How we make decisions

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As a Clinical Commissioning Group (CCG) we are responsible for approximately £800m of your money. This means it is important that we follow national and local guidance on how we make our decisions on commissioning (planning and funding) health and care so that you can access the best possible services. By following an agreed process we can ensure that our decisions are fair and transparent. 

Governing Body

Our Governing Body help us finalise decisions and play a key role in holding us to account publicly.The Governing Body have a number of committees that sit underneath, making decisions on their behalf. Each committee has terms of reference which have been approved by the Governing Body and provides a robust framework for the functions and duties of these committees to be discharged in a manner that ensures the Governing Body retains sufficient oversight of the proper performance of their delegated functions. The Governing Body committees include:

Audit and Governance Committee
Remuneration Committee
Primary Care Co-commissioning Committee
Black Country and West Birmingham Joint Health Commissioning Board


Meetings Held in Public 

Scheme of Reservation and Delegation

The arrangements made by the CCG as set out in this Scheme of Reservation and Delegation of decisions shall have effect as if incorporated into the CCG’s Constitution.

Nothing in the Scheme of Reservation and Delegation should impair the discharge of the direct accountability to the Membership Forum or Governing Body of the Chief Finance Officer (CFO). Outside of these requirements the CFO shall be accountable to the CCG’s Accountable Officer.

The Clinical Commissioning Group remains accountable for all of its functions, including those that it has delegated.

Unless stated in the CCG’s Constitution or in its Scheme of Reservation and Delegation, the CCG’s Chief Officer has responsibility for the operational management of the CCG.

Delegated Financial Limits

The CCG also has a detailed scheme of Delegated Financial Limits. This document sets out the financial limits to the authority of CCG employees and others to commit or approve expenditure on behalf of the CCG.

The above document also makes reference to a number of other documents that support it. These documents can be found here

Governance Handbook

A Governance Handbook has been produced in order to ensure that all committees reporting to, and including the Governing Body are managed effectively and within the guidelines as set out in the Constitution.

This Handbook sets out the Board’s Committee structures and governance arrangements, including respective Terms of Reference, decision making powers, sub-committee’s and groups, and membership. The Documents mentioned above can also be found within the Governance Handbook. 

Involving patients and the public 

In addition to our Governing Body we have a number of patient groups giving local patients and the wider public a chance to scrutinise any decisions we make.

Before we make any changes to services we have a responsibility to involve and consult with our patients and the wider public.

Our Patient and Partnership Advisory Group plays a key part in ensuring the patient voice is heard.  

We follow these principles when involving members of the public.

Our work to involve and engage the public is, where appropriate, informed by Equality Impact Assessments and delivers on Equality Delivery System 2 (EDS2) Goal 2. For more information on EDS2, click here   

You can see our latest consultations as well as other opportunities for you to get involved in the work we do by visiting our get involved pages.

Our members

As a membership led organisation we work closely with our 84 member practices who help us by providing the day to day clinical knowledge and have their say on any proposed commissioning plans.

Our key partners 

We work closely with our partners when developing and implementing new plans to ensure the services we commission are the best for our local population. Our key partners include:

Sandwell and West Birmingham Hospitals NHS Trust
Sandwell Council
Birmingham City Council
NHS England
Healthwatch Sandwell 
Healthwatch Birmingham
Voluntary and Community Sector Organisations -Sandwell and Birmingham 

We hold strategic briefing sessions with the Voluntary and Community Sector (VCS) on a regular basis. We know what a significant role the VCS play in supporting the local population to stay well and healthy; that’s why it’s important that we continually engage the sector and are influenced by them.

National and local policies

There are also a number of national policies we have to follow as well as ensuring that we meet our duties as set out in the Health and Care Act 2012 and the legally binding NHS Constitution. Policies we have to follow include the NHS Mandate, NHS England’s assurance process for CCGs and, at a local level, the joint health and wellbeing strategies developed by the Sandwell and Birmingham Health and Wellbeing Boards. The strategy has been developed following a process called the Joint Strategic Needs Assessment (JSNA) which has helped identify key priorities and areas of action for the city so that we can improve the health and wellbeing of our communities.

As a CCG we also have a range of policies in place to ensure that we follow the same process for commissioning services. For more expensive and rare treatments a patient may need to be subject to our Individual Funding Request (IFR) policy. For more information on IFR's please click here