NHSCFA board-meeting 15th September 2023

Minutes of NHSCFA Board meeting - FCG-BOA-MIN - Meeting – 15.09.23

Date: 15/09/23

Meeting time: 11:00 – 14:30 (London office, included a 30 min break for lunch)

Meeting title: NHSCFA Board Meeting

Members:

  • (TT) Tom Taylor (Non-Executive Director – Chair, NHSCFA)
  • (AF) Andrew Flanagan (Non-Executive Director, NHSCFA)
  • (AC) Alyson Coates (Non-Executive Director, NHSCFA)
  • (MS) Martin Spencer (Non-Executive Director, NHSCFA)
  • (JS) Jayne Scott (Non-Executive Director, NHSCFA)
  • (GH) Gaon Hart (Non-Executive Director, NHSCFA)
  • (AR) Alex Rothwell (Chief Executive Officer, NHSCFA)
  • (MJB) Matthew Jordan-Boyd (Director of Finance & Corporate Governance, NHSCFA)
  • (TM) Tricia Morrison (Director of Performance & Improvement, NHSCFA)

Attendees:

  • (SB) Sean Byrne (Head of DHSC AFU)
  • (JB) Joanne Brown (Associate Director for PWD, NHSCFA)
  • (RH) Richard Hampton (Head of Intelligence & Fraud Prevention, NHSCFA)
  • (RR) Richard Rippin (Head of Operations, NHSCFA)
  • (KS) Kathryn Strachan (Board Apprentice, NHSCFA)
  • (NB) Nicola Burton (Head of Transformation & Change, NHSCFA)
  • (AS) Ann Sturgess (Head of Business Support & Board Secretary, NHSCFA)
  • (GC) George Cooke (Performance, Analytics and PMO Manager, NHSCFA)
  • (PT) Paul Tiffen (Fraud Hub Manager, NHSCFA)
  • (AH) Amy Hind (Business Support Manager, NHSCFA)
  • (SS) Sonia Sousa (Governance & Assurance Assistant, NHSCFA) note taker

Observers:

  • (SL) Stephen Lough (Finance Business Partner & PEG Representative, NHSCFA)
  • (MSmith) Michele Smith (Senior Corporate Communications Officer, NHSCFA)
  • (AHarper) Andrea Harper (Corporate Communications Manager, NHSCFA)

1. Welcome

1.1 TT welcomed all to the meeting and facilitated a round of introductions.

2. Apologies

2.1 No apologies were received for this meeting.

3. Declarations of interest

3.1 AC updated her declarations confirming she had been appointed as a trustee of the Children Society. GH also confirmed his new role as an independent assessor for the GDC (General Dental Council) fitness to practice panel. TT confirmed the end of his tenure as non-executive Board member of the Department of Finance at the Northern Ireland Government.

4. Minutes and action log

4.1 Minutes of Board 10.07.23 were approved.

4.2 The Board reviewed the action log:

Action Point 181, MJB to review the wording in Standing Financial Orders and Standing Financial Instructions regarding co dependant purchases and the requirements to disaggregate these and bring back to the next Board meeting – Carried forward from previous meetings, to be presented at the next Board meeting in November.

Action Point 183, SB to chase advertisement of the NEDs roles on the Public Appointment Website - In progress - advert should go live around w/c 25/09/23.

Action Points 178, 180 & 184 to 188 (incl.) have been completed and considered closed.

5. General update from Chair

5.1 TT highlighted last DHSC accountability, attended by himself and AR had been positive. Key aspects discussed were:

  • CFA Board recruitment
  • In year progress against targets
  • Progress of CFA investigations
  • ALB’s efficiencies and savings (general discussion)

5.2 TT reflected the session on Fraud hosted by himself and AR for the Department for Levelling Up Housing and Communities (as part of the broader stakeholder network engagement) had been very well received. TT also highlighted the increase in good PR, not only around positive outcomes from our investigations but also in our continuous stakeholder engagement efforts.

5.3 TT confirmed his attendance at the upcoming session on Machine Learning (part of the Data Analytics project) as well as the Evolution Sponsor Group meeting, both to be held in October.

6. General update from CEO (Paper 1)

6.1 Paper taken as read. As part of the Ministerial ALB review, AR highlighted the productive conversations with NHS England on mandatory fraud reporting. AR also noted RR is supporting the PSFA with regards to the performance elements of the Continuous Improvement Assessment Framework.

6.2 A brief discussion ensued concerning the upcoming review of our own internal counter fraud arrangements against the new GovS13 standard in January 2024. The Board noted  an exercise is in progress to identify which areas are applicable to the organisation as an Arm’s Length Body. It was agreed by all that, as leaders for the sector, we should aspire to reach the highest rating in each standard.

6.3 Recent NHSCFA investigations have highlighted how, outside of regulated professions, there is no means of determining whether an NHS employee has been dismissed from a healthcare role unless it is self-disclosed. There was a conversation regarding this and the benefits of a data base / fraud register. SB noted that anyone dismissed for gross misconduct involving fraud is required to go on the Civil Service internal fraud register and consequently barred from applying for any position within the Civil Service for 5 years.

7. General update from NEDS

7.1 GH and AR attended the latest Cambridge Economic Crime Symposium. Focus this year was on integrity, both confirmed the sessions were interesting with substantial opportunities for networking.

8. Committee updates (Papers 2 & 3)

REMCO

8.1 AC confirmed ToR for REMCO have been updated to include the new Associate Director for People and Workforce Development (JB).

8.2 REMCO noted the continued development of the workforce data set. Further developments agreed going forward focus on the metrics relevant to vacancies, recruitment, retention and succession planning.

8.3 The Spotlight Survey results were reviewed and the cross-cutting themes arising discussed. Also discussed were the pros and cons of where to take this survey next year, including joining the NHS survey, looking for a bespoke option, etc. JB will lead on this piece of work.

8.4 The next REMCO meeting will be held in October.

ARAC

8.5 JS informed the last ARAC meeting on the 3rd July focused mainly on the year end. There was also a detailed look at the outstanding internal audit recommendations as the progress made over the last 12 months was not satisfactory; new processes have now been put in place which should resolve the issue. An update will be given at the next ARAC meeting in October.

8.6 The Board noted the minutes for the last ARAC and REMCO meetings.

Finance Update (Paper 4)

9.1 Paper taken as read. MJB noted a year-to-date underspend against budget predominantly due to the vacancies but highlighted that recruitment is now progressing at pace. MJB also highlighted that the forecast overspend is predominantly due to an increase in costs for software licences which has been noted across the sector.

10. Q1 Performance Report 2023-24 (Paper 5)

10.1 Paper was taken as read. TM briefly reviewed the report highlighting areas of importance. JS and TT praised the new format of the report.

TT invited questions or comments. In response to a question from KS regarding whether there was any plan to increase/decrease performance targets figures given the difference between the actual and trajectory amounts, TM, GC and AR all gave assurances and explained the work being done in this area to review expectations. TT added that these targets have been agreed with the DHSC and it was not expected to alter them. Other Board members concurred that maintaining integrity was important.

SB enquired how some of the baselines are established; TM clarified that existing data is used and where there is no data, we are working to establish the starting point.

10.2 In response to a query from GH concerning the wider reach of our Corporate Communication, particularly social media, Andrea Harper confirmed a new dashboard of performance indicators is being developed to support monthly performance reporting. Members requested this is shared at the November Board meeting to provide a wider overview of activity in progress.

Action 189: The Corporate Communications dashboard and a supporting report of overall communications activity to be tabled as an agenda item for the next Board meeting.

10.3 Following an observation from GH regarding real time exemption checking, a small discussion ensued with various contributions from RH, GC, AR and TM regarding activities

in this area. It was agreed that a more detailed discussion would be beneficial to understand the work in progress and expected outcomes. TT suggested a workshop approach, to be arranged either as a virtual meeting or following a Board meeting once the new NEDS are in post to explore these areas in more detail.

Action 190: SS to arrange either a virtual meeting or a meeting following a Board meeting to explore real time exemption checking activities and expected outcomes once the new NEDs are in post.  

11. Investigations Operational Report (Paper 6)

11.1 Paper taken as read. RR highlighted that, following the outcome of operation Bukowski, we were approached by the BBC Crimewatch programme asking to feature the investigation in their next series. Filming including interviews with the case senior investigators took place at the London office on 23rd August.

The report was praised by the Board. GH suggested a slight change in format by showing cases by type in Appendix A.

SB requested future reports to reflect the number of open and closed cases and how long cases have been opened for.

RR clarified various points raised by different attendees regarding the Band 3 Dental Claims for children, explaining why these were identified as outliers. He also clarified the

preventative measures taken. AR added that the purpose of the Data Analytics project is to be able to improve our capability to use data to identify potential fraud.

12. Update on key findings from the lessons learned review of the Evolution Project (verbal update)

12.1 NB provided background on how the lessons learned review process was undertaken and highlighted some of the accomplishments.

As a result of all the engagement activities, the key areas found to be in need of improvement were:

  • Resources and impact on resources
  • Structural design
  • Motivation / morale
  • Information shared – people were more interested in understanding the personal impact than the process itself
  • Staggered consultation (caused personal difficulties for some people)
  • Single points of failure – job description development, project management, etc
  • Governance boundaries

12.2 NB confirmed actions have already started to adopt some of the lessons learned from the evaluation process itself and from the recommendations made by the GIAA audit and provided examples.

It was agreed a formal paper will be presented at the next Board meeting for discussion.

13. Analytical tooling – procurement options and approval to procure (Paper 7)

13.1 Paper taken as read. GC emphasised this is very specific data analysis software and the preferred option is option 2 which has also been approved by BSA. AC stressed the importance to look for a provider with whom a long-term partnership can be successfully established.

Following the increase in costs for software licences mentioned earlier in the meeting, JS questioned the affordability issue. MJB gave assurances.

13.2 The Board was content to approve option 2.

14. Case Management System – procurement options and approval to procure update (Paper 8)

14.1 PT provided background on the uses of a case management system and summarised the commercial assessment. Both PT and TM mentioned the high level of support from the BSA team with the procurement options. Preferred option is option 2 - CCS Framework RM 6259.

There was a small discussion with GH and AF advising caution and suggesting that a phased approach might be beneficial. KS suggested flexibility on the renewal of current Clue contract (if contractual terms allow) to minimise the impact of the change. TM and MJB gave assurances that a variety of factors have been taking into consideration, legal advice has been sought and reviewed and a transition strategy considered if the outcome is to move to a new system.

14.2 The Board agreed for procurement to go ahead taking into consideration all the advice given regarding timings, the strength of the NHS name, etc and also not dismissing the old system before a definite new solution has been found.

15. Business Planning 2024-25 approach (Paper 9)

15.1 Paper taken as read. AC praised the paper and suggested flexibility in the approach as situations can change along the way. GH suggested caution with internal engagement approach so as not to overwhelm people. TM gave assurances.

15.2 The Board was happy to approve the approach and timeline to business planning 2024-25.

16. Performance Sub-Committee ToR discussion paper (Paper 10)

16.1 AS clarified the purpose and scope of the Performance & Finance Committee. TT shared his experience chairing a similar committee. The Board agreed to wait until there is enough capacity at Board, post NED recruitment to set this Committee up.

16.2 The new sub-committee was agreed in principle, subject to the new Chair and NEDs being in place. Comments from NEDs on duties and scope to be fed back to AS electronically.

17. PWD (HR) Strategy (Paper 11)

17.1 Board noted the paper. Following discussions earlier in the meeting, GH suggested integrity should be included/ referenced in the strategy. It was agreed for the paper to be reviewed at REMCO and presented at the next Board meeting for discussion.

18. ARA final amendments tracker (Paper 12)

18.1 Paper was noted (previously circulated by email).

19. Review of forward planner and meeting effectiveness

19.1 The next Board meeting is scheduled for the 20th November. It was agreed it would be held face-to-face in Cardiff as some of the attendees are also attending the 4 Nations Summit in the afternoon/ following day. It was also agreed for a holding date to be arranged for another Board meeting in the interim, before the 31st October, in the event that there is anything that requires Board input/approval prior to change in NEDS and to confirm the incoming NEDS

19.2 It was agreed by all that it had been an active and effective meeting with good discussions.