NHS Tayside Assurance and Advisory Group: staging report of findings and recommendations

2. Remit and Methodology

2.1 Context

Each year since 2012/13, NHS Tayside has been unable to operate within the resources available to it. Consequently, NHS Tayside has been under scrutiny by Audit Scotland ^[9] and the Scottish Parliament's Public Audit and Post-legislative Scrutiny Committee ( PAPLS).

NHS Tayside established a Transformation Programme Board in October 2015 to oversee a programme of work to deliver improved services to patients, improve cost effectiveness and return NHS Tayside to sustainable financial balance.

On 29 March 2017, Paul Gray, Director General of Health and Social Care in the Scottish Government and Chief Executive of NHS Scotland established an Assurance and Advisory Group ( AAG) to provide independent scrutiny and challenge on the deliverability of NHS Tayside's latest Five Year Transformation Programme. He requested Professor Sir Lewis Ritchie to chair the AAG and sought support from other colleagues working in the NHS or in a Health and Social Care Partnership. See Appendix 1 for the full remit, membership, technical support and secretariat of the AAG.

2.2 Remit of the Assurance and Advisory Group ( AAG)

The Assurance and Advisory Group was asked to "provide a staging report to Scottish Government on the deliverability of NHS Tayside's 5 year Transformation Programme. This will include a review of:

• the service change plans

• organisational capacity to deliver the service change plans

• robustness of the financial plans, underlying assumptions and the level of risk.

The remit extends to all areas of service and expenditure related to NHS Tayside, including the role of Integration Authorities in delivering the plan, partnership working and public participation."

2.3 Group Process and Engagement

To support the work of the Assurance and Advisory Group, the Scottish Government commissioned the consultancy firm Ernst and Young to undertake a detailed technical analysis of NHS Tayside's financial position, operational planning and programme management arrangements.

The wider methodology adopted by the AAG involved:

• Developing a workplan - shared and agreed with NHS Tayside;

• Undertaking 19 site visits to NHS Tayside sites (listed in Appendix 3) including discussions with frontline staff;

• Examining relevant NHS Tayside financial data for 2016/17 and 2017/18;

• A structured review of organisational documents, reports and minutes of recent key meetings;

• Observing meetings: the Board of NHS Tayside, Transformation Board Meetings (2), Board Governance Committees, Clinical Leaderships groups, Executive Team, Area Clinical and Partnership Fora and Staff Governance Forum;

• A series of individual and group meetings/discussions with NHS Tayside Board Members, staff and others - including the Executive Team, Non-Executive Board Members, Clinical Leads, Public Partners' representatives, Health and Social Care Partnership Chief Officers and the Chief Executives of Angus, Dundee and Perth and Kinross Councils .