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Response to Comptroller and Auditor General's report

13 September 2018

The interim Director General of Health and Community Services, Anthony McKeever, has responded to the Report from the Comptroller and Auditor General about governance arrangements in the former Health and Social Services Department:

Read the report on Governance Arrangements for Health and Social Care

"The Health and Community Services department fully accepts the findings of the Comptroller and Auditor General's report regarding governance arrangements in the former Health and Social Services department.

"We accept that governance has not always been as clear or rigorous as it should have been, and we are committed to doing all we can, following the report's findings, to improve and strengthen governance in the department and implement the report's recommendations.

"My team and I, supported by our Ministers, are fully committed to ensuring that good governance becomes part of the everyday lifeblood of the organisation. Through the changes and improvements we are making, we will be clear about what good governance means for staff as they go about their day-to-day work with patients, clients, and each other. Changes will take time, but my senior team and I are committed to making them happen."

"We note the finding of the Comptroller and Auditor General in the conclusion to her report that: 'At an overall level they (the governance arrangements in place at HSSD) were overly complex for a relatively small health and social care system, but at the same time insufficiently defined and communicated.'

"We agree wholly with the view of the Comptroller and Auditor General that 'the operation of groups without up-to-date terms of reference and without clarity to whom they report detracts from good governance', and plans to review and improve all governance arrangements across what is now Health and Community Services are now in place.

"There is a new senior leadership team in place within the department, and we have developed and are implementing a robust action plan in order to ensure that the right level of oversight is happening across the department. This includes clear reporting lines for all staff, with a staff handbook, which contains clear examples of situations where governance is required, which staff can refer to when needed. This handbook will be actively rolled out and will be easily available to all Health and Community Services staff.

"My senior management team and I recognise the hard work and efforts of staff who may feel that they have been working with unclear governance arrangements until recently, which can hamper work.

"The very nature of the work of Health and Community Services, which is responsible for all health and social care from cradle to grave, with a budget of over £200 million a year, means that the department is, by necessity, diverse. But good governance arrangements around our financial position and day-to-day running should not be complex. In fact, what we do demands that they should be as simple and as rigorous as possible.

"We also note the comments of the Comptroller and Auditor General on the interaction between States of Jersey departments who are concerned with health and social care, and we will continue to work with our colleagues in those other States of Jersey departments to ensure that governance arrangements beyond those in place in Health and Community Care are as smooth as possible.

"As the Comptroller and Auditor General's report notes, there are currently substantial changes being implemented within health and social care. For this reason, as we continue our work in redesigning health and social care services for all, the public needs to have total confidence in what we say and do."

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