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Chamber and committees

Official Report: search what was said in Parliament

The Official Report is a written record of public meetings of the Parliament and committees.  

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Dates of parliamentary sessions
  1. Session 1: 12 May 1999 to 31 March 2003
  2. Session 2: 7 May 2003 to 2 April 2007
  3. Session 3: 9 May 2007 to 22 March 2011
  4. Session 4: 11 May 2011 to 23 March 2016
  5. Session 5: 12 May 2016 to 4 May 2021
  6. Current session: 13 May 2021 to 29 November 2025
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Displaying 3519 contributions

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Public Audit Committee

Section 22 Report: “The 2022/23 audit of NHS Forth Valley”

Meeting date: 25 January 2024

Richard Leonard

Yes. One of the lessons that we have learned is that culture change is one thing, but it is keeping the culture change going that is probably the harder task.

My final question—I think that you alluded to this in answering Graham Simpson’s questions—is about how far there is to go through the assurance board process and so on. Again, when I had a briefing from the assurance board, which I think was as far back as May of last year, the expression that its members used was that they thought that there was a long way to go at that stage. We are now several months down the line, so that position might have been revised but, at that time, the assurance board was saying—I took a note of it—that there was no clear path to de-escalation. What is your assessment of that today?

10:30  

Public Audit Committee

Section 22 Report: “The 2022/23 audit of NHS Forth Valley”

Meeting date: 25 January 2024

Richard Leonard

I want to ask about one of those in particular: the spend on agency and bank staff. In his opening statement, the Auditor General mentioned elected representatives being briefed by the health board. I speak as one of the elected representatives who have had those briefings. One of the features of them, which I have been trying to interrogate, is the extent to which there has been a ballooning in spend by NHS Forth Valley on bank and agency staff.

Back in May 2023, it was reported that there had been an increase in spend, year on year, in the region of 70 or 71 per cent. By December 2023, at the last briefing that I attended, the figure that was being cited was a 46 per cent annual increase in spend on agency and bank staff. Could you give us your understanding of the reasons for such a big escalation in costs in that area on a year-on-year basis? What lies behind it? Do you have any sense of how that compares with the reliance of other health boards of a similar size on agency and bank staff?

Public Audit Committee

Section 22 Report: “The 2022/23 audit of NHS Forth Valley”

Meeting date: 25 January 2024

Richard Leonard

That is fine. I do not know whether I am asking you to break an embargo, but could you give us an early insight into how 70 per cent and 46 per cent increases in spend compare with the figures that you have been unearthing in your preparation of the overall NHS report?

Public Audit Committee

Section 22 Report: “The 2022/23 audit of NHS Forth Valley”

Meeting date: 25 January 2024

Richard Leonard

One of the inferences of what came out of the Healthcare Improvement Scotland report is that, because of things such as poor leadership, there might be higher-than-average levels of absenteeism, and the figure for bank and agency expenditure might be a function of that, but we are being told this morning that that is not the case. I want to try to clarify that.

Public Audit Committee

Section 22 Report: “The 2022/23 audit of NHS Forth Valley”

Meeting date: 25 January 2024

Richard Leonard

I think that Healthcare Improvement Scotland’s initial report identified an excessive reliance on bank and agency staff as one concern. I think that it used the description of “serious concerns” in its report, and that was one of its serious concerns.

We now turn to Colin Beattie, who has some more questions to put, and perhaps an initial observation to start us off.

09:30  

Public Audit Committee

Section 22 Report: “The 2022/23 audit of NHS Forth Valley”

Meeting date: 25 January 2024

Richard Leonard

Did you say 8 per cent?

Public Audit Committee

Section 22 Report: “The 2022/23 audit of NHS Forth Valley”

Meeting date: 25 January 2024

Richard Leonard

Picking up on some of the themes that were developing there, Graham Simpson has some questions on the assurance board, leadership and culture.

Public Audit Committee

Section 22 Report: “The 2022/23 audit of NHS Forth Valley”

Meeting date: 25 January 2024

Richard Leonard

We are drawing towards a close, but I have just a couple of quick questions. Auditor General, you mentioned the importance of staff being listened to, and you referred, for example, to whistleblowing. However, is it not the case that staff being listened to is not just about individual whistleblowers using public interest disclosure, but that it is also about routine collective listening—for example, listening to trade unions and their health and safety forums—as well as partnership working?

Public Audit Committee

Section 22 Report: “The 2022/23 audit of NHS Forth Valley”

Meeting date: 25 January 2024

Richard Leonard

I wonder about that, though, based on your experience. I was quite taken aback when the assurance board said to me and other elected representatives who were taking part in that discussion that it could be years before de-escalation takes place. Is that the sense that you get? Is it the experience that we have had with other health boards that have been escalated to level 4?

Public Audit Committee

Section 22 Report: “The 2022/23 audit of NHS Forth Valley”

Meeting date: 25 January 2024

Richard Leonard

The substantive item on our agenda is consideration of a section 22 report, “The 2022-23 audit of NHS Forth Valley”. I welcome our four witnesses: Stephen Boyle, Auditor General for Scotland; Pat Kenny, associate partner, audit and assurance, at Deloitte; Rebbecca McConnachie, senior manager at Deloitte; and Leigh Johnston, senior manager at Audit Scotland.

We have a number of questions to put to you, based on the report that was produced into the performance of NHS Forth Valley but, before we get to those, I invite the Auditor General to give a short opening statement.