MINUTEs OF the SPECIAL MEETING OF THE NHS fife audit committee HELD AT 11.00 am ON TUESDAY 27 NOVEMBER 2012 IN the ACTIVITIES ROOM, PLAYFIELD INSTITUTE, STRATHEDEN HOSPITAL

Present:

Ms A Rooney (Chairperson) / Mrs J Mitchell, Non-Executive Director
Ms M Harper, Non-Executive Director

In Attendance:

Mr P Adams, Non-Executive Director

Mrs C Bowring, Director of Finance

Mr G Cunningham, Acting Director of Acute Services

Mr A Gaskin, Chief Internal Auditor

Dr I Lowles, Non-Executive Director

Ms J Lyall, Principal Auditor

Ms A Machan, Senior Auditor, Audit Scotland

Ms F Purdon, Non-Executive Director

Mr J Wilson, Chief Executive

Mrs P M King, Corporate Services Manager (Minutes)

The Chair welcomed everyone to the Special Meeting of the Audit Committee.

/ ACTION /
71/12 / APOLOGIES FOR ABSENCE
Apologies were received from Mr A Robertson.
72/12 / DECLARATION OF MEMBERS’ INTERESTS
There were no declarations of interest.
73/12 / WAITING TIMES AUDIT
Mr Wilson reminded the Committee that the Audit Report was being presented to the Audit Committee to review the results of the Internal Audit carried out on NHS Waiting Times Arrangements. It was a confidential report at this stage and required to be presented with other Health Boards’ reports to the Scottish Government Health & Social Care Directorate (SGHSCD) by 18 December 2012. Thereafter, once agreed by SGHSCD, the report would be publicly available and could be reported to the Board in February 2013.
Mrs Bowring advised that NHS Fife was the first client of Internal Audit to have its report completed for submission to its Audit Committee. The report had been considered by several senior managers, with observations incorporated into the final response.
Mr Gaskin took Members through the detailed report. The report set out the background to the document which had followed Price Waterhouse Cooper’s review into aspects of NHS Lothian’s waiting times management and practice. All Health Boards had subsequently been required to undergo a detailed audit of local waiting times management and processes, including reporting mechanisms. The timeline around this, and limitations in scope, were also set out in the report. The Executive Summary was self-explanatory and highlighted a number of good practice points (para 17) and potential areas for improvement (para 18). Mr Gaskin referred Members to para 48 and emphasised that whilst the underlying theme of the NHS Lothian review was around culture and governance within NHS Lothian, there had been no indication from speaking to staff within NHS Fife of anything but a robust, positive culture where things were reported properly. He concluded that this had been a complex and difficult audit and recorded thanks to Ms Lyall and his own team for their hard work in completing the audit. He also thanked NHS Fife staff for their co-operation and prompt responses.
The tightness of the timetable for completing the audit was noted. In response to Ms Rooney, Mr Gaskin confirmed that all the necessary material had been received and the staffing issues within Internal Audit had not compromised the ability to carry out the review.
Considerable discussion took place around the report and Members commented on a range of findings. In particular, the Committee commented on the fact that the audit had been carried out at a particular point in time and that a number of actions had taken place proactively post July to address issues and had not therefore been incorporated into the action plan. The action plan appeared light as it was only residual, and took account of those matters not addressed after the period of the audit. Members also felt that it was not clear from the Management Responses what action had been taken. Mr Gaskin believed that the progress not included in the action plan had been reflected elsewhere in the report. The Audit Committee considered this approach and asked Mr Gaskin to cross reference the recommendations in the report to allow Members to be confident that all recommendations identified had been addressed/ implemented. / AG
Ms Rooney emphasised that the findings in the main were good and that the Committee should be reassured that NHS Fife did not have the same issues as identified in NHS Lothian. There were some areas to be addressed but this was part of audit and continuous improvement. Mr Wilson confirmed that he was pleased with the overall report which clearly stated that the culture in another Board was not evident in NHS Fife. The results of the audit showed that there had been an issue about record keeping which had made it difficult to trace over a period of time; most of the transactions that had not been fully in line with New Ways guidance had been clerical errors. He reassured the Committee that action was underway to tighten up the processes around record keeping, including the tightening up of the policy, advice to staff, etc, all of which would greatly improve how things were recorded within NHS Fife.
The Audit Committee agreed that the report be amended to: / AG
·  include a statement, at the start of the report, on work done proactively prior to the audit.
·  highlight the clear messages around culture, testing, etc, in the Executive Summary;
·  cross reference recommendations in the report (as noted above);
The revised report would be forwarded to Mrs Bowring and Mr Wilson by 3 December 2012 to allow the management responses to be agreed by 5 December 2012. The report would then be circulated for agreement to Audit Committee Members by 7 December 2012. Clarity would also be sought on the NHS Scotland Chief Executive’s statement of assurance requirements of earlier this year to enable a decision to be made on whether any comment was necessary around the adequacy/completeness of the statement. The report remained confidential at this stage.
Ms Rooney, on behalf of the Committee, thanked Ms Lyall and Mr Gaskin for their work. The Audit Committee had been pleased with the findings of the review and all comments had been made in the spirit of ensuring that the report reflected both the findings of the audit and the good work undertaken pro-actively post July 2012.
74/12 / DATE OF NEXT MEETING
Wednesday 19 December 2012 at 09:30 in the Staff Club, Victoria Hospital
File Name: Audit 271112 / Issue 1
Originator: Paula King / Page 2 of 3 / Date: 28.11.12