Quality Committee Terms of Reference

1. CONSTITUTION

The quality committee (the committee) is established by the Integrated Care Board (the board or ICB) as a committee of the board in accordance with its constitution.

These Terms of Reference (ToR), which must be published on the ICB website, set out the membership, the remit, responsibilities and reporting arrangements of the committee and may only be changed with the approval of the board.

The committee is a non-executive chaired committee of the board, and its members are bound by the standing orders and other policies of the ICB.


2. PURPOSE OF THE COMMITTEE

The quality committee has been established to provide the ICB with assurance that 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 Bill 2021. This includes reducing inequalities in the quality of care.

The committee 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.

The committee will provide regular assurance updates to the ICB in relation to activities and items within its remit.


3. DELEGATED AUTHORITY

The quality committee is a formal committee of the ICB. The board has delegated authority to the committee as set out in the scheme of reservation and delegation and may be amended from time to time.

The quality committee holds only those powers as delegated in these Terms of Reference as determined by the ICB board.


4. MEMBERSHIP AND ATTENDANCE

The committee members shall be appointed by the Board in accordance with the ICB constitution.

The board will appoint no fewer than four members of the committee including two who are non-executive members of the board (from the ICB). Other attendees of the committee need not be members of the board, but they may be.

When determining the membership of the committee, active consideration will be made to equality, diversity and inclusion.

The chair may ask any or all of those who normally attend, but who are not members, to withdraw to facilitate open and frank discussion of particular matters.

Chair and vice chair

The committee shall satisfy itself that the ICB’s policy, systems and processes for the management of conflicts, (including gifts and hospitality and bribery) are effective including receiving reports relating to non-compliance with the ICB policy and procedures relating to conflicts of interest.

If a chair has a conflict of interest, then the co-chair or, if necessary, another member of the committee will be responsible for deciding the appropriate course of action.

Members

  • Non-executive member (chair)
  • Non-executive member (deputy chair)
  • ICB chief nurse
  • ICB medical director
  • Director quality assurance & safety
  • Patient safety partner(s)
  • ICB primary care partner member
  • Local authority lead
  • Chair patient involvement and engagement advisory committee

Attendees to include:

  • 1 acute provider representative
  • 1 primary care representative
  • Healthwatch
  • VSCE representative
  • Public health representative
  • Other members clinical directorate will be invited to attend as required

5. MEETING QUORACY AND DECISIONS

The quality committee shall meet on a monthly basis. Additional meetings may be convened on an exceptional basis at the discretion of the committee chair.

Quoracy

There will be a minimum of two non-executive members, plus at least the chief nurse or medical director, and one local authority representative.

Where members are unable to attend, they should ensure that a named and briefed deputy is in attendance who is able to participate on their behalf.

Decision making and voting

Decisions will be taken in according with the standing orders. The committee will ordinarily reach conclusions by consensus. When this is not possible the chair may call a vote.

Only members of the committee may vote. Each member is allowed one vote and a majority will be conclusive on any matter.

Where there is a split vote, with no clear majority, the chair of the committee will hold the casting vote. The result of the vote will be recorded in the minutes.

If a decision is needed which cannot wait for the next scheduled meeting, the chair may conduct business on a ‘virtual’ basis through the use of telephone, email or other electronic communication.


6. RESPONSIBILITIES OF THE COMMITTEE

The responsibilities of the quality committee will be authorised by the ICB Board. It is expected that the quality committee will:

  • Be assured that there are robust processes in place for the effective management of quality
  • Scrutinise structures in place to support quality planning, control and improvement, to be assured that the structures operate effectively, and timely action is taken to address areas of concern
  • Agree and put forward the key quality priorities that are included within the ICB strategy/ annual plan, including priorities to address variation/ inequalities in care
  • Oversee and monitor delivery of the ICB key statutory requirements
  • Review and monitor those risks on the BAF and corporate risk register which relate to quality, and high-risk operational risks which could impact on care.
  • Ensure the ICB is kept informed of significant risks and mitigation plans, in a timely manner
  • Oversee and scrutinise the ICB’s response to all relevant (as applicable to quality) directives, regulations, national standard, policies, reports, reviews and best practice as issued by the DHSC, NHSEI and other regulatory bodies / external agencies (e.g. CQC, NICE) to gain assurance that they are appropriately reviewed and actions are being undertaken, embedded and sustained
  • Maintain an overview of changes in the methodology employed by regulators and changes in legislation/regulation and assure the ICB that these are disseminated and implemented across all sites
  • Oversee and seek assurance on the effective and sustained delivery of the ICB quality improvement programmes
  • Ensure that mechanisms are in place to review and monitor the effectiveness of the quality of care delivered by providers and place
  • Receive assurance that the ICB identifies lessons learned from all relevant sources, including, incidents, never events, complaints and claims and ensures that learning is disseminated and embedded
  • Receive assurance that the ICB has effective and transparent mechanisms in place to monitor mortality and that it learns from death (including coronial inquests and PFD report)
  • To be assured that people drawing on services are systematically and effectively involved as equal partners in quality activities
  • Be assured of the safety and quality of primary care commissioned services using the appropriate assurance frameworks
  • Scrutinise the robustness of the arrangements for and assure compliance with the ICB’s statutory responsibilities for safeguarding adults and children
  • Scrutinise the robustness of the arrangements for and assure compliance with the ICB’s statutory responsibilities for infection prevention and control
  • Scrutinise the robustness of the arrangements for and assure compliance with the ICB’s statutory responsibilities for equality and diversity as it applies to people drawing on services
  • Scrutinise the robustness of the arrangements for and assure compliance with the ICB’s statutory responsibilities for medicines optimisation and safety

Receive and approve ICB policies in relation to :

  • Quality and safeguarding
  • Clinical commissioning
  • Medicines management
  • Have oversight of and approve the Terms of Reference and work programmes for the groups reporting into the quality committee (e.g. system quality groups, infection prevention and control, safeguarding boards / hubs etc)

7. ACCOUNTABILITY and REPORTING ARRANGEMENTS

The quality committee is directly accountable to the ICB. The minutes of meetings shall be formally recorded. The chair of the committee shall report to the board (public session) after each meeting and provide a report on assurances received, escalating any concerns where necessary.

The committee will advise the audit committee on the adequacy of assurances available and contribute to the annual governance statement.

The committee will receive scheduled assurance report from its delegated groups. Any delegated groups would need to be agreed by the ICB board.


8. BEHAVIOURS AND CONDUCT

ICB values

Members will be expected to conduct business in line with the ICB values and objectives. Members of, and those attending, the committee shall behave in accordance with the ICB’s constitution, standing orders, and standards of business conduct policy.

Equality and diversity

Members must demonstrably consider the equality and diversity implications of decisions they make.


9. DECLARATIONS OF INTEREST

All members, ex-officio members and those in attendance must declare any actual or potential conflicts of interest which will be recorded in the minutes. Anyone with a relevant or material interest in a matter under consideration will be excluded from the discussion at the discretion of the committee chair.


10. SECRETARIAT AND ADMINISTRATION

The committee shall be supported with a secretariat function which will include ensuring that:

  • The agenda and papers are prepared and distributed in accordance with the standing orders having been agreed by the chair with the support of the relevant executive lead.
  • Attendance of those invited to each meeting is monitored and highlighting to the chair those that do not meet the minimum requirements.
  • Records of members’ appointments and renewal dates and the board is prompted to renew membership and identify new members where necessary;
  • Good quality minutes are taken in accordance with the standing orders and agreed with the chair and that a record of matters arising, action points and issues to be carried forward are kept;
  • The chair is supported to prepare and deliver reports to the board.
  • The committee is updated on pertinent issues/ areas of interest/ policy developments.
  • Action points are taken forward between meetings and progress against those actions is monitored.

11. REVIEW

The committee will review its effectiveness at least annually and complete an annual report submitted to the board.

These terms of reference will be reviewed at least annually and more frequently if required. Any proposed amendments to the terms of reference will be submitted to the board for approval.

The committee will utilise a continuous improvement approach in its delegation and all members will be encouraged to review the effectiveness of the meeting at each sitting.


Date of approval: 1 July 2022
Date of review: June 2023

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