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Job Title: Lambeth Clinical Commissioning Collaborative Board
Chair
Reporting to: NHS Lambeth Chair
Accountable to: NHS Lambeth Chair
Hours of work: 2 days per week
Terms and Conditions: Selection will be made on a secondment
basis between NHSLambeth and the current employer.
Remuneration: NHS Lambeth will refund the practice/organisation
£55,952 perannum to support backfill.
Tenure: 1st Jan 2011 until 31st March 2012, subject to
review.
Job PurposeThe Lambeth Clinical Commissioning Collaborative
Board Chair will be responsible for theleadership of the Board
covering:
the strategic development of Healthcare in Lambeth acute,
community and mental health commissioning1 and transformation into
a future Lambeth GP Consortium (subject to legislation)
The post holder will be expected to:
secure agreed results as set out in the Strategic and Operating
Plan ensure local adherence to agreed pathways and commissioning
policies review commissioning spend and ensure appropriate action
is taken to manage spend establish and maintain sound
commissioning, organisation and governance processes,
working within relevant Statutory Financial Instructions and
Codes of Conduct ensure transparency and personal accountability
for decisions and performance act as a local champion for GP
Commissioning, establishing and promoting influence
on key stakeholder strategy and delivery
The Lambeth Clinical Commissioning Collaborative Board will have
designated delegatedresponsibility from the NHS Lambeth Board from
April 2011 for the commissioningresponsibilities of NHS Lambeth.
The extent of this is to be determined but will includeagreement
and delivery of the Strategic Plan for 2011/12, in year performance
issues,transition and organisational development to enable full GP
Commissioning by April 2013(subject to legislation)
1Excluding regional & nationally commissioned services,
maternity and prison health services.
Lambeth Clinical Commissioning Collaborative Board
Job Description – Chair
Appendix 1
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Objectives of the role of Chair of the Lambeth Clinical
CommissioningCollaborative Board
To lead an effective outcome orientated Lambeth Clinical
Commissioning CollaborativeBoard that commissions the best health
care within the resources available through theredesign and
implementation of innovative new Care Pathways.
To provide clinical leadership in the development of strategy
and the commissioning ofacute, community and mental health services
within Lambeth
To promote the design and adoption of the most clinically
effective and economic CarePathways for Lambeth residents
To ensure that the optimal quality of care and outcomes
experienced by patients isachieved from commissioned services and
that these conform to the standards assetby the NHS Commissioning
Board (or predecessors).
To develop and sustain effective partnership with key
stakeholders including theLondon Borough of Lambeth through the
Health and Well-being Board and King’sHealth Partners
To develop and sustain effective partnerships To develop
effective and on-going engagement of patients and the public in
the
development of healthcare within Lambeth. To ensure the
provision of an effective management support organisation for
the
Lambeth Clinical Commissioning Collaborative Board.
Key Relationships
NHS Lambeth
NHS Southwark
South East London Sector
Independent Contractors
Provider organisations (includingFoundation Trusts, Mental
HeathTrusts, Community services,Voluntary sector)
London Borough of Lambeth
Patient Representatives (LINks andlocal groups)
Department of Health
NHS London
Public Health
Local Professional Committees
Key Responsibilities
The post holder will be responsible for playing a full part in
the work of the Lambeth ClinicalCommissioning Collaborative
Board:
Specific tasks for the Lambeth Clinical Commissioning
Collaborative Board Chair
Attend and chair formal monthly Lambeth Clinical Commissioning
Collaborative Boardmeetings
Attend the NHS Lambeth Board meetings and Seminars
Support and develop the members of the Lambeth Clinical
Commissioning CollaborativeBoard
Attend informal meetings of the Lambeth Clinical Commissioning
Collaborative Board asmutually agreed by the members
Attend the Lambeth Health & Well-being Board
Provide the clinical leadership for local area networks and in
regional and nationalnetworks as agreed with the NHS Lambeth
Chair.
To ensure mechanisms are in place and monitored to develop
appropriate with all key
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stakeholders especially GP constituency, ensuring local
ownership topriorities, redesign, implementation
To be responsible for ensuring optimal performance of the GP
locality in terms of agreedcommissioning actions and budgetary
management, this may include taking action, withtheir linked
manager’s support, to address non-compliance
To ensure all Lambeth Clinical Commissioning Collaborative Board
members deliveragreed work plans
Collective Tasks
To prepare and agree the Lambeth Clinical Commissioning
Collaborative Board prioritiesand strategy, in particular the
Strategic Plan and Operating Framework and alliedplanning documents
including the Commissioning Strategy Plan and Annual
OperatingPlan.
To establish joint commissioning arrangements for specific
services to other bodies egLondon Borough of Lambeth and
neighbouring PCTs.
To secure appropriate management support to execute the
transactional work toimplement the Strategic Plan and Operating
Plan and allied documents (including theletting of contracts/SLAs,
contract monitoring and reporting for both activity and
finance)
To prioritise the redesign of specific Care Pathways, enable the
redesign and incorporatethe Care Pathways in the Annual Operating
Plan.
To review performance and finance reports and take action so as
to be satisfied that theStrategic and Operating Plan and allied
documents are being fulfilled.
To review the quality and outcomes of commissioned services in
terms of serviceprovided and improved health for Lambeth
residents.
To secure appropriate resources and ensure delivery of PBC/GP
commissioningcommitments
To ensure compliance with Department of Health requirements (as
delegated to NHSLondon or the NHS Commissioning Board)
To ensure robust network with all key stakeholders
The Lambeth Clinical Commissioning Collaborative Board Chair
will meet with the NHSLambeth Chair and Director of Clinical
Pathway Commissioning to agree and monitor anappropriate work
plan.
GeneralThe Lambeth Clinical Commissioning Collaborative Board
Chair is expected to: adhere to organisational policies and
procedures and relevant legislation including the
requirements of any professional bodies to maintain satisfactory
personal performances and professional standards and to
achieve agreed objectives for their role. attend mandatory
training as identified by the organisation participate in the
organisations Performance Appraisal Scheme and to contribute to
their
own development and the development of any staff that they are
responsible forappraising.
ConfidentialityAll workers have both a common law duty and a
statutory duty of confidentiality to protectpatient (and indeed any
personally identifiable) information and only use it for the
purposesfor which it was intended. The disclosure and use of
confidential patient information needs tobe both lawful and
ethical.
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Information GovernanceWorkers must keep up-to-date with the
requirements of InformationGovernance and must follow local
policies and procedures to ensure that information is dealtwith
legally, securely, efficiently and effectively. Staff must
appropriately manage all theInformation they handle during the
course of their employment, making the informationavailable for
sharing in a controlled manner, subject to statutory requirements
and theorganisations Information Governance Policy, and formal
Information Sharing arrangements.
Data ProtectionThe organisation is registered as a data
controller under the Data Protection Act 1998 .Allthe personal
information we hold, obtain, record, use and share as an
organisation isgoverned by this Act. As an employee/contractor of
the organisations you have a legalresponsibility for all personal
information you handle and must not at any time use thepersonal
data in a way incompatible with the guidelines stipulated in this
act. If you are inany doubt regarding what you should or should not
do in connection with the Data ProtectionAct then you must contact
the NHS Lambeth Chair.
Records ManagementYou have a legal responsibility for all
records you work with e.g. patient records, financialrecords,
personal, administrative etc, that you gather or use as part of
your work within theorganisation. The records may be held in a
variety of formats such as paper, electronic,microfiche, audio and
video tapes etc. You must consult the NHS Lambeth Chair if you
haveany doubt as to the correct management of the records with
which you work.
Health and SafetyAll Managers have a general accountability for
ensuring, so far as is reasonably practicable,the health, safety
and welfare of the employee/contractors under their direction at
work. AsClinical Commissioning Board Chair you are responsible to
take reasonable care for his orher own acts or omissions and the
effect that these may have upon the safety of themselvesor any
other person and to use safety equipment or clothing in a proper
manner and for thepurpose intended. Any worker who intentionally or
recklessly misuses anything supplied inthe interests of health and
safety will be subject to disciplinary procedures.Every worker must
work in accordance with any health and safety procedures,
instructionsor training that has been given.No worker may undertake
any task for which they have not been authorised and for whichthey
are not adequately trained.Every worker is required to bring to the
attention of a responsible person any perceivedshortcoming in our
safety arrangements or any defects in work equipment.All workers
are under a duty to familiarise themselves with the organisations
Health andSafety Policies.
Risk ManagementEnsure that you implement systems and procedures
at a local level to fulfil the requirementsof the organisations
Risk Management Strategy including local management and
resolutionof complaints and concerns, management of SUIs/incidents
and near misses.
Emergency PlanningIn accordance with the organisations
responsibilities under the civil contingencies Act 2004,to
undertake duties as is reasonable directed at locations in the
event of and for the durationof a significant internal incident,
major incident or flu pandemic.Dignity and Respect at WorkThe
organisation as adopted an equal opportunities policy and all
employee/contractorsmust be aware of their obligations. All
employee/contractors of Lambeth organisations are
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required to carry out their duties with regard to local policies
andprocedures and respect the cultural beliefs and customs held by
others toabide by the spirit and nature of the policy to avoid
direct and indirect discrimination
Corporate GovernanceYou will be expected to familiarise yourself
with NHS Lambeth governance arrangementswhich outlines the
Management and Committee Structures and Procedures for
theGovernance of the organisations activities including
organisations Standing Orders,Standing Orders and Standing
Financial Instructions. Workers should conform to therequirements
of the Standing Orders, Standing Financial Instructions or other
financialprocedures including the NHS Code of Conduct and
Accountability and the Fraud andCorruption Policy.
Safeguarding Children and Vulnerable AdultsAll workers have a
responsibility for safeguarding and promoting the welfare of
children andvulnerable adults. Further guidance can be sought from
the NHS Lambeth Chair.
Infection ControlAll workers have a responsibility to comply
with the Health Act 2006 and organisations policyand guidance on
infection prevention and control, ensuring a sound knowledge of
standardinfection control precautions. You must keep up to date in
infection control practice relevantto their area of practice and
you are required to practice strict hand hygiene at all timeswhen
carrying out their duties. In addition, to ensure that all staff
are aware of their key rolein infection control and prevention, to
ensure their compliance with the Health Act 2006(Hygiene Code) and
the organisations policies and procedures and be accountable
andresponsible for the provision of a safe, clean environment. In
addition to ensure that staffattend infection control training and
keep up to date with developments.
GeneralThe Lambeth Clinical Commissioning Collaborative Board
Chair may be required to work atany of the organisations sites in
line with the service needs. This job description
describesresponsibilities, as they are currently required. It is
anticipated duties will change over timeand the job description may
need to be reviewed in the future.
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You will need to demonstrate compliance with the essential
requirements set out - examples toshow that these have been met,
can be drawn from any part of your professional life.
Requirements Essential Desirable
Qualifications GMC Registration or suitable alternative
AdvancedManagement/LeadershipQualification orequivalent
Clinical Experience Significant experience in Primary Care
Currently working within Primary Care in
Lambeth
Multi-disciplinaryspecialist community
Setting Direction Experience in generating strategy.
Understanding of NHS strategic planning Awareness of external
drivers affecting local
health and health services. Experience of leading a project eg
care pathway
Improving Services Experience in producing cost effective
planswithin available resources.
Ability to gather and interpret conflictingevidence to design
new health services.
Ability to lead changes in health services toimprove quality for
patients
Understanding of commissioning regime
Management andAdministrativeExperience
Ability to plan, manage resources /people/performance
Can demonstrate the ability to manage
anorganisation/service.
Ability to chair and organise clinical andmanagement teams and
priorities.
Experience of auditmanagement
Working with others Experience in creating an ethos of
patientcentred care
Experience of working in a multi-disciplinaryplanning
environment
Well-developed network/partnership of contacts Able to encourage
consensus with across
organisations and professionals
Personal Attributes Commitment to sustaining professional
ambitionand meeting patients' need
Acts on information that would lead to improvedservices
Ensures professional values and ethics areupheld
Ability to lead and work within a team Enquiring, critical
approach to work Ability to communicate effectively
Lambeth Clinical Commissioning Collaborative Board
Person Specification – Chair
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Job Title: Clinical Commissioning Board Member
Reporting to: Clinical Commissioning Board Chair
Accountable to: NHS Lambeth Chair
Hours of work: 6 x 4 hour sessions per month (63 sessions per
annum) 1 day perweek
Terms and Conditions: Selection will be made on a secondment
basis between NHSLambeth and the current employer.
Remuneration: NHS Lambeth will refund the practice/organisation
£27,976 perannum to support backfill.
Tenure: 1st Jan 2011 until 31st March 2012, subject to
review.
Job PurposeAs part of the Clinical Commissioning Board, the post
holder will be responsible for the clinicalleadership of
commissioning in Lambeth, particularly acute, mental health and
community andthe strategic development of health care for the
population of Lambeth.
The post holder will be expected: To represent, co-ordinate and
lead their GP Commissioning locality working with NHS
Lambeth to ensure the development and delivery of agreed
commissioning plans andobjectives
To work with constituent practices to raise awareness of
commissioning issues andactivities, agree commissioning priorities
that are responsive to local need
To ensure adherence to agreed pathways and commissioning
policies To review commissioning spend and take action to manage
spend To establish and maintain sound commissioning, organisation
and governance processes,
working within relevant Statutory Financial Instructions and
Codes of Conduct To ensure transparency and personal accountability
for decisions and performance
The Clinical Commissioning Board will have designated delegated
responsibility from the NHSLambeth Board from April 2011 for the
commissioning responsibilities of NHS Lambeth. Theextent of this is
to be determined but will include agreement and delivery of the
Strategic Planfor 2011/12, in year performance issues, transition
and organisational development to enablefull GP Commissioning by
April 2013 (subject to legislation)
Appointment ProcessThis appointment is made using a combined
selection and election process. GP commissioningis derived from a
practice list. Eligible candidates will therefore need to have a
connection withand have the written support of at least one Lambeth
GP practice. This may include GPprincipals, salaried GPs, Practice
Nurses, Practice Managers and other administrative staff
orclinicians. Interested individuals may apply for their names to
be added to the ElectionCandidate List. An Appointment Panel will
assess the candidate using application and interview
Lambeth Clinical Commissioning Collaborative Board
Job Description – Board Member
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to determine whether the applicant meets the requirements in the
PersonSpecification. Lambeth GP Practices may use their vote(s) for
any candidateincluded on the Election Candidate List. There are
three constituencies: North, South East andStreatham & Clapham
(South West). Each practice will vote and will have a number of
votesbased on list size.
Objectives To provide clinical leadership in the development of
strategy and the commissioning of
acute, community services2 and mental health services within
Lambeth To promote the design and adoption of the most clinically
effective and economic Care
Pathways for Lambeth residents To ensure that the optimal
quality of care and outcomes experienced by patients is
achieved
from commissioned services and that these conform to the
standards asset by the NHSCommissioning Board (or
predecessors).
Key Relationships
NHS Lambeth
NHS Southwark
South East London Sector
Independent Contractors
Provider organisations (including Foundation Trusts, Mental
Heath Trusts, CommunityServices, voluntary sector)
London Borough of Lambeth
Patient Representatives (LINks and local groups)
Department of Health
NHS London
Public Health
Local Professional Committees
Main TasksThe post holder will be responsible for playing a full
part in the work of the ClinicalCommissioning Board:
Specific Personal Tasks
To personally attend formal monthly Clinical Commissioning Board
meetings, acting as anambassador for commissioning health for the
local population
To personally attend informal meetings of the Clinical
Commissioning Board as mutually bythe members
To take a lead responsibility for a key provider contract and
identified care pathway redesignpriorities, as agreed with the
Chair
To develop and maintain a robust engagement network with all key
stakeholders especiallyGP constituency, ensuring local ownership to
priorities, redesign, implementation
To be responsible for ensuring optimal performance of the GP
locality in terms of agreedcommissioning actions and budgetary
management, this may include taking action, withtheir linked
manager’s support, to address non-compliance
Collective Tasks
2Excluding regional & nationally commissioned services,
maternity and prison health services.
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To prepare and agree the Clinical Commissioning Board priorities
andstrategy, in particular the Strategic Plan and Operating
Framework andallied planning documents esp. Commissioning Strategy
Plan and Annual Operating Plan.
To establish joint commissioning arrangements for specific
services to other bodies eg LocalAuthority and neighbouring
PCTs.
To instruct the management support to execute the transactional
work to implement theStrategic Plan and Operating Plan and allied
documents (i.e. Letting of contracts / SLAs,Contract monitoring and
reporting for both activity & finance)
To prioritise the redesign of specific Care Pathways, enable the
redesign and incorporatethe Care Pathways in the Annual Operating
Plan.
To review performance and finance reports and take action so as
to be satisfied that theStrategic and Operating Plan and allied
documents are being fulfilled.
To review the quality and outcomes of commissioned services in
terms of service providedand improved health for Lambeth
residents.
To secure appropriate resources and ensure delivery of PBC/GP
commissioningcommitments
To ensure compliance with Department of Health requirements (as
delegated to NHSLondon or the NHS Commissioning Board)
The postholder will meet with the Clinical Commissioning Board
Chair and Director of ClinicalPathway Commissioning to agree an
appropriate work plan.
GeneralClinical Commissioning Board members are expected to:
adhere to organisational policies and procedures and relevant
legislation including the
requirements of any professional bodies to maintain satisfactory
personal performances and professional standards and to achieve
agreed objectives for their role. attend mandatory training as
identified by the organisation participate in the organisations
Performance Appraisal Scheme and to contribute to their
own development and the development of any staff that they are
responsible for appraising.
ConfidentialityAll workers have both a common law duty and a
statutory duty of confidentiality to protectpatient (and indeed any
personally identifiable) information and only use it for the
purposes forwhich it was intended. The disclosure and use of
confidential patient information needs to beboth lawful and
ethical.
Information GovernanceWorkers must keep up-to-date with the
requirements of Information Governance and mustfollow local
policies and procedures to ensure that information is dealt with
legally, securely,efficiently and effectively. Staff must
appropriately manage all the Information they handleduring the
course of their employment, making the information available for
sharing in acontrolled manner, subject to statutory requirements
and the organisations InformationGovernance Policy, and formal
Information Sharing arrangements.
Data ProtectionThe organisation is registered as a data
controller under the Data Protection Act 1998 .All thepersonal
information we hold, obtain, record, use and share as an
organisation is governed bythis Act. As an employee/contractor of
the organisations you have a legal responsibility for allpersonal
information you handle and must not at any time use the personal
data in a wayincompatible with the guidelines stipulated in this
act. If you are in any doubt regarding what youshould or should not
do then you must contact the Clinical Commissioning Board
Chair.
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Records ManagementYou have a legal responsibility for all
records you work with e.g. patientrecords, financial records,
personal, administrative etc, that you gather or use as part of
yourwork within the organisation. The records may be held in a
variety of formats such as paper,electronic, microfiche, audio and
video tapes etc. You must consult the Clinical CommissioningBoard
Chair if you have any doubt as to the correct management of the
records with which youwork.
Health and SafetyAll Managers have a general accountability for
ensuring, so far as is reasonably practicable, thehealth, safety
and welfare of the employee/contractors under their direction at
work. As aClinical Commissioning Board member you are responsible
to: take reasonable care for his or her own acts or omissions and
the effect that these may have
upon the safety of themselves or any other person. use safety
equipment or clothing in a proper manner and for the purpose
intended.
Any worker who intentionally or recklessly misuses anything
supplied in the interests of healthand safety will be subject to
disciplinary procedures.Every worker must work in accordance with
any health and safety procedures, instructions ortraining that has
been given.No worker may undertake any task for which they have not
been authorised and for which theyare not adequately trained.Every
worker is required to bring to the attention of a responsible
person any perceivedshortcoming in our safety arrangements or any
defects in work equipment.All workers are under a duty to
familiarise themselves with the organisations Health and
SafetyPolicies.
Risk ManagementEnsure that you implement systems and procedures
at a local level to fulfil the requirements ofthe organisations
Risk Management Strategy including local management and resolution
ofcomplaints and concerns, management of SUIs/incidents and near
misses.
Emergency PlanningIn accordance with the organisations
responsibilities under the civil contingencies Act 2004,
toundertake duties as is reasonable directed at locations in the
event of and for the duration of asignificant internal incident,
major incident or flu pandemic.
Dignity and Respect at WorkThe organisation as adopted an equal
opportunities policy and all employee/contractors mustbe aware of
their obligations. All employee/contractors of Lambeth
organisations are required tocarry out their duties with regard to
local policies and procedures and respect the cultural beliefsand
customs held by others to abide by the spirit and nature of the
policy to avoid direct andindirect discrimination
Corporate GovernanceYou will be expected to familiarise yourself
with NHS Lambeth governance arrangements whichoutlines the
Management and Committee Structures and Procedures for the
Governance of theorganisations activities including organisations
Standing Orders, Standing Orders and StandingFinancial
Instructions. Workers should conform to the requirements of the
Standing Orders,Standing Financial Instructions or other financial
procedures including the NHS Code ofConduct and Accountability and
the Fraud and Corruption Policy.
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Safeguarding Children and Vulnerable AdultsAll workers have a
responsibility for safeguarding and promoting the welfare of
children andvulnerable adults. Further guidance can be sought from
the Clinical Commissioning BoardChair.
Infection ControlAll workers have a responsibility to comply
with the Health Act 2006 and organisations policyand guidance on
infection prevention and control, ensuring a sound knowledge of
standardinfection control precautions. You must keep up to date in
infection control practice relevant totheir area of practice and
you are required to practice strict hand hygiene at all times
whencarrying out their duties. In addition, to ensure that all
staff are aware of their key role ininfection control and
prevention, to ensure their compliance with the Health Act 2006
(HygieneCode) and the organisations policies and procedures and be
accountable and responsible forthe provision of a safe, clean
environment. In addition to ensure that staff attend
infectioncontrol training and keep up to date with
developments.
GeneralClinical Commissioning Board members may be required to
work at any of the organisationssites in line with the service
needs. This job description describes responsibilities, as they
arecurrently required. It is anticipated duties will change over
time and the job description mayneed to be reviewed in the
future.
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Your examples to show that the requirements set out in this
Person Specification have been met, can be drawnfrom any part of
your professional life. The over-riding requirement is for the
candidate to be a Clinical Leader whois able to take forward a
transformational change in the delivery of health care within
Lambeth.
Requirements Essential Desirable
Qualifications GMC Registration or suitable alternative Advanced
GP/OtherManagement orleadership qualification
ClinicalExperience
Significant experience in Primary Care Currently working within
Primary Care in
Lambeth
Multi-disciplinaryspecialist community
Setting Direction Experience in generating strategy.
Understanding of NHS strategic planning Awareness of external
drivers affecting local
health and health services. Experience of leading a project eg
care
pathway redesign
ImprovingServices
Experience in producing cost effective planswithin available
resources.
Ability to gather and interpret conflictingevidence to design
new health services.
Ability to deliver changes in health servicesto improve quality
for patients
Understanding of commissioning regime
Management andAdministrativeExperience
Ability to plan, manage resources / people /performance
Ability to run an efficient GP Practice Ability to chair and
organise clinical and
management teams & priorities.
Experience of auditmanagement
Working withothers
Experience in creating an ethos of patientcentred care
Experience of working in a multi-disciplinaryplanning
environment
Well-developed network/partnership ofcontacts
Ability to encourage consensus with a teamof diverse views.
PersonalAttributes
Commitment to sustaining professionalambition and meeting
patients' need
Acts on information that would lead toimproved services
Ensures professional values and ethics areupheld
Ability to work in a team Enquiring, critical approach to work
Ability to communicate effectively
Derived from the Medical Leadership Competency Framework
Lambeth Clinical Commissioning Collaborative Board
Person Specification – Board Member
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Appendix 2Lambeth Clinical Commissioning Collaborative Board
(LCCCB), Clinical Leads
Updated as at 16 June 2011
JohnBalazs
RajMitra
GillianEllsbury
PatriciaKirkman
RayWalsh
RuthJeffery
AdrianMcLachlan
Planned Care x x x
Unplanned Care x x
Mental Health x x x
Staying Healthy x x x
End of life care andcancer
x
Learning disabilities x
Diabetes x x
COPD/Respiratory x
CVD x
MSK x
Gynae x
Sexual health x
Gastro x
Ophthalmology
Older people x
Dermatology x
Renal x
Integrated Care x
GSTT x
KCH x x
SGH x
Community x
SLAM x x
LAS
Medicines x
IMT x
Workforce x
Training EducationResearch
x
Communications x x
OD x
Health & WellbeingBd
x
PPI x
Governance x
Quality x x
Children (incsafeguarding)
x
Adult Safeguarding
Finance x
Health Scrutiny x
InformationGovernance
x
Cluster Board x
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Appendix 3
TERMS OF REFERENCELambeth Clinical Commissioning Collaborative
Board
Agreed May 2011 Cluster Board
1. Introduction / Purpose / Constitution
In South East London the statutory functions of the six current
PCT/Care Trust Boards will be fulfilled by the six boards operating
jointly.Within these arrangements each Board will establish borough
basedLocal Clinical Commissioning Committees (LCCCs) as formal
sub-committees that have delegated responsibility for local
commissioningbudgets. In Lambeth this LCCC will be known as the
Lambeth ClinicalCollaborative Board (LCCCB) .
2. Duties/ Roles and Responsibilities
The Lambeth Clinical Commissioning Collaborative Board will
operate asa sub-committee of the Lambeth PCT Board and will be a
decisionmaking forum. It will take on delegated responsibilities
that will changeover time as Clinical Commissioning develops in
Lambeth and theLambeth Clinical Commissioning Collaborative Board
takes onincreasing responsibilities for delivery of Lambeth health
commissioning.The Lambeth Clinical Commissioning Collaborative
Board on behalf ofthe Lambeth PCT Board will
Engage with practices across Lambeth, through the three
localitiesin the development of Clinical Commissioning.
Engage with a broad range of clinicians in redesigning
andimplementing new care pathways.
To provide clinical vision and lead strategic thinking for
thecommissioning of health services and health improvement
inLambeth
To provide clinical leadership to commissioning of health
services inLambeth in respect of delegated functions including
pathwayredesign.
To monitor and assure clinical quality to the PCT Board,
includingsafeguarding and infection control.
To drive and monitor delivery and performance, take
remedialaction as necessary and provide assurance to the PCT
Board
Lead the transition to Clinical Commissioning in Lambeth To lead
support the transition to new Health and Wellbeing
arrangements in Lambeth To develop partnership working including
with services across
Lambeth Localities, London Borough of Lambeth, other PCTs
and
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GP commissioners, King’s Health Partners and other secondarycare
providers, Lambeth LINk, Lambeth Scrutiny and the GSTTCharity.
To fulfill the role of the Lambeth PCT Professional
ExecutiveCommittee.
3. Accountability
The Lambeth Clinical Commissioning Collaborative Board members
willhave delegated responsibility from the Lambeth PCT Board and
willhave decision making powers. All members will have equal
standing andtheir role will be to consider the key strategic,
clinical and managerialissues across the commissioning of these
health services in Lambethdelegated to it. The Lambeth Clinical
Commissioning CollaborativeBoard will take responsibility on behalf
of the Lambeth PCT Board for thetransition to Clinical
Commissioning Consortia and Health and Wellbeingarrangements.
Locality Board members will be expected to report backto their
locality. Lambeth Clinical Commissioning Collaborative Boardmembers
will be expected to take on lead roles.
4. Committee Membership
Collaborative ChairNorth Locality memberNorth Locality
memberSouth West Locality memberSouth West Locality memberSouth
East Locality memberSouth East Locality memberLambeth BSU Managing
DirectorDirector of Public Health (joint with LB Lambeth)Nursing
LeadPCT Non Executive DirectorPCT Non Executive Director
If a clinical locality member resigns, a deputy will be co-opted
for up tothree months to allow time for a new member to be
appointed from thatlocality.
If the Chair resigns, a Chair will be appointed from the
existing membersfor up to three months to allow time for a new
Chair to be appointed.
In AttendanceDirector of Integrated Commissioning (joint with LB
Lambeth)Director of Care Pathway CommissioningDirector of Corporate
Affairs and Human ResourcesChief Financial OfficerClinical Network
lead
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InviteesLondon Borough of Lambeth RepresentativeLMC
RepresentativeLINk Representative
5. Reporting Arrangements and supporting structures
The minutes of the each formal LCCCB meeting will be formally
recordedand submitted to the next PCT Board meeting for publication
in publicpapers.
Agendas and supporting papers will be circulated five days in
advance ofmeetings. Minutes of the meeting will be circulated to
all memberswithin five working days. Minutes will be agreed by the
Chair at followingformal meeting of the Lambeth Clinical
Commissioning Collaborative.
6. Quorum rules
The minimum number of LCCCB members required in order to
takedecisions is two practice nominated members and two PCT
Boardmembers.
7. Frequency of Meetings
The Clinical Board will meet formally on a monthly basis and the
Boardmeeting will be held in public on quarterly basis in June,
September,December and March.
8. Monitoring adherence to the Terms of Reference / Review
The LCCCB is committed to evaluating all programmes,
strategic,operating and financial plans delegated to it by the PCT.
The LCCCBwill review it's effectiveness on an annual basis. The
Terms ofReference and membership will be reviewed as required, and
at least onan annual basis.
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Appendix 4Business Plan 2011/2012
1 Introduction
The Lambeth Clinical Commissioning Collaborative (LCCCB) was
recognised by the Department of Health as a GPPathfinder in
February 2011 and was established as a Committee of the Lambeth PCT
Board on 1 April 2011. The LCCCBbuilds on the development of
clinical commissioning over the past two years to develop next
steps in Clinical Commissioningin Lambeth. The LCCCB is supported
by a Lambeth specific Business Support Unit (BSU), operating within
sharedmanagement arrangements, including acute contracting support,
across the south east London Cluster.
The purpose of this Business Plan is to set out the key 2011/12
objectives for NHS Lambeth, under the leadership of theLCCCB.
Implementation of the Business Plan will ensure that NHS Lambeth,
working with our partners, commissionseffective care for our local
population, manages the transition to Clinically Led Commissioning
and the new Health and Well-being arrangements, and delivers the
range of our statutory responsibilities. This Business Plan has
been developed withthe LCCCB and it was agreed that it should
centre around three key areas of our business:
Area of Business Strategic Objective
(i) Our Operational Delivery To deliver our agreed priority
programmes with robust operationalrisk and financial management and
effective high quality care.
(ii) Our Organisational Development To manage the transition of
commissioning responsibility to GPConsortia and the establishment
of new Health and Wellbeingarrangements, within the context of
engaging public and patientsand managing equalities.
(iii) Our Governance and Assurance To ensure systems and
processes are in place to support individual,team and corporate
accountability for delivering patient centred,safe, high quality
care, within our resource limits.
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2 Our Mission, Vision and Values
Our Mission:Our Mission is to improve the health and reduce
health inequalities of Lambeth people and to commission the highest
quality healthservices on their behalf.
Our Vision:1. Health improvement is at the heart of all we do.
We will increase life expectancy for all and reduce the difference
in lifeexpectancy between the most and least deprived in our
diverse communities.2. We will maintain a thriving, financially
viable, health economy delivering safe and effective high quality
care.3. We will commission comprehensive integrated care that meets
the needs of local people. We will value diversity
amongstproviders, but will expect excellent outcomes.4. In
delivering this Vision we recognise the need:
- for a rigorous, population needs based approach to
commissioning, supported by public health expertise.- to work with
Lambeth people and their representatives to commission services
that best meet their needs.- to work in partnership with
colleagues, across geographic, organisational and professional
boundaries. This will include
primary care practitioners, the London Borough of Lambeth,
King's Health Partners and neighbouring health commissioners.- to
support innovation in workforce development and in the local
application of teaching, training and research.- to look first to
local colleagues for management support.
Our Values• We always tell the truth.• We are fair• We are open•
We recognise our responsibilities to service users and the wider
public• We act responsibly as a public sector organisation
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3 Our Governance, Performance and Programme Management
The Lambeth Clinical Commissioning Collaborative Board is a
Committee of the Lambeth PCT Board which itself operateson a
collective basis with the five other PCTs in the South East London
Cluster. Within this governance framework we willwork with all 52
Lambeth practices across our three localities, with a wide range of
clinical colleagues, with our partners andwith our local
communities and their representatives. All of our partners are
critical to our ability to secure our mission andvision. A diagram
showing our key governance and key partnership relationships is set
out below.
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4. Overseeing the Business Plan and Assuring DeliveryThe LCCCB
will oversee delivery of this Business Plan, within an overall
planned agenda, across our three main businessareas. The LCCCB will
receive a comprehensive Integrated Performance and Governance
report addressing i) our BoardAssurance Framework, ii) our risks to
delivery and iii) performance against the objectives as set out in
the Business Plan.
In order to support the delivery of our objectives two
management groups have been set up:
Operations Group – Chaired by the Managing Director, with
membership comprising all NHS Lambeth Directors andAssistant
Directors. This group meets twice a month with the role of
overseeing and quality assuring our operationalperformance,
including the priority programmes and routine contract management.
Where necessary, this will include thedevelopment of Action Plans
in year to ensure performance remains on track. The preparation and
quality assurance ofreports to the LCCCB are co-ordinated through
this meeting.
Development Group – Chaired by the Managing Director, with
membership comprising all NHS Lambeth Directors. Thisgroup meets
twice a month with the role of reviewing progress in organisational
development and issues of assurance andgovernance. This meeting
will quality assure reporting to the LCCCB on policy, patient
safety and organisationaldevelopment objectives.
Locality and practice reporting will be through locality
arrangements, led by the LCCCB clinical leads.
NHS Lambeth meets regularly with the South East London Cluster
to discuss and review performance of the cluster ledcommissioning
and support teams (eg acute and primary care). These meetings will
be used to ensure delivery of elementsof the Business Plan which
are dependent on cluster performance.
The Business Plan will form the basis for individual objective
setting for every member of staff and performance review.
Eachprogramme within the Business Plan has a notified Director lead
and key objectives are assigned at Assistant Director level.
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5. Programme ManagementIn order to deliver our vision and
strategic priorities we have put in place enhanced programme
management arrangements.We have agreed four health programmes, each
with a Director-led Senior Responsible Officer. Two of the
fourProgrammes are managed jointly with Southwark Clinical
Commissioners. This programme structure is set out below;
South East London Joint PCT Boards
F
Joint Lambeth and
reducing inappropriate
Lambeth Clinical Commissioning
Collaborative Board
Mental Health Lambeth Living Well
Collaborative
Southwark GP Leads
Operations Group
Unplanned Carejoint with Southwark
Urgent Care
rail Older People Forensic services
Payment by Results Talking Therapies/
Counselling Dementia
Staying HealthyAccess to preventionTobacco and alcoholAdult and
Childhood obesityPhysical activityPoverty
Health determinants
Planned carejoint with Southwarkmanagement of longterm
conditions(including HIV)early detectionsecondary
preventionmanagement of electivecare in the mostappropriate
settingsshifting service provisionpromoting appropriatereferral
Page 5 of 46
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4. Summary of our Business Plan
Programme Lead Director Clinical Lead Page
Oversight and Leadership Andrew Eyres Adrian McLachlan
1. Our Operational DeliveryPlanned care Programme Moira McGrath
John Balazs/Ruth Jeffery/ Adrian
McLachlan7
Unplanned Care Programme Andrew Eyres Gillian Ellsbury/Patricia
Kirkman
10Frail Older People Helen Charlesworth-MayUrgent Care Moira
McGrath
Mental Health Helen Charlesworth-May Raj Mitra/ Ray Walsh /
Adrian McLachlan 13Staying Healthy Ruth Wallis John Balazs / Raj
Mitra/ RuthJeffery 17Contract Performance Moira McGrath/ Helen
Charlesworth MayJohn Balazs/Ruth Jeffery /Gillian EllsburyRaj
Mitra/ Ray Walsh /Patricia Kirkman
21
2. Our Organisational Development 27Development of Clinical
Commissioning Una Dalton Adrian McLachlanPublic and Patient
Engagement Una Dalton John BalazsEqualities Ruth Wallis TbcHealth
and Wellbeing Board Development Helen Charlesworth-May Patricia
Kirkman
3. Our Governance and Assurance 30Corporate governance and
quality assurance Una Dalton Raj Mitra / Adrian McLachlanFinancial
governance, VFM and assurance Christine Caton Gillian Ellsbury
Integral to our Business Plan is the delivery of our Integrated
Plan so QIPP plans, CQUIN schemes and performance standardshave
been assigned to individual programmes/objectives, with identified
leads. A summary is included at Appendices A, B and C.A glossary of
staff initials and contact details is included at Appendix D.
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Our Operational Delivery: To deliver agreed priority programmes
with robust operational risk andfinancial management and effective
high quality care.
5. 1 Planned Care Programme Senior Responsible Officer: Moira
McGrath
To develop and deliver an outpatient strategy, which reduces the
risk of premature mortality and improve quality of life by:-
sustaining the control of long term conditions (including HIV) and
preventing risk of acute events in people with a LTC- early
detection- secondary prevention- securing the quality, equity and
productivity in the management of elective condition and
identifying the most appropriate
settings for treatment i.e. local v hospital based- facilitating
patient-centred care, with a shift in service provision along the
care pathway, for identified priorities, from treatment
to prevention- Promoting appropriate referral- Reducing
inappropriate variability in care
The strategy will inform and be informed by KHP strategy. The
strategy will enable infrastructure planning, including
AkermanRoad, Norwood Hall and a review of Gracefield Gardens
Neighbourhood Resource Centre and the programme will
overseeimplementation of appropriate referral management
processes.
The programme will be developed and managed jointly with
Southwark clinical commissioners.
QIPP, Key targets and CQUINS
QIPP - All projects comprising the programme are based on QIPP
assumptions as set out in Appendix A (ii).
Key targets (for a detailed list of key performance measures
refer to Appendix B): % of blood pressure control in people with
CHD (WCC) % of patients with diabetes who have HbA1c of 8.5 or less
(excluding exceptions) (WCC) Diabetic retinopathy screening
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Reduction in premature all circulatory disease mortality
(mortality under 75 years old) (VSB02) All age all cause mortality
(VSB01) Cancer mortality (VSB03) Reduction in late diagnosis of HIV
Referral to treatment (RTT) waiting times including cancer waits
Breast, bowel and cervical screening People with LTCs feeling
independent Emergency admissions for LTC All first OP attendances
(including following GP referral or other referrals) Late diagnosis
of HIV (WCC)Review other key targets in relation to NHS, Public
health and social care outcomes frameworks as this develops
further.
CQUIN (for a full list of CQUINs refer to Appendix C): Adaption
of Enhanced Recovery Models of Care Maternity Expand HIV testing in
non-GUM acute settings
Key Objectives Lead Actions DateTo deliver reductions in
outpatientattendances:-
GP/GDP first outpatientreferrals of 7300 attendances
Consultant to Consultantreferrals of 650
Follow ups of 21,300
LD/TF Define programme and project scope across elective, LTCand
sexual health, key deliverables and contribution ofrelative
projects to QIP
Establish governance and programme managementarrangements,
including draft of Terms of Reference
Develop and agree project plans, trajectories andperformance
monitoring with key stakeholders ensuringability to report with
appropriate granularity from agreed2011/12 contracts
Identify 2010/11 pilot services ready for
commissioningprocurement and agree process for managingprocurement
process
May 2011
Mid June2011Mid June2011
End July2011
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Key Objectives Lead Actions DateTo improve health outcomes
forpeople with diabetes (HBA1c asproxy), CVD (blood pressure
controlbelow 150/90) and COPD/Asthma(diagnosis of COPD/Asthma
viaspirometry)
TF Monitor in-year performance Develop models of care and assess
impact for 12/13 Agree market management process and provider
capacity
for 2012 provision and beyond
OngoingSept 2011Sept 2011
To design, implement and monitorappropriate care pathways
fordefined elective and LTC areas.Where appropriate to
commissioncommunity based services as part ofthese pathways
LD/TF Agree contract performance management
arrangementsevaluation criteria
Identify next phase of priorities Inform 2012/13 contracting
round Develop models of care and assess impact for 12/13 Agree
market management process and provider capacity
for 2012 provision and beyond
Ongoing
Sept 2011Sept 2011Sept 2011Sept 2011
To improve the quality andeffectiveness of care pathwaysacross
sexual health and HIVprovision
AY Deliver QIPP Plan for 2011/12 Review HIV care and support
provision across Lambeth Develop model for HIV as a LTC Refresh
sexual healthstrategy for LSL Increase HIV testing
July 2011Sept 2011March 2012March 2012On-going
To complete the business case forfinancial close for Norwood
Hall.–implement business case and secureservices Akerman Road .
Review andevaluate service provision atGracefield Gardens ensuring
ongoingcost effective use of the site.
TF Agree next stage approach to Gracefield Gardensevaluation
Review proposed service strategies Move to Financial Close for
Norwood Hall Draw up action plan for operational implementation
for
Akerman Road Review results of Gracefield Gardens evaluation
May 2011
June 2011July 2011August 2011
Sept 2011
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5.2 Unplanned Care Programme Senior Responsible Officer: Andrew
Eyres
Lambeth continues to have a high number of non-elective
admissions compared to London and England and a high level
ofreliance on hospital based care. Local audits show that between
40-60% of people attending A&E could have their care
providedsafely and appropriately in primary and community settings.
The major service challenge includes the need to improve
equitableaccess, quality and capacity/capability of primary care
services to manage care more effectively including out of hours, to
identifyareas that need require whole system pathway redesign
The Unplanned Care Programme will operate across two main
workstreams: Frail Elderly, (including admission avoidance and
intermediate care) Urgent Care, (including Urgent Care Centres and
Out of Hours).
The Programme will be developed and managed jointly with
Southwark clinical commissioners and will be further
supportedthrough the King’s Health Partners Integrated Care
Project.
The aim of the Unplanned Care Programme to is to design and
implement improved unplanned care services across the twoboroughs
that support improved health outcomes through greater planned and
co-ordinated care. This will be reflected in lowerA&E
attendances and subsequent emergency admissions, fewer
readmissions, enhanced quality of care and the delivery ofnational
standards. This is a key area of QIPP delivery in enhanced quality
and improved productivity of care.
QIPP, Key targets and CQUINS
QIPP – All projects comprising the programme are based on QIPP
assumptions as set out in Appendix A(ii).
Key targets (for a detailed list of key performance measures
refer to Appendix B): A&E performance measures (All clinical
indicators – 5 headline measures) Emergency re-admissions Delayed
Transfers of Care % deaths at home (WCC)
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CQUINS (for a full list of CQUINs refer to Appendix C): To
prevent the development/deterioration of all grades of pressure
ulcers in acute/community (IP & DN services) To reduce the
incidence of falls resulting in harm, and streamline falls service
provision Identify those at end of life and improve their pathway
of care, ensuring that this is streamlined across services and
achieving quality standards To encourage effective
communications between community (DNs/HVs) and GPs Discharge
arrangements/ Communication
Key Objectives Lead Actions DateFrail Older PeopleTo reduce the
number of avoidablehospital admissions for people withdiabetes and
COPD
TF Develop and agree business case for new diabetescommunity
service
Negotiate price and delivery model Implementation Agree
implementation model for COPD business case Implement new model
July 2011
Sept 2011Dec 2011
June 2011Sept 2011
To develop a virtual hospital athome service
LC Agree virtual hospital model Map and review existing services
targeted at admission
avoidance, agree bench marking information. Demand andcapacity
review
Development of clinical pathways for priority conditions
withassociated KPIs
Implementation
Jun 2011Sept 2011
Sept 2011
Dec 2011
Roll out of reablement programme LC Implement phase 3 of
reablement pilot. Tender for reablement provider via domiciliary
care process
July 20112012
Review future commissioning ofIntermediate Care
MM Scope review of Intermediate care Develop commissioning
strategy to inform 2012/13
contracting round
Jul 2011Sept 2011
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Key Objectives Lead Actions DateTo reduce the number of
avoidableemergency readmissions
LC To undertake further analysis of reasons for readmissionsand
agree priorities
To fully engage with KHP Integrated care pilot To assess
assistive technology pilots with focus on reduction
of admissions Roll out of virtual hospital at home scheme To
scope out the review of intermediate care services
June 2011
On-goingSept 11
Dec 11July 2011
To reduce the number of peopledying in hospital who would prefer
todie at home
LC To agree trajectories on targets for the roll out of the
GoldElectronic Patient Register
Review and revise GSF and care home LES Evaluation of Care Home
GSF implementation Work with EOLC Modernisation Initiative on exit
strategy and
commissioning priorities for 2012/12
June 2011
June 2011Sept 2011Dec 2011
Urgent CareRe-commission urgent care centresin A&E
TF Market testing exercise Explore pilot co-location of GP OOH
in A&Es Commissioning case for change developed Specification
finalised Procurement advertised Preferred provider awarded New
service commences
June 2011July 2011July 2011July 2011July 2011Jan 2012April
2012
Implement a single point of accessand 111 number
TF Scope project in partnership with Cluster Review work of
national pilots Develop project plan
July 2011July 2011Aug 2011
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5.3 Mental Health Programme Senior Responsible Officer: Helen
Charlesworth May
The mental health programme is a continuation of the work that
has been carried out over the past year to re-design key
mentalhealth services, including for people with severe mental
illness (SMI), and forensic services, and payment by results. The
review oftalking therapies is also to be taken forward, setting
this in the context of care pathways for people experiencing
anxiety anddepression. In addition a new workstream for care of
people with dementia is being developed.
Transforming primary and community mental health services (for
people with severe mental illness)The 2011/12 work programme will
build on the work initiated by the Lambeth Living Well
Collaborative in 2010 and scale up theinitial new service offer
targeting people with SMI from July 2011 underpinned by a business
case, to be agreed by June 2011. It isexpected that people
receiving services will spend less time in secondary care, that
more people (1,000 over 4 years) will besupported by primary care
and the voluntary sector, through peer support and with a greater
focus on self care and management.
Forensic servicesThis workstream will continue in conjunction
with the criminal justice system/forensic service redesign project,
to agree plans withSlaM to reduce Medium Secure provision by up to
50% by improved case management, recovery and early intervention
andchange in the way Mental Health Act 1983 section and court /
hospital orders are deployed.
Payment by ResultsPreparation for payment by results in mental
health will continue along with roll out of self directed support
and the personal healthbudget pilot.
Talking Therapies/Counselling servicesConsideration of current
service delivery is underway for IAPT and primary care counselling
as both contracts are due to expireduring 2011/12. Proposals to
re-commission and tender services will be considered during 2011
with the aim of new servicearrangements from April 2012 based on
agreed care pathways for people experiencing anxiety and depression
and other commonmental disorders.
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DementiaThe programme will prioritise delivery of the national
dementia strategy. This will include the mobilisation of services
from CliftonHouse, the evaluation of the first stage of the local
memory service, extension of assistive technology solutions for
people withdementia, a review of institutional care including
continuing care for people with dementia, the provision of
domiciliary care forpeople with dementia, improving the quality of
health care experiences for people with dementia, working with
primary care onrecognising dementia and appropriately referring,
and reviewing the carer’s strategy to ensure it is meeting the
needs of carers ofpeople with dementia.
QIPP, Key targets and CQUINS
QIPP 2011/12: CMHT reconfiguration; Day services review,
£1,357,000QIPP 2012/13: Forensic services redesign; continuation of
AMH service redesign (LLWC) £3,628,000All projects comprising the
programme are based on QIPP assumptions as set out in Appendix
A(ii).
Key targets include: CPA 7 day follow up – SQU15 Crisis
resolution/Home Treatment – SQU 13/14 Early Intervention in
psychosis IAPT – numbers into treatment Local – numbers of
secondary care users in employment ; settled accommodation
All four CQUIN targets from SlaM contract are designed to
support transforming primary and community mental health
services(quarterly reporting cycle).
1. Improved access and referral arrangements for mental health
services2. Recovery3. Physical health care4. Patient reported
outcomes
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Objective Lead Actions DateTo develop and implement newservice
offer targeting people withsevere and enduring mental
Illness,including the Lambeth Living WellCollaborative (LLWC)
DO’R Agree business case developed via the LLWC
includingtransitional funding requirements for expanded service
offer andcontribution to QIPP savings target
Commence primary care mental health support service as partof
new service offer
Agree resource centre (Effra Rd) provision and
contractarrangements for service commencement
Complete feasibility of possible social impact bond
initiativeAND GSST bid to support service offer delivery via Third
sector(includes CJS project)
Roll out Collaborative service offer across all 52 practices
fromJuly 2011
Enable 200 people to access the new service offer Organise
workshops for all partners and specific GP events to
support implementation and participation
Jun 2011
Jun 2011
Nov 2011
July 2011
ongoing
Mar 2012Jun/Sept/Dec 2011
To develop and implement recoveryfocussed care pathways for
peoplewith mental health problems incontact with the Criminal
JusticeSystem (CJS)
DO’R Agree MSU disinvestment-reinvestment strategy
includingcontribution to QIPP savings target
Commence hybrid orders and triage pilots in relation to
MDO(mentally disordered offenders)
Monitor impact of new CJS mental health service on AMH
andForensic services
Agree FIPTS exit strategy
July 2011
Jun 2011
quarterly
Sept 2011
To develop an integrated approachto the delivery of therapy
andcounselling services for people withanxiety and depression
DO’R Agree TT/counselling services strategy including care
pathways Commence procurement process for integrated service Agree
terms with providers for service commencement 4/12
Sept 2011Sept 2011Feb 2012
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Objective Lead Actions DateTo implement Payment by
Results(PbR)/self directed care programme
DO’R Meet national timetable – i.e. HoNOS clustering by 12/11
andlocal tariff by 3/12
Agree four borough approach to tariff with SlaM Clarify
implications of roll out of LLWC offer with PbyR
arrangements and commissioning strategy for 12-13. Meet local
authority SDS target Complete review of Personal Health Budget
pilot
Mar 2012
Sept 2011Sept 2011
Mar 2012Mar 2012
To deliver 2011/12 dementiastrategy priorites
LC Clifton House mobilisation Assistive technology to aid those
with dementia Domiciliary care services retendering Review of care
homes demand and the local market Using learning from publicised
poor quality care to improve care
locally Work with GPs regarding recognising dementia &
referring
appropriately Review of carers strategy
Jun 2011Ongoing
2012Jun 2011ongoing
Sept 2011
Nov 2011
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5.4 Staying Healthy Programme Senior Responsible Officer: Ruth
Wallis
To improve health outcomes for Lambeth residents through the
commissioning of systematic health promotion and preventionservices
that have the effect of improving mortality rates, reducing
morbidity, reducing the prevalence/incidence of key risk factorsand
reducing health inequalities. The Programme covers the following
areas; Smoking Cessation and Tobacco Control, NHSHealth Checks
(Vascular Checks), Adult Obesity and Physical activity, Alcohol
Prevention, Lambeth Early Intervention andPrevention Service,
Sexual Health and Infection Prevention.
The staying healthy programme will include the Children’s
Programme Board which will be concentrating on the implementation
ofa programme which aims to begin to stem the tide of increasing
childhood obesity levels in Lambeth. Some evidence tounderstand the
scale of the problem locally has begun to emerge through the
implementation of the National ChildhoodMeasurement Programme
(NCMP). Results of the NCMP (2009/10) (average participation of
93%) showed levels of obesity inLambeth for Reception and Year 6
children were 12.9% and 25.1% respectively, which are significantly
higher than the nationalaverage and slightly higher than the London
average. Five areas of work have been identified:
QIPP, Key targets and CQUINS
All projects comprising the programme are based on QIPP
assumptions as set out in Appendix A(ii).
Key targets (for a detailed list of key performance measures
refer to Appendix B): Increased uptake of all immunisations Improve
% of imms given by HV to hard to reach groups Number of eligible
people who have been offered and/or received an NHS Health Check
Smoking Quitters at 4 weeks 2011/12 (WCC) HbA1c Management (WCC)
CHD Blood Pressure Management (WCC) Reduction of childhood obesity
as measured through the National Child measurement Programme (Year
6) - WCC
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CQUINS (for a full list of CQUINs refer to Appendix C): Increase
the no. of 5 year or under children receiving vaccinations through
HV intervention Smoking cessation (GSTT)
Objective Lead Actions DateTo reduce health inequalities
andimprove health, identifying the needfor interventions that
improvepopulation health (including mentalwell-being) such as
environment,physical activity, nutrition and linkingthese wider
determinants to thedelivery and management ofpreventable LTC
RW/TF
Establish an internal PH led Staying Healthy Group to:
Develop/agree business case for diabetes community service
Negotiate price and delivery model for the implementation of
diabetes service Implementation of the new diabetes community
service Identify PH priorities and gaps Scope BSU projects to
address priorities Scope the potential for partnership projects to
address priorities Take forward early outcomes from socio-economic
research,
considering how this research can be used to reduce
healthinequalities and improve patient care.
Oversee implementation of the SH plans Present proposals and
recommendations for 2012/3 to LCCCB
June 2011Oct 2011
Nov 2011Sep 2011Dec 2011Dec 2011
Mar 2012
Mar 2012Mar 2012
To implement the Lambeth NHSHealth Checks more systematicallyin
line with agreed target
TF Confirm accurate reporting mechanisms. Increase practice
uptake of Service Level Agreement Establish an outreach team to
work with local community
groups to target high risk/high need groups Review quality of
Health Checks provided Review interim findings at regular stages of
evaluation prog Model the health and cost benefits of the
programme
June 2011July 2011Mar 2012
Mar 2012OngoingSep 2011
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Objective Lead Actions DateTo deliver the Smoking Cessation
andTobacco Control commitments by:
(a) Meeting the DH 4 week quittarget ensuring priority
groups(Routine & manual, pregnantand BME smokers)
aretargeted
(b) Implementing the LambethTobacco Control Strategy
inpartnership with key stakeholders
TF/BO
Support providers to systematically improve success
rates,reinforcing this through Service Level Agreements
withproviders and the offer of refresher training
Agree LSSS business plan Explore opportunities for additional
resources to support the
gathering of further intelligence around smoking in pregnancy
inline with NST recommendations.
Support the Lambeth Tobacco Control Alliance in joint
working,advocacy and the implementation of Tobacco Control
strategy
Explore opportunities for further resourcing for
addressingtobacco use with children and young people in a
moresystematic way.
Mar 2012
July 2011July 2011
Mar 2012
July 2011
To explore ways to take forward thecost-saving alcohol
preventioninterventions identified in the PublicHealth modelling
work
TF/AM
Update the findings from the prevention modelling paper andagree
priority interventions with partners.
Further develop the screening and brief intervention training
tostaff/settings identified in the NICE guidance in cooperation
withkey partners in the Council and elsewhere.
Aug 2011
Sept 2011
To support the LCH implementation ofthe new Lambeth Early
Interventionand Prevention (LEIP) Service
TF/BO
To support LCH to develop new service, ensuring evidencebased
approaches are adopted
Ensure appropriate monitoring systems in place to enableadequate
evaluation of service.
Sign off of the final specification and monitoring arrangements
Support LCH tin launching and publicising new service Make the
links with relevant specialist LTC teams e.g. diabetes,
respiratory and heart failure
Aug 2011
July 2011
July 2011June 2011June 2011
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Objective Lead Actions DateTo implement the Childhood
Obesityprogramme
Expressions of interest and tendering information developed
forall services
Extension to MEND programme until end of July 2011 Recruitment
to School Nurse post Initiation of Baby Friendly Initiative
Extension of the Level 1 Lambeth Healthy Weight training to
include children centre staff Commission and implement school
support package Commission and implement weight management
programmes Completion of NCMP (2010/11) exercise Analysis of
results of 2010 NCMP
May 2011
Mar 2012June 2011April 2011Sept 2011
Sept 2011Sept 2011July 2011July 2011
To ensure promoting mental wellbeingis included as an element of
all healthimprovement work
Health Improvement services include promoting mentalwellbeing
for all in their remit
Establish and maintain better links between Health Trainers
andIAPT workers
Ensure frontline staff receive Mental Health First Aid
andwellbeing training
Ensure health promotion campaigns include emotionalwellbeing
element
Forge stronger links between Staying Healthy and MentalHealth
Improvement Programme work eg. Peer support, EPP
Mar 2012
Mar 2012
Mar 2012
Mar 2012
Mar 2012
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5.5 Contract management and monitoring Lead Director: Moira
McGrath and Helen Charlesworth-May
To ensure that all commissioned services are procured and
performance managed appropriately, including building
andmaintaining relationships with all providers and ensuring local
and national health care requirements are delivered through
robustcontracts with providers. Where services are commissioned
either jointly with the Local Authority, or as part of shared
serviceagreements or any other delegated arrangements, NHS Lambeth
will work jointly with partners in order to ensure the needs
ofpatients are met and appropriate, co-ordinated care is
commissioned throughout all aspects of the patient pathway.
QIPP, Key targets and CQUINS
QIPP assumptions are set out in Appendix A(ii).
Key targets (for a detailed list of key performance measures
refer to Appendix B): Mental health easy in and out – improved
access and referral Mental Health recovery Physical health care for
mental health patients Patient reported outcome measures (PROMS)
HCAI measures (MRSA and CDiff) Ambulance Category A response time
and Urgent/Emergency journeys VTE risk assessment A&E quality
indicators Stroke indicators Maternity 12 weeks Patient experience
Staff engagement Carers breaks Access to dentistry Low value
procedures Breast feeding
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Length of Stay (acute and MH) Daycase rate Acute bed capacity GP
written referrals to hospital Elective and non-elective FFCEs
CQUINS (for a full list of CQUINs refer to Appendix C):
Communications with GPs Patient experience VTE
Key Objectives Lead Actions DateTo negotiate and manage the
MentalHealth contract (including contributionto development Lambeth
Living WellCollaborative)
DOR Hold monthly SlaM contract performance monitoring meetings.
Hold quarterly SlaM quality performance (including CQUIN )
monitoring meetings Service and coordinate bi-monthly four
borough PCT/SlaM
contract meetings. Complete final schedules of 2011-12 contract
by qtr1 Further develop user engagement in contract monitoring
including user led audit. Market test provision of talking
therapy services with objective of
new contract arrangements by 4/12 Continue ongoing coproduction
and co-design work linked to
Lambeth Living Well Collaborative and secure agreement
fordisinvestment-reinvestment in collaborative service offer.
Service and coordinate the development of the 2012-13
SlaMcontract on behalf of LSL and Croydon BSUs
MonthlyQuarterly
Bi-Monthly
June 2011Ongoing
July-Mar2012
Ongoing
Oct 2011-Mar 2012
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Key Objectives Lead Actions DateTo negotiate and manage
theCommunity Services Contract withGSTT and oversee the integration
ofCommunity Services across Lambethand Southwark
TF Contract and Quality Meetings in place for year across
Lambethand Southwark
Monitoring agreed including Performance & Quality Measures
Regular Lambeth and Southwark Commissioner meetings and
agreed programme of TCS work with provider Agree programme of
work with regard to integration with cluster,
acute commissioners and trusts Develop QIPP and CRES proposals
for 2012/13
May 2011
June 2011July 2011
July 2011
Sept 2011
To negotiate and manage the acutecontracts ensuring financial
stability
SC/SM
Contract and Quality Meetings in place for year Monitoring
agreed including Performance and Quality Measures Develop QIPP and
CRES proposals for 2012/13
June 2011June 2011Sept 2011
To negotiate and manage Hospicecontracts
RC/LC Monitoring of contract ensuring value for money. To ensure
service provision that enables the PCT to meet its
priorities on EOLC. To engage where required with DH work on the
National Palliative Care Funding Review (awaiting further info from
DH)
Ongoing
TBC
To negotiate and manage Care HomeContracts
RC/LC To develop and agree local contract with Fairley House.
Await further guidance from London Procurement Programme
on approach to nursing homes that are signed up to the LPP
July 2011TBC
To negotiate and manage third sectorcontracts – Domiciliary
continuingcare (adults)
RC/LC To manage current contract To retender the contract as
part of ACS domiciliary care
retendering exercise
On-going2012
To manage the risk associated withcontinuing care budget for
olderadults, physically disabilities, learningdisabilities and
EOLC
LC To ensure efficient processes are in place to manage
continuingcare assessment, re-assessment & decision making
processes
To comply with NHS London reporting requirements. To provide
quarterly activity and financial reports to the
Operational group identifying risk areas at an early stage
On-going
On-goingFrom Q1
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Key Objectives Lead Actions DateTo negotiate and develop
primarycare capacity linked to managementof patients with SMI and
CMI as partof the Lambeth Living WellCollaborative
DOR Finalise contract for provision of primary care mental
healthsupport service with Clapham Family practice
Agree plans to scale up MH support and secure services Liaise
with SE Cluster primary care contract lead over core
contract requirements
June 2011
Sept 2011Ongoing
To negotiate and manage voluntarysector contracts
(includingcontribution to Lambeth Living WellCollaborative)
DOR Hold quarterly contract monitoring meetings with MH
providers Further develop user engagement in MH contract monitoring
Continue ongoing coproduction and co-design work linked to
Lambeth Living Well Collaborative
QuarterlyOngoing
To negotiate and manage HMPBrixton health care contract
DOR Hold monthly contract performance meetings with Care UK.
Hold quarterly partnership meetings. Prepare for tendering of
health care services during 12-13
(contract renewal April 2013)
MonthlyQuarterly
Oct 11onwards
To commissioning a full range ofhealth services for children
FM
FM
FM
FM
Commissioning of CAMHS services to include full review
ofStrategy and Needs Assessment
Manage Continuing Care packages for individual children
andfamilies working with colleagues from Local Authority,
Lewishamand Southwark PCT’s
Commissioning services for children with disabilities and
theirfamilies including the implementation of the Aiming
Highprogramme in partnership with Local Authority
Commissioning services to manage and monitoring coveragefor all
child health requirements including breastfeeding,childhood
immunisations, screening programmes to nationaland local targets.
Working with Public Health colleagues toidentify areas of concern
and commission services accordingly.Work with Local Authority to
support children’s health in earlyyears, schools and youth
settings, including Children’s Centres.
Mar 2012
Ongoing
Ongoing
Ongoing
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Key Objectives Lead Actions DateTo commission a programme of
workto ensure the continued reduction ofunder 18 conceptions and
support toteenage parents.
GM Implement the Teenage Pregnancy & Parenthood Action Plan.
Commission providers to support schools deliver high quality
programmes on sex and relationships, emotional health andwell
being, and substance misuse to young people
Commission services to increase vulnerable young people’saccess
to sexual health advice, information and services.
Commission workforce training to increase capacity andcapability
of those working with young people to talk to themabout
relationships and sexual health as well as other healthissues and
signpost them to appropriate services
Commission a provider to support young parents through one toone
and group work to improve health, social and economicoutcomes for
themselves and their children.
Ongoing
Sept 2011
June 2011
June2011
June/Sept2011
To commission a range of healthservices for adults with
learningdisabilities
AMcT To undertake NHS London LD Self Assessment To manage the
dissolving of the pooled budget arrangements Integration of SLAM
health team into GSTT and implementation
of monitoring processes To manage continuing care packages and
to ensure processes
are in place for assessment and on-going review Monitoring of LD
DES Implementation of Valuing People Now action plan
July 2011
Sept 11
Ongoing
OngoingOngoing
To commission a range of servicesand initiatives to improve
awareness,detection and treatment of cancer
LC Implementation of NHS Lambeth action plan on improvingbreast
screening uptake
Monitoring of NAEDI initiatives with other PCTs Monitoring of
cancer waiting times working closely with the
cancer network to improve performance Participate in peer review
programme via cancer locality group Hold quarterly monitoring
meeting for the CHANT services
Ongoing
OngoingOngoing
Mar 2012Ongoing
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Key Objectives Lead Actions DateTo manage the new
contractualarrangements for communityequipment
LC Hold joint quarterly contract monitoring meeting with LBL
andthe provider
Hold bi-monthly TCES meetings to oversee the implementationof
the new contract
Ongoing
Ongoing
To coordinate the 2011/12 winterplanning arrangements
LC To ensure all local providers have robust winter plans in
place To coordinate plans into a joint Lambeth/Southwark winter
plan To ensure robust monitoring/reporting mechanism are in
place
Sept 11Oct 11
Feb 2012
Ensure safe and cost effectivemedicines management
andprescribing across Lambeth
VB New Accountable Officer for Controlled Drugs in place Agree
primary care focus QIPP areas and incentive schemes Launch with
practices Agree AO functions moving forward with cluster Consult on
developing a commissioner- led local decision
making group jointly with cluster/LSL to take a
populationapproach to managed entry of new drugs locally.
Review and monitoring of acute prescribing in partnership
withcluster acute commissioning team
Provide professional pharmaceutical advice for the
ExceptionalTreatment Arrangements panel, include this in decision
makingand facilitate feedback from panel into business planning
Ensuring that legal aspects of medicines purchasing,
storage,prescribing, supply, administration and destruction are
adheredto including prevention, detection of fraud, issues of
concernand delivery and support of Controlled Drugs
requirements.
April 2011May 2011June 2011Aug 2011Oct 2011
Ongoing
Ongoing
Ongoing
To negotiate and manage thecontracts for sexual health,
HIVvoluntary sector and terminations ofpregnancy
AY Monitoring contracts against agreed SLAs Implement contract
changes to deliver QIPP Procure HIV care and support services
Implement sexual health tariff across GUM and community
sexual health services
On-goingJune 2011April 2012April 2012
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Our Organisational Development: To manage the transition of
commissioning responsibility to GPConsortia and the establishment
of new Health and Wellbeing arrangements, within the context
ofengaging public and patients and managing equalities.
6.1 Organisational Development Programme Lead Director: Una
Dalton
A structured approach will be undertaken to identify the
development needs of the LCCCB and NHS Lambeth with the intention
thatfull commissioning responsibility transfers to the GP Consortia
in 2012/13 and new Health and Wellbeing arrangements are in
placefrom April 2013. NHS London has developed a Pathfinder Toolkit
which provides a core development support programme for
GPPathfinders and this will be used to map out a development plan.
The development plan will cover empowering patient and thepublic,
vision and strategy, finance, leadership, clinical/corporate
governance, planning, agreeing, monitoring, skills and
capacity,process and IM&T.
Key Objectives Lead Actions DateTo manage the transition to
ClinicalLed Commissioning, including: Consortia Support BSU
Development
JC Ensure transitional working arrangements are communicated
toLCCCB, NHS Lambeth staff and practices
Submit Pathfinder Delivery Plan to cluster Appoint external
provider to support delivery of Pathfinder Toolkit Identify
development needs for LCCCB, internal
commissioning/support staff and practices to be
effectivecommissioners (supported by external provider)
Create an effective and accountable leadership team Develop
transformational leadership skills of key clinical and
managerial leaders Develop Clinical Network across a broad range
of clinicians to
support clinical commissioning
June 2011
June 2011Aug 2011Sept 2011
Dec 2011Jan 2012
Aug 2011
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Key Objectives Lead Actions DateTo embed Patient and
PublicEngagement
CF Develop annual patient and public engagement plan
withprogramme leads & clinical commissioners; prioritise areas
forsupport
Develop / inform / deliver engagement training programme
&support tools for clinical board & programme leads
Establish reporting structures & assurance framework
forengagement
Facilitate commissioner engagement in community events Manage /
support engagement events & mechanisms Engage with and through
LINk / Local HealthWatch, refresh
protocols Scrutiny relationships – induction with clinical board
Systematic links with voluntary sector Inform residents of
engagement opportunities Produce annual report on engagement in
commissioning
June 2011
From May
July 2011
From JuneFrom MayJune 2011
June 2011From MayFrom MaySept 2011
To manage equalities SC Engage with the south east London
cluster arrangements forassuring equality and equity and with local
partners both to shareexpertise and to assert a health agenda in
equality work
Identify a lead LCCCB clinician for equality and human rights
towork with public health and the cluster lead to develop a
coherentand effective approach.
With SEL Cluster, agree an approach to commissioning forequality
and equity and how assurance will be demonstrated
Engage LCCCB on both the accountabilities and methods
forcommissioning for equity and equality so as to set objectives
for2011-2012 that will meet anticipated requirements of
theDepartment of Health Equality Delivery System
Ongoing
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Key Objectives Lead Actions DateTo support the development of
theHealth and Well Being Board
HC-M/RW
Use the outputs from the series of facilitated workshops to
informthe development of the shadow H&WB board
Lead the development of JSNA to inform commissioning and thework
of the H&WB board
Develop role for Public Health in H&WB Board
April 2012
To lead the local/Lambethdevelopment of the Public
Healthfunction, in the context of HealthyLives/Healthy People and
theorganisational change
RW Programme for Public Health work with local authorities,
clinicalled commissioning and the sector in collaboration with
clusterDirectors of PH
Liaise with NHS London in the development of Public Health
andPublic Health England
Contribute to national requirements
April 2012
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Our Governance and Assurance: To ensure systems and processes
are in place to support individual,team and corporate
accountability for delivering patient centred, safe, high quality
care within resourcelimits.
7.1 Governance and AssuranceLead Director: Una Dalton (Corporate
Governance and Quality assurance), Christine Caton (Finance)
To ensure that systems and processes are in place to support
individual, team and corporate accountability for delivering safe,
highquality, patient-centered care within financial resource limits
and as set out in the Integrated Plan, as part of delivering its
overallstatutory financial targets. The organisation is responsible
for delivering on key performance indicators and targets (local,
regionaland national) and financial objectives which includes the
delivery of its Quality Improvement Productivity and Prevention
(QIPP)programme. A structured approach will be taken to ensure that
there are robust governance structures and processes in place
formanaging delegated responsibilities. We will work closely in
partnership with the SE London Cluster in order to achieve
financialbalance. We will ensure that financial controls are
effective, that financial systems are managed efficiently and that
the organisationcan demonstrate accountability for the use of
public funds.
Key targets
Key targets (for a detailed list of key performance measures
refer to Appendix B): Financial forecast out-turn and performance
against plan Financial performance scores for NHS Trusts Progress
on delivery of QIPP Total pay costs Year to date financial position
NHS Trusts Break even duty Delivery of 2% recurrent headroom PCT
legacy debt position Underlying financial position of PCTs and NHS
Trusts
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Key Objectives Lead Actions DateEnsure the Clinical Board
receivesappropriate infor