SCOTTISH AMBULANCE SERVICE

115 Pages·2012·0.84 MB·English

SCOTTISH AMBULANCE SERVICE
ANNUAL ACCOUNTS AND NOTES
FOR YEAR ENDED 31 MARCH 2012
ScottishAmbulanceServiceBoard
AnnualAccounts2011-2012
CONTENTS
Page
Directors’Report(includinginterestsofBoardmembers) 1
OperatingandFinancialReview 8
RemunerationReport 16
StatementsofResponsibilities 20
GovernanceStatement 22
IndependentAuditors’Report 27
DirectionbytheScottishMinisters 29
PrincipalFinancialStatements 30
Notestothe Accounts
Note1(AccountingPolicies) 36
Note2–32 48
ScottishFinancialReturns 100
PaymentPolicy 111
ResourceandCashOutturn 112
Sickness Absence 113
Scottish AmbulanceServiceBoard
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SCOTTISH AMBULANCESERVICE
ANNUAL ACCOUNTSANDNOTESFORYEARENDED31MARCH2012
DIRECTORS’REPORT
DIRECTORS’REPORT
1. NAMINGCONVENTION
ScottishAmbulanceServiceisthecommonnamefortheScottishAmbulanceServiceBoard.
2. PRINCIPAL ACTIVITIESANDREVIEWOFTHEBUSINESSANDFUTUREDEVELOPMENTS
The information that fulfils the requirements of the business review, principal activities and future
developments can be found in the Operating and Financial Review, which is incorporated in this report by
reference.
3. DATEOFISSUE
AuditedFinancialStatementswereapprovedandauthorisedforissuebytheBoardon27June2012.
4. ACCOUNTINGCONVENTION
The Annual Accounts and Notes have been prepared under the historical cost convention as modified to
reflect changes in the value of fixed assets and in accordance with the Scottish Government Financial
Reporting Manual (FREM). The Accounts have been prepared under a direction issued by Scottish
Ministers,whichisincludedatPage29oftheaccounts.
The statement of the accounting policies, which are in line with the International Financial Reporting
Standards(IFRS)andhavebeenadopted,areshownatNote1.
5. APPOINTMENTOFAUDITORS
The Public Finance and Accountability (Scotland) Act 2000 places personal responsibility on the Auditor
General for Scotland to decide who is to undertake the audit of each health body in Scotland. The Auditor
General has appointed Deloitte LLP to undertake the audit of the Scottish Ambulance Service. The general
duties of the auditors of health bodies, including their statutory duties, are set out in the Code of Audit
PracticeissuedbyAuditScotlandandapprovedbytheAuditorGeneral.
6. BOARDMEMBERSHIP
Under the terms of the Scottish Health Plan, the Scottish Ambulance Service Board (“the Board”) is a Board
of governance whose membership will be conditioned by the functions of the Board. Members of Health
Boardsareselectedonthebasisoftheirpositionortheparticularexpertisewhichenablesthem tocontribute
tothedecisionmakingprocessatastrategiclevel.
The Board has collective responsibility for the performance of the Service as a whole, and reflects the
partnershipapproach,whichisessentialtoimprovinghealthandhealthcare.
TheScottishAmbulanceServiceBoardcomprisedduring2011/12:
DavidGarbutt Chairman
PaulineHowie ChiefExecutive
CouncillorDavidAlexander Non-ExecutiveDirector
MoiAli Non-ExecutiveDirector
MattBell EmployeeDirector
DrGeorgeCrooks MedicalDirector(part–time)
SuzanneDawson Non-ExecutiveDirector
TheresaHouston Non-ExecutiveDirector
NeelamBakshi Non-ExecutiveDirector(from1July2011)
EdwardFrizzell Non-ExecutiveDirector(from1July2011)
DouglasMarr Non-ExecutiveDirector(until30June2011)
ChristineHumphries Non-ExecutiveDirector(until30June2011)
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PamelaMclauchlan DirectorofFinanceandLogistics
AndrewRichmond Non-ExecutiveDirector
PeterRipley DirectorofServiceDelivery(until5August2011)
DarenMochrie DirectorofServiceDelivery(from8August2011)
ShirleyRogers DirectorofHumanResourcesandOrganisationalDevelopment
New Appointments
Neelam Bakshi and Edward Frizzell were appointed as non-executive directors with effect from 1 July2011.
Peter Ripley Director of Service Delivery resigned to take up a similar post with East Midlands Ambulance
Service. Initially he was replaced with Daren Mochrie in an Acting Director position on 8 August 2011 and
thenasthepermanentDirectorofServiceDeliveryasof1December2011.
The Board members’ responsibilities in relation to the accounts are set out in a statement following this
report.
7. BOARDMEMBERS’ANDSENIORMANAGERS’INTERESTS
ThefollowinginterestshavebeendeclaredbyBoardmembersandseniormanagers:
BoardMember Directorships Ownerships
DavidGarbutt  CharteredfellowoftheCharteredInstituteof SelfEmployed
PersonnelandDevelopment Consultant
 FellowScottishPoliceCollege
 VisitingFellowAustralianInstituteofPolice
Management
PaulineHowie None None
Councillor
 SubstituteMemberCentralScotlandPoliceBoard None
DavidAlexander
 MemberandofficebearerScottishNationalParty
 MemberCNDScotland
 MemberCentralScotlandFireBoard
 ElectedMemberFalkirkCouncil
MoiAli  FellowoftheRSA SelfEmployed
 Governor,NapierUniversity Consultant
 JudicialComplaintsReviewer
 Non-ExecutiveDirectorNHSEducationfor
Scotland
 Member Chartered Institute of Personnel &
NeelamBakshi None
Development(Affiliate)
 FederationofSmallBusiness
 Co–OperativeSociety
 NationalAutisticSociety
 RoyalHorticulturalSociety
 MemberBBCAudienceCouncil
 ApprovedTrainingInstituteAmericanBoardNLP
 NBAssociates-owner;
 ScottishGovernment,Non-ExecutiveMember;
 LayMemberEmploymentTribunalsScotland,
 ReserveForcesTribunal&LayRaceEquality
AssessortoJudiciary
 Member Scotland Committee of Equality &
HumanRightsCommission
MattBell None None
DrGeorgeCrooks  MedicalDirectorNHS24 None
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SuzanneDawson  LaymemberofCounciloftheLawSocietyof Self-employed
Scotland Marketing
 MemberoftheBoardofNewbattleAbbeyCollege Consultant
 FellowofCharteredInstituteofMarketing
 Vice-ChairofCourtofAbertayUniversity,Dundee
EdwardFrizzell  VisitingProfessor,QueenMargaretUniversity, None
Edinburgh
 Non-ExecutiveDirectorNHSEducationfor
TheresaHouston None
Scotland
ChristineHumphries  ViceChairScottishBordersValuationAppeal None
Committee
 MemberBritishAssociationofSocialWorkers
DouglasMarr None None
DarenMochrie None None
 ExecutiveMemberCIPFAinScotland
PamelaMclauchlan
 Non-ExecutiveAuditCommitteeMemberNational None
TheatreforScotland(from1January2012)
AndrewRichmond  Non-ExecutiveMemberofNHSTayside None
 ChairofAngusCHP
 Non-ExecutiveDirectorofFrontierIPGroupPLC
 TrusteeTaysideNHSBoardEndowmentFund
 AssociateofSocietyofInvestmentProfessionals
(ASIP)
 MemberofChurchofScotland
 LayCourtmemberoftheUniversityofDundee
 TrusteeoftheUniversityofDundee
SuperannuationandLifeAssurancescheme
PeterRipley None None
ShirleyRogers None None
SeniorManagers Directorships Ownerships
HeatherKenney None None
7. PUBLICSERVICESREFORM(SCOTLAND) ACT2010
The Public Services Reform (Scotland) Act came into being in October 2010. In Sections 31 and 32 it
placedadutyonallpublic bodiestopublishinformationonexpenditureandcertainothermattersassoonas
isreasonablypracticableaftertheendofeachfinancialyear.Theseitemsinclude:
 OverseasTravel;
 PublicRelations;
 HospitalityandEntertainment;and
 ExternalConsultancy.
In order to comply with this act, the Scottish Ambulance Service places on its external website the
informationrelatingtotheexpenditureincurredundertheseheadingssince1April2011.
In addition, public bodies are required to publish cash payments made to external parties that exceed
£25,000 ona monthlybasis,as soonas themonthlyaccounts are available. A listof thesepayments is also
placedonourExternalWebsite. Thefollowinglinkwilltakereaderstotherelevantinformation:
http://www.scottishambulance.com/AboutUs/PoliciesPublications.aspx
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Payments made to staff that exceed £100k per annum should also be disclosed. This information is
contained in the Directors’ remuneration report. No other members of staff currently earn more than £100k
perannum.
8. PENSIONLIABILITIES
The accounting policy note for pensions is provided in Note 1 and disclosure of the costs is shown within
Note24andtheremunerationreport.
9. REMUNERATIONFORNON-AUDITWORK
Deloitte LLP, the Service’s current External Auditors, have only undertaken audit related work during
2011/12fortheScottishAmbulanceServiceBoard.
10. RELATEDPARTYTRANSACTIONS
During the year, no Board member, key manager or other related parties have undertaken any material
transactionswithanybody.
11. PAYMENTPOLICY
The Scottish Ambulance Service is committed to supporting the Scottish Government in helping businesses
duringthecurrenteconomic situationbypaying bills morequickly. Theintentionis toachieve paymentof all
undisputedinvoiceswithin10workingdaysacrossallpublicbodies.
The target has been communicated to all non-departmental public bodies, who are working towards the
acceleratedpaymenttargetof10workingdays.
TheScottishAmbulanceServicehas endeavouredtowork towards this targetanddoesensurethatinvoices
received that have been correctly checked are processed within 7 working days of date of receipt. However
thosethatrequirefurtherinvestigationresultinthefollowingachievementofthetarget.
 In2011/12 theBoardpaid24%byvalueand18%byvolumewithin10days
(2010/11=8%byvalue&19%byvolume-Restated)
Prior to this, the Board did endeavour to comply with the principles of The Better Payment Practice Code
(http://www.payontime.co.uk) by processing suppliers’ invoices for payment without unnecessary delay and
bysettlingtheminatimelymanner.
 In2011/12 averagecredittakenwas28Days
(2010/11=28Days-Restated)
 In2011/12 theBoardpaid73%byvalueand77%byvolumewithin30days
(2010/11=65%byvalue&76%byvolume-Restated)
12. CORPORATEGOVERNANCE
The Board meets regularly during the year to progress the business of the Scottish Ambulance Service
Board. This includes reviewing of performance against the keytargets for the organisation. Considering the
key strategies and policies the organisation wishes to develop. Seeking assurance that principal decisions
are governed and implemented, as planned. In order to support the work of the Board and to provide a
frameworkofassurancethe followinggovernancecommitteesreporttotheBoard:
 ClinicalGovernance;
 Audit;
 StaffGovernance;and
 Remuneration.
ClinicalGovernanceCommittee
TheClinicalGovernanceCommitteeoftheBoardhastwokeyroles:
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- Systems assurance – to ensure that clinical governance mechanisms are in place and effective
throughouttheScottishAmbulanceServiceSystem;and
- Public health governance – to ensure that the principles and standards of clinical governance are
appliedtothehealthimprovementactivitiesoftheNHSBoard.
TheClinicalGovernanceCommitteecurrentlycomprisesfourNon-ExecutiveDirectors:MsSuzanneDawson
(Chair); Mr Andrew Richmond; Ms Neelam Bakshi; and Ms Theresa Houston. Mr DavidNelson is the
Public/PatientRepresentative.TheCommitteemeetsapproximatelyfourtimesper yeartomonitorstandards
ofcareandmeasuretheeffectivenessofpre-hospitaltreatment.
AuditCommittee
The Audit Committee currently comprises four Non-Executive Directors: Mr Andrew Richmond (Chair); Ms
Moi Ali; Mr Eddie Frizzell and Councillor David Alexander. Mr Frizzell took up his position at the start of July
2011, replacing Mr Doug Marr. Councillor Alexander replaced Ms Christine Humphries at the same time and
Mr Richmond took up position of Chair of the committee. The Audit Committee meets four times per year to
consider thevarious reports from bothinternalandexternal auditors toassess therisksthatmayarise inthe
Service.
StaffGovernanceCommittee
The Staff Governance Committee comprises four Non-Executive Directors: Mr Matt Bell, Employee Director
and Chair, Ms Moi Ali, Councillor David Alexander, Ms Neelam Bakshi and the Chairman, MrDavidGarbutt.
The Committee meets four times per year to ensure effective monitoring of staff governance within the
organisation.
RemunerationCommittee
The Remuneration Committee currently comprises the Chairman and three Non-Executive Directors:
MrEdwardFrizzell;MsSuzanneDawson;andCouncillorDavidAlexander. TheCommitteeischairedbythe
Chairman,MrDavidGarbutt.Itmeetsatleastthreetimesper year toconsiderthe evaluationofperformance
and pay awards for Executive Directors. The committees have an important role in ensuring consistency of
policy and equity of treatment of staff across the local NHS system, including remuneration issues, where
they are not already covered by existing arrangements at national level. The Board Members’
responsibilitiesinrespectofinternalcontrolaresetoutinastatementfollowingthisreport.
13. DISCLOSUREOFINFORMATIONTOAUDITORS
The directors who held office at the date of approval of this directors’ report confirm that, so far as they are
each aware, there is no relevant audit information of which the Board’s auditors are unaware; and each
director has taken all the steps that he/she ought reasonably to have taken as a director to make
himself/herself aware of any relevant audit information and to establish that the Board’s auditors are aware
ofthatinformation.
14. HUMANRESOURCES
Throughout 2011/12, and in the face of difficult economic challenges, we have continued to live out the
values and principles of partnership working, ensuring that effective staff governance exists across the
Service. We are now almost half-way way through our 5 year HR strategy that was set out in “Doing the
Right thing” covering the period 2010 to 2015. This is a strategythat continues to evolve as the expectations
of the public increase and in light of continuing challenges over public sector funding. We are continuing to
challenge ourselves to find innovative ways of developing the services we provide, focused solely on
improvingpatientcare.
Effectiveandefficientcommunicationisakeypartofensuringourstaffarewellinformed.Wehaveinplacea
communications strategy which aligns all the keypieces of strategy work, helping staff to see how the range
of individual projects are coming together to deliver our strategy goals. We have seen significant
improvement in the development of communications channels and re-launched our intranet and external
website. The re-launched internal staff magazine: Response came third at the November 2011 Chartered
InstituteofPublicRelationsAwardsintheInternalNewspaperorMagazinecategory.
The recent introduction of Leadership Patient Safety Walk Rounds has provided an opportunity for senior
staff and the Non-Executive members of the Service Board to meet frontline staff in every station to talk
about how we can collectively improve patient safety. This has been a hugely successful listening exercise,
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and regular updates in the Chief Executive’s weeklybulletin have been keeping staff abreast of the changes
madeinresponsetostafffeedback.
In the summer of 2011 a new recognition and awards scheme was introduced. The award events highlight
the excellent work done by our staff and by our volunteer partners. The events are supported with funding
from the Benevolent Fund and through sponsorship from Scotmid. By recognising individual and team
contributionstooutstandingpatientcareweaim toinspirestafftoreplicategoodpractice.Thishasgenerated
positivecoverageinlocalandnationalmediaforstaffacrosstheService.
Because of the nature of our work, the clinical elements of staff training are highly regulated and provide
assurance that both basic training and professional development activities are carried out to required
standards. The new Ambulance Service Academy based within Glasgow Caledonian University is fast
becoming an exemplar for the NHS and we continue to be the only UK ambulance service that is able to
boast triple accreditation of our training. This accreditation comes from Glasgow Caledonian University, the
HealthProfessionsCouncilandtheCollegeofParamedics.
Supporting our efforts to ensure patient safety we have continued to roll out appropriate training and support
to ensure appropriate Prevention and Control of Infection (PCOI) education programmes are in place. There
arenowsome429CleanlinessChampionsacrosstheServiceandwork isunderwaytomakesurethatevery
teamleaderacrosstheServiceisalsoeducatedtoCleanlinessChampionstatus.
Our firm commitment to the principles of partnership continues with National Partnership and Divisional
Partnerships continuing to operate with the full support of managers and staff. The strength of these
relationships has been critical in us finding solutions to long term issues such as rest breaks.The solution to
which is now being implemented in partnership and to helping us jointly plan for future challenges. While
recognisingthatwehaveastrongpartnershipmodel,wehaveagreedtoreviewthePartnershipForum terms
ofreferenceandreinforcetheprinciplesofpartnershipduring2012/13.
The Scottish Ambulance Service is committed to the principles of Equality and Diversity, and this is
demonstrated by means of the well established policies in this area. We have embraced the new
responsibilitiesinrespectofdiversityandwillbedevelopingthesefurtherin2012/13.
Over the past year we have continued to review and improve our policies and mechanisms that support the
health and safety of our people and the people we serve. We have appropriate risk assessments in place
alongside a system for reporting defective equipment in order to ensure that we place Health and Safety
measures at the forefront in staff’s clinical practice. We provide staff with training and development and
increasingly,wearelinkingthistocontinuouslearning.Ouraim istocreateacultureofoperatingwithaclear
mindset of dynamic risk assessment when faced with circumstances that are by their nature, situational and
createalearningenvironment.
Wehavecontinuedtopromotepro-activemanagementofsickabsencewithanaimofreducingto5%across
theservice.This yearsickabsencehasbeen5.7%.Thisincreaseinabsencerateisasaresultofalltypesof
sickness and from all areas of the organisation. We currently are conducting a comprehensive review of the
causes of sickness absence and options for improvement will be taken to the Board in the Summer of 2012.
We believe this is something that can be improved and it is important to remember that the UK Ambulance
Service average is 6.3%. This recognises the particular pressures on emergency services staff because of
theirworkingenvironment.
In January we reached agreement over the management of rest breaks. A high level action plan has been
developed and the immediate focus is on implementing the new arrangements across the Service. This
agreement, constructed in partnership, will provide a sustainable solution to the issue of rest breaks. It will
addressconcernsoverpatientandstaffsafetyandenhanceresilienceandambulanceservicecapability.
This year we sought accreditation to the Healthy Working Lives award and our efforts have resulted in the
Service being accredited at Bronze level. This standard provides an additional assurance that we have clear
health and safety roles established for our staff and that we plan and record Health and Safety training
activity.
We must always remember that it is the efforts of our dedicated and professional staff that will ultimately
deliver the service to the people of Scotland. Many have chosen to work for the service because of a desire
to serve their fellow citizens. This is often in the face of danger and brings staff into contact with the whole
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spectrum of people in our society. The principles of staff engagement and promoting diversity are the two
areasthathavethegreatestpotentialtodeliverimprovedandefficientpatientcare.
15. EVENTSAFTERTHEENDOFTHEREPORTINGPERIOD
There have been no significant events after the end of the financial year that would materially impact on the
informationcontainedwithintheaccounts.
16. FINANCIALINSTRUMENTS
Information in respect of the financial risk management objectives and policies of the Board and the
exposure of the Scottish Ambulance Service to price risk, credit risk, liquidity risk and cash flow risk is
disclosedinnote27.
The Accounting Officer (Chief Executive) of the Scottish Ambulance Service has authorised these financial
statementsforissueonthe27June2012.
Signed: ........................................................................................................................... Date: 27June2012
MrsPaulineHowie
ChiefExecutive
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OPERATING ANDFINANCIALREVIEW
NHS Boards are required to prepare an Operating and Financial Review under section 7.2 of the FReM. This
provides a narrative explanation of the main trends and factors underlying the development, performance and
position of the Board during the financial year covered by the financial statements, and those which are likely to
affect its future development, performance and position as defined in the Accounting Standards Board Reporting
Statementobjectives.
The operating and financial review has been prepared in accordance with the FReM and complies with best
practice.
1 Principalactivitiesandreviewoftheyear
The Scottish Ambulance Service was established in 1999 under The Scottish Ambulance Service Board Order
1999 which amended the National Health Service (Scotland) Act 1978 and is responsible for the provision of
Accident& EmergencyResponse, PatientTransportationServiceandAir Ambulanceservices for theresidents
ofScotland,includingtheislands’communities. Thiscoversatotalpopulationofover5.2million.
TheroleoftheScottishAmbulanceServiceisto:
 provide accident and emergency, patient transport and air ambulance services to the people of
Scotland;
 improveandprotectthehealthofpeople;
 improvehealthservicesforlocalpeople;
 focusclearlyonhealthoutcomesandpeople’sexperienceoftheirlocalNHSsystem;and
 promoteintegratedhealthandcommunityplanningbyworkingcloselywithotherlocalorganisations.
ThefunctionsoftheScottishAmbulanceServiceBoardcomprise:
 strategydevelopment;
 implementationofstrategicframework;
 resourceallocations;
 implementationofitsDeliveryPlan;and
 performancemanagement.
DuringthisyeartheOrganisationhasdeliveredthefollowing:
 Progressed procurement in partnership with NHS24 of a Single Clinical Triage Tool (SCTT), which will
mean that regardless of whichever route patients use to access emergency and urgent healthcare,
therewillbeconsistencyintheassessmentandtriageofpatients’needs;
 Increased the number of clinical advisors in our Emergency Medical Dispatch Centres (EMDC) to
provideimprovedclinicalcareandassessmentandsupporttheintroductionoftheSCTT;
 Lead the development, with the Long Term Conditions Task and Finish Group looking at falls and
general frailty, of a protocol and screening tool to be used by Scottish Ambulance Service, Primary
CareandOutofHoursclinicianstoassessolderpeoplewhohavefallen;
 Progressed the development of care pathways in respect of diabetes, alcohol/drug abuse, Chronic
obstructivepulmonarydisease(COPD),breathlessnessandmentalhealth;
 Undertaken comprehensive review and stakeholder engagement to improve scheduled care services,
which will result in establishment of 3 regional booking centers for Scotland to increase direct patient
access, the roll out of mobile data across the Patient Transport Service fleet, and an improvement in
thequalityandefficiencyofthescheduledcareservice;
 Completed four Learn and Improve reviews and developed improvement programmes to take forward
findings;thesewerePTS,workforceplanning,administrativeservices,andEMDC;
 Progressed implementation of our Community Resilience Strategy and strengthened our capacity to
supportcommunityengagementandbuildresilience;
 Increased the number of Community First Responder schemes by around 8%, with over 1,000
volunteersacrossover130schemes;
 Increased numbers of public access defibrillators in partnership with British Heart Foundation and
Scotmid amongst others and upgraded our C3 system to track the position of public access
defibrillatorssocalltakersareabletomakecallersaware;
 Continued to work with NHS Boards and communities to take forward appropriate integrated
healthcaremodelsinlinewiththeStrategicOptionsFrameworkforremoteandruralcommunities;
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