NHS Suffolk and North East Essex Integrated Care Board Governance Handbook

Revision History

Revision DateSummary of ChangesAuthor(s)Version
25/05/2022Initial draft completeLizzie Mapplebeck0.1
30/05/2022Update to wording in Section 4 (ToR)Lizzie Mapplebeck0.2
07/06/2022Inclusion of ICP ToRLizzie Mapplebeck0.3
15/06/2022ICB website inserted throughoutLizzie Mapplebeck0.4
16/06/2022Update to wording in Section 4.3 (Quality ToR)
Update to wording in Section 6 (SFIs)		Lizzie Mapplebeck0.5
22/06/2022Inclusion of Finance Committee ToR
Change of wording in Section 4.7 (NEE ToR)		Lizzie Mapplebeck1.0
21/07/2022Inclusion of S0RD Expenditure Limits in Section 3Lizzie Mapplebeck2.0
22/03/2023Amendments made to F&D and SoRD to reflect POD DelegationLizzie Mapplebeck3.0
18/05/2023Addition of Section 9 Guidance for The Appointment of Interim Non-Executive Members to the ICB BoardLizzie Mapplebeck4.0

Document Control Sheet

Document Title:
NHS Suffolk and North East Essex Integrated Care Board Governance Handbook

Document Owner:
This Handbook has been prepared and reviewed by the Corporate Services Department

Who is it aimed at and in which setting?
All staff whether temporary, fixed term, or under consultancy, contract for services or agency arrangements, ICB Board members and Partner members, ICB clinical advisors and anyone else undertaking work for the ICB.

Approved by NHS SNEE ICB Board

Effective date 1st April 2023

Review Date 1st July 2026

1. Introduction

This Governance Handbook supports the NHS Suffolk and North East Essex Integrated Care Board (SNEE ICB) Constitution by bringing together a range of corporate documents into one place. Whilst it is not a legal requirement to have a Governance Handbook, it supports SNEE ICB to build a consistent corporate approach and brings relevant corporate documents together.

It is a requirement that the Governance Handbook is published on the SNEE ICB website as it includes the Terms of Reference for the statutory committees of the ICB. The handbook will be kept updated and when any changes are made to the Terms of Reference within it, the revised version will be updated on the ICBs website.

2. NHS Suffolk and North East Essex Integrated Care Board Functions and Decisions Map

The NHS commissioning landscape has changed with CCG and some NHS England functions being replaced by Integrated Care Boards (ICB).

The Suffolk and North East Essex Functions and Decision Map sets out the governance for the new integrated NHS landscape.

It is an important part of the Integrated Care System but does not cover the whole governance map, such as the Integrated Care Partnership, Health and Wellbeing Boards or governance of individual organisations.

The Suffolk and North East Essex Functions and Decisions Map sets out the governance arrangements that support collective accountability between partner organisations for whole- system delivery and performance, it relates to the delegation of NHS ICB resources.

The purpose of the Functions and Decisions Map is to facilitate transparent decision-making and foster the culture and behaviours that enable system working. This document details the health commissioning duties of NHS Suffolk and North East Essex Integrated Care Board, it does not detail the wider system duties of the Integrated Care Partnership or the Integrated Care System.

This document should be read in conjunction with the ICB Constitution, ICB Statutory Functions document and the Scheme of Reservations and Delegations document.

Functions and Decisions Framework

Grouping One

Receives Delegation from NHS England: Integrated Care Board

Grouping Two

Receives Delegation from Grouping One: Alliance Committees & ICB Committees

Grouping Three

Receives Delegation from Grouping Two: Quality Groups, Estate Groups, Digital Group, Workforce Groups, Finance Groups, Contract Groups, Alliance Delivery Groups, Transformation Delivery Groups, Place Based Transformation Groups, System Wide Transformation Programmes.

Overarching Functions and Decisions Map

Full Functions and Decisions Map

1.NHS England and Improvement, the Department of Health and Social Care and the Department for Levelling Up, Housing and Communities, offer direction and assistance for organising healthcare services that follow the NHS Long Term Plan. They ensure that the Suffolk and North East Essex Integrated Care Board meets its legal obligations.

2. Health and Wellbeing Boards are responsible for meeting their area’s health and wellbeing needs. This includes working on strategies to improve healthcare, promoting collaboration between health and social care, and ensuring everyone can access good health services.

3. The Suffolk and North East Essex Integrated Care Partnership is a committee that’s in charge of creating a plan for providing better care to people who live in Suffolk and North East Essex. They want to ensure everyone in the area has access to quality healthcare.

The Suffolk and North East Essex Integrated Care Board is responsible for planning and buying healthcare services for their community. This means they decide which health services to provide and how to use the budget of around £1.5 billion set by NHS England. They work closely with local government and NHS providers in their area to ensure everyone has access to quality healthcare. Their success is measured by how well their local health and care system is working, and by the health outcomes of their communities. To help them achieve their goals, they have delegated some authority to three place-based partnerships called Alliances, which work on their behalf and hold them accountable for their performance. However, the Integrated Care Board remains accountable for all its functions, including those delegated.

The Integrated Care Board works with the Suffolk and North East Essex Integrated Care Partnership and Health and Wellbeing Boards. They also receive guidance from the ICB General Practitioner Collaborative Group.

4. The ICB General Practitioner Collaborative Group provide advice and recommendations on general practice issues to the ICB Board. This helps the Board to strategically address issues that affect the entire system.

5. Place-based partnerships, also known as Alliances, are groups of health and care organisations that work together to improve the health and well-being of people in their local communities. In the Integrated Care System, three Alliances Committees focus on providing integrated care services to the local population in the North East Essex, West Suffolk, and Ipswich and East Suffolk areas. These partnerships work closely with communities to understand their needs and coordinate services accordingly. They also address social and economic factors that influence health and well-being and support the quality and sustainability of local services. They also collaborate with the Suffolk and North East Essex Integrated Care Partnership.

6. The Integrated Care Board oversees Transformation Programmes that bring important changes to healthcare services. They are monitored by different groups such as Maternity and Neonatal, Cancer and Rapid Diagnostics, Strategic Programs, Elective Care and Diagnostics, and Urgent and Emergency Care. They are accountable to the System Oversight and Assurance Committee and work closely with the Suffolk and North East Essex Integrated Care Partnership.

7. ICB Committees provide governance and assurance to the critical functions of the Integrated Care Board. There are fifteen committees: Remuneration and HR Committee, System Oversight and Assurance Committee, Quality Committee, People Committee, Finance Committee, Audit Committee, Auditor Panel Committee, Digital Committee, People and Communities Committee, Estates Committee, Procurement Committee, Executive Committee, Suffolk Mental Health Collaborative Committee, Specialist Services Commissioning committee, Health Inequalities and Prevention Committee.

Transformation programmes within the Integrated Care Board are accountable to the System Oversight and Assurance Committee.

8. The Suffolk and North East Essex Integrated Care System is our three Place-Based Partnerships, our Integrated Care Board (including all statutory functions) and the Integrated Care Partnership working with the Health and Wellbeing Boards and Provider Collaboratives.

9. To help deliver its statutory duties, the ICB relies on twelve key Cross Cutting Duties and Enablers. These include Sustainability, Population Health Management, Business Intelligence, Prevention, Public Engagement, Safeguarding, Equality, Diversity and Inclusion, Communications, Health Inequalities and Health Equity, Innovation, Engagement and Contracts.

Functions and Decisions Map Grouping One

1. NHS England and Improvement, the Department of Health and Social Care and the Department for Levelling Up, Housing and Communities, offer direction and assistance for organising healthcare services that follow the NHS Long Term Plan. They ensure that the Suffolk and North East Essex Integrated Care Board meets its legal obligations.

2. Health and Wellbeing Boards are responsible for meeting their area’s health and wellbeing needs. This includes working on strategies to improve healthcare, promoting collaboration between health and social care, and ensuring everyone can access good health services.

3. The Suffolk and North East Essex Integrated Care Partnership is a committee in charge of creating a plan for providing better care to people living in Suffolk and North East Essex. They want to ensure everyone in the area has access to quality healthcare.

The Suffolk and North East Essex Integrated Care Board is responsible for planning and buying healthcare services for their community. This means they decide which health services to provide and how to use the budget of around £1.5 billion set by NHS England. They work closely with local government and NHS providers in their area to ensure everyone has access to quality healthcare. Their success is measured by how well their local health and care system is working, and by the health outcomes of their communities. To help them achieve their goals, they have delegated some authority to three place-based partnerships called Alliances, which work on their behalf and hold them accountable for their performance. However, the Integrated Care Board remains accountable for all its functions, including those delegated.

The Integrated Care Board works with the Suffolk and North East Essex Integrated Care Partnership and Health and Wellbeing Boards. They also receive guidance from the ICB General Practitioner Collaborative Group.

4. The ICB General Practitioner Collaborative Group provide advice and recommendations on general practice issues to the ICB Board. This helps the Board to strategically address issues that affect the entire system.

5. The Suffolk and North East Essex Integrated Care System is our three Place-Based Partnerships, our Integrated Care Board (including all statutory functions) and the Integrated Care Partnership working with the Health and Wellbeing Boards and Provider Collaboratives.

Functions and Decisions Map Grouping Two – Committees

ICB Committees provide governance and assurance to the critical functions of the Integrated Care Board. Fifteen committees are accountable to the ICB Board.

1. The Remuneration and HR Committee advises the ICB Board on HR matters, approves policies and procedures, and mitigates risks for the Audit Committee.

2. The System Oversight and Assurance Committee oversees the NHS priorities delivered by the ICB, paying attention to system performance, quality of care outcomes, and individual healthcare providers.

3. The Finance Committee helps the ICB manage financial oversight and assures financial performance to the ICB Board.

4. The Audit Committee objectively assesses the ICB’s financial operations, information, and compliance with NHS regulations.

5. The Suffolk Mental Health Collaborative Committee is responsible for a collective approach to planning, resourcing, and delivering Mental Health services in Suffolk.

6. The Quality Committee ensures quality and improvement across all health providers. They identify risks, coordinate access, and drive progress.

7. The People Committee supports and develops the Health and Care Workforce through the implementation of the NHS People Plan and local priorities.

8. The Digital Committee helps enhance the quality of care provided by service providers through the implementation of a system-wide and regional digital strategy and programme.

9. The Auditor Panel Committee gives advice on which external auditors to hire for the organisation to the ICB Board. They provide independent and objective recommendations.

10. The Specialist Services Commissioning Committee oversees commissioned providers and specialised clinical networks to ensure quality, performance, work programmes, and service transformation at an ICB level.

11. The People and Communities Committee is responsible for providing a channel for diverse communities to inform and influence decisions related to quality, commissioning processes, planning, and prioritisation.

12. The Estates Committee is responsible for creating, executing, and monitoring a strategic plan for estates that encompasses all Health and Care organisations in the Suffolk and North East Essex ICB.

13. The Procurement Committee is responsible for ensuring procurement policies and processes are delivered in a way that is transparent, fair, and non-discriminatory.

14. The Executive Committee is responsible for the oversight and management of the day-to-day functions of the ICB.

15. The Health Inequalities and Prevention Committee is responsible for providing action to address health inequalities through a coordinated whole-system approach.

Functions and Decisions Map Grouping Two – Place Base Partnerships (Alliances)

1. The Ipswich and East Suffolk Alliance Committee and the West Suffolk Alliance Health, Care and Wellbeing Committee work to provide coordinated and personalised healthcare services in their areas. They partner with local communities and coordinate services based on people’s needs while addressing social and economic factors that impact health and wellbeing. They also support the quality and sustainability of local services. The Committees delegate power to other groups for the provision and monitoring of services, such as the Suffolk Children and Young People Group, Suffolk Learning Disability & Autism Group, Primary Care Commissioning Group and the Area Prescribing Group.

2. The Suffolk Children and Young People Group has delegated responsibility for the system commissioning, delivery and performance of Children and Young people services across Suffolk.

3. The Suffolk Learning Disability and Autism Group has delegated responsibility for the system commissioning, delivery and performance of Learning Disability and Autism services across Suffolk.

4. The Primary Care Commissioning Group oversees the development of primary care networks, enhanced services, and local incentive schemes. They also make decisions on new GP practices, practice mergers, and discretionary payments. The Group is responsible for monitoring growth, demographic changes, and workforce in primary medical care services. Additionally, they make system and strategic decisions for dental, pharmacy, and optometry, including approving POD Transformation Business Cases and developing local schemes.

5. The Area Prescribing Group oversees the provision of medicines and pharmacy services in line with the NHS Long Term Plan, the NHS People Plan, NHS England’s Integrated Pharmacy and Medicines Optimisation Programme and the Department of Health and Social Care’s Overprescribing review. The revised Medicines and Pharmacy Committee will affect all Alliance partners.

6. The North East Essex Alliance Health and Wellbeing Committee work to provide coordinated and personalised healthcare services in their areas. They partner with local communities and coordinate services based on people’s needs while addressing social and economic factors that impact health and wellbeing. They also support the quality and sustainability of local services. The Committee delegates power to other groups for the provision and monitoring of services, such as the North East Essex Learning Disability & Autism Group, the Essex Emotional Wellbeing and Mental Health Services Collaborative Commissioning Group and the North East Essex Mental Health Group. Similarly to the Suffolk Alliance Committees, the North East Essex Alliance Health and Wellbeing Committee also delegates responsibility to the Primary Care Commissioning Group and the Area Prescribing Group.

7. The North East Essex Learning Disability and Autism Group has delegated responsibility for the system commissioning, delivery and performance of Learning Disability and Autism services across North East Essex.

8. The Essex Emotional Wellbeing and Mental Health Services Collaborative Commissioning Group has delegated responsibility for the system commissioning, delivery and performance of the Emotional Wellbeing and Mental Health Services Contract.

9. The North East Essex Mental Health Group has delegated responsibility for the oversight, development and implementation of mental health and emotional wellbeing services, particularly aligned to delivery of the NHSE Mental Health Long Term Plan and Mental Health Investment Plan. Discussions are ongoing regarding the establishment of a collaborative for mental health across the three Integrated Care Systems in Essex. Should this proposal come to fruition, it will be integrated into the governance structure.

Functions and Decisions Map Grouping Three

System Transformation Programmes

The following System Transformation Programmes are held to account by the System Oversight and Assurance Committee that oversees the NHS priorities delivered by the ICB, paying attention to system performance, quality of care outcomes, and individual healthcare providers. They also engage with the Suffolk and North East Essex Integrated Care Partnership, the committee in charge of creating a plan for providing better care to people living in Suffolk and North East Essex.

1. The Maternity and Neonatal Group known regionally and nationally as the Maternity and Neonatal Board, has delegated responsibility for the system commissioning, delivery and performance of Maternity Services across Suffolk and North East Essex. They work closely with the three Alliance Committees for place-based delivery and the emerging Acute Provider Collaborative.

2. The Cancer and Rapid Diagnostic Services Group, known regionally and nationally as the Cancer Board and Rapid Diagnostic Services, has delegated responsibility for the system commissioning, delivery and performance of Cancer Services and Rapid Diagnostic Centres across Suffolk and North East Essex. They work closely with the three Alliance Committees for place-based delivery and the emerging Acute Provider Collaborative.

3. The Strategic Programmes, Elective Care and Diagnostics Group, known regionally and nationally as the Strategic Programmes, Elective Care and Diagnostics Board, has delegated responsibility for the system commissioning, delivery and performance of Strategic Programmes (including Diabetes, Respiratory, Stroke, Neuro-Rehabilitation, Cardiovascular Disease), Elective Care and Diagnostics across Suffolk and North East Essex. They work closely with the three Alliance Committees for place-based delivery and the emerging Acute Provider Collaborative.

4. The Urgent and Emergency Care Group, known regionally and nationally as the Urgent and Emergency Care Board, has delegated responsibility for the system commissioning, delivery and performance of Urgent and Emergency Care Services across Suffolk and North East Essex. They work closely with the three Alliance Committees for place-based delivery and the emerging Acute Provider Collaborative.

Ipswich and East Suffolk Alliance

Refer to the top of section 2 (NHS Suffolk and North East Essex Integrated Care Board Functions and Decisions Map) for:

  • information on the Suffolk and North East Essex Integrated Care Partnership, Suffolk and North East Essex Integrated Care Board, Suffolk Health and Wellbeing Board.
  • further details about the Place Based Partnerships and the Committees and groups they delegate responsibilities to.
  • further details about Cross Cutting and Enablers within the Integrated Care Board.

The following Groups, Networks and Teams work under the Ipswich and East Alliance Committee:

  • The Alliance Quality Group, Executive Delivery Group, and the Alliance Clinical Professional Forums report directly into the Ipswich and East Suffolk Alliance Committee.
  • The Community Engagement Group reports into the Alliance Quality Group.
  • The Integrated Neighbourhood Teams and Primary Care Networks work together.
  • The Integrated Neighbourhood Teams work with the INT and Connect Development Group that reports into the Executive Delivery Group.
  • The Primary Care Networks work with Work Programmes and Related Group that report into the Executive Delivery Group.
  • The Tactical Cell reports into the Executive Delivery Group.

West Suffolk Alliance

Refer to the top of section 2 (NHS Suffolk and North East Essex Integrated Care Board Functions and Decisions Map) for:

  • information on the Suffolk and North East Essex Integrated Care Partnership, Suffolk and North East Essex Integrated Care Board, Suffolk Health and Wellbeing Board.
  • further details about the Place Based Partnerships and the Committees and groups they delegate responsibilities to.
  • further details about Cross Cutting and Enablers within the Integrated Care Board.

The following Groups, Networks and Teams work under the West Suffolk Alliance Health, Care and Wellbeing Committee:

  • The Alliance Delivery Group, Future System Programme Group and the Alliance Quality Group report into the West Suffolk Alliance Health, Care and Wellbeing Committee.
  • The Alliance Operational Group reports into the Alliance Delivery Group
  • The Clinical and Care Professional Leadership Group and the Community Engagement Forum report into the Alliance Quality Group.
  • The Alliance Quality Group engages and collaborates with the West Suffolk Partnership Group.
  • The West Suffolk Partnership Group engages and collaborates with the West Suffolk Alliance Health, Care and Wellbeing Committee.

North East Essex Alliance

Refer to the top of section 2 (NHS Suffolk and North East Essex Integrated Care Board Functions and Decisions Map) for:

  • information on the Suffolk and North East Essex Integrated Care Partnership, Suffolk and North East Essex Integrated Care Board, Suffolk Health and Wellbeing Board.
  • further details about the Place Based Partnerships and the Committees and groups they delegate responsibilities to.
  • further details about Cross Cutting and Enablers within the Integrated Care Board.

The following Groups, Networks and Teams work under the North East Essex Alliance Health and Wellbeing Committee:

  • The Alliance Quality Group, Alliance Executive Group, Alliance Operational Group, Widening Equity for Local Lives Group and the Primary Care Operational Group report into the North East Essex Alliance Health and Wellbeing Committee.
  • The Clinical and Professional Forum and Engagement Forum report into the Alliance Quality Group.
  • The Tactical Cell reports into the Alliance Operational Group.
  • The Neighbourhoods Operational Group, reports into the Neighbourhood Steering Group that reports into the Alliance Executive Group and works with the Live Well Domain Leads Group.
  • The Domain Working Groups and Governance Forum, reports into the Live Well Domain Leads Group that reports into the Alliance Executive Group and works with the Neighbourhoods Operational Group.

3. NHS Suffolk and North East Essex Integrated Care Board Schedule of Matters Reserved to the ICB and Scheme of Delegation (SoRD)

Policy areas

Decision 1: Determine the arrangements by which the Members of the Board approve those decisions that are reserved for the Board.

Delegation: This decision is delegated to the ICB Board solely.

Decision 2: Consideration and approval of applications to NHSEI on any matter concerning changes to the ICB Constitution, its committees, membership of committees, the overarching scheme of reservation and delegated powers, arrangements for taking urgent decisions, standing orders and standing financial
instructions.

Delegation: This decision is delegated to the ICB Board solely.

Decision 3: Approve recommendations to NHSEI to change the Constitution, name of the ICB, to merge, federate or amalgamate, or to re- organise boundaries or organisational structures of the ICB.

Delegation: This decision is delegated to the ICB Board solely.

Decision 4: Exercise or delegation of those functions of the Board which have not been retained as reserved by the Board, delegated to the Board, delegated to a committee or sub-committee of the Board or to one of its Members or employees.

Delegation: This decision is delegated to the CEO.

Decision 5: Prepare the ICB’s overarching scheme of reservation and delegation, which sets out those decisions of the Group reserved to the membership and those delegated to the:

  • Board Committees and Sub-Committees

  • An individual who may not be a Member of the Board or a specified person

For inclusion in the ICB Constitution.

Delegation: This decision is delegated to the ICB Board solely.

Decision 6: Approval of the ICBs overarching scheme or reservation and delegation.

Delegation: This decision is delegated to the ICB Board solely.

Decision 7: Prepare the ICB’s operational scheme of delegation, which sets out those key operational decisions delegated to individual employees of the ICB.

Delegation: This decision is delegated to the CEO.

Decision 8: Approval of the ICB’s operational scheme of delegation that underpins the overarching scheme of reservation and delegation’ as set out in its Constitution.

Delegation: This decision is delegated to the CEO.

Decision 9: Prepare standing financial instructions & detailed financial policies that underpin the ICBs prime financial priorities.

Delegation: This decision is delegated to the Director of Nursing.

Decision 10: Approve arrangements for managing exceptional funding requests.

Delegation: This decision is delegated to the CEO and Director of Nursing.

Decision 11: Set out who can execute a document by signature.

Delegation: This decision is delegated to the ICB Board solely.

Decision 12: Approve proposals for primary care development, proposed GMS Local Development Scheme, proposed practice incentive schemes, and proposed new changes in existing GMS infrastructure.

Delegation: This decision is delegated to the NEE Alliance Committee, I&ES Alliance Committee and WS Alliance Committee.

Decision 13: Approve arrangements for identifying and appointing the ICB’s proposed Chief Executive Officer.

Delegation: This decision is delegated to the Chair.

Decision 14: Approve arrangements for identifying and appointing the ICB’s proposed Executive and Non-Executive Members.

Delegation: This decision is delegated to the ICB Board solely.

Decision 15: Confirm the appointment of Executive and Non-Executive Board Members.

Delegation: This decision is delegated to the Chair.

Decision 16: Approve arrangements for identifying and appointing the ICB’s proposed Partner Board Members.

Delegation: This decision is delegated to the ICB Board solely.

Decision 17: Confirm the appointment of Partner Board Members.

Delegation: This decision is delegated to the Chair.

Decision 18: Approve arrangements for the reporting of conflicts of interest and the declaration process.

Delegation: This decision is delegated to the ICB Board solely.

Decision 19: Ensure that Registers of Interests are maintained and published on the ICB’s website.

Delegation: This decision is delegated to the CEO.

Decision 20: Oversight of both performance, including quality of care outcomes and relative development of the ICB.

Delegation: This decision is delegated to the System Oversight & Assurance Committee.

Decision 21: Responsibility for ICB interface with place based Alliances and core commissioned services

Delegation: This decision is delegated to the System Oversight & Assurance Committee.

Decision 22: Agree the vision, values and overall strategic direction of the ICB in delivery of the ICP Integrated Care Strategy.

Delegation: This decision is delegated to the ICB Board solely.

Decision 23: Approval of the ICB’s operational structure.

Delegation: This decision is delegated to the ICB Board solely.

Decision 24: Approval of the ICB’s commissioning plans.

Delegation: This decision is delegated to the ICB Board solely.

Decision 25: Approval of the ICB’s corporate budgets that meet the financial duties as set out in the relevant section(s) of
the Constitution.

Delegation: This decision is delegated to the ICB Board solely.

Decision 26: Approval of variations to the approved budget where variation would have significant impact on the overall approved levels of income and expenditure or the ICB’s ability to achieve its agreed strategic aims.

Delegation: This decision is delegated to the ICB Board solely.

Decision 27: Oversight and scrutiny of financial performance in
relation to:

  • The current and forecast in year financial position receiving detailed reports including progress towards meeting targets agreed
    within the ICB’s financial plan

  • Implementation of QIPP schemes and receiving updates on both the financial and performance activity for each

  • Achievement of any ICB incentive schemes and receiving reports of the actual and forecast performance for each

  • Reviewing the ICB’s medium term financial plans

  • Implementation of any investments and/or transformation schemes and forecast performance for each

  • Receiving and reviewing departmental financial delivery plans

Delegation: This decision is delegated to the Finance Committee.

Decision 28: Approval of the ICB’s annual report and annual accounts.

Delegation: This decision is delegated to the ICB Board solely.

Decision 29: Approval of arrangements for discharging the ICB’s statutory financial duties.

Delegation: This decision is delegated to the ICB Board solely.

Decision 30: Approve the terms and conditions, remuneration and allowances for Board members, including pensions.

Delegation: This decision is delegated to the Rem & HR Committee.

Decision 31: Recommend terms and conditions of employment for all employees of the ICB including pensions, remuneration, fees and travelling or other allowances payable to the employees and to other persons providing services to the ICB.

Delegation: This decision is delegated to the Rem & HR Committee.

Decision 32: Approve disciplinary arrangements for employees, including the Chief Executive and for other persons working on behalf of the ICB.

Delegation: This decision is delegated to the Rem & HR Committee.

Decision 33: Recommend for approval the arrangements for discharging the ICB’s statutory duties as an employer

Delegation: This decision is delegated to the Rem & HR Committee.

Decision 34: Approve human resources policies for employees and for other persons working on behalf of the ICB.

Delegation: This decision is delegated to the Rem & HR Committee.

Decision 35: Approve system wide workforce plans linked to population health management.

Delegation: This decision is delegated to the People Committee.

Decision 36: Approve plans and initiatives aimed at measuring and improving equality, diversity and inclusion.

Delegation: This decision is delegated to the People Committee.

Decision 37: Measuring and analysing workforce data supported by agreed metrics.

Delegation: This decision is delegated to the People Committee.

Decision 38: Responsibility for improving capability and capacity to undertake workforce planning, development and transformation.

Delegation: This decision is delegated to the People Committee.

Decision 39: Approve arrangements, including supporting policies, to minimise clinical risk, maximise patient safety and to secure continuous improvement in quality and patient outcomes.

Delegation: This decision is delegated to the Quality Committee.

Decision 40: Approve arrangements for discharging the ICB’s responsibilities in relation to inspection and review of the ICS by the CQC.

Delegation: This decision is delegated to the Director of Nursing, Medical Director and Quality Committee.

Decision 41: Provide assurance to the ICB that it is delivering its functions in a way which secures continuous improvement in the quality of services against each of the dimensions of quality set out in the Shared Commitment to Quality and enshrined in the Health and Care Bill 2021.

Delegation: This decision is delegated to the Director of Nursing, Medical Director and Quality Committee.

Decision 42: Provide assurance regarding the implementation of all statutory duties in relation to the safeguarding of adults and children.

Delegation: This decision is delegated to the Director of Nursing, Medical Director and Quality Committee.

Decision 43: Monitoring and management of Safeguarding arrangements.

Delegation: This decision is delegated to the Director of Nursing, Medical Director and Quality Committee.

Decision 44: Responsibility for monitoring the continuous improvement in the quality of primary care services.

Delegation: This decision is delegated to the Quality Committee, NEE Alliance Committee, I&ES Alliance Committee and WS Alliance Committee.

Decision 45: Through patient and public involvement, responsibility for influencing discussion about quality and commissioning processes, decision making, planning and prioritising.

Delegation: This decision is delegated to the Patient & Public Involvement Committee.

Decision 46: Responsibility for day to day management and the ICBs key operations forum.

Delegation: This decision is delegated to the Executive Committee.

Decision 47: Executive oversight and assurance to the Board regarding delivery of the ICBs statutory functions.

Delegation: This decision is delegated to the Executive Committee.

Decision 48: Responsibility for approval of expenditure up to and including £3m.

Delegation: This decision is delegated to the Executive Committee.

Decision 49: Approve the ICB’s counter fraud and security management arrangements.

Delegation: This decision is delegated to the Audit Committee.

Decision 50: Approval of the ICB’s risk management arrangements.

Delegation: This decision is delegated to the Audit Committee.

Decision 51: Approve arrangements for risk sharing and or risk pooling with other organisations under section 75 of the NHS Act 2006).

Delegation: This decision is delegated to the ICB Board, NEE Alliance Committee, I&ES Alliance Committee and WS Alliance Committee.

Decision 52: Approval of a comprehensive system of internal control, including budgetary control that underpins the effective, efficient and economic operation of the ICB.

Delegation: This decision is delegated to the Audit Committee.

Decision 53: Responsibility for the Auditor Panel in the selection and appointment of internal and external auditors.

Delegation: This decision is delegated to the ICB Board solely.

Decision 54: Approve proposals for action on litigation against or on behalf of the ICB.

Delegation: This decision is delegated to the ICB Board solely.

Decision 55: Approve the ICB’s arrangements for business continuity and emergency planning.

Delegation: This decision is delegated to the ICB Board and Audit Committee.

Decision 56: Approve the ICB’s arrangements for handling complaints.

Delegation: This decision is delegated to the ICB Board solely.

Decision 57: Approval of the arrangements for ensuring appropriate and safekeeping and confidentiality of records and for the storage, management and transfer of information and data.

Delegation: This decision is delegated to the People Committee.

Decision 58: Determining and approving arrangements for handling Freedom of Information requests.

Delegation: This decision is delegated to the CEO.

Decision 59: Approval of the arrangements for discharging the ICB’s statutory duties associated with its commissioning functions, including but not limited to promoting the involvement of each patient, patient choice, reducing inequalities, improvement in the quality of services, obtaining appropriate advice and public engagement and consultation.

Delegation: This decision is delegated to the ICB Board solely.

Decision 60: Approve arrangements for co- ordinating the commissioning of services with Alliances and/ or with the local authority(ies), where appropriate.

Delegation: This decision is delegated to the ICB Board solely.

Decision 61: Providing joint system leadership for LD&A service commissioning.

Delegation: This decision is delegated to the NEE Alliance Committee, I&ES Alliance Committee and WS Alliance Committee.

Decision 62: Providing joint system leadership for Mental Health service commissioning.

This decision is delegated to the NEE Alliance Committee and Suffolk Mental Health Collaborative Committee.

Decision 63: Providing joint system leadership for Children and Young People service commissioning.

Delegation: This decision is delegated to the NEE Alliance Committee, I&ES Alliance Committee and WS Alliance Committee.

Decision 64: Exercise commissioning responsibility for a proportion of specialised services with national standards and access policies remaining at a national level.

Delegation: This decision is delegated to the Joint Commissioning Committee.

Decision 65: Approval of the arrangements for discharging the ICB’s statutory duties associated.

Delegation: This decision is delegated to the ICB Board solely.

Decision 66: Responsibility for providing oversight and challenge to ensure procurement policy and process is delivered appropriately.

Delegation: This decision is delegated to the Procurement Committee.

Decision 67: Responsibility to secure quality and value for money services through procedures which are transparent, proportionate, fair and non-discriminatory.

Delegation: This decision is delegated to the Procurement Committee.

Decision 68: Make collective decisions on the review, planning and procurement of primary care services.

Delegation: This decision is delegated to the NEE Alliance Committee, I&ES Alliance Committee and WS Alliance Committee.

Decision 69: Exercise such functions as specified by the ICB under delegated arrangements from NHS England and NHS Improvement for Primary Medical Services but
continuing to exclude Section 7A Public Health functions.

Delegation: This decision is delegated to the NEE Alliance Committee, I&ES Alliance Committee and WS Alliance Committee.

Decision 70: Exercise responsibility for Dental (Primary, Secondary and Community), General Optometry, and Pharmaceutical Services (including dispensing doctors and dispensing appliance contractors.

Delegation: This decision is delegated to the NEE Alliance Committee, I&ES Alliance Committee and WS Alliance Committee.

Decision 71: Coordinate the development and implementation of system wide Digital Strategy together with cross cutting programmes.

Delegation: This decision is delegated to the Digital Committee.

Decision 72: Provide assurance and accountability for ICB digital investments in order to deliver priority outcomes.

Delegation: This decision is delegated to the Digital Committee.

Decision 73: Provide strategic leadership, including prioritisation for the ICB Digital Agenda.

Delegation: This decision is delegated to the Digital Committee.

Decision 74: Develop, implement and monitor ICB strategic infrastructure strategy.

Delegation: This decision is delegated to the Estates Committee.

Decision 75: Prioritisation and oversight of infrastructure strategy and associated work programme.

Delegation: This decision is delegated to the Estates Committee.

Decision 76: Ensure effective estates utilisation.

Delegation: This decision is delegated to the Estates Committee.

Decision 77: Development and maintenance of of estates data set and monitor system wide estates metrics.

SoRD Expenditure Limits

Committee/PersonBudget ApprovalProgramme and Primary Care Expenditure Approval (In Budget)Programme and Primary Care Expenditure Approval (Out of Budget)Running Costs
BoardAll budgetsWithin budget ≥ £3MAnything out of Budget ≥ £1MAnything ≥ £500k, including all items out of budget within these sums.
Finance CommitteeVirements between budgets ≥ £100kWithin budget, <£3M but ≥ £1M.Anything out of budget, <£1M but ≥ £100k.Anything <£500k but ≥ £50k, including all items out of budget within these sums.
Alliance CommitteeVirements between budgets ≥ £100k solely relating to intra-Place movementWithin budget, <£3M but ≥£1M, solely relating to that Place.Anything out of budget <£100k in consultation with the FD or their nominated deputy.£NIL
DirectorsVirements between budgets <£100k within their own budgets.Within budget >250k and <£1M, in consultation with appropriate committee/group, or joint sign off with FD/CEX as appropriate. Also, <£250k individuallyAnything out of budget <£100k in consultation with the FD or their nominated deputy.Anything in budget <£50k, out of budget £NIL.
Deputy Directors£NILWithin budget, <£100k£NILAnything in budget < £20k, out of budget £NIL

Additionally, other budget holders with a budget approval of £NIL have the following approval limits:

Series of approval limits (N1) up to a max of £50k (exceptions for CHC expenditure N2) with the budget holder level agreed based on director level approval of that individual. Capped at max of the budget delegated to the individual or the item cap. Running cost approval levels at 1/5th of the Programme/Primary Care approval limits.

N1 – Other budget holder approval limits

Budget Holder LevelMaximum Non-CHC Authority/Delegated Limit (Programme only – see previous table for detail RE running cost).
Level A£50k
Level B£25k
Level C£10k
Level D£5k

N2 – CHC approval limits:

Proposed Limits for CHC Approval

Packages or equipment costs of £700/week or under:

  • Nurse Co-ordinators or;
  • Director of Nursing (or nominated deputy) or;
  • Head of CHC, Clinical Lead or;
  • Head of CHC, Operational Lead; or
  • Clinical Commissioning Manager/Locality Manager; or
  • CHC PHB Clinical Lead

Packages or equipment costs of £1500/week or under:

  • Director of Nursing (or nominated deputy) or;
  • Head of CHC, Clinical Lead or;
  • Head of CHC, Operational Lead; or
  • Clinical Commissioning Manager/Locality Manager; or
  • CHC PHB Clinical Lead

Packages or equipment costs of £4000/week or under:

  • Director of Nursing (or nominated deputy) or;
  • Head of CHC, Clinical Lead or;
  • Head of CHC, Operational Lead

Packages or equipment costs of over £4000/week:

  • Director of Nursing (or nominated deputy) and one of the following:
    • Head of CHC, Clinical Lead or;
    • Head of CHC, Operational Lead

4. Committee Terms of Reference

The terms of reference for the non-statutory and statutory ICB committees are included here. The Integrated Care Boards terms of reference are integral to the ICB’s Constitution.

The included committees terms of reference are as follows:

  • ICB Audit Committee
  • ICB Remuneration and Human Resources Committee
  • ICB Quality Committee
  • ICB People Committee
  • Ipswich and East Suffolk Alliance
  • North East Essex Alliance
  • West Suffolk Alliance
  • Suffolk and North East Essex Integrated Care Partnership

1 Purpose

The People Committee is established by the Integrated Care Board (the Board or ICB) as a Committee of the Board in accordance with its Constitution and Functions and Decisions arrangements. The Committee’s main purpose is to oversee, support and advise on the implementation of priorities for the current and future system workforce, ensuring that Suffolk and North East Essex has an ambitious strategy for its people.

2 Authority

The People Committee is authorised by the Board to:

  • Ensure delivery of the Suffolk and North East Essex People Plan through the three Alliances, providers and commissioners.
  • Improve equality, diversity and inclusion for the current and future system workforce, maximising potential for using work to improve the health and wellbeing of local communities.
  • Promote integrated system working and ensure consistency to support collaborative working at scale.
  • Support relevant infrastructure groups to ensure the People Plan workstreams have clear leadership.
  • Work in partnership with the East of England People Board to ensure that system priorities are delivered in areas where a region wide approach is appropriate.

3 Remit and Responsibilities

The People Committee is responsible for:

  • Increasing diversity across the ICS and developing a leadership culture that embraces equality, diversity and inclusion.
  • Developing and embedding a health and wellbeing agenda for staff.
  • Building and developing workforce capacity and capability.
  • Developing innovative methodologies to ensure the supply of the right workforce with the right knowledge and skills at the right time to deliver high quality care.
  • Enabling innovation and encouraging new ways of working.
  • Supporting and valuing leadership at all levels with lifelong learning.
  • Leading coordinated workforce planning using intelligence and analysis.
  • Supporting system design and development with appropriate workforce inputs.
  • Contributing to wider local social and economic growth and an available local labour market through collaboration with partner organisations.
  • Promoting positive cultures and developing system organisations as agile, inclusive and modern employers to attract, recruit and retain the people needed to deliver plans.
  • Committing to subsidiarity to ensure care is delivered as close to the patient as is possible.

4 Relationship with the ICB Board

The People Committee is accountable to the Board and to the East of England Regional Board and shall report to both Boards on how it discharges its responsibilities.

The People Committee has delegated powers from the ICB Board as set out in the ICB Scheme of Reservation and Delegation.

Formal minutes shall be kept of the proceedings which will be submitted to the ICB Board. Where minutes and reports identify individuals, they will not be made public and will be presented at a meeting of the Board in private session. Public reports will be made as appropriate to satisfy any requirements in relation to disclosure.

The Chair of the Committee in consultation with colleagues on the Committee and senior officers of the ICB will make decisions that are required urgently.

The Committee will provide the Board with an Annual Report. The report will summarise its conclusions from the work it has done during the year.

5 Membership

The People Committee members shall be appointed by the Board in accordance with the ICB Constitution.

When determining the membership of the People Committee, active consideration will be made to diversity and equality.

The membership compromises of:

  • Director of People and Workforce
  • Suffolk and North East Essex Member on the East of England People Board
  • ICB Medical Director
  • ICB Director of Nursing
  • Professional leaders for Pharmacy, Allied Health Professionals and Human Resources
  • Voluntary Care Sector Representative
  • Director of Adult Social Care
  • County Council and Local Authority Representatives
  • HEI Representative
  • Further Education Representative
  • ICB Director of Finance
  • Senior Responsible Partner for Skills for Care
  • Senior Responsible Partner for the Staff Partnership Forum
Chair and Vice Chair

The People Committee will be chaired by a member of the Committee identified by the ICB Chief Executive.

The People Committee members may appoint a Vice Chair from amongst the members.

In the absence of the Chair, or Vice Chair, the remaining members present shall elect one of their number to Chair the meeting.

The Chair will be responsible for agreeing the agenda and ensuring matters discussed meet the objectives as set out in these terms of reference.

Attendees

Only members of the People Committee have the right to attend Committee meetings, but the Chair may invite relevant staff to the meeting as necessary in accordance with the business of the Committee.

6 Secretary and Administration

The People Committee shall be supported with a secretariat function. Which will include ensuring that:

  • The agenda and papers are prepared and distributed in accordance with the Standing Orders having been agreed by the Chair with the support of the relevant executive lead
  • Records of members’ appointments and renewal dates and the Board is prompted to renew membership and identify new members where necessary
  • Good quality minutes are taken in accordance with the standing orders and agreed with the chair and that a record of matters arising, action points and issues to be carried forward are kept
  • The Chair is supported to prepare and deliver reports to the Board
  • The Committee is updated on pertinent issues/ areas of interest/ policy developments
  • Action points are taken forward between meetings.

7 Meeting Quoracy and Decision

For a meeting to be quorate a minimum of five members is required, including the Chair or Vice Chair.

If the quorum has not been reached, then the meeting may proceed if those attending agree, but no decisions may be taken.

Decision Making and Voting

The People Committee will ordinarily reach conclusions by consensus. When this is not possible the Chair may call a vote.

Only members of the Committee may vote. Each member is allowed one vote and a majority will be conclusive on any matter.

Where there is a split vote, with no clear majority, the Chair of the Committee will hold the casting vote.

8 Conduct of the Committee

Benchmarking and Guidance

The People Committee will take proper account of National Agreements and appropriate benchmarking, for example Agenda for Change and guidance issued by the Government, the Department of Health and Social Care, NHS England and the wider NHS in reaching their determinations.

ICB Values

Members will be expected to conduct business in line with the ICB values and objectives and the principles set out by the ICB.

Members of, and those attending the Committee shall behave in accordance with the ICB’s constitution, Standing Orders, and Standards of Business Conduct Policy.

Equality, Diversity and Inclusion

Members must demonstrably consider the equality, diversity and inclusion implications of decisions they make.

9 Review

The People Committee will review on an annual basis its own performance and effectiveness including membership and terms of reference. The ICB Board will approve any resulting changes to the terms of reference or membership.

Date Approved: 1st July 2022
Next Review: 1st July 2023

Remuneration and HR Committee Terms of Reference ( pdf, 287.18 KB )

1 Purpose

The Financial Performance Committee is established by the Integrated Care Board (the Board or ICB) as a Committee of the Board in accordance with its Constitution.

Its main purpose is to contribute to the overall delivery of the ICS objectives by providing oversight and assurance to the Board in the development and delivery of a robust, viable and sustainable system financial plan. This includes:

  • Financial performance of NHS organisations within the formal ICS footprint (system control total) (part 1a)
  • Financial management of the Integrated Care Board (part 1b)

2 Authority

The Financial Performance Committee is authorised by the Board to: Investigate any activity within its terms of reference.

Seek any information it requires within its remit, from any employee or member of the ICB (who are directed to co-operate with any request made by the Committee) as outlined in these terms of reference.

Commission any reports it deems necessary to help fulfil its obligations.

Obtain legal or other independent professional advice and secure the attendance of advisors with relevant expertise if it considers this is necessary to fulfil its functions. In doing so the Committee must follow any procedures put in place by the ICB for obtaining legal or professional advice.

Create task and finish sub-groups in order to take forward specific programmes of work as considered necessary by the Committee’s members. The Committee shall determine the membership and terms of reference of any such task and finish sub-groups in accordance with the ICB’s constitution, Standing Orders and Scheme of Reservation and Delegation (SoRD) but may not delegate any decisions to such groups.

Authorise expenditure on behalf of the ICB Board up to the value set out in the scheme of delegation.

3 Remit and Responsibilities

The Committee will have a part 1a which considers system financial issues, and part 1b which considers issues specific to the internal management of the ICB. The committee’s duties are as follows:

Part 1a

System financial management framework

To set strategic financial framework for ICB and ICS partners where appropriate.

To develop the system financial planning processes to be used to make recommendations to the Board on the system financial plan in line with the strategy and national guidance.

To ensure health and social inequalities are taken into account in financial decision-making.

Resource allocation (revenue)

To develop an approach to distribute resource allocations through commissioning and direct allocation to drive agreed change based on the ICS strategy.

To advise on the process regarding the deployment and monitoring the impact of system wide transformation funding.

To work with ICS partners to identify and allocate resources where appropriate to address finance and performance related issues that may arise.

To work with ICS partners to consider major investment/disinvestment business cases for material service change or efficiency schemes and to agree a process for sign off.

National framework

To advise the ICB and ICS partners on any changes to NHS and non-NHS funding regimes and consider how the funding available to the ICS can be best used within the system to achieve the best outcomes for the local population.

To oversee national system level financial returns.

To ensure the required preparatory work is scheduled to meet national planning timelines.

Financial monitoring information

To articulate the financial position and financial impacts (both short and long-term) to support decision-making.

To work with ICS partners towards common approaches across the system such as financial reporting, estimates and judgements.

To work with ICS partners, including their non-executive members, to seek assurance over the financial performance from system bodies.

To oversee the development of financial, activity and workforce modelling to support the system wide priority areas.

To assure the development of a medium- and long-term financial plan which demonstrates ongoing value and sustainability.

To ensure the system develops an understanding of where costs sit across a system, including its cost drivers and the impact of service changes.

To ensure appropriate information is available to enable the system to manage financial issues, risks and opportunities across the ICS.

To ensure visibility and reporting of system financial and associated risks as part of the overall review of system finances.

Financial Performance

To oversee the management of the system financial target.

To agree key outcomes to assess delivery of the system wide financial strategy.

To monitor and report to the ICB, and to the Integrated Care Partnership as required, the overall financial performance against national and local metrics, highlighting areas of concern.

To monitor and report to the ICB key service performance which should be taken into account in assessing the financial position.

System efficiencies

To ensure system efficiencies are identified and monitored across ICS partners, in particular opportunities at system level where the scale of the ICS partners together and the ability to work across organisations can be leveraged.

To ensure financial resources are used in an efficient way to deliver the objectives of the ICS.

To review exception reports on any material breaches of the delivery of agreed efficiency plan including the adequacy of proposed remedial action plans.

Communication

To co-ordinate and manage communications on financial governance with stakeholders internally and externally.

To develop an approach with partners, including the Integrated Care Partnership, to ensure the relationships between cost, performance, quality and environmental sustainability are understood.

People

To ensure an ICS wide finance staff development strategy is in place to ensure excellence by attracting and retaining the best finance talent.

Capital

To seek assurance that the system capital strategy and associated plan properly balances clinical, strategic and affordability drivers.

To ensure effective oversight of future prioritisation and capital funding bids.

To monitor the system capital programme against the capital envelope and take action to ensure that it is appropriately and completely used.

To gain assurance that short, medium and long term commitments are built into the overall system capital plan.

Part 1b

Internal ICB finances

To ensure development of a reporting framework for the ICB (using the chart of accounts devised by NHS England and the integrated single financial environment (ISFE)).

To oversee the management of the ICB’s own financial targets.

To oversee the development of the ICB financial strategy and agree key outcomes to assess delivery.

To ensure that suitable financial policies and procedures are in place for the ICB to comply with relevant regulatory, legal and code of conduct requirements.

To approve expenditure within the committee’s delegated limit, as listed in the Scheme of Reservation and Delegation.

4 Accountability and Reporting

The Financial Performance Committee is accountable to the Board and shall report to the Board on how it discharges its responsibilities.

Formal minutes shall be recorded by the secretary and submitted to the Board in accordance with the Standing Orders.

The Chair will draw to the attention of the Board any issues that require disclosure to the Board or require the Board to take action.

The Committee will provide an annual report to the Board to describe how it has fulfilled its terms of reference and give details on progress and a summary of key achievements in the delivery of its responsibilities.

5 Membership

The Financial Performance Committee members shall be appointed by the Board in accordance with the ICB Constitution.

When determining the membership of the Financial Performance Committee active consideration will be made to diversity and equality. Members of the committee may be co- opted to ensure diversity of thinking in decision making.

The board will appoint no fewer than four members of the Committee including one who is an Independent Non-Executive Member of the Board. Other members of the committee need not be members of the board but may be.

Members should possess between them knowledge, skills, and experience in:

  • Accounting
  • Risk management
  • And technical or specialist issues pertinent to the business of the committee

Core membership includes:

  • Independent representation – the committee will consist of the Non Executive Member (NEM) who specialises in Finance and Audit, and a second NEM as nominated by the board based on their prior experience. The chair will be selected to ensure that the Audit Committee and the Finance Committee are chaired by different members.
  • Suffolk and North East Essex ICB Director of Finance
  • Suffolk and North East Essex ICB Director of Performance
  • Primary Care ICB Board representative (voting member in part 1a only)
  • ESNEFT Director of Finance (voting member in part 1a only)
  • WSFT Director of Finance (voting member in part 1a only)
  • EEAST Director of Finance (voting member in part 1a only)
  • NSFT Director of Finance (non-voting member)*
  • EPUT Director of Finance (non-voting member)*

* Mental health vote to be shared and logistics agreed at the start of each meeting.

Other Directors of the ICB will be expected to attend part 1b when required to report on significant expenditure areas within the ICB.

Other appropriate representatives from system partners may be invited or may request to attend in agreement with the chair.

Members are expected to attend at least 75% of meetings held each year to ensure consistency.

Where a member is unable to attend, efforts should be made to ensure that a suitable representative attends, as nominated by the member and agreed by the Chair.

Chair and Vice Chair

In accordance with the constitution, the Committee will be chaired by an Independent Non- Executive Member of the Board appointed on account of their specific knowledge, skills and experience making them suitable to chair the Committee.

The Financial Performance Committee members may appoint a Vice Chair from amongst the members.

In the absence of the Chair, or Vice Chair, the remaining members present shall elect one of their number Chair the meeting.

The Chair will be responsible for agreeing the agenda and ensuring matters discussed meet the objectives as set out in these terms of reference.

Attendees

Only members of the Financial Performance Committee have the right to attend meetings, but the Chair may invite relevant staff to the meeting as necessary in accordance with the business of the committee. Other individuals may be invited to attend all or part of any meeting as and when appropriate to assist it with discussions on any particular matter.

The Chair may ask any or all of those who normally attend, but are not members, to withdraw to facilitate open and frank discussion on particular matters.

The Chair and the Chief Executive of the ICB may also be invited to attend one meeting a year in order to gain an understanding of the committee’s operations.

6 Frequency, Secretary and Administration

The Financial Performance Committee shall meet at least quarterly, with meeting frequency increased to monthly where the operating landscape means this would be most appropriate.

The Financial Performance Committee shall be supported with a secretariat function, which will ensure tha

  • l>
  • i>The agenda and papers are prepared and distributed in accordance with the Standing Orders having been agreed by the Chair with the support of the relevant executive lead
  • Records of members’ appointments and renewal dates and the Committee is prompted to renew membership and

    identify new members where necessary

  • Good quality minutes are taken in accordance with the standing orders and agreed with the chair and that a record of matters arising, action points and issues to be carried forward are kept
  • The Chair is supported to prepare and deliver reports to the Board
  • The Financial Performance Committee is updated on pertinent issues/ areas of interest/ policy developments
  • Action points are taken forward between meetings and progress against those is monitored
  • Attendance of those invited to each meeting is monitored and the Chair is made aware as soon as possible of those meetings that do not meet the minimum quoracy requirements

    7 Meetings, Quoracy and Decision

    The Committee will ordinarily be held in person or via video conference. However, meetings may be conducted on a ‘virtual’ basis through the use of email or teleconference communication if necessary.

    The Committee may meet ‘in common’ with other Finance Committees where the Committee deems this appropriate. However, when meeting in common, the committee will have the ability to take its own decisions that might differ from those of the other committee(s) and regardless of any arrangements permitting decisions to be made following discussions by the committees in common, each Committee retains individual accountability for any decisions taken on behalf of organisation: a consensus decision will only be binding if each individual committee consents to that decision.

    For a meeting to be quorate a minimum of 50% members is required, including the Chair or Vice Chair and the ICB Director of Finance (or nominated deputy). Given the differing membership of part a and part b, the members required to reach a quorum for part a and part b may be different.

    If any member of the Committee has been disqualified from participating on an item in the agenda, by reason of a declaration of conflicts of interest, then that individual shall no longer count towards the quorum for that item.

    If the quorum has not been reached, then the meeting may proceed if those attending agree, but no decisions may be taken.

    Decision Making and Voting

    Decisions will be taken in according with the Standing Orders. The Financial Performance Committee will ordinarily reach conclusions by consensus. When this is not possible the Chair may call a vote.

    Only members of the Financial Performance Committee may vote. Each member is allowed one vote and a majority will be conclusive on any matter.

    Where there is a split vote, with no clear majority, the Chair of the Financial Performance Committee will hold the casting vote.

    If a decision is needed which cannot wait for the next scheduled meeting, the Chair may conduct business on a ‘virtual’ basis through the use of telephone, email or other electronic communication. Where such action has been taken between meetings, then these will be reported to the next meeting.

    8 Conduct of the Financial Performance Committee

    Benchmarking and Guidance

    The Financial Performance Committee will take proper account of National Agreements and appropriate benchmarking, for example Agenda for Change and guidance issued by the Government, the Department of Health and Social Care, NHS England and the wider NHS in reaching their determinations.

    Conflict of Interest

    In discharging duties transparently, conflicts of interest must be considered, recorded and managed. Members should have regard to the NHS guidance on managing conflicts of interest.

    All conflicts of interest must be declared and recorded at the start of each meeting. A register of interests must be maintained by the Chair and submitted to the Board. If a conflict of interest arises, the Chair may require the affected member to withdraw at the relevant point, refrain from voting in any votes on the particular matter, or taking part in discussions at the point, depending on the Chair’s view of the best way to manage this conflict of interest.

    ICB Values

    Members will be expected to conduct business in line with the ICB values and objectives and the principles set out by the ICB.

    Members must agree that this overrides all individual or organisational self-interest. Members will be expected to abide by the duty to collaborate and the principles set out by the ICS.

    Members of, and those attending, the Financial Performance Committee shall behave in accordance with the ICB’s constitution, Standing Orders, and Standards of Business Conduct Policy.

    Equality, Diversity and Inclusion

    Members must demonstrably consider the equality, diversity and inclusion implications of decisions they make. They should also consider whether any new resource allocation achieves positive change around inclusion, equality and diversity.

    9 Review

    The Financial Performance Committee will review on an annual basis its own performance and effectiveness including membership and terms of reference. The ICB Board will approve any resulting changes to the terms of reference or membership.

    Date Approved: 1st July 2022
    Next Review: 1st July 2023

Name of Committee: Ipswich and East Suffolk Alliance Committee

Chair: Edward Creasy

Reporting To: NHS Suffolk and North East Essex Integrated Care Board

The Alliance has been established with the aim of transforming the health and wellbeing of the population of Ipswich and East Suffolk by creating a sustainable system of health and wellbeing services that meet the immediate and longer term needs of the population. Alliance partners have agreed to work together, in the firm belief that this is the only way to deliver better population outcomes.

The Ipswich and East Suffolk Alliance is one of three local delivery mechanisms for the North East Essex and Suffolk Integrated Care Board (ICB) the Alliance and the ICB are working with other partners to deliver the Health and Care Strategy for the SNEE area. In addition as part of the Suffolk and Essex footprints there are also strong ties with the Health and Wellbeing Boards and the wider economic development strategies of Essex County and Suffolk County Council.

The Alliance delivery plan is therefore designed to align with the ICB’s overarching goals, outcomes and governance structure, and with programmes that operate on a local geography, ensuring compatibility between delivery plans and a framework to ensure that decisions and programmes of work are interconnected with decisions and activity delegated to the most appropriate level.

The Alliance Committee is the oversight group reporting to the ICB that oversees the delivery of the Alliance delivery plan and is the responsible group for the delivery of the delegated responsibilities from the ICB.

1 Purpose

The purpose of this Committee is to:

  • Support the Ipswich and East Suffolk Alliance (Alliance) via the ICB with:
  • The co-design and co-production with providers and other agencies members of the the Alliance to ensure integrated service and system design meets the outcomes that the local population require within the current resource allocation;
  • The using of the information and data available via the Population Health Management approach, alongside the lived experience of services users and their carers to ensure that the best possible system services are made available within the resources available;
  • Provide leadership for the development and implementation of strategic plans to reduce health and social inequalities informed by robust population health data
  • The understanding of where it is efficient, effective and economical for services to be integrated for the benefit of the users through integrated planning and incentives to the market, as appropriate.
  • Provide the Board with assurance in relation to any assigned or delegated actions and processes relating to the ICB’s and Alliance clinical and system development initiatives within the remit of the Framework.
  • Provide effective oversight of all aspects of clinical and system transformation and delivery on behalf of the ICB to ensure that the ICB achieves its key clinical developments and provides high quality services, promoting patient choice.
  • Manage the delivery of the integrated commissioning plan in support of the implementation of the Framework on behalf of the Board.
  • Be responsible for ensuring wide engagement of public, patients, clinicians and system partners within each of the elements of the commissioning cycle for which they are responsible.
  • Ensure patients and the local community, as well as local government and other partners within the Alliance are properly involved in the process of deciding priorities for the local population.
  • Be accountable for delivery of the Alliance Strategy, including annual reviews and delivery plans.
  • Secure the effective integration of acute, primary care, community, mental health and social care services

2 Principles

  • Commissioning should be driven by the health needs of the local population and should be based on care coordination and case planning, and provision of prevention and community services, with hospital care providing acute, specialist and emergency provision where this is not available in the community.
  • Commissioning must deliver integrated, multi-disciplinary solutions within each locality. Co- producing plans with the public, patients and staff.
  • Commissioning must be person-focused and promote the health and well-being of communities, as well as addressing health inequalities.
  • Commissioning will seek to continually improve quality wherever possible and embrace innovation (including digital innovation, pilot schemes, integrated solutions, etc.) to achieve improvement, within available resources and ensuring value for money.
  • Commissioning must work in the spirit of public service, professionalism and selflessness to serve the local population.
  • Commissioning must be accountable to the population providing confidence that the best decisions are taken for the right reasons, that the quality of healthcare services is protected, and that public money is being spent wisely.
  • This Committee shall ensure the delivery of the outcomes set out in the Alliance Local Delivery Plan and Integrated Care Board Body (ICB) Strategic Plan (collectively known as the Framework).

3 Key Outcomes

To support the Alliance to deliver its Alliance delivery plan and effectively deliver its outcomes legally via the ICB statutory governance;

  • Achievement of a fully integrated, more efficient and more locally focused health and care system, with greater emphasis on efficiency coming from wider system improvements, collaboration and shared resources.
  • Strengthening of relationships with the local communities to enable them to shape the commissioning priorities and contribute to their own wellbeing, care and health.
  • Implementation of the Framework, shared governance, particularly around the Better care fund (BCF), policy and operational changes required by all commissioners and providers in the Suffolk and North East Essex ICB.
  • Re-designing of locally agreed systems of organising and delivering the population health and wellbeing and reducing health inequalities.
  • Placement of patient experience at the centre of all decision making, service redesign and procurement, with patient experience indicators, targets, incentives and rewards aligned and embedded.
  • To support the Alliance to be sustainable and function in line with NHS legislation and the NHS Constitution.

4 Remit and Responsibilities

The Alliance Committee is responsible for:

Integrated Commissioning
  • Define and develop strategies to support new way of working with residents and the organisations within the Alliance.
  • Design and describe how the ICB will continue to meet their on-going statutory functions and duties as part of the wider Alliance.
  • Design the mobilisation plan to be approved by the Board for shifting to the new envisaged integrated commissioning model in the Framework linked to the DOH white paper on integrated care systems.
  • Oversee the detailed implementation and monitor delivery of the ICB and Alliance commissioning strategy and associated delivery plan.
  • Lead on the development of local integrated commissioning strategies and service specifications for services to be delivered to the local population in consultation with the members of the Alliance.
  • Provide the Board with assurance in relation to any assigned or delegated actions and processes relating to the ICB’s clinical development initiatives.
  • Direct resources and responsibility to ensure delivery of transformation projects, implementing objectives consistent with the ICB’s annual plan and the Framework.
  • Engage in the day-to-day management and application of commissioning and related activity in the locality and operate in good faith using all due skill and diligence.
Financial Control and Resource Planning:
  • Ensuring best value for money in Commissioning and System redesign as delegated by the ICB.
  • Ensuring appropriate utilisation of resources to deliver the Local Delivery Plan.
  • Be responsible for the financial strategy, financial management and financial governance of resources delegated by the ICB.
  • Receive reports and assure appropriate arrangements are in place to support, monitor and report on the Alliance finances and provide transparency on the system finance position linked to Alliance working including investments recommended by Alliance Executive Delivery Group on behalf of the Alliance SRO’s.
  • Identify the need for and oversee pooled budgets with Local Authorities (eg BCF) and how these will be managed and reported in annual accounts.
  • Agree any variations to investments as required through continued business justification.
  • Approve individual tendered contracts and agree waiver requests either directly or recommending approval to the Board in accordance with the Standing Financial Instructions and Scheme of Delegation
  • Review draft plans in respect of the application of available financial resources to support the Operating Plan including Integrated Commissioning Plans and Sustainability and Transformation Plans and to forward relevant and agreed elements for approval by the Board. To oversee and monitor delivery against these plans thereafter.
  • Undertake a continuous appraisal of the financial position and performance of the Alliance by means of the provision of information to the Board as they may require from directors, committees and officers of the ICB as set out in management policy statements.
  • Evaluate and scrutinise emerging cost pressures and agree the release of contingency or reserves delegated by the ICB where appropriate and within the limits of the Scheme of Delegation.
  • Manage the ICB’s non recurrent revenue plan related to the Alliance, the strategic capital programme approved by the Board and facilitate the delivery of the required cost savings whilst ensuring sustainable functions.
  • Review and approve significant investment and disinvestment business cases in line with the Committee’s powers under the Schemes of Delegation and to ensure that any business cases outside of their remit are referred to the Board.
Transformation, Planning and Operational Delivery
  • Encourage innovation by enabling and supporting practices, clinicians, staff and the public in creating changes.
  • Review and redesign of local services in consultation with the IBC to meet the outcomes identified in these terms of reference.
  • Work with the Alliance to shape and deliver improvements collectively. Use digital innovation to enable system change and improve outcomes for the local population, as applicable.
  • Undertake population health and social needs assessment to identify inequalities.
  • Use the insight and levers from population health and social needs assessment to work with the ICB to set strategic ambitions, priorities and performance metrics to address inequalities and improve outcomes over the medium to long term.
  • Oversee and make recommendations to the Board on any Project Initiation Document and associated business case that requires Board approval.
  • Monitor and receive written and verbal updates on progress with implementing relevant key projects and initiatives from senior staff and key clinicians. Direct resources and responsibility to deal with operational issues, implement objectives and annual plan, and achieve local and national targets
  • Monitor operational performance and agree plans to mitigate underperformance, where necessary reporting these to the Board through exception reporting.
  • Monitor compliance with provision of mandatory requirements placed upon the ICB.
  • Take urgent operational decisions to ensure that any imposed deadlines are met.
  • Consider and make recommendations to the Board on action on litigation against or on behalf of the ICB.
Risk, Governance, and patient safety
  • Review and discuss the implications and implementation of any relevant key policy documentation issued by statutory authorities which have a potential impact on service development plans and those services commissioned by the ICB and its delegation to the Alliance.
  • Ensure that appropriate action is being taken to manage identified and potential risks delegated by the Board and identified in the CCG’s assurance framework. This Committee will escalate risks to the Board where appropriate.
  • Ensure that patient safety and quality of services is the key focus of the ICB.
  • Ensure high levels of patient engagement and consultation throughout its processes including the review of services and including being cognisant of duties for formal consultation in relation to service reviews.
Governance
  • Review and recommend governing arrangements impacting on the ICB to the Board and ensure that they continue to reflect the principles of good governance as are relevant to it.
  • Develop policies and procedures for the management of risk and to own and maintain the corporate and operational risk registers of the ICB
  • Ensure that appropriate action is taken to manage identified and potential risks delegated by the Board and identified in the ICB’s assurance framework.
  • Escalate risks to the Board, as appropriate, and produce reports to the Board as required under these terms of reference or as requested by the Board.
Operations
  • Provide visible, robust and professional leadership to the Alliance (in accountable roles), Alliance and to system stakeholders.
  • Promote and abide by the values of the Equality Act 2010 with particular focus on:
    (1) The need to eliminate unlawful discrimination harassment and victimisation and other conduct prohibited by the 2010 Act.
    (2) Advancing equality of opportunity between people who share a protected characteristic and those who do not.
    (3) Fostering good relations between people who share a protected characteristic and those who do not.
  • Maintain a register of interests of all members of the Committee and to require and to receive the declaration of any member’s interests which may conflict with those of the ICB, taking account of any waiver which the Secretary of State may have made in any case, and after consultation with the Chief Executive, to determine the extent to which that member may participate in the consideration of a matter in which he/she has an interest.
  • Ensure that the Alliance has appropriate arrangements in place to exercise its functions effectively, efficiently and economically and in accordance with the delegations given to it from the ICB.
  • Ensure that procurement processes are conducted in a legal, open and transparent, non- discriminatory and fair way in compliance with the relevant legislation.
  • Enable the Board to fulfil its statutory functions in relation to financial control, commissioning and delivery.
  • Provide full reports of its activity including Board reports as required by the Board within the specified time.
  • Operate at all times within its approved terms of reference.
  • Ensure that its decisions are both taken and seen to be taken without any possibility of the influence of external or private interest.
Engagement
  • Develop and promote an organisation wide culture which enables clinicians, managers, staff and patient representatives to work both in partnership and individually to effectively delivery safe and sound services.
  • Contribute to the provision of appropriate responses to external and internal service reviews.
  • Develop and/or contribute to responses to relevant consultation documents for various stakeholders.
  • Ensure effective relationship management with key partners and stakeholders.
  • Give consideration to key communications requirements and messages and ensure that all work or projects are underpinned by communication’s strategies. The Communications team within the ICB will support this Committee as necessary.
  • Ensure that patient experience is at the center of all decision making, service redesign and procurement, with patient experience indicators, targets, incentives and rewards aligned and embedded.
  • Ensure wide levels of clinical engagement. This will extend beyond the scope of any clinical membership and should involve clinicians from all professional backgrounds.
  • Promote and specify continuous improvements in quality and outcomes and encourage and support practices, clinicians and the public to be innovative in creating changes.
  • Engage in a collaborative approach with the local NHS in securing new services for patients fully responsible to local health needs.
  • Work collaboratively to deliver the outcomes and milestones set out in any Local Delivery Plan which shall be aligned with the Framework.

5 Relationship with the ICB Board

The Alliance Committee is accountable to the Board and shall report to the Board on how it discharges its responsibilities.

The Alliance Committee has delegated powers from the ICB Board in accordance with the Scheme of Reservation and Delegation, See appendix A.

Formal minutes shall be kept of the proceedings which will be submitted to the ICB Board.

6 Membership

The Alliance Committee members shall be appointed by the Board in accordance with the ICB Constitution, where appropriate to do so.

When determining the membership of the Alliance Committee, active consideration will be made to diversity and equality.

Membership is set out below.

Core Membership Suggested Delegation
Non-Executive Chair (Chair of the Committee) N/A
Clinical Deputy Chair N/A
IES Alliance Director N/A
ICB Director of Finance Delegated to member of team aligned to the Alliance
ICB Director of Nursing Delegated to Deputy Director responsible for IES Alliance
ICB Director of Transformation Delegated to Deputy Director responsible for IES Alliance
ICB Accountable officer TBC
ICB Director of Contracts and Performance Delegated to Deputy Director responsible for IES Alliance
ICB Medical Director Delegated to Deputy Director responsible for IES Alliance
Primary Care office holder (x3)  
Suffolk Family Carers TBC
Ipswich Borough Council TBC
East Suffolk and North Essex NHS Foundation Trust TBC
East of England Ambulance Service TBC
Suffolk County Council TBC
Norfolk and Suffolk NHS Foundation Trust TBC
Suffolk GP Federation TBC
St Elizabeth’s Hospice TBC
East Suffolk Council TBC
HealthWatch Suffolk TBC
Babergh and Mid-Suffolk District Council TBC
Public Health Suffolk TBC

Advisory Participants to include:

  • Clinical representatives from any partner organisation in the Alliance
  • Subject matter experts from across the ICS

The Members shall uphold the following principles at all times:

  • Putting the needs of the population above organisational priorities
  • Communicating clearly and listening to each other, the staff and the local population
  • Communicating key messages and learning back to their respective organisations
  • Enable and promote a culture of challenge and continuous learning
  • Be a critical friend, providing constructive challenge in order to bring about the changes required
  • Champion collaboration and systems working
  • Adopting a culture of innovation and embracing change
  • Delivering change, moving forward together – recognising the importance of partnership
  • Open, honest and transparent working at all levels, across all organisations
  • Committing to the East of England Leadership Compact.
Chair and Vice Chair

The Alliance Committee will be chaired by the Non-Executive Chair.

The Alliance Committee members may appoint a Vice Chair from amongst the members.

In the absence of the Chair, or Vice Chair, the remaining members present shall elect one of their number Chair the meeting.

The Chair will be responsible for agreeing the agenda and ensuring matters discussed meet the objectives as set out in these terms of reference.

Attendees

Only members of the Alliance Committee have the right to attend Alliance Committee meetings, but the Chair may invite relevant staff to the meeting as necessary in accordance with the business of the Alliance Committee.

7 Secretary and Administration

The Alliance Committee shall be supported with a secretariat function. Which will include ensuring that:

  • The agenda and papers are prepared and distributed in accordance with the Standing Orders having been agreed by the Chair with the support of the relevant executive lead
  • Records of members’ appointments and renewal dates and the Committee is prompted to renew membership and identify new members where necessary
  • Good quality minutes are taken in accordance with the standing orders and agreed with the chair and that a record of matters arising, action points and issues to be carried forward are kept
  • The Chair is supported to prepare and deliver reports to the Board
  • The Alliance Committee is updated on pertinent issues/ areas of interest/ policy developments
  • Action points are taken forward between meetings.
  • The meetings shall be held at least on a monthly basis.
  • The Alliance Committee will be supported by a senior administration officer within the ICB.

8 Meeting Quoracy and Decision

For a meeting to be quorate there must be three ICB Officers (this must include the Alliance Director and Director of Finance or Deputy of either if required) plus one Clinical Member and one partner representative

If the quorum has not been reached, then the meeting may proceed if those attending agree, but no decisions may be taken.

Decision Making and Voting

Decisions will be guided by national NHS policy and best practice to ensure that staff are fairly motivated and rewarded for their individual contribution to the organisation, whilst ensuring proper regard to wider influences such as national consistency.

Decisions will be taken in according with the Standing Orders. The Alliance Committee will ordinarily reach conclusions by consensus. When this is not possible the Chair may call a vote.

Where there is a split vote, with no clear majority, the Chair of the Alliance Committee will hold the casting vote.

Only ICB members can be engaged in the exercise of voting owing to it being a statutory body.

As a sub-committee of the ICB Board, only the votes of ICB Officers are legally able to contribute towards the count. However, in the spirit of and in line with the principles of the committee the votes of all members will be taken and recorded for the minutes, to ensure transparency and fair representation in the record.

Any member of the committee shall be entitled to nominate a deputy on his/her behalf in the event he/she cannot attend a meeting. In the absence of an individual, their nominated deputy shall assume their voting rights.

In those circumstances the Chair should be informed one week prior to the meeting. Deputies will be expected to have been fully briefed by the substantive member.
In the event of a vote being taken the process will be as described in the Constitution.

In the event that there is an executive majority, the executive members will abstain from voting until an elected majority is reached. The order of this will be as follows:

  • ICB Director of Transformation and Strategy
  • ICB Director of Nursing and Quality
  • ICB Director of Finance
  • ICB Medical Director
  • Alliance Director
  • ICB Accountable Officer

9 Conduct of the Alliance Committee

Benchmarking and Guidance

The Alliance Committee will take proper account of National Agreements and appropriate benchmarking, for example Agenda for Change and guidance issued by the Government, the Department of Health and Social Care, NHS England and the wider NHS in reaching their determinations.

ICB Values

Members will be expected to conduct business in line with the ICB values and objectives and the principles set out by the ICB.

Members of, and those attending, the Alliance Committee shall behave in accordance with the ICB’s constitution, Standing Orders, and Standards of Business Conduct Policy.

Equality, Diversity and Inclusion

Members must demonstrably consider the equality, diversity and inclusion implications of decisions they make.

10 Review

The Alliance Committee will review on an annual basis its own performance and effectiveness including membership and terms of reference. The ICB Board will approve any resulting changes to the terms of reference or membership.

The Committee will assure its effectiveness by:

  • Providing minutes of meetings to the Board
  • Monitoring attendance
  • Escalating issues as appropriate for consideration as part of board assurance framework

The Committee shall review these terms of reference on annual basis, or as it thinks appropriate.

Date Approved: 1st July 2022
Next Review: 1st July 2023

Name of Committee: NEE Alliance Committee
Chair: NEE Non – Executive Member
Reporting To: NHS Suffolk and North East Essex Integrated Care Board

The Alliance has been established with the aim of transforming the health and wellbeing of the population of North East Essex, by creating a sustainable system of health and wellbeing services that meet the immediate and longer term needs of the population. Alliance partners have agreed to work together, in the firm belief that this is the only way to deliver better population outcomes.

The NEE Alliance is one of three local delivery mechanisms for the North East Essex and Suffolk Integrated Care Board (ICB) the Alliance and the ICB are working with other partners to deliver the Health and Care Strategy for the SNEE area. In addition as part of the Suffolk and Essex footprints there are also strong ties with the Health and Wellbeing Boards and the wider economic development strategies of Essex County and Suffolk County Councils.

The Alliance’s all have an Alliance delivery plan that is designed to align with the ICB’s overarching goals, outcomes and governance structure, and with programmes that operate on a local geography, ensuring compatibility between delivery plans and a framework to ensure that decisions and programmes of work are interconnected with decisions and activity delegated to the most appropriate level.

The Alliance Committee is the oversight group reporting to the ICB that oversees the delivery of the Alliance delivery plan and is the responsible group for the delivery of the delegated responsibilities from the ICB.

1 Principles

Commissioning should be driven by the health needs of the local population, and should be based on care coordination and case planning, and provision of prevention and community services, with hospital care providing acute, specialist and emergency provision where this is not available in the community.

Commissioning must deliver integrated, multi-disciplinary solutions within each locality. Co- producing plans with the public, patients and staff

Commissioning must be person-focused and promote the health and well-being of communities, as well as addressing health inequalities.

Commissioning will seek to continually improve quality wherever possible and embrace innovation (including digital innovation, pilot schemes, integrated solutions, etc.) to achieve improvement, within available resources and ensuring value for money.

Commissioning must work in the spirit of public service, professionalism and selflessness to serve the local population.

Commissioning must be accountable to the population providing confidence that the best decisions are taken for the right reasons, that the quality of healthcare services is protected and that public money is being spent wisely

This Committee shall ensure the delivery of the outcomes set out in the Alliance Local Delivery Plan and Integrated Care Board Body (ICB) Strategic Plan (collectively known as the Framework)

2 Purpose

The purpose of this Committee is to:

support the Health and Wellbeing Alliance (Alliance) via the ICB with:

  • the co-design and co-production with providers and other agencies members of the the Alliance to ensure integrated service and system design meets the outcomes that the local population require within the current resource allocation;
  • the using of the information and data available via the Population Health Management approach, alongside the lived experience of services users and their carers to ensure that the best possible system services are made available within the resources available;
  • provide leadership for the development and implementation of strategic plans to reduce health and social inequalities informed by robust population health data
  • the understanding of where it is efficient, effective and economical for services to be integrated for the benefit of the users through integrated planning and incentives to the market, as appropriate.

Provide the Board with assurance in relation to any assigned or delegated actions and processes relating to the ICB’s and Alliance clinical and system development initiatives within the remit of the Framework;

Provide effective oversight of all aspects of clinical and system transformation and delivery on behalf of the ICB to ensure that the ICB achieves its key clinical developments and provides high quality services, promoting patient choice;

Manage the delivery of the integrated commissioning plan in support of the implementation of the Framework on behalf of the Board;

Be responsible for ensuring wide engagement of public, patients, clinicians and system partners within each of the elements of the commissioning cycle for which they are responsible;

Ensure patients and the local community, as well as local government and other partners within the Alliance are properly involved in the process of deciding priorities for the local population.

Be accountable for delivery of the Alliance delivery plan, including annual reviews

Secure the effective integration of acute, primary care, community, mental health and social care services

3 Key Outcomes

To support the Alliance to deliver its Alliance delivery plan and effectively deliver its outcomes legally via the ICB statutory governance;

Achievement of a fully integrated, more efficient and more locally focused health and care system, with greater emphasis on efficiency coming from wider system improvements, collaboration and shared resources across Alliance Partners.

Strengthening of relationships with the local communities to enable them to shape the commissioning priorities and contribute to their own wellbeing, care and health.

Implementation of the Framework, shared governance, particularly around the Better care fund (BCF), policy and operational changes required by all commissioners and providers in the Suffolk and North East Essex ICB.

Re-designing of locally agreed systems of organising and delivering the population health and wellbeing and reducing health inequalities.

Placement of patient experience at the centre of all decision making, service redesign and procurement, with patient experience indicators, targets, incentives and rewards aligned and embedded.

To support the Alliance to be sustainable and function in line with NHS legislation and the NHS Constitution.

4 Functions

Integrated Commissioning

Define and develop strategies to support new way of working with residents and the organisations within the Alliance.

Design and describe how the ICB will continue to meet their on-going statutory functions and duties as part of the wider Alliance.

Design the mobilisation plan to be approved by the Board for shifting to the new envisaged integrated commissioning model in the Framework linked to the DOH white paper on integrated care systems.

Oversee the detailed implementation and monitor delivery of the ICB and Alliance commissioning strategy and associated delivery plan.

  • Lead on the development of local integrated commissioning strategies and service specifications for services to be delivered to the local population in consultation with the members of the Alliance.
  • Provide the Board with assurance in relation to any assigned or delegated actions and processes relating to the ICB’s clinical development initiatives.
  • Direct resources and responsibility to ensure delivery of transformation projects, implementing objectives consistent with the ICB’s annual plan and the Framework.
  • Engage in the day-to-day management and application of commissioning and related activity in the locality and operate in good faith using all due skill and diligence.
Financial Control and Resource Planning
  • Ensuring best value for money in Commissioning and System redesign as delegated by the ICB.
  • Ensuring appropriate utilisation of resources to deliver the Local Delivery Plan.
  • Be responsible for the financial strategy, financial management and financial governance of the ICB.
  • Receive reports and assure appropriate arrangements are in place to support, monitor and report on the Alliance finances and provide transparency on the system finance position linked to Alliance working including investments recommended by Alliance Executive Group on behalf of the Alliance SRO’s.
  • Identify the need for and oversee pooled budgets with Local Authorities (eg BCF) and how these will be managed and reported in annual accounts.
  • Agree delegated limits for the Alliance Operational Group and sign of recommendations within the financial limit set out in the ICB’s Scheme of Delegation.
  • Agree any variations to investments as required through continued business justification.
  • Approve individual tendered contracts and agree waiver requests either directly or recommending approval to the Board in accordance with the Standing Financial Instructions and Scheme of Reserved Delegation (SoRD)
  • Review draft plans in respect of the application of available financial resources to support the Operating Plan including Integrated Commissioning Plans and Sustainability and Transformation Plans and to forward relevant and agreed elements for approval by the Board. To oversee and monitor delivery against these plans thereafter.
  • Undertake a continuous appraisal of the financial position and performance of the Alliance by means of the provision of information to the Board as they may require from directors, committees and officers of the ICB as set out in management policy statements and to receive at least in summary all monitoring returns required by the Department of Health or NHS England.
  • Evaluate and scrutinise emerging cost pressures and agree the release of contingency or reserves where appropriate and within the limits of the Scheme of Delegation.
  • Manage the ICB’s non recurrent revenue plan related to the Alliance, the strategic capital programme approved by the Board and facilitate the delivery of the required cost savings whilst ensuring sustainable functions.
  • Review and approve significant investment and disinvestment business cases in line with the Committee’s powers under the Schemes of Reserved Delegation and to ensure that any business cases outside of their remit are referred to the Board. An activity or operation shall be regarded as non-significant if it has a gross annual income or expenditure (that is before any set off) less than £500,000.
Transformation, Planning and Operational Delivery
  • Encourage innovation by enabling and supporting practices, clinicians, staff and the public in creating changes.
  • Review and redesign of local services in consultation with the ICB to meet the outcomes identified in these terms of reference and the Alliance Delivery plans.
  • Work with the Alliance to shape and deliver improvements collectively. Use digital innovation to enable system change and improve outcomes for the local population, as applicable.
  • Undertake population health and social needs assessment to identify inequalities.
  • Use the insight and levers from population health and social needs assessment to work with the ICB to set strategic ambitions, priorities and performance metrics to address inequalities and improve outcomes over the medium to long term.
  • Oversee and make recommendations to the Board on any Project Initiation Document and associated business case that requires Board approval.
  • Monitor and receive written and verbal updates on progress with implementing relevant key projects and initiatives from senior staff and key clinicians. Direct resources and responsibility to deal with operational issues, implement objectives and annual plan, and achieve local and national targets
  • Monitor operational performance and agree plans to mitigate underperformance, where necessary reporting these to the Board through exception reporting.
  • Monitor compliance with provision of mandatory requirements placed upon the ICB.
  • Take urgent operational decisions to ensure that any imposed deadlines are met.
  • Consider and make recommendations to the Board on action on litigation against or on behalf of the ICB.
Risk, Governance and patient safety
  • Review and discuss the implications and implementation of any relevant key policy documentation issued by statutory authorities which have a potential impact on service development plans and those services commissioned by the ICB and its delegation to the Alliance.
  • Ensure that appropriate action is being taken to manage identified and potential risks delegated by the Board and identified in the ICB’s Quality assurance framework. This Committee will escalate risks to the Board where appropriate.
  • Ensure that patient safety and quality of services is the key focus of the ICB.
  • Ensure high levels of patient engagement and consultation throughout its processes including the review of services and including being cognisant of duties for formal consultation in relation to service reviews.
Governance
  • Review and recommend governing arrangements impacting on the ICB to the Board and ensure that they continue to reflect the principles of good governance as are relevant to it.
  • Develop policies and procedures for the management of risk and to own and maintain the corporate and operational risk registers of the ICB
  • Ensure that appropriate action is taken to manage identified and potential risks delegated by the Board and identified in the ICB’s assurance framework.
  • Escalate risks to the Board, as appropriate, and produce reports to the Board as required under these terms of reference or as requested by the Board.
Operations
  • Provide visible, robust and professional leadership to the Alliance (in accountable roles), Alliance and to system stakeholders.
  • Promote and abide by the values of the Equality Act 2010 with particular focus on:
    • The need to eliminate unlawful discrimination harassment and victimisation and other conduct prohibited by the 2010 Act.
    • Advancing equality of opportunity between people who share a protected characteristic and those who do not.
    • Fostering good relations between people who share a protected characteristic and those who do not.
  • Maintain a register of interests of all members of the Committee and to require and to receive the declaration of any member’s interests which may conflict with those of the ICB, taking account of any waiver which the Secretary of State may have made in any case, and after consultation with the Chief Executive, to determine the extent to which that member may participate in the consideration of a matter in which he/she has an interest.
  • Ensure that the Alliance has appropriate arrangements in place to exercise its functions effectively, efficiently and economically and in accordance with the delegations given to it from the ICB.
  • Ensure that procurement processes are conducted in a legal, open and transparent, non- discriminatory and fair way in compliance with the relevant legislation.
  • Enable the Board to fulfil its statutory functions in relation to financial control, commissioning and delivery.
  • Provide full reports of its activity including Board reports as required by the Board within the specified time.
  • Operate at all times within its approved terms of reference.
  • Ensure that its decisions are both taken and seen to be taken without any possibility of the influence of external or private interest.
Engagement
  • Develop and promote an organisation wide culture which enables clinicians, managers, staff and patient representatives to work both in partnership and individually to effectively delivery safe and sound services.
  • Contribute to the provision of appropriate responses to external and internal service reviews.
  • Develop and/or contribute to responses to relevant consultation documents for various stakeholders.
  • Ensure effective relationship management with key partners and stakeholders.
  • Give consideration to key communications requirements and messages and ensure that all work or projects are underpinned by communication’s strategies. The Communications team within the ICB will support this Committee as necessary.
  • Ensure that patient experience is at the centre of all decision making, service redesign and procurement, with patient experience indicators, targets, incentives and rewards aligned and embedded.
  • Ensure wide levels of clinical engagement. This will extend beyond the scope of any clinical membership and should involve clinicians from all professional backgrounds.
  • Promote and specify continuous improvements in quality and outcomes and encourage and support practices, clinicians and the public to be innovative in creating changes.
  • Engage in a collaborative approach with the local NHS in securing new services for patients fully responsible to local health needs.
  • Work collaboratively to deliver the outcomes and milestones set out in any Local Delivery Plan which shall be aligned with the Framework.
5 Relationship with the ICB Board

The Alliance Committee is accountable to the Integrated care Board and shall report to the Board on how it discharges its responsibilities.

The Alliance Committee has delegated powers from the ICB Board as set out in the Scheme of reserved delegation. (SoRD) see Appendix 1.

Formal minutes shall be kept of the proceedings which will be submitted to the ICB Board.

6 Membership

The core membership of the NEE Alliance is listed below, along with any suggested delegations.

  • Non-Executive Chair (Chair of the Committee)
  • NEE Alliance Director
  • ICB Director of Finance (suggested delegation: member of team aligned to the Alliance)
  • ICB Director of Nursing (suggested delegation: NEE Deputy Director of Nursing)
  • ICB Director of Transformation
  • Deputy COO
  • ICB Accountable Officer (suggested delegation: standing invitation)
  • ICB Director of Contracts and Performance (suggested delegation: Deputy Director responsible for NEE Alliance)
  • PCN Clinical Director Representative
  • Engagement forum Representative
  • Deputy Director for Primary Care
  • ICB Medical Director
  • Community 360 Chief Executive
  • Community Voluntary Services Tendring Chief Executive
  • Colchester Borough Council
  • East Suffolk and North Essex FT NHS Trust Medical Director and Operations Director
  • East of England Ambulance Service
  • Essex County Council
  • Essex Partnership University Trust Medical Director and Operations director
  • GP Primary Choice chief executive
  • St Helena Hospice chief executive
  • HCRG
  • Tendring District Council

Advisory participants:

  • Clinical representatives from any partner organisation in the alliance
  • Subject matter experts from across the ICS

The Members shall uphold the following principles at all times:

  • Putting the needs of the population above organisational priorities
  • Communicating clearly and listening to each other, the staff and the local population
  • Communicating key messages and learning back to their respective organisations
  • Enable and promote a culture of challenge and continuous learning
  • Be a critical friend, providing constructive challenge in order to bring about the changes required
  • Champion collaboration and systems working
  • Adopting a culture of innovation and embracing change
  • Delivering change, moving forward together – recognising the importance of partnership
  • Open, honest and transparent working at all levels, across all organisations
  • Committing to the East of England Leadership Compact.
Quorum

3 ICB Officers (this must include the Alliance Director and Director of Finance or Deputy of either if required) plus 1 Clinical Members and 1 partner representative

Voting

Only ICB members can be engaged in the exercise of voting owing to it being a statutory body

As a sub committee of the ICB Board, only the votes of ICB Officers are legally able to contribute towards the count. However, in the spirit of and in line with the principles of the committee the votes of all members will be taken and recorded for the minutes, to ensure transparency and fair representation in the record.

Alliance Partners will have one member of the committee unless otherwise stated in the membership.

Any member of the committee shall be entitled to nominate a deputy on his/her behalf in the event he/she cannot attend a meeting. In the absence of an individual, their nominated deputy shall assume their voting rights.

In those circumstances the Chair should be informed 1 week prior to the meeting. Deputies will be expected to have been fully briefed by the substantive member.
In the event of a vote being taken the process will be as described in the Constitution.

In the event that there is an executive majority, the executive members will abstain from voting till an elected majority is reached. The order of this will be as follows

  • ICB Director of Transformation and Strategy
  • ICB Director of Nursing and Quality
  • ICB Director of Finance
  • ICB Medical Director
  • Alliance Director
  • ICB Accountable Officer
Frequency of meetings

Meetings shall be held at least on a monthly basis.

7 Reporting

The Alliance Committee shall receive regular updates and reports in relation to progress against outcomes by the following groups in accordance with their own terms of reference on a [monthly / quarterly] basis:

  • Alliance Finance Report
  • Alliance Executive Group Report
  • Alliance Quality Committee Report
  • Alliance Operational Group Report
  • Alliance highlight/performance report

8 Support to the Committee

This Committee will be supported by a senior admin officer within the ICB.

9 Monitoring Arrangements

The Committee will assure its effectiveness by:

  • Providing minutes of meetings to the Board
  • Monitoring attendance
  • Escalating issues as appropriate for consideration as part of board assurance framework

The Committee shall review these terms of reference on annual basis, or as it thinks appropriate.

Date Approved: 1st July 2022
Next Review: 1st July 2023

1 Context of the Alliance

The Alliance has been established with the aim of transforming the health and wellbeing of the population of West Suffolk by creating a sustainable system of health and wellbeing services that meet the immediate and longer term needs of the population. Alliance partners have agreed to work together, in the firm belief that this is the only way to deliver better population outcomes.

The West Suffolk Alliance has agreed a vision: to make lives better for people in West Suffolk, and a strategy: All About People and Places. The vision is underpinned by three mission statements, and a commitment that resources from across the Alliance are organised to deliver these shared ambitions.

Alliance mission statements:
  • Empower people to live healthy and connected lives
  • Create environments that enable people to thrive
  • Develop services that are joined up, accessible, responsive, and wrapped around people/families in the communities in which they live

The Alliance works as part of the wider system within Suffolk and North East Essex (SNEE) and the county of Suffolk. It is one of three local delivery mechanisms for the North East Essex and Suffolk Integrated Care Body (ICB) and contributes to the delivery of the Suffolk Health and Wellbeing Strategy and the SNEE Integrated Care Strategy.

Our governance structure is intended to strengthen collaboration, communication and action. Whilst each group has its own Terms of Reference, the expectation is that groups will work together on shared agendas.

The Terms of References for all committees and groups support proper governance and decision-making within the West Suffolk Alliance and are consistent with Terms of Reference within Ipswich and East Suffolk Alliance and North East Essex Alliance.

2 Purpose

The West Suffolk Alliance Health, Care and Wellbeing Committee is the decision-making Committee for the Alliance and is established by the NHS Suffolk and North East Essex Integrated Care Board (ICB) as a Committee of the Board in accordance with its Constitution.

The Committee brings together leaders in the West Suffolk system to ensure there is a robust Alliance Delivery Plan which will achieve the shared vision for West Suffolk.

These Terms of Reference reflect the changes arising from the Health and Care Act in respect to delegation of NHS accountabilities to the Committee to demonstrate robust governance at Place for delivery of delegated functions.

The Committee will be accountable for delegated NHS responsibilities from the Board, including functions involving planning, commissioning and budgets as set out in the Scheme of Reservation & Delegation (SoRD). This will involve working with Alliance Partnership Group to:

Through a co-production approach with Alliance partners, our local population and others to ensure integrated service and system design meets the outcomes that the local population require within the current resource allocation;

Use the information and data available via the Population Health Management approach, alongside the lived experience of services users and their carers to ensure that the best possible system services are made available within the resources available;

Provide leadership for the development and implementation of strategic plans to reduce health and social inequalities informed by robust population health data with the understanding of where it is efficient, effective and economical for services to be integrated for the benefit of the users through integrated planning and incentives to the market, as appropriate;

Provide the ICB with assurance in relation to any assigned or delegated actions and processes relating to the ICB’s and Alliance clinical and system development initiatives within the remit of the framework;

Provide effective oversight of all aspects of clinical and system transformation and delivery on behalf of the ICB to ensure that the ICB achieves its key clinical developments and provides high quality services, promoting patient choice;

Manage the delivery of an integrated commissioning plan in support of the implementation of any future commissioning framework on behalf of the Board;

Ensuring wide engagement of public, patients, clinicians and system partners within each of the elements of the commissioning cycle for which they are responsible;

Ensuring patients and the local community, as well as local government and other partners within the Alliance are properly involved in the process of deciding priorities for the local population.

Being accountable for delivery of the Alliance Delivery Plan, including annual reviews

Securing the effective integration of acute, primary care, community, mental health and social care services

3 Key Outcomes

These outcomes support the Alliance to deliver its Alliance Delivery Plan and effectively deliver NHS outcomes via the ICB statutory governance;

Achievement of a fully integrated, more efficient and more locally focused health and care system, with greater emphasis on efficiency coming from wider system improvements, collaboration and shared resources.

Strengthened relationships with the local communities to enable them to shape the commissioning priorities and contribute to their own wellbeing, care and health.

Implementation of a framework for shared governance, particularly around the Better care fund (BCF), policy and operational changes required by all commissioners and providers in the Suffolk and North East Essex ICB.

Re-design of locally agreed systems of organising and delivering the population health and wellbeing and reducing health inequalities

Placement of the experience of people who live and work in West Suffolk at the centre of all decision making, service redesign and procurement, with lived experience indicators, targets, incentives and rewards aligned and embedded.

To support the Alliance to be sustainable and function in line with NHS legislation and the NHS Constitution.

4 Remit and Responsibilities

The West Suffolk Alliance Health, Care and Wellbeing Committee will:

  • Develop the annual Alliance Delivery Plan which will show how the Alliance will deliver our shared vision and ambitions, including the national requirements delegated through the ICB.
  • Hold shared accountability for the delivery of programmes of work outlined in the Alliance Strategy and Delivery Plan to integrate health and care service (including Physical Health, Primary Care, Mental Health, Children and Young People and the wider voluntary sector) in West Suffolk
  • Align (where appropriate) with other transformation plans across the county and the ICS and including sovereign organisational strategies
  • Agree system business cases and utilisation of resource (financial and otherwise) related to the scope of business with the Committee. Pool and align funds and allocate resource to collectively achieve the strategic priorities and further reduce silo working, identify and utilise opportunities for joint commissioning
  • Develop and make decisions using a system view of demand and capacity and outcomes across West Suffolk, taking into account the County wide Joint Strategic Needs Assessment and the Place Based Needs Assessments.
  • Evaluate and monitor progress towards improved population outcomes, review progress, success and learning, escalating issues or opportunities to innovate to the appropriate group within the West Suffolk and ICS Governance structure.
  • Support a culture of listening, engaging and co-production throughout the work of the Committee and sub groups. This will include strengthened relationships with local communities to enable them to shape the commissioning priorities and contribute to their own wellbeing, care and health. Placing the experience of people at the centre of all decision making, service redesign and procurement, with patient/customer experience indicators, targets, incentives and rewards aligned and embedded.
  • Unblock systemic issues that arise and hold the system to account for learning and asking why
  • Determine risk across the system and hold collective accountability for a risk management plan to mitigate risk
  • Develop and deliver a fully integrated model of care which will improve population outcomes and system sustainability over the next 10 years
  • Direct and achieve the transition to deliver more services at place level, reducing reliance on acute services
  • Seek to develop the West Suffolk Locality structure, working with local communities and organisations, recognising the assets we have within our communities and the people within them.
  • Re-designing of locally agreed systems of organising and delivering the population health and wellbeing and reducing health inequalities.
  • Implementation of a framework for shared governance, particularly around the Better care fund (BCF), policy and operational changes required by all commissioners and providers in the Suffolk and North East Essex ICB
Integrated Commissioning
  • Define and develop strategies to support new way of working with residents and the organisations within the Alliance.
  • Design and describe how the Committee will meet their on-going statutory functions and duties in respect of Place and the wider Integrated Care System.
  • Design the mobilisation plan to be approved by the Board for shifting to the new envisaged integrated commissioning model in the Framework linked to the DOH white paper on integrated care systems1
  • Oversee the detailed implementation and monitor delivery of the ICB and Alliance commissioning strategy and associated delivery plan.
    • Lead on the development of local integrated commissioning strategies and service specifications for services to be delivered to the local population in consultation with the members of the Alliance.
    • Provide the Board with assurance in relation to any assigned or delegated actions and processes relating to the ICB’s clinical development initiatives.
    • Direct resources and responsibility to ensure delivery of transformation projects, implementing objectives consistent with the ICB’s annual plan and framework.
  • Engage in the day-to-day management and application of commissioning and related activity in the locality and operate in good faith using all due skill and diligence.
Ensure that commissioning:

1. Is driven by the health needs of the local population, and is based on care coordination and case planning, and provision of prevention and community services, with hospital care providing acute, specialist and emergency provision where this is not available in the community.

2. Delivers integrated, multi-disciplinary solutions within each locality. Plans are co-produced plans with the public, patients and staff

3. Is person-focused and promote the health and well-being of communities, as well as addressing health inequalities.

4. Seeks to continually improve quality wherever possible and embrace innovation (including digital innovation, pilot schemes, integrated solutions, etc.) to achieve improvement, within available resources and ensuring value for money.

5. Works in the spirit of public service, professionalism and selflessness to serve the local population.

6. Is accountable to the population providing confidence that the best decisions are taken for the right reasons, that the quality of healthcare services is protected and that public money is being spent wisely

7. Ensures the delivery of the outcomes set out in the Alliance Local Delivery Plan and Integrated Care Board Body (ICB) Strategic Plan

Financial Control and Resource Planning
  • Ensuring best value for money in commissioning and system redesign as delegated by the ICB.
  • Ensuring appropriate utilisation of resources to deliver the Local Delivery Plan.
  • Be responsible for the financial strategy, financial management and financial governance of the Alliance.
  • Receive reports and assure appropriate arrangements are in place to support, monitor and report on the Alliance finances and provide transparency on the system finance position linked to Alliance working including investments recommended by the Alliance Delivery Group on behalf of the Alliance SRO’s.
  • Identify the need for and oversee pooled budgets with Local Authorities (eg Better Care Fund) and how these will be managed and reported in annual accounts.
  • Agree delegated limits for groups including the Alliance Delivery Group and the Alliance Operational Group and sign of recommendations within the financial limit set out in the ICB’s Scheme of Delegation.
  • Agree any variations to investments as required through continued business justification.
  • Approve individual tendered contracts and agree waiver requests either directly or recommending approval to the Board in accordance with the Standing Financial Instructions and Scheme of Reserved Delegation (SoRD)
  • Review draft plans in respect of the application of available financial resources to support the Operating Plan including Integrated Commissioning Plans and Sustainability and Transformation Plans and to forward relevant and agreed elements for approval by the Board. To oversee and monitor delivery against these plans thereafter.
  • Undertake a continuous appraisal of the financial position and performance of the Alliance by means of the provision of information to the Board as they may require from directors, committees and officers of the ICB as set out in management policy statements and to receive at least in summary all monitoring returns required by the Department of Health or NHS England.
  • Evaluate and scrutinise emerging cost pressures and agree the release of contingency or reserves where appropriate and within the limits of the Scheme of Delegation.
  • Manage the ICB’s non recurrent revenue plan related to the Alliance, the strategic capital programme approved by the Board and facilitate the delivery of the required cost savings whilst ensuring sustainable functions.
  • Review and approve significant investment and disinvestment business cases in line with the Committee’s powers under the Schemes of Reserved Delegation and to ensure that any business cases outside of their remit are referred to the Board. An activity or operation shall be regarded as non-significant if it has a gross annual income or expenditure (that is before any set off) less than £500,000.
Transformation, Planning and Operational Delivery
  • Encourage innovation by supporting our collective partnership through our workforce and local communities.
  • Review and redesign of local services in consultation with the ICB and other partnership groups to meet the outcomes identified in these terms of reference and the Alliance Delivery plans.
  • Work to shape and deliver improvements collectively. Use digital innovation to enable system change and improve outcomes for the local population, as applicable.
  • Undertake population health and social needs assessment to identify inequalities.
  • Use the insight and levers from population health and social needs assessment to work with the ICB to set strategic ambitions, priorities and performance metrics to address inequalities and improve outcomes over the medium to long term.
  • Oversee and make recommendations to the Board on any Project Initiation Document and associated business case that requires Board approval.
  • Monitor and receive written and verbal updates on progress with implementing relevant key projects and initiatives from senior staff and key clinicians. Direct resources and responsibility to deal with operational issues, implement objectives and annual plan, and achieve local and national target.
  • Monitor operational performance and agree plans to mitigate underperformance, where necessary reporting these to the Board through exception reporting.
  • Monitor compliance with provision of mandatory requirements placed upon the ICB.
  • Take urgent operational decisions to ensure that any imposed deadlines are met.
  • Consider and make recommendations to the Board on action on litigation against or on behalf of the ICB.
  • Consider impact of service (re)design/changes/policies/decisions on health inequalities.
Risk, Governance, and patient safety
  • Review and discuss the implications and implementation of any relevant key policy documentation issued by statutory authorities which have a potential impact on service development plans and those services commissioned by the ICB and its delegation to the Alliance.
  • Ensure that appropriate action is being taken to manage identified and potential risks delegated by the Board and identified in the ICB’s Quality assurance framework (including the Alliance Quality Group). This Committee will escalate risks to the Board where appropriate.
  • Ensure that patient safety and quality of services is the key focus of the Committee, embedding a culture of continuous improvement.
  • Ensure high levels of patient engagement and consultation throughout its processes including the review of services and including being cognisant of duties for formal consultation in relation to service reviews.
Governance
  • Review and recommend governing arrangements impacting on the ICB to the Board and ensure that the Committee continues to reflect the principles of good governance as are relevant to it.
  • Develop policies and procedures for the management of risk and to own and contribute to the corporate and operational risk registers of the ICB
  • Ensure that appropriate action is taken to manage identified and potential risks delegated by the Board and identified in the ICB’s assurance framework.
  • Escalate risks to the Board, as appropriate, and produce reports to the Board as required under these terms of reference or as requested by the Board.
Operations
  • Provide visible, robust and professional leadership to the Alliance (in accountable roles), Alliance and to system stakeholders.
  • Promote and abide by the values of the Equality Act 2010 with particular focus on:
    • The need to eliminate unlawful discrimination harassment and victimisation and other conduct prohibited by the 2010 Act.
    • Advancing equality of opportunity between people who share a protected characteristic and those who do not.
    • Fostering good relations between people who share a protected characteristic and those who do not.
  • Maintain a register of interests of all members of the Committee and to require and to receive the declaration of any member’s interests which may conflict with those of the Committee and ICB, taking account of any waiver which the Secretary of State may have made in any case, and after consultation with the Chief Executive, to determine the extent to which that member may participate in the consideration of a matter in which he/she has an interest.
  • Ensure that the Alliance has appropriate arrangements in place to exercise its functions effectively, efficiently and economically and in accordance with the delegations given to it from the ICB as set out in the SoRD.
  • Ensure that procurement processes are conducted in a legal, open and transparent, non- discriminatory and fair way in compliance with the relevant legislation.
  • Enable the Board to fulfil its statutory functions in relation to financial control, commissioning and delivery.
  • Provide full reports of its activity including Board reports as required by the Board within the specified time.
  • Operate at all times within its approved terms of reference.
  • Ensure that its decisions are both taken and seen to be taken without any possibility of the influence of external or private interest.
Engagement
  • Develop and promote an organisation wide culture which enables clinicians, managers, staff and people living and working in West Suffolk to work both in partnership and individually to effectively delivery safe and sound services.
  • Contribute to the provision of appropriate responses to external and internal service reviews.
  • Develop and/or contribute to responses to relevant consultation documents for various stakeholders.
  • Ensure effective relationship management with key partners and stakeholders.
  • Give consideration to key communications requirements and messages and ensure that all work or projects are underpinned by communication’s strategies. The Communications team within the ICB will support this Committee as necessary.
  • Ensure that patient experience is at the centre of all decision making, service redesign and procurement, with patient experience indicators, targets, incentives and rewards aligned and embedded.
  • Promote a culture of co-production, engagement and involvement throughout the work of the Alliance.
  • Ensure wide levels of clinical engagement. This will extend beyond the scope of any clinical membership and should involve clinicians from all professional backgrounds.
  • Promote and specify continuous improvements in quality and outcomes and encourage and support practices, clinicians and the public to be innovative in creating changes.
  • Engage in a c
  • laborative approach with the local NHS in securing new services for patients fully responsible to local health needs.
  • Work collaborat
  • ely to deliver the outcomes and milestones set out in any Alliance Delivery Plan which shall be aligned with the Framework.

5 Authority

The West Suffolk Alliance Health, Care and Wellbeing Committee is authorised by the Board to:

  • Is authorised to make decisions in line with areas of delegation *to be confirmed* from the ICB.
  • Achievement of a fully integrated, more efficient, and more locally focused health and care system, with greater emphasis on efficiency coming from wider system improvements, collaboration and shared resources.
  • To support the Alliance to be sustainable and function in line with NHS legislation and the NHS Constitution.
Relationship with the ICB Board

The WS Alliance Health, Care and Wellbeing Committee is accountable to the ICB Board and shall report to the ICB Board on how it discharges its responsibilities.

The WS Alliance Health, Care and Wellbeing Committee has delegated powers from the ICB Board as set out in the Scheme of Reservation & Delegation (SoRD)

Formal minutes shall be kept of the proceedings which will be submitted to the ICB Board

6 Membership

When determining the membership of the WS Alliance Health, Care and Wellbeing Committee active consideration will be made to diversity and equality.

Membership list:

  • Babergh and Mid Suffolk Councils – Strategic Director
  • Healthwatch – Chief Executive
  • Independent Chair
  • NHS SNEE – tba
  • Norfolk and Suffolk Foundation Trust – Chief Executive
  • Primary Care – tba
  • Suffolk County Council – Director of Adults and Community Services
  • Suffolk County Council – Director for Children and Young People
  • Suffolk County Council – Director of Public Health
  • West Suffolk Alliance Director
  • West Suffolk Foundation Trust – Chief Executive
  • West Suffolk Council – Chief Executive

The Committee may invite other members to join permanently or to attend specific meetings depending on the agenda.

Supporting officers to attend.

Chair and Vice Chair

The West Suffolk Alliance Health, Care and Wellbeing Committee will be chaired by the Alliance Independent Chair.

The West Suffolk Alliance Health, Care and Wellbeing Committee members may appoint a Vice Chair from amongst the members.

In the absence of the Chair, or Vice Chair, the remaining members present shall elect one of their number Chair the meeting.

The Chair will be responsible for agreeing the agenda and ensuring matters discussed meet the objectives as set out in these terms of reference.

Attendees

Only members of the West Suffolk Alliance Health, Care and Wellbeing Committee have the right to attend West Suffolk Alliance Health, Care and Wellbeing meetings, but the Chair may invite relevant staff to the meeting as necessary in accordance with the business of the West Suffolk Alliance Health, Care and Wellbeing Committee

7 Quoracy and Decision

For a meeting to be quorate at least 5 organisations represented, including SCC, WSCCG, NSFT, Primary Care and WSFT.

If the quorum has not been reached, then the meeting may proceed if those attending agree, but no decisions may be taken.

Decision Making and Voting

Decisions delegated by the ICB will be taken in accordance with the ICB Standing Orders.

The West Suffolk Alliance Health, Care and Wellbeing Committee will ordinarily reach conclusions by consensus. When this is not possible the Chair may call a vote.

Only members of the West Suffolk Alliance Health, Care and Wellbeing Committee may vote. Each member is allowed one vote and a majority will be conclusive on any matter.

Where there is a split vote, with no clear majority, the Chair of the West Suffolk Alliance Health, Care and Wellbeing Committee hold the casting vote.

8 Administration

The West Suffolk Alliance Health, Care and Wellbeing Committee shall be supported with a secretariat function. Which will include ensuring that:

  • The agenda and papers are prepared and distributed in accordance with the standing orders have been agreed by the Chair with the support of the relevant executive lead.
  • Records of members’ appointments and renewal dates and the Board is prompted to renew membership and identify new members where necessary.
  • Good quality minutes are taken in accordance with the standing orders and agreed with the chair and that a record of matters arising, action points and issues to be carried forward are kept.
  • The chair is supported to prepare and deliver reports to the ICB board.
  • The West Suffolk Alliance Health, Care and Wellbeing Committee is updated on pertinent issues/ areas of interest/ policy developments.
  • Action points are taken forward between meetings.

9 Conduct of the West Suffolk Alliance Health, Care and Wellbeing Committee

Benchmarking and Guidance

The West Suffolk Alliance Health, Care and Wellbeing Committee will take proper account of National Agreements and appropriate benchmarking, for example Agenda for Change and guidance issued by the Government, the Department of Health and Social Care, NHS England and the wider NHS in reaching their determinations.

ICB Values

Members will be expected to conduct business in line with the ICB values and objectives and the principles set out by the ICB.

Members of, and those attending the West Suffolk Alliance Health, Care and Wellbeing Committee shall behave in accordance with the ICB’s constitution, Standing Orders, and Standards of Business Conduct Policy.

Equality, Diversity and Inclusion

Members must demonstrably consider the equality, diversity and inclusion implications of decisions they make.

Greener NHS

The Committee will support the system approach in collaboration with Carbon Zero, the NHS Green plan and Suffolk Climate Emergency Plan for a Greener NHS.

Suffolk’s public sector leaders have all set out and committed to pursue net zero strategies in our own organisations that respond to local, national and international evidence. Furthermore, we will all work together to support and guide our residents, communities and businesses to make the changes required to best set Suffolk on the path for carbon neutrality by 2030

This group will actively conserve resource use and encourage sustainability in its work as part of the environmental agenda.

10 Review

The West Suffolk Alliance Health, Care and Wellbeing Committee will review on an annual basis its own performance and effectiveness including membership and terms of reference. The ICB Board will approve any resulting changes to the terms of reference or membership.

Date Approved: 1st July 2022
Next Review: 1st July 2023

References

1. Health and social care integration: joining up care for people, places and populations – GOV.UK

Initial Draft v5

a. MoU and b. Terms of Reference

a) Suffolk and North East Essex ICP Memorandum of Understanding

1 Background

The Health and Care Act 2022 received Royal Assent on 28 April 2022. It introduces two-part statutory ICSs, comprised of an NHS Integrated Care Board (ICB), responsible for NHS strategic planning and allocation decisions, and an Integrated Care Partnership (ICP), responsible for bringing together a wider set of system partners to develop a plan to address the broader health, public health and social care needs of the local population, and which will also work with the local Health and Wellbeing Board in this respect (see 2.2, 2.5 & 2.6 below).

This initial MoU and Terms of Reference for the Suffolk and North East Essex ICP is based on early guidance published in March 2022 Integrated care partnership (ICP): engagement summary – GOV.UK from the Department of Health and Social Care (DHSC).
This was based on the trilateral engagement undertaken by DHSC, NHSE and LGA on the ICP engagement document: integrated care system (ICS) implementation by DHSC, NHS England (NHSE) and the Local Government Association (LGA).

This initial draft MoU and Terms of Reference should be considered in the context that 2022 and 2023 are expected to be transitional years for the establishment of ICPs with the following key milestones for development of the ICP and Integrated Care Strategy:

1. July 2022 – ICP formally established by local authorities and ICBs. July 2022 – DHSC to publish guidance on the integrated care strategy
2. December 2022 – ICP to publish an interim integrated care strategy
3. April 2023 – NHS ICB to publish its first 5-year forward plan for healthcare
4. June 2023 – DHSC to refresh integrated care strategy guidance as appropriate

It should also be noted that the ICP is being established in the context of the following wider emerging policy and legislative context around health and care:

5. Integration white paper [Health and social care integration: joining up care for people, places and populations]. This offers new opportunities and some challenges for our Alliances as partners work together to improve integration and empowerment at local place level.
6. People at the Heart of Care: adult social care reform white paper. This proposes a vision of choice, control, quality, fairness and accessibility – with some specific proposals and funding around housing, adoption of technology, carers, local innovation and planning.
7. Build Back Better: Our Plan for Health and Social Care. Government plan for covid recovery. This introduced a Health and Care Levy, mainly going to the NHS, a cap on lifetime care costs and ambitious targets for elective recovery.
8. Levelling Up the United Kingdom white paper. Linked to this are significant transformation programmes as well as likely ‘county deals’ for Suffolk and Essex.
9. A range of other key policy changes including Mental Health Act, Autism Strategy, changes to social care charging and a new action plan for Building the Right Support [supporting people with learning disability and/or autism who may require inpatient care].

This initial draft MoU and Terms of Reference for the SNEE ICP builds on the early work of the ICS and has been developed as part of the wider ICS Transition Programme which engaged stakeholders from across all sectors in discussions about tailoring local implementation of the proposed new health and care legislation. Further information is in the Suffolk and North East Essex ICS Draft Design Framework considered by the ICS Board in April 2022.

2. ICP Role and Function

Section 26 of the Health and Care Act 2022 amends the Local Government and Public Involvement in Health Act 2007 so that the NHS Integrated Care Board and the local upper- tier local authorities (UTLAs) that fall within the area of the integrated care board must establish an Integrated Care Partnership (ICP). The ICP will be a joint committee of these bodies made under the new section inserted in the Act. The partnership must include members appointed by the NHS Integrated Care Board (ICB) and each relevant upper tier local authority. The ICP may determine its own procedures and appoint other members.

The Health and Care Act 2022 also amends section 116ZB of the Local Government and Public Involvement in Health Act 2007 so that:

  • The Suffolk and North East Essex ICP must prepare a strategy on how to meet the needs of the population it serves through the exercise of functions by the Suffolk and North East Essex NHS Integrated Care Board (ICB), NHS England, Suffolk County Council and Essex County Council.
  • Population needs are as identified in the joint strategic needs assessments developed by the Suffolk and Essex Health and Wellbeing Boards.
  • The strategy must address whether the needs could be met more effectively through the use of NHS/local authority section 75 agreements and may include a view on how health and social care could be more closely integrated with health-related services.
  • Suffolk and North East Essex ICP must have regard to the Secretary of State’s mandate to NHS England (national NHS priorities) and the statutory guidance on the integrated care strategy;
  • Suffolk and North East Essex ICP must involve Healthwatch and local people and communities in preparing the strategy.

The Health and Care Act also amends section 116B of the Local Government and Public Involvement in Health Act 2007, so that as upper tier local authorities, Suffolk County Council and Essex County Council and the new Suffolk and North East Essex NHS Integrated Care Board (ICB) must have regard to:

  • any joint assessment of health and social care in relation to the area for which they are responsible
  • any Integrated Care Strategy that applies to the area of the local authority
  • any Joint Health and Wellbeing Strategy prepared by the local authority and any of its partner ICBs

The Suffolk and North East Essex ICP will not perform a Health scrutiny function and will itself be subject to scrutiny by the Health Scrutiny Committees of Suffolk County Councils and Essex County Council or their Joint Health Overview and Scrutiny Committee (JHOSC).

This Initial MoU and Terms of Reference will be further developed in response to experience in operation and guidance on the Integrated Care Strategy to be published in July 2022. This national guidance will be informed by responses to a national trilateral engagement based on five expectations of integrated care partnerships (ICPs). The key findings and further actions from this national engagement were as follows:

Expectation 1: ICPs will drive the direction and policies of the ICS

Key findings

  • designate ICB leaders and local authorities should be having active discussions about the role and running of their ICPs and reaching out to wider partners if they are not doing so already
  • each ICP should publish a single point of contact by April 2022, so that local partners can get in touch and discuss how they might be involved

Further actions:

  • It is also expected that CQC ICS reviews will assess the functioning of the system for the provision of relevant healthcare and adult social care, looking at the relationship between the ICB, and ICP.
Expectation 2: ICPs will be rooted in the needs of people, communities, and places

Key findings:

  • ICPs should promote a listening and responsive culture across the entire ICS, whether at system, place, or neighbourhood level, and ensuring that decisions are made as close to the people and communities they serve as possible
  • Healthwatch and VCSE partners will have a critical role to play in supporting this aspect of ICPs’ work, and the ICP will need to consider the capacity of local Healthwatch organisations to do so effectively
  • it is expected that mental health representatives will play a significant role in partnerships

DHSC will:

  • include in its guidance, recommendations for ICPs on who to consider engaging in the preparation of their integrated care strategies
  • produce guidance setting an expectation that the ICP should consult local children’s leadership, and children, young people, and families themselves, on the integrated care strategy
  • continue to work with organisations representing social care providers to develop principles for their involvement ICPs and ICBs
  • ensure that guidance for the integrated care strategy is aligned with guidance for ICBs and providers on working with people and communities
  • along with NHS England and the LGA, continue to engage with stakeholders on these issues over the coming months and as ICPs are established
Expectation 3: ICPs create a space to develop and oversee population health strategies to improve health outcomes and experiences

Key findings:

  • an ICP’s membership and approach should reflect its role in focussing on wider population health outcomes. All members need to recognise that it is an equal partnership.
  • systems can learn from each other on how to create the right culture and dynamic between partners.

Further actions:

  • Guidance on the integrated care strategy can further reinforce the role of the ICP to focus on the challenges and opportunities that go beyond traditional boundaries and are best addressed at system level.
Expectation 4: ICPs will support integrated approaches and subsidiarity

Key findings:

  • the ICP should consider the existing and potential role of place and neighbourhood to ensure that there are clear mechanisms to enable subsidiarity of decision making and that decisions are taken once at the most appropriate local level
  • during the establishment phase, ICPs should actively learn from emerging models around place and ICP governance, so that they can see how similar systems are designing themselves

Further actions:

  • statutory guidance on the integrated care strategy should set out the challenges and opportunities which are likely to be best overseen by ICPs, as opposed to the other parts of systems (places, local authorities and ICBs)
  • DHSC will refresh guidance for Health and Wellbeing Boards in the light of the wider system changes, and those proposed in the Integration White Paper.
Expectation 5: ICPs should take an open and inclusive approach to strategy development and leadership, involving communities and partners, and utilise local data and insights

Key findings:

  • local authorities and ICB leaders need to work together to build consensus in the selection of the ICP chair. Where local authorities and ICB are not able to identify a chair who has all their support, the local area may wish to contact DHSC, NHSE for support (see chapter on resources and support below) or the LGA to obtain help in finding a solution.
  • successful ICPs will need to build a positive culture of inclusion and collaboration to achieve shared population health outcomes – the support offer is intended to assist local authorities and ICBs to achieve this

Further actions:

  • DHSC will publish statutory guidance on the integrated care strategy in July 2022
  • DHSC will include engagement expectations in its guidance on ICP strategies

Health and Wellbeing Boards were established by Section 194 of the Health and Social Care Act 2012, by requiring each Upper Tier Local Authority to create a health and wellbeing board for its area, as a committee of the local authority and setting out the required membership.
The Health and Care Act does not make any substantial changes to the establishment, functions or duties of Health and Wellbeing Boards, however:

  • The Act requires local authorities to share Joint Strategic Needs Assessments, prepared by the Health and Wellbeing Boards with the integrated care partnerships that overlap with the area of the local authority.
  • Health and Wellbeing Boards are also responsible for preparing joint strategic needs assessments and joint local health and wellbeing strategies, and the Health and Social Care Act 2012 (under section 196) allows local authorities to delegate any functions exercisable by the local authority to the health and wellbeing board that it established.
  • Health and Wellbeing Boards have a duty to promote integration between commissioners of NHS, public health, and social care services for the advancement of the health and wellbeing of the local population. A health and wellbeing board must provide advice, assistance, or other support in order to encourage partnership arrangements such as the developing of agreements to pool budgets or make lead commissioning arrangements under section 75 of the NHS Act.

The establishment of a statutory ICP in Suffolk and North East Essex is a natural next step in the evolution of the current ICS. The current ICS Board already seeks to enable an equal partnership between partners in the ICS supported by an independent secretariat function with a focus on population health and reducing health inequalities, underpinned by Outcome Based Approaches. The current approach is based very much on facilitating whole system ‘Thinking Differently Together’ to develop whole system strategy, working closely with both Health and Wellbeing Boards, Healthwatch and people with lived experience – also facilitating system relationships and positive engagement in the ICS for wider system partners including the VCSE sector. The Suffolk and North East Essex ICP will continue to build on these positive early foundations.

In supporting the equal partnership between the NHS Suffolk and North East Essex ICB, UTLAs and wider partners in the ICS, the ICP will have a key role in maintaining the brand and identity for the Suffolk and North East Essex ICS as a collective brand owned jointly and equally by all partners across the NHS, local government and VCSE sector.

The statutory role of the Suffolk and North East Essex ICP will be to produce the joint strategy as to how to meet the assessed needs of its area. In discharging this role, Suffolk and North East Essex ICP will:

  • be a forum to build on the joint positive working between all partners in Suffolk and North East Essex ICS across the NHS, local authorities and VCSE sector with partners coming together under a distributed leadership model and committing to working together equally.
  • use a collective model of decision-making that seeks to find consensus between system partners and make decisions based on unanimity as the norm, including working though difficult issues where appropriate.
  • agree arrangements for transparency and local accountability, including meeting in public with minutes and papers available online.
  • champion co-production and inclusiveness throughout the ICS.
  • hear the voices of those with lived experience including those experiencing disadvantage and marginalisation so that they inform strategic thinking and planning
  • sign off the strategic intent for the health and social care system including the development of the integrated care strategy underpinned by outcome based approaches that ensure a focus on improving outcomes for people, including improved health and wellbeing, supporting people to live more independent lives, and reduced health inequalities.
  • facilitate ‘Thinking Differently Together’ across the ICS through a range of collective mechanisms and initiatives accessible to all stakeholders
  • oversee integration between the NHS, local government (social care and public health) and VCSE sector (including conversations about shared budgets and investment)
  • support the triple aim (better health for everyone, better care for all and efficient use of NHS resources), the legal duties on statutory bodies to co-operate and the principle of subsidiarity (that decision-making should happen at the most local appropriate level)
  • ensure place-based partnership arrangements are supported, and have appropriate resource, capacity and autonomy to address community priorities, in line with the principle of subsidiarity.
  • drive the delivery of a shift of resources into prevention developing a clear view on the contribution of the health and social care system into prevention and the determinants of health
  • draw on the experience and expertise of professional, clinical, political and community leaders and promote strong clinical and professional system leadership.
  • hear the voices of those on the frontline so that they inform strategic thinking and planning
  • operate a collective model of accountability, where partners hold each other mutually accountable for their shared and individual organisational contributions to shared objectives.
  • hold one another collectively accountable in our role as “anchor institutions”
  • support the work of the health and wellbeing boards (HWBs) and contribute to their work with broader partners on the wider determinants of health
  • create a learning system, sharing evidence and insight across and beyond the ICS, crossing organisational and professional boundaries.
  • own the collective brand and identity of the Suffolk and North East Essex ICS.
3. ICP Values and Principles

Suffolk and North East Essex ICP will work, first and foremost, on the principle of statutorily equal partnership between the NHS and local government to work with and for their wider partners and communities. Essex County Council, Suffolk County Council, NHS Suffolk and North East Essex Integrated Care Board (ICB) and the wider partners in the ICS will meet in the ICP as co-owners and equal partners of the ICP committee.

Local government includes the six district and borough councils across Suffolk and North East Essex, as well as both Essex and Suffolk County Councils. Wider partners across the ICS includes Voluntary, Community and Social Enterprise (VCSE) organisations as well as NHS, social care and public health providers and representatives of people with lived experience or facing marginalisation, adversity or disadvantage.

The focus of the Suffolk and North East Essex ICP will be on building shared purpose and common aspiration across the whole Suffolk and North East Essex Integrated Care System (ICS). As such Suffolk and North East Essex ICP will have a different status and role to the NHS Suffolk and North East Essex Integrated Care Board (ICB) which is a statutory NHS Body, and local statutory Health and Wellbeing Boards. All three statutory mechanism are equally important and complementary components of the ICS.

In addition the work of the ICP as a key element of the ICS will reflect the following broader core values that underpin the way that partners across Suffolk and North East Essex have agreed to continue to work together as a statutory ICS.

Our core values: being ‘Can Do’ in all that we do

We are ambitious about what we can achieve for our population – our Higher Ambitions. We are committed to delivering tangible outcomes for the people.
Collaborative

  • We believe in altruism and that good relationships are essential
  • for our success
  • We are ethical and operate with integrity
  • We are fair. We trust one another
  • We challenge appropriately and treat everyone with respect

Compassionate

  • We are kind
  • We treat people as individuals
  • We listen to and learn from people and their lived experiences
  • We are inclusive of all ages
  • We are allies to people facing adversity and disadvantage and we are all accountable for
    enabling health equality

Creative

  • We are innovative and committed to finding and implementing creative and shared solutions to problems
  • We are open to continuously learning from one another and the people that we serve

Community focused

  • We are committed ta understanding our local population and meeting their needs
  • We are focused on our local places and the assets in our local communities

Cost effective

  • We are transparent and accountable for the decisions that we make and the way that we make them
  • We hold one another accountable for using all of our resources efficiently
  • We are committed to delivering social value in our local communities

Courageous

  • We are brave and have the moral courage to do the right thing.
  • We are committed to enabling equity and justice and tackling the deep inequalities faced by people and communities
  • We start with ‘Why?’

The ICP will seek to uphold a non-hierarchical approach to collaboration with the ICS
operating as a true ‘system’ – an environment that supports all partners to collaborate and work together in however and wherever the work is done best. This includes arrangements for working together in neighbourhoods, primary care, local places, across counties, across the ICS system, with neighbouring systems in the East of England or with other systems across England. As such the ICP will aim to ensure that different ways to collaborate are genuinely interlinked as a true ‘system’.

Different elements of the Suffolk and North East Essex Integrated Care System (ICS) link together, working as an interlinked system – not as a hierarchy.

The Essex Health and Wellbeing Board works alongside the North East Essex Health and Wellbeing Alliance. In turn, the North East Essex Health and Wellbeing Alliance links in with the NHS Suffolk and North East Essex Integrated Care Board (ICB).

The ICB sits at a pivotal point within the system, and works closely with the two other health and wellbeing alliances in our system area: Ipswich and East Suffolk Health and Wellbeing Alliance and West Suffolk Health and Wellbeing Alliance. The ICB also works closely with provider collaboratives.

The Ipswich and East Suffolk Health and Wellbeing Alliance and the West Suffolk Health and Wellbeing Alliance also link in with the Suffolk Health and Wellbeing Board.

Place-based Alliances have a particularly key role in the Suffolk and North East Essex ICS. It is important to ensure that the work undertaken at system level complements, supports, and enables the work undertaken at place level since integration and transformation happen largely at place level, and collaboration between the NHS and local authorities is increasingly devolved from system to place level. The ICP should not duplicate or undermine that work.

Decision making and service delivery needs to happen at the right level and our place-based Alliances have a strong role in transformation and integration. The ICP will provide an overarching set of strategic shared priorities and enabling strategy, with flexibility for Alliances to develop priorities specific to each place.

Roles that the ICP, rather than places, might undertake, include:

  • advocating new place-based approaches – the new legislation requires that ICBs and local authorities take account of integrated care strategies, so the ICP will be well positioned to advocate for considering how the needs of a place are met, whether that be through more integrated approaches, research, innovation, or investment in services for particular populations and cohorts.
  • enabling, encouraging, and challenging Alliances to improve and innovate – the ICP will be able to take an overarching look across the Suffolk and North East Essex ICS and across into neighbouring ICSs and identify differences in place-based planning and provision and opportunities for collaboration, research, peer support and learning to spread good practice. For example, the ICP can identify if one Alliance is innovating in a new integrated delivery programme, or designing a new pooled budget, and suggest that might be something another area could learn from. They could spread ideas and expertise on transformation programmes.
  • system level integration strategies – particularly areas of integration that could benefit from strategic oversight at system level. For example, looking at the integration of children’s health and public health services; or building an integrated workforce strategy that looks across a system footprint and links in with place-based workforce planning; or considering how the system as a whole can support wider socio-economic development and the relationship between work and health.
4. ICP Leadership

Section 26 of the Health and Care Act amends the Local Government and Public Involvement in Health Act 2007 so that the NHS Integrated Care Board and local upper-tier local authorities (UTLAs) that fall within the area of the integrated care board must establish an integrated care partnership. This will be a joint committee of these bodies made under the new section inserted in the Act. The partnership must include members appointed by the integrated care board and each relevant local authority. The integrated care partnership may determine its own procedures and appoint other members.

Based on the principle of the ICP working as a statutorily equal partnership between the NHS and local government, the Suffolk and North East Essex ICP Committee will be co-chaired by appropriate Elected or Non-Executive leaders nominated by the NHS Integrated Care Board (ICB), Essex County Council and Suffolk County Council. The dual roles of the ICP Co-Chairs in the NHS ICB and Health and Wellbeing Boards is important to ensure that the ICP remains aligned to these other key statutory mechanisms in the ICS with its own clearly defined status and role. The two UTLA Co-Chairs of the ICP Committee will be regular participants on the NHS ICB Board with the right to participate in meetings when and as they feel necessary. The role of the ICP Co-Chairs will be to ensure:

  • the creation of a strong and empowered ICP from the outset
  • equal ownership and commitment to the ICP from the NHS and local government
  • a balanced relationship between the ICP and the ICB within the ICS
  • a commitment by wider ICS partners to the ICP values and principles outlined above
  • a clear and dynamic relationship with local Health and Wellbeing Boards
  • effective collaboration and joint working with neighbouring ICPs and wider ICSs.

The ICP Director is jointly accountable for the work and operation of the ICP to the three ICP Co-Chairs. A small independent ICP Secretariat function will be resourced by the NHS ICB, Essex County Council and Suffolk County Council. In order to ensure the different status and role of the ICP to both the NHS Suffolk and North East Essex Integrated Care Board (ICB) and two statutory Health and Wellbeing Boards, the ICP Secretariat will be hosted independently within the ICS with appropriate executive and management lines of responsibility and accountability. It will work closely as appropriate with the NHS Integrated Care Board (ICB) Executive Team, Suffolk Health and Wellbeing Board Programme Office and Essex Health and Wellbeing Board Programme Office. The ICP Director will also be a regular participant on the NHS ICB Board and be in attendance at both Suffolk and Essex Health and Wellbeing Boards. The role of the ICP Secretariat will include to:

  • support the ICP Co-Chairs in their joint leadership of the ICP
  • convene and support statutory meetings of the ICP committee of to include planning and publication of agendas, of minutes and management of actions in line with the agreed standing orders
  • convene a strategy steering group to co-ordinate development of the Integrated Care Strategy based on population needs – as identified through local joint strategic needs assessments – to be delivered through the exercise of functions by the NHS ICB, upper tier local authorities and wider partners.
  • ensure that there is an explicit point of contact and signposting for all stakeholders into ICS that enables and facilitate all wider partners to collaborate equally through the ICP and other forums
  • ensure that all stakeholders can openly access, contribute and engage in the work of the ICP through a broad range of accessible and inclusive mechanisms including a website,
    communications, events, system learning initiatives and campaigns that support stakeholders in ‘Thinking Differently Together’
  • work closely and support key stakeholders and forums that enable key stakeholders to contribute to the work of the ICS – Healthwatch, VCSE sector, non-executive and elected members, clinical and professional forums, those representing people facing discrimination or disadvantage etc.
  • champion and support the use of outcome based thinking in the ICS through the delivery of professional learning opportunities and consultancy
  • champion and promote health equality and health equity through the ICS supporting NHS, local government and wider stakeholders to make a measurable impact through the Suffolk and North East Essex ICS 5 A’s approach to health equality: Anchors, Allyship, Assessment, Awareness, Accountability.
5. ICP Membership

The membership of Suffolk and North East Essex ICP will reflect its role in focussing on wider population health outcomes and recognise that it is an equal partnership. The core statutory membership of the Suffolk and North East Essex ICP will be the three ICP Co-Chairs representing Suffolk County Council, Essex County Council and NHS Suffolk and North East Essex ICB.

The ICP membership will also include other nominated members from these three statutory bodies as agreed by the ICP from time to time.

Public health will play a significant role in the ICP with both local authority directors of public health (or their nominated representatives) acting as key members of the ICP. The Health and Care Act includes a duty on Integrated Care Boards to seek advice from persons with the appropriate expertise on prevention and public health – this may include directors of public health (which complements the existing duty in section 6C regulations for local authorities to provide the NHS with public health advice).

Healthwatch has a specific statutory role within the ICP. The Health and Care Act requires ICPs to involve their local Healthwatch organisations on the preparation of their strategies and embedding a culture of active listening, responding to community concerns
across the whole system, and scrutinising local decisions. Local people and patients will want to know that their voices are being heard and their views are acted upon. As the public champions in health and social care, and with links into seldom heard communities, Healthwatch Suffolk and Healthwatch Essex are well placed to support work of the ICP.

The ICP is specifically required to work with people and communities on the development of the integrated care strategy through existing engagement channels of all partners, making connections to existing community fora and democratic representatives. This will allow decision making within the ICP to be informed by the views of people and communities represented in the ICP membership through representatives of a wider lived experience network including in particular members able to bring forward perspectives from unpaid carers and babies, children, young people and families.

The membership of the Suffolk and North East Essex ICP will be decided by the ICP from time to time. It will include a breadth of clinical and professional perspectives including mental health, safeguarding, social care providers, general practice, medical, nursing, allied health professionals, dentists, optometrists and pharmacists.

Recognising the importance of subsidiarity and working at ‘place’, the ICP membership will include representation from each of the three place-based Alliances in the ICS and District and Borough Councils as determined by the ICP from time to time.

The VCSE sector are key partners in the Suffolk and North East Essex ICS and as such will be represented in the membership of the ICP through members of the ICS VCSE Assembly to include the chair and representatives from infrastructure organisations, hospices and other VCSE sector providers as determined by the ICP from time to time..

Wider stakeholders interests to be represented in the ICP will include those of NHS acute, community, ambulance, mental health and other providers, NHS England and academic organisations as determined by the ICP from time to time.

The ICP will have an appropriately balanced membership drawn from across its footprint to ensure that the interests of stakeholders from North East Essex, West Suffolk and Ipswich and East Suffolk are represented as determined by the ICP from time to time.

Based on the criteria outlined above the initial membership of the ICP could be in excess of 50 members. One of the challenges to be addressed is that the potential membership of the statutory ICP joint committee could end up with a very large number of members. It is intended to actively manage the size of the new statutory ICS committee by doubling up representation where possible e.g. by appointing members able to represent more than one perspective and bringing in new members gradually.

The ICP will keep its membership under review from time to time and may change membership.

b) Suffolk and North East Essex ICP Terms of Reference

1 Background

Section 116ZA of Local Government and Public Involvement in Health Act 2007 requires the Integrated Care Board (ICB) and each upper tier local authority whose are coincides with the area of an ICB to establish an Integrated Care Partnership (ICP) , which is a joint committee of these bodies. The ICP may appoint other members and determine its own procedures.

ICPs have a critical role to play in Integrated Care Systems (ICS), facilitating joint action to improve health and care outcomes and experiences across their populations, and influencing the wider determinants of health, including creating healthier environments and inclusive and sustainable economies.

2 Name

The name of the ICP is ‘The Suffolk and North East Essex Integrated Care Partnership’

3 Objects

The Suffolk and North East Essex ICP will consider what arrangements work best in its area by creating a dedicated forum to enhance relationships between the leaders across the health and care system that:

  • build on existing governance structures such as Health and Wellbeing Boards (HWBs) and other place-based partnerships, and support newly forming structures to ensure governance and decision-making are proportionate, support subsidiarity and avoid duplication across the ICS
  • drive and enhance integrated approaches and collaborative behaviours at every level of the system, where these can improve planning, outcomes, and service delivery
  • foster, structure, and promote an ethos of partnership and co-production, working in partnership with communities and organisations within them
  • address health challenges that the health and care system cannot address alone, especially those that require a longer timeframe to deliver, such as tackling health inequalities and the underlying social determinants that drive poor health outcomes, including employment, reducing offending, climate change and housing
  • continue working with multiagency partners to safeguard people’s rights and ensure people are free from abuse or neglect and not deprived of their liberty or subject to compulsory detainment or treatment without safeguards
  • develop strategies that are focused on addressing the needs and preferences of the population including specific cohorts
4 Functions

Under s116ZB of the Local Government and Public Involvement in Health Act 2007 the Suffolk and North East Essex ICP is required to prepare an integrated care strategy that:

  • Details how the needs of resident of its area will be met by either the ICB, NHS England, or local authorities
  • Considers how NHS bodies and local authorities could work together to meet these needs using section 75 of the National Health Service Act 2006
  • Must have regard to the NHS mandate and guidance published by the Secretary of State
  • Involves the Local Healthwatch and people who live or work in the ICP’s area
  • Is reviewed and revised as required when a new Health and Social Care joint strategic needs assessment is received from a local authority within the ICP
  • Considers how health related services can be more closely integrated with arrangements for the provision of health services and social care in its area
  • Is published and provided to each local authority in its area and each partner Integrated Care Board of those local authorities

Under s116B of the Local Government and Public Involvement in Health Act 2007 a local authority and each of its partner ICPs must have regard to:

  • Any joint assessment of health and social care in relation to the area for which they are responsible
  • Any Integrated Care Strategy that applies to the area of the local authority
  • Any Joint Health and Wellbeing Strategy prepared by the local authority and any of its partner ICBs

The Suffolk and North East Essex ICP will not perform a Health scrutiny function and will itself be subject to scrutiny by the Health Scrutiny Committees of the County Councils of Suffolk and Essex.

5 Membership

There are two classes of members of the ICP:

  • Statutory members
  • Co-opted members

The initial statutory membership of the Suffolk and North East Essex ICP will be one member appointed by each of Suffolk County Council, Essex County Council and the NHS Suffolk and North East Essex ICB.

Voting Members

The voting membership of the Suffolk and North East Essex ICP will comprise the following:

Type/Sector Role
Essex County Council Chair of Essex Health and Wellbeing Board
Suffolk County Council Chair of Suffolk Health and Wellbeing Board
NHS Suffolk and North East Essex Integrated Care Board (ICB) Chair
Co-opted Members

Where a member is to be appointed other than by a county council or the ICB then the ICP will invite nominations via any fair process determined by their appointing organisations and the agreed nominee will be co-opted on to the ICP at a meeting of the ICP. In the event that there is no clear nominee or if there is a dispute as to the identity of the nominee the ICP may co-opt as it thinks fit.

Essex County Council, whose Health and Wellbeing Board now operates across three ICSs will not be exercising Health and Wellbeing Board activity through the Suffolk and North East Essex ICP

Suffolk County Council, whose Health and Wellbeing Board now operates across two ICSs will not be exercising Health and Wellbeing Board activity through the Suffolk and North East Essex ICP.

In addition to the membership of the Suffolk and North East Essex ICP, the Suffolk and North East Essex ICP may appoint such additional persons as it sees fit, either as co-opted members or as observers. Observers shall also be entitled to participate in discussion at meetings of the Suffolk and North East Essex ICP.

6 Professional and Administrative Support

The Suffolk and North East Essex ICP may establish Programme Boards/Advisory Sub- Groups to oversee specific work programmes or broader thematic areas as required.

Programme Boards/Sub-Groups, reporting into the Suffolk and North East Essex ICP, will be managed in accordance with separate terms of reference as agreed by the Suffolk and North East Essex ICP.

The role, remit and membership of Programme Boards/Advisory Sub-Groups will be reviewed regularly by the Suffolk and North East Essex ICP to ensure they remain flexible to the demands of ongoing and new programmes of work.

Administrative support to the Suffolk and North East Essex ICP will be provided by a small independent ICP Secretariat with the reasonable costs of this split between by the NHS Suffolk and North East Essex ICB , Suffolk County Council and Essex County Council subject to the agreement of each authority which is expected to pay.

The Suffolk and North East Essex ICP may from time to time decide that the work of the ICP can be supported by wider partner organisations in the Suffolk and North East Essex ICS.

7 Standing Orders

The Suffolk and North East Essex ICP is governed by Standing Orders approved and amended by the ICP from time to time. The Current standing orders are set out in Annex A attached to these Terms of Reference.

8 Review

This document be reviewed by members of the Suffolk and North East Essex ICP in or around August 2022 following publication of further guidance by DHSC on the role of ICPs expected in July 2022.

Annex A – Suffolk and North East Essex ICP Standing Orders

1 Appointment of Co-Chairs

Based on the principle of the ICP working as a statutorily equal partnership between the NHS and local government, the Suffolk and North East Essex ICP Committee will be co-chaired by appropriate Elected or Non-Executive leaders, one nominated by the NHS Integrated Care Board (ICB), one nominated by Essex County Council and one nominated by Suffolk County Council.

The Co-Chairs will hold office until they resign, cease to be a member of the Suffolk and North East Essex ICP or until their successor is appointed under this paragraph and will be appointed annually at the first meeting taking place after Suffolk County Council and Essex County Council have held their annual meetings.

If a vacancy arises for any position within the Municipal Year, an appointment will be made for the remainder of the Municipal Year.

2 Membership

The initial membership of the ICP will be determined by the three Co-chairs as voting members based on the principles outlined above. Members will be drawn from nominations made by forums or organisations in the ICS representing the perspectives outlined above.

Decisions to add further additional members will be determined by the ICP Committee once convened.

All members will be expected to enable good two-way connections between the ICP and the constituent partners or forums, modelling a collaborative approach to working and listening to the voices of people, patients, and the public.

The Suffolk and North East Essex ICP may appoint representatives to other outside bodies as co-opted members.

Alternate or Substitute Members

Members must be able to prioritise these meetings and make themselves available for the work of the ICP. Members will normally be expected to attend at least 75% of meetings held each calendar year. A tracker recording attendance at ICP Committee meetings will be maintained and circulated together with the papers for each meeting.

Exceptionally where this is not possible a deputy of sufficient seniority may attend. They must have delegated authority to make decisions on behalf of the organisation or forum they represent. For local authority representatives, this will be in accordance with the due political process.

The ICP Co-Chairs must be informed in advance of the relevant meeting of the identity of a substitute via the ICP Secretariat.

Each voting member will be entitled to appoint from time to time one named alternate or substitute member in exceptional circumstances, who may act in all aspects as a voting member of the Suffolk and North East Essex ICP in the absence of the voting member appointed.

ICP Membership

The maximum total membership of the ICP is 63 members.

Three of the members are Co-Chairs of the ICP. These members are:

  • Chair of the Health and Wellbeing Board – Suffolk County Council
  • Chair of the Health and Wellbeing Board – Essex County Council
  • Chair of the Integrated Care Board

Membership of the ICP is broken down below.

County Councils
  • Chair of the Health and Wellbeing Board – Suffolk County Council (Co-Chair of the ICP)
  • Chair of the Health and Wellbeing Board – Essex County Council (Co-Chair of the ICP)
Public Health
  • Director of Public Health – Suffolk
  • Director of Public Health – Essex
    Social Care
  • Director of People and Families – Suffolk
  • Director of Adult Social Care – Suffolk
  • Director of Children’s Social Care – Suffolk
  • Director of Adult Social Care – Essex
  • Director Children, Families and Education – Essex
NHS Integrated Care Board (ICB)
  • ICB Chair (Co-Chair of the ICP)
  • ICB Chief Executive
  • ICB Director Strategy & Transformation
Healthwatch
  • Healthwatch Suffolk (one member)
  • Healthwatch Essex (one member)
NHS Providers
  • East Suffolk & North Essex NHS Foundation Trust (two members)
  • West Suffolk Hospital NHS Foundation Trust (one member)
  • Mental Health Collaborative – EPUT/NSFT (two members)
  • East of England Ambulance NHS Trust (one member)
    District and Borough Councils
  • Suffolk District & Borough Council Rep (one member)
  • North East Essex District & Borough Council Rep (one member)
Social Care Providers
  • Social Care Providers – Domiciliary (one member)
  • Social Care Providers – Care Homes (one member)
NHS England
  • NHS England East of England (one member)
    VCSE Sector
  • VCSE Assembly Chair
  • Hospices (three members)
  • CVS Organisations (three members)
  • VCSE Providers (three members)
Medical
  • ICB Medical Director
Nursing
  • ICB Director of Nursing
Allied Health Professionals
  • Allied Health Professional Representative (one member)
Mental Health professionals
  • Mental Health Clinical Representative (one member)
Social Work professionals
  • Social Work Representative (one member)
Primary Care/PCNs/ LMCs
  • Suffolk LMC (two members)
  • Suffolk GP Federation (one member)
  • Essex LMC (one member)
  • GPPC (one member)
LPNs
  • Pharmacy (one member)
  • Dentistry (one member)
  • Optometry (one member)
Academic Institutions
  • Universities – education or research organisations (three members)
Safeguarding
  • Suffolk Safeguarding Chair
  • Essex Safeguarding Chair
Lived Experience
  • Lived Experience Network (three members)
  • UTLA Elected Members – representing children and adults (two members)
Placed-based Alliances
  • North East Essex Alliance (one member)
  • Ipswich & East Suffolk Alliance (one member)
  • West Suffolk Alliance (one member)
ICP Secretariat
  • ICP Director
3 Term of Office

The term of office of voting and alternate or substitute voting members shall end:

  • if rescinded by the organisation by whom they are appointed; or
  • if a Councillor appointed by a Council ceases to be a member of the appointing Council.
  • if an ex officio member ceases to be appointed in that role
  • if the individual changes role within an organisation and is no longer in the role that led to their appointment to the ICP.
4 Quorum

The quorum for meetings of the Suffolk and North East Essex ICP will be at least one member appointed by Suffolk County Council, one member appointed by Essex County Council and one member appointed by the NHS Suffolk and North East Essex Integrated Care Board (ICB).

If there is no quorum at the published start time for the meeting, a period of ten minutes will be allowed, or longer, at the Chair’s discretion. If there remains no quorum at the expiry of this period, the meeting will be abandoned, and no business will be transacted.

If there is no quorum at any stage during a meeting, the Chair will adjourn the meeting for a period of ten minutes, or longer, at their discretion. If there remains no quorum at the expiry of this period, the meeting will be closed, and no further business will be transacted.

The Quorum provisions above shall apply equally to virtual meetings.

5 Member Conduct

All members of the Suffolk and North East Essex ICP shall comply with any code of conduct applicable to the professional body and/or the organisation they represent.

Members of the Suffolk and North East Essex ICP are required to declare any interests they have in respect of matters being discussed by the Suffolk and North East Essex ICP.

If a member persistently disregards the ruling of the Co-Chair, or person presiding over the meeting, by behaving improperly or offensively or deliberately obstructs business, the Co- Chairs, or person presiding over the meeting, may move that the member be not heard further.

If the member continues to behave improperly after such a motion is carried, the Chair, or person presiding over the meeting, may move that either the member leaves the meeting or that the meeting is adjourned for a specified period.

6 Meetings and Proceedings of the Suffolk and North East Essex ICP

The Suffolk and North East Essex ICP shall hold at least 10 meetings each year. Special meetings may be called at any time by (i) the Co-Chairs or (ii) by a written notice requiring a meeting to be called being served on the Co-Chairs by the NHS ICB or Suffolk County Council or Essex County Council specifying the business to be transacted.

A co-chair present shall preside at the meeting, if there is more than one co-chair present then the Partnership will, as its first item of business agree which Co-chair will preside at the meeting, The person chairing that meeting will be rotated between the co-chairs. In the event that the planned presiding Co-Chair is unable to attend (for example in the event of illness) then one of the other Co-Chairs will act of the presiding Co-Chair on their behalf for that meeting If no co-chair is present then the meeting shall elect another member of the partnership to preside at the meeting.

The agenda for each meeting of the Partnership shall include any report approved by any of the co-chairs of the Partnership.

The Suffolk and North East Essex ICP may hold any meeting remotely using Microsoft Teams, Zoom or any other suitable platform and may live stream the meeting.

7 Notice of and Summons to Meetings

Regular meetings of the statutory ICP will be planned on an annual basis. With the exception of the first formal meeting of the ICP which will take place on Friday 1 July 2022, meetings will normally be held on the morning of the second Friday of each month.

At least five clear working days before each meeting, a copy of the agenda and associated papers will be published online and sent to every member of the ICP. The agenda will give the date, time and confirmation regarding whether the meeting is in person or virtual, will specify the business to be transacted and will be accompanied by such details as are available.

8 Voting

Suffolk and North East Essex ICP members commit to seek, where possible, to operate on the basis of consensus.

If it is not possible in a specific instance to find a consensus, the Chair of the meeting may defer the issue to a later meeting of the Suffolk and North East Essex ICP, which may be an adjournment of the same meeting. Where an item has been deferred for lack of consensus a vote will be taken by the three statutory voting members.

All members of the Suffolk and North East Essex ICP are entitled to speak on any item.

In the case of an equality of votes the person presiding at the meeting will have a second or casting vote.

9 Reports from Health Overview and Scrutiny Committees

The Chair of the Joint Health Overview and Scrutiny Committee (JHOSC) will be invited to be an observer of the ICP. The Suffolk and North East Essex ICP will receive any reports and recommendations from the JHOSC or the Health Scrutiny Committees of either Suffolk or Essex County Council and the Chairs of Health Scrutiny Committees of both Suffolk and Essex County Councils, or a nominated representative on their behalf, will also be entitled to attend meetings of the Suffolk and North East Essex ICP to represent the Committee as an observer.

10 Public Questions

At a meeting of the Suffolk and North East Essex ICP any member of the public who is a resident of West Suffolk, Ipswich and East Suffolk or North East Essex or a registered local government elector in those areas may ask a question about any matter over which the Suffolk and North East Essex ICP has authority or which directly affects the health and wellbeing of the population.

A member of the public who wishes to ask a question shall give written notice, including the text of the proposed question, to the ICP Director at least 7 clear working days before the meeting.

Unless the presiding Co-Chair otherwise agrees and subject to the paragraph below, a member of the public may only ask one question.

Questions shall be put orally at the meeting in the order in which notice of the question has been received and an answer shall be given by the presiding co-chair or such other person as they may nominate. At the end of each reply, the questioner may ask one supplementary question arising from the answer. A member of the Suffolk and North East Essex ICP nominated by the Chair will either give an oral reply to the question and/or any supplementary question orally or will indicate that a written reply will be sent to the questioner within 5 working days. There shall be no debate about the question or any supplementary question between members of the to the Suffolk and North East Essex ICP.

The period of time allocated to questions shall be limited to 15 minutes unless the Presiding co-Chair agrees to extend this time. Any questions remaining after that period has elapsed shall be subject to a written reply within 5 working days.

Answers given orally at the meeting shall be included in the Minutes. Written replies shall be copied to all members of the Suffolk and North East Essex ICP.

For the avoidance of doubt a County Councillor, or a District Councillor for a District Council in Suffolk or Essex, who, in either case, is not a member of the Suffolk and North East Essex ICP shall be regarded as a member of the public.

11 Minutes

The presiding Co-Chair for each meeting will sign the minutes of the proceedings after they have been agreed as a correct record at that meeting. The presiding Co-Chair will then move that the minutes of the previous meeting be signed as a correct record.

The minutes will be accompanied by a list of agreed action points, which may be discussed in considering the minutes of the previous meeting should they not be specifically listed as items on the agenda for the meeting.

12 Interpretation of Standing Orders

The ruling of the Presiding Co-Chairs of the Suffolk and North East Essex ICP as to the interpretation of these Standing Orders shall be final. Each meeting of the ICP will be chaired by one of the three ICP Co-Chairs on a rotating basis. The agenda for each meeting will clearly state who the presiding ICP Co-Chair will be for that meeting. In the event that the planned presiding Co-Chair is unable to attend (for example in the event of illness) then one of the other Co-Chairs will act of the presiding Co-Chair on their behalf for that meeting

13 Suspension of Standing Orders

As far as is lawful, any of these Standing Orders may be suspended by motion passed by the majority of those ICP members present and entitled to vote.

Standards of Business Conduct and Conflicts of Interest Policy

Read the ICB’s Standards of Business Conduct and Conflicts of Interest Policy as HTML.

Detailed Financial Policies (SFIs)

Read the ICB’s Detailed Financial Policies (SFIs) as HTML.

ICB People and Communities Strategy

Read the ICB’s People and Communities Strategy as HTML.

Primary Care Partner Members – Eligible Nominating Practices

Primary Care Partner Members – Eligible Nominating Practices

List of SNEE GP Practices
West Suffolk Alliance
National CodePracticeContract
D83005Angel HillPMS
D83012Clements & Christmas MaltingsPMS
D83013Guildhall & BarrowPMS
D83014Long MelfordPMS
D83021Haverhill Family PracticePMS
D83027Orchard Hse, NewmarketPMS
D83038Mount FarmPMS
D83040Victoria Street, BsePMS
D83055WoolpitPMS
D83060Hardwicke House, SudburyPMS
D83078Reynard, MildenhallPMS
D83610Swan SurgeryPMS
Y00774BrandonPMS
D83062Forest GroupAPMS
D83003WickhambrookGMS
D83018Market Cross, MildenhallGMS
D83029Rookery, NewmarketGMS
D83033BotesdaleGMS
D83045LakenheathGMS
D83064GlemsfordGMS
D83067Oakfield, NewmarketGMS
D83070StantonGMS
D83075Siam Surgery, SudburyGMS
D83076ClareGMS
Ipswich and East Suffolk Alliance
National CodePracticeContract
D83059Barrack LanePMS
D83057Framfield HousePMS
D83049Little St John’s StreetPMS
D83061Wickham MarketPMS
D83074Orchard MedicalPMS
Y01794RavenswoodPMS
D83084Birches Medical CentrePMS
D83050Cardinal Medical PracticePMS
D83079Combs FordPMS
D83041DebenhamPMS
D83051Derby RoadPMS
D83048Grove Medical CentrePMS
D83081Haven HealthPMS
D83080MartleshamPMS
D83044StowhealthPMS
D83028LeistonPMS
D83053SaxmundhamPMS
D83004Felixstowe RoadPMS
D83046Two RiversPMS
D83008Burlington RoadPMS
D83056Hawthorn DrivePMS
D83001Constable CountryPMS
D83037HadleighPMS
D83024Ivry StreetGMS
D83054PeninsulaGMS
D83073Drs Solway & MallickGMS
D83043EyeGMS
D83069FressingfieldGMS
D83015Howard HouseGMS
D83019MendleshamGMS
D83020Holbrook & ShotleyGMS
D83017Needham MarketGMS
D83007IxworthGMS
North East Essex Alliance
National CodePracticeContract
F81212Old Road Medical PracticePMS
F81741North Clacton Medical PracticePMS
F81221Fronks Road SurgeryPMS
F81026CaradocAPMS
F81681Clacton Community PracticeAPMS
Y02646Turner RoadAPMS
F81012West MerseaGMS
F81017Vicarage Lane SurgeryGMS
F81019Mayflower Medical CentreGMS
F81021The HolliesGMS
F81028Wivenhoe SurgeryGMS
F81037East Lynne Medical CentreGMS
F81042Colchester Medical PracticeGMS
F81044Ardleigh SurgeryGMS
F81052St. James SurgeryGMS
F81067Ambrose AvenueGMS
F81069Winstree Medical PracticeGMS
F81091East Hill SurgeryGMS
F81095Abbey Field (formerly Mersea Road)GMS
F81115Creffield Medical CentreGMS
F81116Colne Medical CentreGMS
F81133Tiptree Medical CentreGMS
F81141Rowhedge & University of Essex MPGMS
F81156Ranworth SurgeryGMS
F81213Thorpe-le-Soken SurgeryGMS
F81606Harewood SurgeryGMS
F81633Lawford SurgeryGMS
F81636Mill Road SurgeryGMS
F81679Highwoods SurgeryGMS
F81716Tollgate Medical CentreGMS
F81746Bluebell SurgeryGMS
F81757Riverside Health CentreGMS

Guidance for The Appointment of Interim Non-Executive Members to the ICB Board

1. Introduction

1.1 Non-Executive Members (NEMs) play a key role in ICB governance, acting in the best interests of patients and the public.

1.2 These roles have a key independent supporting function, holding the Executive to account in order to ensure that the Board and organisation as a whole is well governed and can meet its statutory duties and objectives. Some roles have a specific focus – such as remuneration, finance & audit, and quality & safety – and other roles are more generalists or indeed are a blend.

1.3 NEMs also play an important role in identifying and highlighting gaps in accountability, and in making sure that the core tenet of accountability relates to good health outcomes for the public, not just operational delivery of services.

1.4 NEMs are normally three-year fixed term appointees, are not employees and therefore have a letter of appointment rather than a contract of employment.

1.5 Within Suffolk and North East Essex there are currently three NEMs with plans in place to increase this number to five.

1.6 A minimum of one NEM is required at meetings of the SNEE ICB Board to maintain a quorum. The number of NEMs required to maintain a quorum in committees varies by committee but is never less than one and is sometimes two.

2. Interim Non-executive Members

2.1 From time to time and in exceptional circumstances it may be necessary for the ICB to appoint Non-Executive Members on an interim and short-term basis. This may include, for example only:

a) Illness
b) Maternity leave
c) Short term absence for any other reason agreed by the Chair
d) More than one NEM leaving the ICB at the same time potentially resulting in the Board or its constituent committees being inquorate.

2.2 The process for appointing substantive NEMs is set out in the ICB Constitution

2.3 As the ICB Constitution does not make reference to Interim NEMs, this separate guidance is therefore required.

3. Appointing interim non-executive members

3.1 The selection process for Interim NEMs may include local advertising via established channels but as they are short-term appointments this may not be necessary. Prospective candidates may be drawn from the pools and networks as available to the Board members at the time of requirement, and as may be deemed appropriate by the Board members.

3.2 The same eligibility and non-eligibility criteria as for substantive NEM appointees, as set out in the ICB Constitution, will apply equally to interim NEM appointments.

3.3 The term of office for an interim NEM should normally be no more than six months in the first instance, this usually then providing the ICB adequate time to appoint into a vacant NEM position or positions, or to cover periods of absence.

3.4 Panel interviews will not be necessary but prospective interim NEMs will be expected to meet with the Chair, Chief Executive and Director of Workforce and People.

3.5 Interim appointments will be subject to the approval of the Chair.

3.6 The level of remuneration for an interim NEM will be discussed with the the Director of Workforce and People and confirmed by the Chair.

3.7 As for substantive NEMs, interims will receive a letter of short-term appointment and not a contract of employment.

3.8 Also as for substantive NEM positions, candidates are not permitted to hold a role in another health and care organisation in the ICS area as set out in Sections 3.11.3b) and 3.11.4b) of the ICB Constitution.

3.9 Interim NEM appointees may wish to apply for vacant substantive NEM positions, but they will be required to apply in the normal way and compete with other prospective candidates. An interim NEM position does not guarantee appointment to a substantive position.

3.10 When applying for a substantive NEM position, the full selection process will apply, including advertising and panel interviews.

3.11 This guidance will be reviewed annually and updated as necessary.

Amanda Lyes
Director of Workforce and People
May 2023

Page last modified: 7 March 2024
Next review due: 7 September 2024