NHS Mansfield and Ashfield CCG

NHS Mansfield and Ashfield CCG

NHS Mansfield and Ashfield CCG

NHS Newark and Sherwood CCG

Audit Committees

Terms of Reference

1. Purpose

The Audit & Governance Committee provides an independent and objective view on the areas set out in its responsibilities. The Committee is authorised to take decisions on behalf of NHS Mansfield and Ashfield Clinical Commissioning Group and NHS Newark and Sherwood Clinical Commissioning Group on matters relevant to its purpose. It is able to obtain outside legal or independent professional advice and to secure attendance of outsiders with relevant experience and expertise if they consider this to be necessary.

2. Membership

The Committee is appointed by the respective Governing Bodies from amongst the lay and clinical members of the CCGs and will consist of not less than three members. One of the members will be appointed Chair of the Committee by the CCGs’ respective Governing Bodies. In the absence of the Chair one of the other members of the Committee/Sub Committee will chair the meeting as determined by the Chair of the Committee prior to the meeting.

The Clinical Chair will not be members of the Committee.

The membership of the - Committee comprises the following:

  • 1 Audit Chair who is a Lay member of the Governing Bodies’ (joint appointment) (Chair of the Committee)
  • 1 other of the Governing Bodies’ lay members (joint appointment)
  • 1 GP Governing Body member from Mansfield and Ashfield CCG
  • 1 GP Governing Body member from Newark and Sherwood CCG
  • 1 Independent lay member who is a joint appointment but not on either of the CCGs’ Governing Bodies.

The Chief Finance Officer, Accountable Officer, Chief Nurse, and Internal Audit and External Audit representatives will normally attend meetings. The Head of Corporate Governance and/or their nominated officer will also be in attendance.

Additional members may be co-opted as required.

Other directors and members of CCG staff will be invited to attend meetings as appropriate.

The Head of Corporate Governance and/or their nominated representative will attend meetings to provide appropriate support to the Chair and other members and will arrange for minutes of the meeting to be taken.

The Accountable Officer will be invited to attend, at least annually, to discuss the assurance process which supports the respective CCGs’ Annual Governance Reports.

The committee constitutes a Joint Audit Panel where required for the function of appointment of external audit services.

3. Chair and Deputy

One of the lay members who is a member of both the respective Governing Bodies will be appointed Chair of the Committee by the respective CCGs’ Governing Bodies. In the absence of the Chair, the Chair will determine which one of the other members of the Committee will act as the Chair.

4. Quorum and Voting Arrangements

The Committee will be deemed quorate if at least one Governing Body lay member or independent lay member and one GP Governing Body constituency member are present, plus one additional member is present.

5. Frequency of meetings

Meetings of the Committee will normally be held bi-monthly with a minimum of 6 meetings each year.

The Committee will meet as a Committee of the two CCGs for all its business except where the Chair may determine there are particularly sensitive items that relate to one or other of the CCGs in which case any such items will be taken separately.

The External Auditors or Internal Auditors may request a meeting of the Committee if they consider it to be necessary.

The Committee will meet privately, at least annually, with the Internal and External Auditors.

6. Duties

The responsibilities of the Audit and Governance Committee are:-

Governance, Risk Management and Internal Control

  • The Committee will provide the Governing Bodies with assurance on the effectiveness of the CCGs’ Assurance Frameworks and the underlying assurance processes. The Committee will review achievement of strategic objectives and will provide assurance that significant risks to the CCGs’ strategic objectives are being appropriately managed and will give guidance to the Governing Bodies on required remedial actions. The Committee will review the establishment and maintenance of an effective system of integrated governance, risk management and internal control and the activities (both clinical and non-clinical).
  • In particular the Committee will oversee the management of significant risks and will review the adequacy and effectiveness of:

 All risk and control related disclosure statements (in particular the Internal Audit Annual Opinion and External Audit opinion);

 The underlying assurance processes that indicate the degree of achievement of corporate objectives, the effectiveness of the management of principal risk and the appropriateness of the above disclosure statements;

 Compliance with the CCG’s CCGs’ respective Constitutions, Standing Orders, Schemes of Delegation, Financial Policies and other associated policies and procedures;

 The systems in place for the development, management and application of CCGs’ strategies and policies, providing advice to the Governing Body Bodies and on approval and adoption as appropriate.

  • The Committee will primarily utilise work of Internal Audit, External Audit and other assurance functions but will not limit itself to these sources. It will also seek reports and assurances from officers as appropriate, concentrating on the over-arching systems of governance, risk management and internal control, together with indicators of their effectiveness. The Committee will use the CCGs’ Assurance Frameworks to guide its work.
  • The Committee will also provide assurance to the Governing Bodies on the development and delivery of the following strategies and policies:

 Risk management;

 Clinical governance;

 Quality assurance;

 Safeguarding;

 Conflicts of interest.

Internal Audit

The Committee will ensure that there is an effective internal audit function that meets the mandatory Public Sector Internal Audit Standards and provides appropriate independent assurance to the Audit and Governance Committee, Chief Officer and Governing Body Bodies by:

  • Consideration of the provision and cost of the Internal Audit service and any questions of resignation or dismissal;
  • Review and approval of the Internal Audit plans for each of the CCGs ensuring it is consistent with the audit of needs of the CCGs as identified in the CCG Assurance Frameworks;
  • Considering the major findings of Internal Audit work (and management’s response) and ensuring co-ordination between the Internal and External Auditors to optimise audit resources;
  • Ensuring that the Internal Audit function is adequately resourced and has appropriate standing within the organisation;
  • An annual review of the effectiveness of Internal Audit.

External Audit

The Committee will review the work and findings of the External Auditors and consider the implications and management’s responses to their work. This will be achieved by:

  • Consideration of the performance of the External Auditors;
  • Discussion and agreement with the External Auditors, before the audit commences, of the nature and scope of the audit as set out in the annual plans for each of the CCGs;
  • Discussion with the External Auditors of their local evaluation of audit risks the impact on the scope of the Annual Audit Plans;
  • Review all External Audit reports, including the report to those charged with governance, agreement of the Annual Audit Letters for each of the CCGs before submission to the Governing Body Bodies and any work undertaken outside of the Annual Audit Plans, together with the appropriateness of management responses.

Excluded from the responsibilities of the Committee are those functions relating to the selection, appointment and removal/resignation of the External Auditors which shall be the responsibility of the Joint Auditor Panel set up in line with Schedule 4, Paragraph 1 of The Local Audit and Accountability Act 2014 which functions are more specifically set out in the Joint Auditor Panel Terms of Reference approved by the respective Governing Bodies.

Financial Reporting

  • Monitor the integrity of the financial statements of the CCGs and any formal announcements relating to the CCGs’ respective financial performance;
  • Ensure that the systems for financial reporting to the Governing Bodies, (including those relating to budgetary control) are subject to review as to completeness and accuracy of the information provided to the respective Governing Bodies;
  • Review and approve the annual report and annual accounts where timescales or other circumstances dictate for submission to NHS England with a report to the next meeting of the Governing Bodies of the action taken by the Committee.

Counter Fraud, Bribery and Corruption and Whistleblowing

  • The Committee shall satisfy itself that the organization has have adequate arrangements in place for countering fraud, bribery and corruption and shall review the outcomes of counter fraud, bribery and corruption work. The Committee shall seek assurance regarding the organisations’ compliance with NHS Protect’s ‘Standards for Commissioners: Fraud Bribery and Corruption’, by means including: reports from the Counter Fraud Specialist, the respective CCGs’ annual Self-Assessment Review Toolkit (SRT) submission to NHS Protect, and from NHS Protect inspection reports;
  • Review arrangements by which staff may, in confidence, raise concerns about the possible improprieties in matters of financial reporting or other matters.

Other Matters

  • Review the work of other Committees whose work can provide relevant assurance to the Committee’s own scope of work which will include the Governing Bodies and any risk management committees of the Governing Bodies;
  • Request and review reports and positive assurances from directors and managers on the overall arrangements for governance, risk management and internal control and specific reports on individual functions as appropriate;
  • Oversee external assessments including those relating to quality.

The Committee is authorised by the respective Governing Body Bodies to investigate any activity within its Terms of Reference. It is authorised to seek any information it requires from any employees are directed to co-operate with any request made by the Committee.

7. Conduct of Business

The Committee will be expected to conduct itself as an exemplar organization working to the seven Nolan principles of public life namely:

  • Selflessness
  • Integrity
  • Objectivity
  • Accountability
  • Openess
  • Honesty
  • Leadership.

Members of the Committee have a collective responsibility for the operation of the Committee. They will participate in discussion, review evidence and provide objective expert input to the best of their knowledge and ability and will endeavor to reach a collective view.

The Committee may delegate tasks to such individuals, committees or individual members as it shall see fit provided that any such delegations are consistent with the parties’ relevant governance arrangements, are recorded in scheme of delegation, are governed by terms of reference as appropriate and reflect appropriate arrangements for the management of conflicts of interest.

Members of the Committee shall respect confidentially requirements as set out in the CCG’s respective CCGs’ Standing Orders.

8. Administration of Meetings

The Director responsible for overseeing the administration of the Committee is the Chief Finance Officer.

Agendas and supporting papers will be circulated no later than 5 working days in advance of meetings.

Any items placed on the agenda will be sent to the Committee Administrator no later than 7 working days in advance of the meeting. Items that miss the deadline for inclusion on the agenda may be added on receipt of permission of the Chair.

Minutes will be taken at all meetings and circulated to the members of the Committee. The minutes will be approved by agreement of the Committee at the next meeting. The Chair of the Committee will agree minutes for submission to the Governing Bodies prior to formal approval by the Committee where timescales permit.

The Chair will present the Committee’s minutes to the Governing Bodies for information and consideration.

The CCGs will also comply with any reporting requirements set out in their respective Constitutions.

9. Declarations of Interest

The CCGs have a Conflicts of Interest Policy and a Registers of Members’ Interests.

At the beginning of each formal meeting, members will be required to declare any personal interest if it relates specifically to a particular issue under consideration. Any such declaration shall be formally recorded in the minutes for the meeting in accordance with the provisions set out in the CCGs’ policy.

All declared interests will be managed in line with the requirements of the CCGs’ Conflicts of Interest Policy.

10. Reporting Responsibilities

The Committee has been appointed by the respective Governing Bodies and has no executive powers other than those specifically delegated in these terms of reference.

The Committee will report to the Governing Bodies. A progress report and minutes of its meetings will be presented to the Governing Bodies’ meeting.

The Chair of the Committee will draw the Governing Bodies’ attention to any issues that require disclosure or where executive action is necessary.

The Committee will report annually to the Governing Bodies on its work to support the Annual Governance Reports for each of the CCGs, specifically commenting on the fitness for purpose of the CCGs’ Assurance Frameworks, the completeness and embedding of risk management in the CCGs and the integration of governance arrangements.

The Committee may establish working groups to support it in its role. The scope and membership of those working groups will be determined by the Committee.

The Committee will submit an annual report of its work to the CCGs’ Governing Body Bodies.

11. Review of Terms of Reference

The Terms of Reference will be reviewed at least annually or more often when there is a material change to the contents of the Terms of Reference.

Any proposed amendments to the Terms of Reference will be submitted to the Governing Body Bodies for approval.

This review date: October 2017

Next review date: October 2018

1

Top View