Head of the National Audit Office Sir John Bourn has qualified his opinion on the accounts of NHS Direct for the year up to 31 March 2005 because of a lack of evidence to support a significant number of payroll payments. A second reason for the qualification was a lack of evidence to support comparative figures relating to previous years for all aspects of the accounts.
Established in 1998, until April 2004 NHS Direct was centrally managed by the Department of Health but the service was delivered at a local level by 22 NHS Trusts. When NHS Direct became a Special Health Authority in April 2004, it had to put in place new accounting systems and procedures. While these systems were being established the host Trusts which had previously funded and managed the service continued to be responsible for providing accounting and payroll services under service level agreements. Since NHS Direct had not implemented a centralised ledger or payroll system and the payroll providers and records were dispersed across the country, there was an absence of central management control over the processing of payroll.
Work by NHS Direct and the NAO has indicated that in the region of £1.6m of payroll expenditure in 2004-05 may be inaccurate.
According to today’s report, NHS Direct has also been unable to provide evidenced comparative income and expenditure figures for previous years. NHS Direct has estimated total income and expenditure of £121 million for the previous year based on returns provided by the host Trusts to the Department of Health together with an estimate of central departmental costs, but has been unable to provide sufficient evidence to support these figures.