SCOTTISH AMBULANCE SERVICE ANNUAL ACCOUNTS AND NOTES

Transcription

1 SCOTTISH AMBULANCE SERVICE ANNUAL ACCOUNTS AND NOTES FOR YEAR ENDED 31 MARCH 2010

2 Scottish Ambulance Service Board Annual Accounts SCOTTISH AMBULANCE SERVICE ANNUAL ACCOUNTS AND NOTES FOR YEAR ENDED 31 MARCH 2010 CONTENTS Page Directors Report (including interests of Board members) 3 Operating and Financial Review 8 Remuneration Report 16 Statements of Responsibilities and Statement of Internal Control 21 Independent Auditors Report 26 Direction by the Scottish Ministers 28 Principal Financial Statements (Form 1 4) 29 Notes to the Accounts Note 1 (Accounting Policies) 34 Note Scottish Financial Returns 101 Payment Policy 112 Resource and Cash Outturn 113 Sickness Absence 114 2

3 Scottish Ambulance Service Board Annual Accounts SCOTTISH AMBULANCE SERVICE ANNUAL ACCOUNTS AND NOTES FOR YEAR ENDED 31 MARCH 2010 DIRECTORS REPORT DIRECTORS REPORT 1. NAMING CONVENTION Scottish Ambulance Service is the common name for the Scottish Ambulance Service Board. 2. DATE OF ISSUE Financial Statements were approved and authorised for issue by the Board on 30 June ACCOUNTING CONVENTION The Annual Accounts and Notes have been prepared under the historical cost convention modified to reflect changes in the value of fixed assets and in accordance with the Scottish Government Financial Reporting Manual. The Accounts have been prepared under a direction issued by Scottish Ministers, which is included as an annex to the accounts. The statement of the accounting policies, which are in line with the International Financial Reporting Standards (IFRS) and have been adopted, are shown at Note APPOINTMENT OF AUDITORS The Public Finance and Accountability (Scotland) Act 2000 places personal responsibility on the Auditor General for Scotland to decide who is to undertake the audit of each health body in Scotland. The Auditor General appointed PricewaterhouseCoopers LLP to undertake the audit of the Scottish Ambulance Service Board. The general duties of the auditors of health bodies, including their statutory duties, are set out in the Code of Audit Practice issued by Audit Scotland and approved by the Auditor General. 5. BOARD MEMBERSHIP Under the terms of the Scottish Health Plan, the Scottish Ambulance Service Board is a Board of governance whose membership will be conditioned by the functions of the Board. Members of Health Boards are selected on the basis of their position or the particular expertise which enables them to contribute to the decision making process at a strategic level. The Scottish Ambulance Service Board has collective responsibility for the performance of the Service as a whole, and reflects the partnership approach, which is essential to improving health and health care. The Scottish Ambulance Service Board comprised during 2009/10: William Brackenridge Chairman until 30 June 2009 David Garbutt Chairman from 1 July 2009 Non-Executive Director (1 April June 2009) Pauline Howie Acting Chief Executive (1 April September 2009) Chief Executive (from 1 October 2009) Cllr David Alexander Non-Executive Director Alan Bickerstaff Employee Director to 30 June 2009 Matt Bell Employee Director from 1 July 2009 Dr George Crooks Medical Director (part time) Suzanne Dawson Non-Executive Director Theresa Houston Non-Executive Director Christine Humphries Non-Executive Director Douglas Marr Non-Executive Director Pamela Mclauchlan Interim Director of Finance (1 April December 2009) Director of Finance and Logistics from 1 January

4 Scottish Ambulance Service Board Andrew Richmond Non-Executive Director Peter Ripley Director of Service Delivery (from 1 December 2009) Shirley Rogers In Year Appointments Annual Accounts Director of Human Resources and Organisational Development Interim Director of Operations (1 April November 2009) Mr William Brackenridge demitted office as Chairman on the 30 June 2009, at the completion of his term of office. Mr David Garbutt then took up the position of Chairman of the Board from the 1 July Mrs Pauline Howie had been fulfilling the Acting Chief Executive s role and was formally appointed as Chief Executive on 1 October Mr Alan Bickerstaff demitted office as Employee Director at the end of his term of office and was replaced by Mr Matthew Bell on 1 July Mrs Shirley Rogers had been performing both her substantive post as Director of Human Resources and Organisational Development and that of Interim Director of Operations. On the appointment of Mr Peter Ripley as Director of Service Delivery on 1 December 2009, Mrs Rogers was able to return to her substantive post. Mrs Pamela Mclauchlan who had been fulfilling the role of Interim Director of Finance, was appointed as substantive Director of Finance and Logistics and took up this post on 1 January 2010 completing the Board appointments. Ms Heather Kenney took up a new Director position as Director of Strategy and Planning on 22 nd March The Board members responsibilities in relation to the accounts are set out in a statement following this report. 6. BOARD MEMBERS AND SENIOR MANAGERS INTERESTS The following interests have been declared by Board members and senior managers: Board Member Directorships Ownerships William Brackenridge CIPFA Occasional Sub-Contractor Chairman The Helensburgh Partnership Non-Executive Director NHS Highland Chairman, Argyll and Bute, CHP David Garbutt Chartered fellow of the Chartered Institute of Personnel and Development Fellow Scottish Police College Visiting Fellow Australian Institute of Police Management None Self Employed Consultant Pauline Howie None None David Alexander Falkirk Council Elected Member None Member and office bearer Scottish National Party Member CND Scotland Member Central Scotland Fire Board Matt Bell None None Alan Bickerstaff None None George Crooks Medical Director NHS24 None 4

5 Scottish Ambulance Service Board Annual Accounts Suzanne Dawson Chair of the Borders College Board of Management; Member of the Board of the Association of Scotland s Colleges, Chair of BC Consultants (wholly-owned subsidiary of Borders College); Fellow of Chartered Institute of Marketing Self-employed Marketing Consultant Theresa Houston Non-Executive Director NHS Education for Scotland None Christine Humphries Scottish Social Services Council Due Regard Member Registration and Conduct Committee; Member of British Association of Social Workers None Douglas Marr None None Pamela Mclauchlan Executive Member CIPFA in Scotland None Andrew Richmond Non-Executive Member of NHS Tayside Trustee Tayside NHS Board Endowment Fund; Associate of Society of Investment Professionals (ASIP); Member of Angus Conservative & Unionist Association; Member of Carlton Club; Member of Church of Scotland; Member of TAGRA Director of Rushyglen Ltd; Director of Laverock Properties Ltd None Peter Ripley None None Shirley Rogers Non-Executive Member of the Board of Management of Borders College None Senior Managers Directorships Ownerships Heather Kenney None None 7. PENSION LIABILITIES The accounting policy note for pensions is provided in Note 1 and disclosure of the costs is shown within Note 24 and the remuneration report. 8. REMUNERATION FOR NON-AUDIT WORK PriceWaterhouseCoopers LLP, the Service s current External Auditors have only undertaken audit related work during 2009/10, for the Scottish Ambulance Service Board. 9. RELATED PARTY TRANSACTIONS During the year, no Board member, key manager or other related parties have undertaken any material transactions with any body during the year. 5

6 10. PAYMENT POLICY Scottish Ambulance Service Board Annual Accounts The Scottish Ambulance Service is committed to supporting The Scottish Government in helping businesses during the current economic situation by paying bills more quickly. The intention is to achieve payment of all undisputed invoices within 10 working days, across all public bodies. The target has been communicated to all non-departmental public bodies, who are working towards the accelerated payment target of 10 working days. Prior to this, the Boards did endeavour to comply with the principles of The Better Payment Practice Code ( by processing suppliers invoices for payment without unnecessary delay and by settling them in a timely manner. In 2009/10 average credit taken was 41 days (2008/09 = 38 Days) In 2009/10 the Board paid 63% by value and 71% by volume within 30 days (2008/09 = 62% by value & 75% by volume) 11. CORPORATE GOVERNANCE The Board meets regularly during the year to progress the business of the Scottish Ambulance Service Board. The following governance committees report to the Board: - Clinical governance - Audit - Staff Governance - Remuneration Clinical Governance Committee The Clinical Governance Committee of the Health Board has two key roles: - Systems assurance to ensure that clinical governance mechanisms are in place and effective throughout the Scottish Ambulance Service System; and - Public health governance to ensure that the principles and standards of clinical governance are applied to the health improvement activities of the NHS Board. The Clinical Governance Committee currently comprises four Non-Executive Directors: Mrs Christine Humphries (Chair); Mr Andrew Richmond; Ms Suzanne Dawson; and Ms Theresa Houston. Mr David Nelson is the Public/Patient Representative. The Committee meets approximately four times per year to monitor standards of care and measure the effectiveness of pre-hospital treatment. Audit Committee The Audit Committee currently comprises four Non-Executive Directors: Mr Douglas Marr (Chair); Mr Andrew Richmond; Ms Theresa Houston; and Mrs Christine Humphries. Mrs Humphries took up her position in September 2009, replacing Mr David Alexander. The Audit Committee meets four times per year to consider the various reports from both internal and external auditors to assess the risks that may arise in the Service. Staff Governance The Staff Governance Committee comprises three Non-Executive Directors: Mr Matthew Bell, who took up post in July 2009 replacing Mr Alan Bickerstaff as Employee Director and Chair; Mrs Christine Humphries; Mr Douglas Marr; and the Chairman, Mr David Garbutt, who took up his position in July 2009, replacing Mr William Brackenridge. The Committee meets four times per year to ensure effective monitoring of staff governance within the organisation. 6

7 Remuneration Committee Scottish Ambulance Service Board Annual Accounts The Remuneration Committee currently comprises the Chairman and three Non-Executive Directors: Mr Douglas Marr; Ms Suzanne Dawson; and Mr David Alexander. The Committee is chaired by the Chairman, Mr David Garbutt. It meets at least three times per year to consider the evaluation of performance and pay awards for Executive Directors. The committees have an important role in ensuring consistency of policy and equity of treatment of staff across the local NHS system, including remuneration issues, where they are not already covered by existing arrangements at national level. The Board Members responsibilities in respect of internal control are set out in a statement following this report. 12. DISCLOSURE OF INFORMATION TO AUDITORS The directors who held office at the date of approval of this directors report confirm that, so far as they are each aware, there is no relevant audit information of which the Board s auditors are unaware; and each director has taken all the steps that he/she ought reasonably to have taken as a director to make himself/herself aware of any relevant audit information and to establish that the Board s auditors are aware of that information. 13. HUMAN RESOURCES As an equal opportunities employer, the Scottish Ambulance Service Board welcomes applications for employment from disabled persons and actively seeks to provide an environment where they and any employees who become disabled can continue to contribute to the work of the Organisation. The Scottish Ambulance Service Board provides employees with information on matters of concern to them as employees by liaising with unions and staff committees so that their views are taken into account in decisions affecting their interests. The organisation has a national partnership forum which meets six times per year. Representation is present from each of the recognised Staff side groups and Management of the organisation. In addition, each division has its local partnership forum where matters impacting on staff can be discussed and progressed. There is a quarterly staff magazine, regular briefing notes are distributed, and staff have access to the Service Intranet (SAMSON). During 2009/10 significant progress has been made in a number of areas as follows: Extensive communications exercise in support of the development of our future strategy which was agreed this year; Revised Boards [ including management and staff side] in place to support the delivery of new strategy; Extensive opportunities for individual members of staff to influence the development of our Learning and Development strategy which was launched during the year; Delivery of leadership and management development opportunities to a wide range of staff. Conflict resolution training commenced; Staff Survey action plans in place and being monitored along with staff governance action plans; New Induction programme in place; Intranet site improved significantly; Core briefing in place in a number of areas; Implementation of Knowledge and Skills Framework well underway. Systems and processes amended to support changing HPC requirements and reflect a more modern training and development process. Training infrastructure project well underway; Three new partnership forums set up this year; Bullying and Harassment Adviser system in place and being monitored; Significant work undertaken in regard to recruitment policies, procedures and delivery; Significant work in relation managing of absence; Additional cohort of Cleanliness champions; Fast Track Physio continues to produce significant return on investment; Signed:... Date: 30 June 2010 Mrs Pauline Howie Chief Executive 7

8 OPERATING AND FINANCIAL REVIEW Scottish Ambulance Service Board Annual Accounts NHS Boards are required to prepare an Operating and Financial Review under section 7.2 of the FReM. This provides a narrative explanation of the main trends and factors underlying the development, performance and position of the Board during the financial year covered by the financial statements, and those which are likely to affect its future development, performance and position as defined in the Accounting Standards Board Reporting Statement objectives. The operating and financial review has been prepared in accordance with the FReM and complies with best practice. 1 Principal activities and review of the year The Scottish Ambulance Service Board was established in 1999 under The Scottish Ambulance Service Board Order 1999 which amended the National Health Service (Scotland) Act 1978 and is responsible for the provision of Accident & Emergency response, Patient Transportation Service and Air Ambulance services for the residents of Scotland, including the islands communities. This covers a total population of 5 million. The role of the Scottish Ambulance Service Board is to: - provide accident and emergency, patient transport and air ambulance services to the people of Scotland; - improve and protect the health of people; - improve health services for local people; - focus clearly on health outcomes and people s experience of their local NHS system; - promote integrated health and community planning by working closely with other local organisations. The functions of the Scottish Ambulance Service Board comprise: - strategy development - implementation of strategic framework - resource allocations - implementation of its Delivery Plan - performance management During this financial year, The Service has: - carried out an exemplary consultation exercise on which it has developed its five year Strategic Framework: Working together for better patient care set up five programme boards to implement the Strategic Framework - developed its Corporate Plan - developed a learning strategy: Realising Our Potential as well as strategies for Procurement and ICT - Improved response times to emergency calls - developed alternative care pathways for patients who do not require treatment in Accident and Emergency departments - enhanced the role of Paramedic Advisers to provide clinical advice to callers to ensure they are directed to the most appropriate care for their condition - worked in partnership with NHSScotland territorial boards to widen the roll-out of an enhanced service which delivers, in appropriate cases, acute cardiac catheterisation. This procedure unblocks a narrowed coronary artery, which will prevent or minimise damage to the heart muscle. Alternatively, patients will receive a clot busting drug in the community, which is proven to reduce death from heart attacks. - continued to develop its clinical standards and care for patients using the Patient Transport Service - ensured robust clinical audit arrangements are in place in response to the increasing demand for Air Ambulance - responded to a record level of air ambulance demand (4,300 missions) including increases from specialist retrieval services - co-located the East Emergency Dispatch Centre with NHS 24 at Norseman House in South Queensferry 8

9 2 Financial Position Scottish Ambulance Service Board - begun the refurbishment of the North Emergency Dispatch Centre in Inverness - Trained an additional 93 Paramedic staff and 130 Technician Staff - Provided post-proficiency or triennial training for 2640 front-line staff Annual Accounts The Scottish Government Health Directorate (SGHD) sets three financial targets at NHS Board level on an annual basis. These limits are: revenue resource limit - a resource budget for ongoing operations; capital resource limit - a resource budget for new capital investment; and cash requirement - a financial requirement to fund the cash consequences of the ongoing operations and the new capital investment. NHS Boards are expected to contain their net expenditure within these limits, and to report on any variation from the limits set. The Scottish Ambulance Service achieved each of the targets set and the table below indicates the Board s financial performance against them. (1) Limit as set by SGHD 000 (2) Actual Outturn 000 (3) Variance (over)/under (1)-(2) 000 Revenue resource limit 201, , Capital resource limit 13,202 13, Cash requirement 200, , / / (38) Brought forward (surplus) from previous financial year (25) (13) Savings/(excess) against in year revenue resource limit 54 The 2008/09 Annual Accounts were prepared under the convention of UK GAAP however the 2009/10 Annual Accounts were prepared under IFRS. In respect of financial performance: - The Board generated an overall saving of 79k against Revenue Resource Limit at the year end. - The Board contained its costs within the revenue and capital resource limits - The closing bank balance as at 31 March 2010 was 60k (Paymaster General) - Provisions for bad and doubtful debts of 41k were made. - Provision for legal obligations of 1,247k were made, of which 1,145k relates to medical and clinical claims, 77k relates to employers liability claims and 25k relates to third party claims. - Land and Buildings were fully revalued by the Valuation Office Agency at 31 March 2010 on the basis of existing use or market value, where no longer in use. All tangible fixed assets were revalued on the basis of indices at 31 March The net impact was a decrease in value of 2.276m of which 0.336m was charged to the Revaluation Reserve and 1.940m was charged to the Operating Cost Statement. - Total outstanding liabilities are m.This includes a liability for leased vehicles of 258k - Four of the five operating divisions returned deficits against budget in the year, this was due to high utilisation of overtime. The divisions are aware that this situation can not continue in 2010/11. 9

10 Scottish Ambulance Service Board Annual Accounts Key Performance Indicators Health Boards are required to report on their Key Performance Indicators, as agreed with the Scottish Government Health Directorate, shown below. Examples of KPIs include financial breakeven targets, waiting times targets, delayed discharges, absences and suicide rates, which are all examples of the main NHS objectives. These objectives can be classified under four categories: Health Improvement for people in Scotland; Efficiency improvements; Access more quickly to service; and Treatment Appropriate for Patient (HEAT). 10

11 Scottish Ambulance Service Board Annual Accounts NHS Scotland Objective 1: Health Improvement for the people of Scotland improving life expectancy and healthy life expectancy Target No. H1 Save more lives: Target Achieve a return of spontaneous circulation on arrival at hospital of 12% to 20% - Actual 17.8% Cardiac Arrest H12 Cardiac Arrest patients responded to in 8 minutes Target 75% - Actual 78.5% NHS Scotland Objective 2: Efficiency and Governance Improvements continually improve the efficiency and effectiveness of the NHS Target No. E1 E2 E3 E4 E5 E6 Target NHS Boards to operate within their revenue resource limit; operate within their capital resource limit; meet their cash requirement. - Target achieved Deliver a 2% Cash Releasing Efficiency Saving per annum - Actual 2.2% Review of PDPs by March 2011 Target 80% In progress 98% of eligible AfC staff have an e- KSF in place by March 2010 Reduce Sickness absence to a target of 5% - Actual 5.4% Universal use of the CHI number Target 75% - Actual 84.7% Reduce Emissions Target 2% - Actual 2.3% 11

12 Scottish Ambulance Service Board Annual Accounts NHS Scotland Objective 3: Access to Services recognising patients need for quicker and easier use of NHS services Target No. A1 Target Improve response time to Category A (life threatening) emergency incidents target = 75% - Actual = 72.3% Full Year March = 77.5% Improve response time to Category B emergency incidents target = 95% A2 A3 A4 A5 - Actual = 93.7% March = 94.5% Improve response time to Island emergency incidents target = 50% - Actual = 51.6% Improve punctuality for appointment for Priority 1 PTS patients target 70% - Actual = 71.8% Improve punctuality for pick up for Priority 1 PTS patients target = 87% - Actual = 85.3% NHS Scotland Objective 4: Treatment Appropriate to Individuals: ensure patients receive high quality services that meet their needs Target No. Target T 1 Improve Health Outcomes for Patients Improve measured performance against NHS QIS standards for Clinical Governance and Risk Management. Target 10 or above - Actual 11 T 2 T3 T4 T5 Health acquired infection- Compliance with HAI monitoring Meet Target no Reds Achieved Reduce Hospital admissions. Increase % of calls treated at scene target = 11% - Actual = 11.1% % of patients with SEWS Score above 4 taken to hospital Target 95-98% - Actual = 97.1% % of Hyper Acute Stroke patients taken to hospital in 55 minutes Target 90% - Actual = 66.8% 12

13 4 Sustainability and Environmental Reporting Scottish Ambulance Service Board Annual Accounts Significant work has been ongoing during 2009/10 in relation to sustainability and environmental reporting. For our National Headquarters we achieved ISO Environmental Certification for waste management and energy conservation. The organisation achieved a 2.2% reduction in energy consumption 0.2% over and above the expected 2% savings. This equates to an efficiency saving of 43k. An action plan is also in place to reduce carbon emissions from its Fleet. This was produced following a report from the Carbon Trust. Pollution Prevention and Legislative Compliance A complete audit of our estate with regard to pollution prevention and legislative compliance was undertaken on our drainage/water systems. This resulted in drainage drawing being completed at each site, trade effluent agreements being put in place with the water authority (where applicable), and interceptors being installed at sites where required. Waste Minimisation and Recycling A recycling area has been set up at NHQ to recycle toner cartridges, paper, aluminium cans, plastic bottles, batteries, CDs/disks and mobile phones. The recycling initiative has been very popular with staff and the amounts being recycled have been monitored and measured for 2009/10. We will use these figures as our benchmark and monitor and measure against them for 2010/11. Energy Efficiency As part of our property strategy, we install energy saving devices in our upgrades/new builds; in particular, thermostatic valves to all radiators; time clocks to all heating systems; automatic devices for lighting and - within the actual build - energy saving insulation. Transport Vehicle Emissions The Service has continued to monitor its CO 2 emissions on a monthly basis, with month to year trend analysis. The Service is now showing an increase in its overall emissions footprint from its previous plateau on a rolling annual basis. Given that we already recognise the limitations of control of our frontline demand-led Service, more focus has been put on areas where we have control. The leased vehicle essential-user car scheme is nearing completion of its intensive review with greater emphasis now put on fuel efficient, low carbon emission vehicles that will ease the current emissions profile. Vehicle Selection New vehicle acquisition has to consider the Environmental Criteria of Co2 reduction and increased MPG. The latest vehicle selection and trials on A&E fleet will not necessarily reduce emissions but are expected to be the best in class of those vehicles deemed suitable for front line operations Waste Management The workshop waste management process is now well established. Its aim of having a one stop shop for all waste disposal from the Service s workshops has been achieved. This is currently still in place and links to the workshop waste disposal register, where we continue to keep waste disposal consignment certificates kept for audit purposes. Water Efficiency The constant use of water at all of our sites for vehicle cleaning does mean that our water consumption is high. Unfortunately, unless we undertake the vehicle cleaning off site, there is very little latitude to reduce the water consumption. We have therefore concentrated on installing water-saving devices such as touchsensitive taps within certain areas of the station as part of our upgrades/new builds. 13

14 Green Purchasing Scottish Ambulance Service Board Annual Accounts The Service has in place an environmental procurement policy which supports the Service s environmental policy and the Scottish Executive s policy on Public Procurement and Sustainable Development. Environmental Auditing As our National Headquarters has achieved ISO environmental certification, two internal auditors have been trained to undertake regular environmental audits. BSI will also audit bi-annually to comply with the certification process. Our policies focus predominantly on significantly reducing: energy consumption; water consumption; waste disposal; fuel consumption and vehicle emissions. As a national public service, the Scottish Ambulance Service is committed to investing in Green Procurement practices and recycling initiatives that will have a positive impact on sustainability of the environment. 5 Equality and Diversity The Scottish Ambulance Service has a strong commitment to equality for all and recognises that work in this area is a continuing journey as we move towards mainstreaming equality into all that we do. Scotland is an increasingly diverse country. Whilst this provides great opportunities, it also presents significant challenges in ensuring that we, as both a service provider and employer, ensure that we do not consciously or unconsciously discriminate and instead provide equitable access to our services and fair employment practice in the workplace. A review of the Disability Equality Scheme was recently undertaken, setting out what has been achieved during the last three years and developing our Action Plan for Key developments for the future include identifying ways to attract more recruits from the disabled community, developing a communication tool to support disabled patients and reviewing the consent strategy to take account of adults and children with incapacity/use of welfare guardianship. Our annual report on the Gender Equality Scheme highlights some of the work we have done and areas where development is still underway. For example, we are identifying more effective ways of engaging with men and women regarding service development and we are developing a policy for managing gender-based violence in the workplace. Work is soon to commence to review the Gender Equality Scheme. This will be revised and the new Scheme published in June We will continue to monitor the Service Anti-bullying and Harassment campaign, the aim of which is to raise awareness of unacceptable behaviour and encourage staff to raise any concerns/issues at the earliest opportunity in order to resolve problems as soon as possible. The Equality and Diversity Steering Group continues to meet bi-monthly to take some of the key areas of work forward. Membership includes representatives from across the divisions. 6 Equal Pay The Scottish Ambulance Service has received 1 claim under the Equal Pay Act 1970 from a woman seeking compensation for past inequalities with male colleagues, under their pay arrangements. The basis of those claims is as follows: 14

15 Scottish Ambulance Service Board Annual Accounts The Claimant s job has been rated as being of equivalent to that of their comparator using a valid Job Evaluation Study and/or is of equal value to that of their comparator. Their comparator is currently paid or has been paid more than them. They claim equal pay, back pay and interest (back pay is claimed for the statutory maximum of five years.) In the case of Hartley v. Northumbria Healthcare NHS Trust the Employment Tribunal ruled that the Agenda for Change job evaluation scheme was not discriminatory. This decision has curtailed the possibility of claims for any period after 1 October This decision led to the withdrawal of a number of claims by claimants represented by a contingency fee solicitor. The decision in Hartley and other recent decisions call into question how, and whether, several other aspects of claims will be taken forward. Only claims for the period prior to 1 October 2004 are likely to be progressed and the claimants will still have to establish that their jobs were of equal value to comparator jobs for that period. Some cases are now being pursued that seek to establish the position in relation to specific aspects of claims that may impact on their scope and the potential comparator jobs that could be considered. In particular there is a test case that is considering the validity of the explanation which has been provided by the respondents as to why claimants and comparators doing jobs of equal value were in fact paid differently. The explanation is around the different collective bargaining structures that were in place for different staff groups. The outcome of this case will be important and will inform decision making about the strength of similar defences in other cases. Claims still do not provide sufficient detail about the comparator jobs to allow an estimate to be made of the likelihood of the success of the claims or of any financial impact that they may have. The NHS Scotland Central Legal Office and Equal Pay Unit are continuing to monitor the progress of all equal pay claims in NHS Scotland and the developments relating to NHS equal pay claims elsewhere that may further inform the position. They continue to advise that it is not possible to provide any financial quantification at this stage because of the lack of information available. On the basis of their view the appropriate accounting treatment is to disclose the claims as a contingent liability that it is not possible to quantify. Signed:... Date: 30 June 2010 Mrs Pauline Howie Chief Executive 15

16 Scottish Ambulance Service Board Annual Accounts SCOTTISH AMBULANCE SERVICE ANNUAL ACCOUNTS AND NOTES FOR YEAR ENDED 31 MARCH 2009 ANNUAL REPORT REMUNERATION REPORT BOARD MEMBERS AND SENIOR EMPLOYEES REMUNERATION The remuneration of Board members and senior employees is determined in accordance with the NHS MEL(2000)25 Pay and Conditions of Service. This document sets out the pay arrangements for Board members and senior employees of NHS Boards. The arrangements referred to in this document are mandatory from 1 April Performance appraisal for Board members and senior employees is conducted in accordance with HDL(2002)64 Appraisal arrangements for staff on Executive pay ranges. As stated above, the Remuneration Committee meets three times to consider the evaluation of performance and pay awards for Executive Directors. This committee comprises the Chairman and three Non-Executive Directors: Mr Douglas Marr, Ms Suzanne Dawson, and Mr David Alexander. The Committee is chaired by the Chairman, Mr David Garbutt. 16

17 Scottish Ambulance Service Board Annual Accounts REMUNERATION REPORT FOR THE YEAR ENDED MARCH 2010 CURRENT YEAR 2009/10 (AUDITED) Remuneration of: Executive Members Salary (Bands of 5,000) * Real increase in pension At age 60 (Bands of 2,500) Total accrued pension at age 60 at 31 March (bands of 5,000) Cash Equivalent Transfer Value (CETV) at 31 March 2009 Cash Equivalent Transfer Value (CETV) at 31 March 2010 Real increase in CETV in year Benefits in kind '000 '000 '000 '000 Chief Executive: Pauline Howie Director of Finance: Pamela Mclauchlan (from 01/01/10) Interim Director of Finance to 31/12/2009 Director of HR and Organisational Development: Shirley Rogers Part Time Medical Director : George Crooks # # # # # # Director of Service Delivery: Peter Ripley (from 1/12/2009) Non Executive Members Chairman: William Brackenridge to 30/06/ Chairman: David Garbutt from 1/07/ Douglas Marr Christine Humphries Suzanne Dawson Andrew Richmond David Alexander David Garbutt (non - executive until 30/06/2009) Theressa Houston Employee Director: Alan Bickerstaff to 31/07/ Employee Director: Matt Bell from 01/08/ Other Snr Employees Director of Strategy and Planning : Heather Kenney ( from 22/03/2010) 0-5 # # # # # 0 Note # These Directors pension information is included within NHS24 (G Crooks) and NHS Fife (H Kenney) information. * These salary costs include Employers Contributions to National Insurance and NHS Pension Scheme plus on-call allowances. Total 1,313 1,

18 Scottish Ambulance Service Board Annual Accounts REMUNERATION REPORT FOR THE YEAR ENDED MARCH 2010 PRIOR YEAR 2008/09 (AUDITED) Remuneration of: Executive Members Salary (Bands of 5,000) Real increase in pension At age 60 (Bands of 2,500) Total accrued pension at age 60 at 31 March (bands of 5,000) Cash Equivalent Transfer Value (CETV) at 31 March 2008 Cash Equivalent Transfer Value (CETV) at 31 March 2009 Real increase in CETV in year Benefits in kind '000 '000 '000 '000 Chief Executive: Kevin Doran (left 14/11/08) x x x x x x x Director of Finance: Pauline Howie (Acting Chief Executive) Director of HR: Shirley Rogers (& Director of Operations) Director of Operations: Grace Kennedy (left 14/11/08) x x x x x x x Non Executive Members Chairman: William Brackenridge Alan Lawton Douglas Marr Christine Humphries Suzanne Dawson Andrew Richmond David Alexander David Garbutt Theresa Houston Employee Director: Alan Bickerstaff Other Snr Employees Part Time Medical Director : George Crooks # # # # # # Interim Director of Finance : Pamela Mclauchlan # # # # # # Total x Under the provisions of the Data Protection Act these two former Executive Directors have not given permission to disclose their individual remuneration details nor are they included within the overall totals. # These two Interim Directors are seconded from other NHS Boards and their pension information is included in these Boards accounts: George Crooks - NHS24, Pamela Mclauchlan - NHS QIS. Signed:... Date: 30 June 2010 Mrs Pauline Howie Chief Executive 18

19 Scottish Ambulance Service Board Annual Accounts STATEMENT OF THE CHIEF EXECUTIVE S RESPONSIBILITIES AS THE ACCOUNTABLE OFFICER OF THE HEALTH BOARD Under Section 15 of the Public Finance and Accountability (Scotland) Act, 2000, The Principal Accountable Officer (PAO) of the Scottish Executive has appointed me as Accountable Officer of NHS Scottish Ambulance Service. This designation carries with it responsibility for the propriety and regularity of financial transactions under my control and for the economical, efficient and effective use of resources placed at the Board s disposal. In preparing the accounts, I am required to comply with the requirements of the Government s Financial Reporting Manual and in particular to: observe the accounts direction issued by Scottish Ministers including the relevant accounting disclosure requirements and apply suitable accounting policies on a consistent basis; make judgements and estimates on a reasonable basis; state whether applicable accounting standards as set out in the Government s Financial Reporting Manual have been followed and disclose and explain any material departures; prepare the accounts on a going concern basis. I am responsible for ensuring proper records are maintained and that the Accounts are prepared under the principles and in the format directed by Scottish Ministers. To the best of my knowledge and belief, I have properly discharged my responsibilities as Accountable Officer as intimated in the Departmental Accountable Officers letters to me of 24 June 2008 and 5 November Signed:... Date: 30 June 2010 Mrs Pauline Howie Chief Executive 19

20 Scottish Ambulance Service Board Annual Accounts STATEMENT OF HEALTH BOARD MEMBERS RESPONSIBILITIES IN RESPECT OF THE ACCOUNTS Under the National Health Service (Scotland) Act 1978, the Health Board is required to prepare accounts in accordance with the directions of Scottish Ministers which require that those accounts give a true and fair view of the state of affairs of the Health Board as at 31 March 2010 and of its operating costs for the year then ended. In preparing these accounts the Directors are required to: apply on a consistent basis the accounting policies and standards approved for NHSScotland by Scottish Ministers; make judgements and estimates that are reasonable and prudent; state where applicable accounting standards have not been followed where the effect of the departure is material; prepare the accounts on the going concern basis unless it is inappropriate to presume that the Board will continue to operate. The Health Board members are responsible for ensuring that proper accounting records are maintained which disclose with reasonable accuracy at any time the financial position of the Board and enable them to ensure that the accounts comply with the National Health Service (Scotland) Act 1978 and the requirements of the Scottish Executive Health Department. They are also responsible for safeguarding the assets of the Board and hence taking reasonable steps for the prevention of fraud and other irregularities. The NHS Board members confirm they have discharged the above responsibilities during the financial year and in preparing the accounts. Director of Finance and Logistics. Date: 30 June 2010 Mrs Pamela McLauchlan Chairman... Date: 30 June 2010 Mr David Garbutt 20

21 Scottish Ambulance Service Board Annual Accounts SCOTTISH AMBULANCE SERVICE ANNUAL ACCOUNTS 2009/10 STATEMENT ON INTERNAL CONTROL Scope of Responsibility As Accountable Officer, I have responsibility for maintaining a sound system of internal control that supports the achievement of the organisation s policies, aims and objectives, set by Scottish Ministers, whilst safeguarding the public funds and assets for which I am personally responsible, in accordance with the responsibilities assigned to me. Notwithstanding that overall responsibility for risk rests with myself, for practical reasons operational responsibility has been devolved to competent persons at Executive and organisational level. The list below sets out how I have delegated the Interim responsibility throughout the Service for the Management of Risk: The Chief Executive is Chair of the Risk Management Steering Group which meets quarterly to review current risks and mitigating actions. The Director of Finance and Logistics is the Executive Director responsible for the Risk Management function within the Service and those that impact on financial risks. However, each General Manager within the Service is responsible for identifying and managing their own risk log which is then fed into the Operational Management Team and other committees. The Director of HR and Organisational Development is the Executive Director with responsibility for Health and Safety and ensures that the Health and Safety strategy is in place. In addition they ensure that the arrangements are operating effectively to assure that staff are exposed to the absolute minimum level of risk compatible with their activity. The Director of HR chairs the Health, Safety and Welfare Committee and the Control of Infection Committee. The Medical Director has responsibility for clinical risk management and ensures that the arrangements are operating effectively to ensure that patients receive the highest possible quality of care, in accordance with recognised and good practice and subject to the absolute minimum risk. The Director of Service Delivery is responsible for the management of operational risks that directly impact on operational performance targets. The Head of Risk is responsible for co-ordinating compliance with NHSQIS Clinical governance, Risk Management, Patient Safety Standards, maintaining the Service risk register, monitoring Very High Level Risks, ensuring that the Management of Risk Strategy is implemented, and co-ordinating risk management activities across the Service. This includes ensuring adverse incidents are graded and that procedures, including those relating to investigations and reports, are adhered to. The Head of Risk reports incidents and trends to the Risk Management Steering Group and monitors the effectiveness of risk treatments on an ongoing basis. The Head of Risk works as an integrated member of the National Risk and Resilience Department, and in liaison with the Health and Safety Manager. General Managers and Heads of Departments are responsible for monitoring and implementing Service policies and procedures within their area of responsibility. This includes ensuring adequate communication and distribution of all policies and guidelines within their sphere of operations and ensuring that staff have suitable and sufficient information, instructions, training and supervision to provide a safe, reliable and effective service to patients. They are also responsible for monitoring compliance and implementation of Service-wide and local procedures through the involvement of the Divisional Quality Improvement Groups. They must also take appropriate action in the event of a significant incident. Line managers are responsible for managing risk within their area of responsibility. In doing so they are responsible for ensuring that policies for management of risk are implemented and that risk assessment and incident reporting procedures operate effectively. 21

22 22 Scottish Ambulance Service Board Annual Accounts Staff are required to follow Service policy and procedures designed to reduce risk and take part in any training provided to maintain a general level of risk awareness. Risk identification and minimisation is the responsibility of all staff and includes the reporting of unsafe work practices, adverse events and near misses. The Scottish Public Finance Manual (SPFM) is issued by the Scottish Ministers to provide guidance to the Scottish Government and other relevant bodies on the proper handling and reporting of public funds. It sets out the relevant statutory, parliamentary and administrative requirements, emphasises the need for economy, efficiency and effectiveness, and promotes good practice and high standards of propriety. Purpose of the System of Internal Control The system of internal control is designed to manage rather than eliminate the risk of failure to achieve the organisation s aims and objectives; it can therefore only provide reasonable and not absolute assurance of effectiveness. The system of internal control is based on an ongoing process designed to identify and prioritise the principal risks to the achievement of the organisation s aims and objectives, to evaluate the nature and extent of those risks and to manage them efficiently, effectively and economically. The process within the organisation accords with guidance from the Scottish Ministers in the SPFM and supplementary NHS guidance and has been in place for the year up to the date of approval of the annual report and accounts. Risk and Control Framework All NHS Scotland bodies are subject to the requirements of the Scottish Public Finance Manual (SPFM) and must operate a risk management strategy in accordance with relevant guidance issued by Scottish Ministers. The general principles for a successful risk management strategy are set out in the SPFM. The Board meets annually to review and add to the corporate (high level) risk register. The key risks identified are prioritised through a risk matrix scoring methodology that examines likelihood and impact. Thereafter, the key risks have controls or mitigating actions developed which allow the organisation to manage these risks. Quarterly, the Risk Management Steering Group meet to review these key risks and monitor action taken/to be taken. This group also ensures that organisational risks that require escalation can be fed into the Corporate Risk register. The Audit Committee receives updates on how these risks are managed to assure the Board that management is taking effective action. Internal Audit utilise the high level register and the findings from the annual risk workshop to develop their work plan for the forthcoming year. This process ensures that Internal Audit is focused on areas of greatest risk to the organisation. The Board s Risk Management Strategy for was launched in March 2008 and work is ongoing to achieve the goals set out in this document. The Scottish Ambulance Service aims to control, eliminate or reduce significant risk to an acceptable level by creating a culture founded upon assessment and prevention rather than reaction and remedy. The management of risk objectives are to: minimise risks to the quality and delivery of emergency and patient care transport services; protect the services, reputation and finances of the Service; optimise the resources available for patient care by managing risk, thus reducing the financial implications associated with adverse incidents; develop a partnership culture that secures the participation of all staff in risk assessment and incident reporting; integrate our risk management arrangements with our partners, where appropriate; ensure that routine and systematic identification, assessment and control of significant risk is an integral part of all work activities; ensure that an effective reporting process is in place to facilitate the systematic identification of adverse events and near misses; secure commitment of management to promote risk management and provide the necessary leadership and direction; adopt agreed standards of risk management throughout the organisation, monitor compliance and ensure that corrective action is taken where necessary; have in place effective systems of communication to ensure that everyone in the organisation is appropriately informed about risk management.

23 Scottish Ambulance Service Board Annual Accounts The principles of the management of risk strategy are as follows: The Service will positively support all staff to take personal responsibility for their own learning; The Service will create an environment which encourages and supports staff to report adverse events, including their own human errors, so that learning and improvement can take place; The Service will not blame staff for their errors, providing that they are not wilful, criminal or the result of negligence; The Service will make non-threatening arrangements for the open discussion of incidents with the sole purpose of identifying what can be done to prevent it happening again; The Service will make suitable and inclusive arrangements to ensure that our learning is used to improve procedures and processes and share the lessons learned; All staff have a personal responsibility to perform their duties properly and in accordance with any procedures, rules or instructions provided; Consideration of risk should not inhibit innovation; The Service will endeavour to understand the risks faced and be aware of the cost of risk to the organisation. The Patient Safety Group meets quarterly to review patient safety arrangements. The risk manager is responsible for co-ordinating risk management activity across the organisation. Each division has an identified risk champion who liaises with the risk manager. Awareness-raising activities are regularly undertaken, together with more formal training and education to ensure that there is an adequate understanding by staff on the steps that they should be taking to assess and manage risks. Systems for reporting adverse events and near misses have been updated and routine root cause analysis of incidents introduced. Subsequent findings/ recommendations from such analysis then inform the sharing of best practice and lessons learnt. More generally, the organisation is committed to a process of continuous development and improvement: developing systems in response to any relevant reviews and developments in best practice in this area. In particular, in the period covering the year to 31 March 2010 and up to the signing of the accounts, the organisation has completed the following objectives: Completed and recorded our best ever performance with regard to the NHS QIS peer review on Clinical Governance and Risk Management; Review of risk management strategy and policy for to include the management of safety alerts; Monthly Clinical Governance Risk Management and Patient Safety reports to the Board, quarterly reports to the Clinical Governance Committee and Audit Committee; Establishment of National Clinical Governance and Clinical Advisory groups becoming an integral part of the corporate/clinical governance structure; Appointment of full time Clinical Governance and Quality Leads in all operational divisions, and identification of key leads for Air Ambulance and Special Operations (SORT); Risk management steering group becoming an integral part of the senior management team; A regular programme of facilitated workshops to identify and keep up to date the record of risks facing the organisation and train managers and staff on the use of the Service s incident reporting system; Management of risk training courses for all managers and staff; Continue to roll out Root Cause Analysis (NPSA) training across the Service, ensuring we share lessons learned with external stakeholders in a consistent and open manner; Board risk workshop, facilitated by Deloitte, identified new risks for the Service for the coming year and reviewed the effectiveness of the arrangements in place for risk management; Ongoing review of the Incident Reporting System web-based across the organisation; Maintenance of a corporate risk register; All risks recorded in the organisational risk register tracked to ensure their appropriate management; Monitoring our clinical performance reporting capabilities through the cab based terminals on which electronic patient reports are prepared; Monitoring of governance arrangements for clinical advisors within the EMDC; Regular reports from the Chair of the organisation s Audit Committee to the Board, concerning the issues of internal control considered by the Audit Committee; Regular reports by internal audit, which include their independent opinion on the adequacy and effectiveness of the system of internal control together with recommendations for improvement; Further development of Scottish Patient Safety Programme work streams: Leadership PVC Bundle 23

24 Trigger Tools SEWS Scottish Early Warning System SBAR Situation Background Assessment Recommendations or Requirements Scottish Ambulance Service Board Annual Accounts Continued to facilitate the ongoing delivery of the Service s infection control programme and plan; Reviewed resilience arrangements and discussed proposals for Model Response Project (CBRN) with Scottish Government. This included progressing with Phase 2 in 2009/10.. Review of Effectiveness As Accountable Officer, I also have responsibility for reviewing the effectiveness of the system of internal control. My review is informed by: the executive managers within the organisation who have responsibility for the development and maintenance of the internal control framework; the work of the internal auditors, who submit to the organisation's Audit Committee regular reports which include their independent and objective opinion on the adequacy and effectiveness of the organisation's systems of internal control together with recommendations for improvement; comments made by the external auditors in their management letters and other reports; establishment of key performance and risk indicators, including the requirement for all projects to be managed according to PRINCEII project management methodology; maintenance of an organisation-wide risk register formally reviewed; a performance appraisal system is in place for staff with personal objectives and development plans designed to support the Board in the attainment of the corporate objectives set out in the Health Plan and Delivery Plan. In addition, personal development plans for all staff are being developed in line with the KSF framework; an efficient government programme which aims to achieve cash releasing savings and productivity improvements (e.g. overtime management); implementation of a continuous improvement strategy. I have been advised on the implications of the result of my review of the effectiveness of the system of internal control by the Board, the Audit Committee, Clinical Governance Committee and Staff Governance Committee. Plans to address any weaknesses and ensure continuous improvement of the system are in place. During the year a breech of information governance was identified, appropriately reviewed and controls strengthened with immediate effect. Appropriate action is in place to address weaknesses identified and to ensure the continuous improvement of the system. Best Value There are nine Characteristics of Best Value as indicated in the Audit Scotland (2006) Guidance to Accountable Officers namely: Sound Governance Responsiveness and Consultation Commitment and Leadership Use of Review and Options Appraisal Joint working Sustainable development Equal Opportunities Sound Management of Resources Accountability The Scottish Ambulance Service endeavours to embrace these characteristics within its normal business. For example, we held consultation events during 2009/10 to discuss with key stakeholders the future strategic direction of the Scottish Ambulance Service. This enabled the organisation to develop its Strategic Framework which was approved by the Board in November We work closely with other partner health bodies in terms of the implementation of a model of care for the west of Scotland for cardiac patients. We also undertake joint working with other public bodies (police and fire services) to enhance the efficiency of the workshop facilities for repair and maintenance of vehicles across Scotland. 24

25 Scottish Ambulance Service Board Annual Accounts We engage proactively in Audit Scotland s planned best value reviews and have taken part in the Equalities and Planning and Resource alignment best value reviews during 2009/10. Disclosures During the financial year there have been no significant control weaknesses nor failures to achieve the standards set out in the guidance on the Statement on Internal Control. Signed.. Date: 30 June 2010 Mrs Pauline Howie Chief Executive 25

26 Scottish Ambulance Service Board Annual Accounts Independent auditor s report to the members of the Scottish Ambulance Service, the Auditor General for Scotland and the Scottish Parliament We have audited the financial statements of the Scottish Ambulance Service for the year ended 31 March 2010 under the National Health Service (Scotland) Act These comprise the Operating Cost Statement, the Balance Sheet, the Cash Flow Statement, the Statement of Changes in Taxpayers Equity, and the related notes. These financial statements have been prepared under the accounting policies set out within them. We have also audited the information in the Remuneration Report that is described in that report as having been audited. This report is made solely to the parties to whom it is addressed in accordance with the Public Finance and Accountability (Scotland) Act 2000 and for no other purpose. In accordance with paragraph 123 of the Code of Audit Practice approved by the Auditor General for Scotland, we do not undertake to have responsibilities to members or officers, in their individual capacities, or to third parties. Respective responsibilities of the board, Chief Executive and auditor The Board and Chief Executive are responsible for preparing the Annual Report, which includes the Remuneration Report, and the financial statements in accordance with the National Health Service (Scotland) Act 1978 and directions made thereunder by the Scottish Ministers. The Chief Executive is also responsible for ensuring the regularity of expenditure and income. These responsibilities are set out in the Statement of the Chief Executive s Responsibilities as the Accountable Officer of the Health Board. Our responsibility is to audit the financial statements and the part of the Remuneration Report to be audited in accordance with relevant legal and regulatory requirements and with International Standards on Auditing (UK and Ireland) as required by the Code of Audit Practice approved by the Auditor General for Scotland. We report to you our opinion as to whether the financial statements give a true and fair view and whether the financial statements and the part of the Remuneration Report to be audited have been properly prepared in accordance with the National Health Service (Scotland) Act 1978 and directions made thereunder by the Scottish Ministers. We report to you whether, in our opinion, the information which comprises the Operating and Financial Review and Directors Report, included in the Annual Report, is consistent with the financial statements. We also report whether in all material respects the expenditure and income shown in the financial statements were incurred or applied in accordance with any applicable enactments and guidance issued by the Scottish Ministers. In addition, we report to you if, in our opinion, the body has not kept proper accounting records, if we have not received all the information and explanations we require for our audit, or if information specified by relevant authorities regarding remuneration and other transactions is not disclosed. We review whether the Statement on Internal Control reflects the board s compliance with the Scottish Government Health Directorate s guidance, and we report if, in our opinion, it does not. We are not required to consider whether this statement covers all risks and controls, or form an opinion on the effectiveness of the body s corporate governance procedures or its risk and control procedures. We read the other information contained in the Annual Report and consider whether it is consistent with the audited financial statements. This other information comprises only the Directors Report. We consider the implications for our report if we become aware of any apparent misstatements or material inconsistencies with the financial statements. Our responsibilities do not extend to any other information. Basis of audit opinion We conducted our audit in accordance with the Public Finance and Accountability (Scotland) Act 2000 and International Standards on Auditing (UK and Ireland) issued by the Auditing Practices Board as required by the Code of Audit Practice approved by the Auditor General for Scotland. An audit includes examination, on a test basis, of evidence relevant to the amounts, disclosures and regularity of expenditure and income included in the financial statements and the part of the Remuneration Report to be audited. It also includes an assessment of the significant estimates and judgements made by the board and Chief Executive in the preparation of the financial statements, and of whether the accounting policies are most appropriate to the body s circumstances, consistently applied and adequately disclosed. 26

27 Scottish Ambulance Service Board Annual Accounts We planned and performed our audit so as to obtain all the information and explanations which we considered necessary in order to provide us with sufficient evidence to give reasonable assurance that the financial statements and the part of the Remuneration Report to be audited are free from material misstatement, whether caused by fraud or error, and that in all material respects the expenditure and income shown in the financial statements were incurred or applied in accordance with any applicable enactments and guidance issued by the Scottish Ministers. In forming our opinion we also evaluated the overall adequacy of the presentation of information in the financial statements and the part of the Remuneration Report to be audited. Opinions Financial statements In our opinion the financial statements give a true and fair view, in accordance with the National Health Service (Scotland) Act 1978 and directions made there under by the Scottish Ministers, of the state of affairs of the board as at 31 March 2010 and of its net operating cost position, changes in taxpayers equity and cash flows for the year then ended; the financial statements and the part of the Remuneration Report to be audited have been properly prepared in accordance with the National Health Service (Scotland) Act 1978 and directions made there under by the Scottish Ministers; and information which comprises the Operating and Financial Review and Directors Report, included in the Annual Report, is consistent with the financial statements. Regularity In our opinion in all material respects the expenditure and income shown in the financial statements were incurred or applied in accordance with any applicable enactments and guidance issued by the Scottish Ministers. PricewaterhouseCoopers LLP Edinburgh 30th June

28 Scottish Ambulance Service Board Annual Accounts SCOTTISH AMBULANCE SERVICE BOARD DIRECTION BY THE SCOTTISH MINISTERS 1. The Scottish Ministers, in exercise of the powers conferred by sections 86(1), (1B) and (3) of the National Health Service (Scotland) Act 1978, as read with article 5(1) of and the Schedule to the Health Education Board for Scotland Order 1990, (S.I. 1990/2639), and all powers enabling them in that behalf, hereby give the following direction. 2. The statement of accounts for the financial year ended 31 March 2007, and subsequent years, shall comply with the accounting principles and disclosure requirements of the edition of the Government Financial Reporting Manual (FReM) which is in force for the year for which the statement of accounts are prepared. 3. Subject to the foregoing requirements, the accounts shall also comply with any accounts format, disclosure and accounting requirements issued by the Scottish Ministers from time to time. 4. The accounts shall be prepared so as to give a true and fair view of the income and expenditure and cash flows for the financial year, and of the state of affairs as at the end of the financial year. 5. This direction shall be reproduced as an appendix to the statement of accounts. The direction given on 30 December 2002 is hereby revoked. Signed by the authority of the Scottish Ministers 28