Delegated Commissioning Update PCCC April 2017

Delegated Commissioning – Conditions HMS membership voted to take on delegated commissioning of Primary Care in October 2016. The membership set three conditions: Condition Update The primary care budgets should be ringfenced NHSE have agreed to this. The agreement states that the delegated budget can only be used for delegated functions, ie must be used for primary care The CCG should have sight of all the paperwork, including any legacy contractual issues The CCG has now received all the contracts and associated files. There are no contractual issues of which we were not already aware Rent reviews should be up-to-date and the impact of any outdated rent reviews should be funded The CCG has now received all estates information from NHSE, along with assurance that all outstanding rent reviews will be in progress by the handover on 1st April Proposed constitutional changes have now been agreed by NHSE and the CCG has signed the delegation agreement, in preparation for taking on delegated responsibility from 1st April

Delegated Commissioning – Staffing The CCG are now preparing to take on the additional responsibility We are undertaking an internal recruitment for a Band 7 Contracts Manager who, alongside the existing Primary Care Contracts Officer, will be the first point of contact for primary care contracting issues. Both individuals will be based in the Contracting Team, to provide a separation between primary care contractual issues and the primary care team’s existing relationship with practices. HMS will be working closely with the contracting teams in Brighton and Hove (newly delegated) and High Weald Lewes and Havens (already delegated) to share expertise and build resilience. There is also an MOU in place with NHS England for transitional support in 2017/18. NHS England have been providing training, have shared their processes, and will continue to provide support and guidance whilst we build our own expertise.

Delegated Commissioning – Delegated Functions From 1st April, HMS CCG will be responsible for the following List of delegated functions Decisions in relation to the commissioning, procurement and management of Primary Medical Services Contracts Approval of practice mergers Planning primary medical care services in the area Undertaking reviews of primary medical care services in the area Decisions in relation to the management of poorly performing GP practices Management of delegated funds in the area Premises Costs Directions Functions Co-ordinating a common approach to the commissioning of primary care services with other commissioners in the Area where appropriate Such other ancillary activities that are necessary in order to exercise the Delegated Functions

Delegated Commissioning – Processes NHS England have shared their processes for the following issues, for which the CCG will be the first point of contact. Process booklet Rent Review Processes: Notional Rent Actual Rent Premises Costs Reimbursements: Rent Rates Water SFE Payments – Locum Reimbursements: Maternity / Adoption Leave Paternity / Adoption Leave Sickness GP Retainers GP Retainers Bursary Patient Allocations Violent Patient Scheme Contract Variations Interpreting Services Dispensing Services Quality Scheme (DSQS)

Delegated Commissioning – Governance changes A new subgroup of the PCCC will be established to ensure the transactional aspects of primary care commissioning are undertaken quickly, efficiently, clearly and in line with national regulation and local strategy. Duties of PCCOG To make decisions on the following items, in line with agreed SOPs: Remedial and breach notices, 24 hour retirements, cold chain events, Serious Incidents, discretionary payments, minor improvement grants, rent reviews, sale and leaseback, initial scrutiny of Project Initiation Documents (PIDs) for premises developments and other operational issues. To make recommendations in line with SOPs to PCCC: Contract variations, boundary changes, contract mergers, list closures, partnerships becoming sole contractors, branch closures/openings. To recommend decisions to the PCCC on the following: Contract final notices and terminations, major investment decisions, PIDs for premises developments; Year-end sign-off of the Quality and Outcomes Framework (QOF); Other strategic items, as required. To report to the PCCC on the above issues and decisions made. To correspond with practices on the above issues, to ensure decisions are made with the fullest possible information and to communicate back to practices clearly and promptly. To improve quality, safety and patient experience of primary care services, as part of the organisation’s overall responsibilities for improving quality across the board. Review, recommend and approve broader strategic Primary Care developments as they arise, including Locally Commissioned Services To develop and agree a work plan with the Primary Care Commissioning Committee.

Delegated Commissioning – Functions retained by NHS England NHS England continue to be responsible for the following List of reserved functions Management of the national performers list Management of the revalidation and appraisal process Administration of payments in circumstances where a performer is suspended and related performers list management activities Capital Expenditure Functions Section 7A functions Functions in relation to complaints management Such other ancillary activities that are necessary in order to exercise the Reserved Functions; and Responsibility for the GPIT primary care enabling services (IG support service, NHS mail and administration, smart card/registration authority, clinical safety assurance)