Agenda item

(a)       That the Committee notes the progress made on the proactive budget management of outstanding invoices raised by the Council for payment by Betsi Cadwaladr University Health Board; and

(b)       That more work be undertaken to resolve long-standing invoices and that future updates include categories for the reasons for the outstanding debt.

As requested at the previous meeting, the Senior Manager (Safeguarding and Commissioning) provided an update on current long-term debt with Betsi Cadwaladr University Health Board (BCUHB) in respect of the delivery of NHS Continuing Health Care (CHC) packages in Flintshire.  A report with supplementary information on recent debt levels had been shared with the Committee in advance of the meeting.

Since the last report, good progress had been made to address ‘pinch points’ in the system to improve the flow of information and understanding of the process from the perspective of both sides.  Regular meetings at all levels helped to reinforce the efficient processing of invoices and a clear escalation route had been established to refer any significant issues.  Whilst work was continuing on longer term invoices, the main focus was on recent invoices with BCUHB working hard to ensure prompt payment.  An overall unpaid invoice position of £141,917.51 was reported between 12 October and 11 November 2022.

The Chairman referred to comments made by Paul Carter (BCUHB) at the previous meeting that supporting information was missing to support payment of some long-term invoices.  On the list, he welcomed the clearing of recent invoices but raised concerns that of the ten new invoices, the two of higher value remained unpaid and that none of the historical invoices had been cleared which did not give assurance on addressing long-term debt.

In response, the Senior Manager explained that one of the higher amounts related to a combined package for three out of county placements.  She clarified that the list showed the position for all outstanding invoices during the period and that work was ongoing to progress those as soon as possible.

Councillor Bernie Attridge said that the update did not allay his concerns about the outstanding debt, particularly given the Council’s financial position.  In questioning whether all the debts would be cleared, he said that leadership meetings should be held more frequently and that the matter should be escalated through a legal route.

Councillor Chris Dolphin agreed that this was a serious long-standing issue and suggested that including reference to the number of cases and associated costs in future updates would provide a clearer picture on the outstanding debt.

In acknowledging the progress made, Councillor Bill Crease said it was vital to establish reasons for the delays to payments.  He said that issues on the Council’s side should be resolved internally and that delays due to BCUHB should be pursued legally.

In response to the comments, the Chief Officer (Governance) referred to the complex judgements involved in CHC payments and advised against pursuing legal action.  Whilst recognising the significance of this issue, he suggested that focus remain on regular high-level discussions to unblock issues and building upon in-house expertise to challenge BCUHB decisions where needed.

In reiterating the cashflow implications, the Chairman questioned whether the national protocol would clarify the process for resolving disputes.  He thanked the officer for the information and the attention on resolving recent invoices, adding that more could be done to resolve long-standing debts and that the inclusion of categories for outstanding debt (eg  under dispute, unknown invoice etc) in future updates would provide a clearer understanding.

This was proposed and seconded as an additional recommendation by Councillors Bernie Attridge and Bill Crease.

RESOLVED:

(a)       That the Committee notes the progress made on the proactive budget management of outstanding invoices raised by the Council for payment by Betsi Cadwaladr University Health Board; and

(b)       That more work be undertaken to resolve long-standing invoices and that future updates include categories for the reasons for the outstanding debt.