Interim CCG Assurance Framework

1. Interim CCG Assurance Framework Andrew Reed - Area Director East Anglia Area Team May 2013

2. The Assurance Framework Section 1 NHS | Presentation to [XXXX Company] | [Type Date]

3. Three roles of NHS England with CCGs • A development role to work with and support CCGs to become the best they can be • An assurance role to ensure that as a statutory organisation CCGs deliver best possible outcomes for their patients within financial resources • A co-commissioning role to ensure the direct commissioning undertaken by NHSE works across the entire patient pathway and supports delivery of local outcomes • In implementation, these roles are interlinked. When describing the process of assurance we must be clear about respective and joint accountabilities and responsibilities NHS | Presentation to CCG | May 2013

4. Key elements of the CCG Assurance Process • Looks at organisations performance and its health • Identify how well the CCG is performing against their plans to improve services and deliver better outcomes for patients • Work together to assess how the CCG can realise its full potential and support this development • Alongside NHS England, secure quality today and transform services for the future • Framework is outline and interim – process to engage CCGs and other stakeholders over coming months • Definitive assurance framework published in Autumn NHS | Presentation to CCG | May 2013

5. Principles of the Framework • Assurance of quality for patients always at the heart of the process • Promote accountability of CCGs to their local population • Support CCGs to develop ambitious plans for improvement • Identify support a CCG needs to develop its full potential • Clear and consistent basis for NHS England support or intervention. Support CCG to deliver good outcomes. • Focus on role of CCG in securing patient and public engagement • Only use information the CCG needs to manage its own business • Process will continuously evolve • Output of assurance will be proportionate and transparent NHS | Presentation to CCG | May 2013

6. Key elements • Performance aspect based on CCG published progress against plans, performance on key standards and outcomes for local population • ‘Checkpoints’ in July and October – pilots to inform longer term • Style of partnership not hierarchy; shared expectations of behaviours; enable effective relationships to drive improvements • NHS England will only intervene in few circumstances where necessary • Mutual assurance - co-dependent commissioners of NHS services incl LA responsibilities for public health and social care. To be worked through in interim period • Mutual accountability to H&WBB • NHS England will ensure same level of scrutiny for direct commissioning NHS | Presentation to CCG | May 2013

7. Core elements of assurance • Delivery ensuring the CCG is delivering for its population the full range of outcomes and standards (national and local) agreed in its plan • Capability ensuring CCG is set up with required skills and knowledge and exhibiting appropriate behaviours • Support determining the nature and level of support a CCG needs to be a great commissioner NHS | Presentation to CCG | May 2013

8. Quarterly Checkpoint • Delivery against strategic plan • Standards in NHS Constitution • Improvement against Outcomes Framework • On track financially • Some assessment of capability • Progress against authorisation conditions • Agreement about appropriate support • Discuss collaboration areas of joint interest and developmental support • Basis is information CCG publishes locally • Greater role for assessment of quality and outcomes • Assessment by CQC of providers • Voice of patient and other stakeholders to shape service improvement • Quality of complaints resolution • Balanced scorecard which CCGs will publish Annex A = initial proposal • Discuss provider performance concerns and assess actions; discuss mutual support NHS | Presentation to CCG | May 2013

9. Annual Review (work in progress) • Assess capability of CCG • Build on authorisation process • Review organisational health – self assessment, 360, peer review, site visits (rolling programme) • Focus on • Clinical and multi-professional focus , quality centric • Relationship with patients and public • Medium term clear and credible plan • Capacity and capability to assure quality and discharge functions • Behaviours with key stakeholders • Review outcomes of quarterly checkpoints • Opportunity to review how CCG is dealing with local strategic challenges NHS | Presentation to CCG | May 2013

10. Identify support needs • Majority of CCGs receive support on an informal basis • Not just for poor performers as in the past • Support to be great commissioners • Support discussed in line with national framework (Annex B) at each quarterly review • Need to identify a mechanism by which NHS England would use its powers to intervene where there were serious concerns • For interim assurance – as outlined in Annex B NHS | Presentation to CCGs| May 2013

11. Approach to assurance in East Anglia Section 2 NHS | Presentation to [XXXX Company] | [Type Date]

12. Practical matters • We want to make this work for both the CCG and for the Area Team • Vital we develop detail of process together and that we review together whether we are ‘getting it right’ • We need to; • Agree date for production of scorecard by CCG for Q1 & Q2 • Agree subset of health outcomes / local quality premium dataset • Arrange meetings around data availability (July / August). Max 6 weeks from end of quarter • Agree attendance from CCG and Area Team • Half day initially – may get quicker • Develop agenda structure together – intro, business, outcomes of discussion, review of how assurance is working • Develop process for agreeing content to be published on CCG website • Review assurance process and feedback together how we improve it NHS | Presentation to CCG | May 2013