The best possible outcomes for Southwark people 

Organisational Development 
Plan 
 
Authorisation Submission September 2012

The best possible health outcomes for Southwark people

 Contents Page
Introduction from the chair 3

1. The purpose of our organisational development plan 4

2. Background and context 5

2.1 The borough of Southwark 5
2.2 Introducing NHS Southwark CCG 6
2.3 CCG leadership team and responsibilities 6

3. Our strategic context 7

3.1 Goals – our aims for the medium to long term 7
3.2 Our operating position: priorities and finances 7

4. How NHS Southwark CCG will work 9

4.1 Our mission, vision, strategic goals and values 9
4.2 Clinical leadership and Locality working at the heart of the CCG 10
4.3 Our governance arrangements 11
4.4 Defining the organisation’s form – capacity and capability to deliver 11

5. Developing the organisation to deliver our strategic goals 20

5.1 Our OD priorities 20
5.2 Reflecting an emerging organisation 20
5.3 Capacity and capability gaps 21
5.4 The journey so far 22
5.5 Resources 25
5.6 Addressing the Gaps – an OD plan for the future 25

6. Plans to meet our core responsibilities 31

6.1 The Governing Body 31
6.2 Education and Training 31
6.3 Safeguarding children and adults at risk 31

7. Conclusion and next steps 33

Tables
1. CCG OD priorities to ensure development as a membership organisation 4
2. CCG Functions by Point of Delivery 14
3. List of functions to be procured by the CCG 18
4. Initial and repeated Roadmap diagnostic 22
5. Development interventions run in 2011/12 and 2012/13 24
6. Indicative OD interventions 2012-14 26

Figures
1. Our strategic goals 7
2. Southwark CCG commissioning support budgeted expenditure 2013/14 13
3. Southwark CCG Organisational Structure 16
4. Universal improvement by Southwark CCG 22

2
Introduction from the Chair
I am very pleased to introduce the NHS Southwark Clinical Commissioning Group (CCG)
Organisational Development (OD) plan. My clinical colleagues and I are enthusiastic about the
future for our local health services. We are confident that our CCG, as a clinically-led
membership organisation of all Southwark practices, will be in a prime position to ensure local
services of the highest possible quality are organised to deliver better outcomes for our patients.

Those of us who know Southwark understand that it is a vibrant and diverse place to live and
work. We also know that a range of differing needs exist amongst the population here.

Southwark’s clinicians have a tradition of being involved in planning and co-designing services
and of being committed to working with partners for the common good of our patients and
residents.

The coming years represent a time of significant change to the way services will be delivered,
and to limitations in resources. It is in everyone’s interests to ensure that resources are spent
effectively, allocated fairly, that services are of the highest possible quality, and produce the
outcomes the population both need and deserve.

We recognise that the CCG is a new type of commissioning organisation. It will have a different
approach to its responsibilities to those that have gone before and consequently will operate
differently to its predecessors. Key features will be clinical leadership adding value to
commissioning, and a collaborative approach as a membership organisation. Additionally, the
CCG recognises the need to work very effectively with a wide range of communities, partners
and stakeholders to optimise and transform local services. We must bring clinical insights from
practices to the forefront of service design, and better understand the views and priorities of
local patients, residents, carers and communities.

In every case our ambition is to improve the lives of our patients by working to make local health
services the best they can be. To make these improvements a reality we will work hard to
deliver our over-arching strategic goals of improving life expectancy, reducing health inequalities
and narrowing the variation in primary care quality and outcomes.

We have worked hard to develop this OD plan with these goals in mind, and have taken care to
clearly set out how we will meet our responsibilities over the coming years. We recognise the
context for commissioning and the new system architecture continues to change and we will
continue to refine and develop this plan over the coming months leading to April 2013.

We are confident that by working together with our staff, local people and partners in this new,
clinically-led organisation, we can make real improvements to local services and enhance the
lives of people in Southwark.

Dr Amr Zeineldine
Chair of NHS Southwark Clinical Commissioning Group

3
1. The purpose of our organisational development plan

This is a time of unprecedented organisational change in the NHS. CCGs are completely new
organisations, with primary care clinicians leading decisions about commissioning whilst still
conducting their role as family doctors for a local population.

This duality of role means CCGs are organisations with a complex make-up: staff employed by
the CCG, staff employed in small businesses, an organisation of membership practices from a
wide geographical area, clinicians, managers and commissioning support staff – a melee of
different cultures, backgrounds, roles, and experiences. These diverse pieces are now brought
together under the umbrella of a CCG – by strong leadership and a sense of purpose – to
improve patient outcomes.

A different operating style is needed to ensure that the organisation has a culture, mind-set and
behaviours that reflect its ambitions. Organisational development (OD) is a planned and
systematic approach to enabling the sustained performance of an organisation through the
involvement of its people. Southwark CCG must be an effective and responsive organisation if
we are to achieve the best possible healthcare for local residents and serve our staff and
members well.

This OD plan outlines how our variety will be brought together to create synergy; it
identifies how NHS Southwark CCG will use its diversity to ensure clinical value is added to the
commissioning process. Extensive work has already been undertaken by the CCG in Shadow
form, the OD challenge now is to build on this and pull the diverse pockets together into a
cohesive organisation.

Table 1: CCG OD priorities to ensure development as a membership organisation

OD Aims OD Priorities

 Identify quality and how to achieve it  Clinically led

 Is a highly effective commissioner  Customer focussed
 Use partnership, collaboration and matrix working  Collaborative
well  Competent and capable
 Is transparent, accountable and accessible  Communicate effectively

The purpose of this OD plan is to:

 shape and support the CCG to deliver its strategic plan

 ensure that any short term actions support delivery of our longer term objectives
 ensure all organisational enablers necessary are in place and effective
 support NHS Southwark CCG to mature its knowledge and expertise on its journey
towards authorisation and beyond
 be a living document, regularly refreshed as different needs are identified and external
requirements change

4
2. Background and context
2.1 The borough of Southwark

Southwark is a densely populated, geographically small and narrow inner London borough that
stretches from the banks of the river Thames to the beginning of suburban London south of
Dulwich. The population is relatively young, ethnically diverse, with significant contrasts of
poverty and wealth. There is wide distribution in educational achievement, access to
employment and housing quality. Major regeneration programmes have been underway for
some time leading to significant changes in landscape and population structure and this
continues to be the case. Major health indicators such as mortality and life expectancy have
improved, but there are significant inequalities in these indicators for people living in different
parts of the borough.

Southwark’s population is estimated at 294,400 (source ONS 2010). Southwark’s population

has increased by 37,700 over the last 10 years (ONS Mid-1991 Population Estimates) and is
estimated to increase by 37,500 (13%) between 2010 and 2020. 80% of the population is under
the age of fifty with a large proportion of the population aged between 20 and 45. There is a
high level of ethnic diversity with 63% of people being white, 26% black (of which 16% are of
African origin). Amongst younger people, 68% of school pupils are from ethnic minority
backgrounds.

Southwark’s level of deprivation has improved in recent years but still remains the 12th most
deprived London Borough (41st nationally). Deprivation is not evenly distributed across the
borough but concentrated in the area between the more affluent strip close to the river and
Dulwich in the south.

Men in Southwark can expect to live for 77.8 years, women 82.9 years. Male life expectancy is
lower in Southwark than London or England. However, life expectancy for males has increased
over the last decade and the gap between Southwark and England is steadily reducing. Over
the last decade female life expectancy has been steadily increasing and is now higher than the
national average. Within Southwark there is much variation in life expectancy, the difference
between the worst off and best off is 9.5 years for males and 6.9 years for females. Continuing
inequalities in health within the borough remain of concern.

The numbers of deaths per year are reducing in Southwark. The death rate has fallen, from
786.5 per 100,000 in 2000 to 523.4 per 100,000 in 2009, bringing it broadly in line with the rate
for London (523.1) and England (547.3) and below near neighbours Lambeth (644.4) and
Lewisham (604.2). Approximately one third of these deaths are ‘early deaths’ (under the age of
75) with the main causes of premature mortality cancers (35%), circulatory disease (23%) and
respiratory disorders (5%), with major contributions to long term morbidity from diabetes and
renal disease, hypertension, mental illness and HIV, linked to the specific population
demographic.

This is the context in which the CCG will develop as an organisation.

5
2.2 Introducing NHS Southwark CCG

Southwark Clinical Commissioning Group (CCG) is a membership organisation of all general

practices serving the local community. The CCG is coterminous with the London Borough of
Southwark local authority. The combined registered population of Southwark’s 47 general
practices is circa 318,000.

In November 2010 Southwark Health Commissioning was one of eight clinical commissioning
groups in London to be awarded ‘First Wave’ pathfinder status. Building on a strong track record
of local clinical commissioning, the members of the emergent CCG were able to demonstrate
compliance with the three tests set by the Secretary of State (relating to local GP leadership and
support, local authority engagement and an ability to contribute to the delivery of the local QIPP
agenda) at the earliest stage in 2011/12. Since this time the emergent CCG in Southwark has
worked with NHS South East London PCT Cluster to develop the capacity and capability to
assume 100% delegated responsibility for all areas of commissioning that it is scheduled to
assume statutory responsibility for from April 2013.

As a first wave pathfinder and a CCG with significant and long held delegated responsibility for
commissioning we have had an opportunity to shape the development path of these new
organisations and to learn by experience over the last 18 months.

2.3 CCG Leadership Team and Responsibilities

As a membership organisation, the CCG will be run by its member practices. To do this
effectively the CCG has established a Governing Body, which will act to perform those functions
and responsibilities delegated by the CCG member practices and those accountabilities
required in the Health & Social Care Act (2012). The CCG Governing Body is responsible for
assuring the delivery of commissioning and corporate objectives set out in the Integrated Plan.
The CCG is clinically-led and will operate with a borough-based management team to direct
activities across the scope of the commissioning portfolio.

Although the Governing Body will act to take decisions on the vast majority of CCG business,
members have agreed to create a forum for more direct practice involvement in decision making
and have proposed a ‘Council of Members’ on which each practice is represented. The Council
will meet bi-annually and act to both approve the annual commissioning plan and seek direct
assurance from the Governing Body that it is delivering the plans. The Council will also be the
forum for considering any changes to the CCG Constitution ahead of proposing these to the
NHS Commissioning Board.

We have prioritised distributive leadership and partnership working as an organisation and our
OD plans will seek to respond to this.

6
 3. Our strategic context
3.1 Goals – our aims for the medium to long term

NHS Southwark’s CCG strategic plan identifies a number of goals which will be achieved when
we successfully implement improvements in our priority areas.

Figure 1: Our strategic goals:

3.2 Our operating position: priorities and finances

Our service priorities were identified by clinicians and practices, recognising the need to drive
improvement in quality of care and patient outcomes. In considering priorities we worked
closely with public health colleagues and listened to the views of Southwark patients and public
and see our seven priorities as crucial to delivering our goals:

 Better outcomes for people with Long Term Conditions

 Outpatient services that enhance patient experience
 Improve rates of early diagnosis and to better quality of life for people with cancer
 Improve outcomes for people with mental health needs
 Develop a well-integrated and high quality system of urgent care
 Support more people to stay healthy and prevent ill-health
 Embed clinical and cost-effective prescribing across care settings

7
Our Integrated Plan has identified indicators which we will used to evaluate the impact of
clinically-led commissioning on improving quality and outcomes over the life of the strategy.

The CCG will operate with a commissioning budget of circa £400m. The overall CCG risk-
profile has improved as a consequence of strong financial performance in 2011/12 and because
of steps taken to manage financial risk. This includes reducing the risk held on provider over-
performance and strengthening our reserve position. Southwark CCG will inherit a sound
financial platform, although must deliver the major change programmes set out in this plan to
maintain financial balance in the years ahead. A detailed view of the CCG financial position is
included in the Integrated Plan

8
 4. How NHS Southwark CCG will work
4.1 Our mission, vision, strategic goals and values

We will need to work differently and with partners if we want to make this vision a reality.
Organisational success will be measured in terms of improved health outcomes and improved
patient satisfaction with the care provided.

Our behaviours will demonstrate our values. The ambition, values and behaviours our
employees and member practices have signed up to will iteratively shape our organisational
culture and operational priorities.

Mission

The CCG’s mission – or overarching purpose – is to commission high quality services that
improve the physical and mental health and wellbeing of Southwark residents and result in a
reduction in health inequalities.

The CCG will ensure commissioning for our population will be:
 Evidence based
 Focused on clinical outcomes and high quality standards of care
 Led by local frontline healthcare professionals
 Determined by local need
 Informed by genuine patient and public engagement, and
 Result in more information and choice for patients

Vision

The CCG will work to achieve the best possible health outcomes for Southwark people.
The vision for services commissioned on behalf of Southwark’s population is that they function
to ensure:
 People live longer, healthier, happier lives no matter what their situation in life
 The gap in life expectancy between the richest and the poorest in our population continues
to narrow
 The care local people receive is high quality, safe and accessible
 The services we commission are responsive and comprehensive, integrated and innovative,
and delivered in a thriving and financially viable local health economy
 We make effective use of the resources available to us and always act to secure the best
deal for Southwark

Values

We have defined the values and behaviours that we will adhere to and that our members, staff
and patients can expect from us as being:

 Continue to be guided by the founding principle of the NHS - that good healthcare should be
available to all, free at the point of delivery
 Place patients, health improvement and quality at the heart of everything we do
 Be honest and open about the actions and decisions we take

9
 Remain accountable to the public and recognise our responsibility to act in the best interests
of the population we serve
 Ensure our decisions are evidence based, fair and make best use of the resources we have
available to us
 Act responsibly as a public sector organisation and are committed to working in partnership
with local government, voluntary organisations and the wider community to ensure a united
approach to tackling the wider determinants of poor health in Southwark.

Appendix One sets out the alignment between our values, our OD priorities and our strategic
goals

4.2 Clinical Leadership and Locality working at the heart of the CCG

The leadership arrangements and locality working of the CCG are outlined in detail in the CCG
Organisational Structure Document. In summary:

NHS Southwark CCG is a membership organisation of all 47 practices in the borough. It is

organised around three localities of practices. The localities reflect a recent consultation,
‘Transforming Southwark’s NHS’ which involved more than 3,000 local residents and
stakeholders in discussions about future service provision. The localities were agreed as being
representative of areas where clinical teams had already established collective working, so were
retained both as a practical means to organise the CCG and also to plan service change.

Each locality meets at least eight times per year, led by their clinical leads and supported by
members of the CCG Management Team. These forums provide an opportunity for two way
communication between the shadow Governing Body members and their localities, and for
agendas to be set which reflect commissioning issues at that time.

The CCG has established a number of communication routes including an intranet to facilitate
interaction. The agendas, papers and minutes of all shadow Governing Body (SCCC) meetings
are made available to practices ahead of the meetings in order that constituents can be aware
of the discussions, see concerns and issues are ‘played in’ and be able to comment upon those
papers.

Engaging member practices is critical to the success of the CCG. The CCG runs Protected
Learning Time (PLT) events that provide further opportunities for practices to come together,
discuss commissioning issues and convey core messages. Southwark PLTs regularly have an
audience of over 100 people and so have enabled the CCG to keep contact with practices and
representatives across the area.

Our constitution introduces a new forum, a Council of Members, which further involves
members in the running of the organisation.

The clinicians making up the leadership team of the Governing Body each hold a portfolio for
commissioning and for corporate functions to lead and manage the local health system. These
portfolio areas are outlined in the job description and person specification against which GP
leads were recruited via a formal ‘Selection/ Election’ process (May-June 2012). The person
specifications also contained the competencies required as a clinical leader, and all applicants
were interviewed against these before being offered for election by all Southwark GPs. When
taken together the portfolios cover the entirety of commissioning responsibilities across the
borough.

10
GP leads on the Governing Body hold three key responsibilities to allow them to operate with
increasing delegated responsibility:

 A leadership, management and engagement role for member practices in their locality
 A commissioning portfolio across the borough with responsibility for securing agreed
QIPP plans in each area
 A corporate portfolio across the borough with responsibility for ensuring effective
performance management for each area of local commissioning

A secondary care Nurse and Doctor are being recruited to the Governing Body in line with
national recommendations and we anticipate them being in post by Autumn 2012.

A Practice Nurse is also part of our shadow Governing Body to represent their peer group, and
multi-disciplinary views are included through a number of forums.

A “Future Leaders” programme has been run to facilitate clinical succession planning (see
section 5). A similar succession planning programme will be introduced for Lay Members in
recognition of the importance of the role, its isolation from main-stream work and potential
difficulty to fill, and the number high calibre of applicants from a recent recruitment drive.

4.3 Our governance arrangements

The governance arrangements and locality working of the CCG are outlined in detail in the CCG
Organisational Structure document. In summary:

As a membership organisation it is the members of the CCG who are accountable for exercising
its statutory functions and delivering against its responsibilities and objectives. The CCG
remains accountable for all its functions, including those that it has delegated.

The Scheme of Reservation and Delegation in the Southwark CCG constitution sets out the key
functions and who has delegated responsibility for fulfilling these. In essence, the member
practices have:

 delegated key strategic functions to a Council of Members;

 delegated other strategic functions and all operational functions to the Governing Body;
 permitted the Governing Body to delegate appropriate operational functions to its various
committees;

The Governing Body has ultimate responsibility for CCG delivery of plans, purpose and mission.
The Governing Body will consider reports to track the overall position against all aspects of
performance, quality, finance and QIPP delivery whilst delegating responsibility for
implementation to strategic programme boards and committees.

4.4 Defining the organisation’s form – capacity and capability to deliver

Identifying the CCG’s Commissioning Support Intentions

As part of the work completed to develop the governance and organisational structures of the
CCG, the leadership team in Southwark has completed a process of review of all
commissioning support functions to identify those which needed to be local and those that
should be provided at scale. Clinical leads have worked closely with officers to model a number
of scenarios looking at how they should use their running cost allocation to ensure the CCG has

11
the capacity and capability to support the CCG deliver its full range of responsibilities and in this
achieve value for money.

The process allowed clinical leads to understand the scale of change required from existing
staffing structures in order to deliver an efficient and effective commissioning support function
within the £25 per head management cost allowance. In determining the structure of their
commissioning support, the CCG leadership team considered the following factors:

 Opportunity to secure expert support (by sharing resource if needed)

 To maintain a strong borough-based presence to oversee redesign & delivery
 Affordability within £25 per head allocation
 Retain and build upon local relationships where these are working effectively
 Alternative support services available

Southwark CCG’s Organisational Structure was published on 9 August 2012, with post being
filled during August in accordance with the agreed HR processes. Recruitment to vacancies will
take place during September. The new CCG structure will operate in shadow form to promote
team working with clinical commissioners, and to see that staff gain a better understanding of
roles and responsibilities required from April 2012.

Developing the South London Commissioning Support Unit (SLCSU)

Having identified those services that the CCG elected to buy, CCG clinicians and senior
managers participated in workshops across south London CCGs to test the feasibility of a
Commissioning Support Service being provided across the 12 emerging CCGs, recognising the
opportunity for significant efficiencies of services provided at such scale. This work identified
key differences in the approach and requirements of CCGs and underpinned the creation of the
emerging SLCSU.

CCG clinical leads and senior management team have continued to work with the SLCSU on
the development of their Outline Business Cases to support the CSU through the phases of the
NHS Commissioning Board’s BSU’s business review process for authorisation. Extensive work
with SLCSU on clarifying and refining their offer and the interfaces with the CCG’s own staff and
functions has been completed over the previous months, which has included participation in co-
design workshops, function focused groups and reviews (e.g. acute contracting, performance
and information), and supporting the CSU team in writing specifications.

The CCG and CSU structures will work in shadow form from October 2012, enabling the CCG
to be fully-functional before it assumes statutory responsibility for commissioning in April 2013.

Working with the Local Authority

As part of this process the CCG held discussions with Southwark Council about possible
options for procuring support services and joint commissioning arrangements. The CCG and
local authority signed memorandum of understanding committing both organisation to explore
these opportunities in the future. This agreement acknowledged that the Local Authority was
due to undertake a significant restructure of its own management arrangements, now due to
conclude in October 2012.

12
Securing Capacity & Capability

To ensure we have capacity and capability to undertake our full range of responsibilities within
the management cost allowance of £25 per head, the CCG has mapped out what can best be
delivered locally by a dedicated in-borough team and what support would be better procured
and provided at scale. The process we undertook to get there is detailed in the above section
(and in detail with the CCG Organisational Structure document) and the mapping of CCG
commissioning functions is included in figure 2. Table 2 then sets out how the CCG will utilise
its £25 per head of population allowance to secure the capability and capacity required to
enable it to meet its responsibilities and deliver its Integrated Plan.

Figure 2: Southwark CCG Commissioning Support Budgeted Expenditure 2013/14. £-per-head-of-population

Accommodation
£1.90
7%

Administration & Corporate 
Affairs 
Commissioning Support 
£3.34
Unit
13%
£8.75
35%

CCG Based Commissioning
£4.19
17%

Other Non Pay
£0.97
Clinical Lead and Network
4%
£1.19
5% Governing Body
£4.66
19%

13
Table 2: CCG Functions by Point of Delivery
Directly
DH Category Shared with
Function SLCSU Employed
(Towards Service Excellence) other CCGs
by CCG
Patient Involvement Communications & PPE  
Strategic Communications and Public Engagement Communications & PPE 
Patient Experience Communications & PPE  
Infrastructure Services Business Intelligence & IT  
Data Safety Services Business Intelligence & IT 
Clinical Redesign Business Intelligence & IT 
Data Management Services Business Intelligence & IT 
Contract & Financial Activity Information Business Intelligence & IT 
Provider Management Information Business Intelligence & IT 
Local Health Strategic Planning Info Business Intelligence & IT 
Clinical Policy Development Support for Service Redesign  
Implementation of Clinical Policies Support for Service Redesign 
Quality and Value Assessments Support for Service Redesign 
Market Assessment Procurement & Market Management 
Contract Requirements Procurement & Market Management 
Procurement Services Procurement & Market Management 
Management of Complex / Exceptional Cases Procurement & Market Management 
Co-ordination of Joint Commissioning Procurement & Market Management 
Continuing Health Care Procurement & Market Management 
Prescribing Services Procurement & Market Management  
Contract Renewals Management Provider Management 
Provider & Contract Management Provider Management 
Safeguarding Provider Management 
Quality and Governance Provider Management  
Performance Management System Back Office 
Financial Strategy Back Office  
Financial Management Back Office 
Financial Accounting Back Office 
HR & Payroll Back Office 
Legal Services Back Office 
Corporate Governance Back Office 

CCG Structure

The NHS Southwark CCG clinical leadership team values the dedicated support it has received
from NHS Southwark Business Support Unit over the period in which it has operated with
delegated authority from the PCT Board. Clinical leads in Southwark agreed that retaining a
strong-borough based team was absolutely necessary to ensure that the CCG is able to operate
as an effective organisation.

Having completed the scenario planning using the DH Ready Reckoner Tool V2, and having
determined those support functions it wanted to retain ‘in-house’, CCG clinical leadership have
led the design of the CCG’s organisational structure.

The CCG organisational structure is included on figure 3 on the following page. The CCG will be
supported by a borough-based team that includes the following functions:

 Chief Officer & Chief Financial Officer

 Senior Management Team
 CCG Quality & Performance Management
 Strategic and Business Planning
 CCG Governance, Risk Management and Assurance
 Organisational Development
 Membership and public engagement
14
 Service Redesign Team
 Support to CCG Localities and Member Practices
 Community Contract Management
 Mental Health Contract Management
 Mental Health Service Redesign
 Continuing Healthcare Commissioning
 Safeguarding and designated nurse for child protection
 Administrative Team and Corporate Secretariat
 CCG Medicines Management

Functions shared with other CCGs

 Sexual Health Commissioning (with Lambeth)

 SEL CCG Programme Management Office (Across south east London CCGs)
Southwark aims to have full staffed its organisational structure by October 2012, following the
London-wide staff engagement process. The Chief Financial Officer will be responsible for the
management of the SLCSU Service Level Agreement with specific KPIs managed and
monitored by the CCG Senior Management Team.

15
Figure 3: Southwark CCG Organisational Structure

16
SLCSU Structure
The CCG recognise that standardisation of processing functions at greater scale can bring
significant benefits to the organisation by taking advantage of scaled-up services that provide
high-quality expertise and offer economies of scale. Southwark CCG has worked with partner
CCGs in south east and south west London to shape commissioning support services
ensuring we can procure the services we need to enable us to deliver our Integrated Plan.

Having carefully considered, and assessed, our preferred options for the provision of
commissioning support, the Southwark Clinical Commissioning Committee (Governing Body,
post-authorisation) have agreed to procure services from the South London Commissioning
Support Unit. The South London CSU has identified one of its Directors to be the liaison lead
for Southwark, and has outlined plans to introduce a Stakeholder Board comprised of senior
representatives from all its customers.
  
At the end of March 2012 Southwark CCG signed a short MoU with the CSU agreeing to work
jointly to develop CSU services for the CCG. A detailed Memorandum of Understanding has
been subsequently agreed and incorporates the main elements to be included in an SLA
progresses this by agreeing the main elements which will form part of an SLA. The MoU
details how the parties have agreed to work together during 2012/13; acts as a precursor to
the SLA which will be required from 1 April 2013, setting out the key elements which will be
included in the SLA; supports the CSS in preparing its Full Business Plan by evidencing
customer commitment; and explains how the CSS and CCGs will work together during the
period of ‘shadow’ CSS operation (from 0ctober 2012).

The draft SLA is under development and will be agreed by October 2012. It will set the target
standards for operations during the period October to March 2013 and will allow for shadow
running of the SLA before formal commitment to detailed KPIs in early 2013.

We would expect commissioning support service providers to develop and work with other
suppliers to secure best practice products and services, recognising that innovation and
development opportunities may not only be present within the South London CSU at a single
scale. We will continue to test our internal and external commissioning support going forward
and between 2013-16 we will put in place arrangements to go through a compliant
procurement for support services as appropriate.

In planning for this process we have worked with CCG partners to look value for money and
market testing (some of these considerations are included in the draft South London CCG and
South London Commissioning Support Unit Organisational Development narrative to support
authorisation is included as Appendix 2). These arrangements may include CCGs setting
priorities for the CSU to undertake Value for Money reviews on specific services with the aim
of testing all services by 2016. This would include a structured and independently assured
process for benchmarking price and quality against other commissioning support providers or
the business support marketplace. The Chartered Institute of Public Finance (CIPFA) value
for money toolkit will be explored to offer cost and performance comparisons with other public
sector providers.

South London CSU Core Functions

Through its extensive engagement with the SLCSU, the CCG leadership team considered the
following functions in table 3 to be of benefit to the organisation when delivered at scale. The
lists of functions have been agreed through co-production between Southwark CCG, local
CCG partners and the emerging CSU. Clinical leaders have been centrally involved in the
series of development workshops run to establish CCG requirements for their CSU.
17
Securing Communications Capacity & Capability

The CCG has worked with management colleagues, partners in neighbouring CCGs and other
at the SLCSU to agree the shape and structure of dedicated external and internal
communications capacity. The CCG leads recognise this function has a particularly important
role in enabling the CCG to engagement member practices, patients and the public in order to
deliver its Integrated Plan. CCG senior managers and clinicians have participated in SLCSU
workshops specifically focussed on developing a communications service at scale and this
has been secured in the MoU and subsequent SLA with the SLCSU.

Table 3: List of Functions to be procured by Southwark CCG from South London

Commissioning Support Unit

Function Description

Comprehensive contract management service, providing

Acute Contract Management performance, negotiation and transactional support for CCGs across
their acute services contract portfolio

Individual Funding
Requests (IFRs)
Advice & Support on
Clinical Procurement
Performance Reporting &
Data Management
CCG ICT
Financial Management &
Planning
Management of the end-to-end IFR process
The clinical procurement service will provide CCGs with responsive,
flexible and up-to-date advice and guidance in relation to clinical
procurement
Provision of standard reports and data sets across a range of areas
covering: commissioning, financial and clinical, as well as statutory
reporting
A support service which covers the strategic and operational
Information Communication and Technology needs of CCGs
Providing financial and business advice, internal and external
financial reporting

Financial Governance & Support on statutory duties, relationship management of outsourced

Control, Counter-Fraud, services, and technical expertise (e.g. financial controls, governance
Internal Audit advice, cash management)

Support on employee services (transactional), employee

HR
development, and provision of expert advice and support

Advisory service providing expert knowledge on health property and

Estates and Health & Safety
estates related issues

Best practice advice on the purchasing and procurement of non-

Purchasing (non-clinical)
Communications and PPE
clinical resources so that CCGs can achieve cost savings and value
in non-clinical spending
Communicating and engaging with all stakeholders, managing the
reputation

Clinical commissioning
For the commissioning of cancer, CVD and stroke services
network

The Memorandum of Understanding between Southwark CCG and South London

Commissioning Support Unit is attached as Appendix 3.

18
Public Health
The CCG has worked with colleagues in Southwark Local Authority and with partners at
Lambeth CCG and local authority to scope an opportunity to secure a public health resource
once this function transfers to local authorities from April 2013.

Southwark CCG Board has endorsed a proposal for an innovative and progressive specialist
public health service covering both Lambeth and Southwark. The new shared resource will
enable the two boroughs to lead the way in improving health outcomes, reducing health
inequalities, delivering our Integrated Plan and implementing the Health & wellbeing Strategy.
A shared Director of Public Health – to be appointed by September 2012 – will provide the
leadership and expertise over the period of transition. The CCG will begin to work under these
arrangements from October 2012 in shadow form ahead of the transfer of public health to the
local authority in April 2013.

We are currently in the process of developing a core offer and SLA to secure our future public
health resource from the new shared service. A draft Memorandum of Understanding (MoU),
which has been developed in partnership with Southwark Local Authority has been signed
September 2012 and commits both parties to working collaboratively to define the core offer
and work to establish the new organisation in shadow form from January 2013, operating
under these terms and secured with an SLA.

The Southwark Memorandum of Understanding on Public Health is attached as Appendix 4.

19
5. Developing the organisation to deliver our strategic goals

5.1 Our OD priorities

The CCG has identified the strategic goals it will target on in order to improve the quality of
care and patient outcomes. To deliver these the CCG has also identified the OD actions it
needs to take.

This section sets out how we will deliver change and the phases of implementation. The tables
overleaf include OD plans for 2012/13 and headline OD intentions in for 2013/14.

Our OD priorities to support our strategic ambition are summarised below and expanded on in
the tables on subsequent pages. Our OD priorities are:

5.2 Reflecting an emerging organisation

Given the strategic context, NHS Southwark CCG needs to ensure it is offering maximum
support to itself as a new organisation. This OD plan is very much an emerging document
reflecting a continually evolving context. The focus for the next stage is re-defining itself as a
20
membership organisation. The organisational development plan will enable us to progress
through authorisation and beyond in an efficient, effective manner, ensuring we have the
capability, capacity and culture necessary to deliver our responsibilities.

This OD plan is for the two-year period until one year post-authorisation. Before April 2013
the plan will be refreshed and revised in response to the rapidly changing environment and so
clarify the OD priorities for 2013/14.

5.3 Capacity and capability gaps

We recognise that as a First wave Pathfinder and in our early work we prioritised leadership,
governance and structure. This was the right focus in order to define a robust, clinically led
new organisation. Our OD plan now needs to extend across the whole organisation in order
to pull it into a cohesive unit in which everyone understands the mission, goals, priorities, and
their role in achievement of them.

As we recruit to the CCG management team and develop an enhanced understanding of

every members needs we are seeking to continually review our OD plans. At the current time
we have:

 drawn on diagnostics from a variety of sources

 used the diagnostics to define a plan which acknowledges the uncertainties of a new
organisation in a rapidly evolving environment,
 recognised that we must be fleet of foot, open to change, and able to react to emerging
issues
 planned to deliver in-house wherever possible and boost capacity by accessing
whatever external resources we can identify (NMET1 CPD, MADEL, National
Leadership Academy, Top Leaders, National Innovation Institute, etc.)

Sources used to understand our emerging development needs include:

 review of the Pathfinder Development Plan and Statement of Works

 roadmap diagnostic process and refresh undertaken with GP Leads
 online 360 assessment for GP Leads
 development plans for Chief Officer and Chief Financial Officer
 feedback gathered at SCC Away Day sessions, PLTs, locality meetings and practice
visits
 outcomes from staff workshops on developing the CCG and CSU
 staff survey results and action plans
 staff appraisals and PDPs

In a short space of time the CCG has already taken great strides forward on its journey to
become authorised as a statutory organisation, supported by a range of development and
training initiatives.

A national diagnostic tool for CCGs was used to self-assess our readiness for statutory
authorisation. The original and repeat scores are shown below.

1
NMET – non medical education and training levy, MADEL – medical and dental education levy
21
 Table 4: Initial and repeated Roadmap diagnostic scores indicating the priority areas for
shadow Governing Body development:

First Roadmap Diagnostic Repeat Roadmap Diagnostic

Range of 2.2 to 3.6 2.5 to 3.7
mean score
Domains with  Planning ( 2.4 )  Empowering Patients & Public ( 2.8)
lowest mean  Monitoring ( 2.2)  Monitoring ( 3)
scores
 Clinical Governance ( 2.4)  Clinical Governance ( 2.5)

Board members were supported in identifying their training needs and based on this an on-
going development programme has been provided since Autumn 2011.

Figure 4: Universal improvement by Southwark CCG across all domains

Comparative Analysis: Scores by Competency

4.0
3.5
3.0
2.5
2.0
1.5
1.0 Initial Roadmap
0.5 Repeat Roadmap
0.0

5.4 The journey so far

The CCG has a credible track record and has already made significant progress on its
development journey. The shadow Governing Body (SCCC) has been working successfully
since achieving first wave Pathfinder status, though recognises there is still work to ensure the
CCG maintains full capability and capacity for services.

As a new organisation it expects to develop in its role, reviewing and adjusting the OD plan to
reflect learning and emerging issues. Areas it has already moved forward on include

OD advice: The CCG has worked closely with OD teams from five neighbouring CCGs, the
Commissioning Development teams at cluster and NHS London to seek advice on
organisation design and process improvement, benchmarking and best practice for key staff
roles. This informed the design of our employed staff structure, shared areas, and those to be
provided by CSU.

Board Development: Facilitated events have taken place to support the CCG board develop
our strategy, values, and mission beyond the monthly formal Governing Board meetings.

Succession planning: A pilot scheme was run for primary care doctors interested in
developing their leadership and commissioning skills. Following a competitive
22
application/interview process applicants were offered mentoring, participation in development
events, and access to leadership meetings. The scheme was very successful and will be re-
run in 2012/13.

Partnerships: External funding has been secured to provide a bespoke development

programme to support partnership working. This will be run in conjunction with Lambeth and
Lewisham CCGs, the neighbours with whom we will work increasingly in partnership.

Support and development for our member practices: The management team has shaped
an organisation that is practice-facing, meets the needs of the members, and the 3 locality
groupings within the CCG.

For over a year we have been funding, organising and providing ‘Protected Learning Time’
sessions for clinical and non-clinical staff working in member practices. Funding provided via a
LIS (Local Incentive Scheme) allows practices to close for a session a month to undertake
education development. This has provided the opportunity to tailor training events to focus on
clinical updates, and offered the opportunity to ensure that member practices are kept up to
date with progress in the CCG. Each event is evaluated and steps are taken to incorporate
practice views in future plans.

We are about to re-launch a practice nurse forum through our Practice Nurse representative
on the Governing Body. We will support clinicians to undertake the new role of Practice
Representative on the Council of Members. These may take place at each of the protected
learning time events to enable greater coverage.

The constitution was drafted in consultation with member practices. We have written and
circulated a handbook for the member practices as a useful reference guide for them
regarding CCG development.

Staff development and engagement: We recognise the need for greater visibility of CCG
central staff to GP practice teams and more integral working between practice staff, GP leads
and central support managers. Once CCG staff are confirmed in post a programme to build
up team working across boundaries will be launched.

All staff have appraisals and PDPs. Managers will be asked to develop individual and team
objectives for ‘beyond authorisation’ for 2013/14. Regular staff briefings are held to advise
staff of key transition issues as PCT functions increasingly transfer to CCGs. The Chief
Officer (designate) facilitates regular team meetings to take a temperature check of issues and
concerns.

23
Table 5: Some of the development interventions run in 2011/12 and 2012/13.

Authorisation Development needs Some development actions

Domain identified taken so far

A strong clinical and Improved ownership of Leadership away-day run to revisit

multi-professional Southwark Vision vision & increase ownership by GP
focus which brings real Leads
added value More engagement with
secondary care clinicians Vision shared with all GPs at PLTs

Joint development session held

with secondary care and LA to
focus on local needs and service
redesign
Meaningful Need to move from patient Communications review done
engagement with and public engagement to
patients, carers and greater involvement in Patient engagement workshop run
their communities decision-making
1:1 support provided for GP Leads
on patient and public engagement
Clear and credible Basic Finance training for GP Acute Trust Finance session run for
plans which continue leads clinicians
to deliver the QIPP
(quality, innovation, More robust data and Investment and prioritisation Master
productivity and information to understand class run
prevention) challenge primary and secondary care
within financial activity and quality Data and informatics support
resources, in line with provided
national requirements
(including excellent Master class run “Becoming an
outcomes), and local intelligent client”
joint health and
wellbeing strategies

Proper constitutional Develop outcome-based Leadership away day run on

and governance clinical commissioning designing a new-look membership
arrangements, with the focused on pathways organisation
capacity and capability
to deliver all their Contracts and Procurement
duties and workshop run
responsibilities
including financial Practical CoI training run
control, as well as
effectively commission Pathway & outcomes-based
all the services for commissioning Master class run
which they are
responsible Risk Appetite workshop run for
Board

Commissioning Strategy Plans

workshop run on focusing on
outcomes

24
Collaborative Need to work collaboratively Joint development day run with LA,
arrangements for with the LAs and neighbouring Lambeth and Lewisham CCGs
commissioning with CCGs
other CCGs, local Joint Clinical Strategy Committee
authorities and the launched for Lambeth, Southwark
NHS Commissioning and Lewisham
Board as well as the
appropriate external Joint development programme
commissioning scoped with Lambeth and
support Southwark to be delivered in
Autumn 2012

Great leaders who Variation in representation on 1:1 sessions run with GP Leads to
individually and the Board from North and review roles and portfolios
collectively can make a South practices
real difference 1:1 leadership coaching for GP
Clinical Leads based on their 360
feedback

“Future Leaders” programme run

for aspiring clinical leaders

Re-election of Governing Body

using transparent Selection/election
process

5.5 Resources

Southwark CCG has allocated approximately £300k in 2012/13 to enact its organisational
development plan, including elements which may move to other bodies such as Practice
Learning Time events. In addition the CCG management structure includes a Head of OD
and Governance and a dedicated Membership development team to support the delivery of
this plan

5.6 Addressing the Gaps – an OD plan for the future

Having identified our gaps, this plan shows an outline of how we will address our organisation
development needs up to 2014. A full, prioritised OD plan will be developed once structures
and individuals are known.

Table 6: Indicative OD interventions 2012-2014

The following tables expand on our OD goals and the interventions to be achieved in 2012/13
and 2013/14 which were informed by our diagnosis.

25
 When will Who is
1. Clinically Led: Southwark CCG will ensure the organisation is led by decisions based on sound clinical
OD Goal judgement, the added value for which clinical commissioning was introduced
this be responsible to
done? see it is?
Director of
Commissioning
Clarify and support the needs of locality leads to lead & manage their area October 2012 Head of OD and
Transition

Run induction sessions for Practice Representatives about their role in Southwark CCG October 2012 Chair and CFO

September Director of
Recruit Clinical Associates to extend capacity for clinical input to CCG work and delivery of the Integrated Plan 2012 Commissioning
September Head of OD and
Run induction sessions for the Council of Members about their role in Southwark CCG and support the group’s work 2012 Transition

Agree a constitution which maintains a clinical majority of voters on the Governing Body August 2012 CFO

Plans to Agree clinical portfolios in place for GP leads on Governing Body July 2012 Chair and AO
develop as a Director of
Introduce a LIS to encourage member practice involvement in commissioning June 2012
clinically led Commissioning

organisation: Recruit second cohort of Future Leaders to ensure capability and capacity. Our success relies on distributed clinical leadership through November Head of OD and
their capability and capacity to engage in ‘corporate’ business, we need to ensure a pipeline of potential clinical leaders. 2012 Transition
to end 2012/13
November Director of
Identify ways of promoting innovation and best practice across CCG 2012 Commissioning
Practice Nurse
Re-launch Southwark’s practice nurse forum October 2012 Governing Body
member
September Head of OD and
Run quarterly workshops for executive roles on Governing Body to review progress in early stages of CCG 2012 Transition
Head of Governance
Continue to deliver board development support to clinical leads March 2013
and OD

Refresh strategic plan incorporating member views via Practice Representatives and Council of Members March 2013 Head of Planning

Head of Governance
Develop skills and competences for both clinicians and managers in clinical pathway design March 2014
and OD
High level
Continue to provide development support for Governing Body members, new Practice Representatives, Future Leaders and the Council Head of Governance
programmes of Members
March 2014
and OD
for 2013/14 Head of Governance
Review success of programmes in 2012/13 and continue where appropriate April 2013
and OD

26
 2. Customer Focused: Southwark CCG will have the patient at the heart of everything it does, and ensure the When will Who is
OD Goal organisation is aware of and addressing customer needs as effectively as possible whether the customer be this be responsible to
patients, partners, or colleagues done? see it is?

Improve targeting of communication and messages by creating and using a clean database of contacts and their preferred contact October 2012
Membership
methods Manager

November Director of
Review the data provided to practices to improve its quality, appropriateness and timeliness for users 2012 Commissioning
Run staff workshops to ensure they understand the organisations mission, values and priorities, and are supported to manage any October 2012
Head of OD and
resultant conflicts Transition
Plans to Recruit a Lay Member to the Governing Body with a portfolio for quality of service
September
Chair and AO
2012
develop a
customer focus Provide staff training about being more business focussed and responsive to changing environments, and clarify the new role for CCG as November Head of OD and
both “buyer and supplier” of service – from the CSU and to the member practices 2012 Transition
in the
organisation: to Develop a culture of openness and creativity across the wider organisation which can identify and deliver opportunities for service and March 2013 Chair and AO
end 2012/13 quality improvement, and cost reduction, leading to continuous improvement
Head of OD and
Run focus groups with practice managers to help CCG staff set up an effective new organisation, a small business October 2012
Transition

Build relationships between member practices & CCG support staff by a programme of regular visits, and a matching list to give November Director of
consistent contact 2012 Commissioning

November Director of
Use practice and clinical lead involvement to identify how to best deliver locality based services e.g. phlebotomy 2012 Commissioning
Embed PPE concepts through organisation via skills development for staff in using techniques for effective engagement to appreciate July 2013
Membership
importance of patient views Manager
High level
programmes for Review the services being purchased from CSU and market test to check appropriateness for Southwark against competition March 2014 CFO
2013/14 Head of Governance
Review success of programmes in 2012/13 and continue where appropriate April 2013
and OD

27
 When will Who is
3. Collaborative: To ensure our organisation works in partnership to achieve the best for our patients and
OD Goal this be responsible to
population, and best use of the resources available done? see it is?
Our success is reliant upon robust shared arrangements across local CCGs for contracting. Large contracts are negotiated
collaboratively with other commissioners to maximise negotiating leverage and services. We will actively participate in establishing and October 2012 Chief Officer
using neighbouring (LSL) and wider SEL groups including Clinical Strategy, Integrated Governance, Remuneration Committee for this
purpose

Plans to November Director of

Establish and run a multi-disciplinary forum for clinicians across the borough focusing on “hot topics” 2012 Commissioning
develop as a
collaborative Actively participate in Local Authority and Health & Well Being developments October 2012 Chair and AO

organisation: to
Develop opportunities for joint commissioning and service integration across the health and social care community, linked to our strategic September Director of
end 2012/13 priorities 2012 Commissioning

Design and participate in a joint OD programme with Lambeth and Lewisham CCGs (accessed through national development money) November Head of OD and
running projects as active learning sets 2012 Transition

Review the effectiveness of collaboration with providers through projects via programme boards March 2013 Chair and AO

Introduce a Paired Learning programme which matches participating primary care clinician with CCG support manager to run specific September Head of Governance
project. 2013 and OD

High level Build experience of collaboration through exposure of key staff to shadowing and ‘buddying’ arrangements with colleagues in social care March 2014
Head of Governance &
and secondary care. OD and Governing Body
programmes for
2013/14 Promote cross-organisation flows both within Southwark CCG and across neighbouring partners by ensuring participating in an external April 2013
Head of Governance
project is a target in everyone’s PDP and OD

Head of Governance
Review success of programmes in 2012/13 and continue where appropriate March 2013 and OD

28
 When will Who is
4. Communicate effectively: To ensure our organisation communicates effectively as we see this as integral to
OD Goal this be responsible to
the overall success of the organisation done? see it is?

Design and publish a Members Handbook for practices to promote the new organisation and help them understand what NHS Southwark July 2012
Head of OD and
CCG does Transition

November Director of
Recruit a Lay Member to the Governing Body with a portfolio for engagement 2012 Commissioning

Identify suitable and preferred communication methods through database being built, focus groups, survey; make effective use of October 2012 Chair and AO
intranet, briefings, surveys and conferences
Plans to develop
effective Share, socialise and embed vision, mission, values with staff and practices; discuss with staff and members ideas for how to become September Director of
“one organisation” via workshops, surveys and anecdotal sources 2012 Commissioning
communication:
to end 2012/13
Recruit volunteers to focus groups to discuss how to improve listening and appreciating diverse views, and encouraging a climate of November Head of Governance
continuous development 2012 and OD

Run session on presenting information in a positive manner linking any change to an improvement in the quality of service, and therefore March 2013 Chair and AO
develop morale and commitment
Improve cross–directorate working and reduce ‘silos’ through practical and ‘hands-on’ support by all staff of the locality commissioning On-going Chief Officer
groups.
September Head of Governance
Introduce social/sport events to build trust and relationships away from workplace 2013 and OD
Head of Governance
High level Ensure staff are fully engaged with their roles, the CCG vision and QIPP action plan – via an on-going programme of events March 2014 & OD and Governing
programmes for Body

2013/14 Head of Governance

Review success of programmes in 2012/13 and continue where appropriate March 2013
and OD

29
 When will Who is
5. Competent and Capable: To ensure our organisation is competent and capable to undertake our statutory
OD Goal this be responsible to
responsibilities, and is developing its staff, leaders and members to ensure a future talent pipeline done? see it is?
Ensure all staff participate in mandatory training on subjects including Health and Safety, Equality and Diversity, Information Governance Head of OD and
March 2013
and Safeguarding. Transition

November Director of
Promote 1:1s between managers/staff to ensure clarity for all roles and understanding their part in delivery 2012 Commissioning

Run a comprehensive Protected Learning Time (PLT) programme for practices covering clinical and commissioning topics March 2012 Chair and AO

Director of
Recruit a Lay Member to the Governing Body with a portfolio for governance and audit August 2012
Commissioning

Recruit Governing Body including mandatory roles (lay representatives, secondary care doctor and registered nurse) and provide an September AO & Head of OD
induction programme for new members 2012 and Transition

November Head of OD and

Instigate and maintain effective contact with South London LETB to ensure education & training of health staff is in place
Plans to ensure 2012 Transition

a competent Design and run a board development programme to support the Governing Body individually and collectively and ensure this is Head of OD and
August 2012
and capable progressed in advance of the authorisation site visit Transition

organisation; to
Participate in the NHS SEL cluster Mock Board and NHS London Mock Site Visit programme and adjust Board development in the light Head of OD and
end 2012/13 of those events
August 2012
Transition

Ensure effective governance is in place via constitution and committees, and monitored by Governing Body March 2013 Chair and AO

Review learning and development needs for CCG staff against new job roles, making bespoke development available as roles and December Head of OD and
functions are developed 2012 Transition

September Director of
Launch a training initiative for non-medical practice staff to support their development needs in line with CCG priorities 2012 Commissioning
Head of OD and
Ensure all staff have an appraisal and a PDP which will collectively inform the OD plan for 2013/14 March 2013
Transition

September
Re run Conflict of Interest and Risk Appetite workshops for new Governing Body 2012
CFO

Undertake a workforce review to ensure the capacity and capability of all functions, including communications and commissioning Head of Governance
April 2013
support arrangements reflect the on-going needs of the organisation and OD

Undertake a skills audit of non-medical practice staff to identify areas needing development. Design, run/commission training using September Head of Governance
elements of the NHSCB learning and support tool, NIII courses, National Leadership Academy, and bids for NMET CPPD funding 2013 and OD
High level
programmes for Undertake a skills audit of CCG support staff to identify extent of in-house talent and areas needing development. Design and Head of Governance
March 2014
run/commission training using elements as above and OD
2013/14
Head of Governance
Participate in the annual NHS staff survey and act upon results April 2013
and OD
Head of Governance
Review success of programmes in 2012/13 and continue where appropriate March 2013
and OD

30
6. Plans to Meet our Core Responsibilities in 2012/13
To be read in conjunction with the CCG Organisational Structure Document

6.1 The Governing Body

The Governing Body will be in place by Autumn 2012 including the required roles of Chief
Officer, Chief Financial Officer, Chair, Lay Members, secondary care nurse and secondary
care doctor. Meetings will be held in public and papers made available via our website.

6.2 Education and training

Southwark CCG is clear that all staff both in the central CCG and in practices are required to
attend the training deemed as mandatory for their role. Training will be made available in as
convenient a style as possible – including on-line – and tracking systems will review and
monitor take up. This includes as the absolute minimum for all staff health and safety,
information governance and safeguarding. The Practice Nurse forum, being re-introduced in
Autumn 2012 by the Practice Nurse Governing Body representative, will take a lead in
promoting training needs for practice staff.

Southwark also recognises its responsibility to contribute to developing the NHS workforce of
the future, both its own start and those in training. It has already piloted a succession
planning initiative “Future Leaders” which will be re-run during 2012/13.

Southwark is represented on the South London LETB (Local Education and Training Board)
by a clinician from Lambeth CCG and from Bromley CCG. These representatives are
mandated by and report into the South East London Clinical Strategy Committee where any
decisions are discussed and debated.

6.3 Safeguarding children and adults at risk

Safeguarding vulnerable children and adults at risk is a core commitment of the CCG.

Protecting the most vulnerable and promoting their interests is a primary duty. It therefore
features as an integral part of all our planning, commissioning, contracting and monitoring of
delivery. We recognise our responsibility for ensuring the safety of the most vulnerable
children and adults at risk in our community and work with our partners in social care and the
Children’s Trust in establishing robust single and multi-agency standards.

Commissioning standards have been developed to ensure that all providers have
safeguarding embedded in their service delivery plans. We continually review current policy
frameworks to take account of developments such as personalisation and new service
developments, including service areas such as walk in centres and primary care
developments.

The annual reports for both children and adults safeguarding is presented to the Southwark
Council Health Overview & Scrutiny Committee to ensure transparency and further assurance
that safeguarding processes in Southwark are robust and outcomes focussed.

Safeguarding Assurance - annual Safeguarding reports for children and vulnerable adults

Annual safeguarding reports for both children (Section 11) and adults at risk are quality
assured by the Integrated Governance & Performance Committee within the CCG. The
safeguarding children report is presented to the Southwark Safeguarding Children Executive
Board (SSCEB) and the adult safeguarding report is presented at the Adult Safeguarding
31
Partnership Board. This ensures that the organisation is fully compliant with both children’s
safeguarding requirements as set out in Working Together to Safeguard Children and the
Royal College of Paediatrics & Child Health Intercollegiate document 2010 in regards to
training health staff, and in line with government policy on safeguarding adults at risk.

Safeguarding priorities

The main safeguarding priorities for NHS Southwark CCG for 2012/13 onwards are:

 Safeguarding children and adults at risk is safely managed through the current
organisational system changes within the health economy with robust governance
arrangements in place.
 Current partnership arrangements within Southwark are maintained to their present
high standard, this includes engaging with the respective Safeguarding Boards,
Children’s Trust, Health & Well Being Board and providers of NHS-funded health
services, including NHS Foundation Trusts and public, third sector, independent sector
and social enterprises and the NHS Commissioning Board.
 Continued implementation across provider organisations of the safeguarding
commissioning standards.
 All staff within the CCG are trained to appropriate levels of safeguarding for their roles
and responsibilities and have access to supervision / advice from the Designated
Nurse and Designated Doctor, Safeguarding Lead within the CCG and the
Safeguarding Adults Manager within Southwark Council.

Safeguarding children

 NHS Southwark CCG has in place contractual agreements that secure the expertise of
designated health professionals, i.e. designated doctors and nurses for safeguarding
children and for looked after children, and designated paediatricians for unexpected
deaths in childhood. These roles link with relevant local and national strategic bodies
to remain up-to-date with current policy and practice e.g. NHS London, London
Safeguarding Children Board
 The organisation is working towards the development of a Named GP for Safeguarding
Children to promote good professional practice within primary care, provide advice and
expertise to fellow GP professionals, and ensure safeguarding training is in place.
 Take forward key messages and action plans from relevant inspections, including the
2012 Southwark Ofsted / CQC Safeguarding Children and Looked After Children
Inspection, lessons learned and action plans from serious case reviews and internal
management reviews.

Safeguarding adults at risk

 Ensuring that the introduction of personal health budgets takes account of

safeguarding issues and risks within care planning processes
 Work jointly with Adult Social Care and care home providers to ensure the quality of
care delivered within commissioned care homes and intermediate care placements
safeguards this vulnerable client group
 Ensure appropriate safeguarding processes are in place to protect clients placed in
and out of borough who have nursing and continuing care needs, e.g. clients with
learning disability and complex needs, including end of life.
 Increase the uptake of training and awareness around the Mental Capacity Act and
Deprivation of Liberties.

32
7 Conclusion and next steps
Southwark CCG will use this OD plan as a means of driving the organisational change
necessary for our strategic goals to be achieved. It will be tracked regularly through the CCG
committees and Governing Body to ensure the milestones are reached and change enacted.

Our application in wave two of the authorisation process falls in the same period as we are
recruiting to our new structures and to a small number of key roles within the Governing Body.
As a result the following sessions will be held in the next two months to further consider,
review and finalise this ‘living’ document:

Governing Body Half Day workshop: 23 August 2012

Governing Body Half Day workshop: 9 October 2012

Governing Body Whole Day workshop: 30 October 2012

33
Appendix 1: Mapping Southwark CCG values, OD priorities and strategic goals

Southwark CCG – our values Southwark CCG – our strategic goals

1.  2.  3.  4.  5.  6.  Reduction in  Reduction in  To achieve a  All practices  To have 
Accountable  Committed  Health  premature  reduction in  actively   patients play a 
Good  Patients,  Honest and  Decisions 
to public and  to work  Inequalities mortality the variability  involved in  central role in 
healthcare  health  open about  will be  of primary  commissioning commissioning
available to  improveme the actions  responsible  evidenced  with  care 
all  nt and  and  to act in the  based, fair  partners  outcomes & 
regardless  quality at  decisions  best interests  & make  across the  quality
of wealth heart of  we take of population best use of   community  Southwark CCG
everything  resources  to tackle 
poor health
OD priorities
we do

Clinically led

Customer 
focused

Collaborativ
e

Reduction in  Reduction in  Reduction in  Reduction in  Reduction in  Reduction in  Reduction in  Reduction in  Reduction in  Reduction in  Reduction in 
Health  Health  Health  Health  Health  Health 
Communicate  Health  Health  Health  Health  Health 
Inequalities Inequalities Inequalities Inequalities Inequalities Inequalities effectively Inequalities Inequalities Inequalities Inequalities Inequalities

Competent 
and capable

34