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Use of Resources

Use of Resources. Calderdale workshop 18 May 2009. Janet Matthews- Audit Commission Steve Brennan- Calderdale PCT. Objectives. Outline process Areas of overlap PCT/ Council High level view Issues from NHS UOR PCT viewpoint What worked well What can be improved. UOR in 2008/09.

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Use of Resources

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  1. Use of Resources Calderdale workshop 18 May 2009 Janet Matthews- Audit Commission Steve Brennan- Calderdale PCT

  2. Objectives • Outline process • Areas of overlap PCT/ Council • High level view • Issues from NHS UOR • PCT viewpoint • What worked well • What can be improved

  3. UOR in 2008/09 KLOEs reviewed in 2008/09 mainly the same at CPCT as CMBC but Done at Council not PCT • 2.1 Commissioning and procurement • 3.1.Natural resources • Done at PCT not Council • 3.3 Workforce

  4. Areas of overlap between PCT and Council • Managing Finances • Financial Planning- MTFS developed with social services and JSNA drives MTFS • Work with Council in financial planning to understand costs at the disposal of significant partnerships –and can demonstrate how investment has produced more efficient use of resources/ better outcomes

  5. Areas of overlap between Council and PCT • KLOE 2.3 Principles and values of good governance • partnership governance documented in agreed governance documents between Calderdale Council and NHS Calderdale • Calderdale Compact • Demonstrate confidence in partnerships- good governance diagnostic at PCT used

  6. Use of Resources- the harder test • It is a harder test • top down view • not a checklist • considers outcomes.

  7. The High Level view

  8. Issues from NHS use of resources • Issues about how systematic / consistent embedded performance is or can we see isolated examples only? • . Whole life, social, environmental costs- no examples of this. • Partnerships- definition of these? Links between NHS and social care costs.-clear governance arrangements? How are all using LSP to achieve their priorities/ outcomes? • . Outcomes are a crucial aspect of the assessment – can they be identified and linked to financial planning and organisational priorities in a systematic way? Can organisations demonstrate progress to outcomes- is something changing as planned and on the right trend line? • Are costs reviewed with the link to outcomes? • Are savings planned systematically and monitored? • . KLOE 2.3 and 2.4 more closely linked to previous assessment areas • . Workforce- many have not looked at this area before. • How was evidence provided / self assessment done - need to do an overall summary- tell the story

  9. Consistency • Consistency- YHSHA wide 28 April but this is different this year not the final consistency. • Included comparison against national picture • Workforce planning lower scores • KLOE 2.3 and 2.4- more similar to previous but do need evidence for outcomes at level 3- survey results etc

  10. PCT viewpoint • Do not assume that all in the PCT know what is involved in UOR and why it is being done • UOR not a checklist but needed to use the detail as a basis to collect the evidence/ identify key individuals • But dividing the assessment up may not help the context • UOR not just a finance responsibility- need liaison with key individuals to ensure it is seen as part of the job

  11. PCT viewpoint • Starting early was a good thing as it allowed for time to resolve issues- iterative • Don’t expect auditors to have the same viewpoint • But there was a degree of overlap in the improvement areas identified • Auditors need time to understand how it all fits together – how to facilitate this? • Meetings held by auditors with key individuals- to understand context and not just document review • Difficult to obtain evidence for some outcomes

  12. PCT viewpoint-2009/10 • How to collect evidence during the year on an ongoing basis - no World Class Commissioning evidence . • Timescale- not just this year- need to look back to see impact of previous decisions, current impact and set up processes for monitoring impact of current decisions • Cannot only focus on areas for improvement- need to ensure that all processes continue and outcomes are delivered

  13. What went well for the auditor • Self assessment- was down at each assurance- comments against each - linked to evidence – WCC links was an advantage here as PCT had thought about evidence already • Knowledge of organisation from attendance at committees – how it works in practice • Presentation to PCT SMT- UOR is not just a finance responsibility

  14. Opportunities for improvement • Could self assessment/ evidence collection have been at a higher level to tell the story for each area (but this may lead to more audit queries) • Need to collect information of outcomes throughout the year • Consider how to provide evidence of impact of joint working • Need a organisation not just finance approach to UOR

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