Methodology

Provides detail of the methodology and analysis used to assess NHS organisations’ financial governance, assurance and fraud risk management for the periods examined as part of the Covid-19 post event assurance exercise

The number and value of contracts that were directly awarded with extreme urgency (Covid-19 related) under PCR 2015 regulation 32(2)(c), as stipulated under PPN 01/20 and a full review of each contract directly awarded covering the following areas:

  • Supplier and contract details
  • Due diligence checks
  • Whether the provision of goods/services were received (on time and to standard)
  • Records maintained on the decisions and actions taken as stipulated by PCR 2015 and PPN 01/20.
  • ‘Direct award’ standards set by regulation PPN 01/20.

The NHSCFA project team undertook extensive stakeholder engagement to assist with design and development of the Covid-19 PEA, including the identification and access of available Covid-19 financial data and information. Some of the stakeholders we engaged with include:

  • NHS England and NHS Improvement
  • Cabinet Office – PEA Covid-19 Counter Fraud Response Team
  • Cabinet Office – Crown Commercial Team
  • NHS Procurement Leads.

In addition to the above discussions with stakeholders, the project team also hosted two workshops and webinars with LCFSs. The subsequent engagement resulted in the development of a question set for post event assurance based on the PPN guidance.

All NHS provider organisations in England and Wales were written to, advising of the exercise and their expected participation, as covered by the NHS Standard Contract in England, and supported by the Welsh Counter Fraud Steering Group .

The role of the Counter Fraud Steering Group is to provide strategic oversight and review of theCounter Fraud Service provided to NHS Wales. It will make recommendations for change to Welsh Government and to the NHS Wales Director of Finance Group for adoption.

The national exercise sought to provide assurance on NHS spend during the pandemic by testing the areas covered by four PPNs. The exercise also aimed to identify any associated fraud risks and actual fraud. The exercise ran between Jun – Aug 2021. The findings are explained in detail in the main body of this report.

NHSCFA also produced guidance for NHS organisations on completing the exercise and submitting their returns via its Data Capture System.

Conclusions are drawn from self-reported data by the LCFSs / local NHS organisation. Findings in this report were peer reviewed by NHSCFA’s Data Strategy Group.

NHSCFA’s Data Strategy Group provides assurance to the Executive Management Team and the Board. It acts as a conduit for the measuring and application of quantifiable findings for data exercises within NHSCFA at point of commencement and conclusion ensuring there is consistency in terms of how the related metrics are applied, utilised, and recorded.

The methodology of savings attributed to the Contract Risk Management section of this report complies with the methodology applied by DHSC AntiFraud Unit in reporting savings to Government Counter Fraud Function (Cabinet Office).

Response rates

219 NHS (provider) organisations in England and 10 NHS (Welsh Health Board) organisations in Wales were invited to participate in the Covid-19 PEA. There was an 91% response rate comprising the following respondents:

  • 200 NHS organisations in England
  • 10 NHS organisations in Wales.

What questions were asked

LCFSs will require input from their procurement and/or finance teams in the completion of this exercise as well as the potential involvement of their internal audit team to support this work.

Contract cancellations

NHSCFA asked questions around new suppliers that were in the process of being onboarded, but had contracts cancelled and/or payments clawed back due to identified risk (following information relating to suspicious financial transactions and/or concerns around company liquidity and activities).

A full review of each supplier identified was conducted by the NHS organisation’s LCFS covering the following areas:

  • Supplier and contract details
  • Circumstances around the identified risk.

Direct award of contracts

NHSCFA asked NHS organisations the number and value of contracts that were directly awarded with extreme urgency (COVID-19 related) under PCR 2015 regulation 32(2)(c), as stipulated under PPN 01/20.

A full review of each contract directly awarded was conducted by the NHS Organisation’s LCFS covering the following areas:

  • Supplier and contract details
  • Due diligence checks
  • Whether the provision of goods/services were received (on time and to standard)
  • Records maintained on the decisions and actions taken as stipulated by Public Contracts Regulation 2015 and PPN 01/20.
  • ‘Direct award’ standards set by regulation PPN 01/20.

Supplier relief payments

The NHSCFA asked NHS organisations, in relation to the period between 20 March and 30 June 2020, the number and value of ‘at risk’ suppliers that they continued to pay as normal when service delivery was disrupted or suspended. These arrangements and a definition of ‘at risk’ are contained within PPN 02/20.

A full review of each supplier where ‘supplier relief’ payments were made was conducted by the NHS Organisation’s LCFS covering the following areas:

  • Supplier and contract details
  • Supplier relief payments
  • Whether records were maintained on the decisions and actions taken as stipulated by PPN 02/20.

The NHSCFA also asked questions around unsuccessful ‘supplier relief’ applications by suppliers.

A full review of each unsuccessful ‘supplier relief’ application was conducted by the NHS organisation’s LCFS covering the following areas:

  • Supplier and contract details
  • Circumstances around the refusal of ‘supplier relief’.

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