Co-ordinator:
Director Of Finance / Reviewer:
Audit Committee / Approver:
NHS Grampian Board
Signature / Signature / Signature
Identifier:
15th March 2013 / Review date:
26th March 2013 / Implementation date:
4th June 2013
UNCONTROLLED WHEN PRINTED
VERSION 3
NHS Grampian
Scheme of Delegation
Schedule of Reserved Decisions
(a partner document in conjunction with the Operational Scheme of Delegation)
June 2013
C O N T E N T S
Page
Scheme of Delegated Authority
3
/Introduction
4
/NHS Grampian
4
/Meetings
4
/Code of Conduct and Code of Accountability
4
/Other Matters
5
/Decisions Reserved for the Board
6
/Management of NHS Grampian Assets
7
/Financial Plans and Projections
7
/Service Agreements for the Provision of Services
8
/Budgets
8
/Income
8
/Annual Accounts and Reports
8
/Bank and OPG Accounts
9
/Capital Approvals, Capital Investments, PFI, Fixed Asset Registers and Security of Assets
10
/Security of Cash, Cheques and other Negotiable Instruments
10
/Staff Contracts of Employment
11
/Payment of Accounts
11
/Primary Care Contractors
11
/Procurement and Tendering
12
/Ordering, Stores and Receipt of Goods
12
/Patients’ Property
13
/Information Technology
13
/Internal Audit
13
/Disposals and Condemnations, Losses and Special Payments
14
/Endowment Funds
14
/Risk Management and Insurance
14
/Legal Matters
14
/Retention of Documents
Delegated Limits and Authorised Signatories
15
/Quotations, Tendering and Contract Procedures
16
/Endowment Projects and Payments
16
/Endowment Investments
16
/Authorisation of Losses, Compensation and Ex-Gratia Payments
16
/Bank Accounts
17
/Compensation Payments Under Legal Obligation (CNORIS delegated limits)
18
/Fixed Asset Additions and Disposals in relation to Property
18
/Professional Consultancy Commitment and Payment
18
/Travel/Conference/Course/Training/Expenses Payment
18
/Establishment of Cash Floats
18
/Leased Car Ordering
19
/Virement between Revenue Budget Headings
NHS Grampian Schedule of Reserved Decisions
Introduction
The Schedule of Reserved Decisions (SORD) is a corporate governance protocol that provides a high level summary of delegated responsibilities within NHS Grampian. The SORD complements the Operational Scheme of Delegation that details all officers within NHS Grampian who have delegated authority according to the standard categories that have been agreed on a NHS Grampian basis.
It is intended that the SORD will be a key reference document for senior personnel in relation to their delegated duties and delegated authority levels. It also details the decision-making powers of the Board and the responsibilities of committees that report into the Board.
The Board Secretary is the officer responsible for the SORD. Any queries that you may have should be directed in the first instance to either, The Assistant Director of Finance on ext 56211 orthe NHS Grampian Legal Adviser, on ext 58496.
May 2013
Delegated Deputies
To ensure continuity the Board have agreed that the full responsibilities of each principal signatory, as detailed in this Schedule of Reserved decisions, will be delegated to the following designated deputies during times when the principal signatories are not available
Principal Signatory Designated Deputy
Chief Executive. Chief Operating Officer
Director of Finance Deputy Director of Finance or Assistant Director of Finance
NHS Grampian Schedule of Reserved Decisions
1
DELEGATED TO
/DUTIES DELEGATED
NHS Grampian
- Chief Executive
/- Overall responsibility that the organisation meets its obligation to perform within the available financial resources
- Chairman
/- Final authority in interpretation of Standing Orders
Meetings
- Chairman
/- Calling meetings
- Deputy Chairman
/- Calling meetings in the absence of the Chairman
- Chairman
/- Chair all Board meetings and assume associated responsibilities
- Deputy Chairman
/- Chair Board meetings and assume associated responsibilities in the absence of the Chairman
Code of Conduct and Code of Accountability
- Board Secretary
/- Register of Board Members Interests
Other Matters
- Audit Committee
/- Examine every decision to suspend Standing Orders and make recommendations to the Board
- Board Secretary
/- Responsible for preparation and regular review and update of the Standing Orders
- Director of Finance
/- Responsible for preparation and regular review and update of the Standing Financial Instructions
- Audit Committee
/- Review Standing Orders and Standing Financial Instructions regularly and make recommendations to the Board on amendments to the Standing Orders and Standing Financial Instructions
- Chairman and Chief Executive, or delegated deputy (being Deputy Chair or Deputy Chief Executive)
/- Take decisions where, because of urgent time constraints, the Board and/or Committee cannot be consulted. The decision must be reported back to the next Board meeting for homologation.
DELEGATED TO
/DUTIES DELEGATED
Decisions Reserved for the Board
/Approval of:-
- Board Members
/- Regulation and control of Standing Orders and Standing Financial Instructions
- Regulation and control of the establishment, remit and reporting arrangements for any other committee or sub committee acting on behalf of the Board
- Appointments of members to Standing Committees
- Appointments of Executive Directors; membership to other statutory bodies as representing the Board
- Local Health Plan, including financial plans
- Corporate objectives as advised by the Performance Governance Committee
- Operational decisions committing revenue resources in excess of approved budget
- Setting thresholds for obtaining quotations and tenders
- Acceptance of all tenders above £1 million
- Project Documents and additional documentation required to enter in to PFI, HUB orother NPD schemes
- Addition or Disposal of Non Current Assets over £500,000, as advised by the
AssetManagement Group
- Awarding Consultants and Associate Specialists Discretionary Points, as advised by the Remuneration Committee
- Financial and Performance Reporting Arrangements, as advised by the Performance Governance Committee
- All Insurance Arrangements
- Audit Arrangements
- Clinical Governance Arrangements
- Staff Governance Arrangements
- Responsibility for and delegation of exercising financial supervision and control
- Approval of the Annual Accounts
- Approval of variations that exceed the greater of £100,000 or 10% of approved capital schemes
- Approval of non-ehealth projects with a capital cost below £3 million, as detailed in the NHS Grampian Capital Plan (>£3 million – SGHD approval required)
- Approval of e-health projects with a project life cost of less than £2million over the first 4 years of the project, as detailed in the NHS Grampian Capital Plan (or the project life if shorter) (>£2million – SGHD approval required)
DELEGATED TO
/DUTIES DELEGATED
Management of Organisation’s Assets
- Director of Finance
/- Maintenance of register of assets and register of leases
- Chief Executive and Director of Finance
/- Delegation of budgets approved by the Board to appropriate officers
- Chief Executive and Director of Finance
/- Confirm to the officer responsible the authority to proceed with the approved Capital Plan
- Chief Operating Officer
/- Responsible for ensuring tenders are prepared in accordance with SFIs
- Chief Executive and Director of Finance
/- Approve post contract negotiations, where the movement is the Lower of £25,000 or 10% of the contract value
- Chief Executive and Director of Finance or Chief Operating Officer and Director of Finance
/- Condemnations, Losses and Special Payments
- Chief Operating Officer
/- Delegation of responsibility for stock control
- Audit Committee
/- Undertake to review the audit of the Patients Funds
- Director of Finance
/- Procedural instructions for the management of Endowment Funds
- Endowment Committee
/- Review the audit reports of the Endowment Funds and review the adequacy of action taken as a result of audit
- Endowment Committee
/- Appointment of Statutory External Auditors for Endowment Funds
- Director of Nursing
/- Ensure that Risk Management Framework is in place and fully implemented
- Chief Operating Officer
/- Delegation of responsibility for physical Security Arrangements
- Chief Operating Officer
/- Responsible for the preparation for E-health Strategy and procedures for the Control of Computer Systems and Facilities, including e-health security arrangements
- Chief Executive
/- Delegation of responsibility for preparing and implementing procedures for Data Protection Arrangements to the Data Protection Officer
- Director of Finance
/- CNORIS Risk Sharing Arrangements
DELEGATED TO
/DUTIES DELEGATED
- Director of Finance
/- Approve all Financial Operating Procedures
- Board
/- Responsibility for and delegation of exercising financial supervision and control
- Chief Executive
/- Ultimately accountable to the Board for overall responsibility to ensure the organisation meets its obligation to perform within the available financial resources, overall Executive responsibility for the organisation’s activities, responsible for ensuring that the organisation’s financial obligations and targets are met and overall responsibility for the organisation’s systems of internal control
- Director of Finance
/- Ensure that existing Directors and all new appointees are notified of and understand their responsibilities within the Standing Financial Instructions
- Director of Finance
/- Implement financial policies and coordinate any corrective actions where necessary to further the policies
- Director of Finance
/- Prepare the organisation’s financial plans and policies and coordinate any corrective action necessary to further these plans and policies
- Director of Finance
/- Maintain an effective system of internal financial control
- Director of Finance
/- Ensure that effective records are maintained to show and explain the organisation’s transactions
Financial Plans & Projections
- Director or Finance
/- Compile a 5 year financial plan, as an integral part of the Local Delivery Plan
- Director of Finance
/- Report to and advise the Board if any significant variance from the financial plan and remedial actions to be taken
- Director of Finance
/- Compile and submit to the Board financial projections on both revenue and capital
Service Agreements for the Provision of Services
- Chief Operating Officer
/- Establish proper arrangements for the provision of services in to and out of NHS Grampian
DELEGATED TO
/DUTIES DELEGATED
Budgets
- Director of Finance
/- Lead on preparation of budgets and submit to Board for approval
- Director of Finance and Chief Operating Officer
/ - Agree level of delegation to budget holders- Director of Finance
/- Monitor financial performance against budget and Local Delivery Plan
- Budget Holders
/- Provide information as required by the Director of Finance to enable compilation of budgets
- Director of Finance
/- Ensure that adequate training is delivered to budget holders to help them manage effectively
- Director of Finance
/ - Devise and maintain systems of budgetary control- Chief Operating Office and Director of Finance
/- Identify and implement efficiency savings and income generation initiatives
- Chief Executive
/- Lead on strategy to reduce cost base to funding levels
- Director of Finance
/- Ensure appropriate financial monitoring forms are submitted to the Scottish Government
Income
- Director of Finance
/- Design and maintain systems for the proper recording and collection of all monies due
- Director of Finance
/- Ensure that full cost recovery is achieved when setting charges for services
- Director of Finance
/- Approve and regularly review the level of all fees and charges other than those determined by the Scottish Government or by statute
- Director of Finance
/- Take appropriate recovery action on all outstanding debts
Annual Accounts and Reports
- Director of Finance
/- Prepare Annual Accounts and related returns
- Audit Committee
/- Review of the Annual Accounts and present to the Board for approval within agreed timetables
- Board
/- Approval of the Annual Accounts
- Chairman and Chief Executive and Director of Finance
/ - Certify the Annual Accounts in accordance with national guidanceBank and Government Banking Service Accounts
- Director of Finance
/- Responsible for the systems, procedures and operation of the organisation’s bank accounts
DELEGATED TO
/DUTIES DELEGATED
Capital Approvals, Capital Investments, PFI, Fixed Asset Registers and Security of Assets
- Chief Executive
/- Responsible for ensuring a Property and asset Management Strategy is in place, and that plans for capital investments are only agreed where a robust business case has been developed in line with Local Delivery Plan objectives
- Board
/- Approval of non-ehealth projects with a capital cost below £3 million, as detailed in the NHS Grampian Capital Plan (>£3million – SGHD approval required)
- Board
/- Approval of ehealth projects with a project life cost of less than £2 million over the first 4 years of the project, as detailed in the NHS Grampian Capital Plan (or the project life, if shorter) (>£2 million – SGHD approval required)
- Chief Executive and Director of Finance
/ - Responsible for ensuring all Capital Planning guidance is followed- Chief Executive and Director of Finance
/ -Responsible for ensuring:- there is an adequate appraisal and approval process in place for determining capital expenditure priorities and the effect of each proposal upon financial plans and also operational service plans;
- that a Capital programme is brought to the Board for approval;
- that capital investment is not undertaken without confirmation of Board support in terms of the Capital Plan and the availability of resources to finance all revenue consequences, including capital charges
- Chief operating Officer and Director of Finance
/- the management of all stages of capital schemes and that the schemes are delivered on time and within budget
- Chief Executive
/- Ensure that for every capital expenditure proposal over £500,000 and for all PFI, HUB or other NPD schemes a business case is produced for approval by the Board in line with SGHD SCIM guidance
- Asset Management Group
/- Approval of capital expenditure proposals less than £500,000
- Approval of Business Cases for the development of GP premises
- Approval of the acquisition of property, whether by purchase, lease or excambion up to a value of £500,000
DELEGATED TO
/DUTIES DELEGATED
- Chief Operating Officer and Director of Finance
/- Management of capital schemes stage payments in compliance with extant regulations
- Director of Finance
/- Ensure reporting procedures are in place on capital expenditure
- Board
/- Approval of variations that exceed the greater of £100,000 or 10% of approved capital schemes
- Chief Executive and Director of Finance
/- Approval of variations of approved capital schemes <£100,000
- Director of Finance
/- Responsible for demonstrating the use of alternative sources of finance represents value for money
- Director of Finance
/- Approval of disposal of fixed assets below £250,000
- Chief Executive
/- Approval of disposal of fixed assets between £250,000 and £500,000
- Board
/- Approval of disposal of fixed assets above £500,000 on recommendation of the AIG
Security of Cash, Cheques and other Negotiable Instruments
- Director of Finance
/- Responsibility for development of systems to ensure the security of cash, cheques and other negotiable instruments throughout the organisation
Staff Contracts of Employment
- Director of Workforce
/- Ensure that each employee shall be issued with a contract, which shall comply with current employment legislation
- Director of Workforce and Director of Finance
/- Approve all variations to agreed rates of pay and conditions of service on behalf of the Board through the Remuneration Committee where these do not relate to nationally agreed settlements
- Director of Finance
/- Ensure that all payments to staff are properly authorised in accordance with national agreed pay scales or formally approved local agreements
- Director of Workforce and Director of Finance
/- Agree any local agreements in support of changes in local working practices, which involves new rates of pay leading to additional remuneration
- Director of Workforce and Director of Finance
/- Responsible for ensuring procedures governing early retirement and voluntary redundancy in compliance with extant guidance
- Director of Finance
/- Reporting the financial performance of the overall impact of early retirement/voluntary redundancies to the Board
DELEGATED TO
/DUTIES DELEGATED
- Grampian Area Partnership Forum
/- Development and agreement on NHS Grampian wide employee relations matters, subject to approval by the Board and the relevant trade unions in line with national agreements.
Payments of Accounts
- Director of Finance
/- Responsible for the prompt payment of all accounts and claims
- Director of Finance
/- Ensure all payments are made in accordance with the Scheme of Delegation
- Director of Finance
/- Design and maintain systems for the verification, recording and payment of all amounts payable by the organisation
Primary Care Contractors
- Designated CHP General Manager
/- Responsible for preparing, documenting and maintaining systems to control the registers, professional accreditation and service quality of those who are entitled to provide general dental, medical, ophthalmic or pharmaceutical services under the NHS in Grampian
- Director of Finance and Designated CHP General Manager
/- Ensure the preparation, documentation and maintenance of systems, including lines of accountability for:
- Payments to Primary Care Contractors;
- Receipt of income from Primary Care Contractors;
- Recording and verification of all payments under agreed contractual obligations including the quality and outcomes framework;
- Budgetary control of all income streams to support the development of Primary Care
- Agree the SLA with Practitioner Services Division for the agency to support the payment and verification process
Procurement and Tendering
- Director of Finance
/- Advise the Board on the setting of thresholds above which quotations or formal tenders must be obtained
- Chief Operating Officer and Director of Finance
/- Set thresholds above which quotations or formal tenders for obtaining goods, services and works must be obtained
- Director of Finance and Chief Operating Officer
/- Prepare procedural instructions incorporating the thresholds set for obtaining goods, services and works
- Chief Executive or nominated Officer
/- Evaluate quotations and select using a best value for money criterion following agreed protocols outlined in the SFI’s
- Chief Operating Officer and Director of Finance
/- Ensure arrangements for financial control and financial audit of building and engineering contracts and property transactions comply with guidance contained in extant regulations
DELEGATED TO
/DUTIES DELEGATED
- Director of Finance and Chief Operating Officer
/- Responsible for the technical audit of building and engineering contracts
Ordering and Receipt of Goods
- Director of Finance and Chief Operating Officer
/- Preparation, documentation and maintenance of procedures governing the requisitioning of goods and services from whatever source of funds
- Director of Finance and Chief Operating Officer