1. Delegated Commissioning Update PCCC
April 2017

2. Delegated Commissioning – Conditions
HMS membership voted to take on delegated commissioning of Primary Care in October 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Rent reviews should be up-to-date and the impact of any outdated rent reviews should be funded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

3. 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.

4. 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

5. 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)

6. 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.

7. 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)