Brennan Report - Department of Health and Children

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Report of the Commission on Financial Management and Control Systems in the Health ServiceRecommendations on Reports from Health Service Providers to Health BoardsR9.1 With regard to general hospital expenditure:(i) The Head of Specialty/Head of Department/business manager should prepare standardised reportscontaining:(a) The plan for the month (financial and activity) as set out in the specialty/department ServicePlan;(b) Performance against plan;(c) Details of variance against plan;(d) Clear explanations for variance; and(e) Action to be taken (if any) to bring performance back in line with plan.(ii) All reports should follow the same format as the Service Plan and measure performance against thisbenchmark.(iii) The Head of Specialty/Head of Department/business manager should provide reports to hospital CEOwithin 10 days of the end of the period to which they refer.(iv) The hospital CEO should provide the health board CEO with consolidated reports within 15 days of theend of the period to which they refer.R9.2 With regard to non-hospital expenditure:(i) The General Manager should prepare standardised reports containing:(a) The plan for the month (financial and activity) as set out in his/her Service Plan;(b) Performance against plan;(c) Details of variance against plan;(d) Clear explanations for variance; and(e) Action to be taken (if any) to bring performance back in line with plan.(ii) All reports should follow the same format as the Service Plan and measure performance against thisbenchmark.(iii) The General Manager should provide the health board CEO with reports within 10 days of the end ofthe period to which they refer.It will then be necessary for CEOs of the regional health boards to consolidate the reports fromthe various programmes and hospitals within their area and provide a consolidated report tothe Department of Health and Children and, in time, the Executive. As already indicated inrecommendation R7.5, these reports should also contain data on employee numbers and paycosts.Recommendation on Reports from Health Boards to Department of Health and Children/ExecutiveR9.3 Reports should be:(i) Prepared in a standardised format across health boards/agencies.(ii) Contain information on:(a) The plan for the month (financial and activity) as set out in the health board Service Plan;(b) Performance against plan;(c) Details of variance against plan;(d) Clear explanations for variance;(e) Action to be taken (if any) to bring performance back in line with plan; and(f) The health board balance sheet.(iii) Submitted by the health board CEO to the Department of Health and Children/Executive within 20 daysof the end of the period to which they refer.112
Chapter 9 External Reporting ProceduresSimilarly, it will be for the Executive to consolidate reports from the health boards and fromthose hospitals providing a national service that report directly to the Executive and providethis consolidated information to the Department of Health and Children. As already indicatedin recommendation R7.7, national employment data should be included in these reports. Thiscompletes the chain and ensures consistency of reporting (formats and content) across allagencies and levels while taking due account of their differing needs in terms of the level ofdetail required.Recommendations on Reports from the Executive to the Department of Health and ChildrenR9.4 Reports from the Executive to the Department of Health and Children should provide information onperformance against budget. This analysis should be provided:(i) By health board and care group (e.g. child care, disabilities (intellectual and physical), general hospitalservices etc.);(ii) Include supporting data detailing activity/output measured against benchmarks set in the Service Plans;and(iii) Include corrective measures to be taken (as necessary) to bring expenditure back on budget.R9.5 Reports should be submitted by the CEO of the Executive to the Department of Health and Children within 25days of the end of the period to which they refer.9.3 POLICY REVIEW PROCESS (EXPENDITURE REVIEW PROGRAMME)The Expenditure Review Programme operates across all Government Departments. Itsobjectives are to analyse in a systematic manner what is being achieved by Exchequer spendingand to provide a basis on which more informed decisions can be made on priorities within andbetween programmes. Reviews are usually undertaken by the relevant Department, under theaegis of a joint steering group representing both the Department and the Department ofFinance.A Central Steering Committee chaired by the Secretary General of the Department of Financeoversees the process. Expenditure Review topics are approved by Government on a rollingbasis; most recently in April 2002 for the first year of the current three year planning horizonof 2002 to 2004.This process needs to be developed further in the Department of Health andChildren.Expenditure reviews should, of their nature, be based on more in-depth information than thatavailable through the routine monitoring reports recommended above. It is important that thereviews, as a matter of best practice, should always involve the participation of the Departmentof Finance and other relevant Departments/agencies as appropriate. The standard terms ofreference 2 for each review include:●●●●Identifying programme objectives;Examining their continued validity;Examining the effectiveness and efficiency with which these objectives have beenachieved;Evaluating the degree to which the objectives warrant the ongoing allocation of publicfunds;2Source: Department of Finance113
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Commission onFinancial Managementan
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TABLE OF CONTENTSEXECUTIVE SUMMARY
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6.4 COMMUNITY DRUG SCHEMES 80Medica
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Executive SummaryEXECUTIVE SUMMARYT
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Executive SummaryWe do not underest
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Terms of ReferenceTERMS OF REFERENC
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GlossaryEstimates for Public Servic
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Chapter 1 Introduction and Backgrou
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Chapter 1 Introduction and Backgrou
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Chapter 2 Overview and Issues2.2 OR
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Chapter 2 Overview and Issuesother
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Chapter 2 Overview and IssuesTable
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Chapter 2 Overview and IssuesFigure
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Chapter 2 Overview and Issues●●
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Chapter 2 Overview and IssuesIn 200
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Chapter 2 Overview and IssuesTable
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Chapter 2 Overview and IssuesProble
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Chapter 3 Managing the Health Servi
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Chapter 4 Service Planning, Budgeti
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Chapter 4 Service Planning, Budgeti
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Page 65 and 66: Chapter 5 Accountability - Hospital
Page 79 and 80: Chapter 6 Accountability - General
Page 89 and 90: Chapter 7 Accountability - Employme
Page 101 and 102: Chapter 8 Audit ReformCHAPTER 8AUDI
Page 103 and 104: Chapter 8 Audit ReformRecommendatio
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Page 107 and 108: Chapter 8 Audit Reformaudit reports
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Page 119 and 120: Chapter 10 Information SystemsStrat
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Page 123 and 124: Chapter 11 ImplementationRecommenda
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Page 127 and 128: Appendix 1Appendix 1COMMISSION MEMB
Page 129 and 130: Appendix 1He has held this position
Page 131 and 132: Appendix 2SIPTU*South Eastern Healt
Page 133 and 134: Appendix 3Name of AgencyBord na Rad
Page 135 and 136: Appendix 3Name of AgencyIrish Blood
Page 137 and 138: Appendix 3Name of AgencyWomen’s H
Page 139 and 140: Appendix 4Department of Health and
Page 141 and 142: Appendix 4collated and assessed by
Page 143 and 144: Appendix 4The most detailed element
Page 145 and 146: Appendix 4Ratifying and Submitting
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Page 153 and 154: Appendix 5Appendix 5DIAGNOSIS RELAT
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Page 157 and 158: Appendix 6Appendix 6AUDIT OF STRUCT
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Page 161 and 162: Appendix 8Appendix 8 - Integrated M
Page 163 and 164: ADDENDUMNumber Recommendation IT Ti
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Number Recommendation IT TimeframeR
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Brennan Report - Department of Health and Children

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