NHS BOLTON CLINICAL COMMISSIONING GROUP Public Board Meeting AGENDA ITEM NO: 15. Date of Meeting: 26 th October 2018 TITLE OF REPORT:

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1 NHS BOLTON CLINICAL COMMISSIONING GROUP Public Board Meeting AGENDA ITEM NO: 15 Date of Meeting: 26 th October 2018 TITLE OF REPORT: AUTHOR: PRESENTED BY: CCG Audit Committee Minutes Tony Ward, Audit Chair Tony Ward, Audit Chair PURPOSE OF PAPER: (Linking to Strategic Objectives) LINKS TO CORPORATE OBJECTIVES (tick relevant boxes): RECOMMENDATION TO THE BOARD: (Please be clear if decision required, or for noting) COMMITTEES/GROUPS PREVIOUSLY CONSULTED: REVIEW OF CONFLICTS OF INTEREST: VIEW OF THE PATIENTS, CARERS OR THE PUBLIC, AND THE EXTENT OF THEIR INVOLVEMENT: EQUALITY IMPACT ASSESSMENT (EIA) COMPLETED & OUTCOME OF ASSESSMENT: For the Board to receive and review the minutes of the Audit Committee meeting held on 19 th September Delivery of Year 3 Locality Plan. Joint collaborative working with Bolton FT and the Council. Supporting people in their home and community. Shared health care records across Bolton. Regulatory Requirement Standing Item The Board is asked to approve the Minutes. The key points the Board is asked to note from these minutes are:- Approval of the Annual Audit Letter. CCG Audit Committee Conflicts of Interest are reviewed at every meeting. Patient views are not specifically sought as part of this report. EIA and an assessment is not considered necessary for the report. 1

2 MINUTES Audit Committee Date: 19 September 2018 Time: Venue: Present: In attendance: Minutes by: 1.30pm 3.00pm Bevan Room Tony Ward (TW) Alan Stephenson (AS) Dr Charles Hendy (CH) Dr Tarek Bakht (TB) Ian Boyle (IB) Claude Chonzi (CC) Cath Robson (CR) Rob Fenton (RF) Diane Sankey (DS) Richard Leigh (RL) Linda Hughes (LH) Lay Member Governance (Chair) Lay Member GP Board Member GP Board Member Chief Finance Officer, Bolton CCG Senior Internal Audit Manager, MIAA Anti-Fraud Specialist, MIAA KPMG Governance, Risk and Complaints Manager CHC Business Manager Personal Assistant Minute Topic No. 44/18 Introductions and Apologies for Absence Amanda Williams Kelly Knowles Action By 45/18 Declarations of Interest The Chair reminded committee members of their obligation to declare any interest they may have on any issues arising at committee meetings which might conflict with the business of NHS Bolton Clinical Commissioning Group. Declarations declared by members of the CCG Executive are listed in the CCG s Register of Interests. The Register is available either via the Board Secretary to the Governing Body or the CCG website at the following link: There were no declarations of interest. 46/18 Previous Minutes The minutes of the 23 May 2018 were agreed as an accurate record. 47/18 Matters arising from the minutes not otherwise on the agenda and review of action log Page 1 of 7

3 The action log was reviewed and updated. 48.1/18 MIAA (Internal Audit) Progress Report CC updated the committee regarding assurances, key issues and progress made in delivery of the Internal Audit Plan for 2018/19. Comprehensive reports detailing findings, recommendations and agreed actions were provided to the organisation. CC advised that the Personal Health Budget audit had been issued as draft and would be reported at the next committee meeting. A meeting regarding this audit was scheduled with Melissa Maguinness, Director of Service Transformation on 20 th September to discuss further. The Chair requested that if the report had limited assurance, he and the CFO, be advised at the earliest opportunity. CC requested approval for an amendment to the original plan for 2018/19 to incorporate the internal audit of Primary Medical Care Commissioning. Arrangements as in accordance in the draft guidance issued by NHSE (July 2018). The committee agreed to use the contingency/call off days and any additional days as required. CC advised that he will engage with line managers for responses to open internal audit recommendations to ensure these have been fully implemented. The Committed noted the MIAA Progress Report. 48.2/18 Internal Audit Charter CC presented the paper which demonstrated compliance with the Public Sector Internal Audit Standards, and illustrated the roles and responsibilities of both MIAA and the CCG in delivery against these regulations. The Committee noted the Internal Audit Charter. Assurance Framework Benchmarking (2017/18) The paper summarised the results from the detailed individual reviews of 29 Assurance Frameworks across the Clinical Commissioning Groups (CCGs) in MIAA s client base which were undertaken in support of the 2017/18 Director of Audit Opinions. CC reported the CCG should review the outcomes of the benchmarking to identify if there are any learning points. DS to review the report issued in April 2018 and feedback to the committee. DS 48.3/18 The Committee noted the Assurance Framework Benchmarking (2017/18) report Conflicts of Interest Benchmarking (2017/18) Page 2 of 7

4 CC advised the overall purpose of this paper was to enable individual organisations to consider how they compare with others against the prescribed framework issued by NHSE for managing conflicts of interest. The report sets out the level of compliance of the 29 individual CCGs against the statutory guidance in relation to managing conflict of interest (February 17). The assessment against the 26 individual areas combines to give an overall assessment for each of 5 scope areas. CC advised Bolton level of compliance was rated 18 th out of the 29 CCG s. TW requested a copy of the report be sent to the Board Secretary for information informing of the CCG s rating and for her to update at the CCG Conflicts of Interest Committee. LH The Committee noted the Conflicts of Interest Benchmarking (2017/18) report. Audit Committee Update The paper informed members of upcoming events and conferences provided free of charge as clients as part of MIAA s services. CC highlighted the Audit Committee Members event taking place on 2 November TW informed members of the changes HFMA have made to the Audit Committee Handbook to reflect the significant impacts and changing context of the NHS agenda. He highlighted changes regarding partnership working and how audit committees should approach them and their associated risks. Committee noted the Audit Committee Update. 48.4/18 Broad Care Audit Update Richard Leigh, CHC business manager presented and update on the Broad Care follow up report. This was to be discussed further with CC and Melissa Maguinness on 20 September. TW thanked Richard for his update. 48.5/18 Anti-Fraud ½ year Progress Report CR highlighted activities and outcomes undertaken during the period from 1/4/18 to 31/8/2018 for consideration by the committee. Preparation work had commenced regarding the National Fraud Initiative (NFI) and relevant notices actioned informing on the collection of use of personal data. The compliance return had been submitted on behalf of CCG and confirmation had been received. A communications protocol had been implemented at the CCG and the summer newsletter information alert and Page 3 of 7

5 individual alert had been communicated appropriately. A guidance document relating to the management of prescriptions and invoice pre contract procurement fraud had been cascaded. The CCG had completed self-assessments for anti-bribery and the results are being reviewed and benchmarked against other CCGs. The self-assessment regarding whistle blowing should be completed by the CCG by the end of September. Fraud related queries had been dealt with and selfprescribing reported to NHSE and police. Allegations around misappropriation of funds were referred to the police who confirmed there had been no criminal activity. Follow up on actions implementation of 15 all on track with no concerns for audit committee An item documented in the planned delivery dashboard related to the request for the committee to formally approve the proactive detection exercise in relation to conflicts of interest which includes re gifts hospitality and sponsorship being undertaken as a joint review with internal audit. The committee approved this proposal. No investigation activity in reporting period. The Committee noted and approved the Anti-Fraud ½ year Progress Report report. 49.1/18 KPMG (External Audit) Annual Audit Letter The annual audit letter summarised the key issues arising from the audit, highlighting areas of good performance and providing recommendations where appropriate. Members noted the report. A copy of the Annual Audit letter will be published on the CCG website AAW 49.2/18 Technical Update August 2018 The report highlighted the main issues which are currently impacting on the health sector as well as sharing some of the wider work being carried out by KPMG. The Committee noted the report. Page 4 of 7

6 50/18 Board Assurance Framework and Risk Register Q1 DS presented the Q1 Board Assurance Framework and CCG Significant/High Risks which were to be reported to the July CCG Board meeting. The paper provided details of the strategic, financial and operational risks associated with achieving Bolton CCG s 2018/19 objectives. DS advised that from April 2018, BAF risks are no longer reported via the Safeguard database but would be accessible to risk owners via the corporate folder. TW asked for a view on the BAF process overall now the new process was embedded and if risk owners were updating risks on a regular basis. DS advised the BAF dashboard is reviewed on a monthly basis by risk owners and then submitted to CCG Executive for approval. Some risks had been updated with actions completed and where a risk score was reduced, but there was no evidence of action taken to reduce the risk to the CCG, this was challenged by the Governance & Safety Team. There was some duplication of mitigating factors and controls across some of the risks. The Committee noted the report. 51/18 Draft Audit Committee Annual Report 2017/18 The report provided a summary of the Audit Committee s activities, and demonstrated how the Audit Committee had discharged its responsibilities and terms of reference. The report would be presented to the CCG governing body on 28 September CR requested the following changes be made as follows:- Page 3, fourth bullet point, wording to be revised to read The policies and procedures for all work related to fraud bribery and corruption, as outlined in the NHS Counter Fraud Authority (NHS CFA) Standards for Commissioners. Page 6, under the heading of Anti-Fraud, second paragraph, remove reference to internal audit plan and replace with counter fraud plan. IB felt the Chief Officer should be removed from the attendance table on page 2 as she was only required to attend the committee annually. The committee approved the Draft Audit Committee Annual Report 2017/18. 52/18 Corporate Registers The Committee reviewed the following registers updated since the 23 May 2018 meeting which included:- Register of Interests (lists additions/changes to the register only as per Audit Committee recommendations) Page 5 of 7

7 Register of Gifts and Hospitality (update attached) Register of Conflicts of Interests (none to report) Procurement Register Waiver of Standing Financial Instructions (none to report) Whistleblowing Log (none to report) Members queried the process for capturing gifts and hospitality for CCG staff. It was noted that there is a process in place to update new starters via the staff induction programme. The Committee reviewed and approved the Corporate Registers Report. 53/18 Review of Assurance on External Reports Following agreement of the Audit Committee on 18 April 2018, Bolton CCG introduced a central log to capture external reviews issued following assessment of the CCG or its providers. This would help support the CCG s monitoring of quality and performance and provide assurance to the Audit Committee and governing body. The log is coordinated by the Governance and Safety directorate and submitted to the Quality and Safety committee as a routine agenda item. It will include any report issued about NHS providers and Bolton CCG. The external review log for 1 April 31 August 2018 was reviewed by the committee. Discussion took place regarding Shanti Medical Centre and members noted that the GP Federation were now caretaking this practice in the interim. The Committee noted the Review of Assurance on External reports. 54/18 Audit Committee Work Plan The work plan for the 24 April 2019 meeting was discussed and updated as follows:- To add the MIAA Anti-Fraud Management Tracker for 2018/19. LH 55/18 Any Other Business There was no other business discussed. 56/18 Chair reflection on significant decisions/actions/risks that may need reporting to the Board through these minutes. Note the Committee approved the annual audit letter. 57/18 Date of Next Meeting:- Weds 16 January 2-4pm Bevan Room Page 6 of 7

8 Future Meetings: Weds 24 April 1-2pm Bevan Room, Self-Assessment Session. Weds 24 April 2-4pm Bevan Room Weds 29 May 2-4pm Bevan Room Weds 18 Sept 2-4pm Bevan Room 2020 Weds 15 Jan 2-4pm Bevan Room Page 7 of 7