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Clinical Assurance Structure. Guide for Clinicians and Commissioners. Transition to a National Specialised Commissioning Team. - PowerPoint PPT Presentation
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Clinical Assurance StructureGuide for Clinicians and Commissioners
Transition to a National Specialised Commissioning Team
• During July 2011 the NHS Management Board confirmed that there would be four SHA clusters established across England. These will form the sub-national arrangements of the NHS Commissioning Board (NHSCB) when it is formally established in April 2013.
• The NHSCB will deliver specialised commissioning functions through a single operating model and a national leadership team will be formed, with teams based in the four geographic sectors; these teams will undertake the co-ordination of key functions.
• The previous 10 SCGs have clustered in line with SHA geography with a work programme to merge and work as a single team by the start of Q3 2012/13.
The Specialised Commissioning Transition Oversight Group
• This group is established to: put in place oversight arrangements to allow for clear recommendations to be made to the NHS Commissioning regarding the form and function of ‘specialised service’ commissioning.
• This group is chaired by Moira Dumma, SHA Lead Midlands & East, and membership includes:• Chairs of the cluster SCGs (4)• Cluster SHA leads for specialised commissioning (4)• National transition team (6)• Chair of the Transition Directors Group• Chairs of 3 Assurance Groups
The Transition Oversight Group Subcommittees
Transition Oversight Group
Chair: Moira Dumma
Clinical Assurance
GroupChair: James Palmer
Finance Assurance
GroupChair: Vanessa Harris
PPE Steering Group
Chair: Sally Brearly
Note: In Phase I of specialised services transition a group was formed called ‘CAG’ – the clinical advisory group. This group had a specific remit about advising the DH on the scope of services that should be directly commissioned. Currently stood down this group will be reformed as part of the Group 3 work (see later)
The Clinical Assurance Group
• Reporting to the Transition Oversight Group, this assurance group is being established as part of the project framework to deliver change in specialised commissioning. The group will seek to provide assurance that the products (see later) of commissioning have clinical support from as broad a range of sectors and services as possible.
• The Chair is James Palmer, Transition Programme Lead for Quality & Innovation and also currently Medical Director for SW SCG, and a Consultant Neurosurgeon at Plymouth Hospitals NHS Trust.
• Membership of the group includes a Clinical Lead from each of the cluster SCGs, Public Health Leads from the cluster SCGs, and Five Care Group Chairs formed from the constituent Clinical Reference Group chairs (see later).
• Monthly meetings will be in person every other month and by web conference the other month.
The Products of Specialised Commissioning
• The products of commissioning include:• national service specifications• treatment approval policies• quality measures• innovation portfolios.
Programmes of Care
Clin
ical
Ass
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Digestion, renal and hepatobiliary and circulatory system
Infection, cancer, immunity and haematology
Secure and specialised mental health
Traumatic injury, orthopaedics, head and neck and rehabilitation
Women and children’s health, congenital and inherited diseases
Five Programmes of Care will be formed under the Clinical Assurance Group. A single chair for each Programme of Care will be selected from the Chairs of the constituent service specific clinical reference groups.
Clinical Reference Groups
Transition Oversight Group
Clinical Assurance Group
Programmes of Care
Clinical Reference Group
Working below the Programmes of Care and hence the Clinical Assurance Group will be a number of National Clinical Reference Groups. These will be established for each of the specialised services within the SSNDS portfolio. These groups will have the same terms of reference to identify the scope of the work focussed on securing high quality ‘products’ of commissioning. These groups do not have an operational role in delivery of services but may be asked to provide expert advice to the cluster SCG teams. The chairs have been appointed through national advertisement for this voluntary role.
Clin
ica
l Ass
ura
nce
Gro
up
Mental health – secure and specialised mental
health
Specialised Services for Eating Disorders
Forensic and Secure Mental Health
Specialised Mental Health Services for the Deaf
Gender Identity Disorder
Perinatal Mental Health
Tier 4 Child & Adolescent Mental Health Services
Women and children’s health, congenital and
inherited diseases
Infection, cancer, immunity and haematology
Traumatic injury, orthopaedics, head and neck and rehabilitation
Digestion, renal and hepatobiliary and circulatory system
Clin
ica
l Ass
ura
nce
Gro
up
Mental health – secure and specialised mental
health
Women and children’s health, congenital and
inherited diseases
Medical Genetics
Paediatric Surgery
Paediatric Medicine
Paediatric Cancer Services
Paediatric Cardiac Services
Metabolic disorders
Paediatric Intensive Care
Neonatal Critical Care
Paediatric Neurosciences
Complex Gynaecology
Specialised Maternity
Fetal Medicine
Infection, cancer, immunity and haematology
Traumatic injury, orthopaedics, head and neck and rehabilitation
Digestion, renal and hepatobiliary and circulatory system
Clin
ical
Ass
uran
ce G
roup
Mental health – secure and specialised mental
health
Women and children’s health, congenital and
inherited diseases
Infection, cancer, immunity and haematology
Radiotherapy
PET-CT
Specialised Cancer
Blood & Marrow Transplantation
Haemophilia and other bleeding disorders
HIV
Infectious Diseases
Haemoglobinopathies
Specialised Immunology and Allergy Services
Traumatic injury, orthopaedics, head and neck and rehabilitation
Digestion, renal and hepatobiliary and circulatory system
Clin
ical
Ass
uran
ce G
roup
Mental health – secure and specialised mental health
Women and children’s health, congenital and inherited
diseases
Infection, cancer, immunity and haematology
Traumatic injury, orthopaedics, head and neck and
rehabilitation
Complex Disability Equipment
Brain Injury Rehabilitation
Adult Neurosurgery
Neurosciences
Stereotactic Radiosurgery
Burn Care
Cleft Lip & Palate
Specialised Pain
Specialised Ear Surgery
Specialised Orthopaedic Services
Hyperbaric Oxygen Therapy
Specialised Ophthalmology Services
Spinal Injury
Complex Spinal Surgery
Major Trauma
Digestion, renal and hepatobiliary and circulatory
system
Clin
ical
Ass
uran
ce G
roup
Mental health – secure and specialised mental
health
Women and children’s health, congenital and
inherited diseases
Infection, cancer, immunity and haematology
Traumatic injury, orthopaedics, head and neck and rehabilitation
Digestion, renal and hepatobiliary and circulatory system
Cystic Fibrosis
Hepatobiliary and Pancreas
Specialised Medicine
Vascular Disease
Morbid Obesity Surgery
Renal Dialysis
Renal Transplant
Specialised Colorectal Services
Complex Invasive Cardiology
Cardiac Surgery
Pulmonary Hypertension
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The Membership Structure of the Clinical Reference Group
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The Chair of the Clinical Reference Group
• The chairs of the clinical reference groups have been selected through national advertisement and formal expression of interest. This was to allow as broad a field as possible to become involved with the future of specialised commissioning through its transition.
• Role Descriptor. A clinical leader in the field of the clinical service from a broad range of professional backgrounds. Experience as a clinical director, network director, medical director, or professional body leader would be desirable. The role is voluntary supported by the host NHS organisation within the professional activity component of the individual’s role. On average bi-monthly meetings of the group are held using web-conferencing supported by a national administration. A biannual summit of all chairs is planned. The role will seek consensus from the group membership on support for the key products of specialised commissioning.
• The chair reports through one of 5 Programmes of Care leads to the Clinical Assurance Group for specialised services.
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The Public Health Lead for the Clinical Reference Group
• The Public Health Lead for each Clinical Reference Group has been nominated by the Specialised Commissioning Public Health Network
• Role Descriptor. A PH Consultant with a broad experience of the service area who may have been involved in designing service specifications, setting quality standards, defining policies, or undertaking designation. They will provide the group with public health advice and with the commissioning lead act to maintain the group focus on their assurance role. They will maintain communication links to other PH consultants across the PH Network. They will be involved in and where appropriate lead the development of specifications, quality dashboards, and the development of nationally agreed policies.
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The Commissioning Lead for the Clinical Reference Group
• The Commissioning Lead for each Clinical Reference Group has been nominated by the Specialised Commissioning Group Senior Management teams. The final selection was by the Chief Operating Officers of the Cluster SCGs.
• Role Descriptor. A commissioner with a broad experience of the service area who may have been involved in designing service specifications, setting quality standards, or undertaking designation. They will provide the group with commissioning advice and act to maintain the group focus on their assurance role. They will develop communication links to other commissioners in the field in the clusters and within highly specialised services commissioning. They will be involved and where appropriate lead the development of specifications, quality dashboards and will work with the Public Health Consultant on project managing the development of nationally agreed policies.
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The Sector Clinicians for the Clinical Reference Group
• Two clinicians for each Clinical Reference Group has been nominated by the Specialised Commissioning Group Senior Management teams. Where there were more than 2 identified the final selection is by the Chair.
• Role Descriptor. Clinical leaders from a broad range of professions related to the clinical field. They will have already experienced clinical leadership roles such as clinical director, network director, or service lead. They will need to bring a thorough understanding of the clinical field and of any reports, standards, guidance and statutory responsibilities related to the field. They should represent the clinical body across the sector and in doing so should establish communication links across all providers. They will need to declare any conflicts of interest. As the meetings use Web-based conferencing, they will need access to a computer with broadband internet connectivity. This is a voluntary role supported by the individual’s host NHS organisation.
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The PPE Representatives for the Clinical Reference Group
• Two PPE representatives for each Clinical Reference Group are nominated by the PPE Steering Group. Where there were more than 2 identified the final selection is by the Chair.
• Role Descriptor. The nominee will have a thorough understanding of the clinical field from a user’s (patient’s) point of view. This may have been gained as a leader in a support group or organisation. They should represent the patient and public view and in doing so should establish communication links across all patient and public organisations related to the clinical field. They will have had experience of providing advice to NHS organisations.
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Additional Invited Representatives for the Clinical Reference Group
• Up to four additional clinical members can be invited to join the Clinical Reference Group by the Chair. These will ensure that there are links to other reference groups or cover sub-specialty areas.
• There are a further four additional members that can be invited to join the Clinical Reference Group by the Chair of the Clinical Assurance Group. There may be national organisations or other groups that wish to be formally affiliated to the Clinical Reference Group
• The minimum membership is 13 members• The maximum membership is 21 members
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Clinical Reference Group Meeting Organisation
• The Clinical Reference Groups will function as virtual groups using email communication and Webex Web Conferencing
• The use of NHS Mail allows the safe transfer of email communication. All group members will be asked to establish an NHS Mail account.
• We will develop a calendar of work for the clinical reference groups so the completion of products hits the planning milestones for 2013.
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WebEx Web Meeting
• We aim to achieve all the Clinical Reference Groups to learn the benefits of using WebEx web conferencing
• Please click the following link to see a general overview http://www.webex.co.uk/overview/index.html
• You join WebEx from your normal internet connected computer.• On the first time using Webex a control software needs to be
uploaded to your computer – an ActiveX Control. You will need administrator rights to the computer for this.
• When a meeting is set up you receive an email. Click the joining link and follow instructions. When prompted provide Webex your telephone number, Webex rings you to join the meeting.
• Test meetings will be run to ensure you can connect. Do not sign up for Webex on their website.
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Clinical Reference Group Production Teams
• The work to develop the products will be through the following Production Teams• The Specification Production Team will be lead by the CRG
Commissioning lead. The clinical membership on this team will be facilitated and approved by the Chair
• The Policy Production Team will be lead by the CRG Public Health lead and project managed by the CRG Commissioning lead. The clinical membership on this team will be facilitated and approved by the Chair
• The Quality Measures Production Team will be lead by the CRG Chair or nominated clinician. The process will be project managed by the CRG Commissioning lead
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Clinical Reference Group First Actions
1. Chairs confirm they accept the role to proceed [JDP]
2. Members nominated confirm they accept the role to proceed [JDP]
3. Vacant membership slots are filled [Chair]
4. Trial runs of Webex for members [JDP-PA]
5. Selection of Programme of Care Leads [JDP with Chairs]
6. Communication across sectors about the structure [Sector Clinicians]
7. Define a long list of specifications for the CRG [Commissioner]
8. Define a long list of polices for the CRG [PH Lead]
9. First meeting of Clinical Assurance Group to approve Clinical Reference Group Terms of Reference
10. Preparation for Spring Specialised Commissioning Summit
Specialised Commissioning Summit
• It is planned to hold a summit every 6 months for the full range of Clinical Reference Groups to meet
• The first Summit is planned on Monday 26 March and Tuesday 27 March in Bristol. The second day will be reserved for the clinical groups working on the Group 3 services.
• Attendees invited include:• All CRG Chairs• All CRG Public Health Leads• All CRG Commissioning Leads• Sector SCG Chief Operating Officers• National Transition Team
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