Item 10 - Progress Report on Agreed Actions
North Lanarkshire Council · 16 November 2022
Back to IJB Performance, Finance and Audit Committee — 16 November 2022 and its agenda
Text extracted from the council's PDF. Layout and reading order may differ from the original.
Page 1
1 REPORT Item No: 10 1. PURPOSE OF REPORT 1.1 This paper is coming to the Performance, Finance and Audit (PFA) Committee: For approval For endorsement For noting 1.2 This report provides an outline of the actions agreed with the External Auditor, Internal Audit and the Senior Management Team to further develop the IJB governance framework. 2. ROUTE TO THE PERFORMANCE, FINANCE AND AUDIT COMMITTEE 2.1 This paper has been: Prepared By; Chief Financial Officer Reviewed By; Chief Officer 3. RECOMMENDATIONS 3.1 The PFA Committee is asked to agree the following recommendations: (1) That the content of the report is noted; and (2) That further progress reports will be presented to future meetings of the PFA Committee in respect of any ongoing actions. 4. VARIATIONS TO DIRECTIONS 5. BACKGROUND/SUMMARY OF KEY ISSUES 5.1 Recommendations to further strengthen the IJB governance framework were made by both External and Internal Audit. The Senior Management Team (SMT) have also identified improvement opportunities which will further contribute to the IJB’s annual assessment of their governance arrangements. 5.2 The original reports from External and Internal Audit and the SMT were previously reported in full to the IJB and PFA Committee as appropriate. This report summarises the agreed recommendations and provides an update on the progress made to date against each action. Further details are attached at appendices 1 to 3. 5.3 Any actions which are reported as complete will be removed from the next progress report to the PFA Committee. SUBJECT: Progress Report on Agreed Actions TO: Performance, Finance and Audit Committee Lead Officer for Report: Ross McGuffie, Chief Officer North HSCP Author(s) of Report Amanda Kilburn, Chief Financial Officer North HSCP DATE: 16th November 2022 Yes No N/A
Page 2
2 6. CONCLUSIONS 6.1 An update on the progress made to date was reported to the PFA Committee on 16 February 2022. A summary of the current position statement is shown in the table below: 6.1 The ongoing actions are measured against the revised timeline set out at appendices 1 to 3. 7. IMPLICATIONS 7.1 NATIONAL OUTCOMES This report relates to all national outcomes as effective governance arrangements will ensure the IJB can fulfil its statutory duties. Good governance enables the IJB to pursue its vision effectively as well as underpinning that vision with mechanisms for control and management of risk. 7.2 ASSOCIATED MEASURE(S) The implementation of agreed actions will contribute to the ongoing development of the internal control framework and will also inform the Annual Governance Statement for 2022/2023. 7.3 FINANCIAL This paper has been reviewed by Finance: Yes No N/A 7.4 RISK ASSESSMENT/RISK MANAGEMENT When reviewing the current position and achievable timescales, the risks associated with this have been considered. 7.5 PEOPLE None 7.6 INEQUALITIES & FAIRER SCOTLAND DUTY Equality and Diversity Impact Assessment Completed & Fairer Scotland Impact Assessment Form Completed: Yes No N/A 7.7 CARBON MANAGEMENT IMPLICATIONS Yes No N/A Source Total Actions Completed Actions Ongoing Actions External Audit 4 2 2 Internal Audit 9 4 5 Senior Management 7 3 4 TOTAL 20 9 11 45% 55%
Page 3
3 8. BACKGROUND PAPERS None. 9. APPENDICES External Audit Actions Appendix 1 Internal Audit Actions Appendix 2 Senior Management Actions Appendix 3 ........................................... Chief Finance Officer Members seeking further information about any aspect of this report, please contact Amanda Kilburn on telephone number 07816 126362.
Page 4
4 Update on External Audit Actions Appendix 1 Ref Finding Recommendation Management Response Current Position 1 Disaggregation of children, families and justice social work services. An exercise is ongoing to align the finances with the revised integration scheme over an 18- month period. The work to disaggregate the budgets for some more complex areas where the services cut across delegated and non-delegated services is ongoing. There is a risk that the budget disaggregation exercise extends beyond the 18-month transition period and the IJB financial monitoring reports and accounts do not accurately reflect delegated services in 2020/21. Original The IJB should monitor progress against the improvement actions identified in the governance statement and the internal audit review in relation to the transfer of children, families and justice services. Internal Audit Follow Up Management should ensure that: (1) the hosting arrangements for the budgets in respect of cross-cutting services are finalised; (2) the hosting arrangements and detail of the disaggregated budgets which have been agreed are submitted to the IJB and to the relevant Council committees (Adult Health and Social Care and Education and Families). Agreed The budget disaggregation exercise will be concluded in 2020/2021 and a revised direction issued by the IJB to NLC to reflect the total budget transfer in respect of Children, Families and Justice Services and also the hosting arrangements for cross- cutting and support services. Chief Financial Officer Original Timeline: March 2021 Revised Timeline: September 2021 Revised Timeline: June 2022 Revised Responsible Officer: Head of Adult Social Work Head of Planning, Performance and Quality Assurance Revised Timeline: TBC Complete The budget disaggregation exercise has been concluded. The revised IJB direction to NLC issued on 23 March 2021 excludes the total budget transfer in respect of Children, Families and Justice Services. The finalisation of the Service Level Agreement is overdue as per the original timeline of March 2021 which was initially revised to September 2021 but has been extended again to June 2022. Ongoing The Service Level Agreement between Children, Families and Justice Services will be revisited once further clarity has been obtained around what services will be part of the new National Care Service. 2 Financial Management Financial monitoring reports do not provide a forecast of the outturn position for health care services until towards the end of the year and the accuracy of forecasts could improve. The timing of meetings and availability of information means that the IJB is not receiving a financial monitoring report until five months into the year. There is a risk that financial pressures are not identified and managed in a timely manner. Original The CFO should continue to work with partners to improve the timing of financial reporting and outturn forecasts. Agreed In consultation with both partners, further improvements will be implemented to the IJB financial monitoring arrangements to ensure the financial information is reported timeously and forecast projections are accurate. It is noted however that the financial implications of the Covid-19 pandemic have increased the financial uncertainty for the IJB and both partners. Chief Financial Officer Original Timeline: September 2021 Revised Timeline: June 2022 Complete In respect of the current financial year 2021/2022, the first financial monitoring report was presented to the PFA Committee on 24 August 2021. This related to the period to June 2021. On 5 October 2021, additional funding of £300m was announced nationally by the Scottish Government to address winter pressures across Health and Social Care Services. The availability of additional in-year funding is welcomed however the late notification of the funding impacts on the projected outturn. The particular challenges in 20020/2021 as a result of the Covid-19 pandemic are continuing in 2021/2022. These challenges include uncertainty about the impact of the ongoing Covid-19 pandemic on services, in particular the step up / step down of services over the critical winter period, and the totality of the Covid-19 funding which will be made available for 2021/2022. This is expected to be confirmed in February 2022. Notwithstanding these challenges, an indicative projected outturn for the financial year 2021/2022 has been included by the IJB Chief Financial Officer within the IJB Financial Monitoring Report 2021/2022 which is being presented to the PFA on 9 November 2021. This indicative projection is based on the current financial information available. Due to the timing of the closure of the year end accounts, 2022/23 financial reports are not produced from Social Care and Health until mid-June. The timings of the IJB and PFA Committee did not allow for the financial position to be presented for the current financial year until 31 August for the PFA Committee and 21 September for the IJB. Board papers need to be available to members in advance of each committee meeting which further limits the timespan available to produce financial monitoring reports. This is in line with other HSCPs who tend to provide the first update for the financial year at their August/September boards. The CFO will continue to produce timely reports to be submitted to each pre-agenda in line with committee timetables as per North Lanarkshire Financial Framework.
Page 5
5 Update on External Audit Actions (Cont.) Appendix 1 (Cont.) Ref Finding Recommendation Management Response Current Position 3 Hosted service The management of financial resources for hosted services is agreed in principle each year. The accounting policy is clear that the host is responsible for managing the overspends and underspends on these services and this is how the hosted services are being managed in practice, but this is not set out in a formal agreement for future years. There is a risk that this becomes an area of dispute. Original The IJB should set out the arrangements that exist in practice for the management of financial risk for hosted services on a permanent basis. Agreed The financial arrangements for hosted services will be reviewed and will take into consideration the practical experience to date of the current hosted services principles. Following the review, the hosted services arrangements will be set out in a formal agreement to be approved by the North Lanarkshire IJB and the South Lanarkshire IJB. Chief Financial Officer Original Timeline: September 2021 Revised Timeline: June 2022 Complete The review of the financial arrangements for hosted services is overdue as per the original timeline of September 2021 which has been extended to June 2022. Work on this action is being progressed. The impact of the Covid-19 pandemic on the hosted services is currently being taken into consideration before the review of the accounting policy is finalised. Hosted Services paper agreed at Corporate Management Team dated 12 October 2017 outline the financial arrangements for hosted services. Due to the introduction of the National Care Service, this agreement will remain in place for the foreseeable future however, if either North or South HSCPs encounter a future problem before the introduction of the NCS, it will be their responsibility to recommend corrective action. 4 Medium to long term financial plan The IJB now has a medium to long term financial plan that spans the period 2020/21 to 2029/30 but this will need to be updated to reflect the impact of Covid-19 and EU withdrawal. There is a risk that the financial planning assumptions in the medium to long term financial plan may be inaccurate. Original The IJB’s medium to long term financial plan should be reviewed due to the impact of Covid-19 and EU withdrawal. Agreed The IJB medium to long term financial plan will be reviewed to reflect the impact of the Covid-19 pandemic, EU withdrawal and other emerging health and social care cost pressures. The potential impact on the Scottish Government financial settlements both in-year and in future years will also be assessed. Chief Financial Officer Original Timeline: March 2021 Revised Timeline: March 2022 Revised Timeline: March 2023 Ongoing An update on the approach to the preparation of the IJB Financial Plan for 2022/2023 was presented to the IJB on 8 December 2021. This included the key financial planning assumptions underpinning the budget setting process for both partners and the IJB at this stage. The IJB Medium to Long Term Financial Plan is also being updated. This will take into consideration the additional national investment funding announced by the Scottish Government, the proposed North Lanarkshire IJB Business Case, the ongoing and legacy costs of the Covid-19 pandemic and the EU withdrawal, as far as this can be quantified. The Medium-Term Financial Plan 2023 – 2026 is currently underway and will align with the Strategic Commissioning Plan 2023 -2026. It will address the impact of Covid-19, EU withdrawal and the current cost of living as far as this can be quantified.
Page 6
6 Update on Internal Audit Actions Appendix 2 Ref Risk Management Maturity Audit Report Adequate Assurance (Audit Ref: NL04/18) Recommendations / Management Response Current Position 1 Although the IJB has agreed and is implementing a procedure with the Health Board for considering shared risks, this is not reflected in the Risk Management Strategy (RMS). Similar arrangements have not been established with the Local Authority. There is a risk that the IJB and Council may not have a shared approach to these risks and escalation between the two bodies may be ineffective. The RMS does not reflect actual practice. (Priority: Amber) Original A similar approach to that adopted between the IJB and Health Board will be discussed and agreed with the Local Authority. The RMS will also be updated to reflect the revised arrangements. Original Responsible Officer: Chief Officer Original Timeline: March 2020 Revised Responsible Officer: Head of Adult Social Work Services Revised Timeline: June 2021 Revised Timeline: March 2022 Chief Officer Revised timeline: December 2022 Complete A report on the risk register was included on the IJB agenda on 24 March 2020. A further report was considered by the IJB on 22 September 2020. On 25 May 2021, the risks relating to the remit of the PFA Committee were reviewed, the mitigating actions were updated, and the risk ratings were amended. These amendments were subsequently approved by the IJB on 22 June 2021. The current IJB Risk Register is presented to the PFA Committee on 16 February 2022 for approval. Risk Management Strategy has been updated to include how risk is shared, managed, and escalated between partner bodies. In continuing to strengthen the risk management partnership, discussion with internal auditors is continuing to agree a form similar to NHSL to capture future risks. Once formalised, this will be taken to PFA Committee and IJB for approval. The IJB and PFA Committee meetings include risk as a standing agenda. All IJB and PFAC reporting templates have been updated to include operational risk. 2 Whilst the Risk Register is subject to continuous review and is updated regularly, there has not been a fundamental review involving all IJB members and referencing partner body Risk Registers. The Risk Register may not take into account the knowledge and views of all IJB members, and the lessons learned from updating the Strategic Commissioning Plan. (Priority: Amber) Agreed A specific Board Development Event will be organised to review the Risk Register which will take into account lessons learned from the production of the Strategic Commissioning Plan, including potential obstacles to its delivery. The relevant risks from NL, NHSL and SL Risk Registers will also be considered. Original Responsible Officer: Operational & Business Manager Original Timeline: March 2020 Revised Responsible Officer: Head of Performance, Planning and Quality Assurance Revised Timeline: June 2021 Revised Timeline: June 2022 Complete The development event on risk was undertaken at the IJB Liaison Group in March 2020 and, as highlighted in response to action 1 above, the review of the IJB Risk Register has been completed. The current IJB Risk Register includes the strategic risks in respect of the Strategic Commissioning Plan 2020/2023 and also references the partner’s risks, as appropriate. Internal Audit previously advised that the revisions to the Risk Register only considered strategic financial risks and that other risks associated with the strategic planning role of the IJB had still to be fully developed. Management agreed to ensure that risks associated with the strategic planning role of the IJB, and in particular those associated with the Strategic Commissioning Plan 2020/2023, are developed and the IJB Risk Register updated to reflect these. The development event with IJB members is complete. The IJB Risk Register is complete and will be continuously updated with new risks as and when they are identified. IJB and PFA Committee meetings include risk as a standing agenda item which gives assurance to board members and keeps all risks under regular review. 3 The PFA Committee does not receive an annual assurance report on risk management and there are no defined KPIs or performance measures for risk management. There is a risk that the PFA Committee may not be able to conclude on the overall adequacy and effectiveness of Risk Management arrangements. (Priority: Amber) Agreed An appropriate methodology for assessing the adequacy and effectiveness of risk management arrangements will be developed. This will include suitable KPIs and performance measures. Performance Manager Original Timeline: March 2020 Revised Timeline: March 2022 Revised Timeline: March 2023 Ongoing As previously advised, the annual review of the current suite of indicators and targets has been completed. An appropriate methodology for assessing the adequacy and effectiveness of risk management arrangements will be developed. This will include consideration of suitable key performance indicators and performance measures as part of the current review of the HSCP’s performance framework.
Page 7
7 Update on Internal Audit Actions (Cont.) Appendix 2 (Cont.) Ref Risk Management Maturity Audit Report Adequate Assurance (Audit Ref: NL04/18) Recommendations / Management Response Current Position 4 Board and PFAC papers do not routinely report on the Risk Management implications of the issues raised. Decisions may not fully reflect Risk Management considerations. The risk register may not reflect issues highlighted within performance management and other assurance reports. IJB and PFAC papers should contain a section on risk which considers whether issues raised should be included within the risk register and overtly reflect the impact on any existing strategic risks. Performance reports should reference relevant strategic risks and assess whether scores are accurate and whether actions intended to reduce risk to target level are on track. (Priority: Amber) Agreed The format and content of IJB and PFAC reports will be reviewed to ensure that the management of risks is transparent and effective. Original Responsible Officer: Operational & Business Manager Original Timeline: March 2020 Revised Responsible Officer: Chief Officer Revised Timeline: June 2021 Revised Timeline: June 2022 Complete The review of the IJB Risk Register has been concluded. An assessment of risks, current and emerging, is undertaken at the end of each IJB and PFAC meeting. The new IJB and PFAC report template has been amended and includes a specific sub-section on risk assessment and risk management implications. Internal Audit highlighted that were a high proportion of reports submitted to the IJB and the PFAC where the revised template had not been used. This is currently being addressed and action is being taken to ensure that all IJB reports adhere to the correct version of the IJB and PFAC reporting template and the sub-section on risk assessment and risk management within the implication’s sections must be populated for all relevant strategic risks. The IJB Risk Register is complete and will be continuously updated with new risks as and when they are identified. IJB and PFAC meetings include risk as a standing agenda item which gives assurance to board members and keeps all risks under regular review. 5 Improvements are needed to the way in which performance information is reported to better enable Committee members to exercise effective oversight, scrutiny, and challenge. It is considered there is scope for significant improvement in what and how this information is presented. There is a risk that the IJB may not provide adequate performance information to key stakeholders to enable them to make informed decisions and recommend remedial actions to address concerns arising. The IJB Performance, Finance and Audit Committee may not therefore be in a position to fulfil its remit which includes the requirement to ‘Review quarterly performance and recommend remedial action to address concerns’ and to ‘Ensure effective arrangements are in place to register all performance and operational risks’. (Priority: Amber) Agreed Management will undertake a formal review of the current arrangements for monitoring and reporting performance to reflect on whether reports are fit for purpose and contain relevant, comprehensive information useful to stakeholders. This could include comparison with other IJB published reports. Particular consideration should be given to the following areas: an overview of all indicators on the performance scorecard including a mechanism to provide an update on indicators previously reported but now considered satisfactory; proposed actions with timescales, progress with these and how effective they are; greater use of benchmarking with other IJBs and trend information; and incorporating reporting by locality. Performance Manager Original Timeline: January 2020 Revised Timeline: March 2022 Revised timeline: March 2023 Ongoing As previously advised, the annual review of the current suite of indicators and targets has been completed. In August 2022, the IJB’s Performance, Audit and Finance Committee endorsed the development of a revised whole system performance framework for the partnership. The current engagement and participation activity taking place in relation to the development of the new Strategic Commissioning Plan will draw together and build upon the richness of contribution across key partners. A whole system working group will be established to support the performance framework for the emerging Strategic Commissioning Plan. The richness of information that will comprise whole system performance reports will allow Committee members to exercise effective oversight, scrutiny, and challenge.
Page 8
8 Update on Internal Audit Actions (Cont.) Appendix 2 (Cont.) Ref Performance Management Audit Report Adequate Assurance (Audit Ref: 0600/2019/004) Recommendations / Management Response Current Position 6 There is no formal record of the setting and approval of targets and trajectories for indicators on the performance scorecard. Internal Audit noted that targets and trajectories for underlying performance measures are discussed and agreed at the Chief Executives’ Performance Review meetings but no formal record of this is retained. There is therefore no formal documented record or clear rationale for the targets and trajectories set. (Priority: Amber) Agreed Management should ensure that a formal record is retained detailing the rationale for and approval of the targets and trajectories set for the indicators on the performance scorecard and this information should be shared with the Performance, Finance and Audit Committee. Performance Manager Original Timeline: October 2019 Revised Timeline: March 2022 Revised Timeline: December 2022 Ongoing The annual review of the current reporting arrangements was rescheduled as a result of the Covid-19 pandemic. This work however is now being progressed in line with the revised timeline. The annual review of the current reporting arrangements will be reported to the IJB in December 2022 and will set out the agreement for future years. From 23/24 onwards, this will be presented to the board each year in line with quarter one performance cycle. 7 There were a number of issues identified with regards to the methodology and calculation of the Social Work indicator ‘Integrated Equipment and Adaptations Service – percentage of deliveries achieved within 7 working days. The guidance/definition sheet for this particular indicator is not clear or comprehensive. There is a risk that the expected methodology may not be clearly understood or consistently applied, which increases the risk that reported performance information may be inconsistently prepared, inaccurate and/or misleading. (Priority: Green) Agreed Management should review current arrangements for recording, collating, and calculating this Social Work indicator to ensure that: a clear, detailed and unambiguous definition of the indicator is documented; the guidance/definition sheet contains clear and detailed instructions on the methodology to be used in calculating the indicator; and a full record of all adjustments/exclusions is retained. Original Responsible Officer: Service Manager Original Timeline: October 2019 Revised Responsible Officer: Head of Adult Social Work Services Revised Timeline: March 2022 Complete All arrangements for recording, collating, and calculating have been reviewed. KPIMeasurementEA S.docx
Page 9
9 Update on Internal Audit Actions (Cont.) Appendix 2 (Cont.) Ref Financial Due Diligence Audit Report Adequate Assurance Recommendations / Management Response (Audit Ref: 0700/2020/003) Current Position 8 Management needs to formalise and agree the proposed arrangements for those services with a ‘cross cutting function’, to be hosted by either Health and Social Care or Education and Families, and following the approval of the IJB and NLC, to finalise and process the agreed transfer of the remaining cost centres, in relation to the disaggregation of Children, Families and Justice Social Work Services, and their resultant budget. (Priority: Amber) Agreed. IJB management will: (1) liaise with relevant Council officers to ensure that the transfer of the remaining cost centres, and the resultant resources transferred, are agreed/completed as a matter of urgency; (2) in conjunction with Education and Families, determine, agree, and fully document the proposed arrangements for those functions to be ‘hosted’ by Education and Families and accessed by Adult Health and Social Work Services and vice versa, including giving consideration as to whether there should be a recharge system; (3) in conjunction with relevant Council officers, ensure that both the IJB and NLC approve the proposed ‘hosting’ arrangements for the budgets in respect of the cross-cutting services; and (4) liaise with the Council to resolve any other outstanding issues with regards to the disaggregation of Children, Families and Justice Services’ budgets and the treatment thereof. Internal Audit Comment Management should ensure that: (1) the hosting arrangements for the budgets in respect of cross-cutting services are finalised; (2) the hosting arrangements and detail of the disaggregated budgets which have been agreed are submitted to the IJB and to the relevant Council committees (Adult Health and Social Care and Education and Families). Original Responsible Officer: Chief Officer Original Timeline: October 2020 Revised Responsible Officer: Chief Financial Officer Revised Timeline: September 2021 Revised Responsible Officer: Head of Adult Social Work and Head of Planning, Performance and Quality Assurance Revised Timeline: TBC Complete The budget disaggregation exercise has been concluded. The revised IJB direction to NLC issued on 23 March 2021 excludes the total budget transfer in respect of Children, Families and Justice Services. Ongoing The finalisation of the Service Level Agreement is overdue as per the original timeline of March 2021 which was initially revised to September 2021 but has been extended again to June 2022. Once finalised, the Service Level Agreement will be presented to a future meeting of the NLC Adult Health and Social Care Committee, the NLC Education and Families Committee and the IJB for approval. The Service Level Agreement between Children, Families and Justice Services will be revisited once further clarity has been obtained around what services will be part of the new National Care Service.
Page 10
10 9 There is a need for a more formal record of the methodology adopted for disaggregation/the resultant figures/cost centres being transferred from Health and Social Care to Education and Families and the associated risks as a result of changes to the Integration Scheme to be formally reported to key stakeholders (i.e. the IJB and relevant Council Committee). (Priority: Amber) Agreed IJB management should, in conjunction with relevant Council officers, ensure that a report is submitted to the IJB setting out the methodology for the disaggregation of cost centres and budgets associated with Children, Families and Justice Social Work Services, detailing the implications of the full disaggregation. Internal Audit Comment Management should ensure that: (1) the hosting arrangements for the budgets in respect of cross-cutting services are finalised. (2) the hosting arrangements and detail of the disaggregated budgets which have been agreed are submitted to the IJB and to the relevant Council committees (Adult Health and Social Care and Education and Families). Original Responsible Officer: Chief Officer Original Timeline: October 2020 Revised Responsible Officer: Chief Financial Officer Revised Timeline: September 2021 Revised Timeline: June 2022 Revised Responsible Officer: Head of Adult Social Work and Head of Planning, Performance and Quality Assurance Revised Timeline: TBC Complete The budget disaggregation exercise has been concluded. The revised IJB direction to NLC issued on 23 March 2021 excludes the total budget transfer in respect of Children, Families and Justice Services. Ongoing The finalisation of the Service Level Agreement is overdue as per the original timeline of March 2021 which was initially revised to September 2021 but has been extended again to June 2022. Once finalised, the Service Level Agreement will be presented to a future meeting of the NLC Adult Health and Social Care Committee, the NLC Education and Families Committee and the IJB for approval. These reports will also include the detail of the disaggregated budgets which have been agreed. The Service Level Agreement between Children, Families and Justice Services will be revisited once further clarity has been obtained around what services will be part of the new National Care Service. Update on Senior Management Actions Appendix 3 Ref Annual Governance Statement Continuous Improvement Actions Current Position 1 Further consideration of the Ministerial Strategic Group (MSG) proposals. Original Responsible Officer: Chief Officer Original Timeline: March 2021 Revised Responsible Officer: Chief Officer Revised Timeline: March 2022 Ongoing A range of actions were agreed across the partnership to take forward the MSG proposals. These actions were included as part of the overall North Lanarkshire Integration Review and Self-Assessment. An update report on the total of 38 actions was presented to the IJB PFA Committee on 24 August 2021. 35 actions have been completed and 3 actions remain outstanding. Two of the outstanding actions relate to the finance workstream. This includes a review of the support arrangements for the Chief Financial Officer and the link between strategic and operational finance. On 8 December 2021, the North Lanarkshire IJB agreed to create a full-time Chief Financial Officer for each IJB. On 25 January 2022, the South Lanarkshire IJB also agreed to this approach. This option is now being progressed. Complete The third outstanding action relates to the development of systems to support integrated IT arrangements. The Lanarkshire Data Sharing Partnership Board was reviewed, and new structures have been agreed. The role out of Microsoft 365 across all partners is the current priority. The MSG had previously indicated that a second self-evaluation will be undertaken in 12 months to assess progress. The follow up was rescheduled due to the Covid-19 pandemic. The second self-evaluation is currently being progressed in February 2022. Work is also progressing nationally in respect of the development of the National Care Service. The Improvement Service is carrying out a self-evaluation of the function of the IJB as part of a national best value audit. Effective from February 2022, a review of current participation and engagement structures is also being progressed. Complete 2 Review the IJB governance arrangements Ongoing
Page 11
11 This will include the review of the following: IJB joint internal audit arrangements IJB Code of Corporate Governance IJB emergency response arrangements and the further development of the IJB website. Original Responsible Officer: Chief Financial Officer Original Timeline: March 2021 Revised Responsible Officer: Chief Financial Officer Revised Timeline: March 2022 Revised Timeline: March 2023 Work is progressing. The outcome of the overall North Lanarkshire Integration Review and Self-Assessment was reported to the IJB PFA Committee on 24 August 2021. The review of the North Lanarkshire Integration Scheme included consideration of governance arrangements. The governance structure moving forward proposed key interfaces around clinical and care governance. The understanding of the governance requirements underpinning health and social care integration continues to develop and includes an increased awareness of decision-making responsibilities. The further development of collaborative leadership and building relationships with key stakeholders continue to be key improvement actions. The outcome of the National Care Service Consultation will also influence future governance arrangements for the IJB and both partners. The External Audit of the North Lanarkshire IJB Annual Accounts 2020/2021 has now been completed. The External Auditor has concluded that the financial statements of the North Lanarkshire IJB for 2020/2021 give a true and fair view of the state of affairs and of its net expenditure for the year and have therefore issued an unqualified independent auditor’s report. The findings of the audit process have also been reported to the IJB and an action plan approved as set out in the External Auditor’s Annual Audit Report. Current process will remain however further work may be required due to the introduction of the National Care Service. The working group continue to develop the IJB website which will be complete by March 2023.
Page 12
12 Update on Senior Management Actions (Cont.) Appendix 3 (Cont.) Re f Annual Governance Statement Continuous Improvement Actions Current Position 3 Continue to develop the financial framework. This will include the review of the following: IJB Medium to Long Term Financial Strategy IJB Financial Plan (Annual) IJB Financial Regulations IJB Financial monitoring reports IJB reserves strategy the alignment of resources to partner directions and locality needs and finance capacity. Original Responsible Officer: Chief Financial Officer Original Timeline: March 2021 Revised Responsible Officer: Chief Financial Officer Revised Timeline: March 2022 Complete Work continues to progress. In respect of the current financial year 2021/2022, the core budgets and the Lanarkshire Mobilisation Plan funding are being monitored in consultation with the Scottish Government. complete Additional Scottish Government funding has been announced for 2021/2022 and also 2022/2023. The financial implications of these recent funding announcements are being confirmed for both the current financial year 2021/2022 and future financial years. complete The IJB Financial Plan 2022/2023 is being developed. complete The medium to long term financial strategy is being reviewed. Complete and will be superseded by Medium Term Financial Plan 2023 – 2026. Both North and South Chief Finance Officers will continue to update plans and review regulations and strategies as part of everyday business. 4 Finalise the budget transfer from the IJB to NLC, in line with the revised Integration Scheme This will include the following: the conclusion of the budget disaggregation exercise for the transfer of the remaining cost centres and their resultant budgets the finalisation of the Service Level Agreement including the arrangements for those services with a ‘cross cutting function’ the issue of a revised direction to reflect the 2020/2021 financial allocations Original Responsible Officer: Chief Officer Original Timeline: September 2020 Revised Responsible Officer: Chief Financial Officer Revised Timeline: September 2021 Revised Responsible Officer: Head of Adult Social Work and Head of Planning, Performance and Quality Assurance Revised Timeline: TBC Internal Audit Comment Management should ensure that: (1) the hosting arrangements for the budgets in respect of cross- cutting services are finalised; (2) the hosting arrangements and detail of the disaggregated budgets which have been agreed are submitted to the IJB and to the relevant Council committees (Adult Health and Social Care and Education and Families). Complete The budget disaggregation exercise has been concluded. The revised IJB direction to NLC issued on 23 March 2021 excludes the total budget transfer in respect of Children, Families and Justice Services. Ongoing Once finalised, the Service Level Agreement will be presented to a future meeting of the NLC Adult Health and Social Care Committee, the NLC Education and Families Committee and the IJB for approval. The Service Level Agreement between Children, Families and Justice Services will be revisited once further clarity has been obtained around what services will be part of the new National Care Service.
Page 13
13 Update on Senior Management Actions (Cont.) Appendix 3 (Cont.) Re f Self-Evaluation of the North Lanarkshire Health and Social Care Integration Joint Board (IJB) Current Position 5 Evidence how Health and Social Care spending contributes to prevention and early intervention This will include the following: review of the Strategic Commissioning Plan to strengthen outcome 5 around inequalities review of opportunities against resources include a question in all board papers regarding how it impacts upon prevention and early intervention undertake a review of good practice from across Scotland ring-fence funding for prevention and early intervention as part of the Reserves Strategy engage with Academia to establish how we measure success evidence how existing work links to prevention and early intervention and how this aligns to outcomes Original Responsible Officer: Head of Planning, Performance and Quality Assurance and Chief Finance Officer Original Timeline: February 2023 Ongoing Both the Strategic Commissioning Plan 2023-2026 and Medium-Term Financial Plan 2023-2026 are currently underway and will align to strengthen outcomes against resources. By ensuring good practise and lessons learned, both plans will review future funding and reserves to link with outcomes around prevention and early intervention. 6 Embed learning and new ways of working in the IJB from the response to the pandemic to ensure plans and governance are fit for purpose This will include the following: develop scoping paper to pick out key areas of what did and did not work well during the pandemic keep and strengthen relationships with community groups and organisations consider actions to keep up the continuous improvement momentum developed during the pandemic capture lessons learned during the pandemic in a permanent way in case of future emergencies ensure lessons learned have longevity and are fit for purpose within the Health and Social Care structures consider what insights can be gained from service users and staff, from their journey during the pandemic Original Responsible Officer: Head of Planning, Performance and Quality Assurance and Performance Manager Original Timeline: Scoping paper June 2022 Complete During 2022, discussions at Staff Roadshows considered and reviewed the areas of work which were effective during the pandemic and those which presented more of a challenge. These discussions were informed by key inputs from members of the Strategic Leadership Team. These lessons have been shared with a wider audience as part of the engagement events in relation to the development of the new Strategic Commissioning Plan and have been further expanded and built upon with discussion from stakeholders across our communities and localities. These insights will be reflected in the new Strategic Commissioning Plan and its associated Programme of Work. 7 Review how performance information is used by the IJB to ensure it is timely, relevant and provides a good measure of progress towards agreed outcomes This will include the following: identity specific service areas of concern in high level reports to the Board, linking these to the risk register develop a better understanding of the audience for performance reports consider what the IJB and public need from performance reporting, ensuring this is presented in a user-friendly format review the content of what is reported to ensure information is presented in full and within the appropriate context improve the reporting of outcomes and how these have improved the lives of service users ensure the development of IT systems allow for data capturing to be simplified to reduce the number of manual processes Original Responsible Officer: Medical Director and Head of Planning, Performance and Quality Assurance Original Timeline: March 2023 Complete In August 2022, the IJB’s Performance, Audit and Finance Committee endorsed the development of a revised whole system performance framework for the partnership. The current engagement and participation activity taking place in relation to the development of the new Strategic Commissioning Plan will draw together and build upon the richness of contribution across key partners. A whole system working group will be established to support the performance framework for the emerging Strategic Commissioning Plan. The richness of information that will comprise whole system performance reports will allow Committee members to exercise effective oversight, scrutiny and challenge.