Building upon existing Cluster working with strengthened representation to develop a comprehensive understanding of needs and priorities. Clusters will have a direct representation at County level Pan Cluster Planning Groups to inform and influence strategic plans and to propose effective local solutions.
Overview
Cluster working is well established across Wales and has delivered a wide range of innovative service improvements. However, the 2020/21 Cluster Survey identified a series of barriers and informed recommendations for more effective Cluster working.
This retains the principle of a community orientated, needs based approach, using all local services and resources to achieve the greatest benefit for the Cluster population. Professionals work together to understand local needs and to develop solutions that are effective in the local context. There should be a dynamic problem-solving approach, bringing together the appropriate professionals to address specific issues. This work is supported by wider networks of clinical expertise and enabled by managerial skills including project management, finance, IT, public engagement, workforce and OD etc.
The Cluster Plan reflects the actions required at the most local footprint, but this should inform and influence wider organisational and partnership plans.
The membership includes representatives of each of the four independent contractor professions with nursing and allied health professional leadership and third sector services.
Roles and responsibilities
Cluster meetings will be chaired by a Lead representative agreed by the group. The Lead is responsible for ensuring appropriate arrangements are in place for chairing of the meeting in their absence.
The core membership of the Cluster shall comprise of representation from all local services contributing to health and social care within the cluster area and shall include:
In attendance
Other members may be included as required.
Patient representation will not form part of core membership, but Clusters will secure public engagement to inform the planning and development of local plans and services. This may be through the establishment of Patient Engagement / Participation Forums but will be locally determined.
Governance
Clusters are structures to support and enable collaborative service planning and delivery. Cluster Annual Plans / Cluster Integrated Medium Term Plans should be developed to coordinate collaborative activities and to inform Pan Cluster Planning Group analysis, priorities and plans.
Participation should be managed through contractual performance reviews for independent contractors and as part of the performance reviews for salaried staff. Each improvement project should include an evaluation and articulate the financial governance arrangements.
Cluster budgets are determined by Welsh Government and delegated via Health Boards. The Health Board will delegate these budgets to the Clusters via the Pan Cluster Planning Groups. The Health Board and its partners may delegate additional resources to PCPGs and Clusters to achieve agreed outcomes.
All financial decisions must be made in line with agreed Standing Financial Instructions. There will need to be an authorised signatory at the PCPG.
Overall cluster performance will be evaluated through cycles of Peer Review.
Leadership/OD
The Cluster membership will agree a lead as chair.
The lead will:-
A range of development resources and opportunities is hosted by HEIW.
Model Terms of Reference
Cluster meetings Model Terms of Reference
ACD Supporting Governance (Model paper for health board use)
This paper has been written in order to provide a framework for Health Boards to use, such that they are able to clearly articulate the relationship between the Health Board, newly forming Pan Cluster Planning Groups and Clusters. This will allow the Health Board in due course to be confident in exercising the functions of planning ,commissioning and delegation / approval of resources.
This paper sets out the key governance principles, overarching legislation and suggested governance for consideration by health boards in developing and implementing the planning and delivery mechanisms described in the Accelerated Cluster Development programme.