1.
SCHEME OF DELEGATION - PRIMARY CARE COMMISSIONING COMMITTEE
1.1
The arrangements made by the group as set out in this scheme of delegation of decisions shall have effect as if incorporated in the group’s terms of reference.
1.2
The Primary Care Commissioning Committee remains accountable for all of its functions, including those that it has delegated.
1.3
The following table shows those matters which are reserved and delegated for the discharge of the groups’ functions. The Standard Financial Instructions of
Southampton City CCG, as set out below will determine any limits of financial authority.
1.4
Process flow charts for decision making processes, including where urgent decisions are required are set out in a separate document.
1.5
Where decisions are perceived to be ‘novel or contentious’, Primary Care Commissioning Committee members may be called for an exceptional meeting or offline
discussion and decision.
2.
AUTHORISATION OF TENDERS AND COMPETITIVE QUOTATIONS
2.1
Providing all the conditions and circumstances set out in these Standing Financial Instructions have been fully complied with, formal authorisation and
awarding of a contract may be decided by the following staff to the value of the contract as follows (N.B. all values quoted are for the total investment
required (not individual practice values) and are over the lifetime of the contract):
Primary Care Contracts
2.2
Senior Manager - Band 8
up to
£50,000
Associate Director
up to
£75,000
Other Director
up to
£1,000,000
Chief Finance Officer/Chief Officer
up to
£15,000,000
Primary Care Commissioning Committee/Governing Body
over
£15,000,000
These levels of authorisation may be varied or changed and need to be read in conjunction NHS Southampton City CCG Board’s Scheme of
Delegation. Formal authorisation must be put in writing. In the case of authorisation by NHS Southampton City CCG Board, this shall be recorded in
their minutes.
1
Decision pathway for delegated
commissioning of primary care
Operational day-today
Recommendations
Regular
communication with
CCG & NHSE AT
colleagues
Primary Care
Operational Group
Decision Making Process 2
Formal decisions
Accountability /
ratification
Southampton Primary
Care Committee
Southampton CCG
Governing Body
Membership to be agile & include lay
member and LMC reps
Authority to make decisions
where: it is within policy
 it is not exercising
discretion
 it is not exceptional
 It is not exceeding the
financial limits
2
Area
Governing
Body
Primary Care
Commissionin
g Committee
Director e.g
Primary
CFO, Director
Care
of Quality
Operational
and
Group
Integration
Associate
Director
of Quality
Head of
Primary Care
Developmen
t
Primary
Care
Team
NHS
England
GMS / PMS / APMS
Approval of pooled funds
Commissioning
Approval of primary care
business cases
Commissioning
Development of primary care
business cases
Commissioning
Approval of
recommendations regarding
commissioning of urgent
care for out of area patients
Developing
recommendations regarding
commissioning of urgent
care for out of area patients
Approval of decisions
regarding procurement of
APMS
Developing
recommendations for APMS
contracts
 
 
ratified


Commissioning
Commissioning
Contracting
Commissioning
Monitoring of APMS
contracts
Commissioning
Authorise Local contract
variations e.g PMS
Commissioning
Ratified



















 




3
Area
Development of procurement
opportunities for primary care
services
Approval of procurement
opportunities for primary care
services
Developing
recommendations related to
reinvestment of funding
following PMS Contract
Reviews
Approval of decision related
to reinvestment of funding
following PMS Contract
Reviews
Review and planning of
procurement opportunities
for primary care services
Governing
Body
Primary Care
Commissionin
g Committee
Contracting

Contracting
Commissioning

Commissioning



Contracting
Practice list size reviews
Contracting
Approval of practice List Size
Reviews
Contracting
Approval of application for
Branch Surgery Closures
Contracting
Approval of application for
partial Branch Surgery
Closures
Contracting
Approval Termination
Contracting











Associate
Director
of Quality
Head of
Primary Care
Developmen
t
Primary
Care
Team
NHS
England







Contracting
Approval of application for
Closed Lists
Director e.g
Primary
CFO, Director
Care
of Quality
Operational
and
Group
Integration


 





4
Area
Approval of Breach notice
Contracting
Issue Breach notice
Contracting
Approval of Remedial notice
Contracting
Issue remedial action plan
Contracting
Approval of Practice Mergers
Contracting
Decision following appeal of
boundary changes
Contracting
Approval of Boundary
changes
Contracting
Approval of
recommendations regarding
new PMS arrangements
APMS (Alternative Provider
Medical Services) Contract
procurement
Approval of formal contract
disputes (Likely to include
commercially sensitive
information and therefore
would need to in private)
Approval of practice appeal
against contract decision
Governing
Body







Primary Care
Commissionin
g Committee





Contracting





Contracting


Contracting

Contracting

Director e.g
Primary
CFO, Director
Care
of Quality
Operational
and
Group
Integration
Associate
Director
of Quality




Head of
Primary Care
Developmen
t







Primary
Care
Team
NHS
England




 

 
 



5
Area
Authorisation National
contract variations
Contracting
Approval of Primary Care
Budget
Finance
Budget Management Primary Medical Services
Finance
Making recommendations for
the primary care budget
Finance
Monitoring of QOF
achievement /
activity/prevalence/exception
rates
Enhanced Services (DES,
LCS) Approval of
alternatives
Enhanced Service (DES,
LCS) Performance
management
Enhanced Service (DES,
LCS)
Monitoring within contract
Approval of Local
Improvement Scheme and
Quality Improvement
Scheme
Governing
Body
Ratified

Primary Care
Commissionin
g Committee


Director e.g
Primary
CFO, Director
Care
of Quality
Operational
and
Group
Integration







Commissioning

Awarding contracts longer
than 5 years
Contracting





Commissioning
Development of Local
Improvement Scheme
NHS
England



Ratified

Primary
Care
Team

Commissioning
Commissioning
Head of
Primary Care
Developmen
t
Additional services to core contract
Commissioning
Commissioning
Associate
Director
of Quality











6
Area
Monitoring of Local
Improvement Scheme
Approval of Local Incentive
Scheme as Alternative to
QOF
Design and implementation
of Local Incentive Scheme
as Alternative to QOF
Commissioning
Contracting
Contracting
Approval of sub-contracting
arrangements for enhanced
services
Contracting
Payment processing – DES /
LCS / LIS / drugs / Core
Contract
Finance
Approval of QOF Payments
including aspirational
payments
Authorise of QOF
achievement prior to finance
schedules including
aspirational payments
Governing
Body




Primary Care
Commissioning
Committee
Primary
Care
Operation
al Group





Primary
Care
Team
NHS
England
 




Finance
Finance
Head of
Primary Care
Developmen
t

Finance
Finance
Associate
Director
of Quality


Human Resources
Returner & Retainer
Approvals (above budgetary
limits as per operational
scheme of delegation)
Returner & Retainer
Approvals (below budgetary
limits as per operational
scheme of delegation)
Director e.g
CFO, Director
of Quality
and
Integration










7
Area
Discretionary Payments (in
line with policy)
Governing
Body
Primary Care
Commissioning
Committee
Primary
Care
Operation
al Group
Director e.g
CFO, Director
of Quality
and
Integration

Finance
(In line with
financial restriction)
Maternity, paternity and long
term sick leave sick leave
fees (locum fees)
Finance
Decisions regarding actions
that need to be taken on
poorly performing GP
practices that have been
subject to CQC noncompliance
Quality
Feedback from Patient and
public engagement
Quality
Providing assurance
regarding primary care
contractual and practice
performance
Monitoring primary care
contractual and practice
performance
Liaising with NHS England
sub-regional office and
receiving regular reports on
Primary Care contractual and
practice performance issues

(In line with
financial restriction)


Contracting
Contracting
Contracting

Associate
Director
of Quality
Head of
Primary Care
Developmen
t




(In line with
financial restriction)
(In line with
financial restriction)
Primary
Care
Team
NHS
England



Performance






 





8
Area
Providing advice and
arbitration in disputes
between practices and the
Sub-Regional officer on
contractual and payment
issues in cases where issues
cannot be resolved at
contract manager level.
Governing
Body
Primary Care
Commissioning
Committee
Primary
Care
Operation
al Group
Director e.g
CFO, Director
of Quality
and
Integration
Associate
Director
of Quality
Head of
Primary Care
Developmen
t
Primary
Care
Team
NHS
England

Contracting
Premises
Approval of new GP Practice
Contracting
Approval of Section 106
request for funding for
dwellings
Contracting
3 yearly Rent Reviews
Contracting
Rent review appeals
Contracting
Rent and Rates Payments
Finance
Business and Water Rates
Reimbursements
Finance









 




(In line with
financial restriction)
Reimbursement for Clinical
Waste contract
Finance
(In line with
financial restriction)
Premises – improvement
grant revenue, small GMS
2
space increases (less 50 m )
Finance






(In line with
financial restriction)

(In line with
financial restriction)



9
Area
Approval of Premises
Development schemes
Finance
Review of premises
development applications
Finance
Decisions regarding Primary
Care IT (within contract)
Finance
Governing
Body
Primary Care
Commissioning
Committee


Primary
Care
Operation
al Group
Director e.g
CFO, Director
of Quality
and
Integration
Associate
Director
of Quality
Head of
Primary Care
Developmen
t
Primary
Care
Team
NHS
England


(in line
with premises
development
group – CCGs
and NHSE)



(in line with
CCG IM&T
Development Group)



Finance
Settlement of a claim over
£100,000
Finance




Any matter which is novel,
contentious or repercussive
Finance




10