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NHS Manchester Locality Scheme of Delegation

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					                   Locality Board Scheme of Delegation - August 2011

1   Introduction

    This document is to be read in conjunction with the NHS Greater Manchester Cluster
    Governance Manual which incorporates the Standing Orders, Standing Financial
    Instructions and Scheme of Reservation and Delegation. For any inconsistencies between
    this document and Cluster Scheme of Delegation, the Cluster Scheme should be referred
    to as the authoritative document.

    Decisions reserved to the cluster Board and those that have been delegated to Locality
    Board are contained within the Cluster Scheme of Delegation and are not reiterated in this
    document. This document solely states decisions/duties delegated by the locality board to
    committees and to its sub-committees and the Operational Decisions, authorities and duties
    delegated to officers of NHS Manchester (Appendix A) so that committees and Officers of
    those committees do not act ultra vires and leave themselves open to criticism, suspicion or
    ultimately discipline.

    Due to the transitory nature of some elements to this paper, the papers which may require
    further revision have been placed within the appendices. Any amendments to these must
    be within those powers which have been delegated to the Locality Board and its sub
    committees by the Cluster Board and may be subject to the Cluster Board approval or be
    provided for further information.

2   Decisions/duties delegated by the locality board to committees and to its sub-
    committees
    Diagram 1 - NHS Manchester Committee Structure 2011/12




                                             1
2.1   Transitional Commissioning Board

      Reporting to the NHS Manchester Locality Board, the Transitional Commissioning Board
      will be responsible for the executive delivery of the responsibilities outlined in Appendix B
      and those delegated to the Locality Board by the Cluster Board as stated in the Cluster
      Governance Manual Appendix Three Schedule of Delegation. The current Terms of
      Reference for the Transitional Commissioning Board are detailed in Appendix C. Due to the
      fluid nature in the development of this Board and the sub Clinical Commissioning Groups
      this may from time to time require amendment but not beyond the authority designated to it
      by the Cluster Board or NHS Manchester Locality Board.

      Any subsequent documents which details designated authorities to this group will be
      furnished with an addendum in the appendices and will be forwarded to the Cluster Board
      or its officers for information or approval.

3.2   Clinical Commissioning Groups

      Manchester has 3 Clinical Commissioning Groups. Over time an increasing amount of
      executive responsibility will be devolved to them but not beyond the authority designated to
      it by the Cluster Board or NHS Manchester Locality Board. Initially, they will report to the
      Transitional Commissioning Board. Appendix D details the current total budget allocation
      per item for the Cluster Commissioning Groups.

      Any subsequent documents which details designated authorities to these groups will be
      furnished with an addendum in the appendices and will be forwarded to the Cluster Board
      or its officers for information or approval.


3.3   Locality Audit Group

      The Group will as delegated by the Cluster Board and Locality Board:

          Advise the Locality Board on internal audit services
          Monitor the effective systems of integrated governance, risk management and internal
           control
          Monitor compliance with Standing Orders; Standing Financial Instructions and
           operational Operational Decisions, authorities and duties delegated to officers of NHS
           Manchester
          Review schedules of losses and compensations and make recommendations to the
           Locality Board
          Review the annual financial accounts prior to submission to the Audit Committee.
          Review adequacy of local policies for ensuring compliance with relevant regulatory,
           legal and code of conduct requirements in so far as it does not interfere with the
           Cluster Board and Audit Committee work on joint locality board policies.

          Review adequacy of local policies and procedures for all work related to fraud and
           corruption as set out in the Secretary of State Directions and as required by NHS
           Protect in so far as it does not interfere with the Cluster Board and Audit Committee
           work on joint locality board policies.




                                                2
3.4   Governance Committee

      The Committee will as delegated by the Locality Board:
         Maintain an effective system of integrated governance, risk management and internal
          control, across NHS Manchester‟s activities (both clinical and non-clinical), that
          support the achievement of both the Cluster.
         Provide assurance to the Local Audit group, and the Locality Board, that there are
          robust structures, processes and accountabilities in place for the identification and
          management of significant risks facing the organisation.
         Ensure that the organisation has policies for ensuring compliance with relevant
          regulatory, legal and code of conduct requirements, and to approve such policies in so
          far as it does not interfere with the Cluster Board and Audit Committee work on joint
          locality board policies.
         To identify and review lapses in quality and make recommendations for improvements
         Receive and monitor progress against reports from external agencies.
         Work collaboratively to identify and promote “Best Practice”, the sharing of experience,
          expertise and success across the NHS Manchester and with key stakeholders.

      Sub committees of the Governance Committee are not included within this Locality Scheme
      of Delegation. The primary purpose of the Governance Committee subgroups is to support
      the Governance Committee to ensure that NHS Manchester meets its regulatory
      requirements.




Gareth Webb
Corporate Governance and Risk Manager
August 2011




                                               3
     Appendix A

     Operational Decisions, authorities and duties delegated to officers of NHS Manchester

     Key
     Level 1 = Chief Executive
     Level 2 = Cluster Board
     Level 3 = Managing Director
     Level 4 = Locality Board (can be further delegated following Cluster Board approval of the Locality
               governance structure)
     Level 5 = Budget Holders, in accordance with specific levels of authority granted to individuals

Ref:       Authorities/duties       Delegated        Delegated        Notes/details to further
               delegated             to (Level)   Approval Range             guidance
1      Payroll – staff              1 -CEO        Level 2 and         Further guidance set
       appointments,                3 -LMD        above               out     in     Standing
       authorisation of contracts                 Level 4 and         Financial Instructions
       and terminations                           below               and            Financial
                                                                      Procedures
2      Timesheets, special          1 - CEO       Level 2 and 3       See           individual
       duty, other additional       3 -LMD        Level 4             Financial Procedures
       payments, travel             4 – LB        Level 5
3      Approval of business         2 - CB        > £5m
       cases (healthcare and        1 – CEO       £2.5m to £5m
       non healthcare) for both     and DOF
       investment and               4 - LB        < £2.5m
       disinvestment
4      Petty Cash                   3-LMD         < £30               See    Petty     Cash
       reimbursement general        4 – LB                            Procedure    available
                                    5 -BH                             from          Finance
                                                                      Department.

5      Charitable Funds             1 –CEO        > £25k
                                    and DOF
                                    3 - LMD       < £25k
                                    and LDOF

6      Training courses and         1 – CEO       >£100k              See           individual
       agency staff invoices        and/or                            procedures
                                    DOF           < £100k
                                    3 - LMD
                                    and/or
                                    LDOF          <£25k
                                    Associate
                                    Dof

7      Consultancy                  1- CEO        > £100k
                                    3 - LMD       < £100k
8      Contract signing and         3 – LMD       All contracts.      See below
       variations to healthcare     and/or
       and non healthcare           LDOF
       contracts
9      Removal expenses                           As per Cluster
                                                  Removal Policy

10     Losses and special           1- CEO        < £50k              For sums over £50,000
       payments                     2 -CB         < £1k (for ex       or in the case of all
                                                  gratia payments     extra statutory or extra
                                                  to patients and     regulation    payments
                                                  staff for loss of   approval of the NHS
                                                  personal effects    Executive     will   be

                                                            4
                                               only)                required. All losses and
                                                                    special payments to be
                                                                    approved       by    the
                                                                    Locality Audit Group.



Ref:      Authorities/duties     Delegated         Delegated         Notes/details to further
               delegated          to (Level)    Approval Range             guidance
11     Capital                   3-LMD         As per allocated     Use of capital receipts
                                               capital resource     must be authorised by
                                               limit                the Strategic Health
                                                                    Authority    and      the
                                                                    Cluster Board
12     Establishment control     3-5           Any changes
13     Virements between         4-5           as     per    the    A virements Policy will
       budgets – revenue only                  Locality             detail the criteria to be
                                               virement policy      met before virements
                                                                    are made
14     Management of assets      1-5           Responsibility       Responsibility will be
                                               delegated            delegated for making
                                                                    sufficient appropriate
                                                                    arrangements for the
                                                                    management of land,
                                                                    buildings and other
                                                                    assets, in accordance
                                                                    with the local Scheme
                                                                    of Management.
15     Litigation – agreement    1 – CEO       > £250k              All claims will be dealt
       on settlement             or DOF                             with in accordance with
                                 3-LMD         < £250k              NHSE Guidance on
                                                                    Claims     Management
                                                                    Best Practice

16     Disciplinary and          1-CEO         Level 2 and 3        See              detailed
       dismissal:                              officers             Disciplinary Policy

                                 3-LMD and     All other staff
                                 4 -LB


17     Lease Cars                DOF           For all levels of    All new requests for
                                               staff                lease cars after 9 June
                                                                    2011 must also receive
                                                                    DOF approval.
18     Complaints                3-LMD         Final sign off of    According to agreed
                                               complaint            complaints policy
                                               response letter
19     Banking arrangements      DOF or
                                 LDOF          -

20     Signing and sealing of    3-LMD                              See Standing financial
       documents                               -                    instructions. All sealing
                                                                    must be entered in the
                                                                    Register.
21                              Other Goods and Services Invoices
                      Designations                  Invoices              Requisitions
       Locality Managing Director and Locality  ≥ £1,000,000        ≥ £1,000,000
       Director of Finance
        Locality Managing Director              < £1,000,000        < £1,000,000
        Locality Director of Finance            < £750,000          < £750,000
        Locality Director of Commissioning      < £500,000          < £500,000

                                                         5
          Locality Budget Holder                  < £50,000       < £50,000
23           Contract Variations (non-financial amendments)         Contracted Services
                                 Designations
        Locality Managing Director and Locality Director of         N/a
        Finance
        Locality Associate Director of Commissioning (CCG with
        responsibility for the Provider)
        Chief Finance Officer (CCG with responsibility for
        Provider)
24           Approval of monthly contract payment schedules        Limits to be updated
         (Primary Care, Secondary Care & Joint Commissioning)     annually
                                 Designations
        Locality Managing Director and Locality Director of         >£16,000,000
        Finance
        Assistant Director of Finance (Primary Care & Secondary     <£16,000,000
        Care)
        Senior Finance Managers (Secondary Care & Joint             < £16,000,000
        Commissioning)
        Contract Accountant – Primary Care (Medical & Dental)       <£6,000,000

     NB The shaded areas within this table indicate where NHS Manchester has made additions to the Cluster
     Board Scheme of Delegation within the powers which NHS Manchester delegated to it




                                                        6
Appendix B.

Responsibilities of PCT Locality Board during 2011-12 and 2012-13

3.1    DH guidance identifies the following responsibilities for PCT Locality Boards

Integrated delivery plan                Implementation under Cluster guidance


Direct commissioning                    Agreement of 2011/12 contracts
                                        By June 2011 management of 2011/12 delivery as
                                         required by cluster
                                        Agreement and delivery of primary care contracts
                                        Annual accounts
Management and                          Handover of QIPP plans to cluster
implementation of medium-               As required by cluster leadership of service change
term QIPP plans                          elements required by QIPP plans
Oversight of closedown of               Work with cluster on transfer of appropriate people and
PCTs                                     skills to developing arrangements
Enabling development of                 Handover of Clinical Commissioning Groups development
Clinical Commissioning                   process to cluster arrangements in 2011/12
Groups and wider reform                 As required by cluster, support to Clinical Commissioning
                                         Group development
Supporting development of               Support cluster in making people and systems available
commissioning support for                in support of commissioning
Clinical Commissioning
Groups
Governance                              Put in place Board Governance arrangements
                                        Put in place Schemes of Delegation
Maintain talent and support             Support cluster in managing people transition
people through change                   As the employers of staff, abide by relevant employment
                                         legislation and good practice – e.g. in terms of
                                         consultation
Maintain relations with local        2011/12
government and other key              Maintain effective joint working arrangements and
partners                                engagement processes with patients, communities and
                                        seldom-heard and marginalised groups
                                      Plan for transition of public health functions to national
                                        Public Health service and local authorities
                                     2012/13
                                      As above + ensure effective handover to GP consortia
                                        and Local Health and Wellbeing Boards
                                      Support of Local Health and Wellbeing Boards
                                      Transfer of public health functions to national Public
                                        Health service and local authorities




                                                 7
Appendix C



                     Transitional Commissioning Board

                               TERMS OF REFERENCE

1. Purpose and Duties

   The purpose of the Transitional Commissioning Board is threefold:

    To act as the clinically led subcommittee of the Board of NHS Manchester in providing
     clinical leadership and advice during the period of transition prior to the Manchester GP
     commissioning consortia taking full control their budgets in April 2013.

    To assure the delivery of the business change associated with implementing the White
     Paper, „Equity and Excellence: Liberating the NHS‟ and associated documents, as it
     pertains to NHS Manchester and the future commissioning and system leadership
     architecture for healthcare in Manchester.

    To be the primary forum for debate and determination of issues of policy and strategy
     relating to the aforementioned business change; including referral of issues and decision-
     making to other NHSM or external meetings/ structures where necessary/ appropriate

   In providing assurance of delivery to NHSM EMT and Board, the Transition Board will:

    Agree workstream areas and responsible lead officers within the scope of the transition

    Approve „fit for purpose‟ format of assurance documentation for use within the Transitional
     Commissioning Board (eg project initiation documents, highlight reports and RAG ratings)

    Approve detailed implementation plans from each lead for their respective workstream
     areas, including outcomes and key delivery milestones

    Receive highlight progress reports on each workstream area based on key achievements
     and risks to delivery those workstream areas

    Review workstream areas and plans in light of changing national/ regional/ local context
     including (for example) HR Framework, Health Bill, Public Health White Paper, Operating
     Framework.

    Determine any matters of policy or strategy which require debate/ determination at other
     fora within NHSM or externally.

    Determine actions relating to key risks to delivery where these are highlighted through
     progress reports

    there is clarification of how the change can be managed without adversely affecting the
     TCS Programme objectives.

   Outputs from the group will include:
        locally agreed TAPs
        TCS Programme Benefits Realisation Plan


                                               8
2. Membership, Support Arrangements and Attendance

   The core Transition Board membership will comprise :

      Chief Executive, NHSM or Managing Director, Local Office
      Central Shadow GPCC Chair
      South Shadow GPCC Chair
      North Shadow GPCC Chair
      PEC Chair NHSM
      Director of Commissioning, NHSM
      Director of Informatics and Improvement, NHSM
      Turnaround Director NHSM
      Director of Finance, NHSM
      Strategic Head of HR/OD NHSM
      Medical Director NHSM
      Joint Director of Public Health and Partnerships, NHSM/MCC
      Deputy Chief Executive, Manchester City Council


   Additional members may be co-opted as necessary to provide expertise in particular subject
   areas,

   The Chair will be elected by the Board.

   Members should where possible identify Deputies to attend on their behalf in the event of non
   attendance.

   Administrative support to the Board will be provided by the PA to the Chief Executuve.
   Transition Board project management support will be determined and the Terms of Reference
   updated to include this.

   Workstream leads will be invited to attend to present to the Board. Other NHSM, PBC, MCC
   and other external representatives will be invited to attend/ present as appropriate. Requests
   for representatives other than members to attend the Board should be made to the PA to the
   Chief Executive prior to seven days before a meeting date and agreed with the Chair.


3. Meeting Arrangements

   The group shall meet monthly.


4. Quorum

   The quorum for the group shall be five members (including at least two Shadow GPCC chairs
   or their Deputies).

5. Agenda Items/ Papers

   The agenda shall be agreed by the Chair. Any member wishing to request an item for the
   agenda within the purpose and duties of the Board should inform the PA to the Chief Executive
   no later than two weeks prior to the meeting to enable it to be considered in agenda setting.

   Papers for agreed agenda items should be submitted to the PA to the Chief Executive no later
   than one week before the meeting to enable circulation to the Board of agendas and papers
   one week before the meeting.

                                               9
6. Accountability and Reporting Arrangements

   Highlight reports will be provided to NHSM‟s EMT and Board, which will be produced monthly
   within the project management support arrangements. Additionally, Board Minutes will be
   attached to NHS Board papers. The Transitional Commissioning Board will determine matters
   for debate/ determination by those and other groups.

7. Review of Terms of Reference

   The terms of reference of the group shall be kept under review as one of the areas of
   responsibility within the project management support arrangements.




                                            10
  Appendix D

  Total budget allocation as at 24th August 2011 per item for the Clinical
  Commissioning Groups (CCG)


                                        All CCGs
Allocation
                                            £,000
NHS Provider Service Agreements          369,459
Non Contracted Activity                     5,730
Non NHS Services                           19,238
Prescribing (*)                            91,073
PBC Initiatives                             4,213
Community Services                         80,767
Specialist CBS and Bariatric               55,083
Learning Difficulties Non Secure            2,114
Mental health Non Secure                   91,219
Continuing Health Care                     32,781
NHS Funded Nursing Care                     3,862
HIV/Aids - Non NHS                         14,480

Total by Sector                          770,019




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