1 Introduction Directly Commissioned Services Committee Annual Report For the period 1 April 2013 to 31 March 2014 The purpose of the Directly Commissioned Services Committee ( the Committee ) is to oversee the delivery of directly commissioned services within the overall strategy set by NHS England. The Committee is responsible for: Assuring that services are being delivered to quality standards that are clinically led and are patient focused; Ensuring that quality standards for each service are defined; Oversight of national agreements with other parties; Agreeing commissioning priorities and allocation of resources; Assuring that appropriate planning is in place so that services are patient focused and clinically led; and managed within budget Assuring that NHS England has the capacity and capability to commission well. The Committee was established part way through the year and held its inaugural meeting on 14 August 2013. 2 Meetings of the Committee During this period, the Committee met on three occasions, on a quarterly basis. The members of the Committee are: Professor Sir Malcolm Grant (Chair) Lord Victor Adebowale (Non-Executive Director) Dame Barbara Hakin (Chief Operating Officer and Deputy Chief Executive) Paul Baumann (Chief Financial Officer) Bill McCarthy (National Director: Policy) Tim Kelsey (National Director: Patients and Information) Sir Bruce Keogh (National Medical Director) Jane Cummings (Chief Nursing Officer) Rosamond Roughton (National Director: Commissioning Strategy - Interim) Ann Sutton (Director of Commissioning Corporate) Vicky Pleydell (CCG representative) Richard Barker (Regional Director) Ciaran Devane* (Non-Executive Director)
Jo-Anne Wass* (National Director: HR and OD) Sir David Nicholson* (Chief Executive to 31 March 2014) *At the meeting on 28 January 2014 additional members, Ciaran Devane (Nonexecutive Director) and Jo-Anne Wass (National Director of HR and OD), were coopted onto the Committee for a time limited period specifically to oversee the Primary Care Support Services project. Jo-Anne Wass and David Nicholson left NHS England on 31 March 2014. A summary of members attendance is given at Annex One. There was one occasion where the Committee was required to take action by correspondence. Reports from the Committee meetings were provided to the public meetings of the Board on 13 September 2013, November 2013 and 6 March 2014. 3 Sub-committees/groups The Committee has no sub-committees. It is supported the Clinical Priorities Advisory Group, which advises on all clinical matters. It is also supported by a number of Programme Oversight Groups, including the: Specialised Commissioning Oversight Group Primary Care Oversight Group Public Health Oversight Group Health and Justice Oversight Group Armed Forces Oversight Group In addition, a Primary Care Support Services (PCSS) task and finish group was established in January 2014 to undertake specific oversight of the work leading up to the Board s decision on how these services will be secured in the future. The Committee receives detailed reports from each group at every meeting. In addition, a task and finish working group has been established to manage the development of a substantive Ethical Framework and supporting policies, together with ensuring that there is appropriate engagement with stakeholders. The Ethical Framework describes the system within which an organisation makes its decisions. This Framework includes the principles which underpin NHS England s decision-making; and the policies and processes it uses to make those decisions.
4 Delivery of the work programme During the period of this report, key issues were considered by the Committee, including: The six functional areas required to enable NHS England to discharge its duties plus the Terms of Reference to reflect these key areas; The function of the Clinical Priorities Advisory Group (CPAG) and the Programme Oversight Group. It was agreed that CPAG and the programme oversight groups would not be regarded as sub-committees; The endorsement of the recommendations of CPAG for formal adoption by NHS England at each meeting; The receipt of detailed reports at each meeting, on each of the five areas that are directly commissioned by NHS England: Specialised Services; Primary Care; Public Health; Health and Justice; and Armed Forces and their Families. The receipt of regular updates to the committee with regards to the Public Health Section 7a agreement and agreed to the proposed arrangements for strengthening the governance for Public Health; The endorsement of proposals for negotiating improvements to the General Dental Services contracts and the Personal Dental Services agreements for 2014/2015; The specific Primary Care Support Services oversight arrangements and agreement to co-opt two additional members (Ciaran Devan and Jo-Anne Wass) for a time limited period; A summarised report on the key deliverables on specialised services and assurance that the plan is fully developed and resourced; An update on the Prime Ministers Challenge Fund for General Practice and acknowledgment that work is underway to secure the pilot sites and support; The progress made with Liaison and Diversion services was noted and confirmation was given that approval (subject to a number of caveats) was given outside of the committee that NHS England should take lead responsibility from 1 April 2014. 5 Work programme for 2014/15 During 2014/15 the Committee will: Engage with stakeholders regarding the development of the substantive ethical framework and supporting policies and development of the prioritisation framework; To endorse the recommendations of CPAG for formal adoption by NHS England; To receive assurance from each of the five areas of direct commissioning on quality of services, financial performance, delivery of business plan priorities and effective management of risk; To provide an oversight of the financial position with regard to specialised commissioning;
To oversee the development and finalisation of the public health section 7a agreement for 2015/16; To endorse the proposal for the negotiation of the general medical services and general dental services contracts; To provide oversight of the Strategic programmes to include: o Implementation of the Prime Ministers Challenge Fund for General Practice o Liaison and Diversion programme Continue to have oversight of the PCS project to ensure its successful delivery; 6 Review of terms of reference The terms of reference for the Committee have been reviewed. It is proposed that the frequency of meetings is amended to read The Committee will meet on a quarterly basis as a minimum. This amendment will give the Committee the flexibility to add extra meeting dates if it is deemed necessary. In addition, the Chief Executive has confirmed that he will not be attending the Directly Commissioned Services committee meetings, therefore it is proposed that the membership is amended accordingly. Proposed revised terms of reference are attached at Annex Two for approval. 7 Review of effectiveness The Committee remains in relatively early stages of development. In order to meet the requirements delegated by the Board, the Committee continuously assesses its effectiveness and has made a number of changes in the way it operates to this effect. 8 Assurance statement The Committee has met the requirements delegated to it by the Board. There are no areas of significant concern which need to be brought to the attention of the Board. 9 Recommendations The Board is asked to: Note the report; Receive assurance from the Committee with regard to delivery of the work programme; and Adopt the revised Terms of Reference
Professor Sir Malcolm Grant Committee Chair April 2014
Annex One Summary of members attendance for the period 1 April 2013 to 31 March 2014 Date Date Date Member 14 Aug 2013 12 Nov 013 28 Jan 2014 Prof. Sir Malcolm Grant X X X Lord Victor Adebowale X A A Ciaran Devane n/a n/a A Sir David Nicholson n/a X A Dame Barbara Hakin X X X Paul Baumann D A X Bill McCarthy n/a A A Tim Kelsey A A D Sir Bruce Keogh D A X Jane Cummings D D A Rosamond Roughton n/a D X Jo-Anne Wass n/a n/a X Ann Sutton X X X Richard Barker X A X Vicky Pleydell n/a X X Key: X A D in attendance apologies given deputy attended
Annex Two Revised terms of reference Directly Commissioned Services Committee Terms of Reference Purpose To oversee the delivery of directly commissioned services within the overall strategy set by NHS England. Duties The Directly Commissioned Services Committee (DCSC) has been established to oversee the delivery of directly commissioned services, including assurance of the direct commissioning functions in NHS England. The DCSC is responsible for: Assuring that services are being delivered to quality standards that are clinically led and are patient focused; Ensuring that quality standards for each service are defined; Oversight of national agreements with other parties; Agreeing commissioning priorities and allocation of resources; Assuring that appropriate planning is in place so that services are patient focused and clinically led; and managed within budget; Assuring that NHS England has the capacity and capability to commission well. The DCSC is supported by the Clinical Priorities Advisory Group (CPAG). The CPAG has been established to ensure that clinical prioritisation recommendations are provided to the DCSC where there could be a change in service provision, and where there are resource implications which may present collaborative healthcare challenges. The DCSC is supported by five management Programme Oversight Groups. The work of each of these is overseen by an overarching executive group. In addition, the DCSC has established a Primary Care Support (PCS) services group to provide oversight to the programme to redesign delivery of PCS services. Members Chair Non-executive Director Non-executive Director Chief Operating Officer/Deputy Chief Executive or designated deputy Attendees Head of Primary Care Commissioning Head of Specialised Commissioning Head of Public Health, Offender Health and Armed Forces Health
Chief Financial Officer or designated deputy National Director: Policy or designated deputy National Director: Patients and Information or designated deputy Chair Clinical Priorities Advisory Group Director of Commissioning Policy and Primary Care Director of Partnerships National Medical Director or designated deputy Chief Nursing Officer or designated deputy National Director: Commissioning Strategy or designated deputy Director of Commissioning (Corporate) Regional Director Clinical Commissioning Group Leader Quorum The meeting will be quorate if at least four members are present, of whom one must be a Non-executive Director and one must be either the National Medical Director or Chief Nursing Officer, or their deputies. Frequency The committee will meet on a quarterly basis as a minimum. Members are expected to attend all meetings. Where necessary, the committee will communicate electronically to take out of committee decisions and maintain the rolling programme of work, with all decisions taken in this way formally recorded at the next meeting.