1. NHS Reform Update October 2011

2. Context Health Reform Agenda Significant pace of change Clear focus on supporting the Transition Process At the same time need to retain focus on financial challenge and provider performance

3. NHSSocial Care Public Health New Structure of the NHS Department of Health (including public health England) – Overall responsibility for health, public health and social care policy Service delivery Accountability to patients, service users and the public (underpinned by the regulators and Healthwatch England) NHS Commissioning Board Public health delivery Department for Communities and Local Government Local authorities (including health and wellbeing boards) Clinical Commissioning Groups

4. National Commissioning Board Key Functions To agree and deliver improved outcomes and account to ministers and parliament for progress To oversee the commissioning budget ensuring financial control and value for money To develop and oversee a comprehensive system of clinical commissioning groups To commission directly about £20bn of specialist and primary care services To support quality improvement by promoting consistent national quality standards To promote integrated care for patients

5. National Commissioning Board Key Functions cont’d To promote equality and diversity and the reduction of inequalities To develop commissioning guidance, standard contracts, pricing mechanisms and information standards To engage with the public and champion patient interests including ensuring access to information about services To develop a framework to make choice a reality for patients To oversee planning for emergency resilience With partners, develop a medium term strategy for the NHS to help form the basis for local commissioning plans alongside local priorities 4

6. 5 Somerset Cluster Somerset Cluster formed by one Primary Care Trust NHS Somerset governance structures continue Full cluster management team appointed Cluster intended to form a bridge to the new NHS Commissioning Board arrangements

7. 6 Somerset Clinical Commissioning Group (CCG) Established 1 June 2011, as sub committee of the PCT Board Membership: *GP delegates from the 9 Somerset Federations and practice manager representative *Representatives from SCC, LINks and LMC *seconded PCT Directors Framework for delegation of commissioning functions to the CCG approved, by the PCT Board with responsibility for £222 million planned to be delegated by 31 March 2012 Authorisation process during 2012/13, aiming to submit application in July 2012 Overall (CCG) view of PCT commissioning staff and skills is positive

8. CCG Development Update Clinical teams in place for all major contracts, and starting to work with secondary care alongside PCT commissioners Wider membership under consideration following recommendations of NHS Futures Forum Board development programme underway Practice Based Commissioning budgets and workstreams delegated 1 June 2011 Medicines management and prescribing delegated 1 August 2011 Somerset Partnership Contract (mental health and community health services) delegated 1 October 2011 RUH Bath to be delegated from 1 December 2011 7

9. 8 GP Federations in Somerset

10. Public Health Delivery of Public Health Programme being maintained Increased focus on emergency planning Joint work underway with Somerset County Council to plan for transfer of Public Health responsibilities 9

11. Health and Wellbeing Board Plans are well advanced for early implementation of the Health and Wellbeing Board arrangements in Somerset This work is being led by Somerset County Council through the Scrutiny Committee, working jointly with NHS Somerset and the Clinical Commissioning Group Shadow Health and Wellbeing Board anticipated to be in place from 1 October 2011 – first meeting on 31 October 2011 10

12. Commissioning Support Organisations “Commissioning support” is the support that clinical commissioning groups will buy in or share with other organisations to help them carry out their commissioning functions. It does not include those things that clinical commissioning groups need to do, or choose to do, for themselves. It is likely to be shared or bought from NHS developed commissioning support organisations, local authorities, other clinical commissioning groups, commercial and civil society bodies.