1. The Federated Model

2. Myth busting The 4 CCGs have chosen to work together in a federated model The Federation does not exist as a separate body The CCGs remain the statutory bodies responsible for all the functions and duties of CCGs They formally delegate function to federated committees

3. Why work in a federated model Help each CCG to fulfil its statutory duties in an economic, efficient and effective way e.g. FOIs, IFRs Achieve best use of the £25 per head running costs with economies of scale Maximise influence with large providers such as RBFT and BHCT Share risk – annual risk sharing arrangement

4. Access to skills and capacity it would be difficult to access as single CCGs Achieve consistency and integration where a pan CCG approach is required Still scope for CCG level initiatives to address local needs

5. Member Practices QIPP and Performance Committee CCG Commissioning Committee Audit Committee Commissioned Service Quality Committee Remuneration Committee Wokingham CCG South Reading CCG North & West Reading CCG Newbury & District CCG QuarterlyMonthlyPRN Monthly Berkshire West CCGs Governance Structure Long Term Conditions Urgent Care Network Planned Care Joint Commissioning (NB in partnership with UAs) Delegation to shared Committees Council of Member Practice

6. 2 key strands Governance Planning and service redesign

7. Governance Audit committee Remuneration working group Quality committee QIPP and finance committee Commissioning committee

8. Planning and Service Redesign Planned Care Long Term Conditions Urgent Care Partnership Board – now developing a mental health and children’s group Maternity task and finish group - new

9. Programme Boards Agree and manage joint programmes of work across all 4 CCGs where all 4 need to be aligned Contribute to the development of the QIPP – investments and savings Manage delivery of the QIPP at programme level but each CCG still has statutory duty

10. Challenges Programme Boards cause most concern Make the link between member practices, CCG Boards and programme boards work Ensure the process doesn’t stifle valid CCG based initiatives Retain the ability to make rapid decisions across the 4 CCGs.