification that describes the skills, experience and

characteristics required to fulfil the role.

5.7.3 Executive members are appointed following a formal standard

recruitment process during which competency against the defined

specification is assessed.

5.7.4 The Accountable Officer appointment process is subject to requirements

set out by NHS England and the process will include a CCG panel

convened by the Chair. The appointment is subject to formal ratification

by NHS England following selection and nomination by the CCG.

5.7.5 Other executive members of the Governing Body are appointed by a

panel convened by the Accountable Officer.

5.7.6 Membership of the Governing Body is terminated when an individual’s

contract of employment is terminated.

5.7.7 Grounds for removal from office will include material failure to comply

with the terms of the constitution and/or as reasonably determined by the

CCG Chair and in accordance with the contract of employment.


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6 Governing Body Role summaries

6.1 Elected GP Borough Leads on the Governing Body

6.1.1 The Governing Body will have a GP Borough Lead, elected by the

Borough Level membership they represent, for each Borough.

6.1.2 The elected GP Borough Leads will, collectively, provide the clinical

leadership for the CCG. Working with the CCG Chair and other

Governing Body Members they are responsible for helping to set the

vision, culture and values of the organisation.

6.1.3 They are responsible for decisions relating to the commissioning of

services and for ensuring that the organisation is clinically-led

throughout.

6.1.4 Elected Borough Leads have an active role in the management and

operation of the CCG. As members of the CCG’s Governing Body, they

bring their unique understanding of the CCG’s Member practices to the

discussion and decision making of the Governing Body. Borough Leads

will Chair the Borough-level committees of the CCG and take on

delegated responsibility as per the SoRD. The Leads will represent the

views of the Borough Committee and its Member practices to the

Governing Body.

6.1.5 The Elected Borough Lead role includes leading on a portfolio of agreed

responsibilities across areas, potentially including:

a) finance;

b) quality and safety;

c) SRO for clinical pathways and areas such as Primary Care;

d) communications, engagement and Patient and Public Involvement;

e) pathway developments and service redesign; and

f) effective governance and assurance.

6.2 Chair

6.2.1 The Chair 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 Governing Body and its individual

members;

c) ensuring that the CCG has proper Constitutional and governance

arrangements in place;


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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 CCG to deliver its commissioning

responsibilities;

h) overseeing governance and particularly ensuring that the

Governing Body and the wider CCG 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 NHS England; and

k) ensuring that the CCG builds and maintains effective relationships,

particularly with the individuals involved in overview and scrutiny

from the relevant local authority(ies).

6.2.2 Where the Chair of the Governing Body is also the senior clinical voice

of the CCG they will take the lead in interactions with stakeholders,

including NHS England.

6.3 Deputy Chair

6.3.1 The Deputy Chair will assume responsibility for the Chair when the

Chair is absent or cannot participate in discussions due to a declared

conflict of interest in all matters other than clinical leadership duties.

6.4 Clinical Vice Chair

6.4.1 The clinical Vice Chair will deputise for the Chair in respect of their

clinical leadership responsibilities when they are absent or otherwise

unavailable.

6.5 Role of the Accountable Officer

6.5.1 The Accountable Officer of the CCG is a member of the Governing

Body.

6.5.2 The Accountable Officer of the CCG is charged with ensuring that their

CCG complies with its:


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a) duty to exercise its functions effectively, efficiently and

economically;

b) duty to exercise its functions with a view to securing continuous

improvement in the quality of services provided to individuals

for, or in connection with, the prevention, diagnosis or

treatment of illness;

c) financial obligations, including information requests;

d) obligations relating to accounting and auditing;

e) duty to provide information to the NHS England, following

requests from Secretary of State;

f) obligations under any other provision of the Act 2006 specified

by the Board for these purposes; and

g) performs its functions in a way which provides good value for

money.

6.5.3 The Accountable Officer is responsible for ensuring that the CCG 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.

6.5.4 The Accountable Officer will, at all times, ensure 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.

6.5.5 The Accountable Officer, working closely with the Chair of the

Governing Body, 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 ongoing capability

and capacity to meet its duties and responsibilities. This will include

arrangements for the ongoing development of its Members and

employees.

6.6 Role of the Chief Finance Officer

6.6.1 The Chief Finance Officer (CFO) should be the CCG’s most senior

employee with a professional qualification in accountancy, who has the

experience to lead the financial management of the CCG and is a

member of the Governing Body.

6.6.2 The role of the CFO is:


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a) to be the Governing Body’s professional expert on finance and

ensure through robust systems and processes the regularity and

propriety of expenditure is fully discharged;

b) to make appropriate arrangements to support, monitor and report

on the CCG’s finances;

c) to oversee robust audit and governance arrangements leading to

propriety in the use of CCG resources;

d) to be able to advise the Governing Body on the effective, efficient

and economic use of its allocation, to remain within that allocation

and deliver required financial targets and duties; and

e) to produce the financial statements for audit and publication in

accordance with statutory requirements to demonstrate effective

stewardship of public money and accountability to tax payers.

6.7 Lay Members

6.7.1 The CCG will have five Lay Members:

6.7.1.1 One Lay Member, who will be the Audit Committee Chair

(this Lay Member may not act as the Deputy Chair of the CCG,

or as Chair of any other Committee, and must have either the

qualifications, expertise or experience to enable them to lead on

finance, governance and audit matters). The Audit Committee

Chair must be a qualified accountant and a member of one of the

CCAB bodies;

6.7.1.2 A second Lay Member, who will be the Lay Member for

Public and Patient Engagement, and who has demonstrable

knowledge and experience about the CCG area, enabling them

to express an informed view about discharge of the CCG

functions associated with the involvement of the patient and

public voice in NWL; and

6.7.1.3 A third Lay Member, who will be the Finance Chair, and

must have either the qualifications, expertise or experience to

express informed views on finance, planning, commercial and

procurement matters within the NHS.

6.7.1.4 A fourth Lay Member, who will be the Chair of the

Primary Care Commissioning Committee, in line with the

requirements of the Primary Care Commissioning Delegation

Agreement, who will serve as the deputy Chair for the Audit

Committee.


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6.7.1.5 Two of the five Lay Members will support the work of the

CCG, one of whom should be qualified to deputise on audit,

finance and governance matters.

6.8 The Registered Nurse - role

6.8.1 As well as sharing responsibility with the other members for all aspects

of the CCG Governing Body business, as a registered nurse on the

Governing Body, this person will bring a broader view, from their

perspective as a registered nurse, on health and care issues to underpin

the work of the CCG especially the contribution of nursing to patient

care. In addition, the post-holder will fulfil the role of the Executive Chief

Nurse on the Governing Body.

6.9 The secondary care specialist doctor - role

6.9.1 As well as sharing responsibility with the other members for all aspects

of the CCG Governing Body business, this clinical member will bring a

broader view, on health and care issues to underpin the work of the

CCG. In particular, they will bring to the Governing Body an

understanding of patient care in the secondary care setting.

6.9.2 The secondary care specialist doctor will not be an employee or Member

(including shareholder) of, or a partner in, any of the following:

6.9.2.1 a person who is a “provider of primary medical

services” for the purposes of Chapter A2 of the 2006 Act; or

6.9.2.2 a body which provides any “relevant service” to a

person for whom the CCG has responsibility (regulation 12(1)

CCG Regulations 2012).

6.9.3 For the purpose of working with committees, the Secondary Care Doctor

will be considered to be an independent member of that committee.

They will be able to vote (if applicable within the individual committees

ToRs) and will work in line with the role descriptions outlined in these

Standing Orders.


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7. Other key CCG roles and appointments 7.1 Borough Committee Members

7.1.1 For roles that are elected on behalf of the borough, the election

process outlined in sections 5.2.11 to 5.2.15 shall be followed.

7.1.2 The tenure will be 3 years.

7.1.3 An individual wishing to be considered for the Elected Primary Care

Clinical representative membership of the borough must be:

a) be either a GP partner, salaried GP, clinical employee of a

member practice, or have been nominated to stand for election

by the member practice they work with (for example if a

sessional GP as per the BMA definition in 5.1.3); and

b) have worked at least 2 sessions per week in that area for 6 of

the preceding 12 months and continue to work in a member

practice

7.1.4 Further, in addition to the borough Governing Body Primary Care

Clinical member, at least one of the elected Borough positions must

include a GP partner or salaried GP. If, during an individual’s tenure,

their circumstances change and they no longer meet the eligibility

criteria, that individual will stand down immediately and a new elected

representative will be sought.

7.2 Appointed Clinical leads for areas or pathways

7.2.1 Nominations / volunteers will be sought for individuals, as required, and

eligibility will be based on demonstrated expertise in the specific area

required.

7.2.2 The Governing Body shall determine the process for such

appointments and the terms of them, within the bounds of agreed terms

and conditions.

7.2.3 All such roles will be defined in terms of scope, duration, duties, and

measurable objectives and covered written terms and conditions

agreed between the appointer and appointee.


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8. Meetings of the clinical commissioning group

8.1 Member Practice Meetings

8.1.1 Meetings of the full CCG’s membership will be held at least twice

annually at such times and places as the CCG may determine and in

addition to the AGM. Meetings at Borough level will be held at least

quarterly each year for the purpose of communications and

engagement.

8.1.2 For full member council meetings a relevant member practice is a

member of the CCG. For Borough meetings, a relevant member

practice is a member practice that is located within that Borough.

8.1.3 Meetings may be held in person, or through electronic media.

8.1.4 Any person employed or engaged as a healthcare professional by a

relevant member practice on the date of the relevant meeting shall be

entitled to attend and speak at a Member Practice Meeting. However

only Member Practice Representatives, or in their absence their

nominated deputies will be entitled to vote. Voting will, wherever

possible, be undertaken via electronic means.

8.1.5 In normal circumstances, not less than one months’ notice will be

given of any Member Practice Meetings to be held. However, the

CCG’s Chair or a Borough Chair may call a Member Practice Meeting

at any time by giving not less than 14 calendar days’ notice in writing.

8.1.6 In emergency situations the Chair or a Borough Chair may call a

meeting of members with 5 calendar days’ notice by setting out the

reason for the urgency and the decision to be taken.

8.1.7 The membership may request the relevant Chair convene a Member

Practice Meeting by notice in writing signed by one third of the CCG’s

relevant Member Practice Representatives (refer to 8.1.7). Such

requests should specify the matters that the petitioners wish to be

considered at the meeting. If the Chair refuses, or fails, to call a

Member Practice Meeting within seven calendar days of such a

request being presented, the Member Practice Representatives

signing the requisition may call a Member Practice Meeting by giving

not less than 14 calendar days’ notice in writing to all relevant

Member Practices specifying the matters to be considered at the

meeting.


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8.1.8 The agenda and any supporting papers will be circulated to all

relevant Member Practices at least seven calendar days before the

date of the meeting taking place.

8.1.9 A Member Practice Representative who is unable to attend a Member

Practice Meeting may nominate a deputy to attend the meeting who is

authorised to cast a vote on behalf of the relevant Member Practice.

Such deputies should be notified in advance of the meeting to the

Chair.

Quorum:

8.1.10 60% of all relevant member representatives must be present for any

meeting to be quorate and for decisions to be made.

Decision making:

8.1.11 Members meetings will seek to make decisions by consensus where

possible. When this is not possible the Chair or Borough Chair may

determine that a ballot will be held.

8.1.12 Member Practice Representatives (or their nominated deputies) will

be eligible to cast one vote each on behalf of their Member Practice.

This vote will then be weighted in the vote count (see Standing Orders

6.1.11 and 6.1.12).

8.1.13 Member Practices whose raw patient list size is less than the NW

London median of raw patient list size (rounded to the nearest 100)

will count as one vote. Votes cast by Member Practices with a raw

patient list above the rounded NW London (raw) median will be

weighted to count as two votes. Weighted votes are indivisible. In the

case of an equal vote, the person presiding i.e. the Chair of the

meeting, shall have a second and casting vote.

8.1.14 The rounded median raw patient list size for use upon

commencement of this constitution is 6,300. This number will be

reviewed every year and amended, as necessary, to reflect patient list

sizes as at the preceding 1 April. Whilst the median figure will be

revised every year following review. The results will be communicated

promptly to all Member Practices and reflected in the Governance

Handbook, which for 2021/22, is as follows:

a) 6,300 patients or fewer counts as one vote; and

b) 6,301 or more will count as two (but such votes are indivisible).


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8.1.15 A resolution will be passed if 60% of votes are cast in favour of the

resolution other than for votes of no confidence which shall be passed

in accordance with Standing Order 5.2.18-21.

8.1.16 Where a decision is required, Members will be provided 5 working

days’ notice of the issue to be voted on, along with supporting

information.

8.1.17 Decisions will be conducted using an electronic voting process. A

show of hands is not permitted for formal votes.

8.1.18 A record will be maintained of the outcome of all resolutions put to a

vote.

Annual General Meeting

8.1.19 The Member Council will hold one meeting a year in public for the

purpose of presenting the Annual Report and Annual Accounts to

members of the public (AGM).

8.1.20 The AGM shall be held at such time and such place as the Chair shall

determine, having consulted with the members of the Governing

Body.

8.1.21 Notice of the AGM will be given to all Governing Body members and

to all Members; and published on the CCG’s website and at the

CCG’s offices; at least 10 working days before the meeting.

8.1.22 Any official minutes of the AGM shall be published on the CCG’s

website

8.2 Meetings of the Governing Body

Calling meetings

8.2.1 At least four meetings of the Governing Body shall be held each year

at such times and places as the Governing Body may determine.

8.2.2 In normal circumstances, each member of the Governing Body will be

given not less than one month’s notice in writing of any meeting of the

Governing Body to be held. However:

a) The Chair may call a meeting at any time by giving not less than

14 calendar days’ notice in writing.

b) One third of the members of the Governing Body may request the

Chair to convene a meeting by notice in writing, specifying the

matters which they wish to be considered at the meeting. If the


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Chair refuses, or fails, to call a meeting within seven calendar

days of such a request being presented, the Governing Body

members signing the requisition may call a meeting by giving not

less than 14 calendar days’ notice in writing to all members of the

Governing Body specifying the matters to be considered at the

meeting.

c) In emergency situations the Chair may call a meeting with 3 days’

notice by setting out the reason for the urgency and the decision

to be taken.

Chair of a meeting

8.2.3 The CCG Chair shall preside over meetings of the Governing Body.

8.2.4 If the Chair is absent, or is disqualified from participating by a conflict

of interest, the Deputy Chair of the Governing Body will preside.

8.2.5 The CCG’s Governance Handbook sets out expectations regarding

the chairing of meetings and the agreed delineation of responsibilities

between the Chair, Vice Clinical Chair and Deputy Chair of the

Governing Body.

Agenda, supporting papers and business to be transacted

8.2.6 The agenda for each meeting will be drawn up and agreed by the

Chair.

8.2.7 Except where the emergency provisions apply, supporting papers for

all items must be submitted at least seven calendar days before the

meeting takes place. The agenda and supporting papers will be

circulated to all members of the Governing Body at least five calendar

days before the meeting.

8.2.8 Agendas and papers for meetings open to the public, including details

about meeting dates, times and venues, will be published on the

CCG’s website at [insert link on new CCG’s website].

Petitions

8.2.9 Where a petition has been received by the CCG, it shall be included

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

Nominated Deputies

8.2.10 With the permission of the person presiding over the meeting, the

Accountable Officer, Chief Finance Officer, and Chief Nurse are able

to nominate a deputy to attend a meeting of the Governing Body that

they are unable to attend, to speak and vote on their behalf. The


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Chair will be notified in advance of to whom the votes will be

conferred.

8.2.11 The decision of person presiding over the meeting regarding

authorisation of nominated deputies is final.

Quorum

8.2.12 A quorum for the Governing Body will only be reached when at least a

third of members are present. This must include a minimum of two

elected governing body members, one executive member and at least

one lay member.

8.2.13 For the sake of clarity:

a) No person can act in more than one capacity when determining

the quorum.

b) Any member of the Governing Body who has been disqualified

from participating in a discussion on any matter and/or from voting

on any motion by reason of a declaration of a conflict of interest,

shall no longer count towards the quorum.

8.2.14 For matters relating to instances where the quorum is not available

due to declared conflicts of interests, or in an emergency, an

alternative quorum of four non-conflicted members shall apply,

including one of the Accountable Officer or Chief Finance Officer, the

secondary care specialist or registered nurse and a lay member. The

chair is required to ensure a diverse and balanced representation of

views are available in the given circumstances. The rationale for and

use of this alternative quorum will be recorded in the minutes of the

meeting.

8.2.15 For all the CCG’s other 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.

Decision making

8.2.16 Generally it is expected that the Governing Body 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:

a) All members of the Governing Body as defined within paragraphs

5.5.2 and 5.5.3 of the CCG’s Constitution who are present at the

meeting will be eligible to cast one vote each on any resolution.


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b) Governing Body members who are unable to attend a Governing

Body meeting howsoever caused may vote on decisions by proxy

by completing a valid proxy voting form. The proxy voting form

must be received by the Governing Body Chair prior to the

Governing Body meeting to which it relates. The Governance Team

shall establish and maintain the proxy voting form.

c) For the sake of clarity, any additional attendees at the Governing

Body meetings (as detailed within paragraph 5.6. of the CCG’s

Constitution) will not have voting rights.

d) A resolution will be passed if more votes are cast for the resolution

than against it.

e) If an equal number of votes are cast for and against a resolution,

then the Chair (or in their absence, the person presiding over the

meeting) will have a second and casting vote.

f) Should a vote be taken, the outcome of the vote, and any

dissenting views, must be recorded in the minutes of the meeting.

8.2.17 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.

Urgent decisions

8.2.18 In the case of urgent decisions and extraordinary circumstances,

every attempt will be made for the Governing Body to meet virtually.

Where this is not possible the following will apply.

8.2.19 The powers of the CCG which are delegated to, or reserved by, the

Governing Body may for an urgent decision be exercised by the

Accountable Officer and the Chair having consulted at least one Lay

Member.

8.2.20 The exercise of such powers by the Accountable Officer and the Chair

shall be reported to the Governing Body as soon as practicable and

the next formal meeting of the Governing Body for formal ratification.

Such reports should include the justification for using the urgent

decision provisions.

Minutes

8.2.21 The names and roles of all members of the Governing Body present

shall be recorded in the minutes of the Governing Body meetings.


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8.2.22 The minutes 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.

8.2.23 No discussion shall take place upon the minutes except upon their

accuracy or where the person presiding over the meeting considers

discussion appropriate.

8.2.24 Where providing a record of a meeting held in public, the minutes

shall be made available to the public as required by Code of Practice

on Openness in the NHS.

Admission of public and the press

8.2.25 Subject to Standing Order 8.2.26, meetings of the Governing Body will

be open to the public.

8.2.26 The Governing Body may resolve to exclude the public from a

meeting or part of a meeting where it would be prejudicial to the public

interest by reason of the confidential nature of the business to be

transacted or for other special reasons arising from the nature of that

business or of the proceedings or for any other reason permitted by

the Public Bodies (Admission to Meetings) Act 1960 as amended or

succeeded from time to time.

8.2.27 For the purposes of planning meeting arrangements, the Chair, as

advised by the Accountable Officer and executive lead on

governance, may propose meetings or parts thereof that exclude the

public (‘confidential meetings’). Governing Body members’

acceptance of the agenda will constitute a resolution for the purposes

of 8.2.26 above.

8.2.28 Only members of the Governing Body will attend ‘confidential

meetings’.

8.2.29 The person presiding over the meeting shall give such directions as

he/she thinks fit with regard to the arrangements for meetings and

accommodation of the public and representatives of the press such as

to ensure that the Governing Body’s business shall be conducted

without interruption and disruption.

8.2.30 The Governing Body may resolve (as permitted by Section 1(8) Public

Bodies (Admissions to Meetings) Act 1960 as amended from time to

time) to exclude the public from a meeting (whether during whole or

part of the proceedings) to suppress or prevent disorderly conduct or

behaviour.


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8.2.31 Matters to be dealt with by the Governing Body following the exclusion

of representatives of the press, and other members of the public shall

be confidential to the members of the Governing Body.

8.2.32 Any member of the Governing Body or other person who receives any

such minutes or papers in advance of or following a meeting shall not

reveal or disclose the contents of papers or minutes marked as

‘confidential’ outside of the Governing Body, without the express

permission of the Governing Body. This will apply equally to the

content of any discussion during the Governing Body meeting which

may take place on such reports or papers.

9 Suspension of Standing Orders

9.1 In exceptional circumstances, except where it would contravene any

statutory provision or any direction made by the Secretary of State for

Health and Social Care or NHS England, any part of these Standing Orders

may be suspended by the chair or Deputy chair provided a third of

Governing Body members are in agreement, one of whom should be a lay

member and one of whom should be a member of the CCG.

9.2 A decision to suspend Standing Orders together with the reasons for doing

so shall be recorded in the minutes of the meeting.

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.

10 Appointment of committees and sub-committees

10.1 All committees and sub-committees may meet virtually using telephone,

video and other electronic means when necessary, unless the Terms of

Reference prohibit this.

10.2 The CCG may appoint committees and sub-committees of the CCG and

make provision for the appointment of committees and sub-committees of

its Governing Body.

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

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

CCG 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.


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10.4 For committees and sub-committees of the Governing Body, the Governing

body 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.

10.5 Where committees are authorised to establish sub-committees they may

not delegate executive powers to the sub-committee unless expressly

authorised by the holder of the reserved authority.

11 Use of seal and authorisation of documents

11.1 The CCG will use a seal for executing documents where necessary. The

following individuals or officers are authorised to authenticate its use by

their signature:

a) the Accountable Officer;

b) the Chair of the Governing Body;

c) the chief finance officer;

11.2 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

11.3 The Accountable Officer shall keep a register in which he/she shall enter a

record of the sealing of every document.

12 Policy statements: general principles

12.1 The CCG will from time to time agree and approve policy statements /

procedures which will apply to members and / or all specific groups of staff

employed by NHS North West London Clinical Commissioning Group.

12.2 The decisions to approve such policies and procedures will be recorded in

an appropriate minute and will be deemed where appropriate to be an

integral part of the group’s Standing Orders.

13 Common to all meetings

Record of attendance


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13.1.1 The names and roles (and practices, as appropriate) of all members of

the meeting present at the meeting shall be recorded in the minutes of

the CCG’s meetings. The names of all 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.

Minutes

13.1.2 For each meeting, an officer will be nominated to draft minutes. These

will be reviewed by the Chair of the meeting, prior to distribution and

publication.

13.1.3 Names of individuals and their roles will be recorded within the minutes.

13.1.4 Minutes will be confirmed as a true record through formal

acknowledgment at the succeeding meeting that they are indeed a true

reflection. Any amendments will be acknowledged and the minutes

updated accordingly.

13.1.5 Where appropriate, minutes will be made available to constituent

members through appropriate electronic means or accessible to the

public on the website.

14. Disputes Resolution Procedure

14.1 Purpose

14.1.1. The following dispute resolution process will apply to manage any dispute

between a member practice and the CCG governing body. The CCG is committed to

engaging with its members around strategic proposals and developments. However,

where a member finds it has a dispute or grievance with the wider CCG as a whole,

or its governing body or committees or subcommittees or joint committees to whom it

has delegated powers, with regards to:

a) matters of eligibility and disqualification;

b) the interpretation and application of their respective powers and obligations

under this Constitution;

c) a decision which the CCG has made on behalf of its members; or

d) member matters - as members in a commissioning capacity and not matters

relating to GP practices as providers.

14.2 Informal Local Process 14.2.1 If the member wishes to raise an issue with the CCG as a whole:

a) in the first instance, the member may raise such an issue through an elected governing body member, in writing within two calendar months of the issue arising, for resolution;


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b) the elected governing body member will forward the issue to the CCG management who will identify an individual responsible to respond and who will ensure the member receives a response in writing within 30 working days; and

c) if the elected governing body member is unable to resolve the issue, the

member may write formally to the Chair, or, if the Chair is unavailable, to the Vice Chair, clearly outlining the issue(s) and contact details. The Chair, in conjunction with the Accountable Officer where appropriate, will contact the member within 30 working days through the member representative to resolve the dispute.

14.2.2 Mediation Where the dispute is unable to be resolved as above, parties may decide, at their own cost, to refer to mediation, the independent third party mediator being appointed by the Centre for Effective Dispute Resolution. 14.2.3 The member should, at the earliest opportunity discuss such concerns with the Local Medical Committee. 14.3 Formal Local Process 14.3.1 If a member practice is not satisfied that their issues have been satisfactorily addressed through the informal process they may lodge a request for “Formal Local Dispute Resolution” in writing, including the grounds for the request, to the Accountable Officer of the CCG. 14.3.2 Under these circumstances the CCG will set up a Local Dispute Resolution Panel (LDRP) to hear the dispute and resolve the dispute where possible. 14.3.3 The local dispute resolution panel should consist of:

a) Governing Body lay member (Chair); b) Clinical Governing Body member from a different predecessor CCG and

independent from the practice in question; and c) LMC Representative.

14.3.4 Should any members of the LDRP find it necessary to declare an interest in a dispute that is being considered, the Chair will seek to approach another CCG/LMC/Practice nominated representative to nominate alternative panel members. 14.3.5 If a member practice requests a formal dispute resolution, the CCG shall acknowledge receipt of the request in writing within 2 working days. The acknowledgement will explain the procedure to be carried out by the CCG. 14.3.6 The Hearing The Chair of the LDRP, on being satisfied that all attempts at local resolution have been exhausted will arrange a meeting of the LDRP to hear the dispute as soon is practically possible.


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14.3.7 All parties shall be notified of the date and time of the LDRP meeting. The hearing shall be held within 25 working days of the request being lodged (where possible) by the member practice to the CCG. 14.3.8 The Chair of the LDRP will ensure that at least 10 working days’ notice of the date of the hearing will be given to all participants. 14.3.9 Procedure at LDRP Meeting

The Discussions of the panel shall remain confidential;

The Chair of the panel will ensure a written record / minutes are kept of the

meeting;

All written and verbal evidence will be considered;

Should the member practice choose to attend the LDRP they and the CCG

presenting officer will be asked to present their cases and may call witnesses.

Members of the panel will be given the opportunity to ask any questions

relevant to the case.

Following the presentation of their case the member practice and CCG

presenting officer shall withdraw and the panel will deliberate

The panel will reach a decision on the case before them and notify the

member practice in writing, including any recommendations within seven

working days of the hearing.

Where appropriate the decision will be reported to a meeting of the CCG

Executive Team / Board for information.

14.4 Appeal Panel

14.4.1 The Panel will be convened when necessary to consider appeals against

LDRP decisions. The Appeals Panel should consist of the following, none of

whom should have been previously involved in the case:

For GP as a member practice disputes:

o CCG GB Vice Chair (or nominated deputy)

o CCG Chief Officer (or nominated deputy)

o a clinical member of the Board

For GP Contracting disputes:

o CCG Chair

o Chief Officer

o a clinical member of the Board

14.4.2 Process:

a) The member practice wishing to appeal against a LDRP decision must notify

the Chief Officer of their intention, in writing setting out the grounds for appeal,

within one month of their receipt of the decision.

b) The Appeals Panel will consider whether the original decision of the LDRP

followed due process.

c) The Appeals Panel will only consider written evidence. The Appeals Panel will

consider if:


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i. The CCG correctly followed its own procedures (all received

documentation was available and considered within a reasonable

timescales) and / or

ii. All important facts were taken into account when the decision was

made.

d) If these criteria are met the Panel will dismiss the appeal.

e) If the criteria are not met the following actions are available:

i. If the Panel finds that some aspect of the procedure was not followed,

they will assess the significance of the procedural breach and decide

on the appropriate action.

ii. If the panel finds that important facts were not taken into account, they

shall refer the case back to the original LDRP for reconsideration.

f) If the case is referred back to the LDRP for reconsideration of the case, the

LDRP decision will then be final.

g) The Chair of the Appeal Panel will write to the member practice within five

working days of the hearing setting out the Appeal Panel’s decision.

draft standing orders for nwl ccg: v16 18 november 2020€¦ · 18/11/2020 · standing orders...

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