 Fawr iawn. Fawr iawn i'r 11 ym 2014 o'r Cymru Llywodraeth Llywodraeth Cymru. Fawr iawn i'r agenda. Fawr iawn i'r dechleratio. Bob Dorris wedi cael ei wneud o'r Cymru Llywodraeth Cymru. Fawr iawn i'r Cymru Llywodraeth Llywodraeth Cymru. Fawr iawn i'r agenda. is an interesting update, so the Auditor General is a company by Catherine Young and Tricia Meldrum. Will you invite the Auditor General to brief the committee? As you say, the report that I am bringing to the committee today provides an update on how the NHS has been performing against the 4-hour waiting time standard in accident and emergency since our last report in 2010. A and E departments provide a really important service for patients with serious injuries or illness, and it's important that patients are seen quickly. The Government has a standard that 98 per cent of A&U patients should be treated and discharged or admitted within four hours of arriving. In April 2013, it also introduced an interim target of 95 per cent, which it expects NHS boards to achieve for the year ending this September 2014. As the committee is aware from my recent report on NHS financial management, the NHS in Scotland is not currently meeting the four hour waiting time standard for A&E. Performance against the target has deteriorated since 2010, although it improved during 2013. There is significant variation in performance across A&E departments, with 14 of the 31 A&E departments meeting the 95 per cent interim target in December 2013. It's important to say that there's no simple explanation for why more patients are now waiting over four hours. A&E departments are part of a much bigger health and social care system, and pressures across the system can mean that patients can be delayed in A&E. For example, many patients need to be admitted to hospital, and delays can be down to a hospital bed not being available right at the time that it's needed. This may be because another patient is waiting to be discharged from hospital later in the day, and so it's still occupying the bed that the new patient will require. We know that more patients are now being admitted to hospital from A&E, and there are more delays in A&E because patients are waiting for a hospital bed to become available. There's also some evidence to suggest that patients attending A&E now have more serious health problems than they have done in the past. Across Scotland, just over a quarter of A&E patients were admitted to hospital in 2012-13. Staffing challenges can also affect how long patients wait. A&E departments obviously need the right number and mix of staff, and they need those staff to be available when they're required. Since our last report, the number of A&E consultants has increased by 63%, and there are now around 154 whole-time equivalent consultant posts. But there are still pressures around medical staffing, including a reduction in some other grades of staff, difficulties in filling vacancies, and lower numbers of staff available at weekends and evenings. In response to the deteriorating performance, the Scottish Government launched the national unscheduled care action plan in February 2013. One of the aims of the plan is to reduce A&E waiting times, and the Scottish Government and NHS boards are taking steps to address some of the causes of delays. The initial work that they've done has focused on making improvements in acute hospitals, and the next stage is expected to look at the wider health and social care system. It will take time to see the impact of those actions, but we know that there was some improvement in A&E waiting times during 2013. My report makes a number of recommendations for the Scottish Government. These are mostly about sharing good practice on initiatives that can help improve A&E departments' performance and improve waiting times for patients. Convener, as always, my colleagues and I are happy to answer questions. Thank you for that, Auditor General. I know what you say that there has been some improvement in 2013, but it is worrying that, since you last looked at it, we have seen a deterioration despite the investment and despite the commitment to improve matters. It is clearly a matter of concern for the public. The targets are set for good reason. The politicians and officials who set the targets clearly believe that targets are realistic and that there is a purpose for setting those targets, and therefore not to meet the targets is of great concern. I know what you say about some improvement more recently, but if I could raise an issue that is relevant to me locally. The Royal Alexandra hospital in Paisley in the year 2013-14, for November and December, the figures in exhibit 7 actually dipped below 90 per cent. I suppose that, from a west of Scotland perspective, what is more worrying is that, if you look at the western infirmary, consistently the figures are below 90 per cent. While you may have hospitals like the Gilbert Bain hospital, which is again consistently doing well, and the Royal hospital for six children in Edinburgh has a consistently good performance, there are others that are consistently poor. Have you looked at the specific reasons for example why the REH in Paisley and the western infirmary are showing a dip in performance? It is important to say that this report is a performance update rather than the full audit that we carried out in 2010. To a great extent, we have relied on the nationally available data and investigated that as far as we can to explore what is associated with better performance or with worse performance. You are absolutely right to say that A&E waiting times are important both to all of us as patients and family members in that we want to be seen and treated as quickly as possible, and also because there is some evidence that longer delays can compromise clinical effectiveness and the quality of care. That is why the Government has set the targets that it has. It is also important for me to keep this in proportion. As at December, 93.5 per cent of patients across Scotland were being seen within four hours. Equally, there is huge variation across A&E departments as you have highlighted in looking at Exhibit 7 on page 16 of the report. One of the most important things that we are trying to draw out in the report is the need for individual A&E departments to really understand the factors that are leading to delays for them, whether it is availability of beds, availability of clinical staff, availability of alternatives at the right time, and using that to put in place solutions for their particular problems. You will notice, for example, that big, complex specialist hospitals like Ninewells have got very good performance, and we have a case study in the report that highlights a range of things that they have done to tackle that. My recommendations in the report are really recommending that the Government and the Health people should be taking a very similar tailored approach to understand what is causing the bottlenecks in their system, and to look beyond A&E for the solutions to that. Have you identified problems, either with investment or in effective management, as being issues? Again, forgive me for being parochial, but just sticking with Greater Glasgow and Clyde. In December of the 2013-14 period, Glasgow royal infirmary, below 90 per cent, Inverclyde was above it, and RAH and Paisley were below it. Royal hospital for sick children was above it, as was the southern general, but the Victoria and the western infirmary were both below 90 per cent. What would cause that type of cluster? As we say in the report, the things that affect A&E performance really are complex and interrelated. First of all, the rate of attendance at A&E is affected by deprivation in the local area and by the distance from where people live to the A&E department, so that is a starting point. Interestingly, we know that total A&E attendances have dropped very slightly since our last report. There has been a rise in minor injury units, and A&E attendances have gone down, but we have seen an increase in the number of older people attending A&E and an increase in the number of people admitted from A&E, suggesting that people are sicker than they previously were, more seriously in need of attention. As you touched on in your question, there are real differences in the way that A&E departments are managed as part of the wider system. In Tayside, they have worked very hard to make sure that they have appropriate specialist medical staff available not just during the working day but in evenings at weekends. As soon as it looks likely that a patient may need to be admitted, they start the process of identifying a bed so that there is not a wait for that. They work very hard at making sure that GPs can refer directly to wards rather than through A&E, and they sign post-alternatives to accident and emergency departments. That whole system of making it work seems to be very effective in Tayside, and we think that there is scope for other A&E departments to be doing more of that sort of approach. Have you then expected, after the recommendations that you have made with increased investment, the fact that areas such as Tayside can achieve it, that you should be seeing that across Scotland? It is certainly the case that, since the Government's national and schedule care action plan was introduced a year ago in February, we have seen an improvement, as we say in the report. We think that there is scope for that improvement to be more consistent right across Scotland. Equally, we do know that A&E departments can be an important indicator of pressure on the system as a whole. We know that there are financial pressures, we know that the population is ageing, and we know that all of the pressures that we have discussed in the committee before continue. That is why we think that focusing on that specific indicator is not an end in itself, but is an opportunity to look at the way that the system as a whole works. As well as missing the four-hour target, I have to say that I was absolutely worried by the number of other statistics that emerged in the report, in particular on page 18 paragraphs 19, 20 and 21. You have stated quite clearly that the number of patients who waited longer than 12 hours has also increased. The median weight for patients has increased, so that means that it is not just people who are not meeting four hours, but the average experience for patients is getting worse. Very worryingly, a huge number of 70,000 patients are now being seen in the last 10 minutes. That does not paint a very good picture at all, does it? I think that if you look at Exhibit 8, you can see very clearly that sense of the pressure on A&E departments building up, increasing since our last report in 2010. All of that is important because, in spite of all of the efforts that the Government and NHS boards are making to meet the target of 95 per cent of people being seen and either treated or discharged within four hours, those pressures are still there. That is not going to change. We know that the population is ageing, that older people are more likely to attend A&E and more likely to need to be admitted, that more people have got complex health problems. All of that is part of what is going on, and it is why we think that A&E departments need to be seen within the context of the whole health and social care system locally so that those pressures can be properly managed, but they are real. No question about it. You would agree that it is not just about the one target of four hours. The fact is that the overall experience seems to be that there is a problem across the whole area of A&E here. What we say in the report is that this is an indicator of real pressure in A&E and across the health and social care system. The fact that the median weight has increased is not necessarily a bad thing in itself, although it is obviously bad for the people who might have been seen in an hour previously and are now waiting two or three hours. It may mean that there is more appropriate triaging and people are being, their needs are being more tailored in the care that they are getting, but it certainly is an indicator that there is pressure in the system and that we believe a number of boards will find it hard to meet the 95% target by September of this year. Is that the average experience when you talk about the median? How long are patients waiting now compared to what they were waiting? We report in paragraph 20, as you highlighted, that the median has increased from 99 minutes in 2008-9 to 126 minutes in 2012-13. I think that we don't know what that figure is for December 2013 because it's not reported nationally, so we've used the most up-to-date available data that is available nationally. I'd expect there to have been a slight improvement by December 2013 as we've seen across the rest of the A&E performance, but we don't know that yet. I was particularly worried in comment about the prospects or the treatment given to those seen in the last 10 minutes. You suggest that national data show that patients who are admitted just before the end of the four-hour period are likely to spend longer in hospital. That was in paragraph 33. What you're saying is that 11% of all admissions hospitals took place within the last 10 minutes of the four-hour period, and that figure has gone up hugely. Catherine May might want to add to what I say in a moment. First of all, we would all recognise that if you set a four-hour target there will be particular attention on patients who are coming towards that four-hour waiting period. It's one of the inevitable side effects of setting targets. We can't tell from the data that's available whether patients are being admitted inappropriately in that last 10-minute period to avoid breaching the four hours, but we did, as we say in the report, test that through proxy by looking at how long those patients were staying in hospital. Our hypothesis was that if they were being admitted inappropriately, they would have shorter lengths of stay. They'd be in for a short period and then discharged. In fact, we found the opposite. We found patients admitted in that last 10 minutes were likely to have longer lengths of stay, and therefore we didn't conclude that it was likely that they were being admitted inappropriately. We do say, though, that it probably does highlight real pressures with the patient flow through the system. Catherine, do you want to add to it? Yeah, just to add, the decision to admit may well have been made earlier in that four hours, but as the other general has already mentioned, that whole process, the patient flow and identifying that bed early on in the process—in some cases, as you can see in Exhibit 14—doesn't happen until late on in that process for some departments, and that's why we've made a recommendation around the Scottish Government sharing good practice about discharge processes to try and speed up that or start that process earlier for any patients. For a number of reasons, it's very worrying. Clearly, if the targets are being set, being modified and still not being met—that's worrying—if the targets are distorting care, then that's also worrying. It's worrying from both aspects, isn't it, Adam? We are not concluding that they're distorting care, and we did test that, as I said in my answer to your earlier question. We are recognising, first of all, that setting targets and standards can be a good way of focusing managers and clinicians' attention on things that matter to patients, but they tend to have a distorting effect in terms of people seeking to hit the target rather than to necessarily run in a more natural flow of the way patients would be worked. I think what we are seeing and what we say in the report is that there are indications of pressure in the system. 14 of the 31 A&E departments met the four-hour target in December of last year, and we think that many boards will struggle to hit the target date by September of this year for the new target. You said in the—you didn't suggest, but you've highlighted the availability of beds as one of the reasons that might be behind this overall. I believe that the statistics from February this year show that there were 135,000 beds lost due to delayed discharge. I believe that more than 1,500 beds have physically been lost over the past seven years in Scottish hospitals. The number of beds available in hospitals generally is down by 1,500 or possibly more. Which of those factors would be more important? We talk about the issue of bed numbers and bed occupancy in paragraph 40, and you're right that the overall number of acute beds has reduced since our last report. We think by 7 per cent from 17,374 in 2008-9 to 16,230 in 2012-13. Most of those beds are in acute surgery, reflecting the fact that more surgery is being done on a day-case basis rather than patients who had previously been admitted at least overnight and possibly for longer. We've reported on that to this committee before. What's interesting is that the average occupancy rate for acute hospital beds has increased over the same period, particularly in acute medicine, which is often where patients admitted through A&E need to find a bed. I think in acute medicine, the average occupancy rate in 2012-13 was 85 per cent. 85 per cent as an average can conceal some periods of very high occupancy. There is some evidence, although it's not conclusive, that above 85 per cent clinical safety can become more difficult. That's why we think the focus on bed occupancy is so important here. It makes it easier to find a bed if bed occupancy is a bit lower. I think when we look at the correlation between bed occupancy and performance, there's a clear relationship. Catherine, do you want to comment on the relationship there? In paragraph 41, we ran a correlation between higher bed occupancy and performance against the target. We just draw on the range there between Tayside, where the occupancy was 79, almost 80 per cent, where it was much higher in 4th Valley. In 4th Valley, they have weaker performance against the target compared with NHS 4th Valley. It's also about the use of those beds. Again, we highlight that in the good practice for Tayside. It's again identifying early on in the process, identifying having good discharge processes in place. It's not just about the numbers but about how the beds are used and the timing and availability of the beds. When we discussed it in December in your report, we discussed the fact that no health board had made the waiting time target either. There was a lot of concern expressed by the committee that, despite the so-called patient guarantee, patients had no recourse whatsoever. Do patients have any recourse, in this case, for a not meeting a four-hour target? The waiting time target isn't enshrined in statute in the way that the treatment time guarantee is, so there's no recourse other than through the normal complaints procedures that would be taken forward by each health board individually. Thank you, Baradun. Just before I bring Willie Coffey in, can I ask something relating to what Ken Macintosh just said? On Exhibit 14, you show the admissions to A&E in the last 10 minutes. Have you run the figures to show what the targets would have been like had those patients not been seen within the last 10 minutes? How bad or how much worse would the figures have been if those patients hadn't been seen in the last 10 minutes? We haven't done that because those patients were admitted and we didn't find any evidence to suggest that people were being admitted inappropriately. Did you look at all to see whether the patient experience was being rushed or was less thorough than those seen at other times in that four-hour period? In other words, is there anything to suggest that hospitals are suddenly rushing people through A&E in the last 10 minutes in order to make sure that targets are met? No, unlike in 2010, when we did interview patients directly and used focus groups to explore their experience in this update, we've really just used the nationally available data. We are planning some work on unschedule care more generally and, as part of that, we will want to talk to patients again, but all that we've used in this report is the performance data that's available to us. That would be useful if you could do that at some point in the future, because it would be a concern if patients were just suddenly being wheeled into accident in the emergency in order to make sure that bureaucratic targets were being met. Good morning, Mr General. Could I look in a wee bit more detail about the numbers involved here? While it's quite correct for the committee to examine performance in relation to the target, I think that it's appropriate for the committee to acknowledge the good performance that's actually taking place. You mentioned it in your remarks there. 93.5 per cent is pretty good performance, I would suggest. The numbers that are reflected by that are 1,600,000 presentations to A&E, and the amount that is met in relation to the target is 1.5 million. I would suggest to committee members that that's not bad considering the pressures that are brought to bear on the NHS and all the strains that you've mentioned yourself, Auditor General. That's actually pretty good. In terms of comparable stats between, for example, Scotland and Wales, Wales is currently sitting about 87.7 per cent in meeting this target, so in Scotland it's significantly higher, although we want to achieve the target that's been set. Auditor General, could you tell me how far short are we of actually meeting the target in terms of the number of patients that present themselves to A&E and so forth? You're right, it is important to keep this in proportion and often straightforward numbers can be easier to get a grip on than percentages. If I focus on December 2013, which is the latest figures available, and the point at which it was possible to see an improvement from the low point in January 2013, we say in the report that 8,300 patients across Scotland waited for more than four hours, and 118,000 waited for less than four hours. So 118,000 to 8,300, a good performance for those 118,000, but clearly not as good as any of us would hope for the people, the 8,500 people with the longer wait. In terms of what 95 per cent would look like, which is the interim target that government set for September this year, I think you'd expect that 8,300 to come down slightly to somewhere near a 7,500, and we can give you the exact figures separately if that would help. The 98 per cent standard, of course, which is still in existence from the government, would require a further shift again. What we focused on particularly in this report, though, is the variation across Scotland that 14 of the 31 A&E departments reached the target in 2012-13. 17 of them didn't, and as you can see from exhibit 7 on pages 16 and 17, there is still quite significant variation between A&E departments in the extent to which they're meeting the 98 per cent target, those shown in green, meeting the 95 per cent target, those shown in amber, and missing both of the targets, those shown in red. It's that variation that we think it should really be the focus of attention now. Compared to the total number of presentations that we're getting in Scotland in a given year at £1.6 million, the numbers that we need to achieve throughout the health boards and hospitals and so on to reach that 95, it's not significantly high compared to the number of people that are presenting to us. It's not a huge number, as I understand it, to allow us to get to that target. I think I'm at the limit of my ability to do mental arithmetic in front of the committee, so we'll give you the figures separately if we may, Mr Coffey, and I think I can only agree with you that 93.5 per cent is by no means a bad performance. It's higher than it has been historically and higher than in some other parts of the UK, but equally for each of those 8,300 patients who are waiting longer than four hours, it's not ideal, both in terms of their experience and potentially the quality and clinical effectiveness of their care, so I think we're all interested in pushing it up to the Government's target and then on to the standard in due course and recognising that there are real challenges in doing that. In looking at recommendations to how to improve this, I noted in the report that you'd said that discharges from hospitals tend not to occur over the weekend, but that presentations to A&E tend to go up on Mondays and Tuesdays, which was a surprise to me. It seems obvious to me that there's an opportunity there to make a significant improvement by doing something fairly simple, and that is to try to manage the discharge process at an earlier part of the week so that beds become available at the expected point when people present to A&E. Is that something that you made clear in the report? I couldn't quite see that as one of your recommendations. I think it is, and one of our recommendations and one of the things we focus on in terms of bed availability, not just days of the week but time of day. Very often patients who are being discharged leave hospital in the afternoon, which means that if I rock up at the A&E department at 9 o'clock in the morning and the decision is taken to admit me, the bed may not be available until 2 o'clock, which is more than four hours before we start. Places like Ninewells and Perth Royal Infirmary are very good at monitoring the time of day at which patients are discharged, at doing discharge planning better and managing the admissions process better. All of that means that the system comes together in a way that lets them achieve very strong performance consistently in ways that other boards and other A&E departments are still struggling to do. I think that what I say is that it's simple but it's not easy. I think that there's an opportunity there to do something to really make an improvement here. My last point to convener was in that point about the median. The median is the most frequently occurring time. It's not the average, it's the most frequently occurring, and according to your report, the median waiting time is two hours, six minutes, and I recognise that that has gone up, but it's two hours, six minutes, which is well within the target time of four hours. I think that I have to put that in context that, while it has gone up, the median waiting time for patients in Scotland present to A&E is two hours, six minutes, which is well within the four hours. Would you recognise that? Absolutely. One of the purposes of this report and all our reports is to try and be as transparent and objective as we can about that performance data. It's very clear that the median is two hours and six minutes, well below the four hours. It's also true that it has crept up, and I think that our concern is that that's just a sign of growing pressure in the system, and we can see that in some of the A&E departments very clearly. Can I just go back to Ken Mackintosh's point about the 11 per cent of all admissions to hospital from A&E departments took place within the last 10 minutes in powers 32 and 33? I think you said that you didn't, in this particular exercise, assess directly from patients why that was the case, but can you shed any line on the underlying reasons why that figure is as high as you found in your report? Our hypothesis is that it's boards doing what they've been asked to do, which is to make sure that as many patients as possible have been seen and either admitted or discharged within four hours. As Mr Coffey has said, the median time is two hours and six minutes, so we know that for most patients the process is starting well and many can be discharged very quickly once they've been either treated or referred to a more appropriate place. For those who can't, we know there can be delays in finding a bed, in getting a clinical assessment carried out, in identifying a specialist to carry out an assessment where that's needed, and our experience from earlier work is that A&E departments will work very hard to make sure that that is happening within four hours, but if the system is under pressure it may well be happening quite close to four hours and there will be an entirely understandable focus on the patients who are approaching four hours to get them seen, treated, admitted as quickly as possible. Trisha, I think, would like to add to that. If you look at Exhibit 14, it's just to base the point again, we talked about nine wells and nine wells doing more to identify patients who need a bed early in the process and start looking to identify a bed for patients early in the process. Again, you see that nine wells being very low down in that table in terms of the percentage of patients admitted in the last 10 minutes, so they've put in place a number of things that mean that they are able to be admitting patients a bit earlier. I can just say in passing that four hours is a really long time. Just from personal experience in someone in my family, can I say four hours? I mean, it's a long time to be hanging around sitting, waiting, waiting, waiting, but can I just go back to this? If the target was three hours, presumably also there would be a rush for the last 10 minutes. In some ways it doesn't matter when the target is that the system is such that once the target is set there will be enormous amount of pressure on health professionals to move people out of the waiting room as it were and through and into the system so they can take the box. Is that the case? I think that that's right. I think it's clear that targets can be a very good device for focusing any service provider on the thing that is being measured and the thing that's been prioritised and as you say four hours is a long time it's not an unreasonable target or standard to be setting, but if you set it then there will be a real focus on getting as many of the patients who are approaching four hours as possible either discharged or in this case admitted before they hit the four-hour deadline. No, that's fair and so on Willie Coffey's fair point about the median time, why do we have four hours? Why should we put up with four hours as the period of time that we should expect people to have to wait and still be within a notional target set by the government of the days in that sense or set by the NHS? If the median is two hours why don't we get the target down to whatever I forget Willie Coffey's figure but say two hours, 16 minutes why don't we make it two and a half hours? A number of strands to the answer there one of which is that that's a question for government rather than for us who's setting the target equally I'd say any average tends to conceal a wide range of performance so the fact that the median is two hours six minutes doesn't mean that you can make the target two and a half and have a chance of hitting it equally I think the College of Emergency Medicine have cited evidence which says that after four hours there is a risk of both quality and clinical effectiveness being compromised so it as my as we understand it there is some basis in the clinical evidence for four hours even though it can feel like a very long time to be waiting to be treated or discharged in an AA department on a busy Saturday night. Okay and just on finally on this particular point is it your is it your desire to actually from what is Scotland's point of view to do some more work on this in relation to actually understanding from patients and I guess also from health professionals why why the figure would be 11% of all the missions in the last 10 minutes. Yes we are carrying out a wider piece of work on the unschedule care overall not just here. Catherine Ultrisha may want to tell you a bit about what our thinking is on involving patients in that. We're planning to do some work looking at as the auditorium said broader unscheduled care so not just emergency departments but overall emergency and urgent care looking at primary care as well GP out of our services NHS 24 ambulance services so yes we would definitely want to be doing some work. I'm really pleased you're doing that but is the NHS doing that too I mean it shouldn't just be all that Scotland having to do this kind of work I mean I'm assuming that the NHS themselves health board chairman the local boards then you know clinical professionals who have paid a lot of money at the top of these organisations should be driving at this kind of stuff shouldn't they. Each of the 14 health boards territorial health boards has produced and submitted to Government a local unschedule care action plan which we've reviewed as part of this work and we think most of them are looking at the wider system of care and are looking at patients experience but it's too soon for us yet to see the impact of those and as we say the variation is a big part of the issue. And it'll be fair to say also as you say in 32 that some are really good at this the Royal Aberdeen Children's Hospital are excellent at this whereas the Royal Infirmary Venbr that seems to pop up nearly every report you produce for us on the NHS is not good so presumably that's where the focus should be on those who are not delivering. That's very much the point we're making here that 14 out of the 31 A&E departments are hitting the target 17 arm and it our evidence suggests that you need a tailored solution to the particular factors in your A&E department. Thank you can I just ask you very other brief questions convener the second was on you mentioned your opening remarks auditor general that despite increasing the number of consultants available across NHS which obviously would be a good thing and welcome the pressures have increased why is that I mean we are taking on more professionals at consultant level to presumably to to target particular problems and yet the problem and yet these figures that you presented to us today are worse why would that be exhibit 21 on page 34 tries to summarise that and you're right we've seen something like a 63% increase in the number of consultants in post whole time equivalent which is a good thing because that senior decision making seems to make a real difference. We have seen a reduction in the number of doctors in training working in A&E partly because of changes to the way doctors are trained in general which is aiming to give them more of a generalist and less of a specialist training so that they're better able to meet the needs of an aging population and some A&E departments clearly have difficulties in filling vacancies they can be very pressured posts there are all sorts of difficulties in recruiting and retaining staff the other bit of that though I think is about making sure that people are there at the right time making sure that it's not just Monday to Friday nine to five staffing but that specialists are available in the evening at weekends at peak times and again we're going to sound like cheerleaders for Tayside but at Ninewells they do that very well they make sure they've got specialist staffing there till midnight some cover in the quiet period after midnight and really match it to when they know patients are arriving so it's not just about the numbers it's about how people are used as well. I think that's very fair and the final one I just want to understand the point you made right at the in the answer to your question so the question from the convener about the targets we have a 95 target which is as it were an interim target or I forget now exactly how you described it and then as a standard target 98 percent well if we're not hitting 95 the 98 is neither he nor there is it I mean this is where I just get into this targets things are irrelevant to the experience of real patients and real people. The 98 percent to be seen within four hours it has been the government standard for a while and it's what they're aiming towards when it became clear during 2012-13 that there were real pressures and that performance was deteriorating they introduced a 95 target with the aim that that would be hit by September of this year as an interim step on the way to 98 percent. As we say in the report some A&E departments are already hitting that some A&E departments will struggle to do so and it's why we're focusing on the system as a whole. Will we know in September as to whether that 95 target has been hit across the health service? The team will keep me straight about when the data's available by the year ending September 2014 so we will know by then. It was just to clarify the question that you pointed out that there is a tendency for a last-minute surge of admissions during a target so the four-hour target produces a surge but the point of this report today is what which I thought you were highlighting is that this surge has dramatically increased in other words it used to be 45,000 there was a little peak before but the figure's gone up for 45,000 patients admitted in the last 10 minutes to 70,000 patients and so in other words that's a huge surge that's not simply you know caused by a four-hour target because that four-hour target was always there this is a huge increase at the end. I think the point we're making throughout this report is that in spite of great efforts on behalf of people across the NHS and especially people working in A&E departments it is very tough to meet the four-hour target or standard which has been set and that that is to a great extent for reasons outside the control of A&E departments themselves it's why we think that really understanding the problems in each A&E department and tailoring the solutions around the availability of beds, the availability of specialists, signposting people to alternatives is so important that pressure is clearly there even though a great deal of effort is going into making sure that as many patients as possible are treated within four hours. Thank you very much for your very helpful report because it's helped us begin to have a much clearer understanding of what's going on although I accept there's much work still to be done obviously. On that, I'm just on the issue that both Tavish and Ken were dealing with just at the end there. I think it was Catherine who began to explain to us about while people might be finding a bed in the last 10 minutes that's not the beginning of their journey because their journey in terms of their A&E experience starts a lot earlier and actually their diagnosis, the process of finding what's wrong with them and discovering what the issue is coming to a conclusion is on going through that for hours and it might only just be the bed being found at the end. Do you want to just expand a bit more on that, please? There is some evidence in our last report that as the auditor general has mentioned that A&E departments are seeing more serious cases. We found in 2012-13 that 50% of patients were categorised as flow ones which I think in one of our exhibits we show that's minor injury illness compared with 55 in 2008-9. That would indicate that more serious cases are being seen. That combined with more patients being admitted from A&E into hospital links this idea of complexity of care. Again, when you look at the, by 10 minute intervals, more sick patients will need more tests done, more blood work done, so that could also be a factor behind why, you know, whether there is a longer wait for some of these patients. On the issue of those who are more sick, I was intrigued by exhibit 9 when you compare it alongside exhibit 5. Exhibit 9 is about attendencies, A&E performance against the four-hour waiting standard, and exhibit 5 has issues to do with 999s. Is this the issue that I want to pick up on there in terms of column 2? It seemed to me that there was quite a strong correlation between those, apart from 9wells, which seems to be the stick out and everything here, in terms of good practice, between those hospitals which have got high 999s, and those who are performing less well in terms of A&E, which I think is the point that Catherine is making, particularly if you look at exhibit 9Z, which is the highest figure at 28.1. That is the Royal Infirmary of Edinburgh, or you go to A, which is the University Hospital A, which has 18.4 per cent of people who are admitted, of course, coming from 999s, 4th valley at G, which is another one in the sort of quartile at 29 per cent. I mean, I could go on, there is a whole series on them at the bottom end of this. Apart from 9wells in the western, for some reason, where it looks to me to be a correlation between that 999 issue and poorer performing A&Es in regard to the target, would you like to reflect on that? In terms of exhibit 5, the referral sources, we do highlight later on footnote 10, there are some inconsistencies in how A&E departments record self-referals. For example, some record self-referals that come in by ambulance, they record them as self-referals, whereas others record them as 999s. When you ran the correlation with the 999 calls, there was no strong correlation between that and performance. It is likely that, if departments recorded more consistently, there would be a link there. I think that in our last A&E report, we did find patients who were referred by GPs or 999 calls were more likely to stay longer again, therefore, for more complex cases. That would obviously have an impact on performance, dealing with we did find a link between more complex cases and performance. I think that there are some issues around the consistency of those codes, so some may look like they are higher than others because they record the 999s as self-referals. That says to me that there needs to be a bit more work done in that area to examine what is going on. There are other areas in your report that reflect that as well in terms of describing the complexity, the interrelated nature, the problems of some places that the data is collected differently and there is a variety of practices. For instance, on page 20, paragraph 22, where you say that it is difficult to draw clear conclusions about the relative performance departments because of services provided vary across the country. On page 21, paragraph 25, where you say that the methodology in A&E departments used to define flows differs. On page 26, paragraph 31, where it says that, again, the previous audit highlighted the opening hours and levels of staffing vary across the country up to date and national information about how hospitals use these units and how the operate is limited. There is a sense of that right throughout the report. I ask that because it becomes clear to me that to be able to get a full understanding of how we need to make the improvements that are going to be required in future years, we need a much more serious, and I am not saying that this is not a serious analysis, by the way, a more in-depth, serious analysis investigation about where we can make these improvements through the system, where the interrelationships exist. If we look at this bit in isolation, we might end up disturbing another bit of the system and making it worse. I make that point and that you, I know, are going to do further work on that. Do you think that it is appropriate that there should be not only the established raised, the health boards themselves and the Government looking at this, but it might be useful for a parliamentary committee to undertake a full investigation about A&E's sitting in the hall of the exercise to make sure that we get a good examination of all this? It is certainly true that what we have done here is an update of a fuller report that we carried out in 2010, and we have focused on the data that is available nationally about A&E. We have used that fully and as rigorously as we can. Lucy Jones, who is not at this table, I think, has correlated every possible set of factors with each other to see what might be interesting patterns and what might be explanations for them, and we have pulled that out as far as we can. We have also tried to highlight where we think there are consistencies or where simply the data is not available to draw conclusions. That is very much the intention of the work that the Government has asked each of the 14 health boards to do as part of their local action plans in this area. We will be looking at that as part of our next wider piece of work on unschedule care as a whole. There may well be aspects of that that a parliamentary committee would want to explore. I think that the trick is to use the data to ask the questions, and I think that we have done that as well as can be done, and then to go and explore what the answers to those questions are locally, and therefore what that means in terms of solutions. That is very helpful. I have a couple of other small questions. In terms of your comprehensive report, and obviously over the past 12 months, the waiting claims have shown an improvement. Given that reduction over the past year, if performance continues to follow that trend, would you expect the numbers waiting over four hours to fall in the coming years? The conclusion that we have reported here is that we think that some health boards will find it difficult to meet the four-hour target by September this year. Given that challenge, I would not like to call whether the NHS as a whole will meet 95 per cent, but I think that it is very unlikely that all 31A and E departments will hit four hours by this September. We all hope that it will do, and there is lots of good work going on there, but there are a number of indicators behind the four-hour figure in itself that suggests that there is real pressure in many A and E departments. Finally, convener, just in terms of bed numbers, I know that in terms of the stats that we talked about earlier, I am right in saying that during 2012-13 there has been an increase over that year in bed numbers of about 183. I do not have the figures available to confirm that just now. I think that what we are very clear on is that the reduction was an appropriate reduction that reflected a move to day surgery, but that there are signs of pressure around acute medicine beds where the occupancy level across Scotland is at around 85 per cent. It is another one of those areas where a better understanding of what is happening would be very helpful, both at national level and more importantly in each of the 14 health courts. I ask a very general question, which I got from paragraph 3. It refers back to your emergency department's report in August 2010, which included Scottish Ambulance Service and NHS 24. You made some clear recommendations and, in your own words, set out a clearer strategic direction for emergency care services. You go on to say that, since then, performance against the standard deteriorated, your recommendations, guidance and strategic direction were these taken on board and, as a result, the figures deteriorated, the performance against the standard deteriorated or were your recommendations ignored. Some of them were accepted and implemented, some of them a little bit later. I will ask Catherine, if I may, to highlight what happened there. In part 3, we comment on progress in the recommendations that you made in our last report. I think overall, through the work of this national and judge of care action plan, a lot of our recommendations are now being progressed. As the Auditor General has already mentioned, it is quite complex. Some of the quick-win solutions, I think we have highlighted again in this report, the longer-term strategic recommendations, we are now seeing some evidence of that with this new and schedule action plan. In terms of staffing, benchmarking information, use of assessment units, those sorts of recommendations are now being progressed and a lot more evidence of what is of the outcomes of those. Presumably, had all the recommendations been adhered to, we would be seeing an deterioration by greater progress. In your comments at the beginning of the Auditor General, you said that there were more over 65s presenting to A&E. We now have an ageing population. You have also mentioned a couple of times today that there are more complex needs. It is really a supplementary to Ken Macintosh and Tavish Scott. We have got over 18 per cent of people being seen in the last 10 minutes at Hare Myers and the Royal in Edinburgh. If you take those three together, that in some hospitals almost 20 per cent of being seen in the last 10 minutes is in that last 10 minutes, they are more likely to be admitted to hospital and stay longer. Is it—can you not conclude from the evidence that you have given today that the patients with the less complex needs are being seen quicker and that the target could be distorting or prioritising the target, those seen quicker, rather than clinical need? Are the targets distorting clinical need? It seems to me that there is almost sufficient evidence of what you have said today that that is the case. We did not find evidence of that and we tested for it specifically in relation to the patients who were admitted in the last 10 minutes of the four-hour period. We started with the assumption that if those patients were being admitted to avoid breaching four hours, they would probably be discharged more quickly than other patients. In fact, we found that they were staying in hospital for longer than other patients. Clearly, A&E departments need to manage the flow of patients who arrive at their front door to make sure that the most seriously ill or injured patients are getting priority and are receiving the range of assessment and treatment that they need. We did not find any evidence that is not the case. What we did find, though, is another example in Tayside of the reception process when somebody arrives being very clear about whether somebody has got a relatively minor condition that may be able to get them treated and discharged without too much complexity of care and those who are likely to need both more complex assessment and potentially an admission. That made a real difference to their overall performance but also to the quality of care that both of those groups of patients got. They described it as streaming. From the data, we cannot tell how consistently that is happening across Scotland, but we did not find evidence of gaming of the target only of the fact that a target inevitably does have an impact on where the attention of the managers and clinicians tends to focus as you head towards four hours. I think that there is no doubt about it that Tayside is a model of best practice, which, to be fair, is not replicated in other 30 A&E units. I would like to go to Exhibit 5 that Bruce Crawford looked at. I actually found a bit of a difficulty because this time you have looked at accident and emergency within A&E units. The last time I was not on the committee then, I think that you looked at NHS 24 ambulance, etc. I find it difficult because we are looking at one part of quite a large model. I think that in your own words it needs to be seen as an overall part of the health and social care system. To me, Exhibit 5 was more than interesting. I think that, for example, at the Belford and Fort William, 82 per cent are self-referred and zero from 999 and zero from GPs. When I dug slightly deeper into that, I discovered that out of the 31 units, 19 had zero referrals from GPs. Are people just bypassing GPs? Is it too difficult to get a back? I do not know whether I am reading too much into this, but I have to say that I was shocked at that figure. The other figure that I was a bit shocked at, well, the one that I was delighted about was the minor injury units, that there are so few referrals there. To me, that tells me that they are doing an excellent job and they are freeing up resources in A&E. NHS 24 referred 0.7 to the southern general and yet 8.6 to Sir John's. The GP referrals that I have mentioned and Bruce Crawford mentioned the 999 services, so I will not go into them. However, the disparity between different areas of the country is almost like different healthcare models. My final point, convener, is that the self-referos that I have mentioned to the Belford and Fort William 82.5 and the Royal Infirmary in Edinburgh 46, so about half. I do not know, because we are only getting one part of the picture here, but if there was any further drilling down to be done, I think that, as Bruce Crawford has said, it seems to be within here. I think that there are two things that I will highlight here, and Catherine may want to expand on it. First is that, as you say, the model of care varies a lot across Scotland. Partly, that is entirely to be expected. Conditions in the islands, in remote parts of the island, are very different from those in the major cities in the central belt, and what good care looks like is likely to vary as well. We have commented in part three of the report that we think that there is still room for guidance from the Government about different models of care in the way that they work. The relationship with minor injuries units, assessment units, admissions units and so on is still very variable across Scotland, and that will be having an effect that you cannot understand just through the national data. Secondly, as Catherine said in response to Mr Crawford's question, the data here we think is recorded inconsistently, especially in relation to 999 arrivals. It is hard to envisage any A&E departments not having at least some 999 referrals. We understand that, for some hospitals, if the patient or family have dialed the ambulance themselves, that is called self-referral, and if the ambulance was called by a GP, it was a GP referral rather than a 999 referral. There are some inconsistencies in the data that we refer to that need to be better understood. As a Highlands and Islands MSP, I am always quick to look at the islands and the remote areas. Although I used the Belford and Fort William, our highest mountain is close by, and it is a very busy A&E department. However, what I should have said is that here, Myers and the Southern General are 80 per cent and 79.8 per cent. The difference between our two biggest cities in Scotland is that we have 46 per cent self-referral in Edinburgh and 80 per cent self-referral in Glasgow. We cannot bring in any rural or remote factors there. My question is really, are all parts of A&E working well together? I am very impressed at the minor injury unit. I think that that is a fantastic figure. The 0.2 referrals are obviously dealing with what needs to be done. Do we need more minor injury units? Are there more problems in accident and emergency in areas where there are less minor injury units? I do not know. I just think that we need more information about those figures. Are we making best use of the ambulance service and the paramedics, which do a fabulous job and stop many people having to go to A&E? I think that that is the frustration that I am finding today, convener, that we are looking at one part of the service and the different pattern on how it works together throughout Scotland. To me, the shocking figure is that 19 A&E departments out of 31 have no referrals from a GP. I wonder whether the additional work that you mentioned to Bruce Crawford will drill down into those figures, or is there not even a recommendation of best practice nationally that would improve those figures in the longer term? I think that you are absolutely right. The solution to making sure that everybody who needs to go to A&E gets treated quickly and effectively is not about A&E departments, it is about the whole system. The data at the moment helps us to post some of those questions and answer some of them, but not all of them. We will be taking that a bit further in our own work and the Government is trying to do that through its unschedule care action plan. You asked earlier about the recommendations that were made in the last report in 2010. One of the important ones that has not been fully responded to is about providing that guidance on what models of care are most effective. You can see in Exhibit 4 that the distribution of activity between A&E departments and minor injury units, for example, varies a great deal across Scotland and not in ways that you can easily explain by geography or deprivation or anything else. The question is not just about minor injury units but also admissions units, assessment units, the links with GPs and the Ambulance Service and NHS 24. We think that getting those models right in each part of Scotland will go a long way towards relieving the pressure that we know exists. Finally, there also seems to be a culture. I was quite shocked that, in Glasgow, self-referral is about 80 per cent, but 0.7 is through NHS 24, yet you go to other parts of the country, St John's 8.6. Is there a culture of people just turning up at the hospital rather than is NHS 24 perhaps being underutilised in some areas compared to others? We did not look specifically at NHS 24, although we did, as Caroline has mentioned, the previous report look at referrals from NHS 24. Again, I found that those were mostly appropriate referrals because patients were actually quite sick and ended up being admitted to hospital. I would just like to pick up on the point of the GP referrals and GP referrals for admission. That is something, again, we highlight in the report huge inconsistencies in these two codes. This GP referral for admission is a new code to the data mart over the last, I believe, 18 months or so. That is why we have made a recommendation around the Scottish Government sharing good practice on this process, the way in which patients are referred into A&E. For example, some bypass the A&E department and some go direct into award or into especially acute receiving unit and some go via A&E. In order to understand the impact the current models have on performance, ISD Scotland is having discussions with boards around or completing these codes correctly. We know that Lothian records high GP referral for admissions or the split between GP referrals for admissions and GP referrals was not quite right. In our fact check with the board, we discovered that there needs to be a better split between these two codes. There is work on going with boards around this new code GP referral for admissions. We would expect to see that come through the data mart over the next few months. It is interesting that, to the point that Mary raised in relation to the southern general. Again, that emphasises the complexity of it. It will depend on what other services are available in the city. Because the Royal Hospital for Sick Children exists in Glasgow, there may be more NHS 24 referrals being made there. As a result, others—because the kids will be gone there, a lot of them—are in other hospitals. All that emphasises, to me, even more so the complexity of all this and the interrelationship. There is a need to understand the whole system and a need to make sure that we know which models of care do work well. It is partly what services are available. It is partly how well the health board signposts people towards them so that they know that they exist and that they know what is appropriate. It is partly developing those further so that, as Catherine said, if it is more appropriate for GPs to be able to refer patients directly to a ward rather than going through A&E, there is a route for them to do that. All of this can really make a difference. Thank you for bringing the report in front of us. I found it very interesting. Given a number of the comments that have come from other sources, Jason Long, the chair of the College of Emergency Medicine, who has been quite supportive of the scene in which he is the president of the Royal College of Surgeons, who is pleased to see the on-going work that has been done, it seems to me that we are heading in the right direction anyway after coming through a period that we were particularly affected by, say, the norovirus and stuff like that. It does appear to be going by the stuff that you have in your report, plus what others are saying outside. Go just to the beds thing. I pulled the report that was actually produced in March by ISD, which talks in relation to the quarter ending December 13 about beds. It says that the number of available staff beds in acute specialties was recorded as 16223, which was pointed out in the quarter ending December 2013. That is actually an increase of 1.1 per cent from the 16041 in December 12, so going by that, obviously it has not been taken into consideration in this report, have you? What we quote in paragraph 40 is the shift between our baseline in 2008-9, the baseline from our last report, and the latest available figures when we were preparing the report, which was 2012-13. They're consistent with yours. We've got 16230 for March 2013. Your figures sound as though it may have gone up or perhaps down very slightly up from there, but very close, 230 to 223. The publication date of that was the 25th of March. Your figure was 16223? That's what it is, 16223 in the quarter ending December 2013. That's seven beds lower than the figure we've got for March 2013, but very close. It's an increase of 1.1. I'm just trying to say, going by what the professionals appear to be saying outside, coming from where we were, and obviously it's seen things such as, because I know in the likes of the Royal Infirmary there's been a new ward opened up, and I think there's obviously pressures there that come from the fact that the building was built too small, and I think half the problems come from that in itself. But it's really just an acceptance of the fact that we appear to be heading in the right direction, and I would associate myself with Bruce Crawford's comments about perhaps an in-depth look at things from the committee responsible in the Parliament might be more appropriate as we head forward. In terms of the overall direction of travel, we've been very clear in the report and all of our comments about it, that performance has deteriorated slightly since our last report in 2010, but that it improved during 2013, and we think that's a result of the Scottish Government's national and schedule care action plan and the action being taken there. We're not raising a specific concern about bed numbers. The data doesn't support that, but certainly the bed occupancy rates in acute medicine are at the level that starts to give clinicians cause for concern, and I think there's a shared agreement that taking this a step further to really understand the interplay of the different factors, both at a national level and more importantly locally, is the key to helping A&E departments really manage the pressures that they're facing, which are real and reflect demographic change, the overall financial pressures, and all of the other pressures that we're very familiar with. I had a couple of questions that have already been asked, but I'd like to go back, unfortunately, to this last 10 minutes thing. I wonder if any of the evidence shows that instead of it being that we're looking at these people in the last 10 minutes, as Catherine Young said earlier, and Mary Scanlon suggested that maybe what we're doing was we're leaving the most complex to the end. Could it be possible that what's happening is that we're looking at the more complex people earlier, as was kind of suggested in your response, but because of the complexities of the situation, it's taking that period of time to make sure that we get appropriate beds for them? The short answer is yes, and first of all, I don't think it's a surprise that there's a sort of peak of activity just before the four hours. I think that's what targets do quite understandably. We're all human, and we'll do our best to hit it in those circumstances. We didn't find any evidence that that was being done inappropriately. What we have found, though, I think, through case studies like the taste side one, is evidence that if you start your planning as early as possible within the four hours, you can smooth that peak back down. So, as Catherine said, for the Ninewells hospital, they have about four per cent of admissions from A&E in the last 10 minutes, and we think that's very clearly because they're identifying very early on which patients are likely to be admitted and start the process then of finding a bed for them. So they're not taking three hours to decide the patient needs to be admitted and then rushing for the last hour to find a bed. That's happening right the way through the four hours, which is better for everyone involved. I'm a consensus that that's the best practice that others should be looking at, and hopefully that's what we'll have. Okay, thank you. Okay. Final question, Odedr Thurjanol. You mentioned and others have mentioned the numbers of people presenting tax on an emergency and taking it in a wider context. There is a lot of excellent work being done coping with that level of demand. Did you look at all about whether people were going to accident emergency either through self-refero or predominantly through self-refero instead of going to the GPA of our service? We've explored that as far as it's possible to do through the data. As I say, this is an update rather than the full audit that we've done in 2010 and we'll do again next year. What we know is that, as Catherine said, that there's some evidence that people attending A&E are getting sicker, as I can put it in crude terms. They're in the higher flow categories and there are fewer people with minor illness and injury attending. We know there are more older people attending and they tend to be sicker and have more complex needs and are more likely to be admitted, both of which add to the pressure. Overall, A&E attendances in A&E departments, as opposed to minor injury units, have fallen slightly and attendances at minor injury units have gone up quite markedly since our last report, which suggests that there's a move in the right direction. However, you can see from various exhibits throughout the report that that's not consistent across the country. Catherine, do you know what's available on that? We looked at that as part of the last A&E report. In fact, we carried out a patient survey to ask patients why they chose to attend A&E. Overall, we found that they felt that that was the most appropriate place to attend. It's quite difficult to get behind reasons for attendance. I think that any big increase in attendance in any particular A&E department, we would expect as part of the local and schedule care action plans that boards would be looking at why there's an increase in trying to get behind the reasons there. We mentioned that, as part of the signposting away from A&E into more appropriate services, that boards should be looking at what capacity there is in, for example, GP-out-of-hours or GP-in-air services to ensure that there is capacity in other places for patients to go. Thank you very much again, just for the benefit of the committee, while the Auditor General was answering all the questions there. I've tried to work out what the shortfall is in meeting the target. It's about just over £24,000 to meet the target from 93.5%, presently up to 95%. I would hope and expect that that kind of level to meet the target isn't beyond us, given the range of discussions that we've had this morning around the table. We look forward to the next report with some anticipation. Thank you very much for your contribution to the discussion. Item 4 on the agenda, we have a section 22 report, the 2012-13 audit of North Glasgow College governance and financial stewardship. The Auditor General will give a briefing to the committee, along with Mark McPherson, who is the senior manager, and Martin Walker, again assistant director from Audit Scotland, and Chris Brown, who is a partner in Scotland Chief. I'll just wait for change over. What does the General? Thank you, convener. This is a different sort of report from the one that you've been discussing earlier this morning. This is a report produced under section 22 of the Public Finance and Accountability Act 2000 on the annual accounts of North Glasgow College for 2012-13. It might be useful to give the committee a bit of background to that first. On the 1st of November 2013, North Glasgow College merged with John Wheatley College and Stowe College to form the new Glasgow Kelvin College. In the merger period, which covered the two financial years 2011-12 and 2012-13, there was a reduction of around 27 staff employed by the three colleges, including a reduction of six in the number of senior staff. As part of that, the principal and vice principal of North Glasgow College accepted voluntary severance as part of the merger process. The committee will be aware that the early departures of public sector staff, particularly senior staff, has been a matter of ongoing public interest over the last few years. In May 2013, I produced a joint report with the Accounts Commission on managing early departures in the Scottish public sector. The aim of that report was to help public bodies to improve their management and reporting of early severance schemes and to clearly set out the good practice principles. Although the report was published slightly before some of the severance arrangements described in this report were put in place, the principles have applied for much longer, and in the case of the college sector, the Scottish funding council's guidance on severance arrangements for senior staff has applied since January 2000. The early departures report noted that early retirements and voluntary redundants can be a useful way of avoiding the delays and the costs of compulsory redundancies and of quickly reducing staff numbers and costs. It also noted that significant amounts of public funds are spent on those arrangements, and with a continuing need to reduce public spending, they are likely to remain an important management tool. Organisations therefore need to ensure that they follow the principles of good practice in how they design early departure schemes, how they ensure provide value for money and how they report publicly on the costs and savings. The auditor's opinion on the college's accounts for 2012 was not qualified. However, the auditor highlighted that the college did not provide sufficient evidence that the severance arrangements for the two senior members of staff, the principal and vice principal, had been subject to the appropriate approval process, and the college also did not provide evidence that the costs have been assessed as providing value for money. In my report, I have highlighted that it is vital that senior managers and board members should be fully aware of the costs and benefits when making these decisions. Before approving any early departures, those charged with governance must ensure that they represent a good use of public money, and a clear audit trail must be retained. In this case, the college did not retain the evidence necessary to provide assurance to the auditor that these factors have been fully considered. I have also highlighted two other issues in my report. The first is that the college did not include all of the costs relating to severance payments for all staff affected in the merger in its initial calculations. The additional costs were identified during the audit and contributed towards the college reporting a higher than anticipated deficit of £574,000 for the year. The second issue is that the principal and vice principal were granted a period of garden leave. The Scottish Funding Council's guidance notes that there are few occasions where payment of salary in lieu of notice represents value for money, and that senior staff should normally be expected to work their notice period unless there are good reasons otherwise. As with the severance payments, there was a lack of evidence of the basis for the decision to grant garden leave. I understand that the Board of the New Glasgow Kelvin College is currently undertaking a full review of the audit reports to see what further action may be needed. It is worth noting more widely that a small number of other colleges have made similar errors in their calculations, and a small number of others have provided payments in lieu of notice. However, the combination of issues at North Glasgow College contributed to my decision to prepare my report in this case. As in previous years, I plan to publish an overview report on colleges covering the financial years 2012 and 2013-14 in due course. In the meantime, convener will do our best to answer any questions that the committee may have. Thank you for that. My rough calculation is that £1.3 million was spent on severance payments, and of that, just under 20 per cent, £243,000 related to the principal and the vice principal. That is a huge sum of money. I think that those figures are not quite accurate, convener, if I can correct the record. There are 243,000 related to payments to the principal and vice principal out of a total of £1.3 million. Yes, 243,000 of the higher than anticipated deficit of £574,000 related to the principal and vice principal. I think that the total cost relating to their voluntary severances was £480,000. You are correct that £1.29 million was the total cost of voluntary severances for the college. Over 30 per cent, then, of the cost of severance payments related to the principal and vice principal. That is correct. It is worth saying that our concern in this case is not about the cost of the voluntary severances to those individuals. They are, by their nature, more highly paid posts than they turn to at times costs. I do understand that, but it is still a very significant sum of money coming from college budgets, which have been exceptionally hard pressed in recent years. Courses cut, reduced student numbers, staff struggling to cope. Do we know how many people in that college left under severance payments? We have a figure of 27 people, which relates to all three of the colleges in the merger, specifically for North Glasgow. I think that we would need to come back to you unless Martin has got those figures to hand. No, I think that it would be better to come back with you. We know that there were some variations in the numbers. What we have got from the accounts is the number of severances and the number of people at positions. Some people left, some people came into power, so it would be better for accuracy if we were to come back to you with those numbers. Those are huge costs associated with a process that many in the college sector thought was pointless, but we have got it. The colleges are moving on and many are coping well. What is worrying is paragraph 15 in your conclusions. There was a lack of transparency around the process of agreeing severance arrangements. The college did not retain the evidence needed to provide assurance that the arrangements were subject to appropriate scrutiny and approval. As a result, it is unclear whether those charged with governance consider that the associated costs would provide value for money. When we are talking about huge sums of money, like £1.3 million almost, and we have people who are charged with that responsibility, you are saying that it is not evident that they have considered whether there would be value for money, that they have not retained the evidence. It is a serious charge that has been made. Are you aware whether any of the people associated with those decisions are still in positions of responsibility in relation to the new college? Our understanding is that they are not, that they have moved on through the merger process and the formation of the new Glasgow Kelvin College. As I say, we understand that the board of the new college is reviewing both my report and the auditor's report to look at any action that might be required, but that is our understanding at the moment. When I read this, it is more serious than many of the reports that tend to come to us. When I looked at the guidance that has been ignored, the board of management had not been fully consulted. The SFC guidance has been ignored. There seems to be a lack of clear and comprehensive documentation, a lack of accountability and no details provided in any minutes. A, my concern is who is accountable. Will further investigation take place, despite I understand from the convener's question that those who made this decision are no longer employed by the colleges? Nonetheless, what has happened here? Will it just be brushed under the carpet and ignored? What further action will be taken? I think that what I am asking, because I am pretty new to this, was anything that was done illegal? I hesitate to use the word fraudulent. Do you know what concerns are you raising here today? I would hope that we never again see a paper like that in front of us. How can we be sure, as an audit committee, that £1.3 million will be accounted for and that those who took that action will be held to account, whether that is through the courts or through any other process? The reason why I have laid this report before you today is because I share that concern. We have reported in a number of cases that, first of all, voluntary severance arrangements can be an important and, indeed, a necessary way of managing a merger process, of reducing costs. There is nothing wrong with them per se, but the fact that they can result in payments being made to individuals either directly or into their pension funds means that the way in which those decisions are made is very important. In this case, as I said in response to a question from the convener, we have no indication that the amounts that were incurred in relation to any of these severance payments, including those of the principal and vice principal, were calculated wrongly or that they were illegal or fraudulent in any way. That is not why the report is here. It is because I believe that, where public money is involved, it is really important that there is a fair and open and transparent process to make sure that the decisions are made properly, that they represent value for money and that they are properly scrutinised and challenged by those who have governance responsibilities. I will ask Chris if he can talk through his experience of auditing this expenditure and the process that the new college is going through to investigate this. It is not a fair, open and transparent process, but because there is a lack of evidence, surely that does not mean that it is acceptable. I can only agree with you, Mrs Gallan, as to why the report is here. It would be an easy response for any audited body to say that it is absolutely fine, but we have no evidence. For us, the evidence is a central part of being able to demonstrate that good governance has been applied, that this was a fair decision and that it was properly taken. Felly, because you do not have the evidence, would you be recommending further investigation, perhaps, by the police? Let me ask Chris to talk you through the audit work that has been done. Chris is a partner with Scott Monkrieff, who will carry out the annual audit of the college, and he is very close to this. I will then pick up any outstanding questions from that. As the Auditor General says, we have no evidence of fraud, no evidence of any illegality. In fact, we have evidence that the college remuneration committee took legal advice before they made the decisions that they made in terms of severance. What we cannot see is just the openness and transparency that you talk about. So, when we are doing the audit, one of the key aspects of our audit is to look at governance arrangements in our colleges. We are aware that the public and yourselves expect very high standards in terms of governance of public bodies, so we will look at that quite carefully. In this area, the guidance for governance is quite clear. It is the funding council's guidance on severance arrangements. That guidance, as I say, is very clear about the processes that colleges should go through when they are evaluating voluntary severance or any kind of severance arrangement, particularly for senior staff. The process that they should go through should be very open and transparent. There should be clear rationale behind the decisions that they are making. There should be a business case developed. We would expect a business case to consider various options, because this was not the only option that the college could have taken. We should evaluate those options and reach a conclusion on those and document that whole process and retain the documentation for that process, so that, at a later point, people can scrutinise that and challenge the rationale for the decision. The problem that we have here is that we do not know the rationale for the decision, because it was not properly documented, so there is a lack of accountability, a lack of openness and a lack of ability for you to scrutinise and challenge those decisions. That is the key issue that we are raising here. It is not actually that we found any evidence of fraud or illegality or even provide for money. It may well have been good value for money this arrangement. It is just that it is not clear that the college went through the right process in making that decision. I appreciate that, but surely it cannot be acceptable in modern Scotland that £1.3 million of public funds can be dispersed to a hand to three individuals and that there is no audit trail. My question in order that fingers are not pointed at anyone illegally or otherwise is what should be done in order to get this evidence. We have had a case before. It was in national libraries under the previous auditor general that led to a police investigation and detainment, in fact. Is there a case here where we have nothing? That cannot be acceptable to people like yourself. It is not acceptable to me—I cannot speak for my other colleagues—so where do we go from here? We cannot just say that there is no evidence, so we will just move on. In those cases, what further action can you recommend beyond what you have put in front of us today? My main power and responsibility is to report to the Parliament. I think that there is a question for the committee about what further action you may wish to take to hold people to account for this failure of governance. The other route that we are pursuing is to stay close to the action that the new college has taken to investigate what happened during the merger process, to look at what action, if any, is required and to assess whether that is appropriate and adequate. We will stay close to that through the audit process and through the audit of the new college, but it is important for me to be clear that my powers are those of reporting. The new college's investigation will give us the answers that we are looking for today. Will you come back to us with another paper to say that we now have the evidence and we are satisfied and we can clear these accounts? What I can say at this stage is that it is a very positive step that the new college board, the new principal, is taking these reports seriously. My report and Scott Monkree's report is the auditor. It is too soon for me to make any assessment of how effective their investigation is, but we will follow up any issues. I think that Martin may want to add to that. Just to say that it was Monday of this week that the new board of Glasgow, Kelvin, took the report from the new principal on this issue. The first thing there is around transparency in that the principal was keen to make the board aware of the report of the issues. My understanding of where that meeting went is that the board of the new college agreed that it should be remitted to the audit committee of the new college, and it will be for them to determine what the next steps are in terms of further investigation work. I think that I particularly understand from my discussions with the new principal that the board and he are both very keen on ensuring that robust governance arrangements are in place for the new college. What I am not sure about, as we see here today, is the extent to which there is the backward investigation, as well as making sure that things are right and going forward. As the auditor general has said, that is something that we will keep a close eye on through the appointed auditor and with the new college. Can I get some clarification on the issue of remedy? Mr Brown has said that he has not seen any evidence of fraud or illegality, and therefore it is unlikely that that route could be pursued. However, if boards of colleges—and this is about maybe not a warning, but giving information to the boards of the new colleges and indeed any other public agency about what is expected of them—are not there simply to overstamp the wishes of the principals or indeed anyone else in senior management, they have a legal and a moral duty to look after the best interests of the organisation. Is there a civil remedy if it is found that someone has acted without due diligence, maybe not illegally, but has failed to live up to the standards that are expected? Is there a civil remedy that the money can be recovered not from the recipients because they have entered into a legal arrangement, but from those who made the decision to disperse the funds in the first place? I am not aware of a civil remedy which exists in relation to these sorts of decisions, unless it can be shown that the circumstances were such that there is some liability there. That is very unusual in audit terms. We will be staying in close contact with the Scottish Funding Council about the new guidance that applies to colleges, and we will be thinking through when we see the results of the college's own investigation what that throws up about personal culpability, but liability is a difficult question in these cases. It would be worrying if you find that the boards of public bodies act technically within the law, but act in a cavalier way that outrages the general public, that they make decisions about extravagant use of public resources, and then we find that not only is nothing illegal done, there is no civil remedy that they can do as they wish without any worry. That would be of concern if there was no comeback to those who were foolishly using public resources. I want to be clear that I am talking hypothetically here, not about this specific case, but the closest parallel that I am aware of is where an individual has been found wanting through a disciplinary process, and a penalty has been imposed in relation to access to their pension rights in the future. We have seen that in a number of public services in the most egregious cases, but in general it is difficult to show that personal liability, and instead the route is through the audit report, and then the committee is holding to account of the individual's responsibility for the action that they took or failed to take. It looks as though, we will see what happens eventually, but there is no way of holding people to account that they have moved on and that the deed has been done. Can I just ask Chris Brown to establish a couple of facts here? Mr Brown, you mentioned the remuneration committee. Did they make the decision on the severance of those people? That is the key issue that we have. We cannot see sufficient evidence that they did make the decision. There is no paperwork. There is a very brief minute—it is about a page and a half—of a meeting that was held on the 3 June remuneration committee meeting. Most of that meeting was taken up. It appears in the minute with discussion about the new principal's salary, but there is some evidence that there was some discussion about the severance of the outgoing principal and vice principal, but there is no evidence that the full details of the packages that were provided to those individuals were discussed or were available to the committee at that point. That minute then went to the board for approval? That is one of the other big issues that we have raised. That minute does not appear to have gone to the board. How many people were on this remuneration committee? Can we name them? That is a matter of record. Yes, we could find out the names. But, as far as you are aware, they were the people who took the decision. The only documentation that we have is that committee—however many people were on that committee—took the decision in relation to the severance packages of these two individuals. As I say, the point that we are making is that we do not have the evidence that they actually did make the decision. The costs that were incurred by the college we cannot see evidence that those costs were presented to that remuneration committee and that they approved that expenditure. That is the issue that we are raising, we cannot see that. We cannot see that that was then presented to the board. So you think that it was an oral discussion rather than any written—because they could not give you any written evidence at all, it was just an oral discussion without any— It may well have been an oral discussion, but we do not— But you presumably interviewed them, so presumably you asked them—I do not mean to be aggressive about this—but you said directly to them, what did you do? How did you come to this conclusion? One of the issues that we have with this situation is that because the college finished on 31 October, while effectively the new college started on 1 November, the board members of the outgoing college finished on 31 October. Some of them continued into the new college, but the key individuals really were the chair of the remuneration committee, who was the chair of the board of the old college. He finished on 31 October, which was midway through our audit. Actually, I did speak to the chair of the board. He was very keen to talk to me and to give me as much evidence as he had about the rationale for the decision, but he could not give me evidence that had been presented to the remuneration committee and he could not provide evidence that the whole board had seen that evidence and discussed it and approved it. By that time, it is too late because it is all left. The evidence—could you say whether it did or not, even if you could, as it were, face-to-face or over the telephone, tell you he had done that? Yes, he did. He did confirm that. He has confirmed that in writing, in fact, to other members of the remuneration committee. We understand that there was some communication between members of the remuneration committee regarding the severance arrangements, telephone calls or face-to-face discussions rather than anything in writing. There is no email trail or anything like that. There are some letters. We have not seen letters from the remuneration committee to the chairman of the board, but we have seen letters from the chairman of the board back to the remuneration committee members confirming to them that the proper process was followed. He is very clear that the proper process was followed. It is just that we cannot—all we have— That is very helpful. I apologise for pursuing this process point. The other point is just a convener's question about—or the convener's very correct point about the fact that two individuals have gone and they presumably have a legal agreement that they are partied to in terms of what they have received. That legal agreement must be a legal agreement between them as individuals and the previous board. Some lawyer—I do not mean some lawyer in a Georgian sense—our lawyer must have drawn that up on their behalf under instruction. An accountant must, as it were, sign an electronic check. There must be something behind all that. Is all you found that a lawyer was orally told draft up some agreement, a letter to go to said individuals saying, we will pay you X, and the accountant was then told to just rash it on that basis, as it were, to sign the check? I am probably simplifying this enormously. You will understand, I am sure, that the basis of any audit has to be the financial statements or the audit trail or the minutes or the business case that has been drawn up. In this case, as Chris has said, the former chair of the board has told us that due process was followed and we have not seen evidence to support that assertion, which is why we are bringing the report to you today. I need to stress again that we do not have any indication that the amounts that the costs incurred in this were improper, but we are not able to satisfy ourselves that the decisions were properly taken and that they represent value for money for the public purse. I will stop at this, but the crux of this for us in terms of how we analyse what happened, and I appreciate your experts, and we are a committee, and therefore, by definition, not experts, is the person who was the previous chair of that board who seems to have been sure that the proper processes were followed but could not provide you with any correct or any evidence as to how that process was followed. More generally, those charged with governance, the board has a specific responsibility to carry out. Okay, thank you, that's all. Coror Bryn, Bruce Crawford. Mr Bryn, can I clarify? You said that there was no evidence. Do we actually know who took the decision to make these payments? Well, we understand from speaking to the chair of the board of the Immuneration Committee to the decision. That's our understanding, but the point we're making is that we don't have the evidence from a minute of the Immuneration Committee and supporting papers that actually supports that assertion. So, if a college or a remuneration committee of a college decides to make a payment and there is no evidence that they were authorised to do so, does that not then leave them liable for any payment that was made? On whose authority was the payment made if there is no evidence to justify the making of that payment? That's one of the matters that we hope the new college's investigation will explore. You would expect any payment, as Mr Scott suggested, to be properly supported by proper authorisation. The chair of the board has told the auditor that the decision was properly taken. We would expect the new college board to be investigating thoroughly what happened and who is responsible, whether they're a member of the staff or the board of the new college or whether they left in October last year, as Chris has described. Very least, I think, can say we've got a serious breakdown of governance. People, the general public, will expect us to make sure that we follow the public pound and get that value for money and unearth as much as we possibly can. I recognise this investigation is going on with the college. When do we expect that to be completed? I think that might well drive convener what we decide to do as a committee next, in terms of any action we would want to take, because it will depend on how in depth that is able to be and what information it can provide us with. Can you add to that? We need to check with the college around the remit and the timescales in terms of how it's going to consider these issues. As I say, I know that on Monday the new board considered the report and made the decision to refer it to its audit committee. I think an important thing will be the next stage, which is understanding when it will be considered by the audit committee what action the audit committee plans to take in terms of any investigation and looking at the governance arrangements for the new college to ensure that this kind of thing doesn't happen again. When we know what the plan timescales are for that and the remit of that, that obviously puts us in a much better position to be able to see how robust that will be and what that may find in due course. Mr Mark Walker, it might be appropriate, obviously, for yourselves to be completing that exercise or understand that. Do you think it might also be appropriate for this committee ourselves to be writing to the new college asking them the same point? What's the timescale they expect us to be involved in and can they tell us? When do they expect the recommendations that flow from that to be in the public domain so that we can take a decision about what we do with it at that stage? People will expect us to take this to the nth degree. We'll do that then. Ken Macintosh. Just to clarify with the Auditor General, would the money for these payoffs be taken out of the college merger additional funds that are provided for merging Scotland's colleges? I don't think it certainly wouldn't be funded directly in that way. Our understanding is that the impact of the total costs of the voluntary severances are met by the college. There was a small grant available to colleges for some parts of voluntary severance funding and the higher than expected deficit will then fall to be met from new colleges' own funds. We haven't seen the full impact of that yet. We'll need to move into the new financial year to see the way in which that works. As the convener suggested earlier, it is money that is being met from the college's overall budget, which is intended primarily, obviously, for providing education to lifelong learners. As I said, we have no evidence to suggest that the money wasn't appropriately calculated. Our concern is that we don't have the evidence to suggest that it was and was properly decided. Is there a threshold above which any such payments are referred to ministers or to the funding council? I don't think that there is. Colleagues will keep me straight. Would such an agreement contain a compromise agreement or a gagging clause of any kind? As we've reported to the committee before, most voluntary severance arrangements are supported by a settlement agreement. Those should not include gagging clauses or confidentiality clauses other than around the specific circumstances of the individuals. They certainly shouldn't be used as a means of withholding the cost of the public purse involved in the individual arrangements. Chris may know more about the circumstances in this case, but it would be very common for a settlement agreement to be in place in cases like this. Yes, so there were compromise agreements with the senior staff who left, but we don't have any evidence that they were unduly restrictive compromise agreements in terms of containing gagging clauses. I don't think that all compromise agreements have to be referred to ministers. That's right in relation to the NHS. I don't know if it's correct more widely at this stage. I don't want to mislead the committee by suggesting that. Martin, can you help on that point? Certainly, as I understand it, the process was on the back of what was connected to the publication of our report last year around managing early purchase, where the committee has been in correspondence with the Scottish Government around particularly the issue of settlement agreements, compromise agreements, whatever you wish to call them. I know that there was a process under the way that consulting on what the new arrangements will be, which I think believed take effect from this current financial year. There is an expectation in there that there will be consultation with the Scottish Government around cases where settlement agreements are put in place. I understand that the objective of that is to try and ensure that there is much more transparency because I believe that it was the committee themselves that were asking the question about how many, where are they happening, all those kinds of things. At that point in time, the Government's position was that there wasn't a centrally held note of all of those. I think that one of the things around the new arrangements is to try and resolve that situation so that there is more visibility about those things. With that new regime, you're absolutely right that that's exactly what happened, but the new regime has not yet been implemented. Is that right? I think that the intention was to get that in place for the current financial year, but we need to check on the detail of that. I know that there was some consultation going on about that, so we need to get back to you on that. Since colleges became part of the public sector in the first of April, they are now subject to the guidance in the Scottish Public Finance Manual, which is the guidance that Martin referred to that is being updated. At the point in time that we are talking about here in November, they weren't part of the public sector, so the SBFM guidance didn't apply to them at that point. James Thornton. You said that you haven't seen anything that suggests that the proper processes were put in place. In here, you talk about evidence of legal advice given to the committee. I take that as a remuneration committee that has received that evidence. Yes, that was legal advice that was provided to the chair of the remuneration committee. Is there nothing to suggest that the rest of the committee ever saw it or discussed it? There is something to suggest that. The chair of the remuneration committee told me that the remuneration committee did see that evidence, but we just can't see the evidence from the minute or from any papers that we were given from the remuneration committee that showed that. That's very surprising. I was on a remuneration committee and everything just goes to the board for final decision after we make our suggestions. The letter from the chair that you said showed in response to a letter from the remuneration committee that you can't see, was there much detail in that or was it a sort of one liner? No, there was a fair bit of detail in it. Did it suggest that there had been a process, that there had been some discussions at the committee? Yes, it suggested that it set out the process that the chair of the remuneration committee, the chair of the board, the same person, believed had taken place. That was him providing assurance to the remuneration committee members about the process that he described to us actually took place. The letter is quite detailed in terms of a number of bullet points about that process. The fact that there had to be a letter to the remuneration committee describing to that committee the process that they had followed in itself, I think, in our view, supported our view that actually the process wasn't as transparent and open as it should have been in the first place. You don't see it as being a response to a letter from them that was responding to bullet points or whatever. It was more like he was laying out about this as what we did. I think so, because I've not seen the original letter, I can't say that for certain, but I think that that would probably be something that I don't want to speculate on what the board and the audit committee want to investigate and what to look at, but I would imagine that would be one of the things they want to look at. The last thing I'd like to ask is, you said earlier on, you'd correct me if I'm wrong about the language you use, but that the payoff itself wasn't unusual? Would that be fair? We've reported on several occasions in the past that voluntary severance payments can be a necessary way of reshaping public services. Obviously, the situation where you're merging three colleges into one, you have three principals and three vice principals, is the sort of situation where you might expect voluntary severance to be the right approach to getting a new management team in place, but because of the sensitivity of payments being made to individuals or from which they benefit, that's the reason why we think it's so important to have proper governance and transparency around it. Alongside the lack of transparency, the only other issue you have then is the one about garden leave, which you thought was pretty unusual. Could that be right? Yes, I mean, I think the governance concern is the main one. As a convener has said, £1.3 million in total, about £480,000 relating to these two individuals, were cost to the college budget and it's important the college can demonstrate that was done properly. We also do mention some errors made in the initial calculations by the college for all of the voluntary severances that they agreed, and then the question of garden leave or payment in lieu of notice for the two individuals. Do we have any evidence that shows how they worked out the figures in the first place that would get them wrong or is that something else that's missing? There isn't a business case, as Chris has said, which says here are the costs that would be incurred, here are the benefits that we think we would get, and here's why we think it's value for money, and we would expect that as an absolute basic in any voluntary severance decision. Thank you very much. So, Mr Brink, can I just clarify? Did you say that the chair of the board was also the chair of the remuneration committee? Perhaps that's maybe something that we need to look at, whether there should be some kind of split in responsibilities, but we can do that later. Sorry Colin Kear. Thanks. It's really kind of basic one for someone who's not a qualified accountant, however, but I noticed that in the report it says that the auditor gives an unqualified opinion on the college's accounts. Given the questions that I've been asked by two, three, four of the members here just now, Mr Dornan's particularly about the process aspect about chairmanship and all these sort of things. Is that something that you could put a qualified is it just the fact that you feel you've been able to identify the money, it's just the process is controversial as to how that money's been handled? Yes, so the accounts do fairly reflect all of the costs of the severance arrangements, and the payments in themselves are not on the face of irregular payments because they are the kind of normal payment that you might expect to see in a voluntary severance. The payments were in relation to voluntary severance payment, which is a contractual payment, in addition to an enhancement of pension, which is not necessarily a contractual, and costs in relation to gardening leave. A period of time is six months where the individuals weren't actually working for the college but they were getting paid, so all of those costs are normal costs that we might expect to see in a yes situation. Actually, we have seen in other colleges, we've seen other colleges make very similar kinds of arrangements in this kind of situation, but what's happened there is that they've been very clear about making sure they documented the rationale for the decisions that they took in terms of demonstrating that those costs were actually value for money. The problem we've got here is it's purely a value for money and governance process issue. I was just about unclear about what point does the unusual, compared with the usual, end up producing a qualified set of accounts as an unqualified set. If the costs hadn't been reflected in the accounts at all, for example, that would have been a qualified issue for qualification. You've commented, Auditor General, about gardening leave. Do you have any indication that prior to the mergers and creation of the new colleges, how many senior staff were on gardening leave and for how long by college? Not at the moment. One of the things that the team are currently doing is reviewing the accounts and the audit reports for all of the outgoing colleges. In some cases, we're going back and asking further questions of the auditors, either because an issue isn't clear on the face of the council because we'd like to know more about the circumstances. If a particular issue arises at a college, I'll report on that separately. Otherwise, I'd expect to sweep that up as part of my next report on the college sector as part of our update on the progress of reform. It would be interesting to see that because I'm aware of concerns raised, for example, the one on the top of my head, James Watt College in Inverclyde, there could be others, of where senior management were on extended gardening leave. It would be interesting just to see the extent of that and whether colleges were using substantial amounts of public money to ease their way through a change process, so any information you could get would be helpful on it. Let's find a letter that we got as committee in November 2013. It's from the SFC about guidance and it says that the SFC said to a good relation, we expect colleges and internal auditors to consider any risks sent by processes and advising SFC if they do not conform to our guidance. Prior to any payment, they expect them to be notified of any overall severance costs to provide information on a number of staff and associated costs before making any payment towards those costs. So, was the SFC asked? Was the SFC told about this? In this case, they said, by the way, we have received no such advice. This is November 2013, so it might be too close to this case. I think there's a timing issue anyway, as Chris says. These were finishing in 31st October. I also think that the word you use then was to be notified rather than for the SFC to approve them, so that there is a question about the process that was required. But our starting point is that the funding council's guidance, dating back to the year 2000, was absolutely clear about what good governance looks like in those instances. That process didn't meet that guidance by some way. Okay, thank you, Auditor General and your colleagues for the evidence. Before I move on to the next item, can I note for the record that apologies had been received from Colin Beattie and that David Torrance has been attending as his substitute. I apologise for not putting that on record earlier on. We will now move on to private session and take a break for a few minutes.