Agenda Document Pack - Midlothian Integration Joint Board - Audit and Risk Committee - 05/12/2024
Midlothian Council · 5 December 2024
Back to Midlothian Integration Joint Board - Audit and Risk Committee — 5 December 2024 and its agenda
Text extracted from the council's PDF. Layout and reading order may differ from the original.
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Notice of Meeting and Agenda Midlothian Integration Joint Board - Audit and Risk Committee Venue: Virtual Meeting, Date: Thursday, 05 December 2024 Time: 14:00 Morag Barrow Chief Officer Contact: Clerk Name: Democratic Services Clerk Telephone: Clerk Email: democratic.services@midlothian.gov.uk Further Information: This is a meeting which is open to members of the public. Page 1 of 25
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1 Welcome, Introductions and Apologies 2 Order of Business Including notice of new business submitted as urgent for consideration at the end of the meeting. 3 Declaration of Interest Members should declare any financial and non-financial interests they have in the items of business for consideration, identifying the relevant agenda item and the nature of their interest. 4 Minute of Previous Meeting 4.1 Minute of MIJB Audit and Risk - 12 September 2024 Submitted for approval 3 - 9 5 Public Reports 5.1 Matters Arising, Verbal Update by David King - Independent Member - Vice Chair - Datix 5.2 Risk Register, Report by David King 10 - 15 5.3 Recommendations Internal Audit Follow-Up Review- Completed Actions & In Progress Actions, Report by Duncan Stainbank 16 - 25 6 Private Reports No items for discussion 7 Date of Next Meeting The next meeting will be held on Thursday 6 March 2025. Page 2 of 25
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Midlothian Integration Joint Board Meeting Date Time Venue Audit and Risk Committee Thursday, 12 September 2024 9:00am Virtual Meeting held using MS Teams Present (voting members): Val De Souza (Chair) Councillor McManus Councillor Milligan Councillor Parry Present (non-voting members): Morag Barrow (Chief Officer) David King (Chief Finance Officer (Interim)) Duncan Stainbank (Chief Internal Auditor) Kirsty Macdonald Patricia Fraser (External Auditor) Roxanne King (Executive Business Manager) Claire Gardiner In attendance: Hannah Forbes (Democratic Services Officer) Apologies: Gill Main (Integration Manager) MIJB – Audit and Risk Committee Thursday, 12 September 2024 Item No 4.1 Page 3 of 25
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2 MIJB - Audit and Risk Committee Thursday 7 March 2024 1. Welcome and Introductions The Chair welcomed everyone to the meeting of the Midlothian Integration Joint Board (MIJB) – Audit and Risk Committee. 2. Order of Business The Order of Business was as detailed in the agenda. 3. Declarations of interest No declarations of interest were received. 4. Minutes of Meeting 4.1 The Minute of Meeting of the Audit and Risk Committee held on 6 June 2024 was submitted and approved as a correct record. 5. Public Reports 5.1 Matter Arising - David King The interim Chief Financial Officer provided a verbal update on a number of subjects. • It was noted that it would be necessary to arrange a Datix development session, this could be done as an additional 30–45-minute session following a committee meeting. Members were asked to consider whether this would be a good arrangement and either contact the Chief Financial Officer or discuss at the next committee meeting. • The role of the independent member for the committee has been approved. Members agreed it would be very beneficial to have an independent member on the committee as this would ensure further transparency. A further discussion ensued on how to recruit an independent member, such as advertising through the website. Page 4 of 25
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3 MIJB - Audit and Risk Committee Thursday 7 March 2024 • It was noted that a vice chair has yet to be appointed to this committee. This is to be added to the agenda for the next Audit and Risk Committee meeting. • Quorum arrangements for the committee were discussed. If the minimum quorum is three members, and if membership of the committee consists of 2 members from NHS, 2 members from Midlothian Council and one independent member, it may be preferable to recruit an additional independent member or organise a deputy system as otherwise the onus may rest on the independent member to always be available for meetings. After some discussion it was agreed 3 out of 5 members of the committee in attendance was a reasonable arrangement. The matters of the Vice Chair and recruitment of independent member were to be added to the next meeting agenda. 5.2 Risk Register The interim Chief Financial Officer presented the report, The report presents the IJB’s Q2 risk register for discussion by the committee. The Audit and Risk Committee members are requested to: • Note the Q2 risk register. • Consider if any further additions or changes should be made to the risk register. • Agree to the proposal that, at a workshop, a presentation on the use of Datix is provided to the committee along with a further, more detailed consideration of the management of the risk register. The Committee discussed the new risk relating to the National Care Service and if we can be explicit on decisions and the potential impact they may have on Midlothian and the IJB. The chair thanked the Interim Chief Financial Officer for the report and noted the recommendations. 5.3 Annual Accounts 23/24 - report of the appointed auditors - External auditors Page 5 of 25
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4 MIJB - Audit and Risk Committee Thursday 7 March 2024 The IJB’s appointed auditor (from Audit Scotland) presented the Report of the External Auditor on the Annual Accounts and apologised for a slight delay with the report but expressed satisfaction with the progress made. It was noted the external auditor’s view provides a clean audit opinion and that there have been no significant adjustments. Appendix B in the report contains a letter of representation for the Interim Chief Financial Officer to sign on behalf of the Committee having recommended the Annual Accounts to the IJB and the IJB having approved them. The Audit report is in its draft format and will be finalised after today’s meeting. A number of points were highlighted for the Members consideration: • Exhibit 1 – materiality levels – It was noted there has been increased expenditure this year, and that there has been no change in benchmark levels. • An issue was identified where significant insurances did not reflect the numbers, a partner body presented this paper and appropriate action was taken. • The main risk for misstatement were noted, but no adjustments were needed • Management commentary has been improved to tell the story of the IJB better. It was noted that IJB broke even in 2023/24 but had used all its reserves. Audit Scotland is reassured financial sustainability is appropriate, and actions will be taken as appropriate. The report also suggests there is appropriate governance in place. Finally, it was noted that there is evidence of good management, and it was recommended good practice guidelines continue to be observed going forward. The Appointed Auditor thanked the Interim Chief Financial Officer for his cooperation in the process. Page 6 of 25
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5 MIJB - Audit and Risk Committee Thursday 7 March 2024 After discussion Members confirmed they approve the findings of the cover and main audit report, and agreed to recommend approval of the annual accounts to the IJB. 5.4 Annual Accounts 23/24 The interim Chief Financial Officer presented the report, The IJB has prepared annual accounts for the financial year 2023/24; these have now been audited by the IJB’s Independent Auditors. Their report has been presented to committee at item 5.3. As a result of this report Members are being asked to: • Note the report of the independent auditor • Consider the 2023/24 annual accounts of the IJB. • Recommend approval of the accounts by the IJB. The chair thanked the Interim Chief Financial Officer for the report and the committee are happy to note the recommendations. 5.5 Audit Scotland - Audit report on IJB's The Interim Chief Finance Officer presented the report and detailed this paper presents the Accounts Commission’s July 2024 report on Integration. The Committee members are asked to: • Note this report. • Note the report of the accounts commission. • Consider the IJB’s position against the recommendations in the Accounts Commission report. • Request that a further report be made to a Board meeting of the IJB. It was noted by the Committee that this is a very helpful report, and the timing is very helpful. What we have been trying to do leading up to the budget allocations is to be open and honest and transparent about where we are and what we are trying to do to recover. I think this report Page 7 of 25
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6 MIJB - Audit and Risk Committee Thursday 7 March 2024 would be helpful to take this to the Board to give context and position Midlothian and give us an opportunity to reinforce the work that has been going on behind the scenes. 5.6 Audit Report - MIJB directions The Chief Internal Auditor presented the report, The purpose of this report is to present the findings and recommendations. from the recently completed Internal Audit review of Midlothian IJB Directions, completed by the Midlothian Council Internal Audit team. It is recommended the Audit and Risk Committee note the findings and recommendations from the report. The Chair thanked the Internal Auditor for the report. In relation to the recommendations on ensuring that there is a clear link between the Directions issued and the budget allocation the IJB has taken a different route with directions which cut across multiple service areas. As Services are budgeted for it is not possible to provide this direct link, however for 2024/25 each direction has clear links to recovery actions with savings against each one. The chair acknowledged the work completed and noted recommendations of the report. 5.7 Audit Report - NHS Lothian Directions from IJBs The Chief Internal Auditor presented the report and advised that the report reviews the audit work that has been completed across the two partner organisations. The purpose of this report is to: • Inform the MIJB Audit and Risk Committee of the NHS Lothian Internal Audit Report on IJB Directions providing Limited Assurance; and • Inform the MIJB Audit and Risk Committee of the NHS Lothian Internal Audit Report on Financial Sustainability providing Significant Assurance. The MIJB Audit and Risk Committee is asked to: Page 8 of 25
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7 MIJB - Audit and Risk Committee Thursday 7 March 2024 • Note the findings of the NHS Lothian Internal Audit on IJB Directions. • Note the findings of the NHS Lothian Internal Audit on Financial Sustainability. The Chair thanked the Internal Auditor for the report. It was noted that all apart from one of the recommendations on the IJB Directions Report should now be completed and that work had been undertaken in NHS Lothian to implement these recommendations. The Chair noted that the report is welcomed. The Audit and Risk committee noted the actions in the report. 6. Private Reports No private business discussed at this meeting. 7. Date of next meeting The next meeting will be held on Thursday, 5 December 2024 at 2.00pm. The meeting terminated at 10:24am. Page 9 of 25
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Midlothian Integration Joint Board Audit and Risk Committee Midlothian IJB Risk Register – Q3 2024/25 5th December 2024 Item number: 3 Executive summary This report presents the IJB’s Risk Register for Q3 2024/25. The IJB maintains a risk register which is presented to every meeting of this committee and reviewed by management quarterly prior to the next meeting of the committee. Changes agreed at the September meeting have now been actioned and updated into Datix – the Risk Management software used by the IJB. The review of the risks resulted in a reduction in the risk level of risk 5775 (Impact of the Partners or the Scottish Government's decisions on the IJB and its Strategic Plan) which recognised the potential impact on the IJB from the NCS has now, in the light of further briefings on the timescales for the Bill, been wound down to medium. However, the committee should consider - 1. The future provision of a CFO for the IJB and the risk around this role not being properly filled. 2. The impact on the risk level of recent updates on the progress of the NCS. Committee members are asked to: 1. Note the Q3 Risk Register. 2. Consider if any further additions or changes should be made to the risk register. MIJB Audit and Risk Thursday 5 December 2024 Item 5.2 Page 10 of 25
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Midlothian Integration Joint Board – Audit and Risk Committee 3. Report 1. Purpose 1.1 This report presents the IJB’s Q3 risk register for discussion by the committee. 2. Recommendations 2.1 Committee members are asked to • Note the Q3 risk register. • Consider if any further additions or changes should be made to the risk register. 3. Background and main report 3.1 The IJB maintains a risk register in line with best practice. This register lays out the risks to the operation of the IJB – that is risks to the development of the Strategic Plan and the delivery of that plan though directions to its partners. 3.2 At the committee’s meeting in September a range of changes to the risk narratives was agreed along with the addition of a new risk (5934 ‘Impact of the Partners or the Scottish Government’s decisions on the IJB and its Strategic Plan). This risk to recognise impacts on the IJB arising from any decisions made by partners who are themselves trying to manage an extremely challenging financial position and further ‘directions’ from the Scottish Government which have, in the past, impacted on functions that have been delegated to the IJB. 3.3 Risk 5775 (Impact of the Partners or the Scottish Government's decisions on the IJB and its Strategic Plan) which recognised the potential impact on the IJB from the NCS has now, in the light of further briefings on the timescales for the Bill been wound down to medium. The committee should consider if this risk level is correct? 3.4 The IJB’s has had an interim CFO for the past 14 months. That individual is leaving on 6th December and although a great deal of work in on-going to provide another CFO the committee might wish to consider if this risk be added to the risk register. 3.5 The updated risk register is attached as appendix 1. It should be noted that this is an extract from Datix and colleagues from the Datix team have been very supportive in redesigning the report and trying to capture the key issues. 4. Policy Implications Page 11 of 25
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Midlothian Integration Joint Board – Audit and Risk Committee 4.1 There are no further policy implications arising from this report. 5. Equalities Implications 5.1 There are no equalities implications arising from this report 6. Resource Implications 6.1 There are no resource implications arising from this report. 7 Risks 7.1 The risks are described in the risk register which is attached 8 Involving People 8.1 There are no direct implications for involving people as a result of this report. 9 Background Papers 9.2 None AUTHOR’S NAME David King DESIGNATION Interim Chief Finance Officer CONTACT INFO David.king4@nhs.scot DATE November 2024 Appendix 1 – Risk Register Extract– Q3 2024/25. Page 12 of 25
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ID Risk level Division Risk Owner Handler Title Description Controls in place Adequacy of controls Consequence (current) Likelihood (current) Rating (current) Risk level (current) Consequence (Target) Likelihood (Target) Rating (Target) Risk level (Target) Date Opened Date Risk Reviewed Review date Close Date 5934 Integrated Joint Board Midlothian HSCP Barrow, Morag Barrow, Morag Impact of the Partners or the Scottish Government's decisions on the IJB and its Strategic Plan The Partners may have to take decisions on functions delegates to the IJB - driven by operational or financial constraints - which may impact on the ability of the IJB to deliver its strategic plan. Similarly the Scottish Government may issue directive to the NHS on functions that are delegated and therefore impact on the IJB On-going dialogue with the Partners and through a range of national groups (CFO network, CO network) with the Scottish Government. Any such decisions and the impacts thereof should be reported to the IJB along with the impact on its ability to deliver the Strategic Plan. Some weaknesses: Improvement can be demonstrated however not at optimal level. Moderate (3) POSSIBLE (3) 9 Medium Minor (2) POSSIBLE (3) 6 Medium 20/11/2024 20/11/2024 31/03/2025 5775 Integrated Joint Board Midlothian HSCP Barrow, Morag King, David New (and Amended) national legislation may impact on the ability of the IJB to deliver its Strategic Plan Risk Effect: There is a risk of further legislation, policy, or national improvement drivers which impact on the IJBs ability to deliver on the Strategic Plan, examples include the legislation relating to a National Care Service and the Health and Care (Staffing) (Scotland) Act 2019. Risk Consequence: The IJB and it partners may be distracted from the business of delivering the Strategic Plan. Legislation, policy, and national improvement drivers without fiscal supports will result in additional pressure on the IJB. Respond to Scottish Government information requests on impact of future legislation, policies, and national improvement drivers Horizon scanning for policy developments through partners and SMT network groups Close working relations with Scottish Government through Chief Finance Officer, Chief Officer and COSLA. Unknown: The current controls are not known and further work is required to identify the current situation Major (4) POSSIBLE (3) 12 High Moderate (3) POSSIBLE (3) 9 Medium 26/02/2024 20/11/2024 30/04/2024 Page 13 of 25
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5771 Integrated Joint Board Midlothian HSCP Barrow, Morag King, Roxanne Partners' operational resources may be inadequate or unable to deliver the IJB's Strategic Plan Risk Effect: Partners operational services may experience disruption to service delivery. Risk Consequence: The IJB may not see sufficient or adequate progress towards its 6 strategic aims and delivering its strategic plan. Reassurance is required from partners regarding the following 1. Resilience planning and Business continuity 2. Contract monitoring 3. Governance and Assurance 4. Outcomes for people and communities Some weaknesses: Improvement can be demonstrated however not at optimal level. Moderate (3) UNLIKELY (2) 6 Medium Minor (2) POSSIBLE (3) 6 Medium 26/02/2024 20/11/2024 31/03/2025 5773 Integrated Joint Board Midlothian HSCP Barrow, Morag King, Roxanne The IJB cannot properly deliver its Category 1 responder status if its partners are unable to provide the necessary assurances. Risk Effect: IJBs role as Category 1 responders under the Civil Contingencies Act requires that our partners NHS Lothian and Midlothian Council maintain effective business continuity and resilience plans to ensure an appropriate response in times of emergency. There is a risk that our partners may not be able to provide these assurances. Risk Consequence: Failure to maintain up to date and effective resilience plans could result in services unable to maintain essential service delivery Assurance reporting to IJB routinely by Chief Nurse, Chief Social Worker and Resilience. Annual category 1 assurance report submitted to IJB via A&R comittee Robust operational process within Midlothian Health and Social Care to meet requirements Lessons learnt from COVID pandemic have been incorporated within standard service delivery, ongoing work to develop a quality management approach will provide additional partnership wide assurances to IJB. Satisfactory: All controls are working and can be demonstrated through measurement Moderate (3) UNLIKELY (2) 6 Medium Minor (2) UNLIKELY (2) 4 Medium 26/02/2024 20/11/2024 31/03/2025 Page 14 of 25
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5774 Integrated Joint Board Midlothian HSCP Barrow, Morag King, David The IJB is not able to properly deliver its Strategic Plan due to insufficient financial resources. Risk Effect: The IJBs partners may not be able to allocate sufficient resource to deliver its Financial Plan and Strategic Plan. Risk Consequence: The IJB may not be able to deliver the Strategic Plan in order to function within the available resources. The IJB may have to amend the ambitions of Strategic in such a way that the progress towards the 6 strategic aim of the Strategic Plan and 9 National Health and Wellbeing Outcomes is compromised. Chief Finance Officer responsible for the governance, appropriate management of finance and financial administration of the IJB. Strong budgetary control systems in place within NHS Lothian and Midlothian Council. IJB Medium term financial plan developed annually. Working in partnership in the financial environment with Midlothian Council and NHS Lothian. Use of IJBs General Reserve. Weak: The controls in place have not made much difference and the level of risk cannot be reduced Extreme (5) ALMOST CERTAIN (5) 25 Very High Moderate (3) POSSIBLE (3) 9 Medium 26/02/2024 20/11/2024 31/12/2024 5772 Integrated Joint Board Midlothian HSCP Barrow, Morag Main, Gill The IJB's Partners are unable to deliver the IJB's Directions Risk Effect: There is a risk that the IJBs partners have insufficient workforce or other resources to execute the requirements and ambitions of the IJB Directions Risk Consequence: The IJB cannot deliver on its strategic plan or financial plan. Directions are monitored and reported on twice a year for performance updates. financial allocations are included within directions on an annual basis after IJB budgets have been set The Planning, Performance and Programme team continue to support with additional capacity to redesign and transform key areas of service delivery A project management approach continues to support key areas aiming to accelerate progress in the delivery of the MIJB Directions. Some weaknesses: Improvement can be demonstrated however not at optimal level. Moderate (3) UNLIKELY (2) 6 Medium Moderate (3) POSSIBLE (3) 9 Medium 26/02/2024 20/11/2024 31/03/2025 Page 15 of 25
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Midlothian IJB Audit and Risk Committee 06 December 2024 at 2pm MIJB Recommendations Internal Audit Follow-Up Review - Completed Actions & In Progress Actions Executive summary This report details the MIJB’s reported performance in addressing and closing the issues and recommendations raised by Internal Audit. Good progress has been made by Management during the year with the completion of 4 recommendations summarised in Appendix 1. 3 of the 4 recommendations from the 2022/23 MIJB Internal Audit of Medium-Term Financial Planning audit have been fully completed. 1 recommendation from the 2023/24 MIJB Internal Audit of Directions for 2024/25 has also been fully completed. There are currently 9 remaining in-progress Internal Audit Recommendations that are yet to reach the expected target date for implementation for the MIJB which are summarised in Appendix 2. These relate to: • the Medium-term Financial Plan should be developed to include a more explicit link to the MIJB Strategic Plan and its priorities for the years ahead; • the Registers of Interests for Board members should be uploaded to the IJB website and linked through the documented Model Publication Scheme (MPS); • Public Engagement Statement should be reviewed and made available on the MIJB website and linked through the documented MPS; • financial information needs to be appropriate and accessible both online and through the documented MPS; • guidance needs to be included within the documented MPS and online advising the public on how to submit freedom of information requests; • information available online needs to be linked to the relevant class within the documented MPS; • the Scottish Information Commissioners self-assessment checklist needs to be used to assess against current activity and practice; • a Directions Policy should be established for the MIJB; and Item number: Agenda number MIJB Audit and Risk Thursday 5 December Item No 5.3 Page 16 of 25
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Midlothian Integration Joint Board • there needs to be a clearer audit link between the Directions Log and the HSCP Service Plans. The Internal Audit team will continue to monitor progress by Management with implementation of Internal Audit recommendations. The Midlothian IJB Audit and Risk Committee is asked to: • Acknowledge the progress made by Management in implementing Internal Audit recommendations to improve internal controls and governance, and mitigate risks; • Consider whether it is satisfied with the progress made by Management and any other actions required; and • Note that Internal Audit will continue to monitor the completion of the outstanding recommendations and will provide update reports to the MIJB Audit and Risk Committee. Page 17 of 25
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Midlothian Integration Joint Board Report MIJB Recommendations Internal Audit Follow-Up Review - Completed Actions & In Progress Actions 1 Purpose 1.1 The purpose of this report is to: • Inform the MIJB Audit and Risk Committee of the number of recommendations raised by Internal Audit for the MIJB that are in progress; • Note the MIJB’s reported performance in addressing the associated internal control and governance issues by the agreed implementation; and • Highlight the main governance and financial risks where recommendations are found to be outstanding. 2 Recommendations 2.1 The MIJB Audit and Risk Committee is asked to: • Acknowledge the progress made by Management in implementing Internal Audit recommendations to improve internal controls and governance, and mitigate risks; • Consider whether it is satisfied with the progress made by Management and any other actions required; and • Note that Internal Audit will continue to monitor the completion of the outstanding recommendations and will provide update reports to the MIJB Audit and Risk Committee. 3 Background 3.1 Internal Audit suggests recommendations for improving internal control and to assist the MIJB deliver against its objectives. Where MIJB Management agree these recommendations, the actions are input to Ideagen Risk Management (Midlothian Council’s performance management system formerly known as Pentana Risk) along with a date by which Management should have completed the agreed action. 3.2 MIJB Management are responsible for acting on the recommendations by the agreed due date and when complete, closing the recommendation on the Ideagen Risk Management system. The Internal Audit plan includes follow up activity in relation to recommendations made and checks the completed recommendations to determine whether they have been implemented satisfactorily and thus give assurance over the ongoing improvement of internal control, risk management and governance arrangements. The follow-up of completed recommendations is noted in this report. Page 18 of 25
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Midlothian Integration Joint Board 3.3 Internal Audit continues to meet with MIJB officers on a regular basis to follow-up on Management progress with implementation of the remaining recommendations. This enables discussions for agreeing extensions to due dates to ensure that Internal Audit has an oversight of this to further add value and to provide a visible audit trail in the Ideagen Risk Management system. 4 Performance 4.1 Completed Actions Good progress has been made by Management during the year with the completion of 4 recommendations summarised in Appendix 1. The IJB’s strategic risk register includes financial sustainability as a key risk to the IJB‘s delivery of its strategic plan and the risk register which is quarterly reported to the MIJB Audit and Risk Committee. An IJB finance workshop was held to discuss the plans to set a balanced budget for 2024/25; and setting up the financial management planning processes. A revised financial plan for 2024/25 was reported to the MIJB in June 2024 which includes updating the Medium Term 5-year Financial Plan to manage any future forecast financial pressures. Directions for 2024/25 have each of the MIJB recovery actions noted with a saving target noted against each one; and the MIJB is in receipt of regular financial reports from the partners. 4.2 In-Progress Actions There are currently 9 remaining in-progress Internal Audit Recommendations (including sub-actions) for the MIJB which are summarised in Appendix 2. These relate to: the Medium-term Financial Plan should be developed to include a more explicit link to the MIJB Strategic Plan and its priorities for the years ahead; the Registers of Interests for Board members should be uploaded to the IJB website and linked through the documented Model Publication Scheme (MPS); Public Engagement Statement should be reviewed and made available on the MIJB website and linked through the documented MPS; financial information needs to be appropriate and accessible both online and through the documented MPS; guidance needs to be included within the documented MPS and online advising the public on how to submit freedom of information requests; information available online needs to be linked to the relevant class within the documented MPS; the Scottish Information Commissioners self-assessment checklist needs to be used to assess against current activity and practice; a Directions Policy should be established for the MIJB; and there needs to be a clearer audit link between the Directions Log and the HSCP Service Plans. 4.3 Internal Audit will continue to monitor progress by Management with the implementation of Audit recommendations. 5 Directions 5.1 There are no Directions implications arising from this report. 6 Equalities Implications 6.1 There are no direct equalities implications arising from this report. Page 19 of 25
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Midlothian Integration Joint Board 7 Resource Implications 7.1 There are no direct resource implications arising from the proposals in this report. 8 Risk 8.1 The recommendations made by Internal Audit are directly related to reducing the level of risk to which the MIJB is exposed. These recommendations were raised to reduce financial, reputational, strategic and governance risks. 9 Involving people 9.1 The MIJB Chief Officer, Chief Finance Officer, and Integration Manager have been involved in progressing the implementation of the Internal Audit recommendations and have reviewed this report in advance of its consideration by the MIJB Audit and Risk Committee. 10 Background Papers 10.1 Follow-up audit recommendations reports are presented to the MIJB Audit and Risk Committee each year in accordance with the approved MIJB Internal Audit Annual Plan 2024/25. AUTHOR’S NAME Duncan Stainbank DESIGNATION Chief Internal Auditor CONTACT INFO duncan.stainbank@midlothian.gov.uk DATE 22 November 2024 Page 20 of 25
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Appendix 1 – Completed MIJB Actions (Completed 01/04/2023 – 30/09/2024) Status: Completed 4 2022/23 - Midlothian IJB Medium-Term Financial Planning Action Code Action Due Date Icon Progress Notes Service Managed By IA.MIJB- MTFP.01 The Chief Finance Officer should develop a documented financial planning process that records in an agreed template the timeline and critical steps required for the prompt development of the Medium-term Financial Plan for the IJB. This should be shared with the Board and Partners for information. 31-Dec- 2023 100% Q3 23/24: Complete In place and shared with IJB (21.12.23). Going forward is the development of a generic financial planning process that is mapped onto the Strategic Planning and Directions process. Adult Health and Social Care; Health and Social Care Partnership AHSC Performance Officer IA.MIJB- MTFP.03 The Chief Finance Officer and Chief Officer of the IJB should ensure that the responsibility for the ongoing monitoring of financial recovery plan performance is reported to the Board and a schedule of reporting produced to support this. 31-Aug- 2023 100% Q2 23/24: Complete - the IJB receives routine financial recovery plans performance in its finance update reports. Adult Health and Social Care; Health and Social Care Partnership AHSC Performance Officer IA.MIJB- MTFP.04 The Risk Register for the IJB should be developed further to include an additional risk specific to the Board’s financial challenge and its inability to achieve financial balance for the years ahead. The risk should be scored appropriately considering the criticality of the risk and the impact on the delivery of the Board’s strategic priorities. 30-Sep- 2023 100% Q2 23/24: Complete - the IJBs strategic risk register includes the financial sustainability as a key risk to the IJB delivery of its strategic plan. Adult Health and Social Care; Health and Social Care Partnership AHSC Performance Officer 2023/24 - Midlothian Integration Joint Board (MIJB) Directions - Reasonable Assurance Action Code Action Due Date Icon Progress Notes Service Managed By IA.MIJBD.0 3 MIJB should consider linking Directions to the funding allocations; address any delivery 27-Aug- 2025 100% Q1 24/25: Completed during audit review. Adult Health and Social Care; Health AHSC Performance Officer Page 21 of 25
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Action Code Action Due Date Icon Progress Notes Service Managed By issues in the Directions log; and consider issuing out revised Directions during the year in response to ongoing financial developments. Management Comment: Directions are the mechanism to action strategy so by their nature need to be cross cutting over a number of service areas and therefore identifying the funding allocation issue by Direction is impossible. There was operational decision making at HSCP level but no further implication for the IJB in June 2023 for Directions and so there was no need to issue anything further. However, our Directions for 2024/25 do have each of the IJB recovery actions noted with a clear saving target noted against each one. Budgets change nearly every month and the IJB is in receipt of regular financial reports from the partners. and Social Care Partnership Page 22 of 25
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Appendix 2 - MIJB Audit Actions in Progress Status: In Progress 9 (including sub-actions) 2022/23 - Midlothian IJB Medium-Term Financial Planning Action Code Action Due Date Icon Progress Notes Service Managed By IA.MIJB- MTFP.02 The Medium-term Financial Plan should be developed to include a more explicit link to the Midlothian IJB Strategic Plan and its priorities for the years ahead. This should also include the Board's strategic priorities in a local and national context, alongside the financial risks associated with the plan’s assumptions. 31-Dec- 2024 80% Q2 24/25: On target The IJB Chief Financial Officer and IJB Planning Team continue working closely to ensure the medium-term financial plan and 5 year strategic plan are as joined as they can be given the severity of the financial challenges being addressed. Work continues to take place to coordinate work against timescales and key milestones. A series of financial workshops have taken place with the most recent in September 2024. Adult Health and Social Care; Health and Social Care Partnership AHSC Performance Officer 2023/24 - Midlothian IJB Publication Scheme - Reasonable Assurance Action Code Action Due Date Icon Progress Notes Service Managed By IA.IJBPS.01 a The Register of Interests for Board members should be uploaded to the IJB website and linked through the documented Model Publication Scheme (MPS) 30-Dec- 2024 0% Q2 24/25: Management Comment: It has not been possible to complete this action. The integration Manager and Chief Officer have requested the register of interest from the Standards Officer but the documents have not been shared, it has therefore not been possible to upload these to the website or link through the MPS. Adult Health and Social Care; Health and Social Care Partnership AHSC Performance Officer; Integration Manager (Planning, Performance, and Programme) IA.IJBPS.01 b Management should conclude the review of the Public Engagement Statement and make 30-Dec- 2024 40% Q2 24/25: This work has been delayed as the Adult Health and Social Care; Health AHSC Performance Officer; Integration Page 23 of 25
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Action Code Action Due Date Icon Progress Notes Service Managed By this available through the IJB website, linked also through the documented MPS. MIJB quality Framework for Community Engagement self- assessment and improvement plan requires key internal governance steps to be completed, before being presented to SPG. This will be reviewed by management in Q3 and it is anticipated that the review of the Public Engagement Statement will be concluded by 31 January 2025. and Social Care Partnership Manager (Planning, Performance, and Programme) IA.IJBPS.01 c Management should ensure that financial information is appropriate and accessible both online and through the documented MPS. 30-Dec- 2024 90% Q2 24/25: Link What we do Information - Midlothian Health and Social Care Partnership Adult Health and Social Care; Health and Social Care Partnership AHSC Performance Officer; Integration Manager (Planning, Performance, and Programme) IA.IJBPS.01 d Management should ensure that the information available online is linked to the relevant class within the documented MPS. 31-Dec- 2024 80% Q2 24/25: Re opened audit guidance as part of follow-up review of MIJB completed actions. New target date agreed 31 December 2024. An action plan has been created that identifies information requiring updates and who can support the actions. Adult Health and Social Care; Health and Social Care Partnership AHSC Performance Officer; Integration Manager (Planning, Performance, and Programme) IA.IJBPS.02 Management should ensure that there is information included within the documented MPS and online to advise members of the public on how to submit freedom of information requests. 30-Dec- 2024 90% Q2 24/25: Management comment: Action nearly complete requiring only the updated model scheme to be uploaded to the website. Information available on how to make a FOI or SAR is available on website. Adult Health and Social Care; Health and Social Care Partnership AHSC Performance Officer; Integration Manager (Planning, Performance, and Programme) IA.IJBPS.03 Management should consider the Scottish Information Commissioners self-assessment modules and determine the most appropriate to complete, thereafter a schedule for the completion should be agreed. An action plan should be developed to address gaps. 30-Nov- 2024 70% Q2 24/25: Management comment: Self-assessment modules 2, 4 & 6 completed in accordance with the report recommendations. An action plan is being developed which requires input from other areas to provide information and address the gaps. The final draft of the Style Guide is complete and needs to progress Adult Health and Social Care; Health and Social Care Partnership AHSC Performance Officer; Integration Manager (Planning, Performance, and Programme) Page 24 of 25
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Action Code Action Due Date Icon Progress Notes Service Managed By through internal governance. Remains on target. 2023/24 - Midlothian Integration Joint Board (MIJB) Directions - Reasonable Assurance Action Code Action Due Date Icon Progress Notes Service Managed By IA.MIJBD.0 1 A Directions Policy should be established for the MIJB. 31-Mar- 2025 25% Q2 24/25: Management Comment: This work is being taken forward with an initial period of stakeholder engagement, which will include participation from Executive Leadership Team and Strategic Planning Group. This work is on target for March 2025. Adult Health and Social Care; Health and Social Care Partnership AHSC Performance Officer; Integration Manager (Planning, Performance, and Programme) IA.MIJBD.0 2 There needs to be a clearer audit link between the Directions Log and the HSCP Service Plans. 31-Mar- 2025 0% Q2 24/25: No update from previous quarter. Management Comments: This will be addressed by the HSCP services. ELT Lead collating the Group Service Specifications and Service Plans. Adult Health and Social Care; Health and Social Care Partnership AHSC Performance Officer; Executive Business Manager Page 25 of 25