1.0 General Conditions

1.0 General Conditions

1.1Parties to the Agreement:

1.1.1This is a Long Term Agreement (referred to hereinafter as “the

agreement”) between the Welsh Ministers and Public Health Wales National Health Service Trust (referred to hereinafter as “Public Health Wales”).

1.2Contact Details

1.2.1The named contact points for the agreement shall be:

1.3Duration

1.3.1The agreement shall cover a fiveyear rolling period commencing on 1 April 2010.

1.3.2Detailed targets, activity and financial values apply to one year only and will be updated annually.

1.3.3The agreement shall be reviewed and updated annually (by agreement).

1.4Amendment / Termination Clauses

1.4.1The agreement shall not be terminated during the lifetime of the agreement without the express agreement of both parties.

1.4.2 In the event that one party considers the other to have incurred a breach of the agreement, which is serious enough to jeopardise the successful delivery of the terms of the agreement, this will be managed through the disputes procedures outlined in Section 8.

1.4.3 Either party may wish to amend the agreement in accordance with changes in service demand, patterns and delivery. Any intended amendmentswillbe the subject of joint discussion and be agreed by both parties and documented.

1.5Confidentiality

1.5.1 As administering the agreement will inevitably involve access to sensitive data, the parties shall ensure that that they have in place confidentiality policies to which all employees and agents are bound.

1.6Conflicts of Interest

1.6.1 If either party becomes aware of any conflict of interest that has, or is likely to have, an adverse effect on the other party’s decisions within the agreement, that party shall immediately declare the interest to the other. The parties shall agree, and take, such action as is deemed necessary to manage the conflict.

1.7Code of Conduct and Discipline

1.7.1Public Health Walesshall have in place Codes of Conduct which have been adopted by their Boardand which are in accordance with the WHC (2006) 090, issued January 2007 subject to further guidance available in the NHS Governance e-Manual (

1.7.2Agents contracted to either party shall have written into their contracts of engagement such terms as require their conduct to be comparable, and compatible, with that of Public Health WalesandWelsh Assembly Governmentemployees.

1.7.3Both parties shall be responsible for disciplinary actions in connection with their respective employees and agents arising through the delivery of the terms of this agreement and shall not cause the other party to incur any financial loss as a result of the actions of their employees or agents leading to the disciplinary action.This will be in accordance with guidance available in the NHS Governance e-Manual ( for NHS employees or that of the Welsh Assembly Government for its employees.

1.8Complaints Procedure

1.8.1Both parties shall have in place complaints procedures that comply withWelsh Assembly Governmentguidanceavailable in the NHS Governance e-Manual ( NHS employees or that of the Welsh Assembly Government for its employees.

1.8.2Both parties shall co-operate in responding to any complaints received in connection with the services covered by the agreement and shall do so within agreed timescales.

1.9Force Majeure Non Performance

1.9.1There may be exceptional circumstances during the period of the agreement whichthrough no fault of either party prevent the full discharge of the agreement. Immediately that any such factors are identified, the parties willmeet to discuss the impact and determine options for resolving the matter. The parties will also agree any appropriate adjustments to the agreement. Such circumstances could for exampleinclude, but would not be limited to, significant disruption as a result of severe weather, the impact of any arrangements planned as part of the planning for pandemic flu or major fire or staffing crises affecting capacity.

1.10Compliance

1.10.1TheWelsh Ministers have the right to visit Public Health Walesfor the purposes of monitoring and audit at first hand, to review the facilities and services provided under theagreement.

1.10.2 Such meetings will be arranged in conjunction with Public Health Wales.

1.11Freedom of Information

1.11.1Both parties willensure compliance with the Freedom of Information Act 2000 which may require the disclosure of information detailing the relationship between theWelsh Ministers and Public Health Wales, including details in any tender documentation and related correspondence. Should there be any information in this agreement, or related correspondence ordocumentation, which either party deems inappropriate for disclosure to a third party that party must inform the other and give the reasons. Notwithstanding this, both parties reserve the right to disclose such information as the legislation requires.

2.0Purpose of the Agreement

2.0.1TheWelsh Ministers have a duty to protect and improve the health and well being of thepopulation of Walesand are committed to improving the quality and length of life to ensure that everyone has a fair chance to lead a healthy life. The strategic frameworks for achieving this are:

i)The 5 Year Service, Workforce and Financial Strategic Framework;

ii) Local Health, Social Care and Wellbeing Strategies;

iii)Our Healthy Future and

iv)The Annual Operating Framework.

2.0.2Theagreement defines the process for the operational delivery of these strategies described in Section 3.

2.0.3The document has been jointly agreed by theWelsh Ministersand Public Health Wales. It sets out the services and programme activities (described in Section 4) that Public Health Waleswill provide in line with the strategies set out in Section 2.01 above.

2.0.4The document identifies the resources available to Public Health Walesfor the provision of services and programme activity sponsored by theWelsh Ministers, the policies governing variations for under and over performance.

2.0.5The priorities informing this agreement will be routinelyreviewed and updated.

3.0Overriding Statutory and Policy Requirements

3.0.1Public Health Walesis required to operate services within the legal framework established for the NHS, statutory requirements and policy directives and guidance issued by the Welsh Ministers. Public Health Wales’ statutory functions as set out in the Public Health Wales National Health Service Trust (Establishment) Order 2009(2009/2058 w.177) are:

i)to provide to or in relation to the health service in Wales and manage a range of public health, health protection, healthcare improvement, health advisory, child protection and microbiological laboratory services and services relating to the surveillance, prevention and control of communicable diseases;

ii) to develop and maintain arrangements for making information about matters related to the protection and improvement of health in Wales available to the public in Wales; to undertake and commission research into such matters and to contribute to the provision and development of training in such matters;

iii) to undertake the systematic collection, analysis and dissemination of information about the health of the people of Wales in particular including cancer incidence, mortality and survival; and prevalence of congenital anomalies; and

iv)to provide, manage, monitor, evaluate and conduct research into screening of health conditions and screening of health related matters.

3.0.2Specifically,Public Health Walesmust make provision within the totality of the resources received from theWelsh Ministers to provide the following:

3.1Compliance with Clinical Governance, Standards for Health Services in Wales and Quality Assurance

3.1.1Public Health Waleswill:

i)comply with the guidance available in the NHS Governance e-Manual (

ii)work with the Welsh Ministersto develop the Clinical Outcomes of Service indicators,

iii)work with the Welsh Ministers to put Healthcare Standards Improvement Plans in place according to updated guidance.

3.2Compliance with Information Governance and the provision and flows of information

3.2.1The information to be provided by Public Health Walestogether with the requirements of Information Governance can be referred to in the NHS Governance e-Manual (

3.2.2As a general principle, all parties to the agreement should share relevant information in an open and transparent way.

3.2.3Public Health Waleswill ensure:

i)compliance with National Data Protection Standard and standing NHS procedures relating to patient confidentiality with specific reference to the Data Protection Act 1998; and

ii)the provision of timely and robust high quality information on services and their costs and performance in a way that allows access and analysis by theWelsh Ministers.

3.2.4TheWelsh Ministers will:

i)support Public Health Walesin the development of core information requirements and ensuring the timely availability of information and profiles to support the performance agenda;

ii)aim to minimise its requirements for ad-hoc information requests that may present resourcing problems for Public Health Wales.

3.3Compliance with Financial Agreements and Activity profiles

3.3.1Public Health Waleswill:

i)work in conjunction with the Welsh Ministers to ensure that the national and local priorities applicable for the duration of this agreement are achieved;

ii)work with theWelsh Ministers to ensure that regular service discussions regarding the agreement are held with the responsible stakeholders;

iii)ensure compliance with mandated and reasonable requests for information.

3.4Other Issues

3.4.1 Both parties will manage variations through regular meetings and an inyear management plan for the activity.

3.5Compliance with National Policies and Guidance

3.5.1Public Health Waleswill:

i)ensure full compliance with guidance and directives issued by the Welsh Ministers under the powers of the National Health Service (Wales) Act 2006.

ii)ensure compliance with the Welsh Ministers commitment that they see sustainable development as the overarching strategic aim of all policies and programmes across portfolios and that sustainable development will be the central organising principle of the Welsh Ministers and of the public sector in Wales;

iii)ensure that it actively promotes a healthy working environment, including operating a no smoking policy (supported by a written policy statement) and providing comprehensive health improvement opportunities for its staff;

iv)work with partner agencies to reduce health inequities by working together to address the wider determinants of health. Specifically, to work within the framework of the 5 year Service, Workforce and Financial Strategic Framework, the Annual Operating Framework, Our Healthy Future, the Wales Spatial Plan as well aswith Local Services Boards, identifying and tackling complex health problems that require intersectoral action;

v)liaise with Welsh Ministers to ensure effective operational arrangements for emergency planning in accordance with the Civil Contingencies Actand the LHBs Major Incident Plans;

vi)liaise with the Welsh Ministers to ensure full compliance with the requirements set out in the Outbreak Plan, updated as appropriate;

vii)demonstrate how it is working towards full Trust compliance with requirements in respect of safeguarding children, young people and vulnerable adults;

viii)work with colleagues to reflect the particular interests of LHBs through theirHealth, Social Care and Well-Being strategies and AOF targets, in terms of service descriptors, local managerial and clinical links with Public Health Wales, and specific areas of joint collaboration between clinicians in the primary and secondary care services.

3.5.2The Welsh Ministers will work closely with Public Health Walesand other partners to ensure that:

i)the commissioning framework within this agreement supports the effective delivery of national policy and guidance;

ii)arrangements are in place to enable Public Health Wales, and other agencies as appropriate, to work together to meet national policies and standards;

iii)arrangements are in place to reduce health inequities by working together to address the wider determinants of health. Specifically, to work within the frameworks of the 5 year Service, Workforce and Financial Strategic Framework, Our Healthy Future, the Wales Spatial Plan as well aswith Local Service Boards,identifying and tackling complex health problems that require intersectoral action.

3.6 Compliance in respect of Business Cases

3.6.1Public Health Walesmust ensure that appropriate business cases for changes to services and/or capacity:

i)reflect the locally and nationally agreed service strategies and must show how proposed changes integrate into the requirements of the agreement. All business cases must take into consideration the local, regional, and/or national picture for the delivery of these services. These business cases must be evidenced-based, financially sustainable, operationally robust, and comply with the requirements of WHC(2007)52 ‘Developing and Delivering the Capital Investment Programme’.

ii)identify the service impact on all partners and that the cases are sent to those partners for approval. Business cases must include a clear indication of the evidence base for the service improvement, and any impact in terms of activity, waiting times and financial arrangements.

iii)demonstrate how any proposed changes are to be financed within the existing and known financial frameworks, and must identify their impact on existing costs, including costs that are already provided for within the agreement. Where proposed investments cover more than one stakeholder, Public Health Walesmust be able to demonstrate multi-stakeholdersupport for the investment.

4.0Services to be provided

4.0.1Public Health Waleswill provide public health services to Local Health Boards (LHBs), Local Authorities (LAs), voluntary bodies, the Welsh Ministers as well as the public in accordance with the statutory and policy requirements set out in Section 3. Such services will include advice and information on health needs of relevant populations and information on health services quality and delivery.Public Health Wales will contribute to the development and implementation of Local Health, Social Care and Well Being Strategies and other local strategies, policies and plans.

4.0.2Public Health Waleswill support LHBs and LAsin providing health protection and improvementservices and contribute toand where required, co-ordinate emergency responses. Such services will include assessment of risks to population health, identification and control of infections, and the provision of advice and information on chemical and environmental hazards.

4.0.4Public Health Waleswill provide population-based screening services for breast cancer, cervical cancer, bowel cancer, newborn hearing, abdominal aortic aneurisms and supports improvements in the standard of antenatalscreening. New screening programmes may be added to this portfolio as they are developed.

4.0.5Public Health Waleswill plan, develop and deliver and/or pilot health improvement services and programmes and co-ordinate and advise on public health local service plans provided by LHBs.

4.0.6Public Health Waleswill provide a public health intelligence service to Local Health Boards (LHBs), Local Authorities (LAs), voluntary bodies, the Welsh Ministers as well as the public.

4.0.7Public Health Waleswill:

i)Develop and implement effective methods for communicating health information to the public in Wales; specifically provide support, advice and information to LHB Directors of Public Health in the preparation of local Annual Public Health Reports.

ii)Provide leadership and support for the training, education and development of public health in Wales, working with partners within Wales and across the UK.

iii)Support public health research and in particular facilitate strong links between the Observatory and public health research networks.

4.0.8Public Health Waleswill undertake a range of specific actions and projects which are agreed with Welsh Ministers. A list of such specific actions to be provided by Public Health Walescan be found at Appendix 1. Details of actions, outputs and indicators for each individual programme of work are set out in Programme Level Agreements (PLAs) which are agreed between Public Health Walesand stakeholders. The PLAs form the basis by which the performance of specific programmes, services and activitiesof Public Health Walescan be monitored by Welsh Ministers, stakeholders and appropriate Public Health Wales officers.

4.0.9Public Health Walesis required to respond to the Annual Operating Framework for each year of the agreement. The key responses required of Public Health Walesfor the current year are set out in Appendix 2.

5.0Managing the Agreement and Variations to Activity

5.1Monitoring the Agreement

5.1.1The Welsh Ministers are responsible for leading the monitoring of the agreement. The management process itself will be undertaken in partnership with Public Health Wales.

5.1.2Public Health Walesand the Welsh Ministers agree to meet on a quarterly basis to manage the agreement, and agree actions that are necessary in the light of performance to date, including financial reports andforecasts.

5.1.3.The meetings shall be chaired by the Welsh Ministers , and shall have minutes produced for the record.

5.1.4Monthly responses as part of the AOF system will be required as well as quarterly reporting against metrics and performance indicators embedded in each of the PLAs.

5.1.5Each quarterPublic Health Waleswill produce a forecast of activity and performance for the rest of the year to 31 March, which will form the basis for the in-year management of the agreement.

5.2Management Plan

5.2.1Where the agreed performance and activity monitoring information indicates a potential over-performance or under-performance, Public Health Walesandthe Welsh Ministers shall agree a Management Plan.

5.2.2The Management Plan will identify specific actions that need to be taken tominimise the impact of variations in activity and will indicate any residualactivity variations that may be appropriate for financial recompense.