Dorset Healthcare University NHS Foundation Trust Board Meeting

Dorset HealthCare University NHS Foundation Trust

Board Meeting

A special meeting will be held on 25 May 2016 at Sentinel House, 4-6 Nuffield Road, Poole, Dorset, BH17 0RB commencing at 10.30am.

If you are unable to attend please notify Keith Eales on 01202 277008.

Yours Sincerely,

Ann Abraham Chair

PART 1 Initials Paper Time

1. Welcome, apologies and introduction AA Verbal 10:30

2. Annual Report and Accounts 2015/16 AB Verbal 10:35

To receive an overview from PwC on the Financial Statements, Annual Report and the Quality Report

3. ISA 260 Annual External Audit Report and AB Attchd 10:50 Quality Report

To receive reports from PwC on the audit.

4. Letters of Representation 11.00

(a) To consider the letters of representation to AB/JC Attchd PwC.

(b) To consider letters of representation from the RS Attchd Chief Executive to the Board

5. Quality Governance Committee LH Verbal 11:10 Recommendations

To receive a report from the Chair of the Committee in respect of the Quality Report.

6. Audit Committee Report and Recommendations JMc Verbal 11:15

To receive a report from the Chair of the Committee on its review of the Annual Report and Accounts, the ISA 260 report and Letters of Representation.

7. Approval of AA 11.20

(a) Financial Statements App A (b) Annual Report App B (c) Quality Report App C

[A schedule of material changes since these Documents were considered by the Audit Committee is attached].

www.pwc.co.uk

Dorset HealthCare University NHS Foundation Trust

Report to those charged with governance Government and Public Sector Report to the Audit Committee on the audit for the year ended 31 May 2016 March 2016 (ISA (UK&I) 260)

Audit Code and scope of our audit

We perform our audit in accordance with the Comptroller and Auditor General’s Code of Audit Practice (“the Code”), which was issued in April 2015. Contents

Our reports and audit letters are prepared in accordance with the Code and all associated Audit Guidance Notes Executive summary 1 issued by the National Audit Office. Audit approach 2

Reports and letters prepared by Significant audit and accounting matters 8 external auditors and addressed to Value for Money 11 governors, directors or officers are prepared for the sole use of the NHS Other reporting matters 14 Foundation Trust, and no responsibility Internal controls 16 is taken by auditors to any governor, director or officer in their individual Insight into financial procedures 17 capacity, or to any third party. The Risk of fraud 18 matters raised in this and other reports that will flow from the audit are only Fees update 20 those which have come to our attention arising from or relevant to our audit that we believe need to be brought to Appendices 21 your attention. They are not a Appendix 1: Summary of uncorrected misstatements 22 comprehensive record of all the matters arising, and in particular we cannot be Appendix 2: Audit reports issued in 2015/16 23 held responsible for reporting all risks Appendix 3: Letter of representation 24 in your business or all internal control weaknesses. This report has been prepared for and only for this NHS This is a draft prepared for discussion purposes only and should not be relied upon; the contents are subject to Foundation Trust in accordance with amendment or withdrawal and our final conclusions and findings will be set out in our final deliverable. the terms of our engagement letter and for no other purpose. We do not accept or assume any liability or duty of care for any other purpose or to any other person to whom this report is shown or into whose hands it may come save where expressly agreed by our prior consent in writing.

Dorset HealthCare University NHS Foundation Trust PwC  Contents

Executive summary An audit of the financial  The CQC inspection in June 2015 concluded that statements is not designed to Background overall the Trust “requires improvement” with a identify all matters that may be This report tells you about the significant findings from our specific conclusion that the Trust “requires relevant to those charged with audit. We presented our plan to you in January 2016; we improvement” against the domain “are services governance. Accordingly, the have reviewed the plan and concluded that it remains effective” indicating that the Trust did not have proper audit does not ordinarily identify appropriate. We have completed our risk assessment for our arrangements in place throughout the year for the all such matters. Value for Money conclusion and updates are included effective use of its resources. regarding this below.  We have set out in detail our risk assessment, audit approach and conclusions within the Value for Money Audit summary section of this report on pages 11 to 13.  We have completed the majority of our audit work and expect to be able to issue an unmodified audit opinion Quality Report summary on the financial statements on 25 May 2016. We have completed the majority of our work on the Quality  The key outstanding matters, where our work has Report subject to any matters highlighted as outstanding in commenced but is not yet finalised, are: our Long Form Report. A summary of the matters arising  completion of journals testing; from our work is as follows:  related parties testing;  To conclude whether the local interpretation of the  review of the detailed non-financial disclosures in the financial statements; referral to treatment (RTT) indicator impacts on our audit opinion; and  confirming consistency of FTCs with financial statements;  To complete the content and consistency check of the overall Quality Report.  approval of the financial statements and letters of representation; and Please note that management is required by Monitor to send  completion procedures including the review them a copy of this report, in accordance with the NHS process and subsequent events review. Foundation Trust Annual Reporting Manual (‘‘NHS FT  There are a number of key judgements which require ARM’’). the attention of the Audit Committee – further details We look forward to discussing our report with you on 23 May are set within the ‘significant audit and accounting 2016. matters’ section. We thank the management and staff of the Foundation Trust Value for Money summary for their co-operation and assistance during the course of our  We have substantially completed our work on the work. Value for Money conclusion and will be issuing a modified opinion on 25 May 2016.

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Our audit approach meets the requirements of all ISAs (UK&I). Audit approach Our work has been conducted in accordance with the Comptroller Our audit approach was set in our audit plan which we As detailed in our audit plan, our approach consists of smart and Auditor General’s Code of presented to you on 25 January 2016. people, a smart approach and smart technology. Audit Practice, the National Audit Office Auditor Guidance Notes Materiality Smart People and the relevant requirements of the NHS Act 2006. We reported our planned materiality to the Audit Committee We continue to deploy an experienced team on your audit, in our audit plan. As this was based on the 31 March 2015 supported by a substantial investment in training and in our accounts, this has been updated for the results for the year industry programme. ended 31 March 2016. The basis of our materiality calculation We have maintained continuity of staff during the audit for has not changed. this year through inclusion of Anna Blackman, Sasha Lewis, Terri Hanley, Poppy Taylor-Porter and Matt James in your As per audit plan Final materiality audit team, which ensures accumulated audit knowledge is used retained and brought forward to help achieve an efficient audit. Basis Actual income per Actual income per final accounts for the draft accounts Smart Approach the year ended 31 for the year ended Data auditing March 2015 31 March 2016 We use technology-enabled audit techniques to drive quality, Overall £4,920,000 £5,052,000 efficiency and insight. In 2016, our work included the testing materiality of journals through data analysis, to identify and focus our testing on those entries we deem to have the highest inherent Clearly trivial £200,000 £200,000 risk. reporting de- minimis We have included relevant insight from this data analysis on page 17 of this report.

We will also continue to explore ways to extend our use of smart technology and data into other areas where we see an opportunity to add value, as well as for quality and efficiency.

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The PwC Audit consists of: Centre of Excellence  Smart people; We have a Health Centre of Excellence in the UK - a dedicated team of specialists which advises, assists and shares best  A Smart approach; and practice with our audit teams in more complex areas of the audit.  Smart technology. Our team has followed the guidance issued by the Centre of Excellence to ensure we are executing the best possible audit approach. Delivery centres We use dedicated delivery centres to deliver parts of our audit work that are routine and can be done by teams dedicated to specific tasks; for example these include confirmation procedures, preliminary independence checks ‘Client Connect’ and consistency and casting checks of the financial We gave your team access to our Client Connect platform, statements. where all the information requests that we make are logged,

Use of the delivery centres frees up time for your audit team files are uploaded electronically and are securely transferred to concentrate earlier on more complex areas of accounting. to our databases. This technology enables more efficient data transfer. The status of every item is automatically tracked, Smart Technology making it easy for us both to project manage the process. Crucially, this system works both ways allowing your teams to We have designed processes that automate and simplify let us know what you expect from us, and when we need to audit activity wherever possible. provide it to you, including drafts of reports, feedback on Aura’ accounts and technical conclusions. Central to this is PwC’s Aura software, which has set a high standard for audit technology. It is a powerful tool, enabling us to direct and oversee audit activities. Aura’s risk-based approach and workflow technology results in a higher quality, more effective audit and the tailored testing libraries allow us to build standard work programmes for housing audit cycles.

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Audit risks We have summarised below the significant and elevated risks we identified in our audit plan. The following section outlines the approach we took in addressing these risks.

High Management 1 1 override of control 3 2 Fraud in revenue 2 and expenditure recognition

Elevated risk Significant risk Valuation of land 3 and buildings 4

Value for money

Impact 4 conclusion

Elevated risk

Low Low Likelihood High

We have summarised below the significant risks we identified in our audit plan and the audit approach we took to address them. Since we communicated our audit plan, we have amended our audit approach to reflect the changes described in the table below.

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Risk Categorisation Audit approach Our audit work has addressed the significant risks we set out in our Risk of management override of Significant ISA (UK&I) 240 requires that we plan our audit work to consider the risk of fraud, controls which is presumed to be a significant risk in any audit. This includes consideration audit plan of the risk that management may override controls in order to manipulate the Assertions: All financial statements.

We have performed the following procedures:

 Tested the appropriateness of journal entries using Computer Assisted Audit Techniques;  Reviewed accounting estimates for bias and evaluated whether circumstances producing any bias, represent a risk of material misstatement due to fraud;

 Evaluated the business rationale underlying significant transactions; and  Performed ‘unpredictable’ procedures. The results of our testing were satisfactory.

Risk of fraud in revenue recognition Significant Under ISA (UK&I) 240 there is a rebuttable presumption that there are risks of fraud in revenue recognition. Assertions: Cut-off We have performed the following procedures:

 Understood and evaluated key revenue controls;  Evaluated and tested the accounting policy for income recognition to ensure that it is consistent with the requirements of the NHS FT ARM;

 Reviewed intra NHS confirmations of transactions and balances and any disputed amounts to consider any implications on your accounts; and  Performed detailed testing of revenue transactions with a focus on transactions posted in month 12 of 2015/16 and month 1 of 2016/17. We are satisfied that revenue amounts recognised within your accounts are materially correct and that disclosures are in line with the NHS FT ARM.

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Risk Categorisation Audit approach

Risk of fraud in expenditure Significant We extend the presumption that there are risks of fraud in revenue recognition to recognition the recognition of expenditure in the NHS. Assertions: Cut-off, accuracy and We have performed the following procedures: existence  Understood and evaluated key expenditure controls;  Evaluated and tested the accounting policy for expenditure recognition to ensure that it is consistent with the requirements of the NHS FT ARM;

 We have reviewed intra NHS confirmations of transactions and balances and any disputed amounts to consider any implications on your accounts; and

 We have also performed detailed testing of expenditure transactions, with a focus on the areas of greatest risk including transactions posted in month 12 of 2015/16 and month 1 of 2016/17 and the accruals recognised at the year- end. We are satisfied that expenditure amounts recognised within your accounts are materially correct and that disclosures are in line with the NHS FT ARM.

Valuation of Property, Plant and Significant The Trust’s estate represents the largest balance in the Trust’s statement of Equipment (PPE) financial position. The Trust measures its properties at fair value which involves a range of assumptions and the use of external valuation expertise. ISAs (UK&I) 500 Assertions: Valuation and 540 require us, respectively, to undertake certain procedures on the use of external expert valuers and the processes and assumptions underlying the fair value estimates. We have performed the following procedures:

 Used our valuations experts to review the assumptions used in determining the fair value of assets recorded within the Trust’s financial statements;

 Reviewed the data underlying the valuation of assets, including land and building areas being critical to the valuation; and

 Considered whether the Trust’s assumptions underlying the classification of properties are appropriate. We have not identified any significant issues with respect to the land and building valuations.

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Risk Categorisation Audit approach

Arrangements for securing Significant We are required by the Audit Code to report by exception where the Trust has not economy, efficient and effectiveness made proper arrangements for securing economy, efficiency and effectiveness in its of resources use of resources. Assertions: Not applicable The audit plan presented in January 2016 stated that our risk categorisation was to be confirmed. Due to the results of the CQC inspection in June 2015, we have concluded that this area represents a significant risk. We have reviewed a number of documents including the following:

 The CQC inspection report published in October 2015;  The ‘Well-led governance’ report prepared by PM Governance;  The results of relevant internal audit reviews;  Quarterly certifications submitted to Monitor;  Monitor’s governance and financial sustainability risk ratings for the Trust throughout the year;  Intelligent monitoring report from CQC;  The financial results for 2015/16 including achievement of the cost improvement programme (CIPs) schemes for the year; and  The annual plan for 2016/17. This review has led to a modification of the value for money conclusion, which we have discussed in further detail on page 11 below.

Enhanced audit reporting and the Code of Audit Practice The Local Audit and Accountability Act 2014 contained amendments to the 2006 Act which had the effect that NHS foundation trust auditors are required to follow the Code of Audit Practice prepared and published by the Comptroller and Auditor General (C&AG) which is supplemented by detailed guidance to auditors provided by the National Audit Office (NAO). These provisions came into force on 1 April 2015 when the first Code of Audit Practice under the 2014 Act came into effect. The NAO issued an Auditor Guidance Note (AGN 07) in March 2016. In accordance with the AGN we have continued to apply the requirements of ISA (UK&I) 700 for enhanced audit reporting and our audit report includes details of the scope of the audit, materiality, and the risks identified on the audit and how we responded to them.

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The majority of our audit work is complete and we anticipate Significant audit and accounting matters issuing an unqualified audit opinion. ISAs (UK&I) require us to tell you about relevant matters Trust. During previous audits, we have identified relating to the audit of the financial statements sufficiently discrepancies between the land and building areas included promptly to enable you to take appropriate action. in the DV’s report and those recorded by the Trust’s Estates department. We have set out in this section the significant matters arising from our audit as well as the current outstanding matters. As part of our audit work, we have tested both the land and building areas used by the DV to the measurements held by Accounts the Trust’s Estates department (which are based on AutoCAD We have completed our audit of the Foundation Trust’s scans and measurements performed by third parties). accounts in accordance with ISAs (UK&I), subject to the The initial testing performed during our interim procedures following outstanding matters: identified some discrepancies between the areas used by the DV and those recorded by the Trust, which the Trust has  completion of journals testing; worked with the DV to correct. We have therefore concluded  related parties testing; that the land and building areas in the amended DV report  review of the detailed non-financial disclosures in the financial statements; are materially correct.  confirming consistency of FTCs with financial We have used our internal valuations expert to consider the statements; approach and assumptions used by the DV in the valuation  approval of the financial statements and letters and no issues have been noted from the work performed. of representation; and The valuation has resulted in a net gain of £5.8m but this  completion procedures including the review consists of both gains and losses to the valuation of land and process and subsequent events review. buildings and as such has required the Trust to process Subject to the satisfactory resolution of these matters, the complex accounting entries impacting both income and finalisation of the financial statements and their approval by expenditure and the revaluation reserve (as each property those charged with governance we expect to issue an has to be considered separately and the accounting treatment unqualified audit opinion. depends on whether there is a valuation gain or loss and the accounting for previous valuation movements). During the Accounting issues audit, we identified some adjustments to the accounting for The qualitative aspects of the Foundation Trust’s accounting the revaluation relating to whether the adjustments were practices are set out below. classified as revaluations or impairments in the disclosure note totalling £770k. These have been appropriately adjusted Valuation of land and buildings by the Trust. The Trust’s land and buildings were subject to valuation by the District Valuer (DV) based on a physical inspection of all properties and land and buildings areas provided by the

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CQUIN revenue recognition Trust’s decision not to consolidate the Charitable Funds on the basis of materiality is reasonable. The Trust receives performance related (CQUIN) income across the financial year as specified in the contract with the Misstatements and significant audit commissioner. This is measured against a series of performance indicators which are unique to each contract. adjustments The total value of CQUIN income for the Trust in 2015/16 is We have to tell you about all uncorrected misstatements we approximately £4.9m. At the year end, the Trust has found during the audit, other than those which are clearly performed an analysis to assess whether the agreed quality trivial. targets have been met for each contract and the majority of ISA (UK&I) 450 (revised) requires that we record all targets have been met or only marginally missed. The misstatements identified except those which are “clearly majority of the CQUIN revenue is due from Dorset CCG trivial” i.e. those which we do not expect to have a material (£4.6m) and although the Trust has already received this effect on the financial statements even if accumulated. As amount, final agreement of the amount to which the Trust is part of our audit planning procedures we identified that all entitled has not yet been reached with the commissioner. We misstatements less than £200,000 (prior year £200,000) have requested confirmation from the commissioner who has could be classed as clearly trivial and we agreed this responded that formal agreement has not yet been reached threshold with the Audit Committee on 25 January 2016. but they believe the Trust will be entitled to the full payment. We do not have any uncorrected misstatements to report to However, due to uncertainty surrounding the targets which the Audit Committee. have not been met, the Trust has recognised a provision of £345k in respect of this income. We also bring to your attention the following misstatements which are listed in Appendix 1 to this report which have been The amount of CQUIN revenue that will be received for the corrected by management but which we consider you should year is a management estimate and based on the evidence be aware of in fulfilling your governance responsibilities. provided, the amount recognised appears reasonable. Classification of revaluation adjustments Non-consolidation of charitable funds During the audit, we identified some adjustments to the The HM Treasury exemption from consolidating NHS accounting for the revaluation relating to whether the charitable funds was removed for 2013/14, therefore all NHS adjustments were classified as revaluations or impairments Foundation Trusts had to consider whether they were in the disclosure note totalling £770k. These have been required to consolidate their Charitable Funds (where appropriately adjusted by the Trust and there is no overall applicable) into the main financial statements of the Trust. net impact on the treatment of the revaluations in the accounts. The Trust considered the removal of the exemption and determined that consolidation was not required on the Significant accounting principles and grounds of immateriality (by nature and amount). This is a policies judgement which has been made by management. Significant accounting principles and policies are disclosed in We have obtained the draft results of the Charitable Fund as the notes to the financial statements. We will ask at 31 January 2016 and based on the results for the year management and those charged with governance to represent (incoming resources of £124k) and total funds (£505k), the

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to us that the selection of, or changes in, significant  Expenditure: accounting policies and practices that have, or could have, a  The need to recognise provision, prepayments material effect on the financial statements have been and accruals of expenditure at year-end. considered. Please refer to the management representation letter in Appendix 3. We have considered the judgements that have been made by management and have not identified any issues. Judgements and accounting estimates Financial statement disclosures The Foundation Trust is required to prepare its financial statements in accordance with the NHS FT ARM, which As part of our audit work we have reviewed, and tested, the specifies in many areas the accounting policies and material disclosures in the financial statements. We have not estimation techniques that must be applied. Nevertheless, yet fully completed our work, but we have not yet identified there are still many areas where management need to apply any significant issues as part of this work. judgement to the recognition and measurement of items in the financial statements. Financial standing and Going Concern The following significant judgements or accounting estimates As part of our audit work we consider the Foundation Trust’s were used in the preparation of the financial statements: financial standing and ability to continue as a going concern. We have not identified any material uncertainties related to  Property plant and equipment: events and conditions that may cast significant doubt on the --- Which costs to capitalise;

entity's financial standing. --- Assessment of useful economic lives of assets; --- Assessment of whether properties are specialised or non-specialised; --- Assumptions of what a modern equivalent asset would be; and --- Assumptions regarding the underlying causes of impairment.  Provisions:  Whether to recognise a provision; and  Amount of provision to recognise.  Income:  Whether to raise a debtor for healthcare contract activity;  Amount of CQUIN income that is recognised;  Judgement on the recoverability of the amounts due; and  Recognition of accrued and deferred revenue balances.

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Value for Money Economy, efficiency and effectiveness In 2014/15, we issued an unmodified value for money conclusion as we were able to satisfy ourselves that the Trust Under its terms of authorisation, the Foundation Trust is had put in place proper arrangements for securing economy, required to exercise its functions economically, efficiently efficiency and effectiveness in its use of resources. and effectively. During 2015/16 the CQC performed a full inspection of the Under the Code of Audit Practice, we must satisfy ourselves, Trust and issued an inspection report with the overall by examination of the financial statements and otherwise, conclusion of “requires improvement”. This has led to us that you have made proper arrangements for securing classifying this area as a significant risk and we have economy, efficiency and effectiveness in your use of the therefore had to consider the impact of this report on our Trust’s resources. The NAO guidance is included in Auditor opinion for the year. Guidance Note 03 and requires us to reach our statutory conclusion on your arrangements based on the following In summary, we will be issuing a modified value for money overall evaluation criterion: conclusion due to the following significant matters identified as part of our work. “In all significant respects, the audited body had proper arrangements to ensure it took properly informed decisions Planned work and deployed resources to achieve planned and sustainable As part of planning we identified the following detailed outcomes for taxpayers and local people.” procedures to be performed in respect of our assessment of Our conclusion is then informed by three sub-criteria which the Foundation Trust’s arrangements to secure VFM through guide our work: the economic, efficient and effective use of its resources.  informed decision making;  Reviewed the outcomes of regulatory findings  sustainable resource deployment; and including the CQC inspection carried out in June  working with partner and other third parties. 2015, Monitor’s risk ratings and the well-led review carried out by PM Governance; We determine a local programme of value for money (VfM) audit work based on our VfM audit risk assessment,  Considered the outcomes of internal audit reports on informed by these criteria and our statutory responsibilities. areas such as procurement, income contract management and cost improvement programmes; The Code of Audit Practice issued by the National Audit Office and applicable to the financial year 2015/16 requires  Considered financial performance and financial us to report to you our conclusion relating to proper sustainability by reviewing 2015/16 outturn, the arrangements, having regard to the relevant criteria outlined annual plan for 2016/17 and achievement of cost above. improvement targets;  Considered the level of agency spend in light of recent government focus in this area; and

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 Reviewed performance against significant contracts Results of our work and impact on the opinion in year, including adherence to requirements within Our conclusion each year, is based on the evidence available those contracts (e.g. CQUIN). for the year under consideration and hence, our conclusion Significant risks identified for 2015/16 is not a reflection of a deterioration of the position from last year. We recognised last year that the As part of planning we identified the following significant Trust had made significant progress in addressing the risk to our VfM conclusion. concerns that had been raised by the CQC and Monitor and CQC inspection report based on the work we performed and in the absence of any regulatory reports, we issued an unmodified value for money The CQC performed a full inspection across the Trust’s conclusion. locations in June 2015 with the inspection report published in October 2015. This report gave an overall rating for the In accordance with the guidance issued by the NAO, we are Trust of “requires improvement” with the following ratings required to specifically consider whether the Trust had against the five domains reviewed: proper arrangements in place throughout the year to ensure economy, effectiveness and efficiency and to take account of  Are services safe? Requires improvement regulatory reports issued during the year in reaching our  Are services effective? Requires improvement conclusion. The CQC report, with an overall rating of  Are services caring? Good ‘requires improvement’ and the statements in the report that  Are services responsive? Requires improvement the Trust was still in the process of implementing systems,  Are services well-led? Requires improvement indicates that proper arrangements were not fully in place Additionally, in the summary of the report, the CQC have during the first quarter of the year and hence, results in our stated the following: modified value for money conclusion. “Dorset Healthcare University NHS Foundation Trust Based on our risk assessment and work performed, we will be requires improvement. However, we saw that it was well issuing a modified value for money conclusion specifically led by its new leadership team and was in the process of against the effective use of resources and have included the deploying effective systems that we were confident would relevant extract of our audit opinion below. This modified result in the delivery of improved, high quality services for conclusion has not been extended to the economic and its patients it serves.” efficient use of resources. Whilst this is a positive statement and reflects the progress Draft extract of audit opinion – Arrangements for securing that the Trust has been taking to improve its systems and economy, efficiency and effectiveness in the use of resources governance arrangements to ensure the quality of its Under the Code we are required to report to you if we are not services, this indicates that the Trust did not have proper satisfied that the Trust has made proper arrangements for arrangements in place throughout the year and therefore securing economy, efficiency and effectiveness in its use of impacts our conclusion on the Trust’s effective use of resources for the year ended 31 March 2016. We draw your resources. attention to the Trust’s Annual Governance Statement on page XX which includes further details on the matters noted below and the Trust’s action to address the issues.

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We have nothing to report as a result of this requirement except for the matters detailed below, where we have been unable to satisfy ourselves that the Trust has made proper arrangements for securing effectiveness in its use of resources for the year ended 31 March 2016. The Care Quality Commission (CQC) performed a full inspection of the Trust in June 2015 and issued the inspection report with an overall rating for the Trust of “Requires Improvement” and specifically, a rating of ‘Requirements Improvement’ for the ‘Are services effective?’ domain. In the summary of the report, the CQC have noted that the Trust were in the process of deploying effective systems, which the CQC were confident would deliver improved, high quality patient services. This indicates that the Trust did not have proper arrangements in place for the whole of 2015/16 for the effective use of its resources.

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We are not aware of any relationships which may Other reporting matters reasonably be thought to bear on our independence and objectivity. Related parties with those charged with governance”, UK Ethical Standard 1 (Revised) “Integrity, objectivity and independence” and UK In forming an opinion on the financial statements, we are Ethical Standard 5 (Revised) “Non-audit services provided to required to evaluate: audited entities” issued by the UK Auditing Practices Board  whether identified related party relationships and (“APB ES’’). transactions have been appropriately accounted for and Together these require that we tell you at least annually disclosed; and about all relationships between PricewaterhouseCoopers LLP in the UK and other PricewaterhouseCoopers’ firms and We confirm that we are  whether the effects of the related party relationships and associated entities (“PwC”) and the Foundation Trust that, in independent auditors with respect transactions cause the financial statements to be our professional judgement, may reasonably be thought to to the Foundation Trust’s misleading. bear on our independence and objectivity. financial statements. We have not yet fully completed our work, but have not yet identified any significant issues as part of this work. For the purposes of this report we have made enquiries of all PwC teams whose work we intend to use when forming our Management representations opinion on the truth and fairness of the financial statements. The final draft of the representation letter that we ask Relationships between PwC and the Foundation Trust We have reviewed the Foundation management to sign is attached in Appendix 3. We are not aware of any relationships between PwC and the Trusts Annual Governance Annual Governance Statement Foundation Trust that in our professional judgement, may Statement and considered reasonably be thought to bear on our independence and You are required to produce an Annual Governance whether the Foundation trust has objectivity. Statement (“AGS”) for inclusion in the Annual Report and exercised its functions Accounts. The aim of the AGS is to give a sense of how Relationships and Investments economically, efficiently and successfully the Foundation Trust has coped with the We have not identified any potential issues in respect of effectively. challenges it faced, drawing on evidence on governance, risk personal relationships with the Foundation Trust or management and controls. investments in the Foundation Trust held by individuals. We reviewed the AGS and considered whether it complied Employment of PwC staff by the Foundation Trust with relevant guidance and whether it was misleading or We are not aware of any former PwC partners or staff being inconsistent with what we know about the Foundation Trust. employed, or holding discussions in respect of employment, We recommended that additional information regarding the by the Foundation Trust as a director or in a senior results of the CQC inspection be included in the AGS, but management position covering financial, accounting or apart from this, found no areas of concern to report in this control related areas. context. Business relationships Audit independence We have not identified any business relationships between We are required to follow both the International Standard on PwC and the Foundation Trust. Auditing (UK and Ireland) 260 (Revised) “Communication

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We have not provided any Services provided to the Foundation Trust We have complied with the requirements set out in the group additional services to the The audit of the financial statements is undertaken in instructions and have reported this to the NAO in accordance Foundation Trust nor to its accordance with the UK Firm’s internal policies. The audit is with their requirements. Directors and/or Senior also subject to other internal PwC quality control procedures. Management. Foundation Trust Governance Code We have not provided any additional services to the The following principles exist within the FT Governance Foundation Trust. Code: Fees Main principle The analysis of our audit fees for the year ended 31 March C.1.a The board of directors should present a fair, balanced 2016 is included on page 20. and understandable assessment of the NHS foundation Services to Directors and Senior Management trust’s position and prospects. PwC does not provide any services e.g. personal tax services, Supporting principle directly to directors, or senior management. C.1.b The responsibility of the board of directors to present a Gifts and hospitality fair, balanced and understandable assessment extends to all We have not identified any significant gifts or hospitality public statements and reports to regulators and inspectors, provided to, or received from, a member of Foundation as well as information required to be presented by statutory Trust’s Directors, senior management or other staff. requirements. Conclusion C.1.c The board of directors should establish arrangements We hereby confirm that in our professional judgement, as at that will enable it to ensure that the information presented is the date of this document: fair, balanced and understandable. The directors are required to explain in the annual report  we comply with UK regulatory and professional their responsibility for preparing the annual report and requirements, including the Ethical Standards issued accounts, and state that they consider the annual report and by the Auditing Practices Board; and accounts, taken as a whole, are fair, balanced and  our objectivity is not compromised. understandable and provide the information necessary for patients, regulators and other stakeholders to assess the NHS We would ask the Audit Committee to consider the matters foundation trust’s performance, business model and strategy. in this document and to confirm that they agree with our conclusion on our independence and objectivity. We are required to determine whether any matters disclosed in the annual report are materially inconsistent with our Additional procedures for the National knowledge of the trust acquired in the course of performing Audit Office our audit The National Audit Office (‘NAO’) issues group audit No matters have come to our attention as part of our work. instructions which set out additional audit requirements.

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We consider management systems of internal financial control as part of our audit of the Internal controls financial statements. Accounting systems and systems of internal control Management are responsible for developing and implementing systems of internal financial control and to put in place proper arrangements to monitor their adequacy and effectiveness in practice. As auditors, we review these arrangements for the purposes of our audit of the financial statements and our review of the annual governance statement. Reporting requirements We have to report to you any deficiencies in internal control that we found during the audit which we believe should be brought to your attention. We have no significant matters that we wish to bring to your attention.

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Insight into financial procedures What is a CAAT? A computer assisted audit technique (CAAT) is an audit test that has been automated with the use of a computer and associated software. CAATs increase the effectiveness of testing as they enable analysis of the entire population rather than a sample. This helps to decrease audit risk whilst providing more insight into the Trust’s business and financial procedures. Journal CAATs A detailed listing was obtained of all general ledger transactions in the year for the Trust. This listing was used to select a sample of transactions for testing based on the audit teams’ assessment of relevant risk criteria. Based on the information obtained, we have extracted the following analysis which shows trends in manual journals which the Trust may find interesting for further investigation. Insight to follow

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We are responsible for obtaining reasonable assurance that the financial statements taken as a Risk of fraud whole are free from material misstatement, whether caused by International Standards on Auditing (UK&I) state that we, as Responsibility of the Audit Committee fraud or error. auditors, are responsible for obtaining reasonable assurance that the financial statements taken as a whole are free from Your responsibility as part of your governance role is: material misstatement, whether caused by fraud or error.  to evaluate management’s identification of fraud risk, The respective responsibilities of auditors, management and implementation of anti-fraud measures and creation of those charged with governance are summarised below: appropriate “tone at the top”; and Auditors’ responsibility  to investigate any alleged or suspected instances of fraud brought to your attention. Our objectives are: Your views on fraud  to identify and assess the risks of material misstatement of the financial statements due to fraud;  to obtain sufficient appropriate audit evidence In our audit plan presented to the Audit Committee on 25 regarding the assessed risks of material misstatement January 2016 we enquired: due to fraud, through designing and implementing  Whether you have knowledge of fraud, either actual, appropriate responses; and suspected or alleged, including those involving  to respond appropriately to fraud or suspected fraud management? identified during the audit.  What fraud detection or prevention measures (e.g. whistle-blower lines) are in place in the entity? Management’s responsibility  What role you have in relation to fraud? Management’s responsibilities in relation to fraud are:  What protocols / procedures have been established between those charged with governance and  to design and implement programmes and controls to management to keep you informed of instances of prevent, deter and detect fraud; fraud, either actual, suspected or alleged?  to ensure that the entity’s culture and environment promote ethical behaviour; and We ask that the Audit Committee considers these questions  to perform a risk assessment that specifically includes again. We ask for your confirmation that there have been no the risk of fraud addressing incentives and pressures, changes to your view of fraud risk and that no additional opportunities, and attitudes and rationalisation. matters have arisen that should be brought to our attention. A specific confirmation from management in relation to fraud is included in the letter of representation in Appendix 3.

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Our audit fees are set out in the table opposite. Fees update Fees update for 2015/16 We reported our fee proposals in our plan. Our actual fees were in line with our proposals, as follows:

Financial statements 2015/16 2015/16 2014/15 outturn fee proposal actual fee £ £ £ Statutory Audit 51,671 51,671 51,210

Assurance on the Quality Report 12,401 12,401 12,290

Additional procedures performed for the NAO (1) 2,956 3,456 3,426

Additional work on economy, efficiency and effectiveness (2) TBC TBC 10,000

Additional work relating to enhanced audit report 3,027 3,027 3,000

TOTAL TBC TBC 79,926

Non-audit work Nil Nil 191,000

(1) Dorset HealthCare is a non-sampled component for the current year, compared to a full scope component in the prior year and hence, we have reduced our fee to reflect the reduction in work. (2) In accordance with the revised guidance on ‘Auditors’ Work on Value for Money Arrangements’ issued by the National Audit Office reports issued by regulatory bodies such as the CQC need to be considered as part of the work we perform. Due to the results of the CQC report we have categorised this area as a significant risk in our audit plan, which affects the level of work performed for us to reach our conclusion. We will update the Audit Committee in the final version of this ISA260 report.

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Appendices

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We report to you a summary of uncorrected misstatements for Appendix 1: Summary of uncorrected your consideration. misstatements

We do not have any misstatements above the reporting level of £200,000 to report to you that have not been corrected by management. Summary of corrected misstatements We have detailed in the table below misstatements above the reporting level of £200,000 that have been corrected by management that we would like to bring to your attention.

No Description of misstatement Income statement Balance sheet (factual, judgemental, projected)

Dr Cr Dr Cr

1 Dr Revaluations charged to the revaluation reserve Factual £768,186 Cr Impairments charged to revaluation reserve £768,186 Being an adjustment to the categorisation of the revaluation figures between revaluations and impairments charged to the revaluation reserve in the disclosure note. There is no overall net impact on the treatment of the revaluations in the accounts and is simply the reclassification within the disclosure note.

Total corrected misstatements - - £768,186 £768,186

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We have issued seven reports during the year. Appendix 2: Audit reports issued in 2015/16

The following reports have been issued during the year:

 Dorset HealthCare University NHS Foundation Trust report to the Audit Committee: External Audit Plan 2015/16 – presented in January 2016;

 Dorset HealthCare NHS Foundation Trust interim report to the Audit Committee – presented in April 2016;

 Audit opinion for 2015/16 financial statements;

 Independent Auditors’ report to the Council of Governors of Dorset HealthCare University NHS Foundation Trust on the NHS Foundation Trust Consolidation schedules for 2015/16;

 Dorset HealthCare University NHS Foundation Trust Report to the those charged with governance (ISA 260 (UK&I)) 2015/16;

 Limited assurance report for 2014/15 quality report; and

 Dorset HealthCare University NHS Foundation Trust 2014/15 report on external assurance on the Quality Report.

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We ask management to sign a letter on behalf of the Foundation Trust. Appendix 3: Letter of representation

PricewaterhouseCoopers LLP Oceana House 39 – 39 Commercial Road Southampton SO15 1GA

Dear Sirs

This representation letter is provided in connection with your audit of the financial statements of Dorset HealthCare University NHS Foundation Trust (the “NHS foundation trust”) for the year ended 31 March 2016. Your audit is conducted for the purpose of expressing an opinion as to whether the financial statements of the NHS foundation trust give a true and fair view of the NHS foundation trust’s affairs as at 31 March 2016 and of its income and expenditure and cash flows for the year then ended and have been prepared in accordance with the NHS Foundation Trust Annual Reporting Manual 2015/16. We acknowledge that the Chief Executive has been designated as the Accounting Officer for the Trust by Monitor and that the following requirements included in the NHS foundation trust Accounting Officer Memorandum have been complied with:  “An Accounting Officer has particular responsibility to see that appropriate advice is tendered to the Board of Directors and Board of Governors on all matters of financial propriety and regularity and, more broadly, as to all considerations of prudent and economical administration, efficiency and effectiveness.”  “The Board of Directors and the Board of Governors of an NHS foundation trust should act in accordance with the requirements of propriety or regularity. If the Board of Directors, Board of Governors or the Chairman is contemplating a course of action involving a transaction which you as Accounting Officer consider would infringe these requirements, however, you should set out in writing your objection to the proposal and the reasons for this objection.” We confirm that the following representations are made on the basis of enquiries of management and staff of the NHS foundation trust with relevant knowledge and experience and, where appropriate, of inspection of supporting documentation sufficient to satisfy ourselves that we can properly make each of the following representations to you. We confirm, for all directors at the time the directors’ report is approved, to the best of our knowledge and belief, and having made the appropriate enquiries, the following representations:

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Financial Statements We acknowledge as directors our responsibilities under the National Health Service Act 2006 for preparing financial statements of the NHS foundation trust which give a true and fair view, in accordance with the NHS Foundation Trust Annual Reporting Manual 2015/16 and for making accurate representations to you. All transactions have been recorded in the accounting records and are reflected in the financial statements. Significant assumptions used by us in making accounting estimates, including those surrounding measurement at fair value, are reasonable. All events subsequent to the date of the financial statements for which the NHS Foundation Trust Annual Reporting Manual 2015/16 requires adjustment or disclosure have been adjusted or disclosed. The selection and application of accounting policies are appropriate. The following have been recognised, measured, presented or disclosed in accordance with the Foundation Trust Annual Reporting Manual 2015/16:  Plans or intentions that may affect the carrying value or classification of assets and liabilities;  Liabilities, both actual and contingent;  Title to, or control over assets, liens or encumbrances on assets, and assets pledged as collateral; and  Aspects of laws, regulations and contractual agreements that may affect the financial statements, including non- compliance.

Information Provided Each director has taken all the steps that he or she ought to have taken as a director in order to make himself or herself aware of any relevant audit information and to establish that you (the NHS foundation trust's auditors) are aware of that information. We have provided you with:

 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;  Additional information that you have requested from us for the purpose of the audit; and  Unrestricted access to persons within the NHS foundation trust from whom you determined it necessary to obtain audit evidence. So far as each director is aware, there is no relevant audit information of which you are unaware.

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Fraud and non-compliance with laws and regulations We acknowledge our responsibility for the design, implementation and maintenance of internal control to prevent and detect fraud. 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. We have disclosed to you all information in relation to fraud or suspected fraud that we are aware of and that affects the NHS foundation trust and involves:  Management;  Employees who have significant roles in internal control; or  Others where the fraud could have a material effect on the financial statements. We have disclosed to you all information in relation to allegations of fraud, or suspected fraud, affecting the NHS foundation trust financial statements communicated by employees, former employees, analysts, regulators or others. 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. We are not aware of any irregularities, or allegations of irregularities, involving management or employees who have a significant role in the accounting and internal control systems, or that could have a material effect on the financial statements.

Related party transactions We confirm that the attached appendix to this letter is a complete list of the Foundation Trust’s related parties. All transfer of resources, services or obligations between the Foundation Trust and these parties have been disclosed to you, regardless of whether a price is charged. We are unaware of any other related parties, or transactions between disclosed related parties. Related party relationships and transactions have been appropriately accounted for and disclosed in accordance with the requirements of the NHS Foundation Trust Annual Reporting Manual 2015/16. We confirm that we have identified to you all members of key management, as defined by IAS 24, and included their remuneration in the disclosures of key management compensation. Except as disclosed in the financial statements, no transactions involving directors, officers and others requiring disclosure in the financial statements under the NHS Foundation Trust Annual Reporting Manual 2015/16 have been entered into.

Employee Benefits We confirm that we have made you aware of all employee benefit schemes in which employees of the NHS foundation trust participate.

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All retirement benefits that the NHS foundation trust is committed to providing, including any arrangements that are statutory, contractual or implicit in the NHS foundation trust’s actions, wherever they arise, whether funded or unfunded, approved or unapproved, have been identified and properly accounted for and/or disclosed. The NHS foundation trust participates in the NHS pension scheme. We confirm that the NHS foundation trust’s share of the underlying assets and liabilities of this scheme cannot be identified and as a consequence the scheme has been accounted for as a defined contribution scheme.

Contractual arrangements/agreements All contractual arrangements (including side-letters to agreements) entered into by the NHS foundation trust have been properly reflected in the accounting records or, where material (or potentially material) to the financial statements, have been disclosed to you. The NHS foundation 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 regulatory authorities that could have a material effect on the financial statements in the event of non-compliance. We have disclosed all material agreements that have been undertaken by the NHS foundation trust in carrying on its business

Litigation and claims We have disclosed to you all known actual or possible litigation and claims whose effects should be considered when preparing the financial statements and such matters have been appropriately accounted for and disclosed in accordance with the NHS Foundation Trust Annual Reporting Manual 2015/16. We are not aware of any pending or threatened litigation, proceedings, hearings or claims negotiations which may result in significant loss to the NHS foundation trust.

Accounting Estimates Regarding the valuation of land and building, an accounting estimate that was recognised in the financial statements:  We used appropriate measurement processes, including related assumptions and models, in determining the accounting estimate in the context of the NHS Foundation Trust Annual Reporting Manual 2015/16  Measurement processes were consistently applied from year to year.  The assumptions appropriately reflect our intent and ability to carry out specific courses of action on behalf of the NHS foundation trust, where relevant to the accounting estimates and disclosures.  Disclosures related to accounting estimates are complete and appropriate under the NHS Foundation Trust Annual Reporting Manual 2015/16.

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 No subsequent event requires adjustment to the accounting estimates and disclosures included in the financial statements

Assets and liabilities We have no plans or intentions that may materially alter the carrying value and, where relevant, the fair value measurements or classification of assets and liabilities reflected in the financial statements. In our opinion, on realisation in the ordinary course of the business the current assets in the balance sheet are expected to produce no less than the net book amounts at which they are stated. The NHS foundation trust has satisfactory title to all assets and there are no liens or encumbrances on the NHS foundation trust’s assets, except for those that are disclosed in the financial statements. We confirm that we have carried out impairment reviews appropriately, including an assessment of when such reviews are required, where they are not mandatory. We confirm that we have used the appropriate assumptions with those reviews. We have recorded or disclosed, as appropriate, all liabilities, both actual and contingent, and have disclosed in the financial statements all guarantees that we have given to third parties, including oral guarantees made by the NHS foundation trust on behalf of an affiliate, director, officer or any other third party. We confirm that all significant assumptions made in relation to fair value measurement and disclosures are reasonable and appropriately reflect management’s intent and ability to carry out specific courses of action on behalf of the NHS foundation trust where relevant to the fair value of measurements or disclosures.

Provisions Provisions for depreciation and diminution in value including obsolescence have been made against fixed assets on the bases described in the financial statements and at rates calculated to reduce the net book amount of each asset to its estimated residual value by the end of its probable useful life in the NHS foundation trust’s business. In this respect we are satisfied that the probable useful lives have been realistically estimated and that the residual values are expressed in current terms. Full provision has been made for all liabilities at the balance sheet date including guarantees, commitments and contingencies where the items are expected to result in significant loss. Other such items, where in our opinion provision is unnecessary, have been appropriately disclosed in the financial statements.

Using the work of experts We agree with the findings of the District Valuer, experts in evaluating the valuation of land and buildings and have adequately considered the competence and capabilities of the experts in determining the amounts and disclosures used in the preparation of the financial statements and underlying accounting records. We did not give or cause any instructions to be given to experts with respect to the values or amounts derived in an attempt to bias their work, and we are not otherwise aware of any matters that have had an impact on the objectivity of the experts

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Items specific to the NHS We do not have plans to enter into any Private Finance Initiative schemes that might affect the financial statements for 2015/16. We do not have plans to implement any redundancy or early retirement programmes for which we should have made provision in the financial statements. We are not in negotiations to merge with any other NHS body or take on any other NHS body’s functions in the next financial year. We confirm that we have recognised all income receivable in 2015/16 in the Statement of Comprehensive Income/operating cost statement except where this income relates to specific activity to be delivered in future years. The losses and special payments forms have been compiled in accordance with the direction of the Monitor and there are no outstanding items that have been omitted from the losses and special payments register. We confirm that all intra-NHS balances included in the Statement of Financial Position (SOFP) at 31 March 2015 in excess of £100,000 have been disclosed to you and that the Trust has complied with the requirements of the intra-NHS Agreement of Balances exercise. We confirm that the Intra-NHS balances include all balances with NHS counter parties regardless of whether these balances are reported within the SOFP categories formally included within the Agreement of Balances exercise. We are not aware of any reports from the Care Quality Commission (CQC) or other regulators which have not been brought to your attention. This includes any draft reports which are not yet publically available and any correspondence with the CQC detailing preliminary findings.

As minuted by the board of directors at its meeting on 25 May 2016.

...... (Chairman) (Chief Executive/Secretary)

For and on behalf of Dorset HealthCare University NHS Foundation Trust

Date ……………………

[Appendix one: listing of related parties – provided separately to the Trust]

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© 2016 PricewaterhouseCoopers LLP. All rights reserved. In this document, "PwC" refers to the UK member firm, and may sometimes refer to the PwC network. Each member firm is a separate legal entity. Please see www.pwc.com/structure for further details. 130610-142627-JA-UK

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Dorset HealthCare University NHS Foundation Trust

DRAFT Quality Report 2015/16 Government and Public Sector

May 2016

Contents

Background and scope 1 Summary of findings 4 Detailed findings 7 Appendices 17 Appendix A: Matters arising from our limited assurance review of the Foundation Trust’s 2015/16 Quality Report: Content review 17 Appendix B: Matters arising from our limited assurance review of the Foundation Trust’s 2015/16 Quality Report: Performance indicators 19

Scope of this work

We have performed this work in accordance with Monitor’s Detailed guidance for external assurance on quality reports 2015/16 and Monitor’s Detailed requirements for quality reports 2015/16 which were issued in March 2016 and the NHS Foundation Trust Annual Reporting Manual 2015/16. Reports and letters prepared by external auditors and addressed to governors, directors or officers are prepared for the sole use of the NHS Foundation Trust, and no responsibility is taken by auditors to any governor, director or officer in their individual capacity, or to any third party. The matters raised in this report are only those which have come to our attention arising from or relevant to our work that we believe need to be brought to your attention. They are not a comprehensive record of all the matters arising, and in particular we cannot be held responsible for reporting all risks in your business or all internal control weaknesses. This report has been prepared solely for your use in accordance with the terms of our engagement letter dated 12th April 2016 and for no other purpose and should not be quoted in whole or in part without our prior written consent. No responsibility to any third party is accepted as the report has not been prepared for, and is not intended for, any other purpose. This report has been issued in draft and therefore findings are subject to amendment or withdrawal. Our definitive conclusions will be those contained in the final report.

Dorset HealthCare University NHS Foundation Trust PwC  Contents

Background and scope

Background o The Quality Report does not incorporate the matters required to be reported on as specified in Annex 2 to NHS foundation trusts are required to prepare and publish Chapter 7 of the FT ARM and Monitor’s ‘Detailed a Quality Report each year. The Quality Report has to be requirements for quality reports 2015/16’(“the prepared in accordance with the NHS foundation trust requirements”); Annual Reporting Manual (“the FT ARM”). o The Quality Report is consistent in all material As your auditors, we are required to undertake work on your aspects with source documents specified by Monitor; Quality Report under Monitor’s ‘Detailed Guidance for and External Assurance on the Quality Reports 2015/16’ (‘the o The specified indicators have not been prepared in all detailed guidance’) which was published in March 2016. material respects in accordance with the criteria set out in the detailed guidance. The purpose of this report is to provide the Council of Governors of Dorset HealthCare University NHS Foundation A limited assurance engagement is less in scope than Trust (“the Trust”) with our findings and recommendations a reasonable assurance engagement (such as the for improvements, in accordance with Monitor’s external audit of accounts). The nature, timing and requirements. It is referred to by Monitor as the “Governors extent of procedures for gathering sufficient report”. appropriate evidence are deliberately limited compared to a reasonable assurance engagement.

 Governors report: A private report on the outcome of Scope of our work our work that is made available to the Trust’s Governors We are required by Monitor to review the content of the and to Monitor. 2015/16 Quality Report, test three performance indicators and produce two reports: Our limited assurance report is restricted, as required by Monitor, to the content of the Quality Report and two  Limited assurance report: This report is a formal performance indicators only. The Governors report covers document that requires us to conclude whether anything all of our work and, therefore, the third local indicator which has come to our attention that would lead us to believe is chosen by the Governors. that:

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Status of our work The indicators for the year ended 31 March 2016 subject to limited assurance (the “specified indicators”); marked with At the time of writing, the key outstanding matters, where our work has commenced but is not yet finalised, are: the symbol in the Quality Report, consist of the following national priority indicators as mandated by  Confirming the content of the Quality Report against the Monitor: requirements of Monitor’s published guidance;

Specified Indicators  Confirming the consistency of key documentation Specified indicators criteria against the Quality Report; (exact page number where criteria can be found) Percentage of incomplete Page TBC  Review of the disclosures regarding the Quality Report pathways within 18 weeks for within the Annual Governance Statement; patients on incomplete pathways at the end of the  Reconciliation of the performance indicators tested to reporting period the amounts quoted within the Quality Report; and 100% enhanced Care Page TBC Programme Approach patients  Internal review of the performance indicator testing and receiving follow-up contact reconciliation. within seven days of discharge from hospital Content of the Quality Report We are required to issue a limited assurance report in Our procedures included: relation to the content of your Quality Report. This involves:  obtaining an understanding of the design and operation  Reviewing the content of the Quality Report against the of the controls in place in relation to the collation and requirements of Monitor’s published guidance, as reporting of the specified indicators, including controls specified in Annex 2 to Chapter 7 of the FT ARM and over third party information (if applicable) and Monitor’s ‘Detailed requirements for quality reports performing walkthroughs to confirm our understanding; 2015/16’; and  based on our understanding, assessing the risks that the  Reviewing the content of the Quality Report for performance against the specified indicators may be consistency with the source documents specified by materially misstated and determining the nature, timing Monitor in the detailed guidance. and extent of further procedures;

Performance indicators  making enquiries of relevant management, personnel We are required to issue a limited assurance report in respect and, where relevant, third parties; of two out of the three indicators specified by Monitor.  considering significant judgments made by the Trust in preparation of the specified indicators; and

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 performing limited testing, on a selective basis of evidence supporting the reported performance indicators, and assessing the related disclosure.

Local indicator

We are also required to undertake substantive sample testing of one further local indicator. This indicator is not included in our limited assurance report. Instead, we are required to provide a detailed report on our findings and recommendations for improvements in this, our Governors report. The Trust’s Governors select the indicator to be subject to our substantive sample testing. The indicator selected is:

 The total number of avoidable pressure ulcers (graded 3 and above) as a percentage of the total number of avoidable and unavoidable pressure ulcers (graded 3 and above).

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Summary of findings

Content of the Quality Report

No issues have come to our attention that lead us to believe that the Quality Report does not incorporate the matters required to be reported on as specified in Annex 2 to Chapter 7 of the FT ARM and the “Detailed requirements for quality reports 2015/16”

For further information refer to page 7.

Limited Assurance Report As a result of our work, we are able to provide an unqualified limited assurance report in respect of the content of the Quality Report.

Consistency with Other Information

No issues have come to our attention that lead us to believe that the Quality Report is not consistent with the other information sources defined by Monitor’s “Detailed requirements for quality reports 2015/16”.

Limited Assurance Report As a result of our work, we are able to provide an unqualified limited assurance report in respect of the consistency of the Quality Report with the “Detailed requirements for quality reports 2015/16”.

For further information refer to page 7.

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Selected Performance indicators Our findings relating to the performance indicators are summarised as follows:

Performance indicators included in our Findings limited assurance report Percentage of incomplete pathways within 18 weeks One issue identified; this has not impacted our limited for patients on incomplete pathways at the end of the assurance opinion. reporting period 100% enhanced Care Programme Approach patients No issues identified. receiving follow-up contact within seven days of discharge from hospital

For further information refer to page 8.

Limited Assurance Report  As a result of our work, we are able to provide an unqualified limited assurance report in respect of the mandated performance indicators.

Performance indicator not included within Findings our limited assurance report The total number of avoidable pressure ulcers (graded One error identified in sample tested. 3 and above) as a percentage of the total number of avoidable and unavoidable pressure ulcers (graded 3 One control issue identified. and above).

For further information refer to page 11.

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Annual Governance Statement We identified no issues relevant to the Quality Report [subject to the completion of our work on the AGS].

For further details, see page 13.

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Detailed findings

Review against the content requirements  The trust’s complaints report published under regulation 18 of the Local Authority Social Services and NHS We reviewed the content of the Quality Report against the Complaints Regulations 2009, dated 20/05/2016; content requirements which are specified in Annex 2 to Chapter 7 of the FT ARM and the requirements.  The latest national patient survey covering September to November 2015; A number of amendments were made to the draft Quality  The latest national staff survey dated 24/02/2015; Report as a result of the work we performed. These are summarised in Appendix A. Once the amendments were  Care Quality Commission Intelligent Monitoring Report made by the Trust, no further issues came to our attention dated 25/02/2016; that led us to believe that the Quality Report has not been  The Head of Internal Audit’s annual opinion over the prepared in line with the FT ARM or the requirements. Trust’s control environment dated 12/05/2016; Review consistency against specified  Feedback from Dorset Health Scrutiny Committee dated 07/05/2016; and source documents  Feedback from the Borough of Poole Health and Social We reviewed the content of the 2015/16 Quality Report for Care Overview and Scrutiny Committee dated consistency against the following source documents specified 28/04/2016. by Monitor: No issues came to our attention that led us to believe that the  Board minutes for the period April 2015 to the date of Quality Report is not consistent with the information sources signing the limited assurance report (the period) detailed above. (through to April 2016);  Papers relating to Quality reported to the Board over the period April 2015 to the date of signing the limited assurance report;  Feedback from the Commissioner, NHS Dorset Clinical Commissioning Group dated 11/05/2016;  Feedback from Governors dated 07/05/2016;  Feedback from local Healthwatch organisation, Healthwatch Dorset dated 07/05/2016;

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Performance indicators on which we are that the criteria are readily understandable to users of required to issue a limited assurance the Quality Report; conclusion  Obtaining understanding of the key processes and controls for managing and reporting the indicator through making enquiries of Trust staff and through performing a walkthrough; As required by Monitor we have undertaken sample testing of two performance indicators on which we issued our  Checking Trust’s reconciliation of the reported limited assurance report: performance in the Quality Report to the data used to calculate the indicator from the Trust’s underlying systems; 1. Percentage of incomplete pathways within 18 weeks for patients on incomplete pathways at the end of the  Testing a sample of relevant data used to calculate the reporting period indicator back to supporting documentation; and  Obtaining representations that the data used to calculate 2. 100% enhanced Care Programme Approach patients the indicator is accurately captured at source and that no receiving follow-up contact within seven days of sources of information/data relevant to the indicator discharge from hospital performance have been excluded. We are required to obtain an understanding of the key processes and controls for managing and reporting the We only tested a sample of data, as stated above, to indicators and sample test the data used to calculate the supporting documentation. Therefore, the errors reported indicator back to supporting documentation. Our work is below are limited to this sample. performed in accordance with the detailed guidance and included: We have also not tested the underlying systems, for example the patient administration system and the data extraction and recording systems.  Identification of the criteria used by the Trust for measuring the indicator; Our findings are set out below. Recommendations arising  Confirmation that the Trust had presented the criteria from these findings are presented in Appendix B. identified above in the Quality report in sufficient detail

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Percentage of incomplete pathways within 18 weeks for patients on incomplete pathways

Reported performance: 2015/16 Threshold: 92% 2015/16 Actual: 97.54% - TBC Criteria identified: We confirmed the Trust uses the following criteria for measuring the indicator for inclusion in the Quality Report:  The indicator is expressed as a percentage of incomplete pathways within 18 weeks for patients on incomplete pathways at the end of the period;  The indicator is calculated as the arithmetic average for the monthly reported performance indicators for April 2015 to March 2016;  The clock start date is defined as the date that the referral is received by the Foundation Trust, meeting the criteria set out by the Department of Health guidance; and  The indicator includes only referrals for consultant-led service, and meeting the definition of the service whereby a consultant retains overall clinical responsibility for the service, team or treatment.

Issues identified through work performed: No. Issue Impact on limited assurance report 1. Use of local rules and guidance Alongside using the national criteria detailed above, we As the Trust applies the local RTT rules in line with were informed that the Trust has a range of local the national requirements, the limited assurance interpretations (as stipulated by the local Clinical report is not impacted. Commissioning Group) that it applies in measuring the percentage of incomplete pathways within 18 weeks for patients on incomplete pathways. However, we confirmed that the application of these local rules are not inconsistent with the national guidance (full details are set out in Appendix B). 2. Recording of clock start and stop dates Two patients were identified where there were As the indicator was not affected by these cases and differences in the actual length of referral to treatment they were both isolated incidents, the limited compared to that reported. In one case the clock was assurance report is not impacted. started five days prior to the GP’s referral letter. In the second case the clock was stopped one day after

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treatment commenced. Neither issue impacted the indicator. 3. Manual processes used to calculate the indicator – control issue While these manual processes are more likely to The Trust uses a mainly manual process in forming the result in incorrect data, no issues were directly indicator. Two areas identified where there is a risk to identified from their use. As such, there is no the indicator accuracy are: impact on our limited assurance report. 1) For the Blandford and Swanage sites, manual spreadsheets are maintained to record and track RTT pathways and there is no formal reconciliation of these spreadsheets to the data contained within the system (CaMIS - Swanage, iSoft - Blandford).

2) On a monthly basis, the central information team will extract RTT data from the CaMIS system and send this to the remaining three sites (Wimborne, Shelley Road and Wareham) to validate. Individuals at each site will then check the data and send back comments where required. These adjustments will be made by the central team prior to reporting the figures to Monitor. It was noted that: - no audit trail is kept to evidence what adjustments have been made (although evidence is retained to support the submitted information); - there is no formal approval of manual adjustments; and - adjustments made are not subsequently updated within the relevant system. 4. Evidence of referral date – control issue For GP letters sent to the Trust, it is best practice to date As the date of the GP letter was within one day of stamp the letter with date of arrival so that the referral the clock start date, the indicator is not affected. As date can be evidenced. such, there is no impact on our limited assurance For one item in our sample, the GP letter was not date report. stamped, although the date of the letter was the day before the date recorded on the system. Given that the shortest amount of time it would take for a referral letter to reach the Trust is one day, this is

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sufficient evidence that the correct referral date has been recorded. Overall Conclusion: Our substantive testing of the indicator identified four issues. These have not impacted on our limited assurance report.

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100% enhanced Care Programme Approach patients receiving follow-up contact within seven days of discharge from hospital

Reported performance: 2015/16 Target: achieving at least 95% rate of 2015/16 Actual: Q1 - 95.82% patients followed up after discharge each Q2 – 97.27% quarter Q3 - 97.32% Q4 - 97.63% Criteria identified:

We confirmed the Trust uses the following criteria for measuring the indicator for inclusion in the Quality Report:  Detailed descriptor: The percentage of patients on Care Programme Approach (CPA) who were followed up within 7 days after discharge from psychiatric inpatient care during the reporting period.  Numerator = The number of people under adult mental illness specialities on CPA who were followed up (either by face to face contact or by phone discussion) within seven days of discharge from psychiatric in-patient care during the reporting period.  Denominator = The total number of people under adult mental illness specialities on CPA who were discharged from psychiatric in-patient care.  ALL patients discharged from psychiatric inpatient wards are regarded as being on CPA during the reporting period.  Details of the indicator: - All patients discharged to their place of residence, care home, residential accommodation or to non-psychiatric care must be followed up within 7 days of discharge; -Where a patient has been transferred to prison, contact should be made via the prison in-reach team; -The 7 day period should be measured in days not hours and should start on the day after discharge.  Exemptions include: - patients who are readmitted within 7 days of discharge; - patients who die within 7 days of discharge; -patients where legal precedence has forced removal of the patient from the country; -patients transferred to an NHS psychiatric inpatient ward; and - all CAMHS (child and adolescent mental health services) patients.

Overall Conclusion: Our substantive testing of the indicator identified no issues, resulting in an unmodified report in respect of this indicator.

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Performance indicators not included within our limited assurance report Monitor also requires us to undertake substantive sample testing of a local indicator selected by the Governors, the results of which are not included within our limited assurance report.

We obtain an understanding of the key processes and controls for managing and reporting the indicator and sample test the data used to calculate the indicator back to supporting documentation.

We tested only a sample, as stated above. Our reported errors below are limited to this sample.

Our findings are detailed as follows:

The total number of avoidable pressure ulcers (graded 3 and above) as a percentage of the total number of avoidable and unavoidable pressure ulcers (graded 3 and above).

Reported performance: 2015/16 Actual: TBC Criteria identified: We confirmed the Trust uses the following criteria for measuring the indicator for inclusion in the Quality Report:  Numerator = The total number of avoidable pressure ulcers (graded 3 and above).  Denominator = The total number of avoidable and unavoidable pressure ulcers (graded 3 and above).  The Trust use the European Pressure Ulcer Advisory Panel (EPUAP) definitions for gradings of pressure ulcers and this is reflected within the Trust's policy.  Any pressure ulcers rated grade 2 or below are excluded from the indicator.  All grade 3 and above pressure ulcers will be subject to a Root Cause Analysis (RCA) to identify the cause of the pressure ulcer and any lessons to learn. Issues identified through work performed: No. Issue Impact 1. The indicator was not disclosed within the For the local indicator testing in relation to the quality report to first draft of the quality report. provide value for the Trust, the indicator should be disclosed within the report. 2. We tested a sample of 15 pressure ulcers that As the RCA acts as part of the accuracy checking process, there had been identified during the year, to is a risk that delayed or incorrect RCAs lead to pressure ulcers ensure that they had been correctly graded being incorrectly categorised. This may then impact on the

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and categorised as avoidable or unavoidable. indicator if the error relates to the severity of the pressure ulcer In all cases we were able to confirm that the or whether it was avoidable. final grading was correct and therefore the there was no evidence that the indicator was misstated. As part of our testing we reviewed the RCA undertaken on the pressure ulcer. These are used to analyse the ulcer, ensuring it is correctly categorised and the cause understood. As such, while the indicator does not rely on the completion of the RCA, it does act as a control over accuracy. In three cases out of the 15 tested, the RCA was not undertaken within three weeks of the initial request, as required by Trust policy. A further RCA had a significant delay due to the incorrect initial classification. Alongside issues of timeliness, one RCA inaccurately stated in one section that the ulcer was grade 2 rather than grade 3. Conclusion: Our substantive testing of the indicator identified two issues.

The recommendations associated with these findings are presented in Appendix B.

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Annual Governance Statement In the requirements Monitor asks Foundation Trusts to include a brief description of the key controls in place to prepare and publish a Quality Report as part of the Annual Governance Statement in the 2015/16 published accounts.

The Annual Governance Statement, within the Foundation Trust’s 2015/16 Annual Report, includes the following statement specific to the Quality Report:

Annual Quality Report

The directors are required under the Health Act 2009 and the National Health Service (Quality Accounts) Regulations 2010 (as amended) to prepare Quality Accounts for each financial year. Monitor has issued guidance to NHS foundation trust boards on the form and content of annual Quality Reports which incorporate the above legal requirements in the NHS Foundation Trust Annual Reporting Manual.

The Board is able to assure itself that the Quality Report represents a balanced view and that there are appropriate controls in place to ensure the accuracy, completeness and timeliness of the data by the process detailed below.

Progress against the agreed priorities and indicators in the 2015/16 Quality Report have been reported to the Executive Quality and Clinical Risk Group, the Quality Governance Committee and the Trust Board, quarterly throughout the year.

As part of the consultation for the priorities and indicators for the 2016/17 Quality Report the Trust consulted with staff and stakeholders including through the Quality Matters Conference in January 2016 which was attended by 150 members of staff and at the Council of Governors.

Feedback from staff has informed the proposed quality priorities and indicators, which have been provided to external stakeholders including the Trust’s Commissioners and Healthwatch for consultation.

In line with Monitor guidance, the Trust commissions external auditors to carry out an assurance review of the Quality Report. This review includes reviewing the content of the Quality Report for consistency with what has been reported internally to the Trust Board throughout the year, feedback from Commissioners, Governors and other external stakeholders. The Trust’s External Auditors have issued a limited assurance report, limited by scope, which is included in the final Quality Report.

All policies and procedures are produced in line with the NHS Litigation Authority requirements, which are still deemed to be best practice, although the formal risk management assessments do not now take place. The effectiveness of policies in ensuring quality of care provided is monitored through a variety of mechanisms including:

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 as part of root cause analysis,  by undertaking audit,  by monitoring incident and complaint data.

Should the Trust wish to explore a particular aspect in the quality of care in more detail a focussed ‘deep dive’ review will be undertaken.

The Trust wide Clinical Audit programme includes topics from priority areas such as CQC inspection reports, NICE guidance, and contractual requirements. The Trust audit database is a key tool in ensuring monitoring of action plans and that audit activity is effective.

During 2015/16 the Board has utilised a revised integrated corporate dashboard. The metrics are used to populate team level dashboards. All staff will have access to the same information and insights as the Board. These metrics will be monitored by the Executive Quality and Clinical Risk Group.

The data used to support the integrated corporate dashboard comes from various sources including clinical audits, surveys, information management systems, incident reports and internal and external audits. All of these are used to produce the monthly Integrated Dashboard. Data in relation to performance and quality is collated and reviewed by the Directors of Finance, Human Resources and Nursing and Quality. These Directors are responsible for ensuring reliable information is produced on a timely basis.

As part of our report on the financial statements we were required to:

 Review whether the Annual Governance Statement reflects compliance with Monitor’s guidance; and

 Report if it does not meet the requirements specified by Monitor or if the statement is misleading or inconsistent with other information we are aware of from our audit of the financial statements.

The work we undertook on the Annual Governance Statement as part of our work on the financial statements identified no issues relevant to the Quality Report.

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Appendices

Appendix A: Matters arising from our limited assurance review of the Foundation Trust’s 2015/16 Quality Report: Content review

Observation Recommendation

Review of the content requirements

1. A number of the requirements of the FT ARM had The Trust should ensure the requirements of the FT not been met within the initial draft of the Quality ARM are reviewed and incorporated into the Report. These included: Quality Report. Where the exact wording of sentences and/or paragraphs are mandated, these  Omission of appropriate wording in some should be copied word for word and the Trust areas of the Quality Report in line with the should ensure that these are appropriately content checklist; highlighted within the document to avoid  Unclear or misleading statements or inadvertent modification conclusions made within some sections of the Quality Report, for example, the identification of only positive comments from a patient survey and no negative feedback provided in order to provide a balanced viewpoint;  Incomplete sections of the Quality Report, such as the reporting of issues with no specific actions identified going forward; and  Various grammar and wording errors.

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Observation Recommendation The Trust updated these in subsequent versions of the Quality Report.

Review of the consistency of the report with specified source documents

2. At the time of drafting the report, no significant consistency issues were identified between the Quality Report and the source documents.

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Appendix B: Matters arising from our limited assurance review of the Foundation Trust’s 2015/16 Quality Report: Performance indicators

Observation Recommendation

Percentage of incomplete pathways within 18 weeks for patients on incomplete pathways

1. Use of local rules and guidance Alongside using the national criteria, we were informed The Trust should review the local CCG guidance on clock that the Trust follows the local rules as outlined within the stops and ensure Trust procedure is aligned to the Dorset CCG Framework for the Management of Scheduled national definition. This should then be communicated Care guidance. There are rules relating to RTT within this to indicator coding staff and the various site guidance that are not in line with national rules these administrative staff to ensure that clock stops are arrangements being: recorded appropriately. - Patients with two cancellations on an open pathway will be referred back to their GP. - Patients who cancel an appointment and rebook their appointment choosing this to be more than 3 weeks ahead, should have their clock stopped and a new clock started from the date of their cancellation. Patients will be counselled about this and informed that if they cancel for a second time they will be returned to their GP. - If a patient requests time to think about the offer of a clinical intervention, a week’s thinking time can be given and the patient’s clock will continue. If the patient either

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Observation Recommendation does not communicate in the agreed time or cannot make a decision, they will usually be returned to their GP. - Patients who become unwell with an illness that is expected to last less than 2 weeks will remain on the their current pathway and their clock will continue. Patients who become unwell with a condition expected to last more than 2 weeks will be referred back to their GP with an explanation of why this has happened. If they require urgent secondary care intervention in another specialty, they will be referred and the GP will be informed why this has happened. - Patients opting to participate into research projects will be outside of the 18 weeks to enable them to be treated according to the research protocol. - Patient who are sent a partial booking letter, but fail to respond within the requested timescale, will be contacted once more, following which their care will be returned to the GP. - For admitted elective Orthopaedic patients, one reasonable offer date (with three weeks’ notice) will be made. If a patient refuses this offer the clock can be paused for up to 12 weeks. However if after a discussion with the patient, a patient initiated clock pause is not appropriate, the patient will be returned to their GP. However, it was established that the Trust does not apply the latter five rules identified above and only the first two rules are still used across the various Trust sites. In addition to this, it was confirmed that the national guidance provides specific rules around the use of local policies on patient DNAs in that they are appropriate as long as they are publicly available and / or published documents. We confirmed the CCG guidance is publicly available and therefore the Trust are applying these rules appropriately.

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Observation Recommendation As such, these issues have not impacted on our limited assurance report.

2. Recording of clock start and stop dates Staff recording the clock start or stop dates should be Two patients were identified where there were differences reminded of the importance of accurate data input. in the actual length of referral to treatment compared to that reported. In one case the clock was started five days prior to the GP’s referral letter. In the second case the clock was stopped one day after treatment commenced. Neither issue impacted the indicator.

3. Manual processes used to calculate the indicator Processes should be introduced to reconcile manual – control issue spreadsheets to the system data to ensure the data The Trust uses a mainly manual process in forming the captured within the system is accurate. indicator. Two areas identified where there is a risk to the An audit trail should be kept to evidence all manual indicator accuracy are: adjustments made to the system data. Formal approval 1) For the Blandford and Swanage sites, manual from an appropriate senior staff member should then be spreadsheets are maintained to record and track RTT provided for all manual adjustments. Any manual pathways and there is no formal reconciliation of these adjustments made to the reported data should spreadsheets to the data contained within the system subsequently be updated in the system. (CaMIS - Swanage, iSoft - Blandford).

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Observation Recommendation - adjustments made are not subsequently updated within the relevant system.

4. Evidence of referral date – control issue Staff should be reminded that all GP referral letters For GP letters sent to the Trust, it is best practice to date should be date stamped as soon as they arrive at the stamp the letter with date of arrival so that the referral Trust so that the referral date can be evidenced. date can be evidenced. For one item in our sample, the GP letter was not date stamped, although the date of the letter was the day before the date recorded on the system. Given that the shortest amount of time it would take for a referral letter to reach the Trust is one day, this is sufficient evidence that the correct referral date has been recorded.

The total number of avoidable pressure ulcers (graded 3 and above) as a percentage of the total number of avoidable and unavoidable pressure ulcers (graded 3 and above).

5. The indicator was not disclosed within the first draft of In future years the Trust should ensure that the local the quality report. indicator selected for testing is disclosed within the first draft of the Quality Report.

6. We tested a sample of 15 pressure ulcers that had been The Trust should monitor the completion of RCAs identified during the year, to ensure that they had been compared to the timing of the incident. This should correctly graded and categorised as avoidable or include monitoring timeliness and reporting the average unavoidable. In all cases we were able to confirm that the length of time for completion. Sample testing of RCA final grading was correct and therefore the there was no documentation may also help to ensure accuracy. evidence that the indicator was misstated. As part of our testing we reviewed the RCA undertaken on the pressure ulcer. These are used to analyse the ulcer, ensuring it is correctly categorised and the cause understood. As such, while the indicator does not rely on the completion of the RCA, it does act as a control over accuracy. In three cases out of the 15 tested, the RCA was not undertaken within three weeks of the initial request, as required by Trust policy. A further RCA had a significant delay due to the incorrect initial classification. Alongside

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Observation Recommendation issues of timeliness, one RCA inaccurately stated in one section that the ulcer was grade 2 rather than grade 3.

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In the event that, pursuant to a request which Dorset HealthCare University NHS Foundation Trust has received under the Freedom of Information Act 2000, it is required to disclose any information contained in this report, it will notify PwC promptly and consult with PwC prior to disclosing such report. Dorset HealthCare University NHS Foundation Trust agrees to pay due regard to any representations which PwC may make in connection with such disclosure and Dorset HealthCare University NHS Foundation Trust shall apply any relevant exemptions which may exist under the Act to such report. If, following consultation with PwC, Dorset HealthCare University NHS Foundation Trust discloses this report or any part thereof, it shall ensure that any disclaimer which PwC has included or may subsequently wish to include in the information is reproduced in full in any copies disclosed. This document has been prepared for the intended recipients only. To the extent permitted by law, PricewaterhouseCoopers LLP does not accept or assume any liability, responsibility or duty of care for any use of or reliance on this document by anyone, other than (i) the intended recipient to the extent agreed in the relevant contract for the matter to which this document relates (if any), or (ii) as expressly agreed by PricewaterhouseCoopers LLP at its sole discretion in writing in advance. © 2016 PricewaterhouseCoopers LLP. All rights reserved. 'PricewaterhouseCoopers' refers to PricewaterhouseCoopers LLP (a limited liability partnership in the United Kingdom) or, as the context requires, other member firms of PricewaterhouseCoopers International Limited, each of which is a separate and independent legal entity.

Agenda Item 4i

Trust Headquarters Sentinel House 4-6 Nuffield Road Poole Dorset BH17 0RB Tel: 01202 277000

PricewaterhouseCoopers LLP Oceana House 39 – 39 Commercial Road Southampton SO15 1GA 25 May 2016 Dear Sirs

This representation letter is provided in connection with your audit of the financial statements of Dorset HealthCare University NHS Foundation Trust (the “NHS Foundation Trust”) for the year ended 31 March 2016. Your audit is conducted for the purpose of expressing an opinion as to whether the financial statements of the NHS foundation trust give a true and fair view of the NHS foundation trust’s affairs as at 31 March 2016 and of its income and expenditure and cash flows for the year then ended and have been prepared in accordance with the NHS Foundation Trust Annual Reporting Manual 2015/16. We acknowledge that the Chief Executive has been designated as the Accounting Officer for the Trust by Monitor and that the following requirements included in the NHS foundation trust Accounting Officer Memorandum have been complied with: • “An Accounting Officer has particular responsibility to see that appropriate advice is tendered to the Board of Directors and Board of Governors on all matters of financial propriety and regularity and, more broadly, as to all considerations of prudent and economical administration, efficiency and effectiveness.” • “The Board of Directors and the Board of Governors of an NHS foundation trust should act in accordance with the requirements of propriety or regularity. If the Board of Directors, Board of Governors or the Chairman is contemplating a course of action involving a transaction which you as Accounting Officer consider would infringe these requirements, however, you should set out in writing your objection to the proposal and the reasons for this objection.” We confirm that the following representations are made on the basis of enquiries of management and staff of the NHS Foundation Trust with relevant knowledge and experience and, where appropriate, of inspection of supporting documentation sufficient to satisfy ourselves that we can properly make each of the following representations to you. We confirm, for all Directors at the time the Directors’ Report is approved, to the best of our knowledge and belief, and having made the appropriate enquiries, the following representations:

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Financial Statements We acknowledge as Directors our responsibilities under the National Health Service Act 2006 for preparing financial statements of the NHS foundation trust which give a true and fair view, in accordance with the NHS Foundation Trust Annual Reporting Manual 2015/16 and for making accurate representations to you. All transactions have been recorded in the accounting records and are reflected in the financial statements. Significant assumptions used by us in making accounting estimates, including those surrounding measurement at fair value, are reasonable. All events subsequent to the date of the financial statements for which the NHS Foundation Trust Annual Reporting Manual 2015/16 requires adjustment or disclosure have been adjusted or disclosed. The selection and application of accounting policies are appropriate. The following have been recognised, measured, presented or disclosed in accordance with the Foundation Trust Annual Reporting Manual 2015/16: • Plans or intentions that may affect the carrying value or classification of assets and liabilities; • Liabilities, both actual and contingent; • Title to, or control over assets, liens or encumbrances on assets, and assets pledged as collateral; and • Aspects of laws, regulations and contractual agreements that may affect the financial statements, including non-compliance.

Information Provided Each Director has taken all the steps that he or she ought to have taken as a director in order to make himself or herself aware of any relevant audit information and to establish that you (the NHS foundation trust's auditors) are aware of that information. We have provided you with: • 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; • Additional information that you have requested from us for the purpose of the audit; and • Unrestricted access to persons within the NHS Foundation Trust from whom you determined it necessary to obtain audit evidence. So far as each Director is aware, there is no relevant audit information of which you are unaware.

Agenda Item 4i

• Employees who have significant roles in internal control; or • Others where the fraud could have a material effect on the financial statements. We have disclosed to you all information in relation to allegations of fraud, or suspected fraud, affecting the NHS Foundation Trust financial statements communicated by employees, former employees, analysts, regulators or others. 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. We are not aware of any irregularities, or allegations of irregularities, involving management or employees who have a significant role in the accounting and internal control systems, or that could have a material effect on the financial statements.

Related party transactions We confirm that the attached appendix to this letter is a complete list of the Foundation Trust’s related parties. All transfer of resources, services or obligations between the Foundation Trust and these parties have been disclosed to you, regardless of whether a price is charged. We are unaware of any other related parties, or transactions between disclosed related parties. Related party relationships and transactions have been appropriately accounted for and disclosed in accordance with the requirements of the NHS Foundation Trust Annual Reporting Manual 2015/16. We confirm that we have identified to you all members of key management, as defined by IAS 24, and included their remuneration in the disclosures of key management compensation. Except as disclosed in the financial statements, no transactions involving Directors, officers and others requiring disclosure in the financial statements under the NHS Foundation Trust Annual Reporting Manual 2015/16 have been entered into.

Employee Benefits We confirm that we have made you aware of all employee benefit schemes in which employees of the NHS Foundation Trust participate. All retirement benefits that the NHS foundation trust is committed to providing, including any arrangements that are statutory, contractual or implicit in the NHS Foundation Trust’s actions, wherever they arise, whether funded or unfunded, approved or unapproved, have been identified and properly accounted for and/or disclosed. The NHS Foundation Trust participates in the NHS pension scheme. We confirm that the NHS Foundation Trust’s share of the underlying assets and liabilities of this scheme cannot be identified and as a consequence the scheme has been accounted for as a defined contribution scheme.

Agenda Item 4i

We have disclosed all material agreements that have been undertaken by the NHS Foundation Trust in carrying on its business

Accounting Estimates Regarding the valuation of land and building, an accounting estimate that was recognised in the financial statements: • We used appropriate measurement processes, including related assumptions and models, in determining the accounting estimate in the context of the NHS Foundation Trust Annual Reporting Manual 2015/16 • Measurement processes were consistently applied from year to year. • The assumptions appropriately reflect our intent and ability to carry out specific courses of action on behalf of the NHS Foundation Trust, where relevant to the accounting estimates and disclosures. • Disclosures related to accounting estimates are complete and appropriate under the NHS Foundation Trust Annual Reporting Manual 2015/16. • No subsequent event requires adjustment to the accounting estimates and disclosures included in the financial statements

Assets and liabilities We have no plans or intentions that may materially alter the carrying value and, where relevant, the fair value measurements or classification of assets and liabilities reflected in the financial statements. In our opinion, on realisation in the ordinary course of the business the current assets in the balance sheet are expected to produce no less than the net book amounts at which they are stated. The NHS Foundation Trust has satisfactory title to all assets and there are no liens or encumbrances on the NHS Foundation Trust’s assets, except for those that are disclosed in the financial statements. We confirm that we have carried out impairment reviews appropriately, including an assessment of when such reviews are required, where they are not mandatory. We confirm that we have used the appropriate assumptions with those reviews. We have recorded or disclosed, as appropriate, all liabilities, both actual and contingent, and have disclosed in the financial statements all guarantees that we have given to third parties, including oral guarantees made by the NHS Foundation Trust on behalf of an affiliate, Director, officer or any other third party. We confirm that all significant assumptions made in relation to fair value measurement and disclosures are reasonable and appropriately reflect management’s intent and ability to carry out specific courses of action on behalf of the NHS Foundation Trust where relevant to the fair value of measurements or disclosures.

Agenda Item 4i

Provisions Provisions for depreciation and diminution in value including obsolescence have been made against fixed assets on the bases described in the financial statements and at rates calculated to reduce the net book amount of each asset to its estimated residual value by the end of its probable useful life in the NHS Foundation Trust’s business. In this respect we are satisfied that the probable useful lives have been realistically estimated and that the residual values are expressed in current terms. Full provision has been made for all liabilities at the balance sheet date including guarantees, commitments and contingencies where the items are expected to result in significant loss. Other such items, where in our opinion provision is unnecessary, have been appropriately disclosed in the financial statements.

As minuted by the Board of Directors at its meeting on 25 May 2016.

Agenda Item 4i

...... (Chair) (Chief Executive)

For and on behalf of Dorset HealthCare University NHS Foundation Trust

Date ……………………

Agenda Item 4i

Ann Abraham - Trustee of the Picker Institute Europe Related David Brook - Managing Director & Bursar for Canford School parties and Lynne Hunt - Specialist advisor to the Care Quality Commission related party Peter Rawlinson is a Trustee of CfBT Education Trust, Chairman & Trustee of CfBT transactions Schools Trust, Chairman & Director of Harbour Watch Residents Association, Vice appendix CChairmanhairman & Trustee of the Stroke Association and Independent Board MemMemberber of Bournemouth University Key John Hughes is the Medical Director of the Sue Ryder Charity Management Ron Shields wife is an NHS Director of Specialist Service Commissioning Personnel’s Nicholas Kosky is the Chair of Guideline Development Group at NICE (MH adults in contact related with CJS (Criminal Justice System) and a Member of Guideline Development Group at parties NICE (physical health, people in prison) Colin Hague sits on the Health Education Wessex Local Training BBoardoard as a Board Member Linda Boland’s husband is the National ClinicalClinical Lead for Help for Heroes and he has a contract with Dorset County Council to provide psychological support to Head Teachers Eugine Yafele’s wife works as Nurse Practitioner with DorseDorsett HealthCare

Other related parties of Dorset HealthCare University NHS Foundation Trust Ansbury Limited New Wave Integrated Care Limited Dorset HealthCare Charitable Fund

NHS Foundation Trusts 2Gether NHS Foundation Trust 5 Boroughs Partnership NHS Foundation Trust Aintree University Hospital NHS Foundation Trust Airedale NHS Foundation Trust Alder Hey Children's NHS Foundation Trust Ashford and St Peter's Hospitals NHS Foundation Trust Barnsley Hospital NHS Foundation Trust Basildon And Thurrock University Hospitals NHS Foundation Trust Berkshire Healthcare NHS Foundation Trust Birmingham and Solihull Mental Health NHS Foundation Trust Birmingham Children's Hospital NHS Foundation Trust

Agenda Item 4i

Birmingham Women's NHS Foundation Trust Black Country Partnership NHS Foundation Trust Blackpool Teaching Hospitals NHS Foundation Trust Bolton NHS Foundation Trust Bradford District Care NHS Foundation Trust (FT status from 1 May 2015) Bradford Teaching Hospitals NHS Foundation Trust Bridgewater Community Health Services NHS Foundation Trust Burton Hospitals NHS Foundation Trust Calderdale and Huddersfield NHS Foundation Trust Calderstones Partnership NHS Foundation Trust Cambridge University Hospitals NHS Foundation Trust Cambridgeshire and Peterborough NHS Foundation Trust Camden and Islington NHS Foundation Trust Central and North West London NHS Foundation Trust Central Manchester University Hospitals NHS Foundation Trust Chelsea and Westminster Hospital NHS Foundation Trust (merged with West Middlesex University Hospital NHS Trust on 1/09/15) Cheshire and Wirral Partnership NHS Foundation Trust Chesterfield Royal Hospital NHS Foundation Trust City Hospitals Sunderland NHS Foundation Trust Colchester Hospital University NHS Foundation Trust Cornwall Partnership NHS Foundation Trust Countess of Chester Hospital NHS Foundation Trust County Durham and Darlington NHS Foundation Trust Cumbria Partnership NHS Foundation Trust Derby Teaching Hospitals NHS Foundation Trust Derbyshire Community Health Services NHS Foundation Trust Derbyshire Healthcare NHS Foundation Trust Doncaster and Bassetlaw Hospitals NHS Foundation Trust Dorset County Hospital NHS Foundation Trust Dorset Healthcare University NHS Foundation Trust East Kent Hospitals University NHS Foundation Trust East London NHS Foundation Trust Frimley Health NHS Foundation Trust Gateshead Health NHS Foundation Trust Gloucestershire Hospitals NHS Foundation Trust Great Ormond Street Hospital for Children NHS Foundation Trust Great Western Hospitals NHS Foundation Trust

Agenda Item 4i

Greater Manchester West Mental Health NHS Foundation Trust Guy's and St Thomas' NHS Foundation Trust Hampshire Hospitals NHS Foundation Trust Harrogate and District NHS Foundation Trust Heart of England NHS Foundation Trust Hertfordshire Partnership NHS Foundation Trust Homerton University Hospital NHS Foundation Trust Humber NHS Foundation Trust James Paget University Hospitals NHS Foundation Trust Kent Community Health NHS Foundation Trust Kettering General Hospital NHS Foundation Trust King's College Hospital NHS Foundation Trust Kingston Hospital NHS Foundation Trust Lancashire Care NHS Foundation Trust Lancashire Teaching Hospitals NHS Foundation Trust Leeds and York Partnership NHS Foundation Trust Lincolnshire Partnership NHS Foundation Trust Liverpool Heart and Chest Hospital NHS Foundation Trust Liverpool Women's NHS Foundation Trust Luton and Dunstable University Hospital NHS Foundation Trust Medway NHS Foundation Trust Mid Cheshire Hospitals NHS Foundation Trust Mid Staffordshire NHS Foundation Trust (shell entity only) Milton Keynes University Hospital NHS Foundation Trust Moorfields Eye Hospital NHS Foundation Trust Norfolk and Norwich University Hospitals NHS Foundation Trust Norfolk and Suffolk NHS Foundation Trust North East Ambulance Service NHS Foundation Trust North East London NHS Foundation Trust North Essex Partnership University NHS Foundation Trust North Lincolnshire and Goole Hospitals NHS Foundation Trust North Tees and Hartlepool NHS Foundation Trust Northamptonshire Healthcare NHS Foundation Trust Northumberland, Tyne and Wear NHS Foundation Trust Northumbria Healthcare NHS Foundation Trust Nottinghamshire Healthcare NHS Foundation Trust Oxford Health NHS Foundation Trust

Agenda Item 4i

Oxford University Hospitals NHS Foundation Trust (FT status from 1 October 2015) Oxleas NHS Foundation Trust Papworth Hospital NHS Foundation Trust Pennine Care NHS Foundation Trust Peterborough and Stamford Hospitals NHS Foundation Trust Poole Hospital NHS Foundation Trust Queen Victoria Hospital NHS Foundation Trust Rotherham, Doncaster and South Humber NHS Foundation Trust Royal Berkshire NHS Foundation Trust Royal Brompton and Harefield NHS Foundation Trust Royal Devon and Exeter NHS Foundation Trust Royal Free London NHS Foundation Trust Royal Surrey County Hospital NHS Foundation Trust Royal United Hospitals Bath NHS Foundation Trust Salford Royal NHS Foundation Trust Salisbury NHS Foundation Trust Sheffield Children's NHS Foundation Trust Sheffield Health and Social Care NHS Foundation Trust Sheffield Teaching Hospitals NHS Foundation Trust Sherwood Forest Hospitals NHS Foundation Trust Somerset Partnership NHS Foundation Trust South Central Ambulance Service NHS Foundation Trust Torbay and South Devon NHS Foundation Trust (merged with Torbay & South Devon Health and Care Trust on 1/10/15) South East Coast Ambulance Service NHS Foundation Trust South Essex Partnership University NHS Foundation Trust South London and Maudsley NHS Foundation Trust South Staffordshire and Shropshire Healthcare NHS Foundation Trust South Tees Hospitals NHS Foundation Trust South Tyneside NHS Foundation Trust South Warwickshire NHS Foundation Trust South West Yorkshire Partnership NHS Foundation Trust South Western Ambulance Service NHS Foundation Trust Southend University Hospital NHS Foundation Trust Southern Health NHS Foundation Trust St George's University Hospitals NHS Foundation Trust Stockport NHS Foundation Trust Surrey and Borders Partnership NHS Foundation Trust

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Sussex Partnership NHS Foundation Trust Tameside Hospital NHS Foundation Trust Taunton and Somerset NHS Foundation Trust Tavistock and Portman NHS Foundation Trust Tees, Esk and Wear Valleys NHS Foundation Trust The Christie NHS Foundation Trust The Clatterbridge Cancer Centre NHS Foundation Trust The Dudley Group NHS Foundation Trust The Hillingdon Hospitals NHS Foundation Trust The Newcastle Upon Tyne Hospitals NHS Foundation Trust The Queen Elizabeth Hospital King's Lynn NHS Foundation Trust The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust The Rotherham NHS Foundation Trust The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust The Royal Marsden NHS Foundation Trust The Royal Orthopaedic Hospital NHS Foundation Trust The Walton Centre NHS Foundation Trust University College London Hospitals NHS Foundation Trust University Hospital of South Manchester NHS Foundation Trust University Hospital Southampton NHS Foundation Trust University Hospitals Birmingham NHS Foundation Trust University Hospitals Bristol NHS Foundation Trust University Hospitals of Morecambe Bay NHS Foundation Trust Warrington and Halton Hospitals NHS Foundation Trust West Midlands Ambulance Service NHS Foundation Trust West Suffolk NHS Foundation Trust Western Sussex Hospitals NHS Foundation Trust Wirral University Teaching Hospital NHS Foundation Trust Wrightington, Wigan and Leigh NHS Foundation Trust Yeovil District Hospital NHS Foundation Trust York Teaching Hospital NHS Foundation Trust

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Bedford Hospital NHS Trust Birmingham Community Healthcare NHS Trust Bradford District Care NHS Trust ** FT status from 1 May 2015 ** Brighton and Sussex University Hospitals NHS Trust Buckinghamshire Healthcare NHS Trust Cambridgeshire Community Services NHS Trust Central London Community Healthcare NHS Trust Coventry and Warwickshire Partnership NHS Trust Croydon Health Services NHS Trust Dartford and Gravesham NHS Trust Devon Partnership NHS Trust Dudley and Walsall Mental Health Partnership NHS Trust East and North Hertfordshire NHS Trust East Cheshire NHS Trust East Lancashire Hospitals NHS Trust East Midlands Ambulance Service NHS Trust East of England Ambulance Service NHS Trust East Sussex Healthcare NHS Trust Epsom and St Helier University Hospitals NHS Trust George Eliot Hospital NHS Trust Gloucestershire Care Services NHS Trust Hertfordshire Community NHS Trust Hinchingbrooke Health Care NHS Trust Hounslow and Richmond Community Healthcare NHS Trust Hull and East Yorkshire Hospitals NHS Trust Imperial College Healthcare NHS Trust Ipswich Hospital NHS Trust Isle of Wight NHS Trust Kent and Medway NHS and Social Care Partnership NHS Trust Leeds Community Healthcare NHS Trust Leeds Teaching Hospitals NHS Trust Leicestershire Partnership NHS Trust Lewisham and Greenwich NHS Trust Lincolnshire Community Health Services NHS Trust Liverpool Community Health NHS Trust London Ambulance Service NHS Trust London North West Healthcare NHS Trust Maidstone and Tunbridge Wells NHS Trust

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Manchester Mental Health and Social Care NHS Trust Mersey Care NHS Trust Mid Essex Hospital Services NHS Trust Mid Yorkshire Hospitals NHS Trust Norfolk Community Health and Care NHS Trust North Bristol NHS Trust North Cumbria University Hospitals NHS Trust North Middlesex University Hospital NHS Trust North Staffordshire Combined Healthcare NHS Trust North West Ambulance Service NHS Trust Northampton General Hospital NHS Trust Northern Devon Healthcare NHS Trust Nottingham University Hospitals NHS Trust Oxford University Hospitals NHS Trust ** FT status from 1 October 2015 ** Pennine Acute Hospitals NHS Trust Plymouth Hospitals NHS Trust Portsmouth Hospitals NHS Trust Royal Cornwall Hospitals NHS Trust Royal Liverpool and Broadgreen University Hospitals NHS Trust Royal National Orthopaedic Hospital NHS Trust Sandwell and West Birmingham Hospitals NHS Trust Shropshire Community Health NHS Trust Solent NHS Trust South West London and St George's Mental Health NHS Trust Southport and Ormskirk Hospital NHS Trust St Helens and Knowsley Hospitals NHS Trust Staffordshire and Stoke on Trent Partnership NHS trust Surrey and Sussex Healthcare NHS Trust Sussex Community NHS Trust The Princess Alexandra Hospital NHS Trust The Royal Wolverhampton NHS Trust The Shrewsbury and Telford Hospital NHS Trust The Whittington Hospital NHS Trust Torbay and Southern Devon Health and Care NHS Trust (merged with Torbay & South Devon NHS FT on 1/10/15) United Lincolnshire Hospitals NHS Trust University Hospitals of North Midlands NHS Trust University Hospitals Coventry and Warwickshire NHS Trust

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University Hospitals of Leicester NHS Trust Walsall Healthcare NHS Trust West Hertfordshire Hospitals NHS Trust West London Mental Health NHS Trust West Middlesex University Hospital NHS Trust (merged with Chelsea and Westminster Hospitals NHS FT on 1/09/15) Weston Area Health NHS Trust Wirral Community NHS Trust Worcestershire Acute Hospitals NHS Trust Worcestershire Health and Care NHS Trust Wye Valley NHS Trust Yorkshire Ambulance Service NHS Trust NHS Airedale, Wharfdale and Craven CCG NHS Ashford CCG NHS Aylesbury Vale CCG NHS Barking and Dagenham CCG NHS Barnet CCG NHS Barnsley CCG NHS Basildon and Brentwood CCG NHS Bassetlaw CCG NHS Bath and North East Somerset CCG NHS Bedfordshire CCG NHS Bexley CCG NHS Birmingham Crosscity CCG NHS Birmingham South and Central CCG NHS Blackburn With Darwen CCG NHS Blackpool CCG NHS Bolton CCG NHS Bracknell and Ascot CCG NHS Bradford City CCG NHS Bradford Districts CCG NHS Brent CCG NHS Brighton and Hove CCG NHS Bristol CCG NHS Bromley CCG NHS Bury CCG NHS Calderdale CCG NHS Cambridgeshire and Peterborough CCG

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NHS Camden CCG NHS Cannock Chase CCG NHS Canterbury and Coastal CCG NHS Castle Point and Rochford CCG NHS Central London (Westminster) CCG NHS Central Manchester CCG NHS Chiltern CCG NHS Chorley and South Ribble CCG NHS City and Hackney CCG NHS Coastal West Sussex CCG NHS Corby CCG NHS Coventry and Rugby CCG NHS Crawley CCG NHS Croydon CCG NHS Cumbria CCG NHS Darlington CCG NHS Dartford, Gravesham and Swanley CCG NHS Doncaster CCG NHS Dorset CCG NHS Dudley CCG NHS Durham Dales, Easington and Sedgefield CCG NHS Ealing CCG NHS East and North Hertfordshire CCG NHS East Lancashire CCG NHS East Leicestershire and Rutland CCG NHS East Riding of Yorkshire CCG NHS East Staffordshire CCG NHS East Surrey CCG NHS Eastbourne, Hailsham and Seaford CCG NHS Eastern Cheshire CCG NHS Enfield CCG NHS Erewash CCG NHS Fareham and Gosport CCG NHS Fylde & Wyre CCG NHS Gloucestershire CCG NHS Great Yarmouth and Waveney CCG NHS Greater Huddersfield CCG NHS Greater Preston CCG

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NHS Greenwich CCG NHS Guildford and Waverley CCG NHS Halton CCG NHS Hambleton, Richmondshire and Whitby CCG NHS Hammersmith and Fulham CCG NHS Hardwick CCG NHS Haringey CCG NHS Harrogate and Rural District CCG NHS Harrow CCG NHS Hartlepool and Stockton-on-Tees CCG NHS Hastings and Rother CCG NHS Havering CCG NHS Herefordshire CCG NHS Herts Valleys CCG NHS Heywood, Middleton and Rochdale CCG NHS High Weald Lewes Havens CCG NHS Hillingdon CCG NHS Horsham and Mid Sussex CCG NHS Hounslow CCG NHS Hull CCG NHS Ipswich and East Suffolk CCG NHS Isle of Wight CCG NHS Islington CCG NHS Kernow CCG NHS Kingston CCG NHS Knowsley CCG NHS Lambeth CCG NHS Lancashire North CCG NHS Leeds North CCG NHS Leeds South and East CCG NHS Leeds West CCG NHS Leicester City CCG NHS Lewisham CCG NHS Lincolnshire East CCG NHS Lincolnshire West CCG NHS Liverpool CCG NHS Luton CCG NHS Mansfield and Ashfield CCG

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NHS Medway CCG NHS Merton CCG NHS Mid Essex CCG NHS Milton Keynes CCG NHS Nene CCG NHS Newark and Sherwood CCG NHS Newbury and District CCG NHS Newcastle Gateshead CCG (formed from the merger of 00F, 00G and 00H on 1/04/15) NHS Newham CCG NHS North and West Reading CCG NHS North Derbyshire CCG NHS North Durham CCG NHS North East Essex CCG NHS North East Hampshire and Farnham CCG NHS North East Lincolnshire CCG NHS North Hampshire CCG NHS North Kirklees CCG NHS North Lincolnshire CCG NHS North Manchester CCG NHS North Norfolk CCG NHS North Somerset CCG NHS North Staffordshire CCG NHS North Tyneside CCG NHS North West Surrey CCG NHS North, East, West Devon CCG NHS Northumberland CCG NHS Norwich CCG NHS Nottingham City CCG NHS Nottingham North and East CCG NHS Nottingham West CCG NHS Oldham CCG NHS Oxfordshire CCG NHS Portsmouth CCG NHS Redbridge CCG NHS Redditch and Bromsgrove CCG NHS Richmond CCG NHS Rotherham CCG NHS Rushcliffe CCG

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NHS Salford CCG NHS Sandwell and West Birmingham CCG NHS Scarborough and Ryedale CCG NHS Sheffield CCG NHS Shropshire CCG NHS Slough CCG NHS Solihull CCG NHS Somerset CCG NHS South Cheshire CCG NHS South Devon and Torbay CCG NHS South East Staffs and Seisdon Peninsular CCG NHS South Eastern Hampshire CCG NHS South Gloucestershire CCG NHS South Kent Coast CCG NHS South Lincolnshire CCG NHS South Manchester CCG NHS South Norfolk CCG NHS South Reading CCG NHS South Sefton CCG NHS South Tees CCG NHS South Tyneside CCG NHS South Warwickshire CCG NHS South West Lincolnshire CCG NHS South Worcestershire CCG NHS Southampton CCG NHS Southend CCG NHS Southern Derbyshire CCG NHS Southport and Formby CCG NHS Southwark CCG NHS St Helens CCG NHS Stafford and Surrounds CCG NHS Stockport CCG NHS Stoke on Trent CCG NHS Sunderland CCG NHS Surrey Downs CCG NHS Surrey Heath CCG NHS Sutton CCG NHS Swale CCG

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NHS Swindon CCG NHS Tameside and Glossop CCG NHS Telford and Wrekin CCG NHS Thanet CCG NHS Thurrock CCG NHS Tower Hamlets CCG NHS Trafford CCG NHS Vale of York CCG NHS Vale Royal CCG NHS Wakefield CCG NHS Walsall CCG NHS Waltham Forest CCG NHS Wandsworth CCG NHS Warrington CCG NHS Warwickshire North CCG NHS West Cheshire CCG NHS West Essex CCG NHS West Hampshire CCG NHS West Kent CCG NHS West Lancashire CCG NHS West Leicestershire CCG NHS West London (K&C & Qpp) CCG NHS West Norfolk CCG NHS West Suffolk CCG NHS Wigan Borough CCG NHS Wiltshire CCG NHS Windsor, Ascot and Maidenhead CCG NHS Wirral CCG NHS Wokingham CCG NHS Wolverhampton CCG NHS Wyre Forest CCG NHS England (statutory entity - populated by completing table of sub-entities below) Partially completed spells and NCA accruals not attributable to a commissioner Public Health England (PHE) Health and Social Care Information Centre (including Connecting for Health) Health Education England (NDPB from 1/04/15) Health Research Authority National Institute for Health and Care Excellence

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NHS Business Services Authority (incl student bursaries) NHS Litigation Authority NHS Trust Development Authority Care Quality Commission Human Fertilisation and Embryology Authority Human Tissue Authority Professional Standards Authority for Health and Social Care Skipton Fund Monitor NHS Property Services Community Health Partnerships Genomics England Ltd Nursing and Midwifery Council NHS Medical Assets England Limited Department of Health (incl. core trading and NHS Supply Chain Maidstone invoices prefixed with 904, ESR Transactions from NHS BSA , not incl. PDC) Department of Health (PDC dividend only) - not part of agreement of balances

Breakdown of balances recorded against NHS England at 31 March 2016 NHS England - Core NHS Arden & Greater East Midlands Commissioning Support Unit (formed from 1/04/15 merger of 0AA and 0AK) NHS Central Eastern Commissioning Support Unit (CSU now closed on 1/4/15) NHS Central Southern Commissioning Support Unit NHS Cheshire and Merseyside Commissioning Support Unit NHS Greater Manchester Commissioning Support Unit NHS Midlands & Lancashire Commissioning Support Unit (formed from 1/04/15 merger of 0AD and 0AG) NHS North and East London Commissioning Support Unit (merged with 0AP on 1/04/15) NHS North of England Commissioning Support Unit NHS North West London Commissioning Support Unit (CSU closed on 1/4/15) NHS South Commissioning Support Unit NHS South East Commissioning Support Unit (previously South London CSU - merged with 0AM on 1/04/15) NHS South West Commissioning Support Unit NHS Yorkshire and the Humber Commissioning Support Unit NHS England - Central Midlands Local Office (Geography. Merger of Q58 & Q59) NHS England - Cheshire and Merseyside Local Office (Geography. Merger of Q44 & Q48) NHS England - Cumbria and North East Local Office (Geography. Merger of Q45 & Q49) NHS England - East Local Office (Geography. Merger of Q56 & Q57)

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NHS England - Lancashire and Greater Manchester Local Office (Geography. Merger of Q46 & Q47) NHS England - North Midlands Local Office (Geography. Merger of Q55 & Q60) NHS England - South Central Local Office (Geography. Merger of Q64 & Q69) NHS England - South East Local Office (Geography. Merger of Q67 & Q68) NHS England - South West Local Office (Geography. Merger of Q65 & Q66) NHS England - Wessex Local Office (Geography) NHS England - West Midlands Local Office (Geography. Merger of Q53 & Q54) NHS England - Yorkshire and the Humber Local Office (Geography. Merger of Q50, Q51 & Q52) NHS England - Central Midlands Commissioning Hub NHS England - East Commissioning Hub NHS England - London Commissioning Hub NHS England - North East Commissioning Hub NHS England - North West Commisssioning Hub NHS England - South East Commissioning Hub NHS England - South West Commissioning Hub NHS England - Wessex Commissioning Hub NHS England - West Midlands Commissioning Hub NHS England - Yorkshire and the Humber Commissioning Hub NHS England - Central Specialised Commissioning Hub North of England Regional Office Midlands and East Regional Office London Regional Office South Regional Office

Central Government WGA bodies Department for Education Dept of Work and Pensions Home Office (including prisons) HM Revenue & Customs - VAT HM Revenue & Customs - Other taxes and duties and NI contributions (Not PAYE or employee NI) HM Revenue & Customs - Other non tax Valuation Office Agency National Insurance Fund (not to be used for NI contributions which should be recorded against HMRC) Ministry of Defence (MoD) NHS Pension Scheme (Own staff employers contributions only plus other invoiced charges)

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Welsh Health Bodies - Velindre NHS Trust Welsh Health Bodies - Welsh Ambulance Services NHS Trust Welsh Health Bodies - Public Health Wales NHS Trust Welsh Health Bodies - Abertawe Bro Morgannwg University Local Health Board Welsh Health Bodies - Aneurin Bevan Local Health Board Welsh Health Bodies - Betsi Cadwaladr University Local Health Board Welsh Health Bodies - Cardiff and Vale University Local Health Board Welsh Health Bodies - Cwm Taf Local Health Board Welsh Health Bodies - Hywel Dda Health Board Welsh Health bodies - Powys Local Health Board Welsh Assembly Government Scottish Government NHS Blood and Transplant Medicines and Healthcare Products Regulatory Agency Blyth Harbour Commissioners British Council British Railways Board (Residuary) Ltd British Waterways Board Cardiff International Airport Central Office of Information Channel Four Television Corporation Civil Aviation Authority Commonwealth Development Corporation Companies House Defence Science and Technology Laboratory Driver and Vehicle Agency (Trading Fund Element only) - Northern Ireland Driving Standards Agency Dover Harbour Board Export Credits Guarantee Department Financial Conduct Authority Financial Ombudsman Limited Fire Service College Forensic Science Service Forest Enterprise Agency (England) General Lighthouse Fund Government Procurement Service

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Greenwich Hospital Guaranteed Export Finance Corporation Harwich Haven Authority Historic Royal Palaces Trust Intellectual Property Office International Nuclear Services Ltd Land Registry Meteorological Office Milford Haven Port Authority National Employment Savings Trust Corporation (NEST) National Nuclear Laboratory Ltd Navy, Army and Air Force Institute Nexus (Tyne & Wear Passenger Transport Executive) NHS Professionals Northern Ireland Water Ltd Ordnance Survey Pacific Nuclear Transport Ltd Pension Protection Fund (PPF) Porton Biopharma Ltd Poole Harbour Commissioners Port of London Authority Port of Tyne Authority Post Office Limited Prudential Regulation Authority Remploy Royal Mint Shoreham Port Authority UK Hydrographic Office Vehicle and Operator Services Agency Bank Of England Bank Of England Asset Purchase Facility (BEAPF) Bank Of England Issue Department British Nuclear Fuels Caledonian Maritime Assets Ltd Registers of Scotland Scottish Water

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Northern Ireland Housing Executive Northern Ireland Transport Holding Company Competition and Markets Authority Disclosure and Barring Service Financial Services Compensation Scheme Forest Enterprise Agency (Scotland) Help to Buy (HMT) Limited London & Continental Railways Limited Network Rail Office of Nuclear Regulation Office of Qualifications and Examinations Regulator Cabinet Office Civil Service Commission Consolidated Fund Contingencies Fund Debt Management Account Exchange Equalisation Account Heritage Lottery Fund National Loans Fund National Lottery UK Sports Council Lottery National Savings and Investments Public Works Loans Board Government Actuary’s Department Museum of London Office for Standard in Education children's Services and Skills (Ofsted) Office of Gas and Electricity Markets (OFGEM) Office of Rail Regulation Security and Intelligence Agencies Serious Fraud Office The UK Supreme Court UK Statistics Authority (ONS) UK Trade & Investment Water Services Regulation Authority Charity Commission Advantage West Midlands Advisory Conciliation and Arbitration Service (ACAS)

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Arts and Humanities Research Council Biotechnology and Biological Sciences Research Council (BBSRC) Competition Commission Construction Industry Training Board (CITB) Consumer Focus (AKA National Consumer Council) Department for Business, Innovation and Skills East Midlands Development Agency East of England Development Agency Economic and Social Research Council Engineering and Physical Sciences Research Council Engineering Construction Industry Training Board Financial Reporting Council Higher Education Funding Council for England Learning and Skills Improvement Service Medical Research Council National Endowment for Science, Technology and the Arts Natural Environment Research Council North West Regional Development Agency OFCOM ONE North East RCUK Shared Services Centre Ltd Science and Technology Facilities Council South East Development Agency South West of England Regional Development Agency Student Loans Company Limited Technology Strategy Board UK Green Investment Bank plc United Kingdom Atomic Energy Authority United Kingdom Commission for Employment and Skills Yorkshire Forward Commission for Local Administration in England Department for Communities and Local Government Homes and Communities Agency London Thames Gateway Development Corporation Queen Elizabeth II Conference Centre Thurrock Development Corporation

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Valuation Tribual for England Valuation Tribunal Service West Northamptonshire Development Corporation Arts Council of England Arts Council of England Lottery BIG Lottery Fund British Broadcasting Corporation British Broadcasting Corporation - License Fee British Film Institute British Library British Museum Dept. Culture Media and Sport English Sports Council Gambling Commission Geffrye Museum Horniman Museum and Public Park Foundation Horserace Betting Levy Board Imperial War Museum London Organising Committee of the Olympic Games Limited National Gallery National Heritage Memorial Fund National Lottery Distribution Fund National Maritime Museum National Museums and Galleries on Merseyside National Portrait Gallery Natural History Museum Olympic Delivery Authority Olympic Lottery Distribution Fund Olympic Lottery Distributor Royal Armouries Museum S4C Sir John Soane’s Museum Sport England Lottery Tate Gallery UK Sport Victoria and Albert Museum

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VisitBritain Wallace Collection Academies (as established under section 1 of the Academies Act 2010) Children and Family Court Advisory and Support Service Education Funding Agency Agriculture and Horticulture Development Board Commission for Rural Communities Consumer Council for Water Department for Environment, Food and Rural Affairs Environment Agency Forestry Commission (England) Joint Nature Conservation Committee Marine Management Organisation National Forest Company Natural England Royal Botanic Gardens, Kew Sea Fish Industry Authority Sustainable Development Commission Department for International Development British Transport Police Authority (sSRA) Department for Transport Directly Operated Railways Driver and Vehicle Licensing Agency Vehicle Excise Duty (Trust Statement for DVLA) Health and Safety Executive (HSE) Independent Living Fund (ILF) The Pensions Regulator (TPR) Carbon Reduction Commitment Trust Statement Civil Nuclear Police Authority (CNPA) Coal Authority Department of Energy and Climate Change EU Emissions Allowance Trust Statement Nuclear Decommissioning Authority Nuclear Liabilities Fund Petroleum Licences Trust Statement Food Standards Agency

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FCO Services Foreign and Commonwealth Office HM Treasury Infrastructure Finance Unit Limited Local Partnerships LLP Money Advice Service Office for Budget Responsibility UKAR Asset Resolution Limited UK Debt Management Office UK Financial Investments Limited College of Policing Independent Police Complaints Commission Independent Safeguarding Authority National Policing Improvement Agency Security Industry Authority Serious Organised Crime Agency (Abolished in October 2013. Replaced by National Crime Agency) Defence Support Group National Army Museum Royal Air Force Museum Royal Hospital Chelsea Criminal Injuries Compensation Authority Legal Aid Agency (previously Legal Services Commission) Ministry of Justice Office of the Information Commissioner Youth Justice Board for England and Wales Animal Health and Veterinary Laboratories Agency Centre for Environment, Fisheries, Aquacult & Science Dounreay Site Restoration Training Board DWP - Financial Assistance Scheme Electricity Settlements Company Limited Food and Environment Research Agency Forestry Commission (Scotland) Gangmasters Licensing Authority HM Court Service fines and penalties trust statement Learning and Teaching Scotland LLW Repository Limited

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Low Carbon Contracts Company Limited Magnox Limited Maze- Long Kesh Development Corp National Archives of Scotland National Crime Agency National Savings and Investments- Ordinary Deposit Account NDA Archives Limited NNDR Trust Statement Northern Ireland Council for Integrated Education Office of the Registrar of Consultant Lobbyists OFGEM- Fossil Fuel Levy OFT - Competition Act Penalties Trust Statement Planning Inspectorate Radioactive Waste Management Limited Research Site Restoration Limited Royal Household Royal Mail Pension Scheme Rural Payments Agency Science Museum Group Sellafield Limited The Commission for Equality and Human Rights The Housing Ombudsman The National Archives Transport for Manchester Veterinary Medicines Directorate Victims and Survivors Service - NIE Youth Council for Northern Ireland Agri-Food and Biosciences Institute - Northern Ireland Armagh Planetarium and Observatory - Northern Ireland Arts Council of Northern Ireland Arts Council of Northern Ireland Lottery Distribution Account Belfast Education and Library Board - Northern Ireland Belfast Health and Social Care Trust - Northern Ireland Business Services Organisation - Northern Ireland Charity Commission for Northern Ireland Northern Ireland Community Relations Council

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Council for Catholic Maintained Schools - Northern Ireland Criminal Justice Inspection Northern Ireland Department for Employment and Learning - Northern Ireland Department for Regional Development - Northern Ireland Department for Social Development - Northern Ireland Department of Agriculture and Rural Development - Northern Ireland Department of Culture, Arts and Leisure - Northern Ireland Department of Education - Northern Ireland Department of Enterprise, Trade and Investment - Northern Ireland Department of Finance and Personnel - Northern Ireland Department of Health, Social Services and Public Safety - Northern Ireland Department of Justice - Northern Ireland Department of the Environment - Northern Ireland DFP - Superannuation & Other Allowances - Northern Ireland Equality Commission for Northern Ireland Health and Safety Executive for Northern Ireland Health and Social Care Pension Scheme - NI (peviously HPSS Superannuation Account - Northern Ireland) Ilex Urban Regeneration Company Limited - Northern Ireland Invest Northern Ireland National Museums and Galleries of Northern Ireland NI Ambulance Service HSS Trust - Northern Ireland North Eastern Education and Library Board - Northern Ireland Northern Health and Social Care Trust - Northern Ireland Northern Ireland Authority for Utility Regulation Northern Ireland Blood Transfusion Service Northern Ireland Consolidated Fund Northern Ireland Council for Integrated Education Northern Ireland Council for the Curriculum, Examinations and Assessment Northern Ireland Executive Northern Ireland Fire and Rescue Service Northern Ireland Fishery Harbour Authority Northern Ireland Legal Services Commission Northern Ireland Library Authority Northern Ireland Local Government Officers Superannuation Committee Northern Ireland Medical and Dental Training Agency Northern Ireland National Insurance Fund

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Northern Ireland Policing Board Northern Ireland Screen Commission Northern Ireland Tourist Board Office of the First Minister and Deputy First Minister - Northern Ireland Patient and Client Council - Northern Ireland Police Ombudsman for Northern Ireland Police Service of Northern Ireland Pension Scheme Police Service of Northern Ireland Probation Board for Northern Ireland - Northern Ireland Public Prosecution Service - Northern Ireland Regulation and Quality Improvement Authority - Northern Ireland South Eastern Education and Library Board - Northern Ireland South Eastern Health and Social Care Trust - Northern Ireland Southern Education and Library Board - Northern Ireland Southern Health and Social Care Trust - Northern Ireland Sports Council for Northern Ireland Sports Council for Northern Ireland Lottery Distribution Account - Northern Ireland Strategic Investment Board Limited - Northern Ireland Teachers Superannuation Scheme Statements - Northern Ireland Ulster Supported Employment Limited - Northern Ireland Western Education and Library Board - Northern Ireland Western Health and Social Care Trust - Northern Ireland Northern Ireland Office Armed Forces Retired Pay, Pensions etc Cabinet Office: Civil superannuation Department for International Development: Overseas Superannuation Ministry of Justice: Judicial Pensions Scheme Research Councils Pension Scheme Teachers' Pension Scheme (England & Wales) UKAEA pension schemes Scotland Office and Office of Advocate General Scottish Consolidated Fund Care Inspectorate (SCSWIS) Creative Scotland David MacBrayne Ltd Highland and Islands Enterprise

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Highlands and Islands Airport National Galleries of Scotland National Library of Scotland National Museums of Scotland National Records of Scotland Royal Botanic Garden, Edinburgh Scottish Children's Reporter Administration Scottish Court Service Scottish Enterprise Scottish Environment Protection Agency Scottish Further and Higher Education Funding Council Scottish Legal Aid Board Scottish Natural Heritage Scottish Police Services Authority Scottish Qualifications Authority Scottish Social Services Council Skills Development Scotland Sportscotland VisitScotland The Scottish NHS Pension Scheme Scottish Teachers Pension Scheme Crown Prosecution Service HM Procurator General and Treasury Solicitor Wales Office Welsh Consolidated Fund Arts Council of Wales Arts Council of Wales National Lottery Care Council for Wales Children's Commissioner for Wales Countryside Council for Wales Estyn: Her Majesty's Inspectorate for Education & Training for Wales General Teaching Council for Wales Higher Education Funding Council for Wales Local Government Boundary Commission for Wales National Library of Wales National Museums and Galleries of Wales

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Natural Resources Wales Older People's Commissioner for Wales Sports Council for Wales Sports Council for Wales National Lottery Welsh Language Commissioner

Local Government WGA Bodies Adur District Council Allerdale Borough Council Amber Valley Borough Council Arun District Council Ashfield District Council Ashford Borough Council Avon & Somerset Police and Crime Commissioner and Chief Constable Avon Combined Fire and Rescue Authority Aylesbury Vale District Council Babergh District Council Barking & Dagenham London Borough Council Barnet London Borough Council Barnsley Metropolitan Borough Council Barrow-in-Furness Borough Council Basildon District Council Basingstoke and Deane Borough Council Bassetlaw District Council Bath & North East Somerset Council Bedford Unitary Authority Bedfordshire Combined Fire and Rescue Authority Bedfordshire Police and Crime Commissioner and Chief Constable Berkshire Combined Fire and Rescue Authority Bexley London Borough Council Birmingham City Council Blaby District Council Blackburn with Darwen Unitary Authority Blackpool Unitary Authority Bolsover District Council Bolton Metropolitan Borough Council Boston Borough Council Bournemouth Council

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Bracknell Forest Borough Council Bradford City Council Braintree District Council Breckland District Council Brent London Borough Council Brentwood Borough Council Brighton & Hove City Council Bristol City Council Broadland District Council Broads Authority (The) Bromley London Borough Council Bromsgrove District Council Broxbourne Borough Council Broxtowe Borough Council Buckinghamshire Combined Fire and Rescue Authority Buckinghamshire County Council Burnley Borough Council Bury Metropolitan Borough Council Calderdale Metropolitan Borough Council Cambridge City Council Cambridgeshire Combined Fire and Rescue Authority Cambridgeshire County Council Cambridgeshire Police and Crime Commissioner and Chief Constable Camden London Borough Council Cannock Chase District Council Canterbury City Council Carlisle City Council Castle Point Borough Council Central Bedfordshire Unitary Authority Charnwood Borough Council Chelmsford Borough Council Cheltenham Borough Council Cherwell District Council Cheshire Combined Fire and Rescue Authority Cheshire East Unitary Authority Cheshire Police and Crime Commissioner and Chief Constable Cheshire West and Chester Unitary Authority Chesterfield Borough Council

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Chichester District Council Chiltern District Council Chorley Borough Council Christchurch Borough Council City of York Council Cleveland Combined Fire and Rescue Authority Cleveland Police and Crime Commissioner and Chief Constable Colchester Borough Council Common Council of the City of London Copeland Borough Council Corby Borough Council Cornwall Unitary Authority Cotswold District Council County Durham Unitary Authority Coventry City Council Craven District Council Crawley Borough Council Croydon London Borough Council Cumbria County Council Cumbria Police and Crime Commissioner and Chief Constable Dacorum Borough Council Darlington Borough Council Dartford Borough Council Dartmoor National Park Authority Daventry District Council Derby City Council Derbyshire Combined Fire and Rescue Authority Derbyshire County Council Derbyshire Dales District Council Derbyshire Police and Crime Commissioner and Chief Constable Devon & Cornwall Police and Crime Commissioner and Chief Constable Devon and Somerset Combined Fire and Rescue Authority Devon County Council Doncaster Metropolitan Borough Council Dorset Combined Fire and Rescue Authority Dorset County Council Dorset Police and Crime Commissioner and Chief Constable Dover District Council

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Dudley Metropolitan Borough Council Durham Combined Fire and Rescue Authority Durham Police and Crime Commissioner and Chief Constable Ealing London Borough Council East Cambridgeshire District Council East Devon District Council East Dorset District Council East Hampshire District Council East Hertfordshire District Council East Lindsey District Council East London Waste Authority East Northamptonshire District Council East Riding of Yorkshire Council East Staffordshire Borough Council East Sussex Combined Fire and Rescue Authority East Sussex County Council Eastbourne Borough Council Eastleigh Borough Council Eden District Council Elmbridge Borough Council Enfield London Borough Council Epping Forest District Council Epsom and Ewell Borough Council Erewash Borough Council Essex Combined Fire and Rescue Authority Essex County Council Essex Police and Crime Commissioner and Chief Constable Exeter City Council Exmoor National Park Authority Fareham Borough Council Fenland District Council Forest Heath District Council Forest of Dean District Council Fylde Borough Council Gateshead Council Gedling Borough Council Gloucester City Council Gloucestershire County Council

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Gloucestershire Police and Crime Commissioner and Chief Constable Gosport Borough Council Gravesham Borough Council Great Yarmouth Borough Council Greater London Authority Greater Manchester Combined Authority Greater Manchester Fire and Rescue Authority Greater Manchester Police and Crime Commissioner and Chief Constable Greater Manchester Waste Disposal Authority Greenwich London Borough Council Guildford Borough Council Hackney London Borough Council Halton Borough Council Hambleton District Council Hammersmith and Fulham London Borough Council Hampshire Combined Fire and Rescue Authority Hampshire County Council Hampshire Police and Crime Commissioner and Chief Constable Harborough District Council Haringey London Borough Council Harlow District Council Harrogate Borough Council Harrow London Borough Council Hart District Council Hartlepool Borough Council Hastings Borough Council Havant Borough Council Havering London Borough Council Hereford & Worcester Combined Fire and Rescue Authority Herefordshire Council Hertfordshire County Council Hertfordshire Police and Crime Commissioner and Chief Constable Hertsmere Borough Council High Peak Borough Council Hillingdon London Borough Council Hinckley and Bosworth Borough Council Horsham District Council Hounslow London Borough Council

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Humberside Combined Fire and Rescue Authority Humberside Police and Crime Commissioner and Chief Constable Huntingdonshire District Council Hyndburn Borough Council Ipswich Borough Council Isle of Wight Council Isles of Scilly (Council of the) Islington London Borough Council Kensington and Chelsea Council (Royal Borough of) Kent Combined Fire and Rescue Authority Kent County Council Kent Police and Crime Commissioner and Chief Constable Kettering Borough Council Kings Lynn and West Norfolk Borough Council Kingston upon Hull City Council Kingston upon Thames Council (Royal Borough of) Kirklees Metropolitan Council Knowsley Metropolitan Borough Council Lake District National Park Authority Lambeth London Borough Council Lancashire Combined Fire and Rescue Authority Lancashire County Council Lancashire Police and Crime Commissioner and Chief Constable Lancaster City Council Lee Valley Regional Park Authority Leeds City Council Leicester City Council Leicestershire Combined Fire and Rescue Authority Leicestershire County Council Leicestershire Police and Crime Commissioner and Chief Constable Lewes District Council Lewisham London Borough Council Lichfield District Council Lincoln City Council Lincolnshire County Council Lincolnshire Police and Crime Commissioner and Chief Constable Liverpool City Council London Fire and Emergency Planning Authority

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London Legacy Development Corporation Luton Borough Council Maidstone Borough Council Maldon District Council Malvern Hills District Council Manchester City Council Mansfield District Council Mayor’s Office for Policing and Crime and Metropolis Police Commissioner Medway Towns Unitary Authority (The) Melton Borough Council Mendip District Council Merseyside Fire and Rescue Authority Merseyside Integrated Transport Authority (trading as Merseytravel) Merseyside Police and Crime Commissioner and Chief Constable Merseyside Waste Disposal Authority Merton Borough Council Mid Devon District Council Mid Suffolk District Council Mid Sussex District Council Middlesbrough Council Milton Keynes Council Mole Valley District Council New Forest District Council New Forest National Park Authority Newark and Sherwood District Council Newcastle upon Tyne City Council Newcastle-under-Lyme Borough Council Newham London Borough Council Norfolk County Council Norfolk Police and Crime Commissioner and Chief Constable North Devon District Council North Dorset District Council North East Derbyshire District Council North East Lincolnshire Council North Hertfordshire District Council North Kesteven District Council North Lincolnshire Council North London Waste Authority

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North Norfolk District Council North Somerset Council North Tyneside Metropolitan Borough Council North Warwickshire Borough Council North West Leicestershire District Council North York Moors National Park Authority North Yorkshire Combined Fire and Rescue Authority North Yorkshire County Council North Yorkshire Police and Crime Commissioner and Chief Constable Northampton Borough Council Northamptonshire County Council Northamptonshire Police and Crime Commissioner and Chief Constable Northumberland National Park Authority Northumberland Unitary Authority Northumbria Police and Crime Commissioner and Chief Constable Norwich City Council Nottingham City Council Nottinghamshire Combined Fire and Rescue Authority Nottinghamshire County Council Nottinghamshire Police and Crime Commissioner and Chief Constable Nuneaton and Bedworth Borough Council Oadby and Wigston Borough Council Oldham Metropolitan Borough Council Oxford City Council Oxfordshire County Council Peak District National Park Authority Pendle Borough Council Peterborough City Council Plymouth City Council Poole (Borough of) Portsmouth City Council Preston City Council Purbeck District Council Reading Borough Council Redbridge London Borough Council Redcar and Cleveland Borough Council Redditch Borough Council Reigate and Banstead Borough Council

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Ribble Valley Borough Council Richmond upon Thames Borough Council Richmondshire District Council Rochdale Borough Council Rochford District Council Rossendale Borough Council Rother District Council Rotherham Borough Council Rugby Borough Council Runnymede Borough Council Rushcliffe Borough Council Rushmoor Borough Council Rutland County Council Ryedale District Council Salford City Council Sandwell Metropolitan Borough Council Scarborough Borough Council Sedgemoor District Council Sefton Metropolitan Borough Council Selby District Council Sevenoaks District Council Sheffield City Council Shepway District Council Shropshire Combined Fire and Rescue Authority Shropshire Unitary Authority Slough Borough Council Solihull Metropolitan Borough Council Somerset County Council South Bucks District Council South Cambridgeshire District Council South Derbyshire District Council South Downs National Park South Gloucestershire Council South Hams District Council South Holland District Council South Kesteven District Council South Lakeland District Council South Norfolk District Council

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South Northamptonshire Council South Oxfordshire District Council South Ribble Borough Council South Somerset District Council South Staffordshire District Council South Tyneside Council South Yorkshire Fire and Rescue Authority South Yorkshire Integrated Transport Authority South Yorkshire Police and Crime Commissioner and Chief Constable Southampton City Council Southend-on-Sea Borough Council Southwark London Borough Council Spelthorne Borough Council St Albans City and District Council St Edmundsbury Borough Council St Helens Metropolitan Borough Council Stafford Borough Council Staffordshire Combined Fire and Rescue Authority Staffordshire County Council Staffordshire Moorlands District Council Staffordshire Police and Crime Commissioner and Chief Constable Stevenage Borough Council Stockport Metropolitan Borough Council Stockton-on-Tees Borough Council Stoke-on-Trent Unitary Authority Stratford-on-Avon District Council Stroud District Council Suffolk Coastal District Council Suffolk County Council Suffolk Police and Crime Commissioner and Chief Constable Sunderland City Metropolitan Borough Council Surrey County Council Surrey Heath Borough Council Surrey Police and Crime Commissioner and Chief Constable Sussex Police and Crime Commissioner and Chief Constable Sutton London Borough Council Swale Borough Council Swindon Unitary Authority

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Tameside Metropolitan Borough Council Tamworth Borough Council Tandridge District Council Taunton Deane Borough Council Teignbridge District Council Telford and Wrekin (Borough of) Tendring District Council Test Valley Borough Council Tewkesbury Borough Council Thames Valley Police and Crime Commissioner and Chief Constable Thanet District Council Three Rivers District Council Thurrock Unitary Authority Tonbridge and Malling Borough Council Torbay Council Torridge District Council Tower Hamlets London Borough Council Trafford Metropolitan Borough Council Transport for London Tunbridge Wells Borough Council Tyne & Wear Integrated Transport Authority Tyne and Wear Fire and Rescue Authority Uttlesford District Council Vale of White Horse District Council Wakefield City Council Walsall Metropolitan Borough Council Waltham Forest London Borough Council Wandsworth London Borough Council Warrington Borough Council Warwick District Council Warwickshire County Council Warwickshire Police and Crime Commissioner and Chief Constable Watford Borough Council Waveney District Council Waverley Borough Council Wealden District Council Wellingborough Borough Council Welwyn Hatfield District Council

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West Berkshire Council West Devon Borough Council West Dorset District Council West Lancashire District Council West Lindsey District Council West London Waste Authority West Mercia Police and Crime Commissioner and Chief Constable West Midlands Fire and Rescue Authority West Midlands Integrated Transport Authority West Midlands Police and Crime Commissioner and Chief Constable West Oxfordshire District Council West Somerset District Council West Sussex County Council West Yorkshire Fire and Rescue Authority West Yorkshire Integrated Transport Authority West Yorkshire Police and Crime Commissioner and Chief Constable Western Riverside Waste Authority Westminster City Council Weymouth and Portland Borough Council Wigan Metropolitan Borough Council Wiltshire Combined Fire and Rescue Authority Wiltshire Police and Crime Commissioner and Chief Constable Wiltshire Unitary Authority Winchester City Council Windsor and Maidenhead (Royal Borough of) Wirral Metropolitan Borough Council Woking Borough Council Wokingham Council Wolverhampton City Council Worcester City Council Worcestershire County Council Worthing Borough Council Wychavon District Council Wycombe District Council Wyre Borough Council Wyre Forest District Council Yorkshire Dales National Park Authority Blaenau Gwent County Borough Council

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Bridgend County Borough Council Caerphilly County Borough Council Cardiff City and County Council Carmarthenshire County Council Ceredigion County Council Conwy County Borough Council Denbighshire County Council Dyfed Powys Police and Crime Commissioner Flintshire County Council Gwent Police and Crime Commissioner Gwynedd County Council Isle of Anglesey County Council Merthyr Tydfil County Borough Council Mid and West Wales Fire Authority Monmouthshire County Council Neath Port Talbot County Borough Council Newport City Council North Wales Fire Authority North Wales Police and Crime Commissioner Pembrokeshire Coast National Park Authority Pembrokeshire County Council Powys County Council Rhondda Cynon Taff County Borough Council Snowdonia National Park Authority South Wales Fire Authority South Wales Police and Crime Commissioner Swansea City and County Council Torfaen County Borough Council Vale of Glamorgan County Council Wrexham County Borough Council Aberdeen City Council Aberdeenshire Council Angus Council Argyll and Bute Council Central Scotland Fire and Rescue Service Central Scotland Police Clackmannanshire Council Comhairle nan Eilean Siar (Western Isles Council)

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Dumfries and Galloway Council Dundee City Council East Ayrshire Council East Dunbartonshire Council East Lothian Council East Renfrewshire Council Edinburgh City Council Falkirk Council Fife Council Fire Service Scotland Forth Estuary Transport Authority Glasgow City Council Grampian Fire and Rescue Service Grampian Police Highland Council Highlands & Islands Fire Brigade Inverclyde Council Lothian & Borders Fire and Rescue Service Lothian & Borders Police Midlothian Council Moray Council North Ayrshire Council North Lanarkshire Council Northern Constabulary Orkney Islands Council Perth and Kinross Council Police Service Scotland Renfrewshire Council Scottish Borders Council Shetland Charitable Trust Shetland Islands Council South Ayrshire Council South Lanarkshire Council South-East of Scotland Transport Partnership (SESTRAN) Stirling Council Strathclyde Fire and Rescue Service Strathclyde Partnership for Transport Strathclyde Police

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Tay Road Bridge Joint Board Tayside Fire and Rescue Tayside Police West Dunbartonshire Council West Lothian Council Antrim Borough Council - Northern Ireland Arc21 Joint Committee - Northern Ireland Ards Borough Council - Northern Ireland Armagh City and District Council - Northern Ireland Ballymena Borough Council - Northern Ireland Ballymoney Borough Council - Northern Ireland Banbridge District Council - Northern Ireland Belfast City Council - Northern Ireland Carrickfergus Borough Council - Northern Ireland Castlereagh Borough Council - Northern Ireland Coleraine Borough Council - Northern Ireland Cookstown District Council - Northern Ireland Craigavon Borough Council - Northern Ireland Derry City Council - Northern Ireland Down District Council - Northern Ireland Dungannon and South Tyrone Borough Council - Northern Ireland Fermanagh District Council - Northern Ireland Larne Borough Council - Northern Ireland Limavady Borough Council - Northern Ireland Lisburn City Council - Northern Ireland Magherafelt District Council - Northern Ireland Moyle District Council - Northern Ireland Newry and Mourne District Council - Northern Ireland Newtownabbey Borough Council - Northern Ireland North Down Borough Council - Northern Ireland Omagh District Council - Northern Ireland Strabane District Council - Northern Ireland

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Trust Headquarters Sentinel House 4-6 Nuffield Road Poole Dorset BH17 0RB Tel: 01202 277000

PricewaterhouseCoopers LLP Oceana House 39 – 39 Commercial Road Southampton SO15 1GA

For the attention of Anna Blackman

25 May 2016 Management Representation Letter with respect to the limited assurance engagement on Dorset HealthCare University NHS Foundation Trust’s Quality Report for the year ended 31 March 2016

Dear Sir,

This representation letter is provided in connection with your limited assurance engagement to report on the Dorset HealthCare University NHS Foundation Trust’s (“the Foundation Trust”)’s Quality Report for the year ended 31 March 2016.

We are responsible for: • The content and the preparation of the Quality Report in accordance with annex 2 to Chapter 7 of the NHS Foundation Trust Annual Reporting Manual (“FT ARM”) issued by the Independent Regulator of NHS Foundation Trusts (“Monitor”) and Monitor’s “Detailed requirements for quality reports 2015/16”; • The content and the preparation of the Quality Report in accordance with the specified indicators criteria referred in the Quality Report (the "Criteria"); • The conformity of the Criteria with the assessment criteria set out in the FT ARM and the “Detailed requirements for quality reports 2015/16” issued by Monitor; and

• The statements in the Statement of Directors’ Responsibilities in respect of the content of the Quality Report and mandated indicators. We understand that your limited assurance engagement on the Foundation Trust’s Quality Report was conducted in accordance with the International Standard on Assurance Engagements ISAE 3000 (Revised) Assurance Engagements other than Audits or Reviews of Historical Financial Information. The engagement was designed for the purpose of expressing a limited assurance conclusion on the Quality Report for the year ended 31 March 2016 set out in the engagement letter dated 12 April 2016, and your tests of the records and other procedures were limited to those which you considered necessary for that purpose. We recognise that

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obtaining representations from us concerning information in this letter is a significant procedure in enabling you to form a conclusion on the Quality Report.

We confirm that the following representations are made on the basis of enquiries of management and staff of the Foundation Trust with relevant knowledge and experience and, where appropriate, of inspection of supporting documentation sufficient to satisfy ourselves that we can properly make each of the following representations to you. We confirm, to the best of our knowledge and belief, and having made the appropriate enquiries, the following representations:

1. We have fulfilled our responsibilities, as set out in the terms of the engagement letter dated 12 April 2016.

2. All relevant records have been made available to you for the purpose of your work on our Quality Report, and all the data has been properly reflected and recorded in these records. All other records and related information which might affect the completeness and accuracy of the Quality Report has been made available to you.

3. We have made all staff whose work impacts on the Quality Report available to you. We have responded fully to all enquiries made by you during your work on the Quality Report.

4. We acknowledge our responsibility for the application and interpretation of the criteria set out in Monitor’s “Detailed guidance for external assurance on Quality Reports” and confirm, that these criteria together with our interpretations are suitable for the intended users' purpose and will be made available to them in the Quality Report.

5. We have evaluated our performance against the specified performance indicators as defined by Monitor and the Department of Health and believe our reported performance to be complete and accurate.

6. We acknowledge that, as there are different sources from which the percentage of incomplete pathways within 18 weeks for patients on incomplete pathways at the end of the reporting period and 100% enhanced Care Programme Approach patients receiving follow-up contact within seven days of discharge from hospital data is derived/captured. Therefore, the completeness and accuracy of the data used in the indicator calculation is dependent on the completeness and accuracy of the data capture at source. To the best of our knowledge and belief the information used to calculate indicators is complete, accurate and relates to the reporting period.

7. We have established and maintained adequate internal controls to facilitate the complete and accurate preparation of the Quality Report so that it meets the requirements of the NHS FT ARM and Monitor’s “Detailed requirements for quality reports 2015/16” and we confirm that we have disclosed to you all significant deficiencies in the design or operation of internal control over the Quality Report subject matter information, particularly in respect of the mandated performance indicators.

8. There are no sources of the information to be included in the Quality Report that have not been properly determined, based on the NHS Foundation Trust’s underlying records, and included in the reported Quality Report.

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9. We are not aware of any uncorrected differences that would materially impact the information on our performance against the mandated performance indicators.

10. Any estimates or significant assumptions used by us in producing the Quality Report are reasonable.

11. No matters have come to our attention subsequent to the 31 March 2016 up to the present time which would materially impact the quantities, qualitative statements or disclosures included in the Quality Report.

12. Other than matters already disclosed to you, we are not aware of: • Allegations, either written or oral, of misstatements or other misapplication of reporting principles and/or deficiencies in internal control that could reasonably have a material effect on the Quality Report; • Any false statements made affecting the Quality Report; • Communications from regulatory agencies or other parties concerning non-compliance with, or deficiencies in, reporting practices or in the Foundation Trust’s performance that could reasonably be expected to have a material effect on the Quality Report; • Non-compliance with, or deficiencies in, business management systems, local standards requirements and / or provisions of regulatory bodies that could reasonably have a material effect on the Quality Report; • Significant violations of laws and regulations, the effects of which could reasonably have a material effect on the Quality Report.

As minuted by the Board of Directors at its meeting on 25 May 2016.

...... (Chair) (Chief Executive)

For and on behalf of Dorset HealthCare University NHS Foundation Trust

Date ……………………

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Ann Abraham - Trustee of the Picker Institute Europe David Brook - Managing Director & Bursar for Canford School Lynne Hunt - Specialist advisor to the Care Quality Commission Related Peter Rawlinson is a Trustee of CfBT Education Trust, Chairman & Trustee of CfBT parties and Schools Trust, Chairman & Director of Harbour Watch Residents Association, Vice related party Chairman & Trustee of the Stroke Association and Independent Board Member of transactions BourneBournemouthmouth University appendix John Hughes is the Medical DirectorDirector of the Sue Ryder Charity Ron Shields wife is an NHS Director of Specialist Service Commissioning Key Nicholas Kosky is the Chair of Guideline Development Group at NICE (MH adults in contact Management with CJS (Criminal Justice System) and a Member of Guideline Development Group at Personnel’s NICE (physical health, people in prison) related Colin Hague sits on the Health Education Wessex Local Training Board as a Board Member parties Linda Boland’s husband is the National Clinical Lead for Help for Heroes and he has a contract with DorsetDorset County Council to provide psychological support to Head Teachers Eugine Yafele’s wife works as Nurse Practitioner with Dorset HealthCare

Other related parties of Dorset HealthCare University NHS Foundation Trust Ansbury Limited New Wave Integrated Care Limited Dorset HealthCare Charitable Fund

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Birmingham Children's Hospital NHS Foundation Trust Birmingham Women's NHS Foundation Trust Black Country Partnership NHS Foundation Trust Blackpool Teaching Hospitals NHS Foundation Trust Bolton NHS Foundation Trust Bradford District Care NHS Foundation Trust (FT status from 1 May 2015) Bradford Teaching Hospitals NHS Foundation Trust Bridgewater Community Health Services NHS Foundation Trust Burton Hospitals NHS Foundation Trust Calderdale and Huddersfield NHS Foundation Trust Calderstones Partnership NHS Foundation Trust Cambridge University Hospitals NHS Foundation Trust Cambridgeshire and Peterborough NHS Foundation Trust Camden and Islington NHS Foundation Trust Central and North West London NHS Foundation Trust Central Manchester University Hospitals NHS Foundation Trust Chelsea and Westminster Hospital NHS Foundation Trust (merged with West Middlesex University Hospital NHS Trust on 1/09/15) Cheshire and Wirral Partnership NHS Foundation Trust Chesterfield Royal Hospital NHS Foundation Trust City Hospitals Sunderland NHS Foundation Trust Colchester Hospital University NHS Foundation Trust Cornwall Partnership NHS Foundation Trust Countess of Chester Hospital NHS Foundation Trust County Durham and Darlington NHS Foundation Trust Cumbria Partnership NHS Foundation Trust Derby Teaching Hospitals NHS Foundation Trust Derbyshire Community Health Services NHS Foundation Trust Derbyshire Healthcare NHS Foundation Trust Doncaster and Bassetlaw Hospitals NHS Foundation Trust Dorset County Hospital NHS Foundation Trust Dorset Healthcare University NHS Foundation Trust East Kent Hospitals University NHS Foundation Trust East London NHS Foundation Trust Frimley Health NHS Foundation Trust Gateshead Health NHS Foundation Trust

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Gloucestershire Hospitals NHS Foundation Trust Great Ormond Street Hospital for Children NHS Foundation Trust Great Western Hospitals NHS Foundation Trust Greater Manchester West Mental Health NHS Foundation Trust Guy's and St Thomas' NHS Foundation Trust Hampshire Hospitals NHS Foundation Trust Harrogate and District NHS Foundation Trust Heart of England NHS Foundation Trust Hertfordshire Partnership NHS Foundation Trust Homerton University Hospital NHS Foundation Trust Humber NHS Foundation Trust James Paget University Hospitals NHS Foundation Trust Kent Community Health NHS Foundation Trust Kettering General Hospital NHS Foundation Trust King's College Hospital NHS Foundation Trust Kingston Hospital NHS Foundation Trust Lancashire Care NHS Foundation Trust Lancashire Teaching Hospitals NHS Foundation Trust Leeds and York Partnership NHS Foundation Trust Lincolnshire Partnership NHS Foundation Trust Liverpool Heart and Chest Hospital NHS Foundation Trust Liverpool Women's NHS Foundation Trust Luton and Dunstable University Hospital NHS Foundation Trust Medway NHS Foundation Trust Mid Cheshire Hospitals NHS Foundation Trust Mid Staffordshire NHS Foundation Trust (shell entity only) Milton Keynes University Hospital NHS Foundation Trust Moorfields Eye Hospital NHS Foundation Trust Norfolk and Norwich University Hospitals NHS Foundation Trust Norfolk and Suffolk NHS Foundation Trust North East Ambulance Service NHS Foundation Trust North East London NHS Foundation Trust North Essex Partnership University NHS Foundation Trust North Lincolnshire and Goole Hospitals NHS Foundation Trust North Tees and Hartlepool NHS Foundation Trust Northamptonshire Healthcare NHS Foundation Trust

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Northumberland, Tyne and Wear NHS Foundation Trust Northumbria Healthcare NHS Foundation Trust Nottinghamshire Healthcare NHS Foundation Trust Oxford Health NHS Foundation Trust Oxford University Hospitals NHS Foundation Trust (FT status from 1 October 2015) Oxleas NHS Foundation Trust Papworth Hospital NHS Foundation Trust Pennine Care NHS Foundation Trust Peterborough and Stamford Hospitals NHS Foundation Trust Poole Hospital NHS Foundation Trust Queen Victoria Hospital NHS Foundation Trust Rotherham, Doncaster and South Humber NHS Foundation Trust Royal Berkshire NHS Foundation Trust Royal Brompton and Harefield NHS Foundation Trust Royal Devon and Exeter NHS Foundation Trust Royal Free London NHS Foundation Trust Royal Surrey County Hospital NHS Foundation Trust Royal United Hospitals Bath NHS Foundation Trust Salford Royal NHS Foundation Trust Salisbury NHS Foundation Trust Sheffield Children's NHS Foundation Trust Sheffield Health and Social Care NHS Foundation Trust Sheffield Teaching Hospitals NHS Foundation Trust Sherwood Forest Hospitals NHS Foundation Trust Somerset Partnership NHS Foundation Trust South Central Ambulance Service NHS Foundation Trust Torbay and South Devon NHS Foundation Trust (merged with Torbay & South Devon Health and Care Trust on 1/10/15) South East Coast Ambulance Service NHS Foundation Trust South Essex Partnership University NHS Foundation Trust South London and Maudsley NHS Foundation Trust South Staffordshire and Shropshire Healthcare NHS Foundation Trust South Tees Hospitals NHS Foundation Trust South Tyneside NHS Foundation Trust South Warwickshire NHS Foundation Trust South West Yorkshire Partnership NHS Foundation Trust

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South Western Ambulance Service NHS Foundation Trust Southend University Hospital NHS Foundation Trust Southern Health NHS Foundation Trust St George's University Hospitals NHS Foundation Trust Stockport NHS Foundation Trust Surrey and Borders Partnership NHS Foundation Trust Sussex Partnership NHS Foundation Trust Tameside Hospital NHS Foundation Trust Taunton and Somerset NHS Foundation Trust Tavistock and Portman NHS Foundation Trust Tees, Esk and Wear Valleys NHS Foundation Trust The Christie NHS Foundation Trust The Clatterbridge Cancer Centre NHS Foundation Trust The Dudley Group NHS Foundation Trust The Hillingdon Hospitals NHS Foundation Trust The Newcastle Upon Tyne Hospitals NHS Foundation Trust The Queen Elizabeth Hospital King's Lynn NHS Foundation Trust The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust The Rotherham NHS Foundation Trust The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust The Royal Marsden NHS Foundation Trust The Royal Orthopaedic Hospital NHS Foundation Trust The Walton Centre NHS Foundation Trust University College London Hospitals NHS Foundation Trust University Hospital of South Manchester NHS Foundation Trust University Hospital Southampton NHS Foundation Trust University Hospitals Birmingham NHS Foundation Trust University Hospitals Bristol NHS Foundation Trust University Hospitals of Morecambe Bay NHS Foundation Trust Warrington and Halton Hospitals NHS Foundation Trust West Midlands Ambulance Service NHS Foundation Trust West Suffolk NHS Foundation Trust Western Sussex Hospitals NHS Foundation Trust Wirral University Teaching Hospital NHS Foundation Trust Wrightington, Wigan and Leigh NHS Foundation Trust

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Yeovil District Hospital NHS Foundation Trust York Teaching Hospital NHS Foundation Trust

Total DH Group (excluding FTs) Avon and Wiltshire Mental Health Partnership NHS Trust Barking, Havering and Redbridge University Hospitals NHS Trust Barnet, Enfield and Haringey Mental Health NHS Trust Barts Health NHS Trust Bedford Hospital NHS Trust Birmingham Community Healthcare NHS Trust Bradford District Care NHS Trust ** FT status from 1 May 2015 ** Brighton and Sussex University Hospitals NHS Trust Buckinghamshire Healthcare NHS Trust Cambridgeshire Community Services NHS Trust Central London Community Healthcare NHS Trust Coventry and Warwickshire Partnership NHS Trust Croydon Health Services NHS Trust Dartford and Gravesham NHS Trust Devon Partnership NHS Trust Dudley and Walsall Mental Health Partnership NHS Trust East and North Hertfordshire NHS Trust East Cheshire NHS Trust East Lancashire Hospitals NHS Trust East Midlands Ambulance Service NHS Trust East of England Ambulance Service NHS Trust East Sussex Healthcare NHS Trust Epsom and St Helier University Hospitals NHS Trust George Eliot Hospital NHS Trust Gloucestershire Care Services NHS Trust Hertfordshire Community NHS Trust Hinchingbrooke Health Care NHS Trust Hounslow and Richmond Community Healthcare NHS Trust Hull and East Yorkshire Hospitals NHS Trust Imperial College Healthcare NHS Trust Ipswich Hospital NHS Trust Isle of Wight NHS Trust Kent and Medway NHS and Social Care Partnership NHS Trust

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Leeds Community Healthcare NHS Trust Leeds Teaching Hospitals NHS Trust Leicestershire Partnership NHS Trust Lewisham and Greenwich NHS Trust Lincolnshire Community Health Services NHS Trust Liverpool Community Health NHS Trust London Ambulance Service NHS Trust London North West Healthcare NHS Trust Maidstone and Tunbridge Wells NHS Trust Manchester Mental Health and Social Care NHS Trust Mersey Care NHS Trust Mid Essex Hospital Services NHS Trust Mid Yorkshire Hospitals NHS Trust Norfolk Community Health and Care NHS Trust North Bristol NHS Trust North Cumbria University Hospitals NHS Trust North Middlesex University Hospital NHS Trust North Staffordshire Combined Healthcare NHS Trust North West Ambulance Service NHS Trust Northampton General Hospital NHS Trust Northern Devon Healthcare NHS Trust Nottingham University Hospitals NHS Trust Oxford University Hospitals NHS Trust ** FT status from 1 October 2015 ** Pennine Acute Hospitals NHS Trust Plymouth Hospitals NHS Trust Portsmouth Hospitals NHS Trust Royal Cornwall Hospitals NHS Trust Royal Liverpool and Broadgreen University Hospitals NHS Trust Royal National Orthopaedic Hospital NHS Trust Sandwell and West Birmingham Hospitals NHS Trust Shropshire Community Health NHS Trust Solent NHS Trust South West London and St George's Mental Health NHS Trust Southport and Ormskirk Hospital NHS Trust St Helens and Knowsley Hospitals NHS Trust Staffordshire and Stoke on Trent Partnership NHS trust Surrey and Sussex Healthcare NHS Trust

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Sussex Community NHS Trust The Princess Alexandra Hospital NHS Trust The Royal Wolverhampton NHS Trust The Shrewsbury and Telford Hospital NHS Trust The Whittington Hospital NHS Trust Torbay and Southern Devon Health and Care NHS Trust (merged with Torbay & South Devon NHS FT on 1/10/15) United Lincolnshire Hospitals NHS Trust University Hospitals of North Midlands NHS Trust University Hospitals Coventry and Warwickshire NHS Trust University Hospitals of Leicester NHS Trust Walsall Healthcare NHS Trust West Hertfordshire Hospitals NHS Trust West London Mental Health NHS Trust West Middlesex University Hospital NHS Trust (merged with Chelsea and Westminster Hospitals NHS FT on 1/09/15) Weston Area Health NHS Trust Wirral Community NHS Trust Worcestershire Acute Hospitals NHS Trust Worcestershire Health and Care NHS Trust Wye Valley NHS Trust Yorkshire Ambulance Service NHS Trust NHS Airedale, Wharfdale and Craven CCG NHS Ashford CCG NHS Aylesbury Vale CCG NHS Barking and Dagenham CCG NHS Barnet CCG NHS Barnsley CCG NHS Basildon and Brentwood CCG NHS Bassetlaw CCG NHS Bath and North East Somerset CCG NHS Bedfordshire CCG NHS Bexley CCG NHS Birmingham Crosscity CCG NHS Birmingham South and Central CCG NHS Blackburn With Darwen CCG NHS Blackpool CCG

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NHS Bolton CCG NHS Bracknell and Ascot CCG NHS Bradford City CCG NHS Bradford Districts CCG NHS Brent CCG NHS Brighton and Hove CCG NHS Bristol CCG NHS Bromley CCG NHS Bury CCG NHS Calderdale CCG NHS Cambridgeshire and Peterborough CCG NHS Camden CCG NHS Cannock Chase CCG NHS Canterbury and Coastal CCG NHS Castle Point and Rochford CCG NHS Central London (Westminster) CCG NHS Central Manchester CCG NHS Chiltern CCG NHS Chorley and South Ribble CCG NHS City and Hackney CCG NHS Coastal West Sussex CCG NHS Corby CCG NHS Coventry and Rugby CCG NHS Crawley CCG NHS Croydon CCG NHS Cumbria CCG NHS Darlington CCG NHS Dartford, Gravesham and Swanley CCG NHS Doncaster CCG NHS Dorset CCG NHS Dudley CCG NHS Durham Dales, Easington and Sedgefield CCG NHS Ealing CCG NHS East and North Hertfordshire CCG NHS East Lancashire CCG NHS East Leicestershire and Rutland CCG NHS East Riding of Yorkshire CCG

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NHS East Staffordshire CCG NHS East Surrey CCG NHS Eastbourne, Hailsham and Seaford CCG NHS Eastern Cheshire CCG NHS Enfield CCG NHS Erewash CCG NHS Fareham and Gosport CCG NHS Fylde & Wyre CCG NHS Gloucestershire CCG NHS Great Yarmouth and Waveney CCG NHS Greater Huddersfield CCG NHS Greater Preston CCG NHS Greenwich CCG NHS Guildford and Waverley CCG NHS Halton CCG NHS Hambleton, Richmondshire and Whitby CCG NHS Hammersmith and Fulham CCG NHS Hardwick CCG NHS Haringey CCG NHS Harrogate and Rural District CCG NHS Harrow CCG NHS Hartlepool and Stockton-on-Tees CCG NHS Hastings and Rother CCG NHS Havering CCG NHS Herefordshire CCG NHS Herts Valleys CCG NHS Heywood, Middleton and Rochdale CCG NHS High Weald Lewes Havens CCG NHS Hillingdon CCG NHS Horsham and Mid Sussex CCG NHS Hounslow CCG NHS Hull CCG NHS Ipswich and East Suffolk CCG NHS Isle of Wight CCG NHS Islington CCG NHS Kernow CCG NHS Kingston CCG

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NHS Knowsley CCG NHS Lambeth CCG NHS Lancashire North CCG NHS Leeds North CCG NHS Leeds South and East CCG NHS Leeds West CCG NHS Leicester City CCG NHS Lewisham CCG NHS Lincolnshire East CCG NHS Lincolnshire West CCG NHS Liverpool CCG NHS Luton CCG NHS Mansfield and Ashfield CCG NHS Medway CCG NHS Merton CCG NHS Mid Essex CCG NHS Milton Keynes CCG NHS Nene CCG NHS Newark and Sherwood CCG NHS Newbury and District CCG NHS Newcastle Gateshead CCG (formed from the merger of 00F, 00G and 00H on 1/04/15) NHS Newham CCG NHS North and West Reading CCG NHS North Derbyshire CCG NHS North Durham CCG NHS North East Essex CCG NHS North East Hampshire and Farnham CCG NHS North East Lincolnshire CCG NHS North Hampshire CCG NHS North Kirklees CCG NHS North Lincolnshire CCG NHS North Manchester CCG NHS North Norfolk CCG NHS North Somerset CCG NHS North Staffordshire CCG NHS North Tyneside CCG

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NHS North West Surrey CCG NHS North, East, West Devon CCG NHS Northumberland CCG NHS Norwich CCG NHS Nottingham City CCG NHS Nottingham North and East CCG NHS Nottingham West CCG NHS Oldham CCG NHS Oxfordshire CCG NHS Portsmouth CCG NHS Redbridge CCG NHS Redditch and Bromsgrove CCG NHS Richmond CCG NHS Rotherham CCG NHS Rushcliffe CCG NHS Salford CCG NHS Sandwell and West Birmingham CCG NHS Scarborough and Ryedale CCG NHS Sheffield CCG NHS Shropshire CCG NHS Slough CCG NHS Solihull CCG NHS Somerset CCG NHS South Cheshire CCG NHS South Devon and Torbay CCG NHS South East Staffs and Seisdon Peninsular CCG NHS South Eastern Hampshire CCG NHS South Gloucestershire CCG NHS South Kent Coast CCG NHS South Lincolnshire CCG NHS South Manchester CCG NHS South Norfolk CCG NHS South Reading CCG NHS South Sefton CCG NHS South Tees CCG NHS South Tyneside CCG NHS South Warwickshire CCG

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NHS South West Lincolnshire CCG NHS South Worcestershire CCG NHS Southampton CCG NHS Southend CCG NHS Southern Derbyshire CCG NHS Southport and Formby CCG NHS Southwark CCG NHS St Helens CCG NHS Stafford and Surrounds CCG NHS Stockport CCG NHS Stoke on Trent CCG NHS Sunderland CCG NHS Surrey Downs CCG NHS Surrey Heath CCG NHS Sutton CCG NHS Swale CCG NHS Swindon CCG NHS Tameside and Glossop CCG NHS Telford and Wrekin CCG NHS Thanet CCG NHS Thurrock CCG NHS Tower Hamlets CCG NHS Trafford CCG NHS Vale of York CCG NHS Vale Royal CCG NHS Wakefield CCG NHS Walsall CCG NHS Waltham Forest CCG NHS Wandsworth CCG NHS Warrington CCG NHS Warwickshire North CCG NHS West Cheshire CCG NHS West Essex CCG NHS West Hampshire CCG NHS West Kent CCG NHS West Lancashire CCG NHS West Leicestershire CCG

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NHS West London (K&C & Qpp) CCG NHS West Norfolk CCG NHS West Suffolk CCG NHS Wigan Borough CCG NHS Wiltshire CCG NHS Windsor, Ascot and Maidenhead CCG NHS Wirral CCG NHS Wokingham CCG NHS Wolverhampton CCG NHS Wyre Forest CCG NHS England (statutory entity - populated by completing table of sub-entities below) Partially completed spells and NCA accruals not attributable to a commissioner Public Health England (PHE) Health and Social Care Information Centre (including Connecting for Health) Health Education England (NDPB from 1/04/15) Health Research Authority National Institute for Health and Care Excellence NHS Business Services Authority (incl student bursaries) NHS Litigation Authority NHS Trust Development Authority Care Quality Commission Human Fertilisation and Embryology Authority Human Tissue Authority Professional Standards Authority for Health and Social Care Skipton Fund Monitor NHS Property Services Community Health Partnerships Genomics England Ltd Nursing and Midwifery Council NHS Medical Assets England Limited Department of Health (incl. core trading and NHS Supply Chain Maidstone invoices prefixed with 904, ESR Transactions from NHS BSA , not incl. PDC) Department of Health (PDC dividend only) - not part of agreement of balances

Breakdown of balances recorded against NHS England at 31 March 2016 NHS England - Core

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NHS Arden & Greater East Midlands Commissioning Support Unit (formed from 1/04/15 merger of 0AA and 0AK) NHS Central Eastern Commissioning Support Unit (CSU now closed on 1/4/15) NHS Central Southern Commissioning Support Unit NHS Cheshire and Merseyside Commissioning Support Unit NHS Greater Manchester Commissioning Support Unit NHS Midlands & Lancashire Commissioning Support Unit (formed from 1/04/15 merger of 0AD and 0AG) NHS North and East London Commissioning Support Unit (merged with 0AP on 1/04/15) NHS North of England Commissioning Support Unit NHS North West London Commissioning Support Unit (CSU closed on 1/4/15) NHS South Commissioning Support Unit NHS South East Commissioning Support Unit (previously South London CSU - merged with 0AM on 1/04/15) NHS South West Commissioning Support Unit NHS Yorkshire and the Humber Commissioning Support Unit NHS England - Central Midlands Local Office (Geography. Merger of Q58 & Q59) NHS England - Cheshire and Merseyside Local Office (Geography. Merger of Q44 & Q48) NHS England - Cumbria and North East Local Office (Geography. Merger of Q45 & Q49) NHS England - East Local Office (Geography. Merger of Q56 & Q57) NHS England - Lancashire and Greater Manchester Local Office (Geography. Merger of Q46 & Q47) NHS England - North Midlands Local Office (Geography. Merger of Q55 & Q60) NHS England - South Central Local Office (Geography. Merger of Q64 & Q69) NHS England - South East Local Office (Geography. Merger of Q67 & Q68) NHS England - South West Local Office (Geography. Merger of Q65 & Q66) NHS England - Wessex Local Office (Geography) NHS England - West Midlands Local Office (Geography. Merger of Q53 & Q54) NHS England - Yorkshire and the Humber Local Office (Geography. Merger of Q50, Q51 & Q52) NHS England - Central Midlands Commissioning Hub NHS England - East Commissioning Hub NHS England - London Commissioning Hub NHS England - North East Commissioning Hub NHS England - North West Commisssioning Hub NHS England - South East Commissioning Hub NHS England - South West Commissioning Hub NHS England - Wessex Commissioning Hub NHS England - West Midlands Commissioning Hub

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NHS England - Yorkshire and the Humber Commissioning Hub NHS England - Central Specialised Commissioning Hub North of England Regional Office Midlands and East Regional Office London Regional Office South Regional Office

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British Railways Board (Residuary) Ltd British Waterways Board Cardiff International Airport Central Office of Information Channel Four Television Corporation Civil Aviation Authority Commonwealth Development Corporation Companies House Defence Science and Technology Laboratory Driver and Vehicle Agency (Trading Fund Element only) - Northern Ireland Driving Standards Agency Dover Harbour Board Export Credits Guarantee Department Financial Conduct Authority Financial Ombudsman Limited Fire Service College Forensic Science Service Forest Enterprise Agency (England) General Lighthouse Fund Government Procurement Service Greenwich Hospital Guaranteed Export Finance Corporation Harwich Haven Authority Historic Royal Palaces Trust Intellectual Property Office International Nuclear Services Ltd Land Registry Meteorological Office Milford Haven Port Authority National Employment Savings Trust Corporation (NEST) National Nuclear Laboratory Ltd Navy, Army and Air Force Institute Nexus (Tyne & Wear Passenger Transport Executive) NHS Professionals Northern Ireland Water Ltd

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Ordnance Survey Pacific Nuclear Transport Ltd Pension Protection Fund (PPF) Porton Biopharma Ltd Poole Harbour Commissioners Port of London Authority Port of Tyne Authority Post Office Limited Prudential Regulation Authority Remploy Royal Mint Shoreham Port Authority UK Hydrographic Office Vehicle and Operator Services Agency Bank Of England Bank Of England Asset Purchase Facility (BEAPF) Bank Of England Issue Department British Nuclear Fuels Caledonian Maritime Assets Ltd Registers of Scotland Scottish Water Northern Ireland Housing Executive Northern Ireland Transport Holding Company Competition and Markets Authority Disclosure and Barring Service Financial Services Compensation Scheme Forest Enterprise Agency (Scotland) Help to Buy (HMT) Limited London & Continental Railways Limited Network Rail Office of Nuclear Regulation Office of Qualifications and Examinations Regulator Cabinet Office Civil Service Commission Consolidated Fund

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Contingencies Fund Debt Management Account Exchange Equalisation Account Heritage Lottery Fund National Loans Fund National Lottery UK Sports Council Lottery National Savings and Investments Public Works Loans Board Government Actuary’s Department Museum of London Office for Standard in Education children's Services and Skills (Ofsted) Office of Gas and Electricity Markets (OFGEM) Office of Rail Regulation Security and Intelligence Agencies Serious Fraud Office The UK Supreme Court UK Statistics Authority (ONS) UK Trade & Investment Water Services Regulation Authority Charity Commission Advantage West Midlands Advisory Conciliation and Arbitration Service (ACAS) Arts and Humanities Research Council Biotechnology and Biological Sciences Research Council (BBSRC) Competition Commission Construction Industry Training Board (CITB) Consumer Focus (AKA National Consumer Council) Department for Business, Innovation and Skills East Midlands Development Agency East of England Development Agency Economic and Social Research Council Engineering and Physical Sciences Research Council Engineering Construction Industry Training Board Financial Reporting Council Higher Education Funding Council for England

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Learning and Skills Improvement Service Medical Research Council National Endowment for Science, Technology and the Arts Natural Environment Research Council North West Regional Development Agency OFCOM ONE North East RCUK Shared Services Centre Ltd Science and Technology Facilities Council South East Development Agency South West of England Regional Development Agency Student Loans Company Limited Technology Strategy Board UK Green Investment Bank plc United Kingdom Atomic Energy Authority United Kingdom Commission for Employment and Skills Yorkshire Forward Commission for Local Administration in England Department for Communities and Local Government Homes and Communities Agency London Thames Gateway Development Corporation Queen Elizabeth II Conference Centre Thurrock Development Corporation Valuation Tribual for England Valuation Tribunal Service West Northamptonshire Development Corporation Arts Council of England Arts Council of England Lottery BIG Lottery Fund British Broadcasting Corporation British Broadcasting Corporation - License Fee British Film Institute British Library British Museum Dept. Culture Media and Sport

Agenda Item 4ii

English Sports Council Gambling Commission Geffrye Museum Horniman Museum and Public Park Foundation Horserace Betting Levy Board Imperial War Museum London Organising Committee of the Olympic Games Limited National Gallery National Heritage Memorial Fund National Lottery Distribution Fund National Maritime Museum National Museums and Galleries on Merseyside National Portrait Gallery Natural History Museum Olympic Delivery Authority Olympic Lottery Distribution Fund Olympic Lottery Distributor Royal Armouries Museum S4C Sir John Soane’s Museum Sport England Lottery Tate Gallery UK Sport Victoria and Albert Museum VisitBritain Wallace Collection Academies (as established under section 1 of the Academies Act 2010) Children and Family Court Advisory and Support Service Education Funding Agency Agriculture and Horticulture Development Board Commission for Rural Communities Consumer Council for Water Department for Environment, Food and Rural Affairs Environment Agency Forestry Commission (England)

Agenda Item 4ii

Joint Nature Conservation Committee Marine Management Organisation National Forest Company Natural England Royal Botanic Gardens, Kew Sea Fish Industry Authority Sustainable Development Commission Department for International Development British Transport Police Authority (sSRA) Department for Transport Directly Operated Railways Driver and Vehicle Licensing Agency Vehicle Excise Duty (Trust Statement for DVLA) Health and Safety Executive (HSE) Independent Living Fund (ILF) The Pensions Regulator (TPR) Carbon Reduction Commitment Trust Statement Civil Nuclear Police Authority (CNPA) Coal Authority Department of Energy and Climate Change EU Emissions Allowance Trust Statement Nuclear Decommissioning Authority Nuclear Liabilities Fund Petroleum Licences Trust Statement Food Standards Agency FCO Services Foreign and Commonwealth Office HM Treasury Infrastructure Finance Unit Limited Local Partnerships LLP Money Advice Service Office for Budget Responsibility UKAR Asset Resolution Limited UK Debt Management Office UK Financial Investments Limited

Agenda Item 4ii

College of Policing Independent Police Complaints Commission Independent Safeguarding Authority National Policing Improvement Agency Security Industry Authority Serious Organised Crime Agency (Abolished in October 2013. Replaced by National Crime Agency) Defence Support Group National Army Museum Royal Air Force Museum Royal Hospital Chelsea Criminal Injuries Compensation Authority Legal Aid Agency (previously Legal Services Commission) Ministry of Justice Office of the Information Commissioner Youth Justice Board for England and Wales Animal Health and Veterinary Laboratories Agency Centre for Environment, Fisheries, Aquacult & Science Dounreay Site Restoration Training Board DWP - Financial Assistance Scheme Electricity Settlements Company Limited Food and Environment Research Agency Forestry Commission (Scotland) Gangmasters Licensing Authority HM Court Service fines and penalties trust statement Learning and Teaching Scotland LLW Repository Limited Low Carbon Contracts Company Limited Magnox Limited Maze- Long Kesh Development Corp National Archives of Scotland National Crime Agency National Savings and Investments- Ordinary Deposit Account NDA Archives Limited NNDR Trust Statement

Agenda Item 4ii

Northern Ireland Council for Integrated Education Office of the Registrar of Consultant Lobbyists OFGEM- Fossil Fuel Levy OFT - Competition Act Penalties Trust Statement Planning Inspectorate Radioactive Waste Management Limited Research Site Restoration Limited Royal Household Royal Mail Pension Scheme Rural Payments Agency Science Museum Group Sellafield Limited The Commission for Equality and Human Rights The Housing Ombudsman The National Archives Transport for Manchester Veterinary Medicines Directorate Victims and Survivors Service - NIE Youth Council for Northern Ireland Agri-Food and Biosciences Institute - Northern Ireland Armagh Planetarium and Observatory - Northern Ireland Arts Council of Northern Ireland Arts Council of Northern Ireland Lottery Distribution Account Belfast Education and Library Board - Northern Ireland Belfast Health and Social Care Trust - Northern Ireland Business Services Organisation - Northern Ireland Charity Commission for Northern Ireland Northern Ireland Community Relations Council Council for Catholic Maintained Schools - Northern Ireland Criminal Justice Inspection Northern Ireland Department for Employment and Learning - Northern Ireland Department for Regional Development - Northern Ireland Department for Social Development - Northern Ireland Department of Agriculture and Rural Development - Northern Ireland Department of Culture, Arts and Leisure - Northern Ireland

Agenda Item 4ii

Department of Education - Northern Ireland Department of Enterprise, Trade and Investment - Northern Ireland Department of Finance and Personnel - Northern Ireland Department of Health, Social Services and Public Safety - Northern Ireland Department of Justice - Northern Ireland Department of the Environment - Northern Ireland DFP - Superannuation & Other Allowances - Northern Ireland Equality Commission for Northern Ireland Health and Safety Executive for Northern Ireland Health and Social Care Pension Scheme - NI (peviously HPSS Superannuation Account - Northern Ireland) Ilex Urban Regeneration Company Limited - Northern Ireland Invest Northern Ireland National Museums and Galleries of Northern Ireland NI Ambulance Service HSS Trust - Northern Ireland North Eastern Education and Library Board - Northern Ireland Northern Health and Social Care Trust - Northern Ireland Northern Ireland Authority for Utility Regulation Northern Ireland Blood Transfusion Service Northern Ireland Consolidated Fund Northern Ireland Council for Integrated Education Northern Ireland Council for the Curriculum, Examinations and Assessment Northern Ireland Executive Northern Ireland Fire and Rescue Service Northern Ireland Fishery Harbour Authority Northern Ireland Legal Services Commission Northern Ireland Library Authority Northern Ireland Local Government Officers Superannuation Committee Northern Ireland Medical and Dental Training Agency Northern Ireland National Insurance Fund Northern Ireland Policing Board Northern Ireland Screen Commission Northern Ireland Tourist Board Office of the First Minister and Deputy First Minister - Northern Ireland Patient and Client Council - Northern Ireland

Agenda Item 4ii

Police Ombudsman for Northern Ireland Police Service of Northern Ireland Pension Scheme Police Service of Northern Ireland Probation Board for Northern Ireland - Northern Ireland Public Prosecution Service - Northern Ireland Regulation and Quality Improvement Authority - Northern Ireland South Eastern Education and Library Board - Northern Ireland South Eastern Health and Social Care Trust - Northern Ireland Southern Education and Library Board - Northern Ireland Southern Health and Social Care Trust - Northern Ireland Sports Council for Northern Ireland Sports Council for Northern Ireland Lottery Distribution Account - Northern Ireland Strategic Investment Board Limited - Northern Ireland Teachers Superannuation Scheme Statements - Northern Ireland Ulster Supported Employment Limited - Northern Ireland Western Education and Library Board - Northern Ireland Western Health and Social Care Trust - Northern Ireland Northern Ireland Office Armed Forces Retired Pay, Pensions etc Cabinet Office: Civil superannuation Department for International Development: Overseas Superannuation Ministry of Justice: Judicial Pensions Scheme Research Councils Pension Scheme Teachers' Pension Scheme (England & Wales) UKAEA pension schemes Scotland Office and Office of Advocate General Scottish Consolidated Fund Care Inspectorate (SCSWIS) Creative Scotland David MacBrayne Ltd Highland and Islands Enterprise Highlands and Islands Airport National Galleries of Scotland National Library of Scotland National Museums of Scotland

Agenda Item 4ii

National Records of Scotland Royal Botanic Garden, Edinburgh Scottish Children's Reporter Administration Scottish Court Service Scottish Enterprise Scottish Environment Protection Agency Scottish Further and Higher Education Funding Council Scottish Legal Aid Board Scottish Natural Heritage Scottish Police Services Authority Scottish Qualifications Authority Scottish Social Services Council Skills Development Scotland Sportscotland VisitScotland The Scottish NHS Pension Scheme Scottish Teachers Pension Scheme Crown Prosecution Service HM Procurator General and Treasury Solicitor Wales Office Welsh Consolidated Fund Arts Council of Wales Arts Council of Wales National Lottery Care Council for Wales Children's Commissioner for Wales Countryside Council for Wales Estyn: Her Majesty's Inspectorate for Education & Training for Wales General Teaching Council for Wales Higher Education Funding Council for Wales Local Government Boundary Commission for Wales National Library of Wales National Museums and Galleries of Wales Natural Resources Wales Older People's Commissioner for Wales Sports Council for Wales

Agenda Item 4ii

Sports Council for Wales National Lottery Welsh Language Commissioner

Agenda Item 4ii

Braintree District Council Breckland District Council Brent London Borough Council Brentwood Borough Council Brighton & Hove City Council Bristol City Council Broadland District Council Broads Authority (The) Bromley London Borough Council Bromsgrove District Council Broxbourne Borough Council Broxtowe Borough Council Buckinghamshire Combined Fire and Rescue Authority Buckinghamshire County Council Burnley Borough Council Bury Metropolitan Borough Council Calderdale Metropolitan Borough Council Cambridge City Council Cambridgeshire Combined Fire and Rescue Authority Cambridgeshire County Council Cambridgeshire Police and Crime Commissioner and Chief Constable Camden London Borough Council Cannock Chase District Council Canterbury City Council Carlisle City Council Castle Point Borough Council Central Bedfordshire Unitary Authority Charnwood Borough Council Chelmsford Borough Council Cheltenham Borough Council Cherwell District Council Cheshire Combined Fire and Rescue Authority Cheshire East Unitary Authority Cheshire Police and Crime Commissioner and Chief Constable Cheshire West and Chester Unitary Authority Chesterfield Borough Council Chichester District Council

Agenda Item 4ii

Chiltern District Council Chorley Borough Council Christchurch Borough Council City of York Council Cleveland Combined Fire and Rescue Authority Cleveland Police and Crime Commissioner and Chief Constable Colchester Borough Council Common Council of the City of London Copeland Borough Council Corby Borough Council Cornwall Unitary Authority Cotswold District Council County Durham Unitary Authority Coventry City Council Craven District Council Crawley Borough Council Croydon London Borough Council Cumbria County Council Cumbria Police and Crime Commissioner and Chief Constable Dacorum Borough Council Darlington Borough Council Dartford Borough Council Dartmoor National Park Authority Daventry District Council Derby City Council Derbyshire Combined Fire and Rescue Authority Derbyshire County Council Derbyshire Dales District Council Derbyshire Police and Crime Commissioner and Chief Constable Devon & Cornwall Police and Crime Commissioner and Chief Constable Devon and Somerset Combined Fire and Rescue Authority Devon County Council Doncaster Metropolitan Borough Council Dorset Combined Fire and Rescue Authority Dorset County Council Dorset Police and Crime Commissioner and Chief Constable Dover District Council

Agenda Item 4ii

Gloucestershire County Council Gloucestershire Police and Crime Commissioner and Chief Constable Gosport Borough Council Gravesham Borough Council Great Yarmouth Borough Council Greater London Authority Greater Manchester Combined Authority Greater Manchester Fire and Rescue Authority Greater Manchester Police and Crime Commissioner and Chief Constable Greater Manchester Waste Disposal Authority Greenwich London Borough Council Guildford Borough Council Hackney London Borough Council Halton Borough Council Hambleton District Council Hammersmith and Fulham London Borough Council Hampshire Combined Fire and Rescue Authority Hampshire County Council Hampshire Police and Crime Commissioner and Chief Constable Harborough District Council Haringey London Borough Council Harlow District Council Harrogate Borough Council Harrow London Borough Council Hart District Council Hartlepool Borough Council Hastings Borough Council Havant Borough Council Havering London Borough Council Hereford & Worcester Combined Fire and Rescue Authority Herefordshire Council Hertfordshire County Council Hertfordshire Police and Crime Commissioner and Chief Constable Hertsmere Borough Council High Peak Borough Council Hillingdon London Borough Council Hinckley and Bosworth Borough Council

Agenda Item 4ii

Horsham District Council Hounslow London Borough Council Humberside Combined Fire and Rescue Authority Humberside Police and Crime Commissioner and Chief Constable Huntingdonshire District Council Hyndburn Borough Council Ipswich Borough Council Isle of Wight Council Isles of Scilly (Council of the) Islington London Borough Council Kensington and Chelsea Council (Royal Borough of) Kent Combined Fire and Rescue Authority Kent County Council Kent Police and Crime Commissioner and Chief Constable Kettering Borough Council Kings Lynn and West Norfolk Borough Council Kingston upon Hull City Council Kingston upon Thames Council (Royal Borough of) Kirklees Metropolitan Council Knowsley Metropolitan Borough Council Lake District National Park Authority Lambeth London Borough Council Lancashire Combined Fire and Rescue Authority Lancashire County Council Lancashire Police and Crime Commissioner and Chief Constable Lancaster City Council Lee Valley Regional Park Authority Leeds City Council Leicester City Council Leicestershire Combined Fire and Rescue Authority Leicestershire County Council Leicestershire Police and Crime Commissioner and Chief Constable Lewes District Council Lewisham London Borough Council Lichfield District Council Lincoln City Council Lincolnshire County Council

Agenda Item 4ii

Lincolnshire Police and Crime Commissioner and Chief Constable Liverpool City Council London Fire and Emergency Planning Authority London Legacy Development Corporation Luton Borough Council Maidstone Borough Council Maldon District Council Malvern Hills District Council Manchester City Council Mansfield District Council Mayor’s Office for Policing and Crime and Metropolis Police Commissioner Medway Towns Unitary Authority (The) Melton Borough Council Mendip District Council Merseyside Fire and Rescue Authority Merseyside Integrated Transport Authority (trading as Merseytravel) Merseyside Police and Crime Commissioner and Chief Constable Merseyside Waste Disposal Authority Merton Borough Council Mid Devon District Council Mid Suffolk District Council Mid Sussex District Council Middlesbrough Council Milton Keynes Council Mole Valley District Council New Forest District Council New Forest National Park Authority Newark and Sherwood District Council Newcastle upon Tyne City Council Newcastle-under-Lyme Borough Council Newham London Borough Council Norfolk County Council Norfolk Police and Crime Commissioner and Chief Constable North Devon District Council North Dorset District Council North East Derbyshire District Council North East Lincolnshire Council

Agenda Item 4ii

North Hertfordshire District Council North Kesteven District Council North Lincolnshire Council North London Waste Authority North Norfolk District Council North Somerset Council North Tyneside Metropolitan Borough Council North Warwickshire Borough Council North West Leicestershire District Council North York Moors National Park Authority North Yorkshire Combined Fire and Rescue Authority North Yorkshire County Council North Yorkshire Police and Crime Commissioner and Chief Constable Northampton Borough Council Northamptonshire County Council Northamptonshire Police and Crime Commissioner and Chief Constable Northumberland National Park Authority Northumberland Unitary Authority Northumbria Police and Crime Commissioner and Chief Constable Norwich City Council Nottingham City Council Nottinghamshire Combined Fire and Rescue Authority Nottinghamshire County Council Nottinghamshire Police and Crime Commissioner and Chief Constable Nuneaton and Bedworth Borough Council Oadby and Wigston Borough Council Oldham Metropolitan Borough Council Oxford City Council Oxfordshire County Council Peak District National Park Authority Pendle Borough Council Peterborough City Council Plymouth City Council Poole (Borough of) Portsmouth City Council Preston City Council Purbeck District Council

Agenda Item 4ii

Reading Borough Council Redbridge London Borough Council Redcar and Cleveland Borough Council Redditch Borough Council Reigate and Banstead Borough Council Ribble Valley Borough Council Richmond upon Thames Borough Council Richmondshire District Council Rochdale Borough Council Rochford District Council Rossendale Borough Council Rother District Council Rotherham Borough Council Rugby Borough Council Runnymede Borough Council Rushcliffe Borough Council Rushmoor Borough Council Rutland County Council Ryedale District Council Salford City Council Sandwell Metropolitan Borough Council Scarborough Borough Council Sedgemoor District Council Sefton Metropolitan Borough Council Selby District Council Sevenoaks District Council Sheffield City Council Shepway District Council Shropshire Combined Fire and Rescue Authority Shropshire Unitary Authority Slough Borough Council Solihull Metropolitan Borough Council Somerset County Council South Bucks District Council South Cambridgeshire District Council South Derbyshire District Council South Downs National Park

Agenda Item 4ii

South Gloucestershire Council South Hams District Council South Holland District Council South Kesteven District Council South Lakeland District Council South Norfolk District Council South Northamptonshire Council South Oxfordshire District Council South Ribble Borough Council South Somerset District Council South Staffordshire District Council South Tyneside Council South Yorkshire Fire and Rescue Authority South Yorkshire Integrated Transport Authority South Yorkshire Police and Crime Commissioner and Chief Constable Southampton City Council Southend-on-Sea Borough Council Southwark London Borough Council Spelthorne Borough Council St Albans City and District Council St Edmundsbury Borough Council St Helens Metropolitan Borough Council Stafford Borough Council Staffordshire Combined Fire and Rescue Authority Staffordshire County Council Staffordshire Moorlands District Council Staffordshire Police and Crime Commissioner and Chief Constable Stevenage Borough Council Stockport Metropolitan Borough Council Stockton-on-Tees Borough Council Stoke-on-Trent Unitary Authority Stratford-on-Avon District Council Stroud District Council Suffolk Coastal District Council Suffolk County Council Suffolk Police and Crime Commissioner and Chief Constable Sunderland City Metropolitan Borough Council

Agenda Item 4ii

Surrey County Council Surrey Heath Borough Council Surrey Police and Crime Commissioner and Chief Constable Sussex Police and Crime Commissioner and Chief Constable Sutton London Borough Council Swale Borough Council Swindon Unitary Authority Tameside Metropolitan Borough Council Tamworth Borough Council Tandridge District Council Taunton Deane Borough Council Teignbridge District Council Telford and Wrekin (Borough of) Tendring District Council Test Valley Borough Council Tewkesbury Borough Council Thames Valley Police and Crime Commissioner and Chief Constable Thanet District Council Three Rivers District Council Thurrock Unitary Authority Tonbridge and Malling Borough Council Torbay Council Torridge District Council Tower Hamlets London Borough Council Trafford Metropolitan Borough Council Transport for London Tunbridge Wells Borough Council Tyne & Wear Integrated Transport Authority Tyne and Wear Fire and Rescue Authority Uttlesford District Council Vale of White Horse District Council Wakefield City Council Walsall Metropolitan Borough Council Waltham Forest London Borough Council Wandsworth London Borough Council Warrington Borough Council Warwick District Council

Agenda Item 4ii

Warwickshire County Council Warwickshire Police and Crime Commissioner and Chief Constable Watford Borough Council Waveney District Council Waverley Borough Council Wealden District Council Wellingborough Borough Council Welwyn Hatfield District Council West Berkshire Council West Devon Borough Council West Dorset District Council West Lancashire District Council West Lindsey District Council West London Waste Authority West Mercia Police and Crime Commissioner and Chief Constable West Midlands Fire and Rescue Authority West Midlands Integrated Transport Authority West Midlands Police and Crime Commissioner and Chief Constable West Oxfordshire District Council West Somerset District Council West Sussex County Council West Yorkshire Fire and Rescue Authority West Yorkshire Integrated Transport Authority West Yorkshire Police and Crime Commissioner and Chief Constable Western Riverside Waste Authority Westminster City Council Weymouth and Portland Borough Council Wigan Metropolitan Borough Council Wiltshire Combined Fire and Rescue Authority Wiltshire Police and Crime Commissioner and Chief Constable Wiltshire Unitary Authority Winchester City Council Windsor and Maidenhead (Royal Borough of) Wirral Metropolitan Borough Council Woking Borough Council Wokingham Council Wolverhampton City Council

Agenda Item 4ii

Worcester City Council Worcestershire County Council Worthing Borough Council Wychavon District Council Wycombe District Council Wyre Borough Council Wyre Forest District Council Yorkshire Dales National Park Authority Blaenau Gwent County Borough Council Bridgend County Borough Council Caerphilly County Borough Council Cardiff City and County Council Carmarthenshire County Council Ceredigion County Council Conwy County Borough Council Denbighshire County Council Dyfed Powys Police and Crime Commissioner Flintshire County Council Gwent Police and Crime Commissioner Gwynedd County Council Isle of Anglesey County Council Merthyr Tydfil County Borough Council Mid and West Wales Fire Authority Monmouthshire County Council Neath Port Talbot County Borough Council Newport City Council North Wales Fire Authority North Wales Police and Crime Commissioner Pembrokeshire Coast National Park Authority Pembrokeshire County Council Powys County Council Rhondda Cynon Taff County Borough Council Snowdonia National Park Authority South Wales Fire Authority South Wales Police and Crime Commissioner Swansea City and County Council Torfaen County Borough Council

Agenda Item 4ii

Vale of Glamorgan County Council Wrexham County Borough Council Aberdeen City Council Aberdeenshire Council Angus Council Argyll and Bute Council Central Scotland Fire and Rescue Service Central Scotland Police Clackmannanshire Council Comhairle nan Eilean Siar (Western Isles Council) Dumfries and Galloway Council Dundee City Council East Ayrshire Council East Dunbartonshire Council East Lothian Council East Renfrewshire Council Edinburgh City Council Falkirk Council Fife Council Fire Service Scotland Forth Estuary Transport Authority Glasgow City Council Grampian Fire and Rescue Service Grampian Police Highland Council Highlands & Islands Fire Brigade Inverclyde Council Lothian & Borders Fire and Rescue Service Lothian & Borders Police Midlothian Council Moray Council North Ayrshire Council North Lanarkshire Council Northern Constabulary Orkney Islands Council Perth and Kinross Council Police Service Scotland

Agenda Item 4ii

Renfrewshire Council Scottish Borders Council Shetland Charitable Trust Shetland Islands Council South Ayrshire Council South Lanarkshire Council South-East of Scotland Transport Partnership (SESTRAN) Stirling Council Strathclyde Fire and Rescue Service Strathclyde Partnership for Transport Strathclyde Police Tay Road Bridge Joint Board Tayside Fire and Rescue Tayside Police West Dunbartonshire Council West Lothian Council Antrim Borough Council - Northern Ireland Arc21 Joint Committee - Northern Ireland Ards Borough Council - Northern Ireland Armagh City and District Council - Northern Ireland Ballymena Borough Council - Northern Ireland Ballymoney Borough Council - Northern Ireland Banbridge District Council - Northern Ireland Belfast City Council - Northern Ireland Carrickfergus Borough Council - Northern Ireland Castlereagh Borough Council - Northern Ireland Coleraine Borough Council - Northern Ireland Cookstown District Council - Northern Ireland Craigavon Borough Council - Northern Ireland Derry City Council - Northern Ireland Down District Council - Northern Ireland Dungannon and South Tyrone Borough Council - Northern Ireland Fermanagh District Council - Northern Ireland Larne Borough Council - Northern Ireland Limavady Borough Council - Northern Ireland Lisburn City Council - Northern Ireland Magherafelt District Council - Northern Ireland

Agenda Item 4ii

Moyle District Council - Northern Ireland Newry and Mourne District Council - Northern Ireland Newtownabbey Borough Council - Northern Ireland North Down Borough Council - Northern Ireland Omagh District Council - Northern Ireland Strabane District Council - Northern Ireland

Dorset HealthCare NHS Foundation Trust Year ended 31 March 2016 Log of changes to 2015/16 accounts since the Audit Committee meeting on 23rd May 2016

Note 4.6 Exit packages Page A25

Narrative has been updated to reflect current year details as follows:

"A charge of £427k (2014/15 £1,769k charge) has been recognised in the accounts in exit package packages have most significantly been incurred in respect of the transfer of one service to another another service."

Note 26. Related Party Transactions Page A44

The following paragraphs have been updated to reflect accurate information:

"Ron Shields, Chief Executive, resigned as board member of Health Education Wessex during 201 Education England. Mr Shields's wife is NHS Director of specialist service commissioning (part of N Chair, was a Non-Executive Director of Health Education England, but resigned in 2014/15."

"Laurence Mynors-Wallis, resigned from Medical Director on 30th June 2015. Dr Mynors-Wallis was College of Psychiatrists, the tenure for this post ended on 30th June 2015."

"Linda Boland's (Locality Director for East Dorset) husband has a contract to provide psychological Council."

Log of changes to the 2015/16 Annual Report since the Audit Committee meeting on 23rd Ma

Exit packages Pages 62-63

These have been updated so that the amounts agree with the disclosures within the financial statem

Off-payroll disclosures Page 62

The wording has been updated and an additional table has been included. Dorset HealthCare NHS Foundation Trust Year ended 31 March 2016 Log of changes to 2015/16 accounts since draft accounts sent to Audit Committee on 16th May 2016 - Discussed at Audit Committee 23rd May 2016

New Old 2015/16 2015/16

4.2 Average monthly number of employees (whole time equivalent basis) Agency and contract staff 166 150

A different calculation was used to calculate this figure for the Annual Report, to ensure consistency in the reported figures we have adopted the same calculation method and updated the accounts.

£'000 £'000 Note 24.2 Other Financial Commitments Expiry not later than 1 year 1,127 2,270

1,127 2,270

The original figure included a contract with Dorset County Hospital for Community services. The initial understanding was that there was a signed contract in place, however after further investigations it revealed that the contract had expired some years ago and works were in progress to renew it. At the year end there was no contractual obligation so the contract value of £1.14m was removed.

Note 26 Related Party Transactions

To ensure consistency with the Foundation Trust Consolidation Schedules a number of related party balances have been amended/added/deleted. Changes are detailed below:

Original listing: 31 March 31 March Significant Transaction Values with Related Trading 2015/16 2015/16 2016 2016 Organisations: Income Expenditure Receivables Payables £000 £000 £000 £000

NHS Dorset Clinical Commissioning Group 196,474 2,014 111 57 The Royal Bournemouth & Christchurch Hospitals NHS Foundation Trust 624 850 260 317 Dorest County Council 12,104 1,226 1,519 19

New listing: 31 March 31 March Significant Transaction Values with Related Trading 2015/16 2015/16 2016 2016 Organisations: Income Expenditure Receivables Payables £000 £000 £000 £000

NHS Dorset Clinical Commissioning Group 196,474 1,962 111 5 NHS Pension scheme - 18,094 - 2,464 Dorest County Council 12,049 540 298 288 Royal College of Psychiatrists - 41 - - RNLI College Ltd - 2 - - Other NHS Bodies 8,355 7,502 1,257 1,397

N:\Secretariat\Board\Board Meetings\2016\05 - May\25_05_2016 Special Meeting\Additional papers\Item 7i Copy of Audit Committee 23 May 2016 - Log of changes.xlsx Page 1 of 3 Dorset HealthCare NHS Foundation Trust APPENDIX A Year ended 31 March 2016 Log of changes to 2015/16 FTCs

New Old 2015/16 2015/16 £'000 £'000 Tab 28 C&O Table 32A Other Financial Commitments Expiry not later than 1 year 1,127 2,270

1,127 2,270

The original figure included a contract with Dorset County Hospital for Community services. It was originally believed that

Tab 8 Staff Note 4.2 Average number of Employees (WTE basis)

Agency and contract staff 166 150

A different calculation was used by Payroll to provide this figure for the Annual Report, to ensure consistency in the figures reported we have adopted the calculation method and updated the FTCs.

Tab 22 Trade payables Note 24.1 Trade and other payables

Other payables - to other WGA bodies 2,458 - Other payables - to bodies external to gov 1,055 3,513 3,513 3,513

This was to account for the pension payment due to NHS pensions at the year end totalling £2,458k.