Letter - Public Accounts Committee to Chief Executive re. Executive Response to C&AG Report on Management of the Healthcare Response to the COVID-19 Pandemic - 9 June 2021

States Greffe

Chief Executive CONFIDENTIAL: BY EMAIL cc Treasurer of the States Chief Minister

9 June 2021

Dear Chief Executive,

Executive Response to C&AG Report: Management of the Healthcare Response to the Covid-19 pandemic

The Public Accounts Committee has received the Executive Response to the above report, (attached to the email accompanying this letter for ease of reference), and in light of a number of concerns, detailed below, has requested me to ask whether you would want an opportunity to revise it, before we present it alongside our comments, to the States Assembly? Overall, the PAC considered that the Executive Response appeared to reflect a departmental perspective with less overarching corporate oversight:

1. The Government response does not contain an overall summary position. This is unusual for a response to a C&AG report and it would be helpful to understand the Government's overall position in terms of acceptance of the report and intention regarding the implementation of recommendations contained within the report.
2. Recommendation 6 - Risk assessments on guidance issued to staff – the Government response indicates that this is not always possible. The PAC would disagree and maintain that some form of  risk  assessment  (however  short)  should  be  documented  in  all  instances,  even  where guidance needs to be issued at speed.
3. Recommendation 7 - Lessons learnt on business continuity – your response indicates that this recommendation is rejected, however the text appears to indicate that the recommendation is being implemented (and therefore accepted). The Committee would seek clarification.
4. Recommendation 7 (continued) - the responsibility of undertaking the action falls to a position that, as far as the PAC understands, does not exist, namely the Director General for Community and Constitutional Affairs. Our understanding is that the CCA remit has been split between the DG of JHA and the DG of SPPP – we would seek clarity.
5. Recommendation 8 – your response suggests that the report back is to the HCS Finance, Performance  and  Operations  Committee.   The  link  between  it  and  the  Risk  and  Audit Committee is not clear and the PAC would seek clarity.
6. Recommendation 9 – you have rejected this recommendation yet HCS has accepted the need to work up an emergency plan. This may lack the focus the C&AG has suggested as there are many lessons on how the various elements of the system worked together in this pandemic and will need to do so in future pandemics. The PAC would likely comment that a system wide review should be undertaken with the results reported publicly.

7. Recommendation 12 - there remains a significant amount of money to be paid back by GPs. The PAC will be keeping this under review.
8. Recommendation 13 - you have rejected this recommendation which highlights weaknesses in the business continuity and resilience planning of primary and community care services and recommends a review. The C&AG suggests that the Jersey Care Commission is asked to undertake this review. The PAC is not convinced that the action undertaken already addresses the C&AG recommendation sufficiently and will be seeking further information.
9. Recommendation 14 - this recommendation appears to be accepted in principle however it is only noted as partly accepted. As a principle, completion of mandatory training should be recorded. Significant risks exist if the completion of mandatory training is not monitored and recorded.
10. Recommendation 15 - your response indicates that the delivery of effective occupational health services is a risk area. The PAC will follow up on whether improvements are delivered within the new contract for this service.
11. Recommendation 17 - you have rejected this, however the text indicates that work is being undertaken  that  is  relevant  to  the  recommendation.   It  is  unclear  whether  the  normal' procedures identified are sufficiently robust given the findings of the C&AG. The PAC will follow this up.
12. Recommendation 18 - the PAC may wish to follow up on the exercises and reports undertaken to determine whether they have been done robustly and whether recommendations are being implemented.
13. Recommendation 19 - The PAC does not understand why such a long time is required to produce a report clarifying roles and responsibilities.

The PAC would be grateful for a response by 15th June 2021, indicating whether you wish further time to revise the Executive Response or whether you are content for it to be presented to the States Assembly in the usual way with our comments.

Yours sincerely

Deputy Inna Gardiner , Chair, Public Accounts Committee