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HEALTH AND SOCIAL CARE BOARD

ANNUAL ACCOUNTS

FOR THE YEAR ENDED 31 MARCH 2011

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Health and Social Care Board

Annual Accounts

For the year ended 31 March 2011 Laid before the Northern Ireland Assembly under Schedule 1, para 17(5) of the Reform Act for the Regional

Agency, by the Department of Health, Social Services and Public Safety.

On

1 July 2011

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Contents Page

FOREWORD 3

STATEMENT OF RESPONSIBILITIES 4

CERTIFICATES OF DIRECTOR OF FINANCE, CHAIRMAN AND CHIEF EXECUTIVE 5

AUDIT CERTIFICATE 6 - 7

STATEMENT ON INTERNAL CONTROL 8 - 22 STATEMENT OF COMPREHENSIVE NET EXPENDITURE FOR THE YEAR ENDED 31 MARCH 2011 23

STATEMENT OF FINANCIAL POSITION AS AT 31 MARCH 2011 24

STATEMENT OF CASHFLOWS FOR THE YEAR ENDED 31 MARCH 2011 25

STATEMENT OF CHANGES IN TAXPAYERS EQUITY FOR THE YEAR ENDED 31 MARCH 2011 26

NOTES TO THE ACCOUNTS 27 – 70

GENERAL PRACTITIONER LOANS SCHEME 71

ISBN NUMBER 74

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HEALTH & SOCIAL CARE BOARD ACCOUNTS FOR THE YEAR ENDED 31 MARCH 2011 FOREWORD These accounts for the year ended 31 March 2011 have been prepared in a form determined by the Department of Health, Social Services and Public Safety based on guidance from the Department of Finance and Personnel’s Financial Reporting manual (FReM) and in accordance with the requirements of the Health and Social Care (Reform) Act (Northern Ireland) 2009.

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HEALTH & SOCIAL CARE BOARD ACCOUNTS FOR THE YEAR ENDED 31 MARCH 2011 STATEMENT OF HEALTH AND SOCIAL CARE BOARD'S RESPONSIBILITIES AND CHIEF EXECUTIVE’S RESPONSIBILITIES Under the Health and Personal Social Services (Northern Ireland) Order 1972 (as amended by Article 6 of the Audit and Accountability (Northern Ireland) Order 2003) and the Health and Social Care (Reform) Act (Northern Ireland) 2009, the Health and Social Care Board (HSCB) is required to prepare financial statements for each financial year in the form and on the basis determined by the Department of Health, Social Services and Public Safety (DHSSPS). The financial statements are prepared on an accruals basis and must provide a true and fair view of the state of affairs of the HSCB as at 31 March 2011 and of its expenditure and cash flows for the financial year. In preparing the financial statements the HSCB is required to: - observe the accounts direction issued by the DHSSPS including relevant accounting

and disclosure requirements, and apply suitable accounting policies on a consistent basis;

- make judgements and estimates on a reasonable basis; - state whether applicable accounting standards have been followed, and disclose and

explain any material departures in the financial statements; - prepare the financial statements on the going concern basis, unless it is inappropriate

to presume that the HSCB will continue in operation; - keep proper accounting records which disclose with reasonable accuracy at any time

the financial position of the HSCB; and - pursue and demonstrate value for money in the services the HSCB provides and in its

use of public assets and the resources it controls. The Permanent Secretary of the DHSSPS as Accounting Officer for health and personal social services resources in Northern Ireland has designated Mr John Compton of the HSCB as the Accounting Officer for the HSCB. His relevant responsibilities as Accounting Officer, including his responsibility for the propriety and regularity of the public finances for which he is answerable and for the keeping of proper records, are set out in the Accountable Officer Memorandum, issued by the DHSSPS. The Accounting Officer is also responsible for safeguarding the assets of the HSCB and hence for taking reasonable steps to prevent and detect fraud and other irregularities.

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HEALTH & SOCIAL CARE BOARD

ACCOUNTS FOR THE YEAR ENDED 31 MARCH 2011 CERTIFICATES OF DIRECTOR OF FINANCE, CHAIRMAN AND CHIEF EXECUTIVE I certify that the annual accounts set out in the financial statements and notes to the accounts (pages 27 to 70) which I am required to prepare on behalf of the Health and Social Care Board have been compiled from and are in accordance with the accounts and financial records maintained by the Board and with the accounting standards and policies for HSC Bodies approved by the Department of Health, Social Services and Public Safety. Paul Cummings Director of Finance Date Date I certify that the annual accounts set out in the financial statements and notes to the accounts (pages 27 to 70) as prepared in accordance with the above requirements have been submitted to and duly approved by the Health and Social Care Board. Ian Clements Chairman Date John Compton Chief Executive

Date

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HEALTH AND SOCIAL CARE BOARD STATEMENT ON INTERNAL CONTROL Scope of Responsibility The Board of the Health and Social Care Board (HSCB) is accountable for internal control. As Accounting Officer and Chief Executive, I have responsibility for maintaining a sound system of internal control that supports the achievement of the organisation’s policies, aims and objectives, whilst safeguarding the public funds and assets for which I am responsible in accordance with the responsibilities assigned to me by the Department of Health, Social Services and Public Safety (DHSSPS). As Chief Executive, I exercise my responsibility by ensuring that an adequate system for the identification, assessment and management of risk is in place. I have in place a range of organisational controls, commensurate with officers’ current assessment of risk, designed to ensure the efficient and effective discharge of HSCB business in accordance with the law and departmental direction. Every effort is made to ensure that the objectives of the HSCB are pursued in accordance with the recognised and accepted standards of public administration.

Processes by which the HSCB works with Partner Organisations

Public Health Agency Under Section 8 of the Reform Act, the HSCB is required to produce an annual commissioning plan in full consultation and agreement with the PHA. In practice the employees of the HSCB and PHA work in fully integrated/multi-disciplinary teams to support the commissioning process at both local and regional levels.

Business Services Organisation The BSO provides a broad range of support functions for the HSCB under a service level agreement between the two organisations. Functions include: financial services; human resource management; training; equality and human rights; estates, information technology and information management; procurement of goods and services; legal services; internal audit and fraud prevention.

Trusts Trusts must provide services in response to the commissioning plan, and must meet the standards and targets set by the minister. In order that these obligations are met, service and budget agreements (SBAs) between the Trusts and the HSCB are established setting out the range, quantity of services to be provided and linking volumes and outcomes to cost.

Working in close collaboration with the PHA, the HSCB has in place a robust performance management framework. The framework provides the mechanism for managing and monitoring the achievement by Trusts of agreed objectives and targets and also provides a process whereby the HSCB and PHA can work closely in supporting Trusts to improve performance and achieve desired outcomes.

Inter-relationship of DHSSPS and HSCB The HSCB engage in a collaborative relationship with the DHSSPS to ensure that progress towards the achievement of all objectives is fully communicated. The HSCB provide the DHSSPS with prescriptive monthly financial monitoring returns highlighting financial performance and reporting progress towards the achievement of the statutory duty to break-even.

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HEALTH AND SOCIAL CARE BOARD STATEMENT ON INTERNAL CONTROL The HSCB provide DHSSPS with quarterly (or as required) assessments of the progress being made in the delivery of DHSSPS strategic objectives and relevant targets in the current Programme for Government, PSAs and PfAs, demonstrating how resources are being used to achieve these objectives. Senior HSCB officers attend bi-annual accountability reviews with senior departmental officials to discuss the HSCB's operational and financial performance; policy developments and corporate control issues.

The purpose of the system of internal control The system of internal control 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 ongoing process designed to: • identify and prioritise the risks to the achievement of organisational 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 the HSCB for the year ended 31 March 2011, and up to the date of the approval of the Annual Report and Annual Accounts and accords with Department of Health, Social Services and Public Safety guidance. Controls in Respect of the Wider Environment

The HSCB is responsible for commissioning of services, resource allocation and performance management. It is therefore important the Board takes appropriate and effective action in relation to Trust internal control issues that may impact on the quality, safety or accessibility of services delivered.

During 2010/11 the Board has worked closely with Trusts in relation to a number of Internal Control issues, including:

• Western Performance Review During 2010-11, the HSCB (supported by the PHA) commissioned a high level review within the Western HSC Trust, in response to a number of performance related issues in the Trust. The aim of the review was to quality assure the effectiveness of the existing governance framework within the Trust. This was to satisfy the HSCB that the Trust had adequate and appropriate systems and processes in place to monitor its own performance, identify problems and risks and take appropriate remedial action as required. The review found that any variations from service performance areas were rectified and meet agreed performance standards. The review concluded that the work undertaken, by the HSCB with the Trust, has achieved satisfactory performance and the governance arrangements within the Trust are satisfactory. The review also identified strengths and opportunities for improvement in the Trust’s governance arrangements. Progress towards addressing the improvements identified continues to be reviewed at the regular performance monitoring meetings and the HSCB will ensure wider learning across the HSC system.

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HEALTH AND SOCIAL CARE BOARD STATEMENT ON INTERNAL CONTROL

• School of Dentistry, Belfast On 24 November 2010, Belfast HSC Trust contacted HSCB regarding concerns over the management of a number of oral medicine patients. Some of these patients were confirmed as having oral cancer and there was a concern that treatment may have been delayed. Concerns were raised about the clinical performance of the Trust’s single Consultant in Oral Medicine. There was a separate group of patients who may have oral cancer. Actions taken by the HSCB, and actions to be taken, include:

- Requested that the Trust submit a Serious Adverse Incident (SAI) report. When received HSCB established a SAI group to manage the SAI process. This is currently ongoing.

- Liaised with RQIA so that they could take action to ensure that private patients were being appropriately managed.

- Wrote to all Northern Ireland General Dental Practices to ensure that they notified HSCB should the Oral Medicine Consultant approach them to establish a private Oral Medicine clinic.

- Contacted the General Dental Council (GDC) to ensure that the Council was content with clinical supervision arrangements in primary care for the Oral Medicine Consultant.

- Secured advice from a UK expert on the reasonableness of the look-back period and the management of the Consultant's caseload.

- Hosted meetings with Belfast Trust and others to ensure that suitable service continuity arrangements were in place.

- Contacted Trust Chief Executives to request assistance from maxillo-facial surgeons in the call-back exercise and in service continuity arrangements.

- HSCB senior staff attended five fact-finding meetings organised by DHSSPS and two HSCB Assistant Directors sit on the Project Board for the recently established review of hospital dental services.

- HSCB representatives attended action planning meetings organised by the Belfast Trust. HSCB representatives will continue to support and monitor the Trust response.

- HSCB has participated fully in the ongoing independent inquiry into the case.

• Plain-film reporting

Following identification of a backlog in reporting of plain film x-rays at the Western HSC Trust in August 2010, the HSCB sought and received assurances from all other Trusts that no similar backlog existed. The HSCB required the Western Trust to clear the backlog within specified timescales and to ensure the timely reporting of all radiological tests in the future. The Trust submitted regular reports detailing the progress being made towards achieving the deadlines set.

Initial monitoring of plain film reporting times by the HSCB, in February 2011, using the Northern Ireland Picture Archiving and Communication System (NIPACS) identified delays in the Southern HSC Trust. The Trust confirmed that it had identified a significant number of unreported plain film x-rays. The HSCB agreed timescales with the Trust to urgently clear this backlog and to ensure the position was sustained thereafter.

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In February 2011 the HSCB again sought, and received, assurances from all Trusts that no patients were waiting longer than the agreed standards for reporting of plain film x-rays, and that effective monitoring arrangements are in place to ensure these standards continue to be maintained.

As the NIPACS system has now been rolled out in most Trusts, the HSCB Board has put in place arrangements to routinely monitor plain film reporting times from April 2011 along with other diagnostic tests. This will allow plain film reporting times to be closely monitored on an ongoing basis and any issues identified early and raised with Trusts through the established performance management arrangements.

Following a review of the radiology service at the Western Trust, the HSCB has established a Regional Radiology Working Group to take forward issues identified in the review of relevance to all HSC Trusts. Capacity to handle risk During 2010/11 the HSCB has continued to discharge its functions in a way that ensures risks are managed as effectively and efficiently as possible to meet corporate objectives and to continuously improve the quality of services. Good governance hinges on having clear objectives, sound practices, a clear understanding of the risks run by the organisation and effective monitoring arrangements. The HSCB has continued to monitor key quality initiatives and specific governance and risk management issues via a performance monitoring framework within all Trusts. The Regulation and Quality Improvement Authority (RQIA) have not carried out any clinical and social care governance or thematic reviews within the HSCB itself during the period. Last year the HSCB initiated a programme of mandatory training sessions to acquaint staff with organisational protocols on corporate issues such as governance, risk management, health and safety, finance, information governance and complaints. A follow up programme was developed during 2010/11 aimed at maintaining staff awareness and highlighting any changes or developments during the period. This included:

• Identifying and managing corporate risk issues. • Protecting information held by the organisation and maximising its security. • Understanding current organisational protocols and how these should be applied. • Ensuring that all staff remain 'risk aware' as they go about their work each day.

Annual fire safety awareness training was delivered to staff and specialised fire safety refresher training was provided to relevant nominated and deputy nominated fire officers. The risk and control framework Interim Governance Framework

The HSCB established and implemented an Interim Governance Assurance Framework during 2009/10. The framework continues to provide the systematic assurances required by the Board of Directors on the effectiveness of the system of internal control by highlighting the reporting and monitoring mechanisms that are necessary to ensure the commissioning of safe, quality health and social care.

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HEALTH AND SOCIAL CARE BOARD STATEMENT ON INTERNAL CONTROL Over the next six months the HSCB will develop an overarching governance framework which permeates all levels of responsibility within the organisation. The framework will consist of a suite of documents that will provide the HSCB Board with the necessary assurances that the organisation is discharging its functions in a way that ensures risks are managed as effectively and efficiently as possible and to acceptable standards of quality. The specific objective, to protect the organisation against loss, the threat of loss and the consequences of loss, and at the same time highlighting the roles, responsibilities, reporting and monitoring mechanisms that are necessary to ensure commissioning and delivery of high quality health and social care. During the period a Governance Officer Group has been established which is responsible for taking forward this important area of work. Managing Risk

To ensure the robustness of the HSCB’s system of internal control, the HSCB developed a process to have a fully functioning risk register at both directorate and corporate levels during 2009/10. During 2010/11 both corporate and directorate registers were reviewed at the end of each financial quarter. The corporate register underwent a thorough review in December 2010 involving Directors and their senior staff, co-ordinated by senior Governance staff. This has resulted in substantive changes to the register and has provided an assurance mechanism to the Board of Directors that risks to meeting corporate objectives are being effectively managed. The corporate risk register is approved by the Governance and Audit Committee on a quarterly basis and brought to the Board for information annually. Information Risk

During this period a number of measures have been introduced to reduce Information Risk. New software has been introduced preventing portable devices such as unencrypted memory sticks, portable hard drives, and other personal devices from working on board computers. Access to personal e-mail accounts and to social networking sites has been blocked to further reduce the risk to information. Mandatory awareness training for all HSCB staff was completed in March 2011 with all aspects on Information Governance covered by the material. The risks to information are described in the Corporate Services Directorate risk register and control measures are identified and updated quarterly as required. The HSCB continues to participate at a regional level with groups such as the DHSSPS led Information Governance Advisory Group and the Regional Records Management Working Group taking forward projects such as the development of a Health and Social Care (HSC) Data Access Agreement, the development of a regional E-Learning platform and the development of an Information Governance Framework for HSC. Business Continuity A fully operational Business Continuity Plan has been developed this year, which includes the wider service continuity issues that became apparent during the activation of the Business Continuity and Emergency Preparedness arrangements during the period of adverse weather in Winter 2010.

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HEALTH AND SOCIAL CARE BOARD STATEMENT ON INTERNAL CONTROL The Plan is based on ensuring the ‘business critical functions’ as identified by each of the Board Directorates continue to be delivered in a period of serious interruption to normal business. DHSSPS has established a HSC Business Continuity Project Management Group to support HSC organisations in developing their Business Continuity Plans to BS25999 Standard as required by March 2012. Emergency Preparedness A Joint Public Health Agency (PHA)/Business Services Organisation (BSO)/HSCB Emergency Response Plan has been developed under the leadership of the PHA who have statutory responsibility for Emergency Preparedness as part of its Health Protection remit. A Joint Emergency Preparedness Working Group was established to take forward the development of this plan by building upon the interim arrangements developed in the first year of the new organisations’ operation. In addition the Plan reflects the lessons learned from the activation of the Emergency Preparedness arrangements during the period of adverse weather in Winter 2010, and arrangements have been enhanced to reflect this. A ‘communications test’ was undertaken during December 2010 to ensure that contact could be made with key staff across the three organisations, outside of normal hours. Senior Managers of the three organisations have been trained on Emergency Preparedness awareness, and further sessions will be delivered during 2011/12. A desktop exercise will be held in Autumn 2011 to further test the effectiveness of the Joint Emergency Response Plan, which will be reviewed and updated as required following this. Stakeholder Involvement Personal and Public Involvement (PPI) is a legislative requirement for HSC organisations as laid down in the Health and Social Care (Reform) Northern Ireland Act 2009. Considerable efforts were made in 2010/ 2011 to further embed PPI within the HSCB. A Regional HSC PPI Forum, led by the PHA has been established on a collaborative basis between the HSCB and the PHA, under the chairmanship of the Director of Nursing, PHA. The Forum is comprised of senior representation from all HSC organisations in Northern Ireland. Service users, carers and community and voluntary organisations also form part of the Forum’s membership. The Forum will analyse training requirements and roll out a training and development programme, utilise feedback from engagement activity to inform priorities and future practice and develop impact assessment methods to evaluate the effectiveness of PPI. An extensive process of engagement was undertaken on behalf of the HSCB and PHA in respect of the development of a Draft Joint PPI Strategy. This was undertaken following endorsement of the Draft Consultation Scheme by DHSSPS in August 2010. The engagement sought the views on the preparation, content, purpose and goals of a PPI Strategy. A series of workshops were held to inform this work, including workshops with the Regional HSC PPI Forum, HSC staff, and community and voluntary sector partners. Key priority areas of work have been identified which will be taken forward through the work of a Joint PHA/HSCB PPI Implementation Group.

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HEALTH AND SOCIAL CARE BOARD STATEMENT ON INTERNAL CONTROL Local Commissioning Groups continue to engage with service users, carers, the community and voluntary sectors and the wider public, to assist them in the development of their local priorities. Serious Adverse Incidents (SAIs)

The requirement on HSC organisations to routinely report SAIs to the DHSSPS ceased on 1 May 2010. From this date, the revised arrangements for the reporting and follow up of SAIs pending the full implementation of the Regional Adverse Incident Learning (RAIL) system, transferred to the HSCB working in close partnership with the PHA and the RQIA. In April 2010 the HSCB issued the procedure for the Reporting and Follow up of SAIs for full implementation on 1 May 2010. The procedure provides guidance to HSC Trusts and HSCB Integrated Care staff in relation to the reporting and follow up of SAIs arising during the course of business of a HSC organisation/Special Agency or commissioned service. The procedure also details internal processes in relation to the nomination of Designated Review Officers (DROs) from both the HSCB and PHA. A SAI workshop was held in November 2010 allowing stakeholders from across HSC organisations to put forward their views for a further revision of the procedure. A revised procedure is currently being drafted and will be consulted upon prior to being issued. The HSCB has been working in close collaboration with the PHA to implement the RAIL system. The overall aim of the project is to implement agreed proposals for an integrated system that will support a culture of learning from adverse incidents and the effective implementation of that learning across the HSC and Primary Care services. The Regional SAI Review Group, chaired by the Director of Nursing, PHA, meets on a bi-monthly basis to discuss SAIs in depth. The following issues are routinely discussed: • number and breakdown of SAI reports received by Trust and by programmes of care; • specifics of any significant SAIs; • identification of trends; • any problematic issues relating to specific SAIs; • any implications in respect of procedure; • any learning identified by DROs; • the correct mechanisms to share learning is a meaningful way. Overview reports in respect of SAI trend analysis and learning outcomes are submitted to the Governance and Audit Committee of the Board on a bi-annual basis. Complaints Handling On 1 April 2009 ‘Complaints in HSC’ became effective. The revised arrangements placed responsibility on the HSCB for the monitoring and performance management of HSC complaints, as well as providing support and advice to Family Practitioner Services (FPS) in respect of complaints. To undertake the monitoring role, the HSCB receives an agreed level of information from HSC Trusts on a monthly basis and is required to receive a copy of each letter of complaint and response issued from FPS Practices. This information is analysed by complaints staff and is considered at a Regional Complaints Group chaired by the Director of Social Care and Children and attended by the Director of

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HEALTH AND SOCIAL CARE BOARD STATEMENT ON INTERNAL CONTROL Nursing, PHA. Relevant Directorates of the HSCB and PHA also attend this Group, along with representation from the Patient Client Council (PCC). The Group determines if there are any areas of concern that require specific action to be taken by the PHA/HSCB through professional, performance or commissioning mechanisms. The Group has met on eight occasions since established in November 2009 and following a review of the terms of reference, membership and role/remit, will move to a quarterly meeting cycle. This will support the quarterly reporting to SMT and bi-annual reporting to Governance and Audit Committee. The first HSCB Annual Report of Complaints was presented to the Governance and Audit Committee in October 2010 and is available on the HSCB website. DHSSPS have requested the HSCB to undertake a ‘process evaluation’ of ‘Complaints in HSC’ to establish the effectiveness of the new arrangements and if it has been fully implemented across the HSC. The HSCB will report on this to DHSSPS in June 2012. Medical Negligence The number of outstanding pre Trust (1993) medical negligence cases has decreased significantly in the last year from 350 to approximately 160. The management of these cases remains the responsibility of the HSCB until they are concluded. Legal services are provided by the BSO, Directorate of Legal Services, under an agreed Service Level Agreement. The HSCB do not avail of any service from independent legal providers. The PHA provides support in the management of these cases in the form of input from Public Health Consultants. The Western and Northern Trusts continue to provide support to the HSCB on the day to day management of cases. A HSCB Policy in relation to the management of these cases has been developed and approved. This Policy outlines delegated authority levels for settlement of these cases and associated payments. All authorities to engage senior counsel and to settle cases must be granted by relevant HSCB officers within the agreed schedule of delegated authorities. Settlement of medical negligence cases is funded from a central DHSSPS fund, with the HSCB requiring DHSSPS approval for settlement of cases above £250,000. A Preliminary Advisory Group meets on a monthly basis to discuss ongoing cases, in particular those requiring decisions regarding engagement of expert opinion and those progressing towards consultation and hearing. The Preliminary Advisory Group also considers cases recently closed to determine if any learning has been identified. In line with Circular HSC (SQSD) 5/10 the Directorate of Legal Services on behalf of the HSCB will review each ongoing case on at least an annual basis to consider suitability of closure for those cases where there has been no contact with the plaintiff for three years or more. Reports to the Governance and Audit Committee in respect of ongoing Medical Negligence Cases are made on a bi-annual basis.

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HEALTH AND SOCIAL CARE BOARD STATEMENT ON INTERNAL CONTROL Controls Assurance Standards

The HSCB assessed its compliance with the applicable Controls Assurance Standards which were defined by the DHSSPS and against which a degree of progress is expected in 2011/12.

The Organisation achieved the following levels of compliance for 2010/11 Standard DHSSPS Expected Level

of Compliance Level of

Compliance Audited

by Internal

Audit Buildings, land, plant and non-medical equipment 70% - 99% (Substantive)

77%

-

Decontamination of medical devices 70% - 99% (Substantive) Not applicable

-

Emergency Planning 70% - 99% (Substantive) 77% BSO IA

Environmental Cleanliness 70% - 99% (Substantive) Not applicable -

Environment Management 70% - 99% (Substantive) 73% - Financial Management (Core Standard) 70% - 99% (Substantive) 83% BSO IA

Fire safety 70% - 99% (Substantive) 83% -

Fleet and Transport Management 70% - 99% (Substantive) Not applicable -

Food Hygiene 70% - 99% (Substantive) Not applicable -

Governance (Core Standard) 70% - 99% (Substantive) 80% BSO IA

Health & Safety 70% - 99% (Substantive) 77% -

Human Resources 70% - 99% (Substantive) 81% -

Infection Control 70% - 99% (Substantive) Not applicable - Information Communication Technology 70% - 99% (Substantive) 74% - Management of Purchasing and Supply 70% - 99% (Substantive) 77% - Medical Devices and Equipment Management 70% - 99% (Substantive) Not applicable -

Medicines Management 70% - 99% (Substantive) Not applicable -

Records Management 70% - 99% (Substantive) 67%

(Moderate 30-69%) -

Research Governance 70% - 99% (Substantive ) Not applicable - Risk Management (Core Standard) 70% - 99% (Substantive) 77%

BSO IA

Security Management 70% - 99% (Substantive) 80% -

Waste Management 70% - 99% (Substantive) 77% -

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HEALTH AND SOCIAL CARE BOARD STATEMENT ON INTERNAL CONTROL Records Management (Moderate compliance 67%) Progress toward achieving substantive compliance with the controls assurance standard for Records Management was limited during 2010-11, with scores increasing slightly from 63% to 67%. The main reason for limited progress, with the Records Management agenda, was due to unforeseen difficulty in completing the proposed Information Governance staffing structures and a focus on managing requests received under Freedom of Information legislation. With the structures now nearing completion (Information Governance Officer appointed April 2011) it is expected that the Board will make progress to achieve substantive compliance in this standard for 2011/12. Financial Control Framework and Assurance The system of internal financial control was based on the systematic regular monitoring of financial information, comprehensive administrative procedures including appropriate segregation of duties and a formal framework of structured delegation and associated accountability. In particular it included: Comprehensive budgeting systems with an Annual Financial Plan, which was reviewed and

agreed by the Board; Regular reviews by the Board of periodic financial reports, which indicated financial performance

against the forecast on the main areas of Board activity; Setting targets to measure financial and other performances;

Clearly defined capital investment control guidelines to safeguard assets;

As appropriate, formal delegated budget management processes; and

Systematic scrutiny by an independent internal audit.

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HEALTH AND SOCIAL CARE BOARD STATEMENT ON INTERNAL CONTROL Internal Audit The Board secured an independent Internal Audit function which operated to defined standards and whose annual work plan was informed by an analysis of risk to which the Board was exposed. During the period Internal Audit reviewed a number of systems and processes:

• Financial Review • General Ledger • Service and Maintenance Contracts • Management of Contracts with Voluntary and Community Organisations • Visits to Voluntary Organisations • Asset Management • Commissioning – Governance Arrangements • Non Contract Activity • Performance Management • Emergency Planning • Family Practitioner Service • Governance • Risk Management • Information Governance • Serious Adverse Incidents

The Internal Auditor concluded that the Board’s system of internal control was satisfactory; however limited assurance has been provided in relation to information governance, service and maintenance contracts, asset management (BSO managed service) and the use of agency staff within the satisfactory assurance provided for the financial review audit. A satisfactory assurance was also provided for the management of contracts with voluntary and community organisations audit; however a priority one finding was reported with respect to quarterly monitoring of activity with one legacy Board area. The HSCB is taking the necessary action to ensure that the recommendations made by Internal Audit are addressed as quickly as possible. Significant Internal Control Issues (inclusive of progress on prior year issues)

• Quality, Quantity and Financial Controls

This issue reflects the difficulties faced by the HSCB in fully commissioning and supporting the level of services provided for in the service and budget agreements with providers.

Financial constraints in the health and social care sector in 2010/11 necessitated the implementation of an HSC Financial Stability Programme Board chaired by the Chief Executive of the HSCB and made up of Senior Executive members from the HSCB, PHA, BSO, Trusts and the DHSSPS. The financial controls that were implemented did impact on the commissioning and

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performance agendas within the HSC sector. These were the subject of close working with all affected organisations to address any difficulties that arose.

During 2010/11 the HSCB, as directed by the DHSSPS assumed additional responsibilities for the financial management of the HSC sector. This included taking a lead role in the financial management of Trusts and Family Health Services. The HSCB worked closely with the Trusts and with the DHSSPS in monitoring these budgets and has conducted regular financial performance management meetings in order to discuss and resolve difficulties faced.

• Elective Care Priorities for Action (PfA) 2010/11 required Trusts to ensure that by March 2011, no patient waits longer than nine weeks for a first outpatient appointment, nine weeks for a diagnostic test, the majority of inpatients and day cases should be treated within 13 weeks and no patient should wait longer than 36 weeks for treatment.

The deterioration in Trusts’ performance against the elective access targets in the first half of 2010/11 was largely related to the decision to cease transferring patients to the independent sector for assessment and/or treatment, other than in orthopaedics and cardiac surgery, in order to use the available additional funding to expand health service capacity. The majority of the additional posts associated with the 2009/10 £25m recurrent investment have now been appointed. In order to minimise the increase in elective access waiting times and to reduce the number of patients waiting longer than the target waiting times at the end of March 2011, Trusts undertook additional activity, funded non-recurrently by the Board, in the second half of the year. While the number waiting longer than the target waiting times continued to reduce during March, there were a significant number of breaches of the Ministerial targets at year-end. In order to ensure that there is sufficient capacity to meet future elective demand, the Board is currently undertaking a detailed examination of each elective specialty to establish a robust baseline of the level of current capacity, taking into account agreed levels of productivity and efficiency. The outcome of this exercise will allow the Board to ensure that the system delivers the appropriate levels of activity and will inform decisions on where available recurrent funding should be targeted in order to address identified capacity gaps. Pending the outcome of this exercise, Trusts have been asked to produce elective delivery plans to continue to undertake additional in-house activity during quarter one of 2011/12 in those specialties where it is necessary to do so in order to maintain the end of March 2011 maximum waiting times.

• Unscheduled Care (4-hour and 12-hour standards)

Overall, performance against the A&E standards has been below required levels, both in relation to the 12-hour and 4 hour standards. Regionally, there were 7,380 breaches of the 12-hour standard in 2010/11 and cumulatively only 82% of patients were treated and discharged, or admitted within 4 hours of their arrival in A&E during 2010/11.

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A&E performance remains an area of serious concern and working with Trusts to address this is a top priority. To this end, a working group with representation from the Board, PHA and Primary and Secondary Care has been established to oversee a process to ensure Trusts make progress on the implementation of identified key areas for initial focus. The Board’s Rolling Audit Team will undertake a visit to each of the main A&E departments between March and June to assess the current state of implementation of a number of priority areas, and to identify opportunities for further progress. During these visits, the Rolling Audit Team will also undertake a bed utilisation audit to identify opportunities for improvement. The findings from these visits will be formally communicated to Trusts, with timescales to address the recommendations specified. Progress will be monitored through the regular performance meetings with Trusts, and follow-up visits by the Rolling Audit Team will be arranged after six months to monitor progress. As the Board considers further progress is required by Trusts to implement agreed actions to improve A&E performance, it has proposed the introduction of incentives and sanctions from April 2011 which are intended to bring about the required step-change in performance. The details of the proposed arrangements are currently being discussed with the Department.

• Children’s Services

The number of regional unallocated cases continues to be an area of serious concern. Whilst the overall trend in respect of the number of unallocated cases continues downward regionally, the trend is variable amongst individual Trusts. The HSCB is continuing to work with Trusts through the Children’s Service Improvement Programme (involving the five Trust Directors of Social Care and Children, and the Board Directors of Social Care and Children, Performance Management and Service Improvement and Finance) to address this issue as a top priority for the Board. Child protection and child care services are a complex and demanding area of work and the Children’s Service Improvement Programme has led in refining PfA definitions and guidance in respect of the children at risk and in need assessment pathways and appropriate thresholds, and also in reviewing demand and capacity in this service.

During the year the Board has worked closely with Trusts to resolve the difficulties in achieving standardised regional information, and reporting of unallocated cases has now been standardised across all Trusts.

Further work will be progressed to fully understand the demands on the service including the apparent increases in demand and to agree the appropriate response to children at risk and children in need.

21


• Breach of Social Care Statutory Functions

New monitoring arrangements have been agreed with Trusts in respect of the breach of Social Care Statutory Functions. These arrangements are now operating, and this improved reporting will mitigate the possibility of further similar breaches.

• Review of Public Administration (RPA)

Challenges in respect of the RPA were highlighted in the 2009/10 Statement on Internal Control. During the period significant progress has been made in embedding remaining HSCB structures and as a result this has been removed from the HSCB corporate risk register.

Review of Effectiveness As Accounting Officer, I have responsibility for the review of effectiveness of the system of internal control. My review of the effectiveness of the system of internal control is informed by the work of the Internal Auditor and the executive managers within the HSCB who have responsibility for the development and maintenance of the internal control framework, and comments made by the External Auditor in his management letter and other reports. I have been advised on the implications of the result of my review of the effectiveness of the system of internal control by Governance and Audit Committee, and a plan to address weaknesses and ensure continuous improvement to the system is in place. The Board of the HSCB exercises strategic control over the operation of the organisation through a system of corporate governance, which includes:

• A schedule of matters reserved for Board decisions, some of which may have been delegated to

Committees;

• A scheme of delegation, which devolved decision making authority within set parameters to the Chief Executive and other officers;

• Standing Orders and Standing Financial Instructions, which set out the Board’s governance

regulations; • The operation of a Governance and Audit Committee (comprised of Non Executive Directors) to

assure adherence to those regulations; • The operation of five Local Commissioning Groups to exercise the Board’s function under Section

9 of the Health and Social Care (Reform) Act (Northern Ireland) 2009; • The operation of a Reference Committee to exercise the HSCB’s function under the Disciplinary

Procedures Regulations (NI) 1996 with respect to the referral of disciplinary matters relating to Family Practitioner Services.

22


• The operation of a Pharmacy Practices Committee to exercise the functions of the Board under Regulation 6 (9) the Pharmaceutical Services Regulations (NI) 1997, on behalf of the Board and in accordance with Schedule 4 of the same Regulations.

• The operation of a Remuneration and Terms of Service Committee (also comprised of Non

Executive Directors) to advise the Board about appropriate remuneration and terms of service for the Chief Executive and other Senior Executives and Consultants within Departmental policy.

John Compton Chief Executive as Accounting Officer

Date

23

HEALTH AND SOCIAL CARE BOARD STATEMENT OF COMPREHENSIVE NET EXPENDITURE for the year ended 31st March 2011 Restated NOTE 2011 2010 £000s £000s Expenditure Staff costs 3.1 (23,316) (26,635) Depreciation 4.0 (2,672) (2,411) Other Expenditure 4.0 (935,415) (924,464) (961,403) (953,510) Income Income from activities 5.1 42,747 46,679 Other Income 5.2 794 1,394 Transfers from reserves for donated property, plant, equipment & intangibles 5.3 0 0 Reimbursements receivable 5.4 0 0 43,541 48,073 Net Expenditure (917,862) (905,437) RRL’s Issued (to) Belfast HSC Trust (1,015,202) (975,986) South Eastern HSC Trust (445,459) (434,445) Southern HSC Trust (456,651) (445,462) Northern HSC Trust (527,894) (525,283) Western HSC Trust (438,484) (421,104) NIAS HSC Trust (49,038) (52,608) NIMDTA (1,070) (763) NIGALA (51) 0 RQIA (122) 0 Total RRL issued (2,933,971) (2,855,651) Total Commissioner resources utilised (3,851,833) (3,761,088) RRL’s received from DHSSPS (cash and non cash) 25.1 3,851,968 3,761,196 Surplus against RRL 135 108

OTHER COMPREHENSIVE EXPENDITURE Restated 2011 2010 NOTE £000s £000s Net (loss) on revaluation of Property, Plant and Equipment

6.1/10/6.2/10 (1,398) (370)

Net gain on revaluation of intangibles 7.1/10/7.2/10 130 0 Net gain/(loss) on revaluation of available for sales of financial assets

0 0

TOTAL COMPREHENSIVE EXPENDITURE for ended 31 March 2011

(919,130) (905,807)

The notes on pages 27 to 71 form part of these accounts.

24

HEALTH AND SOCIAL CARE BOARD STATEMENT of FINANCIAL POSITION as at 31 March 2011 Restated 2011 2010 2009 NOTE £000s £000s £000s £000s £000s £000s Non Current Assets

Property, Plant and Equipment 6/6.2/ 6.4 21,425 25,288 25,145 Intangible assets 7.1/7.2/7.4 1,560 1,531 1,059 Financial Assets 8 0 0 0 Trade and other Receivables 12 0 0 0 Other Current Assets 12 0 0 0 Total Non Current Assets 22,985 26,819 26,204 Current Assets Assets classified as held for sale 9 0 0 0 Inventories 11 8 2 0 Trade and other Receivables 12 3,902 6,750 3,166 Other current assets 12 1,493 944 117 Financial Assets 8.1 0 0 0 Cash and cash equivalents 13 102 1,562 1,377 Total Current Assets 5,505 9,258 4,660 Total Assets 28,490 36,077 30,864 Current Liabilities Trade and other Payables 14 (201,637) (209,726) (173,188) Total Current Liabilities 14 0 (201,637) (209,726) (173,188) Non current assets plus/less net current assets/liabilities (173,147) (173,649) (142,324) Non Current Liabilities Provisions 16 (45,960) (50,570) (48,035) Other Payables > 1 yr 14 0 0 0 Financial Liabilities 8 0 0 0 Total Non Current Liabilities (45,960) (50,570) (48,035) Assets Less Liabilities (219,107) (224,219) (190,359) Taxpayers’ Equity Donated Asset Reserve 0 0 0 Revaluation Reserve 11,476 12,744 13,114 General Reserve (230,583) (236,963) (203,473) (219,107) (224,219) (190,359) The notes on pages 27-71 form part of these accounts.

Signed Ian Clements (Chairman) Date

Signed John Compton (Chief Executive) Date

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HEALTH AND SOCIAL CARE BOARD STATEMENT OF CASHFLOWS for the year ended 31 March 2011 Restated Note 2011 2010 £000s £000s Cashflows from operating activities Net expenditure after cost of capital and interest (917,862) (905,437) Adjustments for non cash costs 10,403 13,668 Decrease/(increase) in trade & other receivables 2,299 (4,411) (Increase)/decrease in inventories (6) 1 (Decrease)/increase in trade payables (8,089) 36,073 Movement in payables relating to capital 16 (2,279) 465 Use of provisions (11,715) (7,881) Net cash outflow from operating activities (927,249) (867,522) Cashflows from investing activities

6

Purchase of property, plant and equipment 7 (1,265) (4,174) Purchase of Intangible Assets (465) 0 Net Cash (Outflow) from investing activities (1,730) (4,174) Cash flows from financing activities

Grant in aid 927,519 871,881 Net financing 927,519 871,881 (1,460) Net (decrease)/increase in cash and cash equivalents in the period 13 185 Cash and cash equivalents at the beginning of the period 13 1,562 1,377

Cash and cash equivalents at the end of the period

102 1,562

The notes on pages 27-71 form part of these accounts.

26

HEALTH AND SOCIAL CARE BOARD STATEMENT OF CHANGES IN TAXPAYERS EQUITY for the year ended 31 March 2011 Note General Revaluation Total Reserve Reserve £000s £000s £000s Balance at 31 March 2009 (169,405) 13,114 (156,291) Changes in accounting policy – Cost of Capital 0 0 0 Change in accounting policy – clinical negligence (34,068) 0 (34,068) Restated balance at 1 April 2009 (203,473) 13,114 (190,359) Changes in reserves 2009-10 Grant from DHSSPS 871,881 0 871,881 Transfers between reserves 0 0 0 Changes in accounting policy – Cost of Capital 0 0 0 Change in accounting policy – clinical negligence 0 0 0 (Comprehensive expenditure for the year) (905,437) (370) (905,807) Donated asset receipts 0 0 0 Donated asset reserve-transfer to net expend for depreciation 0 0 0 Non cash charges-auditors remuneration 4 66 0 66 Balance at 31 March 2010 (236,963) 12,744 (224,219) Changes in taxpayers equity 2010-11 Grant from DHSSPS 927,519 0 927,519 Transfers between reserves (3,332) 0 (3,332) (Comprehensive expenditure for the year) (917,862) (1,268) (919,130) Donated asset receipts 0 0 0 Donated asset reserve-transfer to net expend for depreciation 0 0 0 Non cash charges-auditors remuneration 4 55 0 55 Balance at 31 March 2011 (230,583) 11,476 (219,107) The notes on pages 27-71 form part of these accounts.

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HEALTH AND SOCIAL CARE BOARD NOTES TO THE ACCOUNTS FOR THE YEAR ENDED 31 MARCH 2011

1. STATEMENT OF ACCOUNTING POLICIES 1.1 Authority

These accounts have been prepared in a form determined by the Department of Health, Social Services and Public Safety (DHSSPS) based on guidance from the Department of Finance and Personnel’s (DFP) Financial Reporting manual (FReM) and in accordance with the requirements of the Health and Social Care (Reform) Act (Northern Ireland) 2009. The accounting policies follow International Financial Reporting Standards (IFRS) to the extent that it is meaningful and appropriate to the Health and Social Care Board (HSCB). Where a choice of accounting policy is permitted, the accounting policy which has been judged to be most appropriate to the particular circumstances of the Board for the purpose of giving a true and fair view has been selected. The Board’s accounting policies have been applied consistently in dealing with items considered material in relation to the accounts.

1.2 Accounting convention

These accounts have been prepared under the historical cost convention modified to account for the revaluation of property, plant and equipment.

1.3 Currency and Rounding

These accounts are presented in UK Pounds sterling. The figures in the accounts are shown to the nearest £1,000.

1.4 Property, Plant and Equipment

Property, plant and equipment assets comprise Land, Buildings, Dwellings, Transport Equipment, Plant & Machinery, Information Technology, Furniture & Fittings, and Assets under construction.

Recognition

Property, plant and equipment must be capitalised if:

● it is held for use in delivering services or for administrative purposes; ● it is probable that future economic benefits will flow to, or service potential will be supplied to, the Board; ● it is expected to be used for more than one financial year; ● the cost of the item can be measured reliably; and ● the item has cost of at least £5,000; or

28

HEALTH AND SOCIAL CARE BOARD NOTES TO THE ACCOUNTS FOR THE YEAR ENDED 31 MARCH 2011 ● Collectively, a number of items have a cost of at least £5,000 and individually have a cost of more than £1,000, where the assets are functionally interdependent, they had broadly simultaneous purchase dates, are anticipated to have simultaneous disposal dates and are under single managerial control; or

● Items form part of the initial equipping and setting-up cost of a new building or unit, irrespective of their individual or collective cost. On initial recognition property, plant and equipment are measured at cost including any expenditure such as installation, directly attributable to bringing them into working condition. Items classified as “under construction” are recognised in the Statement of Financial Position to the extent that money has been paid or a liability has been incurred. Valuation of Land and Buildings Land and buildings are carried at the last professional valuation, in accordance with the Royal Institution of Chartered Surveyors (statement of Asset Valuation Practice) Appraisal and Valuation Standards in so far as these are consistent with the specific needs of the HSC. The last valuation was carried out on 31 January 2010 by Land and Property Services (LPS) which is an independent executive body within the Department of Finance and Personnel. The valuers are qualified to meet the ‘Member of Royal Institution of Chartered Surveyors’ (MRICS) standard.

Professional revaluations of land and buildings are undertaken at least once in every five year period and are revalued annually, between professional valuations, using indices provided by LPS. Land and buildings used for the Board’s services or for administrative purposes are stated in the Statement of Financial Position at their revalued amounts, being the fair value at the date of revaluation less any subsequent accumulated depreciation and impairment losses.

Fair values are determined as follows: ● Land and non-specialised buildings – open market value for existing use ● Specialised buildings – depreciated replacement cost ● Properties surplus to requirements – the lower of open market value less any material directly attributable selling costs, or book value at date of moving to non current assets. Modern Equivalent Asset DFP has adopted a standard approach to depreciated replacement cost valuations based on modern equivalent assets and, where it would meet the location requirements of the service being provided, an alternative site can be valued. Land and Property Services (LPS) have included this requirement within the latest valuation. Assets Under Construction (AUC) Properties in the course of construction for service or administration purposes are carried at cost, less any impairment loss. Cost includes professional fees as allowed by IAS 23 for assets held at fair value. Assets are revalued and depreciation commences when they are brought into use.

29


Fixtures and Equipment Until 31 March 2008, fixtures and equipment were carried at replacement cost, as assessed by indexation. From 1 April 2008 HSC entities had the option to elect to cease indexing all short life assets (other than IT). Short life IT assets are not indexed. Short life is defined as a useful life of up to and including 5 years. The carrying value of existing assets at that date were written off over their remaining useful lives and new fixtures and equipment are carried at depreciated historic cost as this is not considered to be materially different from fair value. Where estimated life of fixtures and equipment exceed 5 years, suitable indices will be applied each year and depreciation will be based on indexed amount. Revaluation Reserve An increase arising on revaluation is taken to the revaluation reserve except when it reverses an impairment for the same asset previously recognised in expenditure, in which case it is credited to expenditure to the extent of the decrease previously charged there. A revaluation decrease is recognised as an impairment charged to the revaluation reserve to the extent that there is a balance on the reserve for the asset and, thereafter, to expenditure.

1.5 Depreciation

No depreciation is provided on freehold land since land has unlimited or a very long established useful life. Items under construction are not depreciated until they are commissioned. Properties that are surplus to requirements and which meet the definition of “non current assets held for sale“ are also not depreciated.

Otherwise, depreciation is charged to write off the costs or valuation of property, plant and equipment and intangible non-current assets, less any residual value, over their estimated useful lives, in a manner that reflects the consumption of economic benefits or service potential of the assets. Assets held under finance leases are also depreciated over their estimated useful lives. The estimated useful life of an asset is the period over which the Board expects to obtain economic benefits or service potential from the asset. Estimated useful lives and residual values are reviewed each year end, with the effect of any changes recognised on a prospective basis. The following asset lives have been used.

Asset Type Asset Life Freehold Buildings 25-60 years Leasehold Property Remaining period of lease IT Assets 3-10 years Intangible assets 3-10 years Other Equipment 3 – 15 years

On initial recognition property, plant and equipment are measured at cost including any expenditure such as installation, directly attributable to bringing them into working condition. Items classified as “under construction” are recognised in the Statement of Financial Position to the extent that money has been paid or a liability has been incurred.

30


1.6 Impairment loss

If there has been an impairment loss due to a general change in prices, the asset is written down to its recoverable amount, with the loss charged to the revaluation reserve to the extent that there is a balance on the reserve for the asset and, thereafter, to expenditure. If the impairment is due to the consumption of economic benefits the full amount of the impairment is charged to the Net Expenditure account and an amount up to the value of the impairment in the revaluation reserve is transferred to the General fund. Where an impairment loss subsequently reverses, the carrying amount of the asset is increased to the revised estimate of the recoverable amount but capped at the amount that would have been determined had there been no initial impairment loss. The reversal of the impairment loss is credited to expenditure to the extent of the decrease previously charged there and thereafter to the revaluation reserve.

1.7 Subsequent Expenditure

Where expenditure enhances an asset beyond its original specification the directly attributable cost is capitalised. Where subsequent expenditure which meets the definition of capital restores the asset to its original specification, the expenditure is capitalised and any existing carrying value of the item replaced is written-out and charged to operating expenses. The overall useful life of the Board’s buildings takes account of the fact that different components of those buildings have different useful lives. This ensures that depreciation is charged on those assets at the same rate as if separate components had been identified and depreciated at different rates.

1.8 Intangible assets

Intangible assets comprise software and licences. Software that is integral to the operating of hardware, for example an operating system is capitalised as part of the relevant item of property, plant and equipment. Software that is not integral to the operation of hardware, for example application software, is capitalised as an intangible asset. Expenditure on research is not capitalised: it is recognised as an operating expense in the period in which it is incurred. Internally-generated assets are recognised if, and only if, all of the following have been demonstrated:

● the technical feasibility of completing the intangible asset so that it will be available for use ● the intention to complete the intangible asset and use it ● the ability to sell or use the intangible asset ● how the intangible asset will generate probable future economic benefits or service potential

● the availability of adequate technical, financial and other resources to complete the intangible asset and sell or ; use it

● the ability to measure reliably the expenditure attributable to the intangible asset during its development

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HEALTH AND SOCIAL CARE BOARD NOTES TO THE ACCOUNTS FOR THE YEAR ENDED 31 MARCH 2011 Recognition

Intangible assets are non-monetary assets without physical substance, which are capable of sale separately from the rest of the Board’s business or which arise from contractual or other legal rights. Intangible assets are considered to have a finite life. They are recognised only when it is probable that future economic benefits will flow to, or service potential be provided to, the Board; where the cost of the asset can be measured reliably. All single items over £5,000 in value must be capitalised while intangible assets which fall within the grouped asset definition must be capitalised if their individual value is at least £1,000 each and the group is at least £5,000 in value.

The amount recognised for internally-generated intangible assets is the sum of the expenditure incurred from the date of commencement of the intangible asset, until it is complete and ready for use.

Intangible assets acquired separately are initially recognised at fair value. Following initial recognition, intangible assets are carried at fair value by reference to an active market, and as no active market currently exits depreciated replacement cost has been used as fair value.

1.9 Donated Assets

The Board had no donated assets in either 2009/10 or 2010/11.

1.10 Non-current assets held for sale

The Board has no non-current assets held for sale in either 2009/10 or 2010/11.

1.11 Inventories

Inventories are valued at the lower of cost and net realisable value. This is considered to be a reasonable approximation to fair value due to the high turnover of stocks.

1.12 Income

Income from activities relates directly to the operating activities of the Board and is recognised when, and to the extent that, performance occurs, and is measured at the fair value of the consideration receivable. Reimbursements receivable for clinical negligence are reflected within income and relate directly to the movement in the clinical negligence provision. Grant in aid Funding received from the DHSSPS is accounted for as grant in aid and is reflected through reserves.

1.13 Investments

The Board did not have any investments in either 2009/10 or 2010/11.

1.14 Other expenses

Other operating expenses for goods or services are recognised when, and to the extent that, they have been received. They are measured at the fair value of the consideration payable.

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1.15 Cash and cash equivalents

Cash is cash in hand and deposits with any financial institution repayable without penalty on notice of not more than 24 hours. Cash equivalents are investments that mature in 3 months or less from the date of acquisition and that are readily convertible to known amounts of cash with insignificant risk of change in value.

1.16 Leases

Leases are classified as finance leases when substantially all the risks and rewards of ownership are transferred to the lessee. All other leases are classified as operating leases. The Board as Lessee Property, plant and equipment held under finance leases are initially recognised, at the inception of the lease, at fair value or, if lower, at the present value of the minimum lease payments, with a matching liability for the lease obligation to the lessor. Lease payments are apportioned between finance charges and reduction of the lease obligation so as to achieve a constant rate on interest on the remaining balance of the liability. Finance charges are recognised in calculating the Board’s surplus/deficit. Operating lease payments are recognised as an expense on a straight-line basis over the lease term. Lease incentives are recognised initially as a liability and subsequently as a reduction of rentals on a straight-line basis over the lease term. Contingent rentals are recognised as an expense in the period in which they are incurred. Where a lease is for land and buildings, the land and building components are separated. Leased land may be either an operating lease or a finance lease depending on the conditions in the lease agreement and following the general guidance set out in IAS 17. Leased buildings are assessed as to whether they are operating or finance leases.

The Board as lessor The Board did not have any lessor agreements in either 2009/10 or 2010/11.

1.17 Private Finance Initiative (PFI) transactions

The Board had no PFI transactions in either 2009/10 or 2010/11.

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1.18 Financial instruments

Financial assets

Financial assets are recognised on the Statement of Financial Position when the Board becomes party to the financial instrument contract or, in the case of trade receivables, when the goods or services have been delivered. Financial assets are derecognised when the contractual rights have expired or the asset has been transferred.

Financial assets are initially recognised at fair value.

Financial liabilities Financial liabilities are recognised on the Statement of Financial Position when the Board becomes party to the contractual provisions of the financial instrument or, in the case of trade payables, when the goods or services have been received. Financial liabilities are de-recognised when the liability has been discharged, that is, the liability has been paid or has expired. Financial liabilities are initially recognised at fair value.

Financial risk management

IFRS 7 requires disclosure of the role that financial instruments have had during the period in creating or changing the risks a body faces in undertaking its activities. The Board has limited powers to borrow or invest surplus funds and financial assets and liabilities are generated by day to day operational activities rather than being held to change the risks facing the Board in undertaking activities. Therefore the Board is exposed to limited credit, liquidity or market risk. Currency

The Board is principally a domestic organisation with the great majority of transactions, assets and liabilities being in the UK and Sterling based. The Board has no overseas operations. The Board therefore has low exposure to currency rate fluctuations. Interest rate risk

The Board has limited powers to borrow or invest and therefore has low exposure to interest rate fluctuations.

Credit risk

Because the majority of the Board’s income comes from contracts with other public sector bodies, the Board has low exposure to credit risk. Liquidity risk

Since the Board receives the majority of its funding from the DHSSPS, it is not exposed to significant liquidity risks.

34

1.19


NOTES TO THE ACCOUNTS FOR THE YEAR ENDED 31 MARCH 2011 Provisions

In accordance with IAS 37, provisions are recognised when the Board has a present legal or constructive obligation as a result of a past event, it is probable that the Board will be required to settle the obligation, and a reliable estimate can be made of the amount of the obligation. The amount recognised as a provision is the best estimate of the expenditure required to settle the obligation at the end of the reporting period, taking into account the risks and uncertainties. Where a provision is measured using the cash flows estimated to settle the obligation, its carrying amount is the present value of those cash flows using DFP’s discount rate of 2.2% in real terms. The Board has also disclosed the carrying amount at the beginning and end of the period, additional provisions made, amounts used during the period, unused amounts reversed during the period and increases in the discounted amount arising from the passage of time and the affect of any change in the discount rate.

When some or all of the economic benefits required to settle a provision are expected to be recovered from a third party, the receivable is recognised as an asset if it is virtually certain that reimbursements will be received and the amount of the receivable can be measured reliably.

Present obligations arising under onerous contracts are recognised and measured as a provision. An onerous contract is considered to exist where the Board has a contract under which the unavoidable costs of meeting the obligations under the contract exceed the economic benefits expected to be received under it.

A restructuring provision is recognised when the Board has developed a detailed formal plan for the restructuring and has raised a valid expectation in those affected that it will carry out the restructuring by starting to implement the plan or announcing its main features to those affected by it. The measurement of a restructuring provision includes only the direct expenditures arising from the restructuring, which are those amounts that are both necessarily entailed by the restructuring and not associated with ongoing activities of the entity.

1.20 Contingencies

Under IAS 37, the Board discloses contingent liabilities where there is a possible obligation that arises from past events and whose existence will be confirmed only by the occurrence or non-occurrence of one or more uncertain future events not wholly within the control of the Board, or a present obligation that is not recognised because it is not probable that a payment will be required to settle the obligation or the amount of the obligation cannot be measured sufficiently reliably. A contingent liability is disclosed unless the possibility of a payment is remote. A contingent asset is a possible asset that arises from past events and whose existence will be confirmed by the occurrence or non-occurrence of one or more uncertain future events not wholly within the control of the Board. A contingent asset is disclosed where an inflow of economic benefits is probable. Where the time value of money is material, contingencies are disclosed at their present value.

35


1.21 Employee benefits

Short-term employee benefits

Under the requirements of IAS 19: Employee Benefits, staff costs must be recorded as an expense as soon as the organisation is obligated to pay them. This includes the cost of any untaken leave that has been earned at the year end. This cost has been estimated using average staff numbers and costs applied to the average untaken leave balance determined from the results of a survey to ascertain leave balances as at 31 March 2008, and reviewed by way of a sample survey on an annual basis thereafter. It is not anticipated that the level of untaken leave will vary significantly from year to year.

Retirement benefit costs

The Board participates in the HSC Superannuation Scheme. Under this multi-employer defined benefit scheme both the Board and employees pay specified percentages of pay into the scheme and the liability to pay benefit falls to the DHSSPS. The Board is unable to identify its share of the underlying assets and liabilities in the scheme on a consistent and reliable basis. Further information regarding the HSC Superannuation Scheme can be found in the HSC Superannuation Scheme Statement in the Departmental Resource Account for the Department of Health, Social Services and Public Safety. The costs of early retirements are met by the Board and charged to the Statement of Comprehensive Net Expenditure Account at the time the Board commits itself to the retirement.

As per the requirements of IAS 19, full actuarial valuations by a professionally qualified actuary are required at intervals not exceeding four years. The actuary reviews the most recent actuarial valuation at the Statement of Financial Position date and updates it to reflect current conditions. The 31 March 2008 valuation will be used in the 2010/11 accounts.

Value Added Tax

Where output VAT is charged or input VAT is recoverable, the amounts are stated net of VAT. Irrecoverable VAT is charged to the relevant expenditure category or included in the capitalised purchase cost of fixed assets.

1.23 Third Party Assets

The Board has no third party assets in 2010/11.

36


1.24 Government Grants

The Board had no Government grants in either 2009/10 or 2010/11.

1.25 Losses and Special Payments

Losses and special payments are items that the Assembly would not have contemplated when it agreed funds for the health service or passed legislation. By their nature they are items that ideally should notarise. They are therefore subject to special control procedures compared with the generality ofpayments. They are divided into different categories, which govern the way that individual cases are handled.

1.26

Losses and special payments are charged to the relevant functional headings in expenditure on an accruals basis, including losses which would have been made good through insurance cover had the HSC Board not been bearing their own risks (with insurance premiums then being included as normal revenue expenditure). However, the note on losses and special payments is compiled directly from the losses and compensations register which reports amounts on an accruals basis with the exception of provisions for future losses. Accounting Standards that have been issued but have not yet been adopted

Under IAS 8 there is a requirement to disclose those standards issued but not yet adopted. Management has reviewed the new accounting policies that have been issued but are not yet effective, nor adopted early for these accounts. Management consider that these are unlikely to have a significant impact on the accounts in the period of the initial application. Change in Accounting policy / Prior Year Restatement There were 2 changes in Accounting policy during the year. The prior year figures have been changed in the accounts (were material) to reflect the change in accounting policy. In the Statement of Financial Position the previous two years have been restated to comply with IAS 1paragraph 29. The changes were;

(i) Capital charges

One of the impacts of the HM Treasury alignment project to closer align budgets, estimates and accounts has resulted in the removal of cost of capital. Therefore from 2010/11 onwards the HSC body is no longer required to reflect a notional cost of capital within its accounts. Expenditure, reserves and non cash RRL have been restated in the comparative years to reflect this.

(ii) Clinical negligence

As a result of new budgetary arrangements for the HSC, following changes in HM Treasury budgeting guidance, cash funding to HSC bodies is now treated as grant in aid, and financial performance is measured with reference to a Revenue Resource Limit (RRL). The relevant changes were first introduced to Trust accounts in 2008/09, and then to the HSCB accounts in 2009/10.

37

HEALTH AND SOCIAL CARE BOARD NOTES TO THE ACCOUNTS FOR THE YEAR ENDED 31 MARCH 2011 However, as a result of the specific circumstances and more complex accounting arrangements relating to clinical negligence transactions and balances, the Department obtained dispensation from DFP which allowed HSC bodies to continue to cover clinical negligence costs by match funding. This was managed through the clinical negligence Central Fund such that re-imbursements receivable from the Central Fund in respect of clinical negligence provisions and liabilities were accounted for as income and reflected within debtors. Clinical negligence provision continues to be fully funded but rather than being re-imbursed by Central fund, it is now matched by RRL non cash cover. The Central Fund will no longer be used to administer settlement of clinical negligence claims, rather HSC bodies will draw cash to cover clinical negligence settlements as grant in aid directly from the Department. HSC bodies are now required to adopt this policy in full and have therefore restated any debtors in respect of amounts reimbursable from the Central Fund. Income, receivables and non cash RRL have been restated in the comparative years to reflect this.

(iii) Impairment

Previously all impairments were charged to the Revaluation Reserve if one existed before the remaining amount was charged to the Statement of Comprehensive Net Expenditure. Treasury/DFP guidance for 2010/11 and future periods is that economic impairments should be charged in full to the Statement of Comprehensive Net Expenditure with a corresponding transfer being made from the Revaluation Reserve to the General Fund. This is considered to be more transparent than the IFRS approach to impairments. There is no change in policy in respect of price impairments. This change did not have any/significant impact on the accounts and a prior year restatement was not required.

2009/10 Cost of Capital

Clinical negligence

£000s £000s Income 0 9,831 Expenditure 5,891 0 Receivables 0 (9,831) Payables 0 0 Reserves 0 0 RRL (5,891) 0 2008/09 Cost of

Capital Clinical

negligence £000s £000s Receivables 0 (34,065) Reserves 0 34,065

38

HEALTH & SOCIAL CARE BOARD NOTES TO THE ACCOUNTS FOR THE YEAR ENDED 31 MARCH 2011 NOTE 2. ANALYSIS OF NET EXPENDITURE BY SEGMENT The HSCB has identified 3 Segments: Commissioning, Family Health Services (FHS) and Administration. Net expenditure is reported by segment as detailed below: Note Restated Summary 2011 2010 £000s £000s Net Expenditure Commissioning 2.1 2,961,947 2,904,324 FHS 2.2 821,578 804,614 Board Administration 2.3 68,309 52,286 Total Commissioner Resources Utilised 3,851,834 3,761,224 2.1 Commissioning Expenditure Belfast HSC Trust NEA 1,015,202 975,986 South Eastern HSC Trust NEA 445,459 434,445 Southern HSC Trust NEA 456,651 445,462 Northern HSC Trust NEA 527,894 525,283 Western HSC Trust NEA 438,484 421,104 NIAS HSC Trust NEA 49,038 52,608 NIMDTA NEA 1,070 763 NIGALA NEA 51 0 RQIA NEA 122 0 Other Providers 4.1 53,443 72,214 2,987,414 2,927,865 Income Income from activities 5.1 25,467 23,541 Reimbursement in respect of provisions 5.4 0 0 25,467 23,541 Commissioning Net Expenditure 2,961,947 2,904,324 2.2 FHS Expenditure General Medical Services 4.1 219,958 223,605 General Dental Services 4.1 106,954 100,514 General Pharmaceutical Services 4.1 492,282 483,872 General Ophthalmic Services 4.1 19,664 19,761 838,858 827,752 Income FHS Receipts & Recovery of Charges 5.1 17,280 23,138 FHS Net Expenditure 821,578 804,614

39

HEALTH & SOCIAL CARE BOARD

NOTES TO THE ACCOUNTS FOR THE YEAR ENDED 31 MARCH 2011 NOTE 2. ANALYSIS OF NET EXPENDITURE BY SEGMENT (cont’d) NOTE Restated 2011 2010 £000s £000s 2.3 Board Administration Expenditure Salaries and Wages 3.1 23,316 26,635 Operating Expenditure 4.2 35,383 13,377 Non Cash Costs 4.3 7,165 11,257 Depreciation 4.3 3,238 2,411 69,102 53,680

Income Staff secondment recoveries 3.1 690 844 Operating Income 103 550 793 1,394 Board Administration Net Expenditure 68,309 52,286

40

HEALTH & SOCIAL CARE BOARD NOTES TO THE ACCOUNTS FOR THE YEAR ENDED 31 MARCH 2011 NOTE 3. STAFF NUMBERS AND RELATED COSTS 3.1 Staff Costs Staff costs comprise 2011 2010

Total

Permanently employed

staff Others Total £000s £000s £000s £000s Wages & Salaries 19,658 17,473 2,185 19,536 Social Security Costs 1,418 1,280 138 1,394 Other Pension Costs 2,240 2,010 230 5,705 Total Staff costs reported in Statement of Comprehensive Expenditure

23,316 20,763 2,553 26,635

Less recoveries in respect of outward secondments 690 844 Total net costs 22,626 25,791 There is £nil staff costs charged to capital projects during the year (2010 £nil). The HSCB participates in the HSC Superannuation Scheme. Under this multi-employer defined benefit scheme both the HSC and employees pay specified percentages of pay into the scheme and the liability to pay benefit falls to the DHSSPS. The Board is unable to identify its share of the underlying assets and liabilities in the scheme on a consistent and reliable basis.

As per the requirements of IAS 19, full actuarial valuations by a professionally qualified actuary are required at intervals not exceeding four years. The actuary reviews the most recent actuarial valuation at the Statement of Financial Position date and updates it to reflect current conditions. A full valuation as at 31 March 2008 was completed at 2010/11. 3.2 Average number of persons employed The average number of whole time equivalent persons employed during the year was as follows: 2011 2010

Total

Permanently employed

staff Others Total No. No. No. No. Commissioning of Health and Social Care 435 372 63 522 Less average staff number relating to capitalised staff costs 0 0 0 0 Less average staff number in respect of outward secondments 8 8 0 16 Total net average number of persons employed 427 364 63 506

41

HEALTH AND SOCIAL CARE BOARD NOTES TO THE ACCOUNTS FOR THE YEAR ENDED 31 MARCH 2011 NOTE 3 STAFF NUMBERS AND RELATED COSTS 3.3 Senior Employees' Remuneration

The salary, pension entitlements and the value of any taxable benefits in kind of the most senior members of the HSCB were as follows: 2010/11 2009/10 2010/11

Name

Salary, including Performance Pay

£000s

Benefits in Kind

(Rounded to nearest £100)

Salary, including

Performance Pay £000s

Benefits in Kind


Real increase in pension and related lump sum at age 60

£000s

Total accrued pension at age 60 and related lump

sum £000s

CETV at

31/03/09 £000s

CETV at

31/03/10 £000s

Real increase

in CETV £000s

Non-Executive Members I Clements 30-35 0 30-35 0 0 0 0 0 0 S J Leach 5-10 0 5-10 0 0 0 0 0 0 M McCullough 5-10 0 5-10 0 0 0 0 0 0 R Gilmore 5-10 0 5-10 0 0 0 0 0 0 B McKeever 5-10 0 5-10 0 0 0 0 0 0 J Mone 5-10 0 5-10 0 0 0 0 0 0 E Kerr 5-10 0 5-10 0 0 0 0 0 0 W R Thompson 5-10 0 5-10 0 0 0 0 0 0 Executive Members

J Compton 140-145 300 145-150 400 0-2.5 pension 5-7.5 lump sum

65-70 pension 200-205 lump sum 1,602 - -

P Cummings 105-110 200 105-110 2,800 0-2.5 pension 5-7.5 lump sum

30-35 pension 100-105 lump sum 571 549 -22

H Mullen (left 02/05/10) 15-20 0 115-120 24,500 No calculation can be made as postholder left 2/05/10

M Bloomfield(acting 04/04/10-30/08/10)

30-35

500 0 0 No calculation can be made as postholder in acting up basis from 1/4/10 to

30/08/10

42


NOTES TO THE ACCOUNTS FOR THE YEAR ENDED 31 MARCH 2011 3.3 Senior Employees' Remuneration (cont’d) 2010/11 2009/10 2010/11

Executive Members (cont’d) Salary, including Performance Pay

£000s

Benefits in Kind


Salary, including

Performance Pay

£000s

Benefits in Kind


Real increase in pension and related lump sum at age 60

£000s

Total accrued pension at age 60 and related lump

sum £000s

CETV at

31/03/09 £000s

CETV at

31/03/10 £000s

Real increase

in CETV £000s

L McMahon (commenced 01/09/10)

60-65 500 0 0 No calculation can be made as postholder took up post on 1/9/10

F E McAndrew 80-85 200 80-85 100 0-2.5 pension 2.5-5 lump sum

15-20 pension 45-50 lump sum 312 321 9

S Harper 120-125 900 85-90 600 2.5-5pension 7.5-10 lump sum

35-40 pension 100-115 lump sum 637 645 8

B Mitchell (retired 26/03/11) 75-80 0 70-75 0 0-2.5 pension

5-7.5 lump sum 30-35 pension 90-95 lump sum 593 614 21

D Sullivan (commenced 01/06/10) 85-90 500 0 0 No calculation can be made as postholder took up post on 1/06/10 *Mr Compton’s contribution ceased in 2010/11 therefore there is no CETV at 31/03/11 As Non-Executive members do not receive pensionable remuneration, there will be no entries in respect of pensions for Non-Executive members. A Cash Equivalent Transfer Value (CETV) is the actuarially assessed capital value of the pension scheme benefits accrued by a member at a particular point in time. The benefits valued are the member's accrued benefits and any contingent spouse's pension payable from the scheme. A CETV is a payment made by a pension scheme, or arrangement to secure pension benefits in another pension scheme or arrangement when the member leaves a scheme and chooses to transfer the benefits accrued in their former scheme. The pension figures shown relate to the benefits that the individual has accrued as a consequence of their total membership of the pension scheme, not just their service in a senior capacity to which the disclosure applies. The CETV figures and the other pension details, include the value of any pension benefits in another scheme or arrangement which the individual has transferred to the HSC pension scheme. They also include any additional pension benefit accrued to the member as a result of their purchasing additional years of pension service in the scheme at their own cost.

CETVs are calculated within the guidelines prescribed by the Faculty of Actuaries. Real Increase in CETV - This reflects the increase in CETV effectively funded by the employer. It takes account of the increase in accrued pension due to inflation, contributions paid by the employee (Including the value of any benefits transferred from another pension scheme or arrangement) and uses common market valuation factors for the start and end of the period.

43


NOTES TO THE ACCOUNTS FOR THE YEAR ENDED 31 MARCH 2011

NOTE 3 STAFF NUMBERS AND RELATED COSTS

3.4 Reporting of early retirement and other compensation scheme exit packages

Exit package cost band

Number of compulsory redundancies Number of other departures agreed Total number of exit packages by cost band

2011 2010 2011 2010 2011 2010 <£10,000 0 0 0 4 0 4 £10,000 - £25,000 0 0 0 8 0 8 £25,000- £50,000 0 0 0 12 0 12 £50,000 - £100,000 0 0 0 15 0 15 £100,000-150,000 0 0 0 10 0 10 £150,000-£200,000 0 0 0 10 0 10 £200,000-£250,000 0 0 0 7 0 7 £250,000-£300,000 0 0 0 4 0 4 £300,000-£350,000 0 0 0 5 0 5 £350,000-£400,000 0 0 0 1 0 1 Total number of exit packages by type

0 0 0 76 0 76

£000s £000s £000s £000s £000s £000s Total resource cost 0 0 0 9,143 0 9,143

Redundancy and other departure costs have been paid in accordance with the provisions of the HSC Pension Scheme Regulations and the Compensation for Premature Retirement Regulations, statutory provisions made under the Superannuation Act 1972. Exit costs are accounted for in full in the year in which the exit package is approved and agreed and are included as operating expenses at note 4. Where early retirements have been agreed, the additional costs are met by the employing authority and not by the HSC pension scheme. Ill health retirement costs are met by the pension scheme and are not included in the table.

44



NOTE 3 STAFF NUMBERS AND RELATED COSTS 3.5 Staff Benefits The HSCB has no staff benefits 3.6 HSCB Management Costs 2011 2010 £000s £000s

HSCB Management Costs 30,628 35,747 Income: RRL from DHSSPS 3,851,968 3,761,196 Less Non Cash RRL 10,405 13,149 Income per Note 5 43,541 48,073 Less interest receivable 0 0 Total Income 3,885,104 3,796,120 % of total income 0.79% 0.94% The Management Costs have been prepared on consistent basis from previous years and have been based on the appropriate HSCB elements contained in the circular HSS (THR) 2/99. 3.7 Retirements due to ill-health During 2010/11 there were no early retirements from the HSCB agreed on the grounds of ill-health.

45

HEALTH AND SOCIAL CARE BOARD NOTES TO THE ACCOUNTS FOR THE YEAR ENDED 31 MARCH 2011 NOTE 4 OPERATING EXPENSES Operating Expenses Restated 4.1 Commissioning:- 2011 2010 £000s £000s HSC Trust General Medical Services 219,958 223,605 General Dental Services 106,954 100,514 General Pharmaceutical Services 492,282 483,872 General Ophthalmic Services 19,664 19,761 NHS Trusts 17,618 13,211 Other providers of healthcare and personal social services 35,825 48,620 Other services 0 1,739 Miscellaneous 0 8,508 Total Commissioning 892,301 899,830 4.2 Operating Expenses:- Supplies and services -general 369 815 Establishment (including redundancy and severance costs) 32,474 10,631 Transport 7 15 Premises 2,389 1,757 Bad debts 1 0 Rentals under operating leases 142 159 Interest charges 1 0 PFI Service charges 0 0 Research & development expenditure 0 0 Costs of exit packages not provided for 0 0 Miscellaneous 0 0 Total Operating Expenses 35,383 13,377 4.3 Non Cash Items:- Depreciation 2,672 2,411 Amortisation 566 386 Impairments 0 345 (Profit) on disposal of assets(excluding profit on land) 0 0 Loss on disposal of assets (including land) 5 44 Provisions provided for in year 6,035 9,201 Unwinding of discount on Provisions 1,070 1,215 Auditors remuneration 55 66 Total Non Cash Items 10,403 13,668 Total 938,087 926,875 During the year the HSCB paid its share (£2,911.70) of regional audit services from its external auditor (NIAO) for the National Fraud Initiative . The Service Level Agreement with the Business Services Organisation (£16m) and regional ICT funding of (£11m) has been reclassified to Operating Expenditure in 2010/11.

Miscellaneous and other commissioning expenditure has been reclassified to other providers within commissioning.

46


NOTE 5 INCOME Restated 5.1 Income from Activities 2011 2010 £000s £000s Income from Department of Education 23,922 22,186 CAWT 520 1,027 Family Health Services Receipts 17,280 23,138 Other Income 1,025 328 Total 42,747 46,679 5.2 Other Operating Income Restated 2011 2010 £000s £000s Accommodation 0 420 Canteen 104 106 Seconded Staff 690 844 Other Income 0 24 Total 794 1,394 5.3 Transfers from reserves for donated property, plant, equipment & Intangibles Donated asset reserve transfer for Impairment 0 0 Donated asset reserve transfer for Depreciation & amortisation 0 0 Total 0 0 5.4 Reimbursements receivable in respect of provisions Movements in reimbursable income from Clinical Negligence Central Fund 0 0

TOTAL INCOME 43,541 48, 073

47

HEALTH AND SOCIAL CARE BOARD NOTES TO THE ACCOUNTS FOR THE YEAR ENDED 31 MARCH 2011 NOTE 6. PROPERTY, PLANT AND EQUIPMENT Summary

2011 Purchased Donated Total £000s £000s £000s Net book value: Land 3,358 0 3,358 Buildings (excluding dwellings) 10,388 0 10,388 Dwellings 0 0 0 Assets under construction 0 0 0 Plant and machinery (Equipment) 0 0 0 Transport Equipment 0 0 0 Information Technology (IT) 7,660 0 7,660 Furniture & Fittings 19 0 19 Total PPE - 31 March 2011 21,425 0 21,425

2010 Purchased Donated Total £000s £000s £000s Net book value: Land 5,435 0 5,435 Buildings (excluding dwellings) 10,914 0 10,914 Dwellings 0 0 0 Assets under construction 0 0 0 Plant and machinery (Equipment) 1 0 1 Transport Equipment 26 0 26 Information Technology (IT) 7,014 0 7,014 Furniture & Fittings 1,898 0 1,898 Total PPE - 31 March 2010 25,288 0 25,288 Professional revaluations of land and buildings are undertaken by Land and Property Services (LPS) at least once in every five year period and are revalued annually, between professional valuations, using indices provided by LPS. See accounting Policy Note 1, Section 1.3 for more details of valuation of Property, Plant and Equipment.

48

HEALTH AND SOCIAL CARE BOARD NOTES TO THE ACCOUNTS FOR THE YEAR ENDED 31 MARCH 2011 NOTE 6.1 Property, Plant & Equipment - Purchased assets - year ended 31 March 2011

Land

Buildings (excluding dwellings)

Plant and Machinery

(Equipment) Transport Equipment

Information Technology

(IT)

Furniture and

Fittings Total £000s £000s £000s £000s £000s £000s £000s Cost or Valuation At 1 April 2010 5,435 11,929 6 53 16,602 2,304 36,329 Indexation 0 452 0 0 7 0 459 Additions 0 346 0 0 3,200 0 3,546 Reclassifications 0 806 0 0 0 (2,140) (1,334) Transfers (541) (2,796) 0 (49) (801) 0 (4,187) Revaluation (721) (106) 0 (4) (166) 0 (997) (Impairments) (815) 0 0 0 0 0 (815) (Disposals) 0 0 0 0 (979) 0 (979) At 31 March 2011 3,358 10,631 6 0 17,863 164 32,022 At 1 April 2010 0 1,015 6 27 9,589 406 11,043 Indexation 0 38 0 0 7 0 45 Reclassifications 0 (1,053) 0 0 0 (281) (1,334) Transfers 0 (25) 0 (29) (801) 0 (855) Revaluation 0 0 0 0 0 0 0 (Impairments) 0 0 0 0 0 0 0 (Disposals) 0 0 0 0 (974) 0 (974) Provided during the year 0 268 0 2 2,382 20 2,672 At 31 March 2011 0 243 6 0 10,203 145 10,597 Net Book Value At 31 March 2011 3,358 10,388 0 0 7,660 19 21,425 At 31 March 2010 5,435 10,914 0 26 7,013 1,898 25,286 Asset financing Owned 3,358 10,388 0 0 7,660 19 21,425 Net Book Value At 31 March 2011 3,358 10,388 0 0 7,660 19 21,425 The total amount of depreciation charged in the Statement of Comprehensive Net Expenditure in respect of assets held under finance leases and hire purchase contracts is £nil (2010 £nil)

49

HEALTH AND SOCIAL CARE BOARD NOTES TO THE ACCOUNTS FOR THE YEAR ENDED 31 MARCH 2011 NOTE 6.2 Property, Plant & Equipment - Purchased assets - year ended 31 March 2010

Land

Buildings (excluding dwellings)

Plant and Machinery

(Equipment) Transport Equipment

Information Technology

(IT)

Furniture and

Fittings Total £000s £000s £000s £000s £000s £000s £000s Cost or Valuation At 1 April 2009 5,746 13,254 5 48 13,451 2,314 34,818 Indexation (915) (1,773) 0 5 487 (272) (2,468) Additions 0 0 0 0 3,315 3 3,318 Reclassifications 0 0 0 0 0 0 0 Transfers 0 50 0 0 54 10 114 Revaluation 635 749 0 0 (5) 249 1,628 (Impairments) (31) (351) 0 0 0 0 (382) (Disposals) 0 0 0 0 (700) 0 (700) At 31 March 2010 5,435 11,929 5 53 16,602 2,304 36,328 At 1 April 2009 0 1,421 3 18 7,927 304 9,673 Indexation 0 (90) 0 2 260 3 175 Reclassifications 0 0 0 0 0 0 0 Transfers 0 50 0 0 64 5 119 Revaluation 0 (645) 0 0 0 0 (645) (Impairments) 0 (37) 0 0 0 0 (37) (Disposals) 0 0 0 0 (656) 0 (656) Provided during the year 0 316 1 7 1,993 94 2,411 At 31 March 2010 0 1,015 4 27 9,588 406 11,040 Net Book Value At 1 April 2009 5,746 11,833 2 30 5,524 2,010 25,145 At 31 March 2010 5,435 10,914 1 26 7,014 1,898 25,288 Asset financing Owned 5,435 10,914 1 26 7,014 1,898 25,288 Net Book Value At 31 March 2010 5,435 10,914 1 26 7,014 1,898 25,288 Asset financing Owned 5,746 11,833 2 30 5,524 2,010 25,145 Net Book Value At 1 April 2009 5,746 11,833 2 30 5,524 2,010 25,145

50

HEALTH AND SOCIAL CARE BOARD NOTES TO THE ACCOUNTS FOR THE YEAR ENDED 31 MARCH 2010 NOTE 6.3 and 6.4 Property, Plant & Equipment – Donated assets – Year ended 31 March 2011 and 31 March 2010 The HSCB has no donated assets. NOTE 7. INTANGIBLE ASSETS Summary 2011

Purchased Donated Total £000s £000s £000s Net book value: Software 1,079 0 1,079 Software licenses 481 0 481 Total Intangible assets - 31 March 2011 1,560 0 1,560 2010 Purchased Donated Total £000s £000s £000s Net book value: Software 394 0 394 Software licenses 1,137 0 1,137

Total Intangible assets - 31 March 2010 1,531 0

1,531

51

HEALTH AND SOCIAL CARE BOARD NOTES TO THE ACCOUNTS FOR THE YEAR ENDED 31 MARCH 2011 NOTE 7.1 Intangible Assets (Purchased) - Year ended 31 March 2011

Software

licenses Software Total Cost or Valuation £000s £000s £000s At 1 April 2010 2,440 611 3,051 Indexation 0 0 0 Additions 465 0 465 Reclassifications 0 0 0 Transfers (2,008) 2,900 892 Revaluation 0 130 130 (Impairments) 0 0 0 (Disposals) 0 0 0 At 31 March 2011 897 3,641 4,538 Amortisation At 1 April 2010 1,303 217 1,520 Indexation 0 0 0 Reclassifications 0 0 0 Transfers (928) 1,820 892 Revaluation 0 0 0 (Impairments) 0 0 0 (Disposals) 0 0 0 Provided during the year 41 525 566 At 31 March 2011 416 2,562 2,978 Net Book Value At 31 March 2011 481 1,079 1,560 At 31 March 2010 1,137 394 1,531 Asset financing Owned 481 1,074 1,560 Financed Leased 0 0 0 On Statement of Financial Position PFI and other service concession arrangements contracts 0 0 0 Net Book Value at 31 March 2011 481 1,074 1,560

52

HEALTH AND SOCIAL CARE BOARD NOTES TO THE ACCOUNTS FOR THE YEAR ENDED 31 MARCH 2011 NOTE 7.2 Intangible Assets (Purchased) - Year ended 31 March 2010

Software

licenses Software Total Cost or Valuation £000s £000s £000s At 1 April 2009 2,197 0 2,197 Indexation 0 0 0 Additions 250 603 853 Reclassifications 0 0 0 Transfers (7) 8 1 Revaluation 0 0 0 (Impairments) 0 0 0 (Disposals) 0 0 0 At 31 March 2010 2,440 611 3,051 Amortisation At 1 April 2009 1,138 0 1,138Indexation 0 0 0Reclassifications 0 0 0Transfers (7) 3 (4)Revaluation 0 0 0(Impairments) 0 0 0(Disposals) 0 0 0Provided during the year 172 214 386At 31 March 2010 1,303 217 1,520 Net Book Value At 1 April 2009 1,059 0 1,059At 31 March 2010 1,137 394 1,531 Asset financing Owned 1,137 394 1,531Finance leased 0 0 0On SoFP PFI and other service concession arrangements contracts 0 0 0Net Book Value at 31 March 2010 1,137 394 1,531Asset financing Owned 1,059 0 1,059Finance leased 0 0 0On SoFP PFI and other service concession arrangements contracts 0 0 0Net Book Value at 31 March 2009 1,059 0 1,059

53



The HSCB has no donated assets. NOTE 8. FINANCIAL INSTRUMENTS 8.1 Financial Instruments Due to the relationships with HSC Commissioners and the manner in which they are funded, financial instruments play a more limited role within the HSCB in creating risk than would apply to a non public sector body of a similar size, therefore the HSCB is not exposed to the degree of financial risk faced by business entities. The HSCB has limited powers to borrow or invest surplus funds and financial assets and liabilities are generated by day to day operational activities rather than being held to change the risks facing the HSCB in undertaking activities. Therefore the HSCB is exposed to little credit, liquidity or market risk. NOTE 9. ASSETS CLASSIFIED AS HELD FOR SALE Non current assets held for sale comprise non current assets that are held for resale rather than for continuing use within the business. The HSCB did not hold any assets classified as held for sale in 2009/10 or 2010/11.

54

HEALTH AND SOCIAL CARE BOARD NOTES TO THE ACCOUNTS FOR THE YEAR ENDED 31 MARCH 2011 10. IMPAIRMENTS 2011

Property, Plant &

Equipment Intangibles Total £000s £000s £000s

Purchased

Donated

Purchased

Donated

Total value of impairments for the period 815 0 0 0 0 Impairments taken through revaluation/donation reserve (815) 0 0 0 0 Impairments charged to Statement of Comprehensive Net Expenditure within Net Expenditure 0 0 0 0 0 2010

Property, Plant &


Purchased

Donated

Purchased

Donated

Total value of impairments for the period 345 0 0 0 345 Impairments taken through revaluation/donation reserve 0 0 0 0 0 Impairments charged to Statement of Comprehensive Net Expenditure within Net Expenditure 345 0 0 0 345 2009 Property, Plant &


Purchased

Donated

Purchased

Donated

Total value of impairments for the period 690 0 0 0 0 Impairments taken through revaluation/donation reserve 0 0 0 0 0 Impairments charged to Statement of Comprehensive Net Expenditure within Net Expenditure 690 0 0 0 0

The HSCB had £nil donated assets nil 2008/09-2010/11

55



11. INVENTORIES 2011 2010 2009 £000s £000s £000s Classification 0 2 0 Stationery 8 0 0 Oil Total 8 2 0

56


NOTES TO THE ACCOUNTS FOR THE YEAR ENDED 31 MARCH 2011 12. TRADE RECEIVABLES AND OTHER CURRENT ASSETS Restated Restated 2011 2010 2009 £000s £000s £000s Amounts falling due within one year Trade Receivables 810 2,709 1,886 Deposits and advances 0 0 0 Clinical Negligence provision Receivable 0 0 0 Clinical Negligence Fund reimbursements receivable 0 0 0 Other receivables 3,092 4,041 1,280 Trade and other Receivables 3,902 6,750 3,166 Prepayments and accrued income 1,493 944 117 Current part of PFI and other service concession arrangements prepayment 0 0 0 Other current assets 1,493 944 117 Amounts falling due after more than one year Trade Receivables 0 0 0 Deposits and advances 0 0 0 Clinical Negligence Receivable 0 0 0 Other receivables 0 0 0 Trade and other Receivables 0 0 0 Prepayments and accrued income 0 0 0 Other current assets falling due after more than one year 0 0 0 TOTAL TRADE AND OTHER RECEIVABLES 3,902 6,750 3,166 TOTAL OTHER CURRENT ASSETS 1,493 944 117 TOTAL RECEIVABLES AND OTHER CURRENT ASSETS 5,395 7,694 3,283 The balances are net of a provision for bad debts of £nil (2010; £nil) (2009; £nil).

57


12 TRADE RECEIVABLES AND OTHER CURRENT ASSETS 12.1 Trade Receivables and other current assets: Intra-Government balances Restated Restated Restated Restated

Amounts falling

due within 1

year 2010/11

Amounts falling

due within 1

year 2009/10

Amounts falling

due within 1

year 2008/09

Amounts falling

due after more

than 1 year

2010/11

Amounts falling

due after more

than 1 year

2009/10

Amounts falling

due after more

than 1 year

2008/09 £000s £000s £000s £000s £000s £000s Name Balances with other central government bodies 3,781 0 710 0 0 0 Balances with local authorities 2 0 4 0 0 0 Balances with NHS /HSC Trusts 1,516 6,827 1,524 0 0 0 Balances with public corporations and trading funds 0 0 0 0 0 0 Intra-Government Balances 5,299 6,827 2,238 0 0 0 Balances with bodies external to government 96 867 1,045 0 0 0 Total Receivables & other current assets at 31 March 5,395 7,694 3,283 0 0 0

58

HEALTH AND SOCIAL CARE BOARD NOTES TO THE ACCOUNTS FOR THE YEAR ENDED 31 MARCH 2011 13. CASH AND CASH EQUIVALENTS Restated Restated 2011 2010 2009 £000s £000s £000s Balance at 1st April 1,562 1,377 996 Net change in cash and cash equivalents (1,460) 185 381 Balance at 31st March 102 1,562 1,377 The following balances at 31 March were held at 2011 2010 2009 £000s £000s £000s Commercial Banks and cash in hand 102 1,562 1,377 102 1,562 1,377

59


NOTES TO THE ACCOUNTS FOR THE YEAR ENDED 31 MARCH 2011 14. TRADE PAYABLES AND OTHER CURRENT LIABILITIES Restated Restated 2011 2010 2009 £000s £000s £000s Amounts falling due within one year Other taxation and social security 172 1,269 863 Bank overdraft 0 0 0 Trade capital payables 2,365 86 551 Trade revenue payables 83,299 114,129 12,184 Payroll payables 2,672 1,551 2,995 Clinical Negligence payables 14 15 0 RPA payables 0 3,167 2,542 BSO payables 6,793 17,194 7,000 Other payables 1,626 8,242 28,199 Accruals and deferred income 104,696 64,073 118,854 Trade and other payables 201,637 209,726 173,188 Total payables falling due within one year 201,637 209,726 173,188 Amounts falling due after more than one year Other Payables, accruals and deferred income 0 0 0 Trade and other payables 0 0 0 Clinical Negligence payables 0 0 0 Total non current other payables 0 0 0 TOTAL TRADE PAYABLES AND OTHER CURRENT LIABILITIES 201,637 209,726 173,188

60


NOTES TO THE ACCOUNTS FOR THE YEAR ENDED 31 MARCH 2011 14 TRADE PAYABLES AND OTHER CURRENT LIABILITIES 14.1 Trade payables and other current liabilities - Intra-government balances Restated Restated Restated Restated

Amounts falling

due within 1

year 2010/11

Amounts falling

due within 1

year 2009/10

Amounts falling

due within 1

year 2008/09

Amounts falling

due after more

than 1 year

2010/11

Amounts falling

due after more

than 1 year

2009/10

Amounts falling

due after more

than 1 year

2008/09 £000s £000s £000s £000s £000s £000s Name Balances with other central government bodies 2,450 1,244 18,191 0 0 0 Balances with local authorities 6 0 3 0 0 0 Balances with NHS /HSC Trusts 18,879 10,385 4,868 0 0 0 Balances with public corporations and trading funds 0 0 0 0 0 0

Intra-Government Balances

21,335 11,629 23,062 0 0 0 Balances with bodies external to government 180,302 198,097 150,126 0 0 0 Total Payables and other liabilities at 31 March 201,637 209,726 173,188 0 0 0

61

HEALTH AND SOCIAL CARE BOARD NOTES TO THE ACCOUNTS FOR THE YEAR ENDED 31 MARCH 2011 NOTE 15. PROMPT PAYMENT POLICY 15.1 Public Sector Payment Policy - Measure of Compliance The Department requires that HSC pay their non HSC trade creditors in accordance with the CBI Prompt Payment Code and Government Accounting Rules. The HSCB’s payment policy is consistent with the CBI prompt payment codes and Government Accounting rules and its measure of compliance is:

2011 2011 2010 2010 Number Value Number Value £’000 £’000 Total bills paid 17,975 69,430 15,868 N/A Total bills paid within 30 day target 16,956 61,568 14,989 N/A % of bills paid within 30 day target 94.3% 88.7% 94.5% N/A 15.2 The Late Payment of Commercial Debts Regulations 2002 The amount included within Interest Payable arising from claims made by small businesses under this legislation are as follows : £ Total 664

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NOTES TO THE ACCOUNTS FOR THE YEAR ENDED 31 MARCH 2011 16. PROVISIONS FOR LIABILITIES AND CHARGES - 2011

Pensions relating to other staff

Clinical negligence Other

Total 2011

£000s £000s £000s £000s Balance at 1 April 2010 13,280 32,160 5,130 50,570 Transfer between provisions (2,190) 0 2,190 0 Provided in year 1,423 13,605 533 15,561 (Provisions not required written back) (611) (7,406) (1,509) (9,526) (Provisions utilised in the year) (1,074) (10,150) (491) (11,715) Unwinding of discount 236 707 127 1,070 At 31 March 2011 11,064 28,916 5,980 45,960 Net Expenditure Account charges 2011 2010 £000s £000s Arising during the year 15,561 17,335 Reversed unused (9,526) (8,134) Unwinding of discount 1,070 1,215 Total charge within Operating costs 7,105 10,416 Analysis of expected timing of discounted flows


Clinical Negligence Other

Total 2011

£000s £000s £000s £000s Within 5 years 5,414 28,213 1,864 35,491 6 -10 years 4,703 301 1,744 6,748 Thereafter 947 402 2,372 3,721 At 31 March 2011 11,064 28,916 5,980 45,960

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NOTES TO THE ACCOUNTS FOR THE YEAR ENDED 31 MARCH 2011 16. PROVISIONS FOR LIABILITIES AND CHARGES - 2010



Total 2010

£000s £000s £000s £000s Balance at 1 April 2009 13,231 29,658 5,146 48,035 Provided in year 1,175 15,791 369 17,335 (Provisions not required written back) (1,158) (6,755) (221) (8,134) (Provisions utilised in the year) (297) (7,330) (254) (7,881) Unwinding of discount 329 796 90 1,215 At 31 March 2010 13,280 32,160 5,130 50,570 Analysis of expected timing of discounted flows



Total 2010

£000s £000s £000s £000s Within 5 years 7,234 31,389 3,297 41,920 6 -10 years 4,950 771 1,112 6,833 Thereafter 1,096 0 721 1,817 At 31 March 2010 13,280 32,160 5,130 50,570

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HEALTH AND SOCIAL CARE BOARD NOTES TO THE ACCOUNTS FOR THE YEAR ENDED 31 MARCH 2011 NOTE 17. CAPITAL COMMITMENTS The HSCB had no capital commitments in 2010/11 or 2009/10. NOTE 18. COMMITMENTS UNDER LEASES 18.1 Operating Leases Total future minimum lease payments under operating leases are given in the table below for each of the following periods. Obligations under operating leases comprise

2011

£000S 2010

£000s

Restated 2009

£000s Land & Buildings Not later than 1 year 142 159 159 Later than 1 year and not later than 5 years 50 192 352 Later than 5 years 0 0 0 192 351 511 Other 0 0 0 Not later than 1 year 0 0 0 Later than 1 year and not later than 5 years 0 0 0 Later than 5 years 0 0 0

18.2 Finance Leases The HSCB had no Finance Leases in 2010/11 or 2009/10. 18.3 Operating Leases The HSCB has no lessor obligations in 2010/11 and 2009/10.

NOTE 19. COMMITMENTS UNDER PFI CONTRACTS AND OTHER SERVICE CONCESSION ARRANGEMENT CONTRACTS

19.1 Off balance sheet PFI and other service concession arrangement schemes The HSCB has no commitments under PFI or other Service Concession arrangement contracts in 2010/11 or in 2009/10.

NOTE 20. FINANCIAL COMMITMENTS

The HSCB did not have any other financial commitments at either 31 March 2011 or 31 March 2010.

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HEALTH AND SOCIAL CARE BOARD NOTES TO THE ACCOUNTS FOR THE YEAR ENDED 31 MARCH 2011 NOTE 21. FINANCIAL GUARANTEES, INDEMNITIES AND LETTERS OF COMFORT Because of the relationships with DHSSPS, and the manner in which the HSCB is funded, financial instruments play a more Limited role within the HSCB in creating risk than would apply to a non public sector body of a similar size, therefore the HSCB is not exposed to the degree of financial risk faced by business entities. The HSCB has limited powers to borrow or Invest surplus funds and financial assets and liabilities are generated by day to day operational activities. Therefore the HSCB Is exposed to little credit, liquidity or market risk. NOTE 22. CONTINGENT LIABILITIES

Material contingent liabilities are noted in the table below, where there is a 50% or less probability that a payment will be required to settle any possible obligations. The amounts or timing of any outflow will depend on the merits of each case.

2011 2010 2009 £000s £000s £000s Total estimate of contingent clinical negligence liabilities 2,667 4,175 7,434 Amount recoverable through non cash RRL (2,667) (4,175) (7,434) Net Contingent Liability 0 0 0 In addition to the above contingent liability, provisions for clinical negligence are given in Note 16. Other clinical litigation claims could arise in the future due to incidents which have already occurred. The expenditure which may arise from such claims cannot be determined as yet.

Contingencies not relating to clinical negligence are as follows: 2011 2010 2009 £000s £000s £000s Public Liability 0 0 0 Employers' Liability 35 2 3 Accrued Leave 0 0 0 Injury Benefit 0 0 0 Other 0 0 792 Total 35 2 795

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NOTES TO THE ACCOUNTS FOR THE YEAR ENDED 31 MARCH 2011 NOTE 23. RELATED PARTY TRANSACTIONS During the year, none of the board members, members of the key management staff or other related parties has undertaken any material transactions with the HSCB. Ms Fionnuala McAndrew (Director of Social Services HSCB) is a member of the Board of Directors of the registered charity, Children in Northern Ireland (CiNI), which may be likely to do business with the HSC in the future. The HSCB is an arms length body of the Department of Health, Social Services and Public Safety and as such the Department is a related Party with which the HSCB has had various material transactions during the year. The HSCB has had various material transactions with the Business Services Organisation for which the Department is regarded as the parent.

NOTE 24. THIRD PARTY ASSETS The HSCB held £nil cash at bank and in hand at the 31 March 2011which related to third parties.

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NOTES TO THE ACCOUNTS FOR THE YEAR ENDED 31 MARCH 2011 NOTE 25. FINANCIAL PERFORMANCE TARGETS 25.1 Revenue Resource Limit The HSCB is given a Revenue Resource Limit which is not permitted to overspend The Revenue Resource Limit (RRL) for HSCB is calculated as follows:

Restated DHSSPS (excludes non cash) Other Government Departments Non Cash RRL (from DHSSPS) Total Agreed RRL Total Revenue Resource Limit to Statement of Comprehensive Net Expenditure 25.2 Capital Resource Limit The HSCB is given a Capital Resource Limit (CRL) which it is not permitted to overspend.

2011 2010 Total Total £000s £000s Gross Capital Expenditure 4,011 4,171 (Receipts from sales of fixed assets) 0 0 Net Capital Expenditure 4,011 4,171 Capital Resource Limit 4,038 4,171 (Underspend)/Overspend against CRL (27) 0

2011 Total

2010 Total

£000s £000s 3,841,564 3,747,529

0 0 0 0

3,851,968 3,761,196

3,851,968 3,761,196

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25.3 Financial Performance Targets The HSCB is required to ensure that it breaks even on an annual basis by containing its net expenditure to within 0.25% of RRL limits.

Restated 2010/11 2009/10

£000s

£000s

Net Expenditure (3,851,833) (3,761,088)

RRL 3,851,968 3,761,196

Surplus/(Deficit) against RRL 135 108

Break Even cumulative position (opening)

88 (20)

Other Adjustments 0 0

Break Even Cumulative position (closing) 223 88 Materiality Test: 2010/11 2009/10 %

%

Break Even in year position as % of RRL

0.00% 0.00%

Break Even cumulative position as % of RRL 0.01% 0.00%

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NOTE 26. LOSSES & SPECIAL PAYMENTS 26.1 Losses Part A

TYPE OF LOSS NO. OF CASES

VALUE £

1 Cash Losses - Theft, fraud etc 0 0

2 Cash Losses - Overpayments of salaries, wages and allowances 0 0

3 Cash Losses - Other causes (including unvouched and incompletely vouched payments) 0 0

4 Nugatory and fruitless payments i. Abandoned capital schemes 0 0 ii. Payment of Commercial Debt 35 664 iii. Late Other 0 0 5 Bad debts and claims abandoned 5 843 6 Stores and Inventory Losses - Theft, fraud, arson (whether

proved or suspected) etc i. Bedding and linen 0 0 ii. Other equipment and property 3 744 7 Stores and Inventory Losses - Incidents of the service

(result of fire, flood, etc) 0 0 8 Stores and Inventory Losses - Deterioration in store 0 0 9 Stores and Inventory Losses - Stocktaking discrepancies 0 0 10 Stores and Inventory Losses - Other causes 0 0 i. Bedding and linen 0 0 ii. Other equipment and property 0 0 11 Compensation payments (legal obligation) 0 0 i. Clinical Negligence 10 8,133,150 ii. Public Liability 0 0 iii. Employers Liability 0 0 12 Ex-gratia payments - Compensation payments (including

payments to patients and staff) 0 0 13 Ex-gratia payments - Other payments 0 0 14 Extra statutory payments 0 0 15 a. Losses sustained as a result of damage to buildings and

fixtures arising from bomb explosions or civil commotion. 0 0 b. Damage to vehicles 0 0

TOTAL 53 8,135,401

There were three settlements relating to 3 individual cases exceeding £250,000. 1) Clinical Negligence £1.2m – complications relating to meningitis 2) Clinical Negligence £3.0m – Birth complications in 1991 resulting in rhesus disease 3) Clinical Negligence £3.5m – Birth complications in 1975 resulting in cerebral palsy

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Part B Losses/payments not recorded in Part A and for which Departmental approval is necessary and awaited.

There are currently no losses or special payments awaiting Departmental approval.

26.1 Part C: Estimate of Loss

Estimate of patient exemption fraud. The calculation was carried out by the Business Services Organisation Information and Registration Unit on the following basis: 1. The BSO on behalf of the HSC Board, handles payments to contractors providing family practitioner services. The Counter Fraud and Probity Service within the BSO is responsible for checking patient entitlement and for taking follow-up action where a patient’s claim to exemption from statutory charges has not been confirmed. 2. Given the volume of Dental and Ophthalmic claims each year, sampling is used to establish an estimate of the total annual potential loss due to fraud. Patients aged 80 and over are excluded from the population from which the sample is drawn. The sample data is passed to the Department for Work and Pensions and the Business Services Organisation to provide independent verification of entitlement across a number of exemption categories. Where entitlement to exemptions is not confirmed for individual patients as part of this process, such instances are referred as cased to the EPES case management system for further investigation. 3. To estimate the total annual loss in the population the BSO applies the estimated rate of loss for each exemption category in the sample to the volumetric and average liability for the category in the population. The total loss for the NI region for 2010/11 has been estimated as £2.2m (£1.6m Dental, 0.6m Ophthalmic). Comparative figures for 2009/10 activity levels are: Dental £1.4m and Ophthalmic £0.5m.

26.1 Part D: Special Payments

The HSCB made no special payments in 2010/11. NOTE 27. POST BALANCE SHEET EVENTS

There are no post balance sheet events having a material effect on the accounts NOTE 28. DATE OF AUTHORISATION The Accounting Officer authorised these financial statements for issue on 29th June 2011

.

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GENERAL PRACTITIONER LOANS SCHEME

SUMMARY OF RECEIPTS AND PAYMENTS ACCOUNT FOR THE YEAR ENDED 31 MARCH 2011

Payments 2011 2010 £ £ Loans to General Medical Practitioners 0 0 Charge for Borrowings 0 0 Repayment to DHSSPS on 8 February 2011 3,905,225.55 3,886,838.38 3,905,225.55 3,886,838.38 Receipts Balance Due From Bank at 1 April 2010 3,886,838.38 3,801,596.66 Loan Repayments 17,338.72 75,172.60 Loan Written Off 0 0 Loan Interest Receivable 1,048.45 10,069.12 3,905,225.55 3,886,838.38

ABSTRACT OF LOANS

Loans Issued Loans Repaid Balance as at 1 April

2010

During the Year Ended 31 March

2011

Total to 31 March 2011

During the Year Ended 31 March

2011

Total to 31 March 2011

Loans Written Off

Balance as at 31 March

2011

£ £ £ £ £ £ £ 0 0 5,108,200.53 0 5,108,200.53 0 0

Certificates I certify that the above Account has been compiled from, and is in accordance with, the Accounts and financial records maintained on the Board's behalf by the Business Services Organisation as certified by the Director of Finance of the Business Services Organisation. This account is not consolidated into the Board's Annual Accounts. Paul Cummings Director of Finance

Date Date I certify that the above account has been submitted to and duly approved by the Board. John Compton Chief Executive

Date

(S.R. & O. 1973 No. 332 Under Article 59 of the Health and Personal Social Services (Northern Ireland) Order 1972)

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ISBN Number 9780337097515

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