eHealth funding: independent review

Introduction

Introduction

Following the identification of the potential misuse of Scottish Government eHealth monies, which may date back to 2012, the Scottish Government NHS Director of Finance commissioned Grant Thornton UK LLP to independently consider the arrangements in place in respect of eHealth, NHS National Services Scotland ( NSS) and NHS Tayside.

The focus of our investigation related to the Scottish Government Health and Social Care Directorate’s ( SGHSCD) eHealth programme resource allocation transactions between 2012 and 2018. These transactions were transfers of resource allocations from NSS to NHS Tayside through the Scottish Government’s revenue allocation process, and ranged in value from £0.538 million to £2.582 million over the time period. In 2017/18 the financial impact on NHS Tayside due to these funds is £5.3million (the unreturned balance in 2016/17 and the 2017/18 funds).

NSS commissioned a separate internal investigation of eHealth funds within NSS, which was undertaken by NSS’s internal audit provider. In addition, NHS Tayside commissioned an internal investigation which was led by NHS Tayside’s Strategic Director of Finance, related to the impact on the NHS Tayside financial position in 2017/18 and 2019/20. Our review has cross referred to the relevant findings from this work where applicable.

Scope

In accordance with our letter of engagement, dated 5 March 2018, the scope of our work was:

• consideration of the controls and processes in place within e-Health to allocate monies to NSS, including how the monies were determined, if there were any conditions over the funds e.g. ring-fenced, the approval process and how the eHealth team then monitored the spend and usage by NSS. We also considered how NSS and NHS Tayside accounted for these monies, and whether that is appropriate;
• consideration of the controls in place at NSS and the arrangements established to allocate and spend the eHealth money received. This included the authorisation (within scheme of delegation) and reporting of the transactions; and
• consideration of the controls in place at NHS Tayside on receipt of the monies from NSS including the purpose of the monies, the payback arrangements, and the nature over which the money was to be used and accounted for within NHS Tayside’s financial reporting and financial statements.

Our work was limited to the scope detailed above and did not constitute a forensic investigation of eHealth transactions or financial accounting. Our audit work was undertaken between 5th and 19th March 2018.

Introduction (continued)

Scope limitations

This report sets out our findings based on the work performed up to 19 March 2018. Should further information become available subsequent to the date of this report, we reserve the right to reconsider our conclusions in light of such additional information.

Our work does not constitute an audit or a forensic examination and therefore and does not provide the same level of assurance as an audit. Our conclusions are based on documentation provided to us by the Scottish Government, NSS and NHS Tayside and interviews with relevant staff.