5 - External Audit Final Report
North Ayrshire Council · 25 August 2022
Back to Integration Joint Board — 25 August 2022 and its agenda
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Issued on 16th August 2022 for the meeting on 25th August 2022 North Ayrshire Integration Joint Board Report to the Integration Joint Boardand the Controller of Audit on the 2021/22 audit
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2 Contents 01 Final Report Introduction 3 Financial Statements Audit Quality Indicators 7 Our Audit Explained 8 Significant Risks 9 Other Significant Findings 12 Our Audit Report 14 Your Annual Report 15 Audit Dimensions and Best Value Overview and Conclusions 17 Purpose of our Report and Responsibility Statement 18 Audit Adjustments 20 Our Other Responsibilities Explained 21 Independence and Fees 22 02 Appendices
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33 Introduction The key messages in this report I have pleasure in presenting our report to the North Ayrshire Integration Joint Board (“the IJB”) for the year ending 31 March 2022 audit. The scope of our audit was set out within our planning report presented to the Audit and Performance Committee in March2022. Thisreportsummarises ourfindingsandconclusions in relationto: • The auditof the annual reportand accounts;and • Consideration of the four audit dimensions that frame the wider scope of public sector audit requirements as illustrated in thefollowingdiagram.Thisincludesourconsiderationof theAccountableOfficers’ dutyto secure best value. Audit quality is our number one priority. We plan our audit to focus on audit quality and have set the following audit quality objectives for this audit: • A robust challenge of the key judgements taken in the preparation of the Annual Report and Accounts. • A strong understanding of your internal control environment. • A well planned and delivered audit that raises findings early with those charged with governance.
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4 Introduction (continued) The key messages in this report (continued) I would like to drawyourattentionto thekey messages of thispaper: Conclusions fromour testing Based on our audit work completed to date we expect to issue an unmodifiedauditopinion. The Management Commentary and Annual Governance Statement comply with the statutory guidance and proper practice and are consistent with theannualaccounts andourknowledge of the Board. Following updates made by management, the auditable parts of the Remuneration Report have been prepared in accordance with the relevant regulations. We identified errors in relation to salary and pension disclosure includingsome relatedto theprioryear. A summary of our work on the significant risks is provided in the dashboardon page 9. Statusof theAnnual Report and Accountsaudit Outstandingmattersto conclude the auditinclude: • Finalisationof internalqualitycontrol procedures; • Receipt of signed managementrepresentationletter;and • Our reviewof eventssince 31 March2022. Conclusions on audit dimensions and best value As set out on page 3, our audit work covered the four audit dimensions. Our separate detailed report presented to the Board in June 2022 set out our findings and conclusions on each dimension. In accordance with the Code of Audit Practice, we have included our overall conclusions within thisreporton page 17. Key highlightsinclude: Financial Management - The Board continues to have effective budget setting and monitoring arrangements in place. This is supported by an experienced finance team and a robust internal audit function, as well as appropriate arrangements for the prevention and detection of fraud and error. Financial sustainability - The Board has set a balanced budget for 2022/23 and holds unearmarked reserves at a level consistent with its Reserves Strategy, therefore is financially sustainable in the short term. It is also continuing to repay the historical loan to North Ayrshire Council. However, it continues to be faced with significant financial challenges over the medium and longer-term, projecting a high level potential funding gap of upto £8.6m over thenext two years. It is positive to see the development of the MTFO during the year, the progress with transformational change programme and the updated Strategic Commissioning Plan with a clear focus on continuous improvement. Significant work is still required to make the level of lasting long-term transformational change needed to ensure financial sustainability. Progress continues to be impacted by the ongoing response to the pandemic. Significant earmarked reserves are projected to be carried forward into future years. It is critical that detailed plans are developed to demonstrate how these funds will be used to make transformationalchange.
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5 Introduction (continued) The key messages in this report (continued) Conclusions on audit dimensions and best value (continued) Governance and transparency – The IJB continues to have strong leadership, with more tailored training being developed for Board members. The governance arrangements also continue to be robust, with recent updates to the Standing Orders and Scheme of Delegation. The IJB continues to be open and transparent. Further work is required to progress with implementing delegated hospital budgets and set aside requirements, in collaboration with the Scottish Government, NHS Ayrshire and Arran and otherAyrshirepartnerships. Value for money –– The IJB continues to have a clear and robust performance management framework in place which analyses data, tracks progress and identifies actions. Regular reporting on performance is provided to the Performance and Audit Committee and the IJB, with a focus on continuousimprovement. Best value - The IJB has sufficient arrangements in place to secure best value and has a clear understanding of areas which require further development. Added value Our aim is to add value to the IJB by providing insight into, and offering foresight on, financial sustainability, risk and performance by identifying areas for improvement and recommending and encouraging good practice. In so doing, we aim to help the IJB promote improved standards of governance, better management and decision making, and more effective use of resources. This is provided throughout both this report and our separate‘AuditDimensionsandBest Value’ report. We also included our “sector developments” within our separate report where we shared Audit Scotland’s national reporting and our research and informed perspective and best practice from our work across the wider publicsector thatare specifically relevantto theIJB. Managing transition to 2022/23 audits 2021/22 is the final year of the current audit appointments. We will minimise disruption to all parties, and maximise the transfer of knowledge of the IJB, by working in partnership with Audit Scotland and the incoming auditors. We would like to put on record our thanks to the Board, management and staff for the good working relationship over the period of our appointment. Pat Kenny Associate Partner
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6 Annual Report and Accounts Audit
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77 Area Grading Reason FY22 FY21 FY20 Timing of key accounting judgements There were no significant accounting judgements included within the IJB Annual Accounts. Thisis in line with ourexpectationsandunderstandingof theIJB. Adherence to deliverables timetable Management provided all evidence in a timely manner, in advance of agreed timelines. Any follow-up requests during the audit were quickly actioned. This is an improvement from the prior year audit. Access to finance team and other key personnel Deloitte and the IJB Finance Team have worked together to facilitate remote communication during the audit which has been successful. There have been no issues with access to thefinanceteam or otherkey personnel. Quality and accuracy of management accounting papers Documentation provided has been of a high standard, which enabled an efficient audit. Working papers were clear and reconcilable to the Annual Report and Accounts. This is borneoutbythe resubmissionrateon requestsforthe auditbeinglow, at 0%. Quality of draft financial statements A full draft of the Annual Report and Accounts was received for audit on 15 June 2022. Requiredchangeswere raised mainlyin relationto thepriorperiodadjustment. Response to control deficiencies identified We identified one control deficiency based on NHS Ayrshire and Arran’scontrols which impact the IJB. Please see page 12 for further details. Volume and magnitude of identified errors We have identifiedtwo errorsin relationto disclosures.For more detailsee page 20. Quality Indicators Impact on the execution of our audit Management and those charged with governance are in a position to influence the effectiveness of our audit, through timely formulation of judgements, provision of accurate information, and responsiveness to issues identified in the course of the audit. This slide summarises some key metrics related to your control environment which can significantly impact the execution of the audit. We consider these metrics important in assessing the reliability of your financialreportingandprovidecontext forothermessages in thisreport. Lagging Developing Mature! !
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88 Our Audit Explained We tailor our audit to your business and your strategy Identify changes in your business and environment Determine materiality Scoping Significant risk assessment Conclude on significant risk areas Other findings Our audit report Identify changes in your business and environment In our planningreport we identified the key changes in your business and articulated how these impactedour auditapproach. Scoping Our planning report set out the scoping of our audit in line with the Code of Audit Practice. We have completed our audit in line with our auditplan. Significant risk assessment In our planning report we explained our risk assessment process and detailed the significant risks we have identified on this engagement. We report our findings and conclusions on these risks in thisreport. Determine materiality When planning our audit, we set our materiality at £5.39m based on forecast gross expenditure, which is the most appropriate benchmark for Board as set out in our planning report. We have updated this to reflect final figures and completed our audit to materiality of £5.58m (2020/21: £5.35m), performance materiality of £3.9m (2020/21: £3.75m) and report to you in this paper all misstatements above £0.25m (2020/21: £0.25m). Other findings As well as our conclusions on the significant risks we are required to report to you our observations on the internal control environment as well as any other findings from the audit. Our audit report Based on the current status of our audit work, we envisage issuing an unmodifiedauditreport. Conclude on significant risk areas We draw to the IJB’s attention our conclusions on the significant audit risks. In particular the IJB must satisfy themselves that management’s judgements are appropriate.
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99 Overly optimistic, likely to lead to future debit. Overly prudent, likely to lead to future credit Significant Risks Dashboard Risk Material Fraud risk Planned approach to controls testing Controls testing conclusion Consistency of judgements with Deloitte’s expectations Comments Page no. Completeness and accuracy of income D+I Satisfactory Satisfactory 10 Management override of controls D+I See page 12 Satisfactory 11 D+I: Testing of the design and implementation of key controls
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10 Completeness and accuracy of income Significant Risks (continued) Risk identified and key judgements Deloitteresponseand challenge ISA 240 states that when identifying and assessing the risks of material misstatement due to fraud, the auditor shall, based on a presumption that there are risks of fraud in income recognition, evaluate which types of income, income transactionsor assertionsgive rise to such risks. The main components of income for the Board are contributions from its funding partners, namely North Ayrshire Council and NHS Ayrshire and Arran. The significant risk is pinpointed to the recognition of this income, being completeness and accuracy of contributions received from the Health Board and the Council. Whilst the Board was projecting a year-end underspend against budget in relation to directly managed services, there remains a risk associated with the additionalCOVID-19expenditureandassociated funding. We have performedthefollowing: • assessed the design and implementation of the controls around recognitionof income; • tested the income to ensure that the correct contributions have been input and received in accordance with that agreed as part of budget process; • tested the reconciliations performed by the Board at 31 March 2022 to confirm all income is correctlyrecordedinthe ledger;and • confirmed that the reconciliations performed during 2021/22 have been reviewedon a regularbasis. Deloitte view We have concluded that income has been correctly recognised in accordance with the requirements of the Code of Practice on Local AuthorityAccounting.
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11 Management override of controls Significant Risks (continued) Risk identified Management is in a unique position to perpetrate fraud because of their ability to manipulate accounting records and prepare fraudulent financial statements by overriding controls that otherwise appear to be operating effectively. Althoughmanagement is responsible for safeguarding the assets of the entity, we planned our audit so that we had a reasonable expectation of detecting material misstatements to the Annual Report and Accounts and accounting records. Deloitteresponseand challenge In considering the risk of management override, we have performed the followingauditproceduresthatdirectlyaddressthisrisk: Journals We have tested the appropriateness of journal entries recorded in the general ledger and other adjustments made in the preparation of the Annual Accounts.In designingandperformingauditproceduresforsuchtests,wehave: • Testedthedesignandimplementationofcontrolsoverjournalentryprocessing; • Made inquiries of individuals involved in the financial reporting process about inappropriate or unusual activity relating to the processing of journal entries andotheradjustments; • Selected journal entries and other adjustments made at the end of a reporting period;and • Considered the need to test journal entries and other adjustments throughout theperiod. Accountingestimatesand judgements We have reviewed accounting estimates for biases and evaluate whether the circumstances producing the bias, if any, represent a risk of material misstatement duetofraud. In performing this review, we have not identified any significant accounting estimatesandjudgementsfromourtesting. Significant and unusual transactions We did not identify any significant transactions outside the normal course of businessor anytransactionswhere thebusinessrationalewas notclear. Deloitte view We have not identified any significant bias in the key judgements made bymanagement. We have not identified any instances of management override of controls in relationto the specific transactionstested. We have identified a control deficiency in relation to NHS Ayrshire and Arran’ssegregationof duties.Furtherinsightcan be seen on page 12.
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1212 Other Significant Findings Internal control The purpose of the audit was for us to express an opinion on the financial statements. The audit included consideration of internal control relevant to the preparation of the financial statements in order to design audit procedures that are appropriate in the circumstances, but not for the purpose of expressing an opinion on the effectiveness of internal control. The matters being reported are limited to those deficiencies that we have identified during the audit and that we have concludedare of sufficientimportanceto merit beingreportedto you. Duringthecourse of ourauditwe have identifiedone internalcontrol finding,which we have includedbelow forinformation. Area Observation Priority Monthly Journal Reviews Each month within NHS Ayrshire and Arran, senior accountants receive a listing of all journals posted by accountants, in their division, for review. The aim of this is to follow up on unusual variances and discrepancies which shouldmitigate againstoverride. Based on a walk through of this control from September 2021, there is no evidence that the reviewer carried out a detailed review as they did not include commentary accompanying the journal listing to demonstrate a robust review. We therefore recommend that management review the adequacy of this control and either enhance the documentation of the review to clearly set out what has been reviewed or identify an alternative control to reviewjournalentriesto ensurethereis sufficientsegregationof duties. We understand that this deficiency is within the control of NHS Ayrshire and Arran. This has been communicated to NHS Ayrshire and Arran as part of their Audit Report. Although, given that NHS Ayrshire and Arran is a partner of the Board,it is appropriateto includethisfindingforcompleteness. Low Priority Medium Priority High Priority
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1313 Qualitativeaspectsof your accountingpractices: The Board has prepared its Annual Accounts in line with the Code of Practice on Local Authority Accounting. We are satisfied that the Board’saccountingpracticesare appropriate. Other mattersrelevantto financial reporting: We have not identified other matters arising from the audit that, in the auditor's professional judgement, are significant to the oversight of the financialreportingprocess. Significant mattersdiscussed with management: Significant matters discussed with management related primarily to the impact of COVID-19 on the organization. Management have made relevantdisclosures in relationto thisimpact in the annualaccounts. The impact of Russia’s invasion on Ukraine was also discussed with management. However, therehas beenno impact of thison the IJB. Other Significant Findings (continued) Financial reporting findings We will obtain written representations from the Board on matters material to the Annual Accounts when other sufficient appropriate audit evidencecannotreasonablybe expectedto exist. A copyof thedraftrepresentationsletterhas beencirculatedseparately. Below, we set out the findings from our audit surrounding your financial reporting process.
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1414 Our opinion on the financial statements Based on our audit work completed to date, we expect to issue an unmodifiedauditopinion. Material uncertainty related to going concern We have not identified a material uncertainty related to going concern and will report by exception regarding the appropriateness of the use of the going concern basis of accounting. Practice Note 10 provides guidance on applying ISA (UK) 570 Going Concern to the audit of public sector bodies. The anticipated continued provision of the service is relevant to the assessment of the continued existence of a particularbody. Emphasis of matter and other matterparagraphs There are no matters we judge to be of fundamental importance in the Annual Accounts that we consider it necessary to draw attention to in an emphasisof matterparagraph. There are no matters relevant to users’ understanding of the audit that we consider necessary to communicate in an other matter paragraph. Other reportingresponsibilities The narrative parts of the Annual Accounts is reviewed in its entirety for material consistency with the annual accounts and the audit work performance and to ensure that they are fair, balanced and reasonable. Our opinion on matters prescribed by the Controller of Audit as discussed furtheron page 15. Our Audit Report Other matters relating to the form and content of our report Here we discuss how the results of the audit impact on other significant sections of our audit report.
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1515 Requirement Deloitteresponse Management Commentary The management commentary comments on financial performance, strategy and performance review and targets. The commentary included both financial and non financial KPIs and made good use of graphs and diagrams. The Board also focuses on the strategicplanningcontext. We have assessed whether the management commentary has been prepared in accordance with the statutoryguidance. We have also read the management commentary and confirmed that the information contained within is materially correct and consistent with our knowledge acquired during thecourse of performingtheaudit,andis nototherwise misleading. We are satisfied that the management commentary hasbeen prepared in accordance with guidance,is consistent with ourknowledge andis not otherwisemisleading. Remuneration Report The remuneration report must be prepared in accordance with the 2014 Regulations, disclosing the remuneration and pension benefitsof the ChiefOfficer. We have audited the disclosures of remuneration, pension benefits and pay bands. We identified a numbers of errors in relation to salary and pension disclosures including some related to the prior year. We can confirm – following the updates made by management - thattheyhave beenproperlypreparedinaccordance with theregulations. Annual Governance Statement The Annual Governance Statement reports that the Board governance arrangements provide assurance, are adequate and are operatingeffectively. We have assessed whether the information given in the Annual Governance Statement is consistent with the financial statements and has been prepared in accordance with the Delivering Good Governance in Local Government Framework. Based on our review of the Annual Accounts, we concluded that they are prepared in accordance with the Annual GovernanceStatementandonlyminoramendmentswere requestedto management. Your Annual Report We are required to provide an opinion on the auditable parts of the Remuneration Report, the Annual Governance Statement and whether the ManagementCommentaryis consistent with thedisclosures in theaccounts.
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16 Audit Dimensions and Best Value
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17 Audit Dimensions and Best Value Overview and conclusions Financial management The IJB continues to have effective budget setting and monitoring arrangements in place. This is supported by an experienced finance team and a robust internal audit function, as well as appropriate arrangements for thepreventionanddetectionof fraudanderror. Financial sustainability The IJB has set a balanced budget for 2022/23 and holds unearmarked reserves at a level consistent with its Reserves Strategy, therefore is financially sustainable in the short term. It is also continuing to repay the historical loan to North Ayrshire Council. However, it continues to be faced with significant financial challenges over the medium and longer-term, projecting a high level potential funding gap of up to £8.6m over the next two years. It is positive to see the development of the MTFO during the year, the progress with transformational change programme and the updated Strategic Commissioning Plan with a clear focus on continuous improvement. Significant work is still required to make the level of lasting long-term transformational change needed to ensure financial sustainability. Progress continues to be impacted by the ongoing response to the pandemic. Significant earmarked reserves have been carried forward into future years. It is critical that detailed plans are developed to demonstrate how these funds will be used to make transformational change. It is important that as the transformation change programme is progressed, a clear benefits tracker is put in place to demonstrate that the transformationinitiativesare achievingthedesiredoutcomes. Governanceand transparency The IJB continues to have strong leadership, with more tailored training being developed for Board members. The governance arrangements also continue to be robust, with recent updates to the Standing Orders and Scheme of Delegation.The IJB continuesto be openandtransparent. Further work is required to progress with implementing delegated hospital budgets and set aside requirements, in collaboration with the Scottish Government,NHS AyrshireandArranandotherAyrshirepartnerships. Value formoney The IJB continues to have a clear and robust performance management framework in place which analyses data, tracks progress and identifies actions. Regular reporting on performance is provided to the Performance and Audit Committee and the IJB, with a focus on continuous improvement. As set out in our audit plan and separate report on the “Audit Dimensions and Best Value” presented to the Committee in June 2022, public audit in Scotland is wider inscope thanfinancialaudits. Ours separatereportsets outourfindingsandconclusions on our auditwork coveringtheareasset outbelow. In accordance with the Code of AuditPractice, ouroverall conclusions on each auditdimensionandbest valueare summarised on thefollowingpage. Deloitteview – Best Value The IJB has sufficient arrangements in place to secure best value and has a clear understandingof areas which requirefurtherdevelopment.
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1818 Purpose of our Report and Responsibility Statement Our report is designed to help you meet your governance duties What we report Our report is designed to help the IJB, and the Board discharge their governance duties. It also represents one way in which we fulfil our obligations under ISA (UK) 260 to communicate with you regarding your oversight of the financial reporting process and your governance requirements.Our reportincludes: • Results of our work on key audit judgements and our observations on the qualityof yourAnnualReportandAccounts; • Our internalcontrol observations;and • Otherinsightswe have identifiedfrom ouraudit. What we don’t report As you will be aware, our audit was not designed to identify all matters that may be relevantto the IJB. Also, there will be further information you need to discharge your governance responsibilities, such as matters reported on by management or byotherspecialist advisers. Finally, our views on internal controls and business risk assessment should not be taken as comprehensive or as an opinion on effectiveness since they have been based solely on the audit procedures performed in the proceduresperformedin fulfillingourauditplan. The scopeof our work Our observations are developed in the context of our audit of the annual accounts. We describedthescope of ourwork in our auditplan. We welcome the opportunity to discuss our report with you and receive yourfeedback. Use of this report This report has been prepared for the Board, as a body, and we therefore accept responsibility to you alone for its contents. We accept no duty, responsibility or liability to any other parties, since this report has not been prepared,andis notintended,foranyotherpurpose. Pat Kenny, CPFA For and on behalf of Deloitte LLP Glasgow | 16th August2022
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19 Appendices
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2020 Audit Adjustments Disclosures and misstatements Disclosure misstatements The following misstatements have been identified up to the date of this report which have been corrected by management. We nonetheless communicate them to you to assist you in fulfilling your governance responsibilities, including reviewing the effectiveness of the system of internal control. There are no uncorrected misstatements. Disclosure Summaryof disclosure requirement Quantitativeor qualitative consideration Prior periodadjustment The disclosure in relation to the prior period adjustment for the Covid- 19 Thank You payments did not initially comply with the Code requirements. Management have since revised the disclosure in accordance with the Code. The misstatement is quantitatively and qualitatively material for the users of the financialstatements. RemunerationReport We identified errors in relation to the salary disclosure for individuals who had interim appointments. The requirement is to show full salary rather than only the additional responsibility payment (which was initially disclosed). This had a linked impact on the full year equivalent salary and pension disclosures including prior year adjustments. This hassince beencorrectedbymanagement. The misstatement is qualitatively material for theusers of thefinancialstatements. Audit misstatements As at the date of this report we have not identified any audit misstatements, corrected or uncorrected.
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2121 Responsibilities: The primary responsibility for the prevention and detection of fraud rests with management and those charged with governance, including establishing and maintaining internal controls over the reliability of financial reporting, effectiveness and efficiency of operations and compliance with applicablelaws andregulations. As auditor, we obtain reasonable, but not absolute, assurance that the financial statements as a whole are free from material misstatement, whethercaused byfraudor error. Required representations: We have asked the Board to confirm in writing that you have disclosed to us the results of your own assessment of the risk that the financial statements may be materially misstated as a result of fraud and that you have disclosed to us all information in relation to fraud or suspected fraud that you are aware of andthataffectstheentity. We have also asked the Board to confirm in writing their responsibility for the design, implementation and maintenance of internal control to prevent anddetect fraudanderror. Audit work performed: In our planning we identified the risk of fraud in relation to completeness of income and management override of controls as a key audit risk for your organisation. During course of our audit, we have had discussions with management and those chargedwith governance. In addition, we have reviewed management’s own documented procedures regardingfraudanderror in thefinancialstatements. Our Other Responsibilities Explained Fraud responsibilities and representations
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2222 Independence and Fees Independence confirmation We confirm the audit engagement team, and others in the firm as appropriate, Deloitte LLP and, where applicable, all Deloitte network firmsare independentof the Boardandandourobjectivityis notcompromised. Fees The audit fee for 2021/22, in line with the expected fee range provided by Audit Scotland, is £27,960, as analysed below: No non-audit services fees have been charged for the period. Non-audit services In our opinion there are no inconsistencies between the FRC’s Ethical Standard and the company’spolicy for the supply of non- audit services or any apparent breach of that policy. We continue to review our independence and ensure that appropriate safeguards are in place including, but not limited to, the rotation of senior partners and professional staff and the involvement of additionalpartnersandprofessionalstaffto carry outreviewsof thework performedandto otherwise advise as necessary. Relationships We are required to provide written details of all relationships (including the provision of non-audit services) between us and the organisation, its board and senior management and its affiliates, including all services provided by us and the DTTL network to the audited entity, its board and senior management and its affiliates, and other services provided to other known connectedpartiesthatwe consider may reasonablybe thoughtto bear on ourobjectivityandindependence. We are notaware of anyrelationshipswhich are requiredto be disclosed. As partof ourobligationsunderInternationalStandardson Auditing(UK), we are requiredto reportto youon thematterslisted below: 2021/22 2021/20 £ £ Auditor remuneration 19,250 18,850 Audit Scotland fixed charges Pooled costs 2,010 1,790 Contribution to PABV 5,670 5,650 Audit support costs 1,030 1,040 Total fee 27,960 27,330
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