Is your CCG Constitution fit for the future?
The purdah period before the General Election provides CCGs with a great opportunity to “put their house in order” so that they are ready to press on with their transformation plans once a new Government is elected. The Constitution is a key document for every CCG, but recent developments suggest that not all constitutions are fit for the future.
Complying with your public involvement duty
Under the NHS Act 2006, each CCG must include in its constitution a description of the arrangements it has made to secure public involvement in its planning and decision-making, and a statement of the principles which it will follow in implementing those arrangements. In a recent judicial review application, one of the grounds relied on by the Claimant in support of an argument that a CCG had failed to comply with its public involvement duty when consulting on major service changes was that its Constitution did not contain these provisions. Are you confident that your CCG Constitution could withstand this level of scrutiny?
Next steps on the NHS Five Year Foward View
The Next Steps document published in March 2017 explained that all STPs need a basic governance and implementation ‘support chassis’ to enable effective working. As a result, all NHS organisations now form part of a Sustainability and Transformation Partnership. In order to ensure that these new structures are consistent with the internal governance arrangements of each CCG, your constitution should allow for appropriate collaborative decision making.Whilst many CCGs amended their constitutions to allow for joint working in the context of the delegation of primary care commissioning responsibilities, some have not created a general power in their Constitutions to enter into joint decision-making structures for other purposes. Many CCGs are now also sharing appointments for their Accountable Officer, CFO and other roles. You need to ensure that your CCG Constitution allows for this approach before adopting joint working arrangements.
Future-proofing your Constitution
Amending your CCG’s constitution can be quite an onerous task. It will require support from the Membership; agreement of the Governing Body and approval from NHS England. Having reviewed more than 30 CCG Constitutions in the last 12 months we have identified various ways in which you can reduce the future burden of making amendments. These include:
- Making the CCG Scheme of Reservation and Delegation an appendix that does not form part of the Constitution so that you do not need to amend the Constitution every time the CCG decides to delegate a function;
- Removing descriptions of each committee of the CCG from the body of the Constitution. This means that you will not need to amend the Constitution each time you form new or additional committees in future;
- Subjecting your Constitution to a “health check” to ensure it includes all the information required by statute; that provisions relating to quorum and voting reflect the composition of the CCG and/or Governing Body and that paragraph references are internally-consistent and accurate.
How we can help
We offer all CCGs a free initial 20 minute consultation to discuss your current constitution, and any changes you are considering. Following that consultation we can carry out a “health check” review of your Constitution and recommend changes that will ensure it is fit for the future, or if you have specific requirements in respect of joint decision-making; shared appointments or other amendments, we can provide wording based on our extensive database of tried and tested clauses.