Primary Care Contracting Group Terms of Reference
1. CONSTITUTION
1.1. The Primary Care Contracting Group (the Group) is established by the Integrated Care Board (the Board or ICB) as a Group reporting to the ICB Executive Management Group in accordance with its Scheme of Delegation and Reservation.
2. PURPOSE OF THE GROUP
2.1. The Primary Care Contracting Group has been established as an expert panel to ensure consistent decision making across the ICB with regards to delegated primary care services.
2.1.1. Whilst exercising this duty it will:
• Ensure delegated commissioning decisions made by the relevant contracting group are made in-line with national legislation and policy
• Ensure all delegated primary care functions are effectively managed
• Promote a culture of continuous improvement and innovation with regards to clinical service delivery, effectiveness and patient experience
• To maintain oversight of contractual and financial performance of primary care contracts
• To maintain oversight of the procurement of primary care contracts
• To review and monitor risks on the Board Assurance Framework and Corporate Risk Register which relate to Primary Care Contracts or the effective and safe delivery of Primary Care services
• Ensure sufficient engagement has taken place prior to making any decision
2.1.2. The Group will provide regular assurance updates to the ICB in relation to activities and items within its remit.
2.1.3. The Group shall have four formal sub-groups, and will also receive reports from the Capital Group:
• Primary Medical Services sub-group
• Pharmaceutical Services sub-group
• Dental Services sub-group (shadow form during 2022/23)
• Eye Health Services sub-group (shadow form during 2022/23)
2.1.4. The Group’s remit covers the contracting and financial oversight of:
• All delegated primary care commissioning functions as defined by the Delegation Agreement
• all enhanced/locally commissioned primary care services
2.1.5. The Group takes accountability in ensuring delegated primary care commissioning decisions are made in-line with national policy and legislation. The group, and associated contracting groups, shall carry out the functions to the commissioning of primary care services under The NHS Act 2006, namely:
• Primary Medical Services, under part 4
• Pharmaceutical Services, under part 7
• Dental Services, under part 5*
• Ophthalmic Services, under part 6*
• As defined by the Delegation Agreement
*Responsibility for these services will not transfer until 1 April 2023
2.1.6. These functions are further defined in the appendix at the end of the document
2.1.7. The Group does not hold responsibilities for functions retained by NHS England for example performers list concerns
2.1.8. The Group shall only make decisions where it is satisfied sufficient place engagement has taken place. The process to decision making will be clearly defined and process mapping document to support these terms of reference will be developed and ratified by the 30 September 2022
3. DELEGATED AUTHORITY
3.1. The Primary Care Contracting Group is a group of the ICB. The Board has delegated authority to the Group as set out in the Scheme of Reservation and Delegation and may be amended from time to time.
3.2. The Primary Care Contracting Group holds only those powers as delegated in these Terms of Reference as determined by the ICB Board.
4. MEMBERSHIP AND ATTENDANCE
4.1. The Board will agree the membership of the Group and the Chair of the ICB will approve the members. Other members of the Group need not be members of the Board, but they may be.
4.2. When determining the membership of the Group, active consideration will be made to equality, diversity and inclusion.
4.3. The Chair may ask any or all of those who normally attend, but who are not members, to withdraw to facilitate open and frank discussion of particular matters.
4.4. Chair and vice chair
4.4.1. The Group shall satisfy itself that the ICB’s policy, systems and processes for the management of conflicts, (including gifts and hospitality and bribery) are followed by group members.
4.4.2. If a Chair has a conflict of interest, then the vice-chair or, if necessary, another member of the Group will be responsible for deciding the appropriate course of action.
4.5. Members*
• Medical Director (Chair)
• Director of Primary Care (Deputy Chair)
• Head of Primary Care
• Senior Finance Lead for Primary Care
4.6. In attendance**
• Associate Medical Director
• Deputy Head of Primary Care
• Senior Primary Care Manager- Contracting
• Healthwatch Representative
4.7. In attendance, where required**
• Clinical Adviser(s)
• Contracting Group Chair
• Place Based Representative
4.7.1. *voting members must not be engaged in the delivery of primary medical or pharmaceutical services
4.7.2. ** those in attendance must not be conflicted by the decisions due to be made during the meeting
5. MEETING QUORACY AND DECISIONS
5.1. The Primary Care Contracting Group shall meet on a monthly basis. Additional meetings may be convened on an exceptional basis at the discretion of the Group Chair.
5.2. Quoracy
5.2.1. There will be a minimum of three members present and must include the following members
• Chair, and/or Director of Primary Care (deputy chair)
• Senior Finance Lead for Primary Care t
5.2.2. Where members are unable to attend, they should ensure that a named and briefed deputy is in attendance who is able to participate on their behalf.
5.3. Decision making and voting
5.3.1. Decisions will be taken in according with the Standing Orders. The Group will ordinarily reach conclusions by consensus. When this is not possible the Chair may call a vote.
5.3.2. Only members of the Group may vote. Each member is allowed one vote and a majority will be conclusive on any matter.
5.3.3. Where there is a split vote, with no clear majority, the Chair of the Group will hold the casting vote. The result of the vote will be recorded in the minutes.
5.3.4. If a decision is needed which cannot wait for the next scheduled meeting, the Chair may conduct business on a ‘virtual’ basis through the use of telephone, email or other electronic communication.
6. RESPONSIBILITIES OF THE GROUP
6.1. The responsibilities of the Primary Care Contracting Group will be authorised by the ICB Board. It is expected that the Primary Care Contracting Group will:
• Hold responsibility for contracting and financial oversight of primary care contracts as articulated
• Hold the following contracting responsibilities:
o To make delegated primary care commissioning decisions in line with the relevant section of The NHS Act 2006
o To maintain oversight of the management of decisions made by the relevant contractor groups
o To ensure contracting plans are consistent with strategic, activity and financial plans
o To ensure contracting documentation is consistent and in line with national guidance
o To take overall responsibility in assessing the need for future procurements and/or extensions to existing contracts
o To consider and manage any contracting concerns escalated to the Group via the relevant sub-groups
o The Group holds the following financial responsibilities:
o To assure robust financial budget management of delegated services
o To consider and recommend clinically supported schemes to support additional core activity within contracted budget levels to the Primary and Integrated Neighbourhood Care Transformation Programme Group
• Hold the following additional responsibilities:
o To hold and maintain a risks and issues register associated with delegated primary care contractors and escalate risks appropriately in alignment with the ICBs Risk Management Framework.
o To approve and ensure compliance with the relevant contract sub-groups terms of reference
o To document all decisions made by the group
o The Group should be satisfied that sufficient engagement has taken place prior to making any decisions, this includes but is not limited to, engagement with place, local representative committees and the public.
7. ACCOUNTABILITY and REPORTING ARRANGEMENTS
7.1. The Primary Care Contracting Group is directly accountable to the ICB executive. The minutes of meetings shall be formally recorded, and a summary report prepared for the next ICB executive meeting. The Chair of the Group shall report to the executive meeting after each meeting and provide a report on assurances received, escalating any concerns where necessary.
7.2. The Group will advise the Audit Committee on the adequacy of assurances available and contribute to the Annual Governance Statement
7.3. The Group will receive scheduled assurance report from its sub-groups. Any sub-groups would need to be agreed by the ICB executive.
8. BEHAVIOURS AND CONDUCT
8.1. ICB values
8.1.1. Members will be expected to conduct business in line with the ICB values and objectives. Members of, and those attending, the Group shall behave in accordance with the ICB’s Constitution, Standing Orders, and Standards of Business Conduct Policy.
8.2. Equality and diversity
8.2.1. Members must demonstrably consider the equality and diversity implications of decisions they make.
9. DECLARATIONS OF INTEREST
9.1. All members, ex-officio members and those in attendance must declare any actual or potential conflicts of interest which will be recorded in the minutes. Anyone with a relevant or material interest in a matter under consideration will be excluded from the discussion at the discretion of the Chair.
10. SECRETARIAT AND ADMINISTRATION
10.1. The Group shall be supported with a secretariat function which will include ensuring that:
• The agenda and papers are prepared and distributed in accordance with the Standing Orders having been agreed by the Chair with the support of the relevant executive lead;
• Attendance of those invited to each meeting is monitored and highlighting to the Chair those that do not meet the minimum requirements;
• Records of members’ appointments and renewal dates are held, and the Board is prompted to renew membership and identify new members where necessary;
• Good quality minutes are taken and agreed with the chair and that a record of matters arising, action points and issues to be carried forward are kept;
• A Summary Report of the minutes, including key discussions, decisions and any areas of concern or assurance is prepared for the Chair to present at the ICB Executive;
• The Chair is supported to prepare and deliver reports to the Board;
• The Group is updated on pertinent issues/ areas of interest/ policy developments;
• Action points are taken forward between meetings and progress against those actions is monitored.
11. REVIEW
11.1. The Group will review its effectiveness at least annually and complete an annual report submitted to the Board.
11.2. These terms of reference will be reviewed at least annually and more frequently if required. Any proposed amendments to the terms of reference will be submitted to the Board for approval.
11.3. The Group will utilise a continuous improvement approach in its delegation and all members will be encouraged to review the effectiveness of the meeting at each sitting.
Date of approval 1 July 2022
Date of review June 2023