Agenda item

8.1  The chair invited the Managing Director of the Southwark CCG, Andrew Bland, and chair of the CCG, Dr Amr Zeineldine, to update on the move to delegated authority.  The CCG representatives explained that in October of this year the CCG completed an authorization test. There were119 tests that covered a range of areas including governance, audits, and the ability to commission health care effectively.

8.2  The Managing Director explained that this involved a process working with an external advisor. The CCG have been advised to do further work on the safeguarding plan, which is still draft, and the budget plans. He explained the budget had been delayed because of the impact of the TSA. He reported that the Safeguarding policy is now complete and the authorizing body is happy with financial plans.

8.3  The CCG representative explained that the CCG will be graded from 1 to 7.  He said that 7 is the poorest grade and they expect to get around a grade 3, which will mean that the CCG is authorised with conditions.

8.4  Member asked if the TSA had also impacted on Lewisham and Lambeth CCG budget plans, however the Managing Director said that Lambeth and Lewisham were not deemed to have the same ambiguities around the TSA. He commented that the CCGs do not have the same team assessing them, but said that Southwark CCG is not seeking to dispute this as they do consider this a good use of time, and the CCG do think that they have been treated fairly. He explained that there are stages and moderation to the assessment.

8.5  The chair commented that he understood that Lewisham have anxieties to the extent that they are wondering what is the point of having a CCG. The chair of the CCG said this is a result of being a membership organisation. The Managing Director said that the Southwark CCG have a council of members that allows a layer of accountability with an independent chair.  He added that the CCG is an active member of the Health and Wellbeing Board and in terms of going forward the CCGs are similar in many ways, but also different in some ways.

8.6  A member asked about the minutes and the Managing Director said that the CCG have been moving to produce these in two weeks, taking these with increased diligence, and they have also been taking amendments, just as this committee agreed tonight.

8.7  The Managing Director reported that they are will be publishing the Register of Interests on an annual basis and the chair requested that the health scrutiny committee receive the Register of Interests every May.

8.8  The Managing Director explained about third of decisions, around four a month, is going to a conflicts of interest panel.

8.9  There was a discussion about the recommendation that a clause is added to all contracts stipulating that providers will be subject to scrutiny and the Managing Director explained that national standard contacts come with set clauses, which are only subject to  minor variation, however the CCG can add clauses to local contracts.

8.10  The Managing Director referred to the recommendation for financial penalties and explained that the national contracts come with a variety of rewards and a plethora of penalties, but these may not meet the area we or you want, and can vary. He then offered to provide a written summary.

8.11  The CCG were then asked about government stipulations on CCG governance and managing conflicts of interest. The Managing Director said that there is guidance, but this is not compulsory. He explained that the CCG have to have a policy about this but there is no national standard. A member commented that this is part of the Localism agenda.  The chair of the CCG reported that there is an assurance process, which the CCG have passed, and that there were some stipulations. He added that they would expect more uniformity among CCGs as clinical commissioning develops. The Managing Director added that the Southwark CCG paid for some  advice from the Good Governance Institute, and the CCG chair said that the Southwark policy has influenced the south east London cluster of CCGs.

RESOLVED

The CCG will provide the committee with members’  ‘Register of Interests’ on an annual basis, at the May meeting.

Southwark Council’s overview & scrutiny and legal team will provide the CCG with the specimen clause currently used by the council in contracts to ensue that all providers are subject to scrutiny, where possible.