Report on the 2016/17 and 2017/18 Audits of NHS Tayside

PDF Published: Wednesday 29 May 2019 (PAPLSS052019R2)

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Overview
Report

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Overview
Report
- Membership changes
- Introduction
  - Structure of this report
- Key findings and recommendations
- Part 1 : Financial challenges faced by NHS Tayside
  - The 2016/17 audit of NHS Tayside
  - Assurance and Advisory Group
  - Subsequent developments
  - The 2017/18 audit of NHS Tayside
- Part 2: Significant governance issues emerging in 2018
  - Use of eHealth funds by NHS Tayside
    
    Background
    
    Lack of financial experience and failure to escalate
    
    Quality of financial reporting and information
    
    Role of the financial directors
    
    Challenge by the board
    
    Role of National Services Scotland
    
    Role of the Scottish Government
    
    Role of internal audit
    
    Conclusions
  - The retrospective application of endowment funds
    
    Background
    
    Decision to vary the Policy and Procedures
    
    Assessing charitable objectives
    
    Decision making processes
    
    Advice from Central Legal Office
    
    Perspective of legal advice
    
    Advice from OSCR
    
    General quality of decision making overall
    
    Conflict of interests
    
    Role of internal audit
    
    Role of the Scottish Government
    
    External audit
  - Overarching governance issues
    
    Quality of financial information and reporting
    
    Oversight and control mechanisms
  - Why these events at NHS Tayside took place
  - Payments made to the former chief executive
    
    Background
    
    2017/18 section 22 report
    
    Change to contractual notice period
    
    Pension contribution
- Part 3: Steps being taken to address the financial challenges
  - Are the financial pressures facing NHS Tayside having an impact on service delivery?
  - Action taken by NHS Tayside – governance issues
  - Action being taken by NHS Tayside to address the financial challenges
  - Moving forward
    
    Effective leadership
    
    Financial strength
    
    Board governance
    
    Scottish Government steps
    
    Tailored Government support
    
    Learning from events at NHS Tayside
- Conclusion
Sources

Audit Scotland. (2017, October). The 2016/17 audit of NHS Tayside - Financial sustainability. Retrieved from http://www.audit-scotland.gov.uk/uploads/docs/report/2017/s22_171010_nhs_tayside.pdf

Audit Scotland. (2017, October 26). NHS in Scotland. Retrieved from http://www.audit-scotland.gov.uk/uploads/docs/report/2017/nr_171026_nhs_overview.pdf

Public Audit and Post-legislative Scrutiny Committee 15 December 2016, Professor Connell, contrib. 155, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=10703&c=1960716

Public Audit and Post-legislative Scrutiny Committee 15 December 2016, Lesley McLay, contrib. 287, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=10703&c=1960848

Public Audit and Post-legislative Scrutiny Committee 15 December 2016, Professor Connell, contrib. 134, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=10703&c=1960695

NHS Tayside Assurance and Advisory Group. (2017, June). First Progress Report. Retrieved from https://www.nhstaysidecdn.scot.nhs.uk/NHSTaysideWeb/idcplg?IdcService=GET_SECURE_FILE&Rendition=web&RevisionSelectionMethod=LatestReleased&noSaveAs=1&dDocName=prod_286487

NHS Tayside Assurance and Advisory Group. (, December 2018). Third Progress Report. Retrieved from https://www.parliament.scot/S5_Public_Audit/General%20Documents/AAG_NHS_Tayside.pdf

Audit Scotland. (2018, December 6). The 2017/18 audit of NHS Tayside. Retrieved from http://www.audit-scotland.gov.uk/uploads/docs/report/2018/s22_181206_nhs_tayside.pdf

Public Audit and Post-legislative Scrutiny Committee 13 December 2018, Caroline Gardner, contrib. 106, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11850&c=2139095

Gray, P. (2018, March 7). Letter from Paul Gray to Convener 7 March 2018. Retrieved from https://www.parliament.scot/S5_Public_Audit/General%20Documents/Letter_from_Paul_Gray_-_NHS_Tayside_(web)_7_March_2018.pdf

Grant Thornton UK LLP. (2018, March). An independent review by Grant Thornton UK LLP on eHealth Funding between eHealth, NHS National Services Scotland and NHS Tayside between 2012 and 2018. Retrieved from https://www.parliament.scot/S5_Public_Audit/General%20Documents/20180323_NHS_Tayside_P_Gray__and_Grant_Thornton_Report.pdf

NHS Tayside Board. (n.d.) Ian McDonald was Director of Finance from 1 January 2010 to 30 June 2015. Lindsay Bedford was Director of Finance up until February 2018.

Grant Thornton UK LLP. (2018, May 21). An independent review by Grant Thornton UK LLP on agreed areas of NHS Tayside financial governance arrangement between the financial years 2012/13-2017/18 - Final Report 21 May 2018. Retrieved from https://www.parliament.scot/S5_PublicPetitionsCommittee/General%20Documents/Letter_from_Paul_Gray_22_May_2018_inc_Grant_Thornton_Report_(Paper_1).pdf

Public Audit and Post-legislative Scrutiny Committee 19 April 2018, Fiona Mitchell-Knight, contrib. 106, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11478&c=2084206

Public Audit and Post-legislative Scrutiny Committee 19 April 2018, Fiona Mitchell-Knight, contrib. 52, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11478&c=2084152

Public Audit and Post-legislative Scrutiny Committee 19 April 2018, Fiona Mitchell-Knight, contrib. 108, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11478&c=2084208

Public Audit and Post-legislative Scrutiny Committee 19 April 2018, Caroline Gardner, contrib. 49, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11478&c=2084149

Public Audit and Post-legislative Scrutiny Committee 19 April 2018, Caroline Gardner, contrib. 54, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11478&c=2084154

KPMG LLP. (2018, March 12). NHS National Services Scotland - Investigation of eHealth funds: Summary of findings and conclusions. Retrieved from https://www.parliament.scot/S5_Public_Audit/General%20Documents/KPMG_Review_NHS_National_Sevices_Scotland.pdf

Public Audit and Post-legislative Scrutiny Committee 29 March 2018, Paul Gray, contrib. 262, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11462&c=2081682

Public Audit and Post-legislative Scrutiny Committee 29 March 2018, Paul Gray, contrib. 270, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11462&c=2081690

Public Audit and Post-legislative Scrutiny Committee 19 April 2018, Caroline Gardner, contrib. 56, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11478&c=2084156

Public Audit and Post-legislative Scrutiny Committee 29 March 2018, Lesley McLay, contrib. 217, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11462&c=2081637

Public Audit and Post-legislative Scrutiny Committee 29 March 2018, Professor Connell, contrib. 250, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11462&c=2081670

Public Audit and Post-legislative Scrutiny Committee 29 March 2018, Alan Gray, contrib. 75, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11462&c=2081495

Public Audit and Post-legislative Scrutiny Committee 29 March 2018, Alan Gray, contrib. 113, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11462&c=2081533

Public Audit and Post-legislative Scrutiny Committee 29 March 2018, Alan Gray, contrib. 42, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11462&c=2081462

Public Audit and Post-legislative Scrutiny Committee 19 April 2018, Caroline Gardner, contrib. 130, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11478&c=2084230

Public Audit and Post-legislative Scrutiny Committee 19 April 2018, Caroline Gardner, contrib. 132, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11478&c=2084232

Public Audit and Post-legislative Scrutiny Committee 29 March 2018, Alan Gray, contrib. 71, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11462&c=2081491

Public Audit and Post-legislative Scrutiny Committee 19 April 2018, Caroline Gardner, contrib. 6, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11478&c=2084106

Public Audit and Post-legislative Scrutiny Committee 29 March 2018, Paul Gray, contrib. 341, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11462&c=2081761

Gray, P. (2018, May 2). Letter from Paul Gray to Convener. Retrieved from https://www.parliament.scot/S5_Public_Audit/General%20Documents/20180502_Letter_from_Paul_Gray_re_reviews.pdf

Gray, P. (2018, May 2). Letter from Paul Gray to Convener - 2016/17 audit of NHS Tayside. Retrieved from https://www.parliament.scot/S5_Public_Audit/General%20Documents/20180502_Letter_from_Paul_Gray_re_reviews.pdf

Fairweather, S. (2018, June 18). Letter from Director of Internal Audit to Paul Gray. Retrieved from https://www.parliament.scot/S5_Public_Audit/General%20Documents/NHS_eHealth_Letter_-_18_June_2018_(2).pdf

BBC News. (2018, April 4). Row over Tayside health board's use of charity fund. Retrieved from https://www.bbc.co.uk/news/uk-scotland-tayside-central-43642557

The Scottish Charity Regulator (OSCR). (2019, February 1). Inquiry Report made under Section 33 of the Charities and Trustee Investment (Scotland) Act 2005. Tayside NHS Board Endowment Funds (SC011042). Retrieved from https://www.parliament.scot/S5_Public_Audit/General%20Documents/2019-02-01_OSCR_section_33_report_final_PDF.pdf

NHS Tayside. (2014, June 24). Tayside NHS Board Endowment Fund Annual Accounts 2013/14. Retrieved from https://www.nhstaysidecdn.scot.nhs.uk/NHSTaysideWeb/idcplg?IdcService=GET_SECURE_FILE&Rendition=web&RevisionSelectionMethod=LatestReleased&noSaveAs=1&dDocName=prod_272650

Public Audit and Post-legislative Scrutiny Committee 24 May 2018, Shona Robison, contrib. 152, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11561&c=2096841

Carson, D., & McDonald, I. (2018, June 14). Letter to Paul Gray, Director-General Health and Social Care in response to Grant Thorton report on 21 May 2018.

Public Audit and Post-legislative Scrutiny Committee 19 April 2018, Caroline Gardner, contrib. 36, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11478&c=2084136

Public Audit and Post-legislative Scrutiny Committee 19 April 2018, Caroline Gardner, contrib. 42, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11478&c=2084142

Public Audit and Post-legislative Scrutiny Committee 24 May 2018, Shona Robison, contrib. 7, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11561&c=2096697

Public Audit and Post-legislative Scrutiny Committee 24 May 2018, Christine McLaughlin (Scottish Government), contrib. 16, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11561&c=2096706

Public Audit and Post-legislative Scrutiny Committee 19 April 2018, Caroline Gardner, contrib. 26, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11478&c=2084126

Public Audit and Post-legislative Scrutiny Committee 19 April 2018, Caroline Gardner, contrib. 40, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11478&c=2084140

Public Audit and Post-legislative Scrutiny Committee 24 May 2018, Shona Robison, contrib. 22, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11561&c=2096712

Public Audit and Post-legislative Scrutiny Committee 10 May 2018, Paul Gray, contrib. 195, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11524&c=2091977

Public Audit and Post-legislative Scrutiny Committee 19 April 2018, Caroline Gardner, contrib. 30, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11478&c=2084130

Public Audit and Post-legislative Scrutiny Committee 10 May 2018, Paul Gray, contrib. 59, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11524&c=2091841

Public Audit and Post-legislative Scrutiny Committee 19 April 2018, Caroline Gardner, contrib. 34, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11478&c=2084134

PriceWaterhouseCoopers LLP. (2014, June 10). NHS Tayside - Annual report to Members and the Auditor General for Scotland. Retrieved from http://www.audit-scotland.gov.uk/docs/health/2014/fa_1314_nhs_tayside.pdf

Public Audit and Post-legislative Scrutiny Committee 24 May 2018, Christine McLaughlin, contrib. 80, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11561&c=2096769

Public Audit and Post-legislative Scrutiny Committee 24 May 2018, Shona Robison, contrib. 90, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11561&c=2096779

Public Audit and Post-legislative Scrutiny Committee 24 May 2018, Shona Robison, contrib. 27, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11561&c=2105081

Public Audit and Post-legislative Scrutiny Committee 19 April 2018, Caroline Gardner, contrib. 22, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11478&c=2084122

Public Audit and Post-legislative Scrutiny Committee 24 May 2018, Christine McLaughlin, contrib. 156, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11561&c=2096845

Public Audit and Post-legislative Scrutiny Committee 19 April 2018, Caroline Gardner, contrib. 58, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11478&c=2084158

Public Audit and Post-legislative Scrutiny Committee 24 May 2018, Shona Robison, contrib. 68, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11561&c=2096757

Public Audit and Post-legislative Scrutiny Committee 10 May 2018, Paul Gray, contrib. 88, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11524&c=2091870

Carson, D., & McDonald, I. (2019, March 9). Letter to Convener - NHS Tayside Endowments Funds regarding Committee meeting on 24 May 2018. Retrieved from https://www.parliament.scot/S5_Public_Audit/General%20Documents/20190309_D_Carson_I_McDonald-_NHS_Tayside_Endowment_Funds.pdf

Public Audit and Post-legislative Scrutiny Committee 24 May 2018, Shona Robison, contrib. 76, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11561&c=2096765

Public Audit and Post-legislative Scrutiny Committee 10 May 2018, Paul Gray, contrib. 90, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11524&c=2091872

Audit Scotland. (2018, December). The 2017/18 audit of NHS Tayside. Retrieved from http://www.audit-scotland.gov.uk/uploads/docs/report/2018/s22_181206_nhs_tayside.pdf

Public Audit and Post-legislative Scrutiny Committee 19 April 2018, Caroline Gardner, contrib. 90, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11478&c=2084190

Public Audit and Post-legislative Scrutiny Committee 17 January 2019, Dr Annie Ingram (NHS Tayside), contrib. 45, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11898&c=2146294

Public Audit and Post-legislative Scrutiny Committee 17 January 2019, Hazel Craik, contrib. 39, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11898&c=2146288

Public Audit and Post-legislative Scrutiny Committee 17 January 2019, Hazel Craik, contrib. 17, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11898&c=2146266

Public Audit and Post-legislative Scrutiny Committee 17 January 2019, Malcolm Wright, contrib. 12, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11898&c=2146261

Public Audit and Post-legislative Scrutiny Committee 17 January 2019, Hazel Craik, contrib. 64, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11898&c=2146313

Public Audit and Post-legislative Scrutiny Committee 17 January 2019, Hazel Craik, contrib. 66, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11898&c=2146315

Public Audit and Post-legislative Scrutiny Committee 17 January 2019, Dr Ingram, contrib. 99, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11898&c=2146348

Public Audit and Post-legislative Scrutiny Committee 17 January 2019, Paul Gray, contrib. 217, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11898&c=2152238

NHS Tayside. (2019, January). Written submission by NHS Tayside. Retrieved from https://www.parliament.scot/S5_Public_Audit/General%20Documents/NHS_Tayside_Written_Evidence_January_2019.pdf

Public Audit and Post-legislative Scrutiny Committee 17 January 2019, Hazel Craik, contrib. 109, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11898&c=2146358

Public Audit and Post-legislative Scrutiny Committee 13 December 2018, Caroline Gardner, contrib. 93, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11850&c=2139082

Public Audit and Post-legislative Scrutiny Committee 17 January 2019, John Brown, contrib. 118, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11898&c=2152236

Public Audit and Post-legislative Scrutiny Committee 17 January 2019, John Brown, contrib. 120, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11898&c=2146369

Public Audit and Post-legislative Scrutiny Committee 17 January 2019, Malcolm Wright, contrib. 127, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11898&c=2146376

Public Audit and Post-legislative Scrutiny Committee 17 January 2019, Malcolm Wright, contrib. 138, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11898&c=2146387

Public Audit and Post-legislative Scrutiny Committee 13 December 2018, Caroline Gardner, contrib. 95, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11850&c=2139084

Public Audit and Post-legislative Scrutiny Committee 13 December 2018, Caroline Gardner, contrib. 5, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11850&c=2138994

Public Audit and Post-legislative Scrutiny Committee 13 December 2018, Leigh Johnston (Audit Scotland), contrib. 104, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11850&c=2139093

Public Audit and Post-legislative Scrutiny Committee 17 January 2019, John Brown, contrib. 156, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11898&c=2146405

Public Audit and Post-legislative Scrutiny Committee 17 January 2019, Malcolm Wright, contrib. 125, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11898&c=2146374

Public Audit and Post-legislative Scrutiny Committee 17 January 2019, John Brown, contrib. 143, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11898&c=2146392

Public Audit and Post-legislative Scrutiny Committee 17 January 2019, Malcolm Wright, contrib. 181, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11898&c=2146430

Public Audit and Post-legislative Scrutiny Committee 17 January 2019, Paul Gray, contrib. 239, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11898&c=2146488

Ritchie, S.L.D., & Lamb, C. (2019, February 14). Further update letter. Retrieved from https://www.parliament.scot/S5_Public_Audit/General%20Documents/AAG_-_update_letter_-_final_version_-_Feb_19.pdf

Public Audit and Post-legislative Scrutiny Committee 29 March 2018, Professor Ritchie, contrib. 11, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11462&c=2081431

Public Audit and Post-legislative Scrutiny Committee 17 January 2019, John Brown (NHS Tayside), contrib. 3, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11898&c=2146252

Audit Scotland. (2018, October). NHS in Scotland 2018. Retrieved from http://www.audit-scotland.gov.uk/uploads/docs/report/2018/nr_181025_nhs_overview.pdf

Public Audit and Post-legislative Scrutiny Committee 29 March 2018, Professor Ritchie, contrib. 21, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11462&c=2081441

Public Audit and Post-legislative Scrutiny Committee 13 December 2018, Caroline Gardner, contrib. 89, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11850&c=2139078

Audit Scotland. (2018, October). NHS in Scotland 2018. Retrieved from http://www.audit-scotland.gov.uk/uploads/docs/report/2018/nr_181025_nhs_overview.pdf [accessed 20 March 2019]

Public Audit and Post-legislative Scrutiny Committee 17 January 2019, John Brown, contrib. 173, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11898&c=2146422

Public Audit and Post-legislative Scrutiny Committee 13 December 2018, Caroline Gardner, contrib. 47, http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=11850&c=2139036

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