Meeting time 11:00 – 13:13
Meeting title: NHSCFA Board Meeting
- (TT) Tom Taylor (Non-Executive Director - Chair)
- (MS) Martin Spencer (Non-Executive Director)
- (JS) Jayne Scott (Non-Executive Director)
- (AC) Alyson Coates (Non-Executive Director)
- (AF) Andrew Flanagan (Non-Executive Director)
- (GH) Gaon Hart (Non-Executive Director)
- (SF) Susan Frith (Chief Executive, NHSCFA)
- (MJB) Matthew Jordan-Boyd (Director of Finance &Corporate Governance, NHSCFA)
- (TM) Tricia Morrison (Director of Performance & Improvement NHSCFA)
- (JA) Jon Arnold (Deputy Policy Manager, DHSC AFU)
- (AS) Ann Sturgess (Corporate Governance Manager and Board Secretary, NHSCFA)
- (RMW) Reg Madden- Waite (Senior Governance & Assurance Officer) note taker
- (RH) Richard Hampton (Head of Intelligence & Fraud Prevention) for paper 4
- (DD) David Dixon (Analytical Intelligence Lead NHSCFA) for paper 5
- (RR) Richard Rippin (NHSCFA Head of Operations and Quality & Compliance NHSCFA) for paper 6
- (JT) Jacqueline Tierney (PEG Observer)
- (SS) Sonia Sousa (Governance & Assurance Assistant) future note taker
TT opened the meeting and welcomed everyone to the meeting.
Declarations of interest
No new declarations of interest were made.
Minutes of Board Meeting 17.3.21
The Board agreed the minutes as a true and accurate record.
The Board reviewed the action log. TT also confirmed he was in the process of setting NED & CEO objectives and finalising his own.
General update from the Chair
TT summarised the accountability meeting held with DHSC, which covered the following:
- confirmation of the 12% budget increase,
- the laying of the Annual Report and Accounts, post Summer recess a performance update
- current constitution of the CEO recruitment panel as TT, MS and the DHSC Director of Finance
- agreement of the SFI and SFO
He went on to cover his meeting with the NAO confirming their intention considering publish NAO recommendations across government which he believed to be a positive move.
He informed the meeting that the NAO were looking to undertake work on test and trace, government delivery through arm’s length bodies as well as tackling the backlogs in the criminal justice system. TT offered to share relevant papers.
TT mentioned other networking opportunities.
General update from NEDs
JS reported that the Scottish Government and Audit Scotland were looking into COVID 19 related fraud and that there may be value in sharing information
In his update MS covered the following topics:
- variations in the success organisations were having in establishing new operating models
- the role of the Government Property Agency in mapping properties against needs
- the spending review and related uncertainties
- shortages in digital skills recruitment
GH mentioned that the Home Office were seeking to organise a strategic overview of tech and banking online fraud and counter fraud measures.
Finance update (paper 1)
MJB introduced paper 1, explaining that DHSC timelines had been met and that the audit pack would be ready next week. NAO were due to start the audit in mid-June.
AF asked whether the overspend on estates would continue in the coming year. MJB acknowledged that there was a risk, but that conversations regarding the Newcastle lease were positive and the budget did not take into account a possible reduction in the London estate from Q4. He undertook to report progress on this in future updates.
GH asked about the absence of a budget allocation in respect of leave accruals. MJB said that these were considered as either one off, or in this last year exacerbated by COVID. The likelihood of them continuing to be of significance is slim. Consequently, they were not specifically budgeted for.
The Board approved the finance update.
Q4 Performance report (paper 2)
TM introduced the paper highlighting:
- the revised financial target for 2020-2021 to £50M
- that the financial target had been exceeded by 8.5%
- that the report, particularly the appendices gave far more detail than previous reports
- that some KPIs had not been met but that the report demonstrated resilience and success in changing work methods, prioritisation, learning and development and stakeholder engagement
AC asked whether the contributions to delivery by NHS Resolution would drop off in year two. TM said that she believed that this would continue.
The Board noted the introduction of a new data strategy forum. Noting the forum will be review the methodologies and proposed data sources for workstreams contributing to performance targets. TM confirmed future performance reports will include milestones demonstrating development of these methodologies and workstreams.
MS complemented TM on the report but raised concerns regarding stakeholder engagement and data acquisition workstream, particularly the apparent loss of £54M through the planned GP capitation exercise.
TM expressed confidence in both work streams. Stakeholder engagement was undertaken with a view to understanding how the stakeholders worked and identifying the best means to engage, whilst maintaining a common message. Data acquisition is being examined in terms of its accuracy through greater governance measures. TM highlighted she was also keen to encourage creativity by including external bodies as well as the Board to consider problems.
TM said that the GP capitation project was on a “long list” and other means of capturing the required data were being explored.
JS also complemented TM on the report and its focus and would take up any further detailed questions outside the meeting.
AF asked whether patient exemption checking would recommence as it was found to have a powerful deterrent effect. TM said there were plans to pursue this. SF said that she believed ministerial approval would be required first. She also pointed out that once introduced early returns would diminish in time.
JA asked how plans to integrate NHSBSA into the Government Counter Fraud Profession were progressing. SF said that the NHSBSA were willing to take this forward, however, COVID 19 had delayed progress and there was no current timetable.
AC asked whether the slower uptake of Fraud Champions in providers was down to a latent lack of engagement or an unwillingness to engage. TM said that the target was very difficult to achieve but that engagement per se had been good, especially where LCFS were concerned. SF pointed out that the initiative was now supported by the revised standards but was keen to get the right people. AC said she could assist with this given her links to providers.
GH asked whether people satisfaction might drop off once the offices reopen. TM felt that smarter working and hybrid models would succeed in maintaining staff satisfaction. MJB made the point that in addition to work patterns staff were doing work that they could see added value. TM said that involving staff in collaborative processes was also important. SF said that leadership development programmes also fed into this. JS believed that caution needed to be exercised if satisfaction did start to drop off.
MS suggested that the new NEDs should be sent the reports relating to both the 19-20 and 20-21 Spotlight surveys. Action point 119 AS to issue the reports on the Spotlight surveys for 19-20 and 20-21 to the new NEDs
The paper was formally noted
AS explained the process for the afternoon’s Q&A session. Three questions had been received in advance.
MS reported that the last full REMCO discussed work planning, the OPD/PDP process, and the staff survey.
The extraordinary REMCO held yesterday had determined the job specification, grade, and salary for the replacement CEO. This would now be referred to the DHSC REMCO.
JS gave a brief account of yesterday’s ARAC meeting concentrating on the following:
- internal audit’s annual opinion of the organisation as “moderate”, which she felt was positive
- the audit opinion concerning stakeholder engagement as “limited” and that the ARAC will monitor this area given the work done since the audit was carried out
- the risk register looking at the robustness of the scoring system and target scores.
Delivering Financial Targets (paper 4)
RH introduced the paper by saying that it compartmentalises activity into separate strands: enforcement, disruption, and prevention. He gave examples of the types of interventions carried out in procurement and post event assurance on COVID 19 spend.
The report was very well received by the Board. MS asked whether the benefits of preventative steps were going to be realised this year or whether there would be a lag. RH said in the procurement exercise he had described there had been a delay in any case because of the pandemic so there would be a lag. GH asked whether he could discuss the statistical elements of the report offline, he also asked whether the COVID 19 exercise was supported by a media strategy as he felt this would garner a great deal of media interest. RH accepted that the way the results are articulated would be important.
AC asked why there was no target for NHS Resolution which had contributed to delivering the financial targets last year. RH said that NHS resolution operated in a different way to enforcement authorities in the way in which they identified and verified false claims. SF said that NHSCFA had done some great work with NHS Resolution, but that they operated like an insurance company as opposed to an investigative authority, largely using civil routes to resolve matters. The methods used to calculate their contribution to the delivery of NHSCFA targets had been agreed with the Cabinet Office.
AF remarked that the calculations go to the heart of credibility and was also keen to learn more.
TT suggested that RH meet with AC, AF and GH and asked AS to facilitate this. AS said that SS will organise a meeting.
Action point 120 AS to facilitate and SS to organise a meeting between RH, AC, AF, and GH.
Data Strategy (paper 5)
DD gave a presentation entitled “NHSCFA Data Strategy 2021-2023: approaching data gathering and analysis”
TT thanked DD for an articulate and interesting presentation which generated several questions.
AC asked DD whether he felt that he had sufficient skills and resources available to him. DD said that his team had bids in to increase resources and that areas of further exploration include machine learning which offered great opportunities.
MS said this was a hugely important area and asked whether DD was aware of data sharing initiatives in Leicester and Scotland and asked whether we were able to “piggy back” on these, pointing out that obtaining licences etc was an expensive process. DD said that most data shares he encountered were problem-centric and specific but would be happy to discuss this offline with MS.
GH said that data sharing was challenging in light of current legislation. DD said that he was aware of legislative developments and explored several different potential gateways to obtain data. He mentioned the Digital Economy Act and the Serious Crime Act and that there was a widespread desire in government to facilitate data sharing.
Operations (investigations) (Paper 6)
RR went through various cases currently going through the criminal justice system. The recent conviction of DAY was discussed, and the Board offered its recognition of the Judges commendation.
RR said that several cases were due for hearings at various stages later this month and in June. Some would attract significant public and media interest.
GH asked whether cases were analysed to identify lessons learned and what part was played by media strategy management, he was unsure whether this was adequate.
RR said that each case involved a wrap up session with the CPS. In addition, lessons learned which could benefit the wider NHS were fed into the fraud prevention process. He described systems weakness reporting as one such method. He said that processes occasionally threw up anomalies which could be fraud related and it was a question of these being spotted and interpreted as such. RR went on to say that he felt media opportunities could be better exploited, citing the case of DAY. TT remarked that the media coverage virtually ignored the NHS element of DAY’s criminal conduct.
The issue of witness support was discussed, and RR said that given the length of the investigative and judicial processes some witnesses may be required to give evidence several years after providing their initial witness statement. RR said it was essential to maintain contact and engagement with witnesses over these time lags but that this was difficult.
BAF – risk report (paper 7)
The paper had been reviewed at the ARAC. AC said that it was worth “unpicking” the change and transformation process and identify the emerging risks including:
- recruitment on an interim basis
- continuing professional development
- succession planning
MJB agreed that this was an area worth discussing.
DHSC / NHSCFA Framework agreement (paper 8)
This was noted
ESR Registration (paper 9)
This was noted
Review of forward planner (paper 10)
AS said that SS will issue dates for future meetings including a slot to sign off the Annual Report and Accounts
TT observed that some future meetings are likely to be face to face however virtual meetings will continue at the current time.
Board Blog volunteer
MS volunteered to do the next Board Blog and JS the one after.
Review of the effectiveness of the meeting
It was agreed that the meeting had been conducted effectively. TT said that given the overrun it may be necessary to extend the timing of future meetings.
GH asked that page numbers of individual papers appear on the agenda for ease of reference. This was agreed. Action point 121 AS to ensure that individual papers appear on the agenda together with their page number.