lambeth clinical commissioning collaborative board job ......page 1 of 12 job title: lambeth...

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Job Title: Lambeth Clinical Commissioning Collaborative Board Chair

Reporting to: NHS Lambeth Chair

Accountable to: NHS Lambeth Chair

Hours of work: 2 days per week

Terms and Conditions: Selection will be made on a secondment basis between NHSLambeth and the current employer.

Remuneration: NHS Lambeth will refund the practice/organisation £55,952 perannum to support backfill.

Tenure: 1st Jan 2011 until 31st March 2012, subject to review.

Job PurposeThe Lambeth Clinical Commissioning Collaborative Board Chair will be responsible for theleadership of the Board covering:

the strategic development of Healthcare in Lambeth acute, community and mental health commissioning1 and transformation into a future Lambeth GP Consortium (subject to legislation)

The post holder will be expected to:

secure agreed results as set out in the Strategic and Operating Plan ensure local adherence to agreed pathways and commissioning policies review commissioning spend and ensure appropriate action is taken to manage spend establish and maintain sound commissioning, organisation and governance processes,

working within relevant Statutory Financial Instructions and Codes of Conduct ensure transparency and personal accountability for decisions and performance act as a local champion for GP Commissioning, establishing and promoting influence

on key stakeholder strategy and delivery

The Lambeth Clinical Commissioning Collaborative Board will have designated delegatedresponsibility from the NHS Lambeth Board from April 2011 for the commissioningresponsibilities of NHS Lambeth. The extent of this is to be determined but will includeagreement and delivery of the Strategic Plan for 2011/12, in year performance issues,transition and organisational development to enable full GP Commissioning by April 2013(subject to legislation)

1Excluding regional & nationally commissioned services, maternity and prison health services.

Lambeth Clinical Commissioning Collaborative Board

Job Description – Chair

Appendix 1

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Objectives of the role of Chair of the Lambeth Clinical CommissioningCollaborative Board

To lead an effective outcome orientated Lambeth Clinical Commissioning CollaborativeBoard that commissions the best health care within the resources available through theredesign and implementation of innovative new Care Pathways.

To provide clinical leadership in the development of strategy and the commissioning ofacute, community and mental health services within Lambeth

To promote the design and adoption of the most clinically effective and economic CarePathways for Lambeth residents

To ensure that the optimal quality of care and outcomes experienced by patients isachieved from commissioned services and that these conform to the standards assetby the NHS Commissioning Board (or predecessors).

To develop and sustain effective partnership with key stakeholders including theLondon Borough of Lambeth through the Health and Well-being Board and King’sHealth Partners

To develop and sustain effective partnerships To develop effective and on-going engagement of patients and the public in the

development of healthcare within Lambeth. To ensure the provision of an effective management support organisation for the

Lambeth Clinical Commissioning Collaborative Board.

Key Relationships

NHS Lambeth

NHS Southwark

South East London Sector

Independent Contractors

Provider organisations (includingFoundation Trusts, Mental HeathTrusts, Community services,Voluntary sector)

London Borough of Lambeth

Patient Representatives (LINks andlocal groups)

Department of Health

NHS London

Public Health

Local Professional Committees

Key Responsibilities

The post holder will be responsible for playing a full part in the work of the Lambeth ClinicalCommissioning Collaborative Board:

Specific tasks for the Lambeth Clinical Commissioning Collaborative Board Chair

Attend and chair formal monthly Lambeth Clinical Commissioning Collaborative Boardmeetings

Attend the NHS Lambeth Board meetings and Seminars

Support and develop the members of the Lambeth Clinical Commissioning CollaborativeBoard

Attend informal meetings of the Lambeth Clinical Commissioning Collaborative Board asmutually agreed by the members

Attend the Lambeth Health & Well-being Board

Provide the clinical leadership for local area networks and in regional and nationalnetworks as agreed with the NHS Lambeth Chair.

To ensure mechanisms are in place and monitored to develop appropriate with all key

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stakeholders especially GP constituency, ensuring local ownership topriorities, redesign, implementation

To be responsible for ensuring optimal performance of the GP locality in terms of agreedcommissioning actions and budgetary management, this may include taking action, withtheir linked manager’s support, to address non-compliance

To ensure all Lambeth Clinical Commissioning Collaborative Board members deliveragreed work plans

Collective Tasks

To prepare and agree the Lambeth Clinical Commissioning Collaborative Board prioritiesand strategy, in particular the Strategic Plan and Operating Framework and alliedplanning documents including the Commissioning Strategy Plan and Annual OperatingPlan.

To establish joint commissioning arrangements for specific services to other bodies egLondon Borough of Lambeth and neighbouring PCTs.

To secure appropriate management support to execute the transactional work toimplement the Strategic Plan and Operating Plan and allied documents (including theletting of contracts/SLAs, contract monitoring and reporting for both activity and finance)

To prioritise the redesign of specific Care Pathways, enable the redesign and incorporatethe Care Pathways in the Annual Operating Plan.

To review performance and finance reports and take action so as to be satisfied that theStrategic and Operating Plan and allied documents are being fulfilled.

To review the quality and outcomes of commissioned services in terms of serviceprovided and improved health for Lambeth residents.

To secure appropriate resources and ensure delivery of PBC/GP commissioningcommitments

To ensure compliance with Department of Health requirements (as delegated to NHSLondon or the NHS Commissioning Board)

To ensure robust network with all key stakeholders

The Lambeth Clinical Commissioning Collaborative Board Chair will meet with the NHSLambeth Chair and Director of Clinical Pathway Commissioning to agree and monitor anappropriate work plan.

GeneralThe Lambeth Clinical Commissioning Collaborative Board Chair is expected to: adhere to organisational policies and procedures and relevant legislation including the

requirements of any professional bodies to maintain satisfactory personal performances and professional standards and to

achieve agreed objectives for their role. attend mandatory training as identified by the organisation participate in the organisations Performance Appraisal Scheme and to contribute to their

own development and the development of any staff that they are responsible forappraising.

ConfidentialityAll workers have both a common law duty and a statutory duty of confidentiality to protectpatient (and indeed any personally identifiable) information and only use it for the purposesfor which it was intended. The disclosure and use of confidential patient information needs tobe both lawful and ethical.

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Information GovernanceWorkers must keep up-to-date with the requirements of InformationGovernance and must follow local policies and procedures to ensure that information is dealtwith legally, securely, efficiently and effectively. Staff must appropriately manage all theInformation they handle during the course of their employment, making the informationavailable for sharing in a controlled manner, subject to statutory requirements and theorganisations Information Governance Policy, and formal Information Sharing arrangements.

Data ProtectionThe organisation is registered as a data controller under the Data Protection Act 1998 .Allthe personal information we hold, obtain, record, use and share as an organisation isgoverned by this Act. As an employee/contractor of the organisations you have a legalresponsibility for all personal information you handle and must not at any time use thepersonal data in a way incompatible with the guidelines stipulated in this act. If you are inany doubt regarding what you should or should not do in connection with the Data ProtectionAct then you must contact the NHS Lambeth Chair.

Records ManagementYou have a legal responsibility for all records you work with e.g. patient records, financialrecords, personal, administrative etc, that you gather or use as part of your work within theorganisation. The records may be held in a variety of formats such as paper, electronic,microfiche, audio and video tapes etc. You must consult the NHS Lambeth Chair if you haveany doubt as to the correct management of the records with which you work.

Health and SafetyAll Managers have a general accountability for ensuring, so far as is reasonably practicable,the health, safety and welfare of the employee/contractors under their direction at work. AsClinical Commissioning Board Chair you are responsible to take reasonable care for his orher own acts or omissions and the effect that these may have upon the safety of themselvesor any other person and to use safety equipment or clothing in a proper manner and for thepurpose intended. Any worker who intentionally or recklessly misuses anything supplied inthe interests of health and safety will be subject to disciplinary procedures.Every worker must work in accordance with any health and safety procedures, instructionsor training that has been given.No worker may undertake any task for which they have not been authorised and for whichthey are not adequately trained.Every worker is required to bring to the attention of a responsible person any perceivedshortcoming in our safety arrangements or any defects in work equipment.All workers are under a duty to familiarise themselves with the organisations Health andSafety Policies.

Risk ManagementEnsure that you implement systems and procedures at a local level to fulfil the requirementsof the organisations Risk Management Strategy including local management and resolutionof complaints and concerns, management of SUIs/incidents and near misses.

Emergency PlanningIn accordance with the organisations responsibilities under the civil contingencies Act 2004,to undertake duties as is reasonable directed at locations in the event of and for the durationof a significant internal incident, major incident or flu pandemic.Dignity and Respect at WorkThe organisation as adopted an equal opportunities policy and all employee/contractorsmust be aware of their obligations. All employee/contractors of Lambeth organisations are

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required to carry out their duties with regard to local policies andprocedures and respect the cultural beliefs and customs held by others toabide by the spirit and nature of the policy to avoid direct and indirect discrimination

Corporate GovernanceYou will be expected to familiarise yourself with NHS Lambeth governance arrangementswhich outlines the Management and Committee Structures and Procedures for theGovernance of the organisations activities including organisations Standing Orders,Standing Orders and Standing Financial Instructions. Workers should conform to therequirements of the Standing Orders, Standing Financial Instructions or other financialprocedures including the NHS Code of Conduct and Accountability and the Fraud andCorruption Policy.

Safeguarding Children and Vulnerable AdultsAll workers have a responsibility for safeguarding and promoting the welfare of children andvulnerable adults. Further guidance can be sought from the NHS Lambeth Chair.

Infection ControlAll workers have a responsibility to comply with the Health Act 2006 and organisations policyand guidance on infection prevention and control, ensuring a sound knowledge of standardinfection control precautions. You must keep up to date in infection control practice relevantto their area of practice and you are required to practice strict hand hygiene at all timeswhen carrying out their duties. In addition, to ensure that all staff are aware of their key rolein infection control and prevention, to ensure their compliance with the Health Act 2006(Hygiene Code) and the organisations policies and procedures and be accountable andresponsible for the provision of a safe, clean environment. In addition to ensure that staffattend infection control training and keep up to date with developments.

GeneralThe Lambeth Clinical Commissioning Collaborative Board Chair may be required to work atany of the organisations sites in line with the service needs. This job description describesresponsibilities, as they are currently required. It is anticipated duties will change over timeand the job description may need to be reviewed in the future.

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You will need to demonstrate compliance with the essential requirements set out - examples toshow that these have been met, can be drawn from any part of your professional life.

Requirements Essential Desirable

Qualifications GMC Registration or suitable alternative AdvancedManagement/LeadershipQualification orequivalent

Clinical Experience Significant experience in Primary Care Currently working within Primary Care in

Lambeth

Multi-disciplinaryspecialist community

Setting Direction Experience in generating strategy. Understanding of NHS strategic planning Awareness of external drivers affecting local

health and health services. Experience of leading a project eg care pathway

Improving Services Experience in producing cost effective planswithin available resources.

Ability to gather and interpret conflictingevidence to design new health services.

Ability to lead changes in health services toimprove quality for patients

Understanding of commissioning regime

Management andAdministrativeExperience

Ability to plan, manage resources /people/performance

Can demonstrate the ability to manage anorganisation/service.

Ability to chair and organise clinical andmanagement teams and priorities.

Experience of auditmanagement

Working with others Experience in creating an ethos of patientcentred care

Experience of working in a multi-disciplinaryplanning environment

Well-developed network/partnership of contacts Able to encourage consensus with across

organisations and professionals

Personal Attributes Commitment to sustaining professional ambitionand meeting patients' need

Acts on information that would lead to improvedservices

Ensures professional values and ethics areupheld

Ability to lead and work within a team Enquiring, critical approach to work Ability to communicate effectively


Person Specification – Chair

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Job Title: Clinical Commissioning Board Member

Reporting to: Clinical Commissioning Board Chair

Accountable to: NHS Lambeth Chair

Hours of work: 6 x 4 hour sessions per month (63 sessions per annum) 1 day perweek

Terms and Conditions: Selection will be made on a secondment basis between NHSLambeth and the current employer.

Remuneration: NHS Lambeth will refund the practice/organisation £27,976 perannum to support backfill.

Tenure: 1st Jan 2011 until 31st March 2012, subject to review.

Job PurposeAs part of the Clinical Commissioning Board, the post holder will be responsible for the clinicalleadership of commissioning in Lambeth, particularly acute, mental health and community andthe strategic development of health care for the population of Lambeth.

The post holder will be expected: To represent, co-ordinate and lead their GP Commissioning locality working with NHS

Lambeth to ensure the development and delivery of agreed commissioning plans andobjectives

To work with constituent practices to raise awareness of commissioning issues andactivities, agree commissioning priorities that are responsive to local need

To ensure adherence to agreed pathways and commissioning policies To review commissioning spend and take action to manage spend To establish and maintain sound commissioning, organisation and governance processes,

working within relevant Statutory Financial Instructions and Codes of Conduct To ensure transparency and personal accountability for decisions and performance

The Clinical Commissioning Board will have designated delegated responsibility from the NHSLambeth Board from April 2011 for the commissioning responsibilities of NHS Lambeth. Theextent of this is to be determined but will include agreement and delivery of the Strategic Planfor 2011/12, in year performance issues, transition and organisational development to enablefull GP Commissioning by April 2013 (subject to legislation)

Appointment ProcessThis appointment is made using a combined selection and election process. GP commissioningis derived from a practice list. Eligible candidates will therefore need to have a connection withand have the written support of at least one Lambeth GP practice. This may include GPprincipals, salaried GPs, Practice Nurses, Practice Managers and other administrative staff orclinicians. Interested individuals may apply for their names to be added to the ElectionCandidate List. An Appointment Panel will assess the candidate using application and interview


Job Description – Board Member

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to determine whether the applicant meets the requirements in the PersonSpecification. Lambeth GP Practices may use their vote(s) for any candidateincluded on the Election Candidate List. There are three constituencies: North, South East andStreatham & Clapham (South West). Each practice will vote and will have a number of votesbased on list size.

Objectives To provide clinical leadership in the development of strategy and the commissioning of

acute, community services2 and mental health services within Lambeth To promote the design and adoption of the most clinically effective and economic Care

Pathways for Lambeth residents To ensure that the optimal quality of care and outcomes experienced by patients is achieved

from commissioned services and that these conform to the standards asset by the NHSCommissioning Board (or predecessors).

Key Relationships

NHS Lambeth

NHS Southwark

South East London Sector

Independent Contractors

Provider organisations (including Foundation Trusts, Mental Heath Trusts, CommunityServices, voluntary sector)

London Borough of Lambeth

Patient Representatives (LINks and local groups)

Department of Health

NHS London

Public Health

Local Professional Committees

Main TasksThe post holder will be responsible for playing a full part in the work of the ClinicalCommissioning Board:

Specific Personal Tasks

To personally attend formal monthly Clinical Commissioning Board meetings, acting as anambassador for commissioning health for the local population

To personally attend informal meetings of the Clinical Commissioning Board as mutually bythe members

To take a lead responsibility for a key provider contract and identified care pathway redesignpriorities, as agreed with the Chair

To develop and maintain a robust engagement network with all key stakeholders especiallyGP constituency, ensuring local ownership to priorities, redesign, implementation

To be responsible for ensuring optimal performance of the GP locality in terms of agreedcommissioning actions and budgetary management, this may include taking action, withtheir linked manager’s support, to address non-compliance

Collective Tasks

2Excluding regional & nationally commissioned services, maternity and prison health services.

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To prepare and agree the Clinical Commissioning Board priorities andstrategy, in particular the Strategic Plan and Operating Framework andallied planning documents esp. Commissioning Strategy Plan and Annual Operating Plan.

To establish joint commissioning arrangements for specific services to other bodies eg LocalAuthority and neighbouring PCTs.

To instruct the management support to execute the transactional work to implement theStrategic Plan and Operating Plan and allied documents (i.e. Letting of contracts / SLAs,Contract monitoring and reporting for both activity & finance)

To prioritise the redesign of specific Care Pathways, enable the redesign and incorporatethe Care Pathways in the Annual Operating Plan.

To review performance and finance reports and take action so as to be satisfied that theStrategic and Operating Plan and allied documents are being fulfilled.

To review the quality and outcomes of commissioned services in terms of service providedand improved health for Lambeth residents.

To secure appropriate resources and ensure delivery of PBC/GP commissioningcommitments

To ensure compliance with Department of Health requirements (as delegated to NHSLondon or the NHS Commissioning Board)

The postholder will meet with the Clinical Commissioning Board Chair and Director of ClinicalPathway Commissioning to agree an appropriate work plan.

GeneralClinical Commissioning Board members are expected to: adhere to organisational policies and procedures and relevant legislation including the

requirements of any professional bodies to maintain satisfactory personal performances and professional standards and to achieve

agreed objectives for their role. attend mandatory training as identified by the organisation participate in the organisations Performance Appraisal Scheme and to contribute to their

own development and the development of any staff that they are responsible for appraising.

ConfidentialityAll workers have both a common law duty and a statutory duty of confidentiality to protectpatient (and indeed any personally identifiable) information and only use it for the purposes forwhich it was intended. The disclosure and use of confidential patient information needs to beboth lawful and ethical.

Information GovernanceWorkers must keep up-to-date with the requirements of Information Governance and mustfollow local policies and procedures to ensure that information is dealt with legally, securely,efficiently and effectively. Staff must appropriately manage all the Information they handleduring the course of their employment, making the information available for sharing in acontrolled manner, subject to statutory requirements and the organisations InformationGovernance Policy, and formal Information Sharing arrangements.

Data ProtectionThe organisation is registered as a data controller under the Data Protection Act 1998 .All thepersonal information we hold, obtain, record, use and share as an organisation is governed bythis Act. As an employee/contractor of the organisations you have a legal responsibility for allpersonal information you handle and must not at any time use the personal data in a wayincompatible with the guidelines stipulated in this act. If you are in any doubt regarding what youshould or should not do then you must contact the Clinical Commissioning Board Chair.

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Records ManagementYou have a legal responsibility for all records you work with e.g. patientrecords, financial records, personal, administrative etc, that you gather or use as part of yourwork within the organisation. The records may be held in a variety of formats such as paper,electronic, microfiche, audio and video tapes etc. You must consult the Clinical CommissioningBoard Chair if you have any doubt as to the correct management of the records with which youwork.

Health and SafetyAll Managers have a general accountability for ensuring, so far as is reasonably practicable, thehealth, safety and welfare of the employee/contractors under their direction at work. As aClinical Commissioning Board member you are responsible to: take reasonable care for his or her own acts or omissions and the effect that these may have

upon the safety of themselves or any other person. use safety equipment or clothing in a proper manner and for the purpose intended.

Any worker who intentionally or recklessly misuses anything supplied in the interests of healthand safety will be subject to disciplinary procedures.Every worker must work in accordance with any health and safety procedures, instructions ortraining that has been given.No worker may undertake any task for which they have not been authorised and for which theyare not adequately trained.Every worker is required to bring to the attention of a responsible person any perceivedshortcoming in our safety arrangements or any defects in work equipment.All workers are under a duty to familiarise themselves with the organisations Health and SafetyPolicies.

Risk ManagementEnsure that you implement systems and procedures at a local level to fulfil the requirements ofthe organisations Risk Management Strategy including local management and resolution ofcomplaints and concerns, management of SUIs/incidents and near misses.

Emergency PlanningIn accordance with the organisations responsibilities under the civil contingencies Act 2004, toundertake duties as is reasonable directed at locations in the event of and for the duration of asignificant internal incident, major incident or flu pandemic.

Dignity and Respect at WorkThe organisation as adopted an equal opportunities policy and all employee/contractors mustbe aware of their obligations. All employee/contractors of Lambeth organisations are required tocarry out their duties with regard to local policies and procedures and respect the cultural beliefsand customs held by others to abide by the spirit and nature of the policy to avoid direct andindirect discrimination

Corporate GovernanceYou will be expected to familiarise yourself with NHS Lambeth governance arrangements whichoutlines the Management and Committee Structures and Procedures for the Governance of theorganisations activities including organisations Standing Orders, Standing Orders and StandingFinancial Instructions. Workers should conform to the requirements of the Standing Orders,Standing Financial Instructions or other financial procedures including the NHS Code ofConduct and Accountability and the Fraud and Corruption Policy.

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Safeguarding Children and Vulnerable AdultsAll workers have a responsibility for safeguarding and promoting the welfare of children andvulnerable adults. Further guidance can be sought from the Clinical Commissioning BoardChair.

Infection ControlAll workers have a responsibility to comply with the Health Act 2006 and organisations policyand guidance on infection prevention and control, ensuring a sound knowledge of standardinfection control precautions. You must keep up to date in infection control practice relevant totheir area of practice and you are required to practice strict hand hygiene at all times whencarrying out their duties. In addition, to ensure that all staff are aware of their key role ininfection control and prevention, to ensure their compliance with the Health Act 2006 (HygieneCode) and the organisations policies and procedures and be accountable and responsible forthe provision of a safe, clean environment. In addition to ensure that staff attend infectioncontrol training and keep up to date with developments.

GeneralClinical Commissioning Board members may be required to work at any of the organisationssites in line with the service needs. This job description describes responsibilities, as they arecurrently required. It is anticipated duties will change over time and the job description mayneed to be reviewed in the future.

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Your examples to show that the requirements set out in this Person Specification have been met, can be drawnfrom any part of your professional life. The over-riding requirement is for the candidate to be a Clinical Leader whois able to take forward a transformational change in the delivery of health care within Lambeth.

Requirements Essential Desirable

Qualifications GMC Registration or suitable alternative Advanced GP/OtherManagement orleadership qualification

ClinicalExperience

Significant experience in Primary Care Currently working within Primary Care in

Lambeth

Multi-disciplinaryspecialist community

Setting Direction Experience in generating strategy. Understanding of NHS strategic planning Awareness of external drivers affecting local

health and health services. Experience of leading a project eg care

pathway redesign

ImprovingServices

Experience in producing cost effective planswithin available resources.

Ability to gather and interpret conflictingevidence to design new health services.

Ability to deliver changes in health servicesto improve quality for patients

Understanding of commissioning regime

Management andAdministrativeExperience

Ability to plan, manage resources / people /performance

Ability to run an efficient GP Practice Ability to chair and organise clinical and

management teams & priorities.

Experience of auditmanagement

Working withothers

Experience in creating an ethos of patientcentred care

Experience of working in a multi-disciplinaryplanning environment

Well-developed network/partnership ofcontacts

Ability to encourage consensus with a teamof diverse views.

PersonalAttributes

Commitment to sustaining professionalambition and meeting patients' need

Acts on information that would lead toimproved services

Ensures professional values and ethics areupheld

Ability to work in a team Enquiring, critical approach to work Ability to communicate effectively

Derived from the Medical Leadership Competency Framework


Person Specification – Board Member

Appendix 2Lambeth Clinical Commissioning Collaborative Board (LCCCB), Clinical Leads

Updated as at 16 June 2011

JohnBalazs

RajMitra

GillianEllsbury

PatriciaKirkman

RayWalsh

RuthJeffery

AdrianMcLachlan

Planned Care x x x

Unplanned Care x x

Mental Health x x x

Staying Healthy x x x

End of life care andcancer

x

Learning disabilities x

Diabetes x x

COPD/Respiratory x

CVD x

MSK x

Gynae x

Sexual health x

Gastro x

Ophthalmology

Older people x

Dermatology x

Renal x

Integrated Care x

GSTT x

KCH x x

SGH x

Community x

SLAM x x

LAS

Medicines x

IMT x

Workforce x

Training EducationResearch

x

Communications x x

OD x

Health & WellbeingBd

x

PPI x

Governance x

Quality x x

Children (incsafeguarding)

x

Adult Safeguarding

Finance x

Health Scrutiny x

InformationGovernance

x

Cluster Board x

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Appendix 3

TERMS OF REFERENCELambeth Clinical Commissioning Collaborative Board

Agreed May 2011 Cluster Board

1. Introduction / Purpose / Constitution

In South East London the statutory functions of the six current PCT/Care Trust Boards will be fulfilled by the six boards operating jointly.Within these arrangements each Board will establish borough basedLocal Clinical Commissioning Committees (LCCCs) as formal sub-committees that have delegated responsibility for local commissioningbudgets. In Lambeth this LCCC will be known as the Lambeth ClinicalCollaborative Board (LCCCB) .

2. Duties/ Roles and Responsibilities

The Lambeth Clinical Commissioning Collaborative Board will operate asa sub-committee of the Lambeth PCT Board and will be a decisionmaking forum. It will take on delegated responsibilities that will changeover time as Clinical Commissioning develops in Lambeth and theLambeth Clinical Commissioning Collaborative Board takes onincreasing responsibilities for delivery of Lambeth health commissioning.The Lambeth Clinical Commissioning Collaborative Board on behalf ofthe Lambeth PCT Board will

Engage with practices across Lambeth, through the three localitiesin the development of Clinical Commissioning.

Engage with a broad range of clinicians in redesigning andimplementing new care pathways.

To provide clinical vision and lead strategic thinking for thecommissioning of health services and health improvement inLambeth

To provide clinical leadership to commissioning of health services inLambeth in respect of delegated functions including pathwayredesign.

To monitor and assure clinical quality to the PCT Board, includingsafeguarding and infection control.

To drive and monitor delivery and performance, take remedialaction as necessary and provide assurance to the PCT Board

Lead the transition to Clinical Commissioning in Lambeth To lead support the transition to new Health and Wellbeing

arrangements in Lambeth To develop partnership working including with services across

Lambeth Localities, London Borough of Lambeth, other PCTs and

DRAFT V0.2 06/04/11 Page 2 of 3

GP commissioners, King’s Health Partners and other secondarycare providers, Lambeth LINk, Lambeth Scrutiny and the GSTTCharity.

To fulfill the role of the Lambeth PCT Professional ExecutiveCommittee.

3. Accountability

The Lambeth Clinical Commissioning Collaborative Board members willhave delegated responsibility from the Lambeth PCT Board and willhave decision making powers. All members will have equal standing andtheir role will be to consider the key strategic, clinical and managerialissues across the commissioning of these health services in Lambethdelegated to it. The Lambeth Clinical Commissioning CollaborativeBoard will take responsibility on behalf of the Lambeth PCT Board for thetransition to Clinical Commissioning Consortia and Health and Wellbeingarrangements. Locality Board members will be expected to report backto their locality. Lambeth Clinical Commissioning Collaborative Boardmembers will be expected to take on lead roles.

4. Committee Membership

Collaborative ChairNorth Locality memberNorth Locality memberSouth West Locality memberSouth West Locality memberSouth East Locality memberSouth East Locality memberLambeth BSU Managing DirectorDirector of Public Health (joint with LB Lambeth)Nursing LeadPCT Non Executive DirectorPCT Non Executive Director

If a clinical locality member resigns, a deputy will be co-opted for up tothree months to allow time for a new member to be appointed from thatlocality.

If the Chair resigns, a Chair will be appointed from the existing membersfor up to three months to allow time for a new Chair to be appointed.

In AttendanceDirector of Integrated Commissioning (joint with LB Lambeth)Director of Care Pathway CommissioningDirector of Corporate Affairs and Human ResourcesChief Financial OfficerClinical Network lead

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InviteesLondon Borough of Lambeth RepresentativeLMC RepresentativeLINk Representative

5. Reporting Arrangements and supporting structures

The minutes of the each formal LCCCB meeting will be formally recordedand submitted to the next PCT Board meeting for publication in publicpapers.

Agendas and supporting papers will be circulated five days in advance ofmeetings. Minutes of the meeting will be circulated to all memberswithin five working days. Minutes will be agreed by the Chair at followingformal meeting of the Lambeth Clinical Commissioning Collaborative.

6. Quorum rules

The minimum number of LCCCB members required in order to takedecisions is two practice nominated members and two PCT Boardmembers.

7. Frequency of Meetings

The Clinical Board will meet formally on a monthly basis and the Boardmeeting will be held in public on quarterly basis in June, September,December and March.

8. Monitoring adherence to the Terms of Reference / Review

The LCCCB is committed to evaluating all programmes, strategic,operating and financial plans delegated to it by the PCT. The LCCCBwill review it's effectiveness on an annual basis. The Terms ofReference and membership will be reviewed as required, and at least onan annual basis.

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June 2011 Page 1 of 46

Appendix 4Business Plan 2011/2012

1 Introduction

The Lambeth Clinical Commissioning Collaborative (LCCCB) was recognised by the Department of Health as a GPPathfinder in February 2011 and was established as a Committee of the Lambeth PCT Board on 1 April 2011. The LCCCBbuilds on the development of clinical commissioning over the past two years to develop next steps in Clinical Commissioningin Lambeth. The LCCCB is supported by a Lambeth specific Business Support Unit (BSU), operating within sharedmanagement arrangements, including acute contracting support, across the south east London Cluster.

The purpose of this Business Plan is to set out the key 2011/12 objectives for NHS Lambeth, under the leadership of theLCCCB. Implementation of the Business Plan will ensure that NHS Lambeth, working with our partners, commissionseffective care for our local population, manages the transition to Clinically Led Commissioning and the new Health and Well-being arrangements, and delivers the range of our statutory responsibilities. This Business Plan has been developed withthe LCCCB and it was agreed that it should centre around three key areas of our business:

Area of Business Strategic Objective

(i) Our Operational Delivery To deliver our agreed priority programmes with robust operationalrisk and financial management and effective high quality care.

(ii) Our Organisational Development To manage the transition of commissioning responsibility to GPConsortia and the establishment of new Health and Wellbeingarrangements, within the context of engaging public and patientsand managing equalities.

(iii) Our Governance and Assurance To ensure systems and processes are in place to support individual,team and corporate accountability for delivering patient centred,safe, high quality care, within our resource limits.

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2 Our Mission, Vision and Values

Our Mission:Our Mission is to improve the health and reduce health inequalities of Lambeth people and to commission the highest quality healthservices on their behalf.

Our Vision:1. Health improvement is at the heart of all we do. We will increase life expectancy for all and reduce the difference in lifeexpectancy between the most and least deprived in our diverse communities.2. We will maintain a thriving, financially viable, health economy delivering safe and effective high quality care.3. We will commission comprehensive integrated care that meets the needs of local people. We will value diversity amongstproviders, but will expect excellent outcomes.4. In delivering this Vision we recognise the need:

- for a rigorous, population needs based approach to commissioning, supported by public health expertise.- to work with Lambeth people and their representatives to commission services that best meet their needs.- to work in partnership with colleagues, across geographic, organisational and professional boundaries. This will include

primary care practitioners, the London Borough of Lambeth, King's Health Partners and neighbouring health commissioners.- to support innovation in workforce development and in the local application of teaching, training and research.- to look first to local colleagues for management support.

Our Values• We always tell the truth.• We are fair• We are open• We recognise our responsibilities to service users and the wider public• We act responsibly as a public sector organisation

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3 Our Governance, Performance and Programme Management

The Lambeth Clinical Commissioning Collaborative Board is a Committee of the Lambeth PCT Board which itself operateson a collective basis with the five other PCTs in the South East London Cluster. Within this governance framework we willwork with all 52 Lambeth practices across our three localities, with a wide range of clinical colleagues, with our partners andwith our local communities and their representatives. All of our partners are critical to our ability to secure our mission andvision. A diagram showing our key governance and key partnership relationships is set out below.

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4. Overseeing the Business Plan and Assuring DeliveryThe LCCCB will oversee delivery of this Business Plan, within an overall planned agenda, across our three main businessareas. The LCCCB will receive a comprehensive Integrated Performance and Governance report addressing i) our BoardAssurance Framework, ii) our risks to delivery and iii) performance against the objectives as set out in the Business Plan.

In order to support the delivery of our objectives two management groups have been set up:

Operations Group – Chaired by the Managing Director, with membership comprising all NHS Lambeth Directors andAssistant Directors. This group meets twice a month with the role of overseeing and quality assuring our operationalperformance, including the priority programmes and routine contract management. Where necessary, this will include thedevelopment of Action Plans in year to ensure performance remains on track. The preparation and quality assurance ofreports to the LCCCB are co-ordinated through this meeting.

Development Group – Chaired by the Managing Director, with membership comprising all NHS Lambeth Directors. Thisgroup meets twice a month with the role of reviewing progress in organisational development and issues of assurance andgovernance. This meeting will quality assure reporting to the LCCCB on policy, patient safety and organisationaldevelopment objectives.

Locality and practice reporting will be through locality arrangements, led by the LCCCB clinical leads.

NHS Lambeth meets regularly with the South East London Cluster to discuss and review performance of the cluster ledcommissioning and support teams (eg acute and primary care). These meetings will be used to ensure delivery of elementsof the Business Plan which are dependent on cluster performance.

The Business Plan will form the basis for individual objective setting for every member of staff and performance review. Eachprogramme within the Business Plan has a notified Director lead and key objectives are assigned at Assistant Director level.

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June 2011

5. Programme ManagementIn order to deliver our vision and strategic priorities we have put in place enhanced programme management arrangements.We have agreed four health programmes, each with a Director-led Senior Responsible Officer. Two of the fourProgrammes are managed jointly with Southwark Clinical Commissioners. This programme structure is set out below;

South East London Joint PCT Boards

F

Joint Lambeth and

reducing inappropriate

Lambeth Clinical Commissioning

Collaborative Board

Mental Health Lambeth Living Well

Collaborative

Southwark GP Leads

Operations Group

Unplanned Carejoint with Southwark

Urgent Care

rail Older People Forensic services

Payment by Results Talking Therapies/

Counselling Dementia

Staying HealthyAccess to preventionTobacco and alcoholAdult and Childhood obesityPhysical activityPoverty

Health determinants

Planned carejoint with Southwarkmanagement of longterm conditions(including HIV)early detectionsecondary preventionmanagement of electivecare in the mostappropriate settingsshifting service provisionpromoting appropriatereferral

Page 5 of 46

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4. Summary of our Business Plan

Programme Lead Director Clinical Lead Page

Oversight and Leadership Andrew Eyres Adrian McLachlan

1. Our Operational DeliveryPlanned care Programme Moira McGrath John Balazs/Ruth Jeffery/ Adrian

McLachlan7

Unplanned Care Programme Andrew Eyres Gillian Ellsbury/Patricia Kirkman

10Frail Older People Helen Charlesworth-MayUrgent Care Moira McGrath

Mental Health Helen Charlesworth-May Raj Mitra/ Ray Walsh / Adrian McLachlan 13Staying Healthy Ruth Wallis John Balazs / Raj Mitra/ RuthJeffery 17Contract Performance Moira McGrath/ Helen

Charlesworth MayJohn Balazs/Ruth Jeffery /Gillian EllsburyRaj Mitra/ Ray Walsh /Patricia Kirkman

21

2. Our Organisational Development 27Development of Clinical Commissioning Una Dalton Adrian McLachlanPublic and Patient Engagement Una Dalton John BalazsEqualities Ruth Wallis TbcHealth and Wellbeing Board Development Helen Charlesworth-May Patricia Kirkman

3. Our Governance and Assurance 30Corporate governance and quality assurance Una Dalton Raj Mitra / Adrian McLachlanFinancial governance, VFM and assurance Christine Caton Gillian Ellsbury

Integral to our Business Plan is the delivery of our Integrated Plan so QIPP plans, CQUIN schemes and performance standardshave been assigned to individual programmes/objectives, with identified leads. A summary is included at Appendices A, B and C.A glossary of staff initials and contact details is included at Appendix D.

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Our Operational Delivery: To deliver agreed priority programmes with robust operational risk andfinancial management and effective high quality care.

5. 1 Planned Care Programme Senior Responsible Officer: Moira McGrath

To develop and deliver an outpatient strategy, which reduces the risk of premature mortality and improve quality of life by:- sustaining the control of long term conditions (including HIV) and preventing risk of acute events in people with a LTC- early detectionsecondary prevention- securing the quality, equity and productivity in the management of elective condition and identifying the most appropriate

settings for treatment i.e. local v hospital based- facilitating patient-centred care, with a shift in service provision along the care pathway, for identified priorities, from treatment

to prevention- Promoting appropriate referral- Reducing inappropriate variability in care

The strategy will inform and be informed by KHP strategy. The strategy will enable infrastructure planning, including AkermanRoad, Norwood Hall and a review of Gracefield Gardens Neighbourhood Resource Centre and the programme will overseeimplementation of appropriate referral management processes.

The programme will be developed and managed jointly with Southwark clinical commissioners.

QIPP, Key targets and CQUINS

QIPP - All projects comprising the programme are based on QIPP assumptions as set out in Appendix A (ii).

Key targets (for a detailed list of key performance measures refer to Appendix B): % of blood pressure control in people with CHD (WCC) % of patients with diabetes who have HbA1c of 8.5 or less (excluding exceptions) (WCC) Diabetic retinopathy screening

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Reduction in premature all circulatory disease mortality (mortality under 75 years old) (VSB02) All age all cause mortality (VSB01) Cancer mortality (VSB03) Reduction in late diagnosis of HIV Referral to treatment (RTT) waiting times including cancer waits Breast, bowel and cervical screening People with LTCs feeling independent Emergency admissions for LTC All first OP attendances (including following GP referral or other referrals) Late diagnosis of HIV (WCC)Review other key targets in relation to NHS, Public health and social care outcomes frameworks as this develops further.

CQUIN (for a full list of CQUINs refer to Appendix C): Adaption of Enhanced Recovery Models of Care Maternity Expand HIV testing in non-GUM acute settings

Key Objectives Lead Actions DateTo deliver reductions in outpatientattendances:-

GP/GDP first outpatientreferrals of 7300 attendances

Consultant to Consultantreferrals of 650

Follow ups of 21,300

LD/TF Define programme and project scope across elective, LTCand sexual health, key deliverables and contribution ofrelative projects to QIP

Establish governance and programme managementarrangements, including draft of Terms of Reference

Develop and agree project plans, trajectories andperformance monitoring with key stakeholders ensuringability to report with appropriate granularity from agreed2011/12 contracts

Identify 2010/11 pilot services ready for commissioningprocurement and agree process for managingprocurement process

May 2011

Mid June2011Mid June2011

End July2011

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Key Objectives Lead Actions DateTo improve health outcomes forpeople with diabetes (HBA1c asproxy), CVD (blood pressure controlbelow 150/90) and COPD/Asthma(diagnosis of COPD/Asthma viaspirometry)

TF Monitor in-year performance Develop models of care and assess impact for 12/13 Agree market management process and provider capacity

for 2012 provision and beyond

OngoingSept 2011Sept 2011

To design, implement and monitorappropriate care pathways fordefined elective and LTC areas.Where appropriate to commissioncommunity based services as part ofthese pathways

LD/TF Agree contract performance management arrangementsevaluation criteria

Identify next phase of priorities Inform 2012/13 contracting round Develop models of care and assess impact for 12/13 Agree market management process and provider capacity

for 2012 provision and beyond

Ongoing

Sept 2011Sept 2011Sept 2011Sept 2011

To improve the quality andeffectiveness of care pathwaysacross sexual health and HIVprovision

AY Deliver QIPP Plan for 2011/12 Review HIV care and support provision across Lambeth Develop model for HIV as a LTC Refresh sexual healthstrategy for LSL Increase HIV testing

July 2011Sept 2011March 2012March 2012On-going

To complete the business case forfinancial close for Norwood Hall.–implement business case and secureservices Akerman Road . Review andevaluate service provision atGracefield Gardens ensuring ongoingcost effective use of the site.

TF Agree next stage approach to Gracefield Gardensevaluation

Review proposed service strategies Move to Financial Close for Norwood Hall Draw up action plan for operational implementation for

Akerman Road Review results of Gracefield Gardens evaluation

May 2011

June 2011July 2011August 2011

Sept 2011

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5.2 Unplanned Care Programme Senior Responsible Officer: Andrew Eyres

Lambeth continues to have a high number of non-elective admissions compared to London and England and a high level ofreliance on hospital based care. Local audits show that between 40-60% of people attending A&E could have their care providedsafely and appropriately in primary and community settings. The major service challenge includes the need to improve equitableaccess, quality and capacity/capability of primary care services to manage care more effectively including out of hours, to identifyareas that need require whole system pathway redesign

The Unplanned Care Programme will operate across two main workstreams: Frail Elderly, (including admission avoidance and intermediate care) Urgent Care, (including Urgent Care Centres and Out of Hours).

The Programme will be developed and managed jointly with Southwark clinical commissioners and will be further supportedthrough the King’s Health Partners Integrated Care Project.

The aim of the Unplanned Care Programme to is to design and implement improved unplanned care services across the twoboroughs that support improved health outcomes through greater planned and co-ordinated care. This will be reflected in lowerA&E attendances and subsequent emergency admissions, fewer readmissions, enhanced quality of care and the delivery ofnational standards. This is a key area of QIPP delivery in enhanced quality and improved productivity of care.


QIPP – All projects comprising the programme are based on QIPP assumptions as set out in Appendix A(ii).

Key targets (for a detailed list of key performance measures refer to Appendix B): A&E performance measures (All clinical indicators – 5 headline measures) Emergency re-admissions Delayed Transfers of Care % deaths at home (WCC)

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CQUINS (for a full list of CQUINs refer to Appendix C): To prevent the development/deterioration of all grades of pressure ulcers in acute/community (IP & DN services) To reduce the incidence of falls resulting in harm, and streamline falls service provision Identify those at end of life and improve their pathway of care, ensuring that this is streamlined across services and

achieving quality standards To encourage effective communications between community (DNs/HVs) and GPs Discharge arrangements/ Communication

Key Objectives Lead Actions DateFrail Older PeopleTo reduce the number of avoidablehospital admissions for people withdiabetes and COPD

TF Develop and agree business case for new diabetescommunity service

Negotiate price and delivery model Implementation Agree implementation model for COPD business case Implement new model

July 2011

Sept 2011Dec 2011

June 2011Sept 2011

To develop a virtual hospital athome service

LC Agree virtual hospital model Map and review existing services targeted at admission

avoidance, agree bench marking information. Demand andcapacity review

Development of clinical pathways for priority conditions withassociated KPIs

Implementation

Jun 2011Sept 2011

Sept 2011

Dec 2011

Roll out of reablement programme LC Implement phase 3 of reablement pilot. Tender for reablement provider via domiciliary care process

July 20112012

Review future commissioning ofIntermediate Care

MM Scope review of Intermediate care Develop commissioning strategy to inform 2012/13

contracting round

Jul 2011Sept 2011

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Key Objectives Lead Actions DateTo reduce the number of avoidableemergency readmissions

LC To undertake further analysis of reasons for readmissionsand agree priorities

To fully engage with KHP Integrated care pilot To assess assistive technology pilots with focus on reduction

of admissions Roll out of virtual hospital at home scheme To scope out the review of intermediate care services

June 2011

On-goingSept 11

Dec 11July 2011

To reduce the number of peopledying in hospital who would prefer todie at home

LC To agree trajectories on targets for the roll out of the GoldElectronic Patient Register

Review and revise GSF and care home LES Evaluation of Care Home GSF implementation Work with EOLC Modernisation Initiative on exit strategy and

commissioning priorities for 2012/12

June 2011

June 2011Sept 2011Dec 2011

Urgent CareRe-commission urgent care centresin A&E

TF Market testing exercise Explore pilot co-location of GP OOH in A&Es Commissioning case for change developed Specification finalised Procurement advertised Preferred provider awarded New service commences

June 2011July 2011July 2011July 2011July 2011Jan 2012April 2012

Implement a single point of accessand 111 number

TF Scope project in partnership with Cluster Review work of national pilots Develop project plan

July 2011July 2011Aug 2011

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5.3 Mental Health Programme Senior Responsible Officer: Helen Charlesworth May

The mental health programme is a continuation of the work that has been carried out over the past year to re-design key mentalhealth services, including for people with severe mental illness (SMI), and forensic services, and payment by results. The review oftalking therapies is also to be taken forward, setting this in the context of care pathways for people experiencing anxiety anddepression. In addition a new workstream for care of people with dementia is being developed.

Transforming primary and community mental health services (for people with severe mental illness)The 2011/12 work programme will build on the work initiated by the Lambeth Living Well Collaborative in 2010 and scale up theinitial new service offer targeting people with SMI from July 2011 underpinned by a business case, to be agreed by June 2011. It isexpected that people receiving services will spend less time in secondary care, that more people (1,000 over 4 years) will besupported by primary care and the voluntary sector, through peer support and with a greater focus on self care and management.

Forensic servicesThis workstream will continue in conjunction with the criminal justice system/forensic service redesign project, to agree plans withSlaM to reduce Medium Secure provision by up to 50% by improved case management, recovery and early intervention andchange in the way Mental Health Act 1983 section and court / hospital orders are deployed.

Payment by ResultsPreparation for payment by results in mental health will continue along with roll out of self directed support and the personal healthbudget pilot.

Talking Therapies/Counselling servicesConsideration of current service delivery is underway for IAPT and primary care counselling as both contracts are due to expireduring 2011/12. Proposals to re-commission and tender services will be considered during 2011 with the aim of new servicearrangements from April 2012 based on agreed care pathways for people experiencing anxiety and depression and other commonmental disorders.

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DementiaThe programme will prioritise delivery of the national dementia strategy. This will include the mobilisation of services from CliftonHouse, the evaluation of the first stage of the local memory service, extension of assistive technology solutions for people withdementia, a review of institutional care including continuing care for people with dementia, the provision of domiciliary care forpeople with dementia, improving the quality of health care experiences for people with dementia, working with primary care onrecognising dementia and appropriately referring, and reviewing the carer’s strategy to ensure it is meeting the needs of carers ofpeople with dementia.


QIPP 2011/12: CMHT reconfiguration; Day services review, £1,357,000QIPP 2012/13: Forensic services redesign; continuation of AMH service redesign (LLWC) £3,628,000All projects comprising the programme are based on QIPP assumptions as set out in Appendix A(ii).

Key targets include: CPA 7 day follow up – SQU15 Crisis resolution/Home Treatment – SQU 13/14 Early Intervention in psychosis IAPT – numbers into treatment Local – numbers of secondary care users in employment ; settled accommodation

All four CQUIN targets from SlaM contract are designed to support transforming primary and community mental health services(quarterly reporting cycle).

1. Improved access and referral arrangements for mental health services2. Recovery3. Physical health care4. Patient reported outcomes

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Objective Lead Actions DateTo develop and implement newservice offer targeting people withsevere and enduring mental Illness,including the Lambeth Living WellCollaborative (LLWC)

DO’R Agree business case developed via the LLWC includingtransitional funding requirements for expanded service offer andcontribution to QIPP savings target

Commence primary care mental health support service as partof new service offer

Agree resource centre (Effra Rd) provision and contractarrangements for service commencement

Complete feasibility of possible social impact bond initiativeAND GSST bid to support service offer delivery via Third sector(includes CJS project)

Roll out Collaborative service offer across all 52 practices fromJuly 2011

Enable 200 people to access the new service offer Organise workshops for all partners and specific GP events to

support implementation and participation

Jun 2011

Jun 2011

Nov 2011

July 2011

ongoing

Mar 2012Jun/Sept/Dec 2011

To develop and implement recoveryfocussed care pathways for peoplewith mental health problems incontact with the Criminal JusticeSystem (CJS)

DO’R Agree MSU disinvestment-reinvestment strategy includingcontribution to QIPP savings target

Commence hybrid orders and triage pilots in relation to MDO(mentally disordered offenders)

Monitor impact of new CJS mental health service on AMH andForensic services

Agree FIPTS exit strategy

July 2011

Jun 2011

quarterly

Sept 2011

To develop an integrated approachto the delivery of therapy andcounselling services for people withanxiety and depression

DO’R Agree TT/counselling services strategy including care pathways Commence procurement process for integrated service Agree terms with providers for service commencement 4/12

Sept 2011Sept 2011Feb 2012

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Objective Lead Actions DateTo implement Payment by Results(PbR)/self directed care programme

DO’R Meet national timetable – i.e. HoNOS clustering by 12/11 andlocal tariff by 3/12

Agree four borough approach to tariff with SlaM Clarify implications of roll out of LLWC offer with PbyR

arrangements and commissioning strategy for 12-13. Meet local authority SDS target Complete review of Personal Health Budget pilot

Mar 2012

Sept 2011Sept 2011

Mar 2012Mar 2012

To deliver 2011/12 dementiastrategy priorites

LC Clifton House mobilisation Assistive technology to aid those with dementia Domiciliary care services retendering Review of care homes demand and the local market Using learning from publicised poor quality care to improve care

locally Work with GPs regarding recognising dementia & referring

appropriately Review of carers strategy

Jun 2011Ongoing

2012Jun 2011ongoing

Sept 2011

Nov 2011

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5.4 Staying Healthy Programme Senior Responsible Officer: Ruth Wallis

To improve health outcomes for Lambeth residents through the commissioning of systematic health promotion and preventionservices that have the effect of improving mortality rates, reducing morbidity, reducing the prevalence/incidence of key risk factorsand reducing health inequalities. The Programme covers the following areas; Smoking Cessation and Tobacco Control, NHSHealth Checks (Vascular Checks), Adult Obesity and Physical activity, Alcohol Prevention, Lambeth Early Intervention andPrevention Service, Sexual Health and Infection Prevention.

The staying healthy programme will include the Children’s Programme Board which will be concentrating on the implementation ofa programme which aims to begin to stem the tide of increasing childhood obesity levels in Lambeth. Some evidence tounderstand the scale of the problem locally has begun to emerge through the implementation of the National ChildhoodMeasurement Programme (NCMP). Results of the NCMP (2009/10) (average participation of 93%) showed levels of obesity inLambeth for Reception and Year 6 children were 12.9% and 25.1% respectively, which are significantly higher than the nationalaverage and slightly higher than the London average. Five areas of work have been identified:


All projects comprising the programme are based on QIPP assumptions as set out in Appendix A(ii).

Key targets (for a detailed list of key performance measures refer to Appendix B): Increased uptake of all immunisations Improve % of imms given by HV to hard to reach groups Number of eligible people who have been offered and/or received an NHS Health Check Smoking Quitters at 4 weeks 2011/12 (WCC) HbA1c Management (WCC) CHD Blood Pressure Management (WCC) Reduction of childhood obesity as measured through the National Child measurement Programme (Year 6) - WCC

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CQUINS (for a full list of CQUINs refer to Appendix C): Increase the no. of 5 year or under children receiving vaccinations through HV intervention Smoking cessation (GSTT)

Objective Lead Actions DateTo reduce health inequalities andimprove health, identifying the needfor interventions that improvepopulation health (including mentalwell-being) such as environment,physical activity, nutrition and linkingthese wider determinants to thedelivery and management ofpreventable LTC

RW/TF

Establish an internal PH led Staying Healthy Group to: Develop/agree business case for diabetes community service Negotiate price and delivery model for the implementation of

diabetes service Implementation of the new diabetes community service Identify PH priorities and gaps Scope BSU projects to address priorities Scope the potential for partnership projects to address priorities Take forward early outcomes from socio-economic research,

considering how this research can be used to reduce healthinequalities and improve patient care.

Oversee implementation of the SH plans Present proposals and recommendations for 2012/3 to LCCCB

June 2011Oct 2011

Nov 2011Sep 2011Dec 2011Dec 2011

Mar 2012

Mar 2012Mar 2012

To implement the Lambeth NHSHealth Checks more systematicallyin line with agreed target

TF Confirm accurate reporting mechanisms. Increase practice uptake of Service Level Agreement Establish an outreach team to work with local community

groups to target high risk/high need groups Review quality of Health Checks provided Review interim findings at regular stages of evaluation prog Model the health and cost benefits of the programme

June 2011July 2011Mar 2012

Mar 2012OngoingSep 2011

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Objective Lead Actions DateTo deliver the Smoking Cessation andTobacco Control commitments by:

(a) Meeting the DH 4 week quittarget ensuring priority groups(Routine & manual, pregnantand BME smokers) aretargeted

(b) Implementing the LambethTobacco Control Strategy inpartnership with key stakeholders

TF/BO

Support providers to systematically improve success rates,reinforcing this through Service Level Agreements withproviders and the offer of refresher training

Agree LSSS business plan Explore opportunities for additional resources to support the

gathering of further intelligence around smoking in pregnancy inline with NST recommendations.

Support the Lambeth Tobacco Control Alliance in joint working,advocacy and the implementation of Tobacco Control strategy

Explore opportunities for further resourcing for addressingtobacco use with children and young people in a moresystematic way.

Mar 2012

July 2011July 2011

Mar 2012

July 2011

To explore ways to take forward thecost-saving alcohol preventioninterventions identified in the PublicHealth modelling work

TF/AM

Update the findings from the prevention modelling paper andagree priority interventions with partners.

Further develop the screening and brief intervention training tostaff/settings identified in the NICE guidance in cooperation withkey partners in the Council and elsewhere.

Aug 2011

Sept 2011

To support the LCH implementation ofthe new Lambeth Early Interventionand Prevention (LEIP) Service

TF/BO

To support LCH to develop new service, ensuring evidencebased approaches are adopted

Ensure appropriate monitoring systems in place to enableadequate evaluation of service.

Sign off of the final specification and monitoring arrangements Support LCH tin launching and publicising new service Make the links with relevant specialist LTC teams e.g. diabetes,

respiratory and heart failure

Aug 2011

July 2011

July 2011June 2011June 2011

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Objective Lead Actions DateTo implement the Childhood Obesityprogramme

Expressions of interest and tendering information developed forall services

Extension to MEND programme until end of July 2011 Recruitment to School Nurse post Initiation of Baby Friendly Initiative Extension of the Level 1 Lambeth Healthy Weight training to

include children centre staff Commission and implement school support package Commission and implement weight management programmes Completion of NCMP (2010/11) exercise Analysis of results of 2010 NCMP

May 2011

Mar 2012June 2011April 2011Sept 2011

Sept 2011Sept 2011July 2011July 2011

To ensure promoting mental wellbeingis included as an element of all healthimprovement work

Health Improvement services include promoting mentalwellbeing for all in their remit

Establish and maintain better links between Health Trainers andIAPT workers

Ensure frontline staff receive Mental Health First Aid andwellbeing training

Ensure health promotion campaigns include emotionalwellbeing element

Forge stronger links between Staying Healthy and MentalHealth Improvement Programme work eg. Peer support, EPP

Mar 2012

Mar 2012

Mar 2012

Mar 2012

Mar 2012

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5.5 Contract management and monitoring Lead Director: Moira McGrath and Helen Charlesworth-May

To ensure that all commissioned services are procured and performance managed appropriately, including building andmaintaining relationships with all providers and ensuring local and national health care requirements are delivered through robustcontracts with providers. Where services are commissioned either jointly with the Local Authority, or as part of shared serviceagreements or any other delegated arrangements, NHS Lambeth will work jointly with partners in order to ensure the needs ofpatients are met and appropriate, co-ordinated care is commissioned throughout all aspects of the patient pathway.


QIPP assumptions are set out in Appendix A(ii).

Key targets (for a detailed list of key performance measures refer to Appendix B): Mental health easy in and out – improved access and referral Mental Health recovery Physical health care for mental health patients Patient reported outcome measures (PROMS) HCAI measures (MRSA and CDiff) Ambulance Category A response time and Urgent/Emergency journeys VTE risk assessment A&E quality indicators Stroke indicators Maternity 12 weeks Patient experience Staff engagement Carers breaks Access to dentistry Low value procedures Breast feeding

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Length of Stay (acute and MH) Daycase rate Acute bed capacity GP written referrals to hospital Elective and non-elective FFCEs

CQUINS (for a full list of CQUINs refer to Appendix C): Communications with GPs Patient experience VTE

Key Objectives Lead Actions DateTo negotiate and manage the MentalHealth contract (including contributionto development Lambeth Living WellCollaborative)

DOR Hold monthly SlaM contract performance monitoring meetings. Hold quarterly SlaM quality performance (including CQUIN )

monitoring meetings Service and coordinate bi-monthly four borough PCT/SlaM

contract meetings. Complete final schedules of 2011-12 contract by qtr1 Further develop user engagement in contract monitoring

including user led audit. Market test provision of talking therapy services with objective of

new contract arrangements by 4/12 Continue ongoing coproduction and co-design work linked to

Lambeth Living Well Collaborative and secure agreement fordisinvestment-reinvestment in collaborative service offer.

Service and coordinate the development of the 2012-13 SlaMcontract on behalf of LSL and Croydon BSUs

MonthlyQuarterly

Bi-Monthly

June 2011Ongoing

July-Mar2012

Ongoing

Oct 2011-Mar 2012

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Key Objectives Lead Actions DateTo negotiate and manage theCommunity Services Contract withGSTT and oversee the integration ofCommunity Services across Lambethand Southwark

TF Contract and Quality Meetings in place for year across Lambethand Southwark

Monitoring agreed including Performance & Quality Measures Regular Lambeth and Southwark Commissioner meetings and

agreed programme of TCS work with provider Agree programme of work with regard to integration with cluster,

acute commissioners and trusts Develop QIPP and CRES proposals for 2012/13

May 2011

June 2011July 2011

July 2011

Sept 2011

To negotiate and manage the acutecontracts ensuring financial stability

SC/SM

Contract and Quality Meetings in place for year Monitoring agreed including Performance and Quality Measures Develop QIPP and CRES proposals for 2012/13

June 2011June 2011Sept 2011

To negotiate and manage Hospicecontracts

RC/LC Monitoring of contract ensuring value for money. To ensure service provision that enables the PCT to meet its

priorities on EOLC. To engage where required with DH work on the National Palliative Care Funding Review (awaiting further info from DH)

Ongoing

TBC

To negotiate and manage Care HomeContracts

RC/LC To develop and agree local contract with Fairley House. Await further guidance from London Procurement Programme

on approach to nursing homes that are signed up to the LPP

July 2011TBC

To negotiate and manage third sectorcontracts – Domiciliary continuingcare (adults)

RC/LC To manage current contract To retender the contract as part of ACS domiciliary care

retendering exercise

On-going2012

To manage the risk associated withcontinuing care budget for olderadults, physically disabilities, learningdisabilities and EOLC

LC To ensure efficient processes are in place to manage continuingcare assessment, re-assessment & decision making processes

To comply with NHS London reporting requirements. To provide quarterly activity and financial reports to the

Operational group identifying risk areas at an early stage

On-going

On-goingFrom Q1

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Key Objectives Lead Actions DateTo negotiate and develop primarycare capacity linked to managementof patients with SMI and CMI as partof the Lambeth Living WellCollaborative

DOR Finalise contract for provision of primary care mental healthsupport service with Clapham Family practice

Agree plans to scale up MH support and secure services Liaise with SE Cluster primary care contract lead over core

contract requirements

June 2011

Sept 2011Ongoing

To negotiate and manage voluntarysector contracts (includingcontribution to Lambeth Living WellCollaborative)

DOR Hold quarterly contract monitoring meetings with MH providers Further develop user engagement in MH contract monitoring Continue ongoing coproduction and co-design work linked to

Lambeth Living Well Collaborative

QuarterlyOngoing

To negotiate and manage HMPBrixton health care contract

DOR Hold monthly contract performance meetings with Care UK. Hold quarterly partnership meetings. Prepare for tendering of health care services during 12-13

(contract renewal April 2013)

MonthlyQuarterly

Oct 11onwards

To commissioning a full range ofhealth services for children

FM

FM

FM

FM

Commissioning of CAMHS services to include full review ofStrategy and Needs Assessment

Manage Continuing Care packages for individual children andfamilies working with colleagues from Local Authority, Lewishamand Southwark PCT’s

Commissioning services for children with disabilities and theirfamilies including the implementation of the Aiming Highprogramme in partnership with Local Authority

Commissioning services to manage and monitoring coveragefor all child health requirements including breastfeeding,childhood immunisations, screening programmes to nationaland local targets. Working with Public Health colleagues toidentify areas of concern and commission services accordingly.Work with Local Authority to support children’s health in earlyyears, schools and youth settings, including Children’s Centres.

Mar 2012

Ongoing

Ongoing

Ongoing

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Key Objectives Lead Actions DateTo commission a programme of workto ensure the continued reduction ofunder 18 conceptions and support toteenage parents.

GM Implement the Teenage Pregnancy & Parenthood Action Plan. Commission providers to support schools deliver high quality

programmes on sex and relationships, emotional health andwell being, and substance misuse to young people

Commission services to increase vulnerable young people’saccess to sexual health advice, information and services.

Commission workforce training to increase capacity andcapability of those working with young people to talk to themabout relationships and sexual health as well as other healthissues and signpost them to appropriate services

Commission a provider to support young parents through one toone and group work to improve health, social and economicoutcomes for themselves and their children.

Ongoing

Sept 2011

June 2011

June2011

June/Sept2011

To commission a range of healthservices for adults with learningdisabilities

AMcT To undertake NHS London LD Self Assessment To manage the dissolving of the pooled budget arrangements Integration of SLAM health team into GSTT and implementation

of monitoring processes To manage continuing care packages and to ensure processes

are in place for assessment and on-going review Monitoring of LD DES Implementation of Valuing People Now action plan

July 2011

Sept 11

Ongoing

OngoingOngoing

To commission a range of servicesand initiatives to improve awareness,detection and treatment of cancer

LC Implementation of NHS Lambeth action plan on improvingbreast screening uptake

Monitoring of NAEDI initiatives with other PCTs Monitoring of cancer waiting times working closely with the

cancer network to improve performance Participate in peer review programme via cancer locality group Hold quarterly monitoring meeting for the CHANT services

Ongoing

OngoingOngoing

Mar 2012Ongoing

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Key Objectives Lead Actions DateTo manage the new contractualarrangements for communityequipment

LC Hold joint quarterly contract monitoring meeting with LBL andthe provider

Hold bi-monthly TCES meetings to oversee the implementationof the new contract

Ongoing

Ongoing

To coordinate the 2011/12 winterplanning arrangements

LC To ensure all local providers have robust winter plans in place To coordinate plans into a joint Lambeth/Southwark winter plan To ensure robust monitoring/reporting mechanism are in place

Sept 11Oct 11

Feb 2012

Ensure safe and cost effectivemedicines management andprescribing across Lambeth

VB New Accountable Officer for Controlled Drugs in place Agree primary care focus QIPP areas and incentive schemes Launch with practices Agree AO functions moving forward with cluster Consult on developing a commissioner- led local decision

making group jointly with cluster/LSL to take a populationapproach to managed entry of new drugs locally.

Review and monitoring of acute prescribing in partnership withcluster acute commissioning team

Provide professional pharmaceutical advice for the ExceptionalTreatment Arrangements panel, include this in decision makingand facilitate feedback from panel into business planning

Ensuring that legal aspects of medicines purchasing, storage,prescribing, supply, administration and destruction are adheredto including prevention, detection of fraud, issues of concernand delivery and support of Controlled Drugs requirements.

April 2011May 2011June 2011Aug 2011Oct 2011

Ongoing

Ongoing

Ongoing

To negotiate and manage thecontracts for sexual health, HIVvoluntary sector and terminations ofpregnancy

AY Monitoring contracts against agreed SLAs Implement contract changes to deliver QIPP Procure HIV care and support services Implement sexual health tariff across GUM and community

sexual health services

On-goingJune 2011April 2012April 2012

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Our Organisational Development: To manage the transition of commissioning responsibility to GPConsortia and the establishment of new Health and Wellbeing arrangements, within the context ofengaging public and patients and managing equalities.

6.1 Organisational Development Programme Lead Director: Una Dalton

A structured approach will be undertaken to identify the development needs of the LCCCB and NHS Lambeth with the intention thatfull commissioning responsibility transfers to the GP Consortia in 2012/13 and new Health and Wellbeing arrangements are in placefrom April 2013. NHS London has developed a Pathfinder Toolkit which provides a core development support programme for GPPathfinders and this will be used to map out a development plan. The development plan will cover empowering patient and thepublic, vision and strategy, finance, leadership, clinical/corporate governance, planning, agreeing, monitoring, skills and capacity,process and IM&T.

Key Objectives Lead Actions DateTo manage the transition to ClinicalLed Commissioning, including: Consortia Support BSU Development

JC Ensure transitional working arrangements are communicated toLCCCB, NHS Lambeth staff and practices

Submit Pathfinder Delivery Plan to cluster Appoint external provider to support delivery of Pathfinder Toolkit Identify development needs for LCCCB, internal

commissioning/support staff and practices to be effectivecommissioners (supported by external provider)

Create an effective and accountable leadership team Develop transformational leadership skills of key clinical and

managerial leaders Develop Clinical Network across a broad range of clinicians to

support clinical commissioning

June 2011

June 2011Aug 2011Sept 2011

Dec 2011Jan 2012

Aug 2011

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Key Objectives Lead Actions DateTo embed Patient and PublicEngagement

CF Develop annual patient and public engagement plan withprogramme leads & clinical commissioners; prioritise areas forsupport

Develop / inform / deliver engagement training programme &support tools for clinical board & programme leads

Establish reporting structures & assurance framework forengagement

Facilitate commissioner engagement in community events Manage / support engagement events & mechanisms Engage with and through LINk / Local HealthWatch, refresh

protocols Scrutiny relationships – induction with clinical board Systematic links with voluntary sector Inform residents of engagement opportunities Produce annual report on engagement in commissioning

June 2011

From May

July 2011

From JuneFrom MayJune 2011

June 2011From MayFrom MaySept 2011

To manage equalities SC Engage with the south east London cluster arrangements forassuring equality and equity and with local partners both to shareexpertise and to assert a health agenda in equality work

Identify a lead LCCCB clinician for equality and human rights towork with public health and the cluster lead to develop a coherentand effective approach.

With SEL Cluster, agree an approach to commissioning forequality and equity and how assurance will be demonstrated

Engage LCCCB on both the accountabilities and methods forcommissioning for equity and equality so as to set objectives for2011-2012 that will meet anticipated requirements of theDepartment of Health Equality Delivery System

Ongoing

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Key Objectives Lead Actions DateTo support the development of theHealth and Well Being Board

HC-M/RW

Use the outputs from the series of facilitated workshops to informthe development of the shadow H&WB board

Lead the development of JSNA to inform commissioning and thework of the H&WB board

Develop role for Public Health in H&WB Board

April 2012

To lead the local/Lambethdevelopment of the Public Healthfunction, in the context of HealthyLives/Healthy People and theorganisational change

RW Programme for Public Health work with local authorities, clinicalled commissioning and the sector in collaboration with clusterDirectors of PH

Liaise with NHS London in the development of Public Health andPublic Health England

Contribute to national requirements

April 2012

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Our Governance and Assurance: To ensure systems and processes are in place to support individual,team and corporate accountability for delivering patient centred, safe, high quality care within resourcelimits.

7.1 Governance and AssuranceLead Director: Una Dalton (Corporate Governance and Quality assurance), Christine Caton (Finance)

To ensure that systems and processes are in place to support individual, team and corporate accountability for delivering safe, highquality, patient-centered care within financial resource limits and as set out in the Integrated Plan, as part of delivering its overallstatutory financial targets. The organisation is responsible for delivering on key performance indicators and targets (local, regionaland national) and financial objectives which includes the delivery of its Quality Improvement Productivity and Prevention (QIPP)programme. A structured approach will be taken to ensure that there are robust governance structures and processes in place formanaging delegated responsibilities. We will work closely in partnership with the SE London Cluster in order to achieve financialbalance. We will ensure that financial controls are effective, that financial systems are managed efficiently and that the organisationcan demonstrate accountability for the use of public funds.

Key targets

Key targets (for a detailed list of key performance measures refer to Appendix B): Financial forecast out-turn and performance against plan Financial performance scores for NHS Trusts Progress on delivery of QIPP Total pay costs Year to date financial position NHS Trusts Break even duty Delivery of 2% recurrent headroom PCT legacy debt position Underlying financial position of PCTs and NHS Trusts

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Key Objectives Lead Actions DateEnsure the Clinical Board receivesappropriate infor

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