The Chair welcomed everyone to the meeting and confirmed a quorum was present.

Transcription

1 POWYS TEACHING HEALTH BOARD AUDIT & ASSURANCE COMMITTEE UNCONFIRMED MINUTES OF THE MEETING HELD ON TUESDAY 14 MARCH 2017, BOARD ROOM, GLASBURY HOUSE, BRONLLYS HOSPITAL Present: Tony Thomas Jonothan White Roger Eagle Sara Williams In Attendance: Karen Gully (Dr) Helen Higgs Catherine Kettering Elaine Matthews Barrie Morris Hugh Richards Sarah Pritchard Eifion Williams Carl Window Mandy Collins Jane Errington Independent Member (Committee Chair) Independent Member Independent Member Independent Member Medical Director Head of Internal Audit Internal Audit Wales Audit Office Grant Thornton External Auditor Internal Audit Head of Financial Services Director of Finance Lead Counter Fraud Specialist - Hywel Dda University Health Board (in part) Board Secretary Committee Secretary (minutes) A&A/17/19 WELCOME AND APOLOGIES FOR ABSENCE The Chair welcomed everyone to the meeting and confirmed a quorum was present. Apologies were received from: Carol Shillabeer, Chief Executive Officer; and Mark Baird, Independent Member. A&A/17/20 DECLARATIONS OF INTEREST The Chair INVITED Members to declare any interests in relation to the items on the Committee agenda. None were declared. Page 1 of 8

2 A&A/17/21 UNCONFIRMED MINUTES OF THE COMMITTEE MEETING HELD ON 17 JANUARY 2017 The minutes of the meeting held on 17 January 2017 were RECEIVED and AGREED as being a true and accurate record subject to the following amendment: A&A/17/006 WAO Structures Assessment-ratification of health board response: Paragraph 4: remove the word gad. A&A/17/09 Auditor General s Report Final paragraph replace the word wok with work A&A/17/12 Internal Audits: Newly Issued Reports Insert a gap after the work Framework. A&A/17/22 MATTERS ARISING FROM THE PREVIOUS MEETING A&A/17/14 Implementation Audit Recommendations: Progress Update. Sara Williams, Independent Member, referred to the last paragraph of this item and noted a management response to the clinical audit review was to be brought forward to this meeting, but the action was not noted in the action log. It was agreed Mandy Collins, Board Secretary would pick this up. Action: Board Secretary A&A/17/23 COMMITTEE ACTION LOG Mandy Collins presented the action log to members and updates on items were noted: A&A/16/14 Estates Assurance Follow up audit: Hugh Richards, Internal Audit, confirmed work was ongoing and progressing, with a meeting set to take place in a month s time. Audit/16/85 Counter Fraud Planning: Mandy Collins, Board Secretary, advised this action was being taken forward to review the capacity of the service. Audit/16/19 Implementation of Audit Recommendations: Page 2 of 8

3 Mandy Collins, Board Secretary, noted that an update on all audit recommendations would be presented to the Committee in May Action: Board Secretary A&A/17/24 EXTERNAL AUDIT PLAN 2017/18 Barrie Morris, Grant Thornton, provided an overview of the report previously circulated. The Chair noted the relationship with Grant Thornton had been excellent to date and thanked colleagues at the table. The chair asked for the possibility of the Director of Finance presenting to the A&A Committee in the Future. The Chair advised the Welsh Audit Chairs meet regularly and recently attended a presentation (they could not remember his name he is from Cwm Taff) suggested inviting him to present to this committee. Elaine Matthews gave an overview of the programme. Work on thematic reviews. It was noted that there was an upcoming workshop on behavioural change. The Committee AGREED the External Audit Plan 2017/18. A&A/17/25 STANDING ORDER REQUIREMENTS: Mandy Collins, Board Secretary, outlined to the Committee the requirement to ensure compliance with the annual requirements set out in Standing Orders. These covered: Committee Terms of Reference review: The Chair suggested the membership be 5 Independent Members which was in place, following appointment of the Trade Union representative. Mandy Collins, Board Secretary, asked members for comments to be sent to her directly. Self assessment: The Board Secretary suggested the draft be worked on at the next Board Development meeting on 27 April as this required full board input. Annual report: Page 3 of 8

4 The Committee agreed it was happy to use the same format as last year. Once populated the Board Secretary would circulate to committee members for comment, prior to presentation to the Board in May Members Agreed to the actions to be taken to ensure compliance with Standing Orders. A&A/17/26 SINGLE TENDER WAIVER Sarah Pritchard, Head of Financial Services, provided an overview of the report previously circulated to Committee. Members discussed the use of single tender waivers. The Committee NOTED the use of Single Tender Waiver as follows: STW 2697 STW 2721 Bausch and Lomb Odstock Medical Ltd Maintenance agreement for 3 years of Stellaris Theatre Machines Medical Equipment for Functional Electrical Stimulation Services 21,000 +VAT 6,030 + VAT 7A&A/17/27 FINANCIAL CONTROL PROCEDURE PATIENT S PROPERTY Sarah Pritchard, Head of Financial Services, provided an overview of the report. This procedure was presented for approval. It was noted that the procedure had been completed in conjunction with ward nurses and discussed within their teams as they would be responsible for policy compliance. Karen Gully joined the meeting Jonothan White, Independent Member, noted there was a gap in recognising how much money a patient had on the ward, making staff vulnerable. Sarah Pritchard confirmed Page 4 of 8

5 that patients are advised not to take items of value into hospital. The Chair suggested the responsibility lies with the directors to ensure these standards are being carried out and checks and balances are in place. The Committee APPROVED the procedure as presented. A&A/17/28 EXTERNAL AUDIT: PROGRESS UPDATE The Committee NOTED the progress report in delivering the External Audit Plan 2016/17. A&A/17/29 EXTERNAL AUDIT REVIEWS Arrangements for securing NHS consultant services Elaine Matthews, Wales Audit Office, presented Committee with the findings of the review into arrangements for securing NHS Consultant Services. Elaine Matthews advised the Committee that the report had concluded that the health board had begun to address the risks that accompany its complex arrangements for securing consultant-led services, although there was further work to do to ensure contracting and job planning arrangements were robust for all consultants working with its patients. The Committee was advised of 7 recommendations, as set out in the report. The Committee was advised that job planning and appraisal arrangements for directly employed consultants were generally working well, although the health board could clarify and standardise its approach across the organisation. Furthermore, the complexity of current commissioning arrangements for services provided by consultants employed primarily by other health bodies highlighted the need for more robust governance arrangements. The Committee noted that the health board was becoming less dependent on high risk, ad hoc arrangements with consultants but services provided in this way did not always conform to good governance principles. Dr Karen Gully, Medical Director, assured the Committee that management had accepted the recommendations and Page 5 of 8

6 responding actions had been agreed, as set out in the report. Karen Gully left the meeting A&A/17/30 INTERNAL AUDIT: PROGRESS UPDATE Helen Higgs, Head of Internal Audit, provided an overview of progress against delivering the Internal Audit Plan. The Head of Internal Audit advised that there had been difficulties over last few months commencing audit work and clearing reports due to delays. The Chair asked if the delays were as a result of management action, or lack of. The Board Secretary confirmed there had been delays caused by management and these had now been discussed with the Chief Executive Officer and were being addressed. The Committee NOTED the progress update. A&A/17/31 INTERNAL AUDIT Statutory and Mandatory Training Follow Up Reasonable Assurance Infection Control Reasonable Assurance Risk Management Framework Reasonable Assurance ADVISORY REVIEWS Facilities Review Page 6 of 8

7 Pain Management Helen Higgs, Head of Internal Audit, provided an overview of the reports and members discussed the documents presented. The Committee NOTED the findings of the reviews and the associated management responses. COUNTER FRAUD ARRANGEMENTS: UPDATE Carl Window, Lead Local Counter Fraud Specialist, provided the committee with an overview of the work he had undertaken and assurance as to the arrangements for counter fraud services moving forward. It was noted that within the report resource implications had been explained and allocation of resources. It was further noted that the resource available had been a continuing concern. Carl Window gave assurances that anything of a high risk of loss would still be investigated by his team, whilst other arrangements were put in place. The Committee was pleased to note that during the interim period, any referrals had been acknowledged and dealt with. Eifion Williams expressed his appreciation for the support Carl Window had continued to provide to the health board. Carl Window left the meeting Eifion Williams, Interim Director of Finance, provided a further update to the committee. The Chair enquired if the possibility of a direct Powys appointment had been considered. The Director of Finance advised that he had wanted to take colleagues advice into account before making a recommendation on a way forward. Eifion Williams requested the Chair and Vice Chair be involved with the shortlisting process for any appointments made. Mandy Collins, Board Secretary, recommended that the candidates be offered the choice of being interviewed in the language of their choice, especially if their first language is Welsh. Members agreed to the Chair and Vice Chair being involved in shortlisting process with Eifion Williams. Page 7 of 8

8 A&A/17/33 ITEMS TO BE BROUGHT TO THE ATTENTION OF THE BOARD AND OTHER COMMITTEES No items were brought forward for the attention of the Board or other committees. A&A/17/34 ANY OTHER BUSINESS There were no further items of business raised. A&A/17/35 NEXT MEETING It was noted that this was scheduled for, 10am 1pm. Page 8 of 8