1.1.1 Apologies were received from Nick Atkinson, Vaughan C. Matthews, David Foley and Peter Christian.
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1 Minutes Meeting of the Haringey Audit Committee 24 May 2013 at 10:00am Hornsey Central Present: Caroline Rivett CR Chair, Governing Body Lay Member Dr Sherry Tang STa GP Governing Body Member, Central Catherine Herman CH Governing Body Lay Member Karen Trew KT Enfield CCG Audit Committee Chair In attendance: David Maloney DM Chief Finance Officer Jennie Williams JM Director of Quality and Integrated Governance Clive Makombera CM Senior Manager, RSM Tenon John Baker JB Fraud Solutions, RSM Tenon Paul Hughes PH Director, Grant Thornton Denise Tyrrell Commissioning Support Director, NEL CSU Steve Beeho SB Head of System Support (Minutes) 1. INTRODUCTION Action 1.1 Apologies for Absence Apologies were received from Nick Atkinson, Vaughan C. Matthews, David Foley and Peter Christian. 1.2 Declarations of interest There were no additional declarations of interest. 1.3 Chair s Introduction and meeting objectives The Chair welcomed everybody present to the meeting, particularly those attending for the first time. 1.4 Minutes of previous meeting The minutes of the meeting held on 15 March 2013 were agreed to be correct. The minutes of the Part II meeting held on 15 March 2013 were also agreed to be correct. 1.5 Matters arising There were no matters arising. 2. Internal audit 2.1 Internal Audit Plan
2 2.1.1 Clive Makombera provided an overview of the Internal Audit Plan which had been shared previously with the CCG s senior management team The length of time allocated to Continuing Healthcare was queried. Clive confirmed that he had discussed this previously with Jill Shattock and the five day allocation was based on the assumption that the CSU would lead a lot of this work. It was agreed that this would be kept under review and would be raised with David Maloney if it looked as if more time would be required The Committee discussed other potential areas that are not on the plan. It was noted that the integration of Health and Social Care had not arisen as an issue during discussions with management. Collaborative working had also been raised at Enfield and it was suggested that this should be considered for the following year s workplan It was agreed that the CCG currently receives sufficient assurance for the review of Continuing Care to be carried out in August-September Caroline Rivett then updated the Committee on a meeting of north central London CCG Audit Committee Chairs which had been held the previous week to discuss how the CSU should be audited and how CCGs will obtain assurance. The Committee Chairs had agreed that an Assurance Committee would be set up to provide challenge and ensure that recommendations are actioned. The Terms of Reference are currently being drafted. This Committee will have an Executive lead and a mechanism will be established for reporting back to the respective Audit Committees This development was welcomed by the Committee Clive Makombera then provided an overview of the CSU Internal Audit Plan which had been developed following a meeting with Harry Turner to identify key areas to address. Work on the plan is already underway The Committee highlighted that it would be important to ensure that appropriate accountability is assessed in the SBS and payroll audits. It was also suggested that the QIPP and Finance reporting should be expanded to include national reporting The Audit Committee APPROVED the Haringey CCG Internal Audit plan for 2013/14 and NOTED the NEL CSU Internal Audit Plan for 2013/ Counter-Fraud Workplan John Baker highlighted that his colleague, David Foley, had previously discussed the workplan with senior officers at the CCG David Maloney noted that John Alway, the Local Counter Fraud Specialist, would be providing a presentation on counter-fraud at the next Governing Body seminar in June The Audit Committee APPROVED the Local Counter-Fraud Services Workplan 2013/ External Audit 3.1 Introduction to External Audit 2
3 3.1.1 Paul Hughes provided an overview of the briefing paper. In addition to being the external auditors of Haringey CCG, Grant Thornton have also been appointed as external auditors for Barnet and Enfield CCGs, and Barnet and Enfield Councils, so it was hoped that this additional perspective would be beneficial David Maloney queried whether a comparison of how the SLA with the CSU compares to other CCG/CSU SLAs in place could be added to the work that Grant Thornton will be undertaking for the CCG during 2013/ Paul Hughes agreed to look into this further The Audit Committee NOTED the Introduction to External Audit, as produced by Grant Thornton ACTION: 05/ To investigate whether benchmarking work can be carried out regarding the CCG/CSU SLA as part of the workplan. PH 4. CCG items 4.1 Risk Register and Board Assurance Framework Jennie Williams provided an overview of the paper which had also been taken to the CCG Governing Body the previous week. She highlighted that further work is required to review the risks previously led by NHS North Central London (NCL) which have since been carried forward. RSM Tenon will also be updating the current Risk Management Strategy. Going forward, the CCG intends to move away from its current ledger-style presentation of risks to a more user-friendly approach Karen Trew queried whether the financial risk share should also be on the Risk Register. David Maloney highlighted that this is implicit in Risk 12 but he agreed that this warranted being extracted as a distinct risk in its own right Catherine Herman noted that she had recommended at the Governing Body meeting that the Equalities and Diversity risk should remain open for the time being as the Governing Body lacks a champion in this area The Committee also noted that the Information Governance risk relating to Patient Identifiable Data that had been inherited from NHS NCL would also need to be updated in light of the recent update that had been provided to the Quality Committee It was agreed that it would be useful for the Chairs of the Quality and Finance and Performance Committees to attend a future Audit Committee meeting to discuss the assurances that these committees are obtaining. This would be added to the workplan that Jennie Williams and Steve Beeho are developing The Audit Committee NOTED the Report and took assurance that Haringey CCG is making good progress in establishing its new risk profile ACTION: 05/ To add the risk relating to the financial risk share not being agreed to the CCG Risk Register ACTION: 05/24 03 To ensure that the Equality and Diversity risk is reinstated on the CCG Risk Register. DM SB 3
4 4.19 ACTION: 05/24 04 To add attendance by the Chairs of the Quality and Finance and Performance Committees at a future Audit Committee meeting to the workplan. SB/ JW 4.2 SLA between Haringey CCG and NEL CSU (This item was taken after Matters Arising) An updated version of the SLA signed on 8 October 2012 had been brought to the meeting. Denise Tyrrell noted that further work had been carried out on it in a series of meetings with CCGs during the run-up to authorisation and summarised the changes that had been agreed over the subsequent six months The Committee agreed that it would be more appropriate for it to recommend to the Governing Body that it should sign off the final SLA, rather than for the Audit Committee to sign it off, as was being asked Denise Tyrrell highlighted that the contract had originally been priced on the basis of a block service but service line costings would be available by the end of Quarter 2. As part of an exercise to help to ensure that the CSU s prices are appropriate, its staff will be completing time-sheets during June and July This was welcomed by the Committee on the basis that it will help to achieve the commitment in the SLA to transparency The Committee then had a detailed discussion about the content of the SLA and how additional refinements should be incorporated The following actions were agreed: The document needs to highlight the ongoing discussions that have taken place before the revised SLA being taken to the Governing Body Clarity is needed over how the outstanding areas of the contract will be signed off The CSU and CCG will need to agree a process for ensuring that any CSU risks that emerge are flagged up to the CCG Peter Conoulty to provide a briefing on data flows to be shared with Committee members The SLA should explicitly provide the CCG with the right to delete services and the opportunity to renegotiate pricings The SLA should also stipulate the criteria for major and minor service changes, and the associated notice periods The revised SLA should provide transparent costings The document should provide an appendix setting out the frequency and detail of regular reports to be provided by the CSU Clarification to be obtained about intellectual property rights in the event of the CCG terminating its contract with the CSU Any additional detailed comments should be sent to Steve Beeho in the first instance, who will then forward them to Jill Shattock, Director of Commissioning The Committee then discussed the sign-off process. There was a general consensus that the Committee should review the revised SLA again at its next meeting in July, before it is taken to the Governing Body for final approval. 4
5 4.2.9 It was suggested that it would also be helpful to obtain external advice on the type of Key Performance Indicators that the CCG should expect from shared services. Waltham Forest CCG is leading on a piece of work to bench-mark CCG services, which could potentially feed into this The Audit Committee NOTED the revised Service Level Agreement ACTION: 05/24 05 To ensure that the revised document highlights the ongoing discussions that have taken place before being taken to the Governing Body ACTION: 05/24 06 To clarify how the outstanding areas of the contract will be signed off ACTION: 05/24 07 To arrange for the CSU and CCG to agree a process for ensuring that any CSU risks that emerge are flagged up to the CCG ACTION: 05/24 08 To arrange for Peter Conoulty to provide a briefing on data flows to be shared with Committee members. SB ACTION: 05/24 09 To ensure that the SLA explicitly provides the CCG with the right to delete services and the opportunity to renegotiate pricings. In SLA ACTION: 05/24 10 To ensure that the SLA stipulates the criteria for major and minor service changes, and the associated notice periods. In SLA ACTION: 05/24 11 To ensure that the revised SLA provides transparent pricing ACTION: 05/ The document should provide an appendix setting out the frequency and detail of regular reports to be provided by the CSU ACTION: 05/24 13 To clarify the position on intellectual property rights in the event of the CCG terminating its contract with the CSU. In SLA ACTION: 05/24 14 To send any additional detailed comments to Steve Beeho in the first instance, who will then forward them to Jill Shattock, Director of Commissioning. ALL 4.3 Scheme of Delegation David Maloney highlighted that the Governing Body had delegated authority to the CCG Audit Committee to approve this Scheme of Delegation at its meeting on 24 May In response to a query from Catherine Herman, David Maloney confirmed that the CSU is drawing up a Procurement Strategy on behalf of the CCGs and a draft is due to be circulated to Chief Finance Officers shortly. The strategy will be placed on the CCG website after it has been approved by the Governing Body Committee members then discussed the proposed Scheme of Delegation. It was agreed that the CCG should require two written quotes for work costing up to 4999, rather than verbal ones. 5
6 4.3.4 John Baker observed that greater clarification is also needed regarding the staff authorisation levels It was also agreed that David Maloney would review the presentation of the Scheme of Delegation with his counterpart in Enfield CCG The Audit Committee APPROVED the Scheme of Delegation, subject to the comments above, and NOTED the CSU financial limits ACTION: 05/ To amend the Scheme of Delegation to require two written quotes for work costing up to 4999, rather than verbal ones. DM ACTION: 05/24 16 To provide greater clarity on staff authorisation levels. DM ACTION: 05/ To review the presentation of the Scheme of Delegation with Enfield CCG. DM 5. Any other business 5.1 There was no other business. 6. Date of next meeting July
1.2.1 The minutes from the last meeting were agreed and recorded as accurate.
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