3.1 C&AG Audit Planning Memorandum
The Deputy Director of Audit C&AG provided the Committee with an update on the progress to date of the audit for the year ended 31 December 2023, noting that the audit had been impacted by the IFMS implementation delays and the Forsa work-to-rule. He advised the Committee that at this juncture the date for the release of the audit certificate has not yet been agreed but it was hoped that this would not slip beyond the end of May 2024.
The Committee noted and discussed the matters that may be included in the audit cert relating to Non-compliant procurement; Vaccines write-off; Storage Costs for PPE; High Earners and Patient Income.
The Deputy Director of Audit advised that the final decision on the audit opinion rests with the C&AG and therefore the matters to be included in the audit certificate will depend on his final review.
3.2 YTD Expenditure and 3.3 Health Budget Oversight Group (HBOG)
The Asst CFO provided a briefing to the Committee on the YTD Financial Position as at January 2024. The draft revenue I&E financial position shows a YTD deficit of €144.3m or 7.6%, which includes a net deficit of €153.7m in Acute Operations, €19.0m in Community and €0.9m in Pension and Demand Led areas which is slightly offset by a surplus of (€29.4m) in Other Operations / Support Services.
The Committee highlighted their concern that the insufficient information provided on the YTD financial condition at this stage in the year does not facilitate good financial governance. The Committee noted that this was due to the Fórsa industrial action which included the non-return of monthly financial data from local systems, and that since the end of the dispute in February, the Finance team have worked to complete the 4 month ends to close out 2023. This led to implications for the commencement of 2024 reporting , and the Asst CFO advised the Committee that the March 2024 Results with commentary will be available for the May 2024 meeting i.e. reporting is now substantially back up to-date.
The Asst CFO advised the Committee that there were no HBOG minutes to be presented, and that a meeting was held with HBOG on 9 April 2024. He advised there had been a robust discussion with regard to the draft HBOG minutes and had requested a redraft.
3.4 Update on Procurement Compliance (Progress of self-assessment of non-compliant procurement)
The ND Procurement presented a paper outlining the update with regard to the Procurement Compliance Self-Assessment returns for 2023 based on data received as of 21 February 2024.
It was outlined that 28,966 invoices (€1.584bn) were issued for assessment which exceeded the €25k threshold; 87% invoices were assessed and returned and 88% declared compliant.
The Committee noted that the compliance rate of 88% for invoices greater than €25k for 2023 showed a decrease from the previous year (2022) in both the compliance rate of returns (92%) and compliance rates (93%), and were provided with an explanation to the 5% difference in both invoices assessed and declared compliance.
The Committee noted that the engagement across the HSE notwithstanding the competing priorities and challenges during 2023 of IFMS introduction and the Fórsa industrial action, and that budget holders across the HSE continue to be educated with regard to the awareness of compliance obligations, which has the potential to translate into more nuanced and accurate selfassessments going forward.
3.6 Contract Approval Requests
The ND Procurement presented to the Committee the following Contract Approval Request (CAR).
- Single-Supplier Framework Contract(s) for the Supply of Cleaning and Paper Hygiene Products.
- Multi-Supplier Panels for the provision of short-term temporary and locum agency Health & Social Care Professionals and Health Care Assistants.
The Committee considered the detail of the proposed CARs and agreed to recommend to the Board for approval.
3.5 Agencies Oversight Agreements – Service Arrangements
The AND Compliance Unit presented to the Committee an update in relation to Agencies Oversight Agreements – Service Arrangements (SA), which are a key control in terms of the funding released to Agencies funded pursuant to Section 38 and Section 39 of the Health Act, 2004. He advised that the HSE currently funds in excess of 1,800 Agencies and in 2022 these Agencies received circa €6.3 Billion. Of these Agencies, 687 are funded through a SA and this accounts for 99% of the funding released in this manner.
The AND Compliance Unit outlined to the Committee the changes to the SA documentation for 2024, the process which commenced in 2023. He noted that the two key drivers of the change were the Dialogue Forum Working Group, which is to further enhance the co-operative approach between the HSE and Section 38 and Section 39 Voluntary Agencies; and the establishment of the Health Regions, where REOs or Lead REOs are now vested with a number of key authorities in the SA, and outlined the changes that have been made to the SA documentation for 2024.
The Committee discussed the issue of the increasing reluctance of Agencies to sign-up to a SA, noting that at the end of 2023 the completion level was 84% of the funding, which is an ongoing concern, in particular, in relation to some of the higher funded Agencies, citing underfunding as the main reason. The Committee stressed that it was unacceptable for Agencies to decline to sign the SA, and needs to be urgently addressed. The Committee welcomed the work each year by service managers in terms of attempting to get all SAs completed, and the work of the Dialogue Forum with voluntary bodies to improve the Agreement itself and noted the recently established Contract Management Support Units which are now playing an important role in terms of managing the relationship with Agencies at CHO-level.
It was agreed that a further update would be brought to the Committee later in the year, and that Service Arrangements be included on the Committee Workplan twice per year.