Upper Lea Valley Locality Commissioning Board Terms of Reference 2015/16

Upper Lea Valley Locality Commissioning Board Terms of Reference 2015/16

1. Introduction 1.1 The Upper Lea Valley Locality Commissioning Board (LCB) Committee (The Committee) is established in accordance with Section 6 of the NHS East and North Hertfordshire Clinical Commissioning Group s (E&NH CCG) constitution as a Committee of the Governing Body. 2. Membership 2.1 Member practices are: Amwell Street Surgery, Castlegate Surgery, Church Street Surgery, Dolphin House Surgery, Hailey View Surgery, Hanscombe House Surgery, The Limes Surgery, The Maltings Surgery, Orchard Surgery, Park Lane Surgery, Wallace House Surgery, Watton Place Clinic, Ware Road Surgery, Puckeridge & Buntingford Medical Centre. The Locality group will also represent Haileybury College Practice. The membership of the committee shall include: Co-chairs Practice Date of appointment Dr Steve Kite The Maltings Surgery 01.04.2013 Dr Nicky Williams Ware Road Surgery 01.04.2013 Dr Mark Andrews The Limes Surgery 01.04.2013 Practice: GP Clinical Lead / Clinical Representative Amwell Street Surgery, Hoddesdon Dr Jo Roberts Castlegate Surgery Dr Alice Baldock Hertford Church Street Surgery, Ware Dr Nicky Williams Dolphin House Surgery, Ware Dr David Maddams Hailey View Surgery, Hoddesdon Dr Rob Mayson Hanscombe House Surgery, Hertford Dr Anita Oates The Limes Surgery, Hoddesdon Dr Mark Andrews (Locality Co-Chair) The Maltings Surgery, Ware Dr Steve Kite (Locality Chair) Park Lane Surgery, Broxbourne Dr Jacqui Sheridan Wallace House Surgery, Hertford Dr Jay Kuruvatti Watton Place Clinic, Dr Dilesh Shah Watton-on-Stone Ware Road Surgery, Hertford Orchard Surgery, Buntingford Buntingford Surgery, Buntingford Puckeridge Surgery Clinical Directors from Ephedra on rotation: Dr Neil Dytham Dr Michael Rule Dr Sejun Adeuja Dr Megan Phillimore-Brown Dr Will Nicholson 2.2 Members of the committee should make every effort to attend all meetings of the committee. The Locality team will monitor attendance and will report on this annually. Attendance figures will be published in the Annual Report and Accounts.

2.3 In the event of the Co- Chairs of the committee being unable to attend all or part of the meeting, they will nominate a replacement from within the Membership to deputise for that meeting. 2.4 Representatives in Attendance 2.4.1 The following representatives will usually be in attendance: Chair of Patient Commissioning Group (PCG) Practice Managers from member practices Nurse / AHP Representative Pharmaceutical Adviser CCG Locality Manager CCG Associate Director CCG Director CCH 2.4.2 Lead Roles The LCB will provide a Prescribing Lead GP; a Mental Health Lead GP; a Patient Engagement Lead, a Long Terms Conditions Lead, a Diabetes Lead to sit on subcommittees of the CCG. The Lead representative will act in a liaison role for the development of their specific areas and engage formally with the LCB either verbally or in writing. These roles will be funded from the locality management allowance. Lead Roles: Long Term Conditions Lead Managing Respiratory pathways redesign Mental Health Prescribing Finance Practice Nurse Lead Name: Dr Martyn Davies (Dolphin House Surgery) Dr Jay Kuruvatti (Wallace House Surgery) Dr Nick Condon (Park Lane Surgery) Dr Jacqui Sheridan Lucy Eldon 3. Quorum 3.1 No formal business of the committee(s) shall be transacted unless at least one half of the whole number of members is present and at least one of either the Chair or Deputy Chair is present. 4. Frequency of meetings and attendance 4.1 Attendance of at least 11 meetings per annum to include Locality Committee Board meetings and TARGET events.

4.2 Minimum Expectations of Member Practices An identified GP Lead or Representative from each Practice to attend 100% of meetings identified in Para 4.1 An identified GP lead or a clinical representative from each practice to attend 80% of meetings for attendance linked payments. In recognition of possible difficulties in attendance for the smaller practices, should a GP attendance be difficult please inform the Locality Manager as soon as possible so that the issues can be documented. Evidence of consideration of the previous LCB minutes and comments to be forwarded to the Locality Manager prior to the meeting. All Practices are to be represented at all Locality TARGET events over the year. GP participation in locality TARGET days/locality wide events Commitment to all components of the Commissioning Framework (see Appendix 1). Engagement in regular practice reviews with the co-leads of the LCB to analyse practice activity, performance in relation to key priorities and expenditure against the individual action plans. It is expected that information from the committee meetings is disseminated at Practice level, as deemed appropriate by attendees. This may be via in-house meetings. It is advised that notes/minutes are taken so that they can be taken into account should the level of engagement be questioned. To support involvement of Practice Managers and other relevant Practice Staff in CCG, all Practice Managers are encouraged to attend the LCB meetings. Participation in data collection, audits, reviews and validation as determined by the locality. GP participation in prescribing forum and engagement with Prescribing Advisors; Attendance criteria as defined by the Forum. Practice Managers are encouraged to attend the monthly Practice Manager forums, attendance at a minimum of 10 meetings per year. Practices to endorse patient representation to attend the Upper Lea Valley Patient Commissioning Group. The Patient representative or their deputy will be invited to attend meetings to provide an outline of the issues raised, either verbally or in writing, at the Patient Commissioning Group that relate to the LCB. 5. Authority 5.1 The committee is authorised by the Governing Body to Appoint and remove Practice Representatives. 6. Emergency powers 6.1 Where an urgent decision needs to be made in-between scheduled meetings, members of the committee can convene an Extra-ordinary meeting to discuss a particular issue. Quorum rules in paragraph 3 still apply. 6.2 If it is not practicable to meet in person, matters can be dealt with through telephone or the exchange of emails. The exercise of such powers shall be reported and minuted at the next committee meeting. 7. Duties 7.1 The duties of the committee can be categorised as follows: Encourage full clinical engagement of member practices to help to develop and deliver CCG objectives.

Be involved in commissioning high quality services for our patients including service redesign and review, to improving outcomes for patients while making appropriate use of resources. When required they should have the mandate of their practices, after consultation with practices, to vote on issues of policy of the Locality Commissioning LCB. Analyse locality expenditure and activity against the Locality Plan/budget allocation with the intention of achieving financial balance by managing elective, unplanned and prescribing spend. Take collective action if Locality Plans drift from targets. Work with the CCG to validate and monitor patient pathways to understand high cost patients and ensure their care is planned to improve their outcome and use of resources. Facilitate two-way communication between the committee and the locality patient commissioning group 8. Reporting arrangements to the Governing Body 8.1 The committee will report to the Governing Body on a quarterly basis and the following documents will be presented: Locality Update Locality Commissioning Plan 8.2 The LCB is accountable to East and North Herts CCG. The Chairs of the LCB will sit on the CCG Governing Body and the locality will have one vote as detailed in the CCG Constitution. 9. Reporting arrangements of other Committees and Groups 9.1 The following committees and groups will report into the committee and provide an update to the LCB as necessary. Meeting Name Locality Prescribing Group Finance Sub Committee Frequency Quarterly Quarterly 10. Statement of Interest Declaration 10.1 All LCB Members to have completed a Statement of Interest Declaration. They are declared prior to discussion of relevant items. They are re-issued annually by the CCG. 11. Voting 11.1 Each of the 15 practices will be represented at the LCB meeting and there will be 1 practice 1 vote. Only practice representatives named in Section 2.1, Membership, or their nominated clinical representative are entitled to vote. A majority vote will be required when decisions are to be taken. 12. Annual review of the Committee 12.1 The committee will undertake an annual self-assessment to: Review that these Terms of Reference have been complied with and whether they remain fit for purpose.

Determine whether its planned activities and responsibilities for the previous year have been sufficiently discharged; and, Recommend any changes and / or actions it considers necessary, in respect of the above. Provide the Governing Body with an annual report, which details the outcome of the annual review. 13. Committee servicing 13.1 The committee shall be supported administratively by the Locality team, whose duties in this respect will include: Agreement of the Agenda with the Chair and collation of papers in-line with the committee s Annual Cycle of Business; Providing written notice of meetings to committee members, and the papers, not less than 5 working days before the meeting; Taking the minutes and keeping a record of matters arising and issues to be carried forward; Producing a single document to track the committee s agreed actions and report progress to the committee; Producing draft minutes for approval within 5 working days of the meeting. Terms of Reference reviewed by: Date approved: Review Date: July 2016 Governing Body Approval Date: Upper lea Valley Locality Commissioning Committee

Commissioning Framework 2015/16 Allocation of Finance Appendix 1 The total available per registered patient under commissioning framework is 5.00; it is broken down in the table below. 1. Engagement Attendance at meetings, defined within Locality Terms of Reference Responses to information requests within four weeks timeframe Support practice nurse network. 1.00 2. Achieving Financial Balance 1.00 3. Working to improve outcomes of patients with LTCs.: Facilitating self-management and integrated care planning for patients with Long Term Conditions Proactive management of patients with long term conditions (LTC) by making use of multi-disciplinary team working. Advanced care planning (ACP) undertaken to support patients decisions and choices which will facilitate high quality end of life (EOL) care. Safe and appropriate prescribing to support practitioners to adhere to the broad spectrum antibiotic guidance. Support improvements in line with CCG Ambitions for Carers Support improvements in line with CCG Ambitions for patients with Cancer Total 5.00