Agenda Item 14.

Audit Committee Chair’s Report

28 January 2016
Public Board Meeting

Presented for:
Information

Presented by:
Caroline Johnstone, Non-Executive Director

Author
Caroline Johnstone, Non-Executive Director

List of meeting
3 December 2015
dates

Trust Goals

The best for patient safety, quality and experience √

The best place to work √

A centre for excellence for research, education and innovation √

Seamless integrated care across organisational boundaries √

Financial sustainability √

Key points

1. To provide an overview of significant issues of interest to the For information

Board, highlight key risks discussed, key decisions taken and
key actions agreed from the Audit Committee meeting held on
the 3 December 2015.

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1. Introduction

Summary of the audit committee – 3 December 2015

As part of our liaison with internal and external auditors, we had a private discussion
with the external auditors before the start of the formal meeting, without any
management or Trust executives present.
The chair referred to her and the other members of the Committee activities since
September. As board members, we had 2 public board meetings, 2 board time outs
and a 2-day board time-out where we addressed long term visioning for the Trust,
medium term financial and estate planning and shorter term winter planning. In
addition, the chair had attended 2 risk committees and 2 members of the committee
had attended 3 Finance and Performance (“F&P”) committee meetings. The chair
had attended a Grand Round at the Trust on the Public Health Agenda and had kept
in touch with both the internal and external auditors. One member of the committee
attends quality committee meetings. Members also attend regular ward walk rounds
and the Chair and another member chair interview panels for Consultant posts. All
of this provides information to triangulate and seek assurance on areas of the Trust.
The meeting recognised that both the Finance & Performance (“F&P”) and Quality
Committees have a very full remit and the audit committee is determined not to
duplicate any of that work as regards assurances but rather focus on assurance as
to the overall approach to risk management, internal control and governance. As
such we choose various topics to explore alongside a close view of the developing
risk approach.

Areas of discussion
 Overseas and private patient income.– at our request, we received an update on
the progress to ensure we are appropriately paid for our services. There is
clearly a lot of work and significant progress in this but still further work to do. We
asked again that monthly information on outstanding debts is part of the F&P
information.
 The committee intended to review the reporting of conflicts, gifts, hospitality etc
for all consultants at this meeting. The Trust had identified an issue with new
email addresses which is now being addressed and we therefore discussed
progress in the whole area which again is very good but more still to do. We
intend to review a list of all declarations by senior staff on a regular basis and
ensure full compliance over the coming months.
 We reviewed the spend map (an overview of who/which companies) we spend
our money with). At this stage, this was not debated in detail and we will oversee
progress with the Carter review and work of the F&P committee.
 The committee reviewed three specific areas:
o The process of clinical audit. The chair had had discussions with the chair
of the quality committee and agreed that the audit committee would
undertake a review of the process of undertaking and responding to
clinical audits. The on-going oversight of clinical audit remains with the
quality committee. The chair had posed questions of the Trust, including
how we could be assured that the process is robust, we benchmark
against other organisations, we learn from the audits and how it is reported
to the board. A very full discussion ensued and, in general, the depth of

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the processes assured the Committee but they were keen to challenge
participation rates and how this work is communicated to board.
o Cyber security. The chair had asked for this topic to be presented to the
committee on how we could be assured that the Trust is limiting risk from
cyber attacks. We had a good and detailed discussion and it appears we
are addressing the obvious and immediate known threats but we need a
more sustained approach to ensure we keep up to date with this ever-
evolving risk. We may need some external expert support on this.
o The board assurance framework which is being developed alongside the
risk register. Again, huge progress in developing risk registers and
embedding risk across every CSU. The framework however is still
developing and will be coming back to board and the Committee on a
regular basis.
 We had updates from the internal auditor on current year audits. We intend to
review a sample of capex projects on a regular basis. We also heard from the
newly appointed external auditors and approved the draft accounting policies for
this financial year. We had our regular update on policies across the Trust and
also Losses and Compensation – in this latter report, we saw increased write-
offs, albeit small in the overall scale of the Trust, which we will keep a close eye
on.

2. Publication Under the Freedom of Information Act

This paper is exempt from publication under the Freedom of Information Act 2000 as
it contains information that is in draft form.

3. Recommendation

The Board is asked to receive and note the Audit Committee Chair’s Report.

Caroline Johnstone
Chair Audit Committee
January 2016