board of directors public board · 5/25/2018 · accounts. these accounts must comply with hm...
TRANSCRIPT
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Board of Directors
Public Board
25th May 2018
wuth.nhs.uk @wuthnhs #proud
MEETING OF THE BOARD OF DIRECTORS ON FRIDAY 25th MAY 2018, 3PM
THE BOARDROOM, EDUCATION CENTRE, ARROWE PARK HOSPITAL
AGENDA 1
Apologies Chair
v
2 3
Declaration of Interests Chair Approval of Annual Report and Accounts 2017/18
• Annual Accounts 2017-18 and Letter of Representation Interim Director of Finance
• Quality Account Annual Report Deputy Medical Director
• Annual Report and Governance Statement Acting Chief Executive
v d d/p d d
4 5 6
External Audit Opinions Grant Thornton Any Other Business Chair Evaluation of the Board Meeting Chair
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25 M
ay 2
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1. Executive summary
The Trust is required under the National Health Service Act 2006 to prepare annualaccounts. These accounts must comply with HM Treasury-approved directions issued byNHS Improvement, in exercising statutory functions conferred on Monitor. In particular, theaccounts must comply with the Department of Health and Social Care Group AccountingManual (DHSC GAM).
The Trust is also required annually to present a letter of management representation to theexternal auditor. In this letter, management state that the financial statements are, to itsknowledge, correct and compliant, and the letter can be relied upon by the auditor in anyareas where other types of audit evidence were not available or sufficient.
The purpose of this paper is to present the 2017/18 annual accounts and letter ofrepresentation to the Board of Directors for approval.
Board of Directors
Agenda Item 3
Title of Report Annual Accounts 2017/18 and Letter of Representation
Date of Meeting 25 May 2018
Author Deborah Harman Assistant Director of Finance – Financial Services
Accountable Executive Karen Edge Acting Director of Finance
BAF References • Strategic Objective
• Key Measure
• Principal Risk
8. Strategic Objective – Enabled by financial, commercial andoperational excellence
Level of Assurance • Positive
• Gap(s)
Positive
Purpose of the Paper • Discussion
• Approval
• To Note
Approval
Data Quality Rating Gold – externally validated data
FOI status Document may be disclosed in full
Equality Impact Assessment Undertaken • Yes
• No
No
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2. Letter of representation
The draft letter of representation on the financial statements is included at Appendix 1. The composition of the letter follows a set format, and the required content is guided by Grant Thornton UK LLP, as it needs to satisfy the external auditor’s requirement.
If approved by the Board of Directors, the Acting Chief Executive Officer and the Acting Director of Finance will sign the letter on its behalf.
3. Annual accounts
Draft annual accounts and Trust Accounts Consolidation (TAC) schedules were submitted to NHS Improvement on 24 April 2018. Copies were provided to the Trust’s external auditor, Grant Thornton UK LLP for the purposes of statutory audit. The draft accounts are to be circulated to members separately.
If approved by the Board of Directors, the Acting Chief Executive Officer will sign the accounts on its behalf.
4. 2017/18 accounts headlines
The Acting Director of Finance will present key messages from the Trust’s annual accounts. Headline financial metrics for 2017/18 are noted below.
5. Conclusions
• The draft annual accounts have been prepared in accordance with IFRSs and sector-specific accounting guidance.
• The signed letter of representation should be presented to the auditor, after which theTrust expects to receive the signed audit opinion for inclusion in the final AnnualReport and Accounts.
• The Audit Committee of 17 May 2018 is expected to recommend to the Board ofDirectors the approval of both the letter of representation and the accounts.
• The final accounts will be submitted to NHS Improvement on or before 29 May 2018,presented within the Trust’s Annual Report and Accounts 2017/18.
£m
Deficit (17.4)
Income and gains 337.0
Expenditure (354.4)
Cash balance at 31 March 8.0
Net borrowings in year 22.4
Capital expenditure in year 13.6
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6. Recommendation
The Trust’s Board of Directors is asked to approve the 2017/18 letter of representation (Appendix 1) and annual accounts.
Deborah Harman Assistant Director of Finance – Financial Services
May 2018
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Grant Thornton UK LLP 4 Hardman Square Manchester M3 3EB
25 May 2018
Dear Sirs
Wirral University Teaching Hospital NHS Foundation Trust financial statements for the year ended 31 March 2018
This representation letter is provided in connection with the audit of the financial
statements of Wirral University Teaching Hospital NHS Foundation Trust for the year
ended 31 March 2018 for the purpose of expressing an opinion as to whether the
financial statements are presented fairly, in all material respects in accordance with
International Financial Reporting Standards, the NHS Foundation Trust Annual
Reporting Manual issued by NHS and the Department of Health and Social Care Group
Accounting Manual 2017-18.
We confirm that to the best of our knowledge and belief having made such inquiries as
we considered necessary for the purpose of appropriately informing ourselves:
Financial Statements
i As Trust Board members, we have fulfilled our responsibilities under the National Health Services Act 2006 for the preparation of the financial statements in accordance with International Financial Reporting Standards, the NHS Foundation Trust Annual Reporting Manual (the ARM) and the Department of Health and Social Care Group Accounting Manual 2017-18 (GAM); in particular the financial statements are fairly presented in accordance therewith.
ii We have complied with the requirements of all statutory directions affecting the Trust and these matters have been appropriately reflected and disclosed in the financial statements.
Appendix 1
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iii The Trust has complied with all aspects of contractual agreements that could have a material effect on the financial statements in the event of non-compliance. There has been no non-compliance with requirements of the Care Quality Commission or other regulatory authorities that could have a material effect on the financial statements in the event of non-compliance.
iv We acknowledge our responsibility for the design, implementation and maintenance of internal control to prevent and detect fraud.
v Significant assumptions used by us in making accounting estimates, including those
measured at fair value, are reasonable. vi In calculating the amount of income to be recognised in the financial statements
from other NHS organisations we have applied judgement, where appropriate, to
reflect the appropriate amount of income expected to be derived by the Trust in
accordance with the International Financial Reporting Standards and the GAM. We
are satisfied that the material judgements used in the preparation of the financial
statements are soundly based, in accordance with International Financial Reporting
Standards and the GAM, and adequately disclosed in the financial statements.
There are no other material judgements that need to be disclosed.
vii We acknowledge our responsibility to participate in the Department of Health and
Social Care's agreement of balances exercise and have followed the requisite
guidance and directions to do so. We are satisfied that the balances calculated for
the Trust ensure the financial statements and consolidation schedules are free from
material misstatement, including the impact of any disagreements.
viii Except as disclosed in the financial statements:
a. there are no unrecorded liabilities, actual or contingent;
b. none of the assets of the Trust has been assigned, pledged or
mortgaged; and
c. there are no material prior year charges or credits, nor exceptional or
non-recurring items requiring separate disclosure.
ix Related party relationships and transactions have been appropriately accounted for and disclosed in accordance with the requirements of International Financial Reporting Standards and the GAM.
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x All events subsequent to the date of the financial statements, and for which International Financial Reporting Standards and the GAM require adjustment or disclosure, have been adjusted or disclosed.
xi The financial statements have been amended for disclosure changes raised during the audit. The financial statements are free of material misstatements, including omissions.
xii Actual or possible litigation and claims have been accounted for and disclosed in
accordance with the requirements of International Financial Reporting Standards. In particular, the Board has assessed the likelihood of any liability crystallising from the current legal claim by Ryhurst and, having sought independent legal advice, consider that the legal claim is properly classified as a contingent liability.
xiii We have no plans or intentions that may materially alter the carrying value or
classification of assets and liabilities reflected in the financial statements.
Information Provided
xiv We have provided you with:
a. access to all information of which we are aware that is relevant to the preparation of the financial statements such as records, documentation and other matters;
b. additional information that you have requested from us for the purpose of your audit; and
c. unrestricted access to persons within the Trust from whom you determined it necessary to obtain audit evidence.
xv We have communicated to you all deficiencies in internal control of which
management is aware. xvi All transactions have been recorded in the accounting records and are reflected in
the financial statements. xvii We have disclosed to you the results of our assessment of the risk that the financial
statements may be materially misstated as a result of fraud. xviii We have disclosed to you all information in relation to fraud or suspected fraud that
we are aware of and that affects the Trust and involves:
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a. management;
b. employees who have significant roles in internal control; or
c. others where the fraud could have a material effect on the financial statements.
xix We have disclosed to you all information in relation to allegations of fraud, or
suspected fraud, affecting the Trust's financial statements communicated by employees, former employees, analysts, regulators or others.
xx We have disclosed to you all known instances of non-compliance or suspected non-compliance with laws and regulations whose effects should be considered when preparing financial statements.
xxi We have disclosed to you the identity of the Trust's related parties and all the related party relationships and transactions of which we are aware.
xxii We have disclosed to you all known actual or possible litigation and claims whose effects should be considered when preparing the financial statements.
xxv The Trust will require an additional cash loan of £25m in 2018/19 to maintain
current payment performance assuming that it delivers its savings plan. Although
the Trust has not received formal notification of future financing, this has always
been available in the past in accordance with the need of the Trust to meet all
essential liabilities and there is no indication that this will not continue. If the Trust
fails to deliver its savings plan in full or its financial deficits are greater than planned
in 2018/19 then further cash loans will be required. As the Trust’s continuing
operational stability depends on finance that has not yet been approved this
represents a material uncertainty for the Trust
Although these factors represent a material uncertainty that may cast significant
doubt over the Trust’s ability to continue as a going concern, the Directors, having
made appropriate enquiries, still have reasonable expectations that the Trust will
have adequate resources to continue in operational existence for the foreseeable
future. As directed by the GAM, the Directors have prepared the financial
statements on a going concern basis as they consider that the services currently
provided by the Trust will continue to be provided in the foreseeable future.
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Annual Report
xxiii The disclosures within the Annual Report fairly reflect our understanding of the
Trust’s financial and operating performance over the period covered by the financial
statements.
Annual Governance Statement
xxiv We are satisfied that the Governance Statement fairly reflects the Trust’s risk
assurance framework and we confirm that we are not aware of any significant risks
that are not disclosed within the Governance Statement.
Approval
The approval of this letter of representation was minuted by the Trust’s Board at its
meeting on 25 May 2018.
Yours faithfully
Name……………………………
Position………………………….
Date…………………………….
Name……………………………
Position………………………….
Date…………………………….
Signed on behalf of the Trust’s Board of Directors
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Board of Directors
Agenda Item 3
Title of Report Quality Account Annual Report
Date of Meeting 25.5.18
Author Joe Roberts, Head of Assurance
Accountable Executive Mrs Gaynor Westray, Director of Nursing and Midwifery Dr Susan Gilby, Medical Director
BAF Reference Risk 1
Level of Assurance Full
Purpose of the Paper For discussion
Data Quality Rating Mixture of gold, silver and bronze data
FOI status Document may be disclosed in full
Equality Impact Assessment Undertaken
Not required
1. Executive Summary The final draft of the Quality Account for 2017/18 has been circulated separately to members. Earlier drafts were reviewed by the Clinical Governance Group at its meeting on 19th April, by the Quality and Safety Committee on 9th May, and by the Audit Committee on 17th May. The draft report was also presented to Wirral Borough Council’s Adult Care and Health Overview & Scrutiny Committee on 9th May. 2. Background The Health and Social Care Act 2009 requires every Trust to produce a Quality Account describing the performance of its clinical services during the previous financial year. The annual Quality Account should measure performance against both mandatory national targets, and local targets which each organisation has set for itself because they are important from the point of view of patient experience, patient safety or clinical
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effectiveness. The format and content of the report is prescribed by national regulations, with limited flexibility to amend it. Some changes have been made to the report since the draft that was presented to the Audit Committee. The principal changes were to:
• Update the performance figures for the A&E 4-hour target in section 2.4, to show separate figures for the Emergency Department alone, as advised by External Audit (earlier drafts showed only a combined performance figure covering the whole site, both our ED and the Walk In Centre run by Wirral Community NHS Trust)
• Include in the appendices the written feedback received from our external statutory consultees, which is copied verbatim.
• Update section 3.2.2 and Appendix 2 (national clinical audits) with some information which was only received shortly before the deadline
• Add the statement provided by Grant Thornton LLP following the completion of their audit of the Quality Account (Appendix 4)
The only other changes were very minor changes to phrasing or presentation, in response to feedback received from readers. 3. Key Issues Performance against our targets: The Trust did not meet the targets which it set itself for nutrition and hydration, for pressure ulcers, or for patient flow. We are required to identify a minimum of three priority topics for the year ahead. In accordance with feedback provided by the Council of Governors in March, the Trust will have just three Quality Account priorities in 2018/19. These will be the three listed above, and the numerical targets will also be rolled forward from 2017/18. This will allow us to concentrate our resources on the areas where improvement is most needed. Starting from this year, Trusts are required to report the percentage of deaths of their patients which have been reviewed to identify lapses in care which could have contributed to the death, and to learn lessons. The Trust revised its Mortality Review Framework in early 2017 in response to national guidance that it should seek to review all deaths occurring in our hospital. However, the new process got off to a slow start at the beginning of 2017/18; approximately 12% of deaths which occurred during the year have been reviewed. External Audit: Grant Thornton LLP, External Auditors, have audited the Quality Account alongside their audit of the Trust’s financial accounts. They focused on three performance indicators within the report. Two of these were national targets which NHS Improvement require to be audited – the four-hour target for Accident and Emergency, and 18 weeks referral to treatment (incomplete pathways), and the other was a local performance indicator selected by the Council of Governors – compliance with MUST nutritional screening assessments for patients who have been in the hospital for seven days or more.
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For the two national indicators, the auditors stated that there was “no evidence that these two indicators were not reasonably stated in all material respects in accordance with the NHS Foundation Trust Annual Reporting Manual 2017/18 and supporting guidance”. They found the same for the nutrition and hydration target although they are not required to provide a formal limited assurance opinion for local performance indicators. The auditor’s opinion represents an improvement for the Trust – in both 2016/17 and 2015/16 they issued qualified audit opinions because of inaccuracies found while testing the two national indicators. Core Indicator Data: Some of the data in section 2.4.5 (Core Indicators) is up to a year old; this has also been the case in previous years. The data is provided by NHS Digital and is the most recent that was available on their portal at the time of writing. No further updates are scheduled by NHS Digital until late June, after the deadline for publishing Quality Accounts. 4. Next Steps Final approval of report: following approval by the Board, the Quality Account will be signed by the Interim Chairman and Acting Chief Executive, and made available on our website and on NHS Choices. It is incorporated within the Annual Report. 5. Conclusion The Quality Account describes an extremely busy and challenging year at the Trust. 6. Recommendation The Board is asked to discuss and approve the report so that it can be published.
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Audit Committee
Agenda Item
3
Title of Report
Draft Annual Report including Annual Governance Statement
Date of Meeting
25 May 2018
Author
Carole Self, Director of Corporate Affairs
Accountable Executive
David Jago. Interim Chief Executive
BAF References
• Strategic Objective
• Key Measure
• Principal Risk
All
Level of Assurance
• Positive
• Gap(s)
Full
Purpose of the Paper
• Discussion
• Approval
• To Note
Recommendation to the Board
Data Quality Rating Silver – quantitative data that has not been externally validated
FOI status
Document may be disclosed in full
Equality Impact Assessment Undertaken
• Yes
• No
N/A
1. Executive Summary
The draft Annual Report including the Annual Governance Statement has been circulated to members under separate cover as the Trust is not permitted to publish the document to the wider public until this has been laid before Parliament. The Audit Committee reviewed the draft Annual Report including Annual Governance Statement at its meeting on the 17th May 2018 and specific feedback regarding the recommendation will be provided via the Chair of Audit Committee report. The draft report has been supplied to the External Auditors who have concluded that this is consistent with the requirements.
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2. Next Steps
The final text for the Annual Report along with the Annual Accounts will be submitted to NHS Improvement on the 29th May 2018 before noon. The period between the 29th May 2018 and submission to Parliament is to allow Trusts time to format the document to the standards required for publication. The final Annual Report and Accounts must be sent to the Parliamentary Clerk at the Department of Health by the 25th June 2018 for laying before Parliament. Once the Annual Report and Accounts are laid before Parliament the Trust will present these to the Annual Members Meeting.
3. Recommendations The Board is asked to approve the Annual Report and the Annual Governance Statement.
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Board of Directors
Agenda Item 4
Title of Report Audit Findings Report 2017/18 and draft opinion documents
Date of Meeting 25 May 2018
Author Stephen Nixon, Grant Thornton UK LLP
Accountable Executive Karen Edge, Acting Director of Finance
BAF References
Strategic Objective
Key Measure
Principal Risk
N/A
Level of Assurance
Positive
Gap(s)
N/A
Purpose of the Paper
Discussion
Approval
To Note
To note
Data Quality Rating N/AFOI status Document may be disclosed in full
Equality Impact Assessment Undertaken
Yes
No
No
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Independent auditor's report to the Council of Governors of Wirral University Teaching Hospital NHS Foundation Trust Report on the Audit of the Financial Statements Opinion
Our opinion on the financial statements is unmodified We have audited the financial statements of Wirral University Teaching Hospital NHS Foundation Trust (the ‘Trust’) for the year ended 31 March 2018 which comprise the Statement of Comprehensive Income, the Statement of Financial Position, the Statement of Changes in Equity, the Statement of Cash Flows and notes to the financial statements, including the accounting policies. The financial reporting framework that has been applied in their preparation is applicable law and the NHS foundation trust annual reporting manual 2017/18. In our opinion the financial statements: give a true and fair view of the financial position of the Trust as at 31 March 2018 and of its expenditure and income for the year then ended; and have been properly prepared in accordance with International Financial Reporting Standards (IFRSs) as adopted by the European Union, as interpreted and adapted by the NHS foundation trust annual reporting manual 2017/2018; and have been prepared in accordance with the requirements of the National Health Service Act 2006.
Basis for opinion We conducted our audit in accordance with International Standards on Auditing (UK) (ISAs (UK)) and applicable law. Our responsibilities under those standards are further described in the Auditor’s responsibilities for the audit of the financial statements section of our report. We are independent of the Trust in accordance with the ethical requirements that are relevant to our audit of the financial statements in the UK, including the FRC’s Ethical Standard, and we have fulfilled our other ethical responsibilities in accordance with these requirements. We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our opinion. Who we are reporting to This report is made solely to the Council of Governors of the Trust, as a body, in accordance with Schedule 10 of the National Health Service Act 2006. Our audit work has been undertaken so that we might state to the Trust's Council of Governors 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 Trust's Council of Governors, as a body, for our audit work, for this report, or for the opinions we have formed. Material uncertainty related to going concern We draw attention to note 1.3.1 in the financial statements, which indicates that the Trust is seeking additional cash support of £25 million in 2018/19 from NHS Improvement. As stated in note 1.3.1, NHS Improvement has not, at the date of our report, confirmed this support. These events or conditions, along with the other matters explained in note 1.3.1, indicate that a material uncertainty exists that may cast significant doubt about the Trust’s ability to continue as a going concern. Our opinion is not modified in respect of this matter.
Overview of our audit approach Overall materiality: £6,664,000 which represents 1.9% of the Trust's gross operating costs (consisting of operating expenses and finance expenses); Key audit matters were identified as:
- Valuation of land and buildings - Occurrence and accuracy of income from NHS contractual and non-contractual variations - Implementation of general ledger upgrade
We performed a full scope audit of Wirral University Teaching Hospital NHS Foundation Trust. We have tested all of the Trust’s material income and expenditure streams and assets and liabilities.
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Key audit matters The graph below depicts the audit risks identified and their relative significance based on the extent of the financial statement impact and the extent of management judgement.
Key audit matters are those matters that, in our professional judgment, were of most significance in our audit of the financial statements of the current year and include the most significant assessed risks of material misstatement (whether or not due to fraud) that we identified. These matters included those that had the greatest effect on: the overall audit strategy; the allocation of resources in the audit; and directing the efforts of the engagement team. These matters were addressed in the context of our audit of the financial statements as a whole, and in forming our opinion thereon, and we do not provide a separate opinion on these matters. In addition to the matter described in the Material uncertainty related to going concern section, we have determined the matters described below to be the key audit matters to be communicated in our report.
Key Audit Matter How the matter was addressed in the audit Risk 1 – Valuation of land and buildings The Trust revalues its land and buildings on a five-yearly basis to ensure the carrying value in the Trust’s financial statements is not materially different from fair value at the financial statements date. The last full revaluation was performed at 31 March 2014. In the intervening years between full revaluations interim desktop revaluations are performed on an annual basis. This valuation represents a significant estimate by management in the financial statements. We therefore identified valuation of property as a significant risk, which was one of the most significant assessed risks of material misstatement.
Our audit work included, but was not restricted to: evaluating management's processes and assumptions for the calculation of the estimate, the instructions issued to valuation experts and the scope of their work assessing the competence, capabilities and objectivity of the valuation expert understanding the basis on which the valuation was carried out and critically assessing the valuer’s report challenging the information and assumptions used by the valuer to assess completeness and consistency with our understanding assessing and challenging the overall reasonableness of the valuation movement. The Trust's accounting policy on valuation of property is shown in note 1.8 to the financial statements and related disclosures are included in note 12. The Audit Committee identified valuation of land and buildings as a significant issue in its report on page 77 of the Annual Report, where the Audit Committee also described the action that it has taken to address this issue. Key observations We obtained sufficient audit assurance to conclude that: the basis of the valuation was appropriate and the assumptions and processes used by management in determining the estimate were reasonable; the valuation of land and buildings disclosed in the financial statements is reasonable.
Valuation of land and buildings
Going concern
High
Potential financial statement impact Low
Low Extent of management judgement High
Operating costs
Employee remuneration
Occurrence and accuracy of income from NHS contractual and non-contractual variations
Implementation of general ledger upgrade Management override of control
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Key Audit Matter How the matter was addressed in the audit Risk 2 – Occurrence and accuracy of activity based contract income and non-contract activity income 89% of the Trust’s operating income is for income from patient care activities which includes £288.6 million from block contracts, and £6.8 million for non-contract activities. Activity based contract income and non-contract activity income is subject to verification and agreement by the Trust’s commissioners. We therefore identified the occurrence and accuracy of activity based contract income and non-contract activity income as a significant risk, which was one of the most significant assessed risks of material misstatement.
Our audit work included, but was not restricted to: evaluating the Trust’s accounting policy for recognition of income for compliance with the Department of Health and Social Care (DHSC) Group Accounting Manual 2017/18; gaining an understanding of the Trust's system for accounting for activity based contract income and non-contract activity income and evaluating the design of the associated controls; agreeing a sample of activity based contract income and non-contract activity income to supporting evidence and testing that it has been accounted for in accordance with the stated accounting policy. The Trust's accounting policy on income is shown in note 1.4 to the financial statements and related disclosures are included in note 2. The Audit Committee identified recognition of income from patient care activities as a significant issue in its report on page 76 of the Annual Report, where the Audit Committee also described the action that it has taken to address this issue. Key observations We obtained sufficient audit evidence to conclude that: the Trust’s accounting policy for recognition of income complies with the DHSC Group Accounting Manual 2017/18 and has been properly applied; and income from patient care activities is not materially misstated.
Risk 3 - Implementation of general ledger upgrade The Trust’s general ledger system is provided by North East Patches (NEP). In December 2017, the Trust became a first wave pilot for the implementation of a significant general ledger upgrade. As a result, there were two general ledger systems in operation during 2017/18. The transactions for the first eight months of 2017/18 were transferred into the updated general ledger system during the year. There is a risk over the completeness and accuracy of the data transfer. We therefore identified the implementation of the general ledger upgrade as a significant risk, which was one of the most significant assessed risks of material misstatement.
Our audit work included, but was not restricted to: obtaining an understanding of the IT controls operating over the upgraded general ledger system agreeing the transactions and balances from the old general ledger for the first 8 months of 2017/18 to the opening position in the upgraded general ledger. The Audit Committee identified the implementation of the general ledger upgrade as a significant issue in its report on page 77 of the Annual Report, where the Audit Committee also described the action that it has taken to address this issue. Key observations We obtained sufficient audit evidence to conclude that the transactions for the first 8 months of 2017/18 had been completely and accurately transferred into the upgraded general ledger system.
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 in determining the nature, timing and extent of our audit work and in evaluating the results of that work. Materiality was determined as follows:
Materiality Measure Trust Financial statements as a whole £ 6,664,000 which is 1.9% of the Trust’s gross operating costs (consisting of operating expenses and finance expenses). This benchmark is considered the most appropriate because we consider users of the financial statements to be most interested in how it has expended its revenue and other funding.
Materiality for the current year is at the same percentage level of gross operating costs as we determined for the year ended 31 March 2017 as we did not identify any significant changes in the Trust or the environment in which it operates.
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Performance materiality used to drive the extent of our testing 75% of financial statement materiality
Specific materiality Disclosure of senior managers’ remuneration in the Remuneration Report £20,000 based on 2% of the total senior managers’ remuneration. Communication of misstatements to the Audit Committee £300,000 and misstatements below that threshold that, in our view, warrant reporting on qualitative grounds.
The graph below illustrates how performance materiality interacts with our overall materiality and the tolerance for potential uncorrected misstatements.
An overview of the scope of our audit Our audit approach was a risk-based approach founded on a thorough understanding of the Trust's business. It included an evaluation of the Trust's internal controls including relevant IT systems and controls over key financial systems. Our work involved obtaining evidence about the amounts and disclosures in the financial statements to give us reasonable assurance that the financial statements are free from material misstatement, whether caused by fraud or error. The scope of our audit included: undertaking an interim audit visit where we:
‒ obtained an understanding of and evaluated the Trust’s overall control environment relevant to the preparation of the financial statements, including its IT systems, ‒ completed walk through tests of the Trust’s controls operating in key financial systems where we consider that there is a risk of material misstatement to the financial statements; ‒ performed interim testing, on a sample basis of operating expenditure and income.
performing year-end testing on the Trust’s financial statements, which focussed on gaining assurance around the Trust’s material income streams and operating costs, testing the Trust’s employee remuneration costs and the notes to the accounts to ensure that they were compliant with the Department of Health and Social Care’s Group Accounting Manual for 2017/18. We tested, on a sample basis of:
‒ all of the Trust’s material income streams; ‒ all of the Trust’s operating expenses; ‒ current and non-current assets; and ‒ current and non-current liabilities.
Other information The Accounting Officer is responsible for the other information. The other information comprises the information included in the Annual Report, other than the financial statements and our auditor’s report thereon. Our opinion on the financial statements does not cover the other information and, except to the extent otherwise explicitly stated in our report, we do not express any form of assurance conclusion thereon. In connection with our audit of the financial statements, our responsibility is to read the other information and, in doing so, consider whether the other information is materially inconsistent with the financial statements or our knowledge of the Trust obtained in the course of our work including that gained through work in relation to the Trust’s arrangements for securing value for money through economy, efficiency and effectiveness in the use of its resources or otherwise appears to be materially misstated. If we identify such material inconsistencies or apparent material misstatements, we are required to determine whether there is a material misstatement in the financial statements or a material misstatement of the other information. If, based on the work we have performed, we conclude that there is a material misstatement of this other information, we are required to report that fact.
25%
75%
Overall materiality - Trust
Tolerance forpotential uncorrectedmistatementsPerformancemateriality
Page 19 of 60
We have nothing to report in this regard. In this context, we also have nothing to report in regard to our responsibility to specifically address the following items in the other information and to report as uncorrected material misstatements of the other information where we conclude that those items meet the following conditions: Fair, balanced and understandable in accordance with provision C.1.1 of the NHS Foundation Trust Code of Governance – the statement given by the directors that they consider the Annual Report and financial statements taken as a whole is fair, balanced and understandable and provides the information necessary for patients, regulators and other stakeholders to assess the Trust’s performance, business model and strategy, is materially inconsistent with our knowledge of the Trust obtained in the audit; or The Audit Committee reporting in accordance with provision C.3.9 of the NHS Foundation Trust Code of Governance – the section describing the work of the Audit Committee does not appropriately address matters communicated by us to the Audit Committee. Other information we are required to report on by exception under the Code of Audit Practice Under the Code of Audit Practice published by the National Audit Office on behalf of the Comptroller and Auditor General (the Code of Audit Practice) we are required to consider whether the Annual Governance Statement does not meet the disclosure requirements set out in the NHS foundation trust annual reporting manual 2017/18. We are not required to consider whether the Annual Governance Statement addresses all risks and controls or that risks are satisfactorily addressed by internal controls. We have nothing to report in this regard.
Our opinion on other matters required by the Code of Audit Practice is unmodified In our opinion: the parts of the Remuneration Report and the Staff Report to be audited have been properly prepared in accordance with IFRSs as adopted by the European Union, as interpreted and adapted by the NHS foundation trust annual reporting manual 2017/18 and the requirements of the National Health Service Act 2006; and based on the work undertaken in the course of the audit of the financial statements and our knowledge of the Trust gained through our work in relation to the Trust’s arrangements for securing economy, efficiency and effectiveness in its use of resources, the other information published together with the financial statements in the Annual Report for the financial year for which the financial statements are prepared is consistent with the financial statements.
Matters on which we are required to report by exception Under the Code of Audit Practice we are required to report to you if: we have reported a matter in the public interest under Schedule 10 (3) of the National Health Service Act 2006 in the course of, or at the conclusion of the audit; or we have referred a matter to the regulator under Schedule 10 (6) of the National Health Service Act 2006 because we had reason to believe that the Trust, or a director or officer of the Trust, was about to make, or had made, a decision which involved or would involve the incurring of expenditure that was unlawful, or was about to take, or had taken a course of action which, if followed to its conclusion, would be unlawful and likely to cause a loss or deficiency. We have nothing to report in respect of the above matters. Responsibilities of the Accounting Officer and Those Charged with Governance for the financial statements As explained more fully in the Statement of Accounting Officer's responsibilities, the Chief Executive, as Accounting Officer, is responsible for the preparation of the financial statements in the form and on the basis set out in the Accounts Directions included in the NHS foundation trust annual reporting manual 2017/18, for being satisfied that they give a true and fair view, and for such internal control as the Accounting Officer determines is necessary to enable the preparation of financial statements that are free from material misstatement, whether due to fraud or error. In preparing the financial statements, the Accounting Officer is responsible for assessing the Trust’s ability to continue as a going concern, disclosing, as applicable, matters related to going concern and using the going concern basis of accounting unless the Trust lacks funding for its continued existence or when policy decisions have been made that affect the services provided by the Trust. The Audit Committee is Those Charged with Governance. Auditor’s responsibilities for the audit of the financial statements Our objectives are to obtain reasonable assurance about whether the financial statements as a whole are free from material misstatement, whether due to fraud or error, and to issue an auditor’s report that includes our opinion. Reasonable assurance is a high level of assurance, but is not a guarantee that an audit conducted in accordance with ISAs (UK) will always detect a material
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misstatement when it exists. Misstatements can arise from fraud or error and are considered material if, individually or in the aggregate, they could reasonably be expected to influence the economic decisions of users taken on the basis of these financial statements. A further description of our responsibilities for the audit of the financial statements is located on the Financial Reporting Council’s website at: www.frc.org.uk/auditorsresponsibilities. This description forms part of our auditor’s report. Report on other legal and regulatory requirements – Conclusion on the Trust’s arrangements for securing economy, efficiency and effectiveness in its use of resources Qualified conclusion On the basis of our work, having regard to the guidance issued by the Comptroller & Auditor General in November 2017, except for the effects of the matters described in the basis for qualified conclusion section of our report, we are satisfied that, in all significant respects, Wirral University Teaching Hospital NHS Foundation Trust put in place proper arrangements for securing economy, efficiency and effectiveness in its use of resources for the year ended 31 March 2018. Basis for qualified conclusion Our review of the Trust’s arrangements for securing economy, efficiency and effectiveness in its use of resources identified the following matters: The Trust has set a deficit budget of £25 million for 2018/19. The Trust does not have sufficient cash to meet its commitments without receiving significant external funding from the Department of Health. The Trust’s reliance on revenue support indicates weaknesses in the Trust’s arrangements for setting a sustainable budget with sufficient capacity to absorb emerging cost pressures. During the year, an independent review of the Trust’s governance arrangements found cultural, behavioural and governance issues at the Trust. These issues led to several resignations from the Trust’s Board, which have adversely impacted the Trust’s leadership capacity and capability. In March 2018, NHS Improvement invoked an additional license condition on the Trust under section 111 of the Health and Social Care Act 2012 in respect of this matter. These matters are evidence of weaknesses in the proper arrangements for: sustainable resource deployment in planning finances effectively to support the sustainable delivery of strategic priorities and maintain statutory functions; and informed decision making by acting in the public interest, through demonstrating and applying the principles and values of sound governance. Responsibilities of the Accounting Officer The Accounting Officer is responsible for putting in place proper arrangements for securing economy, efficiency and effectiveness in the use of the Trust's resources. Auditor’s responsibilities for the review of the Trust’s arrangements for securing economy, efficiency and effectiveness in its use of resources We are required under paragraph 1 of Schedule 10 of the National Health Service Act 2006to be satisfied that the Trust has made proper arrangements for securing economy, efficiency and effectiveness in its use of resources and to report where we have not been able to satisfy ourselves that it has done so. We are not required to consider, nor have we considered, whether all aspects of the Trust's arrangements for securing economy, efficiency and effectiveness in its use of resources are operating effectively. We have undertaken our review in accordance with the Code of Audit Practice, having regard to the guidance on the specified criterion issued by the Comptroller and Auditor General in November 2017, as to whether in all significant respects, the Trust had proper arrangements to ensure it took properly informed decisions and deployed resources to achieve planned and sustainable outcomes for taxpayers and local people. The Comptroller and Auditor General determined this criterion as that necessary for us to consider under the Code of Audit Practice in satisfying ourselves whether the Trust put in place proper arrangements for securing economy, efficiency and effectiveness in its use of resources for the year ended 31 March 2018, and to report by exception where we are not satisfied. We planned our work in accordance with the Code of Audit Practice. Based on our risk assessment, we undertook such work as we considered necessary to be satisfied that the Trust has put in place proper arrangements for securing economy, efficiency and effectiveness in its use of resources.
Report on other legal and regulatory requirements - Certificate We certify that we have completed the audit of the financial statements of Wirral University Teaching Hospital NHS Foundation Trust in accordance with the requirements of Chapter 5 of Part 2 of the National Health Service Act 2006 and the Code of Audit Practice.
Page 21 of 60
Signature to be added Andrew Smith, Director for and on behalf of Grant Thornton UK LLP 4 Hardman Square Manchester M3 3EB Date to be added
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Independent Practitioner's Limited Assurance Report to the Council of Governors of
Wirral University Teaching Hospital NHS Foundation Trust on the Quality Report
We have been engaged by the Council of Governors of Wirral University Teaching Hospital
NHS Foundation Trust to perform an independent limited assurance engagement in respect
of Wirral University Teaching Hospital NHS Foundation Trust’s Quality Report for the year
ended 31 March 2018 (the “Quality Report”) and certain performance indicators contained
therein against the criteria set out in the ‘NHS foundation trust annual reporting manual
2017/18’ and additional supporting guidance in the ‘Detailed requirements for quality reports
2017/18' (the 'Criteria').
Scope and subject matter
The indicators for the year ended 31 March 2018 subject to the limited assurance
engagement consist of the national priority indicators as mandated by NHS Improvement:
Percentage of patients with a total time in A&E of four hours or less from arrival to
admission, transfer or discharge – Arrowe Park A&E only
Percentage of incomplete pathways within 18 weeks for patients on incomplete
pathways
We refer to these national priority indicators collectively as the 'Indicators'.
Respective responsibilities of the directors and Practitioner
The directors are responsible for the content and the preparation of the Quality Report in
accordance with the criteria set out in the 'NHS foundation trust annual reporting manual
2017/18' and supporting guidance issued by NHS Improvement.
Our responsibility is to form a conclusion, based on limited assurance procedures, on
whether anything has come to our attention that causes us to believe that:
the Quality Report is not prepared in all material respects in line with the Criteria set
out in the ‘NHS foundation trust annual reporting manual 2017/18’ and supporting
guidance;
the Quality Report is not consistent in all material respects with the sources specified
in NHS Improvement’s 'Detailed requirements for external assurance for quality
reports 2017/18’; and
the indicators in the Quality Report identified as having been the subject of limited
assurance in the Quality Report are not reasonably stated in all material respects in
accordance with the 'NHS foundation trust annual reporting manual 2017/18' and
supporting guidance and the six dimensions of data quality set out in the ‘'Detailed
requirements for external assurance for quality reports 2017/18’.
We read the Quality Report and consider whether it addresses the content requirements of
the ‘NHS foundation trust annual reporting manual 2017/18’ and supporting guidance, and
consider the implications for our report if we become aware of any material omissions.
We read the other information contained in the Quality Report and consider whether it is
materially inconsistent with:
Board minutes for the period April 2017 to May 2018;
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papers relating to quality reported to the Board over the period 1 April 2017 to May
2018;
feedback from commissioners dated May 2018;
feedback from governors dated March 2018;
feedback from local Healthwatch organisations dated May 2018;
feedback from the Overview and Scrutiny Committee dated May 2018;
the Trust’s complaints report published under regulation 18 of the Local Authority
Social Services and National Health Service Complaints (England) Regulations 2009,
dated April 2018;
the national inpatient survey dated June 2017;
the national staff survey dated February 2018; and
the Head of Internal Audit’s annual opinion over the Trust’s control environment
dated May 2018.
We consider the implications for our report if we become aware of any apparent
misstatements or material inconsistencies with those documents (collectively, the
“documents”). Our responsibilities do not extend to any other information.
The firm applies International Standard on Quality Control 1 (Revised) and accordingly
maintains a comprehensive system of quality control including documented policies and
procedures regarding compliance with ethical requirements, professional standards and
applicable legal and regulatory requirements.
We are in compliance with the applicable independence and competency requirements of
the Institute of Chartered Accountants in England and Wales (ICAEW) Code of Ethics. Our
team comprised assurance practitioners and relevant subject matter experts.
This report, including the conclusion, has been prepared solely for the Council of Governors
of Wirral University Teaching Hospital NHS Foundation Trust as a body, to assist the Council
of Governors in reporting Wirral University Teaching Hospital NHS Foundation Trust’s quality
agenda, performance and activities. We permit the disclosure of this report within the Annual
Report for the year ended 31 March 2018, to enable the Council of Governors to
demonstrate they have discharged their governance responsibilities by commissioning an
independent assurance report in connection with the indicators. To the fullest extent
permitted by law, we do not accept or assume responsibility to anyone other than the
Council of Governors as a body, and Wirral University Teaching Hospital NHS Foundation
Trust for our work or this report, except where terms are expressly agreed and with our prior
consent in writing.
Assurance work performed
We conducted this limited assurance engagement in accordance with International Standard
on Assurance Engagements 3000 (Revised) ‘Assurance Engagements other than Audits or
Reviews of Historical Financial Information’ issued by the International Auditing and
Assurance Standards Board (‘ISAE 3000’). Our limited assurance procedures included:
evaluating the design and implementation of the key processes and controls for
managing and reporting the indicators
making enquiries of management
Page 24 of 60
limited testing, on a selective basis, of the data used to calculate the indicators tested
against supporting documentation
comparing the content requirements of the 'NHS foundation trust annual reporting
manual 2017/18' and supporting guidance to the categories reported in the Quality
Report; and
reading the documents.
A limited assurance engagement is smaller in scope than a reasonable assurance
engagement. The nature, timing and extent of procedures for gathering sufficient appropriate
evidence are deliberately limited relative to a reasonable assurance engagement.
Limitations
Non-financial performance information is subject to more inherent limitations than financial
information, given the characteristics of the subject matter and the methods used for
determining such information.
The absence of a significant body of established practice on which to draw allows for the
selection of different, but acceptable, measurement techniques that can result in materially
different measurements and can affect comparability. The precision of different
measurement techniques may also vary. Furthermore, the nature and methods used to
determine such information, as well as the measurement criteria and the precision of these
criteria, may change over time. It is important to read the Quality Report in the context of the
criteria set out in the 'NHS foundation trust annual reporting manual 2017/18' and supporting
guidance.
The scope of our limited assurance work has not included governance over quality or non-
mandated indicators, which have been determined locally by Wirral University Teaching
Hospital NHS Foundation Trust.
Our audit work on the financial statements of Wirral University Teaching Hospital NHS
Foundation Trust is carried out in accordance with our statutory obligations. This
engagement will not be treated as having any effect on our separate duties and
responsibilities as Wirral University Teaching Hospital NHS Foundation Trust’s external
auditors. Our audit reports on the financial statements are made solely to Wirral University
Teaching Hospital NHS Foundation Trust's members, as a body, in accordance with
paragraph 24(5) of Schedule 7 of the National Health Service Act 2006. Our audit work is
undertaken so that we might state to Wirral University Teaching Hospital NHS Foundation
Trust’s members those matters we are required to state to them in an auditor’s report and for
no other purpose. Our audits of Wirral University Teaching Hospital NHS Foundation Trust’s
financial statements are not planned or conducted to address or reflect matters in which
anyone other than such members as a body may be interested for such purpose. In these
circumstances, to the fullest extent permitted by law, we do not accept or assume any
responsibility to anyone other than Wirral University Teaching Hospital NHS Foundation
Trust and Wirral University Teaching Hospital NHS Foundation Trust’s members as a body,
for our audit work, for our audit reports, or for the opinions we have formed in respect of
those audits.
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Conclusion
Based on the results of our procedures, as described in this report, nothing has come to our
attention that causes us to believe that, for the year ended 31 March 2018:
the Quality Report is not prepared in all material respects in line with the Criteria set
out in the ‘NHS foundation trust annual reporting manual 2017/18’ and supporting
guidance;
the Quality Report is not consistent in all material respects with the sources specified
in NHS Improvement’s 'Detailed requirements for external assurance for quality
reports 2017/18’; and
the indicators in the Quality Report identified as having been subject to limited
assurance have not been reasonably stated in all material respects in accordance
with the 'NHS foundation trust annual reporting manual 2017/18' and supporting
guidance.
To be signed Grant Thornton UK LLP Chartered Accountants Manchester To be dated
Page 26 of 60
© 2
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Gra
nt T
horn
ton
UK
LLP
|
Rep
ort
to t
he G
over
nors
on
the
Qua
lity
Rep
ort
for
WU
TH
NH
S F
ound
atio
n T
rust
|
2017
/18
Re
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Gov
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n th
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ualit
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Gra
nt T
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ort
to t
he G
over
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lity
Rep
ort
for
WU
TH
NH
S F
ound
atio
n T
rust
|
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/18
2
Con
ten
ts
Section
Page
1.
He
ad
lines
3
2.
Co
mp
liance
with
re
gu
latio
ns
4
3.
Co
nsis
tency o
f in
form
atio
n5
4.
Da
ta q
ua
lity o
f re
po
rte
d p
erf
orm
ance
in
dic
ato
rs6
Ap
pe
nd
ices
A.
Actio
n p
lan
B.
Fo
rm o
f lim
ite
d a
ssu
rance
re
po
rt
The c
onte
nts
of
this
report
rela
te o
nly
to t
hose m
atters
whic
h c
am
e t
o o
ur
attention d
uring t
he c
onduct
of
our
norm
al audit p
rocedure
s w
hic
h a
re d
esig
ned f
or
the p
urp
ose o
f expre
ssin
g
our
opin
ion o
n t
he f
inancia
l sta
tem
ents
. O
ur
audit is n
ot
desig
ned t
o t
est
all
inte
rnal contr
ols
or
identify
all
are
as o
f con
trol w
eakness.
How
ever,
where
, as p
art
of
our
testing,
we identify
contr
ol w
eaknesses,
we w
ill r
eport
these t
o y
ou.
In c
onsequence,
our
work
cannot
be r
elie
d u
pon t
o d
isclo
se a
ll defa
lcations o
r oth
er
irre
gula
rities,
or
to inclu
de a
ll possib
le im
pro
vem
ents
in inte
rnal contr
ol th
at
a m
ore
exte
nsiv
e s
pecia
l exam
ination m
ight
identify
. T
his
report
has b
een p
repare
d s
ole
ly f
or
your
benefit
and s
hould
not
be q
uote
d in w
hole
or
in p
art
without
our
prior
written c
onsent. W
e d
o n
ot
accept
any
responsib
ility
for
any
loss o
ccasio
ned t
o a
ny
third p
art
y acting,
or
refr
ain
ing f
rom
acting o
n t
he b
asis
of
the c
onte
nt
of
this
report
, as t
his
report
was n
ot
pre
pare
d f
or,
nor
inte
nded f
or,
any
oth
er
purp
ose.
Gra
nt
Thorn
ton U
K L
LP
is a
lim
ited lia
bili
ty p
art
ners
hip
regis
tere
d i
n E
ngla
nd a
nd W
ale
s: N
o.O
C307742.
Regis
tere
d o
ffic
e:
30 F
insbury
Square
, London,
EC
2A
1A
G.
A lis
t of
mem
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is a
vaila
ble
fro
m o
ur
regis
tere
d o
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Gra
nt
Thorn
ton U
K L
LP
is a
uth
orised a
nd r
egula
ted b
y th
e F
inancia
l C
onduct
Auth
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. G
rant
Thorn
ton U
K L
LP
is a
mem
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firm
of
Gra
nt
Thorn
ton I
nte
rnational
Ltd
(G
TIL
). G
TIL
and t
he m
em
ber
firm
s a
re n
ot
a w
orldw
ide p
art
ners
hip
. S
erv
ices a
re d
eliv
ere
d b
y th
e m
em
ber
firm
s.
GT
IL a
nd its
mem
ber
firm
s a
re n
ot
agents
of, a
nd d
o n
ot
oblig
ate
, one a
noth
er
and a
re n
ot
liable
for
one a
noth
er’s a
cts
or
om
issio
ns.
Yo
ur
ke
y G
ran
t T
ho
rnto
n
tea
m m
em
be
rs a
re:
An
dre
wS
mith
Dir
ecto
r
T:
0161 9
53 6
900
E:
andre
w.j.s
mith@
uk.g
t.com
Ste
ph
en
Nix
on
Se
nio
r M
an
ag
er
T:
0161 2
34
6362
E:
ste
phen.r
.nix
on@
uk.g
t.com
Stu
art
Ba
sn
ett
Assis
tan
t M
an
ag
er
T:
0151 2
24
7232
E:
stu
art
.h.b
asn
ett
@uk.g
t.com
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nt T
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ort
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NH
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ound
atio
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rust
|
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/18
3
Head
lin
es
Th
e Q
ua
lity
Re
po
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Th
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ep
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ma
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da
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ua
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ep
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ts s
pe
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aim
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co
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an
d im
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da
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d, in
all
ma
teri
al r
esp
ects
, in
lin
e w
ith
th
e c
rite
ria
se
t
ou
t in
th
e ‘N
HS
fo
un
da
tio
n tru
st a
nn
ua
l re
po
rtin
g m
an
ua
l 2
01
7/1
8’ a
nd
su
pp
ort
ing
gu
ida
nce
;
•th
e Q
ua
lity R
ep
ort
is n
ot
co
nsis
ten
t, in
all
ma
teri
al re
sp
ects
, w
ith
th
e s
ou
rce
s s
pe
cifie
d
in N
HS
Im
pro
ve
me
nt's
'De
taile
d r
eq
uir
em
en
ts fo
r e
xte
rna
l a
ssu
ran
ce
fo
r q
ua
lity r
ep
ort
s
20
17
/18
’;
•th
e in
dic
ato
rs in
th
e Q
ua
lity R
ep
ort
id
en
tifie
d a
s h
avin
g b
ee
n th
e s
ub
ject o
f lim
ite
d
assu
ran
ce
in th
e Q
ua
lity R
ep
ort
ha
ve
no
t b
ee
n r
ea
so
na
bly
sta
ted
, in
all
ma
teri
al
resp
ects
, in
acco
rda
nce
with
th
e ‘N
HS
fo
un
da
tio
n tru
st a
nn
ua
l re
po
rtin
g m
an
ua
l
20
17
/18
’ a
nd
su
pp
ort
ing
gu
ida
nce
. T
he
se
in
dic
ato
rs a
re A
&E
4 h
ou
r w
aits a
nd
Re
ferr
al
to T
rea
tme
nt 1
8 w
ee
k w
aits; a
nd
•th
e in
dic
ato
r in
th
e Q
ua
lity R
ep
ort
ch
ose
n b
y t
he
Co
un
cil
of G
ove
rno
rs w
hic
h is n
ot
su
bje
ct to
lim
ite
d a
ssu
ran
ce
in th
e Q
ua
lity R
ep
ort
op
inio
n h
as n
ot b
ee
n r
ea
so
na
bly
sta
ted
, in
all
ma
teri
al r
esp
ects
, in
acco
rda
nce
with
th
e ‘N
HS
fo
un
da
tio
n tru
st a
nn
ua
l
rep
ort
ing
ma
nu
al 2
01
7/1
8’ a
nd
su
pp
ort
ing
gu
ida
nce
. T
he
ch
ose
n in
dic
ato
r is
MU
ST
(Ma
lnu
tritio
n S
cre
en
ing
To
ol)
co
mp
letio
n w
ith
in 7
da
ys.
Co
nc
lus
ion
Ou
r w
ork
on
yo
ur
Qu
alit
y R
ep
ort
is s
ub
sta
ntia
lly c
om
ple
te a
lth
ou
gh
we
are
fin
alis
ing
ou
r
pro
ce
du
res in
re
sp
ect o
f:
•ch
eckin
g th
e fin
al ve
rsio
n o
f th
e Q
ua
lity R
ep
ort
, re
fle
ctin
g c
ha
ng
es d
iscu
sse
d w
ith
ma
na
ge
me
nt
•re
vie
win
g fe
ed
ba
ck fro
m s
take
ho
lde
rs to
en
su
re th
at it is r
efle
cte
d in
th
e fin
al ve
rsio
n o
f
the
Qu
alit
y R
ep
ort
•o
bta
inin
g a
le
tte
r o
f re
pre
se
nta
tio
n fro
m m
an
ag
em
en
t.
Su
bje
ct to
th
is, w
e a
re p
rop
osin
g to
issu
e a
n u
nq
ua
lifie
d o
pin
ion
on
yo
ur
Qu
alit
y R
ep
ort
.
Th
e t
ext
of o
ur
pro
po
se
d li
mite
d a
ssu
ran
ce
re
po
rt c
an
be
fo
un
d a
t A
pp
en
dix
C.
Ke
y m
es
sa
ge
s
•W
e c
on
firm
th
at th
e Q
ua
lity R
ep
ort
ha
s b
ee
n p
rep
are
d in
all
ma
teri
al r
esp
ects
in
lin
e
with
th
e r
eq
uir
em
en
ts o
f th
e ‘N
HS
fo
un
da
tio
n tru
st a
nn
ua
l re
po
rtin
g m
an
ua
l 2
01
7/1
8’
an
d s
up
po
rtin
g g
uid
an
ce
•W
e c
on
firm
th
at th
e Q
ua
lity R
ep
ort
is n
ot m
ate
ria
lly in
co
nsis
ten
t w
ith
th
e s
ou
rce
s
sp
ecifie
d in
NH
S I
mp
rove
me
nt's
Gu
ida
nce
•O
ur
testin
g o
f tw
o in
dic
ato
rs in
clu
de
d in
th
e Q
ua
lity R
ep
ort
fo
un
d n
o e
vid
en
ce
th
at
the
se
tw
o in
dic
ato
rs w
ere
no
t re
aso
na
bly
sta
ted
, in
all
ma
teri
al re
sp
ects
, in
acco
rda
nce
with
th
e ‘N
HS
fo
un
da
tio
n tru
st a
nn
ua
l re
po
rtin
g m
an
ua
l 2
01
7/1
8’ a
nd
su
pp
ort
ing
gu
ida
nce
•O
ur
testin
g o
f th
e in
dic
ato
r se
lecte
d b
y t
he
go
ve
rno
rs fo
un
d n
o e
vid
en
ce
th
at th
is
ind
ica
tor
wa
s n
ot re
aso
na
bly
sta
ted
, in
all
ma
teri
al re
sp
ects
, in
acco
rda
nce
with
rele
va
nt g
uid
elin
es o
n c
alc
ula
tio
n. In
lin
e w
ith
NH
S I
mp
rove
me
nt's
Gu
ida
nce
, w
e d
o n
ot
exp
ress a
ny a
ssu
ran
ce
in r
esp
ect o
f th
is in
dic
ato
r.
We h
ave
ma
de
re
co
mm
en
datio
ns fo
r im
pro
ve
me
nt in
re
latio
n to
th
e M
US
T p
erf
orm
an
ce
ind
ica
tor
wh
ich
we
ha
ve
dis
cu
ssed
an
d a
gre
ed
with
ma
na
ge
me
nt. T
he
se
ca
n b
e fo
un
d a
t
Ap
pe
nd
ix A
.
Fe
es
Th
e f
ee
fo
r th
e Q
ua
lity R
ep
ort
au
dit is £
6,0
00
plu
s V
AT
. T
his
is in
acco
rda
nce
with
th
e
pla
nn
ed
fe
e a
gre
ed
with
th
e T
rust.
Ac
kn
ow
led
ge
me
nts
We w
ou
ld lik
e to
th
an
k th
e T
rust
sta
ff fo
r th
eir
co
-op
era
tio
n in
co
mp
letin
g th
is e
ng
ag
em
ent.
Item
4 -
Ext
erna
l Aud
it O
pini
ons
- R
epor
t to
the
Gov
erno
rs o
n th
e Q
ualit
y R
epor
t
Page 29 of 60
© 2
018
Gra
nt T
horn
ton
UK
LLP
|
Rep
ort t
o th
e G
over
nors
on
the
Qua
lity
Rep
ort f
or W
UT
H N
HS
Fou
ndat
ion
Tru
st |
201
7/18
4
Co
mp
lia
nce
wit
h r
eg
ula
tio
ns
We c
he
cke
d th
at th
e Q
ua
lity R
ep
ort
ha
d b
ee
n p
rep
are
d in
lin
e w
ith
th
e r
eq
uir
em
en
ts s
et o
ut in
th
e ‘N
HS
fo
un
da
tio
n tru
st a
nn
ua
l re
po
rtin
g m
an
ua
l 2
01
7/1
8 a
nd
su
pp
ort
ing
gu
ida
nce
.
Co
mp
liance
with
re
gu
latio
ns
Re
qu
ire
me
nt
Wo
rk p
erf
orm
ed
Co
nc
lus
ion
Co
mp
lia
nc
e w
ith
re
gu
lati
on
sW
e r
evie
we
d t
he
co
nte
nt o
f th
e Q
ua
lity R
ep
ort
ag
ain
st th
e
req
uir
em
en
ts o
f th
e ‘N
HS
fo
un
da
tio
n tru
st a
nn
ua
l re
po
rtin
g
ma
nu
al 2
01
7/1
8’a
nd
th
e s
up
po
rtin
g g
uid
an
ce
‘De
taile
d
req
uir
em
en
ts fo
r q
ua
lity r
ep
ort
s fo
r fo
un
da
tio
n tru
sts
20
17
/18
‘.
Ba
se
d o
n th
e r
esu
lts o
f o
ur
pro
ce
du
res, n
oth
ing
ha
s c
om
e to
ou
r a
tte
ntio
n th
at
ca
use
s u
s to
be
lieve
th
at,
fo
r th
e y
ea
r e
nd
ed
31
Ma
rch
20
18
,th
e Q
ua
lity R
ep
ort
is n
ot p
rep
are
d, in
all
ma
teri
al r
esp
ects
, in
lin
e w
ith
th
e c
rite
ria
se
t o
ut in
th
e
NH
S f
ou
nd
atio
n tru
st a
nn
ua
l re
po
rtin
g m
an
ua
l 2
01
7/1
8 a
nd
su
pp
ort
ing
gu
ida
nce
.
Fu
rth
er
to o
ur
revie
w,
ma
na
ge
me
nt in
clu
de
d th
e in
dic
ato
r fo
r M
axim
um
six
we
ek w
ait f
or
dia
gn
ostic p
roce
du
res a
s r
eq
uir
ed
by t
he
Sin
gle
Ove
rsig
ht
Fra
me
wo
rk.
Page 30 of 60
© 2
018
Gra
nt T
horn
ton
UK
LLP
|
Rep
ort t
o th
e G
over
nors
on
the
Qua
lity
Rep
ort f
or W
UT
H N
HS
Fou
ndat
ion
Tru
st |
201
7/18
5
Co
ns
iste
nc
y o
f in
form
ati
on
We c
he
cke
d th
at th
e Q
ua
lity R
ep
ort
ha
d b
ee
n p
rep
are
d in
lin
e w
ith
th
e r
eq
uir
em
en
ts s
et o
ut in
th
e ‘N
HS
fo
un
da
tio
n tru
st a
nn
ua
l re
po
rtin
g m
an
ua
l 2
01
7/1
8 a
nd
su
pp
ort
ing
gu
ida
nce
.
Co
nsis
tency o
f in
form
atio
n
Re
qu
ire
me
nt
Wo
rk p
erf
orm
ed
Co
nc
lus
ion
Co
ns
iste
nc
y w
ith
oth
er
so
urc
es
of
info
rma
tio
n
We r
evie
we
d t
he
co
nte
nt o
f th
e Q
ua
lity R
ep
ort
fo
r co
nsis
tency w
ith
sp
ecifie
d d
ocu
me
nta
tio
n, se
t o
ut in
th
e a
ud
ito
r's g
uid
an
ce
pro
vid
ed
by
NH
SIm
pro
ve
me
nt.
Th
is in
clu
de
s th
e b
oa
rd m
inu
tes a
nd
pa
pe
rs fo
r th
e
ye
ar,
fe
ed
ba
ck r
ece
ive
d o
n th
e Q
ua
lity R
ep
ort
, su
rve
y r
esu
lts fro
m s
taff
an
d p
atie
nts
an
d th
e H
ea
d o
f In
tern
al A
ud
it o
pin
ion
.
Ba
se
d o
n th
e r
esu
lts o
f o
ur
pro
ce
du
res, n
oth
ing
ha
s c
om
e to
ou
r
att
en
tio
n th
at ca
use
s u
s to
be
lieve
th
at,
fo
r th
e y
ea
r e
nd
ed
31
Ma
rch
20
18
,th
e Q
ua
lity R
ep
ort
is n
ot co
nsis
ten
t, in
all
ma
teri
al r
esp
ects
, w
ith
the
so
urc
es s
pe
cifie
d in
NH
S I
mp
rove
me
nt’s 'D
eta
iled
re
qu
ire
me
nts
fo
r
exte
rna
l a
ssu
ran
ce
fo
r q
ua
lity r
ep
ort
s 2
01
7/1
8'.
Oth
er
ch
ec
ks
We a
lso
ch
ecke
d th
e Q
ua
lity R
ep
ort
to e
nsu
re th
at th
e T
rust's
pro
ce
ss
for
ide
ntify
ing
an
d e
ng
ag
ing
sta
ke
ho
lders
in th
e p
rep
ara
tio
n o
f th
e
Qu
alit
y R
ep
ort
ha
s r
esu
lte
d in
ap
pro
pri
ate
co
nsu
lta
tio
n w
ith
pa
tie
nts
,
go
ve
rno
rs, co
mm
issio
ners
, re
gu
lato
rs a
nd
an
y o
the
r ke
y s
take
ho
lde
rs.
Ove
rall,
we
co
nclu
de
d th
at th
e p
roce
ss h
as
resu
lte
d in
ap
pro
pri
ate
co
nsu
lta
tion
.
Item
4 -
Ext
erna
l Aud
it O
pini
ons
- R
epor
t to
the
Gov
erno
rs o
n th
e Q
ualit
y R
epor
t
Page 31 of 60
© 2
018
Gra
nt T
horn
ton
UK
LLP
|
Rep
ort t
o th
e G
over
nors
on
the
Qua
lity
Rep
ort f
or W
UT
H N
HS
Fou
ndat
ion
Tru
st |
201
7/18
6
Data
qu
ali
ty o
f re
po
rte
d p
erf
orm
an
ce
in
dic
ato
rsW
e u
nd
ert
oo
k s
ub
sta
ntive
te
stin
g o
n c
ert
ain
in
dic
ato
rs in
th
e Q
ua
lity R
ep
ort
.
Se
lec
tin
g p
erf
orm
an
ce
in
dic
ato
rs f
or
revie
w
Th
e T
rust
is r
eq
uir
ed
to
ob
tain
assu
ran
ce
fro
m its
au
dito
rs o
ve
r th
ree
in
dic
ato
rs.
NH
S I
mp
rove
me
nt re
qu
ire
s th
at w
e s
ele
ct tw
o in
dic
ato
rs in
a p
rescri
be
d o
rde
r o
f p
refe
ren
ce
fro
m th
e lis
t o
f fo
ur
ma
nd
ate
d in
dic
ato
rsth
at a
re r
ele
va
nt to
th
is T
rust.
Th
ese
tw
o in
dic
ato
rs a
re s
ub
ject to
a lim
ite
d a
ssu
ran
ce
op
inio
n in
lin
e w
ith
th
e r
eq
uir
em
en
ts s
et b
y N
HS
Im
pro
ve
me
nt.
We h
ave
to
re
po
rt o
n w
he
the
r th
ere
is e
vid
en
ce
to
su
gg
est th
at
the
y h
ave
no
t b
ee
n r
ea
so
na
bly
sta
ted
in
all
ma
teri
al r
esp
ects
in
acco
rda
nce w
ith
th
e ‘N
HS
fo
un
da
tio
n tru
st a
nn
ua
l re
po
rtin
g m
an
ua
l 2
01
7/1
8’ a
nd
su
pp
ort
ing
gu
ida
nce
.
In lin
e w
ith
th
e a
ud
ito
r g
uid
an
ce
, w
e h
ave
re
vie
we
d t
he
fo
llow
ing
in
dic
ato
rs:
•P
erc
en
tag
e o
f p
atie
nts
with
a to
tal tim
e in
A&
E o
f fo
ur
ho
urs
fro
m a
rriv
al to
ad
mis
sio
n, tr
an
sfe
r o
r d
isch
arg
e s
ele
cte
d a
s th
e fir
st p
rio
rity
fro
m t
he
su
bse
t o
f m
an
da
ted
ind
ica
tors
. A
ssu
ran
ce
is lim
ite
d to
Arr
ow
eP
ark
A&
E d
ep
art
me
nt o
nly
•P
erc
en
tag
e o
f in
co
mp
lete
pa
thw
ays w
ith
in 1
8 w
ee
ks fo
r p
atie
nts
on
in
co
mp
lete
pa
thw
ays a
t th
e e
nd
of
the
re
po
rtin
g p
eri
od
se
lecte
d a
s th
e s
eco
nd
pri
ori
ty fro
m t
he
su
bse
t o
f m
an
da
ted
in
dic
ato
rs.
In 2
01
7/1
8, N
HS
fo
un
da
tio
n tru
sts
als
o n
ee
d to
ob
tain
assu
ran
ce
th
rou
gh
su
bsta
ntive
sa
mp
le te
stin
g o
ve
r o
ne
ad
ditio
na
l lo
ca
l in
dic
ato
r in
clu
de
d in
th
e Q
ua
lity R
ep
ort
, se
lecte
d b
y t
he
g
ove
rno
rs o
f th
e T
rust.
Alth
ou
gh
th
e T
rust’s e
xte
rna
l a
ud
ito
rs a
re r
eq
uir
ed
to
un
de
rta
ke
th
e w
ork
, th
is in
dic
ato
r d
oe
s n
ot fo
rm p
art
of th
e lim
ite
d a
ssu
ran
ce
re
po
rt.
In lin
e w
ith
th
e a
ud
ito
r g
uid
an
ce
, w
e h
ave
re
vie
we
d t
he
fo
llow
ing
lo
ca
l in
dic
ato
r:
•A
ch
ieve
95
% in
th
e q
ua
rte
rly p
oin
t p
reva
len
ce
stu
dy w
hic
h m
ea
su
res c
om
plia
nce
with
MU
ST
asse
ssm
en
ts a
t se
ve
n d
ays, b
y t
he
en
do
fq
ua
rte
r 4
. T
his
wa
s s
ele
cte
d b
y t
he
Co
un
cil
of
Go
ve
rno
rs a
t th
eir
Ma
rch
20
18
me
etin
g d
ue
to
th
e T
rust’s p
rio
rity
to
en
su
re p
atie
nts
’ nu
tritio
na
l ne
ed
s a
re id
en
tifie
d a
nd
me
t. G
ove
rno
rs w
ere
aw
are
th
at th
e T
rust h
ad
be
en
pe
rfo
rmin
g
po
orl
y in
th
is a
rea
in
ea
rly 2
01
7/1
8 w
hic
h w
as r
ein
forc
ed
by p
oo
r ra
tin
gs fo
r fo
od
in
th
e n
atio
na
l P
LA
CE
(P
atie
nt L
ed
Asse
ssm
en
to
f th
e C
are
En
vir
on
me
nt)
asse
ssm
en
t in
su
mm
er
20
17
.
Da
ta q
ua
lity
of re
po
rte
d p
erf
orm
ance
indic
ato
rs
Page 32 of 60
© 2
018
Gra
nt T
horn
ton
UK
LLP
|
Rep
ort t
o th
e G
over
nors
on
the
Qua
lity
Rep
ort f
or W
UT
H N
HS
Fou
ndat
ion
Tru
st |
201
7/18
7
Data
qu
ali
ty o
f re
po
rte
d p
erf
orm
an
ce
in
dic
ato
rs –
Ind
ica
tors
s
ub
jec
t to
lim
ite
d a
ssu
ran
ce
re
po
rt
Da
ta q
ua
lity
of re
po
rte
d p
erf
orm
ance
indic
ato
rs
Ind
ica
tor
& D
efi
nit
ion
Ind
ica
tor
ou
tco
me
Wo
rkp
erf
orm
ed
Co
nc
lus
ion
Pe
rce
nta
ge
of
pa
tie
nts
wit
h a
to
tal
tim
e in
A&
E o
f fo
ur
ho
urs
fro
m a
rriv
al
to a
dm
iss
ion
, tr
an
sfe
r o
r d
isc
ha
rge
–
Arr
ow
eP
ark
A&
E o
nly
20
17
/18
Ta
rge
t 9
5%
Pe
rfo
rma
nc
e7
4.6
%
We d
ocu
me
nte
d a
nd
wa
lke
d t
hro
ug
h th
e p
roce
ss
use
d b
yth
e T
rust
to c
olle
ct d
ata
fo
r th
e in
dic
ato
r.
We c
he
cke
d th
at th
e in
dic
ato
r p
rese
nte
d in
th
e
Qu
alit
y R
ep
ort
re
co
ncile
d to
th
e u
nd
erl
yin
g d
ata
.
We th
en
te
ste
d a
sa
mp
le o
f 1
0ite
ms
in o
rde
r to
asce
rta
in th
e a
ccu
racy, co
mp
lete
ness, tim
elin
ess,
va
lidity, re
leva
nce
an
d r
elia
bili
ty o
f th
e d
ata
, a
nd
wh
eth
er
the
ca
lcu
latio
n o
f th
e in
dic
ato
r w
as in
acco
rda
nce w
ith
th
e d
efin
itio
n. N
o d
ata
qu
alit
y
err
ors
we
re id
en
tifie
d in
th
e s
am
ple
te
ste
d.
Th
e d
raft
Qu
alit
y R
ep
ort
in
clu
de
d o
nly
th
e
co
mp
osite
A&
E w
ait f
or
Arr
ow
eP
ark
site
in
clu
din
g
the
Walk
In
Ce
ntr
e. M
an
ag
em
en
t u
pd
ate
d th
e
Qu
alit
y R
ep
ort
to
re
po
rt th
e T
rust’s o
wn
A&
E
pe
rfo
rma
nce
up
on
wh
ich
ou
r o
pin
ion
is b
ase
d.
Ba
se
d o
n th
e r
esu
lts o
f o
ur
pro
ce
du
res, n
oth
ing
ha
s c
om
e to
ou
r a
tte
ntio
n th
at ca
use
s u
s to
be
lieve
th
at,
fo
r th
e y
ea
r e
nd
ed
31
Ma
rch
20
18
,
the
in
dic
ato
r h
as n
ot b
ee
n r
ea
so
na
bly
sta
ted
in
all
ma
teri
al r
esp
ects
in
acco
rda
nce w
ith
th
e ‘N
HS
fou
nd
atio
n tru
st a
nn
ua
lre
po
rtin
g m
an
ua
l 2
01
7/1
8’
an
d s
up
po
rtin
g g
uid
an
ce
.
Item
4 -
Ext
erna
l Aud
it O
pini
ons
- R
epor
t to
the
Gov
erno
rs o
n th
e Q
ualit
y R
epor
t
Page 33 of 60
© 2
018
Gra
nt T
horn
ton
UK
LLP
|
Rep
ort t
o th
e G
over
nors
on
the
Qua
lity
Rep
ort f
or W
UT
H N
HS
Fou
ndat
ion
Tru
st |
201
7/18
8
Data
qu
ali
ty o
f re
po
rte
d p
erf
orm
an
ce
in
dic
ato
rs –
Ind
ica
tors
s
ub
jec
t to
lim
ite
d a
ssu
ran
ce
re
po
rt (
co
nti
nu
ed
)
Da
ta q
ua
lity
of re
po
rte
d p
erf
orm
ance
indic
ato
rs
Ind
ica
tor
& D
efi
nit
ion
Ind
ica
tor
ou
tco
me
Wo
rkp
erf
orm
ed
Co
nc
lus
ion
Pe
rce
nta
ge
of
inc
om
ple
te p
ath
wa
ys
wit
hin
18
we
ek
s f
or
pa
tie
nts
on
inc
om
ple
te p
ath
wa
ys
20
17
/18
Ta
rge
t 9
2%
Pe
rfo
rma
nc
e7
9.1
2%
We d
ocu
me
nte
d a
nd
wa
lke
d t
hro
ug
h th
e p
roce
ss
use
d b
yth
e T
rust
to c
olle
ct d
ata
fo
r th
e in
dic
ato
r.
We c
he
cke
d th
at th
e in
dic
ato
r p
rese
nte
d in
th
e
Qu
alit
y R
ep
ort
re
co
ncile
d to
th
e u
nd
erl
yin
g d
ata
.
We th
en
te
ste
d a
sa
mp
le o
f 1
0ite
ms
in o
rde
r to
asce
rta
in th
e a
ccu
racy, co
mp
lete
ness, tim
elin
ess,
va
lidity, re
leva
nce
an
d r
elia
bili
ty o
f th
e d
ata
, a
nd
wh
eth
er
the
ca
lcu
latio
n o
f th
e in
dic
ato
r w
as in
acco
rda
nce w
ith
th
e d
efin
itio
n. N
o d
ata
qu
alit
y
err
ors
we
re id
en
tifie
d in
th
e s
am
ple
te
ste
d.
It s
ho
uld
be
no
ted
th
at th
is in
dic
ato
r w
as q
ua
lifie
d
in 2
01
6/1
7 a
nd
20
15
/16
du
e to
in
co
rre
ct re
po
rtin
g
of clo
ck s
tart
an
d c
lock s
top
tim
es. A
s r
ep
ort
ed
last ye
ar,
th
e T
rust
ha
s r
ecru
ite
d s
pe
cia
list sta
ff
an
d im
ple
me
nte
d a
tra
inin
g p
rog
ram
me
to
imp
rove
RT
T d
ata
qu
alit
y. T
he
Tru
st
ha
s a
lso
rece
ive
d s
up
po
rt fro
m N
HS
Im
pro
ve
me
nt a
nd
th
e
Na
tio
na
l In
ten
siv
e S
up
po
rt T
ea
m t
o r
evis
it a
nd
cle
an
se
pa
tie
nt tr
ea
tme
nt lis
ts (
PT
L).
Th
e T
rust
no
w v
alid
ate
s 1
00
% o
f a
ll clo
ck s
tart
s a
nd
sto
ps
to e
nsu
re d
ata
accu
racy. T
his
in
ve
stm
en
t in
da
ta
qu
alit
y h
as le
d to
an
im
pro
ve
me
nt in
th
e R
TT
da
ta
for
20
17
/18
.
Ba
se
d o
n th
e r
esu
lts o
f o
ur
pro
ce
du
res, n
oth
ing
ha
s c
om
e to
ou
r a
tte
ntio
n th
at ca
use
s u
s to
be
lieve
th
at,
fo
r th
e y
ea
r e
nd
ed
31
Ma
rch
20
18
,
the
in
dic
ato
r h
as n
ot b
ee
n r
ea
so
na
bly
sta
ted
in
all
ma
teri
al r
esp
ects
in
acco
rda
nce w
ith
th
e ‘N
HS
fou
nd
atio
n tru
st a
nn
ua
lre
po
rtin
g m
an
ua
l 2
01
7/1
8’
an
d s
up
po
rtin
g g
uid
an
ce
.
Page 34 of 60
© 2
018
Gra
nt T
horn
ton
UK
LLP
|
Rep
ort t
o th
e G
over
nors
on
the
Qua
lity
Rep
ort f
or W
UT
H N
HS
Fou
ndat
ion
Tru
st |
201
7/18
9
Data
qu
ali
ty o
f re
po
rte
d p
erf
orm
an
ce
in
dic
ato
rs –
Lo
cal
ind
ica
tor
no
t s
ub
jec
t to
lim
ite
d a
ssu
ran
ce
re
po
rt
Da
ta q
ua
lity
of re
po
rte
d p
erf
orm
ance
indic
ato
rs
Ind
ica
tor
& D
efi
nit
ion
Ind
ica
tor
ou
tco
me
Wo
rkp
erf
orm
ed
Co
nc
lus
ion
Ac
hie
ve
95
% i
n t
he
qu
art
erl
y p
oin
t
pre
va
len
ce
stu
dy w
hic
h m
ea
su
res
co
mp
lia
nc
e w
ith
MU
ST
as
se
ss
me
nts
at
se
ve
n d
ays
, b
y t
he
en
d o
f q
ua
rte
r 4
.
(so
urc
e:
po
int
pre
va
len
ce
au
dit
un
de
rta
ke
n b
y t
he
Tru
st’
s C
orp
ora
te
Nu
rsin
g T
ea
m)
In lin
e w
ith
th
e r
eq
uir
em
en
ts o
f N
HS
Imp
rove
me
nt’s G
uid
an
ce
, th
is in
dic
ato
r
is n
ot su
bje
ct to
a lim
ite
d a
ssu
ran
ce
op
inio
n. W
e d
o n
ot p
rovid
e th
e
go
ve
rno
rs w
ith
an
y f
orm
al a
ssu
ran
ce
in
rela
tio
n to
wh
eth
er
this
in
dic
ato
r is
fa
irly
sta
ted
.
20
17
/18
Ta
rge
t 9
5%
Pe
rfo
rma
nc
e5
9%
(co
mp
lia
nc
e a
t 7
da
ys
)
We d
ocu
me
nte
d a
nd
wa
lke
d t
hro
ug
h th
e p
roce
ss
use
d b
yth
e T
rust
to c
olle
ct d
ata
fo
r th
e in
dic
ato
r.
We c
he
cke
d th
at th
e in
dic
ato
r p
rese
nte
d in
th
e
Qu
alit
y R
ep
ort
re
co
ncile
d to
th
e u
nd
erl
yin
g d
ata
.
We th
en
te
ste
d a
sa
mp
le o
f 1
0ite
ms
in o
rde
r to
asce
rta
in th
e a
ccu
racy, co
mp
lete
ness, tim
elin
ess,
va
lidity, re
leva
nce
an
d r
elia
bili
ty o
f th
e d
ata
, a
nd
wh
eth
er
the
ca
lcu
latio
n o
f th
e in
dic
ato
r w
as in
acco
rda
nce w
ith
th
e d
efin
itio
n. N
o d
ata
qu
alit
y
err
ors
we
re id
en
tifie
d in
th
e s
am
ple
te
ste
d.
Ou
r sa
mp
le o
f M
US
Ta
sse
ssm
ents
inclu
de
d o
ne
ca
se
wh
ere
an
oth
er
pa
tie
nt’s a
sse
ssm
ent w
as
inclu
de
d in
th
e p
atie
nt’s W
irra
l Mill
en
niu
m c
ase
no
tes file
. T
he
err
or
wa
s n
ote
d a
nd
a M
US
T
asse
ssm
en
t su
bse
qu
ently c
arr
ied
ou
t o
n t
he
co
rre
ct p
atie
nt w
ith
in th
e p
rescri
be
d tim
esca
le.
Alth
ou
gh
th
e s
am
ple
pa
tie
nt p
asse
d th
e d
ata
qu
alit
y te
stin
g, sta
ff h
ave
in
dic
ate
d th
at
mis
-fili
ng
is n
ot is
ola
ted
an
d w
e h
ave
th
ere
fore
reco
mm
en
ded
th
at a
pro
ce
ss is in
tro
du
ce
d to
imp
rove
fili
ng
of
MU
ST
asse
ssm
ents
.
Ba
se
d o
n th
e r
esu
lts o
f o
ur
pro
ce
du
res w
e d
id n
ot
ide
ntify
an
y m
ate
ria
l issu
es in
re
latio
n to
th
e
ca
lcu
lation
of th
is in
dic
ato
r o
r th
e s
ix d
ime
nsio
ns
of d
ata
qu
alit
y.
Item
4 -
Ext
erna
l Aud
it O
pini
ons
- R
epor
t to
the
Gov
erno
rs o
n th
e Q
ualit
y R
epor
t
Page 35 of 60
© 2
018
Gra
nt T
horn
ton
UK
LLP
|
Rep
ort
to t
he G
over
nors
on
the
Qua
lity
Rep
ort
for
WU
TH
NH
S F
ound
atio
n T
rust
|
2017
/18
10
Acti
on
pla
n
We h
ave
id
en
tifie
d 1
re
co
mm
en
da
tio
n a
s a
re
su
lt o
f is
su
es id
en
tifie
d d
uri
ng
th
e c
ou
rse
of
ou
r w
ork
on
th
e T
rust’s Q
ua
lity R
ep
ort
. W
e h
ave
ag
ree
d o
ur
reco
mm
en
datio
ns w
ith
ma
na
ge
me
nt a
nd
we
will
re
po
rt o
n p
rog
ress o
n th
ese
re
co
mm
en
da
tion
s d
uri
ng
20
18
/19
.
As
se
ss
me
nt
S
ign
ific
an
t d
eficie
ncy –
issu
e le
ad
ing
to
qu
alifica
tio
n o
f lim
ite
d a
ssu
ran
ce
re
po
rt o
r ri
sk o
f sig
nific
an
t m
issta
tem
en
t
D
eficie
ncy –
issu
e f
or
imp
rove
me
nt
in p
roce
sse
s o
r ri
sk o
f in
co
nse
qu
en
tia
l m
issta
tem
en
t
Ap
pe
nd
ixA
As
se
ss
me
nt
Iss
ue
an
dri
sk
Re
co
mm
en
da
tio
ns
Ou
r sa
mp
le o
f M
US
Ta
sse
ssm
ents
inclu
de
d o
ne
ca
se
wh
ere
an
oth
er
pa
tie
nt’s a
sse
ssm
en
t w
as in
clu
de
d in
th
e p
atie
nt’s W
irra
l
Mill
en
niu
m c
ase
no
tes file
. T
he
err
or
wa
s n
ote
d a
nd
a M
US
T
asse
ssm
en
t su
bse
qu
ently c
arr
ied
ou
t o
n t
he
co
rre
ct p
atie
nt w
ith
in
the
pre
scri
be
d tim
esca
le.
•W
e r
eco
mm
en
d th
at m
an
ag
em
en
t in
tro
du
ce
pro
ce
du
res to
ch
eck th
at M
US
T
asse
ssm
en
ts a
re c
orr
ectly file
d in
th
e r
igh
t p
atie
nt’s r
eco
rds, fo
r e
xa
mp
le b
y
ch
eckin
g th
at th
e p
atie
nt’s N
HS
nu
mb
er
is c
on
sis
tent o
n th
e M
US
T f
orm
an
d p
atie
nt
file
.
Ma
na
ge
me
nt
res
po
ns
e
Page 36 of 60
© 2
018
Gra
nt T
horn
ton
UK
LLP
|
Rep
ort
to t
he G
over
nors
on
the
Qua
lity
Rep
ort
for
WU
TH
NH
S F
ound
atio
n T
rust
|
2017
/18
11
Dra
ft f
orm
of
lim
ite
d a
ssu
ran
ce
re
po
rt
Ind
ep
en
de
nt
Pra
cti
tio
ne
r's L
imit
ed
Assu
ran
ce R
ep
ort
to
th
e C
ou
nc
il o
f G
overn
ors
of
Wir
ral U
niv
ers
ity T
each
ing
Ho
sp
ital N
HS
Fo
un
da
tio
n T
rust
on
th
e Q
ua
lity
Rep
ort
We h
ave b
een e
ngaged b
y t
he C
ouncil
of
Govern
ors
of
Wirra
l Univ
ers
ity T
eachin
g H
ospital
NH
S F
oundatio
n T
rust to
perf
orm
an in
dependent
limited a
ssura
nce e
ngagem
ent
in r
espect of
Wirra
l Univ
ers
ity T
eachin
g H
ospital N
HS
Fo
undatio
n T
rust’s Q
ualit
y R
eport
for
the y
ear
ended
31 M
arc
h 2
018 (
the “
Qualit
y R
eport
”) a
nd c
ert
ain
perf
orm
ance in
dic
ato
rs c
onta
ined t
here
in
again
st
the c
rite
ria
set out
in t
he ‘N
HS
foundatio
n t
rust annual re
port
ing m
anual 2017/1
8’ and
additio
nal support
ing g
uid
ance in
the ‘D
eta
iled r
equirem
ents
for
qualit
y r
eport
s 2
017/1
8' (t
he
'Crite
ria
').
Sco
pe
an
d s
ub
ject
matt
er
Th
e in
dic
ato
rs f
or
the y
ear
ended 3
1 M
arc
h 2
018 s
ubje
ct to
the lim
ited a
ssura
nce e
ngagem
ent
consis
t of
the n
ational priority
indic
ato
rs a
s m
andate
d b
y N
HS
Im
pro
vem
ent:
P
erc
enta
ge
of
patie
nts
with
ato
taltim
ein
A&
Eof
four
hours
from
arr
ivalto
adm
issio
n,
transfe
ror
dis
charg
e–
Arr
ow
eP
ark
A&
Eonly
P
erc
enta
ge o
f in
com
ple
te p
ath
ways w
ithin
18 w
eeks f
or
patie
nts
on in
com
ple
te
path
ways
We r
efe
r to
these n
atio
nal prio
rity
in
dic
ato
rs c
olle
ctively
as t
he 'In
dic
ato
rs'.
Resp
ecti
ve r
esp
on
sib
ilit
ies o
f th
e d
irecto
rs a
nd
Pra
cti
tio
ne
r
The d
irecto
rs a
re r
esponsib
le f
or
the c
onte
nt
and t
he p
repara
tion o
f th
e Q
ualit
y R
eport
in
accord
ance w
ith t
he c
rite
ria
set
out
in t
he 'N
HS
foundatio
n t
rust annual re
port
ing m
anual
2017/1
8' and s
upport
ing g
uid
ance issued b
y N
HS
Im
pro
vem
ent.
Our
responsib
ility
is to f
orm
a c
onclu
sio
n,
based o
n lim
ited a
ssura
nce p
rocedure
s,
on w
heth
er
anyth
ing h
as c
om
e to o
ur
att
entio
n t
hat
causes u
s to b
elie
ve t
hat:
th
e Q
ualit
y R
eport
is n
ot
pre
pare
d in
all
mate
ria
l re
spects
in
lin
e w
ith t
he C
rite
ria
set out
in t
he ‘N
HS
foundatio
n t
rust annual re
port
ing m
anual 2017/1
8’ and s
upport
ing
guid
ance;
th
e Q
ualit
y R
eport
is n
ot
consis
tent in
all
mate
ria
l re
spects
with t
he s
ourc
es s
pecifie
d in
NH
S Im
pro
vem
ent’s 'D
eta
iled r
equirem
ents
for
exte
rnal assura
nce f
or
qualit
y r
eport
s
2017/1
8’; a
nd
th
e in
dic
ato
rs in
the Q
ualit
y R
eport
id
entifie
d a
s h
avin
g b
een t
he s
ubje
ct of
limited
assura
nce in
the Q
ualit
y R
eport
are
not
reasonably
sta
ted in
all
mate
ria
l re
spects
in
accord
ance w
ith t
he 'N
HS
foundatio
n t
rust annual re
port
ing m
anual 2017/1
8' and
support
ing g
uid
ance a
nd t
he s
ix d
imensio
ns o
f data
qualit
y s
et out
in t
he ‘'D
eta
iled
requirem
ents
for
exte
rnal assura
nce f
or
qualit
y r
eport
s 2
017/1
8’.
We r
ead t
he Q
ualit
y R
eport
and c
onsid
er
wheth
er
it a
ddre
sses t
he c
onte
nt
requirem
ents
of
the
‘NH
S foundatio
n t
rust annual re
port
ing m
anual 2017/1
8’ and s
upport
ing g
uid
ance,
and
consid
er
the im
plic
atio
ns for
our
report
if w
e b
ecom
e a
ware
of
any m
ate
ria
l om
issio
ns.
We r
ead t
he o
ther
info
rmatio
n c
onta
ined in
the Q
ualit
y R
eport
and c
onsid
er
wheth
er
it is
mate
ria
lly in
consis
tent w
ith:
B
oard
min
ute
s for
the p
erio
d A
pril 2017 t
o M
ay 2
018;
papers
rela
tin
g t
o q
ualit
y r
eport
ed t
o t
he B
oard
over
the p
erio
d 1
April 2017 t
o M
ay
2018;
fe
edback f
rom
com
mis
sio
ners
date
d M
ay 2
018;
fe
edback f
rom
govern
ors
date
d M
arc
h 2
018;
fe
edback f
rom
lo
cal H
ealthw
atc
horg
anis
atio
ns d
ate
d M
ay 2
018;
fe
edback f
rom
the O
verv
iew
and S
cru
tin
y C
om
mitte
e d
ate
d M
ay 2
018;
th
e T
rust’s c
om
pla
ints
report
publis
hed u
nder
regula
tio
n 1
8 o
f th
e L
ocal A
uth
ority
Socia
l
Se
rvic
es a
nd N
ational H
ealth S
erv
ice C
om
pla
ints
(E
ngla
nd)
Regula
tions 2
009,
date
d
June 2
017;
th
e n
atio
nal in
patie
nt
surv
ey d
ate
d J
une 2
017;
th
e n
atio
nal sta
ff s
urv
ey d
ate
d F
ebru
ary
2018;
and
th
e H
ead o
f In
tern
al A
udit’s
annual opin
ion o
ver
the T
rust’s c
ontr
ol environm
ent
date
d
May 2
018.
We c
onsid
er
the im
plic
atio
ns for
our
report
if w
e b
ecom
e a
ware
of
any a
ppare
nt
mis
sta
tem
ents
or
mate
ria
l in
consis
tencie
s w
ith t
hose d
ocum
ents
(colle
ctively
, th
e “
docum
ents
”). O
ur
responsib
ilitie
s d
o n
ot
exte
nd t
o a
ny o
ther
info
rmatio
n.
Th
e f
irm
applie
s I
nte
rnatio
nal S
tandard
on Q
ualit
y C
ontr
ol 1 (
Revis
ed)
and a
ccord
ingly
main
tain
s a
com
pre
hensiv
e s
yste
m o
f qualit
y c
ontr
ol in
clu
din
g d
ocum
ente
d p
olic
ies a
nd
pro
cedure
s r
egard
ing c
om
plia
nce w
ith e
thic
al re
quirem
ents
, pro
fessio
nal sta
ndard
s a
nd
applic
able
le
gal and r
egula
tory
requirem
ents
.
We a
re in
com
plia
nce w
ith t
he a
pplic
able
in
dependence a
nd c
om
pete
ncy r
equirem
ents
of
the
Institu
te o
f C
hart
ere
d A
ccounta
nts
in
Engla
nd a
nd W
ale
s (IC
AE
W)
Code o
f E
thic
s. O
ur
team
com
prised a
ssura
nce p
ractitio
ners
and r
ele
vant
subje
ct m
att
er
expert
s.
This
report
, in
clu
din
g t
he c
onclu
sio
n, has b
een p
repare
d s
ole
ly for
the C
ouncil
of
Govern
ors
of
Wirra
l Univ
ers
ity T
eachin
g H
ospital N
HS
Fo
undatio
n T
rust as a
body,
to a
ssis
t th
e C
ouncil
of
Govern
ors
in
report
ing W
irra
l Univ
ers
ity T
eachin
g H
ospital N
HS
Fo
undatio
n T
rust’s q
ualit
y
agenda,
perf
orm
ance a
nd a
ctivitie
s. W
e p
erm
it the d
isclo
sure
of
this
report
within
the A
nnual
Ap
pe
nd
ix B
Item
4 -
Ext
erna
l Aud
it O
pini
ons
- R
epor
t to
the
Gov
erno
rs o
n th
e Q
ualit
y R
epor
t
Page 37 of 60
© 2
018
Gra
nt T
horn
ton
UK
LLP
|
Rep
ort
to t
he G
over
nors
on
the
Qua
lity
Rep
ort
for
WU
TH
NH
S F
ound
atio
n T
rust
|
2017
/18
12
Fo
rm o
f li
mit
ed
as
su
ran
ce
re
po
rtR
eport
for
the y
ear
ended 3
1 M
arc
h 2
018,
to e
nable
the C
ouncil
of
Govern
ors
to d
em
onstr
ate
they h
ave d
ischarg
ed t
heir g
overn
ance r
esponsib
ilitie
s b
y c
om
mis
sio
nin
g a
n in
dependent
assura
nce r
eport
in
connectio
n w
ith t
he in
dic
ato
rs. T
o t
he f
ulle
st exte
nt
perm
itte
d b
y la
w,
we d
o
not
accept
or
assum
e r
esponsib
ility
to a
nyone o
ther
than t
he C
ouncil
of
Govern
ors
as a
body,
and W
irra
l Univ
ers
ity T
eachin
g H
ospital N
HS
Fo
undatio
n T
rust fo
r our
work
or
this
report
,
except
where
term
s a
re e
xpre
ssly
agre
ed a
nd w
ith o
ur
prio
r consent
in w
ritin
g.
Assu
ran
ce w
ork
pe
rfo
rmed
We c
onducte
d t
his
lim
ited a
ssura
nce e
ngagem
ent
in a
ccord
ance w
ith I
nte
rnatio
nal S
tandard
on
Assura
nce E
ngagem
ents
3000 (
Revis
ed)
‘Assura
nce E
ngagem
ents
oth
er
than A
udits o
r
Revie
ws o
f H
isto
rical F
inancia
l In
form
atio
n’ is
sued b
y t
he I
nte
rnatio
nal A
uditin
g a
nd A
ssura
nce
Sta
ndard
s B
oard
(‘IS
AE
3000’).
Our
limited a
ssura
nce p
rocedure
s in
clu
ded:
evalu
atin
g t
he d
esig
n a
nd im
ple
menta
tio
n o
f th
e k
ey p
rocesses a
nd c
ontr
ols
for
managin
g a
nd r
eport
ing t
he in
dic
ato
rs
m
akin
g e
nquirie
s o
f m
anagem
ent
lim
ited testin
g,
on a
sele
ctive b
asis
, of
the d
ata
used t
o c
alc
ula
te the in
dic
ato
rs teste
d
again
st
support
ing d
ocum
enta
tio
n
com
parin
g the c
onte
nt
requirem
ents
of
the 'N
HS
foundatio
n t
rust annual re
port
ing
manual 2017/1
8' and s
upport
ing g
uid
ance t
o t
he c
ate
gorie
s r
eport
ed in
the Q
ualit
y
Report
; and
re
adin
g t
he d
ocum
ents
.
A lim
ited a
ssura
nce e
ngagem
ent
is s
malle
r in
scope t
han a
reasonable
assura
nce
engagem
ent.
Th
e n
atu
re,
tim
ing a
nd e
xte
nt
of
pro
cedure
s f
or
gath
erin
g s
uff
icie
nt appro
pria
te
evid
ence a
re d
elib
era
tely
lim
ited r
ela
tive t
o a
reasonable
assura
nce e
ngagem
ent.
Lim
itati
on
s
Non-f
inancia
l perf
orm
ance in
form
atio
n is s
ubje
ct to
more
in
here
nt
limitatio
ns than f
inancia
l
info
rmation, giv
en t
he c
hara
cte
ristics o
f th
e s
ubje
ct m
att
er
and t
he m
eth
ods u
sed f
or
dete
rmin
ing s
uch in
form
atio
n.
Th
e a
bsence o
f a s
ignific
ant body o
f esta
blis
hed p
ractice o
n w
hic
h t
o d
raw
allo
ws f
or
the
sele
ctio
n o
f diffe
rent,
but
accepta
ble
, m
easure
ment te
chniq
ues t
hat
can r
esult in
mate
ria
lly
diffe
rent
measure
ments
and c
an a
ffect
com
para
bili
ty. T
he p
recis
ion o
f diffe
rent
measure
ment
techniq
ues m
ay a
lso v
ary
. F
urt
herm
ore
, th
e n
atu
re a
nd m
eth
ods u
sed t
o d
ete
rmin
e s
uch
info
rmatio
n, as w
ell
as the m
easure
ment crite
ria
and t
he p
recis
ion o
f th
ese c
rite
ria
, m
ay c
hange
over
tim
e. It
is im
port
ant to
read t
he Q
ualit
y R
eport
in
the c
onte
xt
of
the c
rite
ria
set out
in t
he
'NH
S foundatio
n t
rust annual re
port
ing m
anual 2017/1
8' and s
upport
ing g
uid
ance.
Th
e s
cope o
f our
limited a
ssura
nce w
ork
has n
ot
inclu
ded g
overn
ance o
ver
qualit
y o
r non
-
mandate
d in
dic
ato
rs, w
hic
h h
ave b
een d
ete
rmin
ed lo
cally
by W
irra
l Univ
ers
ity T
eachin
g
Hospital N
HS
Fo
undatio
n T
rust.
Our
audit w
ork
on t
he f
inancia
l sta
tem
ents
of
Wirra
l Univ
ers
ity T
eachin
g H
ospital N
HS
Fo
undatio
n T
rust is
carr
ied o
ut
in a
ccord
ance w
ith o
ur
sta
tuto
ry o
blig
atio
ns.
Th
is e
ngagem
ent
will
not
be t
reate
d a
s h
avin
g a
ny e
ffect on o
ur
separa
te d
utie
s a
nd r
esponsib
ilitie
s a
s W
irra
l
Univ
ers
ity T
eachin
g H
ospital N
HS
Fo
undatio
n T
rust’s e
xte
rnal auditors
. O
ur
audit r
eport
s o
n
the f
inancia
l sta
tem
ents
are
made s
ole
ly t
o W
irra
l Univ
ers
ity T
eachin
g H
ospital N
HS
Foundation T
rust's m
em
bers
, as a
body,
in a
ccord
ance w
ith p
ara
gra
ph 2
4(5
) of
Schedule
7 o
f
the N
atio
nal H
ealth S
erv
ice A
ct 2006.
Our
audit w
ork
is u
ndert
aken s
o t
hat
we m
ight sta
te to
Wirra
l Univ
ers
ity T
eachin
g H
ospital N
HS
Fo
undatio
n T
rust’s m
em
bers
those m
att
ers
we a
re
required t
o s
tate
to t
hem
in
an a
uditor’s r
eport
and f
or
no o
ther
purp
ose.
Our
audits o
f W
irra
l
Univ
ers
ity T
eachin
g H
ospital N
HS
Fo
undatio
n T
rust’s fin
ancia
l sta
tem
ents
are
not
pla
nned o
r
conducte
d t
o a
ddre
ss o
r re
fle
ct m
att
ers
in w
hic
h a
nyone o
ther
than s
uch m
em
bers
as a
body
may b
e in
tere
ste
d f
or
such p
urp
ose.
In t
hese c
ircum
sta
nces, to
the f
ulle
st exte
nt
perm
itte
d b
y
law
, w
e d
o n
ot
accept
or
assum
e a
ny r
esponsib
ility
to a
nyone o
ther
than W
irra
l Univ
ers
ity
Te
achin
g H
ospital N
HS
Fo
undatio
n T
rust and W
irra
l Univ
ers
ity T
eachin
g H
ospital N
HS
Fo
undatio
n T
rust’s m
em
bers
as a
body,
for
our
audit w
ork
, fo
r our
audit r
eport
s,
or
for
the
opin
ions w
e h
ave f
orm
ed in
respect
of
those a
udits.
Co
nc
lus
ion
Based o
n t
he r
esults o
f our
pro
cedure
s,
as d
escrib
ed in
this
report
, noth
ing h
as c
om
e to o
ur
att
entio
n t
hat
causes u
s to b
elie
ve t
hat,
for
the y
ear
ended 3
1 M
arc
h 2
018:
th
e Q
ualit
y R
eport
is n
ot
pre
pare
d in
all
mate
ria
l re
spects
in
lin
e w
ith t
he C
rite
ria
set out
in t
he ‘N
HS
foundatio
n t
rust annual re
port
ing m
anual 2017/1
8’ and s
upport
ing
guid
ance;
th
e Q
ualit
y R
eport
is n
ot
consis
tent in
all
mate
ria
l re
spects
with t
he s
ourc
es s
pecifie
d in
NH
S Im
pro
vem
ent’s 'D
eta
iled r
equirem
ents
for
exte
rnal assura
nce f
or
qualit
y r
eport
s
2017/1
8’; a
nd
th
e in
dic
ato
rs in
the Q
ualit
y R
eport
id
entifie
d a
s h
avin
g b
een s
ubje
ct
to lim
ited
assura
nce h
ave n
ot
been r
easonably
sta
ted in
all
mate
ria
l re
spects
in
accord
ance w
ith
the 'N
HS
foundatio
n t
rust annual re
port
ing m
anual 2017/1
8' and s
upport
ing g
uid
ance
.
Gra
nt
Th
orn
ton
UK
LLP
Chart
ere
dA
ccounta
nts
Mancheste
r
To
be
date
d
Ap
pe
nd
ix C
Page 38 of 60
© 2
018
Gra
nt T
horn
ton
UK
LLP
|
Rep
ort t
o th
e G
over
nors
on
the
Qua
lity
Rep
ort f
or W
UT
H N
HS
Fou
ndat
ion
Tru
st |
201
7/18
© 2
01
8 G
ran
t T
ho
rnto
n U
K L
LP
. A
ll r
igh
ts r
ese
rve
d.
‘Gra
nt T
ho
rnto
n’ re
fers
to
th
e b
ran
d u
nd
er
wh
ich
th
e G
ran
t T
ho
rnto
n m
em
be
r firm
s p
rovid
e a
ssu
ran
ce
, ta
x a
nd
ad
vis
ory
se
rvic
es
toth
eir
clie
nts
an
d/o
r re
fers
to
on
e o
r m
ore
me
mb
er
firm
s, a
s t
he
co
nte
xt
req
uir
es.
Gra
nt T
ho
rnto
n U
K L
LP
is a
me
mb
er
firm
of G
ran
t T
ho
rnto
n In
tern
atio
na
l L
td (
GT
IL).
GT
IL a
nd
th
e m
em
be
r firm
s a
re n
ot a
wo
rld
wid
ep
art
ne
rsh
ip. G
TIL
an
d e
ach
me
mb
er
firm
is a
se
pa
rate
le
ga
l e
ntity
. S
erv
ice
s a
re d
elive
red
by th
e m
em
be
r firm
s.
GT
IL d
oe
s n
ot p
rovid
e s
erv
ice
s to
clie
nts
. G
TIL
an
d its
me
mb
er
firm
s a
re n
ot a
ge
nts
of,
an
d d
o n
ot
ob
lig
ate
, o
ne
an
oth
er
an
d a
re n
ot lia
ble
fo
r o
ne
an
oth
er’
s a
cts
or
om
issio
ns.
gra
ntt
ho
rnto
n.c
o.u
k
Item
4 -
Ext
erna
l Aud
it O
pini
ons
- R
epor
t to
the
Gov
erno
rs o
n th
e Q
ualit
y R
epor
t
Page 39 of 60
© 2
018
Gra
nt T
horn
ton
UK
LLP
|
Aud
it F
indi
ngs
Rep
ort
for
WU
TH
NH
S F
oundation T
rust
| 20
17/1
8
Au
dit
Fin
din
gs R
ep
ort
Ye
ar
en
de
d 3
1 M
arc
h 2
018
Wirra
l U
niv
ers
ity H
osp
ita
l N
HS
Fo
un
da
tion T
rust
22
Ma
y 2
01
8
Item
4 -
Ext
erna
l Aud
it O
pini
ons
- A
udit
Fin
ding
s R
epor
t
Page 40 of 60
© 2
018
Gra
nt T
horn
ton
UK
LLP
|
Aud
it F
indi
ngs
Rep
ort
for
WU
TH
NH
S F
oundation T
rust
| 20
17/1
82
Con
ten
ts
Section
Page
1.
He
ad
lines
3
2.
Fin
an
cia
l sta
tem
ents
4
3.
Va
lue f
or
mon
ey
13
4.
Oth
er
sta
tuto
ry p
ow
ers
and
du
tie
s17
5.
Inde
pe
nd
en
ce
and
eth
ics
18
Ap
pe
nd
ices
A.
Au
dit a
dju
stm
ents
B.
Fe
es
The c
onte
nts
of
this
report
rela
te o
nly
to t
hose m
atters
whic
h c
am
e t
o o
ur
attention d
uring t
he c
onduct
of
our
norm
al audit p
rocedure
s w
hic
h a
re d
esig
ned f
or
the p
urp
ose o
f expre
ssin
g
our
opin
ion o
n t
he f
inancia
l sta
tem
ents
. O
ur
audit is n
ot
desig
ned t
o t
est
all
inte
rnal contr
ols
or
identify
all
are
as o
f con
trol w
eakness.
How
ever,
where
, as p
art
of
our
testing,
we identify
contr
ol w
eaknesses,
we w
ill r
eport
these t
o y
ou.
In c
onsequence,
our
work
cannot
be r
elie
d u
pon t
o d
isclo
se a
ll defa
lcations o
r oth
er
irre
gula
rities,
or
to inclu
de a
ll possib
le
impro
vem
ents
in inte
rnal contr
ol th
at
a m
ore
exte
nsiv
e s
pecia
l exam
ination m
ight
identify
. T
his
report
has b
een p
repare
d s
ole
ly f
or
your
benefit
and s
hould
not
be q
uote
d in w
hole
or
in
part
without
our
prior
written c
onsent. W
e d
o n
ot
accept
any
responsib
ility
for
any
loss o
ccasio
ned t
o a
ny
third p
art
y acting
, or
refr
ain
ing f
rom
acting o
n t
he b
asis
of
the c
onte
nt
of
this
report
, as t
his
report
was n
ot
pre
pare
d f
or,
nor
inte
nded f
or,
any
oth
er
purp
ose.
Gra
nt
Thorn
ton U
K L
LP
is a
lim
ited lia
bili
ty p
art
ners
hip
regis
tere
d i
n E
ngla
nd a
nd W
ale
s: N
o.O
C307742.
Regis
tere
d o
ffic
e:
30 F
insb
ury
Squar
e, L
on
do
n, E
C2A
1A
G.
A lis
t of
mem
bers
is
availa
ble
fro
m o
ur
regis
tere
d o
ffic
e.
Gra
nt
Thorn
ton U
K L
LP
is a
uth
orised a
nd r
egula
ted b
y th
e F
inancia
l C
onduct
Auth
ority
. G
rant
Thorn
ton U
K L
LP
is a
mem
ber
firm
of
Gra
nt
Thorn
ton I
nte
rnational
Ltd
(G
TIL
). G
TIL
and t
he m
em
ber
firm
s a
re n
ot
a w
orldw
ide p
art
ners
hip
. S
erv
ices a
re d
eliv
ere
d b
y th
e m
em
ber
firm
s.
GT
IL a
nd its
mem
ber
firm
s a
re n
ot
agents
of, a
nd d
o n
ot
oblig
ate
, one a
noth
er
and a
re n
ot
liable
for
one a
noth
er’s a
cts
or
om
issio
ns.
Yo
ur
key G
ran
t T
ho
rnto
n
team
me
mb
ers
are
:
An
dre
w S
mit
h
Dire
cto
r
T:
0161 9
53 6
900
E:
andre
w.j.s
mith@
uk.g
t.com
Ste
ph
en
Nix
on
Se
nio
r M
ana
ge
r
T:
0161 2
34 6
362
E:
ste
phen.r
.nix
on@
uk.g
t.com
Stu
art
Ba
sn
ett
Assis
tant M
an
ag
er
T:
0151 2
24 7
232
E:
stu
art
.h.b
asn
ett
@uk.g
t.com
Page 41 of 60
© 2
018
Gra
nt T
horn
ton
UK
LLP
|
Aud
it F
indi
ngs
Rep
ort
for
WU
TH
NH
S F
oundation T
rust
| 20
17/1
83
He
ad
lin
es
Intr
od
uc
tio
n
Th
ista
ble
sum
ma
rise
sth
ekey
issu
es
arisin
gfr
om
the
sta
tuto
rya
ud
ito
fW
irra
lU
niv
ers
ity
Te
ach
ing
Ho
sp
ital
NH
SF
ou
nd
ation
Tru
st
(‘th
eT
rust’)
and
the
pre
pa
ratio
nof
the
Tru
st's
fin
an
cia
lsta
tem
en
tsfo
rth
eye
ar
en
de
d3
1M
arc
h2
01
8fo
rth
ose
ch
arg
ed
with
go
ve
rna
nce
.
Ac
kn
ow
led
ge
me
nt
We w
ou
ld lik
e to
ta
ke
th
is o
pp
ort
un
ity to
re
co
rd o
ur
ap
pre
cia
tio
n fo
r th
e a
ssis
tan
ce
pro
vid
ed
by t
he
fin
an
ce
te
am
an
d o
the
r s
taff
du
rin
g o
ur
au
dit.
Fin
an
cia
l
Sta
tem
en
ts
Un
de
rIn
tern
atio
nal
Sta
nd
ard
so
fA
ud
it(I
SA
s(U
K))
an
dth
eN
atio
na
l
Au
dit
Off
ice
(NA
O)
Co
de
of
Au
dit
Pra
ctice
('th
eC
od
e'),
we
are
req
uir
ed
tore
po
rtw
he
the
r,in
ou
ro
pin
ion
:
•th
e T
rust's
fin
an
cia
l sta
tem
en
ts g
ive
a
tru
e a
nd
fa
ir v
iew
of
the
fin
an
cia
l po
sitio
n o
f th
e T
rust
an
d its
exp
en
ditu
re a
nd
in
co
me
fo
r
the
ye
ar;
an
d
•T
he
Tru
st’s fin
an
cia
l sta
tem
en
ts,in
clu
din
g th
e a
ud
ite
d p
art
s o
f
the
Re
mu
ne
ratio
n R
ep
ort
an
d th
e S
taff
Re
po
rt h
ave
be
en
pro
pe
rly p
rep
are
d in
acco
rda
nce w
ith
In
tern
atio
na
l Fin
an
cia
l
Re
po
rtin
g S
tan
da
rds, th
e N
HS
fo
un
da
tio
n tru
st a
nn
ua
l re
po
rtin
g
ma
nu
al 2
01
7/1
8, a
nd
th
e r
eq
uir
em
en
ts o
f th
e N
atio
na
l H
ea
lth
Se
rvic
e A
ct 2
00
6.
We a
re a
lso
re
qu
ire
d to
rep
ort
wh
eth
er
oth
er
info
rma
tio
n p
ub
lish
ed
tog
eth
er
with
th
e a
ud
ite
d fin
an
cia
l sta
tem
en
ts (
inclu
din
g th
e A
nn
ua
l
Re
po
rt),
is
ma
teri
ally
inco
nsis
tent w
ith
th
e fin
an
cia
l sta
tem
en
ts o
r o
ur
kn
ow
led
ge
ob
tain
ed
in t
he
au
dit o
r o
the
rwis
e a
pp
ea
rs to
be
ma
teri
ally
mis
sta
ted
.
Ou
r fin
al a
cco
un
ts a
ud
it w
ork
wa
s c
om
ple
ted
on
site
du
rin
g A
pri
l a
nd
Ma
y 2
01
8. O
ur
fin
din
gs
are
su
mm
ari
se
d in
th
is r
ep
ort
. W
e h
ave
no
t id
en
tifie
d a
ny a
dju
stm
en
tsto
th
e fin
an
cia
l
sta
tem
en
ts th
at im
pa
ct o
n th
e T
rust’s r
eta
ine
d d
eficit p
ositio
n. A
ud
it a
dju
stm
en
ts a
re d
eta
iled
in A
pp
en
dix
A
Su
bje
ct to
ou
tsta
nd
ing
qu
eri
es b
ein
g r
eso
lve
d, w
e a
nticip
ate
issu
ing
an
un
qu
alif
ied
au
dit
op
inio
n fo
llow
ing
th
e B
oa
rd m
ee
tin
g o
n 2
5 M
ay 2
01
8. T
he
se
ou
tsta
nd
ing it
em
s in
clu
de
:
-ite
ms h
igh
ligh
ted in
re
d w
ith
in th
e b
od
y o
f th
is r
ep
ort
;
-re
ce
ipt o
f m
an
ag
em
en
t re
pre
sen
tatio
n le
tte
r, fin
al ve
rsio
n o
f th
e A
nn
ua
l R
ep
ort
; A
nn
ua
l
Go
ve
rna
nce
Sta
tem
en
t a
nd
fin
an
cia
l sta
tem
en
ts; a
nd
-fin
al re
vie
w a
nd
qu
alit
y c
on
tro
l ch
eckin
g o
f th
e a
ud
it file
.
We h
ave
co
nclu
de
d th
at
the
oth
er
info
rma
tio
n p
ub
lish
ed
with
th
e fin
an
cia
l sta
tem
en
ts, w
hic
h
inclu
de
s th
e A
nn
ua
l R
ep
ort
, is
co
nsis
tent w
ith
ou
r kn
ow
led
ge
of yo
ur
org
an
isa
tion
an
d th
e
fin
an
cia
l sta
tem
en
ts w
e h
ave
au
dite
d.
Va
lue
fo
r M
on
ey
arr
an
ge
me
nts
Un
de
rth
eC
od
ew
ea
rere
qu
ire
dto
rep
ort
by
exce
ptio
nw
he
the
r,in
ou
ro
pin
ion
:
•th
eT
rust
has
no
tm
ad
ep
rop
er
arr
ang
em
en
tsto
secu
re
econ
om
y,
eff
icie
ncy
and
effe
ctive
ne
ss
inits
use
of
reso
urc
es
('th
e
va
lue
for
mo
ne
y(V
FM
)co
nclu
sio
n').
We h
ave
co
mp
lete
do
ur
risk b
ase
d r
evie
w o
f th
e T
rust’s v
alu
e fo
r m
on
ey a
rra
ng
em
en
ts. W
e
ha
ve
sa
tisfie
d o
urs
elv
es th
at W
irra
l Un
ive
rsity T
ea
ch
ing
Ho
sp
ita
l Tru
st
NH
S F
ou
nd
atio
n T
rust
ha
s p
rop
er
arr
an
ge
me
nts
to
se
cu
re e
co
no
my, e
ffic
ien
cy a
nd
eff
ective
ne
ss in
its
use
of
reso
urc
es, e
xce
pt fo
r in
re
latio
n to
su
sta
ina
ble
re
so
urc
e d
ep
loym
en
t a
nd
in
form
ed
de
cis
ion
ma
kin
g a
s s
et o
ut in
se
ctio
n 3
of
this
re
po
rt.
We th
ere
fore
an
ticip
ate
issu
ing
a q
ua
lifie
d ‘e
xce
pt fo
r’ v
alu
e fo
r m
on
ey c
on
clu
sio
n. O
ur
fin
din
gs a
re s
um
ma
rise
d in
se
ctio
n D
of th
is r
ep
ort
.
Sta
tuto
ryd
uti
es
Th
eN
atio
na
lH
ea
lth
Se
rvic
eA
ct2
00
6(‘
the
Act’)
als
ore
qu
ire
su
sto
:
•re
po
rtto
yo
uif
we
ha
ve
app
lied
an
yo
fth
ea
dditio
nalp
ow
ers
an
d
du
tie
sa
scri
be
dto
us
un
de
rth
eA
ct;
an
d
•ce
rtify
the
clo
su
reo
fth
ea
ud
it.
We h
ave
no
t e
xe
rcis
ed
an
y o
f o
ur
ad
ditio
na
l sta
tuto
ry p
ow
ers
or
du
tie
s.
We h
ave
co
mp
lete
d th
e m
ajo
rity
of w
ork
un
de
r th
e C
od
e a
nd
exp
ect to
be
ab
le to
ce
rtify th
e
co
mp
letio
n o
f th
e a
ud
it w
he
n w
e g
ive
ou
r a
ud
it o
pin
ion
.
.
Item
4 -
Ext
erna
l Aud
it O
pini
ons
- A
udit
Fin
ding
s R
epor
t
Page 42 of 60
© 2
018 G
rant
Th
orn
ton U
K L
LP
| A
udit F
indin
g R
eport
for
WU
TH
NH
S F
oundatio
n T
rust
| 2
017/1
8
DR
AF
T
4
Su
mm
ary
Ove
rvie
w o
f th
e s
co
pe
of
ou
r a
ud
it
Th
is A
ud
it F
ind
ing
s p
rese
nts
th
e o
bse
rva
tio
ns a
risin
g fro
m th
e a
ud
it th
at a
re s
ign
ific
an
t to
the
re
sp
on
sib
ility
of th
ose
ch
arg
ed
with
go
ve
rna
nce
to
ove
rse
e th
e fin
an
cia
l re
po
rtin
g
pro
ce
ss, a
s r
eq
uir
ed
by I
nte
rna
tio
na
l Sta
nd
ard
on
Au
ditin
g (
UK
) 2
60
an
d th
e C
od
e o
f A
ud
it
Pra
ctice
(‘th
e C
od
e’)
. It
s c
on
ten
ts h
ave
be
en
dis
cu
sse
d w
ith
ma
na
ge
me
nt.
As a
ud
ito
r w
e a
re r
esp
on
sib
le fo
r p
erf
orm
ing
th
e a
ud
it, in
acco
rda
nce
with
In
tern
atio
na
l
Sta
nd
ard
s o
n A
ud
itin
g (
UK
), w
hic
h is d
ire
cte
d to
wa
rds f
orm
ing
an
d e
xp
ressin
g a
n o
pin
ion
on
th
e fin
an
cia
l sta
tem
en
ts th
at h
ave
be
en
pre
pa
red
by m
an
ag
em
en
t w
ith
th
e o
ve
rsig
ht o
f
tho
se
ch
arg
ed
with
go
ve
rna
nce
. T
he
au
dit o
f th
e fin
an
cia
l sta
tem
en
ts d
oe
s n
ot re
lieve
ma
na
ge
me
nt o
r th
ose
ch
arg
ed
with
go
ve
rna
nce
of
the
ir r
esp
on
sib
ilitie
s fo
r th
e p
rep
ara
tio
n
of th
e fin
an
cia
l sta
tem
en
ts.
Au
dit
ap
pro
ac
h
Ou
r a
ud
it a
pp
roa
ch
wa
s b
ase
d o
n a
th
oro
ug
h u
nd
ers
tan
din
g o
f th
e T
rust's
bu
sin
ess a
nd
is
risk b
ase
d, a
nd
in
pa
rtic
ula
r in
clu
de
d:
Au
dit
ap
pro
ac
h (
co
ntin
ue
d)
•A
n e
va
lua
tio
n o
f th
e T
rust's
in
tern
al co
ntr
ol e
nvir
on
me
nt in
clu
din
g IT
syste
ms a
nd
co
ntr
ols
an
d s
pe
cific
ally
th
e d
ata
tra
nsfe
r a
nd
co
ntr
ols
asso
cia
ted
with
th
e iC
lou
d
ge
ne
ral le
dg
er
imp
lem
en
tatio
n; a
nd
•S
ub
sta
ntive
te
stin
g o
n s
ign
ific
an
t tr
an
sa
ctio
ns a
nd
ma
teri
al a
cco
un
t b
ala
nce
s,
inclu
din
g th
e p
roce
du
res o
utlin
ed
in
th
is r
ep
ort
in
re
latio
n to
th
e k
ey a
ud
it r
isks
.
Co
nc
lus
ion
We h
ave
su
bsta
ntially
co
mp
lete
d o
ur
au
dit o
f yo
ur
fin
ancia
l sta
tem
en
ts a
nd
su
bje
ct
to
ou
tsta
nd
ing q
ue
rie
s b
ein
g r
eso
lve
d, w
e a
nticip
ate
issu
ing
an
un
qu
alif
ied a
ud
it o
pin
ion
follo
win
g th
e B
oa
rd m
ee
tin
g o
n 2
5 M
ay 2
01
8,.
Fin
an
cia
l sta
tem
ents
Ma
teri
alit
y c
alc
ula
tio
ns r
em
ain
s th
e s
am
e a
s r
ep
ort
ed
in
ou
r a
ud
it p
lan
. W
e d
eta
il in
the
ta
ble
be
low
ou
r a
sse
ssm
ent o
f m
ate
ria
lity fo
r th
e T
rust.
Ou
r a
pp
roa
ch
to
ma
teri
ali
ty
Th
e c
on
ce
pt o
f m
ate
ria
lity is
fu
nd
am
en
tal t
o th
e p
rep
ara
tio
n o
f th
e fin
an
cia
l sta
tem
en
ts a
nd
the
au
dit p
roce
ss a
nd
ap
plie
s n
ot o
nly
to
th
e m
on
eta
ry m
issta
tem
en
ts b
ut a
lso
to
dis
clo
su
re
req
uir
em
en
ts a
nd
ad
he
ren
ce
to
acce
pta
ble
acco
un
tin
g p
ractice
an
d a
pp
lica
ble
law
. Ma
teri
ali
tyA
mo
un
t(£
)Q
ua
lita
tive
fa
cto
rs c
on
sid
ere
d
Ma
teri
alit
y fo
r th
e fin
an
cia
l
sta
tem
en
ts
6,6
64
,00
0C
on
sid
ere
d to
be
th
e le
ve
l a
bo
ve
wh
ich
use
rs o
f th
e a
cco
un
ts w
ou
ld
wis
hto
be
aw
are
in
th
e c
on
text
of o
ve
rall
exp
en
ditu
re.
Pe
rfo
rma
nce
ma
teri
alit
y4
,99
8,0
00
Asse
sse
dto
be
75
% o
f fin
an
cia
l sta
tem
en
t m
ate
ria
lity.
Tri
via
lm
att
ers
30
0,0
00
Ba
se
du
po
n th
e m
inim
um
th
resh
old
se
t b
y t
he
Na
tio
na
l A
ud
it O
ffic
e
for
De
pa
rtm
en
t o
f H
ea
lth
co
nso
lidatio
n p
urp
ose
s. T
his
ha
s in
cre
ase
d
fro
m th
e p
revio
us le
ve
l o
f £
25
0,0
00
sta
ted
in
th
e A
ud
it P
lan
.
Ma
teri
alit
yfo
r sp
ecific
tra
nsa
ctio
ns,
ba
lan
ce
s o
r d
isclo
su
res
Se
nio
r m
an
ag
er
rem
un
era
tio
n2
0,0
00
Th
is ite
m m
eri
ts a
lo
we
r m
ate
ria
lity th
at fin
an
cia
l sta
tem
en
t le
ve
l
ma
teri
alit
y d
ue
to
be
ing
of p
art
icu
lar
inte
rest to
th
e p
ub
lic.
Page 43 of 60
© 2
018 G
rant
Th
orn
ton U
K L
LP
| A
udit F
indin
g R
eport
for
WU
TH
NH
S F
oundatio
n T
rust
| 2
017/1
8
DR
AF
T
5
Sig
nif
ica
nt
au
dit
ris
k -
Go
ing
co
nc
ern
Fin
an
cia
l sta
tem
ents
Ou
r re
sp
on
sib
ilit
y
As a
ud
ito
rs, w
e a
re r
eq
uir
ed
to
“o
bta
in s
uff
icie
nt a
pp
rop
ria
te a
ud
it e
vid
en
ce
ab
ou
t th
e a
pp
rop
ria
ten
ess o
f m
an
ag
em
ent's
use
of th
e g
oin
g c
on
ce
rn a
ssu
mp
tion
in th
e p
rep
ara
tio
n a
nd
pre
se
nta
tio
n o
f th
e fin
an
cia
l sta
tem
en
ts a
nd
to
co
nclu
de
wh
eth
er
the
re is a
ma
teri
al u
nce
rta
inty
ab
ou
t th
e e
ntity
's a
bili
ty t
o c
on
tin
ue
as a
go
ing
co
nce
rn”
(IS
A (
UK
) 5
70
).
Go
ing
co
nc
ern
ma
teri
al u
nc
ert
ain
ty d
isc
los
ure
s
Th
e T
rust
incu
rre
d a
£1
7.4
mill
ion
fin
an
cia
l de
ficit in
de
live
rin
g its
se
rvic
es in
20
17
/18
an
d h
as r
ece
ive
d fin
an
cia
l re
ve
nu
e s
up
po
rt v
ia w
ork
ing
ca
pita
l lo
an
s o
f £
23
mill
ion
du
rin
g th
e y
ea
r.
Ma
na
ge
me
nt a
nticip
ate
s th
at it m
ay ta
ke
a n
um
be
r o
f ye
ars
be
fore
th
e T
rust’s in
co
me
eq
ua
ls o
r e
xce
ed
s its
exp
en
ditu
re. T
he
Tru
stw
ill t
he
refo
re r
eq
uir
e fu
rth
er
ca
sh
su
pp
ort
via
reve
nu
e lo
an
s to
me
ets
it lia
bili
tie
s in
20
18
/19
an
d 2
01
9/2
0. T
he
so
urc
e a
nd
va
lue
of
the
lo
an
s h
as y
et
to b
e c
on
firm
ed
. W
e th
ere
fore
id
en
tifie
d th
e a
de
qu
acy o
f d
isclo
sure
s r
ela
tin
g to
ma
teri
al u
nce
rta
intie
s th
at m
ay c
ast d
ou
bt o
n t
he
Tru
st’s a
bili
ty to
co
ntin
ue
as a
go
ing
co
nce
rn in
th
e fin
an
cia
l sta
tem
en
ts a
s a
sig
nific
an
t ri
sk r
eq
uir
ing
sp
ecia
l au
dit c
on
sid
era
tion
. G
ive
n
the
se
nsitiv
e n
atu
re o
f th
ese
dis
clo
su
res, w
e h
ave
id
en
tifie
d th
is a
ke
y a
ud
it m
att
er
for
the
au
dit.
Au
dit
or
co
mm
en
tary
Ma
na
ge
me
nt'
s a
ss
es
sm
en
t p
roc
es
s
A G
oin
g C
on
ce
rn P
ap
er
wa
s p
rese
nte
d a
nd
ag
ree
d
by m
an
ag
em
en
t a
t th
e F
ina
nce
, B
usin
ess,
Pe
rfo
rma
nce
an
d A
ssu
ran
ce
Co
mm
itte
e o
n 2
3 M
arc
h
20
18
. T
his
se
to
ut th
e b
asis
fo
r m
an
ag
em
en
t’s g
oin
g
co
nce
rn p
resu
mp
tio
n in
clu
din
g:
•In
terp
reta
tio
n o
f G
oin
g C
on
ce
rn r
eq
uir
em
en
ts
•Ju
dg
em
en
ts a
nd
assu
mp
tio
ns ta
ke
n
Ma
na
ge
me
nt co
nclu
de
d th
at th
at th
ere
is a
ma
teri
al
un
ce
rta
inty
re
ga
rdin
g g
oin
g c
on
ce
rn, a
lth
ou
gh
sa
feg
ua
rds w
ere
id
en
tifie
d.
In a
dd
ressin
g th
e r
isk
rela
tin
g to
go
ing
co
nce
rn w
e h
ave
:
co
nsid
ere
d th
e T
rust’s fin
an
cia
l pla
ns fo
r 2
01
8/1
9 a
nd
20
19
/20
, in
clu
din
g c
ash
flo
w f
ore
ca
st a
nd
th
e u
nd
erl
yin
g
assu
mp
tio
ns fo
r ca
sh
su
pp
ort
co
nsid
ere
d m
an
ag
em
en
t’s a
sse
ssm
ent o
f g
oin
g c
on
ce
rn in
th
e fin
an
cia
l sta
tem
en
tsa
nd
as p
rese
nte
d to
th
e F
ina
nce
Bu
sin
ess P
erf
orm
an
ce
an
d A
ssu
ran
ce
Co
mm
itte
e
re
ferr
ed
ma
na
ge
me
nt’s ju
stifica
tio
n fo
r g
oin
g c
on
ce
rn to
Gra
nt T
ho
rnto
nN
atio
na
l C
on
sis
ten
cy P
an
el to
en
su
re th
at a
co
nsis
ten
t a
pp
roa
ch
is ta
ke
n b
y a
ud
ito
rs
We h
ave
co
nsid
ere
d m
an
ag
em
en
t’s in
itia
l asse
ssm
en
t o
f g
oin
g c
on
ce
rn a
nd
th
e p
roce
ss fo
llow
ed
. W
e a
gre
e w
ith
ma
na
ge
me
nt th
at th
ere
is a
ma
teri
al u
nce
rta
inty
to
dis
clo
se
in t
he
fin
an
cia
l sta
tem
en
ts.
Wo
rk p
erf
orm
ed
We h
ave
re
vie
we
d th
e m
an
ag
em
en
t’s d
isclo
su
re
go
ing
co
nce
rn c
ritica
l acco
un
tin
g ju
dg
em
en
t
dis
clo
su
re n
ote
1.3
.1 to
th
e a
cco
un
ts a
nd
su
gg
este
d
ad
ditio
na
l na
rra
tive
to
co
mp
ly w
ith
th
e r
eq
uir
em
en
ts
of th
e G
rou
p A
cco
un
tin
g M
an
ua
l.
We
revie
we
d t
he
Tru
st’s fin
an
cia
l pla
n fo
r 2
01
8/1
9 a
nd
th
e c
ash
re
qu
ire
me
nt u
p to
31
Ma
y 2
01
9. W
e h
ave
als
ore
vie
we
d t
he
ma
in c
om
mis
sio
ne
r co
ntr
acts
wh
ich
are
sig
ne
d fo
r 2
01
8/1
9 a
nd
th
e a
sso
cia
ted c
ash
flo
ws t
ha
t w
ill a
ccru
e. T
he
20
18
/19
Pla
n
fore
ca
sts
a fin
an
cia
l de
ficit o
f £
25
mill
ion
with
an
un
de
rlyin
g c
ash
lo
an
re
qu
ire
me
nt o
f £
25
mill
ion
We a
gre
e w
ith
ma
na
ge
me
nt’s a
sse
ssm
en
t th
at a
ma
teri
al u
nce
rta
inty
exis
ts r
eg
ard
ing
th
e u
nco
mm
itte
d lo
an
£2
5 m
illio
n
req
uir
em
en
t fo
r 2
01
8/1
9.
Ma
na
ge
me
nt in
ten
de
d to
am
en
d th
e n
arr
ative
to
th
e g
oin
g c
on
ce
rn n
ote
to
in
clu
de
qu
an
tita
tive
da
ta, w
hic
h w
as p
rovid
ed
on
ce
th
e 2
01
8/1
9 F
ina
ncia
l Pla
n w
as s
ub
mitte
d to
NH
SI
on
30
Ap
ril 2
01
8.
Co
nc
lud
ing
co
mm
en
tsW
e c
on
sid
er
the
go
ing
co
nce
rn d
isclo
su
re r
eg
ard
ing
fu
ture
ava
ilab
ility
of
fun
ds to
be
a k
ey a
ud
it m
att
er
to d
eta
il in
ou
r
en
ha
nce
da
ud
it r
ep
ort
(a
ud
it o
pin
ion
)
No
fu
rth
er
evid
en
ce
ha
s c
om
e to
lig
ht
ab
ou
t e
ve
nts
or
co
nd
itio
ns id
en
tifie
d in
th
e c
ou
rse
of
the
au
dit th
at m
ay c
ast sig
nific
an
t
do
ub
t o
n th
e e
ntity
's a
bili
ty to
co
ntin
ue
as a
go
ing
co
nce
rn.
Item
4 -
Ext
erna
l Aud
it O
pini
ons
- A
udit
Fin
ding
s R
epor
t
Page 44 of 60
© 2
018
Gra
nt T
horn
ton
UK
LLP
| A
udit F
indin
g R
eport
for
Wirra
l Univ
ers
ity T
eachin
g H
ospital N
HS
Fo
undatio
n T
rust
| 2
017/1
86
Sig
nif
ica
nt
au
dit
ris
ks
Ris
ks
id
en
tifi
ed
in
ou
r A
ud
it P
lan
Co
mm
en
tary
Im
pro
pe
rre
ve
nu
ere
co
gn
itio
n
Un
de
rIS
A(U
K)
24
0th
ere
isa
reb
utta
ble
pre
sum
ed
risk
tha
tre
ve
nu
em
ay
be
mis
sta
ted
due
toth
eim
pro
pe
r
reco
gn
itio
no
fre
ve
nu
e.
89
%o
fth
eT
rust’s
inco
me
isfr
om
pa
tie
nt
ca
reactivitie
s
an
dco
ntr
acts
with
NH
Sco
mm
issio
ne
rs.
Th
ese
co
ntr
acts
inclu
de
the
rate
sfo
ra
nd
leve
lo
fp
atie
nt
ca
re
activity
tob
eu
nd
ert
aken
by
the
Tru
st.
Th
eT
rust
recog
nis
es
pa
tien
tca
reactivity
incom
ed
urin
gth
eye
ar
ba
se
don
the
co
mple
tio
no
fth
ese
activitie
s.
Pa
tie
nt
ca
rea
ctivitie
sp
rovid
ed
tha
ta
read
ditio
na
lto
tho
se
inco
rpo
rate
din
the
se
con
tracts
(activity
ba
sed
co
ntr
act
va
ria
tion
sa
nd
no
n-c
on
tract
activity
inco
me
)a
resu
bje
ct
tove
rifica
tio
na
nd
ag
reem
en
tb
yth
eco
mm
issio
ne
rs.
As
su
ch
,th
ere
isth
erisk
tha
tin
co
me
isre
co
gn
ise
din
the
acco
unts
for
these
ad
ditio
na
lse
rvic
es
tha
tis
not
su
bse
qu
en
tly
ag
ree
dto
by
the
co
mm
issio
ne
rs.
We th
ere
fore
id
en
tifie
d th
e o
ccu
rre
nce
an
d a
ccu
racy o
f
activity b
ase
d c
on
tra
ct in
co
me
an
d n
on
-co
ntr
act a
ctivity
inco
me
as a
sig
nific
ant ri
sk, w
hic
h w
as o
ne
of th
e m
ost
sig
nific
ant a
sse
sse
d r
isks o
f m
ate
ria
l m
issta
tem
en
t.
Au
dit
or
co
mm
en
tary
In a
dd
ressin
g th
e r
isk r
ela
tin
g to
in
co
me
fro
m p
atie
nt a
ctivitie
s w
e;
e
va
lua
ted
th
e T
rust's a
cco
un
ting
po
licy fo
r re
co
gn
itio
n o
f in
co
me
fro
m p
atie
nt ca
re a
ctivitie
s fo
r a
pp
rop
ria
ten
ess
(an
d e
va
lua
tin
g th
e a
pp
rop
ria
ten
ess o
f ch
an
ge
s fro
m th
e p
rio
r ye
ar)
g
ain
ed
an
un
de
rsta
nd
ing
of th
e T
rust's
syste
m fo
r a
cco
un
ting
fo
r in
co
me
fro
m p
atie
nt ca
re a
ctivitie
s a
nd
eva
lua
tin
g
the
de
sig
n o
f th
e a
sso
cia
ted c
on
tro
ls
o
bta
ine
d a
n e
xce
ptio
n r
ep
ort
fo
rm th
e D
ep
art
me
nt o
f H
ea
lth
ad
So
cia
l C
are
(D
HS
C)
tha
t d
eta
ils d
iffe
ren
ce
s in
rep
ort
ed
in
co
me
an
d e
xp
en
ditu
re; a
nd
re
ce
iva
ble
s a
nd
pa
ya
ble
s b
etw
ee
n N
HS
bo
die
s; a
gre
ein
g th
e fig
ure
s in
th
e
exce
ptio
n r
ep
ort
to
th
e T
rust’s fin
an
cia
l re
co
rds; a
nd
fo
r d
iffe
ren
ce
s a
bo
ve
£3
00
,00
0 c
alc
ula
ted
by t
he
DH
SC
fo
r th
e
Tru
st’s m
ain
co
mm
issio
ne
rs, o
bta
inin
g c
orr
ob
ora
tin
g e
vid
en
ce
to
su
pp
ort
th
e a
mo
un
t re
co
rde
d in
th
e fin
an
cia
l
sta
tem
en
ts b
y t
he
Tru
st
a
gre
ed
, o
n a
sa
mp
le b
asis
, a
mo
un
ts r
eco
gn
ise
d a
s in
co
me
fro
m p
atie
nt ca
re a
ctivitie
s in
th
e fin
an
cia
l sta
tem
en
ts to
sig
ne
d c
on
tra
cts
, co
ntr
act va
ria
tio
ns, in
vo
ice
s o
r o
the
r su
pp
ort
ing
do
cu
me
nta
tion
a
gre
ed
on
a s
am
ple
ba
sis
, re
ce
iva
ble
ba
lan
ce
s d
ue
at
31
Ma
rch
20
18
to
su
bse
qu
ent ca
sh
re
ce
ipts
or
invo
ice
s
Ou
r a
ud
it w
ork
ha
s n
ot id
en
tifie
d a
ny issu
es in
re
sp
ect o
f fr
au
du
len
t tr
an
sa
ctio
ns w
ith
in r
eve
nu
e r
eco
gn
itio
n o
rth
e r
isks
ide
ntifie
d. T
he
ma
jori
ty o
f in
co
me
re
ce
ive
d fro
m N
HS
co
mm
issio
ne
rs c
om
es fro
m W
irra
l CC
G.
M
an
ag
em
en
to
ve
rrid
e o
f c
on
tro
ls
Un
de
r IS
A (
UK
) 2
40
th
ere
is a
no
n-r
eb
utt
ab
le
pre
su
me
d r
isk th
at th
e r
isk o
f m
an
ag
em
en
t o
ve
r-ri
de
of
co
ntr
ols
is p
rese
nt in
all
en
titie
s. T
he
Tru
st
face
s
pre
ssu
re to
me
et e
xte
rna
l ta
rge
ts, a
nd
th
is c
ou
ld
po
ten
tia
lly p
lace
ma
na
ge
me
nt u
nd
er
un
du
e p
ressu
re in
term
s o
f h
ow
th
ey r
ep
ort
pe
rfo
rma
nce
.
We id
en
tifie
d m
an
ag
em
en
t o
ve
rrid
e o
f co
ntr
ols
as a
risk r
eq
uir
ing
sp
ecia
l au
dit c
on
sid
era
tio
n.
Au
dit
or
co
mm
en
tary
In a
dd
ressin
g th
e p
resu
me
d r
isk o
f m
an
ag
em
en
t o
ve
rrid
e o
f co
ntr
ols
we
ha
ve
:
re
vie
we
d t
he
en
tity
le
ve
l co
ntr
ols
;
te
ste
d th
e c
om
ple
ten
ess o
f th
e jo
urn
als
listin
g;
id
en
tifie
d a
nd
te
ste
d h
igh
ris
k o
r u
nu
su
al jo
urn
als
en
trie
s;
re
vie
we
d t
he
acco
un
tin
g e
stim
ate
s, ju
dg
em
en
ts a
nd
de
cis
ion
s m
ad
e b
y m
an
ag
em
ent;
an
d
re
vie
we
d u
nu
su
al s
ign
ific
an
t tr
an
sa
ctio
ns.
Ou
r a
ud
it w
ork
ha
s n
ot id
en
tifie
d a
ny e
vid
en
ce
of
ma
na
ge
me
nt o
ve
r-ri
de
of co
ntr
ols
. In
pa
rtic
ula
r th
e fin
din
gs o
f o
ur
revie
w o
f jo
urn
al co
ntr
ols
an
d te
stin
g o
f jo
urn
al e
ntr
ies h
as n
ot id
en
tifie
d a
ny s
ign
ific
ant is
su
es.
Fin
an
cia
l S
tate
me
nts
Page 45 of 60
© 2
018
Gra
nt T
horn
ton
UK
LLP
| A
udit F
indin
g R
eport
for
Wirra
l Univ
ers
ity T
eachin
g H
ospital N
HS
Fo
undatio
n T
rust
| 2
017/1
87
Sig
nif
ica
nt
au
dit
ris
ks
Ris
ks
id
en
tifi
ed
in
ou
r A
ud
it P
lan
Co
mm
en
tary
V
alu
ati
on
of
pro
pe
rty,
pla
nt
an
d e
qu
ipm
en
t
Th
e T
rust
reva
lue
sits la
nd
an
d b
uild
ing
s o
n a
fiv
e-
ye
arl
y b
asis
to
en
su
re th
e c
arr
yin
g v
alu
e in
th
e
Tru
st’s fin
an
cia
l sta
tem
en
ts is
no
t m
ate
ria
lly d
iffe
ren
t
fro
m fa
ir v
alu
e a
t th
e fin
an
cia
l sta
tem
en
ts d
ate
. T
he
last fu
ll re
va
lua
tio
n w
as p
erf
orm
ed
at
31
Ma
rch
20
14
.
In th
e in
terv
en
ing
ye
ars
be
twe
en
fu
ll re
va
lua
tio
ns
inte
rim
de
skto
p r
eva
lua
tio
ns a
re p
erf
orm
ed
on
an
an
nu
al b
asis
.
Th
is v
alu
atio
n r
ep
rese
nts
a s
ign
ific
ant e
stim
ate
by
ma
na
ge
me
nt in
th
e fin
an
cia
l sta
tem
en
ts.
We th
ere
fore
id
en
tifie
d v
alu
atio
n o
f p
rop
ert
y a
s a
sig
nific
ant ri
sk, w
hic
h w
as o
ne
of th
e m
ost sig
nific
ant
asse
sse
d r
isks o
f m
ate
ria
l mis
sta
tem
ent.
Au
dit
or
co
mm
en
tary
In a
dd
ressin
g th
e v
alu
atio
nri
sk w
e h
ave
:
o
bta
ine
d m
an
ag
em
en
t's a
sse
ssm
en
t o
f th
e v
alu
atio
n o
f p
rop
ert
y, p
lan
t a
nd
eq
uip
me
nt a
nd
un
de
rsta
nd
ing
th
e
va
lua
tio
n p
roce
ss, in
clu
din
g k
ey c
on
tro
ls a
nd
assu
mp
tio
ns u
se
d b
y m
an
ag
em
en
t;
a
sse
sse
d th
e c
om
pe
ten
ce
, o
bje
ctivity a
nd
exp
ert
ise
of
ma
na
ge
me
nt’s v
alu
er,
in
clu
din
g u
sin
g th
e w
ork
of a
n a
ud
ito
r’s
exp
ert
to
asse
ss w
he
the
r w
e c
ou
ld p
lace
re
lian
ce
on
ma
na
ge
me
nt’s e
xp
ert
va
lue
r’s
wo
rk;
a
sse
sse
d th
e a
pp
rop
ria
ten
ess o
f th
e in
str
uctio
ns is
su
ed
to
th
e v
alu
er
an
d th
e s
co
pe
of th
eir
wo
rk,
inclu
din
g th
e
co
mp
lete
ness o
f th
e d
ata
pro
vid
ed
to
th
e v
alu
er;
fo
r th
e la
nd
an
d b
uild
ing
s a
sse
ts r
eva
lue
d in
th
e y
ea
r, a
gre
ed
th
e v
alu
atio
n fro
m th
e v
alu
er's
de
sk to
p r
ep
ort
to
asse
t
reg
iste
r a
nd
th
e fin
an
cia
l sta
tem
en
ts;
ch
alle
ng
ed
the
assu
mp
tio
ns m
ad
e b
y m
an
ag
em
en
t in
re
latio
n to
th
e m
od
ern
eq
uiv
ale
nt a
sse
t va
lua
tio
n a
nd
th
e
ap
pro
pri
ate
ness o
f th
e r
ela
ted
alte
rna
tive
sin
gle
site
va
lua
tio
n m
eth
od
olo
gy;
a
gre
ed
th
e to
tal va
lua
tio
n a
dju
stm
en
ts m
ad
e to
th
e fix
ed
asse
t re
gis
ter
an
d th
e fin
an
cia
l sta
tem
en
ts to
th
e v
alu
atio
n
rep
ort
pro
vid
ed
by t
he
Tru
st’s v
alu
er.
Ou
r a
ud
it w
ork
ha
s n
ot id
en
tifie
d a
ny s
ign
ific
an
t is
su
es in
re
latio
n to
va
lua
tio
n o
f p
rop
ert
y, p
lan
t a
nd
eq
uip
me
nt.
Fin
an
cia
l sta
tem
ents
Item
4 -
Ext
erna
l Aud
it O
pini
ons
- A
udit
Fin
ding
s R
epor
t
Page 46 of 60
© 2
018
Gra
nt T
horn
ton
UK
LLP
| A
udit F
indin
g R
eport
for
Wirra
l Univ
ers
ity T
eachin
g H
ospital N
HS
Fo
undatio
n T
rust
| 2
017/1
88
Sig
nif
ica
nt
au
dit
ris
ks
Ris
ks
id
en
tifi
ed
in
ou
r A
ud
it P
lan
Co
mm
en
tary
Im
ple
me
nta
tio
no
f n
ew
ge
ne
ral le
dg
er
sys
tem
Th
e T
rust’s g
en
era
l le
dg
er
syste
m is p
rovid
ed
by
No
rth
Ea
st P
atc
he
s (
NE
P).
In D
ece
mb
er
20
17
, th
e T
rust
be
ca
me
a fir
st w
ave
pilo
t fo
r th
e im
ple
me
nta
tion
of a
sig
nific
ant g
en
era
l
led
ge
r u
pg
rad
e. A
s a
re
su
lt, th
ere
we
re t
wo
ge
ne
ral
led
ge
r syste
ms in
op
era
tio
n d
uri
ng
20
17
/18
. T
he
tra
nsa
ctio
ns fo
r th
e fir
st e
igh
t m
on
ths o
f 2
01
7/1
8
we
re t
ran
sfe
rre
d in
to th
e u
pd
ate
d g
en
era
l le
dg
er
syste
m d
uri
ng
th
e y
ea
r. T
he
re is a
ris
k o
ve
r th
e
co
mp
lete
ness a
nd
accu
racy o
f th
e d
ata
tra
nsfe
r.
We th
ere
fore
id
en
tifie
d th
e im
ple
me
nta
tio
n o
f th
e
ge
ne
ral le
dg
er
up
gra
de
as a
sig
nific
an
t ri
sk, w
hic
h
wa
s o
ne
of th
e m
ost sig
nific
an
t a
sse
sse
d r
isks o
f
ma
teri
al m
issta
tem
ent.
Au
dit
or
co
mm
en
tary
In a
dd
ressin
g th
e r
isk a
sso
cia
ted
with
th
e le
dg
er
imp
lem
en
tatio
n w
e h
ave
:
co
mp
lete
da
n IT
en
vir
on
me
nt re
vie
w b
y o
ur
IT a
ud
it s
pe
cia
lists
to
do
cu
me
nt,
eva
lua
te a
nd
te
st th
e IT
co
ntr
ols
op
era
tin
g w
ith
th
e g
en
era
l le
dg
er
syste
m;
m
ap
pe
d th
e tra
nsfe
r o
f th
e fir
st e
igh
t m
on
ths o
f tr
an
sa
ctio
ns a
nd
ba
lan
ce
s fro
m th
e o
ld 2
01
7/1
8 g
en
era
l le
dg
er
to th
e
op
en
ing
po
sitio
n in
th
e n
ew
ge
ne
ral le
dg
er
for
20
17
/18
.
Ou
r a
ud
it w
ork
ha
s n
ot id
en
tifie
d a
ny s
ign
ific
an
t is
su
es in
re
latio
n to
th
e n
ew
le
dg
er
imp
lem
en
tation
.
Fin
an
cia
l sta
tem
ents
Page 47 of 60
© 2
018
Gra
nt T
horn
ton
UK
LLP
| A
udit F
indin
g R
eport
for
Wirra
l Univ
ers
ity T
eachin
g H
ospital N
HS
Fo
undatio
n T
rust
| 2
017/1
89
Rea
so
na
bly
po
ssib
le a
ud
it r
isk
sR
isk
s id
en
tifi
ed
in
ou
r A
ud
it
Pla
nC
om
me
nta
ry
E
mp
loye
ere
mu
ne
rati
on
Pa
yro
ll e
xp
en
ditu
re r
ep
rese
nts
a
sig
nific
ant p
erc
en
tag
e (
67
%)
of th
e
Tru
st’s o
pe
ratin
g e
xp
en
se
s.
As th
e p
ayro
ll e
xp
en
ditu
re c
om
es
fro
m a
nu
mb
er
of
ind
ivid
ua
l
tra
nsa
ctio
ns a
nd
tw
o d
iffe
ren
t su
b-
syste
ms th
ere
is a
ris
k th
at p
ayro
ll
exp
en
ditu
re in
th
e a
cco
un
ts c
ou
ld
be
un
de
rsta
ted
. W
e th
ere
fore
ide
ntifie
d c
om
ple
ten
ess o
f p
ayro
ll
exp
en
se
s a
s a
ris
k r
eq
uir
ing
pa
rtic
ula
r a
ud
it a
tte
ntio
n.
Au
dit
or
co
mm
en
tary
As p
art
of
ou
r a
ud
it w
ork
we
ha
ve
;
g
ain
ed
an
un
de
rsta
nd
ing
of th
e s
yste
ms u
se
d to
re
co
gn
ise
pa
yro
ll e
xp
en
ditu
re a
nd
eva
lua
ted
th
e d
esig
n o
f th
e a
sso
cia
ted
co
ntr
ols
re
co
ncile
d e
xp
en
ditu
re o
n e
mp
loye
es r
eco
rde
d in
th
e g
en
era
l le
dg
er
to t
he
pa
yro
ll syste
m r
ep
ort
s fo
r e
ach
mo
nth
to
en
su
re th
at a
ll
tra
nsa
ctio
ns fro
m th
e p
ayro
ll syste
m a
re r
efle
cte
d in
th
e fin
an
cia
l sta
tem
en
ts
te
ste
d o
n a
sa
mp
le b
asis
, p
aym
en
ts m
ad
e to
em
plo
ye
es d
uri
ng
th
e y
ea
r to
co
nfirm
th
e c
om
ple
tene
ss a
nd
accu
racy o
f e
mp
loye
e
rem
un
era
tio
n
p
erf
orm
ed
a s
ub
sta
ntive
an
aly
tica
l pro
ce
du
reo
f p
ayro
ll co
sts
an
d in
ve
stig
atin
g u
nu
su
al v
ari
atio
ns to
en
su
re th
at a
ll e
xp
ecte
d c
osts
we
re
inclu
de
d in
th
e fin
an
cia
l sta
tem
en
ts
Ou
r a
ud
it w
ork
ha
s n
ot id
en
tifie
d a
ny s
ign
ific
an
t is
su
es in
re
latio
n to
em
plo
ye
e r
em
un
era
tio
n.
O
pe
rati
ng
ex
pe
ns
es
No
n-p
ay e
xp
en
se
s o
n o
the
r g
oo
ds
an
d s
erv
ice
s a
lso
re
pre
se
nts
a
sig
nific
ant p
erc
en
tag
e (
33
%)
of th
e
Tru
st’s o
pe
ratin
g e
xp
en
se
s.
Ma
na
ge
me
nt u
se
s ju
dg
em
en
t to
estim
ate
accru
als
of u
n-i
nvo
ice
d
co
sts
.
We id
en
tifie
d c
om
ple
ten
ess o
f n
on
-
pa
y e
xp
en
se
s a
s a
ris
k r
eq
uir
ing
pa
rtic
ula
r a
ud
it a
tte
ntio
n:
Au
dit
or
co
mm
en
tary
As p
art
of
ou
r a
ud
it w
ork
we
ha
ve
;
g
ain
ed
an
un
de
rsta
nd
ing
of th
e s
yste
ms u
se
d to
re
co
gn
ise
exp
en
ditu
re o
n g
oo
ds a
nd
se
rvic
es a
nd
ye
ar-
en
d a
ccru
als
, a
nd
eva
lua
tin
g
the
de
sig
n o
f th
e a
sso
cia
ted c
on
tro
ls
re
vie
we
d t
he
ye
ar-
en
d r
eco
ncili
ation
of th
e s
ub
sid
iary
in
terf
ace
an
d g
en
era
l le
dg
er
co
ntr
ol a
cco
un
t, to
en
su
re th
at a
ll tr
an
sa
cti
ons fro
m
the
su
bsid
iary
syste
m a
re r
efle
cte
d in
th
e fin
an
cia
l sta
tem
en
ts
te
ste
d, o
n a
sa
mp
le b
asis
, p
aym
en
ts m
ad
e d
uri
ng
th
e y
ea
r to
en
su
re th
ey a
re p
rop
erl
y r
ep
ort
ed
in
th
e fin
an
cia
l sta
tem
en
ts
te
ste
d, o
n a
sa
mp
le b
asis
, p
ost ye
ar-
en
d p
aym
en
ts o
ne
mo
nth
aft
er
ye
ar-
en
d to
co
nfirm
th
e c
om
ple
ten
ess o
f ye
ar-
en
d c
red
ito
rs a
nd
accru
als
an
d e
nsu
re th
at e
xp
en
ditu
re w
as b
ein
g a
lloca
ted
to
th
e c
orr
ect p
eri
od
u
se
d a
su
mm
ary
of in
co
me
fro
m th
e T
rust a
cco
un
ted
fo
r b
y o
the
r N
HS
bo
die
s, p
rovid
ed
by D
HS
C,
to id
en
tify
an
y s
ign
ific
an
t d
iffe
ren
ce
s
ab
ove
£3
00
,00
0 in
exp
en
ditu
re a
nd
an
y a
sso
cia
ted
pa
ya
ble
ba
lan
ce
s w
ith
co
ntr
actin
g b
od
ies
co
nsid
ere
d th
e c
om
ple
ten
ess o
f re
po
rte
d a
ccru
als
an
d p
rovis
ion
s b
y r
evie
w o
f T
rust
co
mm
itte
e m
inu
tes a
nd
re
po
rts a
nd
eve
nts
su
bse
qu
en
t to
th
e y
ea
r e
nd
Ou
r a
ud
it w
ork
ha
s n
ot id
en
tifie
d a
ny s
ign
ific
an
t is
su
es in
re
latio
n to
exp
en
ditu
re r
eco
gn
itio
n a
nd
co
mp
lete
ne
ss o
r th
e c
om
ple
ten
ess o
f th
e
ye
ar
en
d c
red
ito
r b
ala
nce
.
Fin
an
cia
l sta
tem
ents
Item
4 -
Ext
erna
l Aud
it O
pini
ons
- A
udit
Fin
ding
s R
epor
t
Page 48 of 60
© 2
018
Gra
nt T
horn
ton
UK
LLP
|
Aud
it F
indi
ngs
Rep
ort
for
WU
TH
NH
S F
oundation T
rust
| 20
17/1
810
Ac
co
un
tin
g p
oli
cie
s
Fin
an
cia
l sta
tem
ents
Ac
co
un
tin
ga
rea
Su
mm
ary
of
po
lic
yC
om
me
nts
As
se
ss
me
nt
Re
ve
nu
e r
ec
og
nit
ion
Inco
me
in
re
sp
ect o
f se
rvic
es p
rovid
ed
is r
eco
gn
ise
d
wh
en
an
d to
th
e e
xte
nt
tha
t p
erf
orm
an
ce
occu
rs, a
nd
is
me
asu
red
at th
e fa
ir v
alu
e o
f th
e c
on
sid
era
tio
n
rece
iva
ble
.T
he
ma
in s
ou
rce
of
inco
me
fo
r th
e T
rust is
co
ntr
acts
with
co
mm
issio
ne
rs in
re
sp
ect o
f h
ea
lth
ca
re
se
rvic
es.
T
he
Tru
st's
re
ve
nu
e r
eco
gn
itio
n p
olic
ies a
re c
on
sis
ten
t w
ith
sta
nd
ard
acco
un
tin
g p
olic
ies a
nd
with
gu
ida
nce
issu
ed
by N
HS
I
N
HS
I’s A
nn
ua
l R
ep
ort
ing
Ma
nu
al re
qu
ire
s th
e T
rust's
re
ve
nu
e
reco
gn
itio
n to
be
co
ng
rue
nt w
ith
th
e p
rin
cip
les o
f IA
S 1
8
P
olic
ies a
re a
de
qu
ate
ly d
isclo
se
d w
ith
in t
he
acco
un
ts a
nd
we
ha
ve
no
t b
ee
n m
ad
e a
wa
re o
f a
ny n
ew
ma
teri
al r
eve
nu
e s
tre
am
s
wh
ich
wo
uld
re
qu
ire
ad
ditio
na
l po
licie
s to
be
pu
t in
pla
ce
T
he
Tru
st
exe
rcis
es ju
dg
em
en
t in
arr
ivin
g a
t th
e in
co
me
du
e fo
r
pa
rt c
om
ple
te s
pe
lls. T
he
in
co
me
fo
r th
is h
as b
ee
n a
gre
ed
to
th
e
thir
d p
art
y c
on
firm
atio
n u
sin
g th
e in
tra
-NH
S a
gre
em
en
t o
f
ba
lan
ce
s e
xe
rcis
e.
Ju
dg
em
en
ts a
nd
es
tim
ate
sK
ey e
stim
ate
s a
nd
ju
dg
em
en
ts in
clu
de
:
U
se
ful lif
e o
f P
PE
R
eva
lua
tio
ns
Im
pa
irm
en
ts
P
rovis
ion
s a
nd
co
ntin
ge
nt lia
bili
tie
s
A
ccru
als
P
art
ially
co
mp
lete
d s
pe
lls
Fo
re
ach
of th
ese
estim
ate
s a
nd
ju
dg
em
en
ts w
e h
ave
co
nsid
ere
d
the
:
a
pp
rop
ria
ten
ess o
f th
e p
olic
yu
nd
er
the
re
leva
nt a
cco
un
tin
g
fra
me
wo
rk
e
xte
nt
of ju
dg
em
en
t in
vo
lve
d
a
de
qu
acy o
f d
isclo
su
re o
f a
cco
un
tin
g p
olic
y
We h
ave
re
vie
we
d th
e s
up
po
rtin
g e
vid
en
ce
fo
r th
e c
on
tin
ge
nt
liab
ilitie
s in
th
e d
raft
fin
an
cia
l sta
tem
en
ts a
nd
ob
tain
ed
ad
ditio
na
l
leg
al e
vid
en
ce
fro
m m
an
ag
em
en
t to
su
pp
ort
th
eir
asse
ssm
ent.
We a
re s
atisfie
d th
at th
e T
rust's
use
of e
stim
ate
s a
nd
ju
dg
em
en
ts is
relia
ble
an
d p
rop
erl
y d
isclo
se
d.
As
se
ss
me
nt
M
arg
ina
l a
cco
un
tin
g p
olicy w
hic
h c
ou
ld p
ote
ntia
lly b
e o
pe
n t
o c
ha
lle
ng
e b
y r
eg
ula
tors
A
cco
un
tin
g p
olicy a
pp
rop
ria
te b
ut sco
pe
fo
r im
pro
ve
d d
isclo
su
re
A
cco
un
tin
g p
olicy a
pp
rop
ria
te a
nd
dis
clo
su
res s
uff
icie
nt
Page 49 of 60
© 2
018
Gra
nt T
horn
ton
UK
LLP
|
Aud
it F
indi
ngs
Rep
ort
for
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TH
NH
S F
oundation T
rust
| 20
17/1
811
Ac
co
un
tin
g p
oli
cie
s
Fin
an
cia
l sta
tem
ents
Ac
co
un
tin
ga
rea
Su
mm
ary
of
po
lic
yC
om
me
nts
As
se
ss
me
nt
La
nd
an
d b
uil
din
gs
va
lua
tio
n
me
tho
ds
All
lan
da
nd
bu
ildin
gs a
re r
eva
lue
d b
y p
rofe
ssio
nal
va
lue
rse
ve
ry 5
ye
ars
. T
he
la
st fu
ll re
va
lua
tio
n w
as
pe
rfo
rme
d a
t 3
1 M
arc
h 2
01
4. In
th
e in
terv
en
ing
ye
ars
be
twe
en
fu
ll re
va
lua
tio
ns in
teri
m d
eskto
p r
eva
lua
tio
ns
are
pe
rfo
rme
d o
n a
n a
nn
ua
l b
asis
.
Va
lua
tio
ns a
re c
arr
ied
ou
t b
y C
ush
ma
n a
nd
Wa
kefield
,
wh
ich
is e
xte
rna
l to
th
e T
rust,
an
d in
acco
rda
nce w
ith
the
Ro
ya
l In
stitu
te o
f C
ha
rte
red
Su
rve
yo
rs (
RIC
S)
Ap
pra
isa
l an
d V
alu
atio
n M
an
ua
l.
In b
etw
ee
n th
ese
va
lua
tio
ns th
e T
rust
co
nsid
ers
wh
eth
er
asse
ts a
re s
ub
ject to
sig
nific
ant vo
latilit
y a
nd
,
wh
ere
th
is is th
e c
ase
, u
nd
ert
ake
s a
n a
nn
ua
l va
lua
tio
n.
Th
e T
rust
relie
s u
po
n C
ush
ma
n a
nd
Wakefie
ld (
C&
W)
as e
xte
rna
l
va
lue
rs. C
&W
pe
rfo
rme
d a
de
skto
p r
eva
lua
tio
n o
f la
nd
an
d b
uild
ing
s
at 3
1 M
arc
h 2
01
8. A
t 1
Ap
ril 2
01
6, th
e A
rro
we
Pa
rk a
nd
Cla
tte
rbri
dg
esite
s w
ere
re
va
lue
d o
nto
a s
ing
le s
ite
mo
de
rn
eq
uiv
ale
nt a
sse
t b
asis
.
We a
re s
atisfie
d th
e T
rust's
acco
un
tin
g p
olic
y a
nd
acco
un
tin
g
tre
atm
en
t o
f th
e la
nd
an
d b
uild
ing
s v
alu
atio
n c
om
plie
s w
ith
th
e
req
uir
em
en
ts o
f th
e N
HS
Gro
up
Acco
un
tin
g M
an
ua
l (G
AM
).
Oth
er
cri
tic
al p
oli
cie
sT
he
Tru
st
ha
s a
do
pte
d th
e s
tan
da
rd a
cco
un
ting
po
licie
s a
s s
et o
ut in
th
e G
AM
.
We h
ave
re
vie
we
d th
e a
cco
un
tin
g p
olic
ies a
do
pte
d b
y t
he
Tru
st
an
d
co
nsid
er
tha
t th
ey a
re c
on
sis
tently a
pp
lied
in
th
e fin
an
cia
l
sta
tem
en
ts a
nd
are
co
nsis
ten
t w
ith
th
e G
AM
.
As
se
ss
me
nt
M
arg
ina
l a
cco
un
tin
g p
olicy w
hic
h c
ou
ld p
ote
ntia
lly b
e o
pe
n t
o c
ha
lle
ng
e b
y r
eg
ula
tors
A
cco
un
tin
g p
olicy a
pp
rop
ria
te b
ut sco
pe
fo
r im
pro
ve
d d
isclo
su
re
A
cco
un
tin
g p
olicy a
pp
rop
ria
te a
nd
dis
clo
su
res s
uff
icie
nt
Item
4 -
Ext
erna
l Aud
it O
pini
ons
- A
udit
Fin
ding
s R
epor
t
Page 50 of 60
© 2
018
Gra
nt T
horn
ton
UK
LLP
|
Aud
it F
indi
ngs
Rep
ort
for
WU
TH
NH
S F
oundation T
rust
| 20
17/1
812
Oth
er
co
mm
un
ica
tio
n r
eq
uir
em
en
ts
Fin
an
cia
l S
tate
me
nts
We s
et o
ut b
elo
w d
eta
ils o
f o
the
r m
att
ers
wh
ich
we
, a
s a
ud
ito
rs, a
re r
eq
uir
ed
by a
ud
itin
g s
tan
da
rds a
nd
th
e C
od
e to
co
mm
un
ica
te to
th
ose
ch
arg
ed
with
go
ve
rna
nce
.
Iss
ue
Co
mm
en
tary
M
att
ers
in
re
lati
on
to
fra
ud
W
e h
ave
no
t b
ee
n m
ad
e a
wa
re o
f a
ny in
cid
en
ts w
hic
h w
ou
ld im
pa
ct o
n o
ur
au
dit
risk a
sse
ssm
ent in
th
e p
eri
od
.
N
o issu
es h
ave
be
en
id
en
tifie
d d
uri
ng
th
e c
ou
rse
of o
ur
au
dit p
roce
du
res.
M
att
ers
in
re
lati
on
to
re
late
d
pa
rtie
s
We a
re n
ot a
wa
re o
f a
ny r
ela
ted
pa
rty tra
nsa
ctio
ns w
hic
h h
ave
no
t b
ee
n d
isclo
se
d.
M
att
ers
in
re
lati
on
to
la
ws
an
d
reg
ula
tio
ns
Y
ou
ha
ve
no
t m
ad
e u
s a
wa
re o
f a
ny s
ign
ific
ant in
cid
en
ce
s o
f n
on
-co
mp
liance
with
re
leva
nt la
ws a
nd
re
gu
latio
ns.
W
e h
ave
no
t id
en
tifie
d a
ny in
cid
en
ce
s o
f n
on
-co
mp
lian
ce
fro
m o
ur
au
dit w
ork
.
W
ritt
en
re
pre
se
nta
tio
ns
A
le
tte
r o
f re
pre
se
nta
tio
n h
as b
ee
n r
eq
ue
ste
d fro
m th
e T
rust.
As w
ell
as s
tan
da
rd r
ep
rese
nta
tio
n w
e h
ave
re
qu
este
d m
an
ag
em
en
t to
co
nfirm
th
eir
asse
ssm
ent th
at ca
sh
lo
an
s w
ill b
e a
va
ilab
le d
uri
ng
20
18
/19
to
su
pp
ort
th
e g
oin
g c
on
ce
rn a
sse
rtio
n. W
e h
ave
als
o
req
ue
ste
d a
sp
ecific
re
pre
se
nta
tio
n r
eg
ard
ing
th
e a
cco
un
tin
g fo
r a
sp
ecific
co
ntin
ge
nt lia
bili
ty a
s s
et o
ut o
n p
ag
e 1
0 o
f th
is r
ep
ort
.
C
on
firm
ati
on
re
qu
es
ts f
rom
thir
d p
art
ies
We o
bta
ine
dd
ire
ct co
nfirm
ation
s fro
m N
HS
Im
pro
ve
me
nt (N
HS
I) f
or
loa
ns.
W
e r
eq
ue
ste
d fro
m m
an
ag
em
en
t p
erm
issio
n to
se
nd
co
nfirm
ation
re
qu
ests
to
oth
er
thir
d p
art
y b
an
kers
. T
his
pe
rmis
sio
n w
as g
ran
ted
an
d th
e r
eq
ue
sts
we
re s
en
t.
D
isc
los
ure
s
Ou
r re
vie
w f
ou
nd
no
ma
teri
al o
mis
sio
ns in
th
e fin
an
cia
l sta
tem
en
ts.
A
ud
it e
vid
en
ce
an
d
ex
pla
na
tio
ns
/sig
nif
ican
t
dif
fic
ult
ies
A
ll in
form
atio
n a
nd
exp
lan
atio
ns r
eq
ue
ste
d fro
m m
an
ag
em
en
t w
as p
rovid
ed
.
Page 51 of 60
© 2
018
Gra
nt T
horn
ton
UK
LLP
|
Aud
it F
indi
ngs
Rep
ort
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TH
NH
S F
oundation T
rust
| 20
17/1
813
Va
lue f
or
Mon
ey
Ris
k a
ss
es
sm
en
t
We c
arr
ied
ou
t a
n in
itia
l ri
sk a
sse
ssm
en
t in
Fe
bru
ary
20
18
an
d id
en
tifie
d a
nu
mb
er
of
sig
nific
ant ri
sks in
re
sp
ect o
f sp
ecific
are
as o
f p
rop
er
arr
an
ge
me
nts
usin
g th
e
gu
ida
nce
co
nta
ine
d in
AG
N0
3. W
e c
om
mu
nic
ate
d th
ese
ris
ks to
yo
u in
ou
r A
ud
it P
lan
da
ted
15
Fe
bru
ary
20
18
.
We h
ave
co
ntin
ue
d o
ur
revie
w o
f re
leva
nt d
ocu
me
nts
up
to
th
e d
ate
of g
ivin
g o
ur
rep
ort
, a
nd
ha
ve
no
t id
en
tifie
d a
ny f
urt
he
r sig
nific
ant ri
sks w
he
re w
e n
ee
d to
pe
rfo
rm
furt
he
r w
ork
.
We c
arr
ied
ou
t fu
rth
er
wo
rk o
nly
in
re
sp
ect o
f th
e s
ign
ific
an
t ri
sks w
e id
en
tifie
d fro
m
ou
r in
itia
l a
nd
on
go
ing
ris
k a
sse
ssm
en
t. W
he
re o
ur
co
nsid
era
tion
of th
e s
ign
ific
an
t
risks d
ete
rmin
ed
th
at a
rra
ng
em
en
ts w
ere
no
t o
pe
ratin
g e
ffe
ctive
ly, w
e h
ave
use
d th
e
exa
mp
les o
f p
rop
er
arr
an
ge
me
nts
fro
m A
GN
03
to
exp
lain
th
e g
ap
s in
pro
pe
r
arr
an
ge
me
nts
th
at w
e h
ave
re
po
rte
d in
ou
r V
FM
co
nclu
sio
n.
Va
lue
fo
r M
on
ey
Ba
ck
gro
un
dto
ou
rV
FM
ap
pro
ac
h
We a
re r
eq
uir
ed
to
sa
tisfy
ou
rse
lve
s th
at th
e T
rust h
as m
ad
e p
rop
er
arr
an
ge
me
nts
fo
r
se
cu
rin
g e
co
no
my, e
ffic
ien
cy a
nd
eff
ective
ne
ss in
its
use
of
reso
urc
es a
nd
re
po
rt b
y
exce
ptio
n w
he
re w
e a
re n
ot sa
tisfie
d. T
his
is k
no
wn
as th
e V
alu
e fo
r M
on
ey (
VF
M)
co
nclu
sio
n.
We a
re r
eq
uir
ed
to
ca
rry o
ut su
ffic
ien
t w
ork
to
sa
tisfy
ou
rse
lve
s th
at p
rop
er
arr
an
ge
me
nts
are
in
pla
ce
at
the
Tru
st.
In
ca
rryin
g o
ut th
is w
ork
, w
e a
re r
eq
uir
ed
to
fo
llow
th
e N
AO
's
Au
dito
r G
uid
an
ce
No
te 3
(A
GN
03
) is
su
ed
in
No
ve
mb
er
20
17
. A
GN
03
id
en
tifie
s o
ne
sin
gle
cri
teri
on
fo
r a
ud
ito
rs to
eva
lua
te:
“In
all
sig
nific
an
tre
spe
cts
,th
ea
ud
ite
db
ody
take
sp
rope
rly
info
rme
dde
cis
ion
sa
nd
de
plo
ys
reso
urc
es
toa
ch
ieve
pla
nn
ed
an
dsu
sta
ina
ble
ou
tco
me
sfo
rta
xp
aye
rsa
nd
loca
lp
eo
ple
.”
Th
isis
su
pp
ort
ed
by
thre
esu
b-c
rite
ria
,a
sse
to
utb
elo
w:
Info
rme
d
de
cis
ion
ma
kin
g
Va
lue
fo
r
Mo
ne
y
arr
an
ge
me
nts
cri
teri
aS
us
tain
ab
le
res
ou
rce
de
plo
ym
en
t
Wo
rkin
g
wit
h p
art
ne
rs
& o
the
r th
ird
pa
rtie
s
Item
4 -
Ext
erna
l Aud
it O
pini
ons
- A
udit
Fin
ding
s R
epor
t
Page 52 of 60
© 2
018
Gra
nt T
horn
ton
UK
LLP
|
Aud
it F
indi
ngs
Rep
ort
for
WU
TH
NH
S F
oundation T
rust
| 20
17/1
814
Ou
r w
ork
AG
N 0
3 r
eq
uir
es u
s to
dis
clo
se
ou
r vie
ws o
n s
ign
ific
ant q
ua
lita
tive
asp
ects
of th
e T
rust's
arr
an
ge
me
nts
fo
r d
eliv
eri
ng
eco
no
my, e
ffic
ien
cy a
nd
eff
ective
ne
ss.
We h
ave
fo
cu
se
d o
ur
wo
rk o
n th
e s
ign
ific
an
t ri
sks th
at w
e id
en
tifie
d in
th
e T
rust's
arr
an
ge
me
nts
. In
arr
ivin
g a
t o
ur
co
nclu
sio
n, o
ur
ma
in c
on
sid
era
tion
s w
ere
:
U
nd
er
the
Su
sta
ina
ble
Re
so
urc
e D
ep
loym
en
t cri
teri
a w
e h
ave
co
nsid
ere
d th
e T
rust’s
fin
an
cia
l pe
rfo
rma
nce
in 2
01
7/1
8 a
ga
inst th
e c
on
tro
l to
tal ta
rge
t se
t b
y N
HS
I a
nd
th
e
de
ficit p
lan
fo
r 2
01
8/1
9, in
clu
din
g th
e r
eq
uir
em
en
t fo
r ca
sh
lo
an
s to
op
era
te
U
nd
er
the
In
form
ed
De
cis
ion
Ma
kin
g c
rite
ria
we
ha
ve
co
nsid
ere
d th
e g
ove
rna
nce
co
nce
rns r
ep
ort
ed
by N
HS
I fo
llow
ing
alle
ga
tio
ns m
ad
e a
t th
e T
rust
in D
ece
mb
er
20
17
,
the
un
de
rta
kin
gs a
gre
ed
with
NH
SI
an
d th
e tu
rno
ve
r a
t B
oa
rd le
ve
l
We h
ave
se
t o
ut m
ore
de
tail
on
th
e r
isks w
e id
en
tifie
d, th
e r
esu
lts o
f th
e w
ork
we
pe
rfo
rme
d a
nd
th
e c
on
clu
sio
ns w
e d
rew
fro
m th
is w
ork
on
th
e p
ag
es o
ve
rle
af.
Ove
rall
co
nc
lus
ion
Ou
r re
vie
w o
f th
e T
rust’s a
rra
ng
em
en
ts fo
r se
cu
rin
g e
co
no
my, e
ffic
ien
cy a
nd
eff
ective
ne
ss
in its
use
of re
so
urc
es id
en
tifie
d th
e fo
llow
ing
ma
tte
rs:
T
he
Tru
st
ha
s s
et a
de
ficit b
ud
ge
t o
f £
25
mill
ion
fo
r 2
01
8/1
9, w
hic
h in
clu
de
s a
co
st
imp
rove
me
nt p
rog
ram
me
ta
rge
t o
f £
11
mill
ion
. T
he
Tru
st
do
es n
ot h
ave
su
ffic
ien
t ca
sh
to m
ee
t its c
om
mitm
en
ts w
ith
ou
t re
ce
ivin
g s
ign
ific
an
t e
xte
rna
l fu
nd
ing
fro
m th
e
De
pa
rtm
en
t o
f H
ea
lth
an
d S
ocia
l C
are
. T
he
Tru
st’s r
elia
nce
on
re
ve
nu
e s
up
po
rt
ind
ica
tes w
ea
kn
esse
s in
th
e T
rust’s a
rra
ng
em
en
ts fo
r se
ttin
g a
su
sta
ina
ble
bu
dg
et w
ith
su
ffic
ien
t ca
pa
city to
ab
so
rb e
me
rgin
g c
ost p
ressu
res.
D
uri
ng
th
e y
ea
r, a
n in
de
pe
nd
en
t re
vie
w o
f th
e T
rust’s g
ove
rna
nce
arr
an
ge
me
nts
fo
un
d
cu
ltu
ral, b
eh
avio
ura
l a
nd
go
ve
rna
nce
issu
es a
t th
e T
rust.
Th
e o
utc
om
e o
f th
is r
evie
w
led
to
ch
an
ge
s a
t se
nio
r B
oa
rd le
ve
l in
clu
din
g C
ha
irm
an
an
d C
hie
f E
xe
cu
tive
, w
hic
h
ha
ve
ad
ve
rse
ly im
pa
cte
d th
e T
rust’s le
ad
ers
hip
ca
pa
city a
nd
ca
pa
bili
ty. In
Ma
rch
20
18
,
NH
S I
mp
rove
me
nt in
vo
ke
d a
n a
dd
itio
na
l lic
en
se
co
nd
itio
n o
n th
e T
rust u
nd
er
se
ctio
n
11
1 o
f th
e H
ea
lth
an
d S
ocia
l C
are
Act 2
01
2.
Ove
rall
co
nc
lus
ion
(co
ntin
ue
d)
Th
ese
ma
tte
rs a
re e
vid
en
ce
of w
ea
kn
esse
s in
th
e p
rop
er
arr
an
ge
me
nts
fo
r:
su
sta
ina
ble
re
so
urc
e d
ep
loym
en
t in
pla
nn
ing
fin
an
ce
s e
ffe
ctive
ly to
su
pp
ort
th
e
su
sta
ina
ble
de
live
ry o
f str
ate
gic
pri
ori
tie
s a
nd
ma
inta
in s
tatu
tory
fu
nctio
ns; a
nd
in
form
ed
de
cis
ion
ma
kin
g b
y a
ctin
g in
th
e p
ub
lic in
tere
st,
th
rou
gh
de
mo
nstr
ating
an
d a
pp
lyin
g th
e p
rin
cip
les a
nd
va
lue
s o
f so
un
d g
ove
rna
nce
.
Exce
pt
for
the
ma
tte
rs w
e id
en
tifie
d in
re
sp
ect o
f S
usta
ina
ble
Re
so
urc
e
De
plo
ym
en
t a
nd
In
form
ed
De
cis
ion
Ma
kin
g, th
e T
rust
ha
d p
rop
er
arr
an
ge
me
nts
in
all
sig
nific
ant re
sp
ects
. W
e th
ere
fore
pro
po
se
to
giv
e a
qu
alif
ied
'exce
pt
for'
co
nclu
sio
n o
n y
ou
r a
rra
ng
em
en
ts fo
r se
cu
rin
g e
co
no
my, e
ffic
ien
cy a
nd
eff
ective
ne
ss in
yo
ur
use
of re
so
urc
es.
Re
co
mm
en
da
tio
ns
fo
r im
pro
ve
me
nt
No
re
co
mm
en
da
tion
s h
ave
be
en
ne
ce
ssa
ry a
risin
g fro
m o
ur
au
dit.
Sig
nif
ica
nt
dif
fic
ult
ies
in
un
de
rta
kin
g o
ur
wo
rk
We d
id n
ot id
en
tify
an
y s
ign
ific
an
t d
ifficu
ltie
s in
un
de
rta
kin
g o
ur
wo
rk o
n y
ou
r
arr
an
ge
me
nts
wh
ich
we
wis
h t
o d
raw
to
yo
ur
att
en
tio
n.
Sig
nif
ica
nt
ma
tte
rs d
isc
us
se
d w
ith
ma
na
ge
me
nt
Th
ere
we
re n
o m
att
ers
wh
ere
no
oth
er
evid
en
ce
wa
s a
va
ilab
le o
r m
att
ers
of su
ch
sig
nific
ance
to
ou
r co
nclu
sio
n o
r th
at w
e r
eq
uir
ed
wri
tte
n r
ep
rese
nta
tio
n fro
m
ma
na
ge
me
nt o
r th
ose
ch
arg
ed
with
go
ve
rna
nce
.
Va
lue f
or
Mon
ey
Va
lue
fo
r M
on
ey
Page 53 of 60
© 2
018
Gra
nt T
horn
ton
UK
LLP
|
Aud
it F
indi
ngs
Rep
ort
for
WU
TH
NH
S F
oundation T
rust
| 20
17/1
815
Ke
y f
ind
ing
s
We s
et o
ut b
elo
w o
ur
ke
y fin
din
gs a
ga
inst th
e s
ign
ific
an
t ri
sks w
e id
en
tifie
d th
rou
gh
ou
r in
itia
l ri
sk a
sse
ssm
ent a
nd
fu
rth
er
risks id
en
tifie
d th
rou
gh
ou
r o
ng
oin
g r
evie
w o
f d
ocu
me
nts
.
Va
lue f
or
Mon
ey
Sig
nif
ica
nt
ris
kF
ind
ing
sC
on
clu
sio
n
S
us
tain
ab
leR
es
ou
rce
Dep
loym
en
t–
Fin
an
cia
l
res
ou
rce
sa
nd
futu
res
us
tain
ab
ilit
y
Th
e T
rust
de
live
red
a £
17
.4 m
illio
n d
eficit
in 2
01
7/1
8
co
mp
are
d to
th
e c
on
tro
l to
tal se
t b
y N
HS
I o
f £
0.4
mill
ion
. T
he
de
ficit in
clu
de
d a
£3
.9 m
illio
n g
ain
fro
m
lan
d s
ale
at th
e C
latt
erb
rid
ge
site
an
d S
usta
ina
bili
ty
an
d T
ran
sfo
rma
tio
n (
ST
F)
fun
din
g o
f £
3.4
mill
ion
.
Co
st Im
pro
ve
me
nt S
avin
gs (
CIP
)d
eliv
ere
d £
8.4
mill
ion
of
the
NH
SI
£1
5 m
illio
n ta
rge
t. A
s a
re
su
lto
f
the
de
ficit p
ositio
n th
e T
rust h
as b
ee
n d
ep
en
de
nt
up
on
£2
3 m
illio
n o
f w
ork
ing
ca
pita
l lo
an
s fro
m D
H t
o
me
et co
mm
itm
en
ts.
Fo
r 2
01
8/1
9, th
e T
rust h
as s
ub
mitte
d a
de
ficit p
lan
of
£2
5 m
illio
n a
nd
fo
ra
th
ird
ye
ar
do
es n
ot a
gre
e to
th
e
NH
SI
co
ntr
ol to
tal (£
11
mill
ion
su
rplu
s).
In
arr
ivin
g a
t
the
de
ficit p
lan
th
e T
rust
req
uir
es £
25
mill
ion
of
wo
rkin
g c
ap
ita
l lo
an
s fro
m D
HS
C w
hic
h is n
ot ye
t
form
ally
ag
ree
d.
Ina
rriv
ing
at
ou
rco
nclu
sio
nw
eh
ave
ca
rrie
do
ut
the
follo
win
gw
ork
:
re
vie
we
dth
eT
rust’s
arr
ang
em
en
tsfo
ra
gre
ein
ga
nd
rep
ort
ing
pro
gre
ss
up
on
the
20
17
/18
fina
ncia
lpla
n
inclu
din
gp
rog
ress
on
ach
ievin
gC
IPsa
vin
gs
an
dth
e
Re
co
ve
ryP
lan
re
vie
we
dfin
an
cia
lpe
rfo
rma
nce
rep
ort
sto
Boa
rda
nd
Fin
an
ce
Busin
ess
Pe
rfo
rma
nce
Assu
rance
Co
mm
itte
e
(FB
AC
)to
un
de
rsta
nd
wh
yth
ed
eficit
aro
se
and
ma
na
ge
me
nt’s
resp
on
se
m
et
with
se
nio
rm
an
age
me
nt
toco
nfirm
the
irp
lan
sto
co
ntr
olth
ed
eficit
re
vie
we
dth
eT
rust’s
arr
an
ge
men
tsfo
rid
en
tify
ing
a
su
sta
ina
ble
futu
rese
rvic
econ
figu
ratio
nin
the
med
ium
term
,in
clu
din
gth
ep
rocess
for
ag
reein
ga
bud
ge
tfo
r
20
18
/19
Ove
rall
ou
rre
vie
wh
as
co
nclu
de
dth
at
the
Tru
st
has
exh
ibite
dso
me
are
as
of
we
akne
ss
inno
td
eliv
erin
gth
e
co
ntr
ol
tota
lse
tb
yN
HS
Ia
nd
no
tach
ievin
gth
eb
ud
get
set
for
20
17/1
8a
nd
these
are
rep
ort
ed
inth
eN
HS
Ilic
ence
un
de
rta
kin
gs
ag
ree
dM
arc
h2
01
8re
po
rte
do
ve
rle
af.
Th
eT
rust
ha
sa
lso
not
be
en
ab
leto
se
ta
ba
lan
ced
bu
dg
et
for
20
18
/19
or
ide
ntify
asusta
ina
ble
med
ium
term
pla
nth
at
will
bri
ng
the
fina
nce
sb
ack
into
ba
lance
,a
ltho
ugh
we
recog
nis
eth
at
sig
nific
an
te
ffort
sa
reb
ein
gm
ad
eto
wo
rk
clo
se
lyw
ith
pa
rtne
rsa
cro
ss
the
Wirra
l,in
clu
din
gth
eC
CG
an
dC
ou
ncil
and
with
Cou
nte
ss
of
Ch
este
rH
ospitalto
dri
ve
eff
icie
ncie
sa
nd
imp
rove
pa
tie
ntca
re.
The
Tru
st
ha
s s
et a
de
ficit b
ud
ge
t o
f £
25
mill
ion
fo
r
20
18
/19
, w
hic
h in
clu
de
s a
co
st im
pro
ve
me
nt p
rog
ram
me
targ
et o
f £
11
mill
ion
. T
he
Tru
st
do
es n
ot h
ave
su
ffic
ien
t
ca
sh
to
me
et its c
om
mitm
ents
with
ou
t re
ce
ivin
g s
ign
ific
ant
exte
rna
l fu
nd
ing
fro
m th
e D
ep
art
me
nt o
f H
ea
lth
an
d S
ocia
l
Ca
re. T
he
Tru
st’s r
elia
nce
on
re
ve
nu
e s
up
po
rt in
dic
ate
s
we
akn
esse
s in
th
e T
rust’s a
rra
ng
em
en
ts fo
r se
ttin
g a
su
sta
ina
ble
bu
dg
et w
ith
su
ffic
ien
t ca
pa
city to
ab
so
rb
em
erg
ing
co
st p
ressu
res.
This
ma
tte
r is
evid
en
ce
of w
ea
kn
esse
s in
th
e p
rop
er
arr
an
ge
me
nts
fo
r:su
sta
ina
ble
re
so
urc
e d
ep
loym
en
t in
pla
nn
ing
fin
an
ce
s e
ffe
ctive
ly to
su
pp
ort
th
e s
usta
ina
ble
de
live
ry o
f str
ate
gic
pri
ori
tie
s a
nd
ma
inta
in s
tatu
tory
fun
ctio
ns a
s p
rescri
be
d in
th
e N
AO
Va
lue
fo
r M
on
ey
Co
nclu
sio
n g
uid
an
ce
.
Item
4 -
Ext
erna
l Aud
it O
pini
ons
- A
udit
Fin
ding
s R
epor
t
Page 54 of 60
© 2
018
Gra
nt T
horn
ton
UK
LLP
|
Aud
it F
indi
ngs
Rep
ort
for
WU
TH
NH
S F
oundation T
rust
| 20
17/1
816
Ke
y f
ind
ing
s
We s
et o
ut b
elo
w o
ur
ke
y fin
din
gs a
ga
inst th
e s
ign
ific
an
t ri
sks w
e id
en
tifie
d th
rou
gh
ou
r in
itia
l ri
sk a
sse
ssm
ent a
nd
fu
rth
er
risks id
en
tifie
d th
rou
gh
ou
r o
ng
oin
g r
evie
w o
f d
ocu
me
nts
.
Va
lue f
or
Mon
ey
Sig
nif
ica
nt
ris
kF
ind
ing
sC
on
clu
sio
n
In
form
ed
de
cis
ion
ma
kin
g-
Th
eTrust’s
arr
an
ge
me
nts
toa
dd
res
sth
eg
ove
rna
nc
eis
su
es
rep
ort
ed
toN
HS
Id
uri
ng
De
ce
mb
er
20
17
InD
ece
mb
er
20
17
,N
HS
Ire
ce
ive
da
rep
ort
rais
ing
se
rio
us
cultu
ral,
be
ha
vio
ura
la
nd
go
ve
rnan
ce
issue
s
at
the
Tru
st.
Inre
sp
on
se
,N
HS
Ico
mm
issio
ned
an
ind
ep
en
de
ntin
ve
stig
atio
nto
revie
wth
eis
su
es.
We
ha
ve
co
nsid
ere
dth
efin
din
gs
of
the
NH
SI
rep
ort
an
dco
ndu
cte
da
de
ep
div
ein
toke
ya
reas
wh
ich
imp
actu
po
no
ur
VF
Mco
nclu
sio
nd
utie
s.
Ina
rriv
ing
at
ou
rco
nclu
sio
nw
eh
ave
ca
rrie
do
ut
the
follo
win
gw
ork
:
re
vie
we
dth
eN
HS
Ire
po
rtda
ted
Fe
bru
ary
20
18
by
Ca
role
Ta
ylo
r-B
row
ne
tound
ers
tan
dth
ee
xte
nt
of
go
ve
rnan
ce
con
ce
rns
rais
ed
reg
ard
ing
the
con
duct
of
se
nio
rm
an
age
men
ta
tth
eT
rust
and
the
exte
nt
of
un
acce
pta
ble
cu
ltu
rala
nd
be
ha
vio
ura
lis
su
es
rais
ed
re
vie
we
dth
ea
dd
itio
nal
lice
nce
un
de
rtakin
gsig
ned
by
the
Acting
Ch
ief
Exe
cu
tive
on
28
Ma
rch
20
18
to
ad
dre
ss
ma
na
gem
ent’s
resp
onse
toth
efin
an
cia
l
su
sta
ina
bili
tycon
ce
rns
an
dA
&E
pe
rfo
rma
nce
at
the
Tru
st
m
et
with
se
nio
rm
ana
gem
ent
toun
de
rsta
nd
their
pla
ns
toa
dd
ress
the
con
ce
rns
rais
ed
an
dth
ee
xte
nt
tow
hic
h
the
co
nce
rns
ofsta
ffa
rea
dd
resse
da
tth
eT
rust
m
et
with
the
Actin
gC
hie
fE
xe
cu
tive
tou
nde
rsta
nd
the
rea
so
ns
for
the
resig
na
tio
no
fth
eC
hie
fE
xe
cu
tive
,
Ch
air
ma
na
nd
oth
er
Bo
ard
me
mbe
rsfo
llow
ing
the
De
cem
be
r2
01
7g
ove
rna
nce
con
ce
rns
wh
ich
we
re
inve
stig
ate
db
yN
HS
I
co
mp
are
dth
ere
su
lts
of
sta
ffsu
rve
ys
an
dfr
ien
ds
an
d
fam
ilyte
sts
at
the
Tru
st
ag
ain
st
the
na
tio
na
lpo
sitio
nto
un
de
rsta
nd
ifth
eT
rust
isa
no
utlie
r
Ove
rall
ou
rre
vie
wh
as
sup
po
rte
dth
efind
ing
so
fth
eM
arc
h
20
18
NH
SIn
ve
stig
atio
nR
epo
rt.
We
ha
ve
assu
rance
tha
t
the
Tru
st
ista
kin
gth
em
att
ers
rais
ed
an
dth
ee
nfo
rcem
ent
un
de
rta
kin
gs
se
rio
usly
and
ism
akin
gco
nce
rted
effo
rts
to
fill
the
va
ca
nt
Boa
rdpo
sitio
ns
with
suita
ble
ca
nd
ida
tes.
Alth
ou
gh
the
Tru
st’s
pu
blis
he
dsta
ffsu
rve
ya
nd
frie
nds
and
fam
ilyre
sults
are
wo
rse
tha
na
ve
rag
ein
anu
mbe
ro
fco
re
are
as,
the
rea
restill
som
epositiv
ea
reas
repo
rted
,a
nd
the
Tru
st
isn
otsig
nific
an
tly
be
low
the
ave
rag
eo
ve
rall.
Ou
r re
vie
w o
f th
e T
rust’s a
rra
ng
em
en
ts fo
r se
cu
rin
g
eco
no
my, e
ffic
ien
cy a
nd
eff
ective
ne
ss in
its
use
of
reso
urc
es id
en
tifie
d th
e fo
llow
ing
ma
tte
r:
Du
rin
g th
e y
ea
r, a
n in
de
pe
nd
en
t re
vie
w o
f th
e T
rust’s
go
ve
rna
nce
arr
an
ge
me
nts
fo
un
d c
ultu
ral, b
eh
avio
ura
l an
d
go
ve
rna
nce
issu
es a
t th
e T
rust.
T
he
ou
tco
me
of th
is
revie
w w
as f
ollo
we
d b
y a
n n
um
be
r o
f re
sig
na
tio
ns fro
m
the
Tru
st’s B
oa
rd in
clu
din
g C
ha
irm
an
an
d C
hie
f
Exe
cu
tive
, w
hic
h h
ave
ad
ve
rse
ly im
pa
cte
d th
e T
rust’s
lea
de
rsh
ip c
ap
acity a
nd
ca
pa
bili
ty. In
Ma
rch
20
18
, N
HS
Imp
rove
me
nt in
vo
ke
d a
n a
dd
itio
na
l lic
en
se
co
nd
itio
n o
n
the
Tru
st
un
de
r se
ctio
n 1
11
of
the
He
alth
an
d S
ocia
l C
are
Act 2
01
2.
Th
ese
ma
tte
rs a
re e
vid
en
ce
of w
ea
kn
esse
s in
th
e p
rop
er
arr
an
ge
me
nts
fo
r in
form
ed
de
cis
ion
ma
kin
g b
y a
ctin
g in
the
pu
blic
in
tere
st,
th
rou
gh
de
mo
nstr
atin
g a
nd
ap
ply
ing
the
pri
ncip
les a
nd
va
lue
s o
f so
un
d g
ove
rna
nce
.
Page 55 of 60
© 2
018
Gra
nt T
horn
ton
UK
LLP
|
Aud
it F
indi
ngs
Rep
ort
for
WU
TH
NH
S F
oundation T
rust
| 20
17/1
817
Oth
er
res
po
ns
ibil
itie
s u
nd
er
the
Co
de
Fin
an
cia
l sta
tem
ents
Iss
ue
Co
mm
en
tary
O
the
r in
form
ati
on
We a
re r
eq
uir
ed
to
giv
e a
n o
pin
ion
on
wh
eth
er
the
oth
er
info
rma
tio
n p
ub
lish
ed
to
ge
the
r w
ith
th
e a
ud
ite
d fin
an
cia
l sta
tem
en
ts (
inclu
din
g
the
An
nu
al R
ep
ort
), is m
ate
ria
lly in
co
nsis
ten
t w
ith
th
e fin
an
cia
l sta
tem
en
ts o
r o
ur
kn
ow
led
ge
ob
tain
ed
in th
e a
ud
it o
r o
the
rwis
ea
pp
ea
rs to
be
ma
teri
ally
mis
sta
ted
. N
o in
co
nsis
ten
cie
s h
ave
be
en
id
en
tifie
d. W
e p
lan
to
issu
e a
n u
nq
ua
lifie
d o
pin
ion
in
th
is r
esp
ect.
A
ud
ita
ble
ele
me
nts
of
Re
mu
ne
rati
on
an
d S
taff
Re
po
rt
We a
re r
eq
uir
ed
to g
ive
an
op
inio
n o
n w
he
the
r th
e p
art
of
the
Re
mu
ne
ratio
n R
ep
ort
su
bje
ct to
au
dit h
as b
ee
n p
rep
are
d p
rop
erl
y in
acco
rda
nce w
ith
th
e r
eq
uir
em
en
ts d
ire
cte
d b
y t
he
Se
cre
tary
of S
tate
with
th
e c
on
se
nt o
f th
e T
rea
su
ry.
We h
ave
au
dite
d th
e e
lem
en
ts o
f th
e R
em
un
era
tio
n r
ep
ort
, a
s r
eq
uir
ed
by t
he
Co
de
in
clu
din
g th
e ta
ble
of D
ire
cto
r’s s
ala
rie
s a
nd
pe
nsio
n
en
title
me
nt a
nd
th
e h
igh
est p
aid
sa
lary
mu
ltip
le. W
e fo
un
d n
o issu
es.
M
att
ers
on
wh
ich
we
re
po
rt b
y
ex
ce
pti
on
We a
re r
eq
uir
ed
to
re
po
rt o
n a
nu
mb
er
of m
att
ers
by e
xce
ptio
n in
a n
um
be
r o
f a
rea
s:
We h
ave
no
t id
en
tifie
d a
ny issu
es w
e w
ou
ld b
e r
eq
uir
ed
to
re
po
rt b
y e
xce
ptio
n in
th
e fo
llow
ing
are
as
If th
e A
nn
ua
l G
ove
rna
nce
Sta
tem
en
t d
oe
s n
ot m
ee
t th
e d
isclo
su
re r
eq
uir
em
en
ts s
et ou
t in
th
e G
rou
p A
cco
un
ting
Ma
nu
al o
r is
mis
lea
din
g
or
inco
nsis
tent w
ith
th
e in
form
atio
n o
f w
hic
h w
e a
re a
wa
re f
rom
ou
r a
ud
it
Th
e in
form
atio
n in
th
e A
nn
ua
l R
ep
ort
is m
ate
ria
lly in
co
nsis
ten
t w
ith
th
e in
form
atio
n in
th
e a
ud
ite
d fin
an
cia
l sta
tem
en
ts o
r a
pp
are
ntly
ma
teri
ally
in
co
rre
ct b
ase
d o
n, o
r m
ate
ria
lly in
co
nsis
tent w
ith
, o
ur
kn
ow
led
ge
of
the
Tru
st a
cq
uir
ed
in
th
e c
ou
rse
of p
erf
orm
ing
ou
r a
ud
it,
or
oth
erw
ise
mis
lea
din
g
We h
ave
id
en
tifie
d a
ny in
co
nsis
tencie
s b
etw
ee
n o
ur
kn
ow
led
ge
acq
uir
ed
du
rin
g th
e a
ud
it a
nd
th
e d
ire
cto
rs' s
tate
me
nt th
at th
ey
co
nsid
er
tha
t th
e A
nn
ua
l R
ep
ort
is fa
ir, b
ala
nce
d a
nd
un
de
rsta
nd
ab
le
Th
e A
nn
ua
l R
ep
ort
do
es n
ot a
pp
rop
ria
tely
dis
clo
se m
att
ers
th
at w
ere
co
mm
un
ica
ted
to
th
e A
ud
it C
om
mitte
e w
hic
h w
e c
on
sid
er
sh
ou
ld
ha
ve
be
en
dis
clo
se
d.
R
evie
w o
f a
cc
ou
nts
co
ns
oli
da
tio
n s
ch
ed
ule
sa
nd
sp
ec
ifie
d p
roc
ed
ure
s o
n
be
ha
lf o
f th
e D
ep
art
me
nt
of
He
alt
h a
nd
So
cia
l C
are
(D
HS
C)
gro
up
au
dit
or
We
are
re
qu
ire
d to
giv
e a
se
pa
rate
au
dit o
pin
ion
on
th
e T
rust
acco
un
ts c
on
so
lidation
sch
ed
ule
s a
nd
to
ca
rry o
ut sp
ecifie
d p
roce
du
res
(on
be
ha
lf o
f th
e N
AO
) o
n th
ese
sch
ed
ule
s u
nd
er
the
DH
gro
up
au
dit in
str
uctio
ns. In
th
e g
rou
p a
ud
it in
str
uctio
ns, th
e T
rust
wa
s s
ele
cte
d
as a
sa
mp
led
co
mp
on
en
t.
Th
e p
roce
du
res w
e c
arr
ied
ou
t o
n th
e T
rust's
acco
un
ts c
on
so
lida
tio
n s
ch
ed
ule
s a
t th
e tim
e o
f w
ritin
g d
id n
ot id
en
tify
an
y iss
ue
s. W
e h
ave
a fe
w p
roce
ss s
tep
s to
co
nclu
de
pri
or
to c
om
ple
tin
g o
ur
revie
w o
f th
e c
on
so
lida
tio
n s
ch
ed
ule
s
At
the
tim
e o
f w
ritin
g w
e a
nticip
ate
no
un
ad
juste
d in
co
nsis
ten
cie
s b
etw
ee
n th
e fin
an
cia
l sta
tem
en
ts a
nd
th
e a
cco
un
ts c
on
so
lida
tio
n
sch
ed
ule
s w
hic
h w
e a
re r
eq
uir
ed
to
re
po
rt in
ou
r o
pin
ion
on
th
e c
on
so
lidation
sch
ed
ule
s
C
ert
ific
ati
on
of
the
clo
su
re o
f
the
au
dit
We in
ten
d to
ce
rtify th
e c
losu
re o
f th
e 2
01
7/1
8 a
ud
it o
f th
e T
rust in
ou
r a
ud
ito
r’s r
ep
ort
.
Item
4 -
Ext
erna
l Aud
it O
pini
ons
- A
udit
Fin
ding
s R
epor
t
Page 56 of 60
© 2
018
Gra
nt T
horn
ton
UK
LLP
|
Aud
it F
indi
ngs
Rep
ort
for
WU
TH
NH
S F
oundation T
rust
| 20
17/1
818
Ind
ep
en
de
nc
e a
nd
eth
ics
Ind
ep
en
de
nc
e a
nd
eth
ics
We c
on
firm
th
at th
ere
are
no
sig
nific
ant fa
cts
or
ma
tte
rs th
at im
pa
ct o
n o
ur
ind
ep
en
de
nce a
s a
ud
ito
rs th
at w
e a
re r
eq
uir
ed
or
wis
h to
dra
w t
o y
ou
r a
tte
ntio
n. T
he
fir
m, its p
art
ne
rs, se
nio
r
ma
na
ge
rs, m
an
ag
ers
ha
ve
co
mp
lied
with
th
e F
ina
ncia
l Re
po
rtin
g C
ou
ncil’
s E
thic
al S
tan
da
rds a
nd
co
nfirm
th
at w
e a
re in
de
pe
nd
ent a
nd
are
ab
le to
ex
pre
ss a
n o
bje
ctive
op
inio
n o
n th
e
fin
an
cia
l sta
tem
en
ts.
We c
on
firm
th
at w
e h
ave
im
ple
me
nte
d p
olic
ies a
nd
pro
ce
du
res to
me
et th
e r
eq
uir
em
en
ts o
f th
e F
ina
ncia
l Re
po
rtin
g C
ou
ncil’
s E
thic
al S
tan
da
rd a
nd
we
as a
fir
m, a
nd
ea
ch
co
ve
red
pe
rso
n, co
nfirm
th
at w
e a
re in
de
pe
nd
en
t a
nd
are
ab
le to
exp
ress a
n o
bje
ctive
op
inio
n o
n th
e fin
an
cia
l sta
tem
en
ts.
Fu
rth
er,
we
ha
ve
co
mp
lied
with
th
e r
eq
uir
em
en
ts o
f th
e N
atio
na
l A
ud
it O
ffic
e’s
Au
dito
r G
uid
an
ce
No
te 0
1 issu
ed
in D
ece
mb
er
20
17
wh
ich
se
ts o
ut su
pp
lem
en
tary
gu
ida
nce
on
eth
ica
l
req
uir
em
en
ts fo
r a
ud
ito
rs o
f lo
ca
l p
ub
lic b
od
ies.
De
tails
of fe
es c
ha
rge
d a
re d
eta
iled
in A
pp
en
dix
B.
No
n-a
ud
it s
erv
ice
s
Fo
r th
e p
urp
ose
s o
f o
ur
au
dit w
e h
ave
ma
de
en
qu
irie
s o
f a
ll G
ran
t T
ho
rnto
n U
K L
LP
te
am
s p
rovid
ing
se
rvic
es to
th
e T
rust.
No
no
n-a
ud
it s
erv
ice
s w
ere
id
en
tifie
d.
Th
e a
mo
un
ts d
eta
iled
are
fe
es a
gre
ed
to
-da
te fo
r a
ud
it r
ela
ted
an
d n
on
-au
dit s
erv
ice
s to
be
un
de
rta
ke
n b
y G
ran
t T
ho
rnto
n U
K L
LP
in
th
e c
urr
en
t fin
an
cia
l ye
ar.
Th
ese
se
rvic
es a
re
co
nsis
ten
t w
ith
th
e T
rust’s p
olic
y o
n th
e a
llotm
en
t o
f n
on
-au
dit w
ork
to
yo
ur
au
dito
rs . A
ny c
ha
ng
es a
nd
fu
ll d
eta
ils o
f a
ll fe
es c
ha
rge
d fo
r a
ud
it r
ela
ted
an
d n
on
-au
dit r
ela
ted
se
rvic
es b
y
Gra
nt T
ho
rnto
n U
K L
LP
an
d b
y G
ran
t T
ho
rnto
n In
tern
atio
na
l Lim
ite
d n
etw
ork
me
mb
er
Fir
ms w
ill b
e in
clu
de
d in
ou
r A
ud
it F
ind
ing
sre
po
rt a
t th
e c
on
clu
sio
n o
f th
e a
ud
it.
Independence a
nd e
thic
s
Au
dit
re
late
d s
erv
ice
s
£T
hre
ats
Sa
feg
ua
rds
Assu
ran
ce
on
yo
ur
qu
alit
y
rep
ort
6,0
00
Se
lf-I
nte
rest (b
eca
use
this
is a
re
cu
rrin
g fe
e)
Th
e le
ve
l o
f th
is r
ecu
rrin
g fe
e ta
ke
n o
n its
ow
n is n
ot co
nsid
ere
d a
sig
nific
an
t th
rea
t to
in
de
pe
nd
en
ce
as th
e fe
e
for
this
wo
rk is £
6,0
00
in
co
mp
ari
so
n to
th
e to
tal fe
e fo
r th
e a
ud
it o
f £
38
,40
0 a
nd
in
pa
rtic
ula
r re
lative
to
Gra
nt
Th
orn
ton
UK
LL
P’s
tu
rno
ve
r o
ve
rall.
Fu
rth
er,
it is
a f
ixe
d f
ee
an
d th
ere
is n
o c
on
tin
ge
nt e
lem
en
t to
it.
Th
ese
facto
rs a
ll m
itig
ate
th
e p
erc
eiv
ed
se
lf-i
nte
rest th
rea
t to
an
acce
pta
ble
leve
l.
Ch
ari
tab
le F
un
ds
Ind
ep
en
de
nt E
xa
min
atio
n
1,5
00
Se
lf-I
nte
rest (b
eca
use
this
is a
re
cu
rrin
g fe
e)
Th
e le
ve
l o
f th
is r
ecu
rrin
g fe
e ta
ke
n o
n its
ow
n is n
ot co
nsid
ere
d a
sig
nific
an
t th
rea
t to
in
de
pe
nd
en
ce
as th
e fe
e
for
this
wo
rk is £
1,5
00
in
co
mp
ari
so
n to
th
e to
tal fe
e fo
r th
e a
ud
it o
f £
38
,40
0 a
nd
in
pa
rtic
ula
r re
lative
to
Gra
nt
Th
orn
ton
UK
LL
P’s
tu
rno
ve
r o
ve
rall.
Fu
rth
er,
it is
a f
ixe
d f
ee
an
d th
ere
is n
o c
on
tin
ge
nt e
lem
en
t to
it.
Th
ese
facto
rs a
ll m
itig
ate
th
e p
erc
eiv
ed
se
lf-i
nte
rest th
rea
t to
an
acce
pta
ble
leve
l.
Page 57 of 60
© 2
018
Gra
nt T
horn
ton
UK
LLP
|
Aud
it F
indi
ngs
Rep
ort
for
WU
TH
NH
S F
oundation T
rust
| 20
17/1
819
Au
dit
Ad
jus
tme
nts
We a
re r
eq
uir
ed
to
re
po
rt a
ll n
on
tri
via
l m
issta
tem
en
ts to
th
ose
ch
arg
ed
with
go
ve
rna
nce
, w
he
the
r o
r n
ot th
e a
cco
un
ts h
ave
be
en
ad
juste
d b
y m
an
ag
em
ent.
Ad
jus
ted
an
d u
na
dju
ste
d m
iss
tate
me
nts
Th
e a
ud
it d
id n
ot id
en
tify
an
y m
issta
tem
ents
in t
he
dra
ft a
cco
un
ts a
nd
co
nse
qu
en
tly th
ere
are
no
un
ad
juste
d m
issta
tem
en
ts. T
his
is s
ub
ject to
co
mp
letio
n o
f a
ud
it w
ork
still
in p
rog
ress.
Mis
cla
ss
ific
ati
on
an
d d
isc
los
ure
ch
an
ge
s
Th
e t
ab
le b
elo
w p
rovid
es d
eta
ils o
f m
iscla
ssific
atio
n a
nd
dis
clo
su
re c
ha
ng
es id
en
tifie
d d
uri
ng
th
e a
ud
it w
hic
h h
ave
be
en
ma
de
inth
e fin
al se
t o
f fin
an
cia
l sta
tem
en
ts.
Dis
clo
su
re
De
tail
Ad
jus
ted
?
No
te 1
.3.1
Go
ing
Co
nc
ern
Ma
na
ge
me
nt a
dd
ed
fu
rth
er
qu
an
tita
tive
an
d q
ua
lita
tive
dis
clo
su
re to
im
pro
ve
th
e r
ea
de
rs u
nd
ers
tan
din
g o
f th
e g
oin
g c
on
ce
rn
ma
teri
al u
nce
rta
inty
. W
e r
eco
gn
ise
th
at m
an
ag
em
en
t in
ten
de
d to
ma
ke
th
is c
ha
ng
e o
nce
th
e 2
01
8/1
9 P
lan
wa
s s
ub
mitte
d o
n
30
Ap
ril 2
01
8.
Ap
pe
nd
ixA
Item
4 -
Ext
erna
l Aud
it O
pini
ons
- A
udit
Fin
ding
s R
epor
t
Page 58 of 60
© 2
018
Gra
nt T
horn
ton
UK
LLP
|
Aud
it F
indi
ngs
Rep
ort
for
WU
TH
NH
S F
oundation T
rust
| 20
17/1
820
Fees
Pro
po
se
d f
ee
Fin
al fe
e
Tru
st
Au
dit
£3
8,4
00
£3
8,4
00
Qu
alit
y R
ep
ort
Au
dit
£6
,00
0£
6,0
00
Ch
ari
ty In
de
pe
nd
en
t E
xa
min
atio
n£
1,5
00
£1
,50
0
To
tal
£4
5,9
00
£4
5,9
00
Ap
pe
nd
ixB
We c
on
firm
be
low
ou
r fin
al fe
es c
ha
rge
d fo
r th
e a
ud
it a
nd
co
nfirm
th
ere
we
re n
o fe
es fo
r th
e p
rovis
ion
of
no
n a
ud
it s
erv
ice
s.
Au
dit
Fe
es
Page 59 of 60
© 2
018 G
rant
Th
orn
ton U
K L
LP
| A
udit F
indin
g R
eport
for
WU
TH
NH
S F
oundatio
n T
rust
| 2
017/1
8
DR
AF
T
© 2
01
8 G
ran
t T
ho
rnto
n U
K L
LP
. A
ll r
igh
ts r
ese
rve
d.
‘Gra
nt T
ho
rnto
n’ re
fers
to
th
e b
ran
d u
nd
er
wh
ich
th
e G
ran
t T
ho
rnto
n m
em
be
r firm
s p
rovid
e a
ssu
ran
ce
, ta
x a
nd
ad
vis
ory
se
rvic
es
toth
eir
clie
nts
an
d/o
r re
fers
to
on
e o
r m
ore
me
mb
er
firm
s, a
s t
he
co
nte
xt
req
uir
es.
Gra
nt T
ho
rnto
n U
K L
LP
is a
me
mb
er
firm
of G
ran
t T
ho
rnto
n In
tern
atio
na
l L
td (
GT
IL).
GT
IL a
nd
th
e m
em
be
r firm
s a
re n
ot a
wo
rld
wid
ep
art
ne
rsh
ip. G
TIL
an
d e
ach
me
mb
er
firm
is a
se
pa
rate
le
ga
l e
ntity
. S
erv
ice
s a
re d
elive
red
by th
e m
em
be
r firm
s.
GT
IL d
oe
s n
ot p
rovid
e s
erv
ice
s to
clie
nts
. G
TIL
an
d its
me
mb
er
firm
s a
re n
ot a
ge
nts
of,
an
d d
o n
ot
ob
lig
ate
, o
ne
an
oth
er
an
d a
re n
ot lia
ble
fo
r o
ne
an
oth
er’
s a
cts
or
om
issio
ns.
gra
ntt
ho
rnto
n.c
o.u
k
Item
4 -
Ext
erna
l Aud
it O
pini
ons
- A
udit
Fin
ding
s R
epor
t
Page 60 of 60
