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Health and social care integration: finance guidance

Guidance on financial matters relating to health and social care integration, for the assistance of health boards and local authorities.

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2 Assurance

2.1 Financial assurance

2.1.1 Role of Directors of Finance

Who are the officers that are accountable for the financial governance in the Local Authority and Health Board?

2.1.1.1 The accountable officer for financial management is different between Health Boards and Local Authorities. Within Health Boards the Chief Executive is the accountable officer and is responsible for financial stewardship and governance. Within Local Authorities the accountable officer for financial governance is the Section 95 Officer; usually the Director of Finance, Head of Finance, or a chief officer with a recognised accountancy qualification.

Who will be the accountable officer for financial management?

2.1.1.2 The accountable officer will not change in a lead agency arrangement (although there will be financial accountability for new services) and will be the existing officer in the host authority. The accountable officer of the delegating partner discharges their accountability in respect of the delegated resources through the provisions of the Integration Scheme.

Will the host partner governance arrangements change?

2.1.1.3 Yes. It is recommended that the governance arrangements are revised to include the areas specified under the Integration Scheme. This should include extending the annual governance statement to include reporting on the delegated services. Also, where required, assurances should be provided to the delegating authority.

Will the Directors of Finance of the Health Board and Local Authority be members of the integration joint monitoring committee?

2.1.1.4 Yes; regulations require that the Director of Finance of the host partner is a member of the integration joint monitoring committee; they also permit the integration joint monitoring committee to appoint additional members as it sees fit and it is recommended that the Finance Director from the delegating partner is also appointed.

2.1.2 Financial regulations

What financial regulations will be used?

2.1.2.1 The financial regulations, amended to include the integration arrangements, of the host partner should be used under this model. They should be reviewed and approved following the existing procedures for update.

2.2 Risk management

2.2.1 The risk management arrangements of the host partner should be used and it is recommended that they are updated to reflect the revised risk profile associated with the delegated functions according to the established procedures. The host partner should provide regular reports for assurance and scrutiny purposes to the appropriate committee within the host authority and also to the joint committee.

2.2.2 It is recommended that the delegating partner reviews and amends their own risk management arrangements to include any residual risks they consider to have retained on implementation of the integration arrangements.

What risks should be considered in developing the Integration Scheme?

2.2.3 Regulations require that the Integration Scheme sets out the risk management arrangements for the integration functions. The host partner's existing risk management arrangements should apply to the delegated functions.

2.3 Insurance

2.3.1 The host partner should make appropriate provision for insurance according to the risk management strategy. The Act (Section 65(2)(b)) enables, but does not require Local Authorities to become members of CNORIS; Health Boards will remain mandatory members of the scheme.

2.3.2 Additional information on liability and insurance is included in the statutory guidance on the establishment and operation of Integration Joint Monitoring Committees.

Will the scheme cover all insurable risks?

2.3.3 No. The scheme currently covers Health Boards for:

  • Clinical negligence claims and actions which arise in connection with the acts and omissions of their employees; and
  • Non-clinical claims and actions which arise following loss or bodily injury affecting third parties or employees or certain other pecuniary risks

2.3.4 The Act widens the scope of the scheme (Section 65(3)) to include social care functions but does not extend to other functions in the Local Authority, for example, housing services. Further information on the scope of functions within CNORIS can be obtained from the Scottish Government Health Directorate.

How will the payments to the scheme be calculated?

2.3.5 Members make payments towards the accumulated cost of paying the agreed claims for each financial year based on the assessed risk of the functions which they bring to the scheme. The contribution is calculated annually, with the claims initially being funded by the Scottish Government Health and Social Care Directorate.

Will there be a threshold for paying claims by the scheme?

2.3.5 Yes. Under current arrangements, scheme members are required to meet claims of £25,000 or under from their own budgets. Further information may be found here.

2.4 Internal audit

2.4.1 The assurance and control systems of the host partner will apply to the delegated resources.

Who will provide the internal audit service?

2.4.2 It is recommended that the host partner should review and revise the scope of the existing internal audit arrangements to include the delegated functions. The delegating partners internal audit team should provide information to the host partner as required to develop the arrangements.

Will there be an audit plan for the Integration Authority?

2.4.3 No the internal audit plan of the host partner will be revised to include the new delegated services.

How will the Chief Internal Auditor report on the integration arrangements?

2.4.4 The Chief Internal Auditor will report on the integration arrangements to the Chief Executive of the host authority and the relevant committee in line with agreed governance arrangements of the host partner. Also it is recommended that the Chief Internal Auditor should report to the integration joint monitoring committee on those parts of the internal audit plan relevant to the integration arrangements. The Chief Internal Auditor should also present an annual report to the integration joint monitoring committee.

2.5 External audit

Who will carry out the external audit of the partnership?

2.5.1 The external auditor of the host partner will be responsible for the audit of the delegated services as part of the statutory audit of the authority.

2.6 Following the public pound

2.6.1 Current guidance for Local Authorities[22] where funding is provided by one partner to another to deliver services which would otherwise be provided by the funder, requires arrangements to be in place to maintain control and accountability over the public funds. This applies to the resources delegated to the host partner. The best practice principles are set out in the Code of Guidance on Funding External Bodies and Following the Public Pound[25] should be incorporated into the Integration Scheme (see 1.3.1) to allow the accountable officer of the delegating partner to discharge this duty.

Contact

Email: hscintegration@gov.scot

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