ISA 260 WWL (Draft v2)PT reviewed · • Fixed assets – historical entries in the fixed asset...

Wrightington, Wigan and Leigh NHS Foundation Trust

18 May 2015

Draft report to the Audit Committee on the 2014/15 audit

Contents

A reminder of our audit plan:• Materiality: £2.60m (2013/14:

£2.55m).

• Threshold for reporting misstatements: £130k (2013/14: £128k).

• Significant risks over revenue recognition, property valuations, accounting for capital expenditure, and management override of controls.

• We have taken a substantive audit approach.

Delivering informed challenge

Providing intelligent insight

Growing stakeholder confidence

Building trust in the profession

Our draft report

3 Partner introduction

5 Significant risks

10 Value for money

12 Other findings

15 Our audit report

25 Your annual report

Appendices

29Purpose of our report and responsibilities statement

30 Audit adjustments

32 Fraud responsibilities and representations

33 Independence and fees

36 Audit Quality Review findings and responses

Partner introduction

3© 2015 Deloitte LLP. All rights reserved.

The key messages in this report

Partner introduction

© 2015 Deloitte LLP. All rights reserved. 4

I have pleasure in presenting our draft report to the Audit Committee for the 2014/15 audit. I would like to draw your attention to the key messages of this paper:

Paul ThomsonLead audit partner

Conclusions from our testing

• The key judgements in the audit process related to:

• Revenue recognition

• Valuation of the Trust’s property assets

• Accounting for capital expenditure

• At the time of writing this report, testing is yet to be completed in the areas of revenue recognition, management override of control and accounting for capital expenditure.

• We will be testing for inconsistencies between the financial statements and the FTCs when testing has been substantially completed.

Quality Accounts

• Please see the separate report relating to quality accounts.

Insight • We have raised insights in the following areas (please see page 14 for further details):

• Fixed assets – historical entries in the fixed asset (RAM) system

• Useful economic lives

• Over-reliance on key staff

• Manual mapping of the trial balance to the financial statements

Status of the audit

• At the time of writing this report, testing is outstanding in the following areas of the audit:

• receivables (recoverability of Q3 and Q4 over-performance)

• fixed assets – testing of capitalisation of assets under construction

• assets held for sale

• payables (capital creditors)

• revenue (CCG income, Agreement of Balances, cut off including partially completed spells)

• payroll (directors remuneration and off-payroll arrangements)

• review of the Annual Report against the disclosure checklist

• going concern review

• documents supporting our value for money review

• NAO procedures

• completion of internal quality assurance procedures;

• our review of events since 31 March 2015; and

• receipt of signed management representation letter.

Audit quality is our number one priority. When planning our

audit we set the following audit

quality objectives for this audit:

A robust challenge of the key

judgements taken in the preparation of

the financial statements.

A strong understanding of your internal control

environment.

A well planned and delivered audit that raises findings early with those charged with governance.

Significant risks



Risk identified

The risk of fraud in revenue recognition is a presumed risk under International Standards on Auditing. We have identified recognition of NHS revenue as a key risk due to:

� the complexity of the payment by results regime, in particular in determining the level of performance and CQUINrevenue to recognise;

� the judgemental nature of provisions for disputes with commissioners, including in respect of outstanding over-performance income for quarters 3 and 4 and how this performance relates to any year-end agreements;

� the challenges experienced across the sector in 2013/14 in recovering income and increases in debtor aging;

� the risk of revenue not being recognised at fair value due to adjustments agreed in settling current year disputes and agreement of future year contracts.

Planned audit work to address the significant risk

We are testing recoverability of over performance income and adequacy of provision for underperformance through the year, and evaluate the results of the agreement of balances exercise.

We are obtaining an understanding of the nature of each provision, the basis for the position adopted, and evidence of the historical accuracy of provisions made for disputes with commissioners. We will consider this track record in evaluating year-end provisions.

We have requested from management a paper summarising areas of dispute and actual or potential challenge from commissioners and the rationale for the accounting treatment adopted, in particular in respect of provisions held in respect of unsettled debts.

We are assessing the appropriateness of the judgements made in recognising revenue and providing for disputes on the basis of discussion with staff involved, review of correspondence with commissioners and other relevant documentation, and consideration of benchmark information from our knowledge of the local health economy.

We reviewing with management the key changes and any open areas in setting 2015/16 contracts, and consider whether, taken together with the settlement of current year disputes, there are any indicators of inappropriate adjustments in revenue recognised between periods.

Revenue Recognition

Testing is ongoing in this area

Conclusion

Information is outstanding in the area of revenue to be able to complete our testing on CCG income, including the final Agreement of Balances final mismatch report expected on the 14th May, evidence supporting cut off and partially completed spells.

Inclusion in audit report

We expect to include this risk in our audit report because it had a significant effect upon our overall audit strategy, allocation of resources, and direction of the efforts of the team.

Risk Identified

International Standards on Auditing requires auditors to identify a presumed risk of management override of control. This presumed risk cannot be rebutted by the auditor. This recognises that management may be able to override controls that are in place to present inaccurate or even fraudulent financial reports.


Our work will focus on:• the testing of journals, using data analytics to focus our testing on higher risk journals;• significant accounting estimates; and• any unusual transactions or one-off transactions.Our wider response to the risk of fraud is set out in Appendix 1.In considering the risk of management override, we will:• assess the overall position taken in respect of key judgements and estimates;• consider the sensitivity of the financial statements with respect to the achieving financial performance targets including

COSRR thresholds; • consider remuneration plans and linkage with key management judgements; and • consider our view on the overall control environment and ‘tone at the top’.

Conclusion

No issues have been noted in our testing of journals or testing performed to date in balances with significant judgements.


We do not expect to refer to this risk in our auditor’s report because it did not have a significant effect upon our overall audit strategy, allocation of resources, or direction of the efforts of the team.


Management override of controls

Testing is currently ongoing

Risk Identified

The Trust is required to hold property assets within Property, Plant and Equipment at a modern equivalent use valuation. The valuations are by nature significant estimates which are based on specialist and management assumptions and which can be subject to material changes in value.

Where existing properties are being modernised, the “modern equivalent use” valuation rules can lead to a “day one” impairment where the accumulated cost of the asset exceeds the cost of a newly built facility.


The Trust held £129m of property assets at 31 March 2014 which increased to £132m as at 31 March 2015.

We have reviewed the Trust’s capital and valuation plans as part of the planning process with input from our property specialists, Deloitte Real Estate.

The Trust has had an independent desktop review valuation carried out for the purposes of the 31 March 2015 financial statements, which we have reviewed.

We have compared the movements identified to those of other Trusts and organisations performing valuations.

We have used our valuation specialists, Deloitte Real Estate to review and challenge the appropriateness of the assumptions used in the year-end valuation of the Trust’s properties.

We have commented in our reporting upon the key assumptions used in the valuation.

Conclusion

Our internal valuation specialists have reviewed the work of DTZ and no significant issues were noted with the valuation of land and buildings. No issues have been noted in how this revaluation has been accounted for in the draft financial statements.




Property valuations

We have no significant findings in respect of this risk.

Risk Identified

The Trust has an extensive capital programme, including Wrightington Phase 1 and development of the Health Informatics System (HIS) project. Determining whether expenditure should be capitalised can involve significant judgement as to whether costs should be capitalised under International Financial Reporting Standards, and when to commence depreciation. In addition, previously capitalised works that are being replaced or refurbished need to be appropriately written down.


• We have tested the design and implementation of controls around the capitalisation of costs, and tested spending on a sample basis to confirm that is complies with the relevant accounting requirements.

• We have reviewed the projects ledger and status of individual projects to evaluate whether they have been depreciated from the appropriate point.

• We have checked management’s assessment of whether any impairment arises in respect of newly capitalised expenditure.

• We have checked whether any adjustments to the value of previously capitalised works are required and how these have been calculated.

Conclusion

We have tested the value of additions of assets under construction however we are still performing testing on whether additions have been capitalised in line with the Trust’s policy.

We have raised an insight in relation to management giving consideration to which items are capitalised in the future when there are either new or refurbished areas to complete, please see page 14 for further details.




Accounting for Capital Expenditure

Testing is currently ongoing in this area

Value for money


Value for money

We are required to consider whether the Trust has made proper arrangements for securing economy, efficiency and effectiveness in its use of resources. Our work takes account of:

• the Accounting Officer’s statement in the Annual Governance Statement; and

• the results of work of relevant regulators, including the Care Quality Commission and Monitor.

Work performed

We obtain an understanding of the Trust’s arrangements for securing “value for money”, through a combination of:

• “high level” interviews

• review of the Trust’s draft Annual Governance Statement;

• consideration of issues identified through our other audit and assurance work;

• consideration of the Trust’s results, including benchmarking of actual performance (including on CIP delivery as summarised below) and the 2015/16 Annual Plan;

• review of any reports from the Care Quality Commission;

• review of Monitor’s continuity of service and governance risk ratings;

• benchmarking of the Trust’s performance;

• consideration of the Trust’s NHSLA risk rating; and

• consideration of the Trust’s Information Governance toolkit score.

Conclusion

Testing is ongoing in this area however no issues have been raised to date.


Value for money

Other findings


Internal control and risk management

Other significant findings

ISA 315.12 (UK and Ireland) requires we obtain an understanding of internal control relevant to the audit. It is a matter of the auditor’s professional judgment whether a control, individually or in combination with others, is relevant to the audit. We do not test those controls we do not consider relevant to the audit. Below we provide a view, based on our audit procedures completed to date, on the effectiveness of your system of internal control relevant to the audit risks that we have identified.


Requires significant improvement

Acceptable but could be improved No issues noted

No issues have been noted with respect to the ‘tone at the top’. The Board’s level of focus on internal control and risk management appears appropriate.

Over-reliance on key staff in certain areas

Historical fixed asset recording

The trial balance categories could be more aligned with the financial statements to reduce the amount of manual mapping required

Fixed asset useful economic lives

Observation Priority

Historical fixed asset recording

• During our testing for unrecorded disposals of fixed assets, we identified that historical entries relating to projects such as setting up of new wards were not appropriately separated out therefore it was not possible to verify specifically what assets were included within the balance and therefore whether they were still in existence in the Trust. The finance team are aware of the issue and there is an ongoing project to retrospectively improve entries in the fixed asset register and we recommend that this is continued. We have identified a potential adjustment in relation to this issue

• Management should also consider what costs are capitalised when setting up wards to ensure that the assets can be identified and tracked.

Internal control and risk management

Other significant findings (continued)


Key:

Medium Priority

High Priority

Observation Priority

Useful economic lives of fixed assets

• This insight was raised in the prior year in relation to a recommendation that management reviewed the useful economic lives assigned to assets as there are a significant number of fixed assets that remain in use in the Trust after they are fully depreciated. Given that this was a low priority and management were doing a significant amount of work on the fixed asset register, it was planned to address this as part of the 2015/16 financial year.

Over-relianceon key staff

• In certain areas of the finance team, staff appear to operate in silos with individuals working on complex working papers that are not easily understood by peers. In some cases the clarity of working papers could be improved so that in the event of a staff member leaving/being absent, another member of the team could perform the same task more easily.

Manual mapping of trial balance to the financial statements

• The trial balance (TB) codes are not fully aligned to the financial statements in certain areas (such as operating expenditure) and results in a process of manual mapping being required. The manual mapping adjustments have no formal review process like standard journal entries would, and are therefore more susceptible to risk of error/fraud. As part of the ledger migration, management should consider whether the TB could be better aligned to the financial statements to reduce the amount of manual adjustments required which could speed up the process as well as reducing the risk of error in manual mapping adjustments.

Low Priority

Deloitte view

Our testing of the design and implementation of controls of the specific risks identified no significant issues however the insight regarding manual mapping adjustments to the TB does pose a potential weakness to management override of controls

Our draft audit report


The Audit Committee will need to pay particular attention to the risks of material misstatement, calculated materiality and audit scope that we have used. These judgements will be more transparent to all stakeholders in this year’s report.

Scoping: We disclose an overview of the audit scope, as set out in our previous communications with you, and how we have responded to the identified risks.

Materiality: An explanation of our assessment and application of the concept of materiality is included in the audit opinion. This includes disclosure of the absolute materiality level (£2.6m) and the error reporting threshold to the Audit Committee (£130k).

Significant risks: The opinion includes a summary of the risks of material misstatement assessed as being significant to the audit, and that take the greatest audit effort. At this stage we expect that this will include:• Revenue Recognition;• Property valuations; and• Accounting for capital expenditure.

Other matters to report by exception: We are also required to report by exception on the following matters:• if the Board statement on fair, balanced and

understandable is inconsistent with the knowledge we have acquired during our audit;

• if the description of the significant issues considered by the Audit Committee does not appropriately address matters communicated by us to you, the Audit Committee; or

• proper practices have not been observed in the compilation of the financial statements.

FT specific reports by exception: Under the Audit Code for NHS Foundation Trusts, we are also required to report to you if, in our opinion:• the Annual Governance Statement does not meet the

disclosure requirements set out in the ARM, is misleading, or is inconsistent with information of which we are aware from our audit; or

• the Trust has not made proper arrangements for securing economy, efficiency and effectiveness in its use of resources.

Summary of the risks we comment on



For 2014/15 the NHS Foundation Trust Annual Reporting Manual (ARM) adopted the updated reporting requirements of ISA 700 (UK and Ireland) and changed the format of audit opinions to include additional disclosures. Here we discuss the items that we intend to comment on in our audit report. Our audit report includes comment on materiality and scoping, including how this has changed from last year. We also comment on the key significant risks which have been the focus of our time and efforts on the audit and our observations on internal control.

In our planning report we explained our risk assessment process and how we selected our significant audit risks. Below is a summary of the significant risks we identified. For each we explain the basis on which we have included or excluded from our audit report. We explain why the risk is relevant within the specific circumstances of the Trust and clearly document the specific procedures we have performed to address the risk.

Summary of the risks we report on



Included in:

RiskAudit Committee Report’s

list of significant issues

Critical AccountingJudgements and Key Sources of Estimation Uncertainty (Note 1)

Audit report

Recognition of NHS revenue

� � �

Property valuations � � �

Accounting for capital expenditure

� � �

Management override of controls

� � �

The table below shows how the risks reported through the Annual Report and Accounts and in our Audit Report align.

We recommend that the Trust amends the critical accounting judgements and key sources of estimation and uncertainty in the accounting policies note to align with the Annual Governance Statement and the significant audit risks.

Draft Audit Opinion

We set out below the format of the audit opinion for the current year for the Committee’s consideration.

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Opinion on the financial statements of Wrightington, Wigan and Leigh NHS Foundation Trust

In our opinion the financial statements:

• give a true and fair view of the state of the Trust’s affairs as at 31 March 2015 and of the Trust’s income and expenditure for the year then ended;

• have been properly prepared in accordance with the accounting policies directed by Monitor – Independent Regulator of NHS Foundation Trusts; and

• have been prepared in accordance with the requirements of the National Health Service Act 2006.

The financial statements comprise the Statement of Comprehensive Income, the Statement of Financial Position, the Statement of Changes in Taxpayers’ Equity, the Statement of Cash flows and the related notes 1 to 27. The financial reporting framework that has been applied in their preparation is applicable law and the accounting policies directed by Monitor – Independent Regulator of NHS Foundation Trusts.

Certificate We certify that we have completed the audit of the accounts in accordance with the requirements of Chapter 5 of Part 2 of the National Health Service Act 2006 and the Audit Code for NHS Foundation Trusts. [Please note that this may need to be amended to reflect the outcome of the quality accounts audit]

Going concern We have reviewed the Accounting Officer’s statement contained on page [x] that the Trust is a going concern. We confirm that

• we have concluded that the Accounting Officer’s use of the going concern basis of accounting in the preparation of the financial statements is appropriate; and

• we have not identified any material uncertainties that may cast significant doubt on the Trust’s ability to continue as a going concern.

However, because not all future events or conditions can be predicted, this statement is not a guarantee as to the Trust’s ability to continue as a going concern.

INDEPENDENT AUDITOR’S REPORT TO THE COUNCIL OFGOVERNORS AND BOARD OF DIRECTORS OF Wrightington, Wiganand Leigh NHS FOUNDATION TRUST

© 2015 Deloitte LLP. All rights reserved.

Draft Audit Opinion (continued)

19

Our assessment of risks of material misstatement

The assessed risks of material misstatement described below are those that had the greatest effect on our audit strategy, the allocation of resources in the audit and directing the efforts of the engagement team:

Risk How the scope of our audit responded to the risk

Recognition of NHS revenue

There are significant judgments in the recognition of revenue from care of NHS patients and in provisioning for disputes with commissioners due to:

• the complexity of the Payment by results regime, in particular in determining the level of overperformance and CQUIN (Commissioning for Quality and Innovation) revenue to recognise; and

• the judgmental nature of provisions for disputes, including in respect of outstanding overperformance income for quarters 3 and 4;

• the challenges experienced across the sector in 2013/14 in recovering income and increases in debtor ageing; and

• the risk of revenue not being recognised at fair value due to adjustments being agreed in settling current year disputes and agreement of future year contracts.

The value of this revenue in 2014/15 is [£xm], see note [x] for further details

We performed detailed substantive testing of the recoverability of overperformance income and adequacy of provision for underperformance through the year, and evaluated the results of the agreement of balances exercise.

We tested the historical accuracy of provisions made for disputes with commissioners, and considered this in evaluating bad debt provisions and other provisions in respect of NHS income at 31 March 2015.

We challenged key judgements around specific areas of dispute and actual or potential challenge from commissioners and the rationale for the accounting treatments adopted and reviewed

correspondence with commissioners.

Property valuations

The Trust holds property assets within Property, Plant and Equipment at a modern equivalent asset valuation. The valuations are by nature significant estimates which are based on specialist and management assumptions and which can be subject to material changes in value.

Where existing properties are being modernised, the “modern equivalent use” valuation rules can lead to a “day one” impairment where the accumulated cost of the asset exceeds the cost of a newly built facility.

The value of property and land in 2014/15 is [£xm], see note [x] for further details.

We used internal valuation specialists to review and challenge the methodology of the valuation performed including identification and challenge of significant movements experienced in the period against industry benchmarking and established market practice.

INDEPENDENT AUDITOR’S REPORT TO THE COUNCIL OFGOVERNORS AND BOARD OF DIRECTORS OF Wrightington, Wiganand Leigh NHS FOUNDATION TRUST (continued)


20


Risk How the scope of our audit responded to the risk

Accounting for capital expenditure

The Trust has an extensive capital programme, including Wrightington Phase 1 and development of the Health Informatics System (HIS) project. Determining whether expenditure should be capitalised can involve significant judgement as to whether costs should be capitalised under International Financing Reporting Standards, and when to commence depreciation. In addition, previously capitalised works that are being replaced or refurbished need to be appropriately written down.

The value of assets under construction capitalised in 2014/15 is [£xm], see note [x] for further details.

• We tested the design and implementation of controls around capitalisation of costs and tested spending on a sample basis to confirm that it complied with the relevant accounting requirements

• We reviewed the projects ledger and the status of individual projects to evaluate whether they had been depreciated from the appropriate point.

• We challenged management’s assessment of whether any impairment arose in respect of newly capitalised expenditure.

The description of risks above should be read in co njunction with the significant issues considered by the Audit Committe e discussed on page [x].

Our audit procedures relating to these matters were designed in the context of our audit of the financial statements as a whole, and not to express an opinion on individual accounts or disclosures. Our opinion on the financial statements is not modified with respect to any of the risks described above, and we do not express an opinion on these individual matters.





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Our application of materiality

We define materiality as the magnitude of misstatement in the financial statements that makes it probable that the economic decisions of a reasonably knowledgeable person would be changed or influenced. We use materiality both in planning the scope of our audit work and in evaluating the results of our work.

We determined materiality for the Trust to be £2.6m. This is below 1% of Operating income from continuing operations and below 2% of Taxpayers’ Equity. Our determination of materiality was based upon Operating Income from Continuing Activities as, in our judgment, this represented the most accurate measure of the scale of the Trust.

We agreed with the Audit Committee that we would report to the Committee all audit differences in excess of £130k, as well as differences below that threshold that, in our view, warranted reporting on qualitative grounds.

We also report to the Audit Committee on disclosure matters that we identified when assessing the overall presentation of the financial statements.

An overview of the scope of our audit

Our audit was scoped by obtaining an understanding of the Trust and its environment, including Trust-wide controls, and assessing the risks of material misstatement at the Trust level.

Audit work was performed at the Trust’s offices in Wigan directly by the audit engagement team, led by the audit partner.

The audit team included integrated Deloitte specialists bringing specific skills and experience in property valuations and Information Technology systems.

Opinion on other matters prescribed by the National Health Service Act 2006

In our opinion:

• the part of the Directors’ Remuneration Report to be audited has been properly prepared in accordance with the National Health Service Act 2006, and

• the information given in the Strategic Report and the Directors’ Report for the financial year for which the financial statements are prepared is consistent with the financial statements.



22


Matters on which we are required to report by exception

Annual Governance Statement, use of resources, and compilation of financial statements

Under the Audit Code for NHS Foundation Trusts, we are required to report to you if, in our opinion:

• the Annual Governance Statement does not meet the disclosure requirements set out in the NHS Foundation Trust Annual Reporting Manual, is misleading, or is inconsistent with information of which we are aware from our audit.

• the NHS foundation trust has not made proper arrangements for securing economy, efficiency and effectiveness in its use of resources; or

• proper practices have not been observed in the compilation of the financial statements.

We have nothing to report in respect of these matters.

We are not required to consider, nor have we considered, whether the Annual Governance Statement addresses all risks and controls or that risks are satisfactorily addressed by internal controls.

Our duty to read other information in the Annual Report

Under International Standards on Auditing (UK and Ireland), we are required to report to you if, in our opinion, information in the annual report is:

• materially inconsistent with the information in the audited financial statements;

• apparently materially incorrect based on, or materially inconsistent with, our knowledge of the Trust acquired in the course of performing our audit; or

• otherwise misleading.

In particular, we have considered whether we have identified any inconsistencies between our knowledge acquired during the audit and the directors’ statement that they consider the annual report is fair, balanced and understandable and whether the annual report appropriately discloses those matters that we communicated to the Audit Committee which we consider should have been disclosed. We confirm that we have not identified any such inconsistencies or misleading statements.



23


Respective responsibilities of the accounting officer and auditor

As explained more fully in the Accounting Officer’s Responsibilities Statement, the Accounting Officer is responsible for the preparation of the financial statements and for being satisfied that they give a true and fair view. Our responsibility is to audit and express an opinion on the financial statements in accordance with applicable law, the Audit Code for NHS Foundation Trusts and International Standards on Auditing (UK and Ireland). Those standards require us to comply with the Auditing Practices Board’s Ethical Standards for Auditors. We also comply with International Standard on Quality Control 1 (UK and Ireland). Our audit methodology and tools aim to ensure that our quality control procedures are effective, understood and applied. Our quality controls and systems include our dedicated professional standards review team.

This report is made solely to the Council of Governors and Board of Directors (“the Boards”) of Wrightington, Wigan and Leigh NHS Foundation Trust, as a body, in accordance with paragraph 4 of Schedule 10 of the National Health Service Act 2006. Our audit work has been undertaken so that we might state to the Boards those matters we are required to state to them in an auditor’s report and for no other purpose. To the fullest extent permitted by law, we do not accept or assume responsibility to anyone other than the trust and the Boards as a body, for our audit work, for this report, or for the opinions we have formed.



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Scope of the audit of the financial statements

An audit involves obtaining evidence about the amounts and disclosures in the financial statements sufficient to give reasonable assurance that the financial statements are free from material misstatement, whether caused by fraud or error. This includes an assessment of: whether the accounting policies are appropriate to the Trust’s circumstances and have been consistently applied and adequately disclosed; the reasonableness of significant accounting estimates made by the Accounting Officer; and the overall presentation of the financial statements. In addition, we read all the financial and non-financial information in the annual report to identify material inconsistencies with the audited financial statements and to identify any information that is apparently materially incorrect based on, or materially inconsistent with, the knowledge acquired by us in the course of performing the audit. If we become aware of any apparent material misstatements or inconsistencies we consider the implications for our report.

[Signature]

Paul Thomson, ACA (Senior statutory auditor)

for and on behalf of Deloitte LLPChartered Accountants and Statutory AuditorLeeds, UK

[Date]


Your Annual Report


Our comments on your annual report


We received the draft Annual Report on 11th May and have a meeting with management on 20th May to discuss findings from our review.

Your Annual Governance Statement

The Governance Statement (AGS) should give the reader a clear understanding of the dynamics of the organisation and its control structure, recording the stewardship of the organisation, providing a sense of how vulnerable the organisation’s performance is or might be; and of how successfully the organisation has coped with the challenges it faces.


G No issues noted A Acceptable but could be improved R Requires significant improvement

Critical components Current position

• Has the required format been followed?

• Is there a balanced discussion?

• Does discussion cover quality governance arrangements, include routinely obtaining assurance on compliance with CQC registration requirements”?

• Does the Value for Money discussion link to the rest of the Annual report and KPIs?

• Is there discussion of how assurance is obtained on quality of data used by the board, covering financial and quality data??

• Has adequate disclosure been made around this year’s additional requirements to discuss risks and assurances over the quality of elective waiting time data?

• Is there a meaningful discussion of the outline of the actions taken, or proposed to deal with any significant internal control issues and gaps in control, if applicable?

• Are there meaningful highlights of board committee reports?

We are meeting with management on 20th

May to discuss the AGS

Deloitte viewWe are due to meet with management on 20th May to discuss our comments on the draft annual governance statement.

Appendices

Our report is designed to help you meet your governance duties

Purpose of our report and responsibility statement


What we report Our report is designed to help the Audit Committee and the Board discharge their governance duties. It also represents one way in which we fulfil our obligations under ISA 260 (UK and Ireland) to communicate with you regarding your oversight of the financial reporting process and your governance requirements. Our report includes:• Results of our work on key audit judgements

and our observations on the quality of your Annual Report.

• Other insights we have identified from our audit and in following our audit plan, Audit Quality Promise and Insight Plan.

What we don’t report• As you will be aware, our audit was not

designed to identify all matters that may be relevant to the board.

• Also, there will be further information you need to discharge your governance responsibilities, such as matters reported on by management or by other specialist advisers.

• Finally, our views on internal controls and business risk assessment should not be taken as comprehensive or as an opinion on effectiveness since they have been based solely on the audit procedures performed in the audit of the financial statements and the other procedures performed in fulfilling our audit plan.

The scope of our work• Our observations are developed in the context

of our audit of the financial statements.• We described the scope of our work in our

audit plan and the supplementary “Briefing on audit matters” circulated to you previously.

We welcome the opportunity to discuss our report with you and receive your feedback.

Deloitte LLPChartered AccountantsLeeds[Date]

This report has been prepared for the Board of Directors, as a body, and we therefore accept responsibility to you alone for its contents. We accept no duty, responsibility or liability to any other parties, since this report has not been prepared, and is not intended, for any other purpose. Except where required by law or regulation, it should not be made available to any other parties without our prior written consent.

Unadjusted misstatements

Audit adjustments

The following uncorrected misstatements have been identified up to the date of this report which we request that you ask management to correct as required by International Standards on Auditing (UK and Ireland). Uncorrected misstatements increase the deficit by £1.4 million, decrease net assets by £1.4 million and decrease taxpayer’s equity by £1.4 million.

.


Debit/(credit) income

statement£m

Debit/(credit) in net assets

£m

Debit/(credit) prior year

retained earnings

£m

Debit/(credit) in revenue

£m

Misstatements identified in current yearAs a result of inappropriate historical grouping of assets on the fixed asset register, the Trust were unable to physically verify the existence of assets with a maximum potential impact totalling a net book value of £1.4m. Although it is unlikely that all of these assets are not in use at the Trust, we cannot determine what level remain. The level of this error will reduce in future years as the historical assets are further depreciated.

1.4 (1.4)

Misstatements identified in prior yearsNone noted

Aggregation of misstatements individually 1.4 (1.4)Total 1.4 (1.4)

Disclosures

Audit adjustments


Disclosure misstatements

The following uncorrected disclosure misstatements have been identified up to the date of this report which we request that you ask management to correct as required by International Standards on Auditing (UK and Ireland).

Other disclosure recommendations

The following omitted disclosures are not material to the financial statements. However their omission could impact the users understanding of the financial statements, or their inclusion is considered best practice. We therefore draw them to your attention.

DisclosureSummary of disclosure

requirementQuantitative or qualitative

consideration

We received the draft Annual Report on 11th May are meeting with management on 20th May to discuss findings from our review.

DisclosureSummary of disclosure

requirementQuantitative or qualitative

consideration

We received the draft Annual Report on 11th May and are meeting with management on 20th May to discuss findings from our review.

Responsibilities explained

Fraud responsibilities and representations


• In our planning we identified the risk of fraud in revenue recognition and management override of controls as a key audit risk for the Trust.

• During course of our audit, we have had discussions with management and those charged with governance to understand the perception of risk and the key controls upon which management and those charged with governance rely. These discussions did not identify any specific deficiencies or risks.

• In addition, we have reviewed management’s own documented procedures regarding the fraud and error in the financial statements.

• We have considered the findings of the Local Counter Fraud Specialist (LCFS).

The primary responsibility for the prevention and detection of fraud rests with management and those charged with governance, including establishing and maintaining internal controls over the reliability of financial reporting, effectiveness and efficiency of operations and compliance with applicable laws and regulations. As auditors, we obtain reasonable, but not absolute, assurance that the financial statements as a whole are free from material misstatement, whether caused by fraud or error.

Responsibilities Audit work performed

We have asked the Board to confirm in writing that you have disclosed to us the results of your own assessment of the risk that the financial statements may be materially misstated as a result of fraud and that you have disclosed to us all information in relation to fraud or suspected fraud that you are aware of and that affects the entity or group. We have also asked the Board to confirm in writing their responsibility for the design, implementation and maintenance of internal control to prevent and detect fraud and error.

Required representations

Independence and fees


As part of our obligations under International Standards on Auditing (UK & Ireland), we are required to report to you on the matters listed below:

Independence confirmation

We confirm that we comply with APB Ethical Standards for Auditors and that, in our professional judgement, we and, where applicable, all Deloitte network firms are independent and our objectivity is not compromised.

Fees Our audit fee and fees for non audit services for the year from 1 April 2014 to 31 March 2015 are summarised below.

Non-audit services

In our opinion there are no inconsistencies between APB Ethical Standards for Auditors and the Trust’s policy for the supply of non-audit services or of any apparent breach of that policy. We continue to review our independence and ensure that appropriate safeguards are in place including, but not limited to, the rotation of senior partners and professional staff and the involvement of additional partners and professional staff to carry out reviews of the work performed and to otherwise advise as necessary.

Relationships The following slides provides details of all the relationships we have with Wrightington, Wigan and Leigh NHS FT, its directors and senior management and its affiliates, and other services provided to other known connected parties that we consider may reasonably be thought to bear on our objectivity and independence, together with the related safeguards that are in place.

Independence and fees


As part of our obligations under International Standards on Auditing (UK & Ireland) and the APB’s Ethical Standards we are required to report to you on all relationships (including the provision of non-audit services) between us and the audited entity:

Relationship / Service provided Threats to auditor i ndependence Safeguards in place

Deloitte has been involved in the CCG commissioned Healthier Together programme in relation to the reconfiguration of acute services in the Greater Manchester area. This project is funded in full by the CCGs commissioning the work, hence no non-audit fees have been received from the Trust. However, the project has the potential to impact all acute providers in Greater Manchester including the Trust.

We have regularly discussed with management and those charged with governance our role in the Healthier Together programme. No threats to auditor independence or conflicts of interest were identified in the work that was completed.

No safeguards required.

Deloitte was contracted by the North West Leadership Academy to develop an Executive Team Development Tool in relation to assessing the effectiveness of the executive team. This work was invoiced to the Trust who were then reimbursed by the North West Leadership Academy.

The work was in relation to a tool that was developed for Executive Teams to use to identify areas of development required, this was provided by a separate team to the audit team. No threats to auditor independence of conflicts of interest were identified.

No safeguards required.

Independence and fees (continued)


The professional fees earned by Deloitte in the period from 1 April 2014 to 31 March 2015 are as follows:

2014/15£k

2013/14£k

Financial Statement Audit 41.7 42.1

Quality Accounts 15.9 15.9

Total assurance services 57.6 58.0

Non-audit services (funded by North West Leadership Academy) 8.0 60.5

Total non-audit services 8.0 60.5

Total fees 65.6 118.5

Twelve of the audits reviewed by the AQR were performed to a good standard with limited improvements required and four audits required improvements. We were disappointed that one audit was assessed as requiring significant improvements in relation to the testing of the collective and individual loan loss provisions although this did not cause the AQR to doubt the validity of our audit opinion. The overall analysis of the AQR file reviews by grade for the last five years evidences that, among the largest firms, Deloitte remains at the forefront of audit quality with 67% of audits achieving the top grade from the AQR, the highest proportion amongst our peers.

AQR team report and findings

Recognition of and further impetus for our quality agenda


Audit quality is our number one priority. We pride ourselves on our commitment to quality and our quality control procedures. We have an unyielding pursuit of quality in order to deliver consistent, objective and insightful assurance. We will inform you if the AQR team selects your audit as part of their review for this year and will share its draft report with you when it is complete.

The Financial Reporting Council (“FRC”) issues an Annual Report on Audit Quality Inspections, providing an overview of the activities of its Audit Quality Review (“AQR”) team for the year.

“The firm places considerable emphasis on its overall systems of quality control and, in most areas, has appropriate policies and procedures in place for its size and the nature of its client base. Nevertheless, we have identified certain areas where improvements are required to those policies and procedures…

The firm took a number of steps in response to our prior year findings to achieve improvements in audit quality. This included enhanced guidance, technical communications and audit training on the recurring themes. However, issues continued to arise in some of these areas.”

AQR Report on Deloitte for 2013/14

https://www.frc.org.uk/Our-Work/Publications/Audit-Quality-Review/Audit-Quality-Inspection-Report-May-2014-Deloitte.pdf

Deloitte response• Our strategic objective is to execute high

quality, distinctive audits.• We adopt an open and communicative

approach with the regulator and their contribution to audit quality is respected and supported at all levels of our firm.

• We consider that the AQR's report provides a balanced view of the focus and results of its inspections and its recognition of the emphasis we place on our overall systems of quality control is welcome.

• We value the regulator’s inspection and comments, and the review performed by the AQR forms an important part of our overall inspection process.

• As part of our agenda of continuous improvement we have given careful consideration to each of the FRC’s comments and recommendations. This has included investigation of the root causes of each finding. This has enabled us to develop, in conjunction with findings arising from our own quality review procedures, an effective response to the themes arising.

• Following the AQR review, we have implemented improvements to our audit procedures and our system of quality control.

• Deloitte's Audit Transparency Report provides further information regarding our approach to delivering quality and is available on our website: http://www.deloitte.com/view/en_GB/uk/about/annual-reports/index.htm


Areas identified for particular attention How addre ssed in our audit

Improve the audit approach in relation to the testing of journals, including the selection of journals based on characteristics of fraud risk.

We consider journal testing as part of our response to the risk of management override of controls, asaddressed in page 8 of this paper.

Ensure audit teams pay more attention to the audit of revenue, including the risk assessment and substantive analytical review procedures.

This is a significant audit risk and is addressed in page 7 of this paper.

Improve the audit approach and guidance in relation to the testing of IT controls and reports.

We do not take a controls reliant approach to the audit of the Trust.

Embed a culture where achieving high quality audit work is recognised and rewarded.

All members of our audit practice have specific performance objectives linked to the clients they are booked to work on throughout the year to improve audit quality.

Ensure that on group audits more attention is given to the quality of work performed by the firm at component level.

All work is performed by the main engagement team.

In financial services entities, improve the approach in relation to the audit of collective and individual loan loss provisions.

This is not relevant to the audit of the Trust – actions are being taken on audits of entities affected.

AQR team report and findings

Recognition of and further impetus for our quality agenda

Other than as stated below, this document is confidential and prepared solely for your information and that of other beneficiaries of our advice listed in our engagement letter. Therefore you should not, refer to or use our name or this document for any other purpose, disclose them or refer to them in any prospectus or other document, or make them available or communicate them to any other party. If this document contains details of an arrangement that could result in a tax or National Insurance saving, no such conditions of confidentiality apply to the details of that arrangement (for example, for the purpose of discussion with tax authorities). In any event, no other party is entitled to rely on our document for any purpose whatsoever and thus we accept no liability to any other party who is shown or gains access to this document.

Deloitte LLP is a limited liability partnership registered in England and Wales with registered number OC303675 and its registered office at 2 New Street Square, London EC4A 3BZ, United Kingdom.

Deloitte LLP is the United Kingdom member firm of Deloitte Touche Tohmatsu Limited (“DTTL”), a UK private company limited by guarantee, whose member firms are legally separate and independent entities. Please see www.deloitte.co.uk/about for a detailed description of the legal structure of DTTL and its member firms.

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