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["           SCHEME OF DELEGATION AND EARNED AUTONOMY FRAMEWORK"]
[]
["Reference No:","UHB 217","Version No:",1.7,"Previous Trust / LHB  Ref No:","N/A"]
[]
["Documents to read alongside this document","UHB Standing Orders, Reservation and Delegation of Powers                                                                                                                                                                                              UHB Standing Financial Instructions                                                                                                                                                                                                                            More detailed subject specific policies, procedures and guidelines"]
[]
["Classification of document:",null,"Corporate"]
[]
["Area for Circulation:",null,"UHB Wide"]
[]
["Author/Reviewee",null,"Director of Corporate Governance"]
[]
["Executive Lead: ",null,"Director of Corporate Governance"]
[]
["Group Consulted via/Committee:",null,"Management Executive"]
["                                                                 Audit Committee"]
[]
["Approved by:",null,"UHB Board"]
[]
["Date of Approval:",null,"Version 1.7 -  25 November 2021"]
[]
["Date of Review:",null,"25/11/2024*"]
[]
["Date Published:",null,"2021-11-25"]
[]
["*This is next formal date of review but due to the nature of the document a review before this date is likely. "]
[]
["Disclaimer"]
["When using this document please ensure that the version you are using is the most up to date either by checking on the UHB database for any new versions.If the review date has passed please contact the author."]
[]
["Version Control"]
["Version Number","Date of Review Approved","Date Published","Summary of Amendments"]
[1,"2014-03-25","2014-03-25","New Document. Detailed scheme of delegation and earned autonomy framework to underpin Schedule 1 of UHB Standing Orders, Reservation and Delegation of Powers"]
[1.1000000000000001,"2014-08-18","Not published","Amendments to reflect comments made regarding content of Version 1, revised authorisations for Clinical Boards at Levels 2 and 3 and some categories extended."]
[1.2,"2015-04-08","2015-04-22","Section 8 - Executive lead for Senior Information Risk Officer changed from the Deputy Chief Executive to the Board Secretary"]
[1.3,"2015-05-05","2015-05-20","Review date extended to 30 September 2015"]
[1.4,"2017-01-26","2017-02-27","Amendment to section 5 Disciplinary Investigations and Dismissal of staff"]
[1.5,"2017-12-05","2017-12-20","Finance and Procurement - amend delegated limits for Head of Compliance & Discretionary Capital, Head of Capital Planning and Director of Therapies and Health Sciences.  (AC17/078)"]
[1.6,"2018-02-27","2018-05-18","Finance and Procurement - amend to include off payroll working AC17/097)"]
[1.7,"2021-09-30","2021-10-01","Updated due to change of responsibilites from Executive Director of Strategic Planning to Executive Finance Director and other changes to Executive responsibitlies plus clarifying and consistency in job titles"]
[]
[]
["Contents"]
["Section 1 ","Quality, Safety and Experience"]
["Section 2","Service"]
["Section 3","Commissioning and Provision of Services"]
["Section 4","Finance and Procurement "]
["Section 5","Workforce and Organisational Development"]
["Section 6","Corporate"]
["Section 7","Higher Degree of Delegation and Earned Autonomy at Level 2 and 3"]
["Section 8","Executive Responsibilities \n"]
["Note: Whilst this Scheme of Delegation captures a wide range of subject areas it is not exhaustive.  Reference should also be made to policies, procedures, other written control documents and individual role profiles.\n\nReferences to a post or designation shall be deemed to include a reference to the employee for the time being performing those functions where the post or designation name is altered or the functions are reallocated (for example, the post title of Executive Director of Workforce and OD has changed to Executive Director of People and Culture)\n\nIf further clarification is required please contact the Director of Corporate Governance or Head of Corporate  Governance."]

{"sheet":"Quality & Pt Experience","index":1,"n_rows":115,"n_cols":4,"rows_kept":115,"cut":false,"hidden":false,"merged":[[0,0,0,3],[3,3,4,3]]}
["Quality, Safety and Experience"]
["Area","Delegated Matter","Delegated to","Comment"]
["Legislative Requirements where individuals are named as licence holders or designated individuals ",null,null,"Note: This section concentrates on legislation relating to patient safety and quality.  It is not intended to be exhaustive.  Where appropriate further information will be added to the Scheme of Delegation or will be maintained by Clinical Boards/Corporate Directorates."]
["Human Tissue Act 2004","Licence Holder","Executive Medical Director","Premises must be licensed to carry out post mortem examinations; to remove tissue/organs from a body and to store bodies or tissues/organs removed from bodies. Each Designated Individual has specific personal responsibilties detailed in legislation"]
[null,"Designated Individuals","Clinical Board Director/Head of Department"]
[null,"Approval of agreements with Third Party for the collection of umbilical cord blood","Executive Medical Director"]
["Medicines Act 1968","Medicines and Healthcare Products Regulatory Agency (MHRA) Licenced activities","Chief Executive"]
[null,"Maintenance of standards to ensure ongoing compliance with licencing requirements","Clinical Board Director"]
["Medical Act 1983","Maintaining standards to ensure UHB retains Approved Practice Setting status ","Executive Medical Director"]
["The Blood Safety and Quality Regulations 2005","Authorisation Holder","Chief Executive"]
[null,"Responsible Person (Blood)","Named Consultant Haematologist","This is the person who has been designated pursuant to regulation 6.  A record of Responsible Persons will be maintained by the Governance Directorate.  "]
[null,"Approval of Blood and Component Products Policy","Quality, Safety and Experience Committee"]
[null,"Review of policies and approval of procedures and ensuring that arrangements in place.","Transfusion Group"]
[]
["Concerns/Complaints Management","Set direction, policies and procedures","Executive Nurse Director","Policies approved by Quality, Safety and Experience Committee"]
[null,"Recording, receipt and initial acknowledgement of concern/complaint\n\n","Assistant Director of Patient Experience supported by Concerns Department","Note:  Any written concern  received by any department/individual other that the Chief Executive must be forwarded to the Chief Executive's office immediately.   "]
[null,"Grading of concern/complaint","Executive Nurse Director or Assistant Direct of Patient Experience"]
[null,"Identification of Investigating Officer","Head of Operations and Delivery (Dental), Assistant Director of Therapies/Professional Lead for QSE (CD&T), all other Clinical Boards = Clinical Board Nurse (all Grades of Concern) or Assistant Directors of Corporate Departments"]
[null,"Investigation of complaint","Investigating Officer"]
[null,"Maintaining regular contact with the complainant with regard to the processing of the concern.","Concerns Department"]
[null,"Maintaining regular contact with the complainant with regard to the matters raised in the concern.","Investigating Officer"]
[null,"Preparing final draft response (all Grades of Concern)\n\n\n","Investigating Officer","Note: Refer to level of autonomy for Clinical Boards at Levels 2 and 3"]
[null,"Sign off of final draft ","Head of Operations and Delivery (Dental), Assistant Director of Therapies/Professional Lead for QSE (CD&T), all other Clinical Boards = Clinical Board Nurse (all Grades of Concern) or Assistant Directors of Corporate Departments"]
[null,"Checking of final draft prior to submission to Chief Executive","Identified Executive Director"]
[null,"Sending final response to complainant","Chief Executive"]
[]
["Incident Reporting and Investigation","Set direction, policy and procedures","Executive Nurse Director","Policies approved by Quality, Safety and Experience Committee"]
[null,"a) Completion of Incident Form","Staff member involved in incident or in immediate area"]
[null,"b) Initial Investigation of Incident","Manager of staff member/person in charge of area"]
[null,"c) Reporting of Serious Adverse Incident to Welsh Government","Executive Nurse Director"]
[null,"d) Arranging serious incident (SI) meeting","Assistant Director of Patient Safety or Head of Operations and Delivery (Dental), Assistant Director of Therapies/Professional Lead for QSE (CD&T), all other Clinical Boards = Clinical Board Nurse  "]
[null,"e) Investigation of Serious Incidents","Head of Operations and Delivery (Dental), Assistant Director of Therapies/Professional Lead for QSE (CD&T), all other Clinical Boards = Clinical Board Nurse or Executive Directors to appoint Investigating Officer"]
[null,"f) Preparation of final report","Investigating Officer"]
[null,"g) Agreement of final report prior to submission to the Executive Nurse Director","Clinical Board Director or Executive Director"]
[null,"h) Sign off of final report and closure of investigation.","Executive Nurse Director\n\n"]
[null,"i) Reporting of incidents in accordance with the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations","Head of Health and Safety"]
[null,"j) Reporting of breaches under the Ionising Radiation (Medical Exposure) Regulations to Health Inspectorate Wales (HIW)","Assistant Director of Patient Safety"]
[null,"k) Reporting of Data Protection Breaches to Information Commissioners Office (ICO)","Executive Medical Director"]
[null,"Management of UHB notifications to ICO or received as a result of complaint to the ICO "]
[null," - requests and response management","Head of Information Governance"]
[null," - Local management and provision of information  ","Clinical Board Directors of Operations or Assistant Director of Corporate Directorates "]
[null," - Approval of response","Medical Director"]
[null,"l) Reporting of Incidents to the Police","Unless incident reported at time (see below) Executive Nurse Director"]
[null,"Where a criminal offence is suspected","Person in charge of area"]
[null,"Criminal offence of a violent/harmful nature","Person in charge of area"]
[null,"other\n","Person in charge of area"]
[null,"Where a fraud is suspected","See financial section"]
[null,"Maintaining Datix Risk Management and Incident Reporting system including upload into National Reporting and Learning System (NRLS)","Assistant Director of Patient Safety and Head of Health and Safety "]
[]
["HM Coroner","Maintaining relationship and ensuring appropriate response to requests for information. ","Executive Nurse Director supported by Assistant Director of Patient Safety"]
[null,"Development and implementation of plans following the receipt of \"Prevention of Future Death Reports\" from HM Coroner","Clinical Board Directors of Operations and  Clinical Board Directors of Nursing or Assistant Directors of Corporate Departments"]
[null,"Preparation of response to \"Prevention of Future Death Reports\" from HM Coroner ","Clinical Board Directors of Operations and  Clinical Board Directors of Nursing or Assistant Directors of Corporate Departments"]
[null,"Sign off of Clinical Board response to \"Prevention of Future Death Reports\" from HM Coroner prior to submission to Executive Nurse Director","Clinical Board Director or Executive Director"]
[null,"Sign off of response to \"Prevention of Future Death Reports\" from HM Coroner ","Executive Nurse Director"]
[null,"Sending response to HM Coroner","Chief Executive"]
[]
["Welsh Risk Pool Assessment\n\n\n","Executive Lead","Executive Nurse Director"]
[null,"Co-ordination of assessment","Assistant Director of Patient Safety "]
[null,"Performance against the Welsh Risk Pool Standards and contributing to assessment process.","Clinical Board Directors of Operations and  Clinical Board Directors of Nursing or Assistant Directors of Corporate Departments"]
[]
["Standards for Health Services in Wales","Executive Lead","Executive Nurse Director "]
[null,"Standards for Health Services in Wales - assessment and compliance with provisions of standards","Clinical Board Directors of Operations and  Clinical Board Directors of Nursing or Assistant Directors of Corporate Departments"]
[]
["Patients Safety Alerts ","Executive Lead","Executive Nurse Director"]
[null,"Maintaining record of Alerts and monitoring compliance","Assistant Director of Patient Safety "]
[null,"Responding to alerts and providing information regarding ability to meet requirements","Clinical Board Directors or Assistant Directors of Corporate Departments"]
[null,"Responding to requirements and providing information regarding ability to meet requirements","Clinical Board Directors of Operations and  Clinical Board Directors of Nursing or Assistant Directors of Corporate Departments"]
[]
["National Institute of Clinical Excellence (NICE)","Executive Lead","Executive Medical Director"]
[null,"Maintaining record of publications and recording compliance","Assistant Director of Patient Safety "]
[null,"Responding to requirements and providing information regarding ability to meet requirements","Clinical Board Directors of Operations and  Clinical Board Directors of Nursing or Assistant Directors of Corporate Departments","As above re delegation straight to QSE Lead"]
[]
["National Confidential Enquiry into Patient Outcome and Death (NCEPOD)","Executive Lead","Executive Medical Director"]
[null,"Performing the role of the NCEPOD Ambassador and collation and provision of information to contribute to NCEPOD audit findings","Assistant Medical Director - Clinical Effectiveness and Patient Safety"]
[null,"Maintaining record of publications and recording compliance","Assistant Medical Director - Clinical Effectiveness and Patient Safety"]
[null,"Responding to requirements and providing information regarding ability to meet requirements","Clinical Board Directors or Executive Directors"]
[]
["Approval of compensation for staff and patients personal effects, clinical negligence and personal injury claims",null," ","Refer to Finance and Procurement section"]
[]
["Clinical Audit","Executive Lead","Executive Medical Director"]
[null,"Co-ordination and participation in national audits","Assistant Director of Patient Safety "]
[null,"Development of UHB wide Clinical Audit Plan ","Assistant Director of Patient Safety "]
[null,"Approval of UHB wide Clinical Audit Plan","Quality, Safety and Experience Committee"]
[null,"Development and implementation of Clinical Board Audit Plans ","Clinical Board Directors"]
[null,"Approval of Clinical Board Audit Plans","Clinical Board Quality, Safety and Experience sub-Committees"]
[]
["Infection Prevention and Control","Set direction, policy and procedures","Executive Nurse Director","Policies approved by Quality, Safety and Experience Committee"]
[null,"Implementation of procedures and good practice","All staff"]
[null,"Co-ordination of management of outbreaks","Executive Nurse Director"]
[]
["Professional Standards and Regulation - Nursing","Development of Strategic Framework","Executive Nurse Director"]
[null,"Implementation of Strategic Framework","Deputy  Director of Nursing and Clinical Board Nurse/Clinical Board Lead "]
[null,"Referral to Nursing and Midwifery Council (NMC)","Executive Nurse Director*"]
[null,"Monitoring of registration (NMC regulatory compliance)","Deputy Director of Nursing and Clinical Board Nurse/Clinical Board Lead "]
[]
["Professional Standards and Regulation - Medical and Dental","Development of Strategic Framework","Executive Medical Director"]
[null,"Implementation of Strategic Framework","Clinical Board Directors and Executive Directors"]
[null,"Referral to General Medical Council (GMC)/General Dental Council (GDC)","Executive Medical Director*"]
[null,"Monitoring of registration (GMC/GDC regulatory compliance)","Clinical Board Directors and Executive Directors"]
[]
["Professional Standards and Regulation - Therapies and Health Sciences","Development of Strategic Framework","Executive Director of Therapies and Health Sciences"]
[null,"Implementation of Strategic Framework","Clinical Board Directors and Executive Directors"]
[null,"Referral to appropriate Professional Body","Executive Director of Therapies and Health Sciences*"]
[null,"Monitoring of registration ","Clinical Board Directors or Executive Directors"]
[]
["Safeguarding - Adult Protection","Set direction, policy and procedures","Executive Nurse Director","Policies internal to UHB approved by Quality, Safety and Experience Committee"]
[null,"Implementation of policy and procedures","Assistant Nurse Director/Clinical Board Leads"]
[null,"Investigation in accordance with Protection of Vulnerable Adults (POVA) requirements","Clinical Board Nurse/Designated Lead Managers (DLMs)"]
[]
["Safeguarding - Child Protection","Set direction, policy and procedures","Executive Nurse Director","Policies internal to UHB approved by Quality, Safety and Experience Committee"]
[null,"Implementation of policy and procedures","Executive Nurse Director"]
[null,"Safeguarding Supervision","Executive Nurse Director"]
[]
["Safeguarding - Deprivation of Liberty ","Supervising Authority","Executive Nurse Director"]
[null,"Managing Authority","Executive Nurse Director"]

{"sheet":"Service","index":2,"n_rows":21,"n_cols":5,"rows_kept":21,"cut":false,"hidden":false,"merged":[[0,0,0,4]]}
["Service Freedoms"]
["Area","Delegated Matter","Delegated to",null,"Comment"]
["Management of Capacity","Management of capacity ","Clinical Directors and Assistant Director of Corporate Departments","Need to define further "]
[null,"Variation of operating and clinic sessions within existing resources\n \n- Outpatients\n\n- Theatres\n\n- Other","Clinical Board Directors following appropriate consultation with all affected areas.","Can we split by Clinical Board?\nWhere is this delegated to now?"]
[null,"Changes to Bed Allocations leading to relocation of services or permanent reduction in bed capacity \n"]
[null,"Permanent Change","Chief Operating Officer  ","Can we split by Clinical Board?\nWhere is this delegated to now?","Need to ensure appropriate engagement with Community Health Council in association with Executive Director of Strategic Planning"]
[null,"Temporary Change","Chief Operating Officer",null,"Need to ensure appropriate engagement with Community Health Council in association with Executive Director of Strategic Planning"]
[null,"Changes to Bed Allocations where there is no relocation of services or permanent reduction in bed capacity \n"]
[null,"Permanent Change","Chief Operating Officer ","Can we split by Clinical Board?\nWhere is this delegated to now?","Need to ensure appropriate engagement with Community Health Council in association with Executive Director of Strategic Planning"]
[null,"Temporary Change","Chief Operating Officer",null,"Need to ensure appropriate engagement with Community Health Council in association with Executive Director of Strategic Planning"]
[]
["Plans for service change ","Material service change which impacts across more than one Clinical Board or has capital implications  ","Executive Director of Strategic Planning and Chief Operating Officer",null,"Refer to \"Guidance for Engagement and Consultation on Changes to Health Services\""]
[null,"Material service changes to be identified in line with Integrated Medium Term Plan on an annual basis leading to requirement to potentially engage Community Health Council  ","Executive Director of Strategic Planning to confirm following discussion with Clinical Board "]
[null,"Any substantial service change to be identified in line with Integrated Medium Term Plan on an annual basis leading to requirement to enter into formal public consultation","To be approved by Executive Director of Strategic Planning and endorsed by the Board"]
["Local Delivery Plans\n","Maintaining an up-to-date register of National Delivery Plans, ensuring that the UHBs response to these plans are managed within the required timeframe.","Assistant Director of Strategic Planning"]
[null,"Overall co-ordination, development and implementation of the Local Delivery Plans","Chief Operating Officer in collaboration with Clinical Board Directors"]
[null,"Delegated responsibility to oversee the development of the Local Delivery Plans.","Executive Director of Therapies and Health Sciences",null,"To be managed as part of IMTP and performance management arrangements "]
[]
["Drugs and Medication","See Finance Section",null,null,"See Finance and Procurement for Medicines Management and Procurement"]
[]
["Extended Role Activities","See Workforce Section"]

{"sheet":"Commissioning&Provision of Svs","index":3,"n_rows":75,"n_cols":4,"rows_kept":75,"cut":false,"hidden":false,"merged":[[1,1,1,2],[0,0,0,3]]}
["Commissioning and Provision of Services To and From Other Organisations"]
[]
["Area","Delegated Matter","Delegated to","Comment"]
["Commissioning including primary care but excluding Continuing Healthcare and Funded Nursing Care","Approval to commission new healthcare services from NHS, private, third sector or independent organisations","Executive Director of Strategic Planning","This relates to the commissioning of a new service. Any changes which will have a significant impact on provider strategy must be agreed with the Chief Operating Officer and other relevant Executives prior to agreement. Any additional funding requirements must be agreed with the Director of Finance prior to approval.  May be subject to tendering in line with UHB procurement procedures including significant contract variations"]
[null,"Approval to commission healthcare services from new organisations - NHS, third sector,  primary care, private or independent sector ","Executive Director of Strategic Planning","This relates to commissioning from an organisation not currently commissioned by the NHS. Any changes which will have a significant impact on provider strategy must be agreed with the Chief Operating Officer and other relevant Executives prior to agreement. Any additional funding requirements must be agreed with the Director of Finance prior to approval.  May be subject to tendering in line with UHB procurement procedures including significant contract variations."]
[null,"Agreement to provide services and payments in accordance with Medicines Management Incentive Scheme","Clinical Board Director - Primary, Community and Intermediate Care"]
[null,"Maintaining a register of commissioning contracts","Executive Director of Strategic Planning delegated to Clinical Board Director "]
[null,"Ensuring every commissioning contract has a lead manager responsible for ensuring that contract delivers activity, quality and finance","Executive Director of Strategic Planning delegated to Clinical Board Director "]
[null,"Agreement of annual contract with existing providers and within existing budgets - NHS, third sector, independent or private","Nominated lead manager (within existing budget)"]
[null,"Agreement of contract variations","Nominated lead manager (within existing budget)"]
[null,"Signing contracts of value < £75,000 and contract variations > £25,000","Nominated lead manager "]
[null,"Signing contracts of value < £125,000 and contract variations > £25,000","Director of Finance on recommendation of nominated lead manager"]
[null,"Signing contracts of value < £500,000 and contract variations > £125,000","Chief Executive on recommendation of nominated lead manager"]
[null,"Signing of contracts of value >£500,000","Chair and Chief Executive on authority of Board"]
[null,"Agreement of changes to contracts where this would place a cost pressure on the organisation which cannot be funded within existing budgets","Director of Finance (subject to business case/Integrated Medium Term Plan process)"]
[null,"Agreement of changes to contracts where this would place a cost pressure on the organisation which would have a significant impact on the delivery of outcomes","Executive Director of Strategic Planning"]
[null,"Ensuring there is a comissioning and contracting framework in place which sets out expectations around what will be included in documentation and approach to management including meetings","Executive Director of Strategic Planning","Finance and procurement elements to be signed off by Director of Finance, quality and safety to be signed off by Executive Nurse Director"]
[null,"Ensuring that contracts have appropriate documentation in place including key performance metrics relating to activity, targets, quality and finance and that regular performance monitoring meetings take place","Nominated lead manager"]
[null,"Ensuring that there are regular meetings in place to monitor performance against commissioning contracts, that recovery plans are agreed where there are performance or finance issues and that matters of concern are escalated appropiately","Nominated lead manager"]
[null,"Ensuring every commissioning contract has a lead finance manager responsible for monitoring financial activity and supporting the lead manager to manage the contract","Executive Director of Finance"]
[null,"Authorisation of invoices against contracts (within budget) excluding NHS Long Term Agreements (LTAs)","Nominated lead manager (within delegated authority)"]
[null,"Authorisation of invoices against NHS LTAs","Head of Finance (Financial Management and Strategy)"]
[]
["Commissioning - Continuing Healthcare and Funded Nursing Care","All above sections apply to this area - these are supplementary delegated powers"]
[null,"Approving new care packages","Continuing Healthcare (CHC) panel","In line with UHB procedure and panel decisions"]
[null,"<£75k","Chair of CHC panel"]
[null,"<£125k","Executive Director of Finance"]
[null,"<£500k","Chief Executive"]
[null,"Authorising emergency care packages or changes to care packages outside panel","Director of Operations PCIC or Mental Health"]
[null,"Authorising of invoices against agreed packages of care outside panel","Director of Operations PCIC or Mental Health"]
[null,"Authorising CHC retrospective claims including Powys and UHB claims"]
[null,"<£75k","Director of Operations PCIC and Assistant Director of Finance PCIC"]
[null,"<£125k","Executive Director of Finance"]
[null,"<£500k","Chief Executive"]
[]
["Providing staff to or seconding staff from other organisations (e.g staff with academic commitments, seconding staff to partner agencies)","Value <£75k or extension of existing contract for any value","Directors of Operations or relevant Executive Director"]
[null,"Value > £75k or change in contract >£75k","Director of Finance"]
[null,"Ensuring there is a named contract lead for this","Heads of Operations and Delivery or relevant Executive Director"]
[null,"Ensuring there is an appropriate agreement in place, supported by clear specification of what is to be delivered, monitoring arrangements, financial arrangements and exit arrangements","Named contract lead"]
[]
["Pooled budget arrangements","Approval to enter into pooled budget arrangements under section 33 of the NHS (Wales) Act 2006","Executive Director of Finance on recommendation of Executive Director of Strategic Planning"]
[]
["Provision of services by UHB to other organisations excluding Welsh Health Specialist Services Committee (WHSSC) and provision of staffing","Approval to provide new healthcare services to new and existing organisations\n","Chief Operating Officer on advice of relevant Clinical Board Director","Signed off by Executive Director of Strategic Planning where there is a potential impact on commissioning strategy and Executive Director of Strategic Planning where there is a potential impact on the UHB long-term strategy\nNote: Clinical Boards at Level 3 have autonomy to provide services without deferring to Chief Operating Officer.\n"]
[null,"Maintaining a register of provider contracts","Executive Director of Finance"]
[null,"Ensuring every provider contract has a lead manager responsible for ensuring that contract delivers activity, quality and finance","Executive Director of Finance"]
[null,"Agreement of annual contract ","Nominated lead manager (within existing budget)"]
[null,"Agreement of contract variations","Nominated lead manager (within existing budget)"]
[null,"Signing contracts of value < £75,000 and contract variations > £25,000","Nominated lead manager "]
[null,"Signing contracts of value < £125,000 and contract variations > £75,000","Executive Director of Finance on recommendation of nominated lead manager"]
[null,"Signing contracts of value < £500,000 and contract variations > £125,000","Chief Executive on recommendation of nominated lead manager"]
[null,"Agreement of changes to contracts where this would place a cost pressure on the organisation which cannot be funded within existing budgets","Executive Director of Finance (subject to business case/Integrated Medium Term Plan process)"]
[null,"Ensuring that services are provided to the appropriate standard and within the contract requirements","Nominated lead manager ","Other Clinical Board Directors which provide support services or activity to this contract are responsible for supporting the nominated lead manager in this by delivering their requirements"]
[null,"Ensuring that contracts have appropriate documentation in place including key performance metrics relating to activity, targets, quality and finance and that regular performance monitoring meetings take place","Nominated lead manager"]
[null,"Ensuring every commissioning contract has a lead finance manager responsible for monitoring financial activity and supporting the lead manager to manage the contract","Executive Director of Finance"]
[null,"Ensuring invoices are raised for contracts excluding NHS LTAs","Nominated lead manager (within delegated authority)"]
[null,"Ensuring invoices are raised for NHS LTAs","Head of Finance (Financial Management and Strategy)"]
[]
["Arbitration or legal dispute","Decision to go to arbitration or take legal action in relation to any commissioning or provider contract","Chief Executive (or Executive Director of Finance in his/her absence)"]
[]
["WHSSC as provider","Approval of business cases to go to WHSSC for extension of provision of services or new services","Executive Director of Finance on recommendation of relevant Cllinical Board Director","Must be agreed with any other Clinical Board Directors whose service it will impact on and with the Chief Operating Officer > £0.5m. Cases over £0.5m recurring to be signed off via Management Executive to ensure alignment with UHB commissioning strategy. "]
[null,"Approving and signing the annual contract with WHSSC","Executive Director of Finance "]
[null,"Responding to correspondence from WHSSC","Any Executive Director, Clinical Board Director or Director of Operations","Copied to Director of Finance or Head of Finance (Specialist Services)"]
[null,"Agreeing contract variations with WHSSC","Executive Finance Director or Head of Finance (Specialist Services)","Based on business cases and recommendation of relevant Clinical Board Director"]
[null,"Providing activity and financial contract monitoring information to WHSSC","Head of Finance (Specialist Services)"]
[null,"Providing quality contract monitoring information to WHSSC","Executive Nurse Director"]
[null,"Lead for regular contract monitoring meetings with WHSSC","Executive Director of Finance, Executive Nurse Director, Clinical Board Director, and Clinical Board Director of Operations, Head of Finance for Specialist Services and Women and Children Clinical Boards","Others as appropriate "]
[null,"Ensuring that the services provided to WHSSC are in line with LTA i.e. activity, finance, safety and quality.  Ensuring that appropriate quality of information is provided to enable contract monitoring","Clinical Board Directors,  delegated to Clinical Directors and Directorate Managers"]
[null,"Ensuring that any issues which require escalation around WHSSC contracts are escalated with appropriate proposals around mitigations","All members of staff"]
[]
["WHSSC as commissioner","Attending Joint Committee meetings","Chief Executive"]
[null,"Attending WHSSC Management Group","Executive Director Strategic Planning and Assistant Director - Corporate Finance"]
[null,"Input to WHSSC commissioning decisions and agreement to WHSSC policies","Executive Director of Strategic Planning (and Executive Director of Finance if these involve additional financial commitment)","Appropriate advice to be sought from Medical Director, Chief Operating Officer, other Executives and relevant Clinical Board Directors to gain a UHB view prior to input and/or agreement.  "]
[null,"Dissemination of WHSSC commissioning policies throughout the organisation","Executive Director of Strategic Planning ","In accordance with UHB Policies, Procedures and Written Control Documents Policy"]
[null,"Approving and signing the annual contract with WHSSC as commissioner","Chief Executive"]
[null,"Agreeing contract variations with WHSSC","Executive Director of Finance"]

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[null,"Financial Freedoms"]
[]
["Every cost centre must have a single approved budget holder. They are accountable for ensuring that budgets do not overspend and that expenditure is committed within the UHB financial policies and procedures"]
["Budget holders and their delegated approval levels are approved via the relevant documentation which is provided by the Finance Department with records held in the Finance Department"]
["Budget holders can nominate authorised signatories for individual cost centres who can commit expenditure on the budget within agreed delegation levels.  "]
["Individual members of staff can place orders, but these will be authorised either by a budgetholder or authorised signatory prior to expenditure being committed"]
["Where no budget holder has been nominated for an individual cost centre, the default budgetholder for that cost centre is the Clinical Board Director or the relevant Executive Director"]
["When budget holders are on leave they can appoint a formal deputy whilst they are on leave to manage their budgets. This needs to be confirmed to the budget holder's manager in writing. This will not normally need to be done as the authorised signatories can incur expenditure while the budget holder is absent"]
[]
["Area","Delegated Matter","Delegated to","Comment"]
["Policies and procedures","Approve Standing Financial Instructions and Standing Orders","Board"]
[null,"Approve subsidiary financial  procedures","Executive Director of Finance or Audit Committee where significant risk to the organisation or a control issue"]
[null,"Ensuring that budget holders have appropriate skills/knowledge to manage their budgets","Line manager of budget holder","Director of Finance has ultimate responsibility under SFIs for this"]
[null,"Manage expenditure within budget","Budget manager"]
[null,"Work within financial policies and procedures","All employees"]
[]
["Management of budgets (Excluding Capital Schemes)","Approval of annual budgets - Corporate Departments and Clinical Boards","Board"]
[null,"Approval of annual detailed budgets for Corporate Departments within budget signed off by Board","Relevant Executive Director"]
[null,"Approval of annual detailed budgets for Clinical Boards within budget signed off by Board","Chief Operating Officer and Executive Director of Finance"]
[null,"Delegation of budgets to budget holders including ensuring the appropriate documentation is completed and returned to the Finance Department","Executive Director or Clinical Board Director"]
[null,"Approval of additional budget signatories to budgets including ensuring the appropriate documentation is completed and returned to the Finance Department","Budget holder"]
[null,"Authorisation of expenditure above or outside budget","Chief Executive","Reported to Audit Committee"]
[]
["Budget virements","Within Clinical Board or Corporate Department","Clinical Board Director or relevant Executive Director or Head of Delivery"]
[null,"Across Clinical Boards","Chief Operating Officer and Executive Director of Finance"]
[null,"Across Corporate Departments","Relevant Executive Directors if agreed, or Chief Executive and Executive Director of Finance"]
[null,"Across Corporate Departments and Clinical Boards","Relevant Executive Directors if agreed, or Chief Executive and Executive Director of Finance"]
[null,"Notification of budget virements to Finance Department to ensure the budget is updated","Person authorising the virement"]
[]
["Authority to procure revenue goods and services of  excluding medicines, medical gases and contracts for healthcare ","< £10k","Budgetholder (limit set by Clinical Board or relevant Executive Director)"]
[null,"<£75k","Clinical Board Director, Directors of Operations, Assistant Directors and other Senior Officers (limit set by Clinical Board Director or relevant Executive Director)"]
[null,"<£125k ","Executive Director"]
[null,"<£500k","Chief Executive"]
[null,"<£1m","Board"]
[null,"> £1m (Total cost over the period of the contract)","Welsh Government"]
[]
["Authority to procure medicines and medical gases ","< £10k","Chief Pharmacist or Principal Pharmacist","A detailed scheme of delegation is in place for medicines procurement"]
[null,"> £10k - £50k","Chief Pharmacist or Principal Pharmacist","These relate to the size of an order for a group of medicines, not to an individual medicine"]
[null,"> £50k - £100k","Clinical Board Director - Clinical Diagnostics and Therapeutics"]
[null,">£100k - £250k","Chief Operating Officer "]
[null,"> £250k - £500k","Executive Director of Finance"]
[]
[null,"Stock for use at ward level including controlled drugs","Ward sister/charge nurse"]
[null,"Approval of business case to add/remove medicine to Formulary including NICE and AWMSG recommended drugs","Medical Director via Medicines Management Group"]
[null,"Approval to provide medicine (restricted or not normally available) to individual (exceptional) patient","Relevant Clinical Board Director(s) ","Subject to IPFR framework and policies"]
[]
["Off-payroll working (as per procurement process guidance)","Completion of service specification and check on employment status which is to be forwarded to the Head of Procurement","Clinical Board Director / Clinical Board Director of Operations / Executive Director (support provided by Finance and Workforce)"]
[null,"Procurement process undertaken ensuring suppliers are aware of the employment status.","Assistant Director of Procurement"]
[null,"Clinical Board Director / Clinical Board Director of Operations / Executive Director to be notified of the contract award including reaffirming the employment status of the engagement.","Assistant Director  of Procurement"]
[null,"If status is deemed to be employed, completion of IR35 off-payroll enrolment","Clinical Board Director / Clinical Board Director of Operations / Executive Director"]
[]
["Management of stock","Responsibilty to ensure that stock levels are appropriately managed and rotated","Directors of Operations and Delivery"]
[null,"Agree consignment levels and hold consignment Registers for all stores areas","Assistant Director  of Procurement"]
[null,"Completion of returns requesting write off of stock","Budget Holder"]
[null,"Approval of write off of stock","Reported to Losses and Special Payments Panel and approved by Audit Committee"]
[null,"Responsibility for the security of stock for their area including consignment stock","Directors of Operations - can be devolved to named individuals"]
[]
["Cash including banking and patients' monies","Management of cash and bank accounts","Executive Director of Finance"]
[null,"Approval of petty cash <£20","Budget holders"]
[null,"Approval of petty cash £20-£100","Assistant Finance Director - Corporate and Strategy"]
[null,"Reimbursement of patients' monies held on trust (non-Mental Health)","Cashiers make payment on evidence of information provided within Cash and Valuables Book and official \"system\" receipt","Refer to Patients' Property Policy "]
[null,"Reimbursement of patient monies (Mental Health)"]
[null,"Where patient has capacity","Cashiers make payment on authorisation of patient and Ward Manager/Deputy Ward Manager.","Note Cashiers check that the patient has available funds in their account"]
[null,"Where patient is shown to lack capacity with regard to making this particular decision","Cashiers make payment on authorisation Ward Manager/Deputy Ward Manager witnessed by another member of staff.  Another member of staff collects the money from Cashiers with the patient.","As above.  Need to ensure that adequate checks in place to ensure compliance with Mental Capacity Act"]
[]
["Capital schemes","Approval of business cases for submission to Welsh Government"]
[null,">£1m","Board","This is outside of current delegation limits but at submission stage there is no commitment to provide/recieve funding.  Where the UHB is required to contribute funding the usual limits will apply."]
[null,"<£1m","Chief Executive on advice of Management Executive","As above"]
[null,"Approval of business cases for submission for in-year funding e.g. Health Technologies fund","Management Executive ","As above"]
[null,"Set budgets for capital schemes as part of the annual budget setting arrangements","Board","Based on prioritised recommendations from the Management Executive"]
[null,"Agree budget holders for each capital scheme and ensure appropriate documentation is completed and sent to the Finance Department"," Executive Director of Finance"]
[null,"Nominate an Executive Director for each capital scheme with a value of > £200k ","Executive Director of Finance"]
[null,"Ensure overall UHB capital programme is delivered within budget and financial policies","Assistant Director of Strateci Planning "]
[null,"Ensure individual capital scheme is delivered within budget and within financial policies","Nominated capital budget holder"]
[null,"Budget virements within capital schemes without exceeding approved budget and purpose for which budget originally approved","Nominated capital budget holder, with confirmation from Director of Planning for schemes over £200k"]
[null,"Budget virements across discretionary capital schemes and within discretionary capital budget available including use of contingency "]
[null,"<£500k","Executive Director Strategic Planning, Executive Director of Finance and Chief Operating Officer via Major Capital Group","Note this is above the usual limit for an individual director due to the relative low value within the total capital allocation."]
[null,"<£1m","Chief Executive following recommendation from Major Capital Group","As above"]
[null,">£1m","Board","The Welsh Government will be informed as part of financial monitoring"]
[null,"Approval to sign contracts for capital expenditure - "]
[null,"<£5k","Head of Compliance & Discretionary Capital and Head of Capital Planning"]
[null,"<£25k","Director Capital, Estates and Facilities"]
[null,"<£125k","Executive Directors of Finance"]
[null,"<£500k","Chief Executive"]
[null,">£500k","Board"]
[null,"Approval of staged payments in line with contract for capital expenditure"]
[null,"<£25k","Director of Capital, Estates and Facilities "]
[null,"<£125k","Executive Director of Finance"]
[null,"<£500k","Chief Executive"]
[null,">£500k","Board"]
[null,"Approval of capital expenditure or staged payments for capital expenditure outside budget","Chief Executive, notified to Board"]
[null,"Appointment of architects, quantity surveyors, consultant engineer and other professional advisors with EU Regulations","Director of Capital, Estates and Facilities Executive Director of Finance for all other projects","In line with procurement procedures and within budget available"]
[null,"Day to day liaison with Welsh Government over capital matters (estates, IM&T and medical equipment)","Director of Capital, Estates and Facilities"]
[null,"Approval of additional revenue costs associated with capital expenditure prior to commencement of financial year","Executive Director of Finance following consultation with Management Executive Team","Note: This will also take account of IMTP processes and timescales.\nCBs are not authorised to agree to fund a revenue cost pressure from within their existing resources.\n"]
[null,"Approval of additional revenue costs associated with capital expenditure in year","Chief Executive"]
[null,null,null,"All figures include VAT"]
["Decision to commence with the procurement process with regard to clinical equipment to ensure where appropriate standardisation","Equipment >£5k","Clinical Board Director to ensure agreement as appropriate via Clinical Equipment Group ","Note - for Point of Care Testing Equipment ensure that procurement meets the provisions of the Point of Care Testing Policy"]
[null,"Equipment <£5k","Clinical Director to ensure agreement as appropriate via Medical Equipment Management Group","As above \n"]
[]
["Quotation, tendering and contracting procedures for goods and services excluding primary care, continuing health care and funded nursing care and services commissioned from other health boards","No requirement to obtain quotes for single items up to £1,000 or for items to be purchased using a nationally negotiated contract, but there is always a responsibility to ensure best value","Budget holder","One quote is required \n"]
[null,"Obtaining 2 written quotations for expenditure between £1,000 and £5,000","Assistant Director of Procurement and Directors  of Operations ","Note: up to £5,000 the minimum competition is at the discretion of the Director of Finance\nSingle tender actions shall be permitted under certain limited circumstances.  The Chief Executive has delegated authority to the Director of Finance to approve. (see below) All single tender actions will be reported to the Audit Committee. "]
[null,"Obtaining a minumum of 3 quotations for goods/services from £5,000 to £25,000","Assistant Director of Procurement and Directors  of Operations "]
[null,"Obtaining a minimum of 4 written competitive tenders for goods and services from £25,000-£113k (OJEU Threshold) - Local tender","Assistant Director of Procurement and Directors  of Operations ","This needs to be completed on the E-Bravo system. All quotations should be managed in this way. Procurement Services currently using the electronic system\n"]
[null,"Authority to commence with Single Tender Actions","Executive Director of Finance","See above\n"]
[null,"Approval to go out to contract above EU OJEU limit and upto £1million","Assistant Director of Procurement and Directors  of Operations ","Note: 5 written competitive tenders required.\n"]
[null,"Approval to go out to tender for contracts above £1million","WAG approval required "]
[null,"Approval and signing of contracts < £125 (excluding management consultancy)","Executive Director of Finance"]
[null,"Approval and signing of management consultancy contracts < £125 (excluding capital projects professional advice)","Chief Executive"]
[null,"Approval and signing of contracts £125k - £500k","Chief Executive"]
[null,"Approval of contracts > £500k","Board"]
[null,"Signing of contracts >£500k following approval by the Board","Chief Executive"]
[null,"Approval of contracts > £1million","Welsh Government"]
[null,"Signing of contracts >£1m following approval by the Welsh Government","Chief Executive"]
[null,"Opening Quotations ","E-Bravo System - Procurement"]
[null,"Opening Quotations ","Capital and Estates ","At present Capital and Estates manually process quotations.  This will be moved over to E-Bravo asap"]
[null,"Opening Tenders (Capital and Estates)","Finance Department","This is a temporary arrangement - previously managed by Governance Department"]
[null,"Opening Tenders (Procurement)","E-Bravo System - Procurement","This needs to completed on the ebravo system. All tenders should be managed in this way. Procurement Services currently using the electronic system"]
[null,"Maintenance of Register of Tenders","Assistant Director of Procurement ","This needs to completed on the E-Bravo system. All tenders should be managed in this way. Procurement Services currently using the electronic system"]
[null,"Adding products to catalogues","Assistant Director of Procurement "]
[null,"Inclusion of Supplies within OLR catalogue","Divisional Manager or Clinical Director in conjunction with Supplies Manager or Deputy"]
[null,"All OLR catalogue requisitions up to £20,000","OLR Designated Officer within Divisions"]
[null,"All OLR catalogue requisitions over £20,000","OLR Designated Officer with countersignature of Divisional Manager"]
[null,"Orders exceeding 3 years","Executive Director of Finance or Chief Executive"]
[null,"All contracts for goods and services and subsequent variations to contracts","Executive Director of Finance or Chief Executive with appropriate Clinical Board Director/Executive Director"]
["Information Management &Technology (IM&T)","All purchases of hardware and software must be undertaken in line with agreed IT policies, Procedures and contractual arrangements.",null,"For advice please contact the IT Department"]
[null," No purchase or installation may be made of IT software whether new or upgrades to existing systems other than via the IT department"]
[null,"Purchases of routine desktop hardware should be procured via UHB contracts. Purchasing of servers should always be via IT"]
["Licences and leases for property","Preparation of all tenancy agreements/licences for all staff subject to UHB Policy on accommodation for staff","Director of Capital, Estates and Facilities"]
[null,"Signature of all tenancy agreements/licences for staff (as above)","Executive Director of Finance"]
[null,"Approval of rent based on professional assessment ","Executive Director of Finance"]
[null,"Granting and termination and variation of leases or licences with annual rent less than £100k","Director of Capital, Estates and Facilities","Includes letting of UHB premises to third parties and UHB taking on additional premises"]
[null,"Granting and termination of leases with annual rent greater than £100k","Board"]
[null,"Entering into PFI contract","Board"]
[]
["Condemning and disposal of assets","Maintain losses and special payments register","Executive Director of Finance","Reported to Audit Committee"]
[null,"Items with original value obsolete, obsolescent, redundant, irreparable or cannot be repaired cost effectively"]
[null,"with current/estimated purchase price <£499","Budget Manager"]
[null,"with current purchase new price >£500","Clinical Board Director or relevant Executive Director"]
[null,"with current purchase new price > £5000","Executive Director of Finance"]
[null,"Disposal of mechanical and engineering plant (subject to estimated income exceeding £1,000 per sale)","Executive Director of Finance"]
[null,"Disposal of property or land","Board"]
[]
["Fraud","Reporting a suspected criminal offence relating to business eg fraud, theft etc to the police (see separate section re criminal offences relating to the provision of healthcare or employment)","Executive Director of Finance in association with the Local Counter Fraud Specialist","Refer to Counter Fraud and Corruption Policy"]
[null,"Responsibility to notify Counter Fraud in confidence in case of suspected fraud","All staff"]
[null,"Liaison with the Local Counter Fraud Specialist and Counter Fraud and Security Management Services where there are cases of fraud or corruption or anomalies which indicate fraud or corruption","Executive Director of Finance","Reported to Audit Committee"]
[]
["Losses and compensation","Authorise fruitless payments (including abandoned capital schemes)","Audit Committee (upon recommendations from the Losses and Special Payments Panel)"]
[null,"<£250k","Chief Executive on advice from the Executive Director of Finance"]
[null,">£250k","Welsh Government"]
[null,"Authorise payment for clinical negligence and personal injury claims where legal advice has been obtained and guidance applied (negotiated settlements)","Audit Committee (upon recommendations from the Losses and Special Payments Panel)"]
[null,"<£1m (including plaintiffs' costs)","Executive Nurse Director "]
[null,">£1m","Welsh Government"]
[null,"Other clinical negligence and personal injury claims where legal advice has not been obtained","Audit Committee (upon recommendations from the Losses and Special Payments Panel)"]
[null,"<£25k","Assistant Director of Nursing"]
[null,"£25k-£50k","Executive Nurse Director "]
[null,">£50k","Welsh Government"]
[null,"Authority to write off losses and authorise special payments for bad debts and claims abandoned - private patients, overseas visitors and others."]
[null,"<£50k","Audit Committee (upon recommendations from the Losses and Special Payments Panel)"]
[null,">£50k","Welsh Government"]
[null,"Authority to write off damage to buildings, fittings, furniture and equipment, loss of equipment and property in stores and in use due to culpable causes (e.g. fraud, theft, arson) or other."]
[null,"<£50k","Audit Committee (upon recommendations from the Losses and Special Payments Panel)"]
[null,">£50k","Welsh Government"]
[null,"Authorise compensation payments made under legal obligation (excluding Clinical Negligence and Personal Injury)","Chief Executive"]
[null,"Authorise extra contractual payments to contractors."]
[null,"<£50k","Executive Director of Finance"]
[null,">£50k","Welsh Government"]
[null,"Authorise ex-gratia payments to patients and staff for the loss of personal effects"]
[null,"<£1k","Small Claims Panel"]
[null,"<£10k","Executive Nurse Director "]
[null,"<£50k","Chief Executive"]
[null,">£50k","Welsh Government"]
[null,"Authority to write off Losses of cash due to theft, fraud, overpayment of salaries, wages, fees and allowances"]
[null,"<£50k","Audit Committee (upon recommendations from the Losses and Special Payments Panel) "]
[null,">£50k","Welsh Government"]
[]
["Setting of fees and charges","Private patient, overseas visitors, income generation and other related services","Director of Finance","In line with Welsh Government policy"]
[]
["Sponsorship","Sponsorship to attend courses and conferences","Executive Director or Clinical Board Director. Individual is responsible for ensuring this is notified on the gifts and hospitality register","Refer to Standards of Behaviour Framework Policy incorporating Declarations of Interest, Gifts, Hospitality and Sponsorship"]
[null,"Sponsorship of UHB events e.g. Nursing Conference","Executive Director or Clinical Board Director up to £500. Director of Finance above £500."]
["Fundraising","Approval of fundraising using UHB premises or facilities or staff time within working hours","Executive Director of Finance on recommendation from Clinical Board Director","Need to be clear of difference between UHB and charitable funds"]
[]
["Advertising","Approval of paid for contracts for advertising UHB or its services other than those set out below","Director of Finance","Anything else we routinely advertise?"]
[null,"Advertising relating to sale of properties","Director of Capital, Estates and Facilities"]
[null,"Advertising relating to recruitment","Executive Director of People and Culture"]
[null,"Advertising relating to public health initiatives","Director of Public Health"]
[null,"Public advertisements relating to UHB governance eg advertising AGM or Board meetings","Director of Corporate Governance"]
[null,"Advertising relating to income generation schemes within a Clinical Board up to £5,000","Clinical Board Director "]
[]
["Intellectual Property","Agreement to register intellectual property","Executive Director of Finance"]
[]
["Submission of funding bids excluding Research and Development (R&D)","Agreement to submit proposals for accessing capital or revenue funding from  Welsh Government or any other funding body (excluding R&D but including Invest to Save, Health Technologies Fund etc)","Executive Director of Finance on recommendation of person drawing up the bid","Major bids may need to go via HSMB or Management Executive"]
[]
["Charitable Funds","Agreeing a budget holder for each individual fund","Execytuve Director of Finance","Note, authorised signatories are not allowed for charitable funds"]
[null,"Approval of use of charitable funds < 25k","Budget holders"]
[null,"Approval of use of charitable funds > 25k","Charitable Funds Committee"]
[null,"Approval of new staff expenditure","Charitable Funds Committee"]
[null,"Approval of use of charitable funds > 125k","Trustee"]
[null,"Investment of charitable funds","Executive Director of Finance"]
[]
["Commercial R & D","Approval and execution (by signature), on behalf of the UHB, of the contract between the UHB and commercial Sponsor for the UHB's delivery of a clinical trial/investigation on behalf of the Sponsor. ","Executive Medical Director ","Principal investigators (normally a consultant) initiate R&D authorised commercial clinical trials in association with external funding and external trial management."]
[null,"Approval and execution (by signature) of service level agreements between the UHB and other NHS organisations and/or third parties for support services required for commercial trials ","Executive Medical Director ","UHB provides support to other NHS Institutions (principally Velindre NHS trust) for the delivery of commercial trials and vice versa ( e.g. radiology), other suppliers to the UHB include Spire and Cardiff University (CU)."]
[null,"Allocation of Commercial R & D Income","Executive Director of Finance at direction of Executive Medical Director","Income allocated to Clinical Boards, Directorates, PrincipaI Investigator (PI) accounts, support departments and third parties including Higher Education Institutes (HEIs) (principally CU)  in line with process agreed with R & D Office (ISR-RD-005 FAQS re RD Funding - V1 FINAL 180713)."]
[null,"Responsibility for delivering R&D activity in line with funded budgets and maintaining audit trail of expenditure to demonstrate that it is expended on R&D","Clinical Board Director via R&D Lead","Accountable to Medical Director"]
[null,"Approval of expenditure to support Commercial R & D","Authorised by the relevant Clinical Board/Directorate Manager","Subject to UHB Standing Orders and SFIs"]
[null,"Approval of use of Principal Investigator Balances","Authorised by the relevant Clinical Board/Directorate Manager & Clinical Board/Directorate  R & D Lead","Subject to UHB Standing Orders and SFIs & agreed protocol  (ISR-RD-005 FAQS re RD Funding - V1 FINAL 180713)."]
[null,"Closure of 'Time Barred' (18 month post study closure date) Principal Investigator Balances","Executive Director of Finance","Subject to process agreed with R & D Office & T&F Finance Group (ISR-RD-005 FAQS re RD Funding - V1 FINAL 180713)."]
[null,"Allocation of budgets from  Research Legacy Fund to Clinical Boards","Executive Director of Finance","Subject to process agreed with R & D Office & T&F Finance Group (Use of surplus funds generated from commercial trial activity)"]
[null,"Approval of use of Central Research Legacy Fund","R&D Director"]
[null,"Approval of use of Research Legacy Funds devolved to Clinical Boards ","Expenditure authorised by the relevant Clinical Board/Directorate Manager & Clinical Board/Directorate R & D Lead","The Clinical Board/Directorate Research & Development Leads Group review reports detailing the deployment of the Research Legacy Fund"]
["Non-Commercial Funded \nR & D","Approval of UHB led R & D Grant applications","Executive Director of Finance on recommendation from R&D Office ","PI to complete with advice and input   from Finance Department. Signatures can be required at very short notice. Grant applications can vary from £1k to > £2m"]
[null,"Approval of R & D Grant applications led by other organisations where UHB commitment is <£75k","R&D Director"]
[null,"Approval of R & D Grant applications led by other organisations where UHB commitment is £75k-£125k","Medical Director"]
[null,"Approval of R & D Grant applications led by other organisations where UHB commitment is £125k-£500k","Chief Executive"]
[null,"Acceptance of UHB R & D Grants ","Director of Finance on recommendation from R&D Office ","Terms and Conditions can vary."]
[null,"Agreement to support costs in Grant applications led by external organizations.","Director of R & D (delegated to R&D Manager in absence of R&D Director)","For example, the UHB may be asked to confirm that  NHS support costs included within Cardiff University  grant applications are reasonable and will be supported from core NISCHR funding. "]
[null,"Agreement of annual contract with National Institute for Social Care and Health Research (NISCHR)","Executive Medical Director and Executive Director of Finance"]
[null,"Day to day liaison with NISCHR including submission of bids/proposals/contract changes <£75k","R&D Director"]
[null,"Approval of NISCHR bids/proposals/contract changes >£75k","Executive Medical Director and Executive Director of Finance"]
[null,"Allocation of NISCHR R & D Income","Executive Director of Finance","Determined by Financial Strategy & Plan"]
[null,"Allocation of Budget associated with NISCHR R & D Income","Executive Director of Finance with agreement of Executive Medical Director","The Budget allocation to Clinical Boards & Directorates is informed by the NISCHR Funding formula, R&D Strategy and recommendation from the R&D Director"]
[null,"Approval of application to NISCHR for Excess Treatment Cost Funding","R&D Director","PI to complete with advice and input  from Finance Department.  R&D Director to approve in accordance with NISCHR requirements  "]
[null,"Authorization of Expenditure associated with NISCHR & other externally funded R & D Projects","Expenditure Authorised by the relevant Clinical Board/Directorate Manager & Clinical Board/Directorate R & D Lead"]
[null,"Non Commercial Site Agreements where financial transactions are <£75k","R&D Director"]
[null,"Non Commercial Site Agreements where financial transactions are £75k-£125k","Executive Medical Director"]
[null,"Non Commercial Site Agreements where financial transactions are £125k-£500k","Chief Executive"]
[null,"Service Level Agreements where there are financial transactions <£75k","R&D Director","UHB provides support to other NHS organizations for the conductance of trials."]
[null,"Service Level Agreements where there are financial transactions >£75k-£125k","Executive Medical Director"]
[null,"Service Level Agreements where there are financial transactions £125k-£500k","Chief Executive"]
["Inter Clinical Board trading arrangements","Agreeing inter Clinical Board trading arrangements which involve recharging other Clinical Boards for services","Executive Director of Finance based on proposal to go to HSMB"]
[]
["Business cases for new investment ","Sign off of business cases for new investment","Chief Executive and Executive Director of Finance","Should normally be via annual budget setting process"]
[]
["Welsh Risk  Pool","Approve UHB input into Welsh Risk Pool policies and procedures and financial risk sharing arrangements","Executive Director of Finance and Executive Nurse Director","Note:  Further attention required as risk pooling arrangements change  "]

{"sheet":"Workforce & OD","index":5,"n_rows":62,"n_cols":5,"rows_kept":62,"cut":false,"hidden":false,"merged":[[0,0,0,4],[1,4,2,4],[53,0,53,1],[56,0,56,1],[53,2,53,4],[1,0,2,0],[1,1,2,1],[1,2,2,2]]}
["Workforce and Organisational Development Freedoms"]
["Area","Delegated Matter","Delegated to",null,"Comment"]
[]
["Appointment of staff ","Appointment of staff within funded establishment (all staff groups excl Consultant Medical and Dental)  ","Clinical Board Directors , Corporate Directors and Assistant Directors.",null,"Delegation applies when Clinical Board/Corporate Directorate is in financial balance otherwise special interim arrangements may apply, for example approval via vacancy clearing panel.   "]
[null,"Engagement/Recruitment of Consultant Medical/Dental Staff - New, Replacement and Retire and Return","Chief Operating Officer/Executive Medical Director and Executive  Director of Finance"]
[null,"Engagement of staff outside funded establishment leading to increase in revenue cost but within budget.   ","Chief Executive","Current Scheme of Delegation says nominated deputy in absence of Chief Executive.  Need to cross reference with SFI's "]
[]
["Pay and conditions","Approval of additional increments to staff within budget and All Wales Terms and Conditions on recruitment. ","Heads of Workforce and Organisational Development"]
[null,"Approval of revised job resulting in change in grade in line with agreed policy and All Wales Terms and Conditions","Heads of Workforce and Organisational Development","Current Scheme of Delegation:  Written authority to suitably qualified HR staff "]
[null,"Staff re-grading in line with agreed policy and All Wales Terms and Conditions","Assistant Director of Workforce","Current Scheme of Delegation:  Written authority to suitably qualified HR staff "]
[null,"Agreement to recommend to the Welsh Government payments in accordance with Recruitment and Retention Payments Protocol","Director of People and Culture",null,"Recommendation will be made by the Director of Workforce and Organisational Development following the completion of the appropriate steps within the protocol.\n"]
[null,"Agreement of variations affecting pay and hours of work for existing employees in line with agreed policy and All Wales Terms and Conditions","Directorate/Locality Managers or Heads of Departments for Corporate Departments"]
[null,"Authority to complete standing data forms affecting pay, new starters, variations and leavers","Line Managers"]
[null,"Authority to authorise travel, subsistence expenses and exam fees (within 3 months of incurring expenditure)","Line Managers"]
[null,"Authority to authorise travel, subsistence expenses and exam fees (after 3 months of incurring expenditure)","Heads of Finance"]
[null,"Authorisation of non travel related expenses incurred by staff ","Line Managers","Exceptional circumstances only, supplies procedure should be followed"]
[]
["Approval of relocation costs ","Chief Executive and Directors","Reserved for Remuneration and Terms of Service Committee"]
[null,"Medical and Dental Staff","Executive Medical Director"]
[null,"All other staff groups  ","Executive Directors"]
[]
["Approval of lease cars ","Chief Executive and Directors","Reserved for Remuneration and Terms of Service Committee"]
[null,"Other staff","Executive Director",null,"Refer to Lease Car Policy"]
[]
["Approval of mobile phones","Chief Executive","UHB Chair"]
[null,"Directors","Chief Executive"]
[null,"Other staff","Line Manager based on needs of role",null,"Refer to Management, Issue and Use of UHB Mobile Phone Policy and "]
[]
["Short term engagement of additional staffing resources","Approval of Overtime/Bank","Line Managers"]
[null,"Authorisation Of Temporary/Locum Medical and Dental Staff - on contract (MEDACS)","Clinical Board Director or Executive Directors for Corporate Departments*",null,"Refer to arrangements for engaging staff via MEDACS.  Executive Directors to retain authority for \"corporate departments\" e.g. Infection, Prevention and Control and Public Health.  "]
[null,"Authorisation Of Temporary/Locum Medical and Dental  Staff - off contract ","Clinical Board Director or Executive Directors for Corporate Departments"]
[null,"Approval of other Agency staff where agency on GPS Contract - Nursing","Clinical Board Nurses or Assistant Directors for Corporate Departments"]
[null,"Approval of other Agency Staff - Nursing utilising Thornbury","Executive Nurse Director"]
[null,"Approval of other Agency Staff - Therapies and Health Sciences","Directors of Operations",null,"New section capturing Health Scientists."]
[]
["Providing staff to or seconding staff from other organisations (e.g staff with academic commitments, seconding staff to partner agencies)","See Commissioning and Provision of Services section"]
[]
["Approval of Leave","Setting framework for numbers of staff on leave at any one time to maintain service delivery.  ","Line Managers"]
[null,"Annual leave approval","Line Managers",null,"May be formally delegated by Line Manager to supervisor/team leader"]
[null,"Annual leave - approval of carry forward in exceptional circumstances (up to a maximum of 5 days)","Clinical Board Directors, Clinical Board Nurses or Directors of Operations /Assistant Directors for Corporate Departments",null,"This should also only be in exceptional circumstances "]
[null,"Annual leave - approval of carry forward of leave accrued during periods of approved absence e.g. sickness/maternity leave in accordance with policy and statutory provisions","In accordance with policy",null,"Refer to appropriate policy.  Seek further advice from Heads of Workforce and OD/Assistant Director of HR if necessary. "]
[null,"Approval of Special Leave (to include compassionate, carers and leave with pay)","Line Managers",null,"Refer to Special Leave Policy"]
[null,"Approval of Leave without pay ","Directorate Managers/ Head of Department for Corporate Departments",null,"Refer to Special Leave Policy"]
[null,"Medical and Dental Staff Leave of Absence (Paid and Unpaid)","Clinical Board Director*",null,"Executive Director for \"corporate departments\" e.g. Public Health and Infection, Prevention and Control"]
[null,"Approval of Time off in Lieu","Line Managers"]
[null,"Approval of maternity and paternity leave in line with Policy","Line Managers"]
[null,"Sick Leave - return to work on phased basis to assist recovery in accordance with policy. ","Line Managers"]
[null,"Extension of sick leave on full or ½ pay - Directors","Reserved for Board"]
[null,"Extension of sick leave on full or ½ pay - Other Staff","Chief Operating Officor/Executive Directors for Corporate Departments"]
[null,"Approval of study leave <£2k","Heads of Department"]
[null,"Approval of study leave >£2k (Requires amendment to Scheme of Delegation) ","Clinical Board Directors or Executive Directors","Requires amendment to Scheme of Delegation if to delegate further"]
[]
[]
["Approval of voluntary early release (VERS), redundancy and early retirement",null,"THIS HAS NOT BEEN DELEGATED - RESERVED FOR REMUNERATION AND TERMS OF SERVICE COMMITTEE"]
["Disciplinary Investigations and Dismissal of Staff","Dismissal of staff - in accordance with policy relevant to staff group. Where the policy applicable to the case in question does not confer delegated power (for instance where Welsh Health Circular 90 (22) applies), the UHB may delegate its functions to a sub Committee of the Board, comprising 3 Board Members, none of the Members of the Sub Committee will have had previous involvement with the case.","Appropriate officer with advice of Heads of Workforce and Organisational Development or Sub Committee of the Board as the case may be.","Levels specified in O4E documentation.  What are current arrangements?","Refer to appropriate policy."]
[]
["Recognition of Staff Representatives",null,"Director of People and Culture",null,"Note There should be discussion and agreement with line managers before individuals are put forward for accreditation."]
[]
["Extended Role Activities","Approval of nurses and other professionals to undertake duties/procedures which can be properly described as beyond the normal scope of practice.","Appropriate executive lead in association with the Executive Medical Director"]
[]
["Approval of Consultant Medical and Dental Job Plans","All staff excluding Clinical Directors","Clinical Directors"]
[null,"Clinical Directors","Clinical Board Directors"]

{"sheet":"Corporate","index":6,"n_rows":66,"n_cols":4,"rows_kept":66,"cut":false,"hidden":false,"merged":[[0,0,0,3],[21,2,23,2]]}
["Corporate"]
["Area","Delegated Matter","Delegated to","Comment"]
["Attestation of sealing in accordance with Standing Orders","(a) custody","Director of Corporate Governance"]
[null,"(b) register of sealings","Director of Corporate Governance"]
[]
["Declarations of Interest and Gifts, Hospitality and Sponsorship of individual employees","Set direction, policies and procedures","Director of Corporate Governance","Policies approved by the Board on the recommendation of the Audit Committee\nNote: Policy subject to review"]
[null,"Maintaining the Register of Interests and the Register of Gifts, Hospitality and Sponsorship","Head of Risk and Regulation"]
[null,"Responsibility for declaring a relevant interest or the receipt of a gift, hospitality or sponsorship","All employees","Refer to Standards of Behaviour Framework including Declarations of Interest, Gifts, Hospitality and Sponsorship Policy"]
[null,"Approval of the receipt of any gift, hospitality or sponsorship requires recording under the policy","Clinical Board Directors or Executive Directors","Gifts above £25 should not be accepted but if a gift is offered and it is not possible to decline it must be declared.  Only gifts of low value can be accepted from commercial organisations e.g. pens, diaries. Hospitality only acceptable under very limited circumstances.  Tickets to sporting events must not be accepted.  Refer to above policy for full details."]
[null,"Corporate sponsorship - see Finance section","Executive Director of Finance"]
[]
["Contractor's Responsibilities","Ensuring contractors and their employees are aware of any requirement to comply with Standing Orders and Standing Financial Instructions","Executive Director for area to which contract relates or Designated Capital Scheme Manager","Also refer to Finance and Commissioning sections."]
[]
["Indemnity/Insurance Policies ","Making arrangements to ensure that appropriate insurance/indemnity is in place - UHB wide ","Director of Corporate Governance"]
[null,"Making arrangements to ensure that appropriate insurance/indemnity is in place - Clinical Board Specific ","Directors of Operations Assistant Directors for Corporate Departments","Note: There are strict rules regarding the UHBs ability to purchase commercial insurance.  Advice should be sought from the Governance Department "]
[]
["Risk Management ","Set direction, policies and procedures","Director of Corporate Governance","Policies approved by the Audit Committee"]
[null,"Management and maintenance of the Corporate Risk Register and Assurance Framework","Head of  Risk and Regulation","Refer to Risk Register and Risk Assessment Procedure"]
[null,"Management and maintenance of the Clinical Board Risk Registers","Directors of OperationsAssistant Directors for Corporate Departments","Refer to Risk Register and Risk Assessment Procedure"]
[null,"Management and maintenance of Directorate Risk Registers","Directorate Managers or Heads of Department for Corporate Departments","Refer to Risk Register and Risk Assessment Procedure"]
[]
["Relationships with Press","Non-Emergency General Enquiries","Director of Communications, Manager on call or Executive Director"]
[null,"Within Hours"]
[null,"Outside Hours"]
[]
["Documents for Legal Proceedings","Approve and sign documents necessary either in legal proceedings or resolution of the Board","Refer to Standing Orders and other sections regarding specific categories of documents. "]
[]
["Legal advice","Engagement of UHB Solicitors and contract management","Director of Corporate Governance"]
[null,"Authority to seek legal advice - all issues","Director of Corporate Governance"]
[null,"Authority to seek advice on specific legal issues \n- clinical issues excluding mental health act legislation","Director of Corporate Governance"]
[null,"Advice regarding interpretation of Mental Health Act Legislation","Mental Health Act Manager for urgent items.  Otherwise via Director of Corporate Governance"]
[null,"Advice regarding interpretation of Mental Capacity Legislation/Deprivation of Liberty","Mental Capacity Manager for urgent items.  Otherwise via Corporate Governance"]
[null,"Advice regarding human resources legislation","Assistant Director of Workfoce"]
[null,"Advice regarding property matters (relating to capital works and disposal of property","Director of Capital, Estates and Facilities"]
[null,"Advice regarding clinical negligence and personal injury claims","Claims Managers"]
[]
["Information Governance and Data Protection\n","Set direction, policies and procedures","Director of Digital Health Intelligence","Policies approved by Digital Health Intelligence Committee "]
[null,"Information risk policy and statement of internal control in respect of information governance","Director of Digital Health Intelligence","As above"]
[null,"Operational procedures within the Clinical Boards and Corporate Directorates and ensuring compliance with legal requirements, guidance and best practice.","Directors of Operations or Assistant Directors of Corporate Directorates"]
[null,"Provision of advice and support to Clinical Boards and Corporate Directorates","Head of Information Governance"]
[null,"Corporate training programme - development and maintenance","Head of Information Governance"]
[null,"Clinical Board and Corporate Directorates training programmes - local development and implementation","Directors of Operations or Assistant Directors of Corporate Directorates"]
[null,"Responding to the Records Management NHS Code of Practice - Subject Access Requests - General Enquiries","Head of Health Records "]
[null,"Responding to Data Protection Act - Subject Access Requests - specific to data protection queries and best practice ","Director of Digital Health Intelligence"]
[null,"Data Protection Breaches - refer to Quality and Patient Experience section re incidents"]
["Caldicott Standards\n","Caldicott Standards and Action Plan","Executive Medical Director "]
["Freedom of Information Act Compliance ","Set direction, policies and procedures","Director of Digital Health Intelligence","Policies approved by Digital Health Intelligence Committee "]
[null,"Acknowledgement of request and liaison with requester","Director of Digital Health Intelligence"]
[null,"Ensure framework in place and arrangements for providing information to facilitate provision information to requester","Directors of Operations or Assistant Directors of Corporate Departments"]
[null,"Approval of response prior to sending to requester","Clinical Board Director or Executive Directors"]
[null,"Approval of response where it found that information is not held or will be refused under an appropriate exemption ","Head of Information Governance"]
[null,"Sending final response to requester","Director of Digital Health Intelligence"]
[null,"Management of and response to any complaints received under the Freedom of Information Act","Director of Digital Health Intelligence"]
["Information Sharing Protocols (ISPs)\n","Set direction, policies and procedures in accordance with Welsh Accord for Sharing Personal Information","Director of Digital Health Intelligence"]
[null,"Operational procedures within the Clinical Boards and Corporate Directorates and ensuring compliance with legal requirements, guidance and best practice.","Directors of Operations or Assistant Directors of Corporate Directorates"]
[null,"Provision of advice and support and overall co-ordination","Head of Information Governance"]
[null,"Development of ISPs","Heads of Operations and Delivery or Assistant Directors of Corporate Departments"]
[null,"Approval and sign off of ISPs","Director of Digital Health Intelligence"]
[null,"Archiving of ISPs in corporate library","Head of Information Governance"]
[null,"Corporate training programme - development and maintenance","Head of Information Governance"]
[null,"Clinical Board and Corporate Directorates training programmes - local development and implementation","Directors of Operations or Assistant Directors of Corporate Directorates"]
["Data Quality\n","Set direction , policies and procedures","Director of Finance"]
[null,"Ensuring data input into systems is of appropriate quality, accuracy and timeliness and in accordance with UHB policies and procedures ","All Employees"]
[null,"Ensuring data definitions are clear and in line with Welsh Government requirements  ","Assistant Director - Performance and Information"]
[null,"Ensuring that there is a nominated lead for all external data submission","Clinical Board Director, Clinical Director or Assistant Director responsible for data submission"]
[null,"Ensuring the accuracy and timeliness of data submissions and that any issues highlighted as appropriate","Nominated Lead for external data submission"]

{"sheet":"Additional Freedoms at L2&3","index":7,"n_rows":26,"n_cols":6,"rows_kept":26,"cut":false,"hidden":false,"merged":[[10,0,10,5],[12,0,13,0],[12,1,13,1],[12,5,13,5],[12,2,13,3],[12,4,13,4],[21,0,21,5],[23,0,24,0],[23,1,24,1],[23,2,24,3],[23,5,24,5],[23,4,24,4],[0,0,0,6],[3,0,4,0],[3,1,4,1],[3,5,4,5],[2,0,2,5],[3,2,4,3],[3,4,4,4]]}
["Higher Degree of Delegation and Earned Autonomy at Level 2 and 3\nNote: The matters delegated within the wider Scheme of Delegation are delegated at Level 1 - the matters below are additional freedoms delegated to those Clinical Boards assessed as operating at Levels 2 and 3.\n"]
[]
["Quality, Safety and Experience"]
["Area","Delegated Matter","Level 2",null,"Level 3","Comment"]
[]
["Concerns/Complaints Management","Sign off of final draft prior to sending to complainant",null,null,null,"See Comments in main QSE Section re Concerns Management"]
[null,"Grade 1","Clinical Boards to manage complete process after initial grading of concern.  Copy of response to complainant to be sent to Concerns Department following signature",null,"As Level 2","This level of authorisation is dependent on performance and Executive Nurse Director will formally advise each CB when they can proceed to this level of autonomy."]
[null,"Grade 2",null,null,"Clinical Boards to manage complete process after initial grading of concern.  Copy of response to complainant to be sent to Concerns Department following signature"]
[null,"Some Grade 3 concerns",null,"Clinical Board Director for higher proportion of specified list of Grade 3 Concerns  ","Clinical Boards to manage complete process after initial grading and on advice of Concerns Department.  Copy of response to complainant to be sent to Concerns Department following signature"]
[]
["Workforce and Organisational Development"]
[]
["Area","Delegated Matter","Level 2",null,"Level 3","Comment"]
[]
["Appointment of staff ","Appointment of staff within funded establishment (all staff groups excl Consultant Medical and Dental)  ","Clinical Directors and Community Directors","Clinical Director and Community Directors","Clinical Directors and Community Directors","Delegation applies when Clinical Board/Corporate Directorate is in financial balance otherwise special interim arrangements may apply, for example approval via vacancy clearing panel. \n"]
["Pay and conditions","Staff re-grading in line in line with agreed policy and All Wales Terms and Conditions","Assistant Director of Workforce","Head of Workforce and Organisational Development","Assistant Director of Workforce"]
[]
["Short term engagement of additional staffing resources","Authorisation Of Temporary/Locum Medical and Dental Staff - on contract (MEDACS)","Clinical Board Director","Clinical Board Director has freedom to delegate to Clinical/Locality Directors","Clinical Board Director","Refer to arrangements for engaging staff via MEDACS.  Executive Directors to retain authority for \"corporate departments\" e.g. Infection, Prevention and Control and Public Health.  "]
[]
["Approval of Leave","Medical and Dental Staff Leave of Absence (Paid and Unpaid)","Clinical Board Director","Clinical Board Director has freedom to delegate to Clinical/Locality Directors","Clinical Board Director"]
[]
["Commissioning and Provision of Services To and From Other Organisations"]
[]
["Area","Delegated Matter","Level 2",null,"Level 3","Comment"]
[]
["Provision of services by UHB to other organisations excluding Welsh Health Specialist Services Committee (WHSSC) and provision of staffing","Approval to provide new healthcare services to new and existing organisations\n",null,"Clinical Director and Community Directors","Clinical Board Director"]

{"sheet":"Executive Responsibilities","index":8,"n_rows":112,"n_cols":3,"rows_kept":112,"cut":false,"hidden":false,"merged":[]}
["Executive Director Responsibilities"]
["Delegated Matter","Corresponding Legislation if applicable","Responsible Officer"]
["Freedom of Information - ensuring appropriate UHB response","Freedom of Information Act 2000","Director of Digital Health Intelligence"]
["Information Governance","Data Protection Act 1998","Director of Digital Health Intelligence"]
["Information Governance","Common Law duty of Confidentiality","Director of Digital Health Intelligence"]
["Information Governance","Access to Health Records Act 1990","Medical Director"]
["Mental Health","Mental Health Act 2007","Chief Operating Officer"]
["Mental Health","Mental Health Measure","Chief Operating Officer "]
["Human Rights","Human Rights Act 1998","Executive Director of People and Culture"]
["Equality","Equality Act 2010","Executive Director of People and Culture"]
["Equality","Socio-economic Duty - Equality Act 2010 (Authorities subject to a duty regarding Socio-economic Inequalities) (Wales) Regulations 2021\n","Executive Director of Public Health"]
["Equality","Race Relations Act","Executive Director of People and Culture"]
["Equality","Welsh Language Act","Executive Director of People and Culture"]
["Public Interest/Whistleblowing","Public Interest Disclosure Act / Whistleblowing","Executive Director of People and Culture"]
["Health and Safety - Staff , Students, Contractors and Visitors","Health and Safety at Work Act and Regulations","Executive Director of People and Culture"]
["Health and Safety - Patients ","Health and Safety at Work Act and Regulations","Executive Nurse Director"]
["Health and Safety","Control of Substances Hazardous to Health Regulations","Executive Director of People and Culture"]
["Fire Safety","Fire Safety legislation","Executive Director of People and Culture"]
["Environmental","Environmental Protection Act","Executive Director of People and Culture"]
["Health and Safety","Violence and Aggression legislation","Executive Director of People and Culture"]
["Protection of Children","Children Act 1989, 2004","Executive Nurse Director"]
["Protection of Children","Protection of Children Act 1999","Executive Nurse Director"]
["Protection of Adults and Vulnerable Groups","Care Standards Act","Executive Nurse Director"]
["Protection of Vulnerable Groups","Protecting Vulnerable Groups Act 2006","Executive Nurse Director"]
["Protection of Vulnerable Groups","Sexual Offences Act 2003","Executive Nurse Director"]
["Protection of Adults ","Mental Capacity Act 2005","Executive Nurse Director"]
["Protection of Adults and Vulnerable Groups","Deprivation of Liberty Safeguards","Executive Nurse Director"]
["Concerns","NHS Redress Measure","Executive Nurse Director"]
["Calculating nurse staffing levels for designated acute medical and surgical inpatient wards","Nurse Staffing Levels (Wales) Act 2016","Executive Nurse Director"]
["Food Hygiene","Food Act (Food Hygiene Regulations)","Executive Director of Finance"]
["Clinical Standards","Royal College Standards","Medical Director"]
["Standards","Standards for Health Services in Wales","Executive Nurse Director"]
["Decontamination",null,"Executive Director of Therapies and Health Sciences"]
["Nutrition",null,"Executive Director of Therapies and Health Science"]
["Health and Safety","Ionising Radiation (Medical exposure) Regulations ","Executive Director of Therapies and Health Science"]
["Medicines Management","Medicines legislation (European, UK and Welsh)","Executive Medical Director"]
["Clinical Standards","National Institute for Clinical Excellence Directives","Executive Medical Director"]
["Clinical Standards and Patient Safety","National Patient Safety Agency Directives","Executive Nurse Director"]
["Patient Safety","Blood safety and quality regulations","Executive Medical Director"]
["Patient Safety","Human Tissues Act 2004","Executive Medical Director"]
["Patient Safety","Clinical trials directives and regulations","Executive Medical Director"]
["Patient Safety","Organ Donation","Executive Medical Director"]
["Employment/staff relations","Employment legislation ","Executive Director of People and Culture"]
["Patient Safety","Medical Device Directives and Regulations","Director of Therapies and Health Sciences"]
["Employment/staff relations","European Working Times Directive","Executive Director of People and Culture"]
["NHS Provision","NHS Wales (2006) Act","Executive Director of Strategic Planning"]
["Commissioning","EU Directive on cross border healthcare","Executive Director of Strategic Planning"]
["Public Safety","Civil Contingencies Act 2004","Executive Director of Strategic Planning"]
["Protection of Adults and Vulnerable Groups","Carers Strategy Measure","Executive Nurse Director"]
["Public Health","Smoke Free Premises etc Regulations","Executive Director of Public Health"]
["Public Health","Health Promoting Hospital Vending Directions","Executive Director of Public Health"]
["Finance","NHS Wales Statutory Financial Duties","Executive Director of Finance"]
["Charities","Charities Act ","Executive Director of Finance"]
["Finance and probity","Procurement Legislation","Executive Director of Finance"]
["Information Governance","Computer Misuse Act 1990","Director of Digital Health Intelligence"]
["Continuing Health Care","-","Chief Operating Officer"]
["Funded Nursing Care","-","Chief Operating Officer"]
["Primary Care Contractor management and performance","-","Chief Operating Officer"]
["Admission to Performers List","-","Executive Medical Director"]
["Removal of violent patients from GMS services","Health and Safety at Work Act and Regulations","Chief Operating Officer"]
["Accreditation of enhanced services","-","Chief Operating Officer supported by Executive Medical Director"]
["Dental QAS returns","-","Chief Operating Officer"]
["Primary Care Out of Hours Arrangements",null,"Chief Operating Officer"]
["Representation in Statutory Partnerships","-","Executive Director of Strategic Planning"]
["Unified Assessment",null,"Chief Operating Officer"]
["Care Homes Sector",null,"Chief Operating Officer"]
["Performance Management Arrangements","-","Executive Director of Finance"]
["Receipt and Opening of Quotations","Procurement Legislation","Executive Director of Finance"]
["Cancer Network",null,"Executive Medical Director"]
["Cardiac Network",null,"Chief Operating Officer"]
["Access Targets/Referral to Treatment Times",null,"Chief Operating Officer"]
["Unscheduled Care",null,"Chief Operating Officer"]
["LTA/HCAs",null,"Executive Director of Finance"]
["Land, buildings and assets",null,"Executive Director of Finance"]
["Facilities and Estates Management",null,"Executive Director of Finance"]
["Sustainable Development",null,"Executive Director of Strategic Planning"]
["WHSCC Relationship - Commissioning",null,"Executive Director of Strategic Planning"]
["WHSCC Relationship - Provider",null,"Executive Director of Finance"]
["Primary Care Estates Investments and Approvals",null,"Executive Director of Strategic Planning"]
["Co-ordination of delivery plans (delivery through COO)",null,"Executive Director of Strategic Planning"]
["Clinical Strategy",null,"Executive Director of Strategic Planning"]
["Information Management and Technology (IM&T)",null,"Director of Digital Health Intelligence"]
["Barring and Disclosure",null,"Executive Director of People and Culture"]
["Procurement, Issuing Tenders and Post Tender Negotiations",null,"Executive Director of Finance"]
["External Communications including Media",null,"Chief Executive"]
["Patient Group Directives",null,"Executive Medical Director"]
["Individual Patient Commissioning",null,"Executive Director of Strategic Planning"]
["Caldicott Guardian",null,"Medical Director"]
["Public Health",null,"Executive Director of Public Health"]
["Commissioning",null,"Executive Director of Strategic Planning"]
["Professional Nursing and Midwifery Workforce\nStandards\nEducation\nRegulation",null,"Executive Nurse Director"]
["Professional Medical and Dental Workforce\nStandards\nEducation\nRegulation\nRevalidation",null,"Executive Medical Director"]
["Professional Therapies and Health Sciences Workforce\nStandards\nEducation\nRegulation",null,"Executive Director of Therapies and Health Sciences"]
["Workforce - excluding above \nStandards\nEducation\nRegulation",null,"Executive Director of People and Culture"]
["Patient Experience",null,"Executive Nurse Director"]
["Royal College Guidelines - Implementation and Standards",null,"Executive Medical Director"]
["National Institute for Clinical Excellence (NICE)",null,"Medical Director"]
["Research and Development",null,"Medical Director"]
["Delivery of Clinical Services",null,"Chief Operating Officer"]
["Continuous Service Improvement (Clinical Services)",null,"Chief Operating Officer"]
["Continuous Service Improvement (Corporate Functions)",null,"Executive Directors"]
["Clinical Coding",null,"Director of Digital Health Intelligence"]
["Information",null,"Director of Digital Health Intelligence"]
["Data Quality",null,"Director of Digital Health Intelligence"]
["Corporate Governance",null,"Director of Corporate Governance"]
["Risk Management",null,"Director of Corporate Governance"]
["Intellectual Property Rights and Commercialisation",null,"Executive Director of Finance"]
["Information Governance - Senior Information Risk Owner (SIRO)",null,"Director of Digital Health Intelligence"]
["Professional Public health standards\nEducation; revalidation and regulation",null,"Executive Director of Public Health (discharged through Public Health)"]
["Area Planning Board - Substance Misuse",null,"Executive Director of Public Health"]
["Relationships with Public Services Boards",null,"Executive Director of Strategic Planning"]
["Relationship with Regional Planning Board ",null,"Executive Director of Strategic Planning"]