Organisational Governance and Decision Making Structure in NHS Milton Keynes Clinical Commissioning Group

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Organisational Governance and Decision Making Structure in NHS Milton Keynes Clinical Commissioning Publication date: 7 th November 2012

Strategic Objectives Commissioning value for money services Deliver financial balance against a delegated budget Deliver QIPP programme: provide effective leadership Clinical leadership to make a difference Clinically led strategic decision making Integration, preventative care and sustainability Improve quality and safety Make a positive impact on clinical outcomes and patient experience Effective clinical engagement to improve the quality of care Develop a high performing organisation Effective commissioning support arrangements Deliver authorisation by 31 st March 2013 Engage effectively with all stakeholders

Dr. Nicola Smith Chair NHS MK CCG GP Vice-Chair Mental Health & Learning Disabilities Planned Care Long Term Conditions Primary Care Urgent Care Children & Maternity Services GP s of the

Jeannie Ablett Chief Officer Matt Webb Chief Finance Officer Sue Lacey-Bryant Director of Corporate Affairs & Partnerships Janet Corbett Director of Clinical Development NHS MK CCG Senior Management Team

NHS Milton Keynes Clinical Commissioning Organogram Lay Lay Lay Vice Chair * Chair GP Vice- Chair Primary Care Director of Clinical Development Planned Care Director of Corporate Affairs & Partnerships NHS MK CCG Long Term Conditions Chief Financial Officer Mental Health & Learning Disabilities Chief Officer Secondary Care Doctor Registered Nurse Children & Maternity Non-voting roles in attendance: Director of Public Health, Representative from MK Council, Practice Manager * Lay Vice Chair does not hold voting rights (position currently held by PCT Non Executive Director) Urgent Care

Governance Structure Providers/Partners/ Clinical Networks/Clinical Senate Clinical Forum of Practices CCG Senior Management Team Cluster Until 03/13 CCG Health & Wellbeing Commissioning Support Hub Cluster PCT Cooperation & Competition Panel (until March 2013) Clinical Forum Organisational Development Audit Remuneration Commissioning Delivery Joint Commissioning Management Joint Commissioning Team Primary Care Urgent Care Planned Care Long Term Conditions Mental Health & Learning Difficulties Children & Maternity Delivering Capability North South East West

advisory reports to Clinical s & Projects Network of member practices NHS MK CCG NHS MK CCG Senior Management Team Co-operation & Competition Panel External resources Commissioning Support Hub Joint Commissioning Team NHS MK CCG Delivery Stakeholders Service providers Health and Wellbeing Clinical Networks Clinical Senate Acute Service Review Partner Organisations Patient Congress Practice Participation s LINk:MK & Performance s (4) Planned Care Unplanned Care Mental Health Children & Maternity Long Term Conditions NHS Milton Keynes CCG Management Framework Internal decision making structure

External Scrutiny via: Care Commission (CQC) Strategic Health Authority Cluster (SHA) NHS Milton Keynes CCG Assurance System CDG s Cluster (during transition to CCG Authorisation NHS MK CCG Assurance Report Assurance received via: Monthly Secondary Care Providers visits Quarterly Serious Incident Assurance Meeting (SIAM) Monthly Clinical Review Meetings with Secondary Care Providers Cluster-wide Infection Prevention & Control Safeguarding Adults & Childrens s Quarterly Acute Mortality Review Providing Assurance

Summary Reports NHS MK CCG Assurance Improvement cycle Team Reports Issues Long Term Conditions Planned Care Unplanned Care Mental Health Children & Maternity 4 x & Performance s Changes in practice and/or contract specifications NHS Milton Keynes CCG Clinical Governance Process Depicting quality improvement cycle and board assurance

Safeguarding Governance Health & Wellbeing MKCCG Governing Body GP Lead Local Safeguarding Children and Adults ; MAPPA Head of Prescribing and Head of Safeguarding MKCCG boards children & maternity; Long term conditions Lead adult safeguarding (incl. MCA) Designated Nurse Designated Doctor Note: The Designated Nurse for safeguarding children has been secured within the CCG and CCG commissions sessions from the Designated Dr. Designated Nurse and Designated Dr for LAC are secured through a service specification with MK CHS. The lead paediatrician for Child Death Review is secured through a service specification with MKHfT. The role of safeguarding adults (including lead for Mental Capacity Act) will be secured within the CCG and is currently secured through the Commissioning Support Service. These posts will be supported by CCG Head of Safeguarding, training, CCG and inter agency policies, CCG governance structures and the CCG and Safeguarding strategy and will provide leadership across the health economy. Commissioned Services: Lead Paediatrician Child Death & LAC Designated Professionals

Cluster NHS MK CCG Remuneration Lay Vice Chair Makes recommendations on pay and remuneration Audit Lay Vice Chair Oversees integrated governance Corporate Clinical Finance Information Research Conflict of Interests PPG Champion Chair ship includes SROs and Clinical Leads Makes recommendations to enhance performance with regard to quality and delivery across the group and individual practices Commissioning Delivery Acts as an effective performance management and scrutiny forum to ensure delivery of QIPP and acts as the sponsor group for all CCG s. Organisational Development Ensure the OD systems, processes and overall capability of the CCG are effective and fit for purpose to drive performance. Clinical Forum Enables discussions with and between member practices to agree commissioning priorities, reviews progress of commissioning and facilitates collective decisionmaking NHS Milton Keynes CCG Assurance Structure Taking assurance of performance, delivery and statutory duties

Engagement with Practices 7 member practices 8 member practices South GP North GP GP NHS MK CCG GP GP GP GP West 6 member practices Clinical Forum of Practices East 7 member practices Representatives from each of the 28 member practices