Governance Handbook

The Staffordshire and Stoke-on-Trent Integrated Care Board (ICB) was established on the 1^s July 2022 by the Health Care Act (2022). The Act established the statutory framework to support greater collaboration and partnership working to integrate services for patients. The ICB is part of the wider Integrated Care Partnership.

The Staffordshire and Stoke-on-Trent Integrated Care Partnership is made up of health and care organisations, including primary care, acute providers, mental health, community care services and local authorities, that have come together to plan and deliver joined up services for our community and improve the health of people who live in Staffordshire and Stoke-on-Trent.

Integrated Care Systems (ICSs) are partnerships of health and care organisations that come together to plan and deliver joined up services and to improve the health of people who live and work in their area.

The Staffordshire and Stoke-on-Trent ICB is a statutory NHS body which is unitary in nature. It brings the NHS together locally to establish shared strategic priorities, connecting to wider partnerships across the ICS, to improve population health in Staffordshire and Stoke-on-Trent.

The purpose of the ICB is to achieve the following four aims:

• Improve outcomes in population health and healthcare
• Tackle inequalities in outcomes, experience and access
• Enhance productivity and value for money
• Help the NHS support broader social and economic development

The Staffordshire and Stoke-on-Trent Integrated Care Board has responsibility for the commissioning and oversight of services and is accountable for NHS spend and performance.  It also sets the strategic direction across the system.

The ICB works alongside the Staffordshire and Stoke-on-Trent Integrated Care Partnership (ICP), which is a statutory committee and a local group of health and care organisations, including borough councils and voluntary/community sector members, working across local geographical boundaries.

The Governance Handbook (“the Handbook”) for the Staffordshire & Stoke-on-Trent ICB has been produced in line with NHS England (NHSE) guidance and brings together a range of documents which support the ICB’s Constitution and promotes good governance.

Corporate governance involves a set of relationships between an organisation’s management, board and other stakeholders.  Governance regulates the power and decision making of a small group of people who have been given responsibility for the stewardship of public assets and healthcare services. In the ICB, good governance protects both patients and public funds.

It also protects the reputation of clinicians and others involved in decision-making. Governance exists to ensure that decision-making is lawful, statutory duties and wider legal, regulatory duties are met, and that decision-making is enhanced from a quality and scrutiny perspective.

The Handbook and the ICB’s’ Constitution closely link to each other. Unless it is specifically stated, this Handbook is applicable in its entirety to the Staffordshire & Stoke-on-Trent ICB.

This Handbook sets out in detail the governance arrangements that will support the implementation of the ICB’s Constitution.  It contains practical procedural details for applying the ICB Constitution including the Terms of Reference for committees.

The Handbook is not a legal requirement. Rather it is a collection of key documents and underpinning policies, designed to promote good governance across the ICB.

If there is any ambiguity between the Constitution and this Handbook, the interpretation in the Constitution will apply.

This Handbook will be available on the public websites of the ICB - on the same pages as Constitutions for transparency and ease of access.

The Handbook will be reviewed annually with oversight from the Audit Committee, and any significant changes to the content of the Handbook will be recommended for adoption by the ICB Board.

Respect and dignity:

We value each person as an individual, respect their aspirations and commitments in life, and seek to understand their priorities, needs, abilities and limits.  We take what others have to say seriously.  We are honest about our point of view and what we can and cannot do.

Commitment to quality of care:

We earn the trust placed in us by insisting on quality and striving to get the basics right every time: safety, confidentiality, professional and managerial integrity, accountability, dependable service and good communication.  We welcome feedback, learn from our mistakes and build on our successes.

Compassion:

We respond with humanity and kindness to each person’s pain, distress, anxiety or need.  We search for the things we can do, however small, to give comfort and relieve suffering.  We find time for those we serve and work alongside.  We do not wait to be asked, because we care.

Improving lives:

We strive to improve health and well-being and people’s experiences of the NHS.  We value excellence and professionalism wherever we find it – in the everyday things that make people’s lives better as much as in clinical practice, service improvements and innovation.

Working together for patients:

We put patients first in everything we do, by reaching out to staff, patients, carers, families, communities, and professionals outside the NHS.  We put the needs of patients and communities before organisational boundaries.

Everyone counts:

We use our resources for the benefit of the whole community, and make sure nobody is excluded or left behind.  We accept that some people need more help, that difficult decisions have to be taken – and that when we waste resources, we waste the opportunities of others.  We recognise that we all have a part to play in making ourselves and our communities healthier.

The Committee on Standards in Public Life (Nolan Committee) set out in 1995 seven principles of public life which should apply to all in public service - The First Report of the Committee on Standards in Public Life, 1995. 

These principles have been adopted as the basis for working practices across the ICB.

Selflessness:

Holders of public office should act solely in terms of the public interest.

Integrity:

Holders of public office must avoid placing themselves under any obligation to people or organisations that might try inappropriately to influence them in their work.  They should not act or take decisions in order to gain financial or other material benefits for themselves, their family, or their friends.  They must declare and resolve any interests and relationships.

Objectivity:

Holders of public office must act and take decisions impartially, fairly and on merit, using the best evidence and without discrimination or bias.

Accountability:

Holders of public office are accountable to the public for their decisions and actions and must submit themselves to the scrutiny necessary to ensure this.

Openness

Holders of public office should act and take decisions in an open and transparent manner. Information should not be withheld from the public unless there are clear and lawful reasons for so doing.

Honesty:

Holders of public office should be truthful.

Leadership:

Holders of public office should exhibit these principles in their own behaviour.  They should actively promote and robustly support the principles and be willing to challenge poor behaviour wherever it occurs.

Board Members should act with independence, rigour, integrity, probity, honesty and mutual trust and display high standards of individual and collective conduct.

ICB Members will maintain confidentiality and corporate responsibility. In addition, all ICB Members are required to:

• Declare any potential or real conflicts of interest with regard to any matter on the agenda.
• Accept the principle of corporate responsibility.
• Remember that decisions are taken collectively, therefore responsibility for those decisions remains collective too.
• Adhere to the standards set out in the Professional Standards Authority’s guidance ‘Standards for Members of NHS Boards.

The leaders of the organisations within the ICS have agreed to adopt the following attributes when working together

• Trust
• Respect
• Courage
• Kindness & Compassion
• Openness & Honesty
• Looking Forward
• Leading by Example
• System First

Our vision is to make Staffordshire and Stoke-on-Trent the healthiest place to live and work.

This means:

• Helping our population to live well, for longer, and supporting you to be as independent as possible.
• Delivering Care as close to home as possible, ensuring that experience of health and care is the best it can be.
• Treating people rather than conditions and giving mental health equal priority to physical health.

Our priorities are:

• Improving outcomes in population health & health inequalities
• Improving delivery of elective care services
• Improving cancer services and outcomes in cancer care
• Delivering improvements in Children & Young Peoples services & maternity care
• Improving Emergency Care & delivering more care at home
• Promoting health aging & managing frailty
• Delivering more services through Primary Care to support system transformation Growing & improving mental health services

The area covered by the ICB is the county of Staffordshire, including the city of Stoke-on-Trent. We are responsible for the health and care of 1.1 million people who live in Staffordshire and Stoke-on-Trent, across a geographical area of 1,048 square miles.

We are aligned with two Upper Tier Local Authorities (UTLAs): Staffordshire County Council and Stoke-on-Trent City Council; and these Local Authority Districts (LADs) / Borough Councils: Cannock Chase, East Staffordshire, Lichfield, Newcastle-under-Lyme, South Staffordshire, Stafford and Staffordshire Moorlands.

The ICB is established by order made by NHS England under powers in the 2006 Act. The ICB is a statutory body with the general function of arranging for the provision of services for the purposes of the health service in England and is an NHS body for the purposes of the 2006 Act.

The main powers and duties of the ICB to commission certain health services are set out in sections 3 and 3A of the 2006 Act.  These provisions are supplemented by other statutory powers and duties that apply to ICBs, as well as by regulations and directions (including, but not limited to, those made under the 2006 Act).

In accordance with section 14Z25(5) of and paragraph 1 of Schedule 1B to the 2006 Act, the ICB must have a constitution, which must comply with the requirements set out in that Schedule.  The ICB is required to publish its constitution (section 14Z29).

The ICB must act in a way that is consistent with its statutory functions, both powers and duties.  Many of these statutory functions are set out in the 2006 Act, but there are also other specific pieces of legislation that apply to ICBs: examples include, but are not limited to, the Equality Act 2010 and the Children Acts.  Some of the statutory functions that apply to ICBs take the form of general statutory duties, which the ICB must comply with when exercising its functions. These duties include but are not limited to:

To rebuild new and improved services that address inequalities, and better support individuals, families and communities, we need to talk to local people, find out what matters to them and find out what we can do to support them. 

Our Working with People and Communities Strategy outlines how we are going to do this. It has been produced in collaboration with partners and stakeholders and will continue to develop alongside the Integrated Care Board and the Integrated Care Partnership.

The Staffordshire & Stoke-on-Trent ICB will demonstrate the highest standards of corporate behaviour and responsibility. This will be achieved through the adherence to the values described in the Nolan Committee Report and the standards for business & personal conduct in our Standards of Business Conduct Policy which all ICB colleagues will follow at all times.

The Staffordshire & Stoke-on-Trent ICB is committed to the proper use of public funds and their protection from losses caused by fraud, bribery, or corruption.  The ICB will seek to prevent and detect any such dishonesty and will take action to ensure that anyone who commits fraud or related offences either within or against the ICB is subject to all appropriate criminal, civil, disciplinary and regulatory sanctions. Our Anti-Fraud and Anti-Bribery Policy is published on our website.

Being able to raise concerns, without fear of recrimination and having them taken seriously and acted upon, is a vital requirement within the public sector and particularly within health care.  This is one of the tools which will enable staff to ensure services remain safe and responsive to patient’s need. Our Freedom to Speak Up -Whistleblowing/ Raising Concerns Policy is published on our website.

The Standing Financial Instructions are intended to provide direction to staff and other stakeholders on all aspects of the ICB’s financial governance.

SFIs are an integral part of the ICB’s control environment for managing the ICB’s financial affairs as they are designed to ensure regularity and propriety of financial transactions.  They contribute to good corporate governance, internal control and risk management.  They enable sound administration, lessen the risk of irregularities and support commissioning and delivery of effective, efficient and economical services.  They also provide clear guidelines to the Chief Executive and the Chief Finance Officer to effectively discharge their responsibilities.

The SFIs incorporate the ICB’s delegated financial limits for the approval of transactions and financial decision making.

Losses and special payments are items that Parliament would not have contemplated when it agreed funds for the health service or passed legislation.  By their nature they are items that ideally should not arise.  They are therefore subject to special control procedures compared with the generality of payments.

As a statutory Body, the ICB’s powers, functions and duties are conferred, in the main, by legislation. Additional responsibilities for other functions may be conferred through delegation to the ICB from other bodies (such as NHS England)

The SoRD supports good governance and clear, transparent decision-making within the legislative and delegation framework. The default arrangement is that functions will be exercised by the Board unless they are delegated.

The Board of the ICB is responsible for all the decisions it makes, including those that it delegations to other to make on its behalf. The SoRD sets out which decisions (functions) the Board will delegate and which it reserves to make itself.

This policy sets at the organisations overarching approach information governance. Information is one of our most valuable assets and it is vital that we know what information we hold, how we store it and how we use it. Find out more about Information Governance and Data Security & protection policy

The Code of Conduct supports the Information Governance and Data Security Policy by setting out out clear guidance standards for how staff manage and use information.

Please use the link below to access the ICB’s policies, which are categorised as following:

Commissioning Policies, Corporate Policies, EPRR Policies, Finance Policies, HR Policies, Medicines Optimisation Policies and Quality& Safety and Clinical Policies.

Our publications and policies - Staffordshire and Stoke-on-Trent

The ICB Functions and Decisions (F&D) Map shows the arrangements that are in place within it, and with ICS partners, to support good governance and effective decision making.

This F&D Map complements the SoRD and is locally defined, sets out where decisions are taken and outlines the roles of different committees.

Staffordshire and Stoke-on-Trent ICB set out its governance and leadership arrangements in a constitution formally approved by NHS England. The ICB must ensure that it can effectively discharge its full range of functions. The functions and decisions of the ICB are discussed and considered at Board assurance committees in line with the ICB’s constitution. All committees have a responsibility to operate within their individual Terms of Reference (ToR) which support effective decision making.

The ToR establishes a board committee and details the specific authority that the committee has to oversee a delegated area of responsibility. It includes the roles, responsibilities, operations, tenure and obligations, in accordance with any specific legislative requirements.

The ICB Governance Organogram shows the relationship between the ICB and its sub-committees

Terms of Reference in relation to these Committees are included below for reference.

The Committee is a Non-Executive chaired committee of the Board, is accountable to the Board and provides an independent and objective view of the ICB’s compliance with its statutory responsibilities. The committee is responsible for arranging appropriate internal and external audit.

Find out more in the Audit Committee ToR.

The Committee is the principal mechanism for the ICB’s governance, data/digital and management of all its IG, data protection and information security activities. It shall demonstrate compliance with ICB’s permissible use of personal and patient-confidential data.

The Group is an accountable sub-committee of the ICB Audit Committee. Its purpose is to support and drive the broader IG Data/Digital agenda, thereby providing upwards assurance that effective IG, Data/Digital is in place within the ICB as an NHS Commissioner.

For the IG Data and Digital Committee ToR see our website.

The Committee is accountable to the Board for matters relating to remuneration, fees and other allowances (including pension schemes) for employees and other individuals who provide services to the ICB.

It may make decisions itself, rather than only making recommendations to the ICB board. The remuneration of executives and non-executives is determined within national pay frameworks.  

For the Remuneration Committee ToR see our website.

The Committee is a Non-Executive chaired committee of the Board and its role is to advise and support the Board in scrutinising and tracking delivery of key financial and service priorities, outcomes and targets as specified in the ICS Strategic and Operational Plans.

For the Finance and Performance Committee ToR see our website.

The purpose of the group is to scrutinise the overall performance of the ICB and hold one another to account.  The group utilises monthly finance reports, portfolio performance and project dashboards, along with deep dives into performance to understand the current issues facing the system. The Group is an accountable sub-group of the ICB Finance and Performance Committee.

For the System Performance Group ToR see our website.

The Committee is a Non-Executive chaired committee of the Board and exists to scrutinise the robustness of, and gain and provide assurance to the ICB, that there is an effective system of quality governance and internal control that supports it to effectively deliver its strategic objectives and provide sustainable, high-quality care.

It will also provide the ICB with assurance that it is delivering its functions in a way that secures continuous improvement in the quality of services, against each of the dimensions of quality set out in the Shared Commitment to Quality and enshrined in the Health and Care Act 2022.

For the Quality and Safety Committee ToR see our website.

The purpose of the SQG is to provide a strategic forum at which all partners from across health, social care, public health and wider within the ICS can join up around common priorities (linked to the ICP strategy), routinely and systematically share insight and intelligence, identify opportunities for improvement and concerns / risks to quality, and develop system responses to enable ongoing improvement in the quality and safety of care and services across the ICS.

The SQG does not have executive powers and is a sub-group of and reports to the ICB Quality & Safety Committee.

For the System Quality Group ToR see our website. 

The Committee is a Non-Executive chaired committee of the Board, brings together health and care organisations and key stakeholders to support the transformation ambitions and design of the future state of health and care delivery in the area. The Committee will seek to act in the best interest of citizens, patients, our people and the system as a whole by providing innovative strategic People solutions which will address the cultural changes that are necessary to build a workforce that befits a world-class 21st century health and care system which is recognised as being the best place to work.

For the People Culture & Inclusion Committee ToR see our website.

The Committee is a Non-Executive chaired committee of the Board, established to enable Statutory Commissioning Duties decision-making, collaborating on strategic (including policy) matters and overseeing jointly agreed programmes of work to ensure their delivery. The Board has delegated authority to the Committee, as set out in the Scheme of Reservation & Delegation and Delegated Financial Limits.

For the Strategic Commissioning & Transformation Committee ToR see our website.

The Group is established by the ICB as a Management Group as part of broader ICS synergistic governance. The Group is an accountable sub-group of the ICB Strategic Commissioning and Transformation Committee, acting as its “Strategy & Transformation Management Forum”. Its members, including those who are not members of the Board or ICB staff, are bound by ICB’s Constitution Standing Orders and other key policies of the ICB. The group has executive powers, as delegated in the Scheme of Reservation & Delegation (SoRD) and specified in its TOR.

For the Strategic Transformation Group ToR see our website.

The Primary Care Forum is established as a sub-group of the Strategic Commissioning and Transformation Committee and has oversight of the full Staffordshire and Stoke on Trent area to function as the corporate decision-making forum for the management of the delegated functions and the exercise of the delegated powers relating to Primary Medical Services.

For the Primary Care Forum ToR see our website.

The Senate is established by the ICB as a Committee of the Board in accordance with its Constitution and is charged with ensuring our system is clinically and professionally led, on behalf of the ICB / its ICS partners. The TOR set out the membership, remit, responsibilities and reporting arrangements and may only be changed with approval of the Board.

The Senate is an Executive Committee of the ICB Board and its ICB / ICS members, including those who are not members of the Board or ICB staff, are bound by the ICB’s Constitution Standing Orders and other key policies of the ICB. Executive powers are delegated by the ICB’s Scheme of Reservation & Delegation (SoRD), as specified in its TOR.

For the Health and Care Senate ToR see our website.