Enclosure 11- Audit Committee Minutes 18 May 2005

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Enclosure 11 SUNDERLAND TEACHING PRIMARY CARE TRUST Audit Committee Minutes of the meeting held on Wednesday 18 May 2005 at 9.00 am In the Wearmouth Room, SPTCT, Pemberton House Present: Mr P Watson, Non Executive Director, STPCT (Chair) Mr G K Lloyd-Williams, Non Executive Director, STPCT Mrs S Rooney, Non Executive Director, STPCT Mr K Richardson, Non Executive Director, STPCT In attendance: Mrs A Oswald, Audit Manager, CHS Mrs VJ Peacock, Chief Internal Auditor, CHS Mr J Connolly, Audit Manager, Audit Commission Mr N Mapstone, Audit Commission Mrs N Harris, Head of Corporate Affairs, STPCT Mr C Macklin, Director of Finance, STPCT Mrs P Gray, Personal Assistant, STPCT 1. Apologies: Mrs K Straughair 2. Minutes of the last meeting : (Enclosure 1) error on 6.1 text in light print to be deleted. The minutes were agreed as a true and accurate record 3. Matters Arising Page 3 – Mr Watson requested an update from Mr Macklin regarding the healthcare agreement with Newcastle upon Tyne Hospitals NHS Trust. Mr Macklin responded that agreement had been reached on a legal binding contract. Item 5.2 - Mr Watson asked for comment. Mr Macklin replied that the Information Governance Board had met with the Assistant Directors from Primary Care and had advised that we are keeping on top of audits. Mr Watson stressed the importance that Practices need to be fully compliant. Mr Richardson raised ...

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• Publié par: Veseb
• Nombre de lectures: 16
• Langue: English

Extrait

Sunderland TPCT

Audit Committee Meeting

18 May 2005

1

Enclosure 11

SUNDERLAND TEACHING PRIMARY CARE TRUST

Audit Committee

Minutes of the meeting held on Wednesday 18 May 2005 at 9.00 am

In the Wearmouth Room, SPTCT, Pemberton House

Present:

Mr P Watson, Non Executive Director, STPCT (Chair)

Mr G K Lloyd-Williams, Non Executive Director, STPCT

Mrs S Rooney, Non Executive Director, STPCT

Mr K Richardson, Non Executive Director, STPCT

In attendance:

Mrs A Oswald, Audit Manager, CHS

Mrs VJ Peacock, Chief Internal Auditor, CHS

Mr J Connolly, Audit Manager, Audit Commission

Mr N Mapstone, Audit Commission

Mrs N Harris, Head of Corporate Affairs, STPCT

Mr C Macklin, Director of Finance, STPCT

Mrs P Gray, Personal Assistant, STPCT

1.

Apologies:

Mrs K Straughair

2.

Minutes of the last meeting : (Enclosure 1)

error on 6.1 text in light print to be deleted.

The minutes were agreed as a true and accurate record

3.

Matters Arising

Page 3 – Mr Watson requested an update from Mr Macklin regarding the

healthcare agreement with Newcastle upon Tyne Hospitals NHS Trust.

Mr

Macklin responded that agreement had been reached on a legal binding contract.

Item 5.2

-

Mr Watson asked for comment.

Mr Macklin replied that the

Information Governance Board had met with the Assistant Directors from Primary

Care and had advised that we are keeping on top of audits. Mr Watson stressed

the importance that Practices need to be fully compliant.

Mr Richardson raised

the issue of passwords. Mr Macklin reassured that systems were in place to

monitor adherence to good “password control” procedures.

4.

Strategic Internal Audit Plan (2005/2006-2007/2008)

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Audit Committee Meeting

18 May 2005

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4.1

Mrs Peacock reported on this paper which outlined the new 3 year

strategy for internal audit work. New initiatives had been taken on board

however adequate coverage of topics would be maintained.

The

appendices identify the elements covered.

The main changes were

indicated in red.

Internal Audit would work closely with the Audit

Commission to ensure that any major issues would be brought to the

attention of the Audit Committee.

Mr Watson stated that the report indicated where the “hot spots” were and

how we could address them.

Mr Macklin commented that it showed a balanced plan that could respond

to a situation should the need arise.

Mr Richardson queried whether we are happy with the number of man

days allocated and whether there was an arrangement for additional days

if required. It was noted that there was.

There followed a discussion around the issue of Service Planning within

Primary Care e.g. GMS, PMS and the Pharmaceutical Contract.

The Audit Committee approved Enclosure 4.1

4.2

Tactical Internal Audit Plan (2005/06)

Mrs Peacock reported that she had discussed this document with Mr

Macklin and that significant assurance could be taken from the document.

It highlighted the need for 295 man days to cover audit areas.

Appendices highlighted the audit areas to be covered.

Mr Watson questioned the “man days” proposed and Mr Macklin

replied

that he would be willing to increase the man days if required.

Mrs

Peacock reported that she would provide information of provision and

risk factoring information across the Northern region and bring to a future

Audit Committee.

The Audit Committee approved Enclosure 4.2

4.3

Follow up Internal Audit Recommendations

Mrs Oswald supplied the background to this enclosure stating that 9

recommendations had not been implemented in January 2005. Action to

systems and procedures need to be implemented by August 2005

although 4 out of the 9 were low priority.

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Audit Committee Meeting

18 May 2005

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Mr Macklin stated that the action was required by members of the Finance

team and he would pick this up as an Agenda item at his next Top Team

meeting.

The Audit Committee noted Enclosure 4.3

4.4

CSA – Tactical Internal Audit Plan (2005/06)

Mrs Oswald gave the background to the paper which had been discussed

with Mr Straughan.

It was noted that the CSA provides services for

5 PCTs.

Mrs Oswald highlighted in particular :Governance arrangements and

accountability to PCT, Service Planning, Information Systems and

Contractor Risk Management – changes following the Shipman case.

The Audit Committee approved Enclosure 4.4

5.

Counter Fraud Issues/Reports

5.1

CSA Counter Fraud Plan (2005/06)

Mrs Oswald gave a brief outline to his paper which stated that 20 days

would be required to carry out the work which would mainly focus on

General Ophthalmic Services.

The Audit Committee approved Enclosure 5.1

5.2

TPCT Counter Fraud Plan (2005/06)

Mrs Peacock presented the background to the paper which detailed the

number of days required to carry out the work by the Local Counter Fraud

Specialist.

The 50 days provided is less than the 81 days suggested,

however it will still provide sufficient coverage. Mrs Peacock explained

the areas where the reductions had been made in order to comply with

this guidance.

Mrs Rooney stated the importance of the balance and asked whether

there was a proviso to increase the number of days.

Mr Macklin

responded that there was.

Mr Connolly stated that we need to be able to provide comparatives with

other organisations.

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Audit Committee Meeting

18 May 2005

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The Audit Committee approved Enclosure 7

5.3

Local Counter Fraud Specialist Update

Mrs Oswald presented the background to this paper and drew attention to

a number of areas.

A case of suspected fraud by a GP is still ongoing and we are currently

awaiting a decision regarding criminal action.

There was also a suspicion regarding irregularities in claims for sight tests

conducted by a number of opticians, but the evidence did not support

criminal action.

CFS Risk Management exercise on Optical fraud – CSA providing

information.

Mrs Harris raised the issue of a GP who had been suspended in May 2004

and expressed concerns concerning the length of time taken by the GMC

to make a decision.

Mr Lloyd Williams expressed his concern over the delay and asked that

the TPCT express their concerns as it was not in either the TPCT or the

individual’s interest for the delay.

Mr Watson also registered his concern on behalf of the Audit Committee

and requested that Mr Macklin take this to the Board meeting to express

their unhappiness with the procedure. Mr Macklin agreed to this.

The Audit Committee noted Enclosure 8

6.

Audit Commission Issues/Reports

Jon Connolly introduced Nick Mapstone who was responsible for HR and Agenda

for Change at the Audit Commission. Mr Watson welcomed him to the Audit

Committee.

6.1

Progress Memorandum Report, May 2005

Mr Connolly reported on the background to this paper and stated that work

was progressing in line with the agreed timetable.

There was an issue

concerning the IM&T National Program Choose and Book, that he would

be discussing with Mr Macklin later in the week.

The Audit Committee noted Enclosure 9

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Audit Committee Meeting

18 May 2005

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6.2

PCT – Data Quality Reviews

Mr Connolly presented the background to this paper which highlighted that

as from 1 April 2004 responsibility for independent national commentary

on NHS data quality passed from the Audit Commission to the Healthcare

Commission. Looking at controls in 2 main areas: community equipment

stores and the CHD register, the overall the ratings are good.

Mr Watson stated that systems seem to be progressing and audit plans

are being implemented.

The Audit Committee noted Enclosure 10

6.3

Agenda for Change – Workforce Contracts

Mr Mapstone gave the background to this paper which indicated a very

significant challenge to the organisation.

A summary of the process and

procedures are sound, but there was a significant financial risk around

Agenda for Change. Also, in future years a risk was identified in relation

to incremental and salary drift, the assimilation of nursing staff and staff

getting additional annual leave.

Mr Mapstone also gave a brief background on work reform, KSF and the

human resources strategy.

Mr. Connolly stated that he was looking at future financial risks which

require adequate benchmarking regarding value for money and profiling.

The Department of Health had assumed that 8% of staff will require pay

protection.

Mr Macklin explained that he had deployed a member of the finance staff

to Agenda for Change and that I.T. skills were also being utilised. Our

scores are now amber/green and indicate that Sunderland is one of the

better performers. We hope to complete by the end of September 2005.

Mrs Harris stated that Awareness sessions are to be held directorate by

directorate in order that staff are updated.

Mrs Rooney questioned the arrangements for oversight of payroll

information and how this was being handled. Mr. Macklin responded that

we have a dedicated accountant to liaise with payroll and have a written

agreement with City Hospitals Sunderland to give information on payment

of new grades.

The Audit Committee noted Enclosure 11

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Audit Committee Meeting

18 May 2005

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6.4

Prescribing in Primary Care

Mr Connolly presented the background to this paper which indicated that

spending on prescriptions had increased significantly. The database has

recently been updated and gives analysis on 2 different dimensions. It

also shows that GP’s are in a position to influence which could lead to a

£1.4m reduction.

He drew attention to the chart on Appendix 2 and

indicated that there was room for improvement.

Mr Macklin responded that the TPCT received regular data from the

Regional Pharmaceutical Unit regarding costs which indicated that the

TPCT’s figures are the highest in the SHA.

There had been a local

campaign earlier in the year concerning antibiotics which had been

successful. The next piece of work highlights the cost of “statins” which

could reduce the TPCT’s expenditure.

The Audit Committee noted Enclosure 12

6.5

IM&T User Survey

Mr Connolly stated that IM&T was critical to the success of the TPCT as

an organisation.

The Healthcare Commission has raised issues of

concern and a survey of TPCT staff had been conducted to assess

progress.

An internet survey of 300 people had concluded that good

progress was being made in this area and scores of 90+ recorded in most

areas. One area for improvement highlighted was information shared by

departments.

Mr Macklin reported that this was an area covered in the CHI Action Plan

and the requirement for the Information Governance Group to concentrate

on letting staff know where information exists.

Mrs Harris stressed that the intranet access needs to be set as the home

page.

Mrs Rooney indicated that congratulations need to be passed onto the

team.

The Audit Committee noted Enclosure 13

6.6

External Audit Plan (2005/2006)

Mr Connolly gave the background to the plan which had been prepared

earlier than in previous years and indicated that no substantial work would

Sunderland TPCT

Audit Committee Meeting

18 May 2005

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commence until later in the year. He reported that a new Code of Audit

Practice is being introduced which replaces the 3 old areas: financial

aspects of corporate governance, accounting audits and performance

management.

These 3 areas will be replaced by 2 responsibilities in

relation to the accounts and the use of resources. He drew attention to

the fee which relates to the size of the TPCT and also the Auditor’s Local

Evaluation and Reporting Tool (ALERT) which is the framework that

auditors must use and the scoring system on judgements that have to be

shared with

the Strategic

Health

Authority and

the Healthcare

Commission.

VFM

priorities

include:

performance

management,

workforce contracts, payment by results and partnership working.

The Audit Commission approved Enclosure 6.6

7.

Sunderland TPCT Audit Committee Self Assessment

Check List for Consideration

Mrs Peacock presented the checklist for agreement to the Audit Committee and

requested their views.

The checklist was reviewed and outstanding

comments/action resolved for submission to the July Board meeting.

The Audit Committee noted Enclosure 15

8.

Annual Health Check

Mrs Harris gave the background on the briefing paper that describes a significant

change in how organisations have their performance measured. All information

will have to be made available to the Healthcare Commission which will award

ratings on a new 5 point scale. She outlined the timetable by which information

was to be submitted and stated that by 2006 the Healthcare Commission will

decide whether this is robust and if not will arrange visits.

She also stated that

improvement reviews were also to be carried out on Tobacco Control, Children’s

hospital services, substance misuse, adult community mental health, MRSA and

heart failure. All of these will also feed into the ratings.

Mrs Harris reported that she will update the Audit Committee on progress at the

next meeting.

The Audit Committee noted Enclosure 16

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Audit Committee Meeting

18 May 2005

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9.

Any other business

9.1

B. Braun

Mr Macklin drew the Committee’s attention to the case of a potential fraud

regarding the supplying of patients’ appliances from a warehouse in the

Midlands which should have been supplied from a Sunderland base. This

has been the subject of a long internal study which also involved the

PPA. Hill Dickinson, Solicitors, have informed us that this is a complex

matter, but are awaiting judgement from a similar case. Once judgement

on the similar case is known, the TPCT will be in a better position to

pursue the matter further.

The Audit Committee noted this report

9.2

Bad Debts

Mr Macklin circulated a list detailing bad debts totalling £2,286 that were

over 9 months old seeking write off as part of the final accounts

process.

The Audit Committee agreed this course of action

10.

Date and time of next meeting

The next meeting of the Audit Committee is scheduled to take place on Tuesday,

19 July 2005 in the Wearmouth Room, Pemberton House, at 8.30 am – 12.00

mid-day.

18 May 2005