Kingston Clinical Commissioning Group Report Summary Meeting Title Governing Body in public Date 9 th January 2018 Report Title Audit Committee Minutes Agenda Item 14 Attachment L Purpose (please indicate with X) Approval/ Ratification Discussion / Comment Information x Report Author: (name & job title) Paul Gallagher, Lay Member & Audit Chair Presented by: (name & job title) Paul Gallagher, Lay Member & Audit Chair MINUTES OF THE AUDIT COMMITTEE HELD ON MONDAY 26 SEPTEMBER 2017 KINGS CENTRE, COPPARD GARDENS, CHESSINGTON PRESENT: Paul Gallagher (Chair) Lay Member Jim Smyllie Lay Member David Knowles Lay Member Dr Annette Pautz Governing Body GP IN ATTENDANCE: Nick Atkinson RSM UK Andy Conlan Engagement Manager, Grant Thornton Dr Phil Moore Deputy Chair Clinical Yarlini Roberts Local Director of Finance Vicki Harvey-Piper Local Director of Corporate Affairs & Governance Jenny Sinnott Head of Finance Jo Dandridge Governance & Business Lead Minutes APOLOGIES: Dr Naeem Iqbal Governing Body GP Tonia Michaelides Managing Director, Kingston & Richmond CCGs Dr Naz Jivani Governing Body Chair James Murray Interim Chief Finance Officer, SWL Alliance Iain Murray Associate Director, Grant Thornton Lianna Parker-Carn LCFS RSM UK Gemma Higginson LCFS RSM UK Michael Mulligan NEL CSU 17/52 Welcome and Introductions: Those present were welcomed to the meeting. 17/53 Minutes of the previous meetings: The Minutes of the last meeting held on Monday, 24 th July 2017 were agreed as an accurate record. Version: Final L - 1
17/54 Declarations of any possible conflicts of interest arising: There were no declarations. 17/55 Matters Arising 17/56 Terms of Reference Members received a revised version of the Audit Committee Terms of Reference following the recent governance review that had been undertaken. Members discussed the inappropriateness of non-voting members of the Audit Committee and therefore agreed that the Chief Finance Officer, and members from External Audit and Internal Audit would be listed within the Terms of Reference as in attendance and the local directors, CSU and Governing body chair would be by invitation. Members also noted that reference to NHS Internal Audit Standards within section 8.2 of the Terms of Reference should be amended to read Public Sector Internal Audit Standards and reference to NHS Protect in section 8.5 should be removed. Subject to the amendments agreed as stated above, the Audit Committee APROVED the revised Terms of Reference and these would be included within the CCG s Constitution. 17/57 Scheme of Reservation and Delegation Members received a revised Scheme of Reservation and Delegation which forms part of the CCG s Constitution. Members noted that the main revisions were: the inclusion of a new scheme to allow the Governing Body to delegate responsibility for collaborative decision making to the SWL Committees-in-Common following the formation of the SWL Alliance; and the addition of a new decision to review planning and procurement of primary care services which would be delegated to the Primary Care Commissioning Committee. Members also discussed and agreed the following additional changes: Approval to prepare and recommend an operational scheme of delegation that sets out who has responsibility for operational decisions within the CCG to be delegated to the Managing Director. Approval of the CCG s counter fraud and security management arrangements to be delegated to the Audit Committee Approval of a comprehensive system of internal control, including budgetary control, that underpins the effective, efficient and economic operation of the CCG to be delegated to the Finance Committee Approval of the CCG s contracts for any commissioning support to be delegated to the Managing Director Approval of the CCG s contracts for corporate support to be delegated to the Managing Director Version: Final L - 2
The Audit Committee APPROVED the revised Scheme of Reservation and Delegation subject to the additional amends listed above and noted that these would be included within the CCG s Constitution. 17/58 External Audit Andy Conlan, Engagement Manager from Grant Thornton presented a copy of the progress report against the 2017/18 plan for delivering their responsibilities as the external auditors for the CCG. Members were advised that the External Audit Plan for 2018/19 would be presented to the March 2018 Audit Committee. Members also noted the addition of the new cross sector Board Effectiveness report produced from research which looked at the effectiveness of boards across the corporate, public and not for profit sectors. Members were asked to provide their feedback on the format of the progress report. The Chair questioned whether there would be any major changes to the audit planning for 2018/19 and in response, it was noted that there were currently no major changes to reporting standards. However, regular updates would be provided to the committee and members would be advised of any changes. The Audit Committee noted the External Audit progress report. 17/59 Internal Audit Progress Report Members received a summary report on the progress against the Internal Audit Plan for 2017/18. Members noted the key findings of the completed audit on Financial Planning and QIPP Delivery which had been given a reasonable assurance rating and the following management actions raised: The annual financial plan will be reviewed and approved in a timely manner To develop a budget setting timetable and to monitor this through the Finance Committee Budget holder refresher training will be held for all budget holders on an annual basis Budgets will be approved and signed off in a timely manner, in line with the budget timetable The End of Life scheme to have a completed PID in place, and approved by the Delivery Group Members were advised that the introduction of the working across both Kingston & Richmond Local Delivery Unit had been a challenging environment and caused some issues earlier in the year. Members questioned how realistic it would be to close the 800k gap on an 11m QIPP plan and it was recognised that Kingston CCG had a robust set of assumptions to be used and a well established Delivery Group in operation with no fear to undertake the challenge. Version: Final L - 3
In addition it was recommended that a centralised ideas log for QIPP schemes was created to allow the QIPP manager to track progress and identify which schemes have been considered and rejected in the past, to avoid duplication of work. Members were also advised that the audit on primary care payments had recently been completed and the report would be brought to the next meeting of the Audit Committee. Audit Tracker Members received a copy of the Internal Audit Action Tracker for information. RSM Health Matters A copy of the most recent Health Matters had been circulated for information. Conflicts of Interest Benchmarking Report Members received a report detailing the outcome of the conflicts of interest benchmarking exercise undertaken of 31 CCGs based in London and the South East. The exercise identified common issues and areas of good practice alongside improvement areas across the 25 CCGs reviewed. Members were advised that many CCGs had been waiting for the NHS England online training in order to to ensure they offer training to all employees, Governing Body members, members of CCG Committees and sub committees and practice staff with involvement in CCG business on the management of conflicts of interest. However, NHS England had now withdrew the requirement to complete the training toolkit as it had not been provided. Members suggested that the NEL CSU could be asked to deliver local training. NHS Cyber Security Members received a report detailing how NHS organisations can protect themselves against continued and evolving cyber threats. Members noted that it was hoped the move to the new SWL IT solution cloud based system by CCGs should provide a more robust solution. Members believed with the introduction of GDPR it was crucial for regular reviews of firewall rulesets to be undertaken by providers of IT and Yarlini Roberts advised that she would raise this with Your Healthcare later that week within the contract performance meeting. Action: It was agreed that Yarlini Roberts would ask Your Healthcare for a progress report on preparation for GDPR. High Priority Management Actions A paper detailing an analysis of all high priority management actions agreed in 2016/17 with CCGs and providers had been received for information. Members noted that HR and staffing came out on top for NHS providers, whilst for CCGs it was financial management and pressures that were top. 17/60 LDU & SWL Alliance Governance Arrangements Members received a verbal update on the revised governance arrangements across Kingston & Richmond CCGs following the introduction of the LDU and the SWL Alliance. Version: Final L - 4
Members were advised that both CCGs were retaining their sovereignty, and that with the new shared management resource across Kingston & Richmond, there needed to be revisions made to each respective Constitution to take into account the agreed changes to local governance arrangements. The revised Constitutions were currently with NHS England awaiting approval. Members noted the significant difference in the Constitution was the introduction of a Committees in Common made up of the five SWL CCGs in order to make decisions where sensible to do so across SWL. Members were also advised that some of the less clinical subjects currently reported through the Integrated Governance Committee would now be considered at the Executive Management Team. A review of Terms of Reference for all committees of the CCG had also been undertaken and local Directors would now prioritise their attendance at various CCGs meetings. Members also noted that an independent GP for the Kingston Primary Care Commissioning Committee was needed to be sought from further afield as currently, the independent GP was from Richmond CCG. 17/61 Tender Waivers 17/62 Any Other Business 17/63 Date of next meeting Tuesday, 19 th December 2017 (3.00-5.00pm), King Charles Centre, Hollyfield Road, Surbiton KT5 9AL. Version: Final L - 5