Annual Accounts
2013/14
Manor Hospital Moat Road Walsall West Midlands WS2 9PS 01922 721172 www.walsallhealthcare.nhs.uk Grant Thornton UK LLP 20 Colmore Circus Colmore Plaza Birmingham B4 6AT 4th June 2014 Dear Sirs
Walsall Healthcare NHS Trust
Financial Statements for the year ended 31 March 2014
This representation letter is provided in connection with the audit of the financial statements of Walsall Healthcare NHS Trust for the year ended 31 March 2014 for the purpose of expressing an opinion as to whether the financial statements give a true and fair view in accordance with International Financial Reporting Standards and the accounting policies directed by the Secretary of State with the consent of the Treasury as relevant to the National Health Service in England.
We confirm that to the best of our knowledge and belief having made such inquiries as we considered necessary for the purpose of appropriately informing ourselves:
Financial Statements
i We acknowledge, as Trust Board members our responsibilities under the National
Health Services Act 2006 for preparing financial statements which give a true and fair view and for making accurate representation to you.
ii We acknowledge our responsibility for the design, implementation and
maintenance of internal control to prevent and detect fraud.
iii We have made sufficient enquiries and analysis to support our assertion that the Trust is a going concern.
iv We are satisfied that the provisions in the financial statements are complete to the best of our knowledge and that there are no contract fines due from
underperformance that have not already been accounted for.
v Significant assumptions used by us in making accounting estimates, including
those measured at fair value, are reasonable.
vi Related party relationships and transactions have been appropriately accounted
for and disclosed in accordance with the requirements of International Financial Reporting Standards and the Manual for Accounts.
vii All events subsequent to the date of the financial statements and for which
International Financial Reporting Standards and the Manual for Accounts requires adjustment or disclosure have been adjusted or disclosed.
viii We have not adjusted the misstatements brought to our attention in the Audit Findings report, which are considered to be immaterial to the results of the Trust and its financial position at the year-end. The financial statements are free of material misstatements, including omissions.
ix In calculating the amount of income to be recognized in the accounts from the NHS organisations we have applied judgement, where appropriate, to reflect the appropriate amount of income expected to be received by the Trust in accordance with the Accounting Standards and Manual for Accounts.
x We acknowledge our responsibility to participate in the Department of Health's agreement of balances exercise and have followed the requisite guidance and directions to do so. We are satisfied that the balances calculated for the Trust ensure the financial statements and consolidation schedules are free from material misstatement, including the impact of any disagreements.
xi We have reviewed the accounting treatment with regard to the release of the redundancy provision. We are satisfied that the accounting treatment is
appropriate and that the release of the redundancy provision should not be treated as a priori period adjustment.
Information Provided
xii We have provided you with:
a. access to all information of which we are aware that is relevant to the preparation of the financial statements such as records, documentation and other matters;
b. additional information that you have requested from us for the purpose of your audit; and
c. unrestricted access to persons within the Trust from whom you determined it necessary to obtain audit evidence.
xiii All transactions have been recorded in the accounting records and are reflected in the financial statements.
xiv We have disclosed to you the results of our assessment of the risk that the financial statements may be materially misstated as a result of fraud.
xv We have disclosed to you all information in relation to fraud or suspected fraud that we are aware of and that affects the Trust and involves:
a. management;
b. employees who have significant roles in internal control; or
c. others where the fraud could have a material effect on the financial statements.
xvi We have disclosed to you all information in relation to allegations of fraud, or suspected fraud, affecting the Trust's financial statements communicated by employees, former employees, regulators or others.
xvii We have disclosed to you all known instances of non-compliance or suspected non-compliance with laws and regulations whose effects should be considered when preparing financial statements.
xviii We have disclosed to you the entity of the Trust's related parties and all the related party relationships and transactions of which we are aware.
Annual Report
xix The disclosures within the Annual Report fairly reflect our understanding if the Trust's financial and operating performance over the period covered by the financial statements.
Annual Governance Statement
xx The Trust has complied with all aspects of contractual agreements that could have a material effect on the financial statements in the event of non-compliance.
There has been no non-compliance with requirements of the Care Quality
Commission or other regulatory authorities that could have a material effect on the financial statements in the event of non-compliance.
xxi We are satisfied that the Annual Governance Statement (AGS) fairly reflects the Trust's risk assurance framework and we confirm that we are not aware of any significant risks that are not disclosed within the AGS.
Approval
The approval of this letter of representation was minuted by the Trust's Audit Committee at its meeting on 4 June 2014.
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Annual Governance Statement 2013/14
1. Scope of responsibility
As Accounting Officer, I have responsibility for maintaining a sound system of internal control that supports the achievements of the Trust’s policies, aims and objectives, whilst safeguarding the public funds and departmental assets for which I am personally responsible, in accordance with the responsibilities assigned to me. I am also responsible for ensuring that the Trust is administered prudently and
economically and that resources are applied efficiently and effectively. This Annual Governance Statement acknowledges these responsibilities together with my responsibilities as set out in the Accounting Officer Memorandum.
Purpose of the system of internal control
The risk management framework and underpinning system of internal control within Walsall Healthcare NHS Trust is designed to manage risk to a reasonable level rather than to eliminate all risk of failure to achieve policies, aims and objectives; it can therefore only provide reasonable and not absolute assurance of effectiveness. The system of internal control is based on an on-going process designed to: Identify and prioritise the risks to the achievement of the organisation’s policies, aims and objectives; Evaluate the likelihood of those risks being realised and the impact should they be realised, and to manage them efficiently, effectively and
economically.
The system of internal control has been in place in Walsall Healthcare NHS Trust for the year ended 31 March 2014 and up to the date of approval of the Annual Report and Accounts.
Working Relationships with stakeholders
I have a duty of partnership to discharge and therefore work collaboratively with other partner organisations across the region including neighbouring hospitals, our commissioners, GPs and the local authority. During the year 2013/14, good links continued with the National Trust Development Authority through a range of forums including the Chair and Chief Executive’s meetings, Medical Director Forum, Director of Nursing Forum and the Director of Finance Forum.
A good relationship exists with the Walsall Overview and Scrutiny Committee. Both I and a number of nominated Directors have attended formal meetings of the
Committee throughout the year.
Our strong relationship with the Walsall Clinical Commissioning Group continued to develop in 2013/14. Clinical links with GPs have also developed further through the Joint Clinical Forum enabling strong relationships to be built between Trust Medical
Personnel and GPs.
With regard to the Trust’s NHS Foundation Trust application, the Trust is a member of the NHS Foundation Trust Network at both national and regional levels. The Trust has been fully engaged with the NTDA and all stakeholders, including staff side and Commissioners with the Foundation Trust application. The Trust is currently awaiting a Care Quality Commission Chief Inspector of Hospitals Inspection which will then determine the future timeline for NHS Foundation Trust authorisation.
A full range of activities and engagements have also been developed with patients, the public and staff which includes the Walsall Healthwatch, the Community Leaders Forum, the shadow Foundation Trust membership and MyNHS Walsall Parliament. The ‘In Your Shoes’ component of the organisational development programme ‘For One and All’ has also helped to forge closer working relationships with staff and the public.
2. The Governance Framework of the Organisation
Considerable work to assess and improve Board governance took place in 2012/13. This included a complete review of all of the Board governance structures including a review of the roles, terms of reference and membership of the Board and its
delegated sub-Committees. The review was part of a wider Board Development Programme and Board Governance review supported by Deloitte. The review has delivered:
A Committee structure aligned to latest best practice models;
Reduced duplication of information was amongst Committees and the Board;
An increased focus on the strategic capacity of the Board;
Speedy and timely reporting to the Board;
Enhanced integrated performance reporting to further support effective
decision making.
During 2013/14 we have continued to embed this governance model within the Trust with positive outputs.
Trust Board
Governance Model in operation from July 2012
Quality and Safety Committee Audit Committee Performance, Finance and Investment Committee Nomination and Remuneration Committee
The Audit Committee
Chaired by Mr Robin Cooke (Non-Executive Director)
Purpose:
Considers the annual plans and reports of both the external and internal
auditors
Provides an overview and advises the Board of Directors on the internal
control arrangements put in place by the Board of Directors;
Acts as the co-ordinator of all support documentation in relation to assurance
to the Chief Executive for the sign-off of the Annual Governance Statement; Reviews all matters of internal control;
Liaises with the Quality and Safety as appropriate, particularly in relation to aspects of risk, quality governance, clinical governance and corporate governance;
After due process of review, recommends the Annual Accounts to the Board
of Directors.
Membership:
Three Non-Executive Directors inc the Non-Executive Director chair
Meeting frequency:
At least bi-monthly
Reports to: Trust Board
The Quality and Safety Committee
Chaired by Mr Guy McEvoy (Non-Executive Director)
Purpose:
To ensure that quality is embedded in the Trust’s overall strategy;
To ensure that patient safety and quality are embedded throughout the
organisation;
To ensure that a culture of quality governance and learning is evident
throughout the organisation;
To ensure that there are controls in place to minimise the organisation’s
exposure to risk and to ensure that risks are managed within the framework agreed by the Board of Directors;
To ensure that risks to achieving corporate objectives are monitored via the
Board Assurance Framework and Corporate Risk Register;
To ensure that quality outcomes are discussed in detail on a monthly basis.
Membership:
Three Non-Executive Directors inc the Non-Executive Chair All Executive Directors
Reports to: Audit Committee and Trust Board
The Performance, Finance and Investment Committee
Chaired by Mr Nigel Summers CBE, (Vice Chair of the Trust Board)
Purpose:
The Committee takes actions or makes recommendations to the Trust Board on the basis of reviewing the following areas of the Trust’s work:
Sets quality, financial, activity and workforce plans over the short, medium
and long term. This will include annual quality, financial, activity and workforce targets (including revenue and capital budgets) that need to be approved by the Trust Board on an annual basis prior to the start of the financial year; Monitors in-year performance against the quality, financial, activity and
workforce targets agreed by the Trust Board, discussing and agreeing corrective action where necessary. This will include cost improvement and other productivity improvement programmes;
Monitors the financial and performance implications of externally driven new
legislation, performance targets and guidance impacting the Trust;
Ensuring that the Trust has a coherent financial strategy that is aligned to the Trust’s overall strategic direction and objectives;
Ensures that the Trust’s financial performance is in line with the agreed
annual plan;
Reviews all financial related risks and proposed mitigation plans;
Receives all business cases for investment with a value in excess of £25,000;
Considers and monitors the delivery of cost improvement plans;
Receives and considers post project evaluation reports in relation to the
effectiveness of investment decisions.
Membership:
Three Non-Executive Directors inc the Non-executive Chair All Executive Directors
Meeting frequency: Monthly
Reports to: Trust Board
The Board Nomination and Remuneration Committee
Chaired by Mr Ben Reid OBE, Chair of the Trust Board
Purpose:
To set the remuneration and conditions of Directors within the Trust;
To review the performance of Directors within the Trust;
To determine the contractual arrangements for Executive Directors and the
calculation and scrutiny of any termination payments.
Membership:
Chief Executive and Director of Human Resources (in attendance only)
Meeting frequency: Annually (or more frequently if required)
Reports to: Trust Board
An overview of the coverage of the work of the delegated Committees to the Board is outlined above.
All Committees of the Trust Board are chaired by Non-executive Directors to reflect the need for independence and objectivity, ensuring that effective governance and controls are in place. This structure ensures that the performance of the organisation is fully scrutinised. Attendance at the Board and its Sub-Committees is monitored by the Director of Governance and Trust Secretary. During 2013/14 we have seen positive attendance levels across our Board and Committee Structure. Attendance levels are attached at Appendix A.
The Executive Management Team has a robust governance structure ensuring monitoring and control of the efficient and effective use of the Trust’s resources. Financial monitoring, service performance, quality and workforce information is scrutinised through the following governance structure as demonstrated in Figure 2 below:
Trust Board of Directors
Quality and Safety Committee Audit Committee Performance, Finance and Investment Committee Board Nomination and Remuneration Committee Divisional Quality Teams Trustwide Governance Groups/ Committees Trust Management Board Executive Performance and Finance Committee Care Group Quality Teams
Performance of the Board
The Board undertook a review of its performance as Directors through both 1:1 personal appraisal systems and through a 360 degree appraisal process. A detailed review of the capacity, capability and effectiveness of the Board was undertaken during the previous year which included Board Impact Survey results, third-party board and committee observations, third-party interviews with Board and Committee Members and discussions with wider staff. This exercise will be repeated in 2014/15, In addition, the Trust completed the Board Governance Assurance Framework Self-Assessment and received a third-party report validating this assessment in October
2012. During 2013/14 much work has taken place to implement the
recommendations arising from this review. Personal Development Plans actions were agreed for all Board Members and a Board Development Programme
continues to be deployed with sessions taking place on a monthly basis throughout 2013/14. During the year, the programme has included sessions on Finance and Long Term Financial Modelling, Integration, Risk Management, Safeguarding, the NHS Healthy Board Principles and the Francis Inquiry.
During the year, the Board has seen a small level of turnover, with two new Non-Executive Directors joining the Board (replacing former vacancies created by the 2012/13 resignations of Professor Philip Begg and Mr Stuart Gray) and the
appointment of Mr Ian Baines as Executive Director of Finance and Performance.
Highlights of Board Committee Reports
A notable highlight from the Audit Committee (a Sub-Committee of the Board) was that the Trust received the Annual Report to those charged with Governance for 2012/13, produced by the Trust’s External Auditors and presented to the Audit Committee.
In the report the Trust received a clean bill of health regarding the submission of the 2012/13 financial statements, with no adjustments required to be made to the
reported financial performance from draft to final audited Accounts submission to the Department of Health.
In addition, the Code of Audit Practice 2010 (the Code) describes the Trust’s responsibilities to put in place proper arrangements to:
Secure economy, efficiency and effectiveness in its use of resources;
Ensure proper stewardship and governance;
Review regularly the adequacy and effectiveness of these arrangements.
I am pleased to report that, based on our External Auditors review of the Trust’s arrangements, an unqualified conclusion was received by the Trust (representing a further ‘clean bill of health’ opinion).
The Trust’s Internal Auditors also issued their Head of Internal Audit Opinion to the Audit Committee, confirming that significant assurance can be given that there is a generally sound system of internal control designed to meet the organisation’s objectives, and that controls are generally being applied consistently.
Duties of Corporate Governance
During the year the Board has complied with the Corporate Governance Code, consistently delivering the public service values of accountability, probity and
openness. Board members receive regular updates regarding these responsibilities and the need to maintain an awareness of the Nolan Principles of good governance. The Board’s commitment to uphold the Nolan Principles and Board Code of Conduct were confirmed in public in 2013/14.
Staff throughout the organisation are made aware of their responsibility to maintain high standards of conduct and accountability through the Code of Business Conduct and supplementary key policies such as the Bribery Act Policy. In support of good
governance, and to address issues around the safekeeping and appropriate use of public funds, the Trust also maintains a proactive programme of counter-fraud and a ‘whistle-blowing’ policy. Counter-fraud forms a standing item at Audit Committee meetings.
Quality Governance
The Trust has an externally assessed score of 3.5 against the Monitor Quality Governance Framework. Throughout 2013/14, work has taken place to further strengthen quality governance and has included a refresh of the Trust’s Quality and Safety Strategy to reflect recommendations arising from the Francis Inquiry. A detailed improvement plan arising from the recommendations of Hard Truths has also been developed and is in the stages of implementation. Particular
improvements gained in 2013/14 have included:-
The appointment of a clinical Non-executive Director on the Trust Board. Dr
Jonathan Shapiro has been a member of the Quality and Safety Committee since joining the Board and will assume chairmanship of the Committee from April 2014
The development of enhanced peer quality audits
The review and ratification of the Risk Management Strategy by the Trust
Board
The application of category 6 risk classification in the Care Quality Commission Intelligent Monitoring Report
The removal of a minor concern relating to Care Quality Commission
Outcome 21, with full compliance being awarded to this outcome A reduction in the number of patients falling in the Trust
A reduction in the number of patients developing pressure ulcers within the
Trust
A reduction in Hospital Standardised Mortality Levels
The inclusion of Quality Governance Training on the Trust Leadership
Programme
The continuation of Patient Stories in the Board Room
The Directors are required under the Health Act 2009 and the National Health Service (Quality Accounts) Regulations 2010 to prepare Quality Accounts for each financial year. The Department of Health has issued guidance to NHS Trusts on the form and content of the Annual Quality Account.
The Trust’s Quality Account for 2012/13 was formally audited by Grant Thornton and received by the Audit Committee and the Trust Board. The Account told a generally positive story of quality improvement within the Trust and included statements of support from key stakeholders. Whilst the Quality Account was published and uploaded by the required date of 30 June 2013, the Trust concluded that improvements could have been made to the timeliness of project management arrangements internally. This view was seconded by the external auditors Grant Thornton. A qualification was applied to the Data Quality aspect of VTE within the Account due to discrepancies in data held electronically relating to VTE and data held within the health record. During 2013/14, the Audit Committee commissioned an ongoing internal audit review of data quality in this area which demonstrated the need for improvement actions. The impact of the deployment of these actions has become evident towards the latter end of 2013/14, however the discrepancies which
remained evident in the earlier part of the year have resulted in a qualification being applied to the Account for 2013/14. Project Management improvements in the production of the Quality Account have been seen in 2013/14, with draft versions being presented to the Quality and Safety Committee and Audit Committee, prior to presentation to the Trust Board to present a balanced view.. The formulation of the Quality Account has been led by the Medical Director and the quality priorities for 2013/14 were developed as part of the Trust’s annual planning process. The priorities were also discussed with third parties such as the Walsall Clinical Commissioning Group, Healthwatch and the Health and Wellbeing Board. Clinical Audit outcomes contained in the report have been subject to review and presentation through the Trust’s Quality and Safety System at Clinical Care
Group/Speciality Quality Teams, Divisional Quality Teams and at a more corporate level via the Medical Director’s monthly report to the Quality and Safety Committee. The Trust was disappointed to report two ‘Never Events’ during the course of the year, compared with one in 2012/13. Never Events are serious, largely preventable patient safety incidents that should not occur if the available preventative measures have been implemented.
These Never Events related to:
A retained guidewire used in chest drain insertion
A patient who did not receive insulin as prescribed and suffered a period of
diabetic keto-acidosis
The Trust has taken these incidents very seriously and has made a number of changes to significantly reduce the likelihood of these incidents occurring again. These include:
Revision of our checklist for ward based interventional procedures
Education for staff on insulin administration using focussed Spotlight sessions
on wards
‘10 key messages’ for insulin administration and the use of insulin pens
Development of an insulin administration chart
Each Never Event has been fully scrutinised through the Trust’s incident reporting mechanisms and root cause analysis. Findings have been discussed through the Trust’s Quality and Safety System including full discussion of causation factors, lessons learnt and improvement actions at Trust Board. This approach has been equally applicable to all Serious Incidents occurring in the Trust.
3. Risk assessment How is Risk Assessed?
The leadership and accountability arrangements for myself, as Chief Executive Officer, Trust Board Directors, Divisional Directors, Clinical Directors, Heads of Nursing, Professional Heads of Service and all other staff are set out in the Trust’s Risk Management Strategy. The Trust works within a framework that devolves
responsibility and accountability throughout the organisation via a three tier risk register system (Corporate, Divisional and Departmental) which enables risks to be identified, analysed, prioritised and managed at all levels of the organisation. The method of assessing the severity of risk is by the use of the Australian/New Zealand (1999) risk rating process. This is based on scoring the impact to the Trust of not addressing the risk against the likelihood of its occurrence
The Trust employs appropriately qualified staff who specialise in risk management and health and safety matters. Risk management awareness and health and safety training is delivered to all new members of staff through our induction programme and to existing staff through mandatory training programmes. Additional risk
management training needs of specific staff groups are assessed through the Trust’s Training Needs Analysis.
Relevant policies and procedures are specific with regard to the accountabilities and responsibilities of all staff groups. Systems and procedures are in place to support staff in managing risk and carrying out their duties and to promote learning from experience and sharing of good practice.
The Trust has a Board Assurance Framework and Corporate Risk Register in place which outlines the key strategic and business risks for the organisation and action identified to mitigate these risks.
Our risk management process provides the mechanism through which I as Chief Executive, together with the Board assure all stakeholders that the Trusts internal controls are effective.
Our Risk Profile
Care Quality Commission Intelligent Monitoring Report
The Trust has unconditional registration with the Care Quality Commission. The Quality and Safety Committee and Trust Board considers the status of the Trust’s CQC Intelligent Monitoring Report on a quarterly basis and has noted that the Trust has been awarded category six risk classification status consistently since
publication in October 2014. This means, that based on the quality and safety outcomes of the Trust, there is a low risk of non-compliance with the Care Quality Commission's regulatory standards and fundamentals of care. In 2012/13 the Care Quality Commission applied a minor concern to Outcome 21 (records). I am pleased to report that following an unannounced inspection in March 2014, this concern was removed and the Trust was confirmed to be compliant with this outcome.
An internal audit report review of the systems of internal control for governing compliance with Care Quality Commission standards in 2013/14 demonstrated substantial assurance.
NHS Litigation Authority (NHSLA)
The organisation currently holds:
NHSLA Level 1 for the General Standards (assessed in January 2013) NHSLA level 3 for the Maternity Standards (assessed in February 2014)
Information Governance Toolkit
The Trust has consistently sustained level 2 compliance with the Information
Governance Toolkit throughout the year and was identified as the 18th top performer nationally in terms of compliance for 2012/13. The Trust has sustained 100%
compliance with all Freedom of Information Requests and has reduced the average response time to such requests to 10.4 days. The Information Governance Steering Group has met on a bi monthly basis throughout the year, with an appraisal of their work being presented to the Quality and Safety Committee and Trust Board on a quarterly basis. An internal audit review of the systems of internal control for complying with the Information Governance Toolkit in 2013/14 demonstrated substantial assurance.
Major Risks for the Organisation
During the year, the Trust Board undertook a review of its strategic risks, informed by a SWOT and PEST analysis. This resulted in the identification of the following risks to the organisation. The Integrated Business Plan for the organisation recognises these strategic risks and sets out the action and mitigation to manage the occurrence of such risks:
Strategic Risks
Failure to demonstrate sustainable financial viability/strategy; Viability of service configuration and provision;
Failure to improve the patient experience impacting on loss of activity and
regulatory requirements/standards; Failure to ‘take staff along the journey’; Failure to deliver the integration agenda; External turbulence impact on local instability.
In-Year Risks
2013/14 has seen unprecedented levels of emergency activity at the Trust
representing an increase of 10% on the previous year. This has placed pressure on the capacity of the organisation in terms of workforce, the A&E 4 hour wait and the financial position. The increased risk that this placed on the Trust was evident to the organization through an increase in risk scores in the Corporate Risk Register and gaps in assurance through the Board Assurance Framework.
During quarter 2 of the year, it became evident that the increased cost of temporary staffing aligned to additional activity was placing delivery of the end of year financial surplus at significant risk. The Trust took a range of actions to aim to reduce
temporary staffing spend including a recruitment campaign to fill all vacant nursing posts which included a Board approved over-establishment tolerance to ensure safe staffing levels during periods of heightened pressure. Whilst the campaign was successful, there remained to be some reliance on temporary staffing during the Winter Period and the Trust Board therefore took the decision to renegotiate the end of year financial surplus with the NHS Trust Development Authority.
Delivery of the A&E 4 hour target within an environment of heightened pressure has been challenging for the Trust and the Trust was disappointed to fail to achieve this operating standard throughout 2013/14. A range of additional controls were deployed to mitigate the risk including the further development of the Urgent and Emergency
Care Improvement Programme, enhanced community services provision and
integrated care pathways and the substantive opening of two additional wards within Walsall Manor Hospital. During quarter 3 the Trust Board commissioned an
independent expert review of the factors that were driving this challenging position. This identified that the Trust was experiencing an increase in out of area activity, particularly from the South Staffordshire area and Sandwell area. In addition, there was evidence of an increasingly ageing Walsall population with high acuity and frailty which was placing further demands on the Trust. The review has identified that changes to the ambulatory care pathway within the Trust have also contributed to the pressures experienced by the Trust and a cohesive improvement plan has now been approved by the Trust Board for implementation during 2014/15. These activity pressures also caused difficulties in the delivery of 18 week referral to treatment time standards in the final months of the year.
In addition, the risk management arrangements within the Trust enabled the Trust to identify risk in retaining Clostridium Difficile levels below planned levels for the year. An expert external peer review was commissioned to identify any further areas of control and best practice that could be implemented. Whilst the performance of the Trust improved during the second half of the year, the decline in performance during the period April to September 2013 meant that the Trust was unable to achieve its year-end target in relation to this quality measure.
Newly identified operational risks through the year were included on our Corporate Risk Register which was actively maintained throughout the year. These
predominantly related to demand exceeding capacity within a range of services in the Trust including the capacity to assure timely outpatient follow up appointments and capacity to meet demand within the radiology department. Improvement plans were approved by the Quality and Safety Committee for both of these areas and are now in the stages of implementation.
A further notable risk during the year related to the replacement and deployment of the new Lorenzo Patient Administration System in the Trust. Strong project
management arrangements were put in place to ensure positive preparedness for the switchover in March 2014 and implementation of the system went smoothly. Subsequent risks relating to some aspects of report writing and the need to culturally adjust to the system are now apparent and will focus as a risk on the opening
Corporate Risk Register for 2014/15. Strong project governance continues to address issues that arise as a result of this transition such as 18 week reporting. The Corporate Risk Register was scrutinised on a monthly basis through the Quality and Safety Committee and presented on a quarterly basis to the Trust Board.
Serious Information Governance Related Incidents
During 2013/14 the Trust reported two serious information governance related incidents to the Information Commissioner. Both incidents related to the accidental disclosure of sensitive information. Remedial improvement plans were developed and implemented from the Root Cause Analysis of these incidents. The Information Commissioner concluded that they were satisfied with the way in which the Trust had responded to the incidents and the remedial actions in place.
SUMMARY OF SERIOUS INCIDENT REQUIRING INVESTIGATIONS INVOLVING PERSONAL DATA AS REPORTED TO THE INFORMATION COMMISSIONER’S OFFICE IN 2013/14
Date of incident (month)
Nature of incident Nature
of data involved Number of data subjects potentially affected Notification steps
July Lost or stolen paperwork
(information was returned to the organisation within 24 hours) NHS Patient Data 37 Individuals notified by telephone
October Disclosed in error NHS
Patient Data 1 Individual notified by post Further action on information risk
Walsall Healthcare NHS Trust will continue to monitor and assess its information risks, in light of the events noted above, in order to identify and address any weaknesses and ensure continuous improvement of its systems.
4. The Risk and Control Framework
The Trust Board has the overall responsibility for probity (standards of public behaviour) within the Trust and is accountable for monitoring the organisation against the agreed direction and ensuring corrective action is taken where necessary. As Chief Executive, I remain accountable, but delegate executive
responsibility to the Executive Directors of the Trust for the delivery of organisational objectives, whilst ensuring that there is a high standard of public accountability, probity and performance management. The personal objectives of each Director are shaped to address key risk areas of the Trust.
Risks are identified proactively through the above risk assessment processes, SUMMARY OF OTHER PERSONAL DATA RELATED INCIDENTS IN 2013/14
Category Breach Type Total
A Corruption or inability to recover electronic data 0
B Disclosed in Error
1
C Lost in Transit 2
D Lost or stolen hardware 0
E Lost or stolen paperwork 0
F Non-secure Disposal – hardware 0
together with our quality performance mechanisms which include harm review and mortality reviews and reactively through the monitoring of key business objectives, incidents, complaints and claims. We continue to actively assess ourselves against the Monitor Quality Governance Framework to strengthen controls and assurances in this key area. During the year we continued to embed our quality and safety system through our Divisional and Care Group Quality Teams. This has enabled the Trust to receive more robust assurance of quality outcomes at granular levels and enhance lessons to be learnt.
Agenda setting ensures that the Board is confident that systems and processes are in place to enable individual, corporate and, where appropriate, team accountability for the delivery of high quality safe services. The cycle of Trust Board meetings has been reviewed to ensure that the Board devotes sufficient time to setting and
reviewing strategy and monitoring key risks.
Board Assurance Framework
The Board Assurance Framework (BAF) provides the Trust with a structured top-down approach to recording strategic objectives, thinking about potential factors which may prevent them from being achieved, specifying the controls currently in place to manage these risks and identifying sources of assurance for the Board. The primary focus is confidence that effective processes are in place to deliver the
strategic objectives of the Trust. Strategic risks populating the framework are derived from a process of identification which includes the strategic objectives, the key
business objectives and principal governance risks.
These identified strategic risks are entered onto a register and ranked according to risk as with the operational risk registers. The controls and management action is stated, as well as sources of information or evidence which give assurance that a risk is being managed.
The level of assurance score indicates where further work is required to manage a strategic risk, or where further information to the Board is required in evidence of risk management action. Where any significant gaps in assurance are identified they are transferred to the risk register and an action plan is developed.
Risk Control
The control objective of the Trust is to reduce risk to a reasonable level consistent with its mission to provide highest quality patient care and treatment.
Controls include:
Systems;
Training;
Contingency Plans;
Data Security and Information Governance;
Equality Delivery;
Policies, Procedures, Guidelines, Protocols;
Design of equipment, buildings and materials;
Insurance;
During the year 2013/14, particular improvements have been made to the following local controls:
Systems
Innovation and learning in relation to risk management is critical. As mentioned above, during 2012/13 the Trust has implemented a new Quality and Safety System at Divisional and Care Group levels with key responsibility for risk management and quality outcomes. Throughout 2013/14 we have continued to embed this system and this has aided the early identification and management of risk at Divisional and Care Group levels with evidence of enhanced ownership of quality data and resultant improvement actions.
In addition, we have replicated the Quality Governance corporate assurance process at Divisional levels, with a clear understanding of strengths of control and assurance and associated gaps for improvement. During 2013/14 each Division took part in the Quality Governance Assessment and developed local improvement plans to address any gaps in compliance and control.
Training
The Trust provides a comprehensive programme of risk management training to staff which comprises:
Corporate and local induction programmes to provide relevant aspects of risk
management training to new starters;
Mandatory risk management training in line with the Trust Training Needs
Analysis;
Board risk management training
Where required, tailored training / education / awareness resources are
developed to reflect individual staff needs and their involvement in undertaking risk management activities;
Quality Governance Training as a core module within the Trust;s Leadership
Programme
The ongoing provision of support and advice provided through the
Governance team structure and working arrangements with the divisions.
Data Security and Information Governance
Control measures are in place to ensure that risks to data security are identified, managed and controlled. The Trust has an information risk management process in place and information asset owners have been identified to cover the Trust’s main systems and records stores. All Trust laptops and memory sticks are encrypted and person-identifiable information is required to be held only on Trust servers. Incidents and risks are reviewed by the Information Governance Steering Group who report to the Quality and Safety Committee.
An overall rating of moderate assurance has been given to our IT and Information Governance domain, including a level of substantial assurance for the Information Governance Toolkit.
Equality Delivery System
equality, diversity and human rights legislation are complied with through Trust Policies, training and audit processes. Equality impact assessments are undertaken and published for all new and revised policies. The Trust has adopted the approach that all new or revised policies must require to undertake an Equality Impact
Assessment prior to Trust Management Board approval. This has ensured that equality, diversity and human rights issues are being systematically considered and delivered on core Trust business.
Carbon Reduction
The Trust is fully committed to playing a leading role in developing a truly sustainable NHS and combating climate change. A Board approved Sustainable Development Policy is in place in accordance with emergency preparedness and civil contingency requirements, based on UKCIP 2009 weather projects, to ensure that our obligations under the Climate Change Act and the Adaptation Reporting Requirements are complied with. Over the past 12months the Trust has made major inroads in embedding sustainability and climate change at the core of the organisation. Key successes for 2013/14 have included:-
Development of a Carbon and Sustainability Group
Winner of the Green Apple Award
Review of all Waste Streams
Bribery Act
The Trust has supplemented the Code of Business Conduct with a stand-alone Bribery Act Policy for staff. Risk assessments in this area have also been undertaken by our internal audit department and associated action plans approved and
monitored by the Audit Committee. Our statement of commitment to adhering to the Bribery Act is on our website:
https://www.walsallhealthcare.nhs.uk/about-us/the-bribery-act.aspx.
5. Review of the effectiveness of risk management and internal control
As Accountable Officer, I have responsibility for reviewing the effectiveness of the system of internal control. My review is informed in a number of ways. The Head of Internal Audit provides me with an opinion on the overall arrangements for gaining assurance through the Assurance Framework and on the controls reviewed as part of the internal audit work. Executive managers within the organisation who have responsibility for the development and maintenance of the system of internal control provide me with assurance. The Assurance Framework itself provides me with evidence that the effectiveness of controls that manage the risks to the organisation achieving its principal objectives have been reviewed. My review is also informed by:
The Care Quality Commission compliance levels with the fundamentals of
care as determined by the Intelligent Monitoring Report;
Sustained unconditional registration with the Care Quality Commission;
NHSLA level one accreditation for the General Standards;
NHSLA level three accreditation for Maternity Standards;
Information Governance Toolkit compliance at level 2;
Delivery of internal audit management action plans
The Trust’s Standing Orders and Standing Financial Instructions (and
considered by the Audit Committee prior to approval by the Trust Board;
Reports from external inspecting bodies including PLACE, MHRA, WMQRS,
CQC,Cancer Peer Review, JAG, NHSLA and the HSE.
Patient Experience Feedback
Staff Experience Feedback
My review is also informed by the work of Grant Thornton (the Trust’s external auditors), including their opinion on the Trust’s financial statements, their annual governance letter, final accounts memorandum and annual audit letter.
In addition, the work of the Trust’s internal auditors, has informed this review of internal control (see below).
Counter-fraud work has also continued, with regular reports being made to the Audit Committee throughout the year.
The Role of Internal Audit
The role of internal audit at the Trust is to provide an independent and objective opinion to me, my managers and the Trust Board on the system of control. The work of Internal Audit is undertaken in compliance with NHS Internal Audit Standards. The work to inform the internal audit programme is agreed by the Audit Committee on an annual basis. The audit programme includes a risk assessment based on the Trust’s assurance framework, an evaluation of other risks identified in the Trust risk register and through discussion with management.
Internal Audit reports the findings of its work to management and action plans are agreed to address any identified weaknesses. Internal Audit findings are also reported to the Audit Committee for consideration and further action if significant. A follow-up process is in place to ensure that agreed actions are implemented.
In addition, to routine internal audits, the Trust commissions assurance reviews from internal audit on issues which the Trust has identified as requiring strengthening, where performance improvement is required or where new arrangements have been implemented.
The table below shows the internal audit reviews for 2013/14 as presented to the Audit Committee:-
Audit Domain Area Review Assurance Opinion
Finance General Ledger Maintenance
and Budgetary Control
Substantial
Income and Debtors Substantial
Payroll/Aspects of HR Substantial
Expenditure – Non Pay Substantial
Capital Assets Management Accounting
Substantial
HR/Workforce Payroll/Aspects of HR Substantial
Mandatory Training Substantial
Arrangements Performance and
Operations
Call Centre Moderate
CIP Quality Impact Assessments and Post Implementation Reviews
Moderate
Clinical and Quality Patient Experience (FFT) Moderate
Safety Thermometer Substantial
Clinical Audit Moderate
Patient Records Policy Compliance
Substantial
Governance and Risk
Assurance Framework Substantial
CQC Governance Arrangements
Substantial
Policy Compliance Substantial
IT and Information Governance
Information Governance Toolkit
Substantial
Penetration Testing N3 Optimal
Penetration Testing Internet Substantial
Penetration Testing LAN Insufficient
Public Wireless Penetration Testing
Substantial
IT Strategy and Planning Substantial
Secure Disposal Process ‘Pass’
Management action plans have been agreed to address any recommendations arising from the internal audits to ensure continuous improvement of the system of internal control and assurance is in place.
The Head of Internal Audit’s opinion for 2013/14 is that throughout the year Internal Audit has liaised closely with the Trust with regard to its Assurance Framework and has concluded that ‘significant assurance can be given that there is a generally sound system of internal control designed to meet the organisation’s objectives and that controls are generally being applied consistently’. .
I have been advised on the implications of the result of my review of the effectiveness of the system of internal control by:
The Board, which has the responsibility for setting the overall direction of the Trust, agreeing the Trusts principal objectives / business plan, assessing and managing strategic risks to the delivery of those objectives and monitoring progress through performance monitoring reports;
The Audit Committee which works to an audit plan and provides assurance to
the Board;
..
reviewing risks and the Assurance Framework and to ensure that
arrangements are in place to maintain a sound system of internal control; • Corporate and Divisional Directors;
• Internal Audit, which has reviewed the Trust's Assurance Framework and Care Quality Commission regulatory compliance arrangements, and provided levels of assurances and agreed action plans where required (the Head of Internal Audit Opinion provides further evidence to support this ... "that
substantial assurance can be given that there is a generally sound system of internal control, designed to meet the organisation's objectives, and that controls are generally being applied consistently. However, some weakness in the design and/or inconsistent application of controls put the achievement of particular objectives at risk".
Significant Issues
The level of increase in emergency activity experienced by the Trust in 2013/14 was considered to be a significant issue for the Trust due to the impact this had upon:
• capacity within the organisation
• workforce and temporary staffing usage
• failure to achieve the 4 hour operating standard
• failure to achieve the originally planned financial surplus in year.
The next few years will continue to be a challenge for all NHS Trusts financially. Additional demands of managing capacity and meeting the challenges of the four hour target in A&E mean that in 2014/15 delivering our financial plan will continue to remain a significant risk to the Trust.
The Audit Committee recognised this issue and commissioned two internal audit briefings relating to bed management/patient flow, and A&E data quality, together with a full internal audit investigation into temporary staffing usage. The Trust Board commissioned an independent review into the increase in emergency activity as cited in section 3.0 (In-year risks) above.
6. Conclusion
As part of this Annual Governance Statement I am able to provide significant assurance to the system of risk management and internal control within Walsall Healthcare NHS Trust.
Accountable Officer: Richard Kirby
2013-14 Annual Accounts ofWalsall Healthcare NHS Trust
STATEMENT OF DIRECTORS' RESPONSIBILITIES IN RESPECT OF THE ACCOUNTS
The directors are required under the National Health Service Act 2006 to prepare accounts for each financial year. The Secretary of State, with the approval of the Treasury, directs that these accounts give a true and fair view of the state of affairs of the trust and of the income and expenditure, recognised gains and losses and cash flows for the year. In preparing those accounts, directors are required to:
- apply on a consistent basis accounting policies laid down by the Secretary of State with the approval of the Treasury;
- make judgements and estimates which are reasonable and prudent;
- state whether applicable accounting standards have been followed, subject to any material departures disclosed and explained in the accounts.
The directors are responsible for keeping proper accounting records which disclose with reasonable accuracy at any time the financial position of the trust and to enable them to ensure that the accounts comply with requirements outlined in the above mentioned direction of the Secretary of State. They are also responsible for safeguarding the assets of the trust and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities.
The directors confirm to the best of their knowledge and belief they have complied with the above requirements in preparing the accounts.
By order of the Board
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P' D'2013-14 Annual Accounts ofWalsall Healthcare NHS Trust
STATEMENT OF THE CHIEF EXECUTIVE'S RESPONSIBILITIES AS THE ACCOUNTABLE OFFICER OF THE TRUST
The Chief Executive of the NHS Trust Development Authority has designated that the Chief Executive should be the Accountable Officer to the trust. The relevant
responsibilities of Accountable Officers are set out in the Accountable Officers Memorandum issued by the Chief Executive of the NHS Trust Development Authority. These include ensuring that:
- there are effective management systems in place to safeguard public funds and assets and assist in the implementation of corporate governance;
- value for money is achieved from the resources available to the trust;
- the expenditure and income of the trust has been applied to the purposes intended by Parliament and conform to the authorities which govern them;
- effective and sound financial management systems are in place; and
- annual statutory accounts are prepared in a format directed by the Secretary of State with the approval of the Treasury to give a true and fair view of the state of affairs as at the end of the financial year and the income and expenditure, recognised gains and losses and cash flows for the year.
To the best of my knowledge and belief, I have properly discharged the responsibilities set out in my letter of appointment as an Accountable Officer.
Signed.. / ...~... Chief Executive
Walsall Healthcare NHS Trust - Annual Accounts 2013-14
Statement of Comprehensive Income for year ended 31 March 2014
2013-14 2012-13 NOTE £000s £000s
Gross employee benefits 10.1 (154,766) (145,287)
Other operating costs 8 (73,427) (71,385)
*Extraordinary item - Impairments reversals taken to the SOCI 11,479
-Revenue from patient care activities 5 218,054 214,273
Other Operating revenue 6 18,995 14,136
Operating surplus/(deficit) 20,335 11,737
Investment revenue 12 45 46
Other gains and (losses) 13 8 (10)
Finance costs 14 (8,181) (7,987)
Surplus/(deficit) for the financial year 12,207 3,786
Public dividend capital dividends payable 0 0
Transfers by absorption - gains 0 0
Transfers by absorption - (losses) 0 0
Net Gain/(loss) on transfers by absorption 0 0
Retained surplus/(deficit) for the year 12,207 3,786
Other Comprehensive Income 2013-14 2012-13
£000s £000s
Impairments and reversals taken to the Revaluation Reserve 0 0
Net gain/(loss) on revaluation of property, plant & equipment 1,209 0
Net gain/(loss) on revaluation of intangibles 0 0
Net gain/(loss) on revaluation of financial assets 0 0
Other gain /(loss) 0 0
Net gain/(loss) on revaluation of available for sale financial assets 0 0
Net actuarial gain/(loss) on pension schemes 0 0
Other Pension Remeasurements 0 0
Reclassification Adjustments
On disposal of available for sale financial assets 0 0
Total Comprehensive Income for the year* 13,416 3,786
Financial performance for the year
Retained surplus/(deficit) for the year 12,207 3,786
Prior period adjustment to correct errors and other performance adjustments 0 0
IFRIC 12 adjustment (including IFRIC 12 impairments) 0 0
Impairments (excluding IFRIC 12 impairments) (11,479) 0
Adjustments in respect of donated gov't grant asset reserve elimination (163) 67
Adjustment re Absorption accounting 0 0
Adjusted retained surplus/(deficit) 565 3,853
The supporting notes 1 to 34 form part of this account.
* The Trust attained a £728k trading surplus, though a revaluation of the Trust's land, buildings and dwellings was undertaken for the financial year ending 31st March 2014 and the revaluation increased the surplus by £11,479k resulting in a reported surplus for the Trust of £12,207k (the revaluation by asset category is shown in note 15).
the following pages are to be approved by the Board following external audit and will signed on its behalf
Chief Executive: Date:
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Walsall Healthcare NHS Trust - Annual Accounts 2013-14
Statement of Financial Position as at 31 March 2014
Non-current assets: Property, plant and equipment Intangible assets
Investment property Other financial assets Trade and other receivables Total non-current assets Current assets:
Inventories
Trade and other receivables Other financial assets Other current assets Cash and cash equivalents Total current assets
Non-current assets held for sale Total current assets
Total assets Current liabilities Trade and other payables Other liabilities
Provisions Borrowings
Other financial liabilities
Working capital loan from Department Capital loan from Department Total current liabilities Net current assets/(Iiabilities)
Non-current assets plus/less net current assets/liabilities Non-current liabilities
Trade and other pay abies Other Liabilities
Provisions Borrowings
Other financial liabilities
Working capital loan from Department Capital loan from Department Total non-current liabilities Total Assets Employed: FINANCED BY: TAXPAYERS' EQUITY Public Dividend Capital Retained earnings Revaluation reserve Other reserves
Total Taxpayers' Equity:
The supporting notes 1 to 34 form part of this account.
NOTE 15 16 20.1 19 20.1 21 22 25 23 22 25 23 31 March 2014 £OOOs 152,145 774 0 0 3,254 156,173 2,325 11,876 0 0 10,546 24,747 0 24,747 180,920 (19,789) 0 (180) (3,252) 0 0 0 (23,221) 1,526 157~ 0 0 0 (140,942) 0 0 0 {140,942) 16,757 49,462 (47,091) 14,386 o 16,757 31 March 2013 £OOOs 140,653 1,133 0 0 3,597 145,383 2,148 10,000 0 0 12,621 24,769 0 24,769 170,152 (16,094) 0 (1,808) (3,118) 0 0 0 (21,020) 3,749 149,132 0 0 (2,697) (144,194) 0 0 0 (146,891 ) 2,241 49,358 (60,263) 13,146 o 2,241 SOFP
Walsall Healthcare NHS Trust - Annual Accounts 2013-14
Statement of Changes in Taxpayers' Equity For the year ended 31 March 2014
Public Dividend capital Retained earnings Revaluation reserve Other reserves Total reserves £000s £000s £000s £000s £000s Balance at 1 April 2013 49,358 (60,263) 13,146 0 2,241 Changes in taxpayers’ equity for 2013-14
Retained surplus/(deficit) for the year 0 12,207 0 0 12,207
Net gain / (loss) on revaluation of property, plant, equipment 0 0 1,209 0 1,209
Net gain / (loss) on revaluation of intangible assets 0 0 0 0 0
Net gain / (loss) on revaluation of financial assets 0 0 0 0 0
Net gain / (loss) on revaluation of available for sale financial assets 0 0 0 0 0
Impairments and reversals 0 0 0 0 0
Other gains/(loss) 0 0 0 0 0
Transfers between reserves 0 166 (166) 0 0
Transfers under Modified Absorption Accounting - PCTs & SHAs 0 996 0 0 996
Transfers under Modified Absorption Accounting - Other Bodies 0 0 0 0 0
Reclassification Adjustments
Transfers to/(from) Other Bodies within the Resource Account Boundary 0 0 0 0 0
Transfers between Revaluation Reserve & Retained Earnings in respect of assets transferred under absorption
0 0 0 0 0
On Disposal of Available for Sale financial Assets 0 0 0 0 0
Reserves eliminated on dissolution 0 0 0 0 0
Originating capital for Trust established in year 0 0 0 0 0
New PDC Received - Cash 157 0 0 0 157
New PDC Received/(Repaid) - PCTs and SHAs Legacy items paid for by Department of Health
(53) 0 0 0 (53)
PDC Repaid In Year 0 0 0 0 0
PDC Written Off 0 0 0 0 0
Transferred to NHS Foundation Trust 0 0 0 0 0
Other Movements 0 0 0 0 0
Net Actuarial Gain/(Loss) on Pension 0 0 0 0 0
Other Pensions Remeasurement 0 0 0 0 0
Net recognised revenue/(expense) for the year 104 13,369 1,043 0 14,516
Transfers between reserves in respect of modified absorption - PCTs & SHAs
0 (197) 197 0 0
Transfers between reserves in respect of modified absorption - Other Bodies
0 0 0 0 0
Balance at 31 March 2014 49,462 (47,091) 14,386 0 16,757 Balance at 1 April 2012 49,358 (64,194) 13,291 0 (1,545) Changes in taxpayers’ equity for the year ended 31 March 2013
Retained surplus/(deficit) for the year 0 3,786 0 0 3,786
Net gain / (loss) on revaluation of property, plant, equipment 0 0 0 0 0
Net gain / (loss) on revaluation of intangible assets 0 0 0 0 0
Net gain / (loss) on revaluation of financial assets 0 0 0 0 0
Net gain / (loss) on revaluation of assets held for sale 0 0 0 0 0
Impairments and reversals 0 0 0 0 0
Movements in other reserves 0 0 0 0 0
Transfers between reserves 0 145 (145) 0 0
Release of reserves to Statement of Comprehensive Income 0 0 0 0 0
Reclassification Adjustments
Transfers to/(from) Other Bodies within the Resource Account Boundary 0 0 0 0 0
Transfers between Revaluation Reserve & Retained Earnings Reserve in respect of assets transferred under absorption
0 0 0 0 0
On Disposal of Available for Sale financial Assets 0 0 0 0 0
Reserves eliminated on dissolution 0 0 0 0 0
Originating capital for Trust established in year 0 0 0 0 0
New PDC Received 0 0 0 0 0
PDC Repaid In Year 0 0 0 0 0
PDC Written Off 0 0 0 0 0
Transferred to NHS Foundation Trust 0 0 0 0 0
Other Movements in PDC In Year 0 0 0 0 0
Net Actuarial Gain/(Loss) on Pension 0 0 0 0 0
Net recognised revenue/(expense) for the year 0 3,931 (145) 0 3,786 Balance at 31 March 2013 49,358 (60,263) 13,146 0 2,241
Walsall Healthcare NHS Trust - Annual Accounts 2013-14
STATEMENT OF CASH FLOWS FOR THE YEAR ENDED
31 March 2014
2013-14 2012-13
£000s £000s
Cash Flows from Operating Activities
Operating Surplus/(Deficit) 20,335 11,737
Depreciation and Amortisation 7,345 7,153
Impairments and Reversals (11,479) 0
Other Gains/(Losses) on foreign exchange 0 0
Donated Assets received credited to revenue but non-cash (294) (60)
Government Granted Assets received credited to revenue but non-cash 0 0
Interest Paid (8,181) (7,988)
Dividend (Paid)/Refunded 0 0
Release of PFI/deferred credit 0 0
(Increase)/Decrease in Inventories (177) (114)
(Increase)/Decrease in Trade and Other Receivables (1,289) (360)
(Increase)/Decrease in Other Current Assets 0 0
Increase/(Decrease) in Trade and Other Payables 4,055 (1,532)
(Increase)/Decrease in Other Current Liabilities 0 0
Provisions Utilised (949) (1,195)
Increase/(Decrease) in Provisions (3,376) 1,859
Net Cash Inflow/(Outflow) from Operating Activities 5,990 9,500
CASH FLOWS FROM INVESTING ACTIVITIES
Interest Received 47 44
(Payments) for Property, Plant and Equipment (4,923) (3,931)
(Payments) for Intangible Assets (258) (307)
(Payments) for Investments with DH 0 0
(Payments) for Other Financial Assets 0 0
(Payments) for Financial Assets (LIFT) 0 0
Proceeds of disposal of assets held for sale (PPE) 83 0
Proceeds of disposal of assets held for sale (Intangible) 0 0
Proceeds from Disposal of Investment with DH 0 0
Proceeds from Disposal of Other Financial Assets 0 0
Proceeds from the disposal of Financial Assets (LIFT) 0 0
Loans Made in Respect of LIFT 0 0
Loans Repaid in Respect of LIFT 0 0
Rental Revenue 0 0
Net Cash Inflow/(Outflow) from Investing Activities (5,051) (4,194)
NET CASH INFLOW/(OUTFLOW) BEFORE FINANCING 939 5,306
CASH FLOWS FROM FINANCING ACTIVITIES
Public Dividend Capital Received 311 0
Public Dividend Capital Repaid (207) 0
Loans received from DH - New Capital Investment Loans 0 0
Loans received from DH - New Revenue Support Loans 0 0
Other Loans Received 0 0
Loans repaid to DH - Capital Investment Loans Repayment of Principal 0 0
Loans repaid to DH - Revenue Support Loans 0 0
Other Loans Repaid (3,118) (2,968)
Cash transferred to NHS Foundation Trusts 0 0
Capital Element of Payments in Respect of Finance Leases and On-SoFP PFI and LIFT 0 0
Capital grants and other capital receipts 0 2
Net Cash Inflow/(Outflow) from Financing Activities (3,014) (2,966)
NET INCREASE/(DECREASE) IN CASH AND CASH EQUIVALENTS (2,075) 2,340
Cash and Cash Equivalents (and Bank Overdraft) at Beginning of the Period 12,621 10,281
Effect of Exchange Rate Changes in the Balance of Cash Held in Foreign Currencies 0 0
Cash and Cash Equivalents (and Bank Overdraft) at year end 10,546 12,621
Walsall Healthcare NHS Trust - Annual Accounts 2013-14 NOTES TO THE ACCOUNTS
1. Accounting Policies
The Secretary of State for Health has directed that the financial statements of NHS trusts shall meet the accounting requirements of the NHS Trusts Manual for Accounts, which shall be agreed with HM Treasury. Consequently, the following financial statements have been prepared in accordance with the 2013-14 NHS Manual for Accounts issued by the Department of Health. The accounting policies contained in that manual follow International Financial Reporting Standards to the extent that they are meaningful and appropriate to the NHS, as determined by HM Treasury, which is advised by the Financial Reporting Advisory Board. Where the NHS Trusts Manual for Accounts permits a choice of accounting policy, the accounting policy which is judged to be most appropriate to the particular circumstances of the trust for the purpose of giving a true and fair view has been selected. The particular policies adopted by the trust are described below. They have been applied consistently in dealing with items considered material in relation to the accounts.
1.1 Accounting convention
These accounts have been prepared under the historical cost convention modified to account for the revaluation of property, plant and equipment, intangible assets, inventories and certain financial assets and financial liabilities.
1.2 Acquisitions and discontinued operations
Activities are considered to be ‘acquired’ only if they are taken on from outside the public sector. Activities are considered to be ‘discontinued’ only if they cease entirely. They are not considered to be ‘discontinued’ if they transfer from one public sector body to another. Walsall Healthcare NHS Trust has not made any acquistions or discontinued operations during the year ending 31st March 2014.
1.3 Movement of assets within the DH Group
Transfers as part of reorganisation fall to be accounted for by use of absorption accounting in line with the Treasury FReM. The FReM does not require retrospective adoption, so prior year transactions (which have been accounted for under merger accounting) have not been restated. Absorption accounting requires that entities account for their transactions in the period in which they took place, with no restatement of performance required when functions transfer within the public sector. Where assets and liabilities transfer, the gain or loss resulting is recognised in the SOCNE/SOCNI, and is disclosed separately from operating costs.
Other transfers of assets and liabilities within the Group are accounted for in line with IAS20 and similarly give rise to income and expenditure entries.
For transfers of assets and liabilities from those NHS bodies that closed on 1 April 2013, Treasury has agreed that a modified absorption approach should be applied. For these transactions only, gains and losses are recognised in reserves rather than the SOCNE/SOCNI.
1.4 Charitable Funds
For 2013-14, the divergence from the FReM that NHS Charitable Funds are not consolidated with NHS Trust's own returns is removed. Under the provisions of IAS 27 Consolidated and Separate Financial Statements, those Charitable Funds that fall under common control with NHS bodies are consolidated within the entity's financial statements. In accordance with IAS 1 Presentation of Financial Statements, restated prior period accounts are presented where the adoption of the new policy has a material impact. The Trust has decided not to consolidate the results of its General Charitable Fund into these accounts on the basis that the balances on these funds are not material to the accounts of the Trust.
Walsall Healthcare NHS Trust - Annual Accounts 2013-14 Notes to the Accounts - 1. Accounting Policies (Continued)
1.5 Critical accounting judgements and key sources of estimation uncertainty
In the application of Walsa
