The Department of Health published new guidance last week on Transforming Community Services (TCS), following on from ‘Enabling New Patterns of Provision’, the ‘Quality Framework: Guidance for Community Services’ and the 6 ‘Transformational Guides’. The new guidance entitled, ‘Governance Arrangements to Support PCT Provider Committees’, was developed with the Appointments Commission to provide examples of governance good practice to PCT direct providers (the Guidance).
The Guidance highlights the importance of establishing and maintaining robust governance structures to underpin the delivery of high quality, efficient, safe and innovative community services. The Guidance describes a number of examples of good practice, including:
- Developing a Memorandum of Understanding to set out clear lines of accountability between the PCT Board and the Provider Committee and the relationships between the Chief Executive of the PCT and Provider Committee non- executives.
- Drafting clear and robust Provider Committee terms of reference.
- Revising the existing PCT Scheme of Reservation and Delegation of Powers to ensure requisite powers are delegated to the Provider Committee and its officers and reserved to the PCT Board, as appropriate, to balance the need for Provider Committee autonomy against the need for the PCT to retain high level accountability.
- Updating existing policies and PCT Standing Orders to deal with conflicts of interest arising from PCT non-executive directors carrying out dual roles on the PCT Board and Provider Committee.
- Considering the establishment of Provider Committee sub-committees to deal with audit, remuneration, governance etc.
- Maintaining transparency by holding Provider Committee meetings in public.
A letter from David Nicholson accompanying the Guidance stresses that PCTs should not focus on future organisational structures to the detriment of service transformation and describes a more flexible approach to the timetable for restructuring PCT providers arms. SHAs will now have a key role in setting local timetables for reorganisation and in evaluating the readiness, capability and strength of leadership of the proposed organisational form. When assessing PCT restructuring proposals, SHAs will be required to ask whether ‘the proposals deliver an improvement in quality for patients, using innovation to drive productivity and enhance prevention.’ The implementation of a more flexible, locally driven approach is not designed to slow the transformational process and provider organisations will still need to be ‘business ready’ by October this year (as set out in Enabling New Patterns of Provision).
Hempsons has a wealth of experience in advising the NHS on governance issues and has already assisted a number of PCTs with implementing the strategies described by the Guidance. Our experience in this area enables our PCT clients to focus on service transformation whilst we assist with implementing the governance arrangements that underpin that transformation.
We understand that a ‘one size fits all’ approach to governance is not appropriate and have developed a suite of governance documents including a Memorandum of Understanding, Provider Committee Terms of Reference and a Conflict of Interest Policy which can be tailored to meet the individual needs of your PCT.