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CIPFA North West Audit, Risk and Governance Professional Development Group Warrington, November 2014 Health & Social Care Workshop
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Integrated Health & Social Care: View from a Chief Finance Officer / Deputy Chief Officer CCG View from a LA Assistant Director Auditing the Better Care Fund: Governance and risks Expected Controls Effective commissioning and outcomes Agenda
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Health & Social Care Workshop Workshop Objectives To understand why integration of health & social care is needed What we need to change What is the Better Care Fund Audit approach Governance and risks Effective programme management Network for future support
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Health & Social Care Workshop Why Integration? People are living longer, healthier lives but often living with several complex conditions that need constant care and attention People need more integrated and better co-ordinated care System of health and care is under more pressure than ever before
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Health & Social Care Workshop What do we need to change? Create a culture of co-operation Provide a seamless service focused on the individual within their own home Work to avoid crises which too often result in hospital admissions Embrace the potential of technology and shared information
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Health & Social Care Workshop What is the Better Care Fund? £3.8bn Better Care Fund announced by the Government in June 2013 To ensure a transformation – integration of health and social care. The Better Care Fund (BCF) is one of the most ambitious ever programmes across the NHS and Local Government. Creates a local single pooled budget to incentivise the NHS and local government to work more closely together
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Tom Jackson Chief Finance Officer/Deputy Chief Officer NHS Liverpool Clinical Commissioning Group Background and challenges - what does integration mean for Liverpool
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Simon Kenton Assistant Director Integrated Commissioning Warrington Clinical Commissioning Group /Warrington Council Implementing the better care initiatives and integration in Warrington
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Health & Social Care Workshop Group session: You are auditing the Better Care Fund, what do you consider are the key risks in terms of: Ensuring adequate governance arrangements are in place Health & Wellbeing Board and their discharge of statutory duties; BCF submission and engagement with relevant stakeholders Programme and project management arrangements Management Information Joint Funding Agreements - Section 75 Agreements
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Health & Social Care Workshop Key Risks Lack of adequate governance arrangements HWB fail to reflect the priorities and perspectives of all interested parties Insufficient local engagement means key priorities are not identified Lack of commitment to project strands and sign up by key stakeholders Programme and project risks are not identified, recorded or monitored Poor Data Quality Insufficient Management Information Information Governance – data sharing Poor financial management leading to project overspend and/or project failure
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Health & Social Care Workshop Group session: Having identified these key risks, what controls would you expect to see in place and how would you test them?
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Health & Social Care Workshop Types of Controls Effective governance structures Decisions subject to appropriate levels of approval Contractual arrangements and conditions Effective information governance arrangements including Data Sharing Protocols HWB appropriate TOR, membership, regular meetings BCF submission discussed and agreed by relevant parties, sign off and awareness of BCF submission Robust management information Robust project management arrangements Plans and exception reporting
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Health & Social Care Workshop Measuring Outcomes Purpose: Define objectives and measures and specify in contracts Monitoring and management information: relate monitoring to risk Define monitoring methods Data Capture / Data Sets / IT Reporting: publicise performance to stakeholders
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Health & Social Care Workshop Assurance: A focus for Health and Wellbeing Boards How are services delivered How well are they delivered How much change / effect did we produce Key Considerations: Information Governance Management Information and Data Quality
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Health & Social Care Workshop Further Details..…… www.england.nhs.uk www.local.gov.uk/health-wellbeing-and-adult-social-care
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Health & Social Care Workshop Contact details… Jean Gleave Chief Internal Auditor Warrington Council T: 01925 442 354 E: jgleave2@warrington.gov.ukjgleave2@warrington.gov.uk Steve Connor Commercial Director / Deputy Director Mersey Internal Audit Agency T: 0151 285 4511 E: steve.connor@miaa.nhs.uksteve.connor@miaa.nhs.uk
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