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Memorandum of Understanding in relation to
Joint Commissioning Arrangements within the
Leeds Health Economy
DATED: June 2013
(1) NHS Leeds North Clinical Commissioning Group (2) NHS Leeds South and East Clinical Commissioning Group
(3) NHS Leeds West Clinical Commissioning Group
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TABLE OF CONTENTS
OVERVIEW OF THE COLLABORATIVE COMMISSIONING PROCESS………………. 3 PROVIDER MANAGEMENT PROCESS……………………………………………………. 3
ROLES AND RESPONSIBILITIES……………………………………………………………3
COORDINATING CHIEF OFFICER…………………………………………………………..3
HEAD OF COMMISIONING……………………………………………………………………4
IN-YEAR ACTIVITIES…………………………………………………………………………..4
ANNUAL ACTIVITIES…………………………………………………………………………..5
PROVIDER MANAGEMENT GROUP CLINICAL LEAD……………………………………5
FINANCE LEAD…………………………………………………………………………………5
QUALITY LEAD…………………………………………………………………………………6
INFORMATION LEAD COORDINATOR……………………………………………………..7
PERFORMANCE LEAD………………………………………………………………………..7
REPORTING AND ASSURANCE…………………………………………………………….8
PROCEDURES FOR DEALING WITH DISPUTE RESOLUTION………………………...9
APPROVAL OF THE MEMORANDUM OF UNDERSTANDING…..................................11
APPENDICES
APPENDIX A: A DIAGRAMATIC OVERVIEW OF THE COLLABORATIVE
COMMISSIONING PROCESS……………………………………………..12
APPENDIX B: TABLE OF KEY ROLES ALLOCATED BY CCG…………………………14 APPENDIX C: CONTRACT MANAGEMENT STRUCTURES FOR EACH
CONTRACT…………………………………………………………………..15
APPENDIX D: CONTRACT MANAGEMENT GROUP TERMS OF REFERENCE…….19
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THE JOINT COMMISSIONING PROCESS FOR THE THREE CCGs WITHIN LEEDS
Overview of the Collaborative Commissioning Process
1. Based on the identified purposes and principles for collaborative commissioning the
CCGs have sought to develop a further clear process which will enable them to share
their local commissioning strategies, identify commonalities in order to address
strategic issues across the health community, delegate contracting responsibilities to a
coordinating representative, whilst retaining oversight and accountability for service
planning, quality and outcomes. It will allow for ongoing review of the initial analysis
completed by CCGs that have driven our ‘make’ ‘share’ and ‘buy’ decisions and
ensure that the focus of commissioning at scale whilst retaining local ownership and
local knowledge continue to provide quality and overall value for money.
2. To achieve this the MOU will expand upon the mechanisms for the three primary
collaborative commissioning activities:
(a) The development of a collaborative commissioning strategy for Three CCG
Network;
(b) The delegation of provider management to a co-ordinating organisation and
team - the Provider Management Team;
(c) The ongoing requirements of reporting, assurance and accountability upon all
the contracting CCGs-Reporting and Assurance.
Provider Management Process
3. Once the scope and intentions for commissioning a particular provider have been
confirmed across the city by the CCGs at the relevant Provider Management Group,
responsibility for management of the provider(s) will devolve to the relevant hosted
Provider Management Team, led by the appointed Co-ordinating Chief Officer.
4. The following processes will be implemented for each provider to be managed jointly: Roles and Responsibilities
5. In order to provide assurance to the CCGs regarding due process, at a minimum each
Provider Management Team must have an identified individual, able to fulfil the
following roles: (as summarised in appendix B).
Coordinating Chief Officer
6. The Coordinating Chief Officer is responsible for ensuring that:
(a) Annual contract development, negotiation and sign-off is achieved in line with
national business planning and contract timescales.
(b) Contract development, negotiation and sign-off is in line with the intentions of
the collaborating CCGs, as specified through the relevant Provider
Management Group.
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(c) The performance management of the service provider to deliver internal cost
improvement and transformation schemes
(d) Leadership of affiliated cross city transformational programmes as defined by
the Leeds Health and Social Care Transformation Programme, (all Chief
Officers retain responsibility for local implementation within CCGs)
(e) All appropriate documentation, policies and procedures are in place to
effectively manage the contract
(f) Resources required to deliver and manage the contract are in place. Where
these resources are provided by a CCG(s) other than the Coordinating Chief
Officers’ own, or by another third party the Co-ordinating Chief Officer must
ensure that lines of communication are maintained to ensure team members
have time and resources to support delivery
(g) Communicating the named individual for each role to the collaborative CCGs.
(h) Agreeing any projects that will be developed directly between the provider and
one of the collaborating CCGs on a standalone basis, either directly or through
delegated responsibility to the Provider Management Team.
(i) Ensuring that there is effective communication with each CCG party to this
agreement and with those fulfilling the named roles below such that they are
aware of all material issues relating to the performance and management of the
contract (e.g. issue of remedial breach notices, performance risks etc).
Commissioning Development and Contracting Lead
7. The Head of Commissioning will act as the main point of contact with the Service
Provider to ensure the delivery of contracted services as follows;
(a) Using professional knowledge, understanding and judgement to escalate
issues as appropriate to the Chief Officer.
(b) Ensuring that significant and material changes to contracting terms and
conditions (variations) and contract performance and associated sanctions are
regularly communicated to all CCGs via the Provider Management Group
(c) Managing the relationship with the CSU on behalf of all CCGs in Leeds in
relation to the Service Provider.
(d) Leading a team and commissioning support services to co-ordinate all
administrative activities relevant to provider management including (but not
exclusively:
(e) Recommend the agreement (or otherwise) of Remedial Actions Plans on behalf
of the Commissioners for sign-off by the co-ordinating Chief Officer.
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In Year Activities
Regular reporting of contract performance in relation to activity and
financial forecasting, challenges, risks, sanctions, performance, quality,
demand pressures.
Co-ordinating commissioning responses to reported performance
issues.
Regular communication with the provider and CCGs including
facilitation of key meetings with confirmation and communication of
dates, minutes of meetings and other information as required.
Establishing and servicing the contract management board
infrastructure and relevant subgroups to monitor performance.
Maintenance of contract documentation,
Overseeing the technical validation of activity (PbR) reporting, ensuring
that reporting is robust and that challenges are resolved in a timely way.
Annual Activities
Advise the Co-ordinating Chief Officer in relation to the contract
negotiation process;
Leading stakeholders to ensure appropriate resource are available to
develop the annual contract plan and schedules in line with national
time scales for sign off.
Co-ordinating the development of commissioning intentions for the
annual contract plan, including supporting consultation with members
across three CCGs in relation to development of quality schedules and
understanding of service pressures.
Provider Management Group Clinical Lead
8. The Clinical Lead is responsible for
(a) Providing clinical oversight and insight into the management of providers,
(b) Providing assurance back to individual CCGs.
(c) Representing the views of constituent GP members within their own CCG and
ensuring the views of their constituent CCGs are accounted for in the
commissioning and provider management process.
(d) Providing a link, through the transfer of information and communication
between primary healthcare providers, and the Co-ordination Chief Officer and
Provider Management Team.
(e) Responsible for the development of CQUIN indicators and monitoring of their in
year performance;
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Finance Lead
9. The Finance Lead is responsible for the gathering, assessment and analysis of
financial information relating to the commissioning process and ongoing contract.
(a) Using professional knowledge, understanding and judgement to escalate
issues as appropriate to the co-ordinating Chief Officer
(b) The appropriate monitoring and accounting for financial management of the
contract on behalf of the CCGs;
(c) The timely and clear communication of financial information and concerns to
the Co-ordinating Chief Officer, and via the Co-ordinating Chief Officer to other
impacted CCGs where appropriate. This includes participation in the contract
reporting process;
(d) The management of other contributing team members to ensure appropriate
resource is available to deliver and manage the service contract;
(e) Co-ordinating the payment of the contract on behalf of the collaborating CCGs
Quality Lead
Quality Lead (Hosted by Leeds West CCG)
10. The Quality Lead is responsible for
(a) The gathering, assessment and analysis of quality, safety and NICE
compliance information relating to the commissioning process
(b) Using professional knowledge, understanding and judgement to escalate
issues as appropriate to the co-ordinating Provider Management Team and
Chief Officer;
(c) Support the development of CQUIN indicators and monitoring of their in year
performance;
(d) The escalation of quality, safety and compliance concerns within the contract
management processes;
(e) Overseeing and performance managing the infection control and safeguarding
activities of providers with respect to delivering the contract and acting as the
first point of contact for the provider;
(f) The appropriate monitoring and accounting for the quality management of the
contract on behalf of the collaborating CCGs;
(g) The timely and clear communication of information and concerns regarding
quality to the Co-ordinating Chief Officer, and via the Co-ordinating Chief
Officer to other impacted CCGs where appropriate. This includes participation
in the contract reporting process; and
(h) The management of other contributing team members to ensure appropriate
resource is available to deliver and manage the service contract with respect to
quality.
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Information Lead Coordinator (Within each individual CCG)
11. Information Lead is responsible for the maintenance and ongoing monitoring of the
reporting process relating to the contract including:
(a) Using professional knowledge, understanding and judgement to escalate
issues as appropriate to the co-ordinating Chief Officer;
(b) Commissioning of contract reporting from the Commissioning Support Service
on behalf of the co-ordinating Chief Officer. This includes ensuring that the
timeliness, frequency and quality of reporting is maintained;
(c) Acting as a point of contact for requests for information regarding the contract
from interested parties, including collaborating CCGs and service providers
where the point of contact is otherwise not clear, and also other stakeholders
such as NHS CBA, the Local Authorities and others; and
(d) The management of other contributing team members to ensure appropriate
resource is available to deliver and manage the service contract.
Performance Lead / Information Lead Coordinator (Within each individual CCG)
12. The performance lead is responsible for:
(a) Monitoring contract performance against agreed standards / targets laid out in
the contract
(b) Using professional knowledge, understanding and judgement to escalate
issues as appropriate to the co-ordinating Chief Officer;
(c) Liaison and contact with equivalent Subject Matter Experts (SMEs) in the
provider organisations to gain understanding of underlying issues.
(d) Generating draft Contract Query / Performance Notices / other communications
for sign-off by the co-ordinating Chief Officer
(e) Discuss and, where necessary challenge, providers on proposed Remedial
Action Plans.
(f) Provide Statements of Assurance to the Information Lead to include in reports
to individual CCGs as part of their internal performance reporting /
management processes.
(g) Ensure that the progress of individual actions and milestones in Remedial
Actions Plans is monitored along with the impact on the required improvement
of the performance standard.
(h) Produce Contract Query / Performance Notice Closure Reports for
consideration by the Contract Management Board.
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Reporting and Assurance Reporting
13. The Provider Management Team roles and responsibilities above specify responsibility
for commissioning the required contract reporting on behalf of the Co-ordinating Chief
Officer.
14. The Co-ordinating Chief Officer has overall responsibility for the timely distribution of
reports to the CCGs and other relevant stakeholders.
15. The Co-ordinating Chief Officer must also ensure appropriate measures are in place to
ensure the quality and clarity of reported information.
16. For each contract an update report will be produced and distributed on a monthly
basis.
17. The reports for each contract will cover the following sections and information:
(a) Contract performance including year to date activity levels (absolute and in
comparison to prior year and plan, broken down by CCG and category of
contracted service)
(b) Summary of areas of over/underperformance during the month, including
thresholds for defining this. Summary of follow-up to areas of
over/underperformance in the previous month;
(c) Summary update on progress of QIPP schemes;
(d) Summary of other activities, for example CQC reviews, ongoing service
reconfigurations and so forth; and
(e) For each of the forthcoming areas the report will specify any identified issues;
explain the impact for the overall health economy; explain the impact for
specific CCGs; and, following agreement at the relevant Provider Management
Group, put forward follow-up and mitigating actions, and responsible parties.
(f) The overall aim of the reporting process will be timeliness and clarity. To
achieve this each contract will use the same reporting structure in order to aid
understanding for all users.
Ongoing assurance – obligations of Coordinating Chief Officer to the partner CCGs
18. As set out, the Co-ordinating Chief Officer takes responsibility for monitoring contract
performance.
19. They may delegate aspects of this to appropriate members of the Provider
Management Team; however the Co-ordinating Chief Officer retains overall
responsibility for the effective monitoring and communicating of concerns related to the
contract to relevant partner CCGs and to those fulfilling named roles (quality lead etc).
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This remains the case even where an aspect of the contract management (e.g.
finance, quality and so forth) is resourced by another partner CCG.
20. The Co-ordinating Chief Officer must ensure the timely escalation of contract issues
and the timely production of routine reporting in line with the process specified for the
contract.
21. Where an issue arises requiring an urgency of action beyond that afforded through the
reporting processes, the Co-ordinating Chief Officer is responsible for communicating
the issue to partner CCGs in the most appropriate and timely manner in addition to the
formal reporting.
22. Where key dates and milestones in a contract procurement and management
processes have been agreed by all CCGs the Co-ordinating Chief Officer shall
communicate any potential failure to meet such milestones as soon as it becomes
apparent that this may occur. Reporting of failures/potential failures be made in writing
and sent to the Chief Officers and clinical leads in each member CCG. They shall also
be minuted at official contract meetings and form part of the standard report to CCG
Governing Bodies.
23. Where the Co-ordinating Chief Officer relies on members of the Contracting Team who
sit outside their own CCG, they must also communicate any concerns (for example,
regarding performance or quality of work, or over or under-resourcing) to the line
management within the supporting CCG. Supporting CCGs will retain line
management responsibilities, including personal development and training, for their
own staff.
Ongoing assurance - obligations of the partner CCGs to the Co-ordinating Chief Officer
24. As stated, although the partner CCG may delegate responsibility to the Coordinating
Chief Officer to act as an agent on their behalf for a collaboratively commissioned
contract, each CCG remains accountable to their populations for the quality and
performance of commissioned services.
25. As such the Chief Officer remains responsible for identifying (through reporting),
understanding and ensuring appropriate follow-up and mitigating activity occurs for all
contract issues impacting their population and must assist the Coordinating Chief
Officer to resolve any issues identified.
Procedures for dealing with dispute resolution
26. In the event of a dispute arising from or in connection with the interpretation or
application of the functions referred to in this MOU between any two or more CCGs the
following process will be adopted.
27. Step 1
27.1 The issue in dispute shall be formally identified and raised with the appropriate
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Provider Management Team. The Provider Management Team shall use all reasonable endeavours to resolve the dispute within 5 working days.
28. Step 2
28.1 If the relevant Provider Management Team is unable to resolve the dispute within the timescales set out above, or is a party in the dispute, then both parties shall notify their respective Chief Officers.
28.2 The Chief Officers shall use all reasonable endeavours to resolve the dispute
within a further 5 working days.
28.3 The Chief Officers shall notify the Provider Management Team of their decision in writing.
29. Step 3
29.1 If the Chief Officers are unable to resolve the dispute within the timescales set out
above, unless a further extension of timescale or process is agreed by both Chief Officers, they shall refer the matter to the Managing Director of the Area Team of the NHS CBA who shall determine the matter within 10 working days.
29.2 The decision of the Managing Director of the Area Team of the NHS CBA is final.
The incumbent Chair of the Leeds Clinical Commissioning Group Network will co- ordinate this process.
29.3 The parties will provide a joint report to their respective CCG Governing Bodies
regarding their progress in implementing the next steps referred to above at its next meeting. This report will summarise the parties’ progress and identify any relevant learning’s.
Termination or Withdrawal
30. Termination of this Agreement shall not affect any rights or liabilities of the CCGs that
have accrued prior to the date of termination.
31. All three CCGs may agree, in writing, to terminate this MOU in whole or in part at any
time.
32. An individual CCG may withdraw from one or more parts of the collaborative
arrangements set out in this MOU by giving the other two CCGs not less than 6
month’s written notice at any time;
Shared Appointments and Liabilities
33. All employees within the collaborative will be employed by a CCG. The employment
vehicle will be the CCG that hosts the collaborative function which the employee is
appointed in to.
34. The CCGs shall bear the remuneration and associated employee costs arising in
connection with each of the joint posts. This will include, but are not limited to, gross
salary, income tax, national insurance, superannuation, employment tribunals or
redundancy.
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35. The remuneration and associated employee costs of the collaborative posts will be jointly funded by the three CCGs. The costs will be shared on the basis of the running cost allocation.
Approval of the Memorandum of Understanding
The following parties accept and approve these documents
NHS Leeds North Clinical Commissioning Group
Signed Date
NHS South and East Clinical Commissioning Group
Signed Date
NHS Leeds West Clinical Commissioning Group
Signed Date
APPENDIX A
A DIAGRAMATIC OVERVIEW OF THE COLLABORATIVE COMMISSIONING PROCESS
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APPENDIX B
TABLE OF KEY ROLES ALLOCATED BY CCG
CCG Collaborative
Commissioning team
(CCT) hosted
Contract lead on behalf of the three
Leeds CCGs
Provider Management Groups (PMG) chaired
& managed
Leeds North
CCGs
Mental Health and Learning
Disabilities Commissioning
team
Strategic Urgent Care
Contracting and
Commissioning Team
Informatics Transformation Programme
Management Office
LYPFT, LD pool and other mental health
contracts.
YAS, LCD, Ambulance, 111, WYUC and
other urgent care contracts
Mental Health and LD PMG
Urgent Care PMG
Leeds South
and East
CCG
Community Services and
Families
Continuing Care
Safeguarding
LCH, hospices, intermediate care,
reablement, and other contracts relating to
community, older people and children
Community PMG
Leeds West
CCG
Acute Providers including
Independent Sector and
GPWSI
LTHT, Nuffield, Spire lead commissioner.
Manage other acute contracts
Acute PMG
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APPENDIX C CONTRACT MANAGEMENT STRUCTURES FOR EACH CONTRACT
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APPENDIX D
CONTRACT MANAGEMENT GROUP TERMS OF REFERENCE
DRAFT TERMS OF REFERENCE
NHS North, West, South and East Leeds Clinical Commissioning Groups (CCG’s)
Mental Health (MH) and Learning Disability (LD) Provider Management Group
1. DOCUMENT CONTROL
1.1 VERSION 3
1.2 Review and Approval required by MH/LD Provider Management Group
Prior to sign off by each of the CCG Governing Bodies.
2 Introduction
The 3 Leeds CCG’s have agreed a collaborative approach to manage provider contracts across the city of Leeds. This approach ensures that each CCG has a representative and decision making input into how a contract is negotiated, implemented and managed.
Leeds North Clinical Commissioning Group (LNCCG) has lead responsibility for Mental Health and Learning Disability contracts on behalf of the three Leeds Clinical Commissioning Groups.
Mental Health expenditure is spread across a number of providers within and outside of the NHS. The majority of expenditure is with Leeds & York Partnership NHS Foundation Trust (LYPFT) for the provision of specialist mental health services.
Additional mental health services are contractually provided by other agencies in the city including:
Leeds Community Healthcare NHS Trust ‐ Primary Care Mental Health Service , including Improving Access to Psychological Therapies (IAPT)
Third sector agencies including Touchstone, Community Links, Leeds Mind, St Anne’s and other smaller organisations primarily providing IAPT services, rehabilitation provision, early intervention in psychosis service, peer support and mental health employment support.
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It is the combination of all of these services that contribute to the effective delivery of recovery focussed mental health services in Leeds. These are complemented by mental health services provided and commissioned by Leeds City Council. Successful outcomes for service users are delivered by effective joint working and integration across services and sectors.
Learning Disability expenditure is split between LYPFT inpatient and community provision and Continuing Healthcare provision administered through a Section 75 pooled fund agreement with Leeds City Council.
3 Purpose of Group
The purpose of the Provider Management Group is to ensure clinical value is added to the effective management of all MH and LD contracts. The group will provide the primary forum in which the CCG’s review, monitor, negotiate and implement provider contract requirements. Additionally the group will produce regular reports for CCG Boards and ensure CCG input into the contracting process.
Review and Monitor;
Activity and Finance information against plan
QIPP initiatives
PBR development plans
Quality and Performance reporting and requirements, including CQUINS Clinical Service Development plans and initiatives
Feedback and input from CCG Boards;
Produce regular high level reports and narrative of Performance and Issues arising
Initiate and recommend actions for CCG approval
Provide a forum in which to debate and agree consistent approach
Agree Negotiation Strategy
To be applied during monitoring meetings with Providers
To be applied when negotiating each years contract
4 Principles
The Provider Management Group reflects a joint commitment across the three CCGs to deliver outcome based service models that lower system costs by simplifying care pathways, reducing duplication, and improving the quality of service provided. This is underpinned by three core principles:
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a. Better outcomes and patient and user experience b. Simpler more integrated care pathways and working across organisational
boundaries c. Lower system cost and better value for money
5 Duties and Powers
To manage and develop the relationship with Providers in line with contractual
expectations
To ensure the development of outcome based specifications in line with changing
priorities and citywide outcomes framework.
To oversee the wider provider management of mental health contracts to ensure
that mental health expenditure is focused appropriately to meet local priorities and national targets
To oversee the wider provider management of Learning Disability contracts to
ensure that mental health expenditure is focused appropriately to meet local priorities and national targets
To manage and develop relationships across all contracted mental health / Learning
Disability providers to ensure effective integration
To effectively monitor contract requirements and ensure systems are in place to
effectively reassure CCG’s and where required initiate actions to ensure performance requirements are met.
To make recommendations to CCG Governing Bodies for significant service and or
contractual changes.
To make reports as appropriate to the three CCGs.
Establishing and monitoring the work of any (monthly to bi‐monthly) sub‐groups,
and specific task and finish groups.
To make effective links with the Acute and Community Provider Management
Groups to ensure Mental Health and Learning Disability issues and requirements are actioned appropriately.
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6 Accountability and Reporting Arrangements
The group is accountable to each of the 3 Leeds CCG Boards as agreed through CCG collaborative arrangements as defined by the CCG MOU.
The group will provide minutes and performance reports that will be relayed and feedback to the three CCGs via their clinical leads.
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Core Membership
Leeds North CCG Clinical Lead MH (Chair*)
Leeds West CCG Clinical Lead MH/LD
Leeds South & East CCG Clinical Lead MH/LD
Leeds North CCG – Commissioning & Contracting Lead Leeds North CCG – Finance Lead
Leeds CCG – Mental Health Commissioner Leeds CCG – Mental Health Contract Lead
Leeds CCG – Learning Disability Lead Leeds CCG – Quality lead
* In the event that the chair is unable to attend the provider management group the
role of the deputy will fall onto one of the other CCG clinical leads.
Circulation List
CCG Accountable Officers and Commissioning Leads.
8
Quoracy
The Provider Management Group will be quorate if represented by at least 1 person from 2 of the 3 CCG’s and 1 clinical person.
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Frequency and format of meetings
Meetings will be bi‐monthly – to be reviewed after six months
A list of dates and venues will be circulated
Agendas will be circulated one week in advance of each meeting Minutes will be circulated as soon as possible following each meeting to ensure
actions agreed during the meeting can be completed
10 Support and resources
Leeds North CCG will provide the administrative support and coordination for the meeting
The Chair will be the MH Clinical Lead from North CCG
11 DATE OF APPROVAL AND REVIEW Agreed on 16 November 2012 and to be reviewed in March 2013.
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TERMS OF REFERENCE
Acute Provider Management Group
Version 5. 28.11.12
Author: Leaf Mobbs
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Version Control
Version No Changes Applied By Date
1 1st Draft E. Micklethwaite May 2012
2 2nd
Draft C. Foster Aug 2012
3 3rd
Draft L. Mobbs Sept 2012
4 4th
Draft- from the APMG 24.10.12 C. Foster Sept 2012
5 5th
Draft V. Lovatt Nov 2012
6
7
8
9
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Contents
Page
1 Name of Group
2 Purpose of Group
3 Key Responsibilities
4 Decision Making Process
5 Accountability and Reporting Arrangements
6 Membership
7 Quoracy
8 Chair
9 Frequency of Meetings
10 Communications
11 Date of Approval and Review
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Name of Group
1.1 Acute Provider Management Group
1.2 The Acute Provider Management Group (APMG) is a sub group of the Leeds CCG Collaborative Commissioning Forum. The group is hosted by Leeds West Clinical Commissioning Group (CCG) on behalf of the three CCGs in Leeds.
Purpose
2.1. The purpose of the group is to:
commission high quality hospital services for the Leeds population in a sustainable and cost effective way
deliver equitable access to services and consistent clinical pathways for the population of Leeds.
agree coherent and consistent commissioning strategy for acute and independent hospital providers on behalf of the three CCGs in Leeds providing LWCCG with a clear mandate for managing hosted provider contracts and engaging with other stakeholders and Associates.
ensure that the three Leeds CCGs have a shared understanding of demand, capacity, activity, finance and performance risks in relation to local hospital and planned care services and the specific implications for their own CCG.
Key Responsibilities
Performance Management
3.1. To monitor key national performance risks including:
Referral to Treatment Times
Cancer Waiting Times A&E Performance
MRSA and C. Diff
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3.2. To ensure that providers are managed effectively through the appropriate contract management arrangements and relationships.
3.3. To provide LWCCG with a clear mandate in relation to contract challenges, sanctions and levers.
Demand, Activity, Capacity
3.4. To monitor demand for hospital services across the system at a citywide and CCG level, agreeing mitigating actions.
3.5. To monitor contracted activity plans, understanding key financial and performance risks at a provider and CCG level.
Annual Contract Development
3.6. To sign off the recommendations of the commissioning strategy in relation to acute and independent providers and planned care including CQUINs.
3.7. To develop clinical relationships across primary and secondary care in order to lead development of contracts.
Transformation
3.8. On behalf of the citywide Transformation Programme to maintain oversight of current QiPP and transformational activity, ensuring that the implications are understood by providers and enacted within contracts.
3.9. To make recommendations to the Transformation Board and Transformation Implementation Executive regarding QiPP opportunities in hospital providers and planned care services.
3.10. To support the Transformation Board in performance managing providers to deliver
whole system QiPP and organisation‐specific cost improvement plans.
Administrative
3.11. To develop an annual work programme to include the above, linking to relevant contract management boards and subgroups, and to individual CCG Governing Bodies.
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3.12. To hold and update the risk register on behalf of the acute provider commissioning team, escalating risks to individual governing bodies.
Decision Making Process
4.1. It is a coordinating group which ensures a consistency of approach for the three Leeds CCGs in relation to the management of acute and independent hospital providers.
4.2. Each CCG has equal representation at the PMG and a delegated level of responsibility from their individual CCG Governing Body.
4.3. Each CCG representative individually has the right to escalate an issue to the Leeds
CCG Network where agreement cannot be reached.
4.4. Each CCG representative is responsible for communicating key risks, issues and
strategic commissioning intent to and from the Governing Body of their CCG on behalf of their population.
Delegated Authority
West CCG
4.5. The LWCCG identified clinical and managerial representatives have authority to make commissioning decisions on behalf of the Chief Officer designate where there is no overall change to commissioned activity levels OR where the change in activity levels does not exceed £100,000k. Where financial risk is greater, decisions must be escalated to the CCG Board or a delegated officer.
4.6. North CCG
???
4.7. South East CCG
LSECCG scheme of delegation enables the representative to make commissioning
decisions of up to £100k or 3% of contract value whichever is lower. This is only
within their delegated budget. Amounts above this would need escalation within
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the CCG.
Excess Treatment Costs (ETC)
5. Decisions through APMG
5.1. Email approval (yes or no) and comments via CCG medical directors –co‐ordinated
by the planned care IFR lead.
5.2. Planned care IFR lead feeds back in to APMG with medical directors advice and APMG rubber stamps.
5.3. ETCs will not be approved, other than in exceptional circumstances – in line with other CCGs.
Frequency of Meetings
5.1. The group will meet monthly.
Accountability & Reporting Arrangements
6.1. Accountability and reporting arrangements are described in the Terms of Reference for the Leeds Collaborative Commissioning Forum.
6.2. The arrangements are summarised in the diagram at Appendix 1 and the LTHT Contract Management Structure is show at Appendix 2.
6.3. The group reports into:
Individual CCG Governing Bodies (via CCG representative)
The Leeds CCG Network.
Contract Management Boards (via Contract Lead CCG)
Transformation Board and Transformation Implementation Executive
6.4. The group receives reports from:
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Subcommittees of the LTHT CMB including Planned Care Activity & Performance Group, Quality Group and Cancer Locality Group.
Contract Activity & Finance Working Group. Transformation Implementation Executive
6.5. The group has key relationships with:
The National Commissioning Board.
Commissioning Support Units
Associate CCGs
Local Professional Networks
Membership
6.6. Each CCG will be represented by:
Clinical Lead
Management Lead
6.7. The acute provider commissioning team will be represented by:
Head of Commissioning for Acute Providers
Senior Commissioning Manager for Acute Providers
Head of Quality Information Leads for Acute Providers
Finance Leads for Acute Providers
Contract Lead by invitation Clinical Lead for Planned Care Transformation.
Clinical Director for LWCCG
Quoracy
7.1. The meeting will be quorate when each CCG and the acute provider commissioning team is represented. Each CCG Clinical and Management lead to nominate a deputy to ensure the meeting will be quorate
7.2. The Chair persons can alter this requirement in light of the business under discussion.
Chair
32
8.1. The meeting will be jointly chaired by the Head of Commissioning for Acute Providers and the Medical Director for LWCCG dependant on the business under discussion.
8.2. If both are absent, the meeting will be chaired by a nominated member of the group.
Date of Approval and Review
9.1. Approval September 2012.
9.2. Review in March 2013.
33
Urgent Care Provider Management
Group
Terms of Reference
Approved 5 Dec 2012
Issue Date: August 2012
Review Date: To Be agreed
Version No. Changes Applied By Date
Draft 1.0 Original Amanda
Douglas
August 2012
Draft 1.1 Title and structure Martin Ford 4 September 2012
Draft 1.2 Additions following
management group
discussion
Martin Ford 21 September
2012
Draft 2.0 Changes following UC
PMG
Martin Ford 3 Oct 2012
Approved version Agreed at UCPMG Simon
Ottman
5 Dec 2012
Contents
1. Name of Group 2. Introduction 3. Purpose 4. Scope 5. Duties & Responsibilities 6. Accountability & Reporting Arrangements 7. Membership 8. Frequency & Format of Meetings 9. Support & Resources 10. Date of Approval and Review
1. NAME The group shall be known as the Urgent Care Provider Management Group.
2. INTRODUCTION The Urgent Care Provider Management Group forms part of the Leeds CCG Collaborative
Commissioning arrangements as set out in the agreed Memorandum of Agreement between the
three Leeds CCGs (See Appendix 1).
The Group is chaired by North Leeds CCG.
3. PURPOSE The purpose of the group:
Agrees Leeds citywide position on issues relating to the YAS Emergency and PTS Ambulance,
YAS/LCD NHS 111/WYUC contracts and other urgent care contracts as agreed, providing a
mandate to LNCCG on behalf of the other Leeds based CCGs – interfaces with WY
commissioning lead
Manages contract performance and outcomes via associate membership of YAS/WYUC contracts
Recommends commissioning intentions
Oversight of transformation & provider QIPP targets as may be relevant
Identifies, tasks, and responds to, issues from any task and finish and other subgroups
4. SCOPE
The scope of the group is limited to provision of a mandate to Leeds North CCG in relation only to
the identified urgent care providers.
5. DUTIES & RESPONSIBILITIES
Duties To maintain accurate records of attendance, key discussion points and decisions
To maintain an on‐going list of actions, to specify named individuals, due dates and to keep track of these actions at each meeting
To ensure patient & public involvement and all other stakeholders views are taken into consideration.
To communicate appropriately with all stakeholders (see appendix 3).
Responsibilities To receive review and agree Leeds city wide position on strategic urgent care provider
performance, activity, finance and quality issues as they may arise
Name Position Organisation
Dr Simon Ottman & Dr Saskia De
Mobray
Joint Chairs See below
Dr Simon Ottman Leeds North CCG UC Lead Leeds North CCG
Dr Irfan Shah Leeds S&E CCG UC Lead Leeds S&E CCG
Dr Saskia De Mobray Leeds West CCG UC Lead & City
Wide Urgent care GP Lead
Leeds West CCG
Post holder to be identified through
transition HR processes
Strategic Urgent Care Programme
Manager
Leeds CCGs
Post holder to be identified through
transition HR processes
Senior Urgent Care Commissioning
Manager
Leeds CCGs
Post holder to be identified through
transition HR processes
Information Analyst Leeds CCGs or WYSCU
Post holder to be identified through
transition HR processes
Finance Manager Leeds North CCG
Contract Manager Leeds North CCG
To be confirmed Clinical Governance lead To be confirmed
To be confirmed Public Health Lead Leeds City Council
To manage urgent care contract performance and outcomes
To define and agree strategic urgent care commissioning intentions
To oversee urgent care transformation & provider QIPP targets as may be relevant
To identify tasks, and respond to, issues from any task and finish and other subgroups
6. ACCOUNTABILITY & REPORTING ARRANGEMENTS
The Urgent Care Provider Management Group is accountable to the Governing Bodies of each of the
three Leeds CCGs. This is set out in the Leeds CCG Collaborative Commissioning Memorandum of
Agreement (Appendix 1) and forms part of the Contract Governance Structure (Appendix 2a).
The group will routinely report through the provision of minutes to each of the Governing Bodies,
with representation and presentation as requested/agreed by the CCGs according to routine and/or
by exception.
7. MEMBERSHIP
Core Membership
Other Members
To be agreed as necessary.
Quorum
Representation from at least one member of each Leeds CCG, with delegated authority from their CCG Governing Body (as outlined at section 3), is required to make the Provider Management Group quorate.
If a member fully intends to attend the meeting (no apologies sent), however may miss the meeting
due to circumstances beyond their control, they may ring into the meeting and state “no additional
comments to be made”
Any actions agreed in the meeting can be emailed to non attendees. If all agree actions then the
group can move forward as appropriate
Delegate Substitution
Substitute delegates may be nominated by CCGs.
Chair & Deputy Chair
Dr Simon Ottman and Dr Saskia De Mobray will act as joint chairs, with only one member being
routinely present.
8. FREQUENCY & FORMAT of MEETINGS
Meetings will be held on a quarterly basis and otherwise by exception. Timing will be identified in
order to best fit with provider activity and financial reporting schedules.
9. SUPPORT & RESOURCES
The Leeds Collaborative Commissioning Structure is established to provide support and resources for
the Urgent Care Provider Management Group.
10. DATE OF APPROVAL & REVIEW
Approved 5 December 2012. To be reviewed July 2013.
APPENDICES
Appendix 1
Leeds CCG Collaborative Commissioning Memorandum of Agreement
L:\GPCC\Collaorative\ Governance\Final LC
Appendix 2a
Leeds Collaborative Commissioning Contract Governance Structure
L:\GPCC\Collaorative\ Governance\Final LC
Appendix 3
Stakeholders Leeds North CCG
Leeds S&E CCG
Leeds West CCG LTHT
LCHNT
LYPFT
YAS/LCD Coordinating Commissioner (West Yorkshire/Yorkshire wide) YAS 999 and PTS
Coordinating Commissioner (West Yorkshire/Yorkshire wide) YAS 111 and WYUC Leeds Local Professional Committees as may be appropriate
DRAFT TERMS OF REFERENCE
NHS North, West, South and East Leeds CCG’s
Community Provider Management Group
1. DOCUMENT CONTROL
1.1 VERSION 2
1.2 Review and Approval required by Community Provider Management Group Prior to
sign off by each of the CCG Governing Bodies.
2 Introduction
The 3 Leeds CCG’s have agreed a collaborative approach to manage provider contracts across the city of Leeds. This approach ensures that each CCG has a representative and decision making input into how a contract is negotiated, implemented and managed.
Leeds South and East Clinical Commissioning Group have lead responsibility for Community contracts on behalf of the three Leeds Clinical Commissioning Groups.
Community expenditure is spread across a number of providers within and outside of the NHS. The majority of expenditure is with Leeds Community Healthcare NHS Trust
A full list of contracted providers is held in appendix 1.
3 Purpose of Group
The purpose of the Provider Management Group is to ensure the effective management of all Community contracts. The group will provide the primary forum in which the CCG’s review, monitor, negotiate and implement provider contract requirements. Additionally the group will produce regular reports for CCG Boards and ensure CCG input into the contracting process. The group will also receive priorities, intentions and plans from all Community (Commissioning collaborative groups).
Review and Monitor;
Activity and Finance information against plan
QIPP initiatives Quality and Performance requirements
Clinical Service Development plans and initiatives
Feedback and input from CCG Governing Bodies;
Produce regular high level reports and narrative of Performance and Issues arising
Initiate and recommend actions for CCG approval
Provide a forum in which to debate and agree consistent approach
Agree Negotiation Strategy
To be applied during monitoring meetings with Providers
To be applied when negotiating each years contract
4 Principles
The Provider Management Group reflects a joint commitment across the three CCGs to deliver outcome based service models that lower system costs by simplifying care pathways, reducing duplication, and improving the quality of service provided. This is underpinned by our four core principles:
a. Quality & safety of services b. Patient involvement & engagement c. Integrated care pathways and working across organisational boundaries d. Lower system cost and better value for money
5 Duties and Powers
To agree delegated powers of authority with the CCG Governing Bodies
To manage and develop the relationship with Providers in line with contractual expectations
To ensure the development of outcome based specifications in line with changing priorities
and citywide outcomes framework.
To oversee the wider provider management of Community contracts to ensure that
Community expenditure is focused appropriately to meet local priorities and national targets
To manage and develop relationships across all contracted Community providers to ensure
effective integration
To effectively monitor contract requirements and ensure systems are in place to effectively reassure CCG’s and where required initiate actions to ensure performance requirements are met.
To make recommendations to CCG Governing Bodies for significant service and or
contractual changes.
To report to the three CCGs .
6 Accountability and Reporting Arrangements
The group is accountable to each of the 3 Leeds CCG Governing Bodies as agreed through CCG collaborative arrangements as defined by the CCG MOU, a copy of which is contained in appendix 2
The group will provide minutes and performance reports that will be relayed and fedback to the three CCGs via their clinical leads.
7 Membership
Leeds South & East CCG Clinical Lead (Chair)
Leeds West CCG Clinical Lead
Leeds North CCG Clinical Lead
Leeds CCG – Community commissioning & Contracting Lead (Deputy chair)
Leeds CCG – Children’s commissioning & Contracting Lead
Leeds CCG – Community Finance Lead
Leeds CCG – Community Contract Lead Leeds CCG – Quality lead
Additional representatives from the other CCG’s as appropriate and agreed
8 Quoracy
The Provider Management Group will be quorate if at least one of the CCG Clinical Leads or their delegated deputies are present along with 3 other members.
9 Frequency and format of meetings
Meetings will be bi‐monthly – to be reviewed after six months
A list of dates and venues will be circulated Agendas will be circulated one week in advance of each meeting
Minutes will be circulated as soon as possible following each meeting to ensure actions agreed during the meeting can be completed
10 Support and resources
Leeds South and East CCG will provide the administrative support and coordination for the
meeting
The Chair will be the Community Clinical Lead from South and East CCG
11 DATE OF APPROVAL AND REVIEW Agreed onXXXXXXX– and to be reviewed in March 2013.
MSK: rehab, falls & spinal FNP assessment School Nursing PCMHS (IAPT) Podiatry
Community Provider Management Group – 2012/13
Leeds Community Healthcare Continuing Care Partnership: Children &
Families
Adult Community Nursing
District Nursing
DN Nights
CAPCCS
Tissue Viability
Out of Hospital Care
Intermediate Care Team
CICU
Long Term Conditions
Community Matrons
Cardiac Services
Diabetes Services
Respiratory Services
S<
EPP
CRU (IP & OP)
Community Neurology
Stroke Team
Chronic Pain Service
Specialist Services
Children’s Complex Healthcare
Child Development Centres
Pead Neuro Disability Clinics
CHICS
Children’s OP Clinics
Child Protection Medical service
Children’s Audiology
Children’s Community Eye Service
Children’s Nutrition
Children’s OT
Children’s Physio
Children’s S<
Children’s Nursing & Butterfly team
Continuing Care Nursing Team
CAMHS
CAMHS Specialist Services
Children’s LD Team
Healthy Child
Sickle Cell & Thalassaemia
Inclusion Nursing Service
Early start Service
Care Homes (x38)
Domiciliary Care (x20)
OOA, Specialist, Spot
Purchased services
End of Life Care
St Gemma’s Hospice
Wheatfields Hospice
Leeds Equipment
Service
Intermediate Care
(HBH)
Intermediate
Care
CIC beds – Block
contracts (x4)
CIC beds – Cost Per
case agreements
Martin House Hospice
Circumcision
MSK
Street Lane Paediatrics
Community Gynae
Nutrition & dietetics
CASH
Adult Weight Management
Stop Smoking Service
Health Lifestyle Service
Operational Support Services
Leeds Equipment Service
TB Health Visiting & BCG
Vulnerable Groups
Prison Healthcare, Hep C
York Street Practice
Key
Lead commissioner –
from April 2013:
CCG
Local Authority
NHS CB
Community Provider Management Group – 2012/13
Leeds Community Healthcare Continuing Care Partnership: Children &
Families
Adult Community Nursing
District Nursing
DN Nights
CAPCCS
Tissue Viability
CUCS
Out of Hospital Care
Intermediate Care Team
CICU
Joint Care Management
Long Term Conditions
Community Matrons
Cardiac Services
Diabetes Services
Respiratory Services
S<
EPP
CRU (IP & OP)
Community Neurology
Stroke Team
Chronic Pain Service
CHC Neuro-Physio
Children’s Complex Healthcare
Child Development Centres
Pead Neuro Disability Clinics
CHICS
Children’s OP Clinics
Child Protection Medical service
Children’s Audiology
Children’s Community Eye Service
Children’s Nutrition
Children’s OT
Children’s Physio
Children’s S<
Children’s Nursing & Butterfly team
Continuing Care Nursing Team
Hannah House
CAMHS
CAMHS Specialist Services
Children’s LD Team
Looked after Children
Healthy Child
Care Homes (x38)
Domiciliary Care
OOA, Specialist, Spot
Purchased services
End of Life Care
St Gemma’s Hospice
Wheatfields Hospice
Leeds Equipment
Service
Intermediate Care
(HBH)
Intermediate
Care
CIC beds – Block
contracts (x4)
CIC beds – Cost Per
case agreements
Commissioned Externally
Martin House Hospice
Circumcision
MSK
Street Lane Paediatrics
Specialist Services
Sickle Cell & Thalassaemia
Inclusion Nursing Service NHS Commissioning Board Leeds City Council
Prison Healthcare, Hep C CASH MSK: rehab, falls & spinal
assessment York Street Practice
Community Dental Adult Weight Management
Stop Smoking Service PCMHS (IAPT) Early Start Service Healthy Lifestyle Service Podiatry FNP School Nursing Community Gynae School Immunisations Watch It Nutrition & dietetics BCG Pre-School Referral clinic TB Health Visiting Infection Control
