Date: 20/02/23
Meeting time 09:30 – 12:00
Meeting title: NHSCFA Board Meeting (Hybrid)
Members:
- (JS) Jayne Scott (Non-Executive Director – Chair, NHSCFA)
- (GH) Gaon Hart (Non-Executive Director, NHSCFA)
- (MS) Martin Spencer (Non-Executive Director, NHSCFA)
- (AF) Andrew Flanagan (Non-Executive Director, NHSCFA)
- (AC) Alyson Coates (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)
- (RR) Richard Rippin (Head of Operations, NHSCFA) for paper 5
- (RH) Richard Hampton (Head of Intelligence & Fraud Prevention, NHSCFA)
- (GC) George Cooke (Performance, Analytics & Improvement PMO Manager, NHSCFA)
- (NB) Nicola Burton (Head of Transformation & Change, NHSCFA)
- (KB) Karen Bonham (Finance & Governance Support Lead, NHSCFA)
- (KS) Kathryn Strachan (Board Apprentice, NHSCFA)
- (SS) Sonia Sousa (Governance & Assurance Assistant, NHSCFA) note taker
Observers:
- (JG) Joe Gregory (Senior Corporate Communications Officer, NHSCFA)
Welcome
JS welcomed all to the meeting and informed the Chair of the Board (Tom Taylor) could not attend due to unforeseen circumstances. Everyone introduced themselves briefly and greeted Kathryn Strachan, the new Board apprentice.
Apologies
Apologies were received from Tom Taylor and Ann Sturgess.
Declarations of interest
There were no new declarations of interest.
Minutes of Board Meeting 10-11-22
The Board agreed the minutes as a true and accurate record.
Action log
The Board reviewed the action log:
Action Point 147 & 165, RH to circulate paper (by email) to the Board on outcome of activities undertaken by local health bodies before next Board meeting on 20.02-23, add to agenda to note – RH will circulate report offline w/c 27th February
Action Point 166, SB to continue to pursue opportunities to meet with Lord Markham – SB confirmed this is in progress – to be carried forward
Action Point 167, RH to forward information released on Covid-19 enquiry Module 3 (for information purposes only) – Link circulated, action closed.
Action Point 168, TT requested thoughts on opportunities to recognise staff. AR informed he has had a discussion with SB regarding financial awards but that is not possible. However, the Comms team introduced the Star of the Month initiative which aims to recognise those who have made contributions against a different category at the beginning of each month.
Action Point 169, Detailed paper on Evolution to be presented at the next Board meeting in February 2023 (to include issues raised in the Board Workshop to be held in January 2023) - addressed by agenda item 6
Action Point 170, GH and RR to meet in order to discuss/ review specific retention periods – GH informed this is ongoing and an email exchange has happened.
General update from the CEO
AR informed the meeting he had the opportunity of a sneak preview of the Home Office Fraud Strategy which is based on 3 main pillars and will be published imminently:
- Pursuing Fraud
- Blocking Fraud
- Empowering Victims
Regarding the general NHS position, AR mentioned the ALB’s CEO’s brief by Lord Markham which referred to the bad winter performance results caused by strike action, high levels of sickness, elevated leaving rates and high number of vacancies, in addition to the normal winter pressures. Lord Markham is focusing on improving these results by the end of next financial year, with some of the tactics mentioned being reshaping, recycling and resizing.
In terms of efficiency savings, AR is hopeful we can leverage access to PSFA’s data platform (a cross government data base for procurement, etc). Some work is also in progress in order to develop partnerships with key stakeholders like BSA and NHS England to allow more data collection thus making significant savings.
AR also mentioned the possibility of access to some additional funding as early as next year which SB confirmed noting it needs to be signed off by the Treasury.
A small discussion ensued with the Board members advising caution and expressing some reservations which were promptly clarified by AR and MJB. JS summarized by concluding there are some good opportunities but also risks and practical difficulties, especially in light of the ongoing evolution programme.
General update from NEDs
GH alerted the meeting to the new government bill which will dramatically change the way fraud is perceived within organisations and noted it will be necessary to have appropriate policies in place. GH also mentioned an interview with the ICA (International Compliance Association) which was good in terms of promoting CFA and the Online Safety Bill.
AC alerted for added pressures in the system with not having enough staff or sometimes staff who are not qualified which increases fraud risk.
Committee Updates (Papers 1 & 2)
JS introduced the 2 reports discussed during the exceptional ARAC meeting on the 9th February: Processing Reported Fraud (limited assurance rating) and HR Strategy (unsatisfactory assurance rating). ARAC is satisfied that, in both cases, recommendations made are being followed up as a matter of urgency and timescales were agreed for ARAC to receive detailed updates from management on these. Also discussed in the same meeting were the wider implications of both reviews, particularly that managing business as usual alongside the implementation of the Evolution programme is starting to show signs of strain.
A paper was produced so the Board is aware of the ARAC concerns, in particular the lack of management capacity – AR noted an Associate HR director is being recruited. Recruitment is also a big challenge – AR recognises the Evolution Project drained a lot of resources but noted the process is coming to a close.
AR mentioned the Exec team has been working towards developing a performance focused culture and trying to implement processes that give the small team more flexibility. To that end an Executive Finance & Performance Committee will eventually be created, composed by the Exec team and a Board member.
Action point 171 SS to organise a Performance Management Framework meeting with all Board members and SMT.
Minutes for the ARAC held on the 5th December 2022 were approved. JS informed AF will take over as chair of the ARAC once her term comes to an end in October.
MS started the REMCO update by informing that, similarly, AC will be taking over as chair of the remuneration committee. He proceeded by informing Lee Vincent attended the last meeting to cover discussions on the following areas:
- making sure there is an HR strategy in place
- challenges related to the amount of work resulting from the HR side of the Evolution programme
- recruitment challenges
REMCO also discussed the last workforce data report which clearly shows a retirement cliff edge – this will add to the already existing recruitment challenge. REMCO will continue to review the data and report back to the Board on significant items or trends. AC noted a lot can be learned from clinical workforce management on the NHS like phased retirement, flexible working, etc. AC also noted the importance of retaining knowledge and expertise.
Finance update (Paper 3)
Paper taken as read. MJB reported a similar position as previously with an underspend against the budget. This significant underspend is predominantly due to the planned management of vacancies as the evolution programme is delivered and recruitment made according to the new operating model – recruitment to date, although successful, has been mainly internal which carries no costs.
In terms of capital, a very small overspend is reported due to the increase in costs for the DFU on-premise solution. However, there is still a risk of non-delivery (before the end of the financial year) of required hardware, due to the global supply issues around IT equipment. This situation will cause cost pressures on next year’s budget.
DFU hardware expenditure will need full Board approval and two small direct tender awards in year will also need retrospective Board approval. MJB to circulate a paper offline for that purpose.
GH questioned the lack of budgeting for temporary staff and professional memberships. MJB stated that historically, we never had the latter.
Q3 Performance Report (Paper 4)
Paper taken as read. GC briefly summarised the quarterly position. AF advised caution with the projections for the next 3 years. TM gave a detailed explanation on the sources of revenue which will allow us to reach our targets, stressing collaborative work is of the utmost importance. JS asked that future reports clearly distinguish between values that are within or outside CFA control.
Action point 172 TM to ensure future Performance reports clearly distinguish between values that are within or outside CFA control.
Some of the RAG ratings were queried by the Board. RH, TM and AR confirmed metrics are being reviewed/ worked on to improve the accuracy of the numbers. AR also highlighted that when other organisations don’t see as a priority to help us, it prevents our progress.
Operations (investigations) report (Paper 5)
Paper was taken as read. Regarding Operation Rupture, RR informed the meeting the subject had been found guilty on all charges and will be sentenced in two weeks. This was a Cumbria police led investigation and they requested the proactive publicity to be focused on the sentencing which CFA has agreed to.
Despite on-going trial delays, Operation Bukowski seems to be going the way we anticipated however, the final decision is up to the jury. The trial should conclude in the next two weeks.
GH requested some additional content to be added to the reports going forward in terms of case load comparison with last year, etc. RR agreed that some more information would be useful.
Action point 173 Some additional content in terms of case load comparison, etc. to be added to the Operations report going forward.
Evolution update (Papers 6 & 6a)
MBJ gave a brief introduction in terms of context and informed there are only 2 consultations still to be completed. MJB also clarified that the purpose of the paper was to ask for formal endorsement of the proposed new structure.
AS queried if the plan is realistic in terms of the recruitment deadline. MJB replied that the external recruitment has attracted more interest than usual, and management is hopeful all the roles will have been fulfilled within 3 to 6 months’ time. A discussion ensued and the Board advised caution on several points which were noted by the Exec team.
The paper was noted. The Board felt the detail could not be approved as the structure is fluid until the implementation process has occurred.
Strategy 2023-26 (Papers 7 & 7a) and Business Plan (Papers 8 & 8a)
Papers were taken as read. Both subjects have been heavily discussed previously so JS invited comments from the Board Members. GH made some observations regarding terminology. AF suggested some clarification was needed regarding the connection between the organisation structure and the Business Plan in terms of where responsibilities lie. JS suggested a look (online) at the Coal Authority Strategy and Business Plan as it is quite well structured.
AR confirmed the vision agreed was “Working together to understand, find and prevent fraud, bribery and corruption in the NHS”.
The Board formally approved the documents subject to AR and TT’s approval of any final changes.
Forward Planner (Paper 9)
The forward planner was reviewed, and a few points added.
Review of the effectiveness of the meeting
It was agreed by all that the meeting had been conducted effectively and all the items on the agenda were covered.
AOB
AR mentioned the internal staff conference on the 21st March in London as well as the Fraud Conference in May. The latter is an event hosted by Govnet.
Action point 174 SS to coordinate Board Members’ attendance to the Fraud Conference 2023.
SB confirmed the appointment of the new Board chair and extensions of the NED’s terms are being pursued by the Department and still pending ministerial approval.