Agenda item

Purpose of report: To review the summary of audit findings and Management Action Plan produced as a result of an internal audit review of Initial Health Assessments 17/18.

Witnesses:
David John, Audit Manager
Richard Abigail, Senior Auditor
Carol Douch, Head of Countywide Services

Key points raised in the discussion:

1. Internal Audit Officers explained that they had been invited by the service to review  their performance in delivering Initial Health Assessments (IHA) within statutory timescales  in order to help in their performance improvement process. It was explained that this work had been undertaken during Spring 2018.
   
   
2. Internal Audit Officers noted that statutory timescales had not been met with regard to Initial Health Assessments and that audit could only provide Minimal Assurance. It was noted that four key stages were observed:
   1. Collection of form of consent and referral to provider
   2. Date provider offers an  appointment
   3. Date of the appointment
   4. Return of report to Children’s Services.

Officers noted that there were delays to all of these stages.

3. It was noted that a follow up audit was scheduled for next year to monitor implementation of  the agreed Management Action Plan.
   
   
4. Officers noted that the Children, Families and Learning Directorate accepted the audit assessment of Minimal Assurance.
   
   
5. Members questioned datasets and noted that there had been a reduction of assessments not completed on time and queried how the service had undertaken this. Officers noted that there had been significantly more senior officer oversight of this process in order to drive practice improvement which had led to changes in Surrey County Council’s improvement. It was also noted that senior leaders were in regular weekly contact with the provider to ensure that practice improvement is holistic, which had also led to improvements since this audit was initially conducted.
   
   
6. The Cabinet Member for Children noted that there had been longstanding evidence of poor performance in delivery of Initial Health Assessments within statutory timescales. It was explained that this issue was part of the systemic problems within the service that the improvement and transformation of the service was looking to improve upon.
   
   
7. Officers noted that there had been work undertaken to look at alternative models of delivering this service and best practice across other local authorities. It was stressed that alternative contract models were being looked at to ensure that the service delivered in the best way.
   
   
8. Internal Audit Officers noted that, in the case of a high priority agreed action , audit would monitor progress to ensure that it has been successfully delivered. Audit noted that it would be expecting to conduct its follow up in quarter one of 2019/20 and that the results of this would be circulated to the Committee upon its conclusion.
   
   
9. Internal Audit Officers noted that they had good working relations with Children, Families and Learning and that the new Directors were receptive to change and that audit was undertaking reviews of other areas of change within the service.
   
   

Recommendations:

Members noted that they were encouraged by evidence of improvement. It was recommended that:

1. The Committee receive an update from internal audit on the completion of the follow-up audit in 2019 to assure itself that progress has been made on the Management Action Plan agreed to improve IHA quality.